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<1>
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

<2>
Accession Number
2013281853
Title
Network meta-analysis of treatment strategies in patients with coronary
artery disease and low left ventricular ejection fraction.
Source
Journal of Cardiac Surgery. 36(10) (pp 3834-3842), 2021. Date of
Publication: October 2021.
Author
Yokoyama Y.; Fukuhara S.; Mori M.; Noguchi M.; Takagi H.; Briasoulis A.;
Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Mori) Division of Cardiac Surgery, Yale School of Medicine, New Haven,
CT, United States
(Noguchi) Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical
Center, Urayasu, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Briasoulis) Division of Cardiology, Heart failure and Transplantation,
University of Iowa, Iowa City, IA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York City, NY, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein Medical College, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: The optimal treatment strategy in patients with coronary artery
disease (CAD) and low left ventricular ejection fraction (LVEF) remains
controversial. Herein, we conducted a network meta-analysis comparing
coronary artery bypass graft (CABG), percutaneous coronary intervention
(PCI), and optimal medical therapy (OMT) in patients with CAD and low
LVEF. <br/>Method(s): MEDLINE and EMBASE were searched through March, 2021
to identify randomized controlled trials (RCTs) and propensity-score
matched (PSM) studies comparing CABG, PCI, and OMT. We extracted hazard
ratios (HRs) of the outcomes. <br/>Result(s): A total of three RCTs and 10
PSM trials were identified, yielding a total of 18,855 patients with CAD
with low EF who were treated with CABG (n = 9241), PCI (n = 8771), or OMT
(n = 1003). All-cause mortality was significantly lower in patients with
CABG compared with those with PCI or OMT (HR [95% confidence interval
(CI)] = 0.72 [0.62-0.82], p <.001, HR [95% CI] = 0.65 [0.51-0.82], p
=.004, respectively), while no difference was observed between PCI and
OMT. The rates of MI were significantly lower in patients treated with
CABG compared to those treated with PCI or OMT. However, the subgroup
analysis by limiting the PCI group to patients who received drug-eluting
stent (DES) showed similar all-cause mortality between CABG and PCI, while
both CABG and PCI were associated with lower all-cause mortality compared
with OMT. Concluion: The present study demonstrated that CABG was the
appropriate treatment strategy in patients with CAD and low LVEF. Further
long-term trials were warranted to investigate outcomes of PCI with DES
compared with CABG.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<3>
Accession Number
2014713868
Title
Applicability of Transcatheter Aortic Valve Replacement Trials to
Real-World Clinical Practice: Findings From EXTEND-CoreValve.
Source
JACC: Cardiovascular Interventions. 14(19) (pp 2112-2123), 2021. Date of
Publication: 11 Oct 2021.
Author
Butala N.M.; Secemsky E.; Kazi D.S.; Song Y.; Strom J.B.; Faridi K.F.;
Brennan J.M.; Elmariah S.; Shen C.; Yeh R.W.
Institution
(Butala, Secemsky, Kazi, Strom, Shen, Yeh) Richard A. and Susan F. Smith
Center for Outcomes Research in Cardiology, Division of Cardiovascular
Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
(Butala, Elmariah) Cardiology Division, Department of Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Song) Baim Institute for Clinical Research, Boston, MA, United States
(Faridi) Section of Cardiology, Department of Medicine, Yale School of
Medicine, New Haven, CT, United States
(Brennan) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to examine the applicability of
pivotal transcatheter aortic valve replacement (TAVR) trials to the
real-world population of Medicare patients undergoing TAVR.
<br/>Background(s): It is unclear whether randomized controlled trial
results of novel cardiovascular devices apply to patients encountered in
clinical practice. <br/>Method(s): Characteristics of patients enrolled in
the U.S. CoreValve pivotal trials were compared with those of the
population of Medicare beneficiaries who underwent TAVR in U.S. clinical
practice between November 2, 2011, and December 31, 2017. Inverse
probability weighting was used to reweight the trial cohort on the basis
of Medicare patient characteristics, and a "real-world" treatment effect
was estimated. <br/>Result(s): A total of 2,026 patients underwent TAVR in
the U.S. CoreValve pivotal trials, and 135,112 patients underwent TAVR in
the Medicare cohort. Trial patients were mostly similar to real-world
patients at baseline, though trial patients were more likely to have
hypertension (50% vs 39%) and coagulopathy (25% vs 17%), whereas
real-world patients were more likely to have congestive heart failure (75%
vs 68%) and frailty. The estimated real-world treatment effect of TAVR was
an 11.4% absolute reduction in death or stroke (95% CI: 7.50%-14.92%) and
an 8.7% absolute reduction in death (95% CI: 5.20%-12.32%) at 1 year with
TAVR compared with conventional therapy (surgical aortic valve replacement
for intermediate- and high-risk patients and medical therapy for
extreme-risk patients). <br/>Conclusion(s): The trial and real-world
populations were mostly similar, with some notable differences.
Nevertheless, the extrapolated real-world treatment effect was at least as
high as the observed trial treatment effect, suggesting that the absolute
benefit of TAVR in clinical trials is similar to the benefit of TAVR in
the U.S. real-world setting.<br/>Copyright &#xa9; 2021 American College of
Cardiology Foundation

<4>
Accession Number
2014713866
Title
Impact of Annular Oversizing on Paravalvular Regurgitation and Valve
Hemodynamics: New Insights From PARTNER 3.
Source
JACC: Cardiovascular Interventions. 14(19) (pp 2158-2169), 2021. Date of
Publication: 11 Oct 2021.
Author
Ihdayhid A.R.; Leipsic J.; Hahn R.T.; Pibarot P.; Thourani V.; Makkar R.;
Kodali S.; Russo M.; Kapadia S.; Chen Y.; Mack M.; Webb J.; Bax J.; Leon
M.B.; Blanke P.
Institution
(Ihdayhid, Leipsic, Blanke) Department of Radiology, University of British
Columbia, Vancouver, BC, Canada
(Ihdayhid, Leipsic, Webb, Leon, Blanke) Department of Cardiology,
University of British Columbia, Vancouver, BC, Canada
(Hahn, Kodali) Columbia University Medical Center, New York-Presbyterian
Hospital, New York, NY, United States
(Pibarot) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Universite Laval, Quebec City, QC, Canada
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Russo) Rutgers Health, New Brunswick, NJ, United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Chen) Department of Biostatistics, Edwards Lifesciences, Irvine, CA,
United States
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Bax) Leiden University Medical Center, Leiden, Netherlands
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to investigate the impact of computed
tomography (CT)-based area and perimeter oversizing on the incidence of
paravalvular regurgitation (PVR) and valve hemodynamics in patients
treated with the SAPIEN 3 transcatheter heart valve (THV).
<br/>Background(s): The incremental value of considering annular perimeter
or left ventricular outflow tract measurements and the impact of THV
oversizing on valve hemodynamics are not well defined. <br/>Method(s): The
PARTNER 3 (Placement of Aortic Transcatheter Valves 3) trial included 495
low-surgical-risk patients with severe aortic stenosis who underwent THV
implantation. THV sizing was based on annular area assessed by CT. Area-
and perimeter-based oversizing was determined using systolic annular CT
dimensions and nominal dimensions of the implanted THV. PVR, effective
orifice area, and mean gradient were assessed on 30-day transthoracic
echocardiography. <br/>Result(s): Of 485 patients with available CT and
echocardiography data, mean oversizing was 7.9 +/- 8.7% for the annulus
area and 2.1 +/- 4.1% for the perimeter. A very low incidence of
>=moderate PVR (0.6%) was observed, including patients with minimal
annular oversizing. Incidence of >=mild PVR and need for procedural
post-dilatation were inversely related to the degree of oversizing. For
patients with annular dimensions suitable for 2 THV sizes, the larger THV
with both area and perimeter oversizing was associated with the lowest
incidence of >=mild PVR (12.0% vs 43.4%; P < 0.0001). Left ventricular
outflow tract area oversizing was not associated with PVR. THV prosthesis
size, rather than degree of oversizing, had greatest impact on effective
orifice area and mean gradient. <br/>Conclusion(s): In low-surgical-risk
patients, a low incidence of >=moderate PVR was observed, including
patients with minimal THV oversizing. The degree of prosthesis oversizing
had the greatest impact on reducing mild PVR and incidence of
post-dilatation, without impacting valve hemodynamics. In selected
patients with annular dimensions in between 2 valve sizes, the larger THV
device oversized to both the annular area and perimeter reduced PVR and
optimized THV hemodynamics.<br/>Copyright &#xa9; 2021

<5>
Accession Number
2013785921
Title
Iron supplementation for patients undergoing cardiac surgery: a systematic
review and meta-analysis of randomized controlled trials.
Source
Canadian Journal of Anesthesia. 69(1) (pp 129-139), 2022. Date of
Publication: January 2022.
Author
Yang S.S.; Al Kharusi L.; Gosselin A.; Chirico A.; Baradari P.G.; Cameron
M.J.
Institution
(Yang, Al Kharusi, Gosselin, Chirico, Baradari, Cameron) Faculty of
Medicine, McGill University, Montreal, QC, Canada
(Yang, Cameron) Division of Critical Care, Department of Anesthesia,
Jewish General Hospital, K1400-3755, Cote Sainte Catherine, Montreal, QC
H3T 1E2, Canada
Publisher
Springer
Abstract
Purpose: Iron supplementation has been evaluated in several randomized
controlled trials (RCTs) for its potential to increase baseline hemoglobin
and decrease red blood cell transfusion during cardiac surgery. This
study's main objective was to evaluate the current evidence for iron
administration in cardiac surgery patients. <br/>Method(s): We searched
MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar
from inception to 19 November 2020 for RCTs evaluating perioperative iron
administration in adult patients undergoing cardiac surgery. The RCTs were
assessed using a risk of bias assessment and the quality of evidence was
assessed using the grading of recommendations, assessments, development,
and evaluations. <br/>Result(s): We reviewed 1,767 citations, and five
studies (n = 554) met the inclusion criteria. The use of iron showed no
statistical difference in incidence of transfusion (risk ratio, 0.86; 95%
confidence interval, 0.65 to 1.13). Trial sequential analysis suggested an
optimal information size of 1,132 participants, which the accrued
information size did not reach. <br/>Conclusion(s): The current literature
does not support or refute the routine use of iron therapy in cardiac
surgery patients. Trial registration: PROSPERO (CRD42020161927);
registered 19 December 2019.<br/>Copyright &#xa9; 2021, Canadian
Anesthesiologists' Society.

<6>
Accession Number
2015687216
Title
Meta-Analysis of Nonrandomized Studies to Assess the Optimal Timing of
Coronary Artery Bypass Grafting After Acute Myocardial Infarction.
Source
American Journal of Cardiology. 164 (pp 44-51), 2022. Date of Publication:
01 Feb 2022.
Author
Weigel F.; Nudy M.; Krakowski G.; Ahmed M.; Foy A.
Institution
(Weigel, Ahmed) Department of Internal Medicine
(Nudy, Krakowski, Foy) Division of Cardiology, Penn State Milton S.
Hershey Medical Center, Hershey, PA, United States
Publisher
Elsevier Inc.
Abstract
The optimal timing of coronary artery bypass grafting (CABG) in patients
after an acute myocardial infarction (MI) is unknown. We performed a
systematic review and meta-analysis of studies comparing mortality rates
in patients who underwent CABG at different time intervals after acute MI.
Bias assessments were completed for each study, and summary of proportions
of all-cause mortality were calculated based on CABG at various time
intervals after MI. A total of 22 retrospective studies, which included a
total of 137,373 patients were identified. The average proportion of
patients who died when CABG was performed within 6 hours of MI was 12.7%,
within 6 to 24 hours of MI was 10.9%, within 1 day of MI was 9.8%, any
time after 1 day of MI was 3.0%, within 7 days of MI was 5.9%, and any
time after 7 days of MI was 2.7%. Interstudy heterogeneity, assessed using
I² values, showed significant heterogeneity in death rates
within subgroups. Only 1 study accounted for immortal time bias, and there
was a serious risk of selection bias in all other studies. Confounding was
found to be a serious risk for bias in 55% of studies because of a lack of
accounting for type of MI, MI severity, or other verified cardiac risk
factors. The current publications comparing timing of CABG after MI is at
serious risk of bias because of patient selection and confounding, with
heterogeneity in both study populations and intervention time
intervals.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<7>
Accession Number
2015888685
Title
Tissue Doppler echocardiography in children with OSA before and after
tonsillectomy and adenoidectomy: A systematic review and meta-analysis.
Source
International Journal of Pediatric Otorhinolaryngology. 152 (no
pagination), 2022. Article Number: 111002. Date of Publication: January
2022.
Author
Poupore N.S.; Gudipudi R.; Nguyen S.A.; Pecha P.P.; Pecha T.J.; Carroll
W.W.
Institution
(Poupore, Gudipudi, Nguyen, Pecha, Carroll) Medical University of South
Carolina, Department of Otolaryngology - Head and Neck Surgery, 135
Rutledge Avenue, MSC550, Charleston, SC 29425, United States
(Poupore) University of South Carolina School of Medicine Greenville, 607
Grove Road, Greenville, SC 29605, United States
(Gudipudi) Case Western Reserve University School of Medicine, 9501 Euclid
Ave, Cleveland, OH 44106, United States
(Pecha) Medical University of South Carolina, Department of Anesthesia and
Perioperative Medicine, 167 Ashley Avenue, MSC912, Charleston, SC 29425,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: When to order an echocardiogram in children with obstructive
sleep apnea (OSA) is debated. Studies evaluating the utility of
pre-operative standard echocardiography are inconsistent. Tissue Doppler
imaging (TDI) is an additional technique that quantifies the velocity of
myocardial motion to assess cardiac function. The utility of TDI in
pediatric OSA remains unclear. <br/>Method(s): A systematic review and
meta-analysis were performed in accordance with PRISMA guidelines using
PubMed, Scopus, CINAHL, and Cochrane Library databases. Studies of
echocardiographic findings using TDI in children with polysomnogram
confirmed OSA before and after tonsillectomy and adenoidectomy (T&A) were
included. 1,423 studies were screened, and 4 studies met inclusion
criteria. Meta-analysis of echocardiographic findings was performed.
<br/>Result(s): Data from 560 children were analyzed. Study groups
included pre- and post-T&A children with OSA and non OSA controls. Pre-T&A
S' wave at the tricuspid annulus (S' RV) was decreased with a mean
difference of -1.04 [95% CI -1.57, -0.52, p < 0.001] and E'/A' ratio at
the mitral annulus (E'/A' LV) was decreased with a mean difference of
-0.74 [95% CI -0.85, -0.64, p < 0.001] when compared to controls. These
variables were not statistically different when comparing post-T&A to
controls. <br/>Conclusion(s): TDI appears to successfully detect
subclinical changes in cardiac function in children with OSA. However,
echocardiography parameters of post-T&A and non OSA control children were
similar. Further prospective studies stratified by OSA severity are needed
with both TDI and standard echocardiography to define the utility of
pre-operative cardiac imaging.<br/>Copyright &#xa9; 2021 Elsevier B.V.

<8>
Accession Number
2015885807
Title
Dexmedetomidine Use in Intensive Care Unit Sedation and Postoperative
Recovery in Elderly Patients Post-Cardiac Surgery (DIRECT).
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Chitnis S.; Mullane D.; Brohan J.; Noronha A.; Paje H.; Grey R.; Bhalla
R.K.; Sidhu J.; Klein R.
Institution
(Chitnis, Mullane, Brohan, Grey, Klein) Department of Anesthesiology and
Perioperative Care, Vancouver General and UBC Hospitals, Vancouver, BC,
Canada
(Chitnis) Department of Anaesthesia and Pain Medicine, Fiona Stanley
Hospital, Murdoch, Perth, Western Australia, Australia
(Brohan) Department of Anaesthesia, Cork University Hospital, Wilton,
Cork, Ireland
(Noronha, Paje) Vancouver Coastal Health, Vancouver, BC, Canada
(Bhalla) Neuropsychology Service, Vancouver General Hospital, 899 W 12th
Avenue, Vancouver, BC V5Z 1M9, Canada
(Bhalla) Division of Psychiatry, University of British Columbia,
Vancouver, BC V6T 1Z4, Canada
(Sidhu) Department of Psychiatry, Vancouver General Hospital, Vancouver,
BC, Canada
Publisher
W.B. Saunders
Abstract
Objective: This study examined recovery, delirium, and neurocognitive
outcome in elderly patients receiving dexmedetomidine or propofol sedation
after undergoing cardiac surgery. <br/>Design(s): Open-label randomized
trial. <br/>Setting(s): Single center. <br/>Participant(s): A total of 70
patients older than 75 years without English language limitations and Mini
Mental State Examination scores >20. <br/>Intervention(s): Patients
received either propofol (group P) or dexmedetomidine (group D)
postoperatively until normothermic and hemodynamically stable.
<br/>Measurements and Main Results: Quality of recovery (QoR) was measured
by the QoR-40 questionnaire on postoperative day (POD) three. Secondary
outcomes were incidence and duration of delirium, time to extubation,
length of hospital stay, hospital mortality rate, postoperative quality of
life (QoL; measured by SF-36 performed at baseline and six months
postoperatively), and neurocognitive disorder (measured by Minnesota
Cognitive Acuity Screen [MCAS] performed at baseline, POD5, and six months
postoperatively). A total of sixty-seven patients completed the trial.
There was no significant difference in QoR-40 scores (95% confidence
interval [CI], -7.6081-to-10.9781; p = 1.000), incidence of delirium
(group P, 42%; group D, 24%; p = 0.191), mean hospital stay (95% CI,
-5.4838-to-1.5444; p = 0.297), mean time to extubation (95% CI,
-19.2513-to-7.5561; p = 0.866), or mean duration of delirium (95% CI,
-4.3065-to-1.067; p = 0.206) between groups. No patients died in the
hospital. There were no significant differences in changes in SF-36 or
MCAS scores over time between groups. There was a decline in MCAS score
from preoperatively to POD5 in group P (95% CI, -8.95725-to- -2.61775; p =
0.0005), which was greater than that observed in group D.
<br/>Conclusion(s): The authors' findings demonstrated that the use of
dexmedetomidine compared with propofol in elderly patients undergoing
cardiac surgery was unlikely to improve QoR/postoperative QoL. Although
the study was underpowered to detect secondary outcomes, the results
suggested no reductions in delirium, time to extubation, and hospital
stay, but a potential decrease in delayed neurocognitive
recovery.<br/>Copyright &#xa9; 2021

<9>
Accession Number
2016158441
Title
Comparing the Effects of Gamification and Teach-Back Training Methods on
Adherence to a Therapeutic Regimen in Patients after Coronary Artery
Bypass Graft Surgery: Randomized Clinical Trial.
Source
Journal of Medical Internet Research. 23(12) (no pagination), 2021.
Article Number: e22557. Date of Publication: December 2021.
Author
Ghorbani B.; Jackson A.C.; Noorchenarboo M.; Mandegar M.H.; Sharifi F.;
Mirmoghtadaie Z.; Bahramnezhad F.
Institution
(Ghorbani) School of Nursing and Midwifery, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Jackson) Australian Centre for Heart Health, Melbourne, Australia
(Jackson) Faculty of Health, Deakin University, Geelong, Australia
(Jackson) Centre on Behavioural Health, Hong Kong University, Hong Kong
(Noorchenarboo) Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Mandegar) Department of Cardiac Surgery, Shariati Hospital, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sharifi) Elderly Health Research Center, Endocrinology and Metabolism
Population Sciences Research Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Mirmoghtadaie) Shaheed Beheshti University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Bahramnezhad) School of Nursing & Midwifery, Nursing and Midwifery Care
Research Center, Spiritual Health Group, Research Center of Quran, Hadith
and Medicine, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
JMIR Publications Inc.
Abstract
Background: Patients undergoing coronary artery bypass graft surgery
(CABGS) may fail to adhere to their treatment regimen for many reasons.
Among these, one of the most important reasons for nonadherence is the
inadequate training of such patients or training using inappropriate
methods. <br/>Objective(s): This study aimed to compare the effect of
gamification and teach-back training methods on adherence to a therapeutic
regimen in patients after CABGS. <br/>Method(s): This randomized clinical
trial was conducted on 123 patients undergoing CABGS in Tehran, Iran, in
2019. Training was provided to the teach-back group individually. In the
gamification group, an app developed for the purpose was installed on each
patient's smartphone, with training given via this device. The control
group received usual care, or routine training. Adherence to the
therapeutic regimen was assessed using a questionnaire on adherence to a
therapeutic regimen (physical activity and dietary regimen) and an
adherence scale as a pretest and a 1-month posttest. <br/>Result(s):
One-way analysis of variance (ANOVA) for comparing the mean scores of
teach-back and gamification training methods showed that the mean
normalized scores for the dietary regimen (P<.001, F=71.80), movement
regimen (P<.001, F=124.53), and medication regimen (P<.001, F=9.66) before
and after intervention were significantly different between the
teach-back, gamification, and control groups. In addition, the results of
the Dunnett test showed that the teach-back and gamification groups were
significantly different from the control group in all three treatment
regimen methods. There was no statistically significant difference in
adherence to the therapeutic regimen between the teach-back and control
groups. <br/>Conclusion(s): Based on the results of this study, the use of
teach-back and gamification training approaches may be suggested for
patients after CABGS to facilitate adherence to the therapeutic
regimen.<br/>Copyright &#xa9; Banafsheh Ghorbani, Alun C Jackson, Mohammad
Noorchenarboo, Mohammad H Mandegar, Farshad Sharifi, Zohrehsadat
Mirmoghtadaie, Fatemeh Bahramnezhad. Originally published in the Journal
of Medical Internet Research (https://www.jmir.org),10.12.2021. This is an
open-access article distributed under the terms of the Creative Commons
Attribution License (https://creativecommons.org/licenses/by/4.0/), which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original work, first published in the Journal of Medical
Internet Research, is properly cited. The complete bibliographic
information, a link to the original publication on https://www.jmir.org/,
as well as this copyright and license information must be included.

<10>
Accession Number
636682518
Title
Pyoderma Gangrenosum after Cardiac Surgery.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2021. Date of
Publication: 2021.
Author
Petrov A.; Kappert U.; Schmidt T.; Matschke K.E.; Wilbring M.
Institution
(Petrov, Kappert, Matschke, Wilbring) Department of Cardiac Surgery,
University Heart Center Dresden, Fetscherstrasse 76, Dresden 01307,
Germany
(Schmidt) Department of Cardiac Anesthesiology, University Heart Center
Dresden, Dresden, Germany
Publisher
Georg Thieme Verlag
Abstract
Background Pyoderma gangrenosum after cardiac surgery is a rare,
noninfectious ulcerating skin disease mimicking sternal wound infection.
Methods A systematic search of literature for pyoderma gangrenosum
complicating cases of cardiac surgery was conducted between September 1985
and September 2020 on PubMed and Cochrane databases. A systematic review
and detailed overview of clinical presentation, diagnostic, treatment, and
outcome is provided. Results A total of 15 studies enclosing 15 patients
suffering from pyoderma gangrenosum following cardiac surgery were
identified. Onset of symptoms was observed after a median of 5 days.
Patients were predominantly male (81.3%) with a median age of 64 years.
Typical clinical presentation mimicked sternal site infection, mainly by
means of mediastinitis. Specific signs were rapid progression,
erythematous to violaceous color of the wound border, accompanied by
unspecific symptoms including fever, malaise, and severe pain.
Additionally, pathergy (development of ulcers at the sites of minor
cutaneous trauma) was reported frequently. Biopsy is mandatory with a
cutaneous neutrophilic inflammation confirming the diagnosis. Initial
treatment mostly (75.0% of reported cases) was misled, addressing
suspicion of surgical site infection. After correct diagnosis, the
treatment was switched to an immunosuppressive therapy. Full sternal wound
closure took between 5 weeks and 5 months. Reported case mortality was
12.5% in actually low-risk surgeries. Conclusion Despite pyoderma
gangrenosum has typical signs, it remains an exclusion diagnosis. The
treatment is completely opposite to the main differential diagnosis-the
typical surgical site infection. Knowledge about diagnosis and treatment
is essential in the context of avoiding fatal mistreatment.<br/>Copyright
&#xa9; 2021 American Medical Association. All rights reserved.

<11>
Accession Number
636681128
Title
Scientific Publishing Differences between Sexes in Cardiology, Cardiac,
and General Surgery.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2021. Date of
Publication: 2021.
Author
Farber G.; Alscher L.; Heyne E.; Doenst T.; Schwarzer M.
Institution
(Farber, Alscher, Heyne, Doenst, Schwarzer) Department of Cardiothoracic
Surgery, Jena University Hospital, Thuringen, Jena 07747, Germany
Publisher
Georg Thieme Verlag
Abstract
Background Research and scientific publications are important for the
advancement of science but also for the individual career development.
While women have become the majority of students in medicine we do not
know about female presence and scientific activity in cardiac surgery. We
thus aimed to compare scientific output of women and men in German
University departments of cardiac surgery with cardiology departments
focusing on the same organ and surgical departments not addressing the
heart (general surgery) of 34 universities in Germany. Methods Personnel
working at University departments was identified on the institutions
internet homepage in 2014. Publications in 2011 to 2013 on PubMed were
identified. Author and manuscript characteristics were determined. Results
A lower proportion of women were working in cardiac surgery (25%) compared
with cardiology (35%) and general (32%) surgery independent of executive
function or academic degree. Scientifically active women published fewer
manuscripts per capita than men both, in total and as first author.
Additionally, the mean and the cumulated journal impact factor of the
journals chosen was lower for women compared with men in cardiology but
not in cardiac and general surgery. Conclusion We conclude that the
differences in scientific activity between women and men are more
pronounced in cardiology compared with general and cardiac surgery,
indicating that a higher proportion of women in a field does not result in
reduced differences between sexes. The low number of women together with
the lower number of manuscripts in cardiac surgery may render the
appointment of women as directors challenging.<br/>Copyright &#xa9; 2021
American Medical Association. All rights reserved.

<12>
Accession Number
2014440544
Title
Effect of energy- and/or protein-dense enteral feeding on postoperative
outcomes of infant surgical patients with congenital cardiac disease: A
systematic review and meta-analysis.
Source
Nutrition in Clinical Practice. (no pagination), 2021. Date of
Publication: 2021.
Author
Singal A.; Sahu M.K.; Trilok Kumar G.; Kumar A.
Institution
(Singal) Department of Food and Nutrition, Institute of Home Economics,
University of Delhi, New Delhi, India
(Sahu) Department of Cardiothoracic and Vascular Surgery, CT Centre, All
India Institute of Medical Sciences, New Delhi, India
(Trilok Kumar) Institute of Home Economics, University of Delhi, New
Delhi, India
(Kumar) Department of Neurology, All India Institute of Medical Sciences,
New Delhi, India
Publisher
John Wiley and Sons Inc
Abstract
Infants with congenital heart disease (CHD) are malnourished because of
poor dietary intakes and increased requirements. Energy requirements are
higher due to increased resting energy expenditure. There are lacunae of
nutrition recommendations for these infants. Therefore, this systematic
review and meta-analysis was conducted to determine the effect of energy-
and/or protein-dense feeds in postoperative CHD infants as compared with
the standard feeding. An online literature search was performed on four
databases by using different English-language keywords between 2000 and
2020. The inclusion criteria were peer reviewed journals and open access
original articles on the feeding practices in infants undergoing
congenital heart surgery. Exclusion criteria were editorials,
commentaries, discussion papers, conference abstracts, reviews, duplicate
studies, and articles on preterm infants and preoperative nutrition. A
total of five studies matched the inclusion criteria. The standard mean
difference (SMD) of energy intake (SMD = 13.40 kcal, P = 0.001), protein
intake (SMD = 2.37 g, P = 0.001), and weight (SMD = 4.99 g, P = 0.001) was
significantly higher in the intervention group. The SMD of ventilation
duration (SMD = -0.18 h, P = 0.90), intensive care unit (ICU) length of
stay (LOS) (SMD = -0.25 d, P = 0.70), and hospital LOS (SMD = -0.20 d, P =
0.67) were not statistically significant between the two groups. Enriched
enteral nutrition for the postoperative pediatric patients with cardiac
disease helps in achieving energy and protein goals and improves the
overall postoperative outcomes (ie, ventilation duration, maintenance of
weight, ICU LOS, and hospital LOS).<br/>Copyright &#xa9; 2021 American
Society for Parenteral and Enteral Nutrition

<13>
Accession Number
2014424492
Title
The effects of erector spinae plane block on perioperative opioid
consumption and rehabilitation in video assisted thoracic surgery.
Source
BMC Anesthesiology. 21(1) (no pagination), 2021. Article Number: 313. Date
of Publication: December 2021.
Author
Zhang S.; Han X.; Zhou D.; Sun M.; Cang J.; Miao C.; Liang C.
Institution
(Zhang, Han, Zhou, Sun, Cang, Miao, Liang) Department of Anesthesiology,
Zhongshan Hospital, Fudan University, Shanghai 200032, China
Publisher
BioMed Central Ltd
Abstract
Background: This study aimed to determine whether ultrasound-guided
continuous erector spinae plane block (ESPB) had an effect on opioid
consumption and postoperative rehabilitation in patients undergoing
video-assisted thoracic surgery (VATS). <br/>Method(s): In this
prospective study, 120 patients aged 20-70 years who underwent elective
VATS were randomly allocated to one of three groups: group C (general
anesthesia with patient-controlled intravenous analgesia [PCIA]), group T
(general anesthesia with patient-controlled epidural analgesia [PCEA]), or
group E (general anesthesia with continuous ESPB and PCIA). Perioperative
opioid consumption, visual analog scale (VAS) scores, preoperative and
postoperative Quality of Recovery-15 scores, and postoperative
opioid-related adverse events were all assessed. <br/>Result(s):
Intraoperative sufentanil consumption in groups T and E was significantly
lower than that in group C (both P < 0.001), and the postoperative
sufentanil consumption in group E was also significantly lower than that
in group C (P = 0.001). Compared with group C, the VAS scores at rest or
during coughing immediately out of the post-anesthesia care unit at 6 h,
12 h, and 24 h postoperatively were significantly lower in group T (P <
0.05). However, the VAS scores at rest at 6 h and 12 h postoperatively in
group E were lower than those of group C (P < 0.05), but were
significantly higher than those of group T at all study times (P < 0.05).
<br/>Conclusion(s): Ultrasound-guided continuous ESPB significantly
reduced perioperative opioid consumption during VATS and improved
postoperative rehabilitation. However, these effects were inferior to
those of thoracic epidural anesthesia. Trial registration: The present
study was prospectively registered at http://www.chictr.org/cn
/(registration number: ChiCTR1900023050); registration date: May
82,019.<br/>Copyright &#xa9; 2021, The Author(s).

<14>
Accession Number
636641506
Title
Preoperative Sucrosomial Iron Supplementation Increases Haemoglobin and
Reduces Transfusion Requirements in Elective Heart Surgery Patients: A
Prospective Randomized Study.
Source
Surgical technology international. 39 (pp 321-328), 2021. Date of
Publication: 28 Oct 2021.
Author
Pierelli L.; De Rosa A.; Falco M.; Papi E.; Rondinelli M.B.; Turani F.;
Weltert L.
Institution
(Pierelli) Dipartimento di Medicina Sperimentale, Sapienza University,
Rome, Italy
(Pierelli, De Rosa, Rondinelli) Transfusion Medicine, San Camillo
Forlanini Hospital, Rome, Italy
(Falco, Papi) Department of Anesthesiology, European Hospital, Rome, Italy
(Papi, Turani) Department of Anesthesiology, Aurelia Hospital, Rome, Italy
(Papi, Weltert) San Camillus International University for Health Sciences,
Rome, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Low preoperative haemoglobin is frequently observed in heart
surgery patients and is associated with a significant decrease in
haemoglobin between post-operative days 2 and 3, known as haemoglobin
drift. Overall, these patients tend to receive many RBC transfusions.
Since iron homeostasis is often impaired in these patients, restoration of
iron availability might override iron-restricted erythropoiesis. However,
reduced tolerance to oral iron salts has limited this strategy to
intravenous iron administration. STUDY DESIGN AND METHODS: The purpose of
this study was to assess whether preoperative supplementation with oral
sucrosomial iron, a new iron-delivery technology with improved tolerance
and bioavailability, might be an effective strategy for this patient
population. One thousand consecutive patients were randomized and received
either a one-month course of sucrosomial iron (60 mg/day) or no treatment
prior to elective heart surgery at a single high-volume centre
(ClinicalTrials.gov NCT03560687). Primary end-points were haemoglobin
concentration on the day of hospital admittance and number of blood
transfusions. Secondary end-points were haemoglobin drift, tolerance of
treatment and cost-effectiveness of sucrosomial iron administration.
<br/>RESULT(S): Baseline haemoglobin in the treatment group was higher (by
0.67 g/dL; p<0.001) than that in the control group. The percentage of
patients in the treatment group who required transfusion (35.4%) was half
that in the control group (64.6%). The average number of transfused units
per operation was 0.95 vs. 2.03 in the treatment and control groups,
respectively. Haemoglobin drift was substantially similar in the two
groups, and the tolerability of treatment was excellent (98%). The overall
cost of treatment was 156 Euros less in the treatment group, expressed as
a raw cost of transfusion. <br/>CONCLUSION(S): In elective heart surgery,
routine preoperative sucrosomial iron administration seems to be a safe,
well-tolerated and cost-effective strategy to increase preoperative
haemoglobin and reduce the need for allogeneic blood transfusions.

<15>
Accession Number
2016064757
Title
Postoperative Transfusion Guidelines in Aneurysmal Cerebral Subarachnoid
Hemorrhage: A Systematic Review and Critical Summary of Available
Evidence.
Source
World Neurosurgery. (no pagination), 2021. Date of Publication: 2021.
Author
Mofor P.; Oduguwa E.; Tao J.; Barrie U.; Kenfack Y.J.; Montgomery E.;
Edukugho D.; Rail B.; Hicks W.H.; Pernik M.N.; Adeyemo E.; Caruso J.; El
Ahmadieh T.Y.; Bagley C.A.; De Oliveira Sillero R.; Aoun S.G.
Institution
(Mofor, Oduguwa, Tao, Barrie, Kenfack, Montgomery, Rail, Hicks, Pernik,
Adeyemo, Caruso, Bagley, De Oliveira Sillero, Aoun) Department of
Neurological Surgery, University of Texas Southwestern Medical Center,
Dallas, TX, United States
(Edukugho) Department of Neurological Surgery, Boonshoft School of
Medicine, Wright State University, Dayton, OH, United States
(El Ahmadieh) Department of Neurological Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: Surgical management of aneurysmal subarachnoid hemorrhage (SAH)
often involves red blood cell (RBC) transfusion, which increases the risk
of postoperative complications. RBC transfusion guidelines report on
chronically critically ill patients and may not apply to patients with
SAH. Our study aims to synthesize the evidence to recommend RBC
transfusion thresholds among adult patients with SAH undergoing surgery.
<br/>Method(s): A systematic review was conducted using PubMed, Google
Scholar, and Web of Science electronic databases according to the PRISMA
(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
guidelines to critically assess primary articles discussing RBC
transfusion thresholds and describe complications secondary to RBC
transfusion in adult patients with SAH in the perioperative period.
<br/>Result(s): Sixteen articles meeting our search strategy were
reviewed. Patients with SAH who received blood transfusion were older,
female, had World Federation of Neurosurgical Societies grade IV-V and
modified Fisher grade 3-4 scores, and presented with more comorbidities
such as hypertension, diabetes, and cardiovascular and pulmonary diseases.
In addition, transfusion was associated with multiple postoperative
complications, including higher rates of vasospasms, surgical site
infections, cardiovascular and respiratory complications, increased
postoperative length of stay, and 30-day mortality. Analysis of transfused
patients showed that a higher hemoglobin (>10 g/dL) goal after SAH was
safe and that patients may benefit from a higher whole hospital stay
hemoglobin nadir, as shown by a reduction in risk of cerebral vasospasm
and improvement in clinical outcomes (level B class II).
<br/>Conclusion(s): Among patients with SAH, the benefits of reducing
cerebral ischemia and anemia are shown to outweigh the risks of
transfusion-related complications.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<16>
Accession Number
636079854
Title
Intraoperative Methadone Use in Cardiac Surgery: A Systematic Review.
Source
Pain medicine (Malden, Mass.). 22(12) (pp 2827-2834), 2021. Date of
Publication: 11 Dec 2021.
Author
Lobova V.A.; Roll J.M.; Roll M.L.C.
Institution
(Lobova, Roll) Elson S. Floyd College of Medicine, Washington State
University, Spokane, WA, United States
(Roll) Department of Community and Behavioral Health, Program of
Excellence in the Addictions, Washington State University, Spokane, WA,
United States
(Roll) Macalester College, Saint Paul, Minnesota, USA
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To investigate the effects of intraoperative methadone in
comparison with those of standard-of-care intraoperative opioids, such as
fentanyl and morphine, on pain scores, opioid consumption, and adverse
effects in adults undergoing cardiothoracic surgery. <br/>METHOD(S): The
literature was reviewed in PubMed, Embase, Cochrane Library, and Google
Scholar, followed by a manual search of the reference lists of the
identified articles. Search terms included a combination of
"intraoperative methadone," "methadone," and "cardiac surgery." Our review
includes four studies published between 2011 and 2020. Quality assessment
of the studies was performed. <br/>RESULT(S): The initial search
identified 715 articles, from which 461 duplicates were removed and 236
were eliminated on the basis of inclusion and exclusion criteria. Eighteen
articles underwent full-text review. Four studies evaluating a total of
435 patients with various cardiothoracic procedures were included in this
review. We found that intraoperative methadone decreased acute
postoperative pain and reduced postoperative opioid consumption in the
first 24 postoperative hours in patients who received 0.1-0.3mg/kg
intraoperative methadone in comparison with morphine and fentanyl. No
difference was found in adverse effects between the groups. Quality
assessment of the studies showed a low risk of bias in three of the
randomized controlled trials and a high risk of bias in the retrospective
review because of the baseline confounding bias in the study design.
<br/>CONCLUSION(S): Intraoperative methadone use reduces acute
postoperative pain and lowers opioid consumption in comparison with
morphine and fentanyl. Initial results suggest that methadone may be an
equivalent opioid to be administered during cardiothoracic procedures to
reduce acute postsurgical pain, though further research is
warranted.<br/>Copyright &#xa9; The Author(s) 2021. Published by Oxford
University Press on behalf of the American Academy of Pain Medicine. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<17>
Accession Number
2015287047
Title
Inhibition of p38 MAP kinase in patients with ST-elevation myocardial
infarction - findings from the LATITUDE-TIMI 60 trial.
Source
American Heart Journal. 243 (pp 147-157), 2022. Date of Publication:
January 2022.
Author
Cavender M.A.; O'Donoghue M.L.; Abbate A.; Aylward P.; Fox K.A.; Glaser
R.X.; Park J.-G.; Lopez-Sendon J.; Steg P.G.; Sabatine M.S.; Morrow D.A.
Institution
(Cavender) University of North Carolina at Chapel Hill, Chapel Hill, NC,
United States
(O'Donoghue, Park, Sabatine, Morrow) Brigham and Women's Hospital, Boston,
Massachusetts
(O'Donoghue, Park, Sabatine, Morrow) TIMI Study Group, Boston,
Massachusetts
(Abbate) Virginia Commonwealth University, Richmond, Virginia
(Aylward) South Australian Health and Medical Research Institute, Flinders
University and Medical Centre, Adelaide, Australia
(Fox) Centre for Cardiovascular Science, University of Edinburgh,
Edinburgh, United Kingdom
(Glaser) Metabolic Pathways and Cardiovascular Unit, Research and
Development, GlaxoSmithKline, Collegeville, Pennsylvania, Departement
Hospitalo-Universitaire FIRE, Hopital Bichat, Assistance Publique-Hopitaux
de Paris, Universite Paris-Diderot, Paris, France
(Lopez-Sendon) University Hospital La Paz, Madrid, Spain
(Steg) Departement Hospitalo-Universitaire FIRE, Hopital Bichat,
Assistance Publique-Hopitaux de Paris, Universite Paris-Diderot, Paris,
France
Publisher
Elsevier Inc.
Abstract
Background: p38 mitogen activated kinase (MAPK) mediates the response to
pro-inflammatory cytokines following myocardial infarction (MI) and is
inhibited by losmapimod. <br/>Method(s): LATITUDE-TIMI 60
(ClinicalTrials.gov NCT02145468) randomized patients with MI to losmapimod
or placebo for 12 weeks (24 weeks total follow-up). In this pre-specified
analysis, we examined outcomes based on MI type [ST-segment elevation MI
(STEMI) (865, 25%) and non-STEMI (2624, 75%)]. <br/>Result(s): In patients
with STEMI, inflammation, measured by hs-CRP, was significantly attenuated
with losmapimod at 48 hours (P <0.001) and week 12 (P = 0.01). Losmapimod
lowered NT-proBNP in patients with STEMI at 48 hours (P = 0.04) and week
12 (P = 0.02). The effects of losmapimod on CV death (CVD), MI, or severe
recurrent ischemia requiring urgent coronary artery revascularization at
24 weeks [MACE] differed in patients with STEMI (7.0% vs 10.8%; HR 0.65,
95%CI 0.41 - 1.03; P= 0.06) and NSTEMI (11.4% vs 8.5%; HR 1.30, 95%CI 1.02
- 1.66; P = 0.04; p[int] = 0.009). CVD or HHF among patients with STEMI
were 5.6% (losmapimod) and 8.3% (placebo) (HR 0.66; 95%CI 0.40 - 1.11; P =
0.12) and in NSTEMI were 4.8% (losmapimod) and 4.4% (placebo) (HR 1.09;
95%CI 0.76 - 1.56) in patients with NSTEMI. <br/>Conclusion(s): Patients
with STEMI treated with losmapimod had an attenuated inflammatory
response. Our collective findings raise the hypothesis that mitigating the
inflammatory response may result in different outcomes in patients with
STEMI and NSTEMI. While the difference in outcomes is exploratory, these
findings do support separate examination of patients with STEMI and NSTEMI
and increased emphasis on heart failure in future investigation of
modulators of inflammation in MI.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<18>
Accession Number
2016417041
Title
Technical and safety performance of CT-guided percutaneous microwave
ablation for lung tumors: an ablate and resect study.
Source
Journal of Thoracic Disease. 13(12) (pp 6827-6837), 2021. Date of
Publication: December 2021.
Author
Blackmon S.H.; Sterner R.M.; Eiken P.W.; Vogl T.J.; Pua B.B.; Port J.L.;
Dupuy D.E.; Callstrom M.R.
Institution
(Blackmon, Sterner) Division of General Thoracic Surgery, Mayo Clinic,
Rochester, MN, United States
(Eiken, Callstrom) Department of Radiology, Mayo Clinic, Rochester, MN,
United States
(Vogl) Department of Diagnostic and Interventional Radiology, University
Hospital Frankfurt am Main, Frankfurt am Main, Germany
(Pua) Division of Interventional Radiology, Department of Radiology, Weill
Cornell Medicine, New York, NY, United States
(Port) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York-Presbyterian Hospital, New York, NY, United States
(Dupuy) Department of Diagnostic Imaging, the Warren Alpert Medical School
of Brown University, Providence, RI, United States
Publisher
AME Publishing Company
Abstract
Background: Percutaneous image-guided thermal ablation has an increasing
role in the treatment of primary and metastatic lung tumors. Achieving
acceptable clinical outcomes requires better tools for pre-procedure
prediction of ablation zone size and shape. <br/>Method(s): This was a
prospective, non-randomized, single-arm, multicenter study conducted by
Medtronic (ClinicalTrials.gov ID: NCT02323854). Subjects scheduled for
resection of metastatic or primary lung nodules underwent preoperative
percutaneous microwave ablation. Ablation zones as measured via CT imaging
following ablation immediately and before resection surgically versus
predicted ablation zones as prescribed by the investigational system
software were compared. This CT scan occurred after the ablation was
finished but the antenna still in position. Time (minutes) from antenna
placement to removal was 23.7+/-13.1 (n=14); median: 21.0 (range, 6.0 to
48.0). The definition of the secondary endpoint of complete ablation was
100% non-viable tumor cells based on nicotinamide adenine dinucleotide
hydrogen (NADH) staining. Safety endpoints were type, incidence, and
severity of adverse events. <br/>Result(s): Fifteen patients (mean age
58.9 years; 67% male; 33% female) were enrolled in the study, 33.3% (5/15)
with previous thoracic surgery, 73% (11/15) with metastasis, and 27%
(4/15) with primary lung tumors. All underwent percutaneous microwave
ablation followed by surgical resection the same day. Complete ablation
was detected in 54.4% (6/11), incomplete ablation in 36.4% (4/11), and
delayed necrosis in 9.1% (1/11). There were no device-related adverse
events. Ablation zone volume was overestimated in all patients.
<br/>Conclusion(s): Histological complete ablation was observed in 55% of
subjects. CT scanning less than an hour after ablation and tissue
shrinkage may account for the smaller zone of ablation observed compared
to predicted by the investigational system software.<br/>Copyright &#xa9;
Journal of Thoracic Disease. All rights reserved.

