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<1>
Accession Number
2014151262
Title
Plasma biomarker profiling in heart failure patients with preserved
ejection fraction before and after spironolactone treatment: Results from
the Aldo-DHF trial.
Source
Cells. 10(10) (no pagination), 2021. Article Number: 2796. Date of
Publication: October 2021.
Author
Schnelle M.; Leha A.; Eidizadeh A.; Fuhlrott K.; Trippel T.D.; Hashemi D.;
Toischer K.; Wachter R.; Herrmann-Lingen C.; Hasenfuss G.; Pieske B.;
Binder L.; Edelmann F.
Institution
(Schnelle, Eidizadeh, Binder) Institute for Clinical Chemistry, University
Medical Center Goettingen, Goettingen 37075, Germany
(Schnelle, Leha, Toischer, Wachter, Herrmann-Lingen, Hasenfus, Binder)
DZHK (German Centre for Cardiovascular Research), Partner Site Goettingen,
Goettingen 37075, Germany
(Leha) Department of Medical Statistics, University Medical Center
Goettingen, Goettingen 37075, Germany
(Fuhlrott, Toischer, Wachter, Hasenfus) Clinic of Cardiology and
Pneumology, University Medical Center Goettingen, Goettingen 37075,
Germany
(Trippel, Hashemi, Pieske, Edelmann) Department of Internal Medicine and
Cardiology, Charite-Universitatsmedizin Berlin, Campus Virchow Klinikum,
Berlin 13353, Germany
(Trippel, Hashemi, Pieske, Edelmann) DZHK (German Centre for
Cardiovascular Research), Partner Site Berlin, Berlin 10785, Germany
(Wachter) Clinic and Policlinic for Cardiology, University Hospital
Leipzig, Leipzig 04103, Germany
(Herrmann-Lingen) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Goettingen, Goettingen 37075, Germany
(Pieske, Edelmann) Berlin Institute of Health, Berlin 13353, Germany
(Pieske) Department of Cardiology, Germany Heart Center Berlin, Berlin
13353, Germany
Publisher
MDPI
Abstract
The pathophysiology of heart failure with preserved ejection fraction
(HFpEF) is poorly understood and therapeutic strategies are lacking. This
study aimed to identify plasma proteins with pathophysiological relevance
in HFpEF and with respect to spironolactone-induced effects. We assessed
92 biomarkers in plasma samples from 386 HFpEF patients-belonging to the
Aldo-DHF trial-before (baseline, BL) and after one-year treatment (follow
up, FU) with spironolactone (verum) or a placebo. At BL, various
biomarkers showed significant associations with the two Aldo-DHF primary
end point parameters: 33 with E/e' and 20 with peak VO2. Ten proteins
including adrenomedullin, FGF23 and inflammatory peptides (e.g.,
TNFRSF11A, TRAILR2) were significantly associated with both parameters,
suggesting a role in the clinical HFpEF presentation. For 13 proteins,
expression changes from BL to FU were significantly different between
verum and placebo. Among them were renin, growth hormone, adrenomedullin
and inflammatory proteins (e.g., TNFRSF11A, IL18 and IL4RA), indicating
distinct spironolactone-mediated effects. BL levels of five proteins,
e.g., inflammatory markers such as CCL17, IL4RA and IL1ra, showed
significantly different effects on the instantaneous risk for
hospitalization between verum and placebo. This study identified plasma
proteins with different implications in HFpEF and following spironolactone
treatment. Future studies need to define their precise mechanistic
involvement.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<2>
Accession Number
2013964579
Title
Serum levels of dihomo-gamma (gamma)-linolenic acid (dgla) are inversely
associated with linoleic acid and total death in elderly patients with a
recent myocardial infarction.
Source
Nutrients. 13(10) (no pagination), 2021. Article Number: 3475. Date of
Publication: October 2021.
Author
Nilsen D.W.T.; Myhre P.L.; Kalstad A.; Schmidt E.B.; Arnesen H.; Seljeflot
I.
Institution
(Nilsen) Department of Cardiology, Stavanger University Hospital,
Stavanger 4068, Norway
(Nilsen) Department of Clinical Science, Faculty of Medicine, University
of Bergen, Bergen 5020, Norway
(Myhre, Kalstad, Arnesen, Seljeflot) Institute of Clinical Medicine,
Faculty of Medicine, University of Oslo, Oslo 0315, Norway
(Myhre) Department of Cardiology, Division of Medicine, Akershus
University Hospital, Lorenskog 1474, Norway
(Kalstad, Arnesen, Seljeflot) Center for Clinical Heart Research,
Department of Cardiology, Oslo University Hospital Ullevaal, Oslo 0424,
Norway
(Schmidt) Department of Cardiology, Aalborg University Hospital, Aalborg
9000, Denmark
Publisher
MDPI
Abstract
Dihomo-gamma-linolenic acid (DGLA) is an n-6 polyunsaturated fatty acid
(PUFA) derived from linoleic acid (LA). The LA:DGLA ratio reflects
conversion from LA to DGLA. Low levels of DGLA in serum have been related
to poor outcome in myocardial infarction (MI) patients. <br/>Aim(s): To
assess the association of DGLA and LA:DGLA with total death as a primary
aim and incident cardiovascular events as a secondary objective.
<br/>Method(s): Baseline samples from 1002 patients, aged 70 to 82 years,
included 2-8 weeks after an MI and followed for 2 years, were used. Major
adverse clinical events (MACE) consisted of nonfatal MI, unscheduled
coronary revascularization, stroke, hospitalization for heart failure or
all-cause death. Cox regression analysis was used to relate serum n-6 PUFA
phospholipid levels (%wt) to the risk of MACE, adjusting for the
following: (1) age, sex and body mass index (BMI); (2) adding baseline cod
liver oil supplementation; (3) adding prevalent hypertension, chronic
kidney disease and diabetes mellitus. <br/>Result(s): Median DGLA level in
serum phospholipids was 2.89 (Q1-Q3 2.43-3.38) %wt. DGLA was inversely
related to LA and LA:DGLA ratio. There were 208 incident cases of MACE and
55 deaths. In the multivariable analysis, the hazard ratio (HR) for the
total death in the three higher quartiles (Q2-4) of DGLA as compared to Q1
was 0.54 (0.31-0.95), with p = 0.03 (Model-1), 0.50 (0.28-0.91), with p =
0.02 (Model-2), and 0.47 (0.26-0.84), with p = 0.012 (Model-3), and
non-significant for MACE. Risk of MACE (Model 3) approached borderline
significance for LA:DGLA in Q2-4 vs. Q1 [HR 1.42 (1.00-2.04), p = 0.052].
<br/>Conclusion(s): Low levels of DGLA were related to a high LA:DGLA
ratio and risk of total death in elderly patients with recent
MI.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<3>
Accession Number
2004247942
Title
Extracorporeal membrane oxygenation without therapeutic anticoagulation in
adults: A systematic review of the current literature.
Source
International Journal of Artificial Organs. 43(9) (pp 570-578), 2020. Date
of Publication: 01 Sep 2020.
Author
Fina D.; Matteucci M.; Jiritano F.; Meani P.; Lo Coco V.; Kowalewski M.;
Maessen J.; Guazzi M.; Ballotta A.; Ranucci M.; Lorusso R.
Institution
(Fina, Ballotta, Ranucci) Department of Cardiovascular Anesthesia and ICU,
IRCCS Policlinico San Donato, Milan, Italy
(Fina, Matteucci, Jiritano, Meani, Lo Coco, Kowalewski, Maessen, Lorusso)
Department of Cardiothoracic Surgery, Maastricht University Medical
Centre, Maastricht, Netherlands
(Matteucci) Department of Cardiac Surgery, Circolo Hospital, University of
Insubria, Varese, Italy
(Jiritano) Department of Cardiac Surgery, Magna Graecia University of
Catanzaro, Catanzaro, Italy
(Kowalewski) Thoracic Research Centre, Nicolaus Copernicus University,
Collegium Medicum in Bydgoszcz, Innovative Medical Forum, Bydgoszcz,
Poland
(Guazzi) IRCCS Policlinico San Donato, University of Milan, Milan, Italy
(Lorusso) Cardiovascular Research Institute, Maastricht University,
Maastricht, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Extracorporeal membrane oxygenation is essential for the treatment of
refractory cardiopulmonary failure. Its use may be complicated by worse
haemorrhagic complications exacerbated by extracorporeal membrane
oxygenation-related therapeutic anticoagulation. Progressive technological
advancements have made extracorporeal membrane oxygenation components less
thrombogenic, potentially allowing its application with temporary
avoidance of systemic anticoagulants. A systematic review of all the
available experiences, reporting the use of extracorporeal membrane
oxygenation without systemic anticoagulation in the published literature
was performed. Only patient series were included, irrespective of the
clinical indication. The survival, extracorporeal membrane oxygenation
system-related dysfunction and complications rates, as well as in-hospital
outcome, were analysed. Six studies were selected for the analysis.
Veno-arterial extracorporeal membrane oxygenation was used in 84% of
patients, while veno-venous extracorporeal membrane oxygenation was
applied in the remaining cases. Anticoagulation was avoided because of the
high risk of bleeding after cardiac surgery (64%), active major bleeding
(23%) or presence of severe traumatic injury (9%). Duration of support
ranged from 0.3 to 1128 h. Heparin was antagonized by protamine in all the
post-cardiotomy cases. Successfully extracorporeal membrane oxygenation
weaning was achieved in 74% of the treated cases, with a hospital
discharge of 58% of patients. Rates of extracorporeal membrane oxygenation
malfunctioning due to clot formation and blood transfusion requirement
varied remarkably in the published series. Extracorporeal membrane
oxygenation without systemic anticoagulation appears feasible in selected
circumstances. Further investigations are warranted to elucidate actual
aspects regarding extracorporeal membrane oxygenation system performance,
related adverse events and benefits associated with this
management.<br/>Copyright &#xa9; The Author(s) 2020.

<4>
Accession Number
628273723
Title
Can venous cannula design influence venous return and negative pressure
with a minimally invasive extracorporeal circulation?.
Source
International Journal of Artificial Organs. 42(12) (pp 704-710), 2019.
Date of Publication: 01 Dec 2019.
Author
Bennett M.J.; Hodgkiss S.; Lloyd C.T.; Webb G.
Institution
(Bennett) Cardiothoracic Anaesthesia, University Hospitals Plymouth NHS
Trust, Plymouth, United Kingdom
(Hodgkiss, Webb) Clinical Perfusion, University Hospitals Plymouth NHS
Trust, Plymouth, United Kingdom
(Lloyd) Cardiothoracic Surgery, University Hospitals Plymouth NHS Trust,
Plymouth, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Introduction: Recent advances to make cardiopulmonary bypass more
physiological include the use of kinetic-assisted venous drainage but
without a venous reservoir. Despite manipulation of intravascular volume
and patient positioning, arterial flow is frequently reduced. Negative
venous line pressures can be generated, which may elicit gaseous
microemboli. We investigated the influence of venous cannula design on
venous return and negative venous line pressures. <br/>Method(s): In a
single-centre, single-surgeon, prospective, randomized, double-blind
trial, 48 patients undergoing isolated coronary artery, aortic valve or
combined coronary artery and aortic valve surgery, with a minimally
invasive circuit, were randomized to a conventional two-stage (2S) or
three-stage venous cannula (3S), or to a three-stage venous cannula with
additional 'fenestrated' ridges (F3S). Blood flow, venous line pressures
and gaseous microemboli number and size were measured. <br/>Result(s): The
pump flow achieved was the same between groups, but in each case fell
below the target range of 2.2-2.4 L min^-1 m^-2. The
three-stage cannula recorded significantly lower negative pressure than
the other cannulae. The total count and volume of gaseous emboli detected
with the F3S cannulae was very high in some cases, with wide
heterogeneity. <br/>Discussion(s): The low negative pressures recorded
with three-stage cannula, despite having a larger drainage orifice area,
suggest that negative pressure may be more influenced by lumen diameter
and vena cava collapse rather than drainage hole size. The additional
fenestrations resulted in flow characteristics and negative pressures
similar to the larger two-stage cannula but are associated with generation
of gaseous microemboli.<br/>Copyright &#xa9; The Author(s) 2019.

<5>
Accession Number
600108036
Title
The effect of pulsatile cardiopulmonary bypass on lung function in elderly
patients.
Source
International Journal of Artificial Organs. 37(9) (pp 679-687), 2014. Date
of Publication: 01 Sep 2014.
Author
Engels G.E.; Dodonov M.; Rakhorst G.; van Oeveren W.; Milano A.D.; Gu
Y.J.; Faggian G.
Institution
(Engels, van Oeveren) HaemoScan BV, Groningen, Netherlands
(Dodonov, Milano, Faggian) Department of Cardiothoracic Surgery,
University of Verona Medical School, Verona, Italy
(Rakhorst, van Oeveren, Gu) Department of Cardiothoracic Surgery,
University of Groningen, University Medical Center Groningen, Groningen,
Netherlands
Publisher
Wichtig Publishing Srl
Abstract
Purpose: Cardiopulmonary bypass is still a major cause of lung injury and
delay in pulmonary recovery after cardiac surgery. Although it has been
shown that pulsatile flow induced by intra-aortic balloon pumping is
beneficial for preserving lung function, it is not clear if the same
beneficial effect can be accomplished with pulsatile flow generated in the
extracorporeal circuit. Therefore, we investigated the effect of pulsatile
flow, produced by a centrifugal pump, on lung function in elderly
patients.
Methods: Serial measurements of lung biomarkers Clara cell 16 kD protein,
surfactant protein D, and elastase were performed on blood samples from 37
elderly patients (>=75 years) who underwent elective aortic valve
replacement surgery with CPB, either with pulsatile perfusion or
continuous perfusion. Pulmonary function was assessed by postoperative
ventilation time, the arterial blood oxygenation
(PaO<inf>2</inf>/FiO<inf>2</inf>), the alveolar-arterial oxygen gradient
(Aa-O<inf>2</inf> gradient) and the pulmonary vascular resistance indexed
by body surface area (PVRi).
Results: There was no difference in lung function between both groups, as
assessed by the postoperative ventilation time, the
PaO<inf>2</inf>/FiO<inf>2</inf> ratio, and the Aa-O<inf>2</inf> gradient.
The PVRi, however, was significantly lower in the pulsatile perfusion
group 15 mins after the administration of protamine (p<0.05). The plasma
concentrations of the lung biomarkers increased during surgery and peaked
at 1 h ICU, there were however no differences between groups.
Conclusions: Pulsatile flow does not seem beneficial to postoperative lung
function in elderly patients. Moreover, pulsatile flow does not affect
lung function on a subclinical level as assessed by lung
biomarkers.<br/>Copyright &#xa9; 2014 Wichtig Publishing.

<6>
Accession Number
372289227
Title
Peritoneal dialysis does not adversely affect kidney function recovery
after congenital heart surgery.
Source
International Journal of Artificial Organs. 37(1) (pp 39-47), 2014. Date
of Publication: January 2014.
Author
Riley A.A.; Jefferies J.L.; Nelson D.P.; Bennett M.R.; Blinder J.J.; Ma
Q.; Devarajan P.; Goldstein S.L.
Institution
(Riley) Pediatric Renal Section, Baylor College of Medicine, Houston, TX,
United States
(Jefferies, Nelson, Bennett, Ma, Devarajan, Goldstein) Center for Acute
Care Nephrology, Cincinnati Children's Medical Center, Cincinnati, OH,
United States
(Blinder) Department of Cardiology, Boston Children's Hospital, Boston,
MA, United States
(Jefferies, Nelson, Goldstein) The Heart Institute, Cincinnati Children's
Hospital Medical Center, Cincinnati, OH, United States
Publisher
Wichtig Publishing Srl
Abstract
Purpose: Acute kidney injury (AKI) after cardiopulmonary bypass surgery to
correct congenital heart disease is common. We prevent fluid overload and
further cardiac compromise in oliguric infants with continuous peritoneal
dialysis (CPD). The effect of CPD on kidney recovery is unknown, thus
indications to discontinue CPD are unclear. We aimed to determine if CPD
affects kidney recovery, measured by urine output and novel urinary AKI
biomarker concentrations. <br/>Method(s): Twenty infants <90 days old with
congenital heart disease who underwent bypass surgery and were
post-operatively treated with CPD were randomized at the time of clinical
readiness for CPD discontinuation to 1) discontinue CPD (control) or 2)
continue 24 h more CPD (experimental). Urine output (ml/kg per h), total
output (ml/kg per h) and urinary neutrophil gelatinase-associated
lipocalin, interleukin-18, liver-type fatty acid binding protein, and
kidney injury molecule-1 were assessed postsurgery until CPD catheter
removal. <br/>Result(s): 24 hours preceding randomization, there were no
differences in mean urine output or total output; 24 hours
post-randomization, the control group had higher mean urine output (4.2
+/- 2.6 ml/kg per h vs. 2.8 +/- 2.0 ml/kg per h, p = 0.02) but lower total
output (6.3 +/- 2.1 ml/kg per h vs. 4.7 +/- 2.7 ml/kg per h, p = 0.01).
Median biomarker concentrations did not differ significantly between
groups at any time point. <br/>Conclusion(s): Our results suggest renal
replacement therapy does not change the time course of kidney function
recovery. &#xa9; 2014 Wichtig Editore.

<7>
Accession Number
361711213
Title
Clinical evaluation of the air removal characteristics of an oxygenator
with integrated arterial filter in a minimized extracorporeal circuit.
Source
International Journal of Artificial Organs. 34(4) (pp 374-382), 2011. Date
of Publication: April 2011.
Author
Stehouwer M.C.; Boers C.; de Vroege R.; Kelder J.C.; Yilmaz A.; Bruins P.
Institution
(Stehouwer, Boers) Department of Extracorporeal Circulation, St Antonius
Hospital, Nieuwegein, Netherlands
(de Vroege) Department of Extracorporeal Circulation, HAGA Hospital, The
Hague, Netherlands
(Kelder) Department of Cardiology, St Antonius Hospital, Nieuwegein,
Netherlands
(Yilmaz) Department of Cardiothoracic Surgery, St Antonius Hospital,
Nieuwegein, Netherlands
(Bruins) Department of Anesthesiology, Intensive Care and Pain Management,
St Antonius Hospital, Nieuwegein, Netherlands
Publisher
Wichtig Publishing Srl
Abstract
The use of minimized extracorporeal circuits (MECC) in cardiac surgery is
an important measure to increase the biocompatibility of cardiopulmonary
bypass during coronary artery bypass grafting (CABG). These circuits
eliminate volume storage reservoirs and bubble traps to minimize the
circuit. However, the reduction in volume may increase the risk of gaseous
microemboli (GME). The MECC system as used by our group consists of a
venous bubble trap, centrifugal pump, and an oxygenator. To further reduce
the risk of introducing GME, an oxygenator with an integrated arterial
filter was developed based on the concept of minimal volume and foreign
surface. We studied the air removal characteristics of this oxygenator
with and without integrated arterial filter. The quantity and volume of
GME were measured with precision at both the inlet and outlet of the
devices. Our results showed that integration of an arterial filter into
this oxygenator increased GME reducing capacity from 69.2% to 92%.
Moreover, we were able to obtain data on the impact of an arterial filter
on the exact size-distribution of GME entering the arterial line. The
present study demonstrates that an MECC system and oxygenator with
integrated arterial filter significantly reduces the volume and size of
GME. The use of an integrated arterial filter in an MECC system may
protect the patient from the deleterious effects of CPB and may further
improve patient safety. &#xa9; 2011 Wichtig Editore.

<8>
Accession Number
358099927
Title
Clinical and biomaterial evaluation of a new condensed dual-function
extracorporeal circuit in reoperation for coronary artery bypass surgery.
Source
International Journal of Artificial Organs. 32(11) (pp 802-810), 2009.
Date of Publication: 2009.
Author
Gunaydin S.; McCusker K.; Vijay V.
Institution
(Gunaydin) Department of Cardiovascular Surgery, University of Kirikkale,
Kirikkale, Turkey
(McCusker) Portsmouth Regional Hospital, Portsmouth, NH, United States
(Vijay) State University of New York, Brooklyn, NY, United States
(Gunaydin) Department of CV Surgery, University of K. Kale, Angora Evleri
G-8 Bl. No: 1, Beysukent-Ankara 06800, Turkey
Publisher
Wichtig Publishing Srl
Abstract
Purpose: This prospective, randomized study compared the clinical
performance of three types of circuits: a newly introduced, fully-coated,
interchangeable open-closed circuit with a dual configuration (hard shell
with a bypass shunt), reduced length, and reduced prime of less than 800
cc (CondECC); a completely coated circuit (ECC); and a similar uncoated,
open circuit with standard length and prime (CONT). <br/>Method(s): 75
patients undergoing reoperation for coronary revascularization were
randomly allocated into three groups (n=25): Group 1: CondECC with
shortened tubing, components and an open-closed configuration of low
priming volume with a centrifugal pump and a shunt which bypassed the
reservoir for closed configuration; Group 2: ECC with a roller pump and
hard-shell reservoir; Group 3: CONT. Blood samples for CBC, inflammatory
mediators [interleukin-2 (IL-2), complement-3a (C3a)] and flow cytometry
(CD11b/CD18) were collected after induction (T1) and heparin
administration (T2), 15 min after cardiopulmonary bypass (CPB) (T3),
before cessation of CPB (T4), 15 min after reversal (T5), and the first
postoperative day (T6). <br/>Result(s): Leukocyte counts demonstrated
significant increases at T4, T5 in CONT but remained stable in ECC and
CondECC (p<0.05). Platelets were preserved better at T4, T5 in both ECC
and CondECC study groups (p<0.05). IL-2 and C3a levels were significantly
lower at T3, T4, T5 in CondECC and T4, T5 in ECC (p<0.05). Blood protein
adsorption analysis demonstrated increased amount of microalbumin on CONT
fibers (p<0.05). <br/>Conclusion(s): The CondECC is a flexible,
dual-function, open/closed configuration system that was easy to use, safe
and achieved better biocompatibility when compared to coated and uncoated
conventional circuits. &#xa9; Wichtig Editore, 2009.

<9>
Accession Number
354483285
Title
Body perfusion during adult cardiopulmonary bypass is improved by
pulsatile flow with intra-aortic balloon pump.
Source
International Journal of Artificial Organs. 32(1) (pp 50-61), 2009. Date
of Publication: 2009.
Author
Onorati F.; Santarpino G.; Rubino A.S.; Caroleo S.; Dardano A.; Scalas C.;
Gulletta E.; Santangelo E.; Renzulli A.
Institution
(Onorati, Santarpino, Rubino, Scalas, Renzulli) Department of Clinical and
Experimental Medicine, Cardiac Surgery Unit, Magna Graecia University
Medical School, Catanzaro, Italy
(Caroleo, Santangelo) Department of Clinical and Experimental Medicine,
Anesthesiology Unit, Magna Graecia University Medical School, Catanzaro,
Italy
(Dardano, Gulletta) Department of Clinical and Experimental Medicine,
Biochemistry Unit, Magna Graecia University Medical School, Catanzaro,
Italy
(Onorati) Viale Europa, localita Germaneto, 88100 Catanzaro, Italy
Publisher
Wichtig Editore s.r.l.
Abstract
Purpose: To evaluate if the use of an intra-aortic balloon pump (IABP)
during cardioplegic arrest improves body perfusion. <br/>Method(s): 158
coronary artery bypass graft (CABG) patients were randomized to linear
cardiopulmonary bypass (CPB) (n=71, Group A) or automatic 80 bpm
intra-aortic ballon pump (IABP) induced pulsatile CPB (n=87, Group B). We
evaluated hemodynamic response by Swan-Ganz catheter, inflammation by
cytokines, coagulation and fibrinolysis, transaminase, bilirubin, amylase,
lactate and renal function (estimated glomerular filtration rate (eGFR),
creatinine, and incidence of renal insufficiency and failure).
<br/>Result(s): IABP induced Surplus Hemodynamic Energy was 15.8+/-4.9
mmHg, with higher mean arterial pressure during cross-clamping (p=0.001),
and lower indexed systemic vascular resistances during cross-clamping
(p=0.001) and CPB discontinuation (p=0.034). IL-2 and IL-6 were lower,
while IL-10 proved higher in Group B (p<0.05). Group B showed lower chest
drainage (p<0.05), transfusions (p<0.05), INR (p<0.05), and AT-III
(p=0.001), together with higher platelets, aPTT (p<0.05), fibrinogen
(p<0.05) and D-dimer (p<0.05). Transaminases, bilirubin, amylase, lactate
were lower in Group B (p<0.05); eGFR was better in Group B from
ITU-arrival to 48 hours, both in preoperative kidney disease Stages 1-2
(p<0.03) and Stage 3 (p<0.05), resulting in lower creatinine from
ITU-arrival to 48 hours (p<0.03). Incidence of renal insufficiency
(p=0.004) and need for renal replacement therapy (p=0.044) was lower in
Group B Stage 3. Group B PaO2/FiO2 and lung compliance improved from
aortic declamping to the first day (p<0.003) with shorter intubation time
(p=0.01). <br/>Conclusion(s): Pulsatile flow by IABP improves whole-body
perfusion during CPB. &#xa9; Wichtig Editore, 2009.

<10>
Accession Number
2012327061
Title
The Preventive Effect of Alprostadil on the Contrast-Induced Nephropathy
of Coronary Heart Disease Treated by Percutaneous Coronary Intervention in
Moderate and High-Risk Population Stratified by Mehran Score.
Source
Angiology. 73(1) (pp 33-41), 2022. Date of Publication: January 2022.
Author
Liu X.; Zhang P.; Zhang J.; Zhang X.; Yang S.; Fu N.
Institution
(Liu, Zhang, Zhang, Yang, Fu) Department of Cardiology, Tianjin Chest
Hospital, Tianjin, China
(Zhang) Graduate School of Tianjin Medical University, Tianjin, China
Publisher
SAGE Publications Inc.
Abstract
The Mehran risk score (MRS) was used to classify patients with coronary
heart disease and evaluate the preventive effect of alprostadil on
contrast-induced nephropathy (CIN) after percutaneous coronary
intervention. The patients (n = 1146) were randomized into an alprostadil
and control group and then divided into 3 groups on the basis of the MRS:
low-risk, moderate-risk, and high-risk groups. The primary end point was
the occurrence of CIN (alprostadil + hydration vs simple hydration
treatment); secondary end points included serum creatinine, blood urea
nitrogen, creatinine clearance rate, cystatin C, interleukin-6, C-reactive
protein, proteinuria, and differences in the incidence of major adverse
events. In the low-risk, moderate-risk, and high-risk groups, the
incidence of CIN in the control and alprostadil group was 2.9 versus 2.6%
(P =.832), 11.4 versus 4.9% (P =.030), 19.1 versus 7.7% (P =.041),
respectively. Multivariate logistic regression analysis showed that
alprostadil treatment was a favorable protective factor for moderate-risk
and high-risk CIN patients (OR = 0.343, 95% CI: 0.124-0.951, P =.040).
Alprostadil can be used as a preventive treatment for moderate- and
high-risk CIN patients classified by the MRS. The reduction of CIN by
alprostadil may be related to an anti-inflammatory effect.<br/>Copyright
&#xa9; The Author(s) 2021.

<11>
Accession Number
2014102424
Title
Hybrid convergent ablation versus endocardial catheter ablation for atrial
fibrillation: A systematic review and meta-analysis.
Source
Journal of Arrhythmia. 37(6) (pp 1459-1467), 2021. Date of Publication:
December 2021.
Author
Mhanna M.; Beran A.; Al-Abdouh A.; Ayesh H.; Sajdeya O.; Srour O.;
Alsaiqali M.; Alhasanat O.H.; Burmeister C.; Abumoawad A.M.; Chacko P.
Institution
(Mhanna, Beran, Ayesh, Sajdeya, Srour, Burmeister) Department of Internal
Medicine, University of Toledo, Toledo, OH, United States
(Al-Abdouh) Department of Internal Medicine, Saint Agnes Hospital,
Baltimore, MD, United States
(Alsaiqali) Department of Internal Medicine, State University of New York
Downstate Medical Center, Brooklyn, NY, United States
(Alhasanat) Department of Endocrinology, University of Toledo, Toledo, OH,
United States
(Abumoawad) Department of Internal Medicine, University of Missouri Kansas
City, Kansas City, MO, United States
(Chacko) Department of Cardiovascular Medicine, University of Toledo,
Toledo, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Endocardial catheter ablation (ECA) for atrial fibrillation
(AF) has limited efficacy. Hybrid convergent procedure (HCP) with both
epicardial and endocardial ablation is a novel strategy for AF treatment.
In this meta-analysis, we aimed to evaluate the efficacy and safety of HCP
in AF ablation. <br/>Method(s): We performed a comprehensive literature
search for studies that evaluated the efficacy and safety of HCP compared
with ECA for AF. The primary outcome was freedom of atrial arrhythmia
(AA). The secondary outcome was the periprocedural complication rate.
Pooled relative risk (RR) and corresponding 95% confidence intervals (CIs)
were calculated using the random effects model. <br/>Result(s): A total of
eight studies, including 797 AF patients (mean age: 60.7 +/- 9.8 years,
366 patients with HCP vs. 431 patients with ECA alone), were included. HCP
showed a higher rate of freedom of AA compared with ECA (RR: 1.48, 95% CI:
1.13-1.94, p =.004). However, HCP was associated with higher rates of
periprocedural complications (RR: 3.64, 95% CI: 2.06-6.43; p =.00001).
Moreover, the HCP had a longer procedure time and postprocedural hospital
stay. <br/>Conclusion(s): Although hybrid ablation was associated with a
higher success rate, this should be judged for increased periprocedural
adverse events and extended hospital stay. Prospective large-scale
randomized trials are needed to validate these results.<br/>Copyright
&#xa9; 2021 The Authors. Journal of Arrhythmia published by John Wiley &
Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.

<12>
Accession Number
2013908612
Title
The Effect of N-acetyl Cysteine Injection on Liver Function After On-Pump
Coronary Artery Bypass Graft Surgery: a Randomized Clinical Trial.
Source
SN Comprehensive Clinical Medicine. 3(12) (pp 2533-2539), 2021. Date of
Publication: December 2021.
Author
Javaherforooshzadeh F.; Abbasi Hormozi P.; Akhondzadeh R.; Olapour A.;
Hashemi S.J.
Institution
(Javaherforooshzadeh, Abbasi Hormozi, Akhondzadeh, Olapour, Hashemi)
Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center,
Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic
Republic of
(Javaherforooshzadeh) Imam Khomeini Hospital, Azadegan Street, P.O. Box:
6155979939, Ahvaz, Iran, Islamic Republic of
Publisher
Springer Nature
Abstract
Somebody's organ dysfunctions are associated with the cardiopulmonary
bypass in open-heart surgery such as liver dysfunction. This study aimed
at the impact of the N-acetyl cysteine for improvement of liver function
subsequently on-pump coronary artery bypass graft. Following a clinical
trial design, 60 candidates of on-pump CABG, age 30 to 70 years, normal
liver function, and normal renal function were selected. The candidates
were randomly divided into intervention: IV100 mg/kg N-acetyl cysteine in
three doses (2 intraoperative and 1 postoperative) over 24 h, and control
groups (normal saline as placebo) (n = 30 in each group). The main
outcomes were serum alkaline phosphatase, aspartate aminotransferase,
alanine aminotransferase, bilirubin, partial thromboplastin time, and the
international normalized ratio at first and second postoperative day after
surgery. Secondary outcomes were the hemodynamic variables and blood
product transfusion. There were significant differences in ALP (P <
0.001), AST (P = 0.02), ALT (P < 0.001), bilirubin (P = 0.01), PTT (P <
0.001), and INR (P = 0.005) levels between the two groups at the first day
after surgery. There were significant differences in ALP (P = 0.002), AST
(P < 0.001), ALT (P = 0.001), and bilirubin (P = 0.004) levels between the
two groups on the second day after surgery. These levels were
significantly lower in the N-acetyl cysteine group. Significant
differences were observed between the two groups in terms of MAP levels on
the first day (P = 0.002) and the second day after surgery (P < 0/001).
There was a significant difference between the two groups in terms of
packed cell (P = 0.002) and FFP (P < 0.001) transfusion. Based on the
findings, intravenous administration of N-acetyl cysteine in patients with
CABG significantly may be preserved liver function. Registered under No.
Trial registration number IRCT20190506043492N2, date of registration:
2020.05.23. Retrospectively registered.<br/>Copyright &#xa9; 2021, The
Author(s), under exclusive licence to Springer Nature Switzerland AG.

<13>
Accession Number
2013403946
Title
Activation of the innate immune response and organ injury after cardiac
surgery: a systematic review and meta-analysis of randomised trials and
analysis of individual patient data from randomised and non-randomised
studies.
Source
British Journal of Anaesthesia. 127(3) (pp 365-375), 2021. Date of
Publication: September 2021.
Author
Abbasciano R.G.; Lai F.Y.; Roman M.A.; Rizzello A.; Pathak S.; Ramzi J.;
Lucarelli C.; Layton G.R.; Kumar T.; Wozniak M.J.; Eagle-Hemming B.;
Akowuah E.; Rogers C.A.; Angelini G.D.; Murphy G.J.
Institution
(Abbasciano, Lai, Roman, Rizzello, Pathak, Kumar, Wozniak, Eagle-Hemming,
Murphy) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
(Ramzi) Leicester Medical School, University of Leicester, Leicester,
United Kingdom
(Lucarelli) Department of Cardiac Surgery, University of Verona, Verona,
Italy
(Layton) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Akowuah) South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Rogers) Clinical Trials and Evaluation Unit, Bristol Trials Centre,
University of Bristol, Bristol, United Kingdom
(Angelini) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
Publisher
Elsevier Ltd
Abstract
Background: It is unclear whether the innate immune response represents a
therapeutic target for organ protection strategies in cardiac surgery.
<br/>Method(s): A systematic review of trials of interventions targeting
the inflammatory response to cardiac surgery reporting treatment effects
on both innate immune system cytokines and organ injury was performed. The
protocol was registered at the International Prospective Register of
Systematic Reviews: CRD42020187239. Searches of the Cochrane Central
Register of Controlled Trials, MEDLINE, and Embase were performed.
Random-effects meta-analyses were used for the primary analysis. A
separate analysis of individual patient data from six studies (n=785)
explored sources of heterogeneity for treatment effects on cytokine
levels. <br/>Result(s): Searches to May 2020 identified 251 trials
evaluating 24 interventions with 20 582 participants for inclusion. Most
trials had important limitations. Methodological limitations of the
included trials and heterogeneity of the treatment effects on cytokine
levels between trials limited interpretation. The primary analysis
demonstrated inconsistency in the direction of the treatment effects on
innate immunity and organ failure or death between interventions. Analyses
restricted to important subgroups or trials with fewer limitations showed
similar results. Meta-regression, pooling available data from all trials,
demonstrated no association between the direction of the treatment effects
on inflammatory cytokines and organ injury or death. The analysis of
individual patient data demonstrated heterogeneity in the association
between the cytokine response and organ injury after cardiac surgery for
people >75 yr old and those with some chronic diseases.
<br/>Conclusion(s): The certainty of the evidence for a causal
relationship between innate immune system activation and organ injury
after cardiac surgery is low.<br/>Copyright &#xa9; 2021 British Journal of
Anaesthesia

<14>
Accession Number
2013338112
Title
Right Anterolateral Thoracotomy Versus Sternotomy for Resection of Benign
Atrial Masses: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16(5) (pp 426-433), 2021. Date of Publication: September 2021.
Author
Olsthoorn J.R.; Daemen J.H.T.; de Loos E.R.; ter Woorst J.F.; van Straten
A.H.M.; Maessen J.G.; Sardari Nia P.; Heuts S.
Institution
(Olsthoorn, ter Woorst, van Straten) Department of Cardiothoracic Surgery,
Catharina Ziekenhuis Eindhoven, Netherlands
(Daemen, de Loos) Department of Surgery, Division of General Thoracic
Surgery, Zuyderland Medical Center, Heerlen, Netherlands
(Maessen, Sardari Nia, Heuts) Department of Cardiothoracic Surgery,
Maastricht University Medical Center, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Objective: Primary benign cardiac tumors are rare disease entity that
predominantly originate from the atria. Benign masses can induce heart
failure, arrhythmia, or thromboembolic events. Therefore, surgical
excision is often indicated. Current guidelines on the preferred
approaches for resection (i.e., median sternotomy [MST] or right
anterolateral thoracotomy [RAT]) are lacking. The aim of the current
meta-analysis was to evaluate all studies comparing RAT to MST for
excision of benign atrial masses in terms of safety, efficacy, and
complications. <br/>Method(s): The PubMed and EMBASE databases were
searched through 9 June 2020. Data regarding mortality, complications,
recurrence, ICU stay, and length of hospital stay were extracted and
submitted to meta-analysis using random effects modelling. Heterogeneity
was assessed by the I² test. <br/>Result(s): Four retrospective
observational studies were included, including 196 patients (RAT n = 97,
MST n = 99). Mortality was 0% in both groups. Recurrence was <1% in the
RAT group and 0% in the MST group. Complication rate tended to be lower in
favor of the RAT group. Furthermore, RAT was associated with lower length
of ICU stay (-17.7 hr, P = 0.01) and hospital stay (-4.0 days, P < 0.001).
No significant differences in cardiopulmonary bypass (P = 0.09) and
cross-clamp times (P = 0.15) were observed. <br/>Conclusion(s): The RAT
approach is as safe and effective as MST for the excision of benign atrial
masses. Moreover, RAT is associated with a reduced complication rate and a
reduced duration of hospitalization and could be considered as the
preferred approach in anatomically suitable patients.<br/>Copyright &#xa9;
The Author(s) 2021.

<15>
Accession Number
2013168761
Title
Defining the Proper SYNTAX for Long-Term Benefit of Myocardial
Revascularization With Optimal Medical Therapy.
Source
Journal of the American College of Cardiology. 78(1) (pp 39-41), 2021.
Date of Publication: 06 Jul 2021.
Author
Boden W.E.; Gersh B.J.
Institution
(Boden) VA New England Health Care System, Massachusetts Veterans
Epidemiology, Research, and Informatics Center, Boston University School
of Medicine, Boston, MA, United States
(Gersh) Department of Cardiovascular Medicine, Mayo Clinic College of
Medicine and Science, Rochester, MN, United States
Publisher
Elsevier Inc.

<16>
Accession Number
2012942652
Title
TAVI Beyond 3 Years: Durability and Predictors for Survival.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16(5) (pp 417-425), 2021. Date of Publication: September 2021.
Author
Rahman F.; Resar J.R.
Institution
(Rahman, Resar) Division of Cardiology, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
Publisher
SAGE Publications Ltd
Abstract
The use of transcatheter aortic valve implantation (TAVI) has greatly
increased over the past 2 decades and now has overtaken surgical aortic
valve replacement. We have limited data regarding the long-term durability
of TAVI and the predictors of survival. Calcification, inflammation,
fibrous tissue deposition, and mechanical stress are important in the
structural deterioration of surgical bioprosthetic valves and likely
contribute to TAVI durability. However, TAVI has several differences to
surgical valve replacement such as valve preparation, valve to native
anatomy interaction, and valve sizing which all likely contribute to
durability and long-term survival. Most procedures have been performed on
older patients and therefore long-term follow-up studies have noted
mortality of approximately 50% at 5 years and 75% by 7 years. Current data
are limited by the high mortality of patients who have received TAVI often
as a result of age, frailty, and other competing comorbidities. TAVI as
compared with surgical valve replacement is associated with several
differences including higher conduction abnormalities (i.e., need for
pacemakers) and paravalvular leak, both of which may affect long-term
morbidity and mortality. In this review, we discuss the current status of
our knowledge and identify areas that require further
investigation.<br/>Copyright &#xa9; The Author(s) 2021.

<17>
Accession Number
2011155097
Title
A Phase II study of autologous mesenchymal stromal cells and c-kit
positive cardiac cells, alone or in combination, in patients with
ischaemic heart failure: the CCTRN CONCERT-HF trial.
Source
European Journal of Heart Failure. 23(4) (pp 661-674), 2021. Date of
Publication: April 2021.
Author
Bolli R.; Mitrani R.D.; Hare J.M.; Pepine C.J.; Perin E.C.; Willerson
J.T.; Traverse J.H.; Henry T.D.; Yang P.C.; Murphy M.P.; March K.L.;
Schulman I.H.; Ikram S.; Lee D.P.; O'Brien C.; Lima J.A.; Ostovaneh M.R.;
Ambale-Venkatesh B.; Lewis G.; Khan A.; Bacallao K.; Valasaki K.;
Longsomboon B.; Gee A.P.; Richman S.; Taylor D.A.; Lai D.; Sayre S.L.;
Bettencourt J.; Vojvodic R.W.; Cohen M.L.; Simpson L.; Aguilar D.; Loghin
C.; Moye L.; Ebert R.F.; Davis B.R.; Simari R.D.
Institution
(Bolli, Ikram) University of Louisville, School of Medicine, Louisville,
KY, United States
(Mitrani, Hare, Schulman) University of Miami, Miller School of Medicine,
Miami, FL, United States
(Pepine, March) University of Florida College of Medicine, Gainesville,
FL, United States
(Perin, Willerson, Taylor) Texas Heart Institute, CHI St. Luke's Health
Baylor College of Medicine Medical Center, Houston, TX, United States
(Traverse) Minneapolis Heart Institute Foundation at Abbott Northwestern
Hospital, and University of Minnesota School of Medicine, Minneapolis, MN,
United States
(Henry) The Carl and Edyth Lindner Center for Research and Education, The
Christ Hospital, Cincinnati, OH, United States
(Yang, Lee, O'Brien) Stanford University School of Medicine, Stanford, CA,
United States
(Murphy) Indiana University School of Medicine, Indianapolis, India
(Lima, Ostovaneh, Ambale-Venkatesh) Johns Hopkins University,
Cardiovascular Imaging, Baltimore, MD, United States
(Lewis) Massachusetts General Hospital, Harvard Medical School, Boston,
MA, United States
(Khan, Bacallao, Valasaki, Longsomboon) University of Miami, Miller School
of Medicine, Interdisciplinary Stem Cell Institute, Miami, FL, United
States
(Gee, Richman) Center for Cell and Gene Therapy, Baylor College of
Medicine, Houston, TX, United States
(Lai, Sayre, Bettencourt, Vojvodic, Cohen, Simpson, Aguilar, Moye, Davis)
UTHealth University of Texas Health Science Center at Houston School of
Public Health, Houston, TX, United States
(Aguilar, Loghin) UTHealth University of Texas Health Science Center at
Houston McGovern Medical School, Houston, TX, United States
(Ebert) NIH, National Heart, Lung and Blood Institute, Bethesda, MD,
United States
(Simari) University of Kansas, School of Medicine, Kansas City, KS, United
States
Publisher
John Wiley and Sons Ltd
Abstract
Aims: CONCERT-HF is an NHLBI-sponsored, double-blind, placebo-controlled,
Phase II trial designed to determine whether treatment with autologous
bone marrow-derived mesenchymal stromal cells (MSCs) and c-kit positive
cardiac cells (CPCs), given alone or in combination, is feasible, safe,
and beneficial in patients with heart failure (HF) caused by ischaemic
cardiomyopathy. <br/>Methods and Results: Patients were randomized
(1:1:1:1) to transendocardial injection of MSCs combined with CPCs, MSCs
alone, CPCs alone, or placebo, and followed for 12 months. Seven centres
enrolled 125 participants with left ventricular ejection fraction of 28.6
+/- 6.1% and scar size 19.4 +/- 5.8%, in New York Heart Association class
II or III. The proportion of major adverse cardiac events (MACE) was
significantly decreased by CPCs alone (-22% vs. placebo, P = 0.043).
Quality of life (Minnesota Living with Heart Failure Questionnaire score)
was significantly improved by MSCs alone (P = 0.050) and MSCs + CPCs (P =
0.023) vs. placebo. Left ventricular ejection fraction, left ventricular
volumes, scar size, 6-min walking distance, and peak oxygen consumption
did not differ significantly among groups. <br/>Conclusion(s): This is the
first multicentre trial assessing CPCs and a combination of two cell types
from different tissues in HF patients. The results show that treatment is
safe and feasible. Even with maximal guideline-directed therapy, both CPCs
and MSCs were associated with improved clinical outcomes (MACE and quality
of life, respectively) in ischaemic HF without affecting left ventricular
function or structure, suggesting possible systemic or paracrine cellular
mechanisms. Combining MSCs with CPCs was associated with improvement in
both these outcomes. These results suggest potential important beneficial
effects of CPCs and MSCs and support further investigation in HF
patients.<br/>Copyright &#xa9; 2021 European Society of Cardiology.

<18>
Accession Number
2011044255
Title
Surgical and multimodality treatment of cardiac sarcomas: A systematic
review and meta-analysis.
Source
Journal of Cardiac Surgery. 36(7) (pp 2476-2485), 2021. Date of
Publication: July 2021.
Author
Torabi S.; Arjomandi Rad A.; Vardanyan R.; Lopuszko A.T.; Van den Eynde
J.; Zubarevich A.; Sa M.P.B.O.; Szczechowicz M.; Weymann A.
Institution
(Torabi, Szczechowicz) Department of Anesthesiology and Intensive Care
Medicine, University Hospital of Cologne, Cologne, Germany
(Arjomandi Rad, Vardanyan) Department of Medicine, Faculty of Medicine,
Imperial College London, London, United Kingdom
(Lopuszko) Faculty of Medicine, Barts and The London School of Medicine
and Dentistry, Queen Mary University of London, London, United Kingdom
(Van den Eynde) Department of Cardiovascular Sciences, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Zubarevich, Weymann) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
(Sa) Division of Cardiovascular Surgery-PROCAPE, Universidade de
Pernambuco (UPE), Recife, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Primary cardiac sarcomas (PCSs) are an extremely rare and
aggressive type of malignancies that have been described only by a limited
number of observational studies. This study aimed to evaluate the
currently existing evidence comparing surgical to multimodality treatment
of PCS. <br/>Method(s): We systematically reviewed Embase, MEDLINE,
Cochrane Database, and Google Scholar, from inception to December 2020,
for original articles about surgical and multimodality treatment of PCS.
The outcomes included were mortality at various time points, resection
margin status, and mean estimated survival. The pooled treatment effects
were calculated using a random-effects model. <br/>Result(s): Ten studies
including a total of 1570 patients met our inclusion criteria. Surgery was
associated with significantly lower mortality when compared to
conservative treatment at 1, 2, and 3 years, whereas no significant
difference was found at 5 years. Furthermore, multimodality treatment
showed significantly lower mortality at 1 year when compared to surgery
alone, but not at 2 and 5 years. We found no difference in mortality
between angiosarcomas and other PCS subtypes. <br/>Conclusion(s): Overall,
surgery was found to provide a significant mortality advantage to PCS
patients up to 3 years following treatment. Multimodality treatment might
be of additional benefit, although only within the first year. Prospective
randomized studies are needed to further explore these differences in the
treatment of PCS.<br/>Copyright &#xa9; 2021 The Authors. Journal of
Cardiac Surgery published by Wiley Periodicals LLC.

<19>
Accession Number
2008450239
Title
The Effect of Transcatheter Mitral Valve Repair on Short-Term Mortality in
Patients With Chronic Kidney Disease - A Systematic Review and
Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 30 (pp 78-84), 2021. Date of
Publication: September 2021.
Author
Dave P.; Abunassar J.G.; Sayed N.; Sharma S.; Babiolakis C.S.; Bisleri G.;
Abuzeid W.
Institution
(Dave) Department of Internal Medicine, Kingston Health Sciences Centre,
Queen's University, Kingston, ON, Canada
(Abunassar, Abuzeid) Division of Cardiology, Kingston Health Sciences
Centre, Queen's University, Kingston, ON, Canada
(Sayed, Sharma) Department of Medicine, Undergraduate School of Medicine,
Queen's University, Kingston, ON, Canada
(Babiolakis) Department of Medicine, Division of Cardiology, Queen's
University, Kingston, ON, Canada
(Bisleri) Department of Surgery, Division of Cardiac Surgery, Kingston
Health Sciences Centre, Queen's University, Kingston, ON, Canada
Publisher
Elsevier Inc.
Abstract
Transcatheter Mitral Valve Repair (TMVr) offers clinically significant
benefit to select symptomatic patients with severe mitral regurgitation
(MR). We conducted a systematic review and meta-analysis of clinical
trials and observational studies to identify the effect of pre-procedural
Chronic Kidney disease (CKD) on short-term mortality in TMVr. We found CKD
is a predictor of 30-day mortality in patients undergoing TMVr.
Specifically, a GFR < 30 mL/min conveys a significant increase in 30-day
mortality. This is significant for patient selection, prognostication, as
well as identifies an area of need for further research. Summary for
annotated table of contents: A systematic review and meta-analysis looking
at short-term mortality in patients undergoing Transcatheter Mitral Valve
Repair with chronic kidney disease. Findings show severe renal disease is
associated with increased 30-day mortality.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<20>
Accession Number
2005971082
Title
Preventive effect of trimetazidine on contrast-induced nephropathy
undergoing percutaneous coronary intervention in elderly moderate and high
risk diabetics stratified by mehran score.
Source
Perfusion (United Kingdom). 36(5) (pp 491-500), 2021. Date of Publication:
July 2021.
Author
Zhang X.; Zhang P.; Yang S.; Li W.; Men X.; Fu N.
Institution
(Zhang) Graduate School of Tianjin Medical University, Tianjin, China
(Zhang, Yang, Li, Fu) Department of Cardiology, Tianjin Chest Hospital,
Tianjin, China
(Men) Department of Catheter lab, Dongying Second People's Hospital,
Shandong, China
Publisher
SAGE Publications Ltd
Abstract
Background: The aim of this research was to use the Mehran risk score to
classify elderly diabetics with coronary heart disease to assess the
preventive effect of trimetazidine on contrast-induced nephropathy (CIN)
after percutaneous coronary intervention (PCI) in different risk
population. <br/>Method(s): An uncompromised of 760 elderly diabetics that
went through PCI were included in this research. The patients were first
divided into three groups in the light of MRS: low-risk, moderate-risk,
and high-risk group, then randomized into trimetazidine group and the
control group respectively. The first endpoint was the amount of CIN,
which is described as a rise in serum creatinine levels by 44.2 mumol/L or
25% ratio within 48 or 72 hours after medication. Second endpoint included
differences in creatinine clearance rate (CrCl), blood urea nitrogen
(BUN), serum creatinine (Scr), cystatin-C (Cys-C), and the incidence of
major adverse events after administration. <br/>Result(s): In the three
groups, the incidence of CIN in trimetazidine and control group was 5.0%
versus 4.9%(chi² = 0.005, p > 0.05), 8.0% versus 18.0%
(chi² = 7.685, p < 0.05), 10.4% versus 27.1% (chi² =
4.376, p < 0.05), respectively. The multivariable logistic regression
result demonstrated that trimetazidine intervention was a profitable
element of CIN in moderate and high-risk groups (OR = 0.294, 95% CI
0.094-0.920, p = 0.035). <br/>Conclusion(s): Our study confirmed that
trimetazidine can be considered for preventive treatment of CIN occurrence
in elderly diabetics with moderate and high-risk population, while there
is no obvious advantage compared with hydration therapy in low-risk
patients.<br/>Copyright &#xa9; The Author(s) 2020.

<21>
Accession Number
635772228
Title
Bleeding risk in patients with cardiac disease from ischaemic stroke
reperfusion therapy: An update.
Source
BMJ Neurology Open. 3(2) (no pagination), 2021. Article Number: e000156.
Date of Publication: 17 Aug 2021.
Author
Chen B.J.; Daneshvari N.O.; Johansen M.C.
Institution
(Chen, Daneshvari, Johansen) Department of Neurology, The Johns Hopkins
University School of Medicine, Baltimore, MD, United States
Publisher
BMJ Publishing Group
Abstract
Background Intravenous tissue plasminogen activator (rtPA) and arterial
endovascular therapy (ET) rapidly restore cerebral perfusion in eligible
patients who had an acute ischaemic stroke (AIS). It is unknown whether
patients who had an AIS with premorbid cardiac disease respond differently
to reperfusion therapies than those without. These patients may have risk
factors that worsen outcomes or may represent those who would most benefit
from reperfusion therapy. Objective To determine whether patients who had
an AIS with the most frequently encountered pre-existing cardiac
conditions, atrial fibrillation (AF), heart failure (HF), left ventricular
assist devices (LVADs), or taking anticoagulation for cardiac indications,
are at increased risk for poor outcome, such as symptomatic intracranial
haemorrhage (sICH), after reperfusion therapy. Results Although AF is an
independent risk factor for poor poststroke outcomes, intravenous rtPA is
not associated with increased risk of sICH for those not on
anticoagulants. Likewise, HF is independently associated with mortality
post stroke, yet these patients benefit from reperfusion therapies without
increased rates of sICH. Patients with LVADs or who are on anticoagulation
should not be given IV rtPA; however, ET remains a viable option in those
who meet criteria, even patients with LVAD. Conclusion There is no
evidence of an increased risk for sICH after intravenous rtPA or ET for
those with AF or HF. Intravenous rtPA should not be given to patients on
anticoagulation or with LVADs, but ET should be offered to them when
eligible. Whenever possible, future AIS reperfusion research should
include patients with premorbid cardiac disease as they are frequently
excluded, representing a gap in evidence.<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2021. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<22>
Accession Number
2012895992
Title
Current clinical applications and potential perspective of micro-computed
tomography in cardiovascular imaging: A systematic scoping review.
Source
Hellenic Journal of Cardiology. 62(6) (pp 399-407), 2021. Date of
Publication: 01 Nov 2021.
Author
Papazoglou A.S.; Karagiannidis E.; Moysidis D.V.; Sofidis G.; Bompoti A.;
Stalikas N.; Panteris E.; Arvanitidis C.; Herrmann M.D.; Michaelson J.S.;
Sianos G.
Institution
(Papazoglou, Karagiannidis, Moysidis, Sofidis, Stalikas, Sianos) First
Department of Cardiology, AHEPA University Hospital, Aristotle University
of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
(Bompoti) Medway NHS Foundation Trust, United Kingdom
(Panteris) Biomic_AUTh, Center for Interdisciplinary Research and
Innovation (CIRI-AUTH), Balkan Center, B1.4, Thessaloniki, 10th km
Thessaloniki-Thermi Rd, P.O. Box 8318 GR 57001, Greece
(Arvanitidis) Institute of Marine Biology, Biotechnology and Aquaculture
(IMBBC), Hellenic Centre for Marine Research (HCMR), Heraklion, Crete
70013, Greece
(Arvanitidis) LifeWatch ERIC, Sector II-II, Plaza de Espana, Seville
41071, Spain
(Herrmann, Michaelson) Department of Pathology, Massachusetts General
Hospital and Harvard Medical School, Boston, United States
Publisher
Hellenic Cardiological Society
Abstract
Micro-computed tomography (micro-CT) constitutes an emerging imaging
technique, which can be utilized in cardiovascular medicine to study
in-detail the microstructure of heart and vessels. This paper aims to
systematically review the clinical utility of micro-CT in cardiovascular
imaging and propose future applications of micro-CT imaging in
cardiovascular research. A systematic scoping review was conducted by
searching for original studies written in English according to Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
extension for scoping reviews. Medline, Scopus, ClinicalTrials.gov, and
the Cochrane library were systematically searched through December 11,
2020 to identify publications concerning micro-CT applications in
cardiovascular imaging. Preclinical-animal studies and case reports were
excluded. The Newcastle-Ottawa assessment scale for observational studies
was used to evaluate study quality. In total, the search strategy
identified 30 studies that report on micro-CT-based cardiovascular imaging
and satisfy our eligibility criteria. Across all included studies, the
total number of micro-CT scanned specimens was 1,227. Six studies involved
postmortem 3D-reconstruction of congenital heart defects, while eleven
studies described atherosclerotic vessel (coronary or carotid)
characteristics. Thirteen other studies employed micro-CT for the
assessment of medical devices (mainly stents or prosthetic valves). In
conclusion, micro-CT is a novel imaging modality, effectively adapted for
the 3D visualization and analysis of cardiac soft tissues and devices at
high spatial resolution. Its increasing use could make significant
contributions to our improved understanding of the histopathophysiology of
cardiovascular diseases, and, thus, has the potential to optimize
interventional procedures and technologies, and ultimately improve patient
outcomes.<br/>Copyright &#xa9; 2021 Hellenic Society of Cardiology

<23>
Accession Number
636546163
Title
Propitious temporal changes in clinical outcomes after transcatheter
compared to surgical aortic valve replacement; a meta-analysis of over
65,000 patients.
Source
Journal of cardiothoracic surgery. 16(1) (pp 312), 2021. Date of
Publication: 20 Oct 2021.
Author
Panchal A.; Kyvernitakis A.; Rayarao G.; Doyle M.; Biederman R.W.W.
Institution
(Panchal) Department of Internal Medicine, University of Pittsburgh
Medical Center, PA, Pittsburgh, United States
(Kyvernitakis, Rayarao, Doyle, Biederman) Department of Cardiovascular
disease, Allegheny General Hospital, PA, Pittsburgh, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The treatment of symptomatic severe aortic stenosis (AS) has
rapidly evolved over the past decade, in both transcatheter (TAVR) and
surgical aortic valve replacement (SAVR), resulting in reported improved
clinical outcomes. Operator experience and technical improvements have
improved outcomes especially for patients undergoing TAVR. We sought to
determine and compare 1-year outcomes using a contemporary meta-analysis.
<br/>METHOD(S): We searched the Medline (MESH), Cochrane and Google
scholar databases using keywords "AS", "atrial fibrillation" (AFib) and
"stroke". We performed a meta-analysis to compare TAVR with SAVR
populations for post-procedural stroke, all-cause and cardiovascular
mortality at 1-year. <br/>RESULT(S): A total of 23 studies met criteria
for analysis with total population of 66,857 patients, of which 61,913 had
TAVR and 4944 had SAVR. Temporal trends demonstrated overall improvement
in outcome for both, TAVR and SAVR groups through the decade. Outcomes, in
terms of stroke (3.1% vs. 5%), all-cause (12.4% vs. 10.3%) and
cardiovascular mortality (7.2% vs. 6.2%) were similar at 1-year, in TAVR
versus SAVR, respectively. <br/>CONCLUSION(S): Despite overall gradual
improvement in both TAVR and SAVR outcomes over the decade, there is a
statistical overlap in confidence intervals for all-cause, cardiovascular
mortality and postprocedural stroke at 1-year. While 23 individual studies
demonstrate considerable advantages of each technique in certain cohorts,
integrating over 65,000 pts with our stratified surgical analysis suggests
that TAVR is comparable to SAVR for low and intermediate risk population
while superior to SAVR only in the highest-risk population for short and
intermediate term outcomes. This has substantial socio-economic
implications as we contemplate expanding our TAVR indications to
low/intermediate risk populations.<br/>Copyright &#xa9; 2021. The
Author(s).

<24>
[Use Link to view the full text]
Accession Number
636544100
Title
Clinical risk score for postoperative pneumonia following heart valve
surgery.
Source
Chinese medical journal. 134(20) (pp 2447-2456), 2021. Date of
Publication: 15 Sep 2021.
Author
Wang D.-S.; Huang X.-F.; Wang H.-F.; Le S.; Du X.-L.
Institution
(Wang) Department of Cardiovascular Surgery, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
Hubei 430022, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative pneumonia (POP) is one of the most common
infections following heart valve surgery (HVS) and is associated with a
significant increase in morbidity, mortality, and health care costs. This
study aimed to identify the major risk factors associated with the
occurrence of POP following HVS and to derive and validate a clinical risk
score. <br/>METHOD(S): Adults undergoing open HVS between January 2016 and
December 2019 at a single institution were enrolled in this study.
Patients were randomly assigned to the derivation and validation sets at
1:1 ratio. A prediction model was developed with multivariable logistic
regression analysis in the derivation set. Points were assigned to
independent risk factors based on their regression coefficients.
<br/>RESULT(S): POP occurred in 316 of the 3853 patients (8.2%).
Multivariable analysis identified ten significant predictors for POP in
the derivation set, including older age, smoking history, chronic
obstructive pulmonary disease, diabetes mellitus, renal insufficiency,
poor cardiac function, heart surgery history, longer cardiopulmonary
bypass, blood transfusion, and concomitant coronary and/or aortic surgery.
A 22-point risk score based on the multivariable model was then generated,
demonstrating good discrimination (C-statistic: 0.81), and calibration
(Hosmer-Lemeshow chi2 = 8.234, P = 0.312). The prediction rule also showed
adequate discriminative power (C-statistic: 0.83) and calibration
(Hosmer-Lemeshow chi2 = 5.606, P = 0.691) in the validation set. Three
risk intervals were defined as low-, medium-, and high-risk groups.
<br/>CONCLUSION(S): We derived and validated a 22-point risk score for POP
following HVS, which may be useful in preventive interventions and risk
management. TRIAL REGISTRATION: Chictr.org, ChiCTR1900028127;
http://www.chictr.org.cn/showproj.aspx?proj=46932.<br/>Copyright &#xa9;
2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc.
under the CC-BY-NC-ND license.

<25>
Accession Number
636321024
Title
Commentary on "Motor Developmental Delay After Cardiac Surgery in Children
With a Critical Congenital Heart Defect: A Systematic Literature Review
and Meta-analysis".
Source
Pediatric physical therapy : the official publication of the Section on
Pediatrics of the American Physical Therapy Association. 33(4) (pp
198-199), 2021. Date of Publication: 01 Oct 2021.
Author
Long S.H.; Eagleson K.; Charlton J.K.
Institution
(Long) MelbourneVICAustralia
(Eagleson) Queensland Paediatric Cardiac Service, Queensland Children's
Hospital, Faculty of Medicine The University of Queensland, Brisbane, QLD,
Australia
(Charlton) Mother of HeartKid Emily; Department of Paediatrics, Mercy
Hospital for Women, and Heart Research Group, Murdoch Children's Research
Institute, and Department of Paediatrics, University of Melbourne,
Melbourne, Victoria, Australia
Publisher
NLM (Medline)

<26>
Accession Number
636320870
Title
Motor Developmental Delay After Cardiac Surgery in Children With a
Critical Congenital Heart Defect: A Systematic Literature Review and
Meta-analysis.
Source
Pediatric physical therapy : the official publication of the Section on
Pediatrics of the American Physical Therapy Association. 33(4) (pp
186-197), 2021. Date of Publication: 01 Oct 2021.
Author
Sprong M.C.A.; Broeders W.; van der Net J.; Breur J.M.P.J.; de Vries L.S.;
Slieker M.G.; van Brussel M.
Institution
(Sprong) Center for Child Development, Exercise and Physical literacy
(Mrs/Ms Sprong, Dr van Brussel, Dr van der Net), Pediatric Cardiology ,
Department of Neonatology , Wilhelmina Children's Hospital, University
Medical Center Utrecht, Utrecht, Netherlands
Publisher
NLM (Medline)
Abstract
PURPOSE: To systematically review evidence regarding the severity and
prevalence of motor development in children with a critical congenital
heart defect (CCHD) without underlying genetic anomalies. SUMMARY OF KEY
POINTS: Twelve percent of all included studies reported abnormal mean
motor developmental scores, and 38% reported below average motor scores.
Children with single-ventricle physiology, especially those with
hypoplastic left heart syndrome, had the highest severity and prevalence
of motor delay, particularly at 0 to 12 months. Most included studies did
not differentiate between gross and fine motor development, yet gross
motor development was more affected. RECOMMENDATIONS FOR CLINICAL
PRACTICE: We recommend clinicians differentiate between the type of heart
defect, fine and gross motor development, and the presence of genetic
anomalies. Furthermore, increased knowledge about severity and prevalence
will enable clinicians to tailor their interventions to prevent motor
development delays in CCHD.<br/>Copyright &#xa9; 2021 Academy of Pediatric
Physical Therapy of the American Physical Therapy Association.