<19>
Accession Number
2015194972
Title
Effect of intensive versus limited monitoring on clinical trial conduct
and outcomes: A randomized trial.
Source
American Heart Journal. 243 (pp 77-86), 2022. Date of Publication: January
2022.
Author
Butala N.M.; Song Y.; Shen C.; Cohen D.J.; Yeh R.W.
Institution
(Butala, Song, Shen, Yeh) Richard A. and Susan F. Smith Center for
Outcomes Research in Cardiology, Division of Cardiovascular Medicine, Beth
Israel Deaconess Medical Center, Boston, MA
(Butala) Department of Medicine, Cardiology Division, Massachusetts
General Hospital, Boston, MA
(Butala, Yeh) Harvard Medical School, Boston, MA
(Shen) Biogen Inc., Cambridge, MA
(Cohen) Cardiovascular Research Foundation, New York, NY
(Cohen) St. Francis Hospital, Roslyn, NY
Publisher
Elsevier Inc.
Abstract
Background: Regulatory agencies have endorsed more limited approaches to
clinical trial site monitoring. However, the impact of different
monitoring strategies on trial conduct and outcomes is unclear.
<br/>Method(s): We conducted a patient-level block-randomized controlled
trial evaluating the effect of intensive versus limited monitoring on
cardiovascular clinical trial conduct and outcomes nested within the
CoreValve Continued Access and Expanded Use Studies. Intensive monitoring
included complete source data verification of all critical datapoints
whereas limited monitoring included automated data checks only. This
study's endpoints included clinical trial outcome ascertainment as well as
monitoring action items, protocol deviations, and adverse event
ascertainment. <br/>Result(s): A total of 2,708 patients underwent
transcatheter aortic valve replacement (TAVR) and were randomized to
either intensive monitoring (n = 1,354) or limited monitoring (n = 1,354).
Monitoring action items were more common with intensive monitoring (52% vs
15%; P <.001), but there was no difference in the percentage of patients
with any protocol deviation (91.6% vs 90.4%; P =.314). The reported
incidence of trial outcomes between intensive and limited monitoring was
similar for mortality (30 days: 4.8% vs 5.5%, P =.442; 1 year: 20.3% vs
21.3%, P =.473) and stroke (30 days: 2.8% vs 2.4%, P =.458), as well as
most secondary trial outcomes with the exception of bleeding (intensive:
36.3% vs limited: 32.0% at 30 days, P =.019). There was a higher reported
incidence of cardiac adverse events reported in the intensive monitoring
group at 1 year (76.7% vs 72.4%; P =.019). <br/>Conclusion(s): Tailored
limited monitoring strategies can be implemented without influencing the
integrity of TAVR trial outcomes.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<20>
Accession Number
636862142
Title
Management of mitral stenosis: a systematic review of clinical practice
guidelines and recommendations.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2021. Date of Publication: 08 Dec 2021.
Author
Galusko V.; Ionescu A.; Edwards A.; Sekar B.; Wong K.; Patel K.; Ricci F.;
Khanji M.Y.
Institution
(Galusko) Department of Cardiology, King's College Hospital, London SE5
9RS, United Kingdom
(Ionescu, Sekar) Morriston, UK Cardiac Regional Centre, Swansea Bay Health
Board, Swansea SA6 6NL, UK
(Edwards, Khanji) Newham University Hospital, Barts Health NHS Trust,
London E13 8SL, United Kingdom
(Wong, Patel, Khanji) Barts Heart Centre, Barts Health NHS Trust, London,
West Smithfield, EC1A 7BE, UK
(Ricci) Institute of Advanced Biomedical Technologies, Department of
Neuroscience, Imaging and Clinical Sciences, "G.d'Annunzio" University,
Chieti 66100, Italy
(Ricci) Department of Clinical Sciences, Lund University, Malmo, Sweden
(Ricci) Casa di Cura Villa Serena, 65013 Citta Sant'Angelo, Pescara, Italy
(Khanji) NIHR Barts Biomedical Research Centre, William Harvey Research
Institute, Queen Mary University of London EC1A 7BE, United Kingdom
Publisher
NLM (Medline)
Abstract
A number of guidelines exist with recommendations for diagnosis and
management of mitral stenosis (MS). We systematically reviewed existing
guidelines for diagnosis and management of MS, highlighting their
similarities and differences, in order to guide clinical decision-making.
We searched national and international guidelines in MEDLINE and EMBASE
(5/4/2011 - 5/9/2021), the Guidelines International Network International,
Guideline Library, National Guideline Clearinghouse, National Library for
Health Guidelines Finder, Canadian Medical Association Clinical Practice
Guidelines Infobase, and Web sites of relevant organizations. Two
independent reviewers screened titles and abstracts, and full-text of
potentially relevant articles where needed. Selected guidelines were
assessed for rigor of development; only guidelines with Appraisal of
Guidelines for Research and Evaluation II (AGREE II) instrument score >50%
were included in the final analysis. Four guidelines were retained for
analysis. There was consensus for percutaneous mitral balloon
commissurotomy (PMBC) as first-line treatment of symptomatic severe
rheumatic MS with suitable anatomy. In patients with unfavourable anatomy,
surgical intervention should be considered. Exercise testing is indicated
if discrepancy exists between symptoms and echocardiographic measurements.
There was no clear divide between rheumatic MS and degenerative MS for
their respective diagnoses and management. Pregnancy in severe MS is
discouraged and the stenosis should be treated before conception.
Long-term antibiotic prophylaxis is recommended for patients with
rheumatic MS. Recommendations for the management of patients with mixed
valvular diseases are lacking.<br/>Copyright &#xa9; The Author(s) 2021.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<21>
Accession Number
636860390
Title
Tricuspid Valve Intervention at the Time of Pulmonary Valve Replacement in
Adults With Congenital Heart Disease: A Systematic Review and
Meta-Analysis.
Source
Journal of the American Heart Association. (pp e022909), 2021. Date of
Publication: 07 Dec 2021.
Author
Van den Eynde J.; Callahan C.P.; Lo Rito M.; Hussein N.; Carvajal H.;
Guariento A.; Ruhparwar A.; Weymann A.; Budts W.; Gewillig M.; Sa M.P.;
Kutty S.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart CenterThe Johns Hopkins
Hospital and School of Medicine Baltimore MD
(Van den Eynde) Department of Cardiovascular Sciences Department of
Cardiovascular Diseases KU Leuven, University Hospitals Leuven Leuven
Belgium
(Callahan, Guariento) Division of Cardiovascular Surgery The Hospital for
Sick Children Toronto Canada
(Lo Rito) Department of Congenital Cardiac Surgery IRCCS Policlinico San
Donato San Donato Milanese Italy
(Hussein) Department of Congenital Cardiac Surgery Yorkshire Heart
CentreLeeds General Infirmary England United Kingdom
(Carvajal) Section of Pediatric Cardiothoracic Surgery Department of
Surgery Washington University School of Medicine in St. Louis/St. Louis
Children's Hospital Saint Louis MO
(Ruhparwar, Weymann) Department of Thoracic and Cardiovascular Surgery
West German Heart and Vascular Center Essen University Hospital of
EssenUniversity Duisburg-Essen Essen Germany
(Budts) Department of Cardiovascular Sciences Congenital and Structural
Cardiology Catholic University Leuven, University Hospitals Leuven Leuven
Belgium
(Gewillig) Pediatric Cardiology University Hospitals Leuven Leuven Belgium
(Sa) Department of Cardiac Surgery Lankenau Heart InstituteMain Line
Health Wynnewood PA
(Sa) Department of Cardiac Surgery Research Lankenau Institute for Medical
ResearchMain Line Health Wynnewood PA
Publisher
NLM (Medline)
Abstract
Background Tricuspid regurgitation (TR) is a common finding in adults with
congenital heart disease referred for pulmonary valve replacement (PVR).
However, indications for combined valve surgery remain controversial. This
study aimed to evaluate early results of concomitant tricuspid valve
intervention (TVI) at the time of PVR. Methods and Results Observational
studies comparing TVI+PVR and isolated PVR were identified by a systematic
search of published research. Random-effects meta-analysis was performed,
comparing outcomes between the 2 groups. Six studies involving 749
patients (TVI+PVR, 278 patients; PVR, 471 patients) met the eligibility
criteria. In the pooled analysis, both TVI+PVR and PVR reduced TR grade,
pulmonary regurgitation grade, right ventricular end-diastolic volume, and
right ventricular end-systolic volumes. TVI+PVR, but not PVR, was
associated with a decrease in tricuspid valve annulus size (mean
difference, -6.43 mm, 95% CI, -10.59 to -2.27; P=0.010). Furthermore,
TVI+PVR was associated with a larger reduction in TR grade compared with
PVR (mean difference, -0.40; 95% CI, -0.75 to -0.05; P=0.031). No evidence
could be established for an effect of either treatment on right
ventricular ejection fraction or echocardiographic assessment of right
ventricular dilatation and dysfunction. There was no evidence for a
difference in hospital mortality or reoperation for TR. Conclusions While
both strategies are effective in reducing TR and right ventricular
volumes, routine TVI+PVR can reduce TR grade to a larger extent than
isolated PVR. Further studies are needed to identify the subgroups of
patients who might benefit most from combined valve surgery.

<22>
Accession Number
636857252
Title
Multicentric randomized evaluation of a tricuspid valve percutaneous
repair system (clip for the tricuspid valve) in the treatment of severe
secondary tricuspid regurgitation Tri.Fr Design paper.
Source
European heart journal. Cardiovascular Imaging. (no pagination), 2021.
Date of Publication: 06 Dec 2021.
Author
Donal E.; Leurent G.; Ganivet A.; Lurz P.; Coisne A.; De Groote P.;
Lafitte S.; Leroux L.; Karam N.; Biere L.; Rouleau F.; Sportouch C.;
Dreyfus J.; Nejjari M.; Josselin J.-M.; Anselmi A.; Galli E.; Bajeux E.;
Guerin P.; Obadia J.-F.; Trochu J.-N.; Oger E.
Institution
(Donal, Leurent, Anselmi, Galli) Univ Rennes, CHU Rennes, Inserm, Rennes
1099, France
(Ganivet) Direction for Research and Innovation, CHU Rennes, Rennes,
France
(Lurz) Heart Center at University of Leipzig, Leipzig, Germany
(Coisne, De Groote) Department of Clinical Physiology and
Echocardiography, Univ Lille, CHU Lille, France
(Lafitte, Leroux) CHU Bordeaux, University of Bordeaux, Bordeaux, France
(Karam) University of Paris, Medico-Surgical Heart Valve Unit, European
Hospital Georges-Pompidou, INSERM, Paris U970, France
(Biere, Rouleau) Angers University, CHU Angers, CNRS UMR6015, INSERM U,
Angers 1083, France
(Sportouch) Clinique du Millenaire, Montpellier, France
(Dreyfus, Nejjari) Centre Cardiologique du Nord, Saint Denis, France
(Josselin, Bajeux) IRSET, University Rennes, CHU Rennes, Rennes, France
(Guerin, Trochu) Institut du Thorax, CHU Nantes, University Nantes,
Nantes, France
(Obadia) Department of Cardiac Surgery, Cardiologic CHU Lyon, University
Lyon, Lyon, France
(Oger) CHU Rennes, University Rennes, Rennes, France
Publisher
NLM (Medline)
Abstract
AIMS: Tricuspid regurgitation (TR) is associated with significant
morbidity and mortality. Its independent prognostic role has been
repeatedly demonstrated. However, this valvular heart condition is largely
undertreated because of the increased risk of surgical repair. Recently,
transcatheter techniques for the treatment of TR have emerged, but their
implications for the clinical endpoints are still unknown. METHODS AND
RESULTS: The Tri.fr trial will be a multicentre, controlled, randomized
(1:1 ratio), superior, open-label, and parallel-group study conducted in
300 patients with severe secondary TR that is considered non-surgical by
heart teams. Inclusion will be possible only after core laboratory review
of transthoracic and transoesophageal echocardiography and after
validation by the clinical eligibility committee. A description of the
mechanisms of the TR will be conducted by the core laboratory. Atrial or
ventricular impacts on the severity of the secondary TR will be taken into
account for the randomization. The patients will be followed for 12-month,
and the primary outcome will be the Packer composite clinical endpoint
[combining New York Heart Association class, patient global assessment
(PGA), and major cardiovascular events]. It will test the hypothesis that
a tricuspid valve percutaneous repair strategy using a clip dedicated to
the tricuspid valve is superior to best guideline-directed medical therapy
in symptomatic patients with severe secondary TR. <br/>CONCLUSION(S):
Tri.fr will be the first randomized, academic, multicentre study testing
the value of percutaneous correction in patients with severe secondary
TR.<br/>Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. &#xa9; The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<23>
Accession Number
636869558
Title
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization:
Executive Summary: A Report of the American College of Cardiology/American
Heart Association Joint Committee on Clinical Practice Guidelines.
Source
Circulation. (pp CIR0000000000001039), 2021. Date of Publication: 09 Dec
2021.
Author
Lawton J.S.; Tamis-Holland J.E.; Bangalore S.; Bates E.R.; Beckie T.M.;
Bischoff J.M.; Bittl J.A.; Cohen M.G.; DiMaio J.M.; Don C.W.; Fremes S.E.;
Gaudino M.F.; Goldberger Z.D.; Grant M.C.; Jaswal J.B.; Kurlansky P.A.;
Mehran R.; Metkus T.S.; Nnacheta L.C.; Rao S.V.; Sellke F.W.; Sharma G.;
Yong C.M.; Zwischenberger B.A.
Institution
(Lawton, Bangalore, Bates, Beckie, Bischoff, Bittl, DiMaio, Gaudino,
Grant, Jaswal, Kurlansky, Mehran, Metkus, Nnacheta, Rao, Sellke, Sharma,
Yong, Zwischenberger) ACC/AHA Representative
(Tamis-Holland, Goldberger) ACC/AHA Joint Committee on Clinical Practice
Guidelines Liaison
(Cohen) ACC/AHA Task Force on Clinical Data Standards Representative
(Don) SCAI Representative
Publisher
NLM (Medline)
Abstract
AIM: The executive summary of the American College of Cardiology/American
Heart Association/Society for Cardiovascular Angiography and Interventions
coronary artery revascularization guideline provides the top 10 items
readers should know about the guideline. In the full guideline, the
recommendations replace the 2011 coronary artery bypass graft surgery
guideline and the 2011 and 2015 percutaneous coronary intervention
guidelines. This summary offers a patient-centric approach to guide
clinicians in the treatment of patients with significant coronary artery
disease undergoing coronary revascularization, as well as the supporting
documentation to encourage their use. <br/>METHOD(S): A comprehensive
literature search was conducted from May 2019 to September 2019,
encompassing studies, reviews, and other evidence conducted on human
subjects that were published in English from PubMed, EMBASE, the Cochrane
Collaboration, CINHL Complete, and other relevant databases. Additional
relevant studies, published through May 2021, were also considered.
Structure: Recommendations from the earlier percutaneous coronary
intervention and coronary artery bypass graft surgery guidelines have been
updated with new evidence to guide clinicians in caring for patients
undergoing coronary revascularization. This summary includes
recommendations, tables, and figures from the full guideline that relate
to the top 10 take-home messages. The reader is referred to the full
guideline for graphical flow charts, supportive text, and tables with
additional details about the rationale for and implementation of each
recommendation, and the evidence tables detailing the data considered in
the development of this guideline.

<24>
Accession Number
636869508
Title
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A
Report of the American College of Cardiology/American Heart Association
Joint Committee on Clinical Practice Guidelines.
Source
Circulation. (pp CIR0000000000001038), 2021. Date of Publication: 09 Dec
2021.
Author
Lawton J.S.; Tamis-Holland J.E.; Bangalore S.; Bates E.R.; Beckie T.M.;
Bischoff J.M.; Bittl J.A.; Cohen M.G.; DiMaio J.M.; Don C.W.; Fremes S.E.;
Gaudino M.F.; Goldberger Z.D.; Grant M.C.; Jaswal J.B.; Kurlansky P.A.;
Mehran R.; Metkus T.S.; Nnacheta L.C.; Rao S.V.; Sellke F.W.; Sharma G.;
Yong C.M.; Zwischenberger B.A.
Institution
(Lawton, Bangalore, Bates, Beckie, Bischoff, Bittl, DiMaio, Gaudino,
Grant, Jaswal, Kurlansky, Mehran, Metkus, Nnacheta, Rao, Sellke, Sharma,
Yong, Zwischenberger) ACC/AHA Representative
(Tamis-Holland, Goldberger) ACC/AHA Joint Committee on Clinical Practice
Guidelines Liaison
(Cohen) ACC/AHA Task Force on Data Standards Representative
(Don) SCAI Representative
Publisher
NLM (Medline)
Abstract
AIM: The guideline for coronary artery revascularization replaces the 2011
coronary artery bypass graft surgery and the 2011 and 2015 percutaneous
coronary intervention guidelines, providing a patient-centric approach to
guide clinicians in the treatment of patients with significant coronary
artery disease undergoing coronary revascularization as well as the
supporting documentation to encourage their use. <br/>METHOD(S): A
comprehensive literature search was conducted from May 2019 to September
2019, encompassing studies, reviews, and other evidence conducted on human
subjects that were published in English from PubMed, EMBASE, the Cochrane
Collaboration, CINHL Complete, and other relevant databases. Additional
relevant studies, published through May 2021, were also considered.
Structure: Coronary artery disease remains a leading cause of morbidity
and mortality globally. Coronary revascularization is an important
therapeutic option when managing patients with coronary artery disease.
The 2021 coronary artery revascularization guideline provides
recommendations based on contemporary evidence for the treatment of these
patients. The recommendations present an evidence-based approach to
managing patients with coronary artery disease who are being considered
for coronary revascularization, with the intent to improve quality of care
and align with patients' interests.

<25>
Accession Number
636611041
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in patients with severe aortic stenosis: A systematic review
and meta-Analysis.
Source
BMJ Open. 11(12) (no pagination), 2021. Article Number: e054222. Date of
Publication: 06 Dec 2021.
Author
Swift S.L.; Puehler T.; Misso K.; Lang S.H.; Forbes C.; Kleijnen J.;
Danner M.; Kuhn C.; Haneya A.; Seoudy H.; Cremer J.; Frey N.; Lutter G.;
Wolff R.; Scheibler F.; Wehkamp K.; Frank D.
Institution
(Swift, Misso, Lang, Forbes, Kleijnen, Wolff) Kleijnen Systematic Reviews
Ltd, York, United Kingdom
(Puehler, Haneya, Cremer, Lutter) Department of Cardiac and Vascular
Surgery, Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Puehler, Kuhn, Seoudy, Lutter, Frank) German Centre for Cardiovascular
Research, Kiel, Germany
(Danner, Scheibler) National Competency Center for Shared Decision Making,
Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Kuhn, Seoudy, Frank) Department of Cardiology and Angiology,
Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Frey) Department of Cardiology, Angiology, and Pneumology, University
Hospital Heidelberg, Heidelberg, Germany
(Wehkamp) Department of Internal Medicinei, Universitatsklinikum
Schleswig-Holstein, Kiel, Germany
Publisher
BMJ Publishing Group
Abstract
Objectives Patients undergoing surgery for severe aortic stenosis (SAS)
can be treated with either transcatheter aortic valve implantation (TAVI)
or surgical aortic valve replacement (SAVR). The choice of procedure
depends on several factors, including the clinical judgement of the heart
team and patient preferences, which are captured by actively informing and
involving patients in a process of shared decision making (SDM). We
synthesised the most up-To-date and accessible evidence on the benefits
and risks that may be associated with TAVI versus SAVR to support SDM in
this highly personalised decision-making process. Design Systematic review
and meta-Analysis. Data sources MEDLINE (Ovid), Embase (Ovid) and the
Cochrane Central Register of Controlled Trials (CENTRAL; Wiley) were
searched from January 2000 to August 2020 with no language restrictions.
Reference lists of included studies were searched to identify additional
studies. Eligibility criteria Randomised controlled trials (RCTs) that
compared TAVI versus SAVR in patients with SAS and reported on all-cause
or cardiovascular mortality, length of stay in intensive care unit or
hospital, valve durability, rehospitalisation/reintervention, stroke (any
stroke or major/disabling stroke), myocardial infarction, major vascular
complications, major bleeding, permanent pacemaker (PPM) implantation,
new-onset or worsening atrial fibrillation (NOW-AF), endocarditis, acute
kidney injury (AKI), recovery time or pain were included. Data extraction
and synthesis Two independent reviewers were involved in data extraction
and risk of bias (ROB) assessment using the Cochrane tool (one reviewer
extracted/assessed the data, and the second reviewer checked it).
Dichotomous data were pooled using the Mantel-Haenszel method with
random-effects to generate a risk ratio (RR) with 95% CI. Continuous data
were pooled using the inverse-variance method with random-effects and
expressed as a mean difference (MD) with 95% CI. Heterogeneity was
assessed using the I 2 statistic. Results 8969 records were retrieved and
nine RCTs (61 records) were ultimately included (n=8818 participants). Two
RCTs recruited high-risk patients, two RCTs recruited intermediate-risk
patients, two RCTs recruited low-risk patients, one RCT recruited
high-risk (>=70 years) or any-risk (>=80 years) patients; and two RCTs
recruited all-risk or a operable' patients. While there was no overall
change in the risk of dying from any cause (30 day: RR 0.89, 95% CI 0.65
to 1.22; <=1 year: RR 0.90, 95% CI 0.79 to 1.03; 5 years: RR 1.09, 95% CI
0.98 to 1.22), cardiovascular mortality (30 day: RR 1.03, 95% CI 0.77 to
1.39; <=1 year: RR 0.90, 95% CI 0.76 to 1.06; 2 years: RR 0.96, 95% CI
0.83 to 1.12), or any type of stroke (30 day: RR 0.83, 95% CI 0.61 to
1.14;<=1 year: RR 0.94, 95% CI 0.72 to 1.23; 5 years: RR 1.07, 95% CI 0.88
to 1.30), the risk of several clinical outcomes was significantly
decreased (major bleeding, AKI, NOW-AF) or significantly increased (major
vascular complications, PPM implantation) for TAVI vs SAVR. TAVI was
associated with a significantly shorter hospital stay vs SAVR (MD-3.08
days, 95% CI-4.86 to-1.29; 4 RCTs, n=2758 participants). Subgroup analysis
generally favoured TAVI patients receiving implantation via the
transfemoral (TF) route (vs non-TF); receiving a balloon-expandable (vs
self-expanding) valve; and those at low-intermediate risk (vs high risk).
All RCTs were rated at high ROB, predominantly due to lack of blinding and
selective reporting. Conclusions No overall change in the risk of death
from any cause or cardiovascular mortality was identified but 95% CIs were
often wide, indicating uncertainty. TAVI may reduce the risk of certain
side effects while SAVR may reduce the risk of others. Most long-Term
(5-year) results are limited to older patients at high surgical risk (ie,
early trials), therefore more data are required for low risk populations.
Ultimately, neither surgical technique was considered dominant, and these
results suggest that every patient with SAS should be individually engaged
in SDM to make evidence-based, personalised decisions around their care
based on the various benefits and risks associated with each treatment.
PROSPERO registration number CRD42019138171.<br/>Copyright &#xa9; 2021 BMJ
Publishing Group. All rights reserved.

<26>
Accession Number
2016352076
Title
Impact of procedural variability and study design quality on the efficacy
of cell-based therapies for heart failure - a meta-analysis.
Source
PLoS ONE. 17(1 January) (no pagination), 2022. Article Number: e0261462.
Date of Publication: January 2022.
Author
Xu Z.; Neuber S.; Nazari-Shafti T.; Liu Z.; Dong F.; Stamm C.
Institution
(Xu, Neuber, Nazari-Shafti, Liu, Stamm) Berlin Institute of Health Center
for Regenerative Therapies, Charite-Universitatsmedizin Berlin, Berlin,
Germany
(Neuber, Nazari-Shafti, Stamm) Department of Cardiothoracic and Vascular
Surgery, German Heart Center Berlin, Berlin, Germany
(Neuber, Nazari-Shafti, Stamm) German Centre for Cardiovascular Research,
Partner Site Berlin, Berlin, Germany
(Nazari-Shafti) Berlin Institute of Health at Charite, Universitatsmedizin
Berlin, Berlin, Germany
(Dong) Department of Cardiology, Shenzhen University General Hospital,
Guangdong, Shenzhen, China
(Stamm) Helmholtz Zentrum Geesthacht, Institut fur Aktive Polymere,
Teltow, Germany
Publisher
Public Library of Science
Abstract
Background Cell-based therapy has long been considered a promising
strategy for the treatment of heart failure (HF). However, its
effectiveness in the clinical setting is now doubted. Because previous
meta-analyses provided conflicting results, we sought to review all
available data focusing on cell type and trial design. Methods and
findings The electronic databases PubMed, Cochrane library,
ClinicalTrials.gov, and EudraCT were searched for randomized controlled
trials (RCTs) utilizing cell therapy for HF patients from January 1, 2000
to December 31, 2020. Forty-three RCTs with 2855 participants were
identified. The quality of the reported study design was assessed by
evaluating the risk-of-bias (ROB). Primary outcomes were defined as
mortality rate and left ventricular ejection fraction (LVEF) change from
baseline. Secondary outcomes included both heart function data and
clinical symptoms/events. Between-study heterogeneity was assessed using
the I2 index. Subgroup analysis was performed based on HF type, cell
source, cell origin, cell type, cell processing, type of surgical
intervention, cell delivery routes, cell dose, and follow-up duration.
Only 10 of the 43 studies had a low ROB for all method- and outcome
parameters. A higher ROB was associated with a greater increase in LVEF.
Overall, there was no impact on mortality for up to 12 months follow-up,
and a clinically irrelevant average LVEF increase by LVEF (2.4%, 95% CI =
0.75-4.05, p = 0.004). Freshly isolated, primary cells tended to produce
better outcomes than cultured cell products, but there was no clear impact
of the cell source tissue, bone marrow cell phenotype or cell chricdose
(raw or normalized for CD34+ cells). A meaningful increase in LVEF was
only observed when cell therapy was combined with myocardial
revascularization. Conclusions The published results suggest a small
increase in LVEF following cell therapy for heart failure, but publication
bias and methodologic shortcomings need to be taken into account. Given
that cardiac cell therapy has now been pursued for 20 years without real
progress, further efforts should not be made. Study registry number This
meta-analysis is registered at the international prospective register of
systematic reviews, number CRD42019118872.<br/>Copyright: &#xa9; 2022 Xu
et al. This is an open access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<27>
Accession Number
636634686
Title
Effect of 26 Weeks of Liraglutide Treatment on Coronary Artery
Inflammation in Type 2 Diabetes Quantified by [⁶⁴Cu]Cu-DOTATATE
PET/CT: Results from the LIRAFLAME Trial.
Source
Frontiers in Endocrinology. 12 (no pagination), 2021. Article Number:
790405. Date of Publication: 30 Nov 2021.
Author
Jensen J.K.; Zobel E.H.; von Scholten B.J.; Rotbain Curovic V.; Hansen
T.W.; Rossing P.; Kjaer A.; Ripa R.S.
Institution
(Jensen, Kjaer, Ripa) Department of Clinical Physiology, Nuclear Medicine
and PET Cluster for Molecular Imaging, Copenhagen University Hospital -
Rigshospitalet $, Department of Biomedical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Zobel, von Scholten, Rotbain Curovic, Hansen, Rossing) Steno Diabetes
Center Copenhagen, Gentofte, Denmark
(Zobel, von Scholten) Novo Nordisk A/S, Soborg, Denmark
Publisher
Frontiers Media S.A.
Abstract
Background: Quantification of coronary artery inflammation and
atherosclerosis remains a challenge in high-risk individuals. In this
study we sought to investigate if the glucagon like peptide-1 receptor
agonist liraglutide has a direct anti-inflammatory effect in the coronary
arteries using positron emission tomography (PET) with a radioactive
tracer targeting activated macrophages in the vessel-wall. <br/>Method(s):
Thirty randomly selected participants with type 2 diabetes from the
placebo-controlled trial LIRAFLAME were enrolled in this sub-study.
Participants were, prior to enrollment in this sub-study, randomized to
either treatment with daily liraglutide (n=15) or placebo (n=15). Both
groups underwent a combined [⁶⁴Cu]Cu-DOTATATE positron emission
tomography and computed tomography scan of the heart at baseline and after
26 weeks of treatment. Coronary artery uptake of
[⁶⁴Cu]Cu-DOTATATE were measured as maximum standardized uptake
values (SUV<inf>max</inf>); and means of the maximum values
(mSUV<inf>max</inf>), both values were calculated at the level of each
participant and each individual coronary-segment. <br/>Result(s):
SUV<inf>max</inf> and mSUV<inf>max</inf> values decreased significantly in
the liraglutide group both at the participant level (SUV<inf>max</inf>:
p=0.013; mSUV<inf>max</inf>: p=0.004) and at the coronary-segment level
(SUV<inf>max</inf>: p=0.001; mSUV<inf>max</inf>: p<0.0001). No change was
observed in the placebo group neither at the participant level
(SUV<inf>max</inf>: p=0.69; mSUV<inf>max</inf>: p=0.67) or at the
coronary-segment level (SUV<inf>max</inf>: p=0.49; mSUV<inf>max</inf>:
p=0.30). When comparing the mean change in uptake values between the two
groups at both the participant level (SUV<inf>max</inf>: p=0.076;
mSUV<inf>max</inf>: p=0.077) and the coronary segment level
(SUV<inf>max</inf>: p=0.13; mSUV<inf>max</inf>: p=0.11) a borderline
significant difference was observed. Baseline SUV<inf>max</inf>
[⁶⁴Cu]Cu-DOTATATE uptake values showed a weak positive
correlation with the inflammatory biomarker high-sensitivity c-reactive
protein (tau =0.26, p=0.045). <br/>Conclusion(s): Liraglutide treatment
for 26-weeks caused a significant reduction in
[⁶⁴Cu]Cu-DOTATATE uptake in the coronary arteries whereas this
was not seen in the placebo treated group. In addition,
[⁶⁴Cu]Cu-DOTATATE PET/CT as a marker of coronary inflammation
correlated with the systemic inflammation marker hs-CRP.<br/>Copyright
&#xa9; 2021 Jensen, Zobel, von Scholten, Rotbain Curovic, Hansen, Rossing,
Kjaer and Ripa.

<28>
Accession Number
2013482055
Title
Obstructive Sleep Apnea and Arrhythmias in the Elderly.
Source
Current Sleep Medicine Reports. 7(4) (pp 197-205), 2021. Date of
Publication: December 2021.
Author
Tan E.S.J.; Lee C.-H.
Institution
(Tan, Lee) Department of Cardiology, National University Heart Centre, 1E
Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228, Singapore
(Tan, Lee) Yong Loo Lin School of Medicine, National University Singapore,
Singapore, Singapore
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Obstructive sleep apnea (OSA) is more common in the elderly and carries a
unique phenotype. Elderly patients with OSA are less symptomatic and have
less hypopnea but worse hypoxemia. Repetitive hypoxemic insults during
sleep increase the prevalence of nocturnal arrhythmias in OSA, which may
manifest as bradyarrhythmias, atrial fibrillation, ventricular
arrhythmias, and sudden cardiac death. However, arrhythmogenesis in
elderly OSA patients is complex and involves interactions between OSA,
aging, and cardiovascular risk factors. In OSA, hypoxemia, intrathoracic
pressure changes, inflammation, increased sympathetic activation, and
cardiac structural and electrical alterations contribute to arrhythmia
development. Structural, functional, molecular, and cellular alterations
that occur in the heart with aging and cellular senescence further
increase the propensity to arrhythmias. Finally, comorbidities common to
age and OSA, including hypertension, metabolic syndrome, coronary artery
disease, heart failure, and renal impairment, further add to the increased
arrhythmogenic susceptibility. Continuous positive airway pressure therapy
is an established therapy in OSA but its efficacy in arrhythmia prevention
is uncertain. Limitations in acceptance and adherence among the elderly
add to the difficulty in ascertaining its benefits in arrhythmic
reduction. In summary, OSA and aging increase the predisposition to
arrhythmias through complex interactions of pathways underlying OSA, age,
and shared risk factors.<br/>Copyright &#xa9; 2021, The Author(s), under
exclusive licence to Springer Nature Switzerland AG.

<29>
Accession Number
2012310704
Title
Evaluation of respiratory and peripheral muscle training in individuals
undergoing myocardial revascularization.
Source
Journal of Cardiac Surgery. 36(9) (pp 3166-3173), 2021. Date of
Publication: September 2021.
Author
de Aquino T.N.; de Faria Rosseto S.; Lucio Vaz J.; de Faria Cordeiro Alves
C.; Vidigal F.D.C.; Galdino G.
Institution
(de Aquino, de Faria Rosseto, Lucio Vaz, Galdino) Department of Motricity
Sciences, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
(de Aquino, de Faria Rosseto, Lucio Vaz, de Faria Cordeiro Alves)
Department of Rehabilitation and Cardiology of Hospital Santa Lucia, Pocos
de Caldas, Minas Gerais, Brazil
(Vidigal) Department of Nutrition, Federal University of Alfenas, Alfenas,
Minas Gerais, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To investigate the effect of peripheral muscle strength
training (PMT) and respiratory muscle strength training (RMT) muscle
strength training associated with conventional physical therapy on the
respiratory muscle strength, functional capacity, and quality of life in
the immediate postoperative period of patients undergoing coronary artery
bypass graft (CABG). <br/>Method(s): This was a randomized controlled
trial. Eighty-three patients undergoing CABG were divided into two groups:
Intervention group, patients that received PMT and RMT associated with
conventional physical therapy, one session a day for 5 days; control
group, patients that received conventional physical therapy, one session a
day for 5 days. All patients had respiratory muscle strength, peripheral
muscle strength, functional capacity, and quality of life evaluated by
manovacuometry, dynamometry, 6-min walking test, and 36-item Short-Form
Health Survey Questionnaire, respectively, before and 5 days after CABG.
<br/>Result(s): Both groups showed a significantly reduced respiratory
muscle strength after CABG; however, in the intervention group, the
inspiratory muscle strength reduction was lower (confidence interval [CI]
95%: 2.29 [1.9; 27.54]). The quality of live domains for pain (CI 95%:
3.08 [5.21; 24.97]) and vitality perception (CI 95%: 2.51 [2.12; 19.53])
worsened in the control and improved in the intervention group (pain: CI
95%: 1.19 [-3.38; 13.09]; vitality CI 95%: 0.07 [-6.55; 7.04]). Both
groups showed reduced functional capacity and expiratory muscle strength
after CABG. <br/>Conclusion(s): Conventional physical therapy combined
with PMT and RMT may reduce inspiratory muscle strength loss and improve
pain and vitality perception in the immediate postoperative period after
CABG.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<30>
Accession Number
2016193474
Title
Proximal optimisation technique versus final kissing balloon inflation in
coronary bifurcation lesions: The randomised, multicentre PROPOT trial.
Source
EuroIntervention. 17(9) (pp 747-756), 2021. Date of Publication: October
2021.
Author
Watanabe Y.; Murasato Y.; Yamawaki M.; Kinoshita Y.; Okubo M.; Yumoto K.;
Masuda N.; Otake H.; Aoki J.; Nakazawa G.; Numasawa Y.; Ito T.; Shite J.;
Okamura T.; Takagi K.; Lefevre T.; Chevalier B.; Louvard Y.; Suzuki N.;
Kozuma K.
Institution
(Watanabe, Kozuma) Department of Medicine, Division of Cardiology, Teikyo
University School of Medicine, Tokyo, Japan
(Murasato) Department of Cardiology, National Hospital Organization Kyushu
Medical Center, Fukuoka, Japan
(Yamawaki) Department of Cardiology, Saiseikai Yokohama City Eastern
Hospital, Yokohama, Japan
(Kinoshita) Department of Cardiology, Toyohashi Heart Center, Toyohashi,
Japan
(Okubo) Department of Cardiology, Gifu Heart Center, Gifu, Japan
(Yumoto) Department of Cardiology, Yokohama Rosai Hospital, Yokohama,
Japan
(Masuda) Department of Cardiology, Ageo Central General Hospital, Ageo,
Japan
(Otake) Department of Cardiology, Kobe University Graduate School of
Medicine, Kobe, Japan
(Aoki) Department of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
(Nakazawa) Department of Cardiology, Tokai University School of Medicine,
Isehara, Japan
(Numasawa) Department of Cardiology, Japanese Red Cross Ashikaga Hospital,
Ashikaga, Japan
(Ito) Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
(Shite) Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka,
Japan
(Okamura) Department of Medicine and Clinical Science, Yamaguchi
University Graduate School of Medicine, Ube, Japan
(Takagi) Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
(Kozuma) Department of Biostatistics, Division of Health Sciences and
Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo,
Japan
(Lefevre, Chevalier, Louvard) Department of Cardiology, Ramsay Generale de
Sante, Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques Cartier,
Massy, France
(Suzuki) Division of Cardiology, Teikyo University Mizonokuchi Hospital,
Kawasaki, Japan
Publisher
Europa Group
Abstract
Background: Clinical implications of the proximal optimisation technique
(POT) for bifurcation lesions have not been investigated in a randomised
controlled trial. <br/>Aim(s): This study aimed to investigate whether POT
is superior in terms of stent apposition compared with the conventional
kissing balloon technique (KBT) in real-life bifurcation lesions using
optical coherence tomography (OCT). <br/>Method(s): A total of 120
patients from 15 centres were randomised into two groups - POT followed by
side branch dilation or KBT. Finally, 57 and 58 patients in the POT and
KBT groups, respectively, were analysed. OCT was performed at baseline,
immediately after wire recrossing to the side branch, and at the final
procedure. <br/>Result(s): The primary endpoint was the rate of malapposed
struts assessed by the final OCT. The rate of malapposed struts did not
differ between the POT and KBT groups (in-stent proximal site: 10.4% vs
7.7%, p=0.33; bifurcation core: 1.4% vs 1.1%, p=0.67; core's distal edge:
6.2% vs 5.3%, p=0.59). More additional treatments were required among the
POT group (40.4% vs 6.9%, p<0.01). At one-year follow-up, only one patient
in each group underwent target lesion revascularisation (2.0% vs 1.9%).
<br/>Conclusion(s): POT followed by side branch dilation did not show any
advantages over conventional KBT in terms of stent apposition; however,
excellent midterm clinical outcomes were observed in both
strategies.<br/>Copyright &#xa9; Europa Digital & Publishing 2021. All
rights reserved.

<31>
Accession Number
2016193454
Title
Reply: When is the optimal time point for detecting malapposition in
coronary bifurcation trials?.
Source
EuroIntervention. 17(7) (pp 609-610), 2021. Date of Publication: September
2021.
Author
Watanabe Y.; Murasato Y.; Suzuki N.; Kozuma K.
Institution
(Watanabe, Kozuma) Department of Medicine, Division of Cardiology, Teikyo
University School of Medicine, Tokyo, Japan
(Murasato) Department of Cardiology, National Hospital Organization Kyushu
Medical Center, Fukuoka, Japan
(Suzuki) Division of Cardiology, Teikyo University Mizonokuchi Hospital,
Kawasaki, Japan
Publisher
Europa Group

<32>
[Use Link to view the full text]
Accession Number
633374165
Title
Bariatric Surgery as a Bridge to Heart Transplantation in Morbidly Obese
Patients: A Systematic Review and Meta-Analysis.
Source
Cardiology in review. 30(1) (pp 1-7), 2022. Date of Publication: 01 Jan
2022.
Author
Lee Y.; Anvari S.; Sam Soon M.; Tian C.; Wong J.A.; Hong D.; Anvari M.;
Doumouras A.G.
Institution
(Lee, Sam Soon, Tian, Hong, Anvari, Doumouras) From the Division of
General Surgery, McMaster University, Hamilton, Ontario, Canada
(Anvari) Department of Medicine, McMaster University, Hamilton, Ontario,
Canada
(Wong) Population Health Research Institute, McMaster University,
Hamilton, Ontario, Canada
Publisher
NLM (Medline)
Abstract
Class 2 obesity or greater [body mass index (BMI) >35kg/m2] is a relative
contraindication for heart transplant due to its associated perioperative
risks and mortality. Whether bariatric surgery can act as a potential
bridging procedure to heart transplantation is unknown. The aim of this
systematic review and meta-analysis is to investigate the role of
bariatric surgery on improving transplant candidacy in patients with
end-stage heart failure (ESHF). MEDLINE, EMBASE, CENTRAL, and PubMed
databases were searched up to September 2019 for studies that performed
bariatric surgery on patients with severe obesity and ESHF. Outcomes of
interest included incidence of patients listed for heart transplantation
after bariatric surgery, proportion of patients that successfully received
transplant, the change in BMI after bariatric surgery, and 30-day
complications. Pooled estimates were calculated using a random-effects
meta-analysis of proportions. Eleven studies with 98 patients were
included. Mean preoperative BMI was 44.9 (2.1) kg/m2 and BMI after surgery
was 33.2 (2.3) kg/m2 with an absolute BMI reduction of 26.1%. After
bariatric surgery, 71% [95% confidence interval (CI), 55-86%] of patients
with ESHF were listed for transplantation. The mean time from bariatric
surgery to receiving a heart transplant was 14.9 (4.0) months. Of the
listed patients, 57% (95% CI, 39-74%) successfully received heart
transplant. The rate of 30-day mortality after bariatric surgery was 0%,
and the 30-day major and minor complications after bariatric surgery was
28% (95% CI, 10-49%). Bariatric surgery can facilitate sustained weight
loss in obese patients with ESHF, improving heart transplant candidacy and
the incidence of transplantation.<br/>Copyright &#xa9; 2020 Wolters Kluwer
Health, Inc. All rights reserved.

<33>
Accession Number
2013320320
Title
Cost-Consequence Analysis of Using Cangrelor in High Angiographic Risk
Percutaneous Coronary Intervention Patients: A US Hospital Perspective.
Source
American Journal of Cardiovascular Drugs. 22(1) (pp 93-104), 2022. Date of
Publication: January 2022.
Author
Jensen I.S.; Wu E.; Cyr P.L.; Claussen M.; Winkler T.; Salahuddin K.;
Prats J.; Mahaffey K.W.; Gibson C.M.; Steg P.G.; Stone G.W.; Bhatt D.L.
Institution
(Jensen, Wu, Cyr) Precision Health Economics, 133 Federal Street, 10th
floor, Boston, MA 02110, United States
(Cyr) University of North Carolina at Charlotte, College of Health and
Human Services, Charlotte, NC, United States
(Claussen, Winkler, Salahuddin) Chiesi, Inc., Cary, NC, United States
(Prats) Elysis, CarlisleMAUnited States
(Mahaffey) Department of Medicine, Stanford Center for Clinical Research,
Stanford, CA, United States
(Gibson) Division of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Steg) Universite de Paris, Assistance Publique-Hopitaux de Paris, Hopital
Bichat, INSERM U-1148, Paris, France
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, and the Cardiovascular Research
Foundation, New York, NY, United States
(Bhatt) Brigham and Women's Hospital Heart and Vascular Center, and
Harvard Medical School, Boston, MA, United States
Publisher
Adis
Abstract
Objectives: The objective of this study was to evaluate a US hospital's
cost implications and outcomes of cangrelor use in percutaneous coronary
intervention (PCI) patients with two or more angiographic high-risk
features (HRFs), including avoidance of oral P2Y<inf>12</inf> inhibitor
pretreatment in patients requiring cardiac surgery. Intravenous cangrelor
provides direct, immediate onset and rapid-offset P2Y<inf>12</inf>
inhibition, which may reduce the necessity for oral P2Y<inf>12</inf>
pretreatment. <br/>Method(s): A decision analytic model was developed,
estimating the annual impact over 3 years of cangrelor availability.
Ischemic and bleeding events (48 h) from randomized clinical trial data
were extrapolated to 30 days. Event costs were from the CHAMPION PHOENIX
Economics substudy. Rates of coronary artery disease (CAD) presentation,
PCI, oral P2Y<inf>12</inf> pretreatment, and inpatient hospitalization
costs were from published literature and clinical experts. Scenario
analyses evaluated the impact of cangrelor availability on potential
reduced P2Y<inf>12</inf> pretreatment rates by 50-100%. Drug costs were
2019 wholesale acquisition costs and, where necessary, all costs were
adjusted to 2019 dollars. <br/>Result(s): In a hospital treating 1000 CAD
PCI inpatients annually, increasing cangrelor use from 11 to 32% resulted
in a reduction in 48-h ischemic events/year by 5.7%, while bleeding events
increased by 2.9%. Total costs of $1,135,472 declined 12.8%, with a 50%
reduction in P2Y<inf>12</inf> pretreatment or 30% with no pretreatment.
Savings were driven by a decrease in ischemic events, decrease in
glycoprotein IIb/IIIa inhibitor use, and less need for and shorter oral
P2Y<inf>12</inf> inhibitor washout period for surgery patients.
<br/>Conclusion(s): Use of cangrelor in patients with two or more
angiographic HRFs may improve outcomes and lower hospital budgets, mainly
from avoiding surgery delays necessitated by oral P2Y<inf>12</inf>
inhibitor pretreatment.<br/>Copyright &#xa9; 2021, The Author(s).

<34>
Accession Number
635756748
Title
Long-term 5-year outcome of the randomized IMPRESS in severe shock trial:
percutaneous mechanical circulatory support vs. intra-aortic balloon pump
in cardiogenic shock after acute myocardial infarction.
Source
European heart journal. Acute cardiovascular care. 10(9) (pp 1009-1015),
2021. Date of Publication: 06 Dec 2021.
Author
Karami M.; Eriksen E.; Ouweneel D.M.; Claessen B.E.; Vis M.M.; Baan J.;
Beijk M.; Packer E.J.S.; Sjauw K.D.; Engstrom A.; Vlaar A.; Lagrand W.K.;
Henriques J.P.S.
Institution
(Karami, Ouweneel, Claessen, Vis, Baan, Beijk, Engstrom, Henriques)
Department of Interventional Cardiology, Heart Center, Amsterdam
Cardiovascular Sciences, University of Amsterdam, Meibergdreef 9, AZ
Amsterdam 1105, Netherlands
(Eriksen, Packer) Department of Heart Disease, Haukeland University
Hospital, Jonas Lies vei 65, Bergen 5021, Norway
(Claessen) Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar,
Netherlands
(Sjauw) Department of Cardiology, Medical Center Leeuwarden, Henri
Dunantweg 2, AD Leeuwarden 8934, Netherlands
(Engstrom) Department of Cardiology, Erasmus MC, Rotterdam, Netherlands
(Vlaar, Lagrand) Department of Intensive Care, University of Amsterdam,
Meibergdreef 9, AZ Amsterdam 1105, Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: To assess differences in long-term outcome and functional status of
patients with cardiogenic shock (CS) treated by percutaneous mechanical
circulatory support (pMCS) and intra-aortic balloon pump (IABP). METHODS
AND RESULTS: Long-term follow-up of the multicentre, randomized IMPRESS in
Severe Shock trial (NTR3450) was performed 5-year after initial
randomization. Between 2012 and 2015, a total of 48 patients with severe
CS from acute myocardial infarction (AMI) with ST-segment elevation
undergoing immediate revascularization were randomized to pMCS by Impella
CP (n=24) or IABP (n=24). For the 5-year assessment, all-cause mortality,
functional status, and occurrence of major adverse cardiac and
cerebrovascular event (MACCE) were assessed. MACCE consisted of death,
myocardial re-infarction, repeat percutaneous coronary intervention,
coronary artery bypass grafting, and stroke. Five-year mortality was 50%
(n=12/24) in pMCS patients and 63% (n=15/24) in IABP patients (relative
risk 0.87, 95% confidence interval 0.47-1.59, P=0.65). MACCE occurred in
12/24 (50%) of the pMCS patients vs. 19/24 (79%) of the IABP patients
(P=0.07). All survivors except for one were in New York Heart Association
Class I/II [pMCS n=10 (91%) and IABP n=7 (100%), P=1.00] and none of the
patients had residual angina. There were no differences in left
ventricular ejection fraction between the groups (pMCS 52+/-11% vs. IABP
48+/-10%, P=0.53). <br/>CONCLUSION(S): In this explorative randomized
trial of patients with severe CS after AMI, there was no difference in
long-term 5-year mortality between pMCS and IABP-treated patients,
supporting previously published short-term data and in accordance with
other long-term CS trials.<br/>Copyright &#xa9; The Author(s) 2021.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<35>
Accession Number
2014416838
Title
Target blood pressure management during cardiopulmonary bypass improves
lactate levels after cardiac surgery: a randomized controlled trial.
Source
BMC Anesthesiology. 21(1) (no pagination), 2021. Article Number: 309. Date
of Publication: December 2021.
Author
Miao Q.; Wu D.J.; Chen X.; Xu M.; Sun L.; Guo Z.; He B.; Wu J.
Institution
(Miao, Wu, Chen, Xu, Wu) Department of Anesthesiology, Shanghai Chest
Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Road,
Shanghai 200030, China
(Sun, Guo) Department of Cardiopulmonary Bypass, Shanghai Chest Hospital,
Shanghai Jiao Tong University, Shanghai, China
(He) Department of Intensive Care Unit, Shanghai Chest Hospital, Shanghai
Jiao Tong University, Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: Hyperlactatemia is associated with a poor prognosis in cardiac
surgery patients. This study explored the impact of target blood pressure
management during cardiopulmonary bypass (CPB) on blood lactate levels
after cardiac surgery. <br/>Method(s): Adult patients undergoing cardiac
valve surgery between 20/1/2020 and 30/6/2020 at Shanghai Chest Hospital
were enrolled. The patients were randomized into a low mean arterial
pressure (L-MAP) group (target MAP between 50 and 60 mmHg) or a high mean
arterial pressure (H-MAP) group (target MAP between 70 and 80 mmHg), n =
20 for each. Norepinephrine was titrated only during CPB to maintain MAP
at the target level. Blood lactate levels in the two groups were detected
before the operation (T0), at the end of CPB (T1), at the end of the
operation (T2), 1 h after the operation (T3), 6 h after the operation (T4)
and 24 h after the operation (T5). The primary outcome was the blood
lactate level at the end of the operation (T2). The secondary outcomes
included the blood lactate level at T1, T3, T4, and T5 and the dose of
epinephrine and dopamine within 24 h after the operation, time to
extubation, length of stay in the ICU, incidence of readmission within 30
days, and mortality within 1 year. <br/>Result(s): Forty patents were
enrolled and analyzed in the study. The lactate level in the H-MAP group
was significantly lower than that in the L-MAP group at the end of the
operation (3.1 [IQR 2.1, 5.0] vs. 2.1 [IQR 1.7, 2.9], P = 0.008) and at
the end of CPB and 1 hour after surgery. The dose of epinephrine within 24
h after the operation, time to extubation and length of stay in the ICU in
the L-MAP group were significantly higher than those in the H-MAP group.
<br/>Conclusion(s): Maintaining a relatively higher MAP during CPB
deceased the blood lactate level at the end of surgery, reduced
epinephrine consumption, and shortened the time to extubation and length
of stay in the ICU after surgery. Trial registration: This single-center,
prospective, RCT has completed the registration of the Chinese Clinical
Trial Center at 8/1/2020 with the registration number ChiCTR2000028941. It
was conducted from 20/1/2020 to 30/6/2020 as a single, blinded trial in
Shanghai Chest Hospital.<br/>Copyright &#xa9; 2021, The Author(s).

<36>
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).

<37>
Accession Number
2014388766
Title
Nocturnal dexmedetomidine alleviates post-intensive care syndrome
following cardiac surgery: a prospective randomized controlled clinical
trial.
Source
BMC Medicine. 19(1) (no pagination), 2021. Article Number: 306. Date of
Publication: December 2021.
Author
Dong C.-H.; Gao C.-N.; An X.-H.; Li N.; Yang L.; Li D.-C.; Tan Q.
Institution
(Dong, Li, Tan) Department of Cardiac Surgery, Shandong Provincial
Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi
Road, Jinan, Shandong 250021, China
(Gao) Department of Biostatistics, School of Public Health, Cheeloo
College of Medicine, Shandong University, Jinan, Shandong 250012, China
(Gao) Healthcare Big Data Institute of Shandong University, Jinan,
Shandong 250000, China
(An) Department of Anesthesiology, Shandong Provincial Hospital Affiliated
to Shandong First Medical University, Jinan, Shandong 250021, China
(Li) Department of Gynecology, Shandong Provincial Hospital Affiliated to
Shandong First Medical University, Jinan, Shandong 250021, China
(Yang) Department of Cardiology, Shandong Provincial Hospital Affiliated
to Shandong First Medical University, Jinan, Shandong 250021, China
(Tan) Department of Cardiac Surgery, Shandong Provincial Hospital, Cheeloo
College of Medicine, Shandong University, Jinan, Shandong 250021, China
Publisher
BioMed Central Ltd
Abstract
Background: Dexmedetomidine is a sedative agent that may have the
potential to reduce the risk of post-intensive care syndrome (PICS). This
study aimed to establish whether prophylactic nocturnal dexmedetomidine
safely reduces postoperative PICS incidence and to develop an easy-to-use
model for predicting the risk of PICS following cardiac surgery.
<br/>Method(s): This was a single-center, double-blind, randomized,
prospective, placebo-controlled trial. Patients undergoing cardiac surgery
were randomly assigned (1:1) to dexmedetomidine or placebo (normal saline)
groups between January 2019 and July 2020. Dexmedetomidine or a similar
volume of saline was administered, with an infusion rate up to 1.2
mug/kg/h until the RASS remained between - 1 and 0. The primary study
endpoint was PICS incidence at 6 months follow-up, as defined by
cognitive, physical, or psychological impairments. <br/>Result(s): We
assessed 703 individuals for eligibility, of whom 508 were enrolled. Of
these, there were 251 in the dexmedetomidine group and 257 in the placebo
group that received the trial agent, forming a modified intention-to-treat
population. PICS incidence at 6-month follow-up was significantly
decreased in the dexmedetomidine group (54/251, 21.5%) relative to the
placebo group (80/257, 31.1%) (odds ratio [OR] 0.793, 95% CI 0.665-0.945;
p = 0.014). Psychological impairment was significantly reduced in the
dexmedetomidine group relative to the placebo group (18.7% vs. 26.8%, OR
0.806, CI 0.672-0.967, p = 0.029). However, dexmedetomidine treatment was
associated with a higher rate of hypotension. A nomogram revealed that
age, education, a medical history of diabetes and smoking, dexmedetomidine
treatment, postoperative atrial fibrillation, and sequential organ failure
assessment scores at 8 h post-surgery were independent predictors of PICS.
<br/>Conclusion(s): Prophylactic nocturnal dexmedetomidine administration
significantly reduced PICS incidence by a marked reduction in
psychological impairment within a 6-month follow-up period. Trial
registration: ChiCTR, ChiCTR1800014314. Registered 5 January 2018,
http://www.chictr.org.cn/index.aspx.<br/>Copyright &#xa9; 2021, The
Author(s).

<38>
Accession Number
636658734
Title
Tight glycaemic control and surgical site infections post cardiac surgery:
A systematic review.
Source
Journal of Wound Care. 30(Supplement 12) (pp S22-S28), 2021. Date of
Publication: 01 Dec 2021.
Author
Hweidi I.M.; Zytoo A.M.; Hayajneh A.
Institution
(Hweidi, Zytoo, Hayajneh) Jordan University of Science and Technology,
Faculty of Nursing, P.O. Box 3030, Irbid 22110, Jordan
Publisher
MA Healthcare Ltd
Abstract
Objective: Surgical site infection (SSI) is one of the most serious
potential complications post cardiac surgery among patients with diabetes
and has a number of adverse health outcomes. The literature shows
discrepancies regarding the effect of different glycaemic control
protocols on reducing adverse health outcomes including SSIs. The aim of
this study was to conduct a systematic review that investigated the effect
of the optimal range of tight glycaemic control protocols using a
continuous insulin infusion on reducing the incidence of SSIs in adult
patients with diabetes undergoing cardiac surgery. <br/>Method(s): A
systematic review was conducted following the PRISMA statement and
guidelines. Search terms were used to identify research studies published
between 2000 and 2019 across five key databases, including CINAHL,
Medline, PubMed, Cochrane Database and Google Scholar. <br/>Result(s): A
total of 12 studies met the review inclusion criteria. The reviewed
literature tended to support the implementation of a tight glycaemic
control protocol, particularly in the postoperative phase, that
demonstrated fewer potential complications associated with cardiac
surgery. On the other hand, the literature also supported the application
of a moderate glycaemic control protocol in the intraoperative phase to
obtain better glycaemic stability with fewer potential complications among
those patients with diabetes undergoing cardiac surgery.
<br/>Conclusion(s): This analysis concludes that tight glycaemic control
is more effective than moderate glycaemic control intraoperatively in
terms of glycaemic stability among patients with diabetes undergoing
cardiac surgery. Results also emphasised the importance of time-based
protocol implementation to ensure better health outcomes and better
quality of care for patients. Declaration of interest: The authors have no
conflicts of interest to declare.<br/>Copyright &#xa9; 2021 MA Healthcare
Ltd

<39>
[Use Link to view the full text]
Accession Number
636640660
Title
Icosapent Ethyl Reduces Ischemic Events in Patients With a History of
Previous Coronary Artery Bypass Grafting: REDUCE-IT CABG.
Source
Circulation. 144(23) (pp 1845-1855), 2021. Date of Publication: 07 Dec
2021.
Author
Verma S.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson T.A.;
Dhingra N.K.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz
C.; Gibson C.M.; Pinto D.; Giugliano R.P.; Budoff M.J.; Mason R.P.; Tardif
J.-C.; Ballantyne C.M.
Institution
(Verma, Tardif) Montreal Heart Institute, Universite de Montreal, QC
(Bhatt, Giugliano) Brigham and Women's Hospital Heart and Vascular Center,
Harvard Medical School, Boston
(Steg) Universite de Paris, Hopital Bichat, French Alliance for
Cardiovascular Trials, Institut National de la Sante et de la Recherche
Medicale U-1148, Assistance Publique-Hopitaux de Paris, Paris, United
States
(Miller) Department of Medicine, University of Maryland School of Medicine
(Brinton) Utah Lipid Center
(Jacobson) Office of Health Promotion and Disease Prevention, Department
of Medicine, Emory University School of Medicine, Atlanta, United States
(Dhingra) Division of Cardiac Surgery, St Michael's Hospital, University
of Toronto, ON
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma Inc, R.A.J.,
L.J., R.T.D., Bridgewater, United States
(Gibson, Pinto) Baim Clinical Research Institute, Boston
(Budoff) David Geffen School of Medicine, Torrance
(Mason) Elucida Research, Beverly, United States
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston
Publisher
NLM (Medline)
Abstract
BACKGROUND: Despite advances in surgery and pharmacotherapy, there remains
significant residual ischemic risk after coronary artery bypass grafting
surgery. <br/>METHOD(S): In REDUCE-IT (Reduction of Cardiovascular Events
With Icosapent Ethyl-Intervention Trial), a multicenter,
placebo-controlled, double-blind trial, statin-treated patients with
controlled low-density lipoprotein cholesterol and mild to moderate
hypertriglyceridemia were randomized to 4 g daily of icosapent ethyl or
placebo. They experienced a 25% reduction in risk of a primary efficacy
end point (composite of cardiovascular death, myocardial infarction,
stroke, coronary revascularization, or hospitalization for unstable
angina) and a 26% reduction in risk of a key secondary efficacy end point
(composite of cardiovascular death, myocardial infarction, or stroke) when
compared with placebo. The current analysis reports on the subgroup of
patients from the trial with a history of coronary artery bypass grafting.
<br/>RESULT(S): Of the 8179 patients randomized in REDUCE-IT, a total of
1837 (22.5%) had a history of coronary artery bypass grafting, with 897
patients randomized to icosapent ethyl and 940 to placebo. Baseline
characteristics were similar between treatment groups. Randomization to
icosapent ethyl was associated with a significant reduction in the primary
end point (hazard ratio [HR], 0.76 [95% CI, 0.63-0.92]; P=0.004), in the
key secondary end point (HR, 0.69 [95% CI, 0.56-0.87]; P=0.001), and in
total (first plus subsequent or recurrent) ischemic events (rate ratio,
0.64 [95% CI, 0.50-0.81]; P=0.0002) compared with placebo. This yielded an
absolute risk reduction of 6.2% (95% CI, 2.3%-10.2%) in first events, with
a number needed to treat of 16 (95% CI, 10-44) during a median follow-up
time of 4.8 years. Safety findings were similar to the overall study:
beyond an increased rate of atrial fibrillation/flutter requiring
hospitalization for at least 24 hours (5.0% vs 3.1%; P=0.03) and a
nonsignificant increase in bleeding, occurrences of adverse events were
comparable between groups. <br/>CONCLUSION(S): In REDUCE-IT patients with
a history of coronary artery bypass grafting, treatment with icosapent
ethyl was associated with significant reductions in first and recurrent
ischemic events. Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT01492361.

<40>
Accession Number
2016088230
Title
The role of electrophysiology study in risk stratification of cardiac
sarcoidosis patients: Meta-analyses and systemic review.
Source
International Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Adhaduk M.; Paudel B.; Liu K.; Ashwath M.; Giudici M.
Institution
(Adhaduk, Paudel, Liu, Ashwath, Giudici) The University of Iowa, United
States
Publisher
Elsevier Ireland Ltd
Abstract
Background: The utility of an electrophysiologic study (EPS) in the risk
stratification of cardiac sarcoidosis (CS) patients is not clear. We
conducted a systemic review and meta-analysis to evaluate the utility of
EPS in the risk stratification of CS patients. <br/>Method(s): We searched
PubMed, Embase, and Scopus databases from their inception to 12/4/2020
with search terms "Cardiac sarcoidosis" And "Electrophysiological studies
OR ablation". The first and second authors reviewed all the studies. We
extracted the data of positive and negative EPS, and outcomes defined as
ventricular arrhythmias, implantable cardioverter defibrillator therapy,
death, left ventricular assist device placement, or heart transplantation.
Risk of bias assessment was done by the Quality Assessment of Diagnostic
Accuracy Studies-2 tool. Subgroup analysis of patients with left
ventricular ejection fraction (LVEF) >35%, and probable CS, no prior
ventricular tachycardia (VT) and LVEF >35% were performed. <br/>Result(s):
We found 544 articles after removing duplicates. A total of 52 full
articles were reviewed, and eight studies were included in the
meta-analysis. The pooled sensitivity and specificity (95% confidence
interval) of EPS in predicting clinical outcomes were 0.70 (0.51-0.85) and
0.93 (0.85-0.97), respectively. Subgroup analysis of patients with LVEF
>35% resulted in pooled sensitivity of 0.63 (0.29-0.88) and pooled
specificity of 0.97 (0.92-0.99), and subgroup analysis of patients with
probable CS, no prior VT, and LVEF >35% resulted in pooled sensitivity of
0.71 (0.33-0.93) and pooled specificity of 0.96 (0.88-0.99) in predicting
adverse clinical outcomes. <br/>Conclusion(s): EPS is an effective risk
stratification tool in patients with CS across all subgroups with high
sensitivity and specificity.<br/>Copyright &#xa9; 2021 Elsevier B.V.

<41>
Accession Number
635108025
Title
Cardiac mortality in patients randomised to elective coronary
revascularisation plus medical therapy or medical therapy alone: a
systematic review and meta-analysis.
Source
European heart journal. 42(45) (pp 4638-4651), 2021. Date of Publication:
01 Dec 2021.
Author
Navarese E.P.; Lansky A.J.; Kereiakes D.J.; Kubica J.; Gurbel P.A.; Gorog
D.A.; Valgimigli M.; Curzen N.; Kandzari D.E.; Bonaca M.P.; Brouwer M.;
Uminska J.; Jaguszewski M.J.; Raggi P.; Waksman R.; Leon M.B.; Wijns W.;
Andreotti F.
Institution
(Navarese, Kubica) Interventional Cardiology and Cardiovascular Medicine
Research, Department of Cardiology and Internal Medicine, Nicolaus
Copernicus University, Bydgoszcz, Poland
(Navarese, Raggi) Faculty of Medicine, University of Alberta, Edmonton,
Canada
(Navarese, Kubica) SIRIO MEDICINE research network, Poland
(Lansky) Yale University School of Medicine, CT, New Haven, United States
(Kereiakes) Christ Hospital and Lindner Research Center, Cincinnati, OH,
USA
(Gurbel) Sinai Center for Thrombosis Research and Drug Development, Sinai
Hospital of Baltimore, MD, Baltimore, United States
(Gorog) Faculty of Medicine, National Heart and Lung Institute, Imperial
College, London, United Kingdom
(Gorog) Cardiology Department, East and North Hertfordshire NHS Trust,
Stevenage, United Kingdom
(Valgimigli) Department of Cardiology, Inselspital Universitatsspital,
Bern, Switzerland
(Curzen) University Hospital Southampton NHS Foundation Trust,
Southampton, United Kingdom
(Curzen) University of Southampton, Southampton, United Kingdom
(Kandzari) Department of Interventional Cardiology, Piedmont Heart
Institute, Atlanta, United States
(Bonaca) CPC Clinical Research, University of Colorado School of Medicine,
United States
(Brouwer) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Uminska) Department of Geriatrics, Nicolaus Copernicus University,
Bydgoszcz, Poland
(Jaguszewski) 1st Department of Cardiology, Medical University of Gdansk,
Gdansk, Poland
(Waksman) Section of Interventional Cardiology, MedStar Washington
Hospital Center, DC, WA, United States
(Leon) Division of Cardiovascular Medicine, Columbia University Irving
Medical Center, NY, NY, United States
(Leon) Cardiovascular Research Foundation, NY, NY, United States
(Wijns) Lambe Institute for Translational Medicine and Curam, National
University of Ireland Galway and Saolta University Healthcare Group,
Galway, Ireland
(Andreotti) Direzione Scientifica, Fondazione Policlinico Universitario
Gemelli IRCCS, Rome, Italy
(Andreotti) Cardiovascular Medicine, Catholic University Medical School,
Rome, Italy
Publisher
NLM (Medline)
Abstract
AIMS: The value of elective coronary revascularisation plus medical
therapy over medical therapy alone in managing stable patients with
coronary artery disease is debated. We reviewed all trials comparing the
two strategies in this population. METHODS AND RESULTS: From inception
through November 2020, MEDLINE, EMBASE, Google Scholar, and other
databases were searched for randomised trials comparing revascularisation
against medical therapy alone in clinically stable coronary artery disease
patients. Treatment effects were measured by rate ratios (RRs) with 95%
confidence intervals, using random-effects models. Cardiac mortality was
the pre-specified primary endpoint. Spontaneous myocardial infarction (MI)
and its association with cardiac mortality were secondary endpoints.
Further endpoints included all-cause mortality, any MI, and stroke.
Longest follow-up data were abstracted. The study is registered with
PROSPERO (CRD42021225598). Twenty-five trials involving 19 806 patients
(10 023 randomised to revascularisation plus medical therapy and 9783 to
medical therapy alone) were included. Compared with medical therapy alone,
revascularisation yielded a lower risk of cardiac death [RR 0.79
(0.67-0.93), P<0.01] and spontaneous MI [RR 0.74 (0.64-0.86), P<0.01]. By
meta-regression, the cardiac death risk reduction after revascularisation,
compared with medical therapy alone, was linearly associated with
follow-up duration [RR per 4-year follow-up: 0.81 (0.69-0.96), P=0.008],
spontaneous MI absolute difference (P=0.01) and percentage of multivessel
disease at baseline (P=0.004). Trial sequential and sensitivity analyses
confirmed the reliability of the cardiac mortality findings. All-cause
mortality [0.94 (0.87-1.01), P=0.11], any MI (P=0.14), and stroke risk
(P=0.30) did not differ significantly between strategies.
<br/>CONCLUSION(S): In stable coronary artery disease patients,
randomisation to elective coronary revascularisation plus medical therapy
led to reduced cardiac mortality compared with medical therapy alone. The
cardiac survival benefit after revascularisation improved with longer
follow-up times and was associated with fewer spontaneous
MIs.<br/>Copyright &#xa9; The Author(s) 2021. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<42>
Accession Number
2014419930
Title
Effect of physical manipulation pulmonary rehabilitation on lung cancer
patients after thoracoscopic lobectomy.
Source
Thoracic Cancer. (no pagination), 2021. Date of Publication: 2021.
Author
Zhou T.; Sun C.
Institution
(Zhou) Thoracic surgery Department, Beijing Hospital, National Center of
Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
(Sun) Nursing Department, Beijing Hospital, National Center of
Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: To introduce a new postoperative pulmonary rehabilitation
program named physical manipulation pulmonary rehabilitation (PMPR) and to
explore the effect of perioperative management, including PMPR, on
patients with non-small cell lung cancer (NSCLC) after thoracoscopic
lobectomy. <br/>Method(s): A randomized controlled trial was conducted
between April and June 2021 at the Department of Thoracic Surgery, Beijing
Hospital. Adult patients with NSCLC who had undergone thoracoscopic
lobectomy were allocated to the treatment and control groups using a
random number table. The treatment group received both conventional
pulmonary rehabilitation (CVPR) and 14 days of PMPR after surgery; the
control group patients received CVPR only. PMPR included relaxing and
exercising the intercostal muscles, thoracic costal joint and abdominal
breathing muscles. Pulmonary function tests and the 6-min walk test were
conducted preoperatively and 7, 14, 21 and 28 days postoperatively. The
postoperative length of hospital stay, chest tube retention time and
postoperative pulmonary complications were recorded. The baseline data,
pulmonary function parameters and prognosis were compared with t- and
chi-square tests between the two groups. <br/>Result(s): A total of 86
patients were enrolled, and 44 patients were allocated to the treatment
group. There were no significant differences in the baseline data for age,
sex, body mass index, basic disease, surgical plan or preoperative
pulmonary function between the two groups (all p > 0.05). The peak
expiratory flow of patients in the treatment group was higher than that of
those in the control group 21 days after surgery (316 +/- 95 vs. 272 +/-
103 l/min, respectively, p = 0.043), and forced expiratory volume in the
first second on day 28 after surgery was greater than that in the control
group (2.1 +/- 0.2 vs. 1.9 +/- 0.3 L, respectively, p < 0.001). There were
no significant differences in forced vital capacity or 6-min walk test
scores (both p > 0.05). There were no significant differences in the
incidences of pneumonia and atelectasis between the two groups (both p >
0.05). The postoperative length of hospital stay (3.3 +/- 1.3 vs. 3.9 +/-
1.5 days, p = 0.043) and chest tube retention time (66 +/- 30 vs. 81 +/-
35 h, p = 0.036) in the treatment group were shorter than those in the
control group. <br/>Conclusion(s): We determined that PMPR could improve
early lung function in patients with NSCLC after thoracoscopic lobectomy,
and that chest tube retention time and length of hospital stay were
shortened.<br/>Copyright &#xa9; 2021 The Authors. Thoracic Cancer
published by China Lung Oncology Group and John Wiley & Sons Australia,
Ltd.

<43>
Accession Number
2015854702
Title
Risk factors of invasive fungal infections in lung transplant recipients:
A systematic review and meta-analysis.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2021. Date of
Publication: 2021.
Author
Phoompoung P.; Villalobos A.P.C.; Jain S.; Foroutan F.; Orchanian-Cheff
A.; Husain S.
Institution
(Phoompoung, Villalobos, Foroutan, Husain) Ajmera Transplant Center,
University Health Network, Toronto, Canada
(Phoompoung) Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Jain) Trillium Health Partners, Canada
(Orchanian-Cheff) Library and Information Services, University Health
Network, Toronto, Canada
Publisher
Elsevier Inc.
Abstract
Background: : Invasive fungal infection (IFI) remains a common
complication after lung transplantation, causing significant morbidity and
mortality. We have attempted to quantify systematically risk factors of
IFI in lung transplant recipients. <br/>Method(s): : Studies were
retrieved from Ovid MEDLINE, Ovid Embase, Cochrane database of systematic
reviews and Cochrane central register of controlled trials. All
case-control and cohort studies evaluating the risk factors of IFI in
adult lung transplant recipients were screened. Two researchers reviewed
and assessed all studies independently. We pooled the estimated effect of
each factor associated with IFI by using a random effect model.
<br/>Result(s): : Eight studies were included in the systematic review and
5 studies were eligible for the meta-analysis. Rates of IFI range from 8%
to 33% in lung transplant recipients. Independent risk factors for
invasive aspergillosis (IA) in lung transplantation include previous
fungal colonization (odds ratio [OR] 2.44; 95% confidence interval [CI]
0.08-0.47), cytomegalovirus infection (OR 1.96; 95% CI 1.08-3.56), and
single lung transplantation (OR 1.77; 95% CI 1.08-2.91). Pre-emptive
antifungal therapy is a protective factor for IA in lung transplant (OR
0.2; 95% CI 0.08-0.47). <br/>Conclusion(s): : Cytomegalovirus infection,
previous fungal colonization and single lung transplantation independently
increase the risk of IA in lung transplant recipients. Pre-emptive
antifungal therapy is a protective factor for IA in the lung transplant
population.<br/>Copyright &#xa9; 2021

<44>
[Use Link to view the full text]
Accession Number
633464741
Title
Effects of heparinoid bridging in patients with mechanical heart valves.
Source
Journal of the American Association of Nurse Practitioners. 33(12) (pp
1148-1155), 2020. Date of Publication: 16 Nov 2020.
Author
Torres M.
Institution
(Torres) University of Pennsylvania, School of Nursing, Philadelphia, PA,
United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients with mechanical heart valves (MHVs) require long-term
oral anticoagulation therapy to protect against thromboembolisms. Invasive
procedures with high bleeding risks require oral anticoagulation therapy
cessation. Currently, guidelines recommend the use of either subcutaneous
low-molecular-weight heparin or intravenous unfractionated heparin in the
perioperative period. It is unclear whether the evidence supports the use
of one heparinoid over the other. <br/>OBJECTIVE(S): To compare the
effectiveness of low-molecular-weight heparin and unfractionated heparin
bridging based on the adverse outcomes of thromboembolisms, major
bleeding, and death during the perioperative period. DATE SOURCES: A
literature search was conducted using PubMed, EMBASE, CINAHL, and the
Cochrane Library. Five studies comparing the two bridging therapies in
chronically anticoagulated MHV patients met the inclusion criteria.
<br/>CONCLUSION(S): No statistical significance was found for the
endpoints of thromboembolism and death. One study found a statistically
significant higher occurrence of major bleeding in patients treated with
unfractionated heparin. In all the studies, major bleeding occurred more
often than thromboembolisms. Findings were limited by the study designs
and methodologies. IMPLICATIONS FOR PRACTICE: Based on the available
evidence, neither low-molecular-weight heparin nor intravenous heparin
bridging was found to be more effective in reducing the occurrence of
adverse events. This may be due in part to the study designs and lack of
standardized bridging protocols used in the studies reviewed. Nurse
practitioners should remain informed about bridging protocols and weigh
the risk versus benefit of each bridging agent when caring for patients
with MHVs.<br/>Copyright &#xa9; 2020 American Association of Nurse
Practitioners.