<27>
Accession Number
2014762064
Title
Cardiothoracic surgery in the caribbean.
Source
Brazilian Journal of Cardiovascular Surgery. 36(5) (pp 599-606), 2021.
Date of Publication: 2021.
Author
Vinck E.E.; Ebels T.; Hittinger R.; Peterson T.F.
Institution
(Vinck) Department of Cardiovascular Surgery, Clinica Cardio VID,
Medellin, Colombia
(Ebels) Department of Cardiothoracic Surgery, Groningen UMC, Groningen,
Netherlands
(Hittinger) Department of Cardiovascular Surgery, Martinique University
Hospital, Fort-de-France, Martinique, France
(Peterson) Department of Surgery, Dr. Horacio Oduber Hospital, Oranjestad,
Aruba, Netherlands
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Despite being one of the main vacation destinations in the
world, health care in the Caribbean faces many difficulties. The
challenges involved in these islands' medical care range from low-resource
institutions to lack of specialized care. In the field of thoracic and
cardiac surgery, many limitations exist, and these include the lack of
access to cardiac surgery for many small islands and little governmental
funding for minimally invasive approaches in thoracic surgery.
<br/>Method(s): Literature review was done using PubMed/MEDLINE and Google
Scholar databases to identify articles describing the characteristics of
thoracic and cardiac surgery departments on Caribbean islands. Articles on
the history, current states of practice, and advances in cardiothoracic
surgery in the Caribbean were reviewed. <br/>Result(s): Regardless of the
middle to high-income profile of the Caribbean, there are significant
differences in the speed of technological growth in cardiothoracic surgery
from island to island, as well as disparities between the quality of care
and resources. Many islands struggle to advance the field of
cardiothoracic surgery both through lack of local cardiac surgery centers
and limited financial funding for minimally invasive thoracic surgery.
<br/>Conclusion(s): Cardiac and thoracic surgery in the Caribbean depend
not only on the support from local government policies and proper
distribution of healthcare budgets, but efforts by the surgeons themselves
to change and improve institutional cultures. Although resource
availability still remains a challenge, the Caribbean remains an important
region that deserves special attention with regard to the unmet needs for
long-term sustainability of chest surgery.<br/>Copyright &#xa9; 2021,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<28>
Accession Number
2015850154
Title
Calcium supplementation in colorectal cancer prevention: A systematic
meta-analysis of adverse events.
Source
Biocell. 46(3) (pp 759-767), 2022. Date of Publication: 2022.
Author
Luo X.M.; Khan S.; Malik A.; Aldakheel F.M.; Chaudhary A.A.; Bazarbashi
S.; Tabatabaie F.
Institution
(Luo) Department of General Surgery, Mianzhu People's Hospital of Sichuan,
Mianzhu, China
(Khan, Malik) Department of Pharmaceutics, College of Pharmacy, King Saud
University, Riyadh, Saudi Arabia
(Khan) Department of Biosciences, Shri Ram Group of College (SRGC),
Muzaffarnagar, India
(Khan) Department of Health Sciences, Novel Global Community Educational
Foundation, Sydney, Australia
(Aldakheel) Department of Clinical Laboratory Sciences, College of Applied
Medical Sciences, King Saud University, Riyadh, Saudi Arabia
(Chaudhary) Department of Biology, College of Science, Imam Mohammad Ibn
Saud Islamic University (IMSUI), Riyadh, Saudi Arabia
(Bazarbashi) Oncology Center, King Faisal Specialist Hospital and Research
Center, Riyadh, Saudi Arabia
(Tabatabaie) Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
Publisher
Tech Science Press
Abstract
Despite the multiple systematic reviews and meta-analyses accumulating
evidence on the preventive effect of calcium supplementation for
colorectal cancer, most of the associated adverse effects are not
systematically analyzed. The aim of the study is evaluating adverse events
associated with calcium supplementation for colorectal cancer prevention
through a systematic meta-analysis. We searched Medline, PubMed Central,
EMBASE (Excerpta Medica database), Scopus, Cochrane Central Register of
Controlled Trials, and Web of Science published in English from database
inception up to 31 July 2019. In the current systematic meta-analysis, we
included human studies (including cohort studies, clinical trials,
case-control studies) on supplementation of calcium in patients with or at
risk of colorectal cancer. Assessment of the quality of included studies
was performed by Jadad score. Information on the patient population,
number of enrolled subjects in each group, dose of calcium
supplementation, duration of calcium supplementation, and reported adverse
events were gathered. The data were pooled for incidence rates for any
adverse event during the study period regardless of causality association.
We identified 6 studies, comprising 4583 participants that met the
inclusion criteria. Meta-analysis on pooled incidence rates for adverse
event during study period showed no statistically significant increased
risk for cancer (OR = 0.92, 95% CI: 0.70-1.21, P = 0.577; I² =
0.0%, P = 0.731), coronary revascularization (OR = 1.12, 95% CI:
0.79-1.59, P = 0.492; I² = 0.0%, P = 0.957), myocardial
infarction (OR = 0.81, 95% CI: 0.34-1.91, P = 0.634; I² =
67.9%, P = 0.047), stroke (OR = 0.75, 95% CI: 0.42-1.33, P = 0.332,
I² = 0.00%, P = 0.717), Transient Ischemic Attack (TIA) (OR =
1.37, 95% CI: 0.28-6.51, P = 0.692, I² = 81.9%, P = 0.002),
urolithiasis (OR = 1.23, 95% CI: 0.75-2.01, P = 0.410; I² =
0.0%, P = 0.851), fracture (OR = 0.98, 95% CI: 0.70-1.37, P = 0.938;
I² = 37.8%, P = 0.152) and death (OR = 1.05, 95% CI: 0.71-1.56,
P = 0.786, I² = 12.2%, P = 0.317) in patients receiving calcium
supplementation for colorectal cancer prevention compared to control.
Based on the results of Egger test, publication bias was not observed
among the studies (P = 0.262). The current result of the meta-analysis on
human studies reporting adverse events associated with calcium
supplementation for the prevention of colorectal cancer demonstrated no
statistically significant increased risk for the development of adverse
events compared to control groups.<br/>Copyright &#xa9; 2022 Centro
Regional de Invest. Cientif. y Tecn.. All rights reserved.

<29>
Accession Number
2015465631
Title
Letter regarding "RenalGuard system and conventional hydration for
preventing contrast-associated acute kidney injury in patients undergoing
cardiac interventional procedures: A systematic review and meta-analysis".
Source
International Journal of Cardiology. 346 (pp 18), 2022. Date of
Publication: 01 Jan 2022.
Author
Huang Z.; Mo M.; Huang H.
Institution
(Huang, Huang) Department of Cardiovascular Thoracic Surgery, the Third
Affiliated Hospital of Guangxi Medical University: Nanning Second People's
Hospital, Nanning, China
(Mo) Geriatric Department of Endocrinology, the First Affiliated Hospital
of Guangxi Medical University, Nanning, China
Publisher
Elsevier Ireland Ltd

<30>
Accession Number
2015297291
Title
Rhythm disturbances following rapid-deployment aortic valve replacement.
Source
JTCVS Techniques. (no pagination), 2021. Date of Publication: 2021.
Author
Thuraisingam A.; Newcomb A.E.
Institution
(Thuraisingam, Newcomb) Department of Cardiothoracic Surgery, St Vincent's
Hospital Melbourne, Fitzroy, Australia
(Newcomb) University of Melbourne Department of Surgery, St Vincent's
Hospital Melbourne, Fitzroy, Australia
Publisher
Elsevier Inc.
Abstract
Objectives: There have been reports of postoperative conduction
disturbances after rapid-deployment aortic valve replacement. Our
objective was to assess electrocardiogram changes in patients undergoing
this procedure and review the literature on this topic. <br/>Method(s): In
this retrospective case series, clinical data were extracted from patient
records at St Vincent's Hospital Melbourne and the Australia New Zealand
Society of Cardiac and Thoracic Surgeons database. Electrocardiogram data
were obtained at baseline and postoperatively on day 5 and at week 6 and
reviewed for rhythm disturbances and intracardiac conduction problems.
Pacemaker status was also recorded. <br/>Result(s): From 2013 to 2017, 100
consecutive patients underwent rapid-deployment aortic valve replacement
with 1 valve type at our institution. Three patients were excluded because
of paced rhythm preoperatively, leaving 97 patients (mean age 74.7 +/-
8.12 years; 56.7% male) for analysis. Some 18.6% of patients developed new
left bundle branch block at 5 days postoperatively and only 4.1% of
patients found with persistent left bundle branch block at 6-week
follow-up compared with preoperatively. No significant changes were
observed in the frequencies of atrial fibrillation, first-degree heart
block, and right bundle branch block. However, there was evidence of
increases in paced rhythm and subsequent need for a permanent pacemaker. A
total of 14 patients (14.4%) had a permanent pacemaker implanted at an
average of 11.1 +/- 2.9 days postoperatively. <br/>Conclusion(s): Rhythm
disturbances and conduction abnormalities are noted with the
rapid-deployment aortic valves used at our institution, but appear
comparable to other rapid-deployment aortic valve replacement
bioprostheses. These abnormalities may be related to the effect of the
sub-annular stent frame of the valve system and implantation
technique.<br/>Copyright &#xa9; 2021 The Author(s)

<31>
Accession Number
2014407381
Title
Mitral valve paravalvular leaks: Comprehensive review of literature.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Janmohamed I.K.; Mishra V.; Geragotellis A.; Sherif M.; Harky A.
Institution
(Janmohamed) Faculty of Medicine and Health, University of Leeds School of
Medicine, Leeds, United Kingdom
(Mishra) St. George's University of London Medical School, Tooting,
London, United Kingdom
(Geragotellis) Faculty of Health Sciences, Observatory, University of Cape
Town School of Medicine, Cape Town, South Africa
(Sherif) Department of Cardiothoracic, Northern General Hospital,
Sheffield, United Kingdom
(Harky) Department of Cardiac Surgery, Liverpool Heart and Chest Hospital,
Liverpool, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Mitral paravalvular leaks (mPVL) are a recognized complication
for patients with mitral valve prostheses. Although clinically
insignificant for many patients, it may pose life-threatening haemolysis
and regurgitation-induced heart failure, and so clinicians should have a
high index of suspicion in the presence of new symptoms. <br/>Aim(s): This
review discusses the pathogenesis, clinical features, diagnosis, imaging
and treatment of mPVLs. <br/>Method(s): A comprehensive literature search
was performed using PubMed, EMBASE, Cochrane database, Google Scholar and
Ovid. Search terms used included "mitral valve paravalvular leak,"
"transthoracic echocardiography," "2D transoesophageal echocardiography,"
"3D transoesophageal echocardiography," "cardiac computed tomography,"
(CT) "cardiac magnetic resonance imaging," "intracardiac
echocardiography," "cinefluoroscopy," "fluoroscopy," and "percutaneous
closure.". <br/>Result(s): All patients with mPVLs should undergo regular
full evaluation, including patient history, physical examination,
laboratory work-up, imaging, and referral, if necessary. Echocardiography
is fundamental to the diagnosis, and is augmented with cardiac magnetic
resonance imaging, cardiac computerized tomography and fluoroscopy for
further characterization and procedural planning amongst the structural
heart team. <br/>Conclusion(s): The prevalence of mPVL is expected to
increase proportionally to the growing number of surgical and
transcatheter valve replacements conducted in the ageing population.
Multimodal imaging is instrumental in guiding diagnostic and therapeutic
strategies when managing mPVLs. Advances in imaging and capabilities of
transcather devices will prompt growing uptake of percutaneous treatment
over conventional, higher-risk surgery for mPVL management.<br/>Copyright
&#xa9; 2021 Wiley Periodicals LLC

<32>
Accession Number
2014391241
Title
Long-Term Follow-Up of Pediatric Patients with Severe Postoperative
Pulmonary Hypertension After Correction of Congenital Heart Defects.
Source
Pediatric Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Lindberg L.
Institution
(Lindberg) Institution of Clinical Science, Faculty of Medicine, Lund
University, Lund, Sweden
(Lindberg) Lund University and Children's Hospital, PICU, Skane University
Hospital in Lund, Lund 221 85, Sweden
Publisher
Springer
Abstract
The surgical repair of congenital heart defects in children with
preoperative pulmonary hypertension (PH) is to varying degree associated
with the occurrence of postoperative PH. The objective of this study was
to follow up children with severe postoperative PH (pulmonary
arterial/aortic pressure ratio >= 1.0) to evaluate if pulmonary arterial
pressure spontaneously normalized or needed PH-targeting therapy and to
identify potential high-risk diagnoses for bad outcome. Twenty-five
children who developed clinically significant severe PH on at least three
occasions postoperatively were included in the follow-up (20-24 years).
Data from chart reviews, echocardiographic investigations, and
questionnaires were obtained. Three children died within the first year
after surgery. Three children were lost to follow-up. The remaining 17
children normalized their pulmonary arterial pressure without the use of
PH-targeting drugs at any time during the follow-up. Two children had a
remaining mild PH with moderate mitral valve insufficiency. All three
children with bad outcome had combined cardiac lesions causing
post-capillary pulmonary hypertension. Normalization of the pulmonary
arterial pressure occurred in almost all children with severe
postoperative PH, without any need of supplemental PH-targeting therapies.
All children with bad outcome had diagnoses conformable with
post-capillary PH making the use of PH-targeting therapies relatively
contraindicated. These data emphasize the need to perform randomized,
blinded trials on the use of PH-targeting drugs in children with
postoperative PH before accepting it as an indication for routine
treatment.<br/>Copyright &#xa9; 2021, The Author(s).

<33>
Accession Number
636468362
Title
Urinary biomarkers to predict severe fluid overload after cardiac surgery:
A pilot study.
Source
Biomarkers in Medicine. 15(16) (pp 1451-1464), 2021. Date of Publication:
November 2021.
Author
Elitok S.; Isermann B.; Westphal S.; Devarajan P.; Albert C.; Kuppe H.;
Ernst M.; Bellomo R.; Haase M.; Haase-Fielitz A.
Institution
(Elitok, Ernst) Department of Nephrology and Endocrinology, Ernst von
Bergmann Hospital Potsdam, Charlottenstr. 72, Potsdam 14467, Germany
(Isermann) Institute of Laboratory Medicine, Leipzig University Hospital,
Paul-List-Str. 13/15, Leipzig 04103, Germany
(Westphal) Institute of Laboratory Medicine, Tertiary Hospital Dessau,
Auenweg 38, Dessau-Roslau 06847, Germany
(Devarajan) Department of Nephrology and Hypertension, Cincinnati
Children's Hospital, 3333 Burnet Ave, Cincinnati, OH 45229, United States
(Albert, Haase) Diaverum Renal Care Center, Am Neuen Garten 11, Potsdam
14469, Germany
(Albert) Medical Faculty, University Clinic for Cardiology and Angiology,
Otto Von-Guericke-University Magdeburg, Leipziger Str. 44, Magdeburg
39120, Germany
(Kuppe) Institute of Anesthesiology, German Heart Center, Augustenburger
Platz 1, Berlin 13353, Germany
(Ernst, Haase) Medical Faculty, Otto Von-Guericke-University Magdeburg,
Leipziger Str. 44, Magdeburg 39120, Germany
(Bellomo) Department of Intensive Care, Austin Health, 145 Studley Rd,
Heidelberg, Melbourne, VIC 3084, Australia
(Bellomo) Centre for Integrated Critical Care, The University of
Melbourne, Melbourne, Australia
(Haase-Fielitz) Department of Cardiology, Brandenburg Heart Center,
Immanuel Hospital, Ladeburger Str. 17, Bernau 16321, Germany
(Haase-Fielitz) Brandenburg Medical School Theodor Fontane, Fehrbelliner
Str. 38, Neuruppin 16816, Germany
(Haase-Fielitz) Faculty of Health Sciences Brandenburg, University of
Potsdam, Potsdam, Germany
(Haase-Fielitz) Institute of Social Medicine and Health Care Systems
Research, Otto Von-Guericke-University Magdeburg, Leipziger Str. 44,
Magdeburg 39120, Germany
(Albert, Haase-Fielitz) Diaverum AB, Hyllie Boulevard 35, Malmo 21532,
Sweden
Publisher
Future Medicine Ltd.
Abstract
Aim: To assess the predictive ability of urinary and plasma biomarkers and
clinical routine parameters for subsequent severe fluid overload. Patients
& methods: In a pilot study, we studied 100 adult patients after cardiac
surgery. On intensive care unit admission, we measured biomarkers in urine
(midkine, IL-6, neutrophil gelatinase-associated lipocalin [NGAL],
hepcidin-25) and plasma (creatinine, urea, B-type natriuretic peptide,
lactate, C-reactive protein, leukocytes, IL-6, NGAL, hepcidin-25) to
predict postoperative severe fluid overload. <br/>Result(s): Urinary
midkine, IL-6, NGAL and hepcidin-25 (all AUCs =0.79) predicted
postoperative severe fluid overload (n = 5 patients). Urinary
NGAL/hepcidin-25 ratio (AUC 0.867) predicted postoperative severe fluid
overload after adjustment to EuroScore and need for norepinephrine on
surgery day (odds ratio: 2.4). <br/>Conclusion(s): Urinary biomarkers on
intensive care unit admission might be helpful to predict subsequent
severe fluid overload after cardiac surgery. Lay abstract: Aim: To assess
whether proteins in the urine or blood or clinical routine laboratory
parameters can predict severe body fluid overload after cardiac surgery.
Patients & methods: In a pilot study, we studied 100 adult patients after
cardiac surgery. After surgery, we measured proteins in the urine
(midkine, IL-6, neutrophil gelatinase-associated lipocalin [NGAL],
hepcidin-25) and blood (creatinine, urea, B-type natriuretic peptide,
lactate, C-reactive protein, leukocytes, IL-6, NGAL, hepcidin- 25) to
predict postoperative severe fluid overload. <br/>Result(s): Urinary
midkine, IL-6, NGAL and hepcidin- 25 predicted postoperative severe fluid
overload (n = 5 patients). Urinary NGAL/hepcidin-25 ratio predicted
postoperative severe fluid overload after adjustment to important
covariates. <br/>Conclusion(s): Urinary biomarkers might be helpful to
predict subsequent severe fluid overload after cardiac surgery. Tweetable
abstract In a pilot study with 100 adult patients after cardiac surgery,
we found that urinary biomarkers, but not blood biomarkers can help
predict postoperative severe fluid overload after cardiac
surgery.<br/>Copyright &#xa9; 2021 Future Medicine Ltd.

<34>
Accession Number
2013465791
Title
Developing an intervention to optimise the outcome of cardiac surgery in
people with diabetes: the OCTOPuS pilot study.
Source
Pilot and Feasibility Studies. 7(1) (no pagination), 2021. Article Number:
157. Date of Publication: December 2021.
Author
Holt R.I.G.; Barnard-Kelly K.; Dritsakis G.; Thorne K.I.; Cohen L.; Dixon
E.; Patel M.; Newland-Jones P.; Partridge H.; Luthra S.; Ohri S.;
Salhiyyah K.; Picot J.; Niven J.; Cook A.; Velissaris T.; Johnson P.;
Trodden R.; Green M.; Rojkova J.; Sass T.; Stanley J.; Collier A.; Renz
S.; Boxall J.; Northey J.; Stanton L.; Whitehead A.; Dhatariya K.;
Stanisstreet D.; Baig K.; Voysey M.; Drinkwater D.; Lord J.; Shepherd J.
Institution
(Holt) Human Development and Health, Faculty of Medicine, University of
Southampton, Southampton, United Kingdom
(Holt) Southampton National Institute for Health Research Biomedical
Research Centre, University Hospital Southampton NHS Foundation Trust,
Southampton, United Kingdom
(Barnard-Kelly, Cohen) Barnard Health-Health Psychology Research, Fareham,
United Kingdom
(Barnard-Kelly) Faculty of Health & Social Science, Bournemouth
University, Poole, United Kingdom
(Dritsakis, Thorne, Dixon, Niven, Cook) Clinical Trials Unit, Faculty of
Medicine, University of Southampton, Southampton, United Kingdom
(Patel, Newland-Jones) Diabetes Department, University Hospital
Southampton, Southampton, United Kingdom
(Partridge) Royal Bournemouth and Christchurch Hospitals NHS Foundation
Trust, Bournemouth, United Kingdom
(Luthra, Ohri, Salhiyyah) Division of Cardiac Surgery, Wessex
Cardiothoracic Centre, University Hospital Southampton, Southampton,
United Kingdom
(Salhiyyah) Middle East University, Amman, Jordan
(Picot, Cook) Southampton Health Technology Assessments Centre, University
of Southampton, Southampton, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Cardiothoracic surgical outcomes are poorer in people with
diabetes compared with those without diabetes. There are two important
uncertainties in the management of people with diabetes undergoing major
surgery: (1) how to improve diabetes management in the weeks leading up to
an elective procedure and (2) whether that improved management leads to
improved postoperative outcomes. The aim of this study was to develop and
pilot a specialist diabetes team-led intervention to improve surgical
outcomes in people with diabetes. <br/>Design(s): Open pilot feasibility
study Setting: Diabetes and cardiothoracic surgery departments, University
Hospital Southampton NHS Foundation Trust Participants: Seventeen people
with diabetes undergoing cardiothoracic surgery Intervention: Following
two rapid literature reviews, a prototype intervention was developed based
on a previously used nurse-led outpatient intervention and tested.
<br/>Primary Outcome: Feasibility and acceptability of delivering the
intervention Secondary outcomes: Biomedical data were collected at
baseline and prior to surgery. We assessed how the intervention was used.
In depth qualitative interviews with participants and healthcare
professionals were used to explore perceptions and experiences of the
intervention and how it might be improved. <br/>Result(s): Thirteen of the
17 people recruited completed the study and underwent cardiothoracic
surgery. All components of the OCTOPuS intervention were used, but not all
parts were used for all participants. Minor changes were made to the
intervention as a result of feedback from the participants and healthcare
professionals. Median (IQR) HbA<inf>1c</inf> was 10 mmol/mol (3, 13) lower
prior to surgery than at baseline. <br/>Conclusion(s): This study has
shown that it is possible to develop a clinical pathway to improve
diabetes management prior to admission. The clinical and
cost-effectiveness of this intervention will now be tested in a
multicentre randomised controlled trial in cardiothoracic centres across
the UK. Trial registration: ISRCTN; ISRCTN10170306. Registered 10 May
2018.<br/>Copyright &#xa9; 2021, The Author(s).

<35>
Accession Number
2012858898
Title
Novel autologous, high concentrated fibrin as advanced hemostatic agent
for coronary surgery.
Source
Transfusion and Apheresis Science. 60(4) (no pagination), 2021. Article
Number: 103171. Date of Publication: August 2021.
Author
Micovic S.; Everts P.; Calija B.; Strugarevic E.; Grubor N.; Boricic M.;
Lesanovic J.; Box H.; Abazovic D.
Institution
(Micovic, Calija, Strugarevic, Boricic, Lesanovic) Cardiovascular
Institute Dedinje, Milana Tepica 1, Belgrade 11000, Serbia
(Everts) Gulf Coasts Biologics Inc, 4331 Veronica S Shoemaker Blvd, Fort
Myers, FL 33916, United States
(Grubor) Clinical Centre of Serbia, Pasterova2, Belgrade 11000, Serbia
(Box) St Catherine's Hospital, Michelangelolaan 2, Eindhoven 5623 EJ,
Netherlands
(Abazovic) Emergency Medical Centre of Montenegro, Vaka Durovica bb,
Podgorica 81110, Montenegro
Publisher
Elsevier Ltd
Abstract
Background: Variability in transfusion outcomes and excessive
postoperative bleeding represents a significant problem in cardiac
surgery. The effort to reduce bleeding complications and transfusion
outcomes is desirable. Our study investigated the feasibility of reducing
bleeding complications and transfusion requirements by applying
perioperatively prepared autologous bio-regenerative fibrin sealant.
<br/>Method(s): A prospective, case-control study enrolled 74 patients
undergoing coronary artery bypass grafting by a single surgeon. Patients
in the control group (N = 43), received traditional methods of hemostasis,
while patients in the experimental group (N = 31) were treated
additionally with autologous bio-regenerative fibrin. <br/>Result(s):
Patients were well-matched with regard to basic demographic, laboratory
and procedural data. Allogeneic blood transfusion requirement in control
group was 39.5 % (17 of 43 patients), compared to 6.5 % (2 of 31 patients)
in treated group (p < 0,001). The lower infection rate in the experimental
group was also noted. No safety issues were identified during the
preparation and application process. <br/>Conclusion(s): Autologous
bio-regenerative fibrin can be safely prepared, with no time consuming,
and was demonstrated to be a useful tool to decrease allogeneic blood
transfusion requirements following elective coronary artery bypass
grafting surgery. A prospective randomized trial is needed to confirm
these findings.<br/>Copyright &#xa9; 2021 Elsevier Ltd

<36>
Accession Number
2014999813
Title
Clinical Outcomes Following Isolated Transcatheter Tricuspid Valve Repair:
A Meta-Analysis and Meta-Regression Study.
Source
JACC: Cardiovascular Interventions. 14(20) (pp 2285-2295), 2021. Date of
Publication: 25 Oct 2021.
Author
Bocchino P.P.; Angelini F.; Vairo A.; Andreis A.; Fortuni F.; Franchin L.;
Frea S.; Raineri C.; Pidello S.; Conrotto F.; Montefusco A.; Alunni G.; De
Ferrari G.M.
Institution
(Bocchino, Angelini, Vairo, Andreis, Fortuni, Franchin, Frea, Raineri,
Pidello, Conrotto, Montefusco, Alunni, De Ferrari) Division of Cardiology,
Department of Medical Sciences, University of Turin, "Citta della Salute e
della Scienza" Hospital, Turin, Italy
(Fortuni) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to assess the pooled clinical and
echocardiographic outcomes of different isolated transcatheter tricuspid
valve repair (ITTVR) strategies for significant (moderate or greater)
tricuspid regurgitation (TR). <br/>Background(s): Significant TR is a
common valvular heart disease worldwide. <br/>Method(s): Published
research was systematically searched for studies evaluating the efficacy
and safety of ITTVR for significant TR in adults. The primary outcomes
were improvement in New York Heart Association (NYHA) functional class and
6-minute walking distance and the presence of severe or greater TR at the
last available follow-up of each individual study. Random-effect
meta-analysis was performed comparing outcomes before and after ITTVR.
<br/>Result(s): Fourteen studies with 771 patients were included. The mean
age was 77 +/- 8 years, and the mean European System for Cardiac Operative
Risk Evaluation II score was 6.8% +/- 5.4%. At a weighted mean follow-up
of 212 days, 209 patients (35%) were in NYHA functional class III or IV
compared with 586 patients (84%) at baseline (risk ratio: 0.23; 95% CI:
0.13-0.40; P < 0.001). Six-minute walking distance significantly improved
from 237 +/- 113 m to 294 +/- 105 m (mean difference +50 m; 95% CI: +34 to
+66 m; P < 0.001). One hundred forty-seven patients (24%) showed severe or
greater TR after ITTVR compared with 616 (96%) at baseline (risk ratio:
0.29; 95% CI: 0.20-0.42; P < 0.001). <br/>Conclusion(s): Patients
undergoing ITTVR for significant TR experienced significant improvements
in NYHA functional status and 6-minute walking distance and a significant
reduction in TR severity at mid-term follow-up.<br/>Copyright &#xa9; 2021
American College of Cardiology Foundation

<37>
Accession Number
2014999807
Title
Right Ventricular-Pulmonary Arterial Coupling in Patients With HF
Secondary MR: Analysis From the COAPT Trial.
Source
JACC: Cardiovascular Interventions. 14(20) (pp 2231-2242), 2021. Date of
Publication: 25 Oct 2021.
Author
Brener M.I.; Grayburn P.; Lindenfeld J.; Burkhoff D.; Liu M.; Zhou Z.; Alu
M.C.; Medvedofsky D.A.; Asch F.M.; Weissman N.J.; Bax J.; Abraham W.; Mack
M.J.; Stone G.W.; Hahn R.T.
Institution
(Brener, Burkhoff, Hahn) Division of Cardiology, Columbia University
Irving Medical Center, New York, NY, United States
(Grayburn) Baylor Heart and Vascular Institute, Baylor University Medical
Center, Dallas, TX, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, Vanderbilt
University Medical Center, Nashville, TN, United States
(Burkhoff, Liu, Zhou, Alu, Stone) Cardiovascular Research Foundation, New
York, New York, United States
(Medvedofsky, Asch, Weissman) Cardiovascular Core Laboratory, MedStar
Health Research Institute, Washington, DC, United States
(Bax) Heart Lung Center, Leiden University Medical Center, Leiden,
Netherlands
(Abraham) Davis Heart and Lung Research Institute, The Ohio State
University Medical Center, Columbus, OH, United States
(Mack) Baylor Scott & White Heart and Vascular Hospital, Plano, TX, United
States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to determine the prognostic impact
of right ventricular (RV)-pulmonary arterial (PA) coupling in patients
with heart failure (HF) with severe secondary mitral regurgitation (SMR)
enrolled in the COAPT (Cardiovascular Outcomes Assessment of the MitraClip
Percutaneous Therapy for Heart Failure Patients With Functional Mitral
Regurgitation) trial. <br/>Background(s): RV contractile function and PA
pressures influence outcomes in patients with SMR, but the impact of RV-PA
coupling in patients randomized to transcatheter edge-to-edge repair
(TEER) vs guideline-directed medical therapy (GDMT) is unknown.
<br/>Method(s): RV-PA coupling was assessed by the ratio of RV free wall
longitudinal strain derived from speckle-tracking echocardiography and
noninvasively measured RV systolic pressure. Advanced RV-PA uncoupling was
defined as RV free wall longitudinal strain/RV systolic pressure <=0.5%/mm
Hg. The primary endpoint was a composite of all-cause mortality or HF
hospitalization at 24-month follow-up. <br/>Result(s): A total of 372
patients underwent speckle-tracking echocardiography, and 70.2% had
advanced RV-PA uncoupling. By multivariable analysis, advanced RV-PA
uncoupling was strongly associated with an increased risk for the primary
24-month endpoint of death or HF hospitalization (HR: 1.87; 95% CI:
1.31-2.66; P = 0.0005). A similar association was present for all-cause
mortality alone (HR: 2.57; 95% CI: 1.54-4.29; P = 0.0003). The impact of
RV-PA uncoupling was consistent in patients randomized to TEER and GDMT
alone. Compared with GDMT alone, the addition of TEER improved 2-year
outcomes in patients with (48.0% vs 74.8%; HR: 0.51; 95% CI: 0.37-0.71)
and those without (28.8% vs 47.8%; HR: 0.51; 95% CI: 0.27-0.97) advanced
RV-PA uncoupling (P<inf>interaction</inf> = 0.98). <br/>Conclusion(s): In
the COAPT trial, advanced RV dysfunction assessed by RV-PA uncoupling was
a powerful predictor of 2-year adverse outcomes in patients with HF and
SMR. (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous
Therapy for Heart Failure Patients With Functional Mitral Regurgitation
[The COAPT Trial]; NCT01626079)<br/>Copyright &#xa9; 2021 American College
of Cardiology Foundation

<38>
Accession Number
2013992742
Title
Transition to heart transplantation in post-myocardial infarction
ventricular septal rupture: a systematic review.
Source
Heart Failure Reviews. (no pagination), 2021. Date of Publication: 2021.
Author
Perez-Villa B.; Cubeddu R.J.; Brozzi N.; Sleiman J.R.; Navia J.;
Hernandez-Montfort J.
Institution
(Perez-Villa, Brozzi, Sleiman, Navia, Hernandez-Montfort) Heart, Vascular
and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United
States
(Cubeddu) Naples Heart Institute, NCH Healthcare System, Naples, FL,
United States
Publisher
Springer
Abstract
Post-myocardial infarction ventricular septal rupture (MI-VSR) remains a
dreadful complication with dismal prognosis. Surgical repair is the
primary treatment strategy, whereas the role of heart transplantation (HT)
as a primary option in MI-VSR is limited to case reports (CRs). We
performed a systematic review of CRs to describe in-hospital mortality,
and survival at 6 and 12 months in adult patients with MI-VSR treated with
HT as a primary or bailout strategy. We performed a comprehensive search
of Web of Science, PubMed, and Ovid Medline. The last search was completed
on March 10, 2020. An aggregated score based on the CARE case report
guideline was used to assess the quality of the CRs. We included CRs that
described adult patients with MI-VSR treated with HT as a primary or
bailout strategy. A total of 14 CRs between 1994 and 2015 were included,
retrieving and analyzing the characteristics of 17 patients. A total of 12
patients underwent HT, with HT being the primary strategy in 8 patients
and a bailout strategy for 4 patients following initial surgical repair,
while 5 patients died awaiting HT under mechanical circulatory support
(MCS), accounting for the total in-hospital mortality of this series
(29%). Regarding long-term outcomes, 6 patients were reported to be alive
at 6 months and 1 year after HT, while information was missing in the
remaining 6 patients. In conclusion, HT supported by the use of temporary
and durable MCS as a bridge to HT could be a feasible primary or bailout
strategy to reduce the high in-hospital mortality of patients with
MI-VSR.<br/>Copyright &#xa9; 2021, The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature.