<45>
Accession Number
636847753
Title
Antegrade in-stent CTO recanalization.
Source
European Heart Journal, Supplement. Conference: 82nd SIC National Congress
2021. Virtual. 23(SUPPL G) (pp G71-G72), 2021. Date of Publication:
December 2021.
Author
Giovannini D.; Pesarini G.; Mammone C.
Institution
(Giovannini, Pesarini, Mammone) AOUI Verona, Italy
Publisher
Oxford University Press
Abstract
Methods and results: A 64-year-old man with prior PCI and stent of
proximal LAD due to an anterior ST-elevation myocardial infarction (STEMI)
presented with exertional angina (CCS III), despite optimal medical
therapy (OMT). The echocardiogram showed a dilatated left ventricle with
anterior and apical akinesia and a severely reduced left ventricle
ejection fraction. Coronarography was performed and a chronic total
occlusion was found at the proximal edge of the stent previously implanted
in the proximal LAD, with a thin tapered entry (J-CTO score 1). Moderate
angiographic disease was present in the circumflex (LCX) and in the right
coronary artery (RCA). Interventional collaterals were absent. Dobutamine
stress echocardiogram was performed to unmask myocardial viability.
Indeed, during intravenous Dobutamine administration, we registered an
increase in the left ventricle function, whereas only apex remained still
akinetic. Accordingly, the patient underwent LAD CTO PCI using a 7 Fr EBU
4.0 guiding catheter, via right femoral artery access. The RCA ostium was
engaged with a 6 Fr Judkins right 4.0 guiding catheter, via right radial
artery access. Antegrade wire escalation technique was attempted. Due to
scarce support, a 7 Fr Guidion guiding catheter extension and a Corsair
microcatheter were placed in the proximal LAD. Antegrade crossing was very
difficult due to intrastent high plaque burden. The occlusion was crossed
with an Asahi Conquest Pro 9 guidewire. Subsequently, an Asahi Gaia third
guidewire was advanced through the intrastent segment and then in the
distal part of LAD. The advance of microcatheter was challenging but
successfully achieved taking advantage of the low profile, high
torqueability and trackability of the Asahi Corsair Pro microcatheter.
Microcatheter tip injection confirmed the correct position in the vessel's
true lumen. An Asahi Grand Slam guidewire was placed in the distal LAD to
provide extra support for delivery of interventional devices. The lesion
was pre-dilated with progressively larger balloon, starting from a 1.1mm
diameter semi-compliant over-the-wire balloon (OTW). Two stents were
implanted with a minimal overlap at the distal edge of the proximal stent
(Resolute Onyx 3.0 x 38mm and 2.5 x 24 mm). The result was improved with
stents high-pressure post-dilatation and with selective intracoronary
adenosine and nitroglycerin administration with final Thrombolysis in
Myocardial Infarction (TIMI) grade 3 flow. The total amount of contrast
media used was 210 ml. The total procedure time was with 125 min with 45
min of fluoroscopy. No complications occurred. <br/>Conclusion(s): CTO PCI
still represents one of the most challenging subsets of coronary
interventions despite the improvement in technology and techniques.
Although data regarding percutaneous PCI CTO are still inconsistent,
successful CTO recanalization has been associated with relief of angina
and ischemia-related dyspnoea (Werner at al., 2018). In stable patients
CTO PCI has been associated with a lower risk of death, stroke, and
coronary artery bypass grafting and less recurrent angina pectoris in some
registry studies (Christakopoulos et al., 2015). Additionally, CTO PCI
increased left ventricle function in a subgroup of patients with LAD CTO
(Henriques et al., 2016). Conversely, randomized multicentre failed to
demonstrate a superiority of CTO PCI medical to OMT in terms of major
adverse cardiac events (MACE) and all-cause mortality.

<46>
Accession Number
636847491
Title
Transcatheter aortic valve replacement in aortic stenosis and cardiac
amyloidosis: A systematic review and meta-analysis.
Source
European Heart Journal, Supplement. Conference: 82nd SIC National Congress
2021. Virtual. 23(SUPPL G) (pp G191), 2021. Date of Publication: December
2021.
Author
Cannata F.; Chiarito M.; Pinto G.; Villaschi A.; Sanz-Sanchez J.; Fazzari
F.; Regazzoli D.; Mangieri A.; Bragato R.M.; Colombo A.; Reimers B.;
Condorelli G.; Stefanini G.G.
Institution
(Cannata, Chiarito, Pinto, Villaschi, Condorelli, Stefanini) Department of
Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
(Cannata, Chiarito, Pinto, Villaschi, Fazzari, Regazzoli, Mangieri,
Bragato, Colombo, Reimers, Condorelli, Stefanini) IRCCS Humanitas Research
Hospital, Rozzano-Milan, Italy
(Sanz-Sanchez) Hospital Universitario Y Politecnico La Fe, Valencia, Spain
(Sanz-Sanchez) Centro De Investigacion Biomedica En Red (CIBERCV), Madrid,
Spain
Publisher
Oxford University Press
Abstract
Aims: Aortic stenosis (AS) and cardiac amyloidosis (CA) are typical
diseases of the elderly. Up to 16% of older adults with severe AS referred
to transcatheter aortic valve replacement (TAVR) have a concomitant
diagnosis of CA. CA-AS population suffers from reduced functional capacity
and worse prognosis than AS patients. As the prognostic impact of TAVR in
patients with CA-AS has been historically questioned and in light of
recently published evidence, we aim to provide a comprehensive synthesis
of the efficacy and safety of TAVR in CA-AS patients. <br/>Method(s): We
performed a systematic review and meta-analysis of studies: 1) evaluating
mortality with TAVR as compared to medical therapy in CA-AS patients, and
2) reporting complications and clinical outcomes of TAVR in CA-AS patients
as compared to patients with AS alone. <br/>Result(s): A total of 8
observational studies were identified, 4 of which reporting mortality with
TAVR and 4 reporting complications and clinical outcomes after TAVR of
patients with CA-AS compared with AS alone patients. In patients with
CA-AS, the risk of mortality was lower with TAVR as compared to medical
therapy (OR 0.23, 95% CI 0.07-0.73, I2=0%, P=0.001, number needed to
treat=3). The safety profile of TAVR seems to be similar in patients with
CA-AS as compared to those with AS alone, with comparable risks of stroke,
vascular complications, life-threatening bleeding, acute kidney injury and
30-day mortality, although CA-AS was associated with a trend towards an
increased risk of permanent pacemaker implantation (OR 1.93, 95% CI
0.91-4.09, I2=0%, P=0.085). CA is associated with a numerically higher
rate of longterm mortality and rehospitalizations following TAVR in
patients with CA-AS as compared to those with AS alone.
<br/>Conclusion(s): TAVR is an effective and safe procedure in CA-AS
patients, with a substantial survival benefit as compared to medical
therapy, and a safety profile comparable to patients with AS alone except
for a trend towards higher risk of permanent pacemaker implantation.

<47>
Accession Number
636847469
Title
Long-term clinical impact of permanent pacemaker implantation in patients
undergoing transcatheter aortic valve intervention: A systematic review
and meta-analysis.
Source
European Heart Journal, Supplement. Conference: 82nd SIC National Congress
2021. Virtual. 23(SUPPL G) (pp G83), 2021. Date of Publication: December
2021.
Author
Zito A.; Princi G.; Lombardi M.; D'A Mario D.; Vergallo R.; Aurigemma C.;
Romagnoli E.; Pelargonio G.; Bruno P.; Trani C.; Burzotta F.; Crea F.
Institution
(Zito, Princi, Lombardi) Department of Cardiovascular and Thoracic
Sciences, Catholic University of the Sacred Heart, Rome, Italy
(D'A Mario, Vergallo, Aurigemma, Romagnoli, Pelargonio, Bruno, Trani,
Burzotta, Crea) Department of Cardiovascular Medicine, Fondazione
Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Publisher
Oxford University Press
Abstract
Aims: As compared with surgery, transcatheter aortic valve implantation
(TAVI) is associated with increased need for permanent pacemaker
implantation (PPMI). The clinical impact of PPMI post-TAVI has not been
fully established. To assess by an updated meta-analysis the clinical
outcomes related to PPMI after TAVI at long-term (>=12 months) follow-up
(LTF). <br/>Methods and Results: A comprehensive literature research was
performed on PubMed and EMBASE. The primary endpoint was all-cause death.
Secondary endpoints were rehospitalization for heart failure, stroke, and
myocardial infarction. A subgroup analysis was performed according to
Society of Thoracic Surgeon-Predicted Risk of Mortality (STS-PROM) score.
A total of 31 studies were identified, providing data on 51 069 patients.
The mean duration of follow-up was 22 months. At LTF, PPMI post- TAVI was
associated with a higher risk of all-cause death [22.9% vs. 19.6%; risk
ratio (RR), 1.18, 95% confidence interval (CI), 1.10-1.25; P<0.001] and
rehospitalization for heart failure (16.6% vs. 15.1%; RR, 1.32; 95% CI,
1.13-1.52; P<0.001). In contrast, risks of stroke and myocardial
infarction were not affected. Among the 20 studies that reported surgical
risk, the association between PPMI and LTF all-cause death risk was
statistically significant only in studies enrolling patients with high
STSPROM score (RR, 1.25; 95% CI, 1.12-1.40), although there was a similar
trend in those at medium and low-risk. <br/>Conclusion(s): Patients
necessitating PPMI after TAVI have higher long-term risk of allcause death
and rehospitalization for heart failure as compared to those who do not
receive PPMI. Thus, strategies aimed at reducing need for PPMI might
improve survival after TAVI.

<48>
Accession Number
2016382954
Title
Evaluating the Impact of Cardiopulmonary Bypass Priming Fluids on Bleeding
After Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Siemens K.; Donnelly P.; Hunt B.J.; Carter M.J.; Murdoch I.A.; Tibby S.M.
Institution
(Siemens, Donnelly, Carter, Murdoch, Tibby) PICU Evelina London Children's
Hospital, St Thomas' Hospital, London, United Kingdom
(Hunt, Tibby) Haematology, St Thomas' Hospital, London, United Kingdom
Publisher
W.B. Saunders
Abstract
Objectives: Cardiopulmonary bypass (CPB) predisposes young children to
coagulopathy. The authors evaluated possible effects of CPB priming fluids
on perioperative bleeding in pediatric cardiac surgery. <br/>Design(s):
Meta-analysis and systematic review of previously published studies.
<br/>Setting(s): Each study was conducted in a surgical center or
intensive care unit. <br/>Participant(s): Studies investigating patients
<18 years without underlying hematologic disorders were included.
<br/>Intervention(s): The authors evaluated randomized controlled trials
(RCTs) published between 1980 and 2020 on MEDLINE, EMBASE, PubMed, and
CENTRAL databases. The primary outcome was postoperative bleeding;
secondary endpoints included blood product transfusion, mortality, and
safety. <br/>Measurements and Main Results: Twenty eligible RCTs were
analyzed, with a total of 1,550 patients and a median of 66 patients per
study (range 20-200). The most frequently assessed intervention was adding
fresh frozen plasma (FFP) to the prime (8/20), followed by albumin (5/20),
artificial colloids (5/20), and blood-based priming solutions (3/20). Ten
studies with 771 patients evaluated blood loss at 24 hours in mL/kg and
were included in a meta-analysis. Most of them investigated the addition
of FFP to the priming fluid (7/10). No significant difference was found
between intervention and control groups, with a mean difference of -0.13
(-2.61 to 2.34), p = 0.92, I² = 69%. Further study endpoints
were described but their reporting was too heterogeneous to be
quantitatively analyzed. <br/>Conclusion(s): This systematic review of
current evidence did not show an effect of different CPB priming solutions
on 24-hour blood loss. The analysis was limited by heterogeneity within
the dataset regarding population, type of intervention, dosing, and the
chosen comparator, compromising any conclusions.<br/>Copyright &#xa9; 2021
Elsevier Inc.

<49>
Accession Number
636838063
Title
Ultrasound-guided supra-inguinal fascia Iliaca compartment block for older
adults admitted to the emergency department with hip fracture: a
randomized controlled, double-blind clinical trial.
Source
BMC geriatrics. 21(1) (pp 669), 2021. Date of Publication: 01 Dec 2021.
Author
Chen L.; Shen Y.; Liu S.; Cao Y.; Zhu Z.
Institution
(Chen, Liu, Cao) Department of Anesthesiology, Shengjing Hospital of China
Medical University, Liaoning Province, Shenyang, China
(Shen) Department of Emergency Medicine, Shengjing Hospital of China
Medical University, No.36 Sanhao Street ,Heping DistrictLiaoning Province,
Shenyang 110004, China
(Zhu) Department of Emergency Medicine, Shengjing Hospital of China
Medical University, No.36 Sanhao Street ,Heping DistrictLiaoning Province,
Shenyang 110004, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Hip fracture is common in older adults, and can cause severe
post-fracture pain. Fascia iliaca nerve block has consequently been used
for preoperative analgesia. <br/>METHOD(S): We performed a randomized,
controlled, double-blind clinical trial and recruited older patients with
hip fractures. These patients were randomized into two groups and received
ultrasound-guided fascia iliaca compartment block using either the
supra-inguinal approach (group F) or the classical approach (group C).
Heart rate, blood pressure, and resting and exercising visual analog
scales were recorded before the procedure and at 30min, and 6, 12, and 24h
after completion of the procedure. We recorded the duration of the
procedure-as well as complications such as bleeding, hypotension, and
intractable vomiting; the sleep duration in a 24h period was also
documented. <br/>RESULT(S): A total of 38 patients completed the trial,
and we observed no differences in the baseline characteristics or
pre-procedural measurements between the two groups. Compared with the
patients in group C, patients in group F exhibited significantly lower
exercising VAS scores at 6 and 12h after the procedure, faster heart rates
at 6 and 24h after the procedure, a longer procedural duration, and a
longer sleep duration. There were no differences in the frequencies of
complications between the two groups. The percentages of patients who took
oral analgesics and the numbers of medications consumed were also not
different between the two groups. <br/>CONCLUSION(S): The supra-inguinal
FICB provided effective analgesia and improved exercise tolerance compared
with the classical approach. TRIAL REGISTRATION: The trial was registered
at the Chinese Clinical Trial Registry (registration number:
ChiCTR2100045644, registration date: 2021 April 20).<br/>Copyright &#xa9;
2021. The Author(s).

<50>
Accession Number
636851090
Title
Methodological Standards for the Design, Implementation, and Analysis of
Randomized Trials in Cardiac Surgery: A Scientific Statement From the
American Heart Association.
Source
Circulation. (pp CIR0000000000001037), 2021. Date of Publication: 06 Dec
2021.
Author
Gaudino M.; Chikwe J.; Bagiella E.; Bhatt D.L.; Doenst T.; Fremes S.E.;
Lawton J.; Masterson Creber R.M.; Sade R.M.; Zwischenberger B.A.
Publisher
NLM (Medline)
Abstract
Cardiac surgery presents specific methodological challenges in the design,
implementation, and analysis of randomized controlled trials. The purposes
of this scientific statement are to review key standards in cardiac
surgery randomized trial design and implementation, and to provide
recommendations for conducting and interpreting cardiac surgery trials.
Recommendations include a careful evaluation of the suitability of the
research question for a clinical trial, assessment of clinical equipoise,
feasibility of enrolling a representative patient cohort, impact of
practice variations on the safety and efficacy of the study intervention,
likelihood and impact of crossover, and duration of follow-up. Trial
interventions and study end points should be predefined, and appropriate
strategies must be used to ensure adequate deliverability of the trial
interventions. Every effort must be made to ensure a high completeness of
follow-up; trial design and analytic techniques must be tailored to the
specific research question and trial setting.

<51>
Accession Number
636850684
Title
Fast versus ultra-slow thrombolytic infusion regimens in patients with
obstructive mechanical prosthetic valve thrombosis: a pilot randomized
clinical trial.
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2021. Date of Publication: 04 Dec 2021.
Author
Sadeghipour P.; Saedi S.; Saneei L.; Rafiee F.; Yoosefi S.; Parsaee M.;
Siami R.; Saberi M.; Pouraliakbar H.; Ghadrdoost B.; Bakhshandeh H.;
Peighambari M.M.; Farrashi M.; Mohebbi B.; Naderi N.; Amin A.; Maleki M.;
Khajali Z.; De Caterina R.
Institution
(Sadeghipour, Mohebbi, Maleki) Cardiovascular Intervention Research
Center, Rajaie Cardiovascular Medical and Research Center, Iran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sadeghipour, Ghadrdoost, Bakhshandeh) Clinical Trial Center, Rajaie
Cardiovascular, Medical, Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Saedi, Saneei, Rafiee, Yoosefi, Siami, Saberi, Pouraliakbar, Ghadrdoost,
Bakhshandeh, Peighambari, Naderi, Amin, Khajali) Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Parsaee, Farrashi) Echocardiography Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(De Caterina) University of Pisa and University Cardiology Division, Pisa
University Hospital, Pisa, Italy; and Fondazione VillaSerena per la
Ricerca, Citta Sant'Angelo, Pescara, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thrombolysis is an alternative to surgery for mechanical
prosthetic valve thrombosis (MPVT). Randomized clinical trials have yet to
test safety and efficacy of a proposed ultraslow thrombolytic infusion
regimen. METHODS AND RESULTS: This single-center, open-label, pilot
randomized clinical trial randomized adult patients with acute obstructive
MPVT to an ultraslow thrombolytic regimen (25 mg of recombinant
tissue-type plasminogen activator [rtPA] infused in 25h) and a fast
thrombolytic regimen (50 mg of rtPA infused in 6h). If thrombolysis
failed, a repeated dose of 25 mg of rtPA for 6h was administered in both
groups up to a cumulative dose of 150 mg or the occurrence of a
complication. Primary outcome was a complete MPVT resolution (>75% fall in
the obstructive gradient by transthoracic echocardiography, <10degree
limitation in opening and closing valve motion angles by fluoroscopy, and
symptom improvement). Key safety outcome was a BARC type III or V major
bleeding. Overall, 120 patients, including 63 (52.5%) women, at a mean age
of 36.3+/-15.3 years, were randomized. Complete thrombolysis success was
achieved in 51 patients (85.0%) in the ultraslow-regimen group and 47
patients (78.3%) in the fast-regimen group (OR, 1.58; 95% CI, 0.25 to
1.63; P = 0.34). One case of transient ischemic attack and 3 cases of
intracranial hemorrhage (absolute risk difference, -12.5%; 95% CI, -23.1%
to -1.0%; P = 0.04). were observed only in the fast-regimen group.
<br/>CONCLUSION(S): The ultraslow thrombolytic regimen conferred a high
thrombosis resolution rate without major complications. Such findings
should be replicated in more adequately powered trials
(IRCT20181022041406N2).<br/>Copyright &#xa9; The Author(s) 2021. Published
by Oxford University Press on behalf of the European Society of
Cardiology.

<52>
Accession Number
636841830
Title
Prevalence and outcomes of concomitant cardiac amyloidosis and aortic
stenosis: A systematic review and meta-analysis.
Source
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese.
(no pagination), 2021. Date of Publication: 29 Nov 2021.
Author
Sin-Ying Ho J.; Kor Q.; Kong W.K.; Lim Y.C.; Yan-Yee Chan M.; Syn N.L.;
Ngiam J.N.; Chew N.W.; Yeo T.-C.; Chai P.; Poh K.-K.; Wong R.C.; Lin W.;
Sia C.-H.
Institution
(Sin-Ying Ho) Academic Foundation Programme, North Middlesex University
Hospital NHS Trust, United Kingdom
(Kor, Syn) Department of Medicine, Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
(Kong, Yan-Yee Chan, Yeo, Chai, Poh, Wong, Lin, Sia) Department of
Medicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore; Department of Cardiology, National University Heart
Centre Singapore, Singapore
(Lim, Chew) Department of Cardiology, National University Heart Centre
Singapore, Singapore
(Ngiam) Internal Medicine Residency, University Medicine Cluster, National
University Health System, Singapore
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac amyloidosis (CA) is an increasingly recognised
condition in patients with aortic stenosis (AS). However, there is large
variation in the reported prevalence figures, due to differences in
populations and diagnostic methods. We aimed to investigate the
prevalence, risk factors and outcomes of concomitant CA and AS.
<br/>METHOD(S): We performed a systematic review and meta-analysis of the
literature searched on Medline, EMBASE, Scopus and CENTRAL. We analysed
the prevalence of CA in AS grouped according to diagnostic techniques, and
the risk factors and outcomes of concomitant CA and AS was analysed in AS
patients referred for surgical or transcatheter aortic valve replacement
(AVR). <br/>RESULT(S): A total of 21 studies were included, involving
4,243 patients. The pooled prevalence of CA in patients with AS was 14.4%,
with substantial heterogeneity. The pooled prevalence of AS in CA was
8.7%, with substantial heterogeneity. Patients with both AS and CA had
higher all-cause mortality than those with AS or CA alone. In AS patients
requiring AVR, CA was associated with increasing age, male sex, higher
NT-proBNP levels, increased interventricular septal end diastole thickness
and lower left ventricular ejection fraction. Concomitant AS and CA was
associated with increased all-cause mortality and pacemaker implantation
post-procedure. Study limitations included the heterogeneity of results
and the fair to good quality of studies published. <br/>CONCLUSION(S):
Overall, a substantial proportion of patients with AS may have CA, and
they have poorer prognosis. A high degree of clinical suspicion is needed
to identify "red flags" and perform appropriate diagnostic
imaging.<br/>Copyright &#xa9; 2021 Hellenic Society of Cardiology.
Published by Elsevier B.V. All rights reserved.

<53>
Accession Number
636837731
Title
Effects of ischaemic postconditioning in aortic valve replacement: a
multicenter randomized controlled trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2021.
Date of Publication: 24 Nov 2021.
Author
Kaljusto M.-L.; Bautin A.; Jakobsen O.; Wilimski R.; Brunborg C.; Wennemo
M.; Karpova L.; Nergaard Aas K.; Arendarczyk A.; Landsverk S.A.; Galagudza
M.; Naesheim T.; Czub P.; Gordeev M.; Vaage J.
Institution
(Kaljusto) Department of Cardiothoracic Surgery, Oslo University Hospital,
Oslo, Norway
(Bautin) Research Division of Anesthesiology and Intensive Care, Almazov
National Medical Research Centre, Saint Petersburg, Russian Federation
(Jakobsen, Nergaard Aas, Naesheim) Department of Thoracic and
Cardiovascular Surgery, University Hospital of North Norway, Tromso,
Norway
(Wilimski, Arendarczyk, Czub) Department of Cardiac Surgery, Medical
University of Warsaw, Warsaw, Poland
(Brunborg) Oslo Centre for Biostatistics and Epidemiology, Research
Support Services, Oslo University Hospital, Oslo, Norway
(Wennemo, Landsverk) Department of Anesthesiology, Oslo University
Hospital, Oslo, Norway
(Karpova) Department of Anesthesiology, Almazov National Medical Research
Centre, Saint Petersburg, Russian Federation
(Galagudza) Institute of Experimental Medicine, Almazov National Medical
Research Centre, Saint Petersburg, Russian Federation
(Gordeev) Research Division of Cardiothoracic Surgery, Almazov National
Medical Research Centre, Saint Petersburg, Russian Federation
(Vaage) Institute of Clinical Medicine, University of Oslo, Oslo, Norway
(Vaage) Section of Physiology, Department of Molecular Medicine, Institute
of Basic Medical Sciences, University of Oslo, Oslo, Norway
(Vaage) Division of Emergencies and Critical Care, Department of Research
& Development, Oslo University Hospital, Oslo, Norway
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The effect of ischaemic postconditioning (IPost) on
postcardioplegic cardiac function is not known. We hypothesized that IPost
was cardioprotective in adult patients undergoing elective aortic valve
replacement. <br/>METHOD(S): In a multicentre, prospective, randomized
trial, patients (n = 209) were randomized to either a standard operation
(controls) or postconditioning. Immediately before the cross-clamp was
released, patients in the postconditioning group underwent 3 cycles of
flow/non-flow (2 min each) of normothermic blood via the antegrade
cardioplegia line. The primary end point was cardiac index. Secondary end
points included additional haemodynamic measurements, biomarkers of
cardiomyocyte injury, renal function parameters, intra- and postoperative
arrhythmias and use of inotropic agents. <br/>RESULT(S): There was no
significant difference between the groups regarding cardiac index [mean
between-group difference, 95% confidence interval (CI), 0.11 (-0.1 to
0.3), P = 0.27]. Postconditioning had no effect on other haemodynamic
parametres. There was no between-group difference regarding troponin T or
creatine kinase MB. Postconditioning reduced the relative risk for
arrhythmias by 45% (P = 0.03) when postoperative atrial fibrillation and
intraoperative ventricular fibrillation were combined. There were no
differences in patients with/without diabetes, patients above/below 70
years of age or between the centres. However, after postconditioning, the
cardiac index [95% CI, 0.46 (0.2-0.7), P = 0.001], cardiac output (P <
0.001), mean arterial pressure (P < 0.001) and left ventricular stroke
work index (P < 0.001) were higher in males compared to females.
<br/>CONCLUSION(S): IPost had no overall cardioprotective effects in
patients undergoing aortic valve replacement but improved postoperative
cardiac performance in men compared to women.<br/>Copyright &#xa9; The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<54>
Accession Number
636833857
Title
Coronary flow reserve and cardiovascular outcomes: a systematic review and
meta-analysis.
Source
European heart journal. (no pagination), 2021. Date of Publication: 24
Nov 2021.
Author
Kelshiker M.A.; Seligman H.; Howard J.P.; Rahman H.; Foley M.; Nowbar
A.N.; Rajkumar C.A.; Shun-Shin M.J.; Ahmad Y.; Sen S.; Al-Lamee R.;
Petraco R.
Institution
(Kelshiker, Seligman, Howard, Rahman, Foley, Nowbar, Rajkumar, Shun-Shin,
Sen, Al-Lamee, Petraco) National Heart and Lung Institute, Imperial
College London, Hammersmith Campus ,72 Du Cane Road, London W12 0HS
(Ahmad) Yale School of Medicine, Yale University, 333 Cedar St, New Haven,
CT 06510, United States
Publisher
NLM (Medline)
Abstract
AIMS: This meta-analysis aims to quantify the association of reduced
coronary flow with all-cause mortality and major adverse cardiovascular
events (MACE) across a broad range of patient groups and pathologies.
METHODS AND RESULTS: We systematically identified all studies between 1
January 2000 and 1 August 2020, where coronary flow was measured and
clinical outcomes were reported. The endpoints were all-cause mortality
and MACE. Estimates of effect were calculated from published hazard ratios
(HRs) using a random-effects model. Seventy-nine studies with a total of
59 740 subjects were included. Abnormal coronary flow reserve (CFR) was
associated with a higher incidence of all-cause mortality [HR: 3.78, 95%
confidence interval (CI): 2.39-5.97] and a higher incidence of MACE (HR
3.42, 95% CI: 2.92-3.99). Each 0.1 unit reduction in CFR was associated
with a proportional increase in mortality (per 0.1 CFR unit HR: 1.16, 95%
CI: 1.04-1.29) and MACE (per 0.1 CFR unit HR: 1.08, 95% CI: 1.04-1.11). In
patients with isolated coronary microvascular dysfunction, an abnormal CFR
was associated with a higher incidence of mortality (HR: 5.44, 95% CI:
3.78-7.83) and MACE (HR: 3.56, 95% CI: 2.14-5.90). Abnormal CFR was also
associated with a higher incidence of MACE in patients with acute coronary
syndromes (HR: 3.76, 95% CI: 2.35-6.00), heart failure (HR: 6.38, 95% CI:
1.95-20.90), heart transplant (HR: 3.32, 95% CI: 2.34-4.71), and diabetes
mellitus (HR: 7.47, 95% CI: 3.37-16.55). <br/>CONCLUSION(S): Reduced
coronary flow is strongly associated with increased risk of all-cause
mortality and MACE across a wide range of pathological processes. This
finding supports recent recommendations that coronary flow should be
measured more routinely in clinical practice, to target aggressive
vascular risk modification for individuals at higher risk.<br/>Copyright
&#xa9; The Author(s) 2021. Published by Oxford University Press on behalf
of the European Society of Cardiology.

<55>
Accession Number
636571752
Title
Post-thymectomy myasthenia gravis: A case report and systematic review of
literature.
Source
BMJ Case Reports. 14(12) (no pagination), 2021. Article Number: e246005.
Date of Publication: 02 Dec 2021.
Author
Gurowich L.; Yiin G.; Maxwell A.; Rice A.
Institution
(Gurowich) General Surgery, Taunton and Somerset Nhs Foundation Trust,
Taunton, United Kingdom
(Gurowich, Yiin, Maxwell) Neurology, Swindon and Marlborough Nhs Trust,
Swindon, United Kingdom
(Rice) Histopathology, Royal Brompton Hospital, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Myasthenia gravis (MG) is an autoimmune condition affecting the
neuromuscular junction characterised by weakness and fatiguability,
carrying a high morbidity if treatment is delayed. A clear association
with thymoma has led to management with thymectomy as a common practice,
but MG presenting post-thymectomy has rarely been reported. We present a
case of an 82-year-old woman developing fatigue, ptosis and dysarthria 3
months after thymectomy. After a clinical diagnosis of MG was made, she
responded well to prompt treatment with prednisolone and pyridostigmine.
Her anti-acetylcholine receptor antibody (anti-AChR) subsequently came
back positive. Our systematic review reveals that post-thymectomy MG can
be categorised as early-onset or late-onset form with differing aetiology,
and demonstrated correlation between preoperative anti-AChR titres and
post-thymectomy MG. The postulated mechanisms for post-thymectomy MG
centre around long-lasting peripheral autoantibodies. Clinicians should
actively look for MG symptoms in thymoma patients and measure anti-AChR
preoperatively to aid prognostication.<br/>Copyright &#xa9; BMJ Publishing
Group Limited 2021. No commercial re-use. See rights and permissions.
Published by BMJ.

<56>
Accession Number
2015208345
Title
Surgical Sutureless and Sutured Aortic Valve Replacement in Low-risk
Patients.
Source
Annals of Thoracic Surgery. 113(2) (pp 616-622), 2022. Date of
Publication: February 2022.
Author
Lam K.Y.; Reardon M.J.; Yakubov S.J.; Modine T.; Fremes S.; Tonino P.A.L.;
Tan M.E.; Gleason T.G.; Harrison J.K.; Hughes G.C.; Oh J.K.; Head S.J.;
Huang J.; Deeb G.M.
Institution
(Lam, Tonino, Tan) Department of Cardiothoracic Surgery, Catharina
Hospital Eindhoven, Eindhoven, Netherlands
(Reardon) Department of Cardiovascular Surgery, Houston Methodist Debakey
Heart and Vascular Center, Houston, Texas
(Yakubov) Department of Cardiology, Riverside Methodist-Ohio Health,
Columbus, Ohio
(Modine) Department of Cardiac Surgery, Lille University Hospital, Lille,
France
(Fremes) Department of Surgery, Sunnybrook Health Sciences Centre,
Toronto, Ontario, Canada
(Gleason) Department of Cardiothoracic Surgery, University of Pittsburgh
Medical Center, Pittsburg, PA, United States
(Harrison) Departments of Interventional Cardiology and Cardiothoracic
Surgery, Duke University Medical Center, Durham, North Carolina
(Hughes) Department of Cardiothoracic Surgery, Duke University Medical
Center, Durham, North Carolina
(Oh) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
Minnesota
(Head, Huang) Department of Statistics, Medtronic, Minneapolis, MN, United
States
(Deeb) Department of Cardiac Surgery, University of Michigan Hospitals,
Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Randomized clinical trials have shown that transcatheter
aortic valve replacement is noninferior to surgery in low surgical risk
patients. We compared outcomes in patients treated with a sutured (stented
or stentless) or sutureless surgical valve from the Evolut Low Risk Trial.
<br/>Method(s): The Evolut Low Risk Trial enrolled patients with severe
aortic stenosis and low surgical risk. Patients were randomized to
self-expanding transcatheter aortic valve replacement or surgery. Use of
sutureless or sutured valves was at the surgeons' discretion.
<br/>Result(s): Six hundred eighty patients underwent surgical aortic
valve implantation (205 sutureless, 475 sutured). The Valve Academic
Research Consortium-2 30-day safety composite endpoint was similar in the
sutureless and sutured group (10.8% vs 11.0%, P =.93). All-cause mortality
between groups was similar at 30 days (0.5% vs 1.5%, P =.28) and 1 year
(3.3% vs 2.6%, P =.74). Disabling stroke was also similar at 30 days (2.0%
vs 1.5%, P =.65) and 1 year (2.6% vs 2.2%, P =.76). Permanent pacemaker
implantation at 30 days was significantly higher in the sutureless
compared with the sutured group (14.4% vs 2.9%, P <.001). Aortic
valve-related hospitalizations occurred more often at 1 year with
sutureless valves (9.1% vs 5.1%, P =.04). Mean gradients 1 year after
sutureless and sutured aortic valve replacement were 9.9 +/- 4.2 versus
11.7 +/- 4.7 mm Hg (P <.001). <br/>Conclusion(s): Among low-risk patients,
sutureless versus sutured valve use did not demonstrate a benefit in terms
of 30-day complications and produced marginally better hemodynamics but
with an increased rate of pacemaker implantation and valve-related
hospitalizations.<br/>Copyright &#xa9; 2022 The Society of Thoracic
Surgeons

<57>
Accession Number
2014182252
Title
Lifestyle management to prevent atherosclerotic cardiovascular disease:
evidence and challenges.
Source
Netherlands Heart Journal. 30(1) (pp 3-14), 2022. Date of Publication:
January 2022.
Author
van Trier T.J.; Mohammadnia N.; Snaterse M.; Peters R.J.G.; Jorstad H.T.;
Bax W.A.
Institution
(van Trier, Peters, Jorstad) Department of Cardiology, Amsterdam
University Medical Centre, University of Amsterdam, Amsterdam, Netherlands
(Mohammadnia, Bax) Department of Internal Medicine, Northwest Clinics,
Alkmaar, Netherlands
(Mohammadnia, Bax) Vascular Research Alkmaar, Alkmaar, Netherlands
(Mohammadnia) Department of Cardiology, Northwest Clinics, Alkmaar,
Netherlands
(Snaterse) Amsterdam School of Health Professions, University of Applied
Sciences, Amsterdam, Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Lifestyle management is the cornerstone of both primary and secondary
prevention of atherosclerotic cardiovascular disease (ASCVD) and the
importance of lifestyle management is emphasised by all major guidelines.
Despite this, actual implementation of lifestyle management is poor.
Lifestyle modification includes smoking cessation, weight loss, dietary
change, increasing physical inactivity, and stress management. This review
summarises evidence-based opportunities and challenges for healthcare
professionals to promote healthy lifestyles at an individual level for the
prevention of ASCVD.<br/>Copyright &#xa9; 2021, The Author(s).

<58>
Accession Number
2012049479
Title
Quantification of Right Atrial-Indexed End-Systolic Volumes and Emptying
Fraction in Children Undergoing Cardiac Surgery With Two-Dimensional
Transesophageal Echocardiography: A Prospective Observational Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(1) (pp 202-207),
2022. Date of Publication: January 2022.
Author
Kiran M.; Misra S.; PR S.; Babu S.; Anand A.; Koshy T.
Institution
(Kiran, Misra, PR, Babu, Anand, Koshy) Division of Cardiothoracic and
Vascular Anesthesia, Department of Anesthesia, Sree Chitra Tirunal
Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala,
India
Publisher
W.B. Saunders
Abstract
Objectives: The primary objective of this study was to establish "normal"
right atrial (RA)-indexed end-systolic volumes (ESVs) and emptying
fraction (EF) in children undergoing ventricular septal defect (VSD)
repair using two-dimensional (2D) transesophageal echocardiography (TEE).
Secondary objectives were to obtain RA-indexed ESV and EF in children with
RA/right ventricular (RV) volume overload (atrial septal defect [ASD]) and
RV pressure overload (tetralogy of Fallot [TOF]) and to determine whether
baseline differences existed in these indices among the three lesions.
<br/>Design(s): A prospective observational study. <br/>Setting(s):
Tertiary referral center and a university level teaching hospital.
<br/>Participant(s): The study comprised 90 children (30 in each cohort)
>3 kg and <14 years old admitted for elective repair of either VSD, TOF,
or ASD. <br/>Measurements and Main Results: RA ESV and EF were measured in
the midesophageal four-chamber view using the area-length and the modified
Simpson's methods with 2D TEE in the prebypass period. Mean RA- indexed
ESV (area-length method) in the VSD cohort was 24.2 +/- 6.7
mL/m², whereas it was significantly greater in the TOF (31.9
+/- 9.8 mL/m²; p = 0.0008) and ASD (52 +/- 12.9
mL/m²; p < 0.0001) cohorts. RA EF in the TOF cohort was 48.4%
+/- 7.6%, which was significantly more than in the VSD (41.5% +/- 11.8%; p
= 0.0093) and ASD (39.1% +/- 12.3%; p = 0.0008) cohorts.
<br/>Conclusion(s): This was the first study using 2D TEE to measure RA
indices in children with and without right-sided heart dilation undergoing
cardiac surgery. In this study, RA, ESV, and EF were considerably
different in children with congenital heart disease causing RV pressure or
volume overload. Additional studies can examine how these values can be
used for risk stratification in this cohort of patients or how they
correlate with measures of ventricular performances.<br/>Copyright &#xa9;
2021 Elsevier Inc.

<59>
Accession Number
2007589032
Title
Fractional flow reserve guided versus angiographic guided surgical
revascularization: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 98(1) (pp E18-E23),
2021. Date of Publication: 01 Jul 2021.
Author
Bruno F.; D'Ascenzo F.; Marengo G.; Manfredi R.; Saglietto A.; Gallone G.;
Franchin L.; Piroli F.; Angelini F.; De Filippo O.; Conrotto F.; Omede P.;
Montefusco A.; Pennone M.; Boffini M.; Pocar M.; Rinaldi M.; De Ferrari
G.M.
Institution
(Bruno, D'Ascenzo, Marengo, Manfredi, Saglietto, Gallone, Franchin,
Piroli, Angelini, De Filippo, Conrotto, Omede, Montefusco, Pennone, De
Ferrari) Division of Cardiology, Department of Cardiovascular and
Thoracic, Citta della Salute e della Scienza Hospital and University of
Turin, Turin, Italy
(Boffini, Pocar, Rinaldi) Division of Cardiosurgery, Department of
Cardiovascular and Thoracic, Citta della Salute e della Scienza Hospital
and University of Turin, Turin, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Clinical benefits of FFR (Fraction Flow Reserve) driven CABG
(Coronary Artery Bypass Graft) remain to be established. <br/>Method(s):
All randomized controlled trials (RCTs) and observational studies with
multivariable adjustement were included. MACE (Major Adverse Cardiac
Events) was the primary end point, while its single components (death,
myocardial infarction, and total vessel revascularization [TVR]) along
with number of anastomoses, on pump procedures and graft occlusion at
angiographic follow-up were the secondary ones. Each analysis was
stratified for RCTs versus observational studies. <br/>Result(s): Four
studies (two RCTs and two observational) were included, enrolling 983
patients, 542 angio-guided and 441 FFR-guided. Mean age was 68.45 years,
79% male, with a mean EuroSCORE I of 2.7. Coronary lesions were located in
37% of patients in the left anterior descending artery, 32% in the
circumflex artery, and 26% in the right coronary artery. After a mean
follow-up of 40 months, risk of MACE did not differ (OR 0.86 [0.63-1.18])
as that of all cause death (OR 0.86 [0.59-1.25]), MI (OR 0.57 [0.30-1.11])
and TVR (OR 1.10 [0.65-1.85]). FFR-driven CABG reduced on-pump procedures
(OR 0.58 [0.35-0.93]) and number of anastomoses (-0.40 [-0.80: -0.01])
while incidence of graft occlusion at follow-up did not differ (OR 0.59
[0.30-1.15], all CI 95%). <br/>Conclusion(s): Fraction flow reserve driven
CABG reduced the number of anastomoses and of on-pump procedures without
increasing risk of MACE and without reducing graft occlusion at
angiographic follow-up. ID CRD42020211945.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC.