<39>
Accession Number
2013991878
Title
"Tailored" antiplatelet bridging therapy with cangrelor: moving toward
personalized medicine.
Source
Platelets. (no pagination), 2021. Date of Publication: 2021.
Author
Valenti R.; Muraca I.; Marcucci R.; Ciatti F.; Berteotti M.; Gori A.M.;
Carrabba N.; Migliorini A.; Marchionni N.; Valgimigli M.
Institution
(Valenti, Muraca, Ciatti, Carrabba, Migliorini, Marchionni) Interventional
Cardiology Unit, Cardiovascular Department, Careggi University Hospital,
Florence, Italy
(Marcucci, Berteotti, Gori) Department of Clinical and Experimental
Medicine, University of Florence, Florence, Italy
(Valgimigli) Division of Cardiology, Cardiocentro Ticino Institute, Ente
Ospedaliero Cantonale (Eoc), Lugano, Switzerland
(Valgimigli) Department of Cardiology, University of Bern, Bern,
Switzerland
Publisher
Taylor and Francis Ltd.
Abstract
In the setting of patients with indication to receive dual antiplatelet
therapy undergoing surgery or invasive procedures, the risk of
perioperative cardiac ischemic events, particularly stent thrombosis, is
high, because surgery has a prothrombotic effect and antiplatelet therapy
is withdrawn in order to avoid bleeding complications. Cangrelor, an
intravenous P2Y<inf>12</inf> receptor antagonist, has been tested in a
randomized trial as a "bridge" to cardiac surgery from discontinuation of
oral P2Y<inf>12</inf> receptor antagonists. Thus, a consensus document
extended its off-label use in this setting and before non-cardiac surgery.
Currently, despite the implementation of a standardized bridging protocol
with cangrelor, a residual risk of adverse outcome mainly due to bleeding
events, still persist during the perioperative phase. Accordingly, a
personalized management driven by platelet reactivity serial measurements
and careful assessment of ischemic and bleeding risks has potential to
optimize outcomes and costs as compared to a standardized bridging
protocol, based on average pharmacodynamic data of oral P2Y<inf>12</inf>
inhibitors. While specific indications for bridging have been extensively
addressed in the aforementioned consensus statement, the aim of the
present document is the proposal of a "tailored" clinical decision-making
algorithm inspired to the principle of personalized medicine dealing with
complex clinical scenarios.<br/>Copyright &#xa9; 2021 Taylor & Francis
Group, LLC.

<40>
Accession Number
2013831795
Title
Impact of chronic medications in the perioperative period -anesthetic
implications (Part II).
Source
Postgraduate Medicine. 133(8) (pp 920-938), 2021. Date of Publication:
2021.
Author
Elvir-Lazo O.L.; White P.F.; Cruz Eng H.; Yumul F.; Chua R.; Yumul R.
Institution
(Elvir-Lazo, White, Yumul) Department of Anesthesiology, Cedars-Sinai
Medical Center, Los Angeles, CA, United States
(White) The White Mountain Institute, The Sea Ranch, CA, United States
(Cruz Eng) Adena Health System, department of anesthesiology, Chillicothe,
OH, United States
(Yumul) Department of family medicine, Skagit Regional Health, Family
Medicine, Arlington, WA, United States
(Chua) Department of Internal Medicine, Huntington Hospital, Prasadena,
CA, United States
(Yumul) David Geffen School of Medicine-UCLA, Charles R, Drew University
of Medicine and Science, Los Angeles, CA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: This review article discusses the pharmacodynamic effects of
the most commonly used chronic medications by patients undergoing elective
surgical procedures, namely cardiovascular drugs (e.g., beta blockers,
alpha-2 agonist, calcium channel blockers, ACE inhibitors, diuretics,
etc.), lipid-lowering drugs, gastrointestinal medications (H2-blockers,
proton pump inhibitors), pulmonary medications (inhaled beta-agonists,
anticholinergics,), antibiotics (tetracyclines, clindamycin and macrolide,
linezolid.), opioids and non-opioids analgesics (NSAIDs, COX-2 inhibitors,
acetaminophen), gabapentanoids, erectile dysfunction (ED) drugs,
psychotropic drugs (tricyclic antidepressants [TCAs], monoamine oxidase
inhibitors [MAOI], selective serotonin reuptake inhibitors [SSRIs],
serotonin norepinephrine reuptake inhibitors [SNRIs], and
cannabinol-containing drugs). In addition, the potential adverse
drug-interactions between these chronic medications and commonly used
anesthetic drugs during the perioperative period will be reviewed.
Finally, recommendations regarding the management of chronic medications
during the preoperative period will be provided. <br/>Material(s) and
Method(s): An online search was conducted from January 2000 through
February 2021 with the Medline database through PubMed and Google Scholar
using the following search terms/keywords: "chronic medications in the
perioperative period", and "chronic medications and anesthetic
implications." In addition, we searched for anesthetic side effects
associated with the major drug groups. Results and <br/>Conclusion(s): An
understanding of the pharmacodynamic effects of most used chronic
medications is important to avoid untoward outcomes in the perioperative
period. These drug interactions may result in altered efficacy and
toxicity of the anesthetic medications administered during surgery. These
drug-drug interactions can also affect the morbidity, mortality, recovery
time of surgical patients and acute relapse of chronic illnesses which
could lead to last minute cancellation of surgical procedures. Part II of
this two-part review article focuses on the reported interactions between
most commonly taken chronic medications by surgical patients and
anesthetic and analgesic drugs, as well as recommendations regarding the
handling these chronic medications during the perioperative period.
.<br/>Copyright &#xa9; 2021 Informa UK Limited, trading as Taylor &
Francis Group.

<41>
Accession Number
2013356278
Title
Treating symptoms and reversing remodelling: clinical and
echocardiographic 1-year outcomes with percutaneous mitral annuloplasty
for mild to moderate secondary mitral regurgitation.
Source
European Journal of Heart Failure. 23(11) (pp 1971-1978), 2021. Date of
Publication: November 2021.
Author
Witte K.K.; Kaye D.M.; Lipiecki J.; Siminiak T.; Goldberg S.L.; von
Bardeleben R.S.; Sievert H.; Levy W.C.; Starling R.C.
Institution
(Witte) Department of Internal Medicine I, University Clinic, RWTH Aachen
University, Aachen, Germany
(Kaye) Department of Cardiology, Alfred Hospital, Melbourne, Australia
(Lipiecki) Clinique Pole Sante Republique, Clermont Ferrand, France
(Siminiak) HCP Medical Center, Poznan University of Medical Sciences,
Poznan, Poland
(Goldberg) Tyler Heart Institute at Community Hospital of the Monterey
Peninsula, Monterey, CA, United States
(Goldberg) Cardiac Dimensions, Kirkland, WA, United States
(von Bardeleben) Department of Cardiology, University Medical Centre
Mainz, Mainz, Germany
(Sievert) CardioVascular Center Sankt Katherinen, Frankfurt, Germany
(Sievert) Anglia Ruskin University, Chelmsford, United Kingdom
(Levy) Advanced Heart Failure, Division of Cardiology, University of
Washington Heart Institute, Seattle, WA, United States
(Starling) Section of Heart Failure and Cardiac Transplant Medicine,
Kaufman Center for Heart Failure Treatment and Recovery, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
John Wiley and Sons Ltd
Abstract
Aims: To determine the effects of percutaneous mitral annuloplasty on
symptoms, walk distance and left ventricular (LV) structure and function
in patients with mild or moderate secondary mitral regurgitation (SMR).
<br/>Methods and Results: This was a pooled analysis of patients (n = 68)
who, despite guideline-directed medical therapy had symptomatic heart
failure (HF) with mild (n = 25) or moderate (n = 43) SMR treated with
percutaneous mitral annuloplasty as part of the TITAN, TITAN II, or
REDUCE-FMR trials. Primary outcomes were changes in symptoms, 6-min walk
distance, and quality of life assessed by the Kansas City Cardiomyopathy
Questionnaire (KCCQ) after 1 year. Secondary analyses included changes in
LV structure and function. At 1 year, New York Heart Association class
status was maintained (48%) or improved (46%) in most patients, mean KCCQ
scores increased from baseline by 10 units [95% confidence interval (CI) 3
to17; P < 0.01] and mean 6-min walk test distance increased by 34 m (95%
CI 12 to 57; P < 0.01). SMR grade improved in 25% of patients and was
maintained in 58% of patients with changes in mean regurgitant volume of
-7 mL (95% CI -11 to -3; P < 0.001), vena contracta -0.11 cm (95% CI -0.20
to -0.02; P < 0.05), and effective regurgitant orifice area -0.03
cm² (95% CI -0.06 to -0.01; P < 0.05). There were
non-significant improvements in LV ejection fraction and volumes. Survival
over 1 year was 89% with no difference between mild (96%) and moderate
(86%) SMR (log-rank P = 0.22). Progression-free survival was 70% (82% in
mild vs. 63% in moderate SMR; P = 0.16). Freedom from HF hospitalization
was 73% (87% in mild SMR vs. 66% in moderate SMR; P = 0.07).
<br/>Conclusion(s): Among patients with symptomatic HF and mild or
moderate SMR on guideline-directed medical therapy, percutaneous mitral
annuloplasty was associated with improvements in symptoms, SMR, a
stabilization of LV structure and function, and high survival
rates.<br/>Copyright &#xa9; 2021 The Authors. European Journal of Heart
Failure published by John Wiley & Sons Ltd on behalf of European Society
of Cardiology.

<42>
[Use Link to view the full text]
Accession Number
635747148
Title
Neurocognitive, Quality of Life, and Behavioral Outcomes for Patients With
Covert Stroke After Cardiac Surgery: Exploratory Analysis of Data From a
Prospectively Randomized Trial.
Source
Anesthesia and analgesia. 133(5) (pp 1187-1196), 2021. Date of
Publication: 01 Nov 2021.
Author
Lewis C.; Levine A.; Balmert L.C.; Chen L.; Sherwani S.S.; Nemeth A.J.;
Grafman J.; Gottesman R.; Brown C.H.; Hogue C.W.
Institution
(Lewis, Levine, Sherwani, Hogue) From the Department of Anesthesiology
(Balmert, Chen) Division of Biostatistics, Department of Preventive
Medicine
(Nemeth) Department of Radiology
(Grafman) Shirley Ryan Abilitylab and the Department of Rehabilitation and
Physical Medicine, Northwestern University Feinberg School of Medicine,
Chicago, IL, Mexico
(Gottesman) Department of Neurology
(Brown) Department of Anesthesiology & Critical Care, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Asymptomatic brain ischemic injury detected with
diffusion-weighted magnetic resonance imaging (DWI) is reported in more
than one-half of patients after cardiac surgery. There are conflicting
findings on whether DWI-detected covert stroke is associated with
neurocognitive dysfunction after surgery, and it is unclear whether such
ischemic injury affects quality of life or behavioral outcomes. The
purpose of this study was to perform exploratory analysis on whether
covert stroke after cardiac surgery is associated with delayed
neurocognitive recovery 1 month after surgery, impaired quality of life,
anxiety, or depression. <br/>METHOD(S): Analysis of data collected in a
prospectively randomized study in patients undergoing cardiac surgery
testing whether basing mean arterial pressure (MAP) targets during
cardiopulmonary bypass to be above the lower limit of cerebral
autoregulation versus usual practices reduces the frequency of adverse
neurological outcomes. A neuropsychological testing battery was
administered before surgery and then 1 month later. Patients underwent
brain magnetic resonance imaging (MRI) between postoperative days 3 and 5.
The primary outcome was DWI-detected ischemic lesion; the primary end
point was change from baseline in domain-specific neurocognitive Z scores
1 month after surgery. Secondary outcomes included a composite indicator
of delayed neurocognitive recovery, quality of life measures, state and
trait anxiety, and Beck Depression Inventory scores. <br/>RESULT(S): Of
the 164 patients with postoperative MRI data, clinical stroke occurred in
10 patients. Of the remaining 154 patients, 85 (55.2%) had a covert
stroke. There were no statistically significant differences for patients
with or without covert stroke in the change from baseline in Z scores in
any of the cognitive domains tested adjusted for sex, baseline cognitive
score, and randomization treatment arm. The frequency of delayed
neurocognitive recovery (no covert stroke, 15.1%; covert stroke, 17.6%; P
= .392), self-reported quality of life measurements, anxiety rating, or
depression scores were not different between those with or without DWI
ischemic injury. <br/>CONCLUSION(S): More than one-half of patients
undergoing cardiac surgery demonstrated covert stroke. In this exploratory
analysis, covert stroke was not found to be significantly associated with
neurocognitive dysfunction 1 month after surgery; evidence of impaired
quality of life, anxiety, or depression, albeit a type II error, cannot be
excluded.<br/>Copyright &#xa9; 2021 International Anesthesia Research
Society.

<43>
Accession Number
635236819
Title
Retrograde autologous priming during cardiopulmonary bypass reduces blood
transfusion rate in adult cardiac surgery: A prospective randomized
clinical trial.
Source
Asian journal of surgery. 44(8) (pp 1083-1084), 2021. Date of Publication:
01 Aug 2021.
Author
Chen R.-Q.; Li J.-B.; Lin J.; Lin Z.-J.
Institution
(Chen, Li, Lin, Lin) Department of Anesthesiology, Zhangzhou Municipal
Hospital Affiliated to Fujian Medical University, Zhangzhou 363000, China
Publisher
NLM (Medline)

<44>
Accession Number
636579131
Title
Recommendations for the use of simulators in cardiothoracic surgical
training.
Source
British Journal of Surgery. Conference: 45th Association of Surgeons in
Training International Surgical Conference, ASiT 2021. Virtual. 108(SUPPL
6) (pp vi218), 2021. Date of Publication: September 2021.
Author
Whittaker G.; Salmasi Y.; Asimakopoulos G.; Athanasiou T.
Institution
(Whittaker) Manchester University NHS Foundation Trust, Manchester, United
Kingdom
(Salmasi, Athanasiou) Imperial College London, London, United Kingdom
(Asimakopoulos) Royal Brompton and Harefield NHS Foundation Trust, London,
United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: To systematically review the simulators that are currently available
for cardiothoracic surgical procedures and the validation evidence
supporting them. Additionally, to recommend several simulators for
training based on analysis of results. <br/>Method(s): A systematic
literature search of the MEDLINEVR (1946 to December 2019) and EMBASEVR
(1947 to December 2019) databases was performed to identify simulators for
basic skills and procedures in cardiothoracic surgery. A selection of
keywords and MeSH terms were used to execute the literature search. After
identification of relevant articles, data were extracted and analysed.
<br/>Result(s): Ninety simulators were found in eighty-one articles.
Simulators for basic skills (n=24) and coronary artery bypass graft (n=22)
were the most commonly described, followed by miscellaneous (n=14), valve
surgery (n=13), thoracic lobectomy (n=10), and mechanical circulatory
support (n=7). The majority of models were either benchtop (n=42) or
hybrid (n=33) modalities. Evidence of validity was demonstrated in 38
(42.2%) simulators. Five (5.6%) simulators had three or more elements of
validity established and only one (1.1%) accomplished full validation.
<br/>Conclusion(s): Five simulators were recommended for supplemental
training in cardiothoracic surgery. Low-fidelity models can provide a
broad foundation for surgical skills development and high-fidelity
simulators can be used for immersive training scenarios and appraisals.
These should be utilised in early training, at which point the learning
curve of trainees is steepest.

<45>
Accession Number
636578207
Title
Systematic review and meta-analysis of mortality risk prediction models in
adult cardiac surgery.
Source
British Journal of Surgery. Conference: 45th Association of Surgeons in
Training International Surgical Conference, ASiT 2021. Virtual. 108(SUPPL
6) (pp vi82), 2021. Date of Publication: September 2021.
Author
Sinha S.; Dimagli A.; Dixon L.; Gaudino M.; Caputo M.; Vohra H.; Angelini
G.; Benedetto U.
Institution
(Sinha, Dimagli, Dixon, Caputo, Vohra, Angelini, Benedetto) Bristol Heart
Institute, Bristol, United Kingdom
(Gaudino) Weill Cornell Medical College, New York, United States
Publisher
John Wiley and Sons Ltd
Abstract
Background: The most used mortality risk prediction models in cardiac
surgery are the European System for Cardiac Operative Risk
Evaluation(EuroSCORE)(ES) and Society of Thoracic Surgeons(STS) score.
There is no agreement on which score should be considered more accurate
nor which score should be utilised in each population sub-group. We sought
to provide a thorough quantitative assessment of these 2 models.
<br/>Method(s): We performed a systematic literature review and captured
information on discrimination, as quantified by the area under the
receiver operator curve(AUC), and calibration, as quantified by the ratio
of observed-to-expected mortality(O:E). We performed random effects
meta-analysis of the performance of the individual models as well as
pairwise comparisons and sub-group analysis by procedure type, time and
continent. <br/>Result(s): The ES2(AUC 0.783[95%CI 0.765-0.800];O:E
1.102[95%CI 0.943- 1.289]) and STS(AUC 0.757[95%CI 0.727-0.785];O:E
1.111[95%CI 0.853-1.447]) both showed good overall discrimination and
calibration. There was no significant difference in the discrimination of
the two models(Difference in AUC -0.016; 95%CI -0.034 to -0.002;p0.09).
However, the calibration of ES2 showed significant geographical
variations(p<0.001) and a trend towardsmiscalibration with time(p0.0057).
This was not seen with STS. <br/>Conclusion(s): ES2 and STS are both
reliable predictors of short-term mortality following adult cardiac
surgery in the populations from which they were derived. STS may have
broader applications when comparing outcomes across continents and time
periods as compared to ES2.

<46>
Accession Number
636578070
Title
Aortic valve neocuspidization using glutaraldehyde-treated autologous
pericardium: A literature review.
Source
British Journal of Surgery. Conference: 45th Association of Surgeons in
Training International Surgical Conference, ASiT 2021. Virtual. 108(SUPPL
6) (pp vi80-vi81), 2021. Date of Publication: September 2021.
Author
Chan J.; Basu A.; Discenza G.; Bartlett J.; Fan K.S.; Oo S.
Institution
(Chan) University of Bristol, Bristol, United Kingdom
(Basu, Discenza, Fan) St George's University of London, London, United
Kingdom
(Bartlett) Swansea University Medical School, Swansea, United Kingdom
(Oo) Bristol Heart Institute, Bristol, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Aortic Valve Neocuspidization using glutaraldehydetreated
autologous pericardium was first performed by Ozaki et al. in 2007. This
technique has become an alternative to tissue and mechanical valve as
long-term anticoagulation is not required and shows promising midterm
results and durability. <br/>Method(s): A comprehensive search was
performed on the major database using search terms "Ozaki technique" AND
"Aortic Valve Neocuspidization" AND "AV Neocuspidization" AND "Autologous
pericardium" AND "glutaraldehyde-treated autologous pericardium". Articles
up to 1st of August 2020 were included in this study. <br/>Result(s): A
total of 9 studies with a total of 1342 patients were included. The mean
age was 67.36 and 54.23% were male. 66.32% and 23.92% of patients had
aortic stenosis and aortic regurgitation, respectively. 66% of patients
had a native tricuspid aortic valve and 31.37 % patients' native aortic
valve was bicuspid. Three studies reported their experience performing
Aortic Valve Neocuspidization via mini sternotomy. <br/>Conclusion(s):
Aortic Valve Neocuspidization is an alternative to biological and
mechanical prostheses for surgical aortic valve replacement. The short and
mid-term outcome are comparable without the need for long term oral
anticoagulation. Long term follow-up data is required for this novel
approach to be widely adopted.

<47>
Accession Number
636577766
Title
Semi-skeletonized versus pedicled internal mammary artery harvesting: A
systematic review.
Source
British Journal of Surgery. Conference: 45th Association of Surgeons in
Training International Surgical Conference, ASiT 2021. Virtual. 108(SUPPL
6) (pp vi75), 2021. Date of Publication: September 2021.
Author
Shafi A.M.A.; Mellor S.; Iddawela S.; Brown L.; Harky A.
Institution
(Shafi) St Bartholomew's Hospital, London, United Kingdom
(Mellor, Brown) University of Birmingham, Birmingham, United Kingdom
(Iddawela) University Hospitals Birmingham, Birmingham, United Kingdom
(Harky) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: To compare semi-skeletonized with pedicled harvesting
technique of the internalmammary artery for coronary artery bypass
surgery. <br/>Method(s): A comprehensive literature search was performed
on PubMed, Cochrane database, Embase, Google Scholar and Ovid identifying
articles that compared semi-skeletonised to pedicled internal mammary
artery in the use of coronary artery bypass surgery. Databases were
evaluated and assessed from inception to July 2020. <br/>Result(s): Only
five studies fulfilled the criteria for this review. There was no reported
incidence of sternal wound infection, myocardial infarction, or mortality.
The length of the IMA graft was longer in the semi-skeletonized group
compared to the pedicled group, 16.06cm versus 14.63cm respectively
(p<0.001). The intraoperative diastolic flow was significantly greater in
the semi-skeletonized grafts than in the pedicled grafts during (p=0.003)
and after (p=0.005) cardiopulmonary bypass. The incidence of pleural
effusion (pedicled, 52.6%; semi-skeletonized, 23.6%; p=0.002) and
atelectasis (pedicled, 42.1%; semi-skeletonized, 20.0%, p=0.015) were
significantly higher in pedicled group. Post-operative chest tube drainage
was significantly higher in the pedicled group (608 +/- 58mL compared to
470 +/- 48mL; p=0.027). Additionally, FEV1 was significantly decreased in
the pedicled group 6 days after surgery (pedicled:76.0% +/- 1.6%;
semi-skeletonized: 83.2% +/- 1.6%; p=0.020). <br/>Conclusion(s): These
results demonstrate that the semi-skeletonized preparation technique is
associated with satisfactory outcomes during harvesting the internal
mammary artery. Yet, due to limited numbers of studies, there is need for
larger comparative studies to assess postoperative outcomes with a longer
period of follow up.

<48>
Accession Number
636576764
Title
Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in
Left Main Coronary Artery Disease. A Systematic Review and Meta-Analysis
of Randomized Controlled Trials.
Source
British Journal of Surgery. Conference: 45th Association of Surgeons in
Training International Surgical Conference, ASiT 2021. Virtual. 108(SUPPL
6) (pp vi249), 2021. Date of Publication: September 2021.
Author
Hennessy C.; Henry J.A.
Institution
(Hennessy, Henry) University of Oxford Medical School, Oxford, United
Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: There is still no consensus whether percutaneous coronary
intervention (PCI) is as safe and effective as coronary artery bypass
grafting (CABG) for left main coronary artery (LMCA) disease. Recent
updates from key clinical trials necessitated an updated examination of
the literature on this topic. <br/>Method(s): A systematic search was
performed of the MEDLINE (via PubMed), EMBASE, Cochrane and
clinicaltrials.gov databases from inception to December 20th, 2020.
Selected studies were analysed using the random effects model. Outcomes
measured included all-cause mortality, MACCE, myocardial infarction (MI),
stroke and revascularization. Follow up points were 30 days, 1 year, 5
years and 10 years. <br/>Result(s): Six RCTs with a total population of
4700 were included in the analysis. For all-cause mortality PCI was
non-inferior to CABG at all time points. MACCE favoured PCI at 30 days,
and CABG at 5 years. No difference was seen at 1 year and 10 years. MI
favoured CABG at 5 years follow up, with no difference seen at 30 days, 1
year or five years. For stroke, PCI was favourable to CABG at 30 days and
1 year, with no difference at 5 years and 10 years. Revascularisation
favoured CABG at 1 year and 5 years, with no difference at other
time-points. <br/>Conclusion(s): PCI may be considered as an alternative
to CABG for uncomplicated LMCA disease. More complex lesions may still
benefit from CABG. CABG may be of benefit where future revascularisation
would rather be avoided. Further clinical trials examining this research
question are needed.

<49>
Accession Number
636576594
Title
Oesophago-pleural fistula after pneumonectomy; a systematic review.
Source
British Journal of Surgery. Conference: 45th Association of Surgeons in
Training International Surgical Conference, ASiT 2021. Virtual. 108(SUPPL
6) (pp vi247), 2021. Date of Publication: September 2021.
Author
Phelan L.; Layton G.R.; Lee E.H.; Liampas E.; Bishay E.; Griffiths E.A.
Institution
(Phelan) Department of General Surgery, University Hospitals Birmingham,
Birmingham, United Kingdom
(Layton) Department of Thoracic Surgery, University Hospitals of Leicester
NHS Trust, Leicester, United Kingdom
(Lee) University of Birmingham Medical School, Birmingham, United Kingdom
(Liampas) Department of Thoracic Surgery, University Hospitals of
Leicester NHS Trust, Leicester, United Kingdom
(Bishay) Department of Cardiothoracic Surgery, University Hospitals
Birmingham, Birmingham, United Kingdom
(Griffiths) Department of General Surgery, University Hospitals
Birmingham, Birmingham, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Introduction: Oesophago-pleural fistula (OPF) is an infrequent but highly
complex complication of pneumonectomy with a mortality of up to 63%. There
is a paucity of data on the optimal treatment strategy. <br/>Method(s):
Systematic review was conducted in line with PRISMA guidance concerning
OPF following pneumonectomy. Demographic, operative and management data
were analysed. <br/>Result(s): 30 full manuscripts of the 76 abstracts
were included in the analysis. Data was limited to case reports or small
series. In total, information for 58 patients was included. Median age was
59 years, with a median follow up time was 18 months. Most authors adopted
sepsis control with chest drainage and pleural lavage and the mean number
of interventions was 1.6. Overall mortality was 31% (18/58). There was no
significant difference between the time to presentation following left
(29.2+/-39.28 months) and right pneumonectomy (66.24+/-110.62) (p=0.2271)
nor any significant difference between successful outcomes following
intervention for OPF after left (11/14) compared to right pneumonectomy
(31/41) (p=0.8219) or 90-day mortality (p=0.4571). However, 26% of
patients had synchronous broncho-pleural fistula and 90-day mortality was
significantly higher in these patients (6/15 vs 6/ 43. p=0.0395). 25
patients who underwent additional pericardial, oesophageal or a nodal
resection or intervention at the time of pneumonectomy had a significantly
reduced mean time to presentation with OPF (21.49+/-60.15 vs.
84.99+/-114.31. p=0.0148) and a higher 90-day mortality (8/25 vs 3/32.
P=0.0414). <br/>Conclusion(s): Major heterogeneity of management hinders
the introduction of standardised guidance of post-pnuemonectomy OPF. An
MDT approach involving Oesophago-gastric and Cardio-Thoracic Surgery is
vital.

<50>
Accession Number
636576040
Title
Sternal closure with single compared to double or figure-of-8 wires in
obese patients post cardiac surgery: A systematic review and
meta-analysis.
Source
British Journal of Surgery. Conference: 45th Association of Surgeons in
Training International Surgical Conference, ASiT 2021. Virtual. 108(SUPPL
6) (pp vi240), 2021. Date of Publication: September 2021.
Author
Shafi A.M.A.; Abuelgasim E.; Abuelgasim B.; Iddawela S.; Harky A.
Institution
(Shafi) St Bartholomew's Hospital, London, United Kingdom
(Abuelgasim, Abuelgasim) Imperial College, London, United Kingdom
(Iddawela) University Hospitals Birmingham, Birmingham, United Kingdom
(Harky) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Sternal instability and wound infections are a major cause of
morbidity following cardiac surgery, which is further amplified in
highrisk patients that include diabetics and patients with high BMI. We
compare the different outcomes of different sternal wire closure
techniques following median sternotomy for cardiac surgery in obese
patients Method: A comprehensive electronic literature search was
undertaken according to PRISMA guidelines from inception to July 2020 to
identify all published data comparing single wire sternal closure to
either double wire or figure-of-8 techniques following median sternotomy
for cardiac surgery in obese patients, defined as a BMI >= 30.
<br/>Result(s): Eight studies met the final inclusion criteria; single
wire versus double wire sternal closure (n=2) and single wire versus
figure-of-8 wire closure (n=6). Higher rate of sternal instability was
noted in single wire vs double wire closure (22/150 (14.7%) patients vs
6/150 (4%) patients, p=0.003, OR 0.25 [95% CI 0.10-0.63]). Similarly,
sternal instability was higher in single wire vs figure-of-8 wire closure
technique (33/2422 (1.3%) vs 11/8035 (0.1%), p=0.04 OR 0.30 [95% CI,
0.09-0.96]) respectively. <br/>Conclusion(s): There is benefit in the use
of either double or figure-of-8 sternal wire closure techniques over
single wire closure in terms of sternal instability. However, as the
studies were limited, larger scale comparative studies are required to
provide a solid evidence base for choosing the optimal sternal closure
technique in this high-risk group of patients.

<51>
Accession Number
2015839549
Title
Role of Dexmedetomidine in Early POCD in Patients Undergoing Thoracic
Surgery.
Source
BioMed Research International. 2021 (no pagination), 2021. Article Number:
8652028. Date of Publication: 2021.
Author
Ran J.; Bai X.; Wang R.; Li X.
Institution
(Ran, Bai, Wang, Li) Department of Anesthesiology, West China Hospital,
Sichuan University and the Research Units of West China (2018RU012),
Chinese Academy of Medical Sciences, China
Publisher
Hindawi Limited
Abstract
Importance. Postoperative cognitive dysfunction (POCD) occurs in 6%-53% of
elderly patients receiving major surgery and is related to longer hospital
stays, increased hospital costs, and 1-year mortality. An increasing
number of studies suggest that using dexmedetomidine (Dex) in critical
care units is associated with reduced incidence of delirium. However,
perioperative use of Dex for the prevention of POCD has not been well
studied. Objective. To evaluate whether a low-dose perioperative infusion
of Dex reduces early POCD. Design. This study was a double-blind,
randomized, placebo-controlled trial that randomly assigned patients to
Dex or saline placebo infused during surgery and patient-controlled
intravenous analgesia (PCIA) infusion. Patients were assessed for
postoperative cognitive decline. Interventions. Dex was infused at a
loading dose of 0.5 mug/kg intravenously (15 min after entering the
operation room) followed by a continuous infusion at a rate of 0.5
mug/kg/h until one-lung ventilation or artificial pneumothorax ended.
Patients in the Dex group received regular PCIA pump with additional dose
of Dex (200 mug). Results. In total, 126 patients were randomized, and 102
patients were involved in the result analysis. The incidence of POCD was
36.54% (19/52) in the Dex group and 32.00% (16/50) in the normal saline
(NS) group, with no statistic difference. No significant difference was
observed between the two groups in terms of Telephone Interview for
Cognitive Status-Modified (TICS-m) scores at different times. However, the
TICS-m score at 7 days after surgery was significantly lower than that at
30 days in 102 patients (32.93+/-0.42 vs. 33.92+/-0.47, P=0.03). The
visual analogue scale scores in the Dex group were significantly lower
than those in the NS group 1 day postoperation at rest and activity (2.00
[1.00-3.00] vs. 3.00 [2.00-4.00], P<0.01; 4.00 [3.00-5.00] vs. 5.00
[4.00-6.00], P<0.05, respectively). Patients receiving Dex or NS had no
statistical difference in activities of daily living (ADLs) scores at 7
and 30 days after surgery, but the ADL score at 30 days after surgery
showed a significant reduction compared with that at 7 days (P<0.01).
Patients in the Dex group had a shorter hospital length of stay
(15.26+/-3.77 vs. 17.69+/-5.09, P=0.02) and less expenses
(52458.71+/-10649.30 vs. 57269.03+/-9269.98, P=0.04) than those in the NS
group. Conclusions. Low-dose Dex in the perioperative period did not
reduce the incidence of early POCD in thoracic surgery. However, it
relieved postoperative pain, decreased the hospitalization expenses, and
shortened the length of stay. <br/>Copyright &#xa9; 2021 Jiao Ran et al.

<52>
Accession Number
636585701
Title
Nurse-guided incentive spirometry use and postoperative pulmonary
complications among cardiac surgery patients: A randomized controlled
trial.
Source
International journal of nursing practice. (pp e13023), 2021. Date of
Publication: 22 Oct 2021.
Author
Alwekhyan S.A.; Alshraideh J.A.; Yousef K.M.; Hayajneh F.
Institution
(Alwekhyan) Princess Muna College of Nursing, Mutah University, Jordan
(Alshraideh, Yousef, Hayajneh) School of Nursing, University of Jordan,
Amman, Jordan
(Yousef) School of Humanities, Social Sciences and Health University of
Wollongong, Dubai, United Arab Emirates
Publisher
NLM (Medline)
Abstract
AIMS: To assess the effect of nurse-guided use of incentive spirometer on
postoperative oxygenation and pulmonary complications after coronary
artery bypass graft surgery. BACKGROUND: Deep breathing exercises have
been shown to improve postoperative lung expansion and reduce pulmonary
complications. An incentive spirometer is a deep breathing exercises
device that imitates continuous sigh-like maximal inspiration. DESIGN:
Randomized control trial, two groups nonblinded parallel design.
<br/>METHOD(S): A total of n=89 eligible patients were randomized to
either control or intervention group. Patients in the intervention group
received bihourly nurse-guided incentive spirometry for 48-h
postextubation. The endpoints were: the number and duration of hypoxic
events during the first 24-hr postsurgery, pneumonia and pulmonary
function parameters. Data were collected May to September 2019.
<br/>RESULT(S): Patients in the intervention group had a significantly
lower mean number of hypoxic events with shorter duration and shorter
length of stay in the hospital and the ICU. Patients in the intervention
group also had greater postoperative forced expiratory volume in 1second.
<br/>CONCLUSION(S): Nurse-guided use of the incentive spirometer reduces
the risk of pulmonary complications and hospital length of stay after
cardiac surgery.<br/>Copyright &#xa9; 2021 John Wiley & Sons Australia,
Ltd.

<53>
Accession Number
2006726895
Title
Effect of melatonin on delirium after on-pump coronary artery bypass graft
surgery: A randomized clinical trial.
Source
Iranian Journal of Medical Sciences. 46(2) (pp 120-127), 2021. Date of
Publication: 2021.
Author
Zadeh F.J.; Janatmakan F.; Shafaeebejestan E.; Jorairahmadi S.
Institution
(Zadeh, Janatmakan, Shafaeebejestan, Jorairahmadi) Department of
Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz
Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic Republic
of
Publisher
Shriaz University of Medical Sciences
Abstract
Background: Patients undergoing cardiac surgery are particularly prone to
delirium. This study aimed to evaluate the effect of melatonin
administration on the inhibition of postoperative delirium in patients
undergoing open-heart surgery. <br/>Method(s): This study was conducted as
a double-blind randomized clinical trial in Golestan Hospital. Ahvaz,
Iran, (September 2018 to March 2019). Sixty patients undergoing elective
on-pump coronary artery bypass graft surgery were enrolled in the study,
and they were randomly divided into a group receiving 3 mg of melatonin
and a group receiving a placebo. The main outcomes were delirium
occurrence and delirium intensity up to 48 hours after extubation. The
data were analyzed using SPSS, version 22, (SPSS, Chicago, IL). Group
comparisons were performed using the t test and the Chi-square test.
Statistical significance was defined as a P value of less than 0.05.
<br/>Result(s): On the first postoperative day, delirium developed in four
(13.3%) patients in the melatonin group and 11 (36.6%) patients in the
control group; the difference between the groups was statistically
significant (P=0.037). On the second postoperative day, delirium developed
in three (10%) patients in the melatonin group and 14 (46.6%) patients in
the control group, with the difference in the incidence of delirium
between the groups constituting statistical significance (P=0.029). The
severity of delirium between group was significant on the first and second
postoperative days (P=0.003). <br/>Conclusion(s): Melatonin may be
effective in reducing the severity of delirium after cardiac surgery. The
effect of melatonin as a delirium prevention agent should be considered in
patients admitted in the cardiovascular intensive care. Trial Registration
Number: IRCT20180909040979N3.<br/>Copyright &#xa9; 2021, Shriaz University
of Medical Sciences. All rights reserved.

<54>
Accession Number
2013380040
Title
Preoperative inflammatory mediators and postoperative delirium: systematic
review and meta-analysis.
Source
British Journal of Anaesthesia. 127(3) (pp 424-434), 2021. Date of
Publication: September 2021.
Author
Noah A.M.; Almghairbi D.; Evley R.; Moppett I.K.
Institution
(Noah, Almghairbi, Evley, Moppett) Anaesthesia and Critical Care, Academic
Unit of Injury, Inflammation and Recovery Science, University of
Nottingham, Nottingham, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Postoperative delirium has eluded attempts to define its
complex aetiology and describe specific risk factors. The role of
neuroinflammation as a risk factor, determined by measuring blood levels
of preoperative 'innate' inflammatory mediator levels, has been
investigated. However, results have been conflicting. We conducted a
systematic review and meta-analysis of the evidence on associations
between preoperative blood levels of inflammatory mediators and
postoperative delirium in the older person. Influence of type of surgery
was also assessed. <br/>Method(s): Original, low risk of bias studies,
published in peer-reviewed journals, which fulfilled the eligibility
criteria were included. Seventeen articles fulfilled study criteria. Data
extraction, synthesis, and risk of bias analysis were guided by Preferred
Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and
quality in prognostic studies guidelines. Meta-analyses used a
random-effects model. Inflammatory mediators included C-reactive protein,
interleukin-6, -8, and -10, tumour necrosis factor-alpha, insulin-like
growth factor-1, cortisol, and neopterin. Surgical groups were cardiac,
noncardiac, and hip fracture. <br/>Result(s): Higher preoperative
interleukin-6 was associated with postoperative delirium with a
standardised mean difference (95% confidence interval) of 0.33 (0.11-0.56)
and P=0.003. Higher neopterin was also associated with postoperative
delirium. <br/>Conclusion(s): The association of preoperative blood levels
of inflammatory mediators with postoperative delirium may be influenced by
the type of surgery and the specific mediator. The potential modulating
effect of type of surgery, intrinsic brain vulnerability, and the complex
interactions between inflammatory mediators and binding proteins will need
to be considered in future studies. Clinical trial registration:
CRD42019159471 (PROSPERO).<br/>Copyright &#xa9; 2021 British Journal of
Anaesthesia

<55>
Accession Number
2011566749
Title
Does the Nuss procedure for treating pectus excavatum compromise the long
term internal mammary artery flow? A systematic review.
Source
Journal of Cardiac Surgery. 36(7) (pp 2518-2523), 2021. Date of
Publication: July 2021.
Author
Elsayed H.H.; Ahmed T.A.; Hassaballa A.S.; Sharkawy H.Y.
Institution
(Elsayed) Thoracic Surgery Department, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Ahmed, Hassaballa, Sharkawy) Cardiothoracic Surgery Department, Ain Shams
University, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The Nuss procedure is the most common procedure used to
treat patients with pectus excavatum. The effect of the Nuss bars on the
long-term internal mammary artery flow (IMA) is not well studied. This
could have an impact on patients requiring a coronary artery bypass
grafting surgery after the Nuss procedure. We performed a systematic
review to study the impact of the Nuss bars on the IMA long term flow.
<br/>Method(s): A Medline search from January 1990 to August 2020 was
performed using [Nuss OR thoracoscopic pectus OR minimally invasive
pectus] AND [Internal mammary OR Internal thoracic OR IMA OR ITA]. English
language papers only were included. This trial was registered with
PROSPERO under registration number CRD42021234010. <br/>Result(s): A total
of 48 papers were identified using the reported search, of which three
represented the best evidence to answer the clinical question. One study
looked at the IMA flow via computed tomography (CT)-angiography on the
10th postoperative day after the Nuss procedure and found 15 out of 34
patients (44%) to have abnormal IMA blood flow but with no clinical
consequences. Two studies looked at the IMA flow after removal of the
Nuss-bar. The first study utilized CT-angiography on the 5th postoperative
day after Nuss-bar removal and found four out of the six patients studied
(67%) to have abnormal flow. The last study was composed of 19 patients
and looked at IMA flow during the presence of the Nuss-bars and after its
removal utilizing Doppler-angiography. It found 11 out of 19 patients
(58%) to have abnormal blood flow with the bars in place. After removal of
the bars, only two patients (10%) were found to have unilateral IMA
obstructed flow. <br/>Conclusion(s): In patients undergoing the Nuss
procedure for management of pectus excavatum, the internal mammary artery
flow is compromised in 44%-58% of patients with the bar in situ. When
these patients are assessed 10 days following removal of the bar, some
reversal of compromised IMA flow is evident. However, in up to 67% of
patients, abnormal IMA flow remains. Further studies are required to
determine whether this abnormal flow is permanent, which will require
examining patients at longer follow-up intervals. Patients undergoing
coronary artery bypass grafting who have a history of a Nuss procedure
should receive preoperative IMA imaging.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC

<56>
Accession Number
2011480936
Title
Effect of driving pressure-guided positive end-expiratory pressure (PEEP)
titration on postoperative lung atelectasis in adult patients undergoing
elective major abdominal surgery: A randomized controlled trial.
Source
Surgery (United States). 170(1) (pp 277-283), 2021. Date of Publication:
July 2021.
Author
Mini G.; Ray B.R.; Anand R.K.; Muthiah T.; Baidya D.K.; Rewari V.; Sahni
P.; Maitra S.
Institution
(Mini, Ray, Anand, Muthiah, Baidya, Rewari, Maitra) Department of
Anaesthesiology, Pain Medicine & Critical Care, All India Institute of
Medical Sciences, New Delhi, India
(Sahni) Department of GI Surgery & Liver Transplantation, All India
Institute of Medical Sciences, New Delhi, India
Publisher
Mosby Inc.
Abstract
Background: As respiratory system compliances are heterogenous, we
hypothesized that individualized intraoperative positive end-expiratory
pressure titration on the basis of lowest driving pressure can reduce
postoperative atelectasis and improve intraoperative oxygenation and
postoperative lung functions. <br/>Method(s): Eighty-two adult patients
undergoing major abdominal surgery were recruited in this randomized
trial. In the titrated positive end-expiratory pressure group, positive
end-expiratory pressure was titrated incrementally until lowest driving
pressure was achieved, and the same procedure was repeated in every 2
hours. In the fixed positive end-expiratory pressure group, a positive
end-expiratory pressure of 5 cmH<inf>2</inf>O was used throughout the
surgery. The primary objective of this study was lung ultrasound score
noted at the completion of surgery and 5 minutes after extubation at 12
lung areas bilaterally. <br/>Result(s): Mean (standard deviation) age of
the recruited patients were 43.8 (17.3) years, and 50% of all patients (41
of 82) were women. Lung ultrasound aeration scores were significantly
higher in the fixed positive end-expiratory pressure group both before and
after extubation (median [interquartile range] 7 [5-8] vs 4 [2-6] before
extubation and 8 [6-9] vs 5 [3-7] after extubation; P = .0004 and P =
.0011, respectively). Incidence of postoperative pulmonary complications
was significantly lower in the titrated positive end-expiratory pressure
group (absolute risk difference [95% CI] 17.1% [32.5%-1.7%]; P = .034).
The number of patients requiring postoperative supplemental oxygen therapy
to maintain SpO<inf>2</inf> >95%, the requirement of intraoperative rescue
therapy, and the duration of hospital stay were similar in both of the
groups. <br/>Conclusion(s): Intraoperative titrated positive
end-expiratory pressure reduced postoperative lung atelectasis in adult
patients undergoing major abdominal surgery. Further large clinical trials
are required to know its effect on postoperative pulmonary
complications.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<57>
Accession Number
2011044231
Title
Valve-in-valve transcatheter aortic valve replacement versus redo surgical
aortic valve replacement: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 36(7) (pp 2486-2495), 2021. Date of
Publication: July 2021.
Author
Ahmed A.; Levy K.H.
Institution
(Ahmed, Levy) CUNY School of Medicine, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background/Aim: With the growing contemporary use of bioprosthetic valves,
whose limited long-term durability has been well-documented, an increase
in the need for reintervention is expected. We perform a meta-analysis to
compare the current standard of care, redo surgical aortic valve
replacement (Redo SAVR) with the less invasive alternative, valve-in-valve
transcatheter aortic valve replacement (ViV TAVR) for treating structural
valve deterioration. <br/>Method(s): After a comprehensive literature
search, studies comparing ViV TAVR to Redo SAVR were pooled to perform a
pairwise meta-analysis using the random-effects model. Primary outcomes
were 30-day and follow-up mortality. <br/>Result(s): A total of nine
studies including 9127 patients were included. ViV TAVR patients were
significantly older (mean difference [MD], 5.82; p =.0002) and more
frequently had hypercholesterolemia (59.7 vs. 60.0%; p =.0006), coronary
artery disease (16.1 vs. 16.1%; p =.04), periphery artery disease (15.4
vs. 5.7%; p =.004), chronic obstructive pulmonary disease (29.3 vs. 26.2%;
p =.04), renal failure (30.2 vs. 24.0%; p =.009), and >1 previous cardiac
surgery (23.6 vs. 15.9%; p =.004). Despite this, ViV TAVR was associated
with decreased 30-day mortality (OR, 0.56; p <.0001). Conversely, Redo
SAVR had lower 30-day paravalvular leak (OR, 6.82; p =.04), severe
patient-prosthesis mismatch (OR, 3.77; p <.0001), and postoperative aortic
valve gradients (MD, 5.37; p <.0001). There was no difference in follow-up
mortality (HR, 1.02; p =.86). <br/>Conclusion(s): Despite having patients
with an increased baseline risk, ViV TAVR was associated with lower 30-day
mortality, while Redo SAVR had lower paravalvular leak, severe
patient-prosthesis mismatch, and postoperative gradients. Although ViV
TAVR remains a feasible treatment option in high-risk patients, randomized
trials are necessary to elucidate its efficacy over Redo
SAVR.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<58>
Accession Number
2013379362
Title
Revascularization versus medical therapy in patients aged 80 and older
with stable ischemic heart disease.
Source
Journal of the American Geriatrics Society. 69(12) (pp 3457-3467), 2021.
Date of Publication: December 2021.
Author
Phan D.Q.; Zadegan R.; Lee M.-S.
Institution
(Phan, Zadegan) Regional Cardiac Catheterization Lab, Kaiser Permanente
Southern California, Los Angeles, CA, United States
(Lee) Department of Cardiology, Kaiser Permanente Los Angeles Medical
Center, Los Angeles, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Older patients are underrepresented in landmark randomized
trials for stable ischemic heart disease (SIHD). Therefore, we sought to
evaluate the benefits of revascularization in patients >=80 years old with
SIHD. <br/>Method(s): Retrospective study of patients undergoing invasive
coronary angiography (ICA) for SIHD between 2009 and 2019. Patients were
grouped according to treatment: revascularization (percutaneous coronary
intervention [PCI] or coronary artery bypass grafting [CABG]) versus
initial medical therapy alone. Inverse probability of treatment weighting
(IPTW)-adjusted Cox proportional hazard regression analyses were
performed. Outcomes evaluated were all-cause mortality, non-fatal
myocardial infarction (MI), and repeat revascularization. <br/>Result(s):
A total of 1015 patients (median age 83.0, interquartile range [IQR]
81.3-85.2 years; 29% female) underwent ICA for SIHD. Of these, 557 (55%)
were treated with revascularization and 458 (45%) with initial medical
therapy alone. Baseline characteristics were well balanced after IPTW
adjustment. At median follow-up of 3.5 years (IQR 1.7-5.9 years), there
were no differences in all-cause mortality and non-fatal MI between
treatment groups; but there was an increased need for repeat
revascularization (IPTW adjusted hazard ratio 2.22, 95% confidence
interval 1.53-3.22) with revascularization. Separately comparing PCI or
CABG alone versus medical therapy yielded similar results; as well as in
subgroup analysis (except for patients >=90 years old and those without
prior CABG). <br/>Conclusion(s): There were no differences in all-cause
mortality and non-fatal MI with invasive revascularization (either PCI or
CABG) versus medical therapy alone in patients >=80 years old with SIHD.
Large randomized trials focusing on older patients are warranted to guide
clinical practice in this growing population.<br/>Copyright &#xa9; 2021
The American Geriatrics Society.

<59>
Accession Number
634331358
Title
Continuous Paravertebral Analgesia versus Continuous Epidural Analgesia
after Video-Assisted Thoracoscopic Lobectomy for Lung Cancer: A Randomized
Controlled Trial.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 27(5) (pp
297-303), 2021. Date of Publication: 20 Oct 2021.
Author
Lai J.; Situ D.; Xie M.; Yu P.; Wang J.; Long H.; Lai R.
Institution
(Lai, Situ, Xie, Yu, Wang, Long, Lai) Collaborative Innovation Center for
Cancer Medicine, State Key Laboratory of Oncology in South China, Sun
Yat-Sen University Cancer Center, Guangzhou, China
(Lai, Xie, Yu, Wang, Lai) Department of Anesthesiology, Sun Yat-Sen
University Cancer Center, Guangzhou, China
(Situ, Long) Lung Cancer Research Institute, Sun Yat-sen University,
Guangzhou, China
(Situ, Long) Department of Thoracic Surgery, Sun Yat-Sen University Cancer
Center, Guangzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether continuous thoracic epidural analgesia (TEA) and
continuous paravertebral block (PVB) have similar analgesic effects in
patients undergoing video-assisted thoracic surgery (VATS) lobectomy was
compared in this study. <br/>METHOD(S): In all, 86 patients undergoing
VATS lobectomy were enrolled in the prospective, randomized clinical
trial. Group E received TEA. Group P received PVB. The primary endpoint
was postoperative 24-hour visual rating scale (VAS) on coughing. Side
effects and postoperative complications were also analyzed.
<br/>RESULT(S): Pain scores at rest or on coughing at 24 and 48 h
postoperatively were significantly lower in group E than in group P (P
<0.05). At 24 h postoperatively, more patients in group E suffered from
vomiting (32.6% vs 11.6%, P = 0.019), dizziness (55.8% vs 12.9%, P =
0.009), pruritus (27.9% vs 2.3%, P = 0.002), and hypotension (32.6% vs
4.7%, P = 0.002) than those in group P. Patients in group E were more
satisfied (P = 0.047). Four patients in group P and two patients in group
E suffered from pulmonary complications (P >0.05). The length of hospital
and intensive care unit (ICU) stays were not significantly different.
<br/>CONCLUSION(S): Though TEA has more adverse events than PVB, it may be
superior to PVB in patients undergoing VATS lobectomy.

<60>
Accession Number
2013746396
Title
In-hospital outcomes of self-expanding and balloon-expandable
transcatheter heart valves in Germany.
Source
Clinical Research in Cardiology. 110(12) (pp 1977-1982), 2021. Date of
Publication: December 2021.
Author
Stachon P.; Hehn P.; Wolf D.; Heidt T.; Oettinger V.; Zehender M.; Bode
C.; von zur Muhlen C.; Kaier K.
Institution
(Stachon, Wolf, Heidt, Oettinger, Zehender, Bode, von zur Muhlen)
Department of Cardiology and Angiology I, Faculty of Medicine and Medical
Center, University of Freiburg, Freiburg, Germany
(Stachon, Oettinger, Zehender, von zur Muhlen, Kaier) Center of Big Data
Analysis in Cardiology (CeBAC), Heart Center Freiburg University,
Freiburg, Germany
(Hehn, Kaier) Institute of Medical Biometry and Statistics, Faculty of
Medicine and Medical Center, University of Freiburg, Stefan-Meier-Str. 26,
Freiburg 79104, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: The effect of valve type on outcomes in transfemoral
transcatheter aortic valve replacement (TF-TAVR) has recently been subject
of debate. We investigate outcomes of patients treated with
balloon-expanding (BE) vs. self-expanding (SE) valves in in a cohort of
all these procedures performed in Germany in 2018. <br/>Method(s): All
patients receiving TF-TAVR with either BE (N = 9,882) or SE (N = 7,413)
valves in Germany in 2018 were identified. In-hospital outcomes were
analyzed for the endpoints in-hospital mortality, major bleeding, stroke,
acute kidney injury, postoperative delirium, permanent pacemaker
implantation, mechanical ventilation > 48 h, length of hospital stay, and
reimbursement. Since patients were not randomized to the two treatment
options, logistic or linear regression models were used with 22 baseline
patient characteristics and center-specific variables as potential
confounders. As a sensitivity analysis, the same confounding factors were
taken into account using the propensity score methods (inverse probability
of treatment weighting). <br/>Result(s): Baseline characteristics differed
substantially, with higher EuroSCORE (p < 0.001), age (p < 0.001) and rate
of female sex (p < 0.001) in SE treated patients. After risk adjustment,
no marked differences in outcomes were found for in-hospital mortality
[risk adjusted odds ratio (aOR) for SE instead of BE 0.94 (96% CI
0.76;1.17), p = 0.617] major bleeding [aOR 0.91 (0.73;1.14), p = 0.400],
stroke [aOR 1.13 (0.88;1.46), p = 0.347], acute kidney injury [OR 0.97
(0.85;1.10), p = 0.621], postoperative delirium [aOR 1.09 (0.96;1.24), p =
0.184], mechanical ventilation > 48 h [aOR 0.98 (0.77;1.25), p = 0.893],
length of hospital stay (risk adjusted difference in days of
hospitalization (SE instead of BE): - 0.05 [- 0.34;0.25], p = 0.762) and
reimbursement [risk adjusted difference in reimbursement (SE instead of
BE): - 72 (- 291;147), p = 0.519)] There is, however, an increased risk of
PPI for SE valves (aOR 1.27 [1.15;1.41], p < 0.001). Similar results were
found after application of propensity score adjustment.
<br/>Conclusion(s): We find broadly equivalent outcomes in contemporary
TF-TAVR procedures, regardless of the valve type used. Incidence of major
complications is very low for both types of valve.<br/>Copyright &#xa9;
2021, The Author(s).

<61>
Accession Number
636567978
Title
Identifying critically ill children on the pediatric intensive care unit
at high risk of acute kidney injury.
Source
European Journal of Molecular and Clinical Medicine. Conference: 5th
Annual Congress of the European Society for Translational Medicine,
EUSTM-2017. Berlin Germany. 4(1) (pp 61), 2017. Date of Publication: 2017.
Author
McGaillard R.; Guhadasan R.; Maguire S.; Baines P.; Jennings R.; Siner S.;
Kolamunnage-Dona R.; Newland P.; Peak M.; Chesters C.; Jeffers G.;
Broughton C.; McColl L.; Preston J.; Paulus S.; Cunliffe N.; Carrol E.
Institution
(McGaillard, Guhadasan, Maguire, Kolamunnage-Dona, Jeffers, Broughton,
Preston, Cunliffe, Carrol) University of Liverpool, Liverpool, United
Kingdom
(Baines, Jennings, Siner, Newland, Peak, Chesters, Paulus) Alder Hey
Children's NHS Foundation Trust, Liverpool, United Kingdom
(McColl) Select Statistics, Exeter, United Kingdom
Publisher
EJMCM, International House
Abstract
Objectives: Acute Kidney Injury (AKI) is a serious complication in
critically ill children, associated with increased morbidity and
mortality. Neutrophil Gelatinase Associated Lipocalin (NGAL) has been
shown to be a promising biomarker for the prediction of AKI, but no study
to date has evaluated both urine and plasma NGAL to determine their
diagnostic accuracy in a large cohort of critically ill children. This
study aimed to evaluate the diagnostic and prognostic value of initial and
serial urine (uNGAL) and plasma NGAL (pNGAL), urea and crea-tinine
concentrations in critically ill children to predict AKI. <br/>Method(s):
Children admitted to a tertiary paediatric intensive care unit (PICU) were
enrolled in the study. Plasma urea and creatinine and uNGAL and pNGAL
(pNGAL was only measured on 295 children) were determined daily. Children
were categorised as AKI or no AKI (KIDIGO stage 2). Chi-squared tests were
used to analyse categorical data, Mann Whitney test for continuous
variables, and area under the curves (AUC) for biomarker performance.
Logistic regression Cox proportional-hazards models were fitted to the
outcome RRT, using the independent variables where an association was
found in the univariate analysis. <br/>Result(s): 657 children were
enrolled on the study with a median age at admission of 1.01 years (IQR,
0.30, 5.01). The most common reason for admission was cardiac surgery
(n=350, 53.3%). 104 (15.83%) children developed AKI within 72 hours of
admission. uNGAL and serum creatinine concentrations where significantly
higher in those patients who developed AKI over all 7 days after admission
whereas pNGAL where only significantly higher on the first 3 days. The
maximal AUC for uNGAL was 0.749 (CI, 0.694-0.805; p <0.0001) on day 1 with
an optimal cut off value 61.15 ng/ml. The maximum AUC for pNGAL was 0.684
(CI, 0.602-0.765; p < 0.0001) on day 2. The AUC for creatinine was 0.890
(CI, 0.851-0.928; p < 0.0001) on day 2, with an optimal cut off value of
49.5umol/L. Higher PELOD severity score (OR 1.16, 95% CI 1.10-1.24),
longer bypass time (OR 1.01, 95% CI 1.00-1.02), and higher blood lactate
(OR1.26, 95% CI 1.07-1.48) and procalcitonin (OR 1.01, 95% CI 1.00-1.01)
were associated with increased likelihood of receiving RRT. Older age was
associated with a decreased likelihood of receiving RRT (OR 0.87, 95% CI
0.75-0.97). The risk of RRT was higher in children who had cardiac
surgery. <br/>Conclusion(s): Urine and plasma NGAL increase significantly
in critically ill children who develop AKI. The risk of RRT increases with
higher values of urea and creatinine, and in children who have had cardiac
surgery. This model could be used to plan optimal timing of preemptive
RRT, and also provide thresholds for randomised trials of preemptive RRT.

<62>
Accession Number
621614120
Title
Critical developments of 2017: a review of the literature from selected
topics in transfusion. A committee report from the AABB Clinical
Transfusion Medicine Committee.
Source
Transfusion. 58(4) (pp 1065-1075), 2018. Date of Publication: April 2018.
Author
Cushing M.M.; Kelley J.; Klapper E.; Friedman D.F.; Goel R.; Heddle N.M.;
Hopkins C.K.; Karp J.K.; Pagano M.B.; Perumbeti A.; Ramsey G.; Roback
J.D.; Schwartz J.; Shaz B.H.; Spinella P.C.; Cohn C.S.
Institution
(Cushing, Goel) Department of Pathology, Weill Cornell Medicine, New York,
NY, United States
(Kelley) Department of Laboratory Medicine, The University of Texas MD
Anderson Cancer Center, Houston, TX, United States
(Klapper) Department of Pathology and Laboratory Medicine, Cedars-Sinai
Medical Center, Los Angeles, CA, United States
(Friedman) Blood Bank and Transfusion Medicine Department, Children's
Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA,
United States
(Heddle) McMaster Center for Transfusion Research, McMaster University,
Hamilton, ON, Canada
(Hopkins) Blood Systems Inc., Scottsdale, AZ, United States
(Karp) Department of Pathology, Anatomy, and Cell Biology, Thomas
Jefferson University Hospitals, Philadelphia, PA, United States
(Pagano) Transfusion Medicine Division, Department of Laboratory Medicine,
University of Washington, Seattle, WA, United States
(Perumbeti) Department of Pathology and Laboratory Medicine, Children's
Hospital Los Angeles, Los Angeles, CA, United States
(Ramsey) Department of Pathology, Feinberg School of Medicine,
Northwestern University, Chicago, IL, United States
(Roback) Department of Pathology and Laboratory Medicine, Emory University
School of Medicine, Atlanta, GA, United States
(Schwartz) Department of Pathology and Cell Biology, Columbia University
Medical Center and the New York-Presbyterian Hospital, United States
(Shaz) New York Blood Center, New York, NY, United States
(Spinella) Department of Pediatrics, Division of Pediatric Critical Care,
Washington University School of Medicine, St Louis, MO, United States
(Cohn) Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
BACKGROUND: The AABB compiles an annual synopsis of the published
literature covering important developments in the field of Transfusion
Medicine. For the first time, an abridged version of this work is being
made available in TRANSFUSION, with the full-length report available as an
Appendix S1 (available as supporting information in the online version of
this paper). STUDY DESIGN AND METHODS: Papers published in 2016 and early
2017 are included, as well as earlier papers cited for background.
Although this synopsis is comprehensive, it is not exhaustive, and some
papers may have been excluded or missed. <br/>RESULT(S): The following
topics are covered: duration of red blood cell storage and clinical
outcomes, blood donor characteristics and patient outcomes, reversal of
bleeding in hemophilia and for patients on direct oral anticoagulants,
transfusion approach to hemorrhagic shock, pathogen inactivation,
pediatric transfusion medicine, therapeutic apheresis, and extracorporeal
support. <br/>CONCLUSION(S): This synopsis may be a useful educational
tool.<br/>Copyright &#xa9; 2018 AABB

<63>
Accession Number
2012992412
Title
Indirect comparison of the efficacy and safety of alirocumab and
evolocumab: A systematic review and network meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 7(3) (pp
225-235), 2021. Date of Publication: 01 May 2021.
Author
Guedeney P.; Sorrentino S.; Giustino G.; Chapelle C.; Laporte S.; Claessen
B.E.; Ollier E.; Camaj A.; Kalkman D.N.; Vogel B.; De Rosa S.; Indolfi C.;
Lattuca B.; Zeitouni M.; Kerneis M.; Silvain J.; Collet J.-P.; Mehran R.;
Montalescot G.
Institution
(Guedeney, Vogel, Lattuca, Zeitouni, Kerneis, Silvain, Collet,
Montalescot) Department of Cardiology, Sorbonne Universite, ACTION Study
Group, UMR_S 1166, Institut de Cardiologie, Pitie Salpetriere Hospital
(AP-HP), Paris, France
(Guedeney, Sorrentino, Giustino, Claessen, Camaj, Kalkman, Mehran)
Department of Interventional Cardiovascular Research and Clinical Trials,
The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Sorrentino, De Rosa, Indolfi) Division of Cardiology, Department of
Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy
(Chapelle, Laporte, Ollier) Unite de Recherche Clinique Innovation et
Pharmacologie CHU de Saint-Etienne, Saint-Etienne, France
(Kalkman) Department of Clinical and Experimental Cardiology, Amsterdam
UMC, University of Amsterdam, Heart Center, Amsterdam Cardiovascular
Sciences, Meibergdreef 9, Amsterdam, Netherlands
Publisher
Oxford University Press
Abstract
Aims: Although alirocumab and evolocumab have both been associated with
improved outcomes in patients with dyslipidaemia or established
atherosclerotic cardiovascular disease, data on their respective
performances are scarce. This study aimed at providing an indirect
comparison of the efficacy and safety of alirocumab vs. evolocumab.
<br/>Methods and Results: We conducted a systematic review and network
meta-analysis of randomized trials comparing alirocumab or evolocumab to
placebo with consistent background lipid-lowering therapy up to November
2018. We estimated the relative risk (RR) and the 95% confidence intervals
(CIs) using fixed-effect model in a frequentist pairwise and network
meta-analytic approach. A total of 30 trials, enrolling 59 026 patients
were included. Eligibility criteria varied significantly across trials
evaluating alirocumab and evolocumab. Compared with evolocumab, alirocumab
was associated with a significant reduction in all-cause death (RR 0.80,
95% CI 0.66-0.97) but not in cardiovascular death (RR 0.83, 95% CI
0.65-1.05). This study did not find any significant differences in
myocardial infarction (RR 1.15, 95% CI 0.99-1.34), stroke (RR 0.96, 95% CI
0.71-1.28), or coronary revascularization (RR 1.13, 95% CI 0.99-1.29)
between the two agents. Alirocumab was associated with a 27% increased
risk of injection site reaction compared to evolocumab; however, no
significant differences were found in terms of treatment discontinuations,
systemic allergic reaction, neurocognitive events, ophthalmologic events,
or new-onset of or worsening of pre-existing diabetes. <br/>Conclusion(s):
Alirocumab and evolocumab share a similar safety profile except for
injection site reaction. No significant differences were observed across
the efficacy endpoints, except for all-cause death, which may be related
to the heterogeneity of the studied populations treated with the two
drugs.<br/>Copyright &#xa9; The Author(s) 2020.