<60>
Accession Number
2006875919
Title
Systematic review of the evaluation and management of coronary
pseudoaneurysm after stent implantation.
Source
Catheterization and Cardiovascular Interventions. 98(1) (pp 107-116),
2021. Date of Publication: 01 Jul 2021.
Author
Hassan A.; Uretsky B.F.; Vargas Estrada A.M.; Hassan R.; Al-Hawwas M.;
Agarwal S.K.
Institution
(Hassan, Uretsky, Al-Hawwas, Agarwal) Department of Internal Medicine,
University of Arkansas for Medical Sciences, Little Rock, AR, United
States
(Uretsky, Al-Hawwas, Agarwal) Department of Internal Medicine, Central
Arkansas Veterans Health System, Little Rock, AR, United States
(Vargas Estrada) Department of Internal Medicine, Mercy Hospital, Fort
Smith, AR, United States
(Hassan) Department of Internal Medicine, Advocate Illinois Masonic
Medical Center, Chicago, IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Pseudoaneurysm (PSA) formation is a rare but well-known complication of
coronary stenting. It develops after a procedural perforation disrupts the
integrity of the vessel wall but is contained by a single wall layer,
usually pericardium, extravascular thrombosis and later fibrosis. Medical
literature of PSA consists primarily of case reports. A systematic review
of pseudoaneurysm after coronary stenting was performed to summarize its
presentation, diagnostic imaging modalities, natural history, and
management approaches. Clinical presentations range from asymptomatic to
hemodynamic collapse, size from small to "giant," and treatment approaches
from surgical or percutaneous exclusion to "watchful waiting" and imaging
surveillance. Based on current information, a management algorithm is
provided recommending urgent to emergent exclusion for symptomatic PSA,
elective exclusion for large and giant PSA, and "watchful waiting" and
periodic imaging surveillance for small to moderate sized
PSA.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC.

<61>
[Use Link to view the full text]
Accession Number
636748585
Title
Virtual reality and hypnosis for anxiety and pain management in intensive
care units: A prospective randomised trial among cardiac surgery patients.
Source
European journal of anaesthesiology. 39(1) (pp 58-66), 2022. Date of
Publication: 01 Jan 2022.
Author
Rousseaux F.; Dardenne N.; Massion P.B.; Ledoux D.; Bicego A.; Donneau
A.-F.; Faymonville M.-E.; Nyssen A.-S.; Vanhaudenhuyse A.
Institution
(Rousseaux) From the Laboratory of Cognitive Ergonomics and Work
Intervention, University of Liege, ULiege (B32), Quartier Agora - Place
des Orateurs (FR, AB, ASN), Algology Department, University Hospital of
Liege, CHU Sart Tilman, Domaine Universitaire du Sart Tilman (MEF, AV),
Sensation & Perception Research Group, GIGA Consciousness, University of
Liege, GIGA (B34) (FR, AB, MEF, ASN, AV), Intensive Care Units, University
Hospital of Liege (B35) (PBM, DL), Public Health Department,
Biostatistics, University of Liege, CHU (B35) (ND, AFD) and Anesthesia &
Intensive care, GIGA Consciousness, University of Liege, GIGA (B34),
Quartier Hopital - Avenue de l'Hopital, Liege, Belgium (DL)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Virtual reality and hypnosis are little studied in complex
contexts, such as intensive care, where patients need significant physical
and psychological assistance. <br/>OBJECTIVE(S): To compare and combine
hypnosis and virtual reality benefits on anxiety and pain on patients
before and after cardiac surgery. DESIGN: Prospective randomised
controlled clinical trial. SETTING: The study was conducted in the
University Hospital of Liege (Belgium) from October 2018 to January 2020.
PATIENTS: One hundred patients (66 +/- 11.5 years; 24 women, 76 men) were
included. Participants were adults undergoing cardiac surgery. Exclusion
criteria: psychiatric diseases, claustrophobia, acrophobia, hearing loss,
visual impairment, extreme fatigue, confusion surgery cancelled.
INTERVENTIONS: Patients were randomly assigned to four arms (control;
hypnosis; virtual reality; virtual reality hypnosis) and had 20 min of one
of the techniques the day before and the day after surgery. MAIN OUTCOMES
MEASURES: Anxiety, pain, fatigue, relaxation, physiological parameters,
and opioid use were evaluated before and after each session.
<br/>RESULT(S): The main results did not show any significant differences
between the groups. In all groups, anxiety decreased and pain increased
from baseline to the postoperative day. Relaxation increased in all groups
in the pre-operative (P < 0.0001) and postoperative period (P = 0.03).
There were no significant differences for fatigue, physiological measures,
or opioid use. <br/>CONCLUSION(S): As there were no significant
differences between groups for the measured variables, we cannot affirm
that one technique is better than another. Additional studies are required
to compare and evaluate the cost-effectiveness of these techniques for
critical care patients and caregivers. TRIAL REGISTRATION:
ClinicalTrials.gov: NCT03820700.
https://clinicaltrials.gov/ct2/show/NCT03820700. Retrospectively
registered on 29 January 2019.<br/>Copyright &#xa9; 2021 The Author(s).
Published by Wolters Kluwer Health, Inc. on behalf of the European Society
of Anaesthesiology and Intensive Care.

<62>
Accession Number
2015811384
Title
Individualised or liberal red blood cell transfusion after cardiac
surgery: a randomised controlled trial.
Source
British Journal of Anaesthesia. 128(1) (pp 37-44), 2022. Date of
Publication: January 2022.
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

<63>
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. 128(1) (pp 11-25), 2022. Date of
Publication: January 2022.
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 cardiopulmonary bypass age, and surgery type were
not associated with neurocognitive disorders, stroke, and mortality in
cardiac surgery. Normothermic cardiopulmonary bypass, 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

<64>
Accession Number
2005272144
Title
Cardiogenic shock in autoimmune rheumatologic diseases: an insight on
etiologies, management, and treatment outcomes.
Source
Heart Failure Reviews. 27(1) (pp 93-101), 2022. Date of Publication:
January 2022.
Author
Battisha A.; Sawalha K.; Altibi A.M.; Madoukh B.; Al-Akchar M.; Patel B.
Institution
(Battisha, Sawalha) University of Massachusetts Medical School - Baystate,
Springfield, MA, United States
(Altibi) Harvard T.H. Chan School of Public Health, Harvard University,
Boston, MA, United States
(Altibi) Henry Ford Health System (HFHS), Jackson, MI, United States
(Madoukh) Overland Park Regional Medical Center - HCA Midwest Health,
Kansas City, MO, United States
(Al-Akchar) Southern Illinois University School of Medicine, Springfield,
IL, United States
(Patel) Heart and Vascular Institute, West Virginian University, 1 Medical
Center Dr., Morgantown, WV 26505, United States
Publisher
Springer
Abstract
Autoimmune rheumatological disorders are known to have an increased risk
for cardiovascular diseases including coronary artery disease (CAD),
myocarditis, pericarditis, valvulopathy, and in consequence cardiogenic
shock. Data on cardiogenic shock in rheumatological diseases are scarce;
however, several reports have highlighted this specific entity. We sought
to review the available literature and highlight major outcomes and the
management approaches in each disease. Systematic literature search,
including PubMed, Ovid/Medline, Cochrane Library, and Web of Science, was
conducted between January 2000 and December 2009. We reviewed all cases
reporting cardiogenic shock with rheumatologic conditions, including
systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Takayasu's
arteritis (TA), granulomatosis with polyangiitis (GPA), giant cell
arteritis (GCA), and antiphospholipid syndrome (APS). We selected 45
papers reporting a total of 48 cases. Mean age was 39 +/- 7.3 years and
68.8% were females. Most common rheumatologic conditions associated with
cardiogenic shock were SLE (31%), GPA (23%), TA (14.6%), APA (10.4%), and
RA (8.3%). Cardiogenic shock was found to be caused by eosinophilic
myocarditis in 58% of cases, CAD in 19% of cases, and valvulopathy in 6%
of cases. Most patient required high-dose steroids and second
immunosuppressant therapy. Mechanical circulatory supported was required
in 23 cases, IABP in 16 cases, and ECMO in 12 cases. Complete recovery
occurred in 37 patients while 9 patients died and 2 required heart
transplant. Responsible for two-thirds of cases, eosinophilic myocarditis
should be suspected in young cardiogenic shock patients with underlying
rheumatologic conditions. Lupus and GPA are the two most common
conditions.<br/>Copyright &#xa9; 2020, Springer Science+Business Media,
LLC, part of Springer Nature.

<65>
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.

<66>
Accession Number
636621815
Title
Statin Discontinuation and Cardiovascular Events among Older People in
Denmark.
Source
JAMA Network Open. 4(12) (no pagination), 2021. Article Number: e2136802.
Date of Publication: 02 Dec 2021.
Author
Thompson W.; Morin L.; Jarbol D.E.; Andersen J.H.; Ernst M.T.; Nielsen
J.B.; Haastrup P.; Schmidt M.; Pottegard A.
Institution
(Thompson, Jarbol, Nielsen, Haastrup) Research Unit of General Practice,
Department of Public Health, University of Southern Denmark, J.B.
Winsl?wsvej 9, Odense 5000, Denmark
(Thompson, Pottegard) Hospital Pharmacy Fyn, Odense University Hospital,
Odense, Denmark
(Morin) Inserm CIC 1431, Clinical Investigation Unit, University Hospital
of Besancon, Besancon, France
(Morin) Inserm 1018, High-Dimensional Biostatistics for Drug Safety and
Genomics, Centre de Recherche en Epidemiologie et Sante des Populations,
Villejuif, France
(Andersen, Ernst, Pottegard) Research Unit of Clinical Pharmacology and
Pharmacy, Department of Public Health, University of Southern Denmark,
Odense, Denmark
(Schmidt) Department of Clinical Epidemiology, Aarhus University Hospital,
Aarhus, Denmark
(Schmidt) Department of Cardiology, Regional Hospital West Jutland,
Herning, Denmark
Publisher
American Medical Association
Abstract
Importance: Statin use is common in older persons. Given uncertainties in
ongoing benefit, changes in health status, and shifting goals of care and
preferences, statin discontinuation may be considered in some older
persons, although there is currently little evidence to guide this
decision. <br/>Objective(s): To evaluate the association between statin
discontinuation and the rate of major adverse cardiovascular events (MACE)
among people aged 75 years or older who receive long-term statin
treatment. <br/>Design, Setting, and Participant(s): This cohort study
included all persons in Denmark aged 75 years or older who were treated
with statins for at least 5 consecutive years as of January 1, 2011.
Participants were followed up until December 31, 2016. Data were analyzed
from July to November, 2020. Exposure: Statin discontinuation. <br/>Main
Outcomes and Measures: Rate of occurrence of MACE and its components
(myocardial infarction, ischemic stroke or transient ischemic attack,
coronary revascularization, and death due to myocardial infarction or
ischemic stroke) in persons continuing statins compared with those
discontinuing statins. Confounding adjustment was done using inverse
probability of treatment weighting. Analyses were conducted separately for
primary prevention (no history of cardiovascular disease) and secondary
prevention (history of cardiovascular disease). <br/>Result(s): The study
included 67418 long-term statin users, including 27463 in the primary
prevention analysis (median age, 79 years [IQR, 77-83 years]; 18134 [66%]
female) and 39955 in the secondary prevention analysis (median age, 80
years [IQR, 77-84 years]; 18717 [47%] female). In both primary and
secondary prevention analyses, the rate of MACE was higher among persons
who discontinued statins compared with those who continued statins. In the
primary prevention cohort, the weighted rate difference was 9 per 1000
person-years (95% CI, 5-12 per 1000 person-years) and the adjusted
sub-hazard ratio was 1.32 (95% CI, 1.18-1.48), corresponding to 1 excess
MACE per 112 persons who discontinued statins per year. In the secondary
prevention cohort, the weighted rate difference was 13 per 1000
person-years (95% CI, 8-17 per 1000 person-years) and the adjusted
sub-hazard ratio was 1.28 (95% CI, 1.18-1.39), corresponding to 1 excess
MACE per 77 persons who discontinued statins per year. <br/>Conclusions
and Relevance: In this cohort study, among older adults receiving
long-term statin treatment, discontinuation of statins was associated with
a higher rate of MACE compared with statin continuation in both the
primary and the secondary prevention cohorts. These findings suggest a
need for robust evidence from randomized clinical trials..<br/>Copyright
&#xa9; 2021 American Medical Association. All rights reserved.

<67>
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.

<68>
[Use Link to view the full text]
Accession Number
2015123624
Title
Intrathecal Morphine for Analgesia in Minimally Invasive Cardiac Surgery:
A Randomized, Placebo-controlled, Double-blinded Clinical Trial.
Source
Anesthesiology. 135(5) (pp 864-876), 2021. Date of Publication: 01 Nov
2021.
Author
Dhawan R.; Daubenspeck D.; Wroblewski K.E.; Harrison J.-H.; McCrorey M.;
Balkhy H.H.; Chaney M.A.
Institution
(Dhawan, Daubenspeck, Chaney) The Department of Anesthesia and Critical
Care, University of Chicago Medicine, Chicago, IL, United States
(McCrorey, Balkhy) Department of Cardiothoracic Surgery, University of
Chicago Medicine, Chicago, IL, United States
(Wroblewski) The Department of Public Health Sciences, University of
Chicago, Chicago, IL, United States
(Harrison) The Department of Anesthesiology, University of Wisconsin
School of Medicine and Public Health, Madison, WI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Intrathecal morphine decreases postoperative pain in standard
cardiac surgery. Its safety and effectiveness have not been adequately
evaluated in minimally invasive cardiac surgery. The authors hypothesized
that intrathecal morphine would decrease postoperative morphine
consumption after minimally invasive cardiac surgery. <br/>Method(s): In
this randomized, placebo-controlled, double-blinded clinical trial,
patients undergoing robotic totally endoscopic coronary artery bypass
received either intrathecal morphine (5 mcg/kg) or intrathecal saline
before surgery. The primary outcome was postoperative morphine equivalent
consumption in the first 24 h after surgery; secondary outcomes included
pain scores, side effects, and patient satisfaction. Pain was assessed via
visual analog scale at 1, 2, 6, 12, 24, and 48 h after intensive care unit
arrival. Opioid-related side effects (nausea/vomiting, pruritus, urinary
retention, respiratory depression) were assessed daily. Patient
satisfaction was evaluated with the Revised American Pain Society Outcome
Questionnaire. <br/>Result(s): Seventy-nine patients were randomized to
receive intrathecal morphine (n = 37) or intrathecal placebo (n = 42),
with 70 analyzed (morphine 33, placebo 37). Intrathecal morphine patients
required significantly less median (25th to 75th percentile) morphine
equivalents compared to placebo during first postoperative 24 h (28 [16 to
46] mg vs. 59 [41 to 79] mg; difference, -28 [95% CI, -40 to -18]; P <
0.001) and second postoperative 24 h (0 [0 to 2] mg vs. 5 [0 to 6] mg;
difference, -3.3 [95% CI, -5 to 0]; P < 0.001), exhibited significantly
lower visual analog scale pain scores at rest and cough at all
postoperative timepoints (overall treatment effect, -4.1 [95% CI, -4.9 to
-3.3] and -4.7 [95% CI, -5.5 to -3.9], respectively; P < 0.001), and
percent time in severe pain (10 [0 to 40] vs. 40 [20 to 70]; P = 0.003)
during the postoperative period. Mild nausea was more common in the
intrathecal morphine group (36% vs. 8%; P = 0.004). <br/>Conclusion(s):
When given before induction of anesthesia for totally endoscopic coronary
artery bypass, intrathecal morphine decreases use of postoperative opioids
and produces significant postoperative analgesia for 48 h.<br/>Copyright
&#xa9; 2021, the American Society of Anesthesiologists. All Rights
Reserved.

<69>
[Use Link to view the full text]
Accession Number
2016355488
Title
Prothrombin complex concentrates in cardiac surgery: where are we?.
Source
Current Opinion in Anaesthesiology. 35(1) (pp 36-41), 2022. Date of
Publication: 01 Feb 2022.
Author
Santana J.M.; Brovman E.Y.
Institution
(Santana, Brovman) Department of Anesthesiology, Tufts Medical Center,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Major bleeding in cardiac surgery is commonly
encountered, and, until recently, most frequently managed with fresh
frozen plasma (FFP). However, a Cochrane review found this practice to be
associated with a significant increase in red blood cell (RBC)
transfusions and costs. These findings have led to off-label uses of
prothrombin complex concentrates (PCCs) in cardiac surgery. The purpose of
this review is to compare and contrast the use of FFP and PCC, review the
components, limitations and risks of different types of PCCs, and discuss
the latest evidence for the use of PCC versus FFP in cardiac surgery.
Recent findings A recent review and meta-analysis suggests that PCC
administration in cardiac surgery is more effective than FFP in reducing
RBC transfusions and costs. Summary The current data supports the use of
4F-PCC instead of FFP as the primary hemostatic agent in cases of major
bleeding in cardiac surgery. The use of PCCs is associated with reduced
rates of RBC transfusions while maintaining a favorable safety profile.
Clear advantages of PCC over FFP include its smaller volume, higher
concentration of coagulation factors and shorter acquisition and
administration times.<br/>Copyright &#xa9; 2022 Lippincott Williams and
Wilkins. All rights reserved.

<70>
Accession Number
2016352199
Title
Comparison between Saphenous Vein Graft and Radial Artery Graft in
Coronary Artery Bypass Grafting.
Source
Pakistan Journal of Medical and Health Sciences. 15(12) (pp 3378-3380),
2021. Date of Publication: December 2021.
Author
Salman M.; Rahim S.S.; Khan A.K.; Pannu F.Y.; Ahmed B.; Iqbal S.; Afshan
S.; Shafqat A.
Institution
(Salman, Rahim, Khan) SR Cardiac Surgery, Punjab Institute of Cardiology,
Lahore, Pakistan
(Pannu, Ahmed) SR, Cardiology Department, Mayo hospital Lahore, Pakistan
(Iqbal) SR Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan
(Afshan, Shafqat) Punjab Institute of Cardiology, Lahore, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Background: To bypass the obstruction in native coronary arteries both
arterial and venous grafts are used. Inspite of having radial artery graft
as a favored second conduit for bypass, venous grafts are more frequently
used. <br/>Objective(s): To compare the CT angiography patency findings of
radial artery graft vs. saphenous vein graft 3 months postoperatively.
<br/>Study Design: Randomized controlled trial. <br/>Setting(s): The study
was conductedat the Department of Cardiac Surgery, Mayo Hospital, Lahore.
Data Collection: All patients fulfilling theinclusioncriteria were
recruited. A written informed consentwastaken. The non-dominant arm was
used almostexclusively forharvesting the radial artery in those patients
who have positive modified Allen`s test as a pedicle by atraumatic
"no-touch" technique. After heparanization, it was immersed in diluted
solution (Inj. verapamil hydrochloride 5mg + Inj. nitroglycerin 2.5mg +
Inj. heparin 500 IU + Inj. ringer lactate 300 ml with Inj. 8.4% NaHCO3 0.9
m1). All the patients in the study received LIMA to LAD and were done on
pump. After that the patients were dividedinto2 groups namely Group I and
Group II by computer generated method. In Group I, the patient received
the radial artery as a second graft to a coronary having more than 90%
stenosis. The third or fourth graft if required is saphenous vein graft.
The group II had SVG as second, third or fourth grafts, one of the venous
grafts were to a coronary having more than 90% stenosis. <br/>Result(s):
Average age of all (n=62) patients was 38.82+/-9.93 years. Average age in
Group-I & II patients was 39.09+/-9.49 & 38.54+/-10.50 years respectively.
Among patients 47% were male and 53% were female patients. In Group-I, 12
(38.7%) of the patients were male, and 19 (67.3%) were female, whereas in
Group-II, 17 (54.8%) of the patients were male, and 14 (45.8%) were
female. In Group-I 1(3.2%) patient and in Group-II 3(9.7%) patients died
(p=0.301). Insignificant difference was seen for cardiac arrhythmias i.e.
Group-I:16.1% vs. Group-II: 19.4%, p=0.740. Myocardial infarction in
Group-A 5(16.1%) patients and in Group-B 7(22.6%) (p=0.520). In Group-A,
30(96.8%) patients and in Group-B, 28(90.3%) patients showed patency of
artery after coronary artery bypass grafting(P>0.05). <br/>Conclusion(s):
We discovered no significant difference in the patency of both radial
artery and saphenous vein grafts on 3 months postoperative CT angiography
and clinical outcomes in terms of perioperative mortality, MI, and cardiac
arrhythmias in patients who underwent CABG in this study.<br/>Copyright
&#xa9; 2021 Lahore Medical And Dental College. All rights reserved.

<71>
Accession Number
2016352198
Title
Comparison between Bilateral Internal Mammary Artery Graft and Left
Internal Mammary Artery Graft in Patients Undergoing Coronary Artery
Bypass Grafting.
Source
Pakistan Journal of Medical and Health Sciences. 15(12) (pp 3375-3377),
2021. Date of Publication: December 2021.
Author
Khan A.K.; Rahim S.S.; Salman M.; Pannu F.Y.; Ahmed B.; Iqbal S.; Shafqat
A.; Afshan S.
Institution
(Khan, Rahim, Salman, Iqbal) SR Cardiac Surgery, Punjab Institute of
Cardiology, Lahore, Pakistan
(Pannu, Ahmed) SR, Cardiology Department, Mayo hospital Lahore, Pakistan
(Shafqat, Afshan) Punjab Institute of Cardiology, Lahore, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Background: Increasing evidence continues to demonstrate a survival
advantage for bilateral internal mammary artery (BIMA) over Left internal
mammary artery for coronary artery bypass grafting (CABG). However, there
are still uncertainties about which surgical approach is the best one to
use with BIMA grafting. <br/>Objective(s): To compare Bilateral Internal
Mammary Artery (BIMA) Grafting with Left Internal Mammary Artery (LIMA)
Grafting during Coronary Artery Bypass Grafting (CABG) in terms of early
mortality and sternal wound infections. Materials & Methods Randomized:
control trialtechnique enrolled. The study was conducted at the Cardiac
Surgery Department, King Edward Medical University (KEMU), Mayo Hospital
Lahore Results: Total 96patients undergoing CABG were included in this
study. Patients were randomly divided into 2 groups; each group contains
48 patients. Group A included patients having Left IMA to LAD; second and
third graft by Great Saphenous Vein and Group B included patients having
Bilateral Internal Mammary Arteries with Left IMA to LAD or OM and Right
IMA to RCA, LAD or Ramus Intermedius. The superficial and deep sternal
wound infections was recorded along with the different risk factors
including diabetes, obesity, hypertension, smoking and use of inotropes
intra-operatively and post operatively. The incision site over the sternum
was being evaluated on daily basis throughout the stay of the patients
(from 5-8 days). Diagnosis of Sternal infections was based on the presence
of positive cultures, dehiscence of the sternum incision, fever, redness
pain, and infected (purulent) secretions. Sternal instability and
discharge, ventilation time, length of ICU stay, chest drainage,
re-exploration and length of hospital stay was also recorded.
<br/>Result(s):Not any of the patients included in these two treatment
groups suffered from mortality (LIMA: 0%, BIMA: 0%). Deep sternal wound
infection [LIMA: 4.17% & BIMA: 6.25%, p-value=0.646] and superficial wound
infection [LIMA: 4.17% & BIMA: 6.25%, p-value=0.646] did not show any
statistically significant association towards both grafts type. Patients
who underwent BIMA grafting suffered from higher in hospital stay as
compared to patients who underwent LIMAgrafting. i.e. [LIMA: 7.02 & BIMA:
8.02, P value = 0.000] <br/>Conclusion(s): Results of the study showed no
significant difference for deep sternal wound infection and superficial
wound infection between the two grafts BIMA and LIMA. However, patients
who underwent BIMA grafting had significantly higher hospital stay as
compared to patients who underwent LIMA grafting.<br/>Copyright &#xa9;
2021 Lahore Medical And Dental College. All rights reserved.

<72>
Accession Number
2016352586
Title
Postoperative prophylactic intermittent noninvasive ventilation versus
usual postoperative care for patients at high risk of pulmonary
complications: a multicentre randomised trial.
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Abrard S.; Rineau E.; Seegers V.; Lebrec N.; Sargentini C.; Jeanneteau A.;
Longeau E.; Caron S.; Callahan J.-C.; Chudeau N.; Beloncle F.; Lasocki S.;
Dupoiron D.
Institution
(Abrard, Rineau, Sargentini, Jeanneteau, Longeau, Lasocki) Department of
Anesthesiology and Intensive Care, University Hospital of Angers, Angers,
France
(Abrard, Rineau) MITOVASC Institute, INSERM 1083, CNRS 6015, University of
Angers, Angers, France
(Abrard) Department of Anesthesiology and Critical Care Medicine, Edouard
Herriot Hospital, Hospices Civils de Lyon, Lyon, France
(Seegers) Department of Clinical Research, Integrated Center for Oncology
Paul Papin, Angers, France
(Lebrec, Dupoiron) Anesthesiology and Pain Medicine Department, Integrated
Center for Oncology Paul Papin, Angers, France
(Caron) Department of Anesthesiology, Le Mans Hospital, Le Mans, France
(Callahan, Chudeau) Department of Intensive Care, Le Mans Hospital, Le
Mans, France
(Beloncle) Medical Intensive Care Department, University Hospital of
Angers, Angers, France
Publisher
Elsevier Ltd
Abstract
Background: Pulmonary complications are an important cause of morbidity
and mortality after surgery. We evaluated the clinical effectiveness of
noninvasive ventilation (NIV) in preventing postoperative acute
respiratory failure. <br/>Method(s): This is an open, multicentre
randomised trial that included patients at high risk of postoperative
pulmonary complications after elective or semi-urgent surgery with an
Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score
>=45. Patients were randomly assigned to intermittent prophylactic
face-mask NIV for 6-8 h day^-1 or usual postoperative care. The
primary outcome was in-hospital acute respiratory failure within 7 days
after surgery. Patients who underwent surgery and postoperative extubation
were included in the modified intended-to-treat analysis. Results are
presented as n (%) and odds ratios (ORs) with 95% confidence intervals.
<br/>Result(s): Between November 2017 and October 2019, 266 patients were
randomised and 253 included in the main analysis. 203 patients (80.2%)
were male with a mean age of 68 (11) yr and an ARISCAT score of 53 (6);
237 patients (93.7%) underwent cardiac or thoracic surgery. 125 patients
were allocated to prophylactic NIV and 128 to usual care. Unplanned
treatment termination occurred in 58 patients in the NIV group, which was
linked to NIV discomfort for 36 patients. There was no difference in the
incidence of the primary outcome of postoperative acute respiratory
failure between treatment groups (NIV: 30 of 125 patients [24.0%] vs usual
care: 35 of 128 patients [27.3%]; OR 0.97 [0.90-1.04]; P=0.54).
<br/>Conclusion(s): Prophylactic NIV was difficult to implement after
high-risk surgery because of low patient compliance. Prophylactic NIV did
not prevent acute respiratory failure. Clinical trial registration: NCT
03629431 and EudraCT 2017-001011-36.<br/>Copyright &#xa9; 2021 British
Journal of Anaesthesia

<73>
Accession Number
2014656457
Title
Cardiac transplantation after heparin-induced thrombocytopenia: A
systematic review.
Source
Clinical Transplantation. (no pagination), 2021. Date of Publication:
2021.
Author
Jimenez D.C.; Warner E.D.; Ahmad D.; Rosen J.L.; Al-Rawas N.; Morris R.J.;
Alvarez R.; Rame J.E.; Entwistle J.W.; Massey H.T.; Tchantchaleishvili V.
Institution
(Jimenez, Warner, Ahmad, Rosen, Morris, Entwistle, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Al-Rawas) Department of Anesthesiology, Thomas Jefferson University,
Philadelphia, PA, United States
(Alvarez, Rame) Division of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Purpose: Heparin-induced thrombocytopenia (HIT) presents a unique
challenge in patients requiring orthotopic heart transplantation (OHT). We
sought to pool the existing evidence in a systematic review.
<br/>Method(s): Electronic search was performed to identify all relevant
studies on OHT in patients with HIT. Patient-level data for 33 patients
from 21 studies were extracted for statistical analysis. <br/>Result(s):
Median patient age was 51 [IQR 41, 55] years, with 75.8% (25/33) males.
All patients had a clinical diagnosis of HIT, and anti-PF4/Heparin
antibodies were positive in 87.9% (29/33). Median lowest reported platelet
count was 46 x 10⁹/L [27.2, 73.5]. Intraoperatively, 61%
(20/33) of patients were given unfractionated heparin (UFH), while 39%
(13/33) were given alternative anticoagulants. The alternative agent
subgroup required more antifibrinolytics [54% (7/13) vs 10% (2/20), P
=.02] and clotting factors [69.2% (9/13) vs 15.0% (3/20), P <.01].
Perioperative thrombosis occurred more [53.8% (7/13) vs 0% (0/20, P <.01)
in alternate agent subgroup. More patients in the alternate agent subgroup
required post-operative transfusions [54% (7/13) vs 0% (0/20), P <.01].
Thirty-day mortality of 15.2% (5/33) was comparable between the subgroups.
<br/>Conclusion(s): Heparin use during OHT may be associated with less
adverse effects compared to use of other anticoagulants with no difference
in 30-day mortality.<br/>Copyright &#xa9; 2021 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd.

<74>
Accession Number
2014355319
Title
The Dilemma of Peri-Procedural Warfarin Management: A Narrative Review.
Source
Clinical and Applied Thrombosis/Hemostasis. 27 (no pagination), 2021. Date
of Publication: 29 Nov 2021.
Author
Eljilany I.; El-Bardissy A.; Elewa H.
Institution
(Eljilany, Elewa) College of Pharmacy, QU Health, Qatar University, Doha,
Qatar
(El-Bardissy) Department of Pharmacy, Hamad General Hospital, Hamad
Medical Corporation, Doha, Qatar
Publisher
SAGE Publications Inc.
Abstract
Periprocedural vitamin K antagonist management is a complex process and
inherently entails multiple clinical issues. Marked variations have been
reported in different aspects of this process. These differences were
noted at the clinician and institutional levels owing to the lack of
evidence-based data leading to many discrepancies in decision-making. This
review aims to address the gap of vitamin K antagonist periprocedural
management acknowledged by previously published prescribers'
questionnaires. One of the components of this process is "bridging," which
aims to provide minimal interruption of the anticoagulation period through
the use of heparin products. Recent studies showed that bridging is
increasing bleeding risk. Secondly, interruption decision relies on the
classification of thromboembolism risk which depends on trials that did
not include patients with atrial fibrillation. Thirdly, the interruption
duration is different among different International normalization ratio
levels, which strengthens the difference in the clinical practice of
preoperative vitamin K antagonist management. Lastly, the resumption of a
vitamin-K antagonist after surgery has many scenarios according to the
procedure and patient risk of bleeding. Vitamin-K antagonist
periprocedural management is complicated due to individual practice and
the lack of strictly implemented institutional standardized protocols to
guide, manage and evaluate the process.<br/>Copyright &#xa9; The Author(s)
2021.

<75>
Accession Number
2013930013
Title
The Society for Vascular Surgery implementation document for management of
extracranial cerebrovascular disease.
Source
Journal of Vascular Surgery. 75(1 Supplement) (pp 26S-98S), 2022. Date of
Publication: January 2022.
Author
AbuRahma A.F.; Avgerinos E.D.; Chang R.W.; Darling R.C.; Duncan A.A.;
Forbes T.L.; Malas M.B.; Perler B.A.; Powell R.J.; Rockman C.B.; Zhou W.
Institution
(AbuRahma) Department of Surgery, West Virginia University-Charleston
Division, Charleston, WV, United States
(Avgerinos) Division of Vascular Surgery, University of Pittsburgh School
of Medicine, UPMC Hearrt & Vascular Institute, Pittsburgh, Pa, United
States
(Chang) Vascular Surgery, Permanente Medical Group, San Francisco, Calif,
United States
(Darling) Division of Vascular Surgery, Albany Med Vascular, Albany, NY,
United States
(Duncan, Forbes) Division of Vascular & Endovascular Surgery, University
of Western Ontario, London, ON, Canada
(Malas) Vascular & Endovascular Surgery, University of California San
Diego, La Jolla, Calif, United States
(Perler) Division of Vascular Surgery & Endovascular Therapy, Johns
Hopkins, Baltimore, Md, United States
(Powell) Vascular Surgery, Dartmouth-Hitchcock, Lebanon, NH, United States
(Rockman) Division of Vascular Surgery, New York University Langone, New
York, NY, United States
(Zhou) Division of Vascular Surgery, University of Arizona, Tucson, Ariz,
United States
Publisher
Elsevier Inc.

<76>
Accession Number
2016016189
Title
A systematic review supporting the Society for Vascular Surgery Guidelines
on the management of carotid artery disease.
Source
Journal of Vascular Surgery. 75(1 Supplement) (pp 99S-108S.e42), 2022.
Date of Publication: January 2022.
Author
Hasan B.; Farah M.; Nayfeh T.; Amin M.; Malandris K.; Abd-Rabu R.; Shah
S.; Rajjoub R.; Seisa M.O.; Saadi S.; Hassett L.; Prokop L.J.; AbuRahma
A.F.; Murad M.H.
Institution
(Hasan, Farah, Nayfeh, Amin, Malandris, Abd-Rabu, Shah, Rajjoub, Seisa,
Saadi, Murad) Evidence-Based Practice Research Program, Mayo Clinic,
Rochester, Minn, United States
(Hasan, Farah, Nayfeh, Amin, Malandris, Abd-Rabu, Shah, Rajjoub, Seisa,
Saadi, Murad) Robert D. and Patricia E. Kern Center for the Science of
Health Care Delivery, Mayo Clinic, Rochester, Minn, United States
(Hassett, Prokop) Mayo Clinic Libraries, Mayo Clinic, Rochester, Minn,
United States
(AbuRahma) Department of Surgery, West Virginia University, Charleston,
WV, United States
Publisher
Elsevier Inc.
Abstract
Background: To support the development of guidelines on the management of
carotid disease, a writing committee from the Society for Vascular Surgery
has commissioned this systematic review. <br/>Method(s): We searched
multiple data bases for studies addressing five questions: medical
management vs carotid revascularization (CEA) in asymptomatic patients,
CEA vs carotid artery stenting (CAS) in symptomatic low surgical risk
patients, the optimal timing of revascularization after acute stroke,
screening high-risk patients for carotid disease, and the optimal sequence
of interventions in patients with combined coronary and carotid disease.
Studies were selected and appraised by pairs of independent reviewers.
Meta-analyses were performed when feasible. <br/>Result(s): Medical
management compared with carotid interventions in asymptomatic patients
was associated with better early outcome during the first 30 days.
However, CEA was associated with significantly lower long-term rate of
stroke/death at 5 years. In symptomatic low-risk surgical patients, CEA
was associated with a lower risk of stroke, but a significant increase in
myocardial infarction compared with CAS during the first 30 days. When the
long-term outcome of transfemoral CAS vs CEA in symptomatic patients were
examined using preplanned pooled analysis of individual patient data from
four randomized trials, the risk of death or stroke within 120 days of the
index procedure was 5.5% for CEA and 8.7% for CAS, which lends support
that, over the long term, CEA has a superior outcome compared with
transfemoral CAS. When managing acute stroke, the comparison of CEA during
the first 48 hours to that between day 2 and day 14 did not reveal a
statistically significant difference on outcomes during the first 30 days.
Registry data show good results with CEA performed in the first week, but
not within the first 48 hours. A single risk factor, aside from peripheral
artery disease, was associated with low carotid screening yield. Multiple
risk factors greatly increase the yield of screening. Evidence on the
timing of interventions in patients with combined carotid and coronary
disease was sparse and imprecise. Patients without carotid symptoms, who
had the carotid intervention first, compared with a combined carotid
intervention and coronary artery bypass grafting, had better outcomes.
<br/>Conclusion(s): This updated evidence summary supports the Society for
Vascular Surgery clinical practice guidelines for commonly raised clinical
scenarios. CEA was superior to medical therapy in the long-term prevention
of stroke/death over medical therapy. CEA was also superior to
transfemoral CAS in minimizing long-term stroke/death for symptomatic low
risk surgical patients. CEA should optimally be performed between 2 and 14
days from the onset of acute stroke. Having multiple risk factors
increases the value of carotid screening.<br/>Copyright &#xa9; 2021
Society for Vascular Surgery

<77>
Accession Number
2014603047
Title
Study design for a randomized crossover study investigating myocardial
strain analysis in patients with coronary artery disease at hyperoxia and
normoxemia prior to coronary artery bypass graft surgery
(StrECHO-O<inf>2</inf>).
Source
Contemporary Clinical Trials. 110 (no pagination), 2021. Article Number:
106567. Date of Publication: November 2021.
Author
Fischer K.; Ranjan R.; Friess J.-O.; Erdoes G.; Mikasi J.; Baumann R.;
Schoenhoff F.S.; Carrel T.P.; Brugger N.; Eberle B.; Guensch D.P.
Institution
(Fischer, Ranjan, Friess, Erdoes, Mikasi, Baumann, Eberle, Guensch)
Department of Anaesthesiology and Pain Medicine, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
(Schoenhoff, Carrel) Department of Cardiovascular Surgery, Inselspital,
Bern University Hospital, University of Bern, Bern, Switzerland
(Brugger) Department of Cardiology, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: Supplemental oxygen (O<inf>2</inf>) is used routinely during
anesthesia. In the treatment of acute myocardial infarction, it has been
established that hyperoxia is to be avoided, whereas information on
benefit and risk of hyperoxia in patients with stable coronary artery
disease (CAD) remain scarce, especially in the setting of general
anesthesia. This study will compare the immediate effects of normoxemia
and hyperoxia on cardiac function, with a primary focus on changes in peak
longitudinal left-ventricular strain, in anesthetized stable chronic CAD
patients using peri-operative transesophageal echocardiography (TEE).
<br/>Method(s): A single-center randomized cross-over clinical trial will
be conducted, enrolling 106 patients undergoing elective coronary artery
bypass graft surgery. After the induction of anesthesia and prior to the
start of surgery, cardiac function will be assessed by 2D and 3D TEE.
Images will be acquired at two different oxygen states for each patient in
randomized order. The fraction of inspired oxygen
(F<inf>I</inf>O<inf>2</inf>) will be titrated to a normoxemic state
(oxygen saturation of 95-98%) and adjusted to a hyperoxic state
(F<inf>I</inf>O<inf>2</inf> = 0.8). TEE images will be analyzed in a
blinded manner for standard cardiac function and strain parameters.
<br/>Conclusion(s): By using myocardial strain assessed by TEE, early and
subtle signs of biventricular systolic and diastolic dysfunction can be
promptly measured intraoperatively prior to the onset of severe signs of
ischemia. The results may help anesthesiologists to better understand the
effects of F<inf>I</inf>O<inf>2</inf> on cardiac function and potentially
tailor oxygen therapy to patients with CAD undergoing general
anesthesia.<br/>Copyright &#xa9; 2021 The Authors

<78>
Accession Number
2015137645
Title
Curcumin nanomicelle improves lipid profile, stress oxidative factors and
inflammatory markers in patients undergoing coronary elective
an-gioplasty; a randomized clinical trial.
Source
Endocrine, Metabolic and Immune Disorders - Drug Targets. 21(11) (pp
2090-2098), 2021. Date of Publication: November 2021.
Author
Helli B.; Gerami H.; Kavianpour M.; Heybar H.; Hosseini S.K.; Haghighian
H.K.
Institution
(Helli) Department of Nutrition, Nutrition, and Metabolic Diseases
Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz,
Iran, Islamic Republic of
(Gerami) Nutrition and Food Security Research Center, Shahid Sadoughi
University of Medical Sci-ences, Yazd, Iran, Islamic Republic of
(Gerami) Endocrinology and Metabolism Research Center, Endocrinology and
Metabolism Clinical Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Kavianpour) Department of Tissue Engineering and Applied Cell Sciences,
Faculty of Advanced Technologies in Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Heybar) Atherosclerosis Research Center; Department of Cardiology, School
of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz,
Iran, Islamic Republic of
(Hosseini) Department of Interventional Cardiology, Shariati Hospital,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Haghighian) Department of Nutrition, School of Health, Qazvin University
of Medical Science, Qazvin, Iran, Islamic Republic of
(Haghighian) Metabolic Diseases Research Center, Research Institute for
Prevention of Non-Communicable Diseas-es, Qazvin University of Medical
Sciences, Qazvin, Iran, Islamic Republic of
Publisher
Bentham Science Publishers
Abstract
Background: Curcumin has demonstrated many pharmacological effects
including an-tioxidants, anti-inflammation, eliminating free radicals,
anti-tumor, lipid regulation, and anti-coagu-lation. <br/>Objective(s):
This study aimed to assess and compare the effects of curcumin and
nano-curcumin on lipid profile, oxidative stress, and inflammatory factors
related to patient's heart. <br/>Method(s): This randomized, double-blind,
placebo-controlled clinical trial was conducted on 90 patients undergoing
coronary elective angioplasty who were randomly divided into 3 groups. The
dos-es administered for 8 weeks were a 500 mg capsule of curcumin daily
for the first group and an 80 mg capsule of nano-curcumin for the second
group. However, the placebo group received capsules like curcumin. Lipid
profile, oxidative stress factors, and inflammatory markers were measured
at the baseline and end of the experiment. <br/>Result(s): Statistically
significant changes were observed in the total cholesterol (TC),
triacylg-lycerol (TG) and low-density lipoprotein cholesterol (LDL-C) in
the intervention groups to the control group (p<0.05). Curcumin and
nano-curcumin supplementation also exhibited significant changes in plasma
levels of total antioxidant capacity (TAC), malondialdehyde (MDA),
Super-oxide dismutase (SOD), glutathione peroxidase (GSH-Px),
high-sensitivity C-reactive protein (h-s-CRP), Interleukin 1 beta
(IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) in comparison to
the placebo (p<0.05). Furthermore, the nano-curcumin group compared to the
curcumin group demonstrated significant changes (p<0.05) in TC, TG, SOD,
MDA and TNF-alpha levels. <br/>Conclusion(s): The effects of curcumin on
nano formula may be better for cardiac patients due to its high
bioavailability. Clinical Trial Registrations: The study was registered in
the Iranian Registry of Clinical Trials website by the IRCTID:
IRCT20141025019669N6.<br/>Copyright &#xa9; 2021 Bentham Science
Publishers.

<79>
Accession Number
2014012598
Title
Effect of electroencephalography-guided anesthesia on neurocognitive
disorders in elderly patients undergoing major non-cardiac surgery: A
trial protocol the POEGEA trial (POncd Elderly GEneral Anesthesia).
Source
PLoS ONE. 16(8 August) (no pagination), 2021. Article Number: e0255852.
Date of Publication: August 2021.
Author
Morisson L.; Laferriere-Langlois P.; Carrier F.M.; Page G.; Godbout C.;
Fortier L.-P.; Ogez D.; Letourneau G.; Jarry S.; Denault A.; Fortier A.;
Guertin M.-C.; Verdonck O.; Richebe P.
Institution
(Morisson, Laferriere-Langlois, Godbout, Fortier, Ogez, Verdonck, Richebe)
Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont
Hospital - CIUSSS de L'Est de l'Ile de Montreal, Universite de Montreal,
Montreal, QC, Canada
(Laferriere-Langlois, Carrier, Page, Godbout, Fortier, Ogez, Denault,
Verdonck, Richebe) Department of Anesthesiology and Pain Medicine,
Universite de Montreal, Quebec, Canada
(Carrier) Department of Anesthesiology, Department of Medicine, Critical
Care Division, Centre Hospitalier de l'Universite de Montreal (CHUM),
Universite de Montreal, Montreal, QC, Canada
(Carrier, Page) Research Center of the CHUM (Centre Hospitalier de
l'Universite de Montreal), Universite de Montreal, Montreal, QC, Canada
(Page) Department of Psychology, Universite de Montreal, Montreal, QC,
Canada
(Godbout, Fortier, Ogez, Letourneau, Verdonck, Richebe) Research Center,
CIUSSS de L'Est de l'Ile de Montreal, Universite de Montreal, Montreal,
QC, Canada
(Jarry, Denault) Department of Anesthesiology, Montreal Heart Institute,
Montreal, QC, Canada
(Fortier, Guertin) Department of Statistics, Montreal Health Innovations
Coordinating Center (MHICC), Montreal, QC, Canada
Publisher
Public Library of Science
Abstract
Introduction The number of elderly patients undergoing major surgery is
rapidly increasing. They are particularly at risk of developing
postoperative neurocognitive disorders (NCD). Earlier studies suggested
that processed electroencephalographic (EEG) monitors may reduce the
incidence of postoperative NCD. However, none of these studies controlled
for intraoperative nociception levels or personalized blood pressure
targets. Their results remain unclear if the reduction in the incidence of
postoperative NCD relates to avoidance of any electroencephalographic
pattern suggesting excessive anesthesia depth. Objective The objective of
this trial is to investigate-in patients > 70 years old undergoing major
non-cardiac surgery-the effect of EEG-guided anesthesia on postoperative
NCD while controlling for intraoperative nociception, personalized blood
pressure targets, and using detailed information provided by the EEG
monitor (including burst suppression ratio, density spectral array, and
raw EEG waveform). Material and methods This prospective, randomized,
controlled trial will be conducted in a single Canadian university
hospital. Patients > 70 years old undergoing elective major non-cardiac
surgery will be included in the trial. The administration of sevoflurane
will be adjusted to maintain a BIS index value between 40 and 60, to keep
a Suppression Ratio (SR) at 0%, to keep a direct EEG display without any
suppression time and a spectrogram with most of the EEG wave frequency
within the alpha, theta, and delta frequencies in the EEG-guided group. In
the control group, sevoflurane will be administered to achieve an
age-adjusted minimum alveolar concentration of [0.8-1.2]. In both groups,
a nociception monitor will guide intraoperative opioid administration,
individual blood pressure targets will be used, and cerebral oximetry used
to tailor intraoperative hemodynamic management. The primary endpoint will
be the incidence of NCD at postoperative day 1, as evaluated by the
Montreal Cognitive Assessment (MoCA). Secondary endpoints will include the
incidence of postoperative NCD at different time points and the evaluation
of cognitive trajectories up to 90 days after surgery among EEG-guided and
control groups.<br/>Copyright &#xa9; 2021 Morisson et al. This is an open
access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<80>
Accession Number
2013148920
Title
Incidence of herpes zoster in adult solid organ transplant recipients: A
meta-analysis and comprehensive review.
Source
Transplant Infectious Disease. 23(4) (no pagination), 2021. Article
Number: e13674. Date of Publication: August 2021.
Author
Kwon D.E.; Lee H.S.; Lee K.H.; La Y.; Han S.H.; Song Y.G.
Institution
(Kwon, Lee, La, Han, Song) Division of Infectious Disease, Department of
Internal Medicine, Yonsei University College of Medicine, Seoul, South
Korea
(Lee) Biostatistics Collaboration Unit, Yonsei University College of
Medicine, Seoul, South Korea
Publisher
John Wiley and Sons Inc
Abstract
Background: Chronic immunosuppressive therapy in solid organ transplant
(SOT) recipients can trigger latent varicella zoster virus reactivation
even in those with stable graft function. The inactivated herpes zoster
(HZ) vaccine can be effective in preventing post-transplant HZ, which can
cause severe neuralgia or disseminated disease. This meta-analysis aims to
assess the incidences of HZ across transplant organs in SOT recipients.
<br/>Method(s): We included 12 observational studies (6560 recipients)
from a PubMed and EMBASE search of articles through October 2019 and
collected data from single-center dating from January 2001 to December
2017 (3498 recipients). The pooled HZ incidence and its differences
between subgroups were obtained from random-effect models and
meta-analysis of variance tests using R package. <br/>Result(s): The
overall pooled crude incidence was 9.1% (95% confidence interval [CI],
7.6%-10.8%). The pooled incidence was similar between sexes but
significantly different between transplanted organs (P <.001). Heart
transplants (HT) (n = 644) have the highest pooled incidence with 15.2%
(95% CI, 12.7%-18.2%), followed by lung transplants (LTX) (n = 780) with
11.0% (8.3%-14.4%). Kidney transplants (n = 5435) have the lowest
incidence of 6.7 (5.1%-8.8%). The meta-regression analysis revealed that
HZ development had a relationship with past graft rejection (P =.024).
<br/>Conclusion(s): These data support the need for subunit HZ vaccination
in SOT recipients with a high risk for HZ, especially HT and LTX
recipients, without respect to the late post-transplant
period.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC.

<81>
Accession Number
2012314866
Title
Percutaneous coronary intervention versus coronary artery bypass grafting
in patients with coronary heart disease and type 2 diabetes mellitus:
Cumulative meta-analysis.
Source
Clinical Cardiology. 44(7) (pp 899-906), 2021. Date of Publication: July
2021.
Author
Xie Q.; Huang J.; Zhu K.; Chen Q.
Institution
(Xie, Zhu, Chen) Department of Cardiology, Zhuzhou Central Hospital,
Zhuzhou, China
(Huang) Department of Cardiology, Liling Traditional Chinese Medicine
Hospital, Zhuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Previous meta-analyses showed that coronary artery bypass grafting (CABG)
has lower all-cause mortality than percutaneous coronary intervention
(PCI) for the management of coronary heart disease (CHD), but the
long-term outcomes were not analyzed thoroughly in patients with type 2
diabetes mellitus (T2DM). To perform a meta-analysis of randomized
controlled trials (RCTs) to explore the long-term effectiveness between
CABG and PCI in patients with T2DM and study the temporal trends using a
cumulative meta-analysis. PubMed, Embase, Cochrane library, and Clinical
Trials Registry for eligible RCTs published up to September 2020. The
outcomes were all-cause death, cardiac death, myocardial infarction,
repeat revascularization, and stroke. Nine RCTs and 4566 patients were
included. CABG resulted in better outcomes than PCI in terms of all-cause
death (RR = 1.41, 95%CI: 1.22-1.63, p < 0.001), cardiac death (RR = 1.56,
95%CI: 1.25-1.95, p < 0.001), and repeat revascularization (RR = 2.68,
95%CI: 1.86-3.85, p < 0.001), but with difference regarding the occurrence
of myocardial infarction (RR = 1.20, 95%CI: 0.78-1.85, p = 0.414), while
PCI was associated with better outcomes in terms of stroke occurrence (RR
= 0.51, 95%CI: 0.34-0.77, p = 0.001). The cumulative meta-analysis for
all-cause death showed that the differences between CABG and PCI started
to be significant at 3 years of follow-up, while the difference became
significant at 5 years for cardiac death. In patients with CHD and T2DM,
CABG results in better outcomes than PCI in terms of all-cause death,
cardiac mortality, and repeat revascularization, while PCI had better
outcomes in terms of stroke. The differences are mainly observed over the
long-term follow-up.<br/>Copyright &#xa9; 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<82>
Accession Number
2016184330
Title
Complications during chronic total occlusion percutaneous coronary
intervention: a sign- And symptom-based approach to early diagnosis and
treatment.
Source
Minerva Cardiology and Angiology. 69(6) (pp 773-786), 2021. Date of
Publication: December 2021.
Author
Moroni F.; Santiago R.; Di Pietro R.; Calcagno S.; Azzalini L.
Institution
(Moroni, Azzalini) division of Cardiology, VCU Health Pauley Heart Center,
Virginia Commonwealth University, richmond, Va, United States
(Moroni) irCCS San raffaele Hospital, Vita-Salute San raffaele University,
Milan, Italy
(Santiago) PCi Cardiology group and Bayamon Heart and lung institute,
Bayamon, Puerto Rico
(Di Pietro, Calcagno) Unit of interventional Cardiology, SM goretti
Hospital, latina, Italy
Publisher
Edizioni Minerva Medica
Abstract
Coronary chronic total occlusions (CTO) are frequently found in patients
undergoing coronary angiography. Despite their high prevalence and
indication for revascularization in a relevant proportion of cases, CTO
recanalization is attempted only in a minority of cases. This is due to
higher risk of procedural complications compared to non-CTO interventions
and because CTO-PCIs are the most complex procedures in interventional
cardiology. In particular, the perceived higher risk of complications
during CTO interventions might discourage new operators from engaging in
this challenging field. The aim of this work was to review the potential
complications of CTO percutaneous coronary intervention, and to provide an
algorithmic, sign- and symptom-based approach to facilitate early
recognition and effective management.<br/>Copyright &#xa9; 2021 EDIZIONI
MINERVA MEDICA

<83>
Accession Number
2006907476
Title
Comparing anticoagulation therapy alone versus anticoagulation plus single
antiplatelet drug therapy after transcatheter aortic valve implantation in
patients with an indication for anticoagulation: a systematic review and
meta-analysis.
Source
Cardiovascular Drugs and Therapy. 35(5) (pp 995-1002), 2021. Date of
Publication: October 2021.
Author
Zhu Y.; Meng S.; Chen M.; Jia R.; Nan J.; Li H.; Zhu H.; Li L.; Jin Z.
Institution
(Zhu, Chen, Li, Zhu, Jin) Department of Cardiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing 100029, China
(Meng, Jia, Nan, Li, Jin) Department of Cardiology, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
Publisher
Springer
Abstract
Purpose: This meta-analysis compared the efficacy and safety of oral
anticoagulation (OAC) therapy alone versus OAC plus single antiplatelet
therapy (SAPT) in patients with an indication for chronic OAC (mostly due
to atrial fibrillation) after transcatheter aortic valve implantation
(TAVI). <br/>Method(s): A systematic literature search was performed in
the PubMed, Embase, and Cochrane Library databases to identify relevant
studies. Data was extracted from the eligible studies and outcomes
expressed as relative risks (RRs) with 95% confidence intervals (CIs).
<br/>Result(s): Five studies comprising 1344 patients with an indication
for chronic OAC and undergoing TAVI were included. Of the 1344 patients,
480 patients received OAC therapy alone and 864 patients received OAC plus
SAPT. There were no significant differences between OAC alone versus OAC
plus SAPT in all-cause mortality (RR = 1.05, 95% CI 0.84-1.30, p = 0.69)
and ischemic stroke (RR = 0.95, 95% CI 0.95-1.61, p = 0.86). However, OAC
alone was associated with significantly lower risks of all bleeding events
(RR = 0.62, 95% CI 0.49-0.69, p < 0.0001) and major and/ life-threatening
bleeding events (RR = 0.57, 95% CI 0.42-0.76, p = 0.0002) compared to OAC
plus SAPT. <br/>Conclusion(s): In patients with an indication for chronic
anticoagulation, post-TAVI antithrombotic therapy with OAC alone compared
to OAC plus SAPT may be not significantly different in reducing all-cause
mortality and ischemic stroke, but has an important benefit in a
significantly lower risk of all bleeding and major and/life-threatening
bleeding events.<br/>Copyright &#xa9; 2020, Springer Science+Business
Media, LLC, part of Springer Nature.

<84>
Accession Number
635976172
Title
Cooling as an Adjunctive Therapy to Percutaneous Intervention in Acute
Myocardial Infarction: COOL-MI InCor Trial.
Source
Therapeutic Hypothermia and Temperature Management. 11(3) (pp 135-144),
2021. Date of Publication: September 2021.
Author
Dallan L.A.P.; Giannetti N.S.; Rochitte C.E.; Polastri T.F.; San Martin
C.Y.B.; Hajjar L.A.; Lima F.G.; Nicolau J.C.; Oliveira M.T.D.; Dae M.;
Ribeiro Da Silva E.E.; Kalil Filho R.; Lemos Neto P.A.; Timerman S.
Institution
(Dallan, Giannetti, Rochitte, Polastri, San Martin, Hajjar, Lima, Nicolau,
Oliveira, Ribeiro Da Silva, Kalil Filho, Lemos Neto, Timerman) Department
of Cardiology, InCor Heart Institute, School of Medicine, University of
Sao Paulo, Sao Paulo, Brazil
(Dae) Department of Radiology, Ucsf, University of California, San
Francisco, CA, United States
Publisher
Mary Ann Liebert Inc.
Abstract
Endovascular Therapeutic hypothermia (ETH) reduces the damage caused by
postischemia reperfusion injury syndrome in cardiopulmonary arrest and has
already established its role in patients with sudden death; however, its
role in ST-segment elevation myocardial infarction (STEMI) remains
controversial. The objectives of this study were to investigate the
safety, feasibility, and 30-day efficacy of rapid induction of therapeutic
hypothermia as adjunctive therapy to percutaneous coronary intervention
(PCI) in patients with anterior and inferior STEMIs. This was a
prospective, controlled, randomized, two-arm, prospective, interventional
study of patients admitted to the emergency department within 6 hours of
angina onset, with anterior or inferior STEMI eligible for PCI. Subjects
were randomized to the hypothermia group (primary PCI+ETH) or to the
control group (primary PCI) at a 4:1 ratio. The ETH was induced by 1 L
cold saline (1-4degreeC) associated with the ProteusTM System, by cooling
for at least 18 minutes before coronary reperfusion with a target
temperature of 32degreeC +/- 1degreeC. Maintenance of ETH was conducted
for 1-3 hours, and active reheating was done at a rate of 1degreeC/h for 4
hours. Primary safety outcomes were the feasibility of ETH in the absence
of (1) door-to-balloon (DTB) delay; (2) major adverse cardiac events
(MACE) within 30 days after randomization. The primary outcomes of
effectiveness were infarct size (IS) and left ventricular ejection
fraction (LVEF) at 30 days. An as-treated statistical analysis was
performed. Fifty patients were included: 35 (70%) randomized to the
hypothermia group and 15 (30%) to the control group. The mean age was 58
+/- 12 years; 78% were men; and associated diseases were 60% hypertension,
42% diabetes, and 72% dyslipidemia. The compromised myocardial wall was
anterior in 38% and inferior in 62%, and the culprit vessels were left
anterior descending artery (LAD) (40%), right coronary artery (38%), and
left circumflex (18%). All 35 patients who attempted ETH (100%) had
successful cooling, with a mean endovascular coronary reperfusion
temperature of 33.1degreeC +/- 0.9degreeC. The mean ischemic time was 375
+/- 89.4 minutes in the hypothermia group and 359.5 +/- 99.4 minutes in
the control group. The mean DTB was 92.1 +/- 20.5 minutes in the
hypothermia group and 87 +/- 24.4 minutes in the control group. The
absolute difference of 5.1 minutes was not statistically significant (p =
0.509). The MACE rates were similar between both groups (21.7% vs. 20%
respectively, p = 0.237). In the comparison between the hypothermia and
control groups, no statistically significant differences were observed at
30 days between mean IS (13.9% +/- 8% vs. 13.8% +/- 10.8%, respectively, p
= 0.801) and mean final LVEF (43.3% +/- 11.2% vs. 48.3 +/- 10.9%,
respectively; p = 0.194). Hypothermia as an adjunctive therapy to primary
PCI in STEMI is feasible and can be implemented without delay in coronary
reperfusion. Hypothermia was safe regarding the incidence of MACE at 30
days. However, there was a higher incidence of arrhythmia and in-hospital
infection in the hypothermia group, with no increase in mortality.
Regarding efficacy, there was no difference in IS or LVEF at 30 days that
would suggest additional myocardial protection with ETH.
ClinicalTrials.gov: NCT02664194.<br/>&#xa9; Copyright 2021, Mary Ann
Liebert, Inc., publishers 2021.

<85>
Accession Number
2012318527
Title
Near-infrared spectroscopy device selection affects intervention
management for cerebral desaturation during cardiopulmonary bypass
surgery.
Source
General Thoracic and Cardiovascular Surgery. 70(1) (pp 11-15), 2022. Date
of Publication: January 2022.
Author
Kobayashi K.; Kitamura T.; Kohira S.; Inoue N.; Fukunishi T.; Miyaji K.
Institution
(Kobayashi, Kitamura, Inoue, Fukunishi, Miyaji) Department of
Cardiovascular Surgery, Kitasato University School of Medicine, 1-15-1
Kitasato, Minami, Kanagawa, Sagamihara 252-0375, Japan
(Kohira) Department of Medical Engineering, Kitasato University Hospital,
Sagamihara, Japan
Publisher
Springer Japan
Abstract
Objective: Currently, several near-infrared spectroscopy oximetry devices
are used for detecting cerebral ischemia during cardiopulmonary bypass
(CPB) surgery. We investigated whether two different models of
near-infrared spectroscopy oximetry devices affect the assessment of
cerebral ischemia and its management during CPB. <br/>Method(s): From
January 2017 to August 2017, 70 adult cardiovascular surgery cases were
randomly assigned to 1 of 2 different near-infrared spectroscopy oximetry
devices. The devices were INVOS 5100C (Medtronic, Minneapolis, MN, USA)
(group I; n = 35) and FORE-SIGHT ELITE (CAS Medical Systems, Branford, CT,
USA) (group F; n = 35). <br/>Result(s): There were no significant
differences in patient characteristics. The rSO<inf>2</inf> values were
significantly higher for patients in group F than for patients in group I.
Scalp-Cortex distance showed negative correlations with the mean
rSO<inf>2</inf> values in group I (P = 0.01). Interventions for low
rSO<inf>2</inf> during CPB for groups I and F were increase perfusion flow
(13:5; P = 0.03), blood transfusion (7:1; P = 0.02), and both (6:1; P =
0.04), respectively. The Scalp-Cortex distance in group I was
significantly longer in patients who required intervention than in
patients who did not (17.1 +/- 2.5 vs 15.1 +/- 1.6 mm; P = 0.007).
<br/>Conclusion(s): It is inappropriate to use the same intervention
criteria for different near-infrared spectroscopy oximetry devices.
Moreover, brain atrophy influence rSO<inf>2</inf> values depending on
device selection. It is important to note that inappropriate device
selection may misguide perfusionists into performing unnecessary or
excessive intervention during CPB.<br/>Copyright &#xa9; 2021, The Japanese
Association for Thoracic Surgery.

<86>
[Use Link to view the full text]
Accession Number
635273957
Title
The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP)
Tool: A Critical Narrative Review.
Source
Journal of Acute Care Physical Therapy. 13(1) (pp 24-44), 2022. Date of
Publication: 01 Jan 2022.
Author
Socwell C.P.; Kanagasaba K.; Pope R.
Institution
(Socwell, Kanagasaba) Faculty of Health Sciences and Medicine, Bond
University, 2 Promethean Way, Robina, QLD 4226, Australia
(Pope) School of Community Health, Charles Sturt University, Albury,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: The aim of this critical narrative review was to identify and
synthesize available research evidence on the utility of Mayo Clinic's
Early Screen for Discharge Planning (ESDP) tool to (1) identify adult
patients early during their hospital stay who require referral to
specialized hospital discharge planning services (SHDCPS) and (2) review
its utility in predicting patient outcomes including hospital length of
stay (LOS), readmission risk, and discharge destination. This review also
begins by highlighting the important role of physical therapists in
discharge planning. <br/>Method(s): A critical narrative review was
conducted of relevant studies identified through a systematic search of
PubMed, CINAHL, Embase, and ProQuest databases and subsequent systematic
screening and selection process. Studies were included and critically
appraised if they met eligibility criteria: studies investigating the
development, predictive validity and utility of the ESDP in hospital
patient populations, and studies comparing the ESDP with other discharge
planning tools. Key data were then extracted and tabulated before a
critical narrative synthesis of key findings was completed.
<br/>Result(s): Seven studies met the eligibility criteria, with 5 studies
receiving a rating of "good" quality. The included studies investigated
the ESDP tool in adults within acute inpatient hospital settings,
including heart failure, colorectal surgery, general medical and surgical,
and oncology wards. <br/>Conclusion(s): Five of the 7 included studies
were of good quality and, together, studies provided evidence that the
ESDP tool correctly identifies adults requiring referral to SHDCPS.
However, further research of the ESDP tool is recommended to account for
variations observed in special populations and expand knowledge of its
utility to predict outcomes such as hospital LOS, readmission risk, and
discharge destination.<br/>Copyright &#xa9; 2021 Academy of Acute Care
Physical Therapy, APTA.

<87>
Accession Number
2014159169
Title
Isolated tricuspid valve surgery-Repair versus replacement: A
meta-analysis.
Source
Journal of Cardiac Surgery. 37(2) (pp 329-335), 2022. Date of Publication:
February 2022.
Author
Sarris-Michopoulos P.; Macias A.E.; Sarris-Michopoulos C.; Woodhouse P.;
Buitrago D.; Salerno T.A.; Magarakis M.
Institution
(Sarris-Michopoulos) University of Miami Miller School of Medicine, Miami,
FL, United States
(Macias) Department of Surgery, Jackson Memorial Hospital, University of
Miami Miller School of Medicine, Miami, FL, United States
(Sarris-Michopoulos) Department of Economics, University of Georgia,
Athens, GA, United States
(Woodhouse) Department of Surgery, Vanderbilt University School of
Medicine, Vanderbilt University Medical Center, Nashville, Vanderbilt,
United States
(Buitrago) Department of Surgery, Division of Cardiothoracic Surgery,
University of Miami Miller School of Medicine, Jackson Memorial Hospital,
Miami, FL, United States
(Salerno, Magarakis) Department of Surgery, Division of Cardiothoracic
Surgery, Jackson Memorial Hospital, University of Miami Miller School of
Medicine, Miami, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: There is a paucity of data on outcomes after isolated tricuspid
valve surgery. This meta-analysis aims to compile available data on
isolated tricuspid valve surgery and compare isolated tricuspid valve
repair (iTVr) with isolated tricuspid valve replacement (iTVR) to
elucidate outcomes after tricuspid valve surgery. <br/>Method(s): A
literature search of 6 databases was performed. The primary outcomes was
30-day mortality. Secondary outcomes were early stroke, post-op pacemaker
placement, and tricuspid reoperation within 5 years. Publication bias was
explored using the funnel plot. <br/>Result(s): Ten retrospective studies
involving 1407 patients (iTVr group = 779 patients and iTVR group = 628
patients) were included. A cumulative analysis demonstrated a significant
difference favoring iTVr for 30-day mortality (odds ratio [OR]: 10 studies
[95% confidence interval [CI]]: 0.34 [0.18-0.66]); 4.7% versus 12.6%, for
iTVr and iTVR, respectively. Post-op pacemaker placement favored iTVr (OR:
6 studies [95% CI]: 0.37 [0.18-0.77]). Although stroke rates and TV
reoperation favored iTVr, they did not reach statistical significance. No
publication bias was identified. <br/>Conclusion(s): This meta-analysis
demonstrates that iTVr has better 30-day mortality and fewer permanent
pacemaker placements. Etiology and severity of TR, as well as careful
patient selection remain the most important factors for optimal
outcomes.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<88>
Accession Number
2014068463
Title
Safety and efficacy of concomitant ablation for atrial fibrillation in
rheumatic mitral valve surgery: A meta-analysis.
Source
Journal of Cardiac Surgery. 37(2) (pp 361-373), 2022. Date of Publication:
February 2022.
Author
Ma J.; Wei P.; Yan Q.; Liu J.; Yao X.; Chen Z.; Zhuang J.; Guo H.-M.
Institution
(Ma, Wei, Liu, Chen, Zhuang, Guo) Department of Cardiovascular Surgery,
Guangdong Provincial Key Laboratory of South China Structural Heart
Disease, Guangdong Provincial People's Hospital, Guangdong Cardiovascular
Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
(Yan, Yao) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese
Academy of Medical Sciences, Shenzhen, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This review aimed to evaluate the safety and efficacy of
concomitant surgical ablation (SA) for patients with atrial fibrillation
(AF) undergoing rheumatic mitral valve (MV) surgery. <br/>Method(s): A
systematic search of relevant studies focusing on SA for patients with AF
undergoing rheumatic MV surgery was performed. The primary outcomes
included mortality, efficacy, and complications. <br/>Result(s): Four
randomized controlled trials (RCTs) and four observational studies
covering 1931 patients met the inclusion criteria. In RCTs, no significant
differences in reoperation for bleeding, low cardiac output syndrome,
thromboembolic events, and early (risk ratio [RR], 2.07; 95% confidence
intervals [CI], 0.37-11.40; p =.41) and midterm all-cause death (RR, 1.07;
95% CI, 0.40-2.88; p =.89) were noted between the SA group and the
nonablation group. These results were similar to those obtained from
observational studies. However, ablation was associated with a higher
incidence of permanent pacemaker implantation (RR, 2.44; 95% CI,
1.15-5.18; p =.02) in observational studies but not in RCTs (RR, 2.03; 95%
CI, 0.19-21.26; p =.56). Furthermore, additional SA was significantly more
effective in sinus rhythm (SR) restoration than MV surgery alone at
discharge and at the 12-month and 3-year follow-ups. <br/>Conclusion(s):
Concomitant SA during rheumatic MV surgery does not increase perioperative
adverse events. In addition, SA promotes considerable restoration of SR.
Although some evidence exists that permanent pacemaker implantation is
more common after ablation, not all studies support this
notion.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<89>
Accession Number
2014276871
Title
Surgical ablation in rheumatic heart disease-Uncharted territory.
Source
Journal of Cardiac Surgery. 37(2) (pp 374-376), 2022. Date of Publication:
February 2022.
Author
Leviner D.B.; Sharoni E.
Institution
(Leviner, Sharoni) Department of Cardiothoracic Surgery, Carmel Medical
Center, Haifa, Israel
(Leviner, Sharoni) Technion-Israel Institute of Technology, Faculty of
Medicine, Haifa, Israel
Publisher
John Wiley and Sons Inc
Abstract
Background: Atrial fibrillation is a common arrhythmia with a large impact
on society and on patients. Rheumatic valve disease is still prevalent in
low- and medium-income countries. Performing surgical ablation during
surgery for mitral valve disease has been shown to restore sinus rhythm in
most patients. Aims, <br/>Material(s) and Method(s): In this issue of the
Journal of Cardiac Surgery, Ma et al., publish a meta-analysis of surgical
ablation in patients with rheumatic heart disease (RHD). <br/>Result(s):
They found no difference in short-term outcomes with a higher incidence of
restoration to sinus rhythm. In mid- to long-term follow-up, there was no
difference in mortality with a signal towards more permanent pacemaker
implantation. Discussion and <br/>Conclusion(s): Despite some inherent
limitations and some methodological flows, this meta-analysis has
important insights and is valuable for surgeons taking care of patients
with RHD.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<90>
Accession Number
2014242360
Title
Shedding some light on tricuspid intervention.
Source
Journal of Cardiac Surgery. 37(2) (pp 336-338), 2022. Date of Publication:
February 2022.
Author
Fattouch K.; Moscarelli M.
Institution
(Fattouch) Dicronis, Department of Cardiovascular Surgery, University of
Palermo, Palermo, Italy
(Moscarelli) Department of Cardiac Surgery, GVM Care and Research, Anthea
Hospital, Bari, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: More than 1.6 million Americans have at least moderate to
severe valvular tricuspid regurgitation, yet fewer than 8000 tricuspid
valve operations are performed annually in the USA. The undertreatment for
isolated tricuspid regurgitation might be related to the fact that in the
past years no clear guidelines on 'how' and 'when' to treat tricuspid
regurgitation were issued. <br/>Aim(s): Sarris-Michopoulos and colleagues
carried out a meta-analysis with the aim to investigate the role of
tricuspid valve repair versus tricuspid valve replacement in patients with
isolated tricuspid valve regurgitation. <br/>Material(s) and Method(s):
Outcomes of patients with first-time surgery for isolated tricuspid valve
regurgitation without previous left-sided valve surgery were reviewed. Ten
studies were included with a total of 1407 patients. <br/>Result(s):
Authors concluded that patients who underwent tricuspid valve repair
showed less 30-days mortality than replacement along with a reduced need
for post-operaitve permanent pacemaker implantation rate.
<br/>Discussion(s): Decision on whether to treat or not tricuspid valve is
demanding, particularly in the context of the newest percutaneous
technologies. Before intervention, careful evaluation of both tricuspid
valve and right ventricle must be performed. Nevertheless, intervention,
should not be deferred when clinically indicated. <br/>Conclusion(s): The
findings form this meta-analysis suggest that reparative surgery, perhaps
in an early stage, may be beneficial in selected cohort of
patients.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<91>
Accession Number
2014242358
Title
Predictors for the risk of permanent pacemaker implantation after
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Journal of Cardiac Surgery. 37(2) (pp 377-405), 2022. Date of Publication:
February 2022.
Author
Wang T.; Ou A.; Xia P.; Tian J.; Wang H.; Cheng Z.
Institution
(Wang, Xia, Tian) Department of Cardiovascular Medicine, The Fourth
Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
(Ou) Department of Radiology, Shengjing Hospital of China Medical
University, Shenyang, Liaoning, China
(Wang) Department of Emergency Medicine, The First Affiliated Hospital of
Lanzhou Medical University, Lanzhou, China
(Cheng) Department of Cardiac Surgery, West China Hospital, Sichuan
University, Chengdu, Sichuan, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a less
invasive treatment than surgery for severe aortic stenosis. However, its
use is restricted by the fact that many patients eventually require
permanent pacemaker implantation (PPMI). This meta-analysis was performed
to identify predictors of post-TAVR PPMI. <br/>Method(s): The PubMed,
Embase, Web of Science, and Cochrane Library databases were systematically
searched. Relevant studies that met the inclusion criteria were included
in the pooling analysis after quality assessment. <br/>Result(s): After
pooling 67 studies on post-TAVR PPMI risk in 97,294 patients,
balloon-expandable valve use was negatively correlated with PPMI risk
compared with self-expandable valve (SEV) use (odds ratio [OR]: 0.44, 95%
confidence interval [CI]: 0.37-0.53). Meta-regression analysis revealed
that history of coronary artery bypass grafting and higher Society of
Thoracic Surgeons (STS) risk score increased the risk of PPMI with SEV
utilization. Patients with pre-existing cardiac conduction abnormalities
in 28 pooled studies also had a higher risk of PPMI (OR: 2.33, 95% CI:
1.90-2.86). Right bundle branch block (OR: 5.2, 95% CI: 4.37-6.18) and
first-degree atrioventricular block (OR: 1.97, 95% CI: 1.38-2.79) also
increased PPMI risk. Although the trans-femoral approach was positively
correlated with PPMI risk, the trans-apical pathway showed no statistical
difference to the trans-femoral pathway. The approach did not increase
PPMI risk in patients with STS scores >8. Patient-prosthesis mismatch did
not influence post-TAVR PPMI risk (OR: 0.88, 95% CI: 0.67-1.16). We also
analyzed implantation depth and found no difference between patients with
PPMI after TAVR and those without. <br/>Conclusion(s): SEV selection,
pre-existing cardiac conduction abnormality, and trans-femoral pathway
selection are positively correlated with PPMI after TAVR. Pre-existing
left bundle branch block, patient-prosthesis mismatch, and implantation
depth did not affect the risk of PPMI after TAVR.<br/>Copyright &#xa9;
2021 Wiley Periodicals LLC

<92>
Accession Number
636260129
Title
Rationale and design of the SMall Annuli Randomized To Evolut or SAPIEN
Trial (SMART Trial).
Source
American heart journal. 243 (pp 92-102), 2022. Date of Publication: 01 Jan
2022.
Author
Herrmann H.C.; Abdel-Wahab M.; Attizzani G.F.; Batchelor W.; Bleiziffer
S.; Verdoliva S.; Chang Y.; Gada H.; Gillam L.; Guerrero M.; Mahoney P.D.;
Petronio A.S.; Rogers T.; Rovin J.; Szerlip M.; Whisenant B.; Mehran R.;
Tchetche D.
Institution
(Herrmann) Perelman School of Medicine at the University of Pennsylvania,
PA, Philadelphia, United States
(Abdel-Wahab) Heart Center Leipzig at the University of Leipzig, Leipzig,
Germany
(Attizzani) University Hospitals of Cleveland, Cleveland, OH
(Batchelor) Inova Heart and Vascular Institute, Falls Church, VA
(Bleiziffer) Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
(Verdoliva, Chang) Medtronic, Mounds View, MN
(Gada) PA, Harrisburg, United States
(Gillam) Morristown Medical Center/Atlantic Health System, Morristown,
United States
(Guerrero) Mayo Clinic, MN, Rochester
(Mahoney) Sentara Healthcare, VA, Norfolk
(Petronio) Ospedale di Cisanello Pisa, Universita di Pisa, Italy
(Rogers) MedStar Washington Hospital Center, Washington, DC; National
Institutes of Health, Bethesda, MD
(Rovin) BayCare Health System/Morton Plant Hospital, FL, Clearwater,
United States
(Szerlip) Baylor Scott and White Heart Hospital, TX, Plano, United States
(Whisenant) UT, Intermountain Medical Center, Murray, United States
(Mehran) Mount Sinai School of Medicine, NY, NY
(Tchetche) Clinique Pasteur, Toulouse, France
Publisher
NLM (Medline)
Abstract
BACKGROUND: The SMall Annuli Randomized To Evolut or SAPIEN (SMART) Trial
was designed to compare the performance of the two most widely available
commercial transcatheter aortic valve replacement (TAVR) devices in
patients with symptomatic severe native aortic stenosis with a small
aortic valve annulus undergoing transfemoral TAVR. Patients with small
aortic valve annuli are typically female and are often underrepresented in
clinical trials. <br/>METHOD(S): The SMART Trial is an international,
prospective, multi-center, randomized controlled, post-market trial. The
trial will be conducted in approximately 700 subjects at approximately 90
sites globally. Inclusion criteria include severe aortic stenosis, aortic
valve annulus area of <=430 mm2 based on multi-detector computed
tomography, and appropriate anatomy for both the Medtronic Evolut PRO/PRO+
self-expanding and Edwards SAPIEN 3/3 Ultra balloon-expandable devices.
The primary clinical outcome composite endpoint is defined as mortality,
disabling stroke or heart failure rehospitalization at 12 months. The
co-primary valve function composite endpoint is defined as bioprosthetic
valve dysfunction at 12 months which includes hemodynamic structural valve
dysfunction, defined as a mean gradient >=20 mmHg, non-structural valve
dysfunction, defined as severe prothesis-patient mismatch or >=moderate
aortic regurgitation, thrombosis, endocarditis, and aortic valve
re-intervention. Powered secondary endpoints will be assessed
hierarchically. <br/>CONCLUSION(S): The SMART trial will be the largest
head-to-head comparative trial of transfemoral TAVR using the two most
widely available contemporary TAVR devices in the setting of small aortic
annuli and the largest trial to enroll primarily women. CLINICAL TRIAL
REGISTRATION: URL: www.clinicaltrials.gov, Unique identifier:
NCT04722250.<br/>Copyright &#xa9; 2021 Elsevier Inc. All rights reserved.