<64>
Accession Number
2012992408
Title
Changing paradigms in antiplatelet therapy after coronary intervention.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 7(3) (pp
206-208), 2021. Date of Publication: 01 May 2021.
Author
Sulzgruber P.
Institution
(Sulzgruber) Department of Medicine II, Division of Cardiology, Medical
University of Vienna, Austria
Publisher
Oxford University Press

<65>
Accession Number
2012992407
Title
P2Y12 inhibitors monotherapy after short course of dual antiplatelet
therapy in patients undergoing percutaneous coronary intervention: A
meta-analysis of randomized clinical trials including 29 089 patients.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 7(3) (pp
196-205), 2021. Date of Publication: 01 May 2021.
Author
Bianco M.; Careggio A.; Destefanis P.; Luciano A.; Perrelli M.G.; Quadri
G.; Rossini R.; Campo G.; Vizzari G.; D'Ascenzo F.; Anselmino M.;
Biondi-Zoccai G.; Ibanez B.; Montagna L.; Varbella F.; Cerrato E.
Institution
(Bianco, Careggio, Destefanis, Luciano, Perrelli, Montagna) Cardiology
Division, San Luigi Gonzaga University Hospital, Regione Gonzole 10,
Orbassano, Turin 10043, Italy
(Quadri, Varbella, Cerrato) Interventional Cardiology Unit, Cardiology
Department, San Luigi Gonzaga University Hospital, Regione Gonzole 10,
Orbassano, Turin 10043, Italy
(Quadri, Varbella, Cerrato) Infermi Hospital, Via Rivalta 29, Rivoli,
Turin 10098, Italy
(Rossini) Division of Cardiology, S. Croce e Carle Hospital, Via Michele
Coppino 26, Cuneo 12100, Italy
(Campo) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Via
Aldo Moro 8, Cona (FE) 44124, Italy
(Vizzari) Department of Clinical and Experimental Medicine, University of
Messina, Via Consolare Valeria 1, Messina 98124, Italy
(D'Ascenzo, Anselmino) Division of Cardiology, Department of Medical
Sciences, Citta della Salute e della Scienza di Torino Hospital,
University of Turin, Corso Bramante 88, Turin 10126, Italy
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79,
Latina 04100, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Via Orazio 2, Napoli 80122,
Italy
(Ibanez) National Centre for Cardiovascular Research CNIC, Calle de
Melchor Fernandez Almagro 3, Madrid 28029, Spain
(Ibanez) Fundacion Jimenez Diaz Hospital, Av. de los Reyes Catolicos 2,
Madrid 28040, Spain
(Campo) Maria Cecilia Hospital, GVM Care & Research, Via Corriera 1,
Cotignola (RA) 48033, Italy
Publisher
Oxford University Press
Abstract
Aims: Dual antiplatelet therapy (DAPT) reduces the incidence of thrombotic
complications at the cost of an increase in bleedings. New antiplatelet
therapies focused on minimizing bleeding and maximizing antithrombotic
effects are emerging. The aim of this study is to collect the current
evidence coming from randomized controlled trials (RCTs) on early aspirin
interruption after percutaneous coronary intervention (PCI) and current
drug-eluting stent (DES) implantation and to perform a meta-analysis in
order to evaluate the safety and efficacy of this strategy. <br/>Methods
and Results: MEDLINE/PubMed was systematically screened for RCTs comparing
P2Y12 inhibitors (P2Y12i) monotherapy after a maximum of 3 months of DAPT
(S-DAPT) vs. DAPT for 12 months (DAPT) in patients undergoing PCI with
DES. Baseline features were appraised. Major adverse cardiac and
cerebrovascular events (MACCE: all causes of death, myocardial infarction,
and stroke) and its single composites, stent thrombosis (ST) and Bleeding
Academic Research Consortium (BARC) type 3 or 5 were considered and pooled
with fixed and random-effects with inverse-variance weighting. A total of
four RCTs including a total of 29 089 patients were identified. Overall,
the majority of included patients suffered a stable coronary artery
disease, while ST-elevation myocardial infarction was the least
represented clinical presentation. Complex anatomical settings like left
main intervention, bifurcations, and multi-lesions treatment were included
although representing a minor part of the cases. At 1-year follow-up,
MACCE rate was similar [odds ratio (OR) 0.90; 95% confidence intervals
(CIs) 0.79-1.03] and any of its composites (all causes of death rate: OR
0.87; 95% CIs 0.71-1.06; myocardial infarction: OR 1.06; 95% CIs
0.90-1.26; stroke: OR 1.12; 95% CIs 0.82-1.53). Similarly, also ST rate
was comparable in the two groups (OR 1.17; 95% CIs 0.83-1.64), while BARC
3 or 5 bleeding resulted significantly lower, adopting an S-DAPT strategy
(OR 0.70; 95% CIs 0.58-0.86). <br/>Conclusion(s): After a PCI with current
DES, an S-DAPT strategy followed by a P2Y12i monotherapy was associated
with a lower incidence of clinically relevant bleeding compared to 12
months DAPT, with no significant differences in terms of 1-year
cardiovascular events.<br/>Copyright &#xa9; The Author(s) 2020.

<66>
Accession Number
2012340330
Title
Prophylaxis for patients at Risk to Eliminate Post-operative Atrial
Fibrillation (PREP-AF trial): a protocol for a feasibility randomized
controlled study.
Source
Trials. 22(1) (no pagination), 2021. Article Number: 384. Date of
Publication: December 2021.
Author
Smith H.A.; Kanji S.; Tran D.T.T.; Redpath C.; Ferguson D.; Lenet T.;
Sigler G.; Gilbert S.; Maziak D.; Villeneuve P.; Sundaresan S.; Seely
A.J.E.
Institution
(Smith, Lenet, Sigler) Division of General Surgery, Department of Surgery,
University of Ottawa, Ottawa, Canada
(Kanji) Department of Pharmacy, The Ottawa Hospital and Ottawa Hospital
Research Institute, Ottawa, Canada
(Tran) Division of Cardiac Anesthesiology, Department of Anesthesiology &
Pain Medicine, University of Ottawa Heart Institute, Ottawa, Canada
(Redpath) University of Ottawa Heart Institute, Ottawa, Canada
(Ferguson) Ottawa Hospital Research Institute, Ottawa, Canada
(Gilbert, Maziak, Villeneuve, Sundaresan, Seely) Division of Thoracic
Surgery, Department of Surgery, University of Ottawa, Ottawa, Canada
(Seely) Division of Thoracic Surgery, Department of Surgery and Critical
Care Medicine, University of Ottawa, Ottawa, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative atrial fibrillation (POAF) is a frequent adverse
event after thoracic surgery with associated morbidity, mortality, and
healthcare costs. It has been shown to be preventable with prophylactic
amiodarone, which is only recommended in high-risk individuals due to the
potential associated side effects. Risk factors for POAF have been
identified and incorporated into a prediction model to identify high-risk
patients. Further evaluation in the form of a multicenter clinical trial
is required to assess the effectiveness of prophylaxis specifically in
this high-risk population. The feasibility of such a trial first needs to
be assessed. <br/>Method(s): The PREP-AF trial is a double-blind
randomized controlled feasibility trial. Individuals undergoing major
thoracic surgery who are identified to be high-risk by the POAF prediction
model will be randomized 1:1 to receive a short course of amiodarone vs.
placebo in the immediate postoperative period. The primary outcome is
feasibility, which will be measured by the number of eligible patients
identified, consented, and randomized; intervention adherence; and
measurement of future outcomes of a full trial. <br/>Discussion(s): This
study will determine the feasibility of a randomized controlled trial to
assess the effectiveness of prophylactic amiodarone, in high-risk patients
undergoing major thoracic surgery. This will inform the development of a
multi-center trial to establish if prophylactic amiodarone is safe and
effective at reducing the incidence of POAF. Preventing this adverse event
will not only improve outcomes for patients but also reduce the associated
health resource utilization and costs. Trial registration:
ClinicalTrials.gov NCT04392921. Registered on 19 May 2020.<br/>Copyright
&#xa9; 2021, The Author(s).

<67>
Accession Number
2011656736
Title
Clinical outcome of anomalous coronary artery with interarterial course in
adults: Single-center experience combined with a systematic review.
Source
International Journal of Cardiology. 335 (pp 32-39), 2021. Date of
Publication: 15 Jul 2021.
Author
Blomjous M.S.H.; Budde R.P.J.; Bekker M.W.A.; Kauling R.M.; Cuypers
J.A.A.E.; van den Bosch A.E.; Roos-Hesselink J.W.; Hirsch A.
Institution
(Blomjous, Budde, Hirsch) Department of Radiology and Nuclear Medicine,
Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
(Kauling, Cuypers, van den Bosch, Roos-Hesselink, Hirsch) Department of
Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam,
Rotterdam, Netherlands
(Bekker) Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC,
University Medical Center Rotterdam, Rotterdam, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: Anomalous coronary artery originating from the opposite sinus
of Vasalva with interarterial course (ACAOS-IAC) is associated with sudden
cardiac death (SCD) in young athletes. If identified in adulthood
prognosis is usually more benign, resulting in a dilemma regarding
revascularization. <br/>Method(s): This is a retrospective observational
single-center study, including adults with ACAOS-IAC. Medical records
between 2012 and 2019 were reviewed for management approach, mortality,
cardiac death and coronary related adverse events. Coronary computed
tomographic angiography (CCTA) were reviewed. We provide a literature
review in regard to clinical outcome. <br/>Result(s): We identified 40
patients with ACAOS-IAC (mean age 51). Presentation was acute in 7/40
(18%). Ischemia detection with single photon emission tomography (SPECT),
cardiac magnetic resonance (CMR) or dobutamine stress echocardiography
were performed in 25/40 (63%) patients. Ischemia in the vascular territory
of the anomaly was present in 2/25 (8%). In 39/40 (98%) patients were
treated expectative. During median follow-up of 2.7 years (IQR 1.5-5.3) no
cardiovascular death was observed. Mortality occurred in 1/40 (3%) and
coronary related adverse events in 2/40 (5%). We identified 20 studies
describing 1194 patients. Revascularization was performed in 376/1154
(32.6%) patients. Mortality stratified for clinical management was 23/431
(5.3%) in the non-revascularization versus 16/253 (6.3%) in the
revascularization group during 4.0 years follow-up (weighted median).
Cause of death was cardiovascular in 10/596 (1.7%) in 4.2 years (weighted
median) follow up. <br/>Conclusion(s): Both revascularization and
non-invasive management have good prognosis in adults with ACAOS-IAC
during early follow up. There is need for guidelines and long-term
surveillance.<br/>Copyright &#xa9; 2021 The Authors

<68>
Accession Number
2011595803
Title
Is an antithrombotic strategy after transcatheter aortic valve
implantation clearer now?.
Source
Journal of Thrombosis and Thrombolysis. 52(4) (pp 1160-1164), 2021. Date
of Publication: November 2021.
Author
Lv M.; Jiang S.; Wu T.; Chen W.; Zhang J.
Institution
(Lv, Jiang, Wu, Chen, Zhang) Department of Pharmacy, Fujian Medical
University Union Hospital, Fuzhou 350001, China
(Lv, Jiang, Wu, Chen, Zhang) College of Pharmacy, Fujian Medical
University, Fuzhou 350108, China
Publisher
Springer

<69>
Accession Number
2011294536
Title
Ascorbic Acid in the Acute Care Setting.
Source
Journal of Parenteral and Enteral Nutrition. 45(5) (pp 874-881), 2021.
Date of Publication: July 2021.
Author
Kressin C.; Pandya K.; Woodward B.M.; Donaldson C.; Flannery A.H.
Institution
(Kressin, Pandya, Woodward, Donaldson, Flannery) Acute Care Pharmacy
Services, University of Kentucky HealthCare, Lexington, KY, United States
(Flannery) Department of Pharmacy Practice and Science, University of
Kentucky College of Pharmacy, Lexington, KY, United States
Publisher
John Wiley and Sons Inc
Abstract
Ascorbic acid (AA) is an essential nutrient with many physiologic roles
not limited to the prevention of scurvy. Beyond its role as a supplement,
it has gained popularity in the acute care setting as an inexpensive
medication for a variety of conditions. Because of limitations with
absorption of oral formulations and reduced serum concentrations observed
in acute illness, intravenous (IV) administration, and higher doses, may
be needed to produce the desired serum concentrations for a particular
indication. Following a PubMed search, we reviewed published studies
relevant to AA in the acute care setting and summarized the results in a
narrative review. In the acute care setting, AA may be used for improved
wound healing, improved organ function in sepsis and acute respiratory
distress syndrome, faster resolution of vasoplegic shock after cardiac
surgery, reduction of resuscitative fluids in severe burn injury, and as
an adjunctive analgesic, among other uses. Each indication differs in its
level of evidence supporting exogenous administration of AA, but overall,
AA was not commonly associated with adverse effects in the identified
studies. Use of AA remains an active area of clinical investigation for
various indications in the acute care patient population.<br/>Copyright
&#xa9; 2021 American Society for Parenteral and Enteral Nutrition

<70>
Accession Number
2011071048
Title
Surgical aortic valve replacement in small aortic annulus.
Source
Journal of Cardiac Surgery. 36(7) (pp 2502-2509), 2021. Date of
Publication: July 2021.
Author
Vaidya Y.P.; Cavanaugh S.M.; Sandhu A.A.
Institution
(Vaidya, Cavanaugh) Department of Surgery, SUNY Upstate Medical
University, Syracuse, NY, United States
(Sandhu) Department of Cardiothoracic Surgery, SUNY Upstate Medical
University, Syracuse, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Although aortic valve replacement (AVR) has been the standard
of treatment for severe aortic stenosis, a small aortic annulus (SAA)
poses significant challenges. Improvements in valve designs and evolution
in surgical techniques have led to improved outcomes, however, the ideal
prosthetic valve remains elusive. <br/>Method(s): We performed a
comprehensive literature review to discuss the surgical management of
aortic stenosis, with a special focus on patients with SAA.
<br/>Result(s): Stentless valves and root replacement techniques have been
shown to overcome the hemodynamic challenges associated with conventional
stented bioprostheses, but are technically challenging and require longer
cross-clamp times. Sutureless and rapid deployment valves mitigate the
long operative time while maintaining the hemodynamic advantages. The use
of transcatheter AVR has emerged as another reasonable alternative and has
shown promise among patients with SAA, however, long-term outcomes are
awaited. <br/>Conclusion(s): There is no consensus regarding the type of
valve prosthesis or replacement technique among patients with SAA.
Consideration of patient comorbidities and valvular anatomy is paramount
in planning the optimal strategy for AVR. Further long-term clinical
trials are necessary to assess outcomes and achieve progress toward the
development of the ideal prosthesis.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC

<71>
Accession Number
635252158
Title
Postoperative low molecular weight heparin bridging treatment for patients
at high risk of arterial thromboembolism (PERIOP2): Double blind
randomised controlled trial.
Source
The BMJ. 373 (no pagination), 2021. Article Number: n1205. Date of
Publication: 09 Jun 2021.
Author
Kovacs M.J.; Wells P.S.; Anderson D.R.; Lazo-Langner A.; Kearon C.; Bates
S.M.; Blostein M.; Kahn S.R.; Schulman S.; Sabri E.; Solymoss S.; Ramsay
T.; Yeo E.; Rodger M.A.
Institution
(Kovacs, Lazo-Langner) Department of Medicine, Western University, London,
ON, Canada
(Wells) Department of Medicine, University of Ottawa, Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(Anderson) Department of Medicine, Dalhousie University, Halifax, NS,
Canada
(Kearon, Bates, Schulman) Department of Medicine, McMaster University and
Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada
(Blostein, Kahn, Solymoss, Rodger) Department of Medicine, McGill
University, Montreal, QC, Canada
(Sabri, Ramsay) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Yeo) Department of Medicine, University of Toronto, Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objective To determine the efficacy and safety of dalteparin postoperative
bridging treatment versus placebo for patients with atrial fibrillation or
mechanical heart valves when warfarin is temporarily interrupted for a
planned procedure. Design Prospective, double blind, randomised controlled
trial. Setting 10 thrombosis research sites in Canada and India between
February 2007 and March 2016. Participants 1471 patients aged 18 years or
older with atrial fibrillation or mechanical heart valves who required
temporary interruption of warfarin for a procedure. Intervention Random
assignment to dalteparin (n=821; one patient withdrew consent immediately
after randomisation) or placebo (n=650) after the procedure. Main outcome
measures Major thromboembolism (stroke, transient ischaemic attack,
proximal deep vein thrombosis, pulmonary embolism, myocardial infarction,
peripheral embolism, or vascular death) and major bleeding according to
the International Society on Thrombosis and Haemostasis criteria within 90
days of the procedure. Results The rate of major thromboembolism within 90
days was 1.2% (eight events in 650 patients) for placebo and 1.0% (eight
events in 820 patients) for dalteparin (P=0.64, risk difference -0.3%, 95%
confidence interval -1.3 to 0.8). The rate of major bleeding was 2.0% (13
events in 650 patients) for placebo and 1.3% (11 events in 820 patients)
for dalteparin (P=0.32, risk difference -0.7, 95% confidence interval -2.0
to 0.7). The results were consistent for the atrial fibrillation and
mechanical heart valves groups. Conclusions In patients with atrial
fibrillation or mechanical heart valves who had warfarin interrupted for a
procedure, no significant benefit was found for postoperative dalteparin
bridging to prevent major thromboembolism. Trial registration
Clinicaltrials.gov NCT00432796.<br/>Copyright &#xa9; The Author(s), 2021.

<72>
Accession Number
635179573
Title
Effect of dexamethasone on complications or all cause mortality after
major non-cardiac surgery: Multicentre, double blind, randomised
controlled trial.
Source
The BMJ. 373 (no pagination), 2021. Article Number: n1162. Date of
Publication: 02 Jun 2021.
Author
Asehnoune K.; Le Moal C.; Lebuffe G.; Le Penndu M.; Josse N.C.; Boisson
M.; Lescot T.; Faucher M.; Jaber S.; Godet T.; Leone M.; Motamed C.; David
J.S.; Cinotti R.; El Amine Y.; Liutkus D.; Garot M.; Marc A.; Le Corre A.;
Thomasseau A.; Jobert A.; Flet L.; Feuillet F.; Pere M.; Futier E.;
Roquilly A.
Institution
(Asehnoune, Le Penndu, Marc, Roquilly) CHU Nantes, Universite de Nantes,
Pole Anesthesie-Reanimation, Service d'Anesthesie Reanimation
Chirurgicale, Hotel Dieu, Nantes, France
(Le Moal, Liutkus) Service d'Anesthesie, Centre Hospitalier le Mans, Le
Mans, France
(Lebuffe, Garot) Centre Hospitalier Universitaire (CHU) Lille, Pole
Anesthesie Reanimation, Lille, France
(Josse, Le Corre) Service d'Anesthesie, Hopital Prive du Confluent,
Nantes, France
(Boisson, Thomasseau) CHU de Poitiers, Universite de Poitiers, Service
d'Anesthesie-Reanimation, Poitiers, France
(Lescot) Hopital Saint Antoine, Service d'Anesthesie Reanimation
Chirurgicale, Assistance Publique des Hopitaux de Paris, Paris, France
(Faucher) Institut Paoli Calmette, Service d'Anesthesie, Marseille, France
(Jaber) Anesthesia and Critical Care Department B, Saint Eloi Teaching
Hospital, PhyMedExp, Centre Hospitalier Universitaire Montpellier,
University of Montpellier, INSERM U1046, Montpellier, France
(Godet, Futier) Service d'Anesthesie et Reanimation, Hopital Estaing, CHU
Clermont Ferrand, Clermont-Ferrand, France
(Leone) Department of Anesthesiology and Critical Care Medicine, Hopital
Nord, Aix Marseille University, Assistance Publique Hopitaux de Marseille,
Marseille, France
(Motamed) Departement d'Anesthesie and VVC, Gustave Roussy Cancer Center,
Villejuif, France
(David) Service d'Anesthesie Reanimation, Groupe Hospitalier Sud, Civils
de Lyon, Pierre Benite, France
(Cinotti) CHU Nantes, Universite de Nantes, Pole Anesthesie-Reanimation,
Service d'Anesthesie Reanimation Chirurgicale, Hopital Guillaume et Rene
Laennec, Saint-Herblain, France
(El Amine) CH Valenciennes, Service d'Anesthesie, Valenciennes, France
(Jobert, Pere) CHU de Nantes, Direction de la Recherche, Plateforme de
Methodologie et Biostatistique, Nantes, France
(Flet) CHU Nantes, Service Pharmacie, Hotel Dieu, Nantes, France
(Feuillet) Universite de Nantes, Universite de Tours, INSERM, SPHERE
U1246, Nantes, France
Publisher
BMJ Publishing Group
Abstract
Objective To assess the effect of dexamethasone on complications or all
cause mortality after major non-cardiac surgery. Design Phase III,
randomised, double blind, placebo controlled trial. Setting 34 centres in
France, December 2017 to March 2019. Participants 1222 adults (>50 years)
requiring major non-cardiac surgery with an expected duration of more than
90 minutes. The anticipated time frame for recruitment was 24 months.
Interventions Participants were randomised to receive either dexamethasone
(0.2 mg/kg immediately after the surgical procedure, and on day 1) or
placebo. Randomisation was stratified on the two prespecified criteria of
cancer and thoracic procedure. Main outcomes measures The primary outcome
was a composite of postoperative complications or all cause mortality
within 14 days after surgery, assessed in the modified intention-to-treat
population (at least one treatment administered). Results Of the 1222
participants who underwent randomisation, 1184 (96.9%) were included in
the modified intention-to-treat population. 14 days after surgery, 101 of
595 participants (17.0%) in the dexamethasone group and 117 of 589 (19.9%)
in the placebo group had complications or died (adjusted odds ratio 0.81,
95% confidence interval 0.60 to 1.08; P=0.15). In the stratum of
participants who underwent non-thoracic surgery (n=1038), the primary
outcome occurred in 69 of 520 participants (13.3%) in the dexamethasone
group and 93 of 518 (18%) in the placebo group (adjusted odds ratio 0.70,
0.50 to 0.99). Adverse events were reported in 288 of 613 participants
(47.0%) in the dexamethasone group and 296 of 609 (48.6%) in the placebo
group (P=0.46). Conclusions Dexamethasone was not found to significantly
reduce the incidence of complications and death in patients 14 days after
major non-cardiac surgery. The 95% confidence interval for the main result
was, however, wide and suggests the possibility of important clinical
effectiveness. Trial registration ClinicalTrials.gov
NCT03218553.<br/>Copyright &#xa9; 2021 BMJ Publishing Group. All rights
reserved.

<73>
Accession Number
2014095269
Title
The effects of rational emotive behavior therapy for depressive symptoms
in adults with congenital heart disease.
Source
Heart and Lung. 50(6) (pp 906-913), 2021. Date of Publication: November
2021.
Author
Moon J.R.; Huh J.; Song J.; Kang I.-S.; Park S.W.; Chang S.-A.; Yang
J.-H.; Jun T.-G.; Han J.-S.
Institution
(Moon) Department of Nursing, Adult Congenital Heart Clinic, Heart
Vascular Stroke Institute, Samsung Medical Center, Seoul, South Korea
(Huh, Song, Kang) Division of Cardiology, Department of Pediatrics, Adult
Congenital Heart Clinic, Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Park, Chang) Division of Cardiology, Department of Internal Medicine,
Adult Congenital Heart Clinic, Heart Vascular Stroke Institute, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Yang, Jun) Department of Thoracic & Cardiovascular Surgery, Adult
Congenital Heart Clinic, Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Han) Red College of Nursing, Chung-Ang University (retired), Seoul, South
Korea
Publisher
Mosby Inc.
Abstract
Background: Over 30% of adults with congenital heart disease (CHD)
experience depression. <br/>Objective(s): To evaluate the effectiveness of
Rational Emotive Behavior Therapy (REBT) in reducing depressive symptoms
in adults with CHD. <br/>Method(s): Forty-two adults with CHD were
recruited from an outpatient clinic and randomized to a study group (n =
21), which comprised 8-weekly group-based counseling sessions, or a
control group (n = 21), which received usual care. REBT effectiveness was
examined using the Hamilton Depression Rating Scale, Beck Depression
Inventory, Shorten General Attitude and Belief Scale, and salivary
cortisol levels before therapy, after the last session, and at follow-up 4
weeks later. <br/>Result(s): Average participant ages were 30.1 +/- 7.58
and 33.3 +/- 7.1 years in study and control groups, respectively; 52.4% of
participants in each group were female. After REBT, depression (p <
0.001), irrational beliefs (p < 0.001), and salivary cortisol levels (p =
0.006) were significantly lower in the study group than in the control
group. Effects of REBT in the study group remained consistent at the
4-week follow-up. <br/>Conclusion(s): REBT may be effective in reducing
depression in adults with CHD.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<74>
Accession Number
636553177
Title
Efficacy and safety of postoperative use of morphine, fentanyl and
remifentanyl after coronary artery bypass grafting.
Source
Critical Care. Conference: 40th International Symposium on Intensive Care
and Emergency Medicine 2021. Brussels Belgium. 25(SUPPL 1) (no
pagination), 2021. Date of Publication: 2021.
Author
Loncar Stojiljkovic D.; Stojiljkovic M.P.
Institution
(Loncar Stojiljkovic) Institute for Cardiovascular Surgery Dedinje,
Belgrade, Serbia
(Stojiljkovic) Faculty of Medicine, University of Banja Luka,
Pharmacology, Toxicology and Clinical Pharmacology, Banja Luka, Bosnia and
Herzegovina
Publisher
BioMed Central Ltd.
Abstract
Introduction: Pain after cardiac surgery is significant and may affect
postoperative cardiovascular stability and may develop into chronic pain
thereafter [1]. This postoperative pay should be carefully managed. The
aim of this study was to compare the analgesic effects and safety of
morphine, fentanyl and remifentanil in patients after coronary artery
bypass grafting (CABG) surgery. <br/>Method(s): Study was prospective,
randomized and double-blinded. Forty-five patients undergoing coronary
artery bypass surgery were included in the study. All patients received a
standardized anesthesia. They were randomized into 3 groups consisting of
15 patients each. M group received morphine HCl (1 mg/ml) with an infusion
rate of 0.3 mg/h and 1-mg bolus doses; F group received fentanyl (50 mug/
ml) with an infusion rate of 1 mug/kg/h and 10-mug bolus; and R group
received remifentanil (50 mug/ml) with an infusion rate of 0.05 mug/
kg/min and 0.5-mug/kg bolus, respectively. Continuous infusion was started
immediately after transfer to ICU. <br/>Result(s): Pain was assessed by
using a numerical scale (0-10) and sedation was assessed with the Ramsey
sedation score (1-6) 30 min, 1, 2, 4, 12, and 24 h after extubation. The
number of boluses and demands, time to extubation and side effects were
analyzed. Numerical scale for pain scores, sedation scores and mean
extubation times were similar in all groups. Total number of boluses and
demands were statistically higher in the R group. Nausea and vomiting
occurred more often in group M group (p < 0.05), whereas pruritus was most
frequently registered in group F (p < 0.05). <br/>Conclusion(s): Despite
the different durations of action of these three opioid agents, the
infusion dose of remifentanil was as effective as morphine and fentanyl
after CABG surgery, with fewer side effects.

<75>
Accession Number
636561459
Title
Cardiac troponin and myocardial damage index.
Source
Clinical Chemistry and Laboratory Medicine. Conference: 24th IFCC-EFLM
European Congress of Clinical Chemistry and Laboratory Medicine,
EUROMEDLAB 2021. Munich. 59(SUPPL 1) (pp S239), 2021. Date of Publication:
October 2021.
Author
Dorofeykov V.; Sheshurina T.; Vavilova T.
Institution
(Vavilova) Almazov National Medical Research Centre, St. Petersburg,
Russian Federation
(Dorofeykov, Sheshurina) Lesgaft National State University of Physical
Education, Sport and Health, St. Petersburg, Russian Federation
Publisher
Walter de Gruyter GmbH
Abstract
BACKGROUND-AIM Postoperative cardiac troponin I (Tn) elevation is a common
phenomenon with several potential mechanisms that often leads to
diagnostic confusion. The aims of this study were to determine the
dynamics of Tn levels after cardiac surgery and to develop a method for
assessing myocardial damage and the risk of complications in the
postoperative period. METHODS Patients undergoing cardiac surgery (109
men, mean age 54.3 +/- 7.5 years), were randomized into 3 groups: (1)
coronary artery bypass grafting (CABG) and novel technique of
preconditioning induction (n=29), (2) conventional CABG (n=60), (3) aortic
valve replacement (n=20). The operations were performed using
cardiopulmonary bypass and isothermal blood cardioplegia. Tn levels were
measured before operation and 2,6,12,24,48 hours after the surgery using
immunochemical analyzer (Architect i2000SR, Abbott Diagnostics). RESULTS
Concentration of Tn increases in all patients 2 hours after surgery, and
it increases more than tenfold in the 99th percentile, which is caused by
damage to cardiomyocytes during surgical manipulations on the heart. None
of the patients experienced perioperative myocardial infarction (type 5).
The maximum release of Tn in group (1) was 1819+/-178 ng/L after to 2 h,
in group (2)-1632+/-224 ng/L after to 24 h, in group (3)-2923+/-377 ng/L
after to 6 h surgery. Two patterns of Tn release were noted in the
postoperative period with peak concentrations at 2-6 h or 12-24 h after
surgery. In patients with peak Tn concentration occurring at 12-24 h there
was a tendency towards a longer hospitalization time and higher blood
lactate levels (4,1+/-0,7 mmol/l; p=0.001). Therefore, it is proposed to
measure the levels of Tn after surgery twice, after 2-6 hours (early Tn)
and after 12-24 hours (late Tn), then calculate the myocardial damage
index (MDI) as the ratio of late Tn to early Tn. ROC analysis showed that
the if MDI was 1.8 or more, myocardial damage and the risk of
postoperative complications should be considered high. CONCLUSIONS Peak Tn
at 2-6 h following cardiac surgery appears to be related to the surgical
process and non-specific myocardial injury whilst a continuing increase at
12-24 h indicates an increase in the damage zone. We would suggest Tn
sampling at 2-6 and 12-24 h post cardia surgery and calculating the MDI
for the routine detection of the size of myocardial damage.

<76>
Accession Number
2015797354
Title
Hybrid coronary revascularization versus percutaneous coronary
intervention: A systematic review and meta-analysis.
Source
IJC Heart and Vasculature. 37 (no pagination), 2021. Article Number:
100916. Date of Publication: December 2021.
Author
Van den Eynde J.; Sa M.P.; De Groote S.; Amabile A.; Sicouri S.; Ramlawi
B.; Torregrossa G.; Oosterlinck W.
Institution
(Van den Eynde, De Groote, Oosterlinck) Department of Cardiovascular
Diseases, University Hospitals Leuven & Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Van den Eynde) Helen B. Taussig Heart Center, The Johns Hopkins Hospital
and School of Medicine, Baltimore, United States
(Sa, Ramlawi, Torregrossa) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Main Line Health Wynnewood, PA, United States
(Sa, Sicouri, Ramlawi) Department of Cardiac Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, PA, United States
(Amabile) Division of Cardiac Surgery, Department of Surgery, Yale School
of Medicine, New Haven, CT, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Hybrid coronary revascularization (HCR) is an emerging
approach for multivessel coronary artery disease (MVD) which combines the
excellent long-term outcomes of surgery with the early recovery and
reduced short-term complications of percutaneous coronary intervention
(PCI). Here, we evaluated the effectiveness of HCR compared to PCI in
patients with MVD. <br/>Method(s): A systematic database search in
PubMed/MEDLINE, Embase, Scopus, and CENTRAL/CCTR was conducted by June
2021. Random-effects meta-analysis was performed, comparing major adverse
cardiac and cerebrovascular events (MACCE) at 30 days and at latest
follow-up between patients undergoing HCR versus PCI. <br/>Result(s): A
total of 27,041 patients (HCR: 939 patients, PCI: 26,102 patients) were
included from seven studies published between 2013 and 2021. At latest
follow-up, HCR was associated with lower rates of myocardial infarction
(OR 0.40, 95% CI 0.20-0.80, p = 0.010) and target vessel revascularization
(OR 0.49, 95% CI 0.37-0.64, p < 0.001), while the difference for MACCE did
not reach statistical significance (OR 0.46, 95% CI 0.20-1.05, p = 0.061).
No differences were observed in terms of 30-day outcomes, nor rates of
mortality or stroke at latest follow-up. <br/>Conclusion(s): HCR might be
a valid alternative to multivessel PCI, demonstrating a lower incidence of
MI and TVR. Center experience, well-coordinated heart team discussions,
and good patient selection likely remain essential to ensure optimal
outcomes. Future comparative studies are required to define the optimal
target population.<br/>Copyright &#xa9; 2021

<77>
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. <br/>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. <br/>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.
<br/>Copyright &#xa9; 2021 Published on behalf of the European Society of
Cardiology. All rights reserved.