<93>
Accession Number
2014407381
Title
Mitral valve paravalvular leaks: Comprehensive review of literature.
Source
Journal of Cardiac Surgery. 37(2) (pp 418-430), 2022. Date of Publication:
February 2022.
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

<94>
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.

<95>
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

<96>
Accession Number
636800823
Title
Intraoperative hypotension in elder patients (iHypE): A retrospective
cohort study of hypotension treatment thresholds in Queensland.
Source
Anaesthesia and Intensive Care. Conference: Annual Scientific Meeting of
the Australian and New Zealand College of Anaesthetists 2021. Virtual.
49(2 SUPPL) (pp 10-11), 2021. Date of Publication: October 2021.
Author
Saric S.; Aftab A.; Highton D.
Institution
(Saric, Aftab, Highton) Queensland Anaesthetic Registrars' Research
Collaborative (QARRC), QLD, Australia
(Aftab, Highton) PA Southside Clinical Unit, University of Queensland,
Brisbane, QLD, Australia
Publisher
SAGE Publications Inc.
Abstract
Intraoperative hypotension (IOH) is associated with organ injury (1) and
mortality in older patients (2). Maintaining mean arterial pressure
(MAP)>65mmHg or avoiding a >20% drop from baseline systolic blood pressure
(SBP) are suggested targets, as morbidity is associated with IOH beyond
these boundaries (1). The clinically applied IOH treatment threshold has
not been defined in Australian practice, and this is essential to inform
future research and quality improvement. The aim of this study was to
identify the prevalence and treatment thresholds for IOH in Queensland.
<br/>Method(s): This study was conducted by the Queensland Anaesthetic
Registrars' Research Collaborative (QARRC). Following ethical approval
(LNR/2019/QMS/51569) data were retrospectively collected over 30
consecutive days from 10 Queensland hospitals for patients aged >=65 years
who underwent non-cardiac surgery. IOH was defined as MAP <65mmHg or >20%
reduction from preinduction SBP. Postoperative morbidity was defined via
KDIGO criteria for AKI and elevated serum troponin for myocardial injury.
Data on administration of vasopressor therapy, stroke, and death at 30
days were also collected. Anaesthetists at each site were concurrently
invited to complete an anonymous survey on their intended treatment
thresholds for IOH. <br/>Result(s): There were 1707 patients included
(44.7% female; 58.6% aged 65-74 years; 50.1% ASA 3; 93.5% general
anaesthesia; 25.5% invasive blood pressure monitoring). IOH was extremely
common, with 90.5% of patients experiencing a >20% drop in SBP, and 58.4%
having a MAP <65mmHg during their procedure. Nadir blood pressure most
frequently occurred during the first 30mins of surgery (56.3%). A
composite adverse outcome of postoperative myocardial injury, AKI, stroke,
or death within 30 days occurred in 139 patients (8.1%). This comprised:
myocardial injury 28 (1.6%), 30 day mortality 25 (1.5%), AKI 99 (5.8%),
stroke 0 (0%). AKI was associated with an intraoperative MAP <65mmHg
(OR=1.772, p=0.018, 95% CI [1.104, 2.845]). The survey was completed by
237 anaesthetists (64.6% consultants). Most anaesthetists reported that
they used SBP (71.3%) or MAP (93.2%) to titrate fluid and vasopressor
therapy intraoperatively. The intended treatment threshold (survey) was
<65mmHg MAP for 51% of respondents and below the 20% SBP drop threshold
for 29% of respondents. In observed instances of intraoperative
vasopressor use, 55% of anaesthetists treated at a MAP >=65mmHg, but only
22% treated above a 20% drop in SBP. <br/>Discussion(s): Most patients
aged >=65 years are exposed to IOH during surgery in this Australian
cohort. The majority of anaesthetists aimed to treat a MAP <65mmHg and
this lower target could contribute to the high prevalence of IOH observed
using the study definitions. Tighter control of IOH has substantial
potential as a treatment target, however clinical trials are awaited to
directly inform the impact of IOH treatment on patient outcomes.

<97>
Accession Number
636800203
Title
Bariatric surgery and cardiovascular outcomes in patients with obesity and
cardiovascular disease: A population-based cohort study.
Source
Surgical Endoscopy. Conference: Scientific Session of the Society of
American Gastrointestinal and Endoscopic Surgeons, SAGES 2021. Las Vegas,
NV United States. 35(1) (pp S75), 2021. Date of Publication: December
2021.
Author
Doumouras A.G.; Lee Y.; Wong J.; Paterson M.; Sivapathasundaram B.;
Tarride J.-E.; Thebane L.; Hong D.; Yusuf S.; Anvari M.
Institution
(Doumouras, Lee, Wong, Sivapathasundaram, Tarride, Thebane, Hong, Yusuf,
Anvari) McMaster University
(Paterson) University of Toronto
Publisher
Springer
Abstract
Background: Bariatric surgery has been shown to significantly reduce
cardiovascular risk factors. However, whether surgery can reduce major
adverse cardiovascular events (MACE), especially in patients with
established cardiovascular disease (CVD), remains poorly understood. We
aim to determine the association between bariatric surgery and MACE among
patients with cardiovascular disease and severe obesity. <br/>Method(s):
This was a population-based, matched cohort study using province-wide
multiple-linked administrative databases in Ontario, Canada. Patients with
previous CVD who received bariatric surgery were matched on age, sex,
heart failure history to controls from a primary care medical record
database in a 1:1 ratio. Adjustments were made using the confounders such
as patient socioeconomic status, comorbidities, smoking status, previous
malignancy, cancer screening, healthcare utilization, and psychiatric
history. The primary outcome was the incidence of extended MACE (first
occurrence of all-cause mortality, myocardial infarction (MI),
CABG/percutaneous coronary intervention, cerebrovascular events, and heart
failure hospitalization). Secondary outcome included three-component MACE
(MI, ischemic stroke, and mortality). Outcomes were evaluated through a
combination of matching via propensity scores and subsequent multivariable
adjustment. <br/>Result(s): 2,638 patients (n = 1,319 in each group) were
included with a median follow-up time of 4.6 years. The primary outcome
occurred in 11.5% of the surgery group and 19.6% of the controls (adjusted
hazard ratio [HR] 0.58; 95% confidence interval [CI], 0.48-0.71, P <
0.001). The observed effect was profound for those with heart failure (HR
0.44; 95%CI, 0.31-0.62, P < 0.001; absolute risk reduction [ARR] 19.3%,
95%CI 12.0%-26.7%). Those with ischemic heart disease also saw a
substantial benefit (HR 0.60, 95%CI 0.48 to 0.74, P < 0.001; ARR 7.5%,
95%CI 4.7%-10.5%). Surgery also was associated with lower risk of the
secondary outcome (HR 0.66, 95%CI 0.52-0.84, P = 0.001) and cardiovascular
mortality (HR 0.35, 95%CI 0.15-0.80, P = 0.001). <br/>Conclusion(s):
Bariatric surgery was associated with a large reduction in risk MACE in
patients with CVD and obesity and requires confirmation by a large-scale
randomized trial.

<98>
Accession Number
2016331137
Title
Retrograde autologous priming in cardiac surgery: A systematic review and
meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 60(6) (pp 1245-1256), 2021.
Date of Publication: 01 Dec 2021.
Author
Gupta S.; McEwen C.; Basha A.; Panchal P.; Eqbal A.; Wu N.; Belley-Cote
E.P.; Whitlock R.
Institution
(Gupta, Eqbal, Whitlock) Department of Surgery, Division of Cardiac
Surgery, McMaster University, Hamilton, ON, Canada
(Gupta, Whitlock) Department of Health Research Methods, Evidence and
Impact, McMaster University, Hamilton, ON, Canada
(McEwen, Panchal, Wu) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Basha) Libin Cardiovascular Institute of Alberta, University of Calgary,
Calgary, AB, Canada
(Belley-Cote, Whitlock) Population Health Research Institute, Hamilton,
ON, Canada
(Belley-Cote) Department of Medicine, McMaster University, Hamilton, ON,
Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Guidelines recommend retrograde autologous priming (RAP) of
the cardiopulmonary bypass circuit. However, the efficacy and safety of
RAP is not well-established. We performed a systematic review and
meta-analysis to determine the effects of RAP on transfusion requirements,
morbidity and mortality. <br/>METHOD(S): We searched Cochrane Central
Register of Controlled Trials, Medline, ScienceDirect, Cumulative Index to
Nursing and Allied Health Literature and Embase for randomized controlled
trials (RCTs) and observational studies comparing RAP to no-RAP. We
performed title and abstract review, full-text screening, data extraction
and risk of bias assessment independently and in duplicate. We pooled data
using a random effects model. <br/>RESULT(S): Twelve RCTs (n = 1206) and
17 observational studies (n = 3565) were included. Fewer patients required
blood transfusions with RAP [RCTs; risk ratio 0.58 [95% confidence
interval (CI): 0.51, 0.65], P < 0.001, and observational studies; risk
ratio 0.65 [95% CI: 0.53, 0.80], P < 0.001]. The number of units
transfused per patient was also lower among patients who underwent RAP
(RCTs; mean difference -0.38 unit [95% CI: -0.72, -0.04], P = 0.03, and
observational studies; mean difference -1.03 unit [95% CI: -1.76, -0.29],
P < 0.006). <br/>CONCLUSION(S): This meta-analysis supports the use of RAP
as a blood conservation strategy since its use during cardiopulmonary
bypass appears to reduce transfusion requirements. <br/>Copyright &#xa9;
2021 The Author(s) 2021. Published by Oxford University Press on behalf of
the European Association for Cardio-Thoracic Surgery. All rights reserved.

<99>
[Use Link to view the full text]
Accession Number
2016330533
Title
Risk factors for persistent pain after breast and thoracic surgeries: A
systematic literature review and meta-analysis.
Source
Pain. 163(1) (pp 3-20), 2022. Date of Publication: 01 Jan 2022.
Author
Lim J.; Chen D.; McNicol E.; Sharma L.; Varaday G.; Sharma A.; Wilson E.;
Wright-Yatsko T.; Yaeger L.; Gilron I.; Finnerup N.B.; Haroutounian S.
Institution
(Lim) Saint Louis University, School of Medicine, St. Louis, MO, United
States
(Chen) University of Sydney, School of Medicine, Sydney, Australia
(McNicol) MCPHS University, Boston, MA, United States
(Sharma, Varaday, Sharma, Wilson, Wright-Yatsko, Haroutounian) Department
of Anesthesiology, Washington University in St. Louis, School of Medicine,
St. Louis, MO, United States
(Yaeger) Becker Medical Library, Washington University in St. Louis,
School of Medicine, St. Louis, MO, United States
(Gilron) Department of Anesthesiology and Perioperative Medicine,
Biomedical and Molecular Sciences, Centre for Neuroscience Studies, School
of Policy Studies, Queen's University, Kingston, ON, Canada
(Finnerup) Department of Clinical Medicine, Danish Pain Research Center,
Aarhus University, Aarhus, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
Persistent postsurgical pain (PPSP) is common after breast and thoracic
surgeries. Understanding which risk factors consistently contribute to
PPSP will allow clinicians to apply preventive strategies, as they emerge,
to high-risk patients. The objective of this work was to systematically
review and meta-analyze the literature on risk factors of PPSP after
breast and thoracic surgeries. A systematic literature search using Ovid
Medline, Cochrane Central Register of Controlled Trials, Cumulative Index
to Nursing and Allied Health Literature, Embase, PsycINFO, and Scopus
databases was conducted. Study screening with inclusion and exclusion
criteria, data extraction, and risk of bias assessment was performed
independently by 2 authors. The data for each surgical group were analyzed
separately and meta-analyzed where possible. The literature search yielded
5584 articles, and data from 126 breast surgery and 143 thoracic surgery
articles were considered for meta-analysis. In breast surgery, younger
age, higher body mass index, anxiety, depression, diabetes, smoking,
preoperative pain, moderate to severe acute postoperative pain,
reoperation, radiotherapy, and axillary lymph node dissection were the
main factors associated with higher risk of PPSP. In thoracic surgery,
younger age, female sex, hypertension, preoperative pain, moderate to
severe acute postoperative pain, surgical approach, major procedure, and
wound complications were associated with PPSP. This systematic review
demonstrated certain consistent risk factors of PPSP after breast and
thoracic surgeries, as well as identified research gaps. Understanding the
factors that increase susceptibility to PPSP can help selectively allocate
resources to optimize perioperative care in high-risk patients and help
develop targeted, risk-stratified interventions for PPSP
prevention.<br/>Copyright &#xa9; 2021 International Association for the
Study of Pain

<100>
Accession Number
2016352466
Title
Efficacy of psychological interventions on clinical outcomes of coronary
artery disease: Systematic review and meta-analysis.
Source
Journal of Psychosomatic Research. 153 (no pagination), 2022. Article
Number: 110710. Date of Publication: February 2022.
Author
Magan I.; Jurado-Barba R.; Casado L.; Barnum H.; Jeon A.; Hernandez A.V.;
Bueno H.
Institution
(Magan, Jurado-Barba, Casado) Department of Psychology, Facultad de Salud,
Universidad Camilo Jose Cela, Madrid, Spain
(Jurado-Barba, Bueno) Instituto de Investigacion Biomedica del Hospital 12
de Octubre (Imas12), Madrid, Spain
(Barnum, Jeon, Hernandez) Health Outcomes, Policy, and Evidence Synthesis
(HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT,
United States
(Hernandez) Vicerrectorado de Investigacion, Universidad San Ignacio de
Loyola (USIL), Lima, Peru
(Bueno) Department of Cardiology, Hospital Universitario 12 de Octubre,
Madrid, Spain
(Bueno) Multidisciplinary Translational Cardiovascular Research Group,
Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
(Bueno) Centro de Investigacion Biomedica en Red Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Objectives: Psychological factors influence clinical outcomes in patients
with coronary artery disease (CAD). Therefore, psychological interventions
(PIs) may have beneficial effects in these patients. We evaluated the
efficacy of PIs based on cognitive-behavioral therapy (CBT) and positive
psychology therapy (PPT) on clinical and laboratory outcomes in CAD.
<br/>Method(s): Randomized controlled trials evaluating CBT or PPT in CAD
patients published until May 2020 were systematically reviewed and
analyzed. Primary outcomes were all-cause mortality, cardiovascular
mortality, any cardiovascular event, myocardial infarction (MI), stroke,
coronary revascularization, angina, and readmission. Random effects
meta-analyses using the inverse variance method were performed. Effects
were expressed as risk ratios (RR) or standardized mean difference (SMD)
with 95% confidence intervals (CIs). <br/>Result(s): Twenty-five trials
were included (n = 8119); 22 evaluating the effects of multi-component CBT
(n = 7909), and three PPT (n = 210). Thirteen RCTs were at high risk of
bias due to limitations in randomization or blinding. Compared with
control groups any cardiovascular event (RR 0.82; 0.70 to 0.97; 5
studies), MI (RR 0.72; 0.52 to 0.98; 9 studies), and angina duration and
intensity (SMD -0.64; -0.98 to -0.30; 4 studies; and -0.64; -1.17 to
-0.11; 2 trials) were significantly reduced with PIs at the end of
follow-up. PIs had no effect on other primary outcomes, laboratory or
anthropometrical results and presented a moderate to high heterogeneity.
<br/>Conclusion(s): CBT- and PPT-based PIs reduce the risk of
cardiovascular events, MI and angina in patients with CAD. Future research
should assess the individual role of CBT and PPT in CAD
populations.<br/>Copyright &#xa9; 2021

<101>
Accession Number
2016331157
Title
Perioperative platelet reduction after sutureless or stented valve
implantation: Results from the PERSIST-AVR controlled randomized trial.
Source
European Journal of Cardio-thoracic Surgery. 60(6) (pp 1359-1365), 2021.
Date of Publication: 01 Dec 2021.
Author
Lorusso R.; Jiritano F.; Roselli E.; Shrestha M.; Folliguet T.; Meuris B.;
Pollari F.; Fischlein T.
Institution
(Lorusso, Jiritano) Cardio-Thoracic Surgery Department, Heart and Vascular
Center, Maastricht University Medical Center (MUMC+), Maastricht,
Netherlands
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Jiritano) Cardiac Surgery Unit, Department of Experimental and Clinical
Medicine, University "magna Graecia" of Catanzaro, Catanzaro, Italy
(Roselli) Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH,
United States
(Shrestha) Hannover Medical School, Hannover, Germany
(Folliguet) Department of Cardiac Surgery, Hopital Henri Mondor,
Universite Paris 12, Creteil, Paris, France
(Meuris) Cardiac Surgery Department, Universitaire Ziekenhuizen Leuven,
Leuven, Belgium
(Pollari, Fischlein) Klinikum Nurnberg, Cardiovascular Center, Paracelsus
Medical University, Nuremberg, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Platelet count reduction is a common but not fully understood
phenomenon after aortic valve replacement (AVR) with bioprosthesis
implantation. The aim of the present study was to investigate the
occurrence and the clinical impact of platelet count reduction in patients
receiving the Perceval bioprosthesis compared to those receiving standard
sutured stented bioprosthetic aortic valve in a randomized, controlled AVR
study. <br/>METHOD(S): PERceval Sutureless Implant versus STandard Aortic
Valve Replacement is a prospective, randomized, adaptive, open-label
trial. Patients were randomized (March 2016-September 2018) to AVR with a
sutureless or stented valve. Ad hoc analyses have been performed to
evaluate the occurrence of platelet count reduction and the clinical
impact of the platelet variations in the 2 groups. <br/>RESULT(S): The
Perceval group showed a higher platelet reduction than the control group
(46% vs 32%). The phenomenon was transient in both groups, with a slow
recovery of the platelet count by hospital discharge. No differences were
observed between groups regarding need of transfusions, blood loss, major
bleeding and stroke events. <br/>CONCLUSION(S): The Perceval sutureless
aortic bioprosthesis implantation is associated with higher rate of
transient platelet reduction as compared to stented bioprostheses for AVR.
However, the platelet count reduction is transient and the decline does
not affect the patient's clinical outcomes. Current explanations for this
phenomenon are speculative, and further investigations are required to
elucidate it. Clinical trial registration number: NCT02673697 -
ClinicalTrials.gov - 4 February 2016. <br/>Copyright &#xa9; 2021 The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<102>
Accession Number
2016331139
Title
Intimal aortic atherosclerosis in cardiac surgery: Surgical strategies to
prevent embolic stroke.
Source
European Journal of Cardio-thoracic Surgery. 60(6) (pp 1259-1267), 2021.
Date of Publication: 01 Dec 2021.
Author
Knol W.G.; Budde R.P.J.; Mahtab E.A.F.; Bekkers J.A.; Bogers A.J.J.C.
Institution
(Knol, Mahtab, Bekkers, Bogers) Cardiothoracic Surgery, Erasmus Medical
Center, Rotterdam, Netherlands
(Knol, Budde) Radiology and Nuclear Medicine, Erasmus Medical Center,
Rotterdam, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Although the incidence of perioperative stroke after cardiac
surgery gradually decreased over the last decades, there is much variation
between centres. This review aimed to create a concise overview of the
evidence on possible surgical strategies to prevent embolic stroke in
patients with intimal aortic atherosclerosis. <br/>METHOD(S): The PubMed
and EMBASE databases were searched for studies on surgical management of
aortic atherosclerosis and the association with perioperative stroke in
cardiac surgery, including specific searches on the most common types of
surgery. Articles were screened with emphasis on studies comparing
multiple strategies and studies reporting on the patients' severity of
aortic atherosclerosis. The main findings were summarized in a figure,
with a grade of the corresponding level of evidence. <br/>RESULT(S):
Regarding embolic stroke risk, aortic atherosclerosis of the tunica intima
is most relevant. Although several strategies in general cardiac surgery
seem to be beneficial in severe disease, none have conclusively been
proven most effective. Off-pump surgery in coronary artery bypass grafting
should be preferred with severe atherosclerosis, if the required expertise
is present. Although transcatheter aortic valve replacement is used as an
alternative to surgery in patients with a porcelain aorta, the risk
profile concerning intimal atherosclerosis remains poorly defined.
<br/>CONCLUSION(S): A tailored approach that uses the discussed
alternative strategies in carefully selected patients is best suited to
reduce the risk of perioperative stroke without compromising other
outcomes. More research is needed, especially on the perioperative stroke
risk in patients with moderate aortic atherosclerosis. <br/>Copyright
&#xa9; 2021 The Author(s) 2021. Published by Oxford University Press on
behalf of the European Association for Cardio-Thoracic Surgery.

<103>
Accession Number
2016352752
Title
Minimal fresh gas flow sevoflurane anesthesia and postoperative acute
kidney injury in on-pump cardiac surgery: a randomized comparative trial.
Source
Brazilian Journal of Anesthesiology (English Edition). (no pagination),
2022. Date of Publication: 2022.
Author
Lineburger E.B.; Modolo N.S.P.; Braz L.G.; do Nascimento P.
Institution
(Lineburger) Hospital Sao Jose, Anestesiologia e Controle da Dor,
Criciuma, SC, Brazil
(Modolo, Braz, do Nascimento) Universidade Estadual Paulista "Julio de
Mesquita Filho" (UNESP), Faculdade de Medicina de Botucatu, Departamento
de Especialidades Cirurgicas e Anestesiologia, Sao Paulo, SP, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: Compound A is generated by sevoflurane when it reacts with
carbon dioxide absorbers with strong bases at minimal fresh gas flow (FGF)
and is nephrotoxic in animals. No conclusive data has shown increased risk
in humans. The aim of this study was to investigate if minimal FGF
promotes an increase in the incidence of acute kidney injury (AKI) when
compared to high FGF in patients undergoing on-pump cardiac surgery under
sevoflurane anesthesia. <br/>Method(s): Two hundred and four adult
patients scheduled for on-pump cardiac surgery under sevoflurane
anesthesia were randomly allocated to two groups differentiated by FGF:
minimal FGF (0.5 L.min^-1) or high FGF (2.0 L.min^-1).
Baseline creatinine measured before surgery was compared daily to values
assayed on the first five postoperative days, and 24-hour urinary output
was monitored, according to the KDIGO (Kidney Disease Improving Global
Outcomes) guideline to define postoperative cardiac surgery-associated
acute kidney injury (CSA-AKI). Creatinine measurements were also obtained
20 and 120 days after hospital discharge. <br/>Result(s): Postoperative
AKI occurred in 55 patients, 26 patients (29.5%) in the minimal FGF group
and 29 patients (31.5%) in the high FGF group (p = 0.774). Twenty days
after discharge, 11 patients (6.1%) still had CSA-AKI and 120 days after
discharge only 2 patients (1.6%) still had CSA-AKI. <br/>Conclusion(s):
When compared to high FGF, minimal FGF sevoflurane anesthesia during
on-pump cardiac surgery is not associated with increased risk of
postoperative AKI in this population at high risk for renal
injury.<br/>Copyright &#xa9; 2021 Sociedade Brasileira de Anestesiologia

<104>
[Use Link to view the full text]
Accession Number
2016329723
Title
Interleukin-6 Is an Early Plasma Marker of Severe Postoperative
Complications in Thoracic Surgery: Exploratory Results from a Substudy of
a Randomized Controlled Multicenter Trial.
Source
Anesthesia and Analgesia. 134(1) (pp 123-132), 2022. Date of Publication:
01 Jan 2022.
Author
Neff T.A.; Braun J.; Rana D.; Puhan M.; Filipovic M.; Seeberger M.; Stuber
F.; Neff S.B.; Beck-Schimmer B.; Schlapfer M.
Institution
(Neff, Neff) Department of Anesthesiology, Cantonal Hospital
Muensterlingen, Switzerland
(Braun, Puhan) Epidemiology, Biostatistics and Prevention Institute,
University of Zurich, Zurich, Switzerland
(Rana, Beck-Schimmer, Schlapfer) Institute of Anesthesiology, University
Hospital Zurich, Zurich, Switzerland
(Filipovic) Department of Anesthesiology, Cantonal Hospital St. Gallen,
St. Gallen, Switzerland
(Seeberger) Department of Anesthesiology, University Hospital Basel,
Basel, Switzerland
(Stuber) Department of Anesthesiology, University Hospital Bern, Bern,
Switzerland
(Beck-Schimmer, Schlapfer) Institute of Physiology, University Zurich,
Zurich, Switzerland
(Beck-Schimmer) Department of Anesthesiology, University of Illinois at
Chicago, Chicago, IL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Postoperative complications in surgery are a significant
burden, not only for the patients but also economically. While several
predicting factors have already been identified, it is still not well
known if increased levels of inflammatory markers in the immediate
perioperative phase correlate with a higher incidence of postoperative
complications. This study aimed to evaluate which patient characteristics
and intraoperative parameters correlate with increased plasma values of
monocyte chemoattractant protein 1 (MCP-1) and interleukin 6 (IL-6) of
thoracic surgery patients. A second goal was to explore whether MCP-1 and
IL-6 are associated with the incidence of postoperative complications. We
hypothesized that there is a positive association between inflammatory
markers and the occurrence of complications within 6 months after surgery.
<br/>METHOD(S): This is a substudy of a recent randomized controlled
trial, which defined the effect of desflurane versus propofol anesthesia
on morbidity and mortality in patients undergoing thoracic surgery. MCP-1
and IL-6 were determined in plasma obtained before and 30 minutes after
1-lung ventilation, 6 hours after surgery, and on postoperative days 1 and
2. Complications were recorded for 6 months. Mixed linear models were used
to examine factors associated with MCP-1 and IL-6 levels. Logistic
regression models and receiver operating characteristic curves were used
to determine the association between MCP-1 and IL-6 and postoperative
complications. <br/>RESULT(S): In the original study, 460 patients were
included, MCP-1 and IL-6 levels were determined in 428 patients. MCP-1 was
positively associated with the duration of surgery (P =.016), whereas IL-6
levels increased with both the length (P <.001) and invasiveness of lung
surgery (thoracoscopic wedge resection or lobectomy versus open lobectomy,
P =.005; thoracoscopic wedge resection or lobectomy versus pneumonectomy,
P =.021). In an exploratory approach, elevated IL-6 plasma peaks were
associated with the occurrence of severe complications defined as
Clavien-Dindo score grade >=IVa during the postoperative phase up to 6
months after thoracic surgery (P =.006). <br/>CONCLUSION(S): In summary,
this substudy reveals factors, which correlate with high MCP-1 and IL-6
values. Moreover, higher IL-6 seems to be associated with postoperative
severe complications. Perioperative IL-6 monitoring might be helpful for
risk estimation in the perioperative setting of patients after lung
surgery.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<105>
[Use Link to view the full text]
Accession Number
2016330038
Title
Response to the Comment on "long-term and Temporal Outcomes of
Transcatheter Versus Surgical Aortic-valve Replacement in Severe Aortic
Stenosis: A Meta-analysis".
Source
Annals of Surgery. 274(6) (pp E837-E838), 2021. Date of Publication: 01
Dec 2021.
Author
Zhang X.-L.; Zhang X.-W.; Xu W.; Xu B.
Institution
(Zhang, Xu, Xu) Department of Cardiology, Affiliated Drum Tower Hospital,
Nanjing University, School of Medicine, Nanjing, China
(Zhang) Department of Endocrinology, Affiliated Drum Tower Hospital,
Nanjing University, School of Medicine, Nanjing, China
Publisher
Lippincott Williams and Wilkins

<106>
Accession Number
2015232640
Title
Transcatheter Aortic Valve Implantation With or Without Percutaneous
Coronary Artery Revascularization Strategy: A Systematic Review and
Meta-Analysis.
Source
Journal of the American Heart Association. 6(6) (no pagination), 2017.
Article Number: e005960. Date of Publication: 2017.
Author
Kotronias R.A.; Kwok C.S.; George S.; Capodanno D.; Ludman P.F.; Townend
J.N.; Doshi S.N.; Khogali S.S.; Geeneereux P.; Herrmann H.C.; Mamas M.A.;
Bagur R.
Institution
(Kotronias, Kwok, George, Mamas, Bagur) Keele Cardiovascular Research
Group, Institute for Applied Clinical Science and Centre for Prognosis
Research, Institute of Primary Care and Health Sciences, University of
Keele, Stoke-on-Trent, United Kingdom
(Kotronias) Oxford University Clinical Academic Graduate School, Oxford
University, Oxford, United Kingdom
(Kwok, George, Mamas) The Heart Centre, Royal Stoke Hospital, University
Hospital of North Midlands Trust, Stoke-on-Trent, United Kingdom
(Capodanno) Cardio-Thoracic-Vascular Department, Ferrarotto Hospital,
University of Catania, Italy
(Ludman, Townend, Doshi) Department of Cardiology, Queen Elizabeth
Hospital Birmingham, Birmingham, United Kingdom
(Khogali) The Heart and Lung Centre, New Cross Hospital, Wolverhampton,
United Kingdom
(Geeneereux) Cardiovascular Research Foundation, New York, NY, United
States
(Geeneereux) Columbia University Medical Center/New York-Presbyterian
Hospital, New York, NY, United States
(Geeneereux) Morristown Medical Center, Morristown, NJ, United States
(Herrmann) Cardiology Division, Department of Medicine, Perelman School of
Medicine of the University of Pennsylvania, Philadelphia, PA, United
States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, London, ON, Canada
(Bagur) Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, Western University, London, ON, Canada
Publisher
American Heart Association Inc.
Abstract
Background--Recent recommendations suggest that in patients with severe
aortic stenosis undergoing transcatheter aortic valve implantation and
coexistent significant coronary artery disease, the latter should be
treated before the index procedure; however, the evidence basis for such
an approach remains limited. We performed a systematic review and
meta-analysis to study the clinical outcomes of patients with coronary
artery disease who did or did not undergo revascularization prior to
transcatheter aortic valve implantation. Methods and Results--We conducted
a search of Medline and Embase to identify studies evaluating patients who
underwent transcatheter aortic valve implantation with or without
percutaneous coronary intervention. Random-effects meta-analyses with the
inverse variance method were used to estimate the rate and risk of adverse
outcomes. Nine studies involving 3858 participants were included in the
meta-analysis. Patients who underwent revascularization with percutaneous
coronary intervention had a higher rate of major vascular complications
(odd ratio [OR]: 1.86; 95% confidence interval [CI], 1.33-2.60; P=0.0003)
and higher 30-day mortality (OR: 1.42; 95% CI, 1.08-1.87; P=0.01). There
were no differences in effect estimates for 30-day cardiovascular
mortality (OR: 1.03; 95% CI, 0.35-2.99), myocardial infarction (OR: 0.86;
95% CI, 0.14-5.28), acute kidney injury (OR: 0.89; 95% CI, 0.42-1.88),
stroke (OR: 1.07; 95% CI, 0.38-2.97), or 1-year mortality (OR: 1.05; 95%
CI, 0.71-1.56). The timing of percutaneous coronary intervention (same
setting versus a priori) did not negatively influence outcomes.
Conclusions--Our analysis suggests that revascularization before
transcatheter aortic valve implantation confers no clinical advantage with
respect to several patient-important clinical outcomes and may be
associated with an increased risk of major vascular complications and
30-day mortality. In the absence of definitive evidence, careful
evaluation of patients on an individual basis is of paramount importance
to identify patients who might benefit from elective revascularization. (
J Am Heart Assoc.<br/>Copyright &#xa9; 2017 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley.

<107>
Accession Number
2014644893
Title
Changes in eicosapentaenoic acid and docosahexaenoic acid and risk of
cardiovascular events and atrial fibrillation: A secondary analysis of the
OMEMI trial.
Source
Journal of Internal Medicine. (no pagination), 2022. Date of Publication:
2022.
Author
Myhre P.L.; Kalstad A.A.; Tveit S.H.; Laake K.; Schmidt E.B.; Smith P.;
Nilsen D.W.T.; Tveit A.; Solheim S.; Arnesen H.; Seljeflot I.
Institution
(Myhre, Tveit, Smith) Department of Cardiology, Division of Medicine,
Akershus University Hospital, Lorenskog, Norway
(Myhre, Kalstad, Tveit, Smith, Tveit, Arnesen, Seljeflot) Institute of
Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
(Kalstad, Laake, Solheim, Arnesen, Seljeflot) Center for Clinical Heart
Research, Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(Schmidt) Department of Cardiology, Aalborg University Hospital and
Aalborg University, Aalborg, Denmark
(Nilsen) Department of Cardiology, Stavanger University Hospital,
Stavanger, Norway
(Nilsen) Department of Clinical Science, Faculty of Medicine, University
of Bergen, Bergen, Norway
(Tveit) Department of Medical Research, Vestre Viken Hospital Trust,
Baerum Hospital, Gjettum, Norway
Publisher
John Wiley and Sons Inc
Abstract
Background: The cardiovascular benefit from n-3 polyunsaturated fatty
acids (PUFAs) after acute myocardial infarction (AMI) is controversial,
and the importance of serum eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA) concentrations for clinical events is unclear.
<br/>Objective(s): To assess changes in EPA and DHA serum concentrations
during n-3 PUFA supplementation and their association with incident
cardiovascular events. <br/>Method(s): In the OMEMI trial, elderly
patients with a recent AMI were randomized to 1.8 g/day of EPA/DHA or
control (corn oil) for 2 years. The primary outcome was a composite of
AMI, coronary revascularization, stroke, heart failure hospitalization, or
all-cause death (major adverse cardiovascular event [MACE]) and the
secondary outcome was new-onset atrial fibrillation (AF). <br/>Result(s):
EPA and DHA measurements were available in 881 (92% of survivors)
participants at randomization and study completion. EPA and DHA increased
in the active treatment arm (n = 438) by a median of 87% and 16%,
respectively. Greater on-treatment increases in EPA and DHA were
associated with decreasing triglycerides, increasing high-density
lipoprotein cholesterol, and lower baseline EPA and DHA concentrations.
Greater on-treatment increases in EPA were associated with lower risk of
MACE (adjusted hazard ratio 0.86 [95% confidence interval, CI, 0.75-0.99],
p = 0.034), and higher risk of AF (adjusted hazard ratio (HR) 1.36 [95% CI
1.07-1.72], p = 0.011). Although there were similar tendencies for DHA
changes and outcomes, these associations were not statistically
significant (HR 0.84 [0.66-1.06] for MACE and 1.39 [0.90-2.13] for AF).
<br/>Conclusion(s): Greater on-treatment increases in EPA were associated
with lower risk of MACE and higher risk of new-onset AF. These data
suggest that the cardiovascular effects of increasing n-3 PUFA levels
through supplements are complex, involving both potential benefits and
harm.<br/>Copyright &#xa9; 2021 The Authors. Journal of Internal Medicine
published by John Wiley & Sons Ltd on behalf of Association for
Publication of The Journal of Internal Medicine.

<108>
Accession Number
2014651857
Title
Cardiac allograft vasculopathy: A review.
Source
Pediatric Transplantation. (no pagination), 2022. Date of Publication:
2022.
Author
Laks J.A.; Dipchand A.I.
Institution
(Laks) Heart Institute, Johns Hopkins All Children's Hospital, St
Petersburg, FL, United States
(Dipchand) Labatt Family Heart Centre, The Hospital for Sick Children,
Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Heart transplantation has become the standard of care for
pediatric patients with end-stage heart disease, and outcomes have
consistently improved over the last few decades. CAV, however, remains a
leading cause of morbidity and mortality in heart transplantation and is
the leading cause of death beyond 3 years post-transplantation. We sought
out to provide an in-depth overview of CAV in the pediatric heart
transplant population. <br/>Method(s): Database searches were conducted in
both Medline and Embase on the topic of cardiac vasculopathy in pediatric
heart transplant recipients. The search used five broad concept terms:
heart transplant; pediatric; CAV; diagnosis, prognosis, and risk factors;
and guidelines and reviews. References were captured if there was at least
one term in each of the concepts. The search was limited to articles in
the English language. <br/>Result(s): A total of 148 articles were
identified via the literature search with further articles identified via
review of references. Pediatric data regarding the etiology and
development of CAV remain limited although knowledge about the immune and
non-immune factors playing a role are increasing. CAV continues to be
difficult to detect with many invasive and non-invasive methods available,
yet their effectiveness in the detection of CAV remains suboptimal. There
remains no proven medical intervention to treat or reverse established CAV
disease, and CAV is associated with high rates of graft loss once
detected. However, several medications are used in hopes of preventing,
slowing progression, or modifying the outcomes. <br/>Conclusion(s): This
review provides a comprehensive overview of CAV, discusses its clinical
presentation, risk factors, diagnostic tools used to identify CAV in the
pediatric population, and highlights the current therapeutic options and
the need for ongoing research.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC

<109>
Accession Number
2014647315
Title
The use of a vascular occlusion test combined with near-infrared
spectroscopy in perioperative care: a systematic review.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2022. Date
of Publication: 2022.
Author
Niezen C.K.; Massari D.; Vos J.J.; Scheeren T.W.L.
Institution
(Niezen, Massari, Vos, Scheeren) Department of Anesthesiology, University
Medical Center Groningen, University of Groningen, PO Box 30 001,
Groningen 9700 RB, Netherlands
Publisher
Springer Science and Business Media B.V.
Abstract
In the perioperative phase oxygen delivery and consumption can be
influenced by different factors, i.e. type of surgery, anesthetic and
cardiovascular drugs, or fluids. By combining near-infrared spectroscopy
(NIRS) monitoring of regional tissue oxygen saturation (StO<inf>2</inf>)
with an ischemic provocation test, the vascular occlusion test (VOT),
local tissue oxygen consumption and vascular reactivity at the
microcirculatory level can be assessed. This systematic review aims to
give an overview of the clinical information that VOT-derived NIRS values
can provide in the perioperative period. After performing a systematic
literature search, we included 29 articles. It was not possible to perform
a meta-analysis because of the lack of comparable data and the
observational nature of the majority of the included articles. We have
clustered the found articles in two groups: non-cardiac surgery and
cardiac surgery. We found that VOT-derived NIRS values show a wide
variability and are influenced by the effects of anesthetics,
cardiovascular drugs, fluids, and by the type of surgery. Additionally,
deviations in VOT-derived NIRS values are also associated with adverse
patients' outcomes, such as postoperative complications, prolonged
mechanical ventilation and prolonged hospital length of stay. However,
given the variability in VOT-derived NIRS values, clinical applicability
remains elusive. Future clinical interventional trials might provide
additional insight into the potential of VOT associated with NIRS to
optimize perioperative care by targeting specific interventions to
optimize the function of the microvasculature.<br/>Copyright &#xa9; 2022,
The Author(s), under exclusive licence to Springer Nature B.V.