<78>
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. <br/>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. <br/>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).
<br/>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.<br/>Copyright &#xa9; 2021
AME Publishing Company. All rights reserved.

<79>
Accession Number
2014735920
Title
Surgical strategies for cardiac perforation after catheter ablation or
electrophysiology study: A systemic review.
Source
International Heart Journal. 62(6) (pp 1257-1264), 2021. Date of
Publication: 2021.
Author
Wu S.-J.; Fan Y.-F.; Chien C.-Y.
Institution
(Wu, Fan, Chien) Division of Cardiovascular Surgery, Departments of
Surgery, MacKay Memorial Hospital, Taipei, Taiwan (Republic of China)
Publisher
International Heart Journal Association
Abstract
Catheter ablation is a treatment modality which has been increasingly used
for cardiac arrhythmias. How-ever, it is not complication-free, and
cardiac perforation is one of its most life-threatening complications. As
surgery is usually not the first-line treatment for this emergent episode,
there were only very few sporadic surgical reports in the literature. This
systemic review primarily aims to collect different surgical approaches
for catheter-induced cardiac perforation to help surgeons manage this kind
of uncommon and critical patients. Of the 452 initially screened articles,
22 studies (38 patients) were included in the systemic review. Of all the
included patients, 84% (32/38) were found to have pericardial effusion
acutely following catheter-related proce-dures, and 16% (6/38) experienced
delayed-onset episodes. Regarding the surgical procedures, four patients
underwent removal of clots only, eight patients underwent suture repair of
the left ventricle (LV), nine patients underwent suture repair of the
right ventricle (RV), five patients underwent suture repair of the LA, and
four patients underwent sutureless repair of the LV and pulmonary vein (LV
1, RV 1, pulmonary vein 1). In addition to repair of perforation sites,
the concomitant combined procedures included repair of intercostal vessels
(compli-cation of pericardiocentesis) for one patient, cryoablation for
two patients, and maze procedure for one patient. For cardiac perforation
following catheter ablation or electrophysiology study, although the
majority of the patients are treated with pericardiocentesis and medical
management at first, cardiovascular surgeons have to pre-pare to take over
if the bleeding is persistent or if the cardiac tamponade is not
relieved.<br/>Copyright &#xa9; 2021, International Heart Journal
Association. All rights reserved.

<80>
Accession Number
2015771495
Title
Glycopyrrolate versus atropine for preventing bradycardia induced by
neostigmine injection after general anesthesia surgery: A randomized open,
parallel-controlled multicenter clinical trial.
Source
American Journal of Translational Research. 13(11) (pp 12996-13002), 2021.
Date of Publication: 2021.
Author
Yun Y.; Cao D.; Zhang X.; Ouyang W.; Min S.; Lv J.; Li L.; Huang F.
Institution
(Yun) Department of Anesthesiology, Beijing Chaoyang Hospital, Capital
Medical University, Beijing 100000, China
(Cao) Department of Anesthesiology, Affiliated Hospital of Guangdong
Medical University, Guangdong, Zhanjiang 524000, China
(Zhang) Department of Anesthesiology, Shanghai Tongji Hospital, Shanghai
200000, China
(Ouyang) Department of Anesthesiology, The Third Xiangya Hospital, Central
South University, Hunan, Changsha 410000, China
(Min) Department of Anesthesiology, The First Affiliated Hospital of
Chongqing Medical University, Chongqing 400000, China
(Lv) Department of Anesthesiology, The Second Affiliated Hospital of Xi'an
Jiaotong University, Shaanxi, Xi'an 710000, China
(Li) Department of Anesthesiology, General Hospital of Shenyang Military
Region of PLA, Liaoning, Shenyang 110000, China
(Huang) Department of Anesthesiology, The First People's Hospital of
Changde, Hunan, Changde 415000, China
Publisher
E-Century Publishing Corporation
Abstract
Objective: With atropine as a positive control, randomized controlled
clinical trials were conducted to verify the efficacy of glycopyrrolate
injection in preventing bradycardia caused by neostigmine. <br/>Method(s):
Patients undergoing elective general anesthesia and non-cardiac surgery
were randomly divided into an experimental group (129 cases) and control
group (127 cases) (ChiCTR2100046022,
http://www.chictr.org.cn/showproj.aspx?proj=126075). At the end of the
operation, the test group was given glycopyrrolate 6 ug/kg + neostigmine
0.04 mg/kg, and the control group was given atropine 0.016 mg/kg +
neostigmine 0.04 mg/kg, bolus time 1 min, to antagonize muscle residual
effects of relaxants. We compared the area under the time curve (AUC) of
the difference between heart rate and baseline heart rate within 15
minutes of administration, the measured value of heart rate per minute,
and the change in heart rate compared with baseline. We verified the
safety of glycopyrrolate injection through laboratory tests, clinical
symptoms, signs, and adverse events/serious adverse events.
<br/>Result(s): The AUC of the experimental group's heart rate within 15
minutes after the administration was lower than the baseline heart rate
change value, (P<005). The measured value of the heart rate at each time
changed less than the control group; the experimental group's heart rate
remained at the baseline level for longer than the control group (P<005).
There was no significant difference in the incidence of adverse reactions
between the two groups of patients (P>005). <br/>Conclusion(s):
Glycopyrrolate and atropine are safe to prevent heart rate slowing induced
by the non-depolarizing muscle relaxant antagonist neostigmine, and
glycopyrrolate is more conducive to maintaining a stable heart rate in
patients.<br/>Copyright &#xa9; 2021 E-Century Publishing Corporation. All
rights reserved.

<81>
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. <br/>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. <br/>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. <br/>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. <br/>Funding(s): None<br/>Copyright &#xa9;
2021 Elsevier Ltd

<82>
Accession Number
2014293606
Title
The eff ect of sex counselling in the sexual activity of acute myocardial
infarction patients after primary percutaneous coronary intervention.
Source
Acta Cardiologica. 70(4) (pp 460-464), 2015. Date of Publication: 2015.
Author
Xu F.; Ming Q.; Hou L.
Institution
(Xu, Hou) Shanghai Ninth People's Hospital affi liated Shanghai Jiaotong
University School of Medicine, Shanghai, China
(Ming) The Tenth People's Hospital, Tongji University, Shanghai, China
Publisher
Taylor and Francis Ltd.
Abstract
Background Primary percutaneous coronary intervention has improved the
outcome of acute myocardial infarction (AMI) patients. Counselguided sex
rehabilitation effi cacy in acute myocardial infarction patients receiving
percutaneous coronary intervention remains unknown. Objective The aim of
the study was to study counsel-guided sex rehabilitation effi cacy in AMI
patients receiving percutaneous coronary intervention. Methods 240 AMI
patients who received percutaneous coronary intervention were randomly
divided into a control and a counselling group. Control group patients
were given written sex rehabilitation instruction before discharge, while
counselling group patients were given written instruction before discharge
and monthly counselling with healthcare providers. Before discharge, the
fi rst evaluation was performed for frequency of and satisfaction with
sexual activity before AMI. At one year of follow-up, the time of
resuming, frequency of and satisfaction with sexual activity was
evaluated. The main adverse event rates were also investigated. Results No
signifi cant diff erences in age, sex, smoking status, hypertension,
diabetes, PVD (peripheral vascular disease), EF (ejection fraction) or
GRACE (Global Registry of Acute Coronary Events) score were found between
the groups. Both groups suff ered reduced frequency of and satisfaction
with sexual activity after AMI as compared with prior to presentation with
AMI. However, compared with controls, the counselling group had higher
scores for frequency of and satisfaction with sexual activity after AMI.
The time to resume sexual activity after AMI in the counselling group was
signifi cantly shorter than was found for the control group. There were no
signifi cant diff erences between the groups for recurrent AMI, non-fatal
stroke, admitting the patient for angina, all-cause death or adverse
events. Conclusions Intermittent discussions between healthcare providers
and AMI patients improved resumption of sexual activity. Encouraging
patients who received complete coronary revascularization to resume sexual
activity shortly after AMI was safe.<br/>Copyright &#xa9; 2015 Taylor and
Francis Group LLC.

<83>
Accession Number
2015811384
Title
Individualised or liberal red blood cell transfusion after cardiac
surgery: a randomised controlled trial.
Source
British Journal of Anaesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
Fischer M.-O.; Guinot P.-G.; Debroczi S.; Huette P.; Beyls C.; Babatasi
G.; Bafi K.; Guilbart M.; Caus T.; Lorne E.; Dupont H.; Hanouz J.-L.;
Diouf M.; Abou-Arab O.
Institution
(Fischer, Debroczi, Bafi, Hanouz) Normandy University, UNICAEN, CHU de
Caen Normandie, Service d'Anesthesie Reanimation, Caen, France
(Guinot) Department of Anesthesiology and Critical Care Medicine, Dijon
University Hospital, Dijon, France
(Huette, Beyls, Guilbart, Dupont, Abou-Arab) Department of Anesthesiology
and Critical Care Medicine, Amiens Picardy University Hospital, Amiens,
France
(Babatasi) Normandy University, UNICAEN, CHU de Caen Normandie, Department
of Cardiac Surgery, Caen, France
(Caus) Department of Cardiac Surgery, Amiens University Hospital, Amiens
Picardy University Hospital, Amiens, France
(Lorne) Department of Anesthesiology and Critical Care Medicine, Clinique
du Millenaire, Montpellier, France
(Diouf) Department of Biostatistics, Amiens Picardy University Hospital,
Amiens, France
Publisher
Elsevier Ltd
Abstract
Background: Current practice guidelines for red blood cell (RBC)
transfusion in ICUs are based on haemoglobin threshold, without
consideration of oxygen delivery or consumption. We aimed to evaluate an
individual physiological threshold-guided by central venous oxygen
saturation ScvO<inf>2</inf>. <br/>Method(s): In a randomised study in two
French academic hospitals, 164 patients who were admitted to ICU after
cardiac surgery with postoperative haemoglobin <9 g dl^-1 were
randomised to receive a transfusion with one unit of RBCs (haemoglobin
group) or transfusion only if the ScvO<inf>2</inf> was <70%
(individualised group). The primary outcome was the number of subjects
receiving at least one unit of RBCs. The secondary composite outcome was
acute kidney injury, stroke, myocardial infarction, acute heart failure,
mesenteric ischaemia, or in-hospital mortality. One- and 6-month mortality
were evaluated during follow-up. <br/>Result(s): The primary outcome was
observed for 80 of 80 subjects (100%) in the haemoglobin group and in 61
of 77 patients (79%) in the individualised group (absolute risk -21%
[-32.0; -14.0]; P<0.001). There was no significant difference in the
secondary outcome between the two groups. Follow-up showed a
non-significant difference in mortality at 1 and 6 months.
<br/>Conclusion(s): An individualised strategy based on an central venous
oxygen saturation threshold of 70% allows for a more restrictive red blood
cell transfusion strategy with no incidence on postoperative morbidity or
6-month mortality. Clinical trial registration: NCT02963883.<br/>Copyright
&#xa9; 2021 British Journal of Anaesthesia

<84>
Accession Number
2015811369
Title
Targeted temperature management in cardiac surgery: a systematic review
and meta-analysis on postoperative cognitive outcomes.
Source
British Journal of Anaesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
Linassi F.; Maran E.; De Laurenzis A.; Tellaroli P.; Kreuzer M.; Schneider
G.; Navalesi P.; Carron M.
Institution
(Linassi, Maran, De Laurenzis, Navalesi, Carron) Department of Medicine,
Anaesthesiology and Intensive Care, University of Padova, Padova, Italy
(Linassi, Kreuzer, Schneider) Department of Anaesthesiology and Intensive
Care, Klinikum rechts der Isar, Technical University of Munich, School of
Medicine, Munich, Germany
(Tellaroli) Department of Developmental Psychology and Socialisation,
University of Padova, Padova, Italy
Publisher
Elsevier Ltd
Abstract
Background: Postoperative cognitive decline occurs commonly after cardiac
surgery. The available literature is inconclusive on the role of
intraoperative causal or protective factors. <br/>Method(s): We
systematically reviewed studies evaluating delayed neurocognitive recovery
(DNR), postoperative neurocognitive disorder (NCD), stroke, and the
mortality rates among patients undergoing hypothermic or normothermic
cardiopulmonary bypass (CPB). We further performed a subgroup analysis for
age, surgery type (coronary artery bypass grafting [CABG], valve surgery,
or combined), and the mean arterial blood pressure (MAP) during CPB, and
conducted a proportion meta-analysis after calculation of single
proportions and confidence intervals (CIs). <br/>Result(s): We included a
total of 58 studies with 9609 patients in our analysis. Among these, 1906
of 4010 patients (47.5%) had DNR, and 2071 of 7160 (28.9%) had
postoperative NCD. Ninety of 4625 patients (2.0%) had a stroke, and 174 of
7589 (2.3%) died. There was no statistically significant relationship
between the considered variables and DNR, NCD, stroke, and mortality. In
the subgroup analysis comparing hypothermic with normothermic CPB, we
found higher NCD rates after combined surgery; for normothermic CPB cases
only, the rates of DNR and NCD were lower after combined surgery compared
with CABG surgery. A MAP >70 mm Hg compared with MAP=50-70 mm Hg during
CPB was associated with a lower rate of DNR. <br/>Conclusion(s):
Temperature, MAP during CPB, age, and surgery type were not associated
with neurocognitive disorders, stroke, and mortality in cardiac surgery. A
normothermic CPB, particularly when performed with MAP >70 mm Hg, may
reduce the risk of postoperative neurocognitive decline after cardiac
surgery. PROSPERO registration number: CRD42019140844.<br/>Copyright
&#xa9; 2021 British Journal of Anaesthesia

<85>
Accession Number
2015797838
Title
Rationale and design of the BA-SCAD (Beta-blockers and Antiplatelet agents
in patients with Spontaneous Coronary Artery Dissection) randomized
clinical trial.
Source
Revista Espanola de Cardiologia. (no pagination), 2021. Date of
Publication: 2021.
Author
Alfonso F.; de la Torre Hernandez J.M.; Ibanez B.; Sabate M.; Pan M.;
Gulati R.; Saw J.; Angiolillo D.J.; Adlam D.; Sanchez-Madrid F.
Institution
(Alfonso) Departamento de Cardiologia, Hospital Universitario de La
Princesa, Instituto de Investigacion Sanitaria Princesa (IIS-IP),
Universidad Autonoma de Madrid, Madrid, Spain
(Alfonso, Ibanez, Sabate, Sanchez-Madrid) Centro de Investigacion
Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
(de la Torre Hernandez) Departamento de Cardiologia, Hospital
Universitario Marques de Valdecilla, IDIVAL, Santander, Cantabria, Spain
(Ibanez) Departamento de Cardiologia, IIS-Fundacion Jimenez Diaz, Centro
Nacional Investigaciones Cardiovasculares (CNIC), Madrid, Spain
(Sabate) Departamento de Cardiologia, Instituto Cardiovascular, Hospital
Clinic, IDIBAPS, Barcelona, Spain
(Pan) Departamento de Cardiologia, Hospital Universitario Reina Sofia,
Universidad de Cordoba, IMIBIC, Cordoba, Spain
(Gulati) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
Minnesota, United States
(Saw) Division of Cardiology, Vancouver General Hospital, University of
British Columbia, Vancouver, BC, Canada
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, Florida, United States
(Adlam) Department of Cardiovascular Sciences and National Institute for
Health Research, Leicester Biomedical Research Centre, Glenfield Hospital,
United Kingdom
(Sanchez-Madrid) Departamento de Inmunologia, Hospital Universitario de La
Princesa, Instituto de Investigacion Sanitaria Princesa (IIS-IP),
Universidad Autonoma de Madrid, Madrid, Spain
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction y objectives: Spontaneous coronary artery dissection (SCAD)
is a rare cause of acute coronary syndrome. Most patients are empirically
treated with beta-blockers and antiplatelet drugs. The Beta-blockers and
Antiplatelet agents in patients with Spontaneous Coronary Artery
Dissection (BA-SCAD) is an academic, pragmatic, prospective, randomized,
open-label, blinded-endpoint clinical trial, performed under the auspices
of the Spanish Society of Cardiology, to assess the efficacy of
pharmacological therapy in patients with SCAD. <br/>Method(s): Using a 2 x
2 factorial design, 600 patients will be randomized (1:1/1:1) to: a)
beta-blockers (yes/no) and b) "short" (1 month) vs "prolonged" (12 months)
antiplatelet therapy. Only patients with preserved left ventricular
ejection fraction will be randomized to beta-blockers (yes/no) because
patients with reduced left ventricular ejection fraction will receive
beta-blockers according to current guidelines. Similarly, only
conservatively managed patients (ie, no coronary intervention) will be
randomized to the antiplatelet stratum, as patients requiring coronary
interventions will receive 1-year dual antiplatelet therapy. The primary
efficacy endpoint includes a composite of death, myocardial infarction,
stroke, coronary revascularization, recurrent SCAD, and unplanned
hospitalization for acute coronary syndrome or heart failure at 1 year.
The primary safety endpoint will be bleeding. All patients will be
clinically followed up yearly. A comprehensive set of additional
substudies (clinical, imaging, revascularization, biomarkers,
inflammatory, immunologic, pharmacogenetics, and genetic) will be
conducted to ensure a holistic view of this unique and challenging
clinical entity. <br/>Conclusion(s): The results of the BA-SCAD randomized
clinical trial will advance our knowledge in the treatment of patients
with SCAD. The study was registered at ClinicalTrials.gov (Identifier:
NCT04850417).<br/>Copyright &#xa9; 2021 Sociedad Espanola de Cardiologia

<86>
Accession Number
2015783952
Title
Surgical outcomes of diaphragmatic resection during cytoreductive surgery
for advanced gynecological ovarian neoplasia: A randomized single center
clinical trial - DRAGON.
Source
Gynecologic Oncology. (no pagination), 2021. Date of Publication: 2021.
Author
Cianci S.; Fedele C.; Vizzielli G.; Pasciuto T.; Gueli Alletti S.;
Cosentino F.; Chiantera V.; Fagotti A.; Scambia G.
Institution
(Cianci) Department of Human Pathology of Adult and Childhood "G.
Barresi", University Hospital "G. Martino", Messina, Italy
(Cianci, Fedele, Vizzielli, Gueli Alletti, Fagotti, Scambia) Gynecologic
Oncology Unit, Women Wealth Area, Department of Woman and Child Health and
Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS,
Rome, Italy
(Pasciuto) Research Core Facilty Data Collection G-STeP, Fondazione
Policlinico Universitario Agostino Gemelli IRCCS, Italy
(Cosentino) Division of Gynecologic Oncology, Gemelli Molise Hospital,
Campobasso, Italy
(Chiantera) Department of Gynecologic Oncology, ARNAS Civico Di Cristina
Benfratelli, Palermo, Italy
(Chiantera) Gynecologic Oncology, University of Palermo, Palermo, Italy
(Fagotti, Scambia) Catholic University of Sacred Heart, Rome, Italy
Publisher
Academic Press Inc.
Abstract
Introduction: Ovarian cancer (OC) represent nearly 4% of gynecologic
malignancies and it is often diagnosed at advanced stage. Diaphragmatic
surgery, a fundamental step of advanced stage ovarian cancer (ASOC)
debulking surgery, is associated with a high post-operative complication
incidence, which is supposedly reduced with thoracostomy tube placement.
We assessed the role of intra-operative thoracostomy tube placement, as a
prevention measure for post-operative complications, after diaphragmatic
resection. <br/>Method(s): This was a single center prospective randomized
trial. Ovarian cancer patients, who underwent mono-lateral diaphragmatic
resection, were randomized 1:1 into two arms. Arm A included patients
receiving intra-operative thoracostomy tube placement (TP); Arm B patients
did not receive thoracostomy tube placement (NTP). After surgery, all
patients underwent seriate chest x-ray and ultrasound to record thoracic
complications. Statistical analysis included uni- and multivariable
logistic regression model (proportional odds model). <br/>Result(s): Three
hundred seventy-one patients were screened and 88 patients were enrolled:
44 in arm A and B, respectively. No statistically significant differences
for intra-operative (p = 0.291) and any grade of post-operative
complication (p = 0.072) were detected, while 6.8% of patients in arm A
and 22.7% in arm B experienced severe respiratory symptoms (p = 0.035);
18.2% of patients in arm A had a moderate/large pleural effusion versus
65.9% in arm B (p < 0.0001). At multivariable analysis, results confirmed
that the NTP-group had a higher risk to receive post-operative
thoracostomy tube placement due to pleural effusion than the TP-group
(odds ratio [95% Confidence Interval] = 14.5 [3.7-57.4]).
<br/>Conclusion(s): Thoracostomy intra-operative tube placement after
diaphragmatic resection is effective to prevent post-operative thoracic
complications. The extension of resection does not influence outcomes and
the risk of post-operative thoracentesis or TP remain
elevated.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<87>
Accession Number
2015769494
Title
A Scoping Review of Alternative Anticoagulation Strategies for
Hemodialysis Patients with a Mechanical Heart Valve.
Source
American Journal of Nephrology. (pp 861-870), 2021. Date of Publication:
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, Maryland, United States
(Thomson, Pilkey, Holden) Division of Nephrology, Department of Medicine,
Queen's University, Kingston, Ontario, Canada
(Monteith) Division of Hematology, Department of Medicine, Queen's
University, Kingston, Ontario, 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. <br/>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. <br/>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. <br/>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. <br/>Copyright &#xa9; 2021

<88>
Accession Number
2014343865
Title
Indonesian Study: Triiodothyronine for Infants Less than 5 Months
Undergoing Cardiopulmonary Bypass.
Source
Pediatric Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Marwali E.M.; Lopolisa A.; Sani A.A.; Rayhan M.; Roebiono P.S.; Fakhri D.;
Haas N.A.; Slee A.; Portman M.A.
Institution
(Marwali, Lopolisa, Sani, Rayhan) Pediatric Cardiac Intensive Care Unit,
National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Marwali, Roebiono) Department of Cardiology and Vascular Medicine,
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
(Roebiono) Pediatric Cardiology Unit, National Cardiovascular Center
Harapan Kita, Jakarta, Indonesia
(Fakhri) Pediatric Cardiac Surgery Unit, National Cardiovascular Center
Harapan Kita, Department of Cardiothoracic Vascular Surgery, Faculty of
Medicine, Universitas Indonesia, Jakarta, Indonesia
(Haas) Department of Pediatric Cardiology and Pediatric Intensive Care,
Medical Hospital of the University of Munich, Munich, Germany
(Slee) Axio Research, Seattle Children's Hospital and Research Institute,
Seattle, United States
(Portman) Seattle Children's Hospital, University of Washington, Seattle,
WA, United States
(Marwali) National Cardiovascular Center Harapan Kita, Jl. Let. Jend. S.
Parman, Kav 87, Slipi, West Jakarta 11420, Indonesia
Publisher
Springer
Abstract
This study evaluates the efficacy and safety of oral triiodothyronine on
time to extubation for infants less than 5 months undergoing heart surgery
in Indonesia, and primarily relates to patients in emerging programs with
high malnutrition and mortality. In this randomized, double-blind,
placebo-controlled trial, oral triiodothyronine (T3, Tetronine) 1
mug/kg-body weight/dose or placebo (saccharum lactis) was administered via
nasogastric tube every 6 h for 60 h to treatment group. A total of 120
patients were randomized into T3 (61 patients) and placebo (59 patients)
groups. The majority of the patients had moderate to severe malnutrition
(55.83%) with a high post-operative mortality rate of 23.3%. The T3 group
showed significantly higher serum FT3 levels from 1 until 48 h post
cross-clamp removal (p < 0.0001), lower incidence of low cardiac output
syndrome at both 6 h (28 [45.9%] vs. 39 [66.1%] patients, p = 0.03, OR
2.3, 95% CI: 1.10-4.81) and 12 h after cross-clamp removal (25 [41.7%] vs.
36 [63.2%], p = 0.02, OR 2.40, 95% CI: 1.14-5.05). Although not
statistically significant, the treatment group had shorter median (IQR)
intubation time (2.59 [1.25-5.24] vs. 3.77 [1.28-6.64] days, p = 0.16, HR
1.36, 95% CI: 0.88-2.09)] and lower mortality (10 [16.4%] vs. 18 [30.5%],
p = 0.07]. Patients with Aristotle score < 10.0 (low risk) receiving T3
had faster extubation than placebo patients (p = 0.021, HR of 1.90, 95%
CI: 1.10-3.28) and were significantly less likely to require CPR or
experience infection (p = 0.027, OR 8.56, 95% CI:0.99-73.9 and p = 0.022,
OR 4.09 95% CI: 1.16-14.4, respectively). Oral T3 supplementation reduced
overall incidence of low cardiac output syndrome and significantly reduced
the time to extubation in low-risk patients. Therefore, prophylactic oral
T3 administration may be beneficial in these patients. Trial Registration:
ClinicalTrials.gov NCT02222532.<br/>Copyright &#xa9; 2021, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<89>
Accession Number
2014325523
Title
Improving respiratory outcomes after pediatric cardiac surgery: New uses
for nitric oxide.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Scharoun J.H.
Institution
(Scharoun) Department of Anesthesiology, Weill Cornell Medicine, New
York-Presbyterian Hospital, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: This month's issue of Journal of Cardiac Surgery features a
retrospective study on the effect of combining inhaled nitric oxide with
high frequency oscillator ventilation to rescue infants who have failed
conventional ventilation after congenital heart surgery. <br/>Aim(s): This
commentary aims to place that study within the context of available
published literature on the topic. <br/>Material(s) and Method(s): The
PubMed database was queried for all English-language entries between 1995
and 2021 with the terms nitric oxide, congenital heart disease,
oscillator, and respiratory failure. The results were then assessed for
relevance and impact by the author. <br/>Result(s): From these results, 15
articles were selected for use in this review. The cost of prolonged
mechanical ventilation is described. The use of nitric oxide has been used
to improve outcomes in hypoxic respiratory failure. High-frequency
oscillator ventilation has also been studied in pediatric patients with
ARDS. To date, no studies have been published showing the benefit of
combining these two modalities in pediatric cardiac surgical patients.
<br/>Discussion(s): The results of this month's study on nitric oxide and
high frequency oscillator ventilation are placed in the context of current
literature and suggestions for further study are presented.
<br/>Conclusion(s): Pediatric patients with hypoxic respiratory failure
following congenital heart surgery have a new treatment strategy that
appears effective. Further studies to confirm this should be
undertaken.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<90>
Accession Number
2014308080
Title
Ultrafiltration and cardiopulmonary bypass associated acute kidney injury:
A systematic review and meta-analysis.
Source
Clinical Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Kandil O.A.; Motawea K.R.; Darling E.; Riley J.B.; Shah J.; Elashhat
M.A.M.; Searles B.; Aiash H.
Institution
(Kandil, Motawea) Faculty of Medicine, Alexandria University, Alexandria,
Egypt
(Darling, Riley, Searles, Aiash) Department of Cardiovascular Perfusion,
State University of New York Upstate Medical University, Syracuse, NY,
United States
(Shah) Medical Research Center, Kateb University, Kabul, Afghanistan
(Elashhat) Aswan Heart Center (Magdy Yacoub Foundation), Aswan
Governorate, Aswan, Egypt
(Aiash) Department of Family Medicine, Faculty of Medicine, Suez Canal
University, Ismailia, Egypt
(Aiash) Department of Surgery, State University of New York Upstate
Medical University, Syracuse, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Cardiopulmonary bypass is known to raise the risk of acute
kidney injury (AKI). Previous studies have identified numerous risk
factors of cardiopulmonary bypass including the possible impact of
perioperative ultrafiltration. However, the association between
ultrafiltration (UF) and AKI remains conflicting. Thus, we conducted a
meta-analysis to further examine the relationship between UF and AKI.
Hypothesis: Ultrafiltration during cardiac surgery increases the risk of
developping Acute kidney Injury. <br/>Method(s): We searched PubMed, Web
of Science, EBSCO, and SCOPUS through July 2021. The RevMan (version 5.4)
software was used to calculate the pooled risk ratios (RRs) and mean
differences along with their associated confidence intervals (95% CI).
<br/>Result(s): We identified 12 studies with a total of 8005 patients.
There was no statistically significant difference in the incidence of AKI
between the group who underwent UF and the control group who did not (RR =
0.90, 95% CI = 0.64-1). Subgroup analysis on patients with previous renal
insufficiency also yielded nonsignificant difference (RR = 0.84, 95% CI =
0.53 -1.33, p =.47). Subgroup analysis based on volume of ultrafiltrate
removed (> or <2900 ml) was not significant and did not increase the AKI
risk as predicted (RR = 0.82, 95% CI = 0.63 -1.07, p =.15). We also did
subgroup analysis according to the type of UF and again no significant
difference in AKI incidence between UF groups and controls was observed in
either the conventional ultrafiltration (CUF), modified ultrafiltration
(MUF), zero-balanced ultrafiltration (ZBUF), or combined MUF and CUF
subgroups. <br/>Conclusion(s): UF in cardiac surgery is not associated
with increased AKI incidence and may be safely used even in baseline
chronic injury patients.<br/>Copyright &#xa9; 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<91>
Accession Number
2012992411
Title
Aspirin-omitted dual antithrombotic therapy in non-valvular atrial
fibrillation patients presenting with acute coronary syndrome or
undergoing percutaneous coronary intervention: Results of a meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 7(3) (pp
218-224), 2021. Date of Publication: 01 May 2021.
Author
Luo C.-F.; Mo P.; Li G.-Q.; Liu S.-M.
Institution
(Luo, Mo, Li, Liu) Department of Cardiology, Guangzhou Institute of
Cardiovascular Disease, The Second Affiliated Hospital of Guangzhou
Medical University, Guangdong Key Laboratory of Vascular Diseases, State
Key Laboratory of Respiratory Disease, Changgangdong Road, 250, Guangzhou,
China
Publisher
Oxford University Press
Abstract
Aims: To investigate the effects of aspirin-omitted dual antithrombotic
therapy (DAT) on myocardial infarction and stent thrombosis in
non-valvular atrial fibrillation (NVAF) patients presenting with acute
coronary syndrome (ACS) or undergoing percutaneous coronary intervention
(PCI). <br/>Methods and Results: A systematic review and meta-analysis
were performed using PubMed to search for randomized clinical trials
comparing DAT with triple antithrombotic therapy (TAT) in this setting.
Three trials involving 8845 patients were included (4802 and 4043 patients
treated with DAT and TAT, respectively). There were no significant
differences in all-cause death and stroke between the aspirin-omitted DAT
group and TAT group. Otherwise, the incidence of myocardial infarction was
significantly higher with aspirin-omitted DAT vs. TAT [odds ratio (OR):
1.29, 95% confidence interval (CI): 1.02-1.63; P = 0.04; I2 = 0%].
Similarly, the incidence of stent thrombosis increased in patients treated
with aspirin-omitted DAT vs. TAT (OR: 1.61, 95% CI: 1.02-2.53; P = 0.04;
I2 = 0%). The occurrence of major bleeding and clinically relevant
non-major bleeding events, as defined by the International Society on
Thrombosis and Haemostasis, was significantly lower with aspirin-omitted
DAT vs. TAT (OR: 0.61, 95% CI: 0.48-0.78; P = 0.02; I2 = 76%). Similar
results were found according to the International Society on Thrombosis
and Haemostasis major bleeding, Thrombolysis in Myocardial Infarction
major or minor bleeding, and Thrombolysis in Myocardial Infarction major
bleeding scales. <br/>Conclusion(s): Aspirin-omitted DAT reduces the
occurrence of bleeding episodes, with a higher rate of myocardial
infarction and stent thrombosis in NVAF patients presenting with ACS or
undergoing PCI.<br/>Copyright &#xa9; The Author(s) 2020.

<92>
Accession Number
2012992409
Title
De-escalation of antiplatelets after percutaneous coronary intervention: A
Bayesian network meta-analysis of various de-escalation strategies.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 7(3) (pp
209-215), 2021. Date of Publication: 01 May 2021.
Author
Khan S.U.; Khan M.Z.; Khan M.S.; Mahmood A.; Kalra A.; Kaluski E.; Michos
E.D.; Alkhouli M.
Institution
(Khan, Khan) Department of Medicine, West Virginia University, 1 Medical
Center Drive, Morgantown, WV 26508, United States
(Khan) Department of Medicine, John H Stroger Jr. Hospital of Cook County,
1969 Ogden Ave, Chicago, IL 60612, United States
(Mahmood) Department of Internal Medicine, Eastern Idaho Regional Medical
Center, 3100 Channing Way, Idaho Falls, ID 83404, United States
(Kalra) Department of Cardiovascular Medicine, Heart and Vascular
Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United
States
(Kaluski) Department of Cardiovascular Medicine, Guthrie Health
System/Robert Packer Hospital, 1 Guthrie Square, Sayre, PA 18840, United
States
(Michos) Division of Cardiology, Department of Medicine, Ciccarone Center
for the Prevention of Cardiovascular Disease, Johns Hopkins School of
Medicine, Blalock 524-B, 600 North Wolfe Street, Baltimore, MD 21287,
United States
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, 200 First
Street SW, Rochester, MN 55905, United States
Publisher
Oxford University Press
Abstract
Aims: To compare early de-escalation of dual antiplatelet therapy (DAPT)
(1-3 months) to monotherapy with either P2Y12 inhibitor or aspirin vs. 12
months DAPT after percutaneous coronary intervention (PCI) with
drug-eluting stent (DES). <br/>Methods and Results: Electronic databases
of Medline, Embase, and Cochrane library were searched through February
2020 to identify randomized controlled trials. A Bayesian network
meta-analysis was conducted with random effects model. The main endpoints
of interest were cardiovascular mortality and total bleeding events. Among
seven trials (35 821 patients), 52.6% patients were presented with acute
coronary syndrome. A total of 3359 patients and 14 530 patients were
de-escalated to aspirin and P2Y12 inhibitor monotherapy, respectively. At
a median follow-up of 12 months, compared with 12 months of DAPT, there
was no significant difference in cardiovascular mortality between 1-month
DAPT followed by P2Y12 inhibitor monotherapy [hazard ratio (HR) 0.84 (95%
credible interval 0.29-2.43)], 3 months of DAPT followed by P2Y12
inhibitor monotherapy [HR 0.74 (0.39-1.46)], or 3 months of DAPT [HR 1.00
(0.54-1.86)] followed by aspirin monotherapy. Except for de-escalation of
DAPT to aspirin monotherapy after 3 months [HR 0.75 (0.43-1.20)],
de-escalation to P2Y12 inhibitor monotherapy after 1 month [HR 0.28
(0.10-0.83)], or 3 months [HR 0.57 (0.33-0.98)] were associated with
significant decrease in total bleeding events. There were no significant
differences in terms of ischaemic endpoints among different DAPT
strategies. <br/>Conclusion(s): Early de-escalation of DAPT (1-3 months)
to monotherapy with a P2Y12 inhibitor instead of aspirin might be a safer
and equally effective approach compared with 12 months of DAPT in patients
with PCI and DES.<br/>Copyright &#xa9; The Author(s) 2020.

<93>
Accession Number
2012278153
Title
The American Association for Thoracic Surgery Congenital Cardiac Surgery
Working Group 2021 consensus document on a comprehensive perioperative
approach to enhanced recovery after pediatric cardiac surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 162(3) (pp 931-954), 2021.
Date of Publication: September 2021.
Author
Fuller S.; Kumar S.R.; Roy N.; Mahle W.T.; Romano J.C.; Nelson J.S.;
Hammel J.M.; Imamura M.; Zhang H.; Fremes S.E.; McHugh-Grant S.; Nicolson
S.C.; Caldarone C.A.; Chen J.M.; Rosengart T.K.; Emani S.M.
Institution
(Fuller) Division of Cardiothoracic Surgery, Department of Surgery, The
Children's Hospital of Philadelphia, Perelman School of Medicine at the
University of Pennsylvania, Philadelphia, Pa, United States
(Kumar) Division of Cardiac Surgery, Department of Surgery, Department of
Pediatrics, Keck School of Medicine of the University of Southern
California, Heart Institute, Children's Hospital Los Angeles, Los Angeles,
Calif, United States
(Roy) Department of Cardiac Surgery, Boston Children's Hospital,
Department of Surgery, Harvard Medical School, Boston, MA, United States
(Mahle) Division of Cardiology, Department of Pediatrics, Emory
University, Children's Healthcare of Atlanta, Atlanta, Ga, United States
(Romano) Departments of Cardiac Surgery and Pediatrics, University of
Michigan, CS Mott Children's Hospital, Ann Arbor, Mich, United States
(Nelson) Department of Cardiovascular Services, Nemours Children's
Hospital, Department of Surgery, University of Central Florida College of
Medicine, Orlando, Fla, United States
(Hammel) Department of Cardiothoracic Surgery, Children's Hospital and
Medical Center of Omaha, Omaha, Neb, United States
(Imamura) Division of Congenital Heart Surgery, Texas Children's Hospital,
Baylor College of Medicine, Houston, Tex, United States
(Zhang) Department of Cardiothoracic Surgery, Shanghai Children's Medical
Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Fremes) Division of Cardiac Surgery, Department of Surgery, Schulich
Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto,
Toronto, ON, Canada
(McHugh-Grant) Division of Cardiothoracic Surgery, The Children's Hospital
of Philadelphia, Philadelphia, Penn, United States
(Nicolson) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology and Critical Care Medicine, The Children's Hospital of
Philadelphia, Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Penn, United States
Publisher
Mosby Inc.

<94>
Accession Number
2010983563
Title
Benefits of mitral valve repair over replacement in the elderly: a
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 36(7) (pp 2524-2530), 2021. Date of
Publication: July 2021.
Author
Di Tommaso E.; Rapetto F.; Guida G.A.; Zakkar M.; Bruno V.D.
Institution
(Di Tommaso, Bruno) Bristol Medical School, Translational Health Science,
University of Bristol, Bristol, United Kingdom
(Rapetto, Guida) Bristol Heart Institute, University Hospital Bristol and
Weston NHS Foundation Trust, Bristol, United Kingdom
(Zakkar) Department of Cardiovascular Sciences, Clinical Sciences Wing,
Glenfield General Hospital, University of Leicester, Leicester, United
Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Mitral valve (MV) repair has demonstrated excellent short- and
long-term outcomes, however, its merit in the elderly population is still
debated. We conducted a meta-analysis of studies that have compared the MV
repair to replacement in the elderly population. <br/>Method(s): A
systematic literature search was conducted for any study published on MV
surgery on elderly patients (>=75 years old). A pooled risk-ratio
meta-analysis was done to evaluate short-term mortality, postoperative
complications, surgical timings, and long-term survival rates.
<br/>Result(s): A total of nine retrospective observational studies were
included in the quantitative meta-analysis. Pooled meta-analysis showed a
reduced risk of short-term mortality for the MV repair group (risk ratio
[RR] = 0.41 [0.24-0.71], p-value =.005). Postoperative neurological
complications were in favor of repair, although not significantly (RR =
0.49 [0.21-1.11], p-value =.07). Operative timings (cardiopulmonary bypass
and crossclamp time) were not different between the groups although no
data were available on the complexity of the repairs. Long-term survival
rates were in favor of the repairs (pooled treatment effect of -0.47
[-0.64; -0.29], p =.005). <br/>Conclusion(s): MV surgery is a safe and
effective procedure for the elderly. MV repair demonstrated better
short-term outcomes compared to replacement. Long-term survival rates are
significantly better after repair.<br/>Copyright &#xa9; 2021 The Authors.
Journal of Cardiac Surgery published by Wiley Periodicals LLC

<95>
Accession Number
2010933939
Title
Absence of electrocardiographic left ventricular hypertrophy and poor
outcome in patients undergoing transcatheter aortic valve replacement-A
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 36(7) (pp 2233-2239), 2021. Date of
Publication: July 2021.
Author
Martha J.W.; Pranata R.; Yonas E.; Wibowo A.; Akbar M.R.
Institution
(Martha, Pranata, Wibowo, Akbar) Department of Cardiology and Vascular
Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum
Pusat Hasan Sadikin, Bandung, Indonesia
(Pranata) Faculty of Medicine, Universitas Pelita Harapan, Tangerang,
Indonesia
(Yonas) Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia
Publisher
John Wiley and Sons Inc
Abstract
Objective: This systematic review and meta-analysis aimed to evaluate
whether the absence of electrocardiographic (ECG) left ventricular
hypertrophy (LVH) was associated with poor outcome in patients undergoing
transcatheter aortic valve replacement (TAVR). <br/>Method(s): We
performed systematic review search on PubMed, Embase, and Scopus up until
January 22, 2021. The key exposure was the absence of ECG LVH, defined as
the absence of LVH by electrocardiographic criteria. The outcome of
interest was composite poor outcome, which is a composite of mortality
and/or rehospitalization after TAVR. The effect estimate was reported as
hazard ratio (HR). In addition, we generate sensitivity and specificity,
positive and negative likelihood ratio (PLR and NLR), diagnostic odds
ratio (DOR), and area under curve (AUC). <br/>Result(s): There are four
studies comprising of 827 patients included in this systematic review and
meta-analysis. The prevalence of poor outcome in this pooled analysis was
30%. The absence of ECG LVH was associated with increased poor outcome in
patients undergoing TAVR (HR: 1.86, [1.34, 2.57], p <.001; I²:
0%). Absence of ECG LVH was associated with a sensitivity of 0.75 [0.64,
0.83], specificity of 0.42 [0.30, 0.55], PLR of 1.3 [1.1, 1.5], NLR of
0.60 [0.45, 0.80], DOR 2 [1, 5], and AUC of 0.66 [0.62, 0.70]. Fagan's
nomogram indicates in a 22% prevalence of poor outcome in the included
studies, the absence of ECG LVH and ECG LVH was associated with 27% and
15% posttest probability for poor outcome, respectively.
<br/>Conclusion(s): Absence of ECG LVH was associated with poor outcome in
patients undergoing TAVR.<br/>Copyright &#xa9; 2021 The Authors. Journal
of Cardiac Surgery published by Wiley Periodicals LLC

<96>
Accession Number
2010888347
Title
The effects of neuro-linguistic programming and guided imagery on the pain
and comfort after open-heart surgery.
Source
Journal of Cardiac Surgery. 36(7) (pp 2389-2397), 2021. Date of
Publication: July 2021.
Author
Dogan A.; Saritas S.
Institution
(Dogan) Department of Nursing, Faculty of Health Sciences, Toros
University, Mersin, Turkey
(Saritas) Department of Surgical Nursing, Faculty of Nursing, Inonu
University, Malatya, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Objective: The present study aims to evaluate the effects of
neuro-linguistic programming (NLP) and guided imagery on postoperative
pain and comfort after open-heart surgery. <br/>Method(s): In the current,
prospective, randomized, single-blind clinical study, the participants
received NLP with a new behavior formation technique or the guided imagery
relaxation technique using an audio compact disc for a duration of 30 min.
<br/>Result(s): The patients in the NLP group had significantly lower
posttest pain levels, compared to the patients in the guided imagery and
control groups. Moreover, the patients in the guided imagery group had
significantly higher posttest comfort levels, compared to the patients in
the NLP and control groups. <br/>Conclusion(s): The application of both
NLP and guided imagery interventions resulted in reduced postoperative
pain and increased postoperative comfort levels after open-heart
surgery.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<97>
Accession Number
636442218
Title
Assessment of Discrepancies between Follow-up Infarct Volume and 90-Day
Outcomes among Patients with Ischemic Stroke Who Received Endovascular
Therapy.
Source
JAMA Network Open. 4(11) (no pagination), 2021. Article Number: e2132376.
Date of Publication: 04 Nov 2021.
Author
Ganesh A.; Ospel J.M.; Menon B.K.; Demchuk A.M.; McTaggart R.A.; Nogueira
R.G.; Poppe A.Y.; Almekhlafi M.A.; Hanel R.A.; Thomalla G.; Holmin S.;
Puetz V.; Van Adel B.A.; Tarpley J.W.; Tymianski M.; Hill M.D.; Goyal M.
Institution
(Ganesh, Menon, Demchuk, Almekhlafi, Hill, Goyal) Calgary Stroke Program,
Department of Clinical Neurosciences, University of Calgary, Calgary, AB,
Canada
(Ospel) Department of Radiology, University Hospital Basel, University of
Basel, Basel, Switzerland
(Menon, Almekhlafi, Hill, Goyal) Seaman Family MR Research Centre,
Department of Radiology, University of Calgary, Foothills Medical Centre,
1403 29 St NW, Calgary, AB T2N 2T9, Canada
(Menon, Almekhlafi, Hill, Goyal) Department of Community Health Sciences,
University of Calgary, Calgary, AB, Canada
(Menon, Demchuk, Almekhlafi, Hill) Hotchkiss Brain Institute, University
of Calgary, Calgary, AB, Canada
(McTaggart) Departments of Diagnostic Imaging, Neurology, and
Neurosurgery, Warren Alpert Medical School, Brown University, Providence,
RI, United States
(Nogueira) Departments of Neurology, Neurosurgery, and Radiology, Emory
University, School of Medicine, Atlanta, GA, United States
(Nogueira) Neuroendovascular Service, Marcus Stroke and Neuroscience
Center, Grady Memorial Hospital, Atlanta, GA, United States
(Poppe) Department of Neurosciences, Centre Hospitalier, L'Universite de
Montreal (CHUM), Universite de Montreal, Montreal, QC, Canada
(Hanel) Lyerly Neurosurgery, Baptist Hospital, Jacksonville, FL, United
States
(Thomalla) Departments of Neurology and Neuroradiology, University Medical
Center Hamburg-Eppendorf, Hamburg, Germany
(Holmin) Department of Clinical Neuroscience, Karolinska Institutet,
Departments of Neuroradiology and Neurology, Karolinska University
Hospital, Stockholm, Sweden
(Puetz) Dresden Neurovascular Center, Department of Neurology, University
Hospital Carl Gustav Carus, Technische Universitat Dresden, Dresden,
Germany
(Van Adel) McMaster University, Hamilton, ON, Canada
(Tarpley) Providence Little Company of Mary Medical Center, Providence
Saint John's Health Center, Pacific Neuroscience Institute, Torrance, CA,
United States
(Tymianski) Division of Neurosurgery and Neurovascular Therapeutics
Program, University Health Network, Departments of Surgery and Physiology,
University of Toronto, Toronto Western Hospital, Research Institute,
Toronto, Canada
(Tymianski) NoNO Inc, Toronto, ON, Canada
(Hill) Department of Medicine, University of Calgary, Cumming School of
Medicine, Calgary, AB, Canada
Publisher
American Medical Association
Abstract
Importance: Some patients have poor outcomes despite small infarcts after
endovascular therapy (EVT), while others with large infarcts do well.
Understanding why these discrepancies occur may help to optimize EVT
outcomes. <br/>Objective(s): To validate exploratory findings from the
Endovascular Treatment for Small Core and Anterior Circulation Proximal
Occlusion with Emphasis on Minimizing CT to Recanalization Times (ESCAPE)
trial regarding pretreatment, treatment-related, and posttreatment factors
associated with discrepancies between follow-up infarct volume (FIV) and
90-day functional outcome. <br/>Design, Setting, and Participant(s): This
cohort study is a post hoc analysis of the Safety and Efficacy of
Nerinetide in Subjects Undergoing Endovascular Thrombectomy for Stroke
(ESCAPE-NA1) trial, a double-blind, randomized, placebo-controlled,
international, multicenter trial conducted from March 2017 to August 2019.
Patients who participated in ESCAPE-NA1 and had available 90-day modified
Rankin Scale (mRS) scores and 24-hour to 48-hour posttreatment follow-up
parenchymal imaging were included. Exposures: Small FIV (volume <=25th
percentile) and large FIV (volume >=75th percentile) on 24-hour computed
tomography/magnetic resonance imaging. Baseline factors, outcomes,
treatments, and poststroke serious adverse events (SAEs) were compared
between discrepant cases (ie, patients with 90-day mRS score >=3 despite
small FIV or those with mRS scores <=2 despite large FIV) and
nondiscrepant cases. <br/>Main Outcomes and Measures: Area under the curve
(AUC) and goodness of fit of prespecified logistic models, including
pretreatment (eg, age, cancer, vascular risk factors) and
treatment-related and posttreatment (eg, SAEs) factors, were compared with
stepwise regression-derived models for ability to identify small FIV with
higher mRS score and large FIV with lower mRS score. <br/>Result(s): Among
1091 patients (median [IQR] age, 70.8 [60.8-79.8] years; 549 [49.7%]
women; median [IQR] FIV, 24.9 mL [6.6-92.2 mL]), 42 of 287 patients
(14.6%) with FIV of 7 mL or less (ie, <=25th percentile) had an mRS score
of at least 3; 65 of 275 patients (23.6%) with FIV of 92 mL or greater
(ie, >=75th percentile) had an mRS score of 2 or less. Prespecified models
of pretreatment factors (ie, age, cancer, vascular risk factors)
associated with low FIV and higher mRS score performed similarly to models
selected by stepwise regression (AUC, 0.92 [95% CI, 0.89-0.95] vs 0.93
[95% CI, 0.90-0.95]; P =.42). SAEs, specifically infarct in new territory,
recurrent stroke, pneumonia, and congestive heart failure, were associated
with low FIV and higher mRS scores; stepwise models also identified
24-hour hemoglobin as treatment-related/posttreatment factor (AUC, 0.92
[95% CI, 0.90-0.95] vs 0.94 [95% CI, 0.91-0.96]; P =.14). Younger age was
associated with high FIV and lower mRS score; stepwise models identified
absence of diabetes and higher baseline hemoglobin as additional
pretreatment factors (AUC, 0.76 [95% CI, 0.70-0.82] vs 0.77 [95% CI,
0.71-0.83]; P =.82). Absence of SAEs, especially stroke progression,
symptomatic intracerebral hemorrhage, and pneumonia, was associated with
high FIV and lower mRS score2; stepwise models also identified 24-hour
hemoglobin level, glucose, and diastolic blood pressure as posttreatment
factors associated with discrepant cases (AUC, 0.80 [95% CI, 0.74-0.87] vs
0.79 [95% CI, 0.72-0.86]; P =.92). <br/>Conclusions and Relevance: In this
study, discrepancies between functional outcome and post-EVT infarct
volume were associated with differences in pretreatment factors, such as
age and comorbidities, and posttreatment complications related to index
stroke evolution, secondary prevention, and quality of stroke unit care.
Besides preventing such complications, optimization of blood pressure,
glucose levels, and hemoglobin levels are potentially modifiable factors
meriting further study..<br/>Copyright &#xa9; 2021 American Medical
Association. All rights reserved.

<98>
Accession Number
2013963717
Title
Slow gait speed is associated with worse postoperative outcomes in cardiac
surgery: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(1) (pp 197-204), 2022. Date of Publication:
January 2022.
Author
Chang J.; Nathalie J.; Nguyenhuy M.; Xu R.; Virk S.A.; Saxena A.
Institution
(Chang) The Royal Melbourne Hospital, Parkville, VIC, Australia
(Nathalie) St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
(Nguyenhuy) Western Hospital, Footscray, VIC, Australia
(Xu) The University of Melbourne, Parkville, VIC, Australia
(Virk) Department of Cardiology, Concord Repatriation General Hospital,
Concord West, NSW, Australia
(Saxena) Department of Cardiothoracic Surgery and Transplantation, Fiona
Stanley Hospital, Murdoch, WA, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Frailty is associated with poorer outcomes in cardiac surgery,
but the heterogeneity in frailty assessment tools makes it difficult to
ascertain its true impact in cardiac surgery. Slow gait speed is a simple,
validated, and reliable marker of frailty. We performed a systematic
review and meta-analysis to examine the effect of slow gait speed on
postoperative cardiac surgical patients. <br/>Method(s): PubMED, MEDLINE,
and EMBASE databases were searched from January 2000 to August 2021 for
studies comparing slow gait speed and "normal" gait speed. Primary outcome
was in-hospital mortality. Secondary outcomes were composite mortality and
major morbidity, AKI, stroke, deep sternal wound infection, prolonged
ventilation, discharge to a healthcare facility, and ICU length of stay.
<br/>Result(s): There were seven eligible studies with 36,697 patients.
Slow gait speed was associated with increased likelihood of in-hospital
mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]:
1.87-2.87). Additionally, they were more likely to suffer from composite
mortality and major morbidity (RR: 1.52; 95% CI: 1.38-1.66), AKI (RR:
2.81; 95% CI: 1.44-5.49), deep sternal wound infection (RR: 1.77; 95% CI:
1.59-1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48-2.63),
reoperation (RR: 1.38; 95% CI: 1.05-1.82), institutional discharge (RR:
2.08; 95% CI: 1.61-2.69), and longer ICU length of stay (MD: 21.69; 95%
CI: 17.32-26.05). <br/>Conclusion(s): Slow gait speed is associated with
poorer outcomes in cardiac surgery. Frail patients are twofold more likely
to die during hospital admission than nonfrail counterparts and are at an
increased risk of developing various perioperative
complications.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<99>
Accession Number
2013959776
Title
Adhesion barriers in cardiac surgery: A systematic review of efficacy.
Source
Journal of Cardiac Surgery. 37(1) (pp 176-185), 2022. Date of Publication:
January 2022.
Author
Head W.T.; Paladugu N.; Kwon J.H.; Gerry B.; Hill M.A.; Brennan E.A.;
Kavarana M.N.; Rajab T.K.
Institution
(Head, Paladugu, Kwon, Gerry, Hill, Kavarana, Rajab) Department of
Surgery, Medical University of South Carolina, Charleston, SC, United
States
(Brennan) Department of Research & Education Services (Libraries), Medical
University of South Carolina, Charleston, SC, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Postoperative pericardial adhesions have been associated with
increased morbidity, mortality, and surgical difficulty. Barriers exist to
limit adhesion formation, yet little is known about their use in cardiac
surgery. The study presented here provides the first major systematic
review of adhesion barriers in cardiac surgery. <br/>Method(s): Scopus and
PubMed were assessed on November 20, 2020. Inclusion criteria were
clinical studies on human subjects, and exclusion criteria were studies
not published in English and case reports. Risk of bias was evaluated with
the Cochrane Risk of Bias Tool. Barrier efficacy data was assessed with
Excel and GraphPad Prism 5. <br/>Result(s): Twenty-five studies were
identified with a total of 13 barriers and 2928 patients.
Polytetrafluoroethylene (PTFE) was the most frequently evaluated barrier
(13 studies, 67% of patients) with adhesion formation rate of 37.31% and
standardized tenacity score of 26.50. Several barriers had improved
efficacy. In particular, Cova CARD had a standardized tenacity score of
15.00. <br/>Conclusion(s): Overall, the data varied considerably in terms
of study design and reporting bias. The amount of data was also limited
for the non-PTFE studies. PTFE has historically been effective in
preventing adhesions. More recent barriers may be superior, yet the
current data is nonconfirmatory. No ideal adhesion barrier currently
exists, and future barriers must focus on the requirements unique to
operating in and around the heart.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC

<100>
Accession Number
2013959738
Title
Comparative efficacy of five surgical methods in the treatment of mitral
regurgitation: A systematic review and network meta-analysis.
Source
Journal of Cardiac Surgery. 37(1) (pp 186-196), 2022. Date of Publication:
January 2022.
Author
Huang W.; Hou B.; Li Q.; Zhang Y.; Wang L.
Institution
(Huang, Hou, Li, Zhang) Baotou Clinical Medical College of Inner Mongolia
Medical University, Baotou, China
(Wang) Department of Cardiology, Baotou Central Hospital, Baotou, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: This study has been compared the effectiveness of different
surgical methods in the treatment of mitral regurgitation (MR) in adults
by using the network meta-analysis method, so as to provide reference for
clinical selection of the best surgical scheme. <br/>Method(s): The
PubMed, EMBASE, the Cochrane Library, CNKI, and Chongqing VIP Information
databases were comprehensively searched until December 2020. We collected
retrospective comparative studies on surgical procedures including 3D
endoscopic mitral valve surgery (3D-MVS), robot-assisted mitral valve
surgery (R-MVS); totally thoracoscopic mitral valve surgery (T-MVS), small
incision mitral valve surgery (M-MVS), and traditional thoracotomy mitral
valve surgery (C-MVS). Stata16.0 and Addis1.16.8 software was used for
network meta-analysis using the Bayesian approach. <br/>Result(s): A total
of 31 studies were included, 12,998 patients, involving five surgical
methods. Network meta-analysis showed that: in terms of complications
(odds ratio [OR]: 0.65, 95% CI: 0.13-3.00, probability rank = 0.37) and MR
(OR: 0.03, 95% CI: 0.0-8315, probability rank = 0.64), the 3D-MVS group
had the lowest event rate. In terms of blood transfusion rate (OR: 0.55,
95% CI: 0.16-1.84, probability rank = 0.45), T-MVS had the lowest event
rate. In addition, with the exception of operation time and chest
drainage, the R-MVS group has the best curative effect.
<br/>Conclusion(s): This minimally invasive surgery has their own
advantages and disadvantages. Overall, 3D-MVS is most satisfactory, but
more samples are needed.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<101>
Accession Number
2013482841
Title
Integrative echocardiographic assessment of patients with secondary mitral
regurgitation undergoing transcatheter edge-to-edge repair.
Source
Catheterization and Cardiovascular Interventions. 98(7) (pp 1404-1412),
2021. Date of Publication: 01 Dec 2021.
Author
Brugger N.; Kassar M.; Siontis G.C.M.; Widmer S.; Okuno T.; Winkel M.G.;
Corpataux N.; Grani C.; Bullesfeld L.; Hunziker L.; Pilgrim T.; Windecker
S.; Praz F.
Institution
(Brugger, Kassar, Siontis, Widmer, Okuno, Winkel, Corpataux, Grani,
Hunziker, Pilgrim, Windecker, Praz) Department of Cardiology, Inselspital,
University of Bern, Bern, Switzerland
(Bullesfeld) Department of Internal Medicine and Cardiology, GFO Hospitals
Bonn, Bonn, Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To investigate whether the integrative echocardiographic
criteria used in the cardiovascular outcomes assessment of the mitraclip
percutaneous therapy (COAPT) for heart failure patients with functional
mitral regurgitation study predict outcomes after edge-to-edge
trancatheter mitral valve repair (TMVr) for the treatment of secondary
mitral regurgitation (SMR). <br/>Background(s): Two randomized controlled
trials comparing TMVr to medical treatment reported conflicting findings.
Differences in patient selection criteria may have contributed to these
diverging results. <br/>Method(s): Patients undergoing TMVr were
stratified following the integrative COAPT echocardiographic criteria in
noneligible and eligible patients who were further classified into three
tiers according to effective regurgitant orifice (EROA) (Tier 1: EROA >=
0.3cm²; Tier 2: EROA 0.2cm² and 0.29cm²;
Tier 3: EROA<0.2cm²) combined with several other severity
criteria. We assessed between group differences in all-cause mortality,
successful SMR reduction, and symptom relief from baseline to 2-year
follow-up. <br/>Result(s): Between March 2011 and March 2018, 138 patients
(mean age 75 years) satisfying the inclusion criteria underwent TMVr for
treatment of symptomatic SMR. The mean EROA area was 0.35 +/- 0.17
mm². Ten patients (7%) died within 30 days, 29 (21%) within 12
months, and 41 (30%) within 2 years. After stratification according to the
COAPT echocardiographic criteria that were fulfilled in 72% of the studied
population, Tier 2 patients (45%), as well as noneligible patients (38%)
had a higher mortality rate compared to those in Tier 1 (19%).
<br/>Conclusion(s): SMR patients stratified into tiers according to the
COAPT integrative echocardiographic criteria have diverging prognostic and
symptomatic benefit after edge-to-edge TMVr.<br/>Copyright &#xa9; 2021
Wiley Periodicals LLC.

<102>
Accession Number
2013410248
Title
Direct oral anticoagulants in patients with atrial fibrillation and
bioprosthetic valve replacement: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 98(7) (pp E1007-E1016),
2021. Date of Publication: 01 Dec 2021.
Author
Lacy S.C.; Saint Croix G.R.; Porter K.; Latib A.; Beohar N.
Institution
(Lacy) Loyola University Medical Center, Maywood, IL, United States
(Saint Croix, Beohar) Columbia University Division of Cardiology at Mount
Sinai Medical Center, Miami Beach, FL, United States
(Porter) Jackson Memorial Hospital/University of Miami Hospital, Miami,
FL, United States
(Latib) Montefiore Medical Center, Albert Einstein College of Medicine,
New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This systematic review and meta-analysis compares direct oral
anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in patients
with atrial fibrillation and bioprosthetic valve replacement or repair
(BVR). <br/>Background(s): The optimal anticoagulation therapy for
patients with atrial fibrillation and a history of bioprosthetic valve
replacement or repair (BVR) is not well understood. <br/>Method(s): We
performed a systematic literature review to identify clinical studies that
compared anticoagulation therapies for patients with atrial fibrillation
and BVR. The primary outcomes of stroke, major bleeding, and mortality
were reported as random effects risk ratio (RR) with 95% confidence
interval. No prior ethical approval was required since all data is public.
<br/>Result(s): Our search yielded 101 potential studies. We included six
studies reporting on 1911 patients. There was a lower risk of stroke and
major bleeding in patients with atrial fibrillation after BVR treated with
DOACs when compared to VKAs with risk ratios of 0.44 (95% CI 0.24-0.82, p
< 0.01) and 0.53 (95% CI 0.34-0.83, p < 0.01), respectively. There was no
statistically significant difference in mortality between patients with
atrial fibrillation after BVR treated with DOACs compared to patients
treated with VKAs with a risk ratio of 1.12 (95% CI 0.73-1.74, p = 0.60).
<br/>Conclusion(s): This systematic review and meta-analysis suggests that
DOACs are superior to VKAs with respect to stroke and major bleeding in
patients with atrial fibrillation and BVR.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC.

<103>
Accession Number
2010667182
Title
Music reduces patient-reported pain and anxiety and should be routinely
offered during flexible cystoscopy: Outcomes of a systematic review.
Source
Arab Journal of Urology. 19(4) (pp 480-487), 2021. Date of Publication:
2021.
Author
Gauba A.; Ramachandra M.N.; Saraogi M.; Geraghty R.; Hameed B.M.Z.;
Abumarzouk O.; Somani B.K.
Institution
(Gauba, Ramachandra, Saraogi, Geraghty, Somani) Department of Urology,
University Hospital Southampton NHS Trust, Southampton, United Kingdom
(Hameed) Department of Urology, Kasturba Medical College Manipal, Manipal
Academy of Higher Education, Manipal, India
(Abumarzouk) Department of Surgery, Hamad General Hospital, Hamad Medical
Corporation, Doha, Qatar
Publisher
Taylor and Francis Ltd.
Abstract
Objective: To conduct a systematic review of the literature to assess
whether music reduces the use of analgesics and anxiolytics during
flexible cystoscopy. <br/>Method(s): The systematic review was performed
in line with the Cochrane guidelines and Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) checklist. The databases
searched included the Medical Literature Analysis and Retrieval System
Online (MEDLINE), Scopus, Cumulative Index to Nursing and Allied Health
Literature (CINAHL), Clinicaltrials.gov, the Excerpta Medica dataBASE
(EMBASE), Cochrane library, Google Scholar, and Web of Science from
inception of the databases to February 2020. The primary outcome measure
was the effect of music on pain and anxiety, and secondary outcome
measures were patient heart rate and blood pressure. <br/>Result(s): The
initial search yielded 234 articles and after going through titles and
abstracts, four studies (399 patients, 199 in the music group and 200 in
no music group) were included for the final review. There were three
randomised controlled trials and one prospective study published between
2014 and 2017. These studies were done in China, the USA and Italy, with
the study duration between 9 and 24 months. All patients had 2% topical
lignocaine jelly given per-urethra before the procedure. The choice of
music was classical in three studies and a mixture of different music
types in one study. Three of the four studies showed significantly reduced
pain and anxiety with the use of music for flexible cystoscopy procedures.
Heart rate was noted to be higher for the no music group, reflecting a
higher pain perceived by these patients. <br/>Conclusion(s): The present
review showed that listening to music was associated with reduced anxiety
and pain during flexible cystoscopy. Listening to music is therefore
likely to increase procedural satisfaction and willingness to undergo the
procedure again, considering repeated flexible cystoscopy is often needed
for surveillance. As music is simple, inexpensive and easily accessible,
it should be routinely offered to patients for outpatient and office-based
urological procedures. Abbreviations: IQR: interquartile range; NRS:
numerical rating scale; PTSD: post-traumatic stress disorder; RCT:
randomised control trial; STAI: State-trait Anxiety Inventory; VAS: visual
analogue scale.<br/>Copyright &#xa9; 2021 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.