<110>
Accession Number
636817701
Title
Effect of an mHealth self-help intervention on readmission after adult
cardiac surgery: Protocol for a pilot randomized controlled trial.
Source
Journal of advanced nursing. (no pagination), 2021. Date of Publication:
28 Nov 2021.
Author
Wynne R.; Nolte J.; Matthews S.; Angel J.; Le A.; Moore A.; Campbell T.;
Ferguson C.
Institution
(Wynne, Ferguson) Blacktown Clinical & Research School, Blacktown
Hospital, Western Sydney Nursing & Midwifery Research CentreWestern Sydney
University & Western Sydney Local Health District, Blacktown, NSW,
Australia
(Wynne) School of Nursing & Midwifery, Deakin University, Geelong, VIC,
Australia
(Wynne, Nolte, Matthews, Angel) Royal Melbourne Hospital, Parkville, VIC,
Australia
(Matthews) National Heart Foundation, VIC, Australia
(Le) Liverpool Hospital, South West Sydney Local Health District,
Liverpool, NSW, Australia
(Moore, Campbell) MelbourneVICAustralia
Publisher
NLM (Medline)
Abstract
AIM: To describe a protocol for the pilot phase of a trial designed to
test the effect of an mHealth intervention on representation and
readmission after adult cardiac surgery. DESIGN: A multisite, parallel
group, pilot randomized controlled trial (ethics approval:
HREC2020.331-RMH69278). <br/>METHOD(S): Adult patients scheduled to
undergo elective cardiac surgery (coronary artery bypass grafting, valve
surgery, or a combination of bypass grafting and valve surgery or aortic
surgery) will be recruited from three metropolitan tertiary teaching
hospitals. Patients allocated to the control group with receive usual care
that is comprised of in-patient discharge education and local paper-based
written discharge materials. Patients in the intervention group will be
provided access to tailored 'GoShare' mHealth bundles preoperatively, in a
week of hospital discharge and 30 days after surgery. The mHealth bundles
are comprised of patient narrative videos, animations and links to
reputable resources. Bundles can be accessed via a smartphone, tablet or
computer. Bundles are evidence-based and designed to improve patient
self-efficacy and self-management behaviours, and to empower people to
have a more active role in their healthcare. Computer-generated permuted
block randomization with an allocation ratio of 1:1 will be generated for
each site. At the time of consent, and 30, 60 and 90 days after surgery
quality of life and level of patient activation will be measured. In
addition, rates of representation and readmission to hospital will be
tracked and verified via data linkage 1 year after the date of surgery.
DISCUSSION: Interventions using mHealth technologies have proven
effectiveness for a range of cardiovascular conditions with limited
testing in cardiac surgical populations. IMPACT: This study provides an
opportunity to improve patient outcome and experience for adults
undergoing cardiac surgery by empowering patients as end-users with
strategies for self-help. TRIAL REGISTRATION: Australian New Zealand
Clinical Trials Registry (ANZCTR): ACTRN12621000082808.<br/>Copyright
&#xa9; 2021 The Authors. Journal of Advanced Nursing published by John
Wiley & Sons Ltd.

<111>
Accession Number
2014620774
Title
Fixed Versus Variable Dosing of Prothrombin Complex Concentrate for
Bleeding Complications of Vitamin K Antagonists-The PROPER3 Randomized
Clinical Trial.
Source
Annals of Emergency Medicine. 79(1) (pp 20-30), 2022. Date of Publication:
January 2022.
Author
Abdoellakhan R.A.; Khorsand N.; ter Avest E.; Lameijer H.; Faber L.M.;
Ypma P.F.; Nieuwenhuizen L.; Veeger N.J.G.M.; Meijer K.
Institution
(Abdoellakhan, Meijer) Department of Haematology, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
(Khorsand) Department of Pharmacy, OLVG, Amsterdam, Netherlands
(ter Avest) Department of Emergency Medicine, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
(Lameijer) Department of Emergency Medicine, Medical Center Leeuwarden,
Leeuwarden, Netherlands
(Faber) Department of Haematology, Rode Kruis Ziekenhuis, Beverwijk,
Netherlands
(Ypma) Department of Haematology, Hagaziekenhuis, The Hague, Netherlands
(Nieuwenhuizen) Department of Haematology, Maxima Medisch Centrum,
Eindhoven, Netherlands
(Veeger) Department of Epidemiology, University of Groningen, University
Medical Center Groningen, Groningen, Netherlands
Publisher
Elsevier Inc.
Abstract
Study objective: To determine if a fixed dose of 1000 IU of 4-factor
prothrombin complex concentrate (4F-PCC) is as effective as traditional
variable dosing based on body weight and international normalized ratio
(INR) for reversal of vitamin K antagonist (VKA) anticoagulation.
<br/>Method(s): In this open-label, multicenter, randomized clinical
trial, patients with nonintracranial bleeds requiring VKA reversal with
4F-PCC were allocated to either a 1,000-IU fixed dose of 4F-PCC or the
variable dose. The primary outcome was the proportion of patients with
effective hemostasis according to the International Society of Thrombosis
and Haemostasis definition. The design was noninferiority with a lower 95%
confidence interval of no more than -6%. When estimating sample size, we
assumed that fixed dosing would be 4% superior. <br/>Result(s): From
October 2015 until January 2020, 199 of 310 intended patients were
included before study termination due to decreasing enrollment rates. Of
the 199 patients, 159 were allowed in the per-protocol analysis. Effective
hemostasis was achieved in 87.3% (n=69 of 79) in fixed compared to 89.9%
(n=71 of 79) in the variable dosing cohort (risk difference 2.5%, 95%
confidence interval -13.3 to 7.9%, P=.27). Median door-to-needle times
were 109 minutes (range 16 to 796) in fixed and 142 (17 to 1076) for the
variable dose (P=.027). INR less than 2.0 at 60 minutes after 4F-PCC
infusion was reached in 91.2% versus 91.7% (P=1.0). <br/>Conclusion(s):
The large majority of patients had good clinical outcome after 4F-PCC use;
however, noninferiority of the fixed dose could not be demonstrated
because the design assumed the fixed dose would be 4% superior.
Door-to-needle time was shortened with the fixed dose, and INR reduction
was similar in both dosing regimens.<br/>Copyright &#xa9; 2021 American
College of Emergency Physicians

<112>
Accession Number
2014598168
Title
Blood loss after coronary artery bypass by aspirin responsiveness assessed
with preoperative VerifyNow aspirin testing.
Source
Research and Practice in Thrombosis and Haemostasis. 5(8) (no pagination),
2021. Article Number: e12623. Date of Publication: December 2021.
Author
Willemsen L.M.; Vlot E.A.; Janssen P.W.A.; Visser C.D.; Zheng K.; Kelder
J.C.; Noordzij P.G.; van den Dool E.-J.; Klein P.; Hackeng C.M.; ten Berg
J.M.
Institution
(Willemsen, Janssen, Zheng, Kelder, ten Berg) Department of Cardiology, St
Antonius Hospital, Nieuwegein, Netherlands
(Vlot, Noordzij) Department of Anesthesiology, Intensive Care, and Pain
Medicine, St Antonius Hospital, Nieuwegein, Netherlands
(Visser) Department of Clinical Pharmacy and Toxicology, Leiden University
Medical Center, Leiden, Netherlands
(van den Dool, Hackeng) Department of Clinical Chemistry, St Antonius
Hospital, Nieuwegein, Netherlands
(Klein) Department of Cardiothoracic Surgery, St Antonius Hospital,
Nieuwegein, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Aspirin is important for preventing thrombotic events but also
increases bleeding complications. Minimizing bleeding while preventing
thrombotic events remains challenging in patients undergoing coronary
artery bypass grafting (CABG). Establishing the patient's preoperative
aspirin response could distinguish patients at risk for perioperative
blood loss. <br/>Objective(s): Aim was to compare 12-h blood loss after
CABG between aspirin-sensitive and aspirin-resistant patients.
Patients/Methods: The primary analysis of this substudy of the POPular
CABG trial (NCT02352402) included patients that used aspirin monotherapy
preoperatively. A preoperative platelet function test by the VerifyNow
aspirin assay was performed before CABG and patients were classified as
aspirin-sensitive or aspirin-resistant based on an aspirin reaction units
cutoff value of 550. The primary end point was 12-hour blood loss after
CABG. The secondary end point was, among others, clinical bleeding events
after CABG. <br/>Result(s): A total of 128 patients were included in the
primary analysis. Of these, 116 patients were aspirin sensitive and 12
were aspirin resistant. Mean blood loss 12 hours after CABG was 555 +/-
278 mL in aspirin-sensitive patients and 406+/-110 mL in aspirin-resistant
patients (P =.04). All bleeding events (n = 15; 11.7%) occurred in
aspirin-sensitive patients. <br/>Conclusion(s): In patients who are on
aspirin preoperatively, aspirin sensitivity was associated with 12-hour
blood loss after CABG, suggesting that preoperative VerifyNow aspirin
testing could identify patients undergoing CABG at high risk for
perioperative bleeding.<br/>Copyright &#xa9; 2021 The Authors. Research
and Practice in Thrombosis and Haemostasis published by Wiley Periodicals
LLC on behalf of International Society on Thrombosis and Haemostasis
(ISTH).

<113>
Accession Number
2014577867
Title
Outcome of strict peri-operative glycemic control in diabetic patients
following open heart surgery.
Source
Medical Forum Monthly. 32(7) (pp 43-47), 2021. Date of Publication: July
2021.
Author
Imran-Ul-hassan S.; Sharyar; Rashid M.; Liaqat M.; Saleem J.; Zulfiqar T.
Institution
(Imran-Ul-hassan, Sharyar, Liaqat, Saleem, Zulfiqar) Department of
Anesthesia, Punjab Institute of cardiology, Lahore, Pakistan
(Rashid) Department of Anesthesia, University College of Medicine and
Dentistry, University of Lahore, Pakistan
Publisher
Medical Forum Monthly
Abstract
Objective: To compare the outcome in terms of post-operative complications
and early morality of strict glycemic control among diabetics having open
heart surgery with control group following open heart surgery. <br/>Study
Design: Prospective Cohort Study Place and Duration of Study: This study
was conducted at the Department of Anesthesia, Punjab Institute of
Cardiology, Lahore from November 2020 to April 2021. <br/>Material(s) and
Method(s): In this study, 60 patients were randomly assigned to two groups
(30 patients in each group) according to a computer-generated allocation
table. All the diabetic patients of 18 years to 60 years old with ASA II
and III planned for cardiac surgery during this study period was included.
In the control group no insulin was given to the patient unless blood
glucose level exceeded 180 mg/dl. While in the study group glucose level
between 80 and 110 mg/dl was targeted using continuous infusion of insulin
in saline. Cardiac, Pulmonary, Renal and Neurological problems were noted.
Early mortality was also documented. <br/>Result(s): Mean duration of
diabetes in the strict control of diabetes group was 13.57+6.32 years and
in conventional group it was 12.89+5.88 years. Complications or poor
outcome due to occurrence of complications or early mortality was seen in
29 patients in the conventional glycemic control group while only 8
patients in the strict glycemic control group. Cardiac complications were
three times less in the tight control group. Early mortality was observed
in the control group in 2 patients as compared to none in the strict/tight
control group, difference was statistically significant p value <0.0001.
<br/>Conclusion(s): Intra-operative tight glycemic control can help in
controlling post-operative morbidity after open heart surgery. With
control of post-operative complications, the recovery process can be
improved. All types of complications are decreased with strict glycemic
control.<br/>Copyright &#xa9; 2021 Medical Forum Monthly. All rights
reserved.

<114>
Accession Number
634316525
Title
Effects of Dexmedetomidine on Perioperative Stress Response and Cellular
Immunity in Elderly Patients with Posterior Lumbar Surgery.
Source
Nano LIFE. 11(3) (no pagination), 2021. Article Number: 2140001. Date of
Publication: 01 Sep 2021.
Author
Lin M.; Wang X.; Liu X.; Zhang H.; Liu S.; Huang C.
Institution
(Huang, Wang, Zhang, Liu) Department of Anesthesia, Zhabei District Centre
Hospital of Shanghai, 619 Zhonghuaxin Rd, Shanghai 200070, China
(Lin) Department of Anesthesia, People's Hospital of Suzhou New District,
95 Huashan Rd, Suzhou 215163, China
(Liu) Department of Spine Surgery, Zhabei District Centre Hospital of
Shanghai, 619 Zhonghuaxin Rd, Shanghai 200070, China
(Huang) Department of General Surgery, Huadong Hospital Affiliated to
Fudan University, 221 Yan'an West Rd, Shanghai 200040, China
Publisher
World Scientific
Abstract
The aim of this study was to investigate the effects of dexmedetomidine on
perioperative stress response and cellular immunity in elderly patients
with posterior lumbar surgery. Sixty patients with lumbar degenerative
disease requiring posterior lumbar surgery were included and randomly
divided into the dexmedetomidine group (the test group, n=30) and the
control group (n=30). After the experimental group entered the room,
dexmedetomidine was intravenously pumped 10min before induction of
anesthesia and dexmedetomidine was continuously pumped after anesthesia.
The control group replaced dexmedetomidine with the same amount of normal
saline, and the other operations were exactly the same as the experimental
group. Hemodynamic parameters were routinely monitored and the percentages
of T lymphocyte subsets were analyzed by flow cytometry. Samples for
stress response parameters were sent to the Clinical Laboratory of our
hospital, and perioperative pain, postoperative adverse reactions and
complications were evaluated during the study. The levels of postoperative
stress hormones, including noradrenaline (NE), epinephrine (E), cortisol
(Cor) and acetylcholine (Ach), were reduced in the test group compared
with those in the control group (P<0.05). Proportions of CD3+, CD4+, CD8+
and NK as well as the CD4+/CD8+ in the control group were significantly
decreased at postoperative Day 1 (T6), Day 3 (T7) and Day 7 (T8) compared
with those at preoperative Day 1 (T-1) (P<0.05), while the proportions of
CD4+ and NK in the test group were significantly increased at T6, T7 and
T8 compared with those at T-1 (P<0.05). The mean arterial pressure (MAP)
of the test group was decreased compared with that of the control group at
each time point (P<0.05). After the operation, the heart rate (HR) of the
patients in the test group was significantly decreased compared with the
control group (P<0.05) and the VAS score of the control group were
increased compared with the test group at each time point (P<0.05).
Dexmedetomidine can decrease the stress response and improve postoperative
cellular immune function in patients with posterior lumbar surgery by
reducing postoperative stress hormones to alleviate the postoperative
cellular immunosuppression and the pain in patients.<br/>Copyright &#xa9;
2021 World Scientific Publishing Company.

<115>
Accession Number
2013325076
Title
Late arrhythmias in patients with new-onset persistent left bundle branch
block after transcatheter aortic valve replacement using a
balloon-expandable valve.
Source
Heart Rhythm. 18(10) (pp 1733-1740), 2021. Date of Publication: October
2021.
Author
Muntane-Carol G.; Nombela-Franco L.; Serra V.; Urena M.; Amat-Santos I.;
Vilalta V.; Chamandi C.; Lhermusier T.; Veiga-Fernandez G.; Kleiman N.;
Canadas-Godoy V.; Francisco-Pascual J.; Himbert D.; Castrodeza J.;
Fernandez-Nofrerias E.; Baudinaud P.; Mondoly P.; Campelo-Parada F.; De la
Torre Hernandez J.M.; Pelletier-Beaumont E.; Philippon F.; Rodes-Cabau J.
Institution
(Muntane-Carol, Pelletier-Beaumont, Philippon, Rodes-Cabau) Department of
Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City,
QC, Canada
(Nombela-Franco, Canadas-Godoy) Instituto Cardiovascular, Hospital Clinico
San Carlos, IdISSC, Madrid, Spain
(Serra, Francisco-Pascual) Department of Cardiology, Hospital Universitari
Vall d'Hebron, CIBER-CV, Barcelona, Spain
(Urena, Himbert) Department of Cardiology, Assistance Publique-Hopitaux de
Paris, Hopital Bichat-Claude Bernard, Paris, France
(Amat-Santos, Castrodeza) Department of Cardiology, Hospital Universitario
de Valladolid, Valladolid, Spain
(Vilalta, Fernandez-Nofrerias) Department of Cardiology, Hospital Germans
Trias i Pujol, Badalona, Spain
(Chamandi, Baudinaud) Department of Cardiology, Hopital Europeen George
Pompidou, Paris, France
(Mondoly, Campelo-Parada) Department of Cardiology, Hopital Universitaire
de Toulouse, Toulouse, France
(Veiga-Fernandez, De la Torre Hernandez) Department of Cardiology,
Hospital Marques de Valdecilla, Santander, Spain
(Kleiman) Department of Cardiology, Houston Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
(Rodes-Cabau) Hospital Clinic de Barcelona, Barcelona, Spain
Publisher
Elsevier B.V.
Abstract
Background: The arrhythmic burden after discharge in patients with
new-onset left bundle branch block (LBBB) undergoing transcatheter aortic
valve replacement (TAVR) with the balloon-expandable SAPIEN 3 (S3) valve
remains largely unknown. <br/>Objective(s): The purpose of this study was
to determine the incidence of late arrhythmias in patients with new-onset
LBBB undergoing TAVR with the balloon-expandable S3 valve. <br/>Method(s):
This was a multicenter, prospective study that included 104 consecutive
TAVR patients with new-onset persistent LBBB following TAVR with the S3
valve. An implantable cardiac monitor (Reveal XT, Reveal LINQ) was
implanted before discharge. The primary endpoint was the incidence of
high-degree atrioventricular block or complete heart block (HAVB/CHB).
<br/>Result(s): A total of 40 patients (38.5%) had at least 1 significant
arrhythmic event, leading to a treatment change in 17 (42.5%). Significant
bradyarrhythmias occurred in 20 of 104 patients (19.2%) (34 HAVB/CHB
episodes, 252 severe bradycardia episodes), with 10 of 20 patients (50%)
exhibiting at least 1 episode of HAVB/CHB. Most HAVB/CHB episodes (60%)
occurred within 4 weeks after discharge. Nine patients (8.7%) underwent
permanent pacemaker implantation at 12 months based on the Reveal findings
(6 HAVB/CHB, 3 severe bradycardia). <br/>Conclusion(s): S3 valve
recipients with new-onset LBBB have a high arrhythmic burden, with more
than one-third of patients exhibiting at least 1 significant arrhythmic
episode within 12 months (HAVB/CHB in 10% of patients). About one-half of
bradyarrhythmic events occurred within 4 weeks after discharge. These
results should inform future strategies on the use of continuous
electrocardiographic monitoring in TAVR S3 patients with new conduction
disturbances following the procedure.<br/>Copyright &#xa9; 2021 Heart
Rhythm Society

<116>
Accession Number
2014637976
Title
Current and Future Applications of Virtual, Augmented, and Mixed Reality
in Cardiothoracic Surgery.
Source
Annals of Thoracic Surgery. 113(2) (pp 681-691), 2022. Date of
Publication: February 2022.
Author
Sadeghi A.H.; Mathari S.E.; Abjigitova D.; Maat A.P.W.M.; Taverne
Y.J.H.J.; Bogers A.J.J.C.; Mahtab E.A.F.
Institution
(Sadeghi, Mathari, Abjigitova, Maat, Taverne, Bogers, Mahtab) Department
of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam,
Netherlands
Publisher
Elsevier Inc.
Abstract
Background: This review aims to examine the existing literature to address
currently used virtual, augmented, and mixed reality modalities in the
areas of preoperative surgical planning, intraoperative guidance, and
postoperative management in the field of cardiothoracic surgery. In
addition this innovative technology provides future perspectives and
potential benefits for cardiothoracic surgeons, trainees, and patients.
<br/>Method(s): A targeted, nonsystematic literature assessment was
performed within the Medline and Google Scholar databases to help identify
current trends and to provide better understanding of the current
state-of-the-art extended reality (XR) modalities in cardiothoracic
surgery. Related articles published up to July 2020 were included in the
review. <br/>Result(s): XR is a novel technique gaining increasing
application in cardiothoracic surgery. It provides a 3-dimensional and
realistic view of structures and environments and offers the user the
ability to interact with digital projections of surgical targets. Recent
studies showed the validity and benefits of XR applications in
cardiothoracic surgery. Examples include XR-guided preoperative planning,
intraoperative guidance and navigation, postoperative pain and
rehabilitation management, surgical simulation, and patient education.
<br/>Conclusion(s): XR is gaining interest in the field of cardiothoracic
surgery. In particular there are promising roles for XR applications in
televirtuality, surgical planning, surgical simulation, and perioperative
management. However future refinement and research are needed to further
implement XR in the aforementioned settings within cardiothoracic
surgery.<br/>Copyright &#xa9; 2022 The Society of Thoracic Surgeons

<117>
Accession Number
2014824563
Title
Ticagrelor or Aspirin After Coronary Artery Bypass in Patients With
Chronic Kidney Disease.
Source
Annals of Thoracic Surgery. 113(2) (pp 554-562), 2022. Date of
Publication: February 2022.
Author
Sandner S.E.; Schunkert H.; Kastrati A.; Milojevic M.; Boning A.; Zimpfer
D.; Zellmer S.; Wiedemann D.; Laufer G.; von Scheidt M.
Institution
(Sandner, Zimpfer, Wiedemann, Laufer) Department of Cardiac Surgery,
Medical University of Vienna, Vienna, Austria
(Schunkert, Kastrati, Zellmer, von Scheidt) German Heart Center Munich,
Technical University of Munich, Munich, Germany
(Schunkert, Kastrati, Zellmer, von Scheidt) German Center for
Cardiovascular Research, Munich Heart Alliance, Munich, Germany
(Milojevic) Department of Cardiothoracic Surgery, Erasmus University
Medical Center, Rotterdam, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Boning) Department of Cardiovascular Surgery, University Hospital
Giessen, Giessen, Germany
Publisher
Elsevier Inc.
Abstract
Background: The optimal antiplatelet therapy for patients with chronic
kidney disease (CKD) undergoing coronary artery bypass graft surgery
remains unknown. <br/>Method(s): This post hoc analysis of the Ticagrelor
in Coronary Artery Bypass (TiCAB) trial examined the efficacy and safety
of ticagrelor vs aspirin in patients with and patients without CKD. The
primary endpoint was major adverse cardiac and cerebrovascular events
(MACCE), namely, the composite of cardiovascular death, stroke, myocardial
infarction, or revascularization at 1 year after coronary artery bypass
graft surgery. Secondary endpoints included individual components of the
primary endpoint, all-cause death, and major bleeding. <br/>Result(s):
Chronic kidney disease was present in 276 of 1843 randomized patients
(15%). Patients with CKD vs patients without CKD had higher 1-year rates
of MACCE (13% vs 8.3%, hazard ratio [HR] 1.63; 95% confidence interval
[CI], 1.12 to 2.39; P =.01) and major bleeding (5.6% vs 3.1%, HR 1.84; 95%
CI, 1.03 to 3.28; P =.04). The 1-year rate of MACCE was increased with
ticagrelor vs aspirin in patients with CKD (18.2% vs 8.9%, HR 2.15; 95%
CI, 1.08 to 4.30; P =.03), but not in patients without CKD (8.5% vs 8.1%,
HR 1.05; 95% CI, 0.74 to 1.49; P =.79; P<inf>interaction</inf> =.067).
There was no difference in the 1-year rate of major bleeding with
ticagrelor vs aspirin in patients with CKD (6.6% vs 4.7%, HR 1.44; 95% CI,
0.52 to 3.97; P =.48) and patients without CKD (3.3% vs 2.9%, HR 1.14; 95%
CI, 0.64 to 2.01; P =.65). <br/>Conclusion(s): Among patients with CKD and
coronary artery bypass graft surgery, those who received ticagrelor had a
higher incidence of MACCE but a similar incidence of major bleeding
compared with those who received aspirin.<br/>Copyright &#xa9; 2022 The
Society of Thoracic Surgeons

<118>
Accession Number
2014745132
Title
Higher Mortality in Women After Coronary Artery Bypass: Meta-analysis and
Bias Analysis of Confounding.
Source
Annals of Thoracic Surgery. 113(2) (pp 674-680), 2022. Date of
Publication: February 2022.
Author
Shi D.; Zhang B.; Motamed M.; Lee S.; Wang P.; McLaren C.; Petsikas D.;
Brogly S.B.
Institution
(Shi, Motamed, Wang, McLaren) School of Medicine, Queen's University,
Kingston, Ontario, Canada
(Zhang) School of Medicine, McMaster University, Hamilton, Ontario, Canada
(Lee) Faculty of Health Sciences, McMaster University, Hamilton, Ontario,
Canada
(Petsikas, Brogly) Department of Surgery, Queen's University, Kingston,
Ontario, Canada
Publisher
Elsevier Inc.
Abstract
Background: Some studies suggest that the observed higher mortality in
women compared with men after coronary artery bypass grafting (CABG) is
due to confounding. Our meta-analysis aimed to (1) summarize the effect of
sex on mortality after CABG and (2) identify whether unmeasured
confounding likely explains the apparent higher mortality in women.
<br/>Method(s): We searched MEDLINE, Embase, and CENTRAL databases for
studies examining sex and 30-day mortality after CABG. We used
random-effects meta-analysis to estimate the summary odds ratio (OR) of
mortality in women versus men using (1) unadjusted study results and (2)
adjusted study results. Available confounders data from included studies
were identified. Using the OR of measured confounders and the risk of
death to inform unmeasured confounding effects, we performed bias analysis
simulation to correct potential unmeasured confounding in the summary OR.
<br/>Result(s): From 7,138 retrieved studies, 112 were included (N =
5,008,262 patients); 25 studies reported adjusted OR (N = 770,450
patients). Overall 30-day mortality was 4.9% in women versus 3.3% in men.
The unadjusted summary OR (1.81; 95% confidence interval, 1.72-1.91) and
adjusted summary OR (1.40, 95% confidence interval, 1.35-1.45)
demonstrated women had an increased risk for 30-day mortality compared
with men. Simulations correcting for unmeasured confounding mostly ranged
from 1.05 to 1.80, which supports a higher risk for death in women after
CABG. <br/>Conclusion(s): The findings of this review suggest that
confounding is unlikely to account for the increased risk for mortality in
women after CABG and that biological factors have a causal
effect.<br/>Copyright &#xa9; 2022 The Society of Thoracic Surgeons

<119>
Accession Number
2015701745
Title
Infective endocarditis following heart transplantation: A systematic
review.
Source
Transplantation Reviews. 36(1) (no pagination), 2022. Article Number:
100672. Date of Publication: January 2022.
Author
Jordan A.M.; Tatum R.; Ahmad D.; Patel S.V.; Maynes E.J.; Weber M.P.; Moss
S.; Royer T.L.; Tchantchaleishvili V.; Massey H.T.; Rame J.E.; Zurlo J.J.;
Aburjania N.
Institution
(Jordan, Tatum, Ahmad, Patel, Maynes, Weber, Tchantchaleishvili, Massey)
Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia,
PA, United States
(Moss, Royer, Zurlo, Aburjania) Division of Infectious Disease, Thomas
Jefferson University, Philadelphia, PA, United States
(Rame) Department of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
W.B. Saunders
Abstract
Purpose: Infective endocarditis (IE) is a rare but potentially fatal
complication following heart transplantation (HTx). There is a lack of
literature regarding the patterns and clinical course of IE development
following HTx. We sought to pool the existing data in regards to defining
characteristics, management options, and outcomes of IE following HTx.
<br/>Method(s): An electronic search of Cochrane Central Register of
Controlled Trials, Cumulative Index to Nursing and Allied Health
Literature, Ovid Medline, and the Scopus databases were performed to
identify all articles in the English literature that report IE following
HTx in adult patients. Patient-level data were extracted and analyzed.
<br/>Result(s): Systematic search yielded 57 patients from 32 articles.
Median patient age was 52 [IQR 43, 59] and 75% of patients (43/57) were
male. Median time to IE presentation post-HTx was 8.4 [IQR 3.0, 35.8]
months. IE of the mitral valve was observed in 36.8% (21/57) of patients,
followed by mural IE in 24.6% (14/57), and tricuspid valve IE in 21.1%
(12/57). The most common organisms were Staphylococcus aureus in 26.3%
(15/57), Aspergillus fumigatus in 19.3% (11/57), Enterococcus faecalis in
12.3% (7/57), and an undetermined or unspecified organism in 14.0% (8/57)
patients. Overall case fatality was 44.6% (25/56). Fungal IE was
associated with a significantly higher case fatality 75.0% (9/12) than
that of bacterial IE 36.1% (13/36) (p = 0.02). Surgical management of
post-HTx IE was observed in 35.1% (20/57) of patients. This included valve
surgery for 70.0% (14/20), including the mitral valve in 50.0% (7/14),
aortic valve in 35.7% (5/14), and the tricuspid valve in 14.3% (2/14) of
patients. <br/>Conclusion(s): In addition to bacterial organisms, fungi
also represent a frequent cause of IE in post-HTx patients. Overall HTx
patient survival in the setting of IE is poor and may be worse if caused
by A. fumigatus.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<120>
Accession Number
2015297291
Title
Rhythm disturbances following rapid-deployment aortic valve replacement.
Source
JTCVS Techniques. 10 (pp 219-226), 2021. Date of Publication: December
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)

<121>
Accession Number
636157688
Title
Early percutaneous mitral commissurotomy or conventional management for
asymptomatic mitral stenosis: a randomised clinical trial.
Source
Heart (British Cardiac Society). 107(24) (pp 1980-1986), 2021. Date of
Publication: 01 Dec 2021.
Author
Kang D.-H.; Lee S.-A.; Lee S.; Kim D.-H.; Park D.-W.; Yun S.-C.; Hong
G.-R.; Song J.-M.; Hong M.-K.; Park S.W.; Park S.-J.
Institution
(Kang) Division of Cardiology, Asan Medical Center, Seoul, South Korea
(Park, Park) Division of Cardiology, Samsung Medical Center, Seoul, South
Korea
(Lee, Lee, Kim, Park, Song, Park) Division of Cardiology, Asan Medical
Center, Seoul, South Korea
(Yun) Department of Biostatistics, University of Ulsan College of
Medicine, Seoul, South Korea
(Hong) Division of Cardiology, Severance Cardiovascular Hospital, Yonsei
University Health System, Seoul, South Korea
(Hong) Division of Cardiology, Severance Cardiovascular Hospital, Yonsei
University Health System, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The decision to perform percutaneous mitral commissurotomy
(PMC) on asymptomatic patients requires careful weighing of the potential
benefits against the risks of PMC, and we conducted a multicentre,
randomised trial to compare long-term outcomes of early PMC and
conventional treatment in asymptomatic, severe mitral stenosis (MS).
<br/>METHOD(S): We randomly assigned asymptomatic patients with severe MS
(defined as mitral valve area between 1.0 and 1.5 cm2) to early PMC (84
patients) or to conventional treatment (83 patients). The primary endpoint
was a composite of major cardiovascular events, including PMC-related
complications, cardiovascular mortality, cerebral infarction and systemic
thromboembolic events. The secondary endpoints were death from any cause
and mitral valve (MV) replacement during follow-up. <br/>RESULT(S): In the
early PMC group, there were no PMC-related complications. During the
median follow-up of 6.4 years, the composite primary endpoint occurred in
seven patients in the early PMC group (8.3%) and in nine patients in the
conventional treatment group (10.8%) (HR 0.77; 95% CI 0.29 to 2.07;
p=0.61). Death from any cause occurred in four patients in the early PMC
group (4.8%) and three patients in the conventional treatment group (3.6%)
(HR 1.30; 95% CI 0.29 to 5.77). Ten patients (11.9%) in the early PMC
group and 17 patients (20.5%) in the conventional treatment group
underwent MV replacement (HR 0.59; 95% CI 0.27 to 1.29).
<br/>CONCLUSION(S): Compared with conventional treatment, early PMC did
not significantly reduce the incidence of cardiovascular events among
asymptomatic patients with severe MS during the median follow-up of 6
years. TRIAL REGISTRATION NUMBER: NCT01406353.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2021. No commercial re-use. See rights
and permissions. Published by BMJ.

<122>
Accession Number
2014492991
Title
Cardiac rehabilitation early after sternotomy using new assistive
vr-enhanced robotic exoskeleton-study protocol for a randomised controlled
trial.
Source
International Journal of Environmental Research and Public Health. 18(22)
(no pagination), 2021. Article Number: 11922. Date of Publication:
November-2 2021.
Author
Mocan M.; Vlaicu S.I.; Farcas A.D.; Feier H.; Dragan S.; Mocan B.
Institution
(Mocan, Vlaicu) Department of Internal Medicine, University of Medicine
and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca 400012, Romania
(Farcas) Department of Cardiology, University of Medicine and Pharmacy
Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca 400012, Romania
(Feier) Department of Thoracic Surgery, Institute of Cardiovascular
Diseases Timisoara, University of Medicine and Pharmacy Victor Babes,
Timisoara 300041, Romania
(Dragan) Department of Cardiology, Clinic of Cardiovascular Prevention and
Rehabilitation, University of Medicine and Pharmacy Victor Babes,
Timisoara 300041, Romania
(Mocan) Department of Industrial Engineering and Robotics, Technical
University of Cluj-Napoca, Cluj-Napoca 400020, Romania
Publisher
MDPI
Abstract
(1) Background and objective: Cardiac rehabilitation (CR) means delivering
health education by structured exercises with the means of risk reduction,
in a cost-effective manner. Wellconducted CR improves functional capacity,
decreases re-hospitalization, and reduces mortality up to 25%. We bring to
attention the protocol of a randomised control trial with the aim of
validating the prototype of an assistive upper-body robotic exoskeleton
system enhanced with a non-immersive virtual reality exergame
(CardioVR-ReTone) in patients who undergone cardiac surgery. (2) Methods:
Description of the CardioVR-ReTone system and the technical specification,
followed by the group selection, randomization and evaluated variables.
(3) Expected results: The primary outcome measurement is the modification
of life quality at the end of the CR exercise training program. Secondary
outcomes will encompass measurements of sternal stability, muscular
activity, cardiac response to exercise, pain level and
compliance/adherence to CR. (4) <br/>Conclusion(s): Implementing these
novel features of the CardioVR-ReTone system, addressability, and efficacy
of CR, so problematic in certain situations and especially in cardiac
surgery, will be greatly facilitated, being independent of the skills and
availability of the rehabilitation therapist.<br/>Copyright &#xa9; 2021 by
the authors. Licensee MDPI, Basel, Switzerland. This article is an open
access article.

<123>
Accession Number
2014308080
Title
Ultrafiltration and cardiopulmonary bypass associated acute kidney injury:
A systematic review and meta-analysis.
Source
Clinical Cardiology. 44(12) (pp 1700-1708), 2021. Date of Publication:
December 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.

<124>
Accession Number
635123488
Title
The Effectiveness of the Transitional Care Program Among People Awaiting
Coronary Artery Bypass Graft Surgery: A Randomized Control Trial.
Source
Journal of nursing scholarship : an official publication of Sigma Theta
Tau International Honor Society of Nursing. 53(5) (pp 585-594), 2021. Date
of Publication: 01 Sep 2021.
Author
Yuroong A.; Asdornwised U.; Pinyopasakul W.; Wongkornrat W.; Chansatitporn
N.
Institution
(Yuroong) PhD Candidate, Faculty of Nursing, Ramathibodi School of
Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Bangkok, Thailand
(Asdornwised, Pinyopasakul) Faculty of Nursing, Mahidol University,
Bangkok, Thailand
(Wongkornrat) Cardiothoracic Division, Department of Surgery, Siriraj
Hospital, Mahidol University, Bangkok, Thailand
(Chansatitporn) Department of Biostatistics, Faculty of Public Health,
Mahidol University, Bangkok, Thailand
Publisher
NLM (Medline)
Abstract
PURPOSE: This study examined the effectiveness of the Transitional Care
Program (TCP) on the anxiety, depression, cardiac self-efficacy, number of
hospitalizations, and satisfaction with care among people awaiting
elective coronary artery bypass graft (CABG) surgery. DESIGN: The study
design was a randomized controlled trial. <br/>METHOD(S): The participants
with coronary artery disease who met the study criteria (n = 104) were
randomly assigned to the intervention group (n = 52) receiving the TCP
plus routine care, or the control group (n = 52) receiving routine care
only. The TCP, developed based on the Transitional Care Model, comprised
hospital discharge planning and six weekly home telephone follow-ups to
provide health education, counseling, monitoring, and emotional support
tailored to the individual's needs. Data were collected at baseline, and
then at weeks 1, 6, and 8 after program enrollment. Data were analyzed
using descriptive statistics, repeated-measures analysis of variance, and
the Z test. FINDINGS: The intervention group had lower anxiety and
depression than did the control group at weeks 1, 6, and 8 after program
enrollment. At weeks 6 and 8, the intervention group exhibited higher
cardiac self-efficacy and satisfaction with care than the control group.
Further, the intervention group had a significantly lower number of
hospitalizations than the control group at week 8. <br/>CONCLUSION(S): The
TCP can reduce anxiety, depression, and number of hospitalizations, while
increasing cardiac self-efficacy and satisfaction with care among people
awaiting CABG. CLINICAL RELEVANCE: Nurses are in a pivotal position to
make care transitions safer. Provision of discharge education and regular
telephone contacts could enhance positive outcomes regarding patients
awaiting elective cardiac surgery.<br/>Copyright &#xa9; 2021 Sigma Theta
Tau International.

<125>
Accession Number
2016332345
Title
Permanent pacemaker implantation following transcatheter aortic valve
implantation using self-expandable, balloon-expandable, or mechanically
expandable devices: A network meta-analysis.
Source
Europace. 23(12) (pp 1998-2009), 2021. Date of Publication: 01 Dec 2021.
Author
Ravaux J.M.; Di Mauro M.; Vernooy K.; Kats S.; Mariani S.; Ronco D.; Actis
Dato G.; Simons J.; Hof A.W.V.; Maessen J.G.; Lorusso R.
Institution
(Ravaux, Di Mauro, Kats, Mariani, Ronco, Actis Dato, Simons, Maessen,
Lorusso) Departement of Cardio-Thoracic Surgery, Heart and Vascular
Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25,
Maastricht 6202 AZ, Netherlands
(Vernooy, Hof) Department of Cardiology, Maastricht University Medical
Centre (MUMC), Maastricht, Netherlands
(Vernooy, Hof, Maessen, Lorusso) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University Medical Center, Maastricht,
Netherlands
(Vernooy) Department of Cardiology, Radboud University Medical Center
(Radboudumc), Nijmegen, Netherlands
(Ronco) Department of Medicine and Surgery, Circolo Hospital, University
of Insubria, Varese, Italy
Publisher
Oxford University Press
Abstract
Aims: Permanent pacemaker implantation (PPI) still limits the expansion of
indications for transcatheter aortic valve implantation (TAVI). Comparison
between different systems remains scarce. We aimed to determine the impact
of the device type used on post-TAVI PPI. <br/>Methods and Results: A
systematic literature review was performed to identify studies reporting
the use of balloon-expandable valve (BEV), self-expandable valve (SEV),
and mechanically expandable valve (MEV) and post-TAVI PPI. A network
meta-analysis was used to compare TAVI mechanisms (Analysis A) and
transcatheter heart valves (Analysis B) with respect to post-TAVI PPI.
Analysis A included 40 181 patients with a pooled PPI rate of 19.2% in
BEV, 24.7% in SEV, and 34.8% in MEV. Balloon-expandable valve showed lower
risk compared to either SEV or MEV and SEV demonstrated lower risk for PPI
than MEV. Implantation of BEV was associated with 39% and 62% lower PPI
rate with respect to SEV and MEV. Implantation of SEV was associated with
38% lower PPI rate with respect to MEV. Analysis B included 36.143
patients with the lowest pooled PPI rate of 9.6% for Acurate Neo or
others, and the highest pooled PPI rate of 34.3% for Lotus. CoreValve,
Evolut Portico, and Lotus influenced significantly PPI rate, while Sapien
group did not. <br/>Conclusion(s): Implantation of BEV and also SEV were
associated with lower post-TAVI PPI rate, while MEV were associated with
higher post-TAVI PPI. Patient tailored-approach including devices
characteristics may help to reduce post-TAVI PPI and to allow TAVI to take
the leap towards extension of use in younger patients. <br/>Copyright
&#xa9; 2021 Published on behalf of the European Society of Cardiology. All
rights reserved.

<126>
Accession Number
2014636633
Title
Commentary: Prevention of saphenous vein graft disease remains elusive.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Hays N.M.; Balsam L.B.
Institution
(Hays) Department of Surgery, University of Massachusetts Chan Medical
School, Worcester, MA, United States
(Balsam) Division of Cardiac Surgery, UMass Memorial Medical Center,
Worcester, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
One-year outcomes of Ticagrelor Antiplatelet Therapy to Reduce Graft
Events and Thrombosis (TARGET), a randomized double-blinded clinical trial
comparing post-coronary artery bypass surgery antiplatelet therapy with
ticagrelor versus aspirin are published in this issue of the Journal.
Although the authors did not detect statistically significant differences
in their primary outcome (saphenous vein graft patency at 1 year) and
major adverse cardiovascular events, their findings must be interpreted
with caution given important limitations in the design and execution of
the trial.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC