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<1>
Accession Number
636193093
Title
Is Perioperative Dexmedetomidine Associated With a Reduced Risk of
Perioperative Neurocognitive Disorders Following Cardiac Surgery? A
Systematic Review and Meta-Analysis With Trial Sequential Analysis of
Randomized Controlled Trials.
Source
Frontiers in Medicine. 8 (no pagination), 2021. Article Number: 645975.
Date of Publication: 29 Sep 2021.
Author
Xiong X.; Chen D.; Shi J.
Institution
(Xiong, Shi) Department of Anesthesiology, The Affiliated Hospital of
Guizhou Medical University, Guiyang, China
(Chen) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Background: To assess the effect of dexmedetomidine on the reducing risk
of perioperative neurocognitive disorders (PNDs) following cardiac
surgery. Method(s): A systematic review and meta-analysis with trial
sequential analysis (TSA) of randomized controlled trials were performed.
PubMed, Embase, Cochrane Library, and CNKI databases (to August 16, 2020)
were searched for relevant articles to analyze the incidence of PND for
intraoperative or postoperative dexmedetomidine administration after
cardiac surgery. PND included postoperative cognitive dysfunction (POCD)
and postoperative delirium (POD). Result(s): A total of 24 studies
with 3,610 patients were included. Compared with the control group, the
incidence of POD in the dexmedetomidine group was significantly lower
(odds ratio [OR]: 0.59, 95% CI: 0.43-0.82, P = 0.001), with firm evidence
from TSA. Subgroup analyses confirmed that dexmedetomidine reduced the
incidence of POD with firm evidence following coronary artery bypass
grafting surgery (OR: 0.45, 95% CI: 0.26-0.79, P = 0.005), and
intervention during the postoperative period (OR: 0.48, 95% CI: 0.34-0.67,
P < 0.001). Furthermore, the incidence of POD in the dexmedetomidine group
was also decreased in mixed cardiac surgery (OR: 0.68, 95% CI: 0.47-0.98,
P = 0.039). Irrespective of whether "Confusion Assessment Method/Confusion
Assessment Method for intensive care unit" or "other tools" were used as
diagnostic tools, the results showed a decreased risk of POD in the
dexmedetomidine group. There was no significant difference in the
incidence of POCD (OR: 0.47, 95% CI: 0.22-1.03, P = 0.060) between the two
groups, but this result lacked firm evidence from TSA. Conclusion(s):
The administration of dexmedetomidine during the perioperative period
reduced the incidence of POD in patients after cardiac surgery, but there
was no significant benefit in the incidence of POCD. The effect of
dexmedetomidine on the incidence of POD or POCD following different types
of surgery and the optimal dose and timing of dexmedetomidine warrant
further investigation. Trial registration: PROSPERO registration number:
CRD42020203980. Registered on September 13, 2020. © Copyright
© 2021 Xiong, Chen and Shi.

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

<3>
Accession Number
2015451083
Title
Comparison of Renal Function in Coronary Artery Bypass Graft Surgery with
Pulsatile versus Non-pulsatile Perfusion: A Randomized Clinical Trial.
Source
International Cardiovascular Research Journal. 15(3) (pp 105-110), 2021.
Article Number: e112221. Date of Publication: Sep 2021.
Author
Mali S.; Montazerghaem H.; Salehi S.; Jambarsang S.; Tajamolian A.
Institution
(Mali, Salehi, Tajamolian) Cardiovascular Research Center, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Montazerghaem) Cardiovascular Research Center, Hormozgan University of
Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Jambarsang) Research Center of Prevention and Epidemiology of
Non-Communicable Disease, Department of Biostatistics and Epidemiology,
School of Public Health, Shahid Sadoughi University of Medical Sciences,
Yazd, Iran, Islamic Republic of
Publisher
Iranian Cardiovascular Research Journal
Abstract
Background: Despite numerous studies on tissue perfusion, capillary
circulation, and their related factors, there is still no consensus on the
utilization of pulsatile versus non-pulsatile perfusion methods to provide
proper perfusion in patients undergoing Coronary Artery Bypass Graft
(CABG) surgery. Objective(s): This study aimed to compare the effects
of pulsatile versus non-pulsatile perfusion methods on renal function in
patients undergoing CABG surgery in Shahid Mohammadi hospital, Bandar
Abbas, Iran in 2018. Method(s): In this randomized clinical trial, 50
patients aged > 18 years who underwent CABG surgery were randomly divided
into a pulsatile and a non-pulsatile group (n = 25 in each group). The two
groups were compared in terms of laboratory findings including the plasma
levels potassium, sodium, creatinine, and blood urea nitrogen, Glomerular
Filtration Rate (GFR), urinary output, and ejection fraction.
 Result(s): The results revealed a significant difference between the
two groups regarding the trend of GFR changes during the study (P = 0.01).
Accordingly, postoperative GFR increased more in the pulsatile group than
in the non-pulsatile group. Moreover, creatinine and blood urea nitrogen
levels reduced in the pulsatile group compared to the baseline. However,
no significant differences were observed in the mean levels of potassium,
sodium, and creatinine, urinary output, and ejection fraction in the two
groups before and after the surgery. Conclusion(s): According to the
results, pulsatile method was preferred to the non-pulsatile perfusion
method due to its positive effects on creatinine and blood urea nitrogen
levels as well as on GFR during and after the CABG surgery. Copyright
© 2021, Iranian Cardiovascular Research Journal. All rights reserved.

<4>
Accession Number
633048120
Title
Wound Infection after CABG Using Internal Mammary Artery Grafts: A
Meta-Analysis.
Source
Thoracic and Cardiovascular Surgeon. 69(7) (pp 639-648), 2021. Date of
Publication: 01 Oct 2021.
Author
Oswald I.; Boening A.; Pons-Kuehnemann J.; Grieshaber P.
Institution
(Oswald, Boening, Grieshaber) Department of Adult and Pediatric
Cardiovascular Surgery, Justus Liebig University Giessen,
Rudolf-Buchheim-Strabetae 7, Giessen 35392, Germany
(Pons-Kuehnemann) Institute of Medical Informatics, Department of Medical
Statistics, Justus Liebig University Giessen, Giessen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background Internal mammary arteries show better long-term patency rates
than venous grafts. The use of both mammary arteries is associated with a
higher risk of sternal wound infections. This meta-analysis was designed
to assess the incidence of a wound healing disorder after bilateral
compared with single mammary artery bypass grafting. Compared with
existing meta-analysis this paper includes more current literature and one
randomized controlled trial. Methods A literature search was performed
using PubMed and the Cochrane Library. The quality of the articles was
assessed by the Newcastle Ottawa Scale. The odds ratio was used as a
measure of the chance of developing a wound healing disorder after
bilateral internal mammary artery (BIMA) surgery. Meta-analyses were
performed for different subgroups. Results Twenty studies met the quality
criteria, including one randomized controlled trial. The use of both
mammary arteries significantly increased the risk of superficial (odds
ratio [OR] 1.72) and deep (OR 1.75) wound healing disorder in the total
population (OR 1.80) as well as in the diabetic subgroup (OR 1.38) and
with both preparation techniques. The increased risk with BIMA grafting
was present independently of the preparation technique (pedicled: OR 1.89,
skeletonized: OR 1.37). Conclusion Bilateral internal mammary artery
grafting, especially in high-risk and diabetic patients, is associated
with an increased risk of wound healing impairment. Skeletonized
preparation does not eliminate the elevated wound healing disorder risk
after BIMA use. Copyright © 2021 Georg Thieme Verlag. All rights
reserved.

<5>
Accession Number
2011115966
Title
Association between frailty and postoperative delirium: a meta-analysis of
cohort study.
Source
Aging Clinical and Experimental Research. 34(1) (pp 25-37), 2022. Date of
Publication: January 2022.
Author
Fu D.; Tan X.; Zhang M.; Chen L.; Yang J.
Institution
(Fu, Zhang, Chen, Yang) Intensive Care Unit, Chongqing General Hospital,
University of Chinese Academy of Sciences, No. 118 Xingguang Avenue,
Liangjiang New Area, Chongqing 400010, China
(Tan) Department of Urology, Chongqing University Central Hospital,
Chongqing 400010, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Frailty has been suggested as a possible risk factor for
postoperative delirium (POD). However, results of previous studies were
not consistent. We performed a meta-analysis of cohort study to evaluate
the above association. Method(s): Relevant studies were obtained via
systematic search of PubMed, Embase, SCOPUS, and Web of Science databases.
Only studies with multivariate analysis were included. A random-effect
model incorporating the potential heterogeneity was used to combine the
results. Result(s): Fifteen cohort studies including 3250 adult
patients who underwent surgery were included, and the prevalence of
frailty was 27.1% (880/3250) before surgeries. Overall, POD occurred in
513 patients (15.8%). Pooled results showed that frailty was associated
with a higher risk of POD (adjusted odds ratio [OR]: 3.23, 95% confidence
interval [CI]: 2.56-4.07, P < 0.001) without significant heterogeneity (P
for Cochrane's Q test = 0.25, I2 = 18%). Subgroup analyses
showed a more remarkable association between frailty and POD in
prospective cohort studies (OR: 3.64, 95% CI: 2.95-4.49, P < 0.001) than
that in retrospective cohort studies (OR: 2.32, 95% CI: 1.60-3.35, P <
0.001; P for subgroup difference = 0.04). Moreover, the association was
not affected by country of the study, age group of the patient, elective
or emergency surgeries, cardiac and non-cardiac surgeries, evaluation
instruments for frailty, diagnostic methods for POD, or quality score of
the study (P for subgroup difference all > 0.05). Conclusion(s):
Frailty may be associated with a higher risk of POD in adult
population. Copyright © 2021, The Author(s), under exclusive
licence to Springer Nature Switzerland AG.

<6>
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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. 145(4) (pp e129-e142), 2022. Date of Publication: 25 Jan
2022.
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.

<7>
Accession Number
637098793
Title
Impact of Exercise Modalities on Peripheral and Central Components of
Cardiorespiratory Capacity in Heart Transplantation Patients: A Systematic
Review and Meta-Analysis.
Source
Medicina (Kaunas, Lithuania). 58(1) (no pagination), 2021. Date of
Publication: 24 Dec 2021.
Author
Turri-Silva N.; Santos F.V.; Rodrigues W.C.C.; Freire J.S.; Cahalin L.C.;
Verboven K.; Quaglioti Durigan J.L.; Hansen D.; Cipriano G.
Institution
(Turri-Silva, Santos, Rodrigues, Freire, Quaglioti Durigan, Cipriano)
Health and Technologies in Health Sciences Program, University of
Brasilia, Brasilia 72220-275, Brazil
(Turri-Silva, Verboven, Hansen) REVAL/BIOMED-Rehabilitation Research
Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek
3590, Belgium
(Turri-Silva) Heart Centre Hasselt, Jessa Hospital, Hasselt 3500, Belgium
(Santos) Department of Education and Training in Oncology, Cancer
Institute of Sao Paulo, Sao Paulo 03102-002, Brazil
(Cahalin, Hansen) Department of Physical Therapy, University of Miami
Miller School of Medicine, FL 33167-3495, Coral Gables, United States
Publisher
NLM (Medline)
Abstract
Background and Objectives: To analyze the effects of aerobic, resistance,
and combined training on peripheral and central components related to
cardiorespiratory capacity after HTx. Material(s) and Method(s): No
time restriction was applied for study inclusion. MEDLINE/PubMed; EMBASE,
CENTRAL, and PEDro databases were investigated. Studies reporting heart
transplanted patients older than 19 years following aerobic, resistance,
and combined training according. The outcomes included: V'O2 peak,
VE/V'CO2 slope, heart rate (HR peak), systolic and diastolic blood
pressure (SBP and DBP peak), maximum repetition test(1RM), sit-to-stand
test, and flow-mediated dilation (FMD). The studies were selected by
consensus. Four hundred ninety-two studies initially met the selection
criteria. Cochrane handbook was used for abstracting data and assessing
data quality and validity. Independent extraction by two observers was
applied. Result(s): Isolated aerobic training leads to a greater
increase in V'O2 peak than combined training compared to the control group
(p < 0.001, I2 = 0%). However, no significant differences were found in
the subgroup comparison (p = 0.19, I2 = 42.1%). HR peak increased
similarly after aerobic and combined training. High-intensity interval
training (HIIT) was better than moderate continuous intensity to increase
the V'O2 after long term in HTx. Still, there is scarce evidence of HIIT
on muscle strength and FMD. No change on VE/V'CO2 slope, FMD, and SBP, DBP
peak. 1RM and the sit-to-stand test increased after resistance training (p
< 0.001, I2 = 70%) and CT (p < 0.001, I2 = 0%) when compared to control.
 Conclusion(s): Aerobic and combined training effectively improve VO2
peak and muscle strength, respectively. HIIT seems the better choice for
cardiorespiratory capacity improvements. More studies are needed to
examine the impact of training modalities on VE/V'CO2 slope and FMD.

<8>
Accession Number
636725823
Title
Effects of short-term bisoprolol on perioperative myocardial injury in
patients undergoing non-cardiac surgery: a randomized control study.
Source
Scientific reports. 11(1) (pp 22006), 2021. Date of Publication: 10 Nov
2021.
Author
Wongcharoen W.; Chotayaporn T.; Chutikhongchalermroj K.; Tantraworasin A.;
Saeteng S.; Arworn S.; Rerkasem K.; Phrommintikul A.
Institution
(Wongcharoen, Chotayaporn, Chutikhongchalermroj, Phrommintikul) Division
of Cardiology, Department of Internal Medicine, Faculty of Medicine,
Chiang Mai University, Chiang Mai, Thailand
(Tantraworasin, Saeteng) Division of Thoracic Surgery, Department of
Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Arworn, Rerkasem) Division of Vascular Surgery, Department of Surgery,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Rerkasem) Environmental Occupational Health Sciences and Non Communicable
Diseases Center of Excellence, Research Institute of Health Sciences,
Chiang Mai University, Chiang Mai, Thailand
(Phrommintikul) Center for Medical Excellence, Faculty of Medicine, Chiang
Mai University, Chiang Mai, Thailand
Publisher
NLM (Medline)
Abstract
The protective role of preoperative beta-blocker in patients undergoing
non-cardiac surgery is unknown. We aimed to evaluate the effects of
beta-blocker on perioperative myocardial injury in patients undergoing
non-cardiac surgery. We consecutively enrolled 112 patients undergoing
non-cardiac surgery. They were randomly allocated to receive bisoprolol or
placebo given at least 2 days preoperatively and continued until 30 days
after surgery. The primary outcome was incidence of perioperative
myocardial injury defined by a rise of high-sensitive troponin-T (hs-TnT)
more than 99th percentile of upper reference limit or a rise of hs-TnT
more than 20% if baseline level is abnormal. Baseline characteristics were
comparable between bisoprolol and placebo in randomized cohort Mean age
was 62.5+/-11.8 years and 76 (67.8%) of 112 patients were male. Among 112
patients, 49 (43.8%) underwent vascular surgery and 63 (56.2%) underwent
thoracic surgery. The median duration of assigned treatment prior to
surgery was 4 days (2-6 days). We did not demonstrate the significant
difference in the incidence of perioperative myocardial injury [52.6% (30
of 57 patients) vs. 49.1% (27 of 55 patients), P=0.706]. In addition, the
incidence of intraoperative hypotension was higher in bisoprolol group
than placebo group in patients undergoing non-cardiac surgery [70.2% (40
of 57 patients) vs. 47.3% (26 of 55 patients), P=0.017]. We demonstrated
that there was no statistically significant difference in perioperative
myocardial injury observed between patients receiving bisoprolol and
placebo who had undergone non-cardiac surgery. Copyright © 2021.
The Author(s).

<9>
Accession Number
637106961
Title
Effect of perioperative levosimendan administration on postoperative
N-terminal pro-B-type natriuretic peptide concentration in patients with
increased cardiovascular risk factors undergoing non-cardiac surgery:
protocol for the double-blind, randomised, placebo-controlled IMPROVE
trial.
Source
BMJ open. 12(1) (pp e058216), 2022. Date of Publication: 21 Jan 2022.
Author
Reiterer C.; Kabon B.; Taschner A.; Adamowitsch N.; Graf A.; Fraunschiel
M.; Horvath K.; Kuhrn M.; Clement T.; Treskatsch S.; Berger C.;
Fleischmann E.
Institution
(Reiterer, Fleischmann) Department of Anesthesia, Intensive Care Medicine
and Pain Medicine, Outcome Research Consortium, Cleveland, OH, United
States
(Kabon, Taschner, Adamowitsch, Horvath, Kuhrn, Clement, Fleischmann)
Department of Anaesthesia, Intensive Care Medicine and Pain Medicine,
Medical University of Vienna, Wien, Austria
(Graf) Center for Medical Statistics, Informatics and Intelligent Systems,
Medical University of Vienna, Wien, Austria
(Fraunschiel) ITSC - IT Systems & Communications, Medical University of
Vienna, Wien, Austria
(Treskatsch, Berger) Department of Anesthesiology and Intensive Care
Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Elevated N-terminal pro-brain natriuretic peptide
(NT-pro-BNP) after non-cardiac surgery is a strong predictor for
cardiovascular complications and reflects increased myocardial strain.
NT-pro-BNP concentrations significantly rise after non-cardiac surgery
within the first 3 days. Levosimendan is a potent inotropic drug that
increases calcium sensitivity to cardiac myocytes, which results in
improved cardiac contractility that last for approximately 7 days. Thus,
we will test the effect of a pre-emptive perioperative administration of
levosimendan on postoperative NT-pro-BNP concentration as compared with
the administration of a placebo in patients undergoing moderate-risk to
high-risk major abdominal surgery. METHODS AND ANALYSIS: We will conduct a
double-blinded prospective randomised trial at the Medical University of
Vienna, Vienna, Austria (and potentially a second centre in Germany),
including 230 patients at-risk for cardiovascular complications undergoing
moderate- to high-risk major abdominal surgery. Patients will be randomly
assigned to receive a single dose of 12.5 mg levosimendan versus placebo
after induction of anaesthesia. The primary outcome will be the
postoperative maximum NT-pro-BNP concentration between both group within
the first three postoperative days. Our secondary outcomes will be the
incidence of myocardial ischaemia, myocardial injury after non-cardiac
surgery and a composite of myocardial infarction and death within 30 days
and 1 year after surgery between both groups. Our further secondary
outcome will be stratification of NT-pro-BNP values according to
previously thresholds to predict mortality of myocardial infarction after
surgery. ETHICS AND DISSEMINATION: The study was approved by the Ethics
Committee of the Medical University of Vienna on 14 July 2020 (EK
2187/2019). Written informed consent will be obtained from all patients a
day before surgery. Results of this study will be submitted for
publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER:
NCT04329624. Copyright © Author(s) (or their employer(s)) 2022.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<10>
Accession Number
2016694612
Title
Tongxinluo capsule as supplementation and cardiovascular endpoint events
in patients with coronary heart disease: A systematic review and
meta-analysis of randomized, double-blind, placebo-controlled trials.
Source
Journal of Ethnopharmacology. 289 (no pagination), 2022. Article Number:
115033. Date of Publication: 10 May 2022.
Author
Lv J.; Liu S.; Guo S.; Gao J.; Song Q.; Cui X.
Institution
(Lv, Song) Department of General Internal Medicine, Guang'anmen Hospital,
China Academy of Chinese Medical Sciences, Beijing 100053, China
(Liu) College of Traditional Chinese Medicine, China Academy of Chinese
Medical Science, Beijing 100000, China
(Guo) College of Traditional Chinese Medicine, Shandong University of
Traditional Chinese Medicine, Jinan, Shandong Province 250355, China
(Gao, Cui) Department of Cardiology, Guang'anmen Hospital, China Academy
of Chinese Medical Sciences, Beijing 100053, China
Publisher
Elsevier Ireland Ltd
Abstract
Ethnopharmacological relevance: Tongxinluo Capsule(TXLC) is a well-known
traditional Chinese medicine prescription with effects of tonifying Qi and
activating blood based on the Chinese herbal medicine theory that has been
recommended as routine adjuvant treatment in patients with coronary heart
disease (CHD) in China. Aim of the study: This meta-analysis aimed to
evaluate the efficacy and safety of TXLC as supplementation in the
prevention of adverse cardiovascular events in patients with CHD.
 Material(s) and Method(s): We performed a literature search in
Pubmed, Cochrane Library, China National Knowledge Infrastructure (CNKI),
Chinese Scientific Journals Database (VIP), Wan Fang Database, and Chinese
Biomedical Database (CBM) from their inceptions to March 2020. Only
randomized controlled trials (RCTs) that assessed supplementation with
TXLC or placebo and with adverse cardiovascular outcomes, were included in
this meta-analysis. Primary end points were myocardial infarction (MI),
target vessel revascularization (TVR) or in-stent restenosis (ISR), and
cardiovascular death. Secondary end points included cerebrovascular
accidents, heart failure (HF), and unscheduled readmission for
cardiovascular diseases (CVDs). Adverse drug events were also evaluated.
Trial sequential analysis (TSA) was conducted to reduce random errors
introduced by possible insufficient sample size. Result(s): Eleven
RCTs involving 1505 patients were analyzed. The mean(SD) age of included
patients were 59.03(9.7) years. Treatment duration varied from 2 months to
12 months. Compared with placebo, TXLC supplementation showed significant
effects on reducing the risk of MI (RR = 0.44, [95% CI, 0.24-0.80]), TVR
or ISR (RR = 0.43, [95% CI, 0.31-0.58]), cerebrovascular accidents(RR =
0.17, [95% CI, 0.06-0.46]), HF (RR = 0.41, [95% CI, 0.21-0.79]), and
unscheduled readmission for CVDs (RR = 0.72, [95% CI], P = 0.04), but did
not have associations with incidence of cardiovascular death (RR = 0.53,
[95% CI, 0.15-1.91]). Subgroups of trials with 2-month (MI: RR = 0.44,
[95% CI, 0.13-1.53]; cardiovascular death: RR = 0.30, [95% CI, 0.01-7.67];
cerebrovascular accidents: RR = 0.04, [95% CI, 0.01-0.26]; unscheduled
readmission for CVDs: RR = 0.43, [95% CI, 0.20-0.94]) and 12-month (MI: RR
= 0.42, [95% CI, 0.20-0.89]; TVR or ISR: RR = 0.42, [95% CI, 0.31-0.58];
HF: RR = 0.34, [95% CI, 0.14-0.78]; unscheduled readmission for CVDs: RR =
0.85, [95% CI, 0.59-1.22]) intervention period were analyzed. The adverse
drug reactions were mild with no significant difference between TXLC and
placebo. Conclusion(s): This meta-analysis indicated that TXLC
supplementation had beneficial effects on the prevention of cardiovascular
adverse events, especially in TVR or ISR after coronary revascularization
and may possibly lower the incidence of first or recurrent MI and HF
within 12 months in patients with CHD, while insufficient sample size
implied that these results lacked certain stability. And the effects of
TXLC on cardiovascular mortality, cerebrovascular events, and unscheduled
readmission for CVDs could not be confirmed due to insufficient cases.
Clinical trials with large-sample sizes and extended follow-up time are of
interest in the future researches. Copyright © 2022 Elsevier B.V.

<11>
Accession Number
2016680137
Title
Multicentre analysis of practice patterns regarding benzodiazepine use in
cardiac surgery.
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Janda A.M.; Spence J.; Dubovoy T.; Belley-Cote E.; Mentz G.; Kheterpal S.;
Mathis M.R.
Institution
(Janda, Dubovoy, Mentz, Kheterpal, Mathis) Department of Anesthesiology,
University of Michigan, Ann Arbor, MI, United States
(Spence) Departments of Anesthesia and Critical Care, McMaster University,
Hamilton, ON, Canada
(Spence, Belley-Cote) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
(Belley-Cote) Divisions of Cardiology and Critical Care, Department of
Medicine, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Ltd
Abstract
Background: There is controversy regarding optimal use of benzodiazepines
during cardiac surgery, and it is unknown whether and to what extent there
is variation in practice. We sought to describe benzodiazepine use and
sources of variation during cardiac surgeries across patients, clinicians,
and institutions. Method(s): We conducted an analysis of adult
cardiac surgeries across a multicentre consortium of USA academic and
private hospitals from 2014 to 2019. The primary outcome was
administration of a benzodiazepine from 2 h before anaesthesia start until
anaesthesia end. Institutional-, clinician-, and patient-level variables
were analysed via multilevel mixed-effects models. Result(s): Of 65
508 patients cared for by 825 anaesthesiology attending clinicians
(consultants) at 33 institutions, 58 004 patients (88.5%) received
benzodiazepines with a median midazolam-equivalent dose of 4.0 mg
(inter-quartile range [IQR], 2.0-6.0 mg). Variation in benzodiazepine
dosage administration was 54.7% attributable to institution, 14.7% to
primary attending anaesthesiology clinician, and 30.5% to patient factors.
The adjusted median odds ratio for two similar patients receiving a
benzodiazepine was 2.68 between two randomly selected clinicians and 4.19
between two randomly selected institutions. Factors strongly associated
(adjusted odds ratio, <0.75, or >1.25) with significantly decreased
likelihoods of benzodiazepine administration included older age (>80 vs
<=50 yr; adjusted odds ratio=0.04; 95% CI, 0.04-0.05), university
affiliation (0.08, 0.02-0.35), recent year of surgery (0.42, 0.37-0.49),
and low clinician case volume (0.44, 0.25-0.75). Factors strongly
associated with significantly increased likelihoods of benzodiazepine
administration included cardiopulmonary bypass (2.26, 1.99-2.55), and drug
use history (1.29, 1.02-1.65). Conclusion(s): Two-thirds of the
variation in benzodiazepine administration during cardiac surgery are
associated with institutions and attending anaesthesiology clinicians
(consultants). These data, showing wide variations in administration,
suggest that rigorous research is needed to guide evidence-based and
patient-centred benzodiazepine administration. Copyright © 2021
British Journal of Anaesthesia

<12>
Accession Number
2014818391
Title
Higher body mass index raises immature platelet count: potential
contribution to obesity-related thrombosis.
Source
Platelets. (no pagination), 2022. Date of Publication: 2022.
Author
Goudswaard L.J.; Corbin L.J.; Burley K.L.; Mumford A.; Akbari P.; Soranzo
N.; Butterworth A.S.; Watkins N.A.; Pournaras D.J.; Harris J.; Timpson
N.J.; Hers I.
Institution
(Goudswaard, Burley, Hers) School of Physiology, Pharmacology and
Neuroscience, University of Bristol, Bristol, United Kingdom
(Goudswaard, Hers) Bristol Heart Institute, Bristol, United Kingdom
(Goudswaard, Corbin, Timpson) Medical Research Council (MRC) Integrative
Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
(Goudswaard, Corbin, Timpson) Department of Population Health Sciences,
Bristol Medical School, University of Bristol, Bristol, United Kingdom
(Mumford) School of Cellular and Molecular Medicine, University of
Bristol, Bristol, United Kingdom
(Akbari, Butterworth) Department of Public Health and Primary Care,
British Heart Foundation Cardiovascular Epidemiology Unit, University of
Cambridge, Cambridge, United Kingdom
(Akbari, Soranzo, Butterworth) National Institute for Health Research
Blood, Transplant Research Unit (NIHR BTRU) in Donor Health and Genomics,
University of Cambridge, Cambridge, United Kingdom
(Akbari) MRC Biostatistics Unit, University of Cambridge, Cambridge,
United Kingdom
(Akbari, Soranzo) Human Genetics, Wellcome Sanger Institute, Hinxton,
United Kingdom
(Soranzo) Department of Haematology, School of Clinical Medicine,
University of Cambridge, Cambridge, United Kingdom
(Butterworth) British Heart Foundation Centre of Research Excellence,
University of Cambridge, Cambridge, United Kingdom
(Butterworth) NIHR Cambridge Biomedical Research Centre, University of
Cambridge and Cambridge University Hospitals, Cambridge, United Kingdom
(Butterworth) Health Data Research UK Cambridge, Wellcome Genome Campus
and University of Cambridge, Cambridge, United Kingdom
(Watkins) NHS Blood and Transplant, Cambridge, Biomedical Campus,
Cambridge, United Kingdom
(Pournaras) Department of Bariatric and Metabolic Surgery, Southmead
Hospital, North Bristol NHS Trust, Bristol, United Kingdom
(Harris) Trials Centre, Faculty of Health Sciences, University of Bristol,
Bristol, United Kingdom
Publisher
Taylor and Francis Ltd.
Abstract
Higher body mass index (BMI) is a risk factor for thrombosis. Platelets
are essential for hemostasis but contribute to thrombosis when activated
pathologically. We hypothesized that higher BMI leads to changes in
platelet characteristics, thereby increasing thrombotic risk. The effect
of BMI on platelet traits (measured by Sysmex) was explored in 33 388 UK
blood donors (INTERVAL study). Linear regression showed that higher BMI
was positively associated with greater plateletcrit (PCT), platelet count
(PLT), immature platelet count (IPC), and side fluorescence (SFL, a
measure of mRNA content used to derive IPC). Mendelian randomization (MR),
applied to estimate a causal effect with BMI proxied by a genetic risk
score, provided causal estimates for a positive effect of BMI on both SFL
and IPC, but there was little evidence for a causal effect of BMI on PCT
or PLT. Follow-up analyses explored the functional relevance of platelet
characteristics in a pre-operative cardiac cohort (COPTIC). Linear
regression provided observational evidence for a positive association
between IPC and agonist-induced whole blood platelet aggregation. Results
indicate that higher BMI raises the number of immature platelets, which is
associated with greater whole blood platelet aggregation in a cardiac
cohort. Higher IPC could therefore contribute to obesity-related
thrombosis. Copyright © 2021 The Author(s). Published with
license by Taylor & Francis Group, LLC.

<13>
Accession Number
2014806647
Title
Evaluation of Different Pain-Control Procedures for Post-cardiac Surgery:
A Systematic Review and Network Meta-Analysis.
Source
Surgical Innovation. (no pagination), 2022. Date of Publication: 2022.
Author
Hu M.; Wang Y.; Hao B.; Gong C.; Li Z.
Institution
(Hu, Gong, Li) Department of Hepatobiliary and Pancreatic Surgery,
Zhongnan Hospital of Wuhan University, Wuhan, China
(Wang) Department of Cardiovascular Surgery, TEDA International
Cardiovascular Hospital, Chinese Academy of Medical Sciences Peking Union
Medical College, Tianjin, China
(Hao) School of Nursing, Huanggang Polytechnic College, Huanggang, China
Publisher
SAGE Publications Inc.
Abstract
Objective: To identify superior pain-control procedures for postoperative
patients who undergo cardiac surgeries. Method(s): Literature
searches were conducted in globally recognized databases, including
MEDLINE, EMBASE and Cochrane Central, to identify randomized controlled
trials (RCTs) investigating pain-control procedures after cardiac
surgeries. The parameters evaluating analgesic efficacy and postoperative
recovery, namely, the pain score and ICU stay, were quantitatively pooled
and estimated using Bayesian methods. The values of the surface under the
cumulative ranking (SUCRA) probabilities regarding each parameter were
calculated to enable the ranking of various pain-control procedures.
Node-splitting analysis was performed to test the inconsistency of the
main results, and the publication bias was assessed by examining the
funnel-plot symmetry. Result(s): After a detailed review, 13 RCTs
containing 7 different procedures were included in the network
meta-analysis. After pooling the results together, an erector spinae plane
block (ESPB) and a local parasternal block (LPB) plus target-controlled
infusion (TCI) presented the best analgesic effects for reducing pain at
rest (SUCRA,.47) and during movement (SUCRA,.52), respectively, while the
former also achieved the shortest ICU stay (SUCRA,.48). Moreover, the
funnel-plot symmetries showed no inconsistencies or obvious publication
bias in the current study. Conclusion(s): The current evidence
indicates that ESPB is a potential superior analgesic strategy for
post-cardiac surgery patients. To verify this conclusion further, it is
imperative to obtain more high-quality evidence and conduct relevant
investigations in the future. Copyright © The Author(s) 2022.

<14>
Accession Number
637109215
Title
Meta-Analysis of Transcatheter Aortic Valve Implantation Using the Sapien
3 Versus Sapien 3 Ultra Valves.
Source
The American journal of cardiology. (no pagination), 2022. Date of
Publication: 20 Jan 2022.
Author
Abdelfattah O.M.; Sayed A.; Ghonim M.; Saleh Y.; Genereux P.; Goel S.S.;
Krishnaswamy A.; Yun J.; Kapadia S.R.
Institution
(Abdelfattah) Department of Medicine, Morristown Medical Center, Altantic
Health System, Morristown, NJ, United States
(Sayed, Ghonim) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Saleh) Department of Cardiology, Houston Methodist Hospital, Houston,
Texas, USA; Department of Cardiology, Alexandria University, Alexandria,
Egypt
(Genereux) Department of Cardiovascular Medicine, Gagnon Cardiovascular
Institute, Morristown Medical Center, Atlantic Health System, Morristown,
NJ, United States
(Goel) Department of Cardiology, Houston Methodist Hospital, Houston, TX,
United States
(Krishnaswamy, Yun) Heart Vascular and Thoracic Institute, Department of
Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
(Kapadia) Heart Vascular and Thoracic Institute, Department of
Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
Publisher
NLM (Medline)

<15>
Accession Number
637103672
Title
Control of Postoperative Hypotension Using a Closed-Loop System for
Norepinephrine Infusion in Patients After Cardiac Surgery: A Randomized
Trial.
Source
Anesthesia and analgesia. (no pagination), 2022. Date of Publication: 21
Jan 2022.
Author
Desebbe O.; Rinehart J.; Van der Linden P.; Cannesson M.; Delannoy B.;
Vigneron M.; Curtil A.; Hautin E.; Vincent J.-L.; Duranteau J.; Joosten A.
Institution
(Desebbe, Delannoy, Hautin) From the Department of Anesthesiology and
Perioperative Care, Lyon, France
(Rinehart) Department of Anesthesiology and Perioperative Care, University
of California, Irvine, CA
(Van der Linden) Department of Anesthesiology, Brugmann Hospital,
Universite Libre de Bruxelles, Brussels, Belgium
(Cannesson) Department of Anesthesiology and Perioperative Medicine, David
Geffen School of Medicine, University of California, Los Angeles, CA,
Mexico
(Vigneron, Curtil) Department of Cardiac Surgery, Lyon, France
(Vincent) Department of Intensive Care, Erasme University Hospital,
Universite Libre de Bruxelles, Brussels, Belgium
(Duranteau, Joosten) Department of Anesthesiology and Intensive Care,
Hopitaux Universitaires Paris-Sud, Bicetre and Paul Brousse Hospitals,
Universite Paris-Sud ,Universite Paris-SaclayAssistance Publique Hopitaux
de Paris, Villejuif, France
(Joosten) Department of Anesthesiology, Erasme University Hospital,
Brussels, Belgium
Publisher
NLM (Medline)
Abstract
BACKGROUND: Vasopressors are a cornerstone for the management of
vasodilatory hypotension. Vasopressor infusions are currently adjusted
manually to achieve a predefined arterial pressure target. We have
developed a closed-loop vasopressor (CLV) controller to help correct
hypotension more efficiently during the perioperative period. We tested
the hypothesis that patients managed using such a system postcardiac
surgery would present less hypotension compared to patients receiving
standard management. METHOD(S): A total of 40 patients admitted to
the intensive care unit (ICU) after cardiac surgery were randomized into 2
groups for a 2-hour study period. In all patients, the objective was to
maintain mean arterial pressure (MAP) between 65 and 75 mm Hg using
norepinephrine. In the CLV group, the norepinephrine infusion was
controlled via the CLV system; in the control group, it was adjusted
manually by the ICU nurse. Fluid administration was standardized in both
groups using an assisted fluid management system linked to an advanced
hemodynamic monitoring system. The primary outcome was the percentage of
time patients were hypotensive, defined as MAP <65 mm Hg, during the study
period. RESULT(S): Over the 2-hour study period, the percentage of
time with hypotension was significantly lower in the CLV group than that
in the control group (1.4% [0.9-2.3] vs 12.5% [9.9-24.3]; location
difference, -9.8% [95% CI, -5.4 to -15.9]; P < .001). The percentage of
time with MAP between 65 and 75 mm Hg was also greater in the CLV group
(95% [89-96] vs 66% [59-77]; location difference, 27.6% [95% CI,
34.3-19.0]; P < .001). The percentage of time with an MAP >75 mm Hg (and
norepinephrine still being infused) was also significantly lower in
patients in the CLV group than that in the control group (3.2% [1.9-5.4]
vs 20.6% [8.9-32.5]; location difference, -17% [95% CI, -10 to -24]; P <
.001).The number of norepinephrine infusion rate modifications over the
study period was greater in the CLV group than that in the control group
(581 [548-597] vs 13 [11-14]; location difference, 568 [578-538]; P <
.001). No adverse event occurred during the study period in both groups.
 CONCLUSION(S): Closed-loop control of norepinephrine infusion
significantly decreases postoperative hypotension compared to manual
control in patients admitted to the ICU after cardiac
surgery. Copyright © 2022 International Anesthesia Research
Society.

<16>
Accession Number
2015243958
Title
Biomarkers-in-Cardiology 8 RE-VISITED-Consistent Safety of Early Discharge
with a Dual Marker Strategy Combining a Normal hs-cTnT with a Normal
Copeptin in Low-to-Intermediate Risk Patients with Suspected Acute
Coronary Syndrome-A Secondary Analysis of the Randomized
Biomarkers-in-Cardiology 8 Trial.
Source
Cells. 11(2) (no pagination), 2022. Article Number: 211. Date of
Publication: January-2 2022.
Author
Giannitsis E.; Garfias-Veitl T.; Slagman A.; Searle J.; Muller C.;
Blankenberg S.; Haehling S.V.; Katus H.A.; Hamm C.W.; Huber K.; Vollert
J.O.; Mockel M.
Institution
(Giannitsis, Katus) Medizinische Klinik III, Department of Cardiology,
Angiology and Pulmology, University Hospital of Heidelberg, Heidelberg
69120, Germany
(Garfias-Veitl, Haehling) Department of Cardiology and Pneumology,
University of Gottingen Medical Center, German Center for Cardiovascular
Research (DZHK), Partner site Gottingen, Gottingen 37075, Germany
(Slagman, Searle, Mockel) Department of Emergency Medicine Campus Mitte
and Virchow and Department of Cardiology, Charite-Universitatsmedizin,
Berlin 13353, Germany
(Muller) Cardiovascular Research Institute Basel (CRIB) and Department of
Cardiology, University Hospital Basel, University of Basel, Basel 4031,
Switzerland
(Blankenberg) Department of Cardiology, University Heart and Vascular
Centre Hamburg, Hamburg 20251, Germany
(Hamm) Department of Cardiology, University of Giessen, Campus Kerckhoff,
Bad Nauheim 61231, Germany
(Huber) 3rd Department of Internal Medicine, Cardiology and Intensive Care
Medicine, Wilhelminenhospital, Vienna 1060, Austria
(Vollert) BRAHMS GmbH Deutschland, Berlin 16761, Germany
Publisher
MDPI
Abstract
Regarding the management of suspected Non-ST-segment-elevation acute
coronary syndrome (ACS), the main Biomarker-in-Cardiology (BIC)-8
randomized controlled trial study had reported non-inferiority for the
incidence of major adverse cardiac events at 30 days in the Copeptin group
(dual marker strategy of copeptin and hs-cTnT at presentation) compared to
the standard process (serial hs-cTnT testing). However, in 349 (38.7%) of
the 902 patients, high-sensitivity cardiac troponin was not available for
the treating physicians. High sensitivity cardiac troponin T was
remeasured from thawed blood samples collected at baseline. This cohort
qualified for a re-analysis of the 30-day incidence rate of MACE (death,
survived cardiac death, acute myocardial infarction, re-hospitalization
for acute coronary syndrome, acute unplanned percutaneous coronary
intervention, coronary bypass grafting, or documented life-threatening
arrhythmias), or components of the primary endpoint including death or
death/MI. After re-measurement of troponin and exclusion of 9 patients
with insufficient blood sample volume, 893 patients qualified for
re-analysis. A total of 57 cases were detected with high sensitivity
cardiac troponin T >= 14 ng/L who had been classified as "troponin
negative" based on a conventional cardiac troponin T or I < 99th
percentile upper limit of normal. Major adverse cardiac events rates after
exclusion were noninferior in the Copeptin group compared to the standard
group (4.34% (95% confidence intervals 2.60-6.78%) vs. 4.27% (2.55-6.66%).
Rates were 53% lower in the per-protocol analysis (HR 0.47, 95% CI:
0.18-1.15, p = 0.09). No deaths occurred within 30 days in the discharged
low risk patients of the Copeptin group. Copeptin combined with high
sensitivity cardiac troponin is useful for risk stratification and allows
early discharge of low-to-intermediate risk patients with suspected acute
coronary syndrome is as safe as a re-testing strategy at 3 h or
later. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<17>
[Use Link to view the full text]
Accession Number
2015926211
Title
Risk of bleeding with ticagrelor in elderly patients over 75 years old A
systematic review and meta-analysis.
Source
Medicine (United States). 100(44) (no pagination), 2021. Article Number:
27398. Date of Publication: 05 Nov 2021.
Author
Alaamri S.; Al Dalbhi S.
Institution
(Alaamri) Cardiology Department, College of Medicine, Jeddah University,
Saudi Arabia
(Al Dalbhi) Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Bleeding is an untoward outcome in the management of elderly
patients with acute coronary syndrome (ACS). Although the potent oral
P2Y12 inhibitor, ticagrelor is clinically beneficial, its association with
bleeding events in elderly ACS patients (>=75years) is poorly understood.
 Method(s): We conducted a systematic search of 7 databases up to May
20, 2020 to identify studies which examined the risk of bleeding (defined
according to each study) among elderly ACS patients (>=75years) receiving
ticagrelor compared to clopidogrel. Summary risk ratios (RR) were
estimated using the random effects model. Result(s): Eight studies
consisting of 5 observational studies and 3 randomized controlled trials
involving 7032 elderly patients met the eligibility criteria. The mean age
of the patients was 77.8 years, and the mean follow-up duration was
12months. Overall, the pooled RRs showed higher risk of a bleeding event
with ticagrelor compared to clopidogrel (RR 1.20, 95% confidence interval
[95% CI] 1.03-1.40; P=.017). No statistically significant heterogeneity
was observed among the studies (Q=6.93; P=.44; I2=0). Also, pooled RRs did
not show a higher risk of major bleeding (RR 1.32, 95% CI 0.91-1.92;
P=.15) or minor bleeding (RR 1.09, 95% CI 0.76-1.58; P=.64) when comparing
the ticagrelor to the clopidogrel group. Conclusion(s): There is a
20% increased risk of a bleeding event in elderly ACS patients treated
with ticagrelor compared to clopidogrel; for such patients, clopidogrel
may be considered as an alternative agent to ticagrelor due to its lower
risk of bleeding. Copyright © 2021 the Author(s).

<18>
Accession Number
2016536944
Title
Outcomes of cardiac surgical procedures performed by trainees versus
consultants: A systematic review with meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Escorel Neto A.C.; Sa M.P.; Van den Eynde J.; Rotbi H.; Do-Nguyen C.C.;
Olive J.K.; Cavalcanti L.R.P.; Torregrossa G.; Sicouri S.; Ramlawi B.;
Hussein N.
Institution
(Escorel Neto, Cavalcanti) Division of Cardiovascular Surgery of Pronto
Socorro Cardiologico de Pernambuco - PROCAPE, Recife, Brazil
(Escorel Neto, Cavalcanti) University of Pernambuco - UPE, Recife, Brazil
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Main Line Health, Wynnewood, Pa, United States
(Sa, Sicouri, Ramlawi) Department of Cardiac Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, Pa, United States
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Radboud Institute for Health Sciences, Department of Physiology,
Radboud University Medical Center, Nijmegen, Netherlands
(Do-Nguyen) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Mich, United States
(Olive) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC
(Hussein) Department of Congenital Cardiac Surgery, Yorkshire Heart
Centre, Leeds General Infirmary, England, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objectives: Cardiac surgery is highly demanding and the ideal teaching
method to reach competency is widely debated. Some studies have shown that
surgical trainees can safely perform full operations with equivocal
outcomes compared with their consultant colleagues while under
supervision. We aimed to compare outcomes after cardiac surgery with
supervised trainee involvement versus consultant-led procedures.
 Method(s): We systematically reviewed databases (PubMed/MEDLINE,
Embase, the Cochrane Central Register of Controlled Trials,
ClinicalTrials.gov, Google Scholar) and reference lists of relevant
articles for studies that compared outcomes of cardiac surgery performed
by trainees versus consultants. Primary end points included: operative
mortality, coronary events, neurological/renal complications, reoperation,
permanent pacemaker implantation, and sternal complications. Secondary
outcomes included cardiopulmonary bypass and aortic cross-clamp times and
intensive care/in-hospital length of stay. Random effects meta-analysis
was performed. Result(s): Thirty-three observational studies that
reported on a total of 81,616 patients (trainee: 20,154; consultant:
61,462) were included. There was a difference favoring trainees in terms
of operative mortality in the main analysis and in an analysis restricted
to propensity score-matched samples, whereas other outcomes were not
consistently different in both analyses. Overall cardiopulmonary bypass
and aortic cross-clamp times were longer in the trainee group but did not
translate in longer intensive care unit or hospital stay.
 Conclusion(s): In the right conditions, good outcomes are possible in
cardiac surgery with trainee involvement. Carefully designed training
programs ensuring graduated hands-on operative exposure as primary
operator with appropriate supervision is fundamental to maintain
high-quality training in the development of excellent cardiac
surgeons. Copyright © 2021

<19>
Accession Number
2016536933
Title
Heart transplantation in systemic lupus erythematosus: A case report and
meta-analysis.
Source
Heart and Lung. (no pagination), 2022. Date of Publication: 2022.
Author
Chapa J.J.; Ilonze O.J.; Guglin M.E.; Rao R.A.
Institution
(Chapa) Indiana University School of Medicine, Department of Medicine
(Ilonze, Guglin, Rao) Indiana University School of Medicine, Department of
Medicine, Division of Cardiology
Publisher
Elsevier Inc.
Abstract
Cardiac involvement in Systemic Lupus Erythematosus can present as end
stage heart failure necessitating orthotopic heart transplantation. Most
transplant centers regard Lupus as a contraindication to transplant due to
risk of disease recurrence in the transplanted organ. Limited reports of
heart transplant in Lupus exist in the literature. Herein, we aim to
report on the successful transplant and long-term survival of a
24-year-old woman with Lupus and biventricular heart failure. Given the
rarity of transplant in Lupus, we also conducted a meta-analysis of
reported cases in the literature to assess post-transplant outcomes and
evaluate immunosuppression strategies. Our case underlines the feasibility
of transplant in Lupus patients, outlines a detailed immunosuppression
strategy and favorable long-term outcome to guide centers contemplating
such transplants. The long-term survival of our patient, together with
review of the thirteen previously described cases, supports that
orthotopic heart transplantation can be considered in select patients with
Systemic Lupus Erythematosus. Copyright © 2022 Elsevier Inc.

<20>
Accession Number
2016514159
Title
Prognostic Value of Pulmonary Hypertension, Right Ventricular Function and
Tricuspid Regurgitation on Mortality After Transcatheter Mitral Valve
Repair: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Meijerink F.; de Witte S.M.; Limpens J.; de Winter R.J.; Bouma B.J.; Baan
J.
Institution
(Meijerink, de Witte, de Winter, Bouma, Baan) Department of Cardiology,
Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Limpens) Medical Library, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
Publisher
Elsevier Ltd
Abstract
Background: Pulmonary hypertension (PH), right ventricular (RV)
dysfunction, and tricuspid regurgitation (TR) are commonly present in
patients with mitral regurgitation (MR) and known to impair prognosis.
This systematic review and meta-analysis aimed to determine the prognostic
value of PH, RV function, and TR on mortality after transcatheter mitral
valve repair (TMVR). Method(s): A systematic search was performed to
identify studies investigating PH, RV function, or TR in patients who
underwent TMVR. Studies were included for pooled analysis if hazard ratios
(HR) for all-cause mortality were given. Result(s): A total of 8,672
patients from 21 selected studies were included (PH, 11 studies; RV
function, nine studies; TR, 10 studies). Mean follow-up was 2.7+/-1.6
years. The HRs and 95% CIs for all-cause mortality of PH (dichotomised: HR
1.70 95% CI 1.00-2.87; per 10 mmHg increase in systolic PAP: HR 1.17 95%
CI 1.07-1.29), RV function (dichotomised: HR 1.86 95% CI 1.45-2.38; per 5
mm decrease in TAPSE: HR 1.18 95% CI 0.97-1.43) and TR (HR 1.51 95% CI
1.28-1.79) indicated a significant association. Conclusion(s):
Prognosis after TMVR is worse in patients with significant MR when
concomitant PH, RV dysfunction, or TR are present. Careful assessment of
these parameters should therefore precede clinical decision-making for
TMVR. The current results encourage investigation into whether (1)
intervention at an earlier stage of MR reduces incidence of PH, RV
dysfunction, and TR; and (2) transcatheter treatment of concomitant TR can
improve clinical outcome and prognosis for these patients. Copyright
© 2021 The Author(s)

<21>
Accession Number
2013385714
Title
Infective endocarditis by Enterobacter cloacae: a systematic review and
meta-analysis.
Source
Journal of Chemotherapy. 34(1) (pp 1-8), 2022. Date of Publication: 2022.
Author
Ioannou P.; Vamvoukaki R.; Kofteridis D.P.
Institution
(Ioannou, Vamvoukaki, Kofteridis) Department of Internal Medicine &
Infectious Diseases, University Hospital of Heraklion, Crete, Heraklion,
Greece
Publisher
Taylor and Francis Ltd.
Abstract
Enterobacter species are Gram-negative, non-spore-forming, facultative
anaerobes typically motile due to the presence of peritrichous flagella.
E. cloacae, the species responsible for the majority of Enterobacter
infections in humans, is part of the intestinal microbiota and may cause
infection in patients that have previously received antimicrobial therapy
or who have been admitted to the Intensive Care Unit. E. cloacae may cause
several infections, such as pneumonia, urinary tract, skin and soft tissue
and intravascular infections. Infective Endocarditis (IE) is a rare
disease with notable morbidity and mortality. Even though IE is rarely
caused by E. cloacae, these infections can be problematic due to the
relative lack of experience in their management. The purpose of this study
was to systematically review all published cases of IE by E. cloacae in
the literature. A systematic review of PubMed, Scopus and Cochrane library
(through 14th November 2020) for studies providing
epidemiological, clinical, microbiological as well as treatment data and
outcomes of IE by E. cloacae was performed. A total of 20 studies,
containing data of 20 patients, were included. A prosthetic valve was
present in 27.8%. Mitral valve was the commonest infected site, followed
by aortic valve. Diagnosis was facilitated by transthoracic and
transesophageal echocardiography in 38.5% each, while the diagnosis was
set at autopsy in 10%. Fever, sepsis, shock and immunologic phenomena were
the most common clinical presentations, followed by heart failure.
Aminoglycosides, cephalosporins and carbapenems were the most common
antimicrobials used. Clinical cure was noted in 75%, while overall
mortality was 30%. Development of shock and treatment with the combination
of piperacillin with tazobactam were associated with overall
mortality. Copyright © 2021 Edizioni Scientifi che per
l'Informazione su Farmaci e Terapia.

<22>
Accession Number
2007586930
Title
Effects of remote ischemic preconditioning on platelet activation and
reactivity in patients undergoing cardiac surgery using cardiopulmonary
bypass: a randomized controlled trial.
Source
Platelets. 33(1) (pp 123-131), 2022. Date of Publication: 2022.
Author
Cho Y.J.; Nam K.; Yoo S.J.; Lee S.; Bae J.; Park J.-Y.; Kim H.-R.; Kim
T.K.; Jeon Y.
Institution
(Cho, Nam, Yoo, Lee, Bae, Kim, Jeon) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Park) FACS Core Facility, Seoul National University College of Medicine,
Seoul, South Korea
(Kim) Department of Biomedical Sciences, BK21 FOUR Biomedical Science
Project, Seoul National University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae
Medical Center, Seoul National University College of Medicine, Seoul,
South Korea
Publisher
Taylor and Francis Ltd.
Abstract
During cardiopulmonary bypass (CPB), platelet activation and dysfunction
are associated with adverse outcomes. Remote ischemic preconditioning
(RIPC) has been shown to attenuate platelet activation. We evaluated the
effects of RIPC on platelet activation during CPB in patients undergoing
cardiac surgery. Among 58 randomized patients, 26 in the RIPC group and 28
in the sham-RIPC group were analyzed. RIPC consisted of 4 cycles of 5-min
ischemia induced by inflation of pneumatic cuff pressure to 200 mmHg,
followed by 5-min reperfusion comprising deflation of the cuff on the
upper arm. Platelet activation was assessed using flow cytometry analysis
of platelet activation markers. The primary endpoint was the AUC of CD62P
expression during the first 3 h after initiation of CPB. Secondary
outcomes were the AUC of PAC-1 expression and monocyte-platelet aggregates
(MPA) during 3 h of CPB. The AUCs of CD62P expression during 3 h after
initiation of CPB were 219.4 +/- 43.9 and 211.0 +/- 41.2 MFI in the RIPC
and sham-RIPC groups, respectively (mean difference, 8.42; 95% CI, -14.8
and 31.7 MFI; p =.471). The AUCs of PAC-1 expression and MPA did not
differ between groups. RIPC did not alter platelet activation and
reactivity during CPB in patients undergoing cardiac
surgery. Copyright © 2020 Taylor & Francis Group, LLC.

<23>
Accession Number
2014816652
Title
In-hospital outcomes of transesophageal versus intracardiac
echocardiography guided left atrial appendage closure.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Morcos R.; Megaly M.; Saad M.; Barakat A.F.; Rubens M.; Saxena A.;
Elbadawi A.; Kucharik M.; Luna M.; Garcia S.; Veledar E.; Maini B.;
Khalili H.
Institution
(Morcos, Maini, Khalili) Division of Cardiology, Florida Atlantic
University, Boca Raton, FL, United States
(Megaly) Division of Cardiology, Banner University Medical
Center/University of Arizona, Phoenix, AZ, United States
(Saad) Division of Cardiology, Brown University, Providence, RI, United
States
(Barakat) Division of Cardiology, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Rubens, Saxena, Veledar) Baptist Health South Florida, Miami, FL, United
States
(Rubens, Saxena, Veledar) School of Public Health, Florida International
University, Miami, FL, United States
(Elbadawi) Section of Cardiology, Baylor College of Medicine, Houston, TX,
United States
(Kucharik) Charles E. Schmidt College of Medicine, Florida Atlantic
University, Boca Raton, FL, United States
(Luna) School of Medicine, University of Texas Southwestern, Dallas, TX,
United States
(Garcia) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transesophageal echocardiogram (TEE) is the preferred imaging
modality to guide transcatheter left atrial appendage closure (LAAC).
Intracardiac echocardiography (ICE) has evolved as a less invasive
alternative to TEE. Several observational studies have shown similar
success rates and perioperative complications between TEE and ICE for
LAAC. Objective(s): We sought to examine the temporal trends and
patient characteristics of TEE versus ICE use in LAAC using a national
database. We also evaluated hospital outcomes including periprocedural
complications, mortality, and length of hospital stay. Method(s):
This is a retrospective analysis of data from the National Readmission
Database, collected from 2016 to 2018. The primary outcome was major
adverse events (MAE) defined as in-hospital mortality, cardiac arrest,
pericardial effusion with or without tamponade, pericardiocentesis or
window pericardiocentesis and pericardial window, pericardial effusion and
tamponade, and hemorrhage requiring transfusion. Result(s): Trend
analysis showed that TEE-guided LAAC increased from 96.6% in 2016 to 98.4%
in 2018 (relative increase, 1.9%), while ICE-guided LAAC decreased from
3.4% to 1.6% during the same period (relative decrease, 53%, p for trend =
0.08). In the unmatched cohorts, the MAE was significantly lower in
TEE-guided LAAC compared to ICE-guided LAAC (6.5% vs. 9.3%, p = 0.022). In
the propensity score matching analysis, MAE remained significant (5.6% vs.
9.4%, p < 0.001). The incidence of pericardial effusion with or without
tamponade remained significantly lower in the TEE group (2.3% vs. 5.8%, p
< 0.001). Length of stay (3.4 vs. 1.9 days, p < 0.001) and hospitalization
cost ($34,826 vs. $20,563, p < 0.001) remained significantly lower for
TEE-guided LAAC. Conclusion(s): Compared to ICE, the incidence of MAE
was significantly lower for TEE-guided LAAC, driven mainly by less
pericardial effusion events. Large-scale randomized trials are needed to
confirm the findings of the current and previous studies. Copyright
© 2022 Wiley Periodicals LLC

<24>
Accession Number
2014799221
Title
The Efficacy of Corticosteroids, NSAIDs, and Colchicine in the Treatment
of Pediatric Postoperative Pericardial Effusion.
Source
Pediatric Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Somani N.; Breur H.
Institution
(Somani, Breur) Department of Pediatric Cardiology, University Medical
Center Utrecht, Lundlaan 6, Utrecht 3584 EA, Netherlands
Publisher
Springer
Abstract
The objective of this study is to investigate and compare the efficacy of
corticosteroids, NSAIDs, and colchicine in treating postoperative
pericardial effusion (PPE) following cardiac surgery in the pediatric
setting, on the basis of available literature. To investigate and compare
the efficacy of corticosteroids, NSAIDs, and colchicine in treating
postoperative pericardial effusion (PPE) following cardiac surgery in the
pediatric setting, on the basis of available literature. A systematic
review was conducted by carrying out a database search in PubMed on April
20th, 2021. An English language filter was added, but no time restrictions
were applied. Lack of pediatric literature prompted a broadening of the
search to include adult literature. One pediatric and four adult studies
were included, but the pediatric evidence was not found to be of
satisfactory quality, and the findings of adult literature could not be
readily generalized to the pediatric setting. No well-founded conclusions
could be drawn regarding the efficacy of corticosteroids, NSAIDs, or
colchicine in treating PPE, as a striking lack of evidence for their
efficacy in the pediatric setting were revealed. A knowledge gap was found
in the literature, indicating a need for good-quality randomized
controlled trials to bridge this gap. Copyright © 2022, The
Author(s).

<25>
Accession Number
2014782427
Title
Narrative review of the systemic inflammatory reaction to cardiac surgery
and cardiopulmonary bypass.
Source
Artificial Organs. (no pagination), 2022. Date of Publication: 2022.
Author
Squiccimarro E.; Stasi A.; Lorusso R.; Paparella D.
Institution
(Squiccimarro, Paparella) Division of Cardiac Surgery, Department of
Medical and Surgical Sciences, University of Foggia, Foggia, Italy
(Squiccimarro, Lorusso) Cardio-Thoracic Surgery Department, Heart &
Vascular Centre, Maastricht University Medical Centre, Maastricht,
Netherlands
(Stasi) Department of Emergency and Organ Transplantation, University of
Bari, Bari, Italy
(Lorusso) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
(Paparella) Division of Cardiac Surgery, Santa Maria Hospital, GVM Care &
Research, Bari, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Data from large cardiac surgery registries have been depicting
a downward trend of mortality and morbidities in the last 20 years.
However, despite decades of medical evolution, cardiac surgery and
cardiopulmonary bypass still provoke a systemic inflammatory response,
which occasionally leads to worsened outcome. This article seeks to
outline the mechanism of the phenomenon. Method(s): A thorough review
of the literature has been performed. Criteria for considering studies for
this non-systematic review were as follows: observational and
interventional studies investigating the systemic inflammatory response to
cardiac surgery, experimental studies describing relevant molecular
mechanisms, and essential review studies pertinent to the topic.
 Result(s): The intrinsic variability of the inflammatory response to
cardiac surgery, together with its heterogenous perception among
clinicians, as well as the arduousness to early discriminate
high-responder patients from those who will not develop a clinically
relevant reaction, concurred to hitherto unconclusive randomized
controlled trials. Furthermore, peremptory knowledge about the
pathophysiology of maladaptive inflammation following heart surgery is
still lacking. Conclusion(s): Systemic inflammation following cardiac
surgery is a frequent entity that occasionally becomes clinically
relevant. Specific genomic differences, age, and other preoperative
factors influence the magnitude of the response, which elements display
extreme redundancy and pleiotropism that the target of a single pathway
cannot represent a silver bullet. Copyright © 2022 The Authors.
Artificial Organs published by International Center for Artificial Organ
and Transplantation (ICAOT) and Wiley Periodicals LLC

<26>
Accession Number
2016159049
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
Journal of the American College of Cardiology. 79(2) (pp e21-e129), 2022.
Date of Publication: 18 Jan 2022.
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.
Publisher
Elsevier Inc.
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. 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. Copyright © 2022 The American
College of Cardiology Foundation and the American Heart Association, Inc.

<27>
Accession Number
2016680202
Title
Outcomes in Patients With Asymptomatic Aortic Stenosis (from the Evolut
Low Risk Trial).
Source
American Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Merhi W.M.; Heiser J.; Deeb G.M.; Yakubov S.J.; Lim D.S.; Bladergroen M.;
Tadros P.; Zorn G.; Byrne T.; Kirshner M.; Huang J.; Reardon M.J.
Institution
(Merhi, Heiser) Departments of Cardiothoracic Surgery and Interventional
Cardiology, Spectrum Health Hospitals, Grand Rapids, MI, United States
(Deeb) Departments of Cardiac Surgery and Interventional Cardiology,
University of Michigan Hospitals, Ann Arbor, MI, United States
(Yakubov) Department of Cardiology, Ohio Health Riverside Methodist
Hospital, Columbus, OH, United States
(Lim) Department of Cardiology, University of Virginia Health,
Charlottesville, VA, United States
(Bladergroen) Department of Thoracic Surgery, Bon Secours Saint Mary's
Hospital, Richmond, Virginia
(Tadros, Zorn) Departments of Thoracic Surgery and Interventional
Cardiology, The University of Kansas Hospital, Kansas City, Kansas
(Byrne, Kirshner) Department of Cardiology, Abrazo Arizona Heart Hospital,
Phoenix, Arizona
(Huang) Statistical Services, Medtronic, Minneapolis, MN, United States
(Reardon) Department of Cardiothoracic Surgery and Interventional
Cardiology, Methodist DeBakey Heart and Vascular Center, Houston
Methodist, Houston, Texas
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) has comparable outcomes
with surgical aortic valve replacement (SAVR) in symptomatic patients with
severe aortic stenosis, including those at low risk for surgery. Less is
known about TAVI outcomes in asymptomatic patients. This analysis compares
clinical, hemodynamic, and quality of life (QOL) outcomes after TAVI or
SAVR for low-risk asymptomatic patients. The randomized Evolut Low Risk
trial enrolled asymptomatic patients treated with TAVI (n = 76) and SAVR
(n = 62). New York Heart Association functional class I identified
patients without symptoms. Clinical outcomes, echocardiographic findings,
and QOL in both groups were compared 30 days and 12 months after AVR.
Asymptomatic patients had a mean Society of Thoracic Surgeons score of 1.7
+/- 0.6, 73% were men, and mean age was 74.2 +/- 5.8 years. The composite
end point of all-cause mortality or disabling stroke was similar at 12
months in patients with TAVI (1.3%) and SAVR (6.5%; p = 0.11), although
patients with SAVR tended to have higher rates of all-cause mortality
(4.8%) compared with patients with TAVI (0.0%, p = 0.05). Patients with
TAVI had lower mean aortic valve gradients (8.1 +/- 3.2 mm Hg) and larger
mean effective orifice area (2.3 +/- 0.6 mm Hg) than patients with SAVR
(10.8 +/- 3.8; p <0.001 and 1.9 +/- 0.6; p = 0.001, respectively), and
showed significant improvement in Kansas City Cardiomyopathy Questionnaire
scores from baseline to 30 days (12.1 +/- 23.6; p <0.001), whereas
patients with SAVR did not (2.2 +/- 20.3; p = 0.398). Patients with TAVI
and SAVR had a significant improvement in QOL by 12 months compared with
baseline. In conclusion, low risk asymptomatic patients with severe aortic
stenosis who underwent TAVI had comparable clinical outcomes to SAVR, with
superior valve performance and faster QOL improvement. Copyright
© 2022 Elsevier Inc.

<28>
Accession Number
2016587284
Title
Respect versus resect approaches for mitral valve repair: A study-level
meta-analysis.
Source
Trends in Cardiovascular Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Sa M.P.; Cavalcanti L.R.P.; Van den Eynde J.; Amabile A.; Escorel Neto
A.C.; Perazzo A.M.; Weymann A.; Ruhparwar A.; Sicouri S.; Bisleri G.;
Torregrossa G.; Geirsson A.; Ramlawi B.
Institution
(Sa, Torregrossa) Department of Cardiac Surgery, Lankenau Heart Institute
/ Main Line Health, Philadelphia, PA, United States
(Sa, Sicouri, Torregrossa) Division of Cardiac Surgery Research, Lankenau
Institute for Medical Research / Main Line Health, Philadelphia, PA,
United States
(Cavalcanti, Escorel Neto, Perazzo, Ramlawi) Division of Cardiovascular
Surgery of Pronto Socorro Cardiologico de Pernambuco - PROCAPE, Recife,
Brazil
(Cavalcanti, Escorel Neto, Perazzo, Ramlawi) University of Pernambuco -
UPE., Recife, Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Amabile, Geirsson) Division of Cardiac Surgery, Department of Surgery,
Yale School of Medicine, New Haven, CT, United States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
(Bisleri) Division of Cardiac Surgery, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Mitral valve repair (MVr) restores leaflets coaptation while preserving
the patient's own valve. The two main techniques are: (a) chordal
replacement ("respect approach"), whereby artificial neochordae are used
to resuspend prolapsed segments of the affected leaflet - and (b) leaflet
resection ("resect approach"), whereby diseased leaflet segment is
resected, and the remaining segments are sutured together. Both techniques
of MVr are associated with better long-term results, fewer valve-related
complications and lower mortality when compared with mitral valve
replacement (MVR). They also restore quality of life and improve survival
to rates equivalent to those of the general population. We performed a
meta-analysis to pool data of clinical studies that compared outcomes of
MVr stratified by the surgical technique. Seventeen studies accounting for
6,046 patients fulfilled our eligibility criteria. The "respect approach"
outperformed the "resect approach" with lower permanent pacemaker
implantation rates and lower mean gradients. Despite any possible
advantages of one technique over the other, which approach is best for
each patient must be decided on a case-by-case basis and more long-term
follow-up data are warranted. Copyright © 2022

<29>
[Use Link to view the full text]
Accession Number
637100925
Title
Evaluating the impact of personalized rehabilitation nursing intervention
on postoperative recovery of respiratory function among thoracic surgery
intensive care unit patients: A protocol for systematic review and
meta-analysis.
Source
Medicine. 101(3) (pp e28494), 2022. Date of Publication: 21 Jan 2022.
Author
Li C.-Y.; Liang W.; He Y.-Q.; Han Q.
Institution
(Li) First People's Hospital of Jiangxia District, Hubei Province, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Exercise tolerance and lung function can be improved by
pulmonary rehabilitation. As a result, it may lower thoracic surgery
intensive care unit (ICU) patients' postoperative problems and death.
Enhanced recovery after surgery has advanced significantly in the
perioperative care of thoracic surgery ICU patients in recent years, and
it now plays an essential role in improving ICU patients' postoperative
prognosis. Appropriate tailored rehabilitation nursing intervention is
required to promote the postoperative recovery of respiratory function in
thoracic surgery ICU patients. This study aims to look at the influence of
tailored rehabilitation nurse intervention on postoperative respiratory
function recovery in thoracic surgery ICU patients. METHOD(S): To
find relevant papers, a comprehensive search of electronic databases will
be conducted, including three English databases (PubMed, EMBASE, and the
Cochrane Library) and two Chinese databases (Chinese National Knowledge
Infrastructure and WanFang). Only research that has been published in
either English or Chinese will be considered. The retrieval period will
run from November 2021 to November 2021. We will look at randomized
controlled trials (RCTs) studies that looked at the effect of a customized
rehabilitation nursing intervention on the recovery of respiratory
function in thoracic surgery ICU patients after surgery. Two writers will
review the literature, retrieve study data, and assess the included
studies' quality. Any disagreements will be settled via consensus. RevMan
5.3 will be used to do the meta-analysis. RESULT(S): This research
will offer high-quality data on the influence of customized rehabilitation
nurse intervention on postoperative respiratory function recovery in
thoracic surgery ICU patients. CONCLUSION(S): This study will look at
whether a targeted rehabilitation nurse intervention might help thoracic
surgery ICU patients recover their respiratory function more quickly after
surgery. ETHICS AND DISSEMINATION: There will be no need for ethical
approval. REGISTRATION NUMBER: December 12, 2021.osf.io/9rdu2/
(https://osf.io/9rdu2/). Copyright © 2022 the Author(s).
Published by Wolters Kluwer Health, Inc.

<30>
Accession Number
636958433
Title
Effect of a postoperative home-based exercise and self-management
programme on physical function in people with lung cancer (CAPACITY):
Protocol for a randomised controlled trial.
Source
BMJ Open Respiratory Research. 9(1) (no pagination), 2022. Article Number:
e001189. Date of Publication: 17 Jan 2022.
Author
Granger C.L.; Edbrooke L.; Antippa P.; Wright G.; McDonald C.F.; Lamb
K.E.; Irving L.; Krishnasamy M.; Abo S.; Whish-Wilson G.A.; Truong D.;
Denehy L.; Parry S.M.
Institution
(Granger, Abo, Whish-Wilson, Truong, Parry) Department of Physiotherapy,
The Royal Melbourne Hospital, Melbourne, VIC, Australia
(Granger, Edbrooke, Abo, Whish-Wilson, Truong, Denehy, Parry) Department
of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
(Granger, McDonald) Institute for Breathing and Sleep, Heidelberg, VIC,
Australia
(Edbrooke, Denehy) Department of Allied Health, Peter MacCallum Cancer
Centre, Melbourne, VIC, Australia
(Antippa, Wright) Department of Cardiothoracic Surgery, The Royal
Melbourne Hospital, Melbourne, VIC, Australia
(Wright) Department of Cardiothoracic Surgery, St Vincent's Hospital
Melbourne, Fitzroy, VIC, Australia
(Wright) Research and Education Lead Program, Victorian Comprehensive
Cancer Centre, Melbourne, VIC, Australia
(McDonald) Department of Respiratory and Sleep Medicine, Austin Hospital,
Heidelberg, VIC, Australia
(Lamb) Centre for Epidemiology and Biostatistics, Melbourne School of
Population and Global Health, The University of Melbourne, Melbourne, VIC,
Australia
(Lamb) Methods and Implementation Support for Clinical Health Research
Platform MISCH, Faculty of Medicine, Dentistry and Health Sciences, The
University of Melbourne, Melbourne, VIC, Australia
(Irving) Department of Respiratory and Sleep Medicine, The Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Krishnasamy) Department of Nursing, The University of Melbourne,
Melbourne, VIC, Australia
(Krishnasamy) Academic Nursing Unit, Peter MacCallum Cancer Centre,
Melbourne, VIC, Australia
Publisher
BMJ Publishing Group
Abstract
Introduction Exercise is important in the postoperative management of lung
cancer, yet no strong evidence exists for delivery of home-based
programmes. Our feasibility (phase I) study established feasibility of a
home-based exercise and self-management programme (the programme)
delivered postoperatively. This efficacy (phase II) study aims to
determine whether the programme, compared with usual care, is effective in
improving physical function (primary outcome) in patients after lung
cancer surgery. Methods and analysis This will be a prospective,
multisite, two-arm parallel 1:1, randomised controlled superiority trial
with assessors blinded to group allocation. 112 participants scheduled for
surgery for lung cancer will be recruited and randomised to usual care (no
exercise programme) or, usual care plus the 12-week programme. The primary
outcome is physical function measured with the EORTC QLQ c30
questionnaire. Secondary outcomes include health-related quality of life
(HRQoL); exercise capacity; muscle strength; physical activity levels and
patient reported outcomes. HRQoL and patient-reported outcomes will be
measured to 12 months, and survival to 5 years. In a substudy, patient
experience interviews will be conducted in a subgroup of intervention
participants. Ethics and dissemination Ethics approval was gained from all
sites. Results will be submitted for publications in peer-reviewed
journals. Trial registration number ACTRN12617001283369. Copyright
©

<31>
Accession Number
637084158
Title
Cost Effectiveness of Coronary-Artery Bypass Surgery versus Medicine in
Ischemic Cardiomyopathy: The STICH Randomized Clinical Trial.
Source
Circulation. (no pagination), 2022. Date of Publication: 19 Jan 2022.
Author
Chew D.S.; Cowper P.A.; Al-Khalidi H.; Anstrom K.J.; Daniels M.R.;
Davidson-Ray L.; Li Y.; Michler R.E.; Panza J.A.; Pina I.L.; Rouleau J.L.;
Velazquez E.J.; Mark D.B.
Institution
(Chew) Duke Clinical Research Institute, Duke University, Durham, NC;
O'Brien Institute for Public Health, University of Calgary, Calgary,
Alberta, Canada
(Cowper, Daniels, Davidson-Ray, Li) Duke Clinical Research Institute, Duke
University, Durham
(Al-Khalidi, Anstrom) Duke Clinical Research Institute, Duke University,
Durham, NC; Department of Biostatistics and Bioinformatics, Duke
University, Durham, NC
(Michler) Department of Cardiothoracic and Vascular Surgery, Montefiore
Medical Center, Bronx, NY
(Panza) Department of Cardiology, Westchester Medical Center, Westchester
Medical Center Health Network, Valhalla, NY
(Pina) Department of Medicine, Wayne State University, MI, Detroit, United
States
(Rouleau) Institut de Cardiologie de Montreal, QC, Universite de Montreal,
Canada
(Velazquez) Section of Cardiovascular Medicine, Yale School of Medicine,
CT, New Haven, United States
(Mark) Duke Clinical Research Institute, Duke University, Durham, NC;
Division of Cardiology, Department of Medicine, Duke University Medical
Center, Durham, NC
Publisher
NLM (Medline)
Abstract
Background: The Surgical Treatment for Ischemic Heart Failure Trial
(STICH) demonstrated that coronary artery bypass grafting (CABG) reduced
all-cause mortality rates out to 10 years compared with medical therapy
alone (MED) in patients with ischemic cardiomyopathy and reduced left
ventricular function (ejection fraction <=35%). We examined the economic
implications of these results Methods: We used a decision-analytic
patient-level simulation model to estimate the lifetime costs and benefits
of CABG and MED using patient-level resource use and clinical data
collected in the STICH trial. Patient-level costs were calculated by
applying externally derived US cost weights to resource use counts during
trial follow-up. A 3% discount rate was applied to both future costs and
benefits. The primary outcome was the incremental cost-effectiveness ratio
(ICER) assessed from the US healthcare sector perspective. Result(s):
For the CABG arm, we estimated 6.53 quality-adjusted life years (QALYs)
(95% confidence internal (CI) 5.70 to 7.53) and a lifetime cost of
$140,059 (95% CI $106,401 to $180,992). For the MED arm, the corresponding
estimates were 5.52 (95% CI 5.06 to 6.09) QALYs and $74,894 lifetime cost
(95% CI $58,372 to $93,541). The ICER for CABG compared to MED was $63,989
per QALY gained. At a societal willingness-to-pay threshold of $100,000
per QALY gained, CABG was found to be economically favorable compared to
medical therapy in 87% of microsimulations. Conclusion(s): In STICH
patients with ischemic cardiomyopathy and reduced left ventricular
function, CABG was economically attractive relative to medical therapy at
current benchmarks for value in the United States.

<32>
Accession Number
637083178
Title
Prognostic Significance of Elevated Troponin in Adult Heart Transplant
Recipients: A Systematic Review and Meta-Analysis.
Source
Experimental and clinical transplantation : official journal of the Middle
East Society for Organ Transplantation. (no pagination), 2022. Date of
Publication: 14 Jan 2022.
Author
Liu Z.; Perry L.A.; Penny-Dimri J.C.; Handscombe M.; Overmars I.; Plummer
M.; Segal R.; Smith J.A.
Institution
(Liu) From the Department of Anaesthesia, Royal Melbourne Hospital,
Parkville, Australia
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Cardiac troponin is a highly specific biomarker of myocardial
injury that is of prognostic significance in a range of cardiovascular
diseases. However, the prognostic value of elevated troponin in cardiac
transplant recipients is uncertain. We aimed to evaluate the prognostic
value of elevated cardiac troponin in predicting adverse recipient
outcomes following heart transplant. MATERIALS AND METHODS: We searched
MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library from inception
until December 2020 and included studies reporting associations between
elevated recipient troponin and outcomes after cardiac transplant. We
generated summary odds ratios for associations with short- and long-term
adverse events and used descriptive analyses where meta-analyses were
inappropriate. RESULT(S): We included 15 studies involving 1830
patients undergoing cardiac transplant. The risk of primary graft failure
was greater in recipients with elevated troponin than in those without
(odds ratio = 3.09; 95% CI, 1.08-8.87). Considerable interstudy
heterogeneity (I2 statistic 98%) was partially explained by variations in
study design, troponin subtype, and overall risk of bias. Descriptive
analyses suggested associations between elevated recipient troponin and
long-term adverse cardiac events, coronary artery disease, and mortality.
 CONCLUSION(S): Elevated cardiac troponin in cardiac transplant
recipients may be prognostic for primary graft failure, adverse cardiac
events, coronary artery disease, and mortality. Further high-quality,
prospective, and multicenter research is needed to demonstrate the
clinical applicability of these findings.

<33>
Accession Number
637081941
Title
Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney
Injury during Percutaneous Cardiovascular Procedures.
Source
Cardiorenal medicine. (pp 1-9), 2022. Date of Publication: 14 Jan 2022.
Author
Peabody J.; Paculdo D.; Valdenor C.; McCullough P.A.; Noiri E.; Sugaya T.;
Dahlen J.R.
Institution
(Peabody, Paculdo, Valdenor) QURE Healthcare, San Francisco, CA, United
States
(Peabody) University of California, School of Medicine, San Francisco, CA,
United States
(Peabody) University of California, Fielding School of Public Health, Los
Angeles, CA, United States
(McCullough) Texas Christian University and the University of North Texas
Health Sciences Center School of Medicine, Dallas, TX, United States
(Noiri) Department of Nephrology and Endocrinology, University of Tokyo
Hospital, Tokyo, Japan
(Noiri) National Center Biobank Network, National Center for Global Health
and Medicine, Tokyo, Japan
(Sugaya) TokyoJapan
(Sugaya) St. Marianna University School of Medicine, Kawasaki, Japan
(Dahlen) San DiegoCAUnited States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Contrast-induced acute kidney injury (CI-AKI) is a major
clinical complication of percutaneous cardiovascular procedures requiring
iodinated contrast. Despite its relative frequency, practicing physicians
are unlikely to identify or treat this condition. METHOD(S): In a
2-round clinical trial of simulated patients, we examined the clinical
utility of a urine-based assay that measures liver-type fatty acid-binding
protein (L-FABP), a novel marker of CI-AKI. We sought to determine if
interventional cardiologists' ability to diagnose and treat potential
CI-AKI improved using the biomarker assay for 3 different patient types:
pre-procedure, peri-procedure, and post-procedure patients.
 RESULT(S): 154 participating cardiologists were randomly divided into
either control or intervention. At baseline, we found no difference in the
demographics or how they identified and treated potential complications of
AKI, with both groups providing less than half the necessary care to their
patients (46.4% for control vs. 47.6% for intervention, p = 0.250). The
introduction of L-FABP into patient care resulted in a statistically
significant improvement of 4.6% (p = 0.001). Compared to controls,
physicians receiving L-FABP results were 2.9 times more likely to
correctly identify their patients' risk for AKI (95% CI 2.1-4.0) and were
more than twice as likely to treat for AKI by providing volume expansion
and withholding nephrotoxic medications. We found the greatest clinical
utility in the pre-procedure and peri-procedure settings but limited value
in the post-procedure setting. CONCLUSION(S): This study suggests
L-FABP as a clinical marker for assessing the risk of potential CI-AKI,
has clinical utility, and can lead to more accurate diagnosis and
treatment. Copyright © 2022 The Author(s). Published by S. Karger
AG, Basel.

<34>
Accession Number
2016495644
Title
Randomized evidence on graft patency after off-pump versus on-pump
coronary artery bypass grafting: An updated meta-analysis.
Source
International Journal of Surgery. 98 (no pagination), 2022. Article
Number: 106212. Date of Publication: February 2022.
Author
Zhou Z.; Fu G.; Feng K.; Huang S.; Chen G.; Liang M.; Wu Z.
Institution
(Zhou, Fu, Feng, Huang, Chen, Liang, Wu) Department of Cardiac Surgery,
First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
(Zhou, Fu, Feng, Huang, Chen, Liang, Wu) NHC Key Laboratory of Assisted
Circulation, Sun Yat-sen University, Guangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: The debate between off-pump CABG (OPCAB) and on-pump CABG
(ONCAB) has been ongoing for decades. We aimed to provide a comprehensive
update of the current randomized controlled trials (RCTs) in evaluating
the graft patency of OPCAB versus ONCAB. Material(s) and Method(s): A
literature search was conducted in PubMed, EMBASE, and the Cochrane
Library databases until April 30, 2021. All RCTs from 2003 to 2020
comparing the results of graft patency between OPCAB and ONCAB were
included. We compared the overall graft occlusion between the two groups,
and subgroup analyses were conducted based on different types of conduits
and target territories, crossover from off-pump to on-pump rate, and the
length of follow-up. Result(s): Sixteen RCTs were identified, with
5743 grafts in the OPCAB group and 5898 in the ONCAB group. OPCAB was
associated with a higher risk of occlusion in the overall graft (RR: 1.31;
95% CI, 1.17-1.46), saphenous vein graft (SVG) (RR: 1.40; 95% CI,
1.23-1.59), grafts to left anterior descending (LAD) territory (RR: 1.52;
95% CI, 1.11-2.08) and left circumflex artery (LCX) territory (RR: 1.45;
95% CI, 1.19-1.76), while no significant difference was observed between
the two groups in respect of arterial conduits and grafts to right
coronary artery (RCA) territory. Furthermore, the lower crossover rate and
longer length of follow-up appeared to reduce the association between
OPCAB and lower graft patency. Conclusion(s): The current
meta-analysis indicates that, compared with ONCAB, graft patency is poorer
with OPCAB for overall grafts, SVG grafts, grafts to LAD and LCX
territories, whereas the results remain comparable for arterial conduits
and grafts to RCA territory. Copyright © 2022 IJS Publishing
Group Ltd

<35>
[Use Link to view the full text]
Accession Number
2015903863
Title
Pancreaticoduodenectomy preserving aberrant gastroduodenal artery utilized
in a previous coronary artery bypass grafting: A case report and review of
literature.
Source
Medicine (United States). 100(48) (no pagination), 2021. Article Number:
e27788. Date of Publication: 03 Dec 2021.
Author
Toda T.; Kanemoto H.; Tokuda S.; Takagi A.; Oba N.
Institution
(Toda) Department of Gastroenterological Surgery, Shizuoka General
Hospital, 4-27-1 Kita-Ando, Aoi-Ku, Shizuoka-Shi, Shizuoka, Japan
(Kanemoto, Tokuda, Takagi, Oba) Department of Gastroenterological Surgery,
Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi-Ku, Shizuoka-Shi,
Shizuoka, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Rationale: Pancreaticoduodenectomy (PD) is a technically demanding
procedure with high rates of morbidity and mortality. Therefore,
preoperative evaluation of anatomy is indispensable. Multi-detector row
computed tomography (CT) enables us to precisely understand arterial
anatomy. It is a well-known fact that anatomical variants are often
present in the hepatic artery (HA) but rarely in the gastroduodenal artery
(GDA). We present the case of a patient with ampullary cancer with a rare
anatomical anomaly, "replaced GDA (rGDA)" arising from the superior
mesenteric artery, along with a history of coronary artery bypass grafting
(CABG) using right gastroepiploic artery (RGEA). Patient concerns: A
69-year-old male patient was referred to our department for further
investigation of elevated hepatobiliary enzymes. He presented with no
symptoms besides intermittent fever of 38degreeC. He had an operative
history of CABG using the RGEA. Diagnosis: Abdominal CT and
esophagogastroduodenoscopy showed an ampullary tumor and biopsy specimen
from the lesion revealed adenocarcinoma. CT angiography revealed the rGDA
instead of a normal common HA. Intervention(s): We performed a safe
PD, preserving the rGDA and the RGEA to maintain hepatic and cardiac
perfusion. Outcome(s): Owing to the presence of a refractory
pancreatic fistula, the length-of-hospital stay was extended, and he was
discharged on postoperative day 72 without vascular complications. At
present, the patient is in good physical condition and does not present
with cardiovascular complications as well as tumor recurrence at 6 months
after surgery. Lessons: This is possibly the first case of a patient who
underwent PD and has a proper HA following a GDA arising from a superior
mesenteric artery (rGDA) and has a previous operative history of CABG
using the gastroepiploic artery. The coexistence of the history of
cardiovascular surgery made PD for this patient considerably more
challenging. In the case of a rare anatomical anomaly, a coronary artery
bypass via the RGEA should not be considered as an obstacle when R0
resection is achievable. Copyright © 2021 the Author(s).

<36>
Accession Number
2015903801
Title
Dexmedetomidine effect on delirium in elderly patients undergoing general
anesthesia: A protocol for systematic review and meta-analysis.
Source
Medicine (United States). 100(48) (no pagination), 2021. Article Number:
027782. Date of Publication: 03 Dec 2021.
Author
Wang Y.; Bu X.; Zhao N.; Wang S.; Wang X.; Ge Y.; Yi H.
Institution
(Wang) Department of Anesthesiology, Nanjing First Hospital, Nanjing
Medical University, Nanjing, China
(Bu, Wang, Ge) Department of Anesthesiology, Nanjing First Hospital,
Nanjing, China
(Zhao, Wang) School of Public Health, Gansu University of Traditional
Chinese Medicine, Lanzhou, China
(Zhao) Center for Evidence-based Medicine, Gansu University of Traditional
Chinese Medicine, Lanzhou, China
(Yi) Department of Biostatistics, School of Public Health, Nanjing Medical
University, Nanjing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Delirium is a common postoperative complication. Many studies
have found that dexmedetomidine is associated with a reduced incidence of
postoperative delirium (POD). This meta-analysis aimed to analyze the
effects of dexmedetomidine on POD incidence among elderly patients
undergoing general anesthesia. Method(s):We searched 4 electronic
databases (i.e., Pubmed, Embase, Cochrane, and Web of Science) from
inception to November 30, 2020, for randomized controlled trials that
evaluated the effects of dexmedetomidine in preventing the occurrence of
POD in elderly patients (aged >=60 years). The study protocol was
registered in PROSPERO (CRD42020192114). Result(s):14 studies with
4173 patients showed that dexmedetomidine was significantly associated
with a decreased POD incidence among elderly patients (relative risk [RR]
= 0.58; 95% confidence interval [CI] = 0.44-0.76). The incidence of POD
was significantly reduced in the noncardiac surgery group (RR 0.51; 95% CI
0.37-0.72), when dexmedetomidine was applied during the postoperative
period (RR = 0.53; 95% CI = 0.40-0.70), and in patients received low-doses
(RR = 0.54; 95% CI = 0.34-0.87) and normal-doses (RR = 0.59; 95% CI =
0.42-0.83). There were no significant differences in POD incidence in the
cardiac surgery group (RR = 0.71; 95% CI = 0.45-1.11), and when
dexmedetomidine was applied during the intra- (RR = 0.55; 95% CI =
0.29-1.01) or perioperative period (RR = 0.95; 95% CI = 0.64-1.40).
 Conclusion(s):Our meta-analysis suggests that dexmedetomidine may
significantly reduce POD incidence in elderly noncardiac surgery patients
and when applied during the postoperative period, in addition, both low-
and normal-doses of dexmedetomidine may reduce POD incidence. However, its
use in cardiac surgery patients and during the intra- or perioperative
period may have no significant effects on POD incidence. Copyright
© 2021 Lippincott Williams and Wilkins. All rights reserved.

<37>
Accession Number
2005714493
Title
Transcatheter mitral valve repair for functional mitral regurgitation:
Evaluating the evidence.
Source
Journal of Thoracic and Cardiovascular Surgery. 162(5) (pp 1504-1511),
2021. Date of Publication: November 2021.
Author
Gelijns A.C.; Moskowitz A.J.; O'Gara P.T.; Giustino G.; Mack M.J.; Mancini
D.M.; Bagiella E.; Hung J.; Ailawadi G.; Leon M.B.; Acker M.A.; Alexander
J.H.; Dickert N.W.; Taddei-Peters W.C.; Miller M.A.
Institution
(Gelijns, Moskowitz, Giustino, Mancini, Bagiella) Population Health
Science and Policy, Icahn School of Medicine at Mount Sinai, NY, United
States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
(Mack) Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott &
White Health, Plano, Tex, United States
(Hung) Division of Cardiology, Massachusetts General Hospital, Boston, MA,
United States
(Ailawadi) Section of Adult Cardiac Surgery, University of Virginia,
Charlottesville, Va, United States
(Leon) Center for Interventional Vascular Therapy, Columbia University
Medical Center/New York-Presbyterian Hospital and Cardiovascular Research
Foundation, New York, NY, United States
(Acker) Cardiovascular Surgery, Surgery, University of Pennsylvania School
of Medicine, Philadelphia, Pa, United States
(Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke
University School of Medicine, Durham, NC, United States
(Dickert) Division of Cardiology, Emory University School of Medicine,
Atlanta, Ga, United States
(Taddei-Peters, Miller) Division of Cardiovascular Sciences, National
Heart, Lung, and Blood Institute, Bethesda, Md, United States
Publisher
Elsevier Inc.
Abstract
Objectives: Two trials (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients with Functional
Mitral Regurgitation Trial and Percutaneous Repair with the MitraClip
Device for Severe Functional/Secondary Mitral Regurgitation Trial) were
published in 2018 evaluating the effectiveness and safety of transcatheter
repair for patients with heart failure with significant functional mitral
regurgitation, which yielded different results. This article reviews the
strength of the evidence, differences in trial designs, ethical and
implementation implications, and delineates future research needs to help
guide the appropriate dissemination of transcatheter repair for functional
patients with mitral regurgitation. Method(s): The National Heart,
Lung, and Blood Institute convened a workshop of interdisciplinary experts
to address these objectives. Result(s): Transcatheter repair of
functional mitral regurgitation can provide significant benefits in terms
of heart failure hospitalizations, survival, and quality of life when
appropriate heart failure candidates with moderate to severe or severe
mitral regurgitation while on optimal guideline-directed medical therapy
can be identified. Key ingredients for success are preoperative evaluation
and management and postoperative care by an interdisciplinary heart team.
 Conclusion(s): Given the discordance observed between trials, ongoing
innovation in patient management, and potential expansion of indications
for use, the evidence base must be expanded to optimize appropriate
implementation of this complex therapy. This will require more complete
capture of outcome data in real-world settings for all eligible candidates
whether or not they receive this therapy. Inevitably, the indications for
use of this therapy will expand, as will the devices and therapeutic
approaches for this population, necessitating the study of comparative
effectiveness through randomized trials or observational studies.
Moreover, given the substantial variations in care delivery, conducting
implementation research to delineate characteristics of the optimal care
model would be of benefit. Copyright © 2020

<38>
[Use Link to view the full text]
Accession Number
2016330349
Title
Efficiency and safety of ablation procedure for the treatment of atrial
fibrillation in valve surgery A PRISMA-compliant cumulative systematic
review and meta-analysis.
Source
Medicine (United States). 100(50) (pp E28180), 2021. Date of Publication:
17 Dec 2021.
Author
Zhang T.; Wu X.; Zhang Y.; Zeng L.; Liu B.
Institution
(Zhang, Zhang, Zeng) Department of Anesthesiology, the First Affiliated
Hospital of Chengdu Medical College, Sichuan, China
(Wu, Liu) National Clinical Research Center for Geriatrics, Department of
Anesthesiology, West China Hospital, Sichuan University, Sichuan Province,
Chengdu, China
(Liu) National Clinical Research Center for Geriatrics, Department of
Anesthesiology, West China Hospital, Sichuan University, Sichuan Province,
Chengdu 610500, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Atrial fibrillation is the main complication of patients who
suffer from valvular heart disease (VHD), which may lead to an increased
susceptibility to ventricular tachycardia, atrial dysfunction, heart
failure, and stroke. Therefore, seeking a safe and effective therapy is
crucial in prolonging the lives of patients with VHD and improving their
quality of life. Method(s): Our target database included PubMed, Web
of Science, Embase, and Cochrane Library, from which published articles
were retrieved from inception to June 2020. We retrieved all randomized
controlled trials (RCTs) that compared patients undergoing valve surgery
with (VSA) or without ablation (VS) procedure. Studies to be included were
screened and data extraction was performed independently by 2
investigators. The Cochrane risk-of-bias table was used to evaluate the
methodological quality of the included RCTs. The mean difference (MD) with
95% confidence interval (CI) and relative risk (RR) ratio was calculated
to analyze the data. Heterogeneity was evaluated using I2 and
chi-square tests. Egger test and the trim and fill analysis were used to
further determine publication bias. Result(s): Fourteen RCTs that
included 1376 patients were eventually selected for this meta-analysis.
Surgical ablation was found to be effective in restoring sinus rhythm in
valvular surgery patients at discharge (RR 2.91, 95% CI [1.17, 7.20],
I2 97%, P = .02), 3 to 6 months (RR 2.85, 95% CI [2.27, 3.58],
I2 49%, P < .00001), 12 months, and more than 1 year after
surgery (RR 3.54, 95% CI [2.78, 4.51], I2 27%, P < .00001).
All-cause mortality (RR 0.98, 95% CI [0.64, 1.51], I2 0%, P =
.94) and stroke (RR 1.29, 95% CI [0.70, 2.39], I2 0%, P = .57)
were similar in the VSA and VS groups. Compared with VS, VSA prolonged
cardiopulmonary bypass time (MD 30.44, 95% CI [17.55, 43.33],
I2 88%, P < .00001) and aortic cross-clamping time (MD 19.57,
95% CI [11.10, 28.03], I2 89%, P < .00001). No significant
differences were found between groups with respect to the risk of bleeding
(RR 0.64, 95% CI [0.37, 1.12], I2 0%, P = .12), heart failure
(RR 1.11, 95% CI [0.63, 1.93], I2 0%, P = .72), and low cardiac
output syndrome (RR 1.41, 95% CI [0.57, 3.46], I2 18%, P =
.46). However, the demand for implantation of a permanent pacemaker was
significantly higher in the VSA group (RR 1.84, 95% CI [1.15, 2.95],
I2 0%, P = .01). Conclusion(s): Although we found high
heterogeneity in the restoration of sinus rhythm at discharge, we assume
that the comparison is valid at this time, given the current state in the
operating room. This study provides evidence of the efficacy and security
of concomitant ablation intervention for patients with VHD and atrial
fibrillation. Surgical ablation would increase the safety of implantation
of a permanent pacemaker in the population that underwent valve
surgery. Copyright © 2021 the Author(s).

<39>
Accession Number
2014169439
Title
Outcome measures in solid organ donor management research: a systematic
review.
Source
British Journal of Anaesthesia. 127(5) (pp 745-759), 2021. Date of
Publication: November 2021.
Author
Bera K.D.; Shah A.; English M.R.; Ploeg R.
Institution
(Bera, Ploeg) Oxford Transplant Centre, Nuffield Department of Surgical
Sciences, Churchill Hospital, Oxford, UK, United Kingdom
(Bera) Vascular Surgery Department, Oxford University Hospitals NHS
Foundation Trust, Oxford, UK, United Kingdom
(Shah) Radcliffe Department of Medicine, University of Oxford, Oxford, UK,
United Kingdom
(Shah) Adult Intensive Care Unit, Oxford University Hospitals NHS
Foundation Trust, Oxford, UK, United Kingdom
(English) Oxford Medical School, University of Oxford, Oxford, UK, United
Kingdom
Publisher
Elsevier Ltd
Abstract
Aim: We systematically reviewed published outcome measures across
randomised controlled trials (RCTs) of donor management interventions.
 Method(s): The systematic review was conducted in accordance with
recommendations by the Cochrane Handbook and Preferred Reporting Items for
Systematic Reviews and Meta-Analyses statement. We searched MEDLINE,
Embase, CENTRAL, Web of Science, and trial databases from 1980 to February
2021 for RCTs of donor management interventions. Result(s):
Twenty-two RCTs (n=3432 donors) were included in our analysis. Fourteen
RCTs (63.6%) reported a primary outcome relating to a single organ only.
Eight RCTs primarily focused on aspects of donor optimisation in critical
care. Thyroid hormones and methylprednisolone were the most commonly
evaluated interventions (five and four studies, respectively). Only two
studies, focusing on single organs (e.g. kidney), evaluated outcomes
relating to other organs. The majority of studies evaluated physiological
or biomarker-related outcomes. No study evaluated recipient health-related
quality of life. Only one study sought consent from potential organ
recipients. Conclusion(s): The majority of RCTs evaluating donor
management interventions only assessed single-organ outcomes or effects on
donor stability in critical care. There is a need for an evaluation of
patient-centred recipient outcomes and standardisation and reporting of
outcome measures for future donor management RCTs. Copyright ©
2021 British Journal of Anaesthesia

<40>
Accession Number
2014072515
Title
Effects of inorganic nitrate on ischaemia-reperfusion injury after
coronary artery bypass surgery: a randomised controlled trial.
Source
British Journal of Anaesthesia. 127(4) (pp 547-555), 2021. Date of
Publication: October 2021.
Author
Eriksson K.E.; Eidhagen F.; Liska J.; Franco-Cereceda A.; Lundberg J.O.;
Weitzberg E.
Institution
(Eriksson, Eidhagen, Lundberg, Weitzberg) Department of Physiology and
Pharmacology, Karolinska Institutet, Stockholm, Sweden
(Eriksson, Weitzberg) Department of Perioperative Medicine and Intensive
Care, Karolinska University Hospital, Stockholm, Sweden
(Eidhagen) Stockholm Center for Spine Surgery (RKC), Stockholm, Sweden
(Liska, Franco-Cereceda) Department of Molecular Medicine and Surgery,
Karolinska Institutet, Stockholm, Sweden
(Liska, Franco-Cereceda) Department of Cardiothoracic Surgery, Karolinska
University Hospital, Stockholm, Sweden
Publisher
Elsevier Ltd
Abstract
Background: Nitric oxide (NO) is an important signalling molecule in the
cardiovascular system with protective properties in ischaemia-reperfusion
injury. Inorganic nitrate, an oxidation product of endogenous NO
production and a constituent in our diet, can be recycled back to
bioactive NO. We investigated if preoperative administration of inorganic
nitrate could reduce troponin T release and other plasma markers of injury
to the heart, liver, kidney, and brain in patients undergoing cardiac
surgery. Method(s): This single-centre, randomised, double-blind,
placebo-controlled trial included 82 patients undergoing coronary artery
bypass surgery with cardiopulmonary bypass. Oral sodium nitrate (700 mgx2)
or placebo (NaCl) were administered before surgery. Biomarkers of
ischaemia-reperfusion injury and plasma nitrate and nitrite were collected
before and up to 72 h after surgery. Troponin T release was our predefined
primary endpoint and biomarkers of renal, liver, and brain injury were
secondary endpoints. Result(s): Plasma concentrations of nitrate and
nitrite were elevated in nitrate-treated patients compared with placebo.
The 72-h release of troponin T did not differ between groups. Other plasma
biomarkers of organ injury were also similar between groups. Blood loss
was not a predefined outcome parameter, but perioperative bleeding was 18%
less in nitrate-treated patients compared with controls.
 Conclusion(s): Preoperative administration of inorganic nitrate did
not influence troponin T release or other plasma biomarkers of organ
injury in cardiac surgery. Clinical trial registration:
NCT01348971. Copyright © 2021 The Authors

<41>
Accession Number
2015776499
Title
Prognostic value of platelet/lymphocyte ratio and CAMI-STEMI score for
major adverse cardiac events in patients with acute ST segment elevation
myocardial infarction after percutaneous coronary intervention: A
prospective observational study.
Source
Medicine (United States). 100(33) (no pagination), 2021. Article Number:
e26942. Date of Publication: 20 Aug 2021.
Author
Wang Y.; Peng Z.
Institution
(Wang) Department of Pharmacy, The First People's Hospital of Lianyungang,
First Affiliated Hospital of Kangda College of Nanjing Medical University,
Lianyungang, China
(Peng) Department of Cardiology, The First People's Hospital of
Lianyungang, First Affiliated Hospital of Kangda College of Nanjing
Medical University, Lianyungang, China
Publisher
Lippincott Williams and Wilkins
Abstract
The aim of this study was to investigate the predictive value of the
platelet-to-lymphocyte ratio (PLR) and the China Acute Myocardial
Infarction registry-ST segment elevation myocardial infarction
(CAMI-STEMI) score for major adverse cardiovascular events (MACE) in
ST-segment elevation myocardial infarction (STEMI) patients undergoing
percutaneous coronary intervention (PCI) within 6 months. We enrolled
STEMI patients who received emergency PCI in the First Hospital of
Lianyungang from January 2016 to December 2019. The clinical
characteristics of the patients, the PLR, and the CAMI-STEMI score were
recorded. The MACE included heart failure, nonfatal re-infarction,
recurrent angina pain, re-hospitalization for cardiovascular-related
illness, repeat PCI, coronary artery bypass grafting, and all-cause
mortality. According to the incidence of MACE during the follow-up the
patients were divided into the MACE group (96 cases, 24.8%) and the
non-MACE group (291 cases, 75.2%). The PLR, 147.62 (121.13-205.20) in MACE
group, was 111.19 (90.23-146.42) in the non-MACE group in comparison, the
PLR was higher in MACE group than that in non-MACE group (P < .01).
Multivariate regression analysis showed that PLR (odds ratio (OR) = 1.007,
95% confidence interval (CI) 1.002-1.012, P < .01) and CAMI-STEMI score
(OR = 1.575, 95% CI: 1.311-1.892, P < .01) were independent predictors of
MACE. Besides, I-BIL was also an independent predictor of MACE (OR =
1.007, 95% CI: 1.011-1.146, P = .021). Reciever-operating characteristic
curve showed that the area under curve of PLR was 0.704 (95%CI
0.644-0.763, P < .001). The cutoff value was 112.6, the sensitivity and
specificity were 84.4% and 51.9%, respectively. PLR and CAMI-STEMI scores
were independent risk factors of MACE after PCI in STEMI
patients. Copyright © 2021 the Author(s). Published by Wolters
Kluwer Health, Inc.

<42>
Accession Number
2015085919
Title
Rationale and design of a mechanistic clinical trial of JAK inhibition to
prevent ventilator-induced diaphragm dysfunction.
Source
Respiratory Medicine. 189 (no pagination), 2021. Article Number: 106620.
Date of Publication: 01 Nov 2021.
Author
Shrager J.B.; Wang Y.; Lee M.; Nesbit S.; Trope W.; Konsker H.; Fatodu E.;
Berry M.S.; Poulstides G.; Norton J.; Burdon T.; Backhus L.; Cooke R.;
Tang H.
Institution
(Shrager, Wang, Lee, Nesbit, Trope, Konsker, Fatodu, Berry, Burdon,
Backhus, Tang) Division of Thoracic Surgery, Department of Cardiothoracic
Surgery, Stanford University School of Medicine, Stanford, CA, United
States
(Shrager, Wang, Lee, Konsker, Fatodu, Burdon, Backhus, Tang) Veterans
Affair Palo Alto Health Care System, Palo Alto, CA, United States
(Poulstides, Norton) Department of Surgery, Stanford University School of
Medicine, Stanford, CA, United States
(Cooke) Department of Biochemistry and Biophysics, University of
California San Francisco, San Francisco, CA, United States
Publisher
W.B. Saunders Ltd
Abstract
Introduction: Ventilator-induced diaphragm dysfunction (VIDD) is an
important phenomenon that has been repeatedly demonstrated in experimental
and clinical models of mechanical ventilation. Even a few hours of MV
initiates signaling cascades that result in, first, reduced specific
force, and later, atrophy of diaphragm muscle fibers. This severe,
progressive weakness of the critical ventilatory muscle results in
increased duration of MV and thus increased MV-associated
complications/deaths. A drug that could prevent VIDD would likely have a
major positive impact on intensive care unit outcomes. We identified the
JAK/STAT pathway as important in VIDD and then demonstrated that JAK
inhibition prevents VIDD in rats. We subsequently developed a clinical
model of VIDD demonstrating reduced contractile force of isolated
diaphragm fibers harvested after ~7 vs ~1 h of MV during a thoracic
surgical procedure. Material(s) and Method(s): The NIH-funded
clinical trial that has been initiated is a prospective, placebo
controlled trial: subjects undergoing esophagectomy are randomized to
receive 6 preoperative doses of the FDA-approved JAK inhibitor Tofacitinib
(commonly used for rheumatoid arthritis) vs. placebo. The primary outcome
variable will be the difference in the reduction that occurs in force
generation of diaphragm single muscle fibers (normalized to their
cross-sectional area), in the Tofacitinib vs. placebo subjects, over 6 h
of MV. Discussion(s): This trial represents a first-in-human,
mechanistic clinical trial of a drug to prevent VIDD. It will provide
proof-of-concept in human subjects whether JAK inhibition prevents
clinical VIDD, and if successful, will support an ICU-based clinical trial
that would determine whether JAK inhibition impacts clinical outcome
variables such as duration of MV and mortality. Copyright © 2021

<43>
Accession Number
2013997721
Title
The independent reduction in mortality associated with guideline-directed
medical therapy in patients with coronary artery disease and heart failure
with reduced ejection fraction.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 7(4) (pp
416-421), 2021. Date of Publication: 01 Oct 2021.
Author
Wolfe N.K.; Mitchell J.D.; Brown D.L.
Institution
(Wolfe, Mitchell, Brown) Department of Medicine, Cardiovascular Division,
Washington University School of Medicine, 660 S. Euclid Ave, Campus Box
8086, St. Louis, MO 63110, United States
Publisher
Oxford University Press
Abstract
Aims: Guideline-directed medical therapy (GDMT) is underutilized in
patients with coronary artery disease (CAD). However, there are no studies
evaluating the impact of GDMT adherence on mortality among patients with
CAD and heart failure with reduced ejection fraction (HFrEF). We sought to
investigate the association of GDMT adherence with long-term mortality in
patients with CAD and HFrEF. Methods and Results: Surgical Treatment
for Ischaemic Heart Failure (STICH) was a trial of patients with an left
ventricular ejection fraction <=35% and CAD amenable to coronary artery
bypass graft surgery (CABG) who were randomized to CABG plus medical
therapy (N = 610) or medical therapy alone (N = 602). Median follow-up
time was 9.8 years. We defined GDMT for the treatment of CAD and HFrEF as
the combination of at least one antiplatelet drug, a statin, a
beta-blocker, and an angiotensin-converting enzyme inhibitor or
angiotensin receptor blocker. The primary outcome was all-cause mortality.
Assessment of the independent association between GDMT and mortality was
performed using multivariable Cox regression with GDMT as a time-dependent
covariate. In the CABG arm, 63.6% of patients were on GDMT throughout the
study period compared to 66.5% of patients in the medical therapy arm (P =
0.3). GDMT was independently associated with a significant reduction in
mortality (hazard ratio 0.65, 95% confidence interval 0.56-0.76; P <
0.001). Conclusion(s): GDMT is associated with reduced mortality in
patients with CAD and HFrEF independent of revascularization with CABG.
Strategies to improve GDMT adherence in this population are needed to
maximize survival. Copyright © 2020 Published on behalf of the
European Society of Cardiology.

<44>
[Use Link to view the full text]
Accession Number
2016443205
Title
Posterior myocardial infarction caused by superdominant circumflex
occlusion over an absent right coronary artery Case report and review of
literature.
Source
Medicine (United States). 100(27) (pp E26604), 2021. Article Number:
e26604. Date of Publication: 09 Jul 2021.
Author
Oh S.; Kim J.H.; Kim M.C.; Hong Y.J.; Ahn Y.; Jeong M.H.
Institution
(Oh, Kim, Kim, Hong, Ahn, Jeong) Department of Cardiology, Chonnam
National University Hospital, Gwangju, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Rationale: Congenital agenesis of the right coronary artery (CARCA)
initially presenting as acute myocardial infarction (AMI) due to total
occlusion is a rare clinical condition that can lead to severe
complications, including death. We report a case of successful
percutaneous coronary intervention (PCI) in a patient with this condition.
Patient concerns: A 57-year-old man was admitted to our center with chest
pain that had occurred several hours prior. Since he was initially
diagnosed with AMI with ST-segment elevation, we promptly commenced
coronary angiography (CAG). Diagnosis: CAG revealed the absence of a right
coronary artery (RCA). In the left coronary cusp area, the left circumflex
coronary artery (LCX) was occluded totally. Intervention(s): We
performed PCI for total occlusion of the proximal part of the LCX.
Follow-up CAG showed a superdominant branch of the LCX, sprouting into the
RCA territory. Outcome(s): The patient was discharged uneventfully
after successful PCI. Lessons: CARCA with AMI, which is an extremely
unusual case, can be fatal; however, PCI seems to be an effective
treatment option. Copyright © 2021 the Author(s).

<45>
Accession Number
636334325
Title
Assessment of Nonfatal Myocardial Infarction as a Surrogate for All-Cause
and Cardiovascular Mortality in Treatment or Prevention of Coronary Artery
Disease: A Meta-analysis of Randomized Clinical Trials.
Source
JAMA Internal Medicine. 181(12) (pp 1575-1587), 2021. Date of Publication:
December 2021.
Author
O'Fee K.; Deych E.; Ciani O.; Brown D.L.
Institution
(O'Fee, Deych, Brown) Department of Medicine, Washington University,
School of Medicine in St Louis, St Louis, MO, United States
(Deych, Brown) Cardiovascular Division, Washington University, School of
Medicine in St Louis, 660 S Euclid Ave, Campus Box 8086, St Louis, MO
63110, United States
(Ciani) Center for Research in Health and Social Care Management, SDA
Bocconi, Milan, Italy
(Ciani) University of Exeter, College of Medicine and Health, Exeter,
United Kingdom
Publisher
American Medical Association
Abstract
Importance: Although nonfatal myocardial infarction (MI) is associated
with an increased risk of mortality, evidence validating nonfatal MI as a
surrogate end point for all-cause or cardiovascular (CV) mortality is
lacking. Objective(s): To examine whether nonfatal MI may be a
surrogate for all-cause or CV mortality in patients with or at risk for
coronary artery disease. Data Sources: In this meta-analysis, PubMed
was searched from inception until December 31, 2020, for randomized
clinical trials of interventions to treat or prevent coronary artery
disease reporting mortality and nonfatal MI published in 3 leading
journals. Study Selection: Randomized clinical trials including at least
1000 patients with 24 months of follow-up. Data Extraction and Synthesis:
Trial-level correlations between nonfatal MI and all-cause or CV mortality
were assessed for surrogacy using the coefficient of determination
(R2). The criterion for surrogacy was set at 0.8. Subgroup
analyses based on study subject (primary prevention, secondary prevention,
mixed primary and secondary prevention, and revascularization), era of
trial (before 2000, 2000-2009, and 2010 and after), and follow-up duration
(2.0-3.9, 4.0-5.9, and >=6.0 years) were performed. Main Outcomes and
Measures: All-cause or CV mortality and nonfatal MI. Result(s): A
total of 144 articles randomizing 1211897 patients met the criteria for
inclusion. Nonfatal MI did not meet the threshold for surrogacy for
all-cause (R2= 0.02; 95% CI, 0.00-0.08) or CV (R2=
0.11; 95% CI, 0.02-0.27) mortality. Nonfatal MI was not a surrogate for
all-cause mortality in primary (R2= 0.01; 95% CI, 0.001-0.26),
secondary (R2= 0.03; 95% CI, 0.00-0.20), mixed primary and
secondary prevention (R2= 0.001; 95% CI, 0.00-0.08), or
revascularization trials (R2= 0.21; 95% CI, 0.002-0.50). For
trials enrolling patients before 2000 (R2= 0.22; 95% CI,
0.08-0.36), between 2000 and 2009 (R2= 0.02; 95% CI,
0.00-0.17), and from 2010 and after (R2= 0.01; 95% CI,
0.00-0.09), nonfatal MI was not a surrogate for all-cause mortality.
Nonfatal MI was not a surrogate for all-cause mortality in randomized
clinical trials with 2.0 to 3.9 (R2= 0.004; 95% CI, 0.00-0.08),
4.0 to 5.9 (R2= 0.06; 95% CI, 0.001-0.16), or 6.0 or more years
of follow-up (R2= 0.30; 95% CI, 0.01-0.55). Conclusions
and Relevance: The findings of this meta-analysis do not appear to
establish nonfatal MI as a surrogate for all-cause or CV mortality in
randomized clinical trials of interventions to treat or prevent coronary
artery disease.. Copyright © 2021 American Medical Association.
All rights reserved.

<46>
Accession Number
2016506550
Title
Sex-Specific Outcomes Following Percutaneous Coronary Intervention Versus
Coronary Artery Bypass Grafting for Left Main Disease: A Systematic Review
and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Zhou J.Y.; Tie E.N.; Liew D.; Duffy S.J.; Shaw J.; Walton A.; Chan W.;
Stub D.
Institution
(Zhou, Tie, Liew, Duffy, Shaw, Walton, Chan, Stub) Department of
Cardiology, The Alfred Hospital, Melbourne, Vic, Australia
(Liew, Duffy, Stub) School of Public Health and Preventive Medicine,
Monash University, Melbourne, Vic, Australia
(Chan, Stub) Western Health, Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Objective: To assess whether outcomes following percutaneous coronary
intervention (PCI) versus coronary artery bypass grafting (CABG) for left
main coronary artery (LMCA) disease differ between men and women.
 Background(s): Current guidelines recommend either PCI or CABG for
patients with unprotected LMCA disease and low-to-intermediate anatomical
complexity. However, it is unclear whether these guidelines apply to
women, who are underrepresented in clinical trials. Method(s): An
electronic search was performed to identify studies reporting sex-specific
outcomes after PCI versus CABG in patients with LMCA disease. Trial level
hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled by
random-effects modelling. Result(s): Eight (8) studies met inclusion
criteria, comprising 13,066 patients (24.3% women). In both sexes, there
was no difference between PCI and CABG with respect to the primary
composite endpoint of death, myocardial infarction or stroke (HR in women:
1.03, 95% CI 0.76-1.40; HR in men: 1.04, 95% CI 0.92-1.17). However, both
sexes were more likely to require repeat revascularisation after PCI.
There was no interaction between sex and treatment effect for the primary
composite endpoint nor for the individual outcomes of death, stroke and
repeat revascularisation. However, in women the risk of myocardial
infarction was higher after PCI compared with CABG (HR 1.84, 95% CI
1.06-3.18), with a trend toward the opposite in men (HR 0.78, 95% CI
0.54-1.13; p-interaction=0.01). Conclusion(s): Percutaneous coronary
intervention and CABG have a comparable risk of the composite outcome of
death, stroke or myocardial infarction in patients undergoing
revascularisation for LMCA disease, with no significant interaction
between sex and treatment effect. Copyright © 2021 Australian and
New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the
Cardiac Society of Australia and New Zealand (CSANZ)

<47>
Accession Number
2016506473
Title
Colchicine for Secondary Prevention of Coronary Artery Disease: A
Meta-Analysis of Randomised Controlled Trials.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Xu H.; Mao L.; Liu H.; Lin Z.; Zhang Y.; Yang J.
Institution
(Xu, Liu, Lin, Yang) Department of Cardiology, The Affiliated Huaian No. 1
People's Hospital of Nanjing Medical University, Jiangsu, Huai'an, China
(Mao) Department of Thyroid and Breast Surgery, The Affiliated Huai'an
Hospital of Xuzhou Medical University and The Second People's Hospital of
Huai'an, Jiangsu, Huai'an, China
(Zhang) Department of Medical Laboratory, The Affiliated Huaian No. 1
People's Hospital of Nanjing Medical University, Jiangsu, Huai'an, China
Publisher
Elsevier Ltd
Abstract
Background: Colchicine has become prominent as an anti-inflammatory
therapy for secondary cardiovascular prevention in patients with coronary
artery disease (CAD). This meta-analysis was performed to evaluate the
efficacy and safety of colchicine in patients with CAD. Method(s):
Randomised controlled trials (RCTs) that compare major adverse
cardiovascular events (MACEs) between patients with CAD randomised to
colchicine versus placebo (or no colchicine) were included. Random effect
risk ratios (RRs) were calculated for clinical outcomes. Result(s): A
total of 12,071 patients in seven RCTs were included in the meta-analysis.
Compared with placebo or no colchicine, colchicine was associated with a
significantly lower incidence of MACEs (RR 0.64 95% CI 0.51-0.80 p<0.01).
The reduction in MACEs in the colchicine group was driven by statistically
significant reductions in the incidence of myocardial ischaemia (RR 0.74
95% CI 0.58-0.95 p=0.02), coronary revascularisation (RR 0.61 95% CI
0.42-0.89 p=0.01), and stroke (RR 0.48 95% CI 0.28-0.83 p=0.01). However,
there was no statistically significant difference for cardiovascular death
(RR 0.82 95% CI 0.55-1.22 p=0.33). All-cause and non-cardiovascular
mortality, gastrointestinal events, infection, and cancer were not
significantly different between the colchicine and control groups.
 Conclusion(s): Colchicine is a reasonably efficacious and safe drug
that could be successfully utilised for the secondary prevention of
CAD. Copyright © 2021 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<48>
Accession Number
2016159052
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
Journal of the American College of Cardiology. 79(2) (pp 197-215), 2022.
Date of Publication: 18 Jan 2022.
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.
Publisher
Elsevier Inc.
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. 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. Copyright © 2022 The American
College of Cardiology Foundation and the American Heart Association, Inc.

<49>
Accession Number
2014727343
Title
Valve replacement or repair in native mitral valve infective
endocarditis-Which is better? A meta-analysis and systematic review.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
He K.; Song J.; Luo H.; Su H.; Liang W.; Bian L.; Yue H.; Wu Z.
Institution
(He, Song, Luo, Liang, Bian, Yue, Wu) Department of Cardiovascular
Surgery, West China Hospital of Sichuan University, Sichuan, Chengdu,
China
(Su) Department of Cardiovascular Surgery, West China (Sanya) Hospital,
Sichuan University, Hainan, Sanya, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Native mitral valve infective endocarditis (IE) plagues
patients and surgeons alike because of its high mortality and recurrence
rates as well as poor prognosis. Mitral valve repair (MVP) and mitral
valve replacement (MVR) are two main surgical methods. However, the
question of which benefits patients more remains controversial. Thus, we
conducted a meta-analysis to systematically review the two approaches,
focusing on the early survival rate and long-term outcomes.
 Method(s): A meta-analysis and systematic review were conducted using
studies sourced from the PubMed, Embase, and Cochrane literature databases
to compare MVP and MVR, with data extracted for baseline characteristics,
mortality, survival, recurrent endocarditis, and valve reoperation. Risk
ratio (RR) or hazard ratio (HR) values were calculated, and publication
bias was tested. Result(s): A total of 17 relevant publications with
a total population of 3759 patients, with 1180 patients having undergone
MVP and 2579 patients having undergone MVR, respectively, were analyzed.
Patients who underwent MVP may benefit from a lower risk of early
mortality (RR, 0.51; 95% confidence interval [CI], 0.39-0.66; p <.00001),
a higher long-term survival rate (HR, 0.69; 95% CI, 0.58-0.81; p <.001;
I2 = 0%), and a lower risk of recurrence (RR, 0.66; 95% CI,
0.40-1.09; p =.10; I2 = 0%). However, a similar risk of
reoperation was observed for both groups (RR, 1.02; 95% CI, 0.36-2.91; p
=.96; I2 = 43%). Conclusion(s): This meta-analysis
suggests that MVP may lead to better outcomes compared to MVR. Among
patients with mitral valve IE, MVP can reduce in-hospital mortality,
improve long-term survival, and has a lower risk of recurrent
endocarditis. As a result, MVP may be suitable as a primary treatment
choice and should be considered whenever possible in most IE
patients. Copyright © 2022 Wiley Periodicals LLC.

<50>
Accession Number
2010182627
Title
A systematic review and meta-analysis of delayed coronary artery access
for coronary angiography with or without percutaneous coronary
intervention (PCI) in patients who underwent transcatheter aortic valve
replacement (TAVR).
Source
Cardiovascular Intervention and Therapeutics. 37(1) (pp 167-181), 2022.
Date of Publication: January 2022.
Author
Diaz M.A.; Patton M.; Valdes P.; Vieira J.L.; Rmeileh A.; Macedo F.Y.
Institution
(Diaz, Patton, Valdes, Rmeileh, Macedo) Division of Cardiology, Department
of Internal Medicine, Palmetto General Hospital, 2001 W 68th St, Hialeah,
FL 33016, United States
(Vieira) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
Springer Japan
Abstract
Coronary artery disease (CAD) and severe aortic valve stenosis frequently
coexist. Given the progressive nature of CAD, silent or non-significant
CAD may become symptomatic or functionally relevant years after TAVR.
However, there is a paucity of data documenting the feasibility of either
coronary angiography and/or PCI after TAVR. We systematically searched
Medline, Pubmed, Embase, Cochrane database, Google Scholar, Science
Direct, Web of Science, and conference abstracts from conception to March
2020 using OvidSP in TAVR patients undergoing coronary angiography with or
without PCI at least 6 months after TAVR. Patients and procedural
characteristics were summarized. The primary outcome of interest was
successful coronary angiography for either the left main coronary artery
(LMCA) or right coronary artery (RCA) with or without PCI. Pooled
estimates were calculated using a random-effects meta-analysis. The study
protocol was registered in PROSPERO. Eleven reports for a total of 696
coronary angiograms and 287 PCI were included in the analysis. Patients
were slightly predominantly male, older and had a mean left ventricular
ejection fraction of more than 50% with an intermediate STS. The summary
estimate rates of successful LMCA and RCA angiography with a Medtronic
self-expandable valve (SEV) were 84% (95% CI 73-90%, I2 = 79, p
= 0.015) and 69% (95% CI 37-89%, I2 = 86, p = 0.23),
respectively, while with the Edwards Lifesciences balloon expandable valve
(BEV), the summary estimate rates for successful LMCA and RCA angiography
were 94% (95% CI 72-99%, I2 = 66, p = 0.003) and 95% (95% CI
48-99%, I2 = 83, p = 0.05), respectively. The summary estimate
rate of successful PCI post TAVR with either a Medtronic SEV or Edwards
Lifesciences BEV was 93% (95% CI 86-96%, I2 = 33, p = 0.0001).
The overall achievement of a successful coronary angiography with or
without PCI in post-TAVR patients is high, with a lower success rate for
RCA angiography in patients with the Medtronic SEV Mortality and bleeding
did not differ in our analysis. Copyright © 2021, Japanese
Association of Cardiovascular Intervention and Therapeutics.

<51>
Accession Number
2007179059
Title
Application of the Hybrid Operating Room in Surgery: A Systematic Review.
Source
Journal of Investigative Surgery. 35(2) (pp 378-389), 2022. Date of
Publication: 2022.
Author
Jin H.; Liu J.
Institution
(Jin) The Second Department of General Surgery, Zhuhai People's Hospital
(Zhuhai Hospital Affiliated with Jinan University), Guangdong, Zhuhai,
China
(Liu) Zhuhai Health Bureau, Guangdong, Zhuhai, China
Publisher
Taylor and Francis Ltd.
Abstract
Background and objective: The hybrid operating room has been widely
applied in surgery, including neurology, general surgery, gynecology, and
obstetrics. By reviewing application of the hybrid operating room in
different categories of surgery, we aim to summarize both advantages and
disadvantages of the hybrid operating room and discuss what to do for
further improving the application of it. Method(s): We searched
related literature in websites including Pubmed, MEDLINE, Web of science,
using the keywords "hybrid operating room", "surgery", "technique",
"intervention", and "radiology". All the searched papers were screened and
underwent quality evaluation. The eventually selected papers were
carefully read, with related information extracted and summarized.
 Result(s): After screening and assessment, a total of 29 literature
was collected. Application of the hybrid operating room in general
surgery, neurosurgery, thoracic surgery, urology, gynecologic and
obstetrics surgery, and cardiovascular surgery was summarized. Both
advantages and disadvantages of the hybrid operating room were discussed
in order to improve application of the hybrid operating room in surgery.
 Conclusion(s): Surgeries performed in the hybrid operating room take
advantages over those conventional operating rooms mainly in terms of
higher procedure accuracy, less operative time, and less risk of
hemorrhage during the transportation between radiology departments and
operating suites. Further efforts should be made to reduce radiation
exposure from imaging systems equipped in the hybrid operating room and
increase cost-effectiveness ratio of the hybrid operating
room. Copyright © 2022 Taylor & Francis Group, LLC.

<52>
Accession Number
2014782537
Title
Conventional Versus Minimally Invasive Aortic Valve Replacement Surgery: A
Systematic Review, Meta-Analysis, and Meta-Regression.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2022. Date of Publication: 2022.
Author
Almeida A.S.; Ceron R.O.; Anschau F.; de Oliveira J.B.; Leao Neto T.C.;
Rode J.; Rey R.A.W.; Lira K.B.; Delvaux R.S.; de Souza R.O.R.R.
Institution
(Almeida, de Oliveira, Leao Neto, de Souza) Postgraduate Studies Program
in Minimally Invasive Cardiovascular Surgery, Goiania, Brazil
(Almeida, Ceron, Anschau, Rode, Rey, Lira, Delvaux) Cardiothoracic Surgery
Division, Hospital Nossa Senhora da Conceicao, Grupo Hospitalar Conceicao,
Porto Alegre, Brazil
(Almeida, Anschau) Health Technology Assessment Center (NATS), Grupo
Hospitalar Conceicao, Porto Alegre, Brazil
(Anschau) Postgraduate Program in Technology Assessment for SUS
(PPGATSUS/GHC), Grupo Hospitalar Conceicao, Porto Alegre, Brazil
(de Oliveira, Leao Neto, de Souza) Cardiothoracic Surgery Division,
Hospital Ruy Azeredo, Goiania, Brazil
Publisher
SAGE Publications Ltd
Abstract
Objective: To assess the potential benefits of minimally invasive aortic
valve replacement (MIAVR) compared with conventional AVR (CAVR) by
examining short-term outcomes. Method(s): A systematic search
identified randomized trials comparing MIAVR with CAVR. To assess study
limitations and quality of evidence, we used the Cochrane Risk of Bias
tool and GRADE and performed random-effects meta-analysis. We used
meta-regression and sensitivity analysis to explore reasons for diversity.
 Result(s): Thirteen studies (1,303 patients) were included. For the
comparison of MIAVR and CAVR, the risk of bias was judged low or unclear
and the quality of evidence ranged from very low to moderate. No
significant difference was observed in mortality, stroke, acute kidney
failure, infectious outcomes, cardiac events, intubation time, intensive
care unit stay, reoperation for bleeding, and blood transfusions. Blood
loss (mean difference [MD] = -130.58 mL, 95% confidence interval [CI] =
-216.34 to -44.82, I2 = 89%) and hospital stay (MD = -0.93
days, 95% CI = -1.62 to -0.23, I2 = 81%) were lower with MIAVR.
There were shorter aortic cross-clamp (MD = 5.99 min, 95% CI = 0.99 to
10.98, I2 = 93%) and cardiopulmonary bypass (CPB) times (MD =
7.75 min, 95% CI = 0.27 to 15.24, I2 = 94%) in the CAVR group.
In meta-regression analysis, we found that age was the variable with the
greatest influence on heterogeneity. Conclusion(s): MIAVR seems to be
an excellent alternative to CAVR, reducing hospital stay and incidence of
hemorrhagic events. Despite significantly greater aortic cross-clamp and
CPB times with MIAVR, this did not translate into adverse effects, with no
changes in the results found with CAVR. Copyright © The Author(s)
2022.

<53>
Accession Number
2014753202
Title
Randomized controlled trial of an alternative drainage strategy vs routine
chest tube insertion for postoperative pain after thoracoscopic wedge
resection.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 27. Date
of Publication: December 2022.
Author
Wei S.; Zhang G.; Ma J.; Nong L.; Zhang J.; Zhong W.; Cui J.
Institution
(Wei) Department of Anaesthesiology, The First Affiliated Hospital of
Jinan University, Guangzhou 510632, China
(Zhang, Ma, Nong, Cui) Department of Anaesthesiology, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510080, China
(Zhang, Zhong) Guangdong Lung Cancer Institute, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510080, China
Publisher
BioMed Central Ltd
Abstract
Background: Thoracoscopic surgery has greatly alleviated the postoperative
pain of patients, but postsurgical acute and chronic pain still exists and
needs to be addressed. Indwelling drainage tubes are one of the leading
causes of postoperative pain after thoracic surgery. Therefore, the aim of
this study was to explore the effects of alternative drainage on acute and
chronic pain after video-assisted thoracoscopic surgery (VATS).
 Method(s): Ninety-two patients undergoing lung wedge resection were
selected and randomly assigned to the conventional chest tube (CT) group
and the 7-Fr central venous catheter (VC) group. Next, the numeric rating
scale (NRS) and pain DETECT questionnaire were applied to evaluate the
level and characteristics of postoperative pain. Result(s): NRS
scores of the VC group during hospitalization were significantly lower
than those of the CT group 6 h after surgery, at postoperative day 1, at
postoperative day 2, and at the moment of drainage tube removal. Moreover,
the number of postoperative salvage analgesics (such as nonsteroidal
anti-inflammatory drugs [(NSAIDs]) and postoperative hospitalization days
were notably reduced in the VC group compared with the CT group. However,
no significant difference was observed in terms of NRS pain scores between
the two groups of patients during the follow-up for chronic pain at 3
months and 6 months. Conclusion(s): In conclusion, a drainage
strategy using a 7-Fr central VC can effectively relieve perioperative
pain in selected patients undergoing VATS wedge resection, and this may
promote the rapid recovery of such patients after surgery. Trial
registration: ClinicalTrials.gov, NCT03230019. Registered July 23,
2017. Copyright © 2022, The Author(s).

<54>
Accession Number
636185145
Title
Extended, virtual and augmented reality in thoracic surgery: a systematic
review.
Source
Interactive cardiovascular and thoracic surgery. 34(2) (pp 201-211), 2022.
Date of Publication: 18 Jan 2022.
Author
Arjomandi Rad A.; Vardanyan R.; Thavarajasingam S.G.; Zubarevich A.; Van
den Eynde J.; Sa M.P.B.O.; Zhigalov K.; Sardiari Nia P.; Ruhparwar A.;
Weymann A.
Institution
(Arjomandi Rad, Vardanyan, Thavarajasingam) Department of Medicine,
Faculty of Medicine, Imperial College London, London, United Kingdom
(Zubarevich, Zhigalov, Ruhparwar, Weymann) Department of Thoracic and
Cardiovascular Surgery, West German Heart and Vascular Center Essen,
University Hospital of Essen, University Duisburg-Essen, Essen, Germany
(Van den Eynde) Department of Cardiovascular Diseases, University
Hospitals Leuven, KU Leuven, Leuven, Belgium
(Sa) Department of Cardiovascular Surgery, Pronto Socorro Cardiologico de
Pernambuco (PROCAPE), University of Pernambuco, Recife, Brazil
(Sardiari Nia) Department of Cardiothoracic Surgery, Maastricht University
Medical Center, Maastricht, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Extended reality (XR), encompassing both virtual reality (VR)
and augmented reality, allows the user to interact with a
computer-generated environment based on reality. In essence, the immersive
nature of VR and augmented reality technology has been warmly welcomed in
all aspects of medicine, gradually becoming increasingly feasible to
incorporate into everyday practice. In recent years, XR has become
increasingly adopted in thoracic surgery, although the extent of its
applications is unclear. Here, we aim to review the current applications
of XR in thoracic surgery. METHOD(S): A systematic database search
was conducted of original articles that explored the use of VR and/or
augmented reality in thoracic surgery in EMBASE, MEDLINE, Cochrane
database and Google Scholar, from inception to December 2020.
 RESULT(S): Our search yielded 1494 citations, of which 21 studies
published from 2007 to 2019 were included in this review. Three main areas
were identified: (i) the application of XR in thoracic surgery training;
(ii) preoperative planning of thoracic procedures; and (iii)
intraoperative assistance. Overall, XR could produce progression along the
learning curve, enabling trainees to reach acceptable standards before
performing in the operating theatre. Preoperatively, through the
generation of 3D-renderings of the thoracic cavity and lung anatomy, VR
increases procedural accuracy and surgical confidence through
familiarization of the patient's anatomy. XR-assisted surgery may have
therapeutic use particularly for complex cases, where conventional methods
would yield inadequate outcomes due to inferior accuracy.
 CONCLUSION(S): XR represents a salient step towards improving
thoracic surgical training, as well as enhancing preoperative planning and
intraoperative guidance. Copyright © The Author(s) 2021.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<55>
[Use Link to view the full text]
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. 145(3) (pp e4-e17), 2022. Date of Publication: 18 Jan 2022.
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. 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.

<56>
Accession Number
637065826
Title
Aortic valve repair for the treatment of rheumatic aortic valve disease: a
systematic review and meta-analysis.
Source
Scientific reports. 12(1) (pp 674), 2022. Date of Publication: 13 Jan
2022.
Author
Zhao M.; Tang Y.; Li L.; Dai Y.; Lu J.; Liu X.; Zhou J.; Wu Y.
Institution
(Zhao, Tang, Li, Dai, Liu, Zhou, Wu) Department of Cardiovascular Surgery,
First Affiliated Hospital of Nanjing Medical University, Jiangsu Province,
Nanjing 210029, China
(Lu) Department of Cardiology, First Affiliated Hospital of Nanjing
Medical University, Nanjing, Jiangsu, China
Publisher
NLM (Medline)
Abstract
Valvuloplasty for rheumatic aortic valve disease remains controversial. We
conducted this study to explore whether aortic valvuloplasty is
appropriate for the rheumatic population. A comprehensive search was
conducted, and 7 eligible retrospective studies were identified from
PubMed, Embase, Medline and Cochrane (up to April 7, 2020) according to
the inclusion and exclusion criteria. The data for hospital mortality,
5-year survival, 5-year reoperation, aortic insufficiency grade (AIG) and
aortic valve gradient (AVG) were extracted by 2 independent reviewers and
were analysed to evaluate the safety and availability of aortic
valvuloplasty for rheumatic patients. The heterogeneity of the results was
estimated using the Q test and I2 statistics. The fixed pooling model was
used when I2<=50%; otherwise, the random pooling model was selected. 7
articles with 418 patients were included. The pooled hospital mortality,
5-year survival and 5-year reoperation rates were 3.2%, 94.5% and 9.9%,
respectively. The heterogeneities of the weighted mean differences (WMD)
values of the AIG and AVG between preoperation and postoperation were
extremely high (I2=81.5%, p<0.001 in AIG, I2=97.6%, p=0.003 in AVG).
Subgroup analysis suggested that the AIG and AVG were improved by 3.03
grades (I2=0%, p<0.001) and 3.16 mmHg (I2=0%, p<0.001) in the European
group, respectively. In the Asian group, the AIG and AVG were improved by
2.57 grades (I2=0%, p<0.001) and 34.39 mmHg (I2=0%, p<0.001),
respectively. Compared with the values at discharge, the AIG was increased
by 0.15 grades (I2=0%, p=0.031) and the AVG was still decreased by 2.07
mmHg (I2=0%, p=0.031) at the time of follow up. Valvuloplasty is safe and
effective to treat rheumatic aortic insufficiency and stenosis, and the
duration of maintenance required to improve stenosis was longer than that
of insufficiency. Copyright © 2022. The Author(s).

<57>
Accession Number
2016672498
Title
Clinical assessment of efficacy of poly-L-lactide sternal pin on sternal
stability and post-operative pain: a prospective randomized trial in
cardiovascular surgery.
Source
Journal of Thoracic Disease. 14(1) (pp 76-89), 2022. Date of Publication:
January 2022.
Author
Takahara S.; Sasaki K.; Saito T.; Sakuma K.; Fujiwara H.; Yoshioka I.;
Kumagai K.; Sun W.; Takase K.; Saiki Y.
Institution
(Takahara, Sasaki, Saito, Sakuma, Fujiwara, Yoshioka, Saiki) Division of
Cardiovascular Surgery, Tohoku University Graduate School of Medicine,
Sendai, Japan
(Kumagai, Saiki) Research Division of Science for Aortic diseases, Tohoku
University Graduate School of Medicine, Sendai, Japan
(Sun, Takase) Department of Diagnostic Radiology, Tohoku University
Graduate School of Medicine, Sendai, Japan
Publisher
AME Publishing Company
Abstract
Background: Although the incident rate is low, sternal dislocation and
dehiscence due to unstable sternal fixation after cardiovascular surgery
could cause potentially lethal complications. Thus, to enforce the
stability of closed sternum, the sternal pins have been utilized at
surgeon's discretion. However, there is no randomized clinical trial to
test whether these pins are effective to stabilize a sternum. Hence, this
study aimed to examine the clinical efficacy of bioabsorbable
poly-L-lactide (PLLA) sternal pins in reinforcing sternal stability and
preventing instability of the sternum after full sternotomy.
 Method(s): We conducted a single institutional, prospective,
randomized, single-blinded clinical study involving 100 patients who
underwent an initial cardiovascular surgery via sternotomy. Patients were
randomly allocated into two groups: with (group P) and without (group N)
PLLA sternal pins, at 1:1 ratio from November 2013 to April 2016. Sternal
deviation and stability were assessed with postoperative computed
tomography (CT) at two postures to put shear stress on the sternum.
Additionally, information on patient demographic indices was obtained
prospectively, and patient's pain intensity was assessed with numerical
rating scoring system during rehabilitation. Furthermore, propensity score
matching was performed for further comparative sub-analysis.
 Result(s): Ninety-one patients (43 in group P and 48 in group N) were
analyzed using the intention-to-treat method. Group N had a significantly
higher proportion of males (P=0.015) and ischemic disease as a primary
diagnosis (P=0.040) than group P. Postoperative CT showed that the degree
of sternal deviation and stability were comparable between the groups.
Similarly, the numerical rating score of pain during rehabilitation showed
no difference between the groups. Even after adjusting for patient
characteristics using propensity score matching method, no significant
differences in sternal gaps, stability, and numerical rating score of pain
were observed. Of note, no material-related adverse event such as wound
infection was found. Conclusion(s): We could not identify the
efficacy of the sternal pin in enforcing sternal stability based on CT
measurements with mild shear stress on sternum after cardiovascular
surgery. Nevertheless, our results with no adverse events might encourage
further investigations with a more specific cohort who is susceptible to
infection but requires an additional sternal fixation. Trial Registration:
This study was registered in University Hospital Medical Information
Network Clinical Trial Registry (UMIN000017357). Copyright ©
Journal of Thoracic Disease. All rights reserved.

<58>
Accession Number
2016672495
Title
Negative pressure wound therapy for massive subcutaneous emphysema: a
systematic review and case series.
Source
Journal of Thoracic Disease. 14(1) (pp 43-53), 2022. Date of Publication:
January 2022.
Author
Janssen N.; Laven I.E.W.G.; Daemen J.H.T.; Hulsewe K.W.E.; Vissers Y.L.J.;
de Loos E.R.
Institution
(Janssen, Laven, Daemen, Hulsewe, Vissers, de Loos) Department of Surgery,
Division of General Thoracic Surgery, Zuyderland Medical Centre, Heerlen,
Netherlands
Publisher
AME Publishing Company
Abstract
Background: Massive subcutaneous emphysema can cause considerable
morbidity with respiratory distress. To resolve this emphysema in
short-term, negative pressure wound therapy could be applied as added
treatment modality. However, its use is sparsely reported, and a variety
of techniques are being described. This study provides a systematic review
of the available literature on the effectiveness of negative pressure
wound therapy as treatment for massive subcutaneous emphysema. In
addition, our institutional experience is reported through a case-series.
 Method(s): The PubMed, Embase and Cochrane Library were
systematically searched for publications on the use of negative pressure
wound therapy for subcutaneous emphysema following thoracic surgery,
trauma or spontaneous pneumothorax. Moreover, patients treated at our
institution between 2019 and 2021 were retrospectively identified and
analyzed. Result(s): The systematic review provided 10 articles
presenting 23 cases. Studies demonstrated considerable heterogeneity
regarding the location of incision, creation of prepectoral pocket, and
surgical safety margin. Also closed incision negative pressure wound
therapy and PICO© device were discussed. Despite the
apparent heterogeneity, all techniques provided favorable outcomes. No
complications, reinterventions or recurrences were documented.
Furthermore, retrospective data of 11 patients treated at our clinic
demonstrated an immediate response to negative pressure wound therapy and
a full remission of the subcutaneous emphysema at the end of negative
pressure wound therapy. No recurrence requiring intervention or
complications were observed. Conclusion(s): The findings of this
study suggest that negative pressure wound therapy, despite the varying
techniques employed, is associated with an immediate regression of
subcutaneous emphysema and full remission at the end of therapy. Given the
relatively low sample size, no technique of choice could be identified.
However, in general, negative pressure wound therapy appears to provide
fast regression of subcutaneous emphysema and release of symptoms in all
cases. Copyright © Journal of Thoracic Disease. All rights
reserved.

<59>
Accession Number
2015459248
Title
Sutureless versus Hand-Sewn Coronary Anastomoses: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 11(3) (no pagination), 2022. Article Number:
749. Date of Publication: February-1 2022.
Author
Hoogewerf M.; Schuurkamp J.; Kelder J.C.; Jacobs S.; Doevendans P.A.
Institution
(Hoogewerf, Schuurkamp, Doevendans) Department of Cardiology, University
Medical Centre Utrecht, Utrecht 3584 CX, Netherlands
(Hoogewerf) Department of Cardiothoracic Surgery, St. Antonius Hospital,
Nieuwegein 3435 CM, Netherlands
(Kelder) Department of Cardiology, St. Antonius Hospital, Nieuwegein 3435
CM, Netherlands
(Jacobs) Department of Cardiothoracic and Vascular Surgery, German Heart
Centre Berlin, Berlin 13353, Germany
(Doevendans) Netherlands Heart Institute, Utrecht 3511 EP, Netherlands
(Doevendans) Central Military Hospital, Utrecht 3584 EZ, Netherlands
Publisher
MDPI
Abstract
Background: Sutureless coronary anastomotic devices are intended to
facilitate minimally invasive coronary artery bypass grafting (MICS-CABG)
by easing and eventually standardizing the anastomotic technique. Within
this systematic review and meta-analysis, we aim to determine patency and
to evaluate safety outcomes for the sutureless anastomoses.
 Method(s): CENTRAL, MED-LINE, and EMBASE were searched from database
start till August 2021 in a predefined search strategy combining the key
concepts: 'coronary artery bypass grafting', 'sutureless coronary
anastomoses', and 'hand-sewn coronary anastomoses' by the Boolean
operation 'AND'. Study characteristics, patient demographics,
interventional details, and all available outcome data were extracted. A
meta-analysis was performed on patency at longest follow-up. Safety
outcomes were presented. Result(s): A total of eleven trials towards
six sutureless anastomotic devices were included, comprising 3724 patients
(490 sutureless and 3234 hand-sewn). There was no significant difference
in patency at a mean follow-up duration of 546.3 (range 1.5-2691) days,
with a risk ratio of 0.77 (95% CI 0.55-1.06). MACE was reported in 4.5%
sutureless and 3.9% hand-sewn patients, including all-cause mortality
(resp. 1.3 vs. 1.9%), myocardial infarction (resp. 1.6 vs. 1.7%), and
coronary revascularization (resp. 1.8 vs. 0.5%). Incomplete hemostasis
occurred in 24.8% of the sutureless anastomoses. Intra-operative device
failure forced conversion to hand-sewn or redo-anastomosis in 5.8% of the
sutureless cases. Conclusion(s): Based on the systematic review and
meta-analysis including six devices, we conclude that sutureless coronary
anastomotic devices appear safe and effective when used by well-trained
and dedicated surgical teams. Copyright © 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<60>
Accession Number
2011266692
Title
Dexmedetomidine reduces postoperative cognitive and behavioral dysfunction
in adults submitted to general anesthesia for non-cardiac surgery:
meta-analysis of randomized clinical trials.
Source
Brazilian Journal of Anesthesiology (English Edition). 71(4) (pp 413-420),
2021. Date of Publication: 01 Jul 2021.
Author
Goveia C.S.; Miranda D.B.D.; Oliveira L.V.D.B.; Praxedes F.B.; Moreira
L.G.; Guimaraes G.M.N.
Institution
(Goveia, Oliveira, Praxedes, Moreira, Guimaraes) Universidade de Brasilia,
Centro de Ensino e Treinamento - Centro de Anestesiologia, Brasilia, DF,
Brazil
(Goveia, Moreira, Guimaraes) Sociedade Brasileira de Anestesiologia,
Brazil
(Goveia) Universidade de Brasilia, Brasilia, DF, Brazil
(Miranda) Universidade Federal de Goias, Instituto de Medicina Tropical e
Saude Publica, Goiania, GO, Brazil
(Guimaraes) Universidade de Sao Paulo (USP), Sao Paulo, SP, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Introduction and objectives: Dexmedetomidine (DEX) has been associated
with a decrease in postoperative cognitive and behavioral dysfunction in
patients submitted to general anesthesia, whether inhalation or total
intravenous anesthesia. Consequently, the DEX effects on postoperative
agitation and delirium in patients submitted to general anesthesia for
non-cardiac surgery have been investigated. Method(s): A systematic
review and meta-analysis of randomized and double-blind clinical trials
(RCTs) was undertaken assessing adults submitted to elective procedures
under general anesthesia receiving DEX or placebo. The search included
articles published in English in the Pubmed and Web of Science databases
using keywords such as dexmedetomidine, delirium, and agitation. Duplicate
publications, studies involving cardiac surgery or using active control
(other than saline solution) were included. A random effects model was
adopted using the DerSimonian-Laird method and estimate of Odds Ratio (OR)
for dichotomous variables, and weighted mean difference for continuous
variables, with their respective 95% Confidence Intervals (95% CI).
 Result(s): Of the 484 articles identified, 15 were selected
comprising 2,183 patients (1,079 and 1,104 patients in the DEX and control
group, respectively). The administration of DEX was considered a
protective factor for postoperative cognitive and behavioral dysfunction
(OR = 0.36; 95% CI 0.23-0.57 and p < 0.001), regardless of the anesthesia
technique used. Conclusion(s): Dexmedetomidine administration reduced
by at least 43% the likelihood of postoperative cognitive and behavioral
dysfunction in adult patients submitted to general anesthesia for
non-cardiac surgery. Copyright © 2021

<61>
Accession Number
637051676
Title
The effect of ultrasound-guided bilateral thoracic retrolaminar block on
analgesia after pediatric open cardiac surgery: a randomized controlled
double-blind study.
Source
Korean journal of anesthesiology. (no pagination), 2022. Date of
Publication: 12 Jan 2022.
Author
Abdelbaser I.; Mageed N.A.; Elfayoumy S.I.; Magdy M.; Elmorsy M.M.;
ALseoudy M.M.
Institution
(Abdelbaser, Mageed, Magdy, ALseoudy) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
(Elfayoumy) Department of Anesthesia and Surgical Intensive Care, Faculty
of Medicine, Portsaid University, Egypt
(Elmorsy) Department of Anesthesia and Surgical Intensive Care, Faculty of
Medicine, Damietta University, Damietta, Egypt
Publisher
NLM (Medline)
Abstract
Background: Thoracic retrolaminar block (TRLB) is a relatively new
regional analgesic technique that can be used as an alternative to
thoracic paravertebral block. This study aimed to evaluate the
postoperative analgesic effects of ultrasound-guided TRLB in children
undergoing open cardiac surgery via median sternotomy incision.
 Method(s): Sixty-six patients aged 2 to 8 years undergoing cardiac
open cardiac surgery via median sternotomy incision were recruited. In the
TRLB group, 0.25% bupivacaine 0.4mL/kg was injected into the retrolaminar
space on each side at the level of T4 lamina. Patients in the control
group were injected with 0.9% saline. The primary outcome measure was the
24h post-extubation fentanyl consumption. The secondary outcome measures
were total intraoperative fentanyl consumption, postoperative modified
objective pain score (MOPS) and time to extubation. Result(s): The
mean+/-SD total intraoperative fentanyl requirements (mug/kg) and the 24h
post-extubation fentanyl consumption (mug/kg) were significantly lower
(P<0.001) in the TRLB group (9.3+/-1.2&6.9+/-2.1 respectively) than the
control group (12.5+/-1.4&16.6+/-2.8 respectively). The median (Q1, Q3)
time (h) of extubation and the mean+/-SD time (h) of ICU length of stay
were significantly shorter (P<0.001) in the TRLB group (2 [1-3]
&23.8+/-3.2 respectively) in comparison with the control group (6 [4.5-6]
& 30.3+/-3.2 respectively). MOPS was significantly lower (P<0.05) in the
TRLB group than the control group at the following time points, 0, 2, 4,
8, 12 and16 hours after extubation. Conclusion(s): Bilateral
ultrasound-guided TRLB is effective in providing postoperative analgesia
in children undergoing open cardiac surgery via median sternotomy
incision.

<62>
Accession Number
637066488
Title
Revascularization strategies in patients with diabetes and stable ischemic
heart disease: a systematic review and meta-analysis of randomized trials.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). (no pagination),
2021. Date of Publication: 29 Nov 2021.
Author
Noguchi M.; Ueyama H.; Fujisaki T.; Takagi H.; Kuno T.
Institution
(Noguchi) Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical
Center, Urayasu, Japan
(Ueyama, Kuno) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Beth Israel
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, NY, United States
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, NY, United States
Publisher
NLM (Medline)
Abstract
Aims: The optimal treatment strategy comparing invasive revascularization
versus optimal medical therapy (OMT) in patients with diabetes mellitus
(DM) and stable ischemic heart disease (SIHD) still remains unclear. We
aimed to investigate clinical outcomes of invasive revascularization
(percutaneous coronary intervention, coronary artery bypass grafting or
both) versus OMT in patients with DM and SIHD from updated published
randomised-controlled trials (RCTs). Method(s): We conducted a
comprehensive literature search through PubMed and EMBASE to investigate
the effect of revascularization versus OMT for patients with DM and SIHD.
The studies were limited to RCTs or their subgroup data for a
meta-analysis. The outcomes of interest were major adverse cardiovascular
events (MACE) in patients with DM and SIHD. Result(s): Our search
identified subgroup data with DM of four RCTs including a total of 5742
patients with SIHD. Our results showed that invasive revascularization was
not associated with a decreased risk of MACE when compared to OMT [hazard
ratio (95% confidence interval): 0.95 (0.85-1.05), P = 0.31; I2 = 0%].
 Conclusion(s): Invasive revascularization was not associated with a
decreased risk of MACE when compared with OMT. Copyright (C) 2022
Italian Federation of Cardiology. All rights reserved.

<63>
Accession Number
2010397108
Title
Cardiohelp System use in school age children and adolescents at a center
with interfacility mobile extracorporeal membrane oxygenation capability.
Source
International Journal of Artificial Organs. 45(2) (pp 134-139), 2022. Date
of Publication: February 2022.
Author
Ignat T.; Desai A.; Hoschtitzky A.; Smith R.; Jackson T.; Frall D.; Evans
E.; Trimlett R.; Ledot S.; Chan-Dominy A.
Institution
(Ignat, Desai, Frall, Evans, Chan-Dominy) Pediatric Intensive Care Unit,
Royal Brompton Harefield NHS Foundation Trust, London, United Kingdom
(Hoschtitzky) Department of Congenital Heart Surgery, Royal Brompton
Harefield NHS Foundation Trust, London, United Kingdom
(Smith, Jackson) Department of Perfusion, Royal Brompton Harefield NHS
Foundation Trust, London, United Kingdom
(Trimlett) Department of Cardiothoracic Surgery, Royal Brompton Harefield
NHS Foundation Trust, London, United Kingdom
(Trimlett, Ledot, Chan-Dominy) Department of Cardiothoracic Critical Care
and Anesthesia, Royal Brompton Harefield NHS Foundation Trust, London,
United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Cardiohelp System use for pediatric extracorporeal membrane oxygenation
(ECMO) beyond the transport setting is sparsely described in literature.
We report the use of Getinge's Cardiohelp System in children and
integrated utilization of Mobile ECMO Retrieval Team (MERT) at an all-age
specialized cardiorespiratory center. Electronic database of all patients
under 16 years of age who received ECMO with use of the Cardiohelp System
between January 2018 and March 2020 was retrospectively reviewed and
analyzed for demographics, set-up, complications, and outcomes. Out of 41
patients, seven patients (four in middle childhood, three in early
teenage) with median age of 10 years (range 8.8-15.6) were supported with
use of Cardiohelp System. Median weight and height were 34 kg (range
28-53) and 145 cm (range 134-166) respectively. Initial ECMO deployment
was veno-arterial (V-A) in five patients and veno-venous (V-V) in two.
There were three interhospital transfers by our MERT, and 12 intrahospital
transfers for interventions or imaging. The median ECMO therapy was 7 days
(range 4-25), with standard 3/8-inch tubing and ECMO flow rate range at
56-100 mL/kg/min (1.89-5.0 LPM). There were two circuit changes and three
reconfigurations of support. Two patients received continuous veno-venous
hemofiltration via ECMO circuit. The 90-day and 180-day survival rates
were 100% (including two heart transplants at day 7 and day 8). There were
no transport-related or circuit-related complications during the 1750 h of
Cardiohelp use. Cardiohelp System use is safe in pediatric patients for
diverse application of ECMO support including inter- and intrahospital
transfers. Copyright © The Author(s) 2021.

<64>
Accession Number
637006518
Title
Timing of intraoperative crystalloid infusion may decrease total volume of
infusate without affecting early graft function in live related renal
transplant surgery: A randomized, surgeon-blinded clinical study.
Source
Indian Journal of Urology. 38(1) (pp 53-61), 2022. Date of Publication:
January-March 2022.
Author
Singh A.; Ramachandran R.; Chandralekha C.; Trikha A.; Ray B.R.; Bansal
V.K.; Mahajan S.; Asuri K.; Rewari V.
Institution
(Singh, Ramachandran, Chandralekha, Trikha, Ray, Asuri, Rewari) Department
of Anesthesiology, Pain Medicine and Critical Care, All India Institute of
Medical Sciences, New Delhi, India
(Bansal) Department of Surgical Disciplines, All India Institute of
Medical Sciences, New Delhi, India
(Mahajan) Department of Nephrology, All India Institute of Medical
Sciences, New Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Early graft function is crucial for successful kidney
transplantation. Intravascular volume maintenance is paramount in ensuring
reperfusion of transplanted kidney. This study was planned to compare
whether the timing of fluid infusion can help to decrease amount of fluid
given without altering early graft function during renal transplantation.
 Material(s) and Method(s): The present study included forty
recipients, randomized into standard (Group-S) or targeted fluid therapy
(Group-T). Group S received fluid according to conventional fasting
deficit while Group T received at 1 ml/kg/h from the start of surgery till
start of vascular anastomosis after which fluid infusion rate in both
group was increased to maintain a central venous pressure of 13-15 mm of
Hg till reperfusion. Primary outcome measured was serum creatinine level
on first postoperative day while secondary outcomes were IV fluid given,
perioperative hemodynamics, onset of diuresis, graft turgidity, urine
output, and renal function during first 6 postoperative days.
 Result(s): The study showed Group T postoperatively had early fall in
serum creatinine (day 3) than S (day 6) although this difference was not
statistically significant. Group T had received significantly less fluid
per kg of dry weight (T-42.7 +/- 9.7 ml/kg, S-61.1 +/- 11.1 ml/kg, P <
0.001), had early diuresis, better graft turgidity and urine output than
Group S. Conclusion(s): Targeted hydration significantly decreases
the total amount of fluid infused during the intraoperative period without
altering early graft function. Targeted hydration during vascular
anastomosis produced stable hemodynamics and early diuresis without any
side-effects pertaining to hypo or hyper-volemia. Copyright ©
2022 Indian Journal of Urology.

<65>
[Use Link to view the full text]
Accession Number
2015904110
Title
Prophylactic dialysis improves short-term clinical outcome in patients
with non-dialysis-dependent chronic kidney disease undergoing cardiac
surgery: A meta-analysis of randomized controlled trials.
Source
Coronary Artery Disease. 31(1) (pp E73-E79), 2022. Date of Publication: 01
Jan 2022.
Author
An X.; Ye N.; Bian W.; Cheng H.
Institution
(An, Ye, Bian, Cheng) Division of Nephrology, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Several studies have reported that prophylactic dialysis can
reduce the mortality of non-dialysis-dependent chronic kidney disease
(CKD) patients after cardiac surgery. However, the results of
complications in these randomized controlled trials (RCTs) were not
consistent. We aimed to perform a meta-analysis to systematically evaluate
the effect of prophylactic dialysis in these non-dialysis-dependent CKD
patients. Method(s): We systematically searched Medline, Embase,
Cochrane's Library and other online sources for related RCTs. Effects of
prophylactic dialysis on the incidence of 30 days' mortality and
postoperative complications were analyzed. Result(s): Four RCTs
comprising 395 patients were included, all of them treated by coronary
artery bypass grafting. Treatment of preoperative and intraoperative
prophylactic dialysis significantly reduced the rate of 30-day all-cause
mortality (risk ratio [RR]: 0.27, 95% confidence interval [CI], 0.13-0.58,
P < 0.001, I2 = 0%) and the incidence of pulmonary complications (RR:
0.39, 95% CI, 0.20-0.77, P = 0.007, I2 = 0%), low cardiac output (RR:
0.29, 95% CI, 0.09-0.99, P = 0.05, I2 = 0%), and acute kidney injury (RR:
0.19, 95% CI: 0.07-0.52, P = 0.001, I2 = 0%). However, there were no
statistically significant differences between the dialysis group and the
control group in gastrointestinal bleeding, sepsis or multiple organ
failure, wound infection, arrhythmia, transient neurologic deficit, stroke
and re-exploration for bleeding. Conclusion(s): Prophylactic dialysis
can improve the 30-day clinical outcomes of non-dialysis-dependent CKD
patients undergoing cardiac surgery, it was associated with the 30-day
mortality benefit and led to a decrease in the incidence of pulmonary
complications, as well as low cardiac output, and acute kidney
injury. Copyright © 2021 The Author(s). Published by Wolters
Kluwer Health, Inc.

<66>
Accession Number
2015065808
Title
Effect of desflurane on changes in regional cerebral oxygenation in
patients undergoing one-lung ventilation is equivalent to the effect of
propofol.
Source
Respiratory Physiology and Neurobiology. 296 (no pagination), 2022.
Article Number: 103798. Date of Publication: February 2022.
Author
Sato S.; Edanaga M.; Kondo M.; Yamakage M.
Institution
(Sato, Edanaga, Kondo, Yamakage) Department of Anesthesiology, Sapporo
Medical University School of Medicine, West 16, South 1, Chuo-ward,
Sapporo, Hokkaido 060-8543, Japan
Publisher
Elsevier B.V.
Abstract
Objectives: Desaturation is an important clinical problem during one-lung
ventilation (OLV) since it may induce cerebral hypoxia. Measurement of
cerebral oxygenation has been shown to provide accurate information about
episodes of cerebral hypoxemia. The purpose of this study was to compare
the effect of desflurane on changes in cerebral oxygenation during OLV
with the effect of propofol. Method(s): A randomized, single-blinded,
prospective study was conducted. Fifty adult patients who were scheduled
to undergo thoracic surgery were randomly assigned to anesthetic
management using desflurane with remifentanil (Group D: n = 25) or using
propofol and remifentanil (Group P: n = 25). Result(s): The
characteristics of the patients were very similar. Intergroup analysis of
changes in cerebral oxygenation showed no significant difference on the
operative side (two-way ANOVA, F (7, 368) = 0.425, p = 0.887) or the
non-operative side (two-way ANOVA, F (7, 367) = 1.342, p = 0.229).
Intragroup analysis of changes in cerebral oxygenation using one-way ANOVA
showed no significant difference on the operative side (Group P; p =
0.585, Group D; p = 0.928) or the non-operative side in both groups (Group
P; p = 0.657, Group D; p = 0.602). Conclusion(s): The effects of
desflurane and propofol on changes in cerebral oxygenation in patients
undergoing OLV were equivalent. Our results indicated that desflurane
might be an appropriate anesthetic during OLV for maintaining cerebral
oxygenation with an effective equivalent to that of
propofol. Copyright © 2021 Elsevier B.V.

<67>
Accession Number
2012319103
Title
The effect of non-point-of-care haemostasis management protocol
implementation in cardiac surgery: A systematic review.
Source
Transfusion Medicine. 31(5) (pp 328-338), 2021. Date of Publication:
October 2021.
Author
Boxma R.P.J.; Garnier R.P.; Bulte C.S.E.; Meesters M.I.
Institution
(Boxma, Garnier, Bulte) Department of Anesthesiology, Amsterdam University
Medical Center, Location VU Medical Center, Amsterdam, Netherlands
(Meesters) Department of Anesthesiology, Catharina Hospital Eindhoven,
Eindhoven, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This systematic review aims to outline the evidence on the
implementation of a non-point-of-care (non-point-of-care [POC])
haemostasis management protocol compared to experience-based practice in
adult cardiac surgery. Background(s): Management of coagulopathy in
cardiac surgery is complex and remains highly variable among centres and
physicians. Although various guidelines recommend the implementation of a
transfusion protocol, the literature on this topic has never been
systematically reviewed. Method(s): PubMed, Embase, Cochrane Library,
and Web of Science were searched from January 2000 till May 2020.
 Result(s): A total of seven studies (one randomised controlled trial
[RCT], one prospective cohort study, and five retrospective studies) met
the inclusion criteria. Among the six non-randomised, controlled studies,
the risk of bias was determined to be serious to critical, and the one RCT
was determined to have a high risk of bias. Five studies showed a
significant reduction in red blood cells, fresh frozen plasma, and/or
platelet transfusion after the implementation of a structural non-POC
algorithm, ranging from 2% to 28%, 2% to 19.5%, and 7% to17%,
respectively. One study found that fewer patients required transfusion of
any blood component in the protocol group. Another study had reported a
significantly increased transfusion rate of platelet concentrate in the
haemostasis algorithm group. Conclusion(s): Owing to the high
heterogeneity and a substantial risk of bias of the included studies, no
conclusion can be drawn on the additive value of the implementation of a
cardiac-surgery-specific non-POC transfusion and haemostasis management
algorithm compared to experience-based practice. To define the exact
impact of a transfusion protocol on blood product transfusion, bleeding,
and adverse events, well-designed prospective clinical trials are
required. Copyright © 2021 The Authors. Transfusion Medicine
published by John Wiley & Sons Ltd on behalf of British Blood Transfusion
Society.

<68>
Accession Number
2005366453
Title
Subclinical valve thrombosis in transcatheter aortic valve implantation: A
systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 162(5) (pp 1491-1499.e2),
2021. Date of Publication: November 2021.
Author
Woldendorp K.; Doyle M.P.; Black D.; Ng M.; Keech A.; Grieve S.M.; Bannon
P.G.
Institution
(Woldendorp, Black, Ng, Keech, Grieve, Bannon) Sydney Medical School, The
University of Sydney, Sydney, Australia
(Woldendorp, Doyle, Black, Bannon) The Baird Institute of Applied Heart
and Lung Surgical Research, Sydney, Australia
(Woldendorp, Doyle, Bannon) Cardiothoracic Surgical Unit, Royal Prince
Alfred Hospital, Sydney, Australia
(Ng, Keech) Cardiology Department, Royal Prince Alfred Hospital, Sydney,
Australia
(Grieve) Department of Radiology, Royal Prince Alfred Hospital, Sydney,
Australia
(Grieve) Sydney Translational Imaging Laboratory, Heart Research Institute
& Charles Perkins Centre, Sydney Medical School, University of Sydney,
Sydney, Australia
(Bannon) Institute of Academic Surgery, Royal Prince Alfred Hospital,
Sydney, Australia
Publisher
Elsevier Inc.
Abstract
Background: Recent high-resolution computed tomography studies after
transcatheter aortic valve insertion (TAVI) have reported a high
prevalence of subclinical valve thrombosis (SCVT), potentially
contributing to increased risk of late stroke. We aimed to investigate
SCVT in patients after TAVI, with a focus on prevalence, predisposing
factors, management, and potential sequelae. Method(s): A
comprehensive literature review of patients with SCVT after TAVI was
carried out on all published studies in 3 major electronic databases from
their inception until October 2019. Studies with sufficient data were
included in a meta-analysis comparing the risk of stroke between patients
with SCVT and those with normal valve function, as well as the protective
effects of antiplatelet and anticoagulation on preventing SCVT.
 Result(s): From 3456 patients examined in a comprehensive review, 398
patients (11.5%) demonstrated evidence of SCVT during follow-up. Dual
antiplatelet therapy was given in 45.5% of cases, single antiplatelet
therapy in 19.8%, and oral anticoagulation in 28.5%. A meta-analysis
demonstrated that rates of stroke were more than 3 times greater in
patients with SCVT compared with those without (logistic odds, 1.10; 95%
confidence interval, 0.63-1.57, P < .0001). Oral anticoagulation was
superior to dual antiplatelet therapy or single antiplatelet therapy,
preventing the formation of SCVT (logistic odds, -1.05, 95% confidence
interval, -1.71 to -0.39, P < .0001). Conclusion(s): Subclinical
valve thrombosis is seen in 11.5% of patients after TAVI and is associated
with increased risk of stroke. When oral anticoagulation is used
postprocedurally, it is more effective than either dual or
single-antiplatelet therapy in preventing subclinical valve thrombosis.
These findings suggest that further studies are needed to define the
optimal antithrombotic regimen to mitigate thrombotic and embolic sequelae
after TAVI. Copyright © 2020

<69>
[Use Link to view the full text]
Accession Number
2015776713
Title
Initial optimal medical therapy with or without invasive strategy for
stable coronary disease: A meta-analysis and systematic review.
Source
Coronary Artery Disease. 32(8) (pp 721-729), 2021. Date of Publication: 01
Dec 2021.
Author
Barbarawi M.; Alabdouh A.; Barbarawi O.; Lakshman H.; Alkasasbeh M.;
Khallad M.; Radaideh Q.
Institution
(Barbarawi) Department of Cardiology, University of Connecticut,
Farmington, CT, United States
(Alabdouh) Department of Internal Medicine, Saint Agnes Hospital,
Baltimore, MD, United States
(Barbarawi) Department of Internal Medicine, Mutah University, Al-Karak,
Jordan
(Lakshman) Department of Internal Medicine, Hurley Medical Center,
Michigan State University, Flint, MI, United States
(Alkasasbeh) Department of Health Administration, Western Connecticut
State University, Danbury, CT, United States
(Khallad) Department of Internal Medicine, Ross University, School of
Medicine, Miramar, FL, United States
(Radaideh) Department of Internal Medicine, University of Iowa Hospitals
and Clinics, IA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction There is a persistent controversy regarding the benefit and
timing of angiography in patients with stable coronary artery disease
(CAD). With this meta-analysis of randomized controlled trials (RCTs) the
advantages of initial invasive strategy and medical therapy compared with
only medical therapy. Methods We conducted a literature search of the
following databases Pubmed/MEDLINE, Cochrane Library and Embase. Data was
collected from all the RCTs that compared early invasive approach with
medical therapy alone in treating stable CAD which was conducted by two
independent authors. Primary outcomes were all-cause mortality and
myocardial infarction (MI), while the secondary outcomes included major
adverse cardiovascular events (MACE), cardiovascular mortality,
cardiovascular hospitalization, hospitalization due to unstable angina and
revascularization events. The Mantel-Haenszel random-effects model was
used to estimate risk ratios (RRs) and 95% confidence intervals (CIs).
Results We included 15 RCTs (13 916 patients, mean age 63.1, 78.9% men).
The early invasive strategy, compared with medical therapy alone, did not
reveal a significant reduction in the incidence of all-cause mortality
(RR, 0.94; 95% CI, 0.84-1.05, P = 0.30) or MI (RR, 0.93; 95% CI,
0.79-1.10, P = 0.42). Furthermore, the early invasive strategy did not
reduce the incidence of cardiovascular mortality, cardiovascular
hospitalization or the revascularization rate compared with medical
therapy alone (P > 0.05). However, the incidence of MACE and
hospitalization due to unstable angina were lower in patients treated with
early invasive strategy (RR, 0.79; 95% CI, 0.63-0.99, P = 0.04), and (RR,
0.46; 95% CI, 0.32-0.67, P < 0.0001), respectively. Conclusions Early
invasive strategy with medical therapy did not reduce the incidence of
all-cause mortality and MI when compared with medical therapy alone among
patients with stable CAD with significant stenosis. However, there was a
significant reduction in the incidence of MACE and hospitalization due to
unstable angina in the early invasive group. Copyright © 2021
Wolters Kluwer Health, Inc. All rights reserved.

<70>
[Use Link to view the full text]
Accession Number
2015776706
Title
Early coronary healing in ST segment elevation myocardial infarction:
Sirolimus-eluting stents vs. drug-coated balloons after bare-metal stents.
The PEBSI-2 optical coherence tomography randomized study.
Source
Coronary Artery Disease. 32(8) (pp 673-680), 2021. Date of Publication: 01
Dec 2021.
Author
Garcia-Touchard A.; Gonzalo N.; Goicolea J.; Gomez-Lara J.; Martin-Yuste
V.; Peral V.; Martinez-Romero P.; Vaquerizo B.; Sanchez-Recalde A.;
Sarnago F.; Oteo J.F.; Alfonso F.
Institution
(Garcia-Touchard, Goicolea, Oteo) Interventional Cardiology, Hospital
Puerta de Hierro, Majadahonda, Spain
(Gonzalo) Hospital Clinico San Carlos, Madrid, Spain
(Gomez-Lara) Hospital Univeritari de Bellvitge, L'Hospitalet de Llobregat,
Mallorca, Spain
(Martin-Yuste) Department of Cardiology, Clinic Thorax Institute, Hospital
Clinic de Barcelona, Mallorca, Spain
(Peral) Department of Cardiology, Hospital Son Espases, Health Research
Institute of the Balearic Islands (IdISBa), Mallorca, Spain
(Martinez-Romero) Department of Cardiology, Puerto Real University
Hospital, Cadiz, Spain
(Vaquerizo) Unidad de Cardiologia Intervencionista, Departamento de
Cardiologia, Hospital del Mar, Barcelona, Spain
(Sanchez-Recalde) Hospital Ramon y Cajal, Madrid, Spain
(Sarnago) Servicio de Cardiologia, Hospital Universitario 12 de Octubre,
Madrid, Spain
(Alfonso) Department of Cardiology, Hospital Universitario de La Princesa,
CIBER-CV, IIS-IP, Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives Drug-coated balloons (DCBs) have theoretical advantages over
drug-eluting stents (DESs) to facilitate stent healing. We studied
whether, in patients undergoing primary coronary interventions (pPCIs), a
strategy of DCB after bare-metal stent improves early healing as
determined by optical coherence tomography (OCT) compared with
new-generation DES. Methods pPCI patients were randomized (1:1) to
treatment with new-generation sirolimus-eluting stents (DES group) or
DCB-strategy. Vessel healing was assessed by OCT at 90days. Results
Fifty-three patients were randomized (26 DES vs. 27 DCB). At 90days, both
strategies showed a low rate of uncovered struts (3.2 vs. 3.2%, P=0.64)
and a very high and similar rate of covered and apposed struts (96.6 vs.
96.1%, respectively; P=0.58). However, DCB group had a significantly lower
rate of major coronary evaginations (68 vs. 37%, P=0.026), and more
frequently developed a thin homogeneous neointimal layer (20 vs. 70.4%,
P=0.001) suggesting distinct superior healing at 3months compared to DES.
Conclusions In pPCI both, sirolimus-DES and DCB-strategy, provide
excellent strut coverage at 3months. However, DCB ensures more advanced
and optimal stent healing compared to sirolimus-DES. Further research is
needed to determine whether, in patients undergoing pPCI, DCB offers
superior long-term clinical and angiographic outcomes than new-generation
DES (NCT03610347). Copyright © 2021 Wolters Kluwer Health, Inc.
All rights reserved.

<71>
Accession Number
636658734
Title
Tight glycaemic control and surgical site infections post cardiac surgery:
A systematic review.
Source
Journal of Wound Care. 30(Supplement 12) (pp S22-S28), 2021. Date of
Publication: 01 Dec 2021.
Author
Hweidi I.M.; Zytoo A.M.; Hayajneh A.
Institution
(Hweidi, Zytoo, Hayajneh) Jordan University of Science and Technology,
Faculty of Nursing, P.O. Box 3030, Irbid 22110, Jordan
Publisher
MA Healthcare Ltd
Abstract
Objective: Surgical site infection (SSI) is one of the most serious
potential complications post cardiac surgery among patients with diabetes
and has a number of adverse health outcomes. The literature shows
discrepancies regarding the effect of different glycaemic control
protocols on reducing adverse health outcomes including SSIs. The aim of
this study was to conduct a systematic review that investigated the effect
of the optimal range of tight glycaemic control protocols using a
continuous insulin infusion on reducing the incidence of SSIs in adult
patients with diabetes undergoing cardiac surgery. Method(s): A
systematic review was conducted following the PRISMA statement and
guidelines. Search terms were used to identify research studies published
between 2000 and 2019 across five key databases, including CINAHL,
Medline, PubMed, Cochrane Database and Google Scholar. Result(s): A
total of 12 studies met the review inclusion criteria. The reviewed
literature tended to support the implementation of a tight glycaemic
control protocol, particularly in the postoperative phase, that
demonstrated fewer potential complications associated with cardiac
surgery. On the other hand, the literature also supported the application
of a moderate glycaemic control protocol in the intraoperative phase to
obtain better glycaemic stability with fewer potential complications among
those patients with diabetes undergoing cardiac surgery.
 Conclusion(s): This analysis concludes that tight glycaemic control
is more effective than moderate glycaemic control intraoperatively in
terms of glycaemic stability among patients with diabetes undergoing
cardiac surgery. Results also emphasised the importance of time-based
protocol implementation to ensure better health outcomes and better
quality of care for patients. Declaration of interest: The authors have no
conflicts of interest to declare. Copyright © 2021 MA Healthcare
Ltd

<72>
Accession Number
636064264
Title
Comparison of three ultrasound views for internal jugular venous
cannulation in patients undergoing cardiac surgery: A randomized trial.
Source
Journal of Medical Ultrasound. 29(3) (pp 176-180), 2021. Date of
Publication: July-September 2021.
Author
Chennakeshavallu G.N.; Gadhinglajkar S.; Sreedhar R.; Babu S.; Sankar S.;
Dash P.K.
Institution
(Chennakeshavallu, Gadhinglajkar, Sreedhar, Babu, Sankar, Dash) Department
of Cardiac Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences
and Technology, Kerala, Thiruvananthapuram, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: The quality of needle visualization during ultrasound-guided
internal jugular vein (IJV) cannulation determines the ease of procedure,
whereas posterior IJV wall puncture is the most common risk associated.
The IJV can be imaged in different views, which offer certain advantages
over each other. We compared three different ultrasound views for IJV
cannulation short axis (SAX), long axis (LAX), and oblique axis (OAX) with
respect to the quality of needle visualization, first pass success rate,
and posterior IJV wall puncture. Method(s): Two hundred ten patients
undergoing elective cardiac surgery were analyzed in this prospective
randomized clinical trial. Patients were randomly assigned to one of the
three groups: SAX (n = 70), LAX (n = 70), and OAX (n = 70). The quality of
needle visualization, first pass success rate, and incidence of posterior
IJV wall puncture in each of the three ultrasound views were studied. The
Chi-square test and ANOVA were used for the comparison of means and
proportion between the groups. Result(s): The quality of needle
visualization was graded as good in 90% patients in OAX group, 81.4%
patients in LAX group, and 14.2% patients in SAX group, respectively (P <
0.0001). OAX group had the highest first pass success rate (94.2%)
followed by SAX (88.5%), and then, LAX (82.8%), but it was statistically
insignificant among the groups (P = 0.105). The mean IJV access time was
longer in LAX group when compared to OAX and SAX group (P < 0.0001).The
incidence of IJV posterior wall puncture was 14.2% patients in SAX group
and none in other groups (P = 0.0011). Conclusion(s): The results
suggest that OAX view can be adopted as standard approach during
ultrasound-guided IJV cannulation as it safe and reliable. Copyright
© 2021 Journal of Medical Ultrasound

<73>
Accession Number
2015178836
Title
Risk prediction models for atherosclerotic cardiovascular disease: A
systematic assessment with particular reference to Qatar.
Source
Qatar Medical Journal. 2021(2) (no pagination), 2021. Article Number: 42.
Date of Publication: 2021.
Author
Sheikh A.; Nurmatov U.; Al-Katheeri H.A.; Al Huneiti R.A.
Institution
(Sheikh) Usher Institute, University of Edinburgh, Edinburgh, United
Kingdom
(Nurmatov) School of Medicine, Cardiff University, Cardiff, United Kingdom
(Al-Katheeri) Strategic Planning and Performance Department, Ministry of
Public Health, Qatar
(Al Huneiti) Healthcare Quality and Patient Safety, Strategic Planning and
Performance Department, Ministry of Public Health, Qatar
Publisher
HBKU Press
Abstract
Background: Atherosclerotic cardiovascular disease (ASCVD) is a common
disease in the State of Qatar and results in considerable morbidity,
impairment of quality of life and mortality. The American College of
Cardiology/American Heart Association Pooled Cohort Equations (PCE) is
currently used in Qatar to identify those at high risk of ASCVD. However,
it is unclear if this is the optimal ASCVD risk prediction model for use
in Qatar's ethnically diverse population. Aim(s): This systematic
review aimed to identify, assess the methodological quality of and compare
the properties of established ASCVD risk prediction models for the Qatari
population. Method(s): Two reviewers performed head-to-head
comparisons of established ASCVD risk calculators systematically. Studies
were independently screened according to predefined eligibility criteria
and critically appraised using Prediction Model Risk Of Bias Assessment
Tool. Data were descriptively summarized and narratively synthesized with
reporting of key statistical properties of the models. Result(s): We
identified 20,487 studies, of which 41 studies met our eligibility
criteria. We identified 16 unique risk prediction models. Overall, 50% (n
1/4 8) of the risk prediction models were judged to be at low risk of
bias. Only 13% of the studies (n 1/4 2) were judged at low risk of bias
for applicability, namely, PREDICT and QRISK3.Only the PREDICT risk
calculator scored low risk in both domains. Conclusion(s): There is
no existing ASCVD risk calculator particularly well suited for use in
Qatar's ethnically diverse population. Of the available models, PREDICT
and QRISK3 appear most appropriate because of their inclusion of
ethnicity. In the absence of a locally derived ASCVD for Qatar, there is
merit in a formal head-to-head comparison between PCE, which is currently
in use, and PREDICT and QRISK3. Copyright © 2021 Sheikh,
Nurmatov, Al-Katheeri, Al Huneiti, licensee HBKU Press.

<74>
Accession Number
2007157250
Title
Venous or arterial samples for activated clotting time measurements: a
systematic review.
Source
Perfusion (United Kingdom). 36(8) (pp 845-852), 2021. Date of Publication:
November 2021.
Author
Iddawela S.; Swamy P.; Member S.; Harky A.
Institution
(Iddawela) Department of Respiratory Medicine, University Hospitals
Birmingham, Birmingham, United Kingdom
(Swamy) GKT School of Medical Education, King's College London, London,
United Kingdom
(Member) Lancashire School of Medicine and Dentistry, University of
Central Lancashire, Greenbank Building, Preston, Lancashire, United
Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Health and life
sciences, University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Harky) Department of Cardiac Surgery, Alder Hey Children Hospital,
Liverpool, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: The systematic review aims to investigate the effect of
sampling source on activated clotting time (ACT) measurement within
cardiovascular surgery and cardiac catheterisation. It also examines the
evidence surrounding novel clot assessment techniques and associated
sampling variation. Method(s): A comprehensive electronic search was
conducted using PubMed, MEDLINE, Scopus, Cochrane database, and Google
Scholar until 20th June 2020. All studies reporting sampling source
variability of ACT in cardiac surgery, vascular surgery and cardiac
catheterisation were included. Result(s): Fourteen studies were
included in the systematic review. Inconsistent reports of variability
were seen in cardiac surgery and cardiac catheterisation. There were no
studies directly examining ACT variability in vascular surgery. Novel clot
assessment techniques have been validated in cardiac surgery, but
measurements vary depending on sampling source. Conclusion(s):
Sampling source should be kept consistent to facilitate effective
haemostatic strategies. More research is needed regarding variability in
vascular surgery and novel clot assessment techniques. Copyright
© The Author(s) 2020.

<75>
Accession Number
2011084047
Title
Frequency, Impact, and Predictors of Access Complications With Plug-Based
Large-Bore Arteriotomy Closure - A Patient-Level Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 34 (pp 69-74), 2022. Date of
Publication: January 2022.
Author
Nuis R.-J.; Wood D.; Kroon H.; van Wiechen M.; Bigelow D.; Buller C.;
Daemen J.; de Jaegere P.; Krajcer Z.; Webb J.; Van Mieghem N.
Institution
(Nuis, Kroon, van Wiechen, Daemen, de Jaegere, Van Mieghem) Department of
Cardiology, Erasmus Medical Center, Rotterdam, Netherlands
(Wood, Webb) Centre for Cardiovascular and Heart Valve Innovation, St.
Paul's and Vancouver General Hospital, Vancouver, Canada
(Bigelow, Buller) Clinical and Medical Affairs, Teleflex Inc., Exton, PA,
United States
(Krajcer) Baylor St Luke Hospital, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background/purpose: The MANTA is a dedicated plug-based large-bore
vascular closure device (VCD) providing safe hemostasis in most patients,
but data on the clinical impact and mechanisms of MANTA related
complications are limited. This study sought to determine the frequency,
impact and predictors of MANTA-related access complications.
Methods/materials: This patient-level meta-analysis included data from 2
medical device approval studies and 1 post-approval registry. The primary
endpoint was the composite of major and minor access complications.
Technical success was defined as hemostasis with MANTA closure device
without need for vascular surgery or stenting. Result(s): Eight
hundred ninety-one patients (mean age 80) underwent transcatheter aortic
valve replacement (n = 814), endovascular aortic repair (n = 71), balloon
aortic valvuloplasty (n = 4) or mechanical circulatory support (n = 2).
Technical success was 96.4% and median time to hemostasis was 31
(interquartile range: 17-76) seconds. The primary endpoint occurred 9.1%
and bailout vascular surgery or stenting was necessary in 32 patients
(3.6%). Female gender (OR: 2.63, CI: 1.46-4.73, p = 0.001), left femoral
access (OR: 2.18, CI: 1.17-4.06, p = 0.015) and unfavorable arteriotomy
phenotype (combination of a small femoral artery diameter with a deep
arteriotomy; OR 2.27: 1.26-4.10, p = 0.006) independently predicted access
complications. Access complications most often consisted of vessel
dissection, stenosis or occlusion and predominantly occurred in patients
with an unfavorable arteriotomy phenotype. Conclusion(s): Large-bore
arteriotomy closure with MANTA VCD provided fast and safe hemostasis with
an acceptable complication rate. Refined procedure planning and
risk-stratification may further improve MANTA VCD
performance. Copyright © 2021 The Authors

<76>
Accession Number
2011059434
Title
Design and Rationale of a Randomized Trial of COBRA PzF Stenting to REDUCE
Duration of Triple Therapy (COBRA-REDUCE).
Source
Cardiovascular Revascularization Medicine. 34 (pp 17-24), 2022. Date of
Publication: January 2022.
Author
Colleran R.; Joner M.; Cutlip D.; Urban P.; Maeng M.; Jauhar R.; Barakat
M.; Michel J.M.; Mehran R.; Kirtane A.J.; Maillard L.; Kastrati A.; Byrne
R.A.
Institution
(Colleran, Joner, Michel, Kastrati) Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, Munich, Germany
(Joner, Kastrati) German Centre for Cardiovascular Research (DZHK),
partner site Munich Heart Alliance, Munich, Germany
(Cutlip) Cardiology Division, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
(Urban) La Tour Hospital, Geneva, Switzerland
(Urban) CERC (Cardiovascular European Research Center), Massy, France
(Maeng) Aarhus University Hospital, Aarhus, Denmark
(Mehran) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Kirtane) Department of Medicine, Columbia University Irving Medical
Center/New York Presbyterian Hospital, New York, NY, United States
(Kirtane) Cardiovascular Research Foundation, New York, NY, United States
(Maillard) GCS-ES Axium-Rambot, Clinique Axium, Aix en Provence, France
(Byrne) Cardiovascular Research Institute Dublin, Mater Private Hospital,
Dublin, Ireland
(Byrne) School of Pharmacy and Biomolecular Sciences, Royal College of
Surgeons University of Medicine and Health Sciences, Dublin, Ireland
(Jauhar) North Shore University Hospital, Manhasset New York, NY, United
States
(Barakat) Celonova Biosciences Inc., San Antonio, TX, United States
Publisher
Elsevier Inc.
Abstract
Background/purpose: A coronary stent with thromboresistant and pro-healing
properties such as the polymer polyzene F-coated (COBRA PzF) stent might
safely allow for a very short duration of triple therapy in patients
taking oral anticoagulation (OAC) who undergo coronary stenting.
 Method(s): The COBRA-REDUCE trial is a prospective, multinational,
randomized, open-label, assessor-blinded trial. A total of 996 patients at
high bleeding risk because of requirement for OAC (with a vitamin K
antagonist or non-vitamin K antagonist for any indication) will be
randomized at sites in the United States and Europe to treatment with the
COBRA-PzF stent followed by very short duration (14 days) DAPT or a Food
and Drug Administration (FDA)-approved new generation drug-eluting stent
followed by guideline-recommended DAPT duration (3 or 6 months). Two
co-primary endpoints will be tested at 6 months: a bleeding co-primary
endpoint (bleeding academic research consortium [BARC] >=2 bleeding beyond
14 days or after hospital discharge, whichever is later [superiority
hypothesis]) and a thrombo-embolic co-primary endpoint (the composite of
all-cause death, myocardial infarction, definite/probable stent thrombosis
or ischaemic stroke [non-inferiority hypothesis]). The trial is registered
at clinicaltrials.gov (NCT02594501). Conclusion(s): The COBRA-REDUCE
trial will determine whether coronary stenting with the COBRA PzF stent
followed by 14 days of clopidogrel will reduce bleeding without increasing
thrombo-embolic events compared with FDA-approved DES followed by 3-6
months clopidogrel in patients taking OAC and aspirin. Copyright
© 2021 The Authors

<77>
Accession Number
2010819417
Title
Single Versus Dual Antiplatelet Therapy After Transcatheter Aortic Valve
Replacement: A Meta-Analysis of Randomized Clinical Trials.
Source
Cardiovascular Revascularization Medicine. 34 (pp 46-53), 2022. Date of
Publication: January 2022.
Author
Ahmad Y.; Howard J.P.; Madhavan M.V.; Leon M.B.; Makkar R.R.
Institution
(Ahmad, Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Howard) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Madhavan, Leon) Columbia University Medical Center, New York, NY, United
States
(Leon) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Guidelines recommend dual antiplatelet therapy (DAPT) after
transcatheter aortic valve replacement (TAVR) but guidelines predate the
publication of the largest randomized trial. There have been few trials in
the field to date, and with a small number of total patients; pooling
their results may therefore be helpful. Method(s): We systematically
identified all randomized trials comparing SAPT to DAPT after TAVR. The
primary endpoint was the risk of major bleeding. Secondary endpoints
included all bleeding, life-threatening bleeding, stroke, myocardial
infarction, death and cardiac death. Result(s): Four trials,
randomizing 1086 participants, were eligible (541 randomized to SAPT and
545 randomized to DAPT). The weighted mean follow-up was 9.1 months. The
risk of major bleeding was significantly increased after DAPT (relative
risk (RR) 2.36, 95% confidence interval (CI) 1.27 to 4.40, P = 0.007).
There was a similar increased risk for all bleeding (RR 1.65, 95% CI 1.24
to 2.19, P < 0.001), although not for life-threatening bleeding (RR 1.44,
95% CI 0.74 to 2.77, P = 0.282). There were no significant differences in
the risk of stroke, myocardial infarction (MI), death or cardiac death.
There was no heterogeneity observed for any endpoint (I2 =
0.0%). Conclusion(s): DAPT after TAVR is associated with an increased
risk of major bleeding and all bleeding. There is no evidence of a
significant difference between DAPT or SAPT for the risks of stroke, MI,
death or cardiac death. However, the total number of patients randomized
is small and the duration of follow-up is short. Larger scale randomized
trials with longer follow-up are required to assess for any potential
differences in ischemic endpoints or mortality. Copyright © 2021
The Author(s)

<78>
Accession Number
2010154591
Title
Clinical outcomes in nonagenarians undergoing transcatheter aortic valve
implantation: a systematic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 37(1) (pp 202-208), 2022.
Date of Publication: January 2022.
Author
Noguchi M.; Ueyama H.; Ando T.; Takagi H.; Toshiki K.
Institution
(Noguchi) Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical
Center, Uyarasu, Japan
(Ueyama, Toshiki) Department of Medicine, Icahn School of Medicine at
Mount Sinai, Mount Sinai Beth Israel, New York, NY, United States
(Ando) Department of Cardiology, Kawasaki Saiwai Hospital, Kawasaki, Japan
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
Publisher
Springer Japan
Abstract
To compare the risk of procedural complications and mortality after
transcatheter aortic valve implantation (TAVI) in nonagenarians (age >= 90
years) compared to younger patients (< 90 years). Although TAVI could be
considered as a treatment option in nonagenarians, several previous
studies have shown conflicting outcomes between nonagenarians and younger
patients who underwent TAVI. We conducted a comprehensive literature
search through PubMed and EMBASE to investigate the clinical outcomes of
nonagenarians after TAVI. The outcomes of interest were short- and
long-term mortality and procedural complications. Our study identified 16
observational studies including a total of 179,565 patients (21,674
nonagenarian patients and 157,891 younger patients. Nonagenarians had a
significantly higher rate of short- (hazard ratio [HR], 95% confidence
interval [CI]: 1.48, 1.38-1.59; P < 0.001) and long-term mortality (HR,
95% CI: 1.34, 1.24-1.44; P < 0.001) than younger patients after TAVI.
Furthermore, there were significant differences in major and/or
life-threatening bleeding (risk ratio [RR], 95% CI: 1.21, 1.05-1.39; P =
0.008), stroke (HR, 95% CI: 1.24, 1.11-1.40; P < 0.001), and major
vascular complication (RR, 95% CI: 2.15, 1.35-3.42; P = 0.001) between
nonagenarians and younger patients after TAVI. Minor vascular
complication, myocardial infarction and permanent pacemaker implantation
rate were similar between the two groups. Nonagenarians had significantly
higher rate of short- and long-term mortality, major and/or
life-threatening bleeding, stroke, and major vascular complication after
TAVI. Although TAVI is a treatment option in nonagenarians, careful and
appropriate selection of patients is essential to improve clinical
outcomes. Copyright © 2021, Japanese Association of
Cardiovascular Intervention and Therapeutics.

<79>
Accession Number
2016503839
Title
Multiple arterial coronary bypass grafting is associated with better
survival compared with second-generation drug-eluting stents in patients
with stable multivessel coronary artery disease.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Rocha R.V.; Fang J.; Tam D.Y.; Elbatarny M.; Austin P.C.; Gaudino M.F.L.;
Lee D.S.; Fremes S.E.
Institution
(Rocha, Tam, Elbatarny, Fremes) Division of Cardiac Surgery, Schulich
Heart Centre, Department of Surgery, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Ontario, Canada
(Fang, Austin, Lee) Cardiovascular Program, ICES, Toronto, Ontario, Canada
(Austin, Fremes) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, Ontario, Canada
(Gaudino) Department of Cardio-Thoracic Surgery, Weill Cornell Medicine,
New York, NY
(Lee) Division of Cardiology, Peter Munk Cardiac Centre, University Health
Network, University of Toronto, Toronto, Ontario, Canada
Publisher
Elsevier Inc.
Abstract
Objective: We sought to compare the long-term outcomes of multiarterial
graft (MAG) coronary artery bypass grafting (CABG) versus percutaneous
coronary intervention (PCI) with second-generation drug-eluting stents
(DES) to treat stable multivessel coronary artery disease. Method(s):
This study was a multicenter population-based retrospective analysis of
all residents of Ontario, Canada, from January 1, 2011, to December 31,
2019. We identified 3600 cases of elective primary isolated CABG with MAG
and 2187 cases of PCI with second-generation DES. Result(s): After
the application of propensity score-weighting using overlap weights, MAG
was associated with better survival over 5 years compared with DES (96.8%
vs 94.5%; hazard ratio [HR], 0.56; 95% CI, 0.37-0.85). MAG was also
associated with better secondary outcomes including a composite of death,
myocardial infarction, and stroke (94.3% vs 88.5%; HR, 0.49; 95% CI,
0.36-0.65). The rate of death, stroke, myocardial infarction, and repeat
revascularization (91.2% vs 70.7%; HR, 0.24; 95% CI, 0.20-0.30), and the
individual end points of myocardial infarction (1.4% vs 6.9%; HR, 0.22;
95% CI, 0.13-0.35), and repeat revascularization (4.1% vs 24.2%; HR, 0.14;
95% CI, 0.10-0.18) were lower with MAG. PCI with second-generation DES was
associated with a lower rate of stroke up to 5 years (0.6% vs 1.8%; HR,
3.97; 95% CI, 1.45-10.88). Conclusion(s): CABG with MAG was
associated with better survival and fewer major cardiac adverse events
compared with second-generation DES and might be considered the treatment
of choice for patients with stable multivessel coronary artery disease.
Further randomized controlled trials are needed to confirm this
hypothesis. Copyright © 2021 The American Association for
Thoracic Surgery

<80>
Accession Number
2014261122
Title
Robot-assisted thoracic surgery versus video-assisted thoracic surgery for
treatment of patients with thymoma: A systematic review and meta-analysis.
Source
Thoracic Cancer. 13(2) (pp 151-161), 2022. Date of Publication: January
2022.
Author
Shen C.; Li J.; Che G.
Institution
(Shen, Li, Li, Che) Department of Thoracic Surgery, West-China Hospital,
Sichuan University, Chengdu, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Surgical resection of the thymus is indicated in the presence
of primary thymic diseases such as thymoma. Video-assisted thoracoscopic
surgery (VATS) and robot-assisted thoracic surgery (RATS) offer a
minimally invasive approach to thymectomy. However, there is no clear
conclusion whether RATS can achieve an equal or even better surgical
effect when compared with VATS in treatment of thymoma. We performed this
meta-analysis to explore and compare the outcomes of RATS versus VATS for
thymectomy in patients with thymoma. Method(s): PubMed, Cochrane
Library, EMBASE, China National Knowledge Infrastructure (CNKI), Medline,
and Web of Science databases were searched for full-text literature
citations. The quality of the articles was evaluated using the
Newcastle-Ottawa Scale and the data analyzed using Review Manager 5.3
software. Fixed or random effect models were applied according to
heterogeneity. Subgroup analysis was conducted. Result(s): A total of
11 studies with 1418 patients, of whom 688 patients were in the RATS group
and 730 in the VATS group, were involved in the analysis. Compared with
VATS, RATS was associated with less blood loss in operation, lower volume
of drainage, fewer postoperative pleural drainage days, shorter
postoperative hospital stay, and fewer postoperative complications. There
was no significant difference in operative time and patients with or
without myasthenia gravis between the two groups. Conclusion(s): RATS
has more advantages over VATS, indicating that RATS is better than VATS in
terms of postoperative recovery. We look forward to more large-sample,
high-quality randomized controlled studies published in the
future. Copyright © 2021 The Authors. Thoracic Cancer published
by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

<81>
Accession Number
2013939989
Title
Late health outcomes after dexrazoxane treatment: A report from the
Children's Oncology Group.
Source
Cancer. 128(4) (pp 788-796), 2022. Date of Publication: 15 Feb 2022.
Author
Chow E.J.; Aplenc R.; Vrooman L.M.; Doody D.R.; Huang Y.-S.V.; Aggarwal
S.; Armenian S.H.; Baker K.S.; Bhatia S.; Constine L.S.; Freyer D.R.; Kopp
L.M.; Leisenring W.M.; Asselin B.L.; Schwartz C.L.; Lipshultz S.E.
Institution
(Chow, Doody, Baker, Leisenring) Fred Hutchinson Cancer Research Center,
Seattle Children's Hospital, Seattle, WA, United States
(Aplenc, Huang) Children's Hospital of Philadelphia, Philadelphia, PA,
United States
(Vrooman) Dana-Farber Cancer Institute, Boston Children's Hospital,
Boston, MA, United States
(Aggarwal) Wayne State University, Detroit, MI, United States
(Armenian) City of Hope, Duarte, CA, United States
(Bhatia) University of Alabama at Birmingham, Birmingham, AL, United
States
(Constine, Asselin) Golisano Children's Hospital, University of Rochester
Medical Center, Rochester, NY, United States
(Freyer) Children's Hospital Los Angeles, University of Southern
California, Los Angeles, CA, United States
(Kopp) University of Arizona, Tucson, AZ, United States
(Schwartz) Children's Wisconsin, Medical College of Wisconsin, Milwaukee,
WI, United States
(Lipshultz) Oishei Children's Hospital, Roswell Park Comprehensive Center,
University at Buffalo Jacobs School of Medicine and Biomedical Sciences,
Buffalo, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The objective of this study was to examine long-term outcomes
among children newly diagnosed with cancer who were treated in
dexrazoxane-containing clinical trials. Method(s): P9404 (acute
lymphoblastic leukemia/lymphoma [ALL]), P9425 and P9426 (Hodgkin
lymphoma), P9754 (osteosarcoma), and Dana-Farber Cancer Institute 95-01
(ALL) enrolled 1308 patients between 1996 and 2001: 1066 were randomized
(1:1) to doxorubicin with or without dexrazoxane, and 242 (from P9754)
were nonrandomly assigned to receive dexrazoxane. Trial data were linked
with the National Death Index, the Organ Procurement and Transplantation
Network, the Pediatric Health Information System (PHIS), and Medicaid.
Osteosarcoma survivors from the Childhood Cancer Survivor Study (CCSS; n =
495; no dexrazoxane) served as comparators in subanalyses. Follow-up
events were assessed with cumulative incidence, Cox regression, and
Fine-Gray methods. Result(s): In randomized trials (cumulative
prescribed doxorubicin dose, 100-360 mg/m2; median follow-up,
18.6 years), dexrazoxane was not associated with relapse (hazard ratio
[HR], 0.84; 95% confidence interval [CI], 0.63-1.13), second cancers (HR,
1.19; 95% CI, 0.62-2.30), all-cause mortality (HR, 1.07; 95% CI,
0.78-1.47), or cardiovascular mortality (HR, 1.45; 95% CI, 0.41-5.16).
Among P9754 patients (all exposed to dexrazoxane; cumulative doxorubicin,
450-600 mg/m2; median follow-up, 16.6-18.4 years), no
cardiovascular deaths or heart transplantation occurred. The 20-year heart
transplantation rate among CCSS osteosarcoma survivors (mean doxorubicin,
377 +/- 145 mg/m2) was 1.6% (vs 0% in P9754; P =.13). Among
randomized patients, serious cardiovascular outcomes (cardiomyopathy,
ischemic heart disease, and stroke) ascertained by PHIS/Medicaid occurred
less commonly with dexrazoxane (5.6%) than without it (17.6%; P =.02),
although cardiomyopathy rates alone did not differ (4.4% vs 8.1%; P =.35).
 Conclusion(s): Dexrazoxane did not appear to adversely affect
long-term mortality, event-free survival, or second cancer
risk. Copyright © 2021 American Cancer Society

<82>
Accession Number
2015507120
Title
Meta-Analysis Evaluating High-Sensitivity Cardiac Troponin T Kinetics
after Coronary Artery Bypass Grafting in Relation to the Current
Definitions of Myocardial Infarction.
Source
American Journal of Cardiology. 163 (pp 25-31), 2022. Date of Publication:
15 Jan 2022.
Author
Heuts S.; Denessen E.J.S.; Daemen J.H.T.; Vroemen W.H.M.; Sels J.-W.;
Segers P.; Bekers O.; van 't Hof A.W.J.; Maessen J.G.; van der Horst
I.C.C.; Mingels A.M.A.
Institution
(Heuts, Segers, Maessen) Department of Cardiothoracic Surgery
(Denessen, Vroemen, Bekers, Mingels) Department of Central Diagnostic
Laboratory
(Sels, van der Horst) Department of Intensive Care Medicine, and
(Sels, van 't Hof) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
(Denessen, Bekers, van 't Hof, Maessen, van der Horst, Mingels)
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Daemen) Department of Surgery, and
(van 't Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
Elsevier Inc.
Abstract
Various definitions of myocardial infarction type 5 after coronary artery
bypass grafting (CABG) have been proposed (myocardial infarction [MI-5],
also known as peri-procedural MI), using different biomarkers and
different and arbitrary cut-off values. This meta-analysis aims to
determine the expected release of high-sensitivity cardiac troponin T
(hs-cTnT) after CABG in general and after uncomplicated surgery and
off-pump CABG in particular. A systematic search was applied to 3
databases. Studies on CABG as a single intervention and reporting on
postoperative hs-cTnT concentrations on at least 2 different time points
were included. All data on hs-cTnT concentrations were extracted, and mean
concentrations at various points in time were stratified. Eventually, 15
studies were included, encompassing 2,646 patients. Preoperative hs-cTnT
was 17 ng/L (95% confidence interval [CI] 13 to 20 ng/L). Hs-cTnT peaked
at 6 to 8 hours postoperatively (628 ng/L, 95% CI 400 to 856 ng/L; 45x
upper reference limit [URL]) and was still increased after 48 hours. In
addition, peak hs-cTnT concentration was 614 ng/L (95% CI 282 to 947 ng/L)
in patients with a definite uncomplicated postoperative course (i.e.,
without MI). For patients after off-pump CABG compared to on-pump CABG,
the mean peak hs-cTnT concentration was 186 ng/L (95% CI 172 to 200 ng/L,
13 x URL) versus 629 ng/L (95% CI 529 to 726 ng/L, 45 x URL),
respectively. In conclusion, postoperative hs-cTnT concentrations surpass
most of the currently defined cut-off values for MI-5, even in perceived
uncomplicated surgery, suggesting thorough reassessment. Hs-cTnT release
differences following on-pump CABG versus off-pump CABG were observed,
implying the need for different cut-off values for different surgical
strategies. Copyright © 2021 The Author(s)

<83>
Accession Number
2014759838
Title
The impact of intraoperative blood pressure variability on the risk of
postoperative adverse outcomes in non-cardiac surgery: a systematic
review.
Source
Journal of Anesthesia. (no pagination), 2022. Date of Publication: 2022.
Author
Putowski Z.; Czok M.; Krzych L.J.
Institution
(Putowski, Czok) Students' Scientific Society, Department of
Anaesthesiology and Intensive Care, Faculty of Medical Sciences in
Katowice, Medical University of Silesia, Medykow 14 Street, Katowice
40752, Poland
(Krzych) Department of Anaesthesiology and Intensive Care, Faculty of
Medical Sciences in Katowice, Medical University of Silesia, Katowice,
Poland
Publisher
Springer Japan
Abstract
Hemodynamic stability during surgery seems to account for positive
postoperative outcomes in patients. However, little is known about the
impact of intraoperative blood pressure variability (IBPV) on the
postoperative complications. The aim was to investigate whether IBPV is
associated with the development of postoperative complications and what is
the nature of this association. We conducted a systematic search in
PubMed, Medical Subject Headings, Embase, Web of Science, SCOPUS,
clinicaltrials.gov, and Cochrane Library on the 8th of April, 2021. We
included studies that only focused on adults who underwent primarily
elective, non-cardiac surgery in which intraoperative blood pressure
variation was measured and analyzed in regard to postoperative,
non-surgical complications. We identified 11 papers. The studies varied in
terms of applied definitions of blood pressure variation, of which
standard deviation and average real variability were the most commonly
applied definitions. Among the studies, the most consistent analyzed
outcome was a 30-day mortality. The studies presented highly heterogeneous
results, even after taking into account only the studies of best quality.
Both higher and lower IBPV were reported to be associated for
postoperative complications. Based on a limited number of studies, IBPV
does not seem to be a reliable indicator in predicting postoperative
complications. Existing premises suggest that either higher or lower IBPV
could contribute to postoperative complications. Taking into account the
heterogeneity and quality of the studies, the conclusions may not be
definitive. Copyright © 2022, The Author(s).

<84>
Accession Number
2014759317
Title
Biomarkers of acute kidney injury after pediatric cardiac surgery: a
meta-analysis of diagnostic test accuracy.
Source
European Journal of Pediatrics. (no pagination), 2022. Date of
Publication: 2022.
Author
Van den Eynde J.; Schuermans A.; Verbakel J.Y.; Gewillig M.; Kutty S.;
Allegaert K.; Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, United States
(Van den Eynde, Schuermans, Gewillig) Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Verbakel) Department of Public Health and Primary Care, KU Leuven,
Leuven, Belgium
(Verbakel) Nuffield Department of Primary Care Health Sciences, University
of Oxford, Oxford, United Kingdom
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Allegaert) Department of Development and Regeneration, KU Leuven, Leuven,
Belgium
(Allegaert) Department of Pharmacy and Pharmaceutical Sciences, KU Leuven,
Leuven, Belgium
(Allegaert) Department of Hospital Pharmacy, Erasmus Medical Center,
Rotterdam, Netherlands
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Acute kidney injury (AKI) occurs frequently after cardiac surgery in
children. Although current diagnostic criteria rely on serum creatinine
and urine output, changes occur only after considerable loss of kidney
function. This meta-analysis aimed to synthesize the knowledge on novel
biomarkers and compare their ability to predict AKI. PubMed/MEDLINE,
Embase, Scopus, and reference lists were searched for relevant studies
published by March 2021. Diagnostic accuracy parameters were extracted and
analyzed using hierarchical summary receiver operating characteristic
(HSROC) method. Pooled estimates of the area under the curve (AUC) were
calculated using conventional random-effects meta-analysis. Fifty-six
articles investigating 49 biomarkers in 8617 participants fulfilled our
eligibility criteria. Data from 37 studies were available for
meta-analysis. Of the 10 biomarkers suitable for HSROC analysis, urinary
neutrophil gelatinase-associated lipocalin (uNGAL) to creatinine (Cr)
ratio yielded the highest diagnostic odds ratio (91.0, 95% CI 90.1-91.9),
with a sensitivity of 91.3% (95% CI 91.2-91.3%) and a specificity of 89.7%
(95% CI 89.6-89.7%). These results were confirmed in pooled AUC analysis,
as uNGAL-to-Cr ratio and uNGAL were the only elaborately studied
biomarkers (> 5 observations) with pooled AUCs >= 0.800. Liver fatty
acid-binding protein (L-FABP), serum cystatin C (sCysC), serum NGAL
(sNGAL), and interleukin-18 (IL-18) all had AUCs >= 0.700.
 Conclusion(s): A variety of biomarkers have been proposed as
predictors of cardiac surgery-associated AKI in children, of which uNGAL
was the most prominent with excellent diagnostic qualities. However, more
consolidatory evidence will be required before these novel biomarkers may
eventually help realize precision medicine in AKI management.What is
Known:* Acute kidney injury (AKI) occurs in about 30-60% of children
undergoing cardiac surgery and is associated with increased in-hospital
mortality and adverse short-term outcomes. However, in current clinical
practice, AKI definitions and detection often rely on changes in serum
creatinine and urine output, which are late and insensitive markers of
kidney injury.* Although various novel biomarkers have been studied for
the diagnosis of AKI in children after cardiac surgery, it remains unclear
how these compare to one another in terms of diagnostic accuracy.What is
New:* Pooled analyses suggest that for the diagnosis of AKI in children
who underwent cardiac surgery, NGAL is the most accurate among the most
frequently studied biomarkers.* A number of other promising biomarkers
have been reported, although they will require further research into their
diagnostic accuracy and clinical applicability. Copyright © 2022,
The Author(s), under exclusive licence to Springer-Verlag GmbH Germany,
part of Springer Nature.

<85>
Accession Number
2014741083
Title
Morbidity and mortality in patients managed with high compared with low
blood pressure targets during on-pump cardiac surgery: a systematic review
and meta-analysis of randomized controlled trials.
Source
Canadian Journal of Anesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
McEwen C.C.; Amir T.; Qiu Y.; Young J.; Kennedy K.; Grocott H.P.; Kessani
H.; Mazer D.; Brudney S.; Kavosh M.; Jacobsohn E.; Vedel A.; Wang E.;
Whitlock R.P.; Belley-Cote E.P.; Spence J.
Institution
(McEwen) Department of Surgery (Cardiac Surgery), McMaster University,
Hamilton, ON, Canada
(Amir, Qiu, Wang) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Young) Health Sciences Library, McMaster University, Hamilton, ON, Canada
(Kennedy) Department of Health Research Methods, Evaluation, and Impact,
McMaster University, Hamilton, ON, Canada
(Grocott, Kessani, Kavosh) Department of Anesthesia and Perioperative
Medicine, University of Manitoba, Winnipeg, MB, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Brudney, Jacobsohn) Departments of Medicine (Critical Care) and
Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg,
MB, Canada
(Vedel) Department of Cardiothoracic Anesthesiology, Copenhagen University
Hospital, Copenhagen, Denmark
(Whitlock) Departments of Surgery (Cardiac Surgery) and Health Research
Methods, Evaluation, and Impact, McMaster University, Hamilton, ON, Canada
(Whitlock, Belley-Cote, Spence) Perioperative Research Division,
Population Health Research Institute, Hamilton, ON, Canada
(Belley-Cote) Departments of Medicine (Cardiology and Critical Care) and
Health Research Methods, Evaluation, and Impact, McMaster University,
Hamilton, ON, Canada
(Spence) Departments of Anesthesia and Critical Care and Health Research
Methods, Evaluation, and Impact, McMaster University, Hamilton, ON, Canada
Publisher
Springer
Abstract
Purpose: Many believe that blood pressure management during cardiac
surgery is associated with postoperative outcomes. We conducted a
systematic review and meta-analysis of randomized controlled trials (RCTs)
to determine the impact of high compared with low intraoperative blood
pressure targets on postoperative morbidity and mortality in adults
undergoing cardiac surgery on cardiopulmonary bypass (CPB). Our primary
objective was to inform the design of a future large RCT. Source: We
searched MEDLINE, EMBASE, Web of Science, CINAHL, and CENTRAL for RCTs
comparing high with low intraoperative blood pressure targets in adult
patients undergoing any cardiac surgical procedure on CPB. We screened
reference lists, grey literature, and conference proceedings. Principal
findings: We included eight RCTs (N =1,116 participants); all examined the
effect of blood pressure management only during the CPB. Trial definitions
of high compared with low blood pressure varied and, in some, there was a
discrepancy between the target and achieved mean arterial pressure. We
observed no difference in delirium, cognitive decline, stroke, acute
kidney injury, or mortality between high and low blood pressure targets
(very-low to low quality evidence). Higher blood pressure targets may have
increased the risk of requiring a blood transfusion (three trials; n = 456
participants; relative risk, 1.4; 95% confidence interval, 1.1 to 1.9; P =
0.01; moderate quality evidence) but this finding was based on a small
number of trials. Conclusion(s): Individual trial definitions of high
and low blood pressure targets varied, limiting inferences. The effect of
high (compared with low) blood pressure targets on other morbidity and
mortality after cardiac surgery remains unclear because of limitations
with the body of existing evidence. Research to determine the optimal
management of blood pressure during cardiac surgery is required. Study
registration: PROSPERO (CRD42020177376); registered: 5 July
2020. Copyright © 2022, Canadian Anesthesiologists' Society.

<86>
Accession Number
2014718407
Title
Rapid deployment technology versus conventional sutured bioprostheses in
aortic valve replacement.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Salmasi M.Y.; Ramaraju S.; Haq I.; B. Mohamed R.A.; Khan T.; Oezalp F.;
Asimakopoulos G.; Raja S.G.
Institution
(Salmasi, Ramaraju, Haq) Department of Surgery, Imperial College London,
United Kingdom
(Salmasi, B. Mohamed, Khan, Oezalp, Asimakopoulos, Raja) Department of
Cardiac Surgery, Royal Brompton and Harefield Trust, London, United
Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Despite the benefits of rapid deployment aortic valve
prostheses (RDAVR), conventional sutured valves (cAVR) are more commonly
used in the treatment for aortic stenosis. Given the paucity of randomized
studies, this study aimed to synthesize available data to compare both
treatment options. Method(s): A systematic search of Pubmed, OVID,
and MEDLINE was conducted to retrieve comparative studies for RDAVR versus
cAVR in the treatment of aortic stenosis. Out of 1773 returned titles, 35
papers were used in the final analysis, including 1 randomized study, 1
registry study, 6 propensity-matched studies, and 28 observational
studies, incorporating a total of 10,381 participants (RDAVR n = 3686;
cAVR n = 6310). Result(s): Random-effects meta-analysis found no
difference between the two treatment groups in terms of operative
mortality, stroke, or bleeding (p >.05). The RDAVR group had reduced
cardiopulmonary bypass (standardized mean difference [SMD]: -1.28, 95%
confidence interval [CI]: [-1.35, -1.20], p <.001) and cross-clamp times
(SMD: -1.05, 95% CI: [-1.12, -0.98], p <.001). Length of stay in the
intensive care unit was also shorter in the RDAVR group (SMD: -0.385, 95%
CI: [-0.679, -0.092], p =.010). The risk of pacemaker insertion was higher
for RDAVR (odds ratio [OR]: 2.41, 95% CI: [1.92, 3.01], p <.001) as was
the risk of paravalvular leak (PVL) at midterm follow-up (OR: 2.52, 95%
CI: [1.32, 4.79], p =.005). Effective orifice area and transvalvular
gradient were more favorable in RDAVR patients (p >.05).
 Conclusion(s): Despite the benefits of RDAVR in terms of reduced
operative time and enhanced recovery, the risk of pacemaker insertion and
midterm PVL remains a significant cause for concern. Copyright ©
2022 The Authors. Journal of Cardiac Surgery published by Wiley
Periodicals LLC.

<87>
Accession Number
2014717037
Title
Valve endocarditis, to repair or not to repair, is that really the
question?.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Di Mauro M.; Bonalumi G.; Calafiore A.M.; Lorusso R.
Institution
(Di Mauro, Lorusso) Cardio-Thoracic Surgery Unit, Heart and Vascular
Centre, Maastricht University Medical Centre (MUMC), Maastricht,
Netherlands
(Bonalumi) Department of Cardiac Surgery, Centro Cardiologico Monzino,
Milan, Italy
(Calafiore) Division of Cardiac Surgery A, Henry Dunant Hospital, Athens,
Greece
Publisher
John Wiley and Sons Inc
Abstract
The meta-analysis by He et al. has the worth to cover, as much as
possible, a gap of scientific evidence were conducting a randomized trial
appears very complex for ethical and logistical reasons. The authors
concluded that mitral valve repair (MVP) provides better-pooled results,
both early and late, with respect to mitral valve replacement. However,
the superiority of MVP is driven by some single large cohort studies where
surgeons had wide experience in the field of MVP for infective
endocarditis. This finding is also confirmed by other studies. But if
mitral repair produces such a better short- and long-term survival than
replacement, why are there no clear indications from consensus and
guidelines pushing surgeons toward the pursuit of a reconstructive
procedure at almost any cost? We wonder to repair or not to repair, is
that really the question? The AATS consensus suggests repairing "whenever
possible" but without providing more specific indications. If the two
primary goals of surgery are total removal of infected tissues and
reconstruction of cardiac morphology, including repair or replacement of
the affected valve(s), probably MVP should be performed in case of less
extensive tissue detriment by the infection. In more wide valve
involvement, MVP may be the choice but only in very expert hands and in
Centers with a very large volumes of valve repairing. This decision
cannot, therefore, be the result of the choice of an individual but must
derive from a careful multidisciplinary discussion to be held in an
EndoTeam. Copyright © 2022 Wiley Periodicals LLC

<88>
Accession Number
2014717012
Title
Are outcomes in congenital cardiac surgery better than ever?.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Holcomb R.M.; Undar A.
Institution
(Holcomb, Undar) Penn State Hershey Pediatric Cardiovascular Research
Center, Departments of Pediatrics, Penn State College of Medicine, Penn
State Health Children's Hospital, Hershey, PA, United States
(Holcomb) Surgery, Penn State College of Medicine, Penn State Health
Children's Hospital, Hershey, PA, United States
(Undar) Biomedical Engineering, Penn State College of Medicine, Penn State
Health Children's Hospital, Hershey, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim of the Study: Congenital heart disease is the most
common congenital defect among infants born in the United States. Within
the first year of life, 1 in 4 of these infants will need surgery. Only
one generation removed from an overall mortality of 14%, many changes have
been introduced into the field. Have these changes measurably improved
outcomes?. Method(s): The literature search was conducted through
PubMed MEDLINE and Google Scholar from inception to October 31, 2021.
Ultimately, 78 publications were chosen for inclusion. Result(s): The
outcome of overall mortality has experienced continuous improvements in
the modern era of the specialty despite the performance of more
technically demanding surgeries on patients with complex comorbidities.
This modality does not account for case-mix, however. In turn, clinical
outcomes have not been consistent from center to center. Furthermore,
variation in practice between institutions has also been documented. A
recurring theme in the literature is a movement toward standardization and
universalization. Examples include mortality risk-stratification that has
allowed direct comparison of outcomes between programs and improved
definitions of morbidities which provide an enhanced framework for
diagnosis and management. Conclusion(s): Overall mortality is now
below 3%, which suggests that more patients are surviving their
interventions than in any previous era in congenital cardiac surgery.
Focus has transitioned from survival to improving the quality of life in
the survivors by decreasing the incidence of morbidity and associated
long-term effects. With the transformation toward standardization and
interinstitutional collaboration, future advancements are
expected. Copyright © 2022 Wiley Periodicals LLC

<89>
Accession Number
2014716774
Title
Multidetector CT findings of primary pleural angiosarcoma : a systematic
review, an additional cases report.
Source
Cancer Imaging. 22(1) (no pagination), 2022. Article Number: 6. Date of
Publication: December 2022.
Author
Gil B.M.; Chung M.H.; Lee K.-N.; Jung J.I.; Yoo W.J.; Kwon S.S.; Lee H.
Institution
(Gil, Chung, Yoo) Department of Radiology, Bucheon St. Mary's Hospital,
College of Medicine, The Catholic University of Korea, 327, Sosa-ro,
Gyeonggi-do, Bucheon-si 14647, South Korea
(Lee) Department of Radiology, Dong-A University Hospital, Busan, South
Korea
(Lee) Kosin University Gospel Hospital, Busan, South Korea
(Jung) Department of Radiology, Seoul St. Mary's Hospital, College of
Medicine, The Catholic University of Korea, Seoul, South Korea
(Kwon) Division of Allergy and Pulmonary, Department of Internal Medicine,
BUCHEON St. Mary's Hospital, College of Medicine, The Catholic University
of Korea, Seoul, South Korea
(Lee) Department of Pathology, Bucheon St. Mary's Hospital, Colloge of
Medicine, The Catholic University of Korea, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: To demonstrate and analyze the relatively common imaging
findings in this rare primary pleural angiosarcoma (PPA). Case
presentation: Three cases of PPA, proven by video-assisted thoracic
surgery biopsies are retrospectively reviewed. Patients were all male. Age
ranges from 65 to 75 years old age (mean; 69). Major chief complaints were
dyspnea and chest pain. One has a history of colon cancer, the other has a
tuberculosis history and the other has no known history. Multidetector
chest CT and PET CT were all done. Immunohistochemical studies were
performed including CD31, CD34, or factor VIII-related antigen, vimentin,
and cytokeratin. We also review the literatures on recently published PPA.
All masses were from 1 to 10 cm. All three patients had multiple pleural
based masses, which were ovoid in shape with relatively sharp margin in
unilateral hemithorax. Multiple small circumscribed pleural masses are
limited in the pleural space in two patients, whereas two, huge lobulated
masses about up to 10 cm were present with pleural and extrapleural
involvement in one patient. In two patients with pleural mass only,
multiple pleural masses were only seen in parietal pleura in one patient
and were in both visceral and parietal pleura in one patient. Pleural
effusion were found in one side in one patient and in both sides in one
patient. One angiosarcoma was arised from chronic tuberculotic pleurisy
sequelae. All pleural masses are heterogenous with irregular internal low
densities in all patients. Hematogenous metastases were found in liver,
vertebra, rib in one patient, and were in lungs with mediastinal lymph
node metastases in the other patient. Three patients survived for longer
than 3months after diagnosis, but continued to deteriorate rapidly. Two
patients underwent chemotherapy after surgical excision, and the other one
with multiple metastases treated chemotherapy after CT-guided biopsy, but
eventually all died. As a result of comparative analysis of a total of 13
patients' images including 10 cases previously published, there was
pleural effusion in all except 2 cases. Conclusion(s): PPA were all
necrotic without any vascularized enhancing nature, and manifested as
unilateral circumscribed or localized pleural-based masses. Copyright
© 2022, The Author(s).

<90>
Accession Number
2014711499
Title
Stress exercise haemodynamic performance and opening reserve of a stented
bovine pericardial aortic valve bioprosthesis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Porterie J.; Salaun E.; Ternacle J.; Clavel M.-A.; Dagenais F.
Institution
(Porterie, Dagenais) Department of Cardiac Surgery, Heart and Lung
University Institute, Quebec City, QC, Canada
(Salaun, Ternacle, Clavel) Department of Clinical Research, Heart and Lung
University Institute, Quebec City, QC, Canada
(Salaun, Clavel) Department of Medicine, Faculty of Medicine, Laval
University, Quebec City, QC, Canada
(Ternacle) Department of Cardiology, Hopital Cardiologique Haut-Leveque,
CHU de Bordeaux, France
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Despite unusual high rates of patient-prosthesis mismatch
(PPM), excellent midterm clinical outcomes have been reported after
surgical aortic valve replacement (SAVR) with the AvalusTM bioprosthetic
valve (Medtronic). To elucidate this "PPM conundrum," the Avalus valve
haemodynamics were assessed during exercise testing. Method(s): Of
the 148 patients who had undergone SAVR with the Avalus valve at our
institution, 30 were randomly selected among those in whom stress test was
deemed feasible and underwent a resting transthoracic echocardiography
immediately followed by exercise echocardiography. Severe PPM was defined
as indexed effective orifice area (iEOA) (Formula presented.) 0.65
cm2/m2 and moderate PPM as iEOA (Formula presented.)
0.65 and (Formula presented.) 0.85 cm2/m2. Measured
PPM was determined with the use of the measured iEOA at rest or stress,
while the estimated PPM was based on the estimated iEOA, derived from the
mean EOA reported for each valve size in the manufacturer chart.
 Result(s): Measured EOA significantly increased from rest to peak
exercise in all PPM groups (p <.05) and the rates of moderate and severe
measured PPM decreased from 40% and 20% to 27% and 0%, respectively. The
patients with low-flow state (flow < 250 ml/s) had significantly lower
measured rest EOA (p =.03). On the basis of the estimated iEOA, there was
no severe PPM and 19 patients had moderate PPM (63.3%), with a
significantly lower opening reserve than the patients without estimated
PPM (p =.04). The estimated iEOA was more reliably correlated to the
measured iEOA at maximal stress than the measured iEOA at rest, especially
in patients with a low-flow state. Conclusion(s): This study supports
the concept of an opening reserve of the Avalus valve to explain the PPM
conundrum and promotes the use of exercise Doppler-echocardiography to
complete the assessment of mismatch, especially in patients with a
low-flow state. Published estimated EOA seems reliable to predict the
haemodynamic performance of the Avalus valve, whether the flow conditions
at rest. Copyright © 2022 Wiley Periodicals LLC

<91>
Accession Number
2016458033
Title
Efficacy and Safety of Emergent Transcatheter Aortic Valve Implantation in
Patients with Acute Decompensated Aortic Stenosis: Systematic Review and
Meta-Analysis.
Source
Journal of Interventional Cardiology. 2021 (no pagination), 2021. Article
Number: 7230063. Date of Publication: 2021.
Author
Shao R.; Li J.; Qu T.; Fu X.; Liao Y.; Chen M.
Institution
(Shao, Li, Chen) Laboratory of Heart Valve Disease, West China Hospital,
Sichuan University, Chengdu, China
(Shao, Fu) Department of Cardiology, West China Hospital, Sichuan
University, Chengdu, China
(Qu) West China School of Medicine, Sichuan University, Chengdu, China
(Liao, Chen) Department of Clinical Research Management, West China
Hospital, Sichuan University, Chengdu, China
Publisher
Hindawi Limited
Abstract
Introduction. The aim of this systematic review and meta-analysis was to
investigate the efficacy and safety of emergent transcatheter aortic valve
implantation (TAVI) in patients with decompensated aortic stenosis (AS) by
comparing the clinical outcomes with the patients who had received the
elective TAVI. Methods. By searching PubMed, EMBASE, and Cochrane
databases, we obtained the studies comparing the clinical outcomes of
emergent TAVI and elective TAVI. Finally, 14 studies were included.
Results. A total of 14 eligible articles with 73,484 patients were
included in this meta-analysis. Emergent TAVI was associated with a higher
mortality during hospitalization (HR 2.09, 95% CI [1.39 to 3.14]), 30 days
(HR 2.29, 95% CI [1.69 to 3.10]), and 1 year (HR 1.96, 95% CI [1.55 to
2.49]). Consistently, the incidence of acute kidney injury (AKI) (RR 2.48,
95% CI [1.85 to 3.32]), dialysis (RR 2.37, 95% CI [1.95 to 2.88]),
bleeding (RR 1.62, 95% CI [1.27 to 2.08]), major bleeding (RR 1.05, 95% CI
[1.00 to 1.10]), and 30-day rehospitalization (RR 1.30, 95% CI [1.07,
1.58]) were more common in patients receiving emergent TAVI. No
statistical differences were found in the occurrence rate of vascular
complications (RR 1.11, 95% CI [0.90, 1.36]), major vascular complications
(RR 1.14, 95% CI [0.52, 2.52]), permanent pacemaker (PPM) placement (RR
1.05, 95% CI [0.99, 1.11]), cerebrovascular events (RR 1.11, 95% CI [0.98,
1.25]), moderate to severe paravalvular leakage (PVL) (RR 1.23, 95% [CI
0.94 to 1.61]), and device success (RR 0.99, 95% CI [0.97, 1.01]).
Conclusion. Emergent TAVI is associated with some postoperative
complications and increased mortality compared with elective TAVI.
Emergent TAVI should be implemented cautiously and
individually. Copyright © 2021 Ruochen Shao et al.

<92>
Accession Number
636761748
Title
Myocardial viability testing: all STICHed up, or about to be REVIVED?.
Source
European heart journal. 43(2) (pp 118-126), 2022. Date of Publication: 13
Jan 2022.
Author
Ryan M.; Morgan H.; Chiribiri A.; Nagel E.; Cleland J.; Perera D.
Institution
(Ryan, Morgan, Perera) School of Cardiovascular Medicine and Sciences,
King's College London, Westminster Bridge Road, London SE1 7EH, United
Kingdom
(Chiribiri) School of Biomedical Engineering and Imaging Sciences, King's
College London, Westminster Bridge Road, London SE1 7EH, United Kingdom
(Nagel) Institute for Experimental and Translational Cardiovascular
Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital
Frankfurt, Frankfurt am Main, Germany
(Cleland) Robertson Centre for Biostatistics, University of Glasgow,
University Avenue, Glasgow G12 8QQ, United Kingdom
Publisher
NLM (Medline)
Abstract
Patients with ischaemic left ventricular dysfunction frequently undergo
myocardial viability testing. The historical model presumes that those who
have extensive areas of dysfunctional-yet-viable myocardium derive
particular benefit from revascularization, whilst those without extensive
viability do not. These suppositions rely on the theory of hibernation and
are based on data of low quality: taking a dogmatic approach may therefore
lead to patients being refused appropriate, prognostically important
treatment. Recent data from a sub-study of the randomized STICH trial
challenges these historical concepts, as the volume of viable myocardium
failed to predict the effectiveness of coronary artery bypass grafting.
Should the Heart Team now abandon viability testing, or are new paradigms
needed in the way we interpret viability? This state-of-the-art review
critically examines the evidence base for viability testing, focusing in
particular on the presumed interactions between viability, functional
recovery, revascularization and prognosis which underly the traditional
model. We consider whether viability should relate solely to dysfunctional
myocardium or be considered more broadly and explore wider uses of
viability testingoutside of revascularization decision-making. Finally, we
look forward to ongoing and future randomized trials, which will shape
evidence-based clinical practice in the future. Copyright © The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<93>
Accession Number
633261873
Title
Atrial nitroso-redox balance and refractoriness following on-pump cardiac
surgery: a randomized trial of atorvastatin.
Source
Cardiovascular research. 118(1) (pp 184-195), 2022. Date of Publication:
07 Jan 2022.
Author
Jayaram R.; Jones M.; Reilly S.; Crabtree M.J.; Pal N.; Goodfellow N.;
Nahar K.; Simon J.; Carnicer R.; DeSilva R.; Ratnatunga C.; Petrou M.;
Sayeed R.; Roalfe A.; Channon K.M.; Bashir Y.; Betts T.; Hill M.; Casadei
B.
Institution
(Jayaram, Reilly, Crabtree, Pal, Goodfellow, Nahar, Simon, Carnicer,
Channon, Casadei) Division of Cardiovascular Medicine, Radcliffe
Department of Medicine, University of Oxford, West Wing, Oxford OX3 9DU,
United Kingdom
(Jones, Bashir, Betts) Cardiology, Oxford Heart Centre, Oxford University
Hospitals NHS Foundation Trust, Oxford, United Kingdom
(DeSilva, Ratnatunga, Petrou, Sayeed) Cardiothoracic Surgery, Oxford Heart
Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United
Kingdom
(Roalfe) Nuffield Department of Primary Care Health Sciences, University
of Oxford, Oxford, United Kingdom
(Hill) Clinical Trial Service Unit, Nuffield Department of Population
Health, University of Oxford, Oxford, United Kingdom
Publisher
NLM (Medline)
Abstract
AIMS: Systemic inflammation and increased activity of atrial
NOX2-containing NADPH oxidases have been associated with the new onset of
atrial fibrillation (AF) after cardiac surgery. In addition to lowering
LDL-cholesterol, statins exert rapid anti-inflammatory and antioxidant
effects, the clinical significance of which remains controversial. METHODS
AND RESULTS: We first assessed the impact of cardiac surgery and
cardiopulmonary bypass (CPB) on atrial nitroso-redox balance by measuring
NO synthase (NOS) and GTP cyclohydrolase-1 (GCH-1) activity, biopterin
content, and superoxide production in paired samples of the right atrial
appendage obtained before (PRE) and after CPB and reperfusion (POST) in
116 patients. The effect of perioperative treatment with atorvastatin
(80mg once daily) on these parameters, blood biomarkers, and the
post-operative atrial effective refractory period (AERP) was then
evaluated in a randomized, double-blind, placebo-controlled study in 80
patients undergoing cardiac surgery on CPB. CPB and reperfusion led to a
significant increase in atrial superoxide production (74% CI 71-76%, n=46
paired samples, P<0.0001) and a reduction in atrial tetrahydrobiopterin
(BH4) (34% CI 33-35%, n=36 paired samples, P<0.01), and in GCH-1 (56% CI
55-58%, n=26 paired samples, P<0.001) and NOS activity (58% CI 52-67%,
n=20 paired samples, P<0.001). Perioperative atorvastatin treatment
prevented the effect of CPB and reperfusion on all parameters but had no
significant effect on the postoperative right AERP, troponin release, or
NT-proBNP after cardiac surgery. CONCLUSION(S): Perioperative statin
therapy prevents post-reperfusion atrial nitroso-redox imbalance in
patients undergoing on-pump cardiac surgery but has no significant impact
on postoperative atrial refractoriness, perioperative myocardial injury,
or markers of postoperative LV function. CLINICAL TRIAL REGISTRATION:
https://clinicaltrials.gov/ct2/show/NCT01780740. Copyright © The
Author(s) 2020. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<94>
Accession Number
636903316
Title
Rockwood Clinical Frailty Scale as a predictor of adverse outcomes among
older adults undergoing aortic valve replacement: A protocol for a
systematic review.
Source
BMJ Open. 12(1) (no pagination), 2022. Article Number: e049216. Date of
Publication: 11 Jan 2022.
Author
Prendiville T.; Leahy A.; Quinlan L.; Saleh A.; Shanahan E.; Gabr A.;
Peters C.; Casserly I.; O'Connor M.; Galvin R.
Institution
(Prendiville, Leahy, Quinlan, Saleh, Shanahan, Gabr, Peters, O'Connor)
Department of Ageing and Therapeutics, University Hospital Limerick,
Dooradoyle, Limerick, Ireland
(Casserly) Department of Cardiology, Mater Misericordiae University
Hospital, Dublin, Ireland
(Galvin) School of Allied Health, Faculty of Education and Health
Sciences, Ageing Research Centre, Health Research Institute, University of
Limerick, Limerick, Ireland
Publisher
BMJ Publishing Group
Abstract
Introduction Frailty is associated with adverse outcomes relating to
cardiac procedures. It has been proposed that frailty scoring should be
included in the preoperative assessment of patients undergoing aortic
valve replacement. We aim to examine the Rockwood Clinical Frailty Scale
(CFS), as a predictor of adverse outcomes following aortic valve
replacement. Methods and analysis Prospective and retrospective cohort
studies and randomised controlled trials assessing both the preoperative
frailty status (as per the CFS) and incidence of adverse outcomes among
older adults undergoing either surgical aortic valve replacement or
transcatheter aortic valve replacement will be included. Adverse outcomes
will include mortality and periprocedural complications, as well as a
composite of 30-day complications. A search will be conducted from 2005 to
present using a prespecified search strategy. Studies will be screened for
inclusion by two reviewers, with methodological quality assessed using the
Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
Relative risk ratios with 95% CIs will be generated for each outcome of
interest, comparing frail with non-frail groups. Data will be plotted on
forest plots where applicable. The quality of the evidence will be
determined using the Grading of Recommendations, Assessment, Development
and Evaluation tool. Ethics and dissemination Ethical approval is not
required for this study as no primary data will be collected. We will
publish the review in a peer-reviewed journal on completion. PROSPERO
registration number CRD42020213757. Copyright ©

<95>
Accession Number
2007324785
Title
Clinical outcomes of transcatheter aortic valve implantation in failed
bioprosthetic surgical valves vs. native aortic stenosis: insights from a
meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 37(1) (pp 182-190), 2022.
Date of Publication: January 2022.
Author
Yashima F.; Yokoyama Y.; Takagi H.; Briasoulis A.; Kuno T.
Institution
(Yashima) Department of Cardiology, Saiseikai Utsunomiya Hospital,
Utsunomiya, Japan
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Briasoulis) Division of Cardiovascular Medicine, Section of Heart Failure
and Transplantation, University of Iowa, IA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, First Avenue, 16th street, New York, NY 10003,
United States
Publisher
Springer Japan
Abstract
There is no meta-analysis comparing clinical outcomes between
valve-in-valve transcatheter aortic valve implantation for failed surgical
bioprosthetic valves (ViV-TAVI) and native valve TAVI for aortic stenosis
(NV-TAVI). We aimed to investigate clinical outcomes between ViV-TAVI and
NV-TAVI using a meta-analysis. EMBASE and MEDLINE were searched through
April 2020 to investigate the comparative outcomes between ViV-TAVI and
NV-TAVI. The main outcomes were short-term (30-day/in-hospital) mortality,
pacemaker implantation (PMI), life threatening and/or major bleeding,
stroke, and coronary obstruction, and long-term (1-year) mortality and
stroke. Our search identified 5 observational studies enrolling a total of
8428 patients (1442 patients with ViV-TAVI and 6986 with NV-TAVI).
ViV-TAVI was associated with significantly lower rates of short-term
mortality, PMI, and life threatening and/or major bleeding, compared with
NV-TAVI (relative risk [RR] [95% CI] 0.54 [0.34-0.84], P = 0.007; 0.25
[0.19-0.35], P < 0.0001; 0.64 [0.46-0.89], P = 0.008, respectively). There
were no significant differences in rates of short-term stroke and coronary
obstruction between ViV-TAVI and NV-TAVI (RR [95% CI] 0.59 [0.35-1.01], P
= 0.06; 1.86 [0.78-4.41], P = 0.16, respectively). ViV-TAVI was also
associated with a significantly lower rate of 1-year mortality compared
with NV-TAVI (RR [95% CI] 0.64 [0.51-0.81], P = 0.0002), whereas there was
no significant difference in long-term stroke (RR [95% CI] 0.71
[0.45-1.12], P = 0.51). ViV-TAVI was associated with significantly lower
rates of short-term mortality, PMI, and life threatening and/or major
bleeding, and long-term mortality, without increased risks of stroke and
coronary obstruction, compared with NV-TAVI. Copyright © 2020,
Japanese Association of Cardiovascular Intervention and Therapeutics.

<96>
Accession Number
634837253
Title
The effects of showering in 48-72 h after coronary artery bypass graft
surgery through median sternotomy on wound infection, pain, comfort, and
satisfaction: randomized controlled trial.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. 21(1) (pp
56-66), 2022. Date of Publication: 11 Jan 2022.
Author
Gok F.; Demir Korkmaz F.; Emrecan B.
Institution
(Gok) Faculty of Health Sciences, Department of Surgical Diseases Nursing,
Pamukkale University, Denizli 20020, Turkey
(Demir Korkmaz) Faculty of Nursing, Department of Surgical Diseases
Nursing, Ege University, 35100 Izmir, Turkey
(Emrecan) Faculty of Medicine, Department of Cardiac Surgery, Pamukkale
University, Denizli 20020, Turkey
Publisher
NLM (Medline)
Abstract
AIMS : Time of showering after surgery is still a controversial issue for
surgical patients and health professionals. We evaluated the effects of
showering in 48-72h after median sternotomy on sternal wound infections,
pain due to sternotomy, patient comfort, and satisfaction levels. METHODS
AND RESULTS : The study was a randomized controlled clinical trial.
Fifty-one patients were randomly allocated (1:1) to the shower (n=26) or
non-shower group (n=25). The patients in the shower group (intervention
group) showered in the first 48-72h after surgery and the patients in the
non-shower group (control group) were not allowed to shower until their
chest tube sutures were removed. They were instructed to shower on the
next day after removal of the chest tube sutures. The rate of sternal
wound infections was significantly lower in the shower group (n=2, 7.7%)
than in the non-shower group patients (n=8, 32.0%; P=0.038). A logistic
regression analysis showed that early post-operative showering was
protective and significantly reduced the risk of sternal wound infections
independently of other variables [odds ratio (OR): 0.177; 95% confidence
interval (CI): 0.033-0.940; P=0.042]. The pain severity score was
significantly lower in the shower group patients. Also, comfort and
satisfaction scores were significantly higher in this group (P<0.05).
CONCLUSION : Early showering after sternotomy was found to be protective
against sternal wound infections and had a positive effect on pain,
comfort, and satisfaction. TRIAL REGISTRATION : Clinical Trials.gov
registration number NCT04250961
(https://clinicaltrials.gov/ct2/show/NCT04250961). Copyright Published
on behalf of the European Society of Cardiology. All rights reserved.
© The Author(s) 2021. For permissions, please email:
journals.permissions@oup.com.

<97>
Accession Number
634754014
Title
The effects of Nurse Led Transitional Care Model on elderly patients
undergoing open heart surgery: a randomized controlled trial.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. 21(1) (pp
46-55), 2022. Date of Publication: 11 Jan 2022.
Author
Coskun S.; Duygulu S.
Institution
(Coskun) Bolu Abant Izzet Baysal University, Faculty of Health Sciences,
Nursing Department, Turkey
(Duygulu) Hacettepe University, Faculty of Nursing, 06100 S?hhiye/ Ankara
/ Turkey
Publisher
NLM (Medline)
Abstract
AIMS : Rate and number of successful cases in open heart surgery has been
increasing due to the advances in medical technology and surgery. To
improve patient convalescence results and reduce rate of post-discharge
readmission to hospital and unplanned post-discharge rehospitalization,
home-care and follow-up process of patients should be managed
successfully. To evaluate the effectiveness of Nurse Led Transitional Care
Model on the functional autonomy, quality of life, readmission, and
rehospitalization rates of elderly patients undergoing open heart surgery.
A randomized controlled trial was conducted from November 2017 to December
2018 and performed according to the CONSORT Guidelines. METHODS AND
RESULTS : Sixty-six elderly patients were randomly allocated to the
intervention (n: 33) and control (n: 33) groups. Patients in intervention
group were given care based on the Transitional Care Model until the
post-discharge 9th week starting from date of hospitalization. Patients in
control group were given standard care services. Functional autonomy,
quality of life levels, and repeated admission/re-hospitalization rates to
the clinic were evaluated. The Functional Autonomy Measurement System and
SF-36 Quality of Life Scale scores of the intervention group were higher
than that of the control group at the 9th week (P < 0.05). In addition,
rate of readmission and rehospitalization during the follow-up period
(6months) of patients in the intervention group was found to be lower than
the patients in the control group (P<0.05). CONCLUSION : Care services
offered under the Transitional Care Model improved functional autonomy and
quality of life and decreased post-discharge hospital readmission and
rehospitalization rates of patients. TRIAL REGISTRATION: The study was
registered on ClinicalTrials.gov (ID: NCT04384289). Copyright
Published on behalf of the European Society of Cardiology. All rights
reserved. © The Author(s) 2021. For permissions, please email:
journals.permissions@oup.com.

<98>
Accession Number
636125874
Title
Effects of initial invasive vs. initial conservative treatment strategies
on recurrent and total cardiovascular events in the ISCHEMIA trial.
Source
European heart journal. 43(2) (pp 148-149), 2022. Date of Publication: 13
Jan 2022.
Author
Lopez-Sendon J.L.; Cyr D.D.; Mark D.B.; Bangalore S.; Huang Z.; White
H.D.; Alexander K.P.; Li J.; Nair R.G.; Demkow M.; Peteiro J.; Wander
G.S.; Demchenko E.A.; Gamma R.; Gadkari M.; Poh K.K.; Nageh T.; Stone
P.H.; Keltai M.; Sidhu M.; Newman J.D.; Boden W.E.; Reynolds H.R.;
Chaitman B.R.; Hochman J.S.; Maron D.J.; O'Brien S.M.
Institution
(Lopez-Sendon) Cardiology department, Hospital Universitario La Paz,
Idipaz, UAM, Paseo de la Castellana 261, Madrid 28046, Spain
(Cyr, Mark, Huang, Alexander, Li, O'Brien) Duke Clinical Research
Institute and Duke University, 300 W. Morgan Street, Durham, United States
(Bangalore, Newman, Reynolds, Hochman) NYU Grossman School of Medicine,
530 First Avenue, NY, NY, United States
(White) Auckland City Hospital Green Lane Cardiovascular Services and
University of Auckland ,2 Park Road, Grafton, Auckland 1023, New Zealand
(Nair) Government Medical College, Thiruvananthapuram, Kerala 695002,
India
(Demkow) Department of Coronary and Structural Heart Diseases, National
Institute of Cardiology, Alpejska 42, Warsaw 04-628, Poland
(Peteiro) CHUAC, Universidad de A Coruna, As Xubias ,84, A Coruna 15006,
Spain
(Wander) Dayanand Medical College & Hospital, Civil Lines ,Tagore Nagar,
Ludhiana, Punjab 141001, India
(Demchenko) Almazov National Medical Research Centre, Russian Federation
(Gamma) Broomfield Hospital, Court Rd, Broomfield, Chelmsford CM1 7ET, UK
(Gadkari) Kem Hospital Maharashtra, 489, Mudaliar Rd, Rasta Peth, Pune,
Maharashtra 411011, India
(Poh) National University Heart Center Singapore, Singapore
(Poh) Yong Loo Lin School of Medicine, National University of Singapore,
10 Medical Dr, Singapore
(Nageh) Southend University Hospital, Westcliff-on-Sea, Prittlewell Chase,
United Kingdom
(Stone) Brigham and Women's Hospital, MA, 75 Francis St, Boston, United
States
(Keltai) Semmelweis University, Ulloi ut 26, Budapest 1085, Hungary
(Sidhu) Albany Medical College, 47 New Scotland Avenue, Physicians
Pavilion, 2nd Floor, Albany, NY 12208, USA
(Boden) VA New England Healthcare System, Boston University School of
Medicine, MA, 150 South Huntington Avenue, Boston, United States
(Chaitman) St Louis University School of Medicine Center for Comprehensive
Cardiovascular Care, 1034 S. Brentwood Blvd., Suite 1120, St. Louis, MO,
USA
(Maron) Department of Medicine, Stanford University, 300 Pasteur Drive,
Falk CVRC 265, Stanford, CA 94305-5406, USA
Publisher
NLM (Medline)
Abstract
AIMS: The International Study of Comparative Health Effectiveness with
Medical and Invasive Approaches (ISCHEMIA) trial prespecified an analysis
to determine whether accounting for recurrent cardiovascular events in
addition to first events modified understanding of the treatment effects.
METHODS AND RESULTS: Patients with stable coronary artery disease (CAD)
and moderate or severe ischaemia on stress testing were randomized to
either initial invasive (INV) or initial conservative (CON) management.
The primary outcome was a composite of cardiovascular death, myocardial
infarction (MI), and hospitalization for unstable angina, heart failure,
or cardiac arrest. The Ghosh-Lin method was used to estimate mean
cumulative incidence of total events with death as a competing risk. The
5179 ISCHEMIA patients experienced 670 index events (318 INV, 352 CON) and
203 recurrent events (102 INV, 101 CON). A single primary event was
observed in 9.8% of INV and 10.8% of CON patients while >=2 primary events
were observed in 2.5% and 2.8%, respectively. Patients with recurrent
events were older; had more frequent hypertension, diabetes, prior MI, or
cerebrovascular disease; and had more multivessel CAD. The average number
of primary endpoint events per 100 patients over 4years was 18.2 in INV
[95% confidence interval (CI) 15.8-20.9] and 19.7 in CON (95% CI
17.5-22.2), difference -1.5 (95% CI -5.0 to 2.0, P=0.398). Comparable
results were obtained when all-cause death was substituted for
cardiovascular death and when stroke was added as an event.
 CONCLUSION(S): In stable CAD patients with moderate or severe
myocardial ischaemia enrolled in ISCHEMIA, an initial INV treatment
strategy did not prevent either net recurrent events or net total events
more effectively than an initial CON strategy. CLINICAL TRIAL
REGISTRATION: ISCHEMIA ClinicalTrials.gov number, NCT01471522,
https://clinicaltrials.gov/ct2/show/NCT01471522. Copyright Published
on behalf of the European Society of Cardiology. All rights reserved.
© The Author(s) 2021. For permissions, please email:
journals.permissions@oup.com.

<99>
Accession Number
637054040
Title
Evidence of patient blood management-results of the First International
Consensus Conference in Frankfurt/Main 2018.
Source
Transfusion Medicine and Hemotherapy. Conference: 52. Jahrestagung der
Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie, DGTI.
Mannheim Germany. 46(SUPPL 1) (pp 4), 2019. Date of Publication: 2019.
Author
Muller M.M.; Van Remoortel H.; Meybohm P.; Aranko K.; Seifried E.
Institution
(Muller, Seifried) DRK Blutspendedienst Baden-Wurttemberg und Hessen,
Frankfurt a. M., Germany
(Van Remoortel) Belgian Red Cross, Centre for Evidence-Based Practice
(CEBaP), Mechelen, Belgium
(Meybohm) University Hospital, Department of Anaesthesiology,Intensive
Care Medicine and Pain Therapy, Frankfurt a. M., Germany
(Aranko) European Blood Alliance, Amsterdam, Netherlands
(Aranko) Finnish Red Cross Blood Service, Helsinki, Finland
Publisher
S. Karger AG
Abstract
Background: "Patient blood management (PBM) is a patient-focused,
evidence-based and systematic approach to optimize the management of
patient and transfusion of blood products for quality and effective
patient care. [.]" Citing the WHO 2011 definition of PBM, it becomes
evident, that the published evidence base of PBM is essential for high
quality patient-centred haemotherapy. The international Consensus
Conference (ICC) was set up in order to develop evidence-based clinical
and research recommendations for preoperative anaemia, red blood cell
(RBC) transfusion thresholds in adult patients and implementation of PBM
programmes. Method(s): An international scientific committee (SC)
defined 17 populationintervention- comparison-outcome (PICO) questions for
the three topics mentioned above. From these 17 PICO questions, the
literature search in 4 biomedical databases was driven. Several
meta-analyses, forest plots, the GRADE methodology (= grading of
recommendations, assessment, development and evaluation), GRADEpro, the
open source online database for GRADE as well as the Evidence-to-Decision
(EtD) framework were used in order to keep the development of
recommendations as evidence- based and transparent as possible. Three
expert panels (EP) consisting of clinicians, scientists, nurses, patient
representatives and methodologists used these methods to develop
recommendations driven by published evidence. Result(s): Out of more
than 17,500 literature citations, 145 studies (63 randomised trials & 82
observational studies) were included into the final analysis. The EP for
preoperative anaemia developed 4 clinical and 3 research recommendations.
A strong recommendation advocates for early detection and management of
preoperative anaemia before major elective surgery. For RBC transfusion
thresholds, 4 clinical and 6 research recommendations came out of the
process. Two strong clinical recommendations for PBC transfusion
thresholds advocate a haemoglobin level (hb) of < 7 g/dL for critical ill,
but clinical stable adult intensive care patients independent of septic
shock and < 7.5 g/dL for adults undergoing cardiac surgery. For
implementation of PBM programmes, 2 clinical and 3 research
recommendations were phrased. Conclusion(s): This is the first ICC
for PBM defining the evidence base for three topics. The relative paucity
of strong evidence in current PBM literature underscores the ongoing
struggle to a.) find internationally accepted definitions e.g. for anaemia
and b.) execute internationally planned meaningful multicentre trials in
the open fields of PBM. The clinical recommendations found here however
should be considered and accepted in clinical practice.

<100>
Accession Number
2015451084
Title
Comparative Myocardial Protection Effects of Buckberg and del Nido in
Mitral Valve Surgery: A Prospective Randomized Trial.
Source
International Cardiovascular Research Journal. 15(4) (pp 143-148), 2021.
Article Number: e117124. Date of Publication: 01 Dec 2021.
Author
Mousavizadeh M.; Ghanbari A.; Zirak N.; Ghadrdoost B.; Yaghubi M.;
Hosseini S.
Institution
(Mousavizadeh, Ghanbari, Ghadrdoost, Hosseini) Heart Valve Disease
Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Zirak) Lung Disease Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
(Yaghubi) Department of Extra Corporeal Circulation, Razavi Hospital, Imam
Reza International University, Mashhad, Iran, Islamic Republic of
Publisher
Iranian Cardiovascular Research Journal
Abstract
Background: Myocardial protection during cardiopulmonary bypass requires
essential techniques to preserve myocardial function and protect the
myocardium from cellular damage. Objective(s): This study aimed to
investigate the efficacy of del Nido cardioplegia in mitral valve surgery
compared to Buckberg solution. Method(s): All patients who underwent
mitral valve surgery from April 2018 to December 2018 were recruited in
the present trial. The patients were assigned randomly into del Nido and
Buckberg groups. Trans-thoracic and trans-esophageal echocardiography were
performed before and after the procedure to evaluate left ventricular
ejection fraction, as the primary outcome. Result(s): A total of 152
patients (77 in the del Nido group and 75 in the Buckberg group) were
included in the final analysis. The mean age of the participants was 51.3
+/- 13.4 years, and 55.3% of the patients were female. The two groups were
comparable in terms of all baseline characteristics. The results also
showed no significant difference between the two groups regarding
pre-operative ejection fractions (P = 0.063). However, ventilation time
and the mean length of ICU stay were higher in the Buckberg group (0.018
and 0.001, respectively). Moreover, the results indicated a more prominent
reduction in left ventricular ejection fraction measured via
trans-thoracic and trans-esophageal echocardiography in the Buckberg group
compared to the del Nido group (13.7% versus 4.7%, P < 0.001 for
trans-thoracic echocardiography). Conclusion(s): Del Nido
cardioplegia solution exerted beneficial effects on myocardial protection
evaluated by echocardiography compared to Buckberg in adult patients with
preserved ejection fraction undergoing mitral valve surgery. Copyright
© 2021, Iranian Cardiovascular Research Journal. All rights reserved.

<101>
Accession Number
2015447303
Title
Cerebral Oximetry-Monitored Nitroglycerin Infusion and Tissue Perfusion
during Rewarming of Cardiopulmonary Bypass in Cardiac Surgery: A
Prospective Randomized Trial.
Source
Journal of Clinical Medicine. 11(3) (no pagination), 2022. Article Number:
712. Date of Publication: February-1 2022.
Author
Chen J.-L.; Hsu Y.-C.; Huang G.-S.; Lin C.-Y.; Ke H.-Y.; Hsu P.-S.; Chung
C.-H.; Tsai C.-S.; Lin T.-C.
Institution
(Chen, Hsu, Huang, Lin) Department of Anesthesiology, Tri-Service General
Hospital, National Defense Medical Center, Taipei 11490, Taiwan (Republic
of China)
(Lin, Ke, Hsu, Tsai) Division of Cardiovascular Surgery, Department of
Surgery, Tri-Service General Hospital, National Defense Medical Center,
Taipei 11490, Taiwan (Republic of China)
(Chung) Department of Medical Research, Tri-Service General Hospital,
School of Public Health, National Defense Medical Center, Taipei 11490,
Taiwan (Republic of China)
(Tsai) Department and Graduate Institute of Pharmacology, National Defense
Medical Center, Taipei 11490, Taiwan (Republic of China)
Publisher
MDPI
Abstract
Background: Nitroglycerin facilitates microcirculation and oxygen delivery
through vasodilation. The purpose of this study was to clarify the effects
of nitroglycerin-induced vasodilation and potential hypotension on tissue
perfusion under cerebral oximetry monitoring during rewarming in
cardiopulmonary bypass. Method(s): Elective cardiac surgical patients
were randomly assigned to either a nitroglycerin group (n = 32) with an
intravenous infusion of 1-5 mcg/kg/min or a control group (n = 31) with
0-0.1 mcg/kg/min infusion, since the initiation of rewarming.
Perioperative arterial blood gas data were collected in addition to
hemodynamic variables, cerebral oximetry values, urine output, and
postoperative outcomes. Result(s): Nearly one-fifth (6/32) of
patients in the nitroglycerin group experienced transient (<= 5 min)
profound hypotension (mean arterial blood pressure <= 40 mmHg) after the
initiation of infusion. There were no significant differences between
groups in terms of perioperative levels of cerebral oximetry, cardiac
index, plasma glucose, lactate, bicarbonate, base excess, or post-bypass
activated coagulation time. In the nitroglycerin group, urine output was
nonsignificantly higher during cardiopulmonary bypass (p = 0.099) and
within 8 h after surgery (p = 0.157). Perioperative transfused blood
products, postoperative inotropic doses, extubation time, and intensive
care unit stay were comparable for the two groups. Conclusion(s):
Initiation of intravenous nitroglycerin infusion (at 1- 5 mcg/kg/min)
during rewarming in hypothermic cardiopulmonary bypass resulted in
transient profound hypotension in one-fifth of patients and did not
improve perioperative cerebral oxygenation, tissue perfusion, and
coagulation in cardiac surgery. Copyright © 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<102>
Accession Number
637036757
Title
In low-risk patients aged >70-75 with severe aortic stenosis, is
transcatheter superior to surgical aortic valve replacement in terms of
reported cardiovascular composite outcomes and survival?.
Source
Interactive cardiovascular and thoracic surgery. 34(1) (pp 40-44), 2022.
Date of Publication: 06 Jan 2022.
Author
Magro P.L.; Sousa-Uva M.
Institution
(Magro, Sousa-Uva) Department of Cardiothoracic Surgery, Hospital de Santa
Cruz, Carnaxide, Portugal
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was: In low-risk patients aged
>70-75 with severe aortic stenosis, is transcatheter superior to surgical
aortic valve replacement in terms of reported composite outcomes and
survival? More than 73 papers were found using the reported search, of
which 8 represented the best evidence to answer the clinical question. The
authors, journal, date and country of publication, patient group studied,
study type, relevant outcomes and results of these papers were tabulated.
The only low-risk randomized control trial to date [Nordic Aortic Valve
Intervention (NOTION)] regarding an elderly population did not show a
statistically significant difference between the 2 approaches regarding
the composite endpoint of death, stroke or myocardial infarction. A
subgroup analysis of elderly patients in the 2 main low-risk randomized
control trials did not yield statistically different results from those of
the overall population; the results indicated the superiority of
transcatheter aortic valve implantation regarding the composite of death,
stroke or rehospitalization at 1year [The Safety and Effectiveness of the
SAPIEN 3 Transcatheter Heart Valve in Low Risk Patients With Aortic
Stenosis (PARTNER 3)] and non-inferiority regarding a composite of death
or stroke at 2years [Medtronic Evolut Transcatheter Aortic Valve
Replacement in Low-Risk Patients (Evolut LR)]. The results from lower
evidence studies are largely consistent with these findings. Overall,
there is no compelling evidence indicating that older age should be an
isolated criterion for the choice between transcatheter aortic valve
replacement and surgical aortic valve replacement in otherwise low-risk
patients. The superiority of either technique regarding the aforementioned
composite short-term outcomes in this particular subgroup of patients is
unclear. Copyright © The Author(s) 2021. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<103>
Accession Number
637060835
Title
Topical antibiotic prophylaxis for surgical wound infections in clean and
clean-contaminated surgery: a systematic review and meta-analysis.
Source
BJS open. 5(6) (no pagination), 2021. Date of Publication: 09 Nov 2021.
Author
Chen P.-J.; Hua Y.-M.; Toh H.S.; Lee M.-C.
Institution
(Chen) Department of Emergency Medicine, Chi Mei Medical Center, Tainan,
Taiwan (Republic of China)
(Hua, Lee) Department of Pharmacy, Chi Mei Medical Center, Tainan, Taiwan
(Republic of China)
(Toh) Department of Intensive Care Medicine, Chi Mei Medical Center,
Tainan, Taiwan (Republic of China)
(Toh) Institute of Clinical Medicine, College of Medicine, National Cheng
Kung University, Tainan, Taiwan (Republic of China)
(Toh) Department of Health and Nutrition, Chia Nan University of Pharmacy
& Science, Tainan, Taiwan (Republic of China)
(Lee) Department of Public Health, College of Medicine, National Cheng
Kung University, Tainan, Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Topical antibiotics are widely prescribed as prophylaxis for
surgical site infection (SSI). Despite giving high drug concentrations at
local wound sites, their efficacy remains controversial. This study is a
systematic review and meta-analysis designed to compare the efficacy and
safety of topical antibiotics with non-antibiotic agents in preventing
SSI. METHOD(S): Randomized controlled trials (RCTs) comparing topical
antibiotics in patients with clean and clean-contaminated postsurgical
wounds were included. Relevant trials published before 30 September 2020,
were searched in the PubMed, Embase, and Cochrane databases, without
language restrictions. The primary outcome was the incidence of SSIs,
presented as the event rate. The secondary outcome was the incidence of
contact dermatitis (safety outcome). Data were synthesized using the
random-effects model, with the results expressed as risk ratio (RR) with
95 per cent confidence intervals (c.i.). RESULT(S): Thirteen RCTs
were included. The incidence of SSIs and contact dermatitis showed no
significant difference between topical antibiotics and non-antibiotic
agents (RR 0.89, 95 per cent c.i. 0.59 to 1.32 (P = 0.56, I2 = 48 per
cent); and RR 2.79, 95 per cent c.i. 0.51 to 15.19 (P = 0.24, I2 = 0 per
cent), respectively). In the subgroup analyses, a reduction in SSIs was
also not observed in dermatological (RR 0.77, 95 per cent c.i. 0.39 to
1.55; P = 0.46, I2 = 65 per cent), ocular (RR 0.08, 95 per cent c.i. 0.00
to 1.52; P = 0.09), spinal (RR 1.34, 95 per cent c.i. 0.65 to 2.77; P =
0.43, I2 = 0 per cent), orthopaedic (RR 0.69, 95 per cent c.i. 0.37 to
1.29; P = 0.25, I2 = 0 per cent), or cardiothoracic surgeries (RR 1.60, 95
per cent c.i. 0.79 to 3.25; P = 0.19). CONCLUSION(S): Given the
current evidence, the routine application of topical antibiotics to
surgical wounds did not reduce the incidence of SSI. Further trials are
needed to assess their effectiveness in high-risk surgeries or in selected
patient groups. Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of BJS Society Ltd.

<104>
Accession Number
637031720
Title
Meta-Analysis of Surgical Left Atrial Appendage Occlusion During Cardiac
Surgery.
Source
The American journal of cardiology. (no pagination), 2022. Date of
Publication: 05 Jan 2022.
Author
Eagle G.E.; Whitlock R.P.; Belley-Cote E.P.
Institution
(Eagle) Department of Medicine, McMaster University, Hamilton, Ontario,
Canada. Electronic address: emilie.belley-cote@phri.ca
(Whitlock) Faculty of Health Science, McMaster University, ON, Canada
(Belley-Cote) Department of Surgery, McMaster University, Hamilton,
Ontario, Canada
Publisher
NLM (Medline)

<105>
Accession Number
637036461
Title
Hybrid coronary revascularization in multivessel coronary artery disease:
a systematic review.
Source
Future cardiology. (no pagination), 2022. Date of Publication: 10 Jan
2022.
Author
Nenna A.; Nappi F.; Spadaccio C.; Greco S.M.; Pilato M.; Stilo F.;
Montelione N.; Catanese V.; Lusini M.; Spinelli F.; Chello M.
Institution
(Nenna, Greco, Stilo, Montelione, Catanese, Lusini, Spinelli, Chello)
Cardiovascular surgery, Universita Campus Bio-Medico di Roma, Via Alvaro
del Portillo 200, Italy
(Nappi) Cardiac surgery, Centre Cardiologique du Nord, Rue des Moulins
Gemeaux 32, Paris, France
(Spadaccio) Cardiac surgery, Golden Jubilee National Hospital, Agamemnon
St, Clydebank G814DY, Glasgow, United Kingdom
(Greco, Pilato) Cardiac surgery, Via Ernesto Tricomi 5, Italy
Publisher
NLM (Medline)
Abstract
Aim: Hybrid coronary revascularization (HCR) for multivessel coronary
artery disease (CAD) integrates coronary artery bypass grafting (CABG) and
percutaneous intervention in a planned revascularization strategy. This
systematic review summarizes the state of this art of this technique.
 Method(s): Major databases searched until October 2021.
 Result(s): The available literature on HCR includes three randomized
trials, ten meta-analysis and 27 retrospective studies. The greatest
benefits are observed in patients with low-to-intermediate risk and less
complex coronary anatomy; highly complex disease and the presence of risk
factors favored conventional CABG in terms of adverse events and survival.
 Conclusion(s): HCR is an interesting approach for multivessel CAD but
should not be considered a 'one-size-fits-all' procedure. Further studies
will specify the subset of patients likely to benefit most from this
hybrid approach.

<106>
Accession Number
637033904
Title
A Systematized Review of Professional Employment Following Thoracic
Transplantation.
Source
Progress in transplantation (Aliso Viejo, Calif.). (pp
15269248211064883), 2022. Date of Publication: 10 Jan 2022.
Author
Jobst S.; Schaefer J.; Kleiser C.; Kugler C.
Institution
(Jobst, Schaefer, Kleiser, Kugler) Institute of Nursing Science,
University of Freiburg, Freiburg, Germany
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Acknowledging the evolved landscape in thoracic
transplantation, professional employment becomes an important outcome
measure to quantify the success of this costly procedure.
 OBJECTIVE(S): We aimed to assess rates of and characterize factors
associated with professional employment in patients following thoracic
transplantation, and create an evidence-base on the relationship between
professional employment and relevant outcome parameters. METHOD(S):
We systematically searched Medline, Cinahl, and GoogleScholar to identify
studies published between 1998 and 2021 reporting on professional
employment following heart and lung transplantation. RESULT(S):
Twenty-two studies from 11 countries with varying sample sizes (N=27; 10
066) were included. Employment rates ranged from 19.7% to 69.4% for heart,
and from 7.4% to 50.8% for lung transplant recipients. Most frequently
reported positively associated factors with employment after transplant
were younger age, higher education, and history of pretransplant
employment. Longer duration of unemployment prior to transplantation and
Medicaid coverage were the most frequently reported negatively associated
factors. Relationships between professional employment and clinical
outcomes included lower rates of acute and chronic rejection, less
infection episodes, and better quality of life among working patients; one
study reported a lower 5-year-mortality rate. Reasons not to work were
"physical or mental health-related," "employment-related," "financial
reasons," and "lifestyle choices." DISCUSSION: Substantial proportions of
patients following thoracic transplantation are not professionally
employed, potentially diminishing the success of transplantation on
individual and societal levels. Considering adverse clinical outcomes in
employed transplant recipients were low, more efforts are needed to
identify modifiable factors for employment in these populations.

<107>
Accession Number
637041955
Title
Determining the Effectiveness of Forced-Air Warming Blankets in
Maintaining Postoperative Body Temperature: A Randomized Controlled Trial.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2022. Date of
Publication: 07 Jan 2022.
Author
Isikli A.G.; Findik UY.
Institution
(Isikli) Trakya University, Health Research and Practice Centre of Trakya
University, Thoracic Surgery Department, Balkan Campus, Edirne, Turkey
(Findik) Trakya University Faculty of Health Sciences Nursing Department,
Trakya University Balkan Campus, Edirne, Turkey
Publisher
NLM (Medline)
Abstract
PURPOSE: The aim of this study is to determine the effectiveness of
forced-air warming blankets in normalizing body temperature in the
postoperative period. DESIGN: Randomized controlled trial METHODS: The
study sample consisted of patients (N = 67) who underwent lung lobectomy
in the Thoracic Surgery Service of a university hospital. Forced-air
warming blankets were used in the treatment group and 100% cotton blankets
were used in the control group. Patients' body temperatures were monitored
using a tympanic thermometer until it reached 37degreeC. FINDINGS: The
body temperature of the patients in the treatment group reached 37degreeC
in a shorter time than that of the patients in the control group (52.27
+/- 29.79 min and 139.0 +/- 81.93 min, respectively; P < .001), and that
the perception of comfort of the patients in the treatment and control
groups increased (P < .001) after warming. CONCLUSION(S): We
recommend that forced-air warming blankets are used for patients
undergoing lung lobectomy in order to reach normal body temperature in a
shorter time. Copyright © 2021 American Society of PeriAnesthesia
Nurses. Published by Elsevier Inc. All rights reserved.

<108>
Accession Number
637040081
Title
Effect of ulinastatin on the inflammatory response after video-assisted
thoracic lobectomy in patients with lung cancer: a randomized controlled
study.
Source
Chinese medical journal. (no pagination), 2022. Date of Publication: 06
Jan 2022.
Author
Hwang W.J.; Joo M.A.; Joo J.
Institution
(Hwang) Department of Anesthesiology and Pain Medicine, Seoul St. Mary's
Hospital, College of Medicine, Catholic University of Korea, Seoul, South
Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: The first-line treatment for lung cancer is surgical
resection, and one-lung ventilation (OLV) is the most basic anesthetic
management method in lung surgery. During OLV, inflammatory cytokines are
released in response to the lung tissue damage and promote local and
contralateral lung damage through the systemic circulation. We designed a
randomized, prospective study to evaluate the effect of the urinary
trypsin inhibitor (UTI) ulinastatin on the inflammatory response after
video-assisted thoracic lobectomy in patients with lung cancer.
 METHOD(S): Adult patients aged 19 to 70 years, who were scheduled for
video-assisted thoracic lobectomy surgery to treat lung cancer between May
2020 and August 2020, were enrolled in this randomized, prospective study.
UTI (300,000 units) mixed with 100 mL of normal saline in the ulinastatin
group and 100 mL of normal saline in the control group was administered
over 1 h after inducing anesthesia. RESULT(S): The baseline (T0)
interferon-gamma (IFN-gamma)/interleukin-4 (IL-4) ratio was not different
between the groups (6941.3 +/- 2778.7 vs. 6954.3 +/- 2752.4 pg/mL,
respectively; P > 0.05). The IFN-gamma/IL-4 ratio was significantly higher
in ulinastatin group at 30 min after entering the recovery room than
control group (20,148.2 +/- 5054.3 vs. 6674.0 +/- 2963.6, respectively;
adjusted P value for significance <0.017). CONCLUSION(S):
Administering UTI attenuated the anti-inflammatory response, in terms of
INF-gamma expression and the IFN-gamma/IL-4 ratio, after video-assisted
thoracic surgery in lung cancer patients. TRIAL REGISTRATION: Clinical
Research Information Service of Korea National Institute of Health (CRIS),
KCT0005533. Copyright © 2022 by Lippincott Williams & Wilkins,
Inc.

<109>
Accession Number
637064262
Title
Aortic regurgitation management: a systematic review of clinical practice
guidelines and recommendations.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2022. Date of Publication: 13 Jan 2022.
Author
Galusko V.; Thornton G.; Jozsa C.; Sekar B.; Aktuerk D.; Treibel T.A.;
Petersen S.E.; Ionescu A.; Ricci F.; Khanji M.Y.
Institution
(Galusko) Department of Cardiology, King's College Hospital, London SE5
9RS, United Kingdom
(Thornton, Jozsa, Aktuerk, Treibel, Petersen, Khanji) Barts Heart Centre,
Barts Health NHS Trust, London, West Smithfield, EC1A 7BE, UK
(Thornton, Treibel) Institute of Cardiovascular Science, University
College London, London WC1E 6DD, United Kingdom
(Jozsa, Khanji) Newham University Hospital, Barts Health NHS Trust, London
E13 8SL, United Kingdom
(Sekar) Department of Cardiology, Gloucestershire Hospitals NHS Foundation
Trust, Gloucester GL1 3NN, United Kingdom
(Petersen, Khanji) NIHR Barts Biomedical Research Centre, William Harvey
Research Institute, Queen Mary University of London EC1A 7BE, United
Kingdom
(Ionescu) Morriston, UK Cardiac Regional Centre, Swansea Bay Health Board,
Swansea SA6 6NL, UK
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences,
"G.d'Annunzio" University of Chieti-Pescara, Chieti 66100, Italy
(Ricci) Department of Clinical Sciences, Lund University, Malmo, Sweden
(Ricci) Casa di Cura Villa Serena, 65013 Citta Sant'Angelo, Pescara, Italy
Publisher
NLM (Medline)
Abstract
Guidelines for the diagnosis and management of aortic regurgitation (AR)
contain recommendations which do not always match. We systematically
reviewed clinical practice guidelines and summarised similarities and
differences in the recommendations as well as gaps in evidence on the
management of AR. We searched MEDLINE and EMBASE (01/01/2011 -
01/09/2021), Google Scholar, and websites of relevant organisations for
contemporary guidelines that were rigorously developed as assessed by the
Appraisal of Guidelines for Research and Evaluation II tool. Three
guidelines met our inclusion criteria. There was consensus on the
definition of severe AR and use of echocardiography and of multimodality
imaging for diagnosis, with emphasis on comprehensive assessment by the
heart valve team to assess suitability and choice of intervention. Surgery
is indicated in all symptomatic patients and aortic valve replacement is
the cornerstone of treatment. There is consistency in the frequency of
follow-up of patients, and safety of non-cardiac surgery in patients
without indications for surgery. Discrepancies exist in recommendations
for 3-D imaging and the use of global longitudinal strain and biomarkers.
Cut-offs for left ventricular ejection fraction and size for recommending
surgery in severe asymptomatic AR also vary. There are no specific AR
cut-offs for high-risk surgery and the role of percutaneous intervention
is yet undefined. Recommendations on the treatment of mixed valvular
disease are sparse and lack robust prospective data. Copyright ©
The Author(s) 2022. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<110>
Accession Number
637061168
Title
Novel Insights into the 1969 Whole-Eye Transplant: Medical Ethics and
Evolving Safety Mechanisms: The 1969 Whole-Eye Transplant and Medical
Ethics.
Source
American journal of ophthalmology. (no pagination), 2022. Date of
Publication: 13 Jan 2022.
Author
Blodi C.F.
Institution
(Blodi) Truhlsen Eye Institute, Department of Ophthalmology, University of
Nebraska Medical Center, Omaha, NE
Publisher
NLM (Medline)
Abstract
PURPOSE: The controversial whole-eye transplant (WET) of 1969 performed by
Texas Medical Center (TMC) eye surgeon Conard Moore, MD is examined to
determine whether he performed a WET or a different operation. New
materials are reviewed to evaluate the conflicting historical WET reports:
Moore claimed that he performed the world's first WET, then retracted his
claim amid criticism. Medical and ethical factors are explored. The
parameters for experimental surgery of that era are compared to current
policies. DESIGN: Perspective. METHOD(S): This is a retrospective
analysis of a single patient's ophthalmic operations performed in April of
1969 and the controversial claim of the world's first WET. Oral and
written interviews with witnesses were conducted. Primary and secondary
literature sources were reviewed. Ocular illustrations provided by the
surgeon in 1969 were reviewed and compared to verbal reports.
 RESULT(S): A newly uncovered book chapter by Moore's departmental
chairman Louis Girard, MD supports the initial claim of a WET, as do
recent interviews with medical journalist Miriam Kass, JD. Ophthalmic
pathologist Milton Boniuk, MD states that he did not receive the whole eye
for examination. Moore made his claim of a WET amid the intense attention
on TMC's aggressive heart transplant operations. Moore retracted his claim
after professional criticism. CONCLUSION(S): New evidence supports
Moore's initial claim that he performed a WET, while other scenarios
remain plausible. This case highlights the boundary between accepted and
experimental operations and underscores the need for modern bioethics
oversight to provide safeguards for novel surgical
procedures. Copyright © 2022. Published by Elsevier Inc.

<111>
Accession Number
637052674
Title
Non-Invasive Imaging in the Evaluation of Cardiac Allograft Vasculopathy
in Heart Transplantation: A Systematic Review.
Source
Current problems in cardiology. (pp 101103), 2022. Date of Publication:
08 Jan 2022.
Author
Ajluni S.C.; Mously H.; Chami T.; Hajjari J.; Stout A.; Zacharias M.;
ElAmm C.; Wilson D.; Janus S.E.; Al-Kindi S.G.
Institution
(Ajluni, Hajjari) Department of Medicine, University Hospitals, Cleveland,
OH, United States
(Mously, Janus, Al-Kindi) Department of Medicine, University Hospitals,
Cleveland, Ohio; Harrington Heart and Vascular Institute, University
Hospitals and School of Medicine, Case Western Reserve University,
Cleveland, Ohio
(Chami) Minneapolis Heart Institute, Minneapolis, MN, United States
(Stout, ElAmm, Wilson) Core Library, University Hospitals Cleveland
Medical Center, Cleveland, OH, United States
(Zacharias) Harrington Heart and Vascular Institute, University Hospitals
and School of Medicine, Case Western Reserve University, Cleveland, OH,
United States
Publisher
NLM (Medline)
Abstract
Cardiac allograft vasculopathy (CAV) is the leading cause of long-term
graft dysfunction in patients with heart transplantation and is linked
with significant morbidity and mortality. Currently, the gold standard for
diagnosing CAV is coronary imaging with intravascular ultrasound (IVUS)
during traditional invasive coronary angiography (ICA). Invasive imaging,
however, carries increased procedural risk and expense to patients in
addition to requiring an experienced interventionalist. With the
improvements in non-invasive cardiac imaging modalities such as
transthoracic echocardiography (TTE), computed tomography (CT), magnetic
resonance imaging (MRI) and positron emission tomography (PET), an
alternative non-invasive imaging approach for the early detection of CAV
may be feasible. In this systematic review, we explored the literature to
investigate the utility of non-invasive imaging in diagnosis of CAV in
>3000 patients across 49 studies. We also discuss the strengths and
weaknesses for each imaging modality. Overall, all four imaging modalities
show good to excellent accuracy for identifying CAV with significant
variations across studies. Majority of the studies compared non-invasive
imaging with ICA without intravascular imaging. In summary, non-invasive
imaging modalities offer an alternative approach to invasive coronary
imaging for CAV. Future studies should investigate longitudinal
non-invasive protocols in low-risk patients after heart
transplantation. Copyright © 2022. Published by Elsevier Inc.

<112>
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.
 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). 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.
 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. Copyright © 2021

<113>
Accession Number
2012510869
Title
New-onset atrial fibrillation in patients with worsening heart failure and
coronary artery disease: an analysis from the COMMANDER-HF trial.
Source
Clinical Research in Cardiology. 111(1) (pp 50-59), 2022. Date of
Publication: January 2022.
Author
Ferreira J.P.; Cleland J.G.; Lam C.S.P.; Anker S.D.; Mehra M.R.; van
Veldhuisen D.J.; Byra W.M.; LaPolice D.A.; Greenberg B.; Zannad F.
Institution
(Ferreira, Zannad) Centre D'Investigation Clinique 1433 Module
Plurithematique, CHRU Nancy - Hopitaux de Brabois, CHRU de Nancy, FCRIN
INI-CRCT, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu,
Universite de Lorraine, Nancy, France
(Cleland) Robertson Centre for Biostatistics and Clinical Trials,
University of Glasgow, Glasgow, United Kingdom
(Lam) National Heart Centre Singapore, Duke-National University of
Singapore, Singapore, Singapore
(Lam, van Veldhuisen) Department of Cardiology, University Medical Center
Groningen, University of Groningen, Groningen, Netherlands
(Anker) Berlin-Brandenburg Center for Regenerative Therapies, Berlin,
Germany
(Anker) Department of Cardiology, German Center for Cardiovascular
Research Partner Site Berlin, Charite Universitatsmedizin Berlin, Berlin,
Germany
(Mehra) Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
(Byra, LaPolice) Janssen Research and Development, Raritan, NJ, United
States
(Greenberg) Cardiology Division, Department of Medicine, University of
California, San Diego, La Jolla, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Atrial fibrillation (AF) in the presence of heart failure (HF)
is associated with poor outcomes including a high-risk of stroke and other
thromboembolic events. Identifying patients without AF who are at
high-risk of developing this arrhythmia has important clinical
implications. Aim(s): To develop a risk score to identify HF patients
at high risk of developing AF. Method(s): The COMMANDER-HF trial
enrolled 5022 patients with HF and a LVEF <= 40%, history of coronary
artery disease, and absence of AF at baseline (confirmed with an
electrocardiogram). Patients were randomized to either rivaroxaban (2.5 mg
bid) or placebo. New-onset AF was confirmed by the investigator at study
visits. Result(s): 241 (4.8%) patients developed AF during the
follow-up (median 21 months). Older age (>= 65 years), LVEF < 35%, history
of PCI or CABG, White race, SBP < 110 mmHg, and higher BMI (>= 25
kg/m2) were independently associated with risk of new-onset AF,
whereas the use of DAPT was associated with a lower risk of new-onset AF.
We then built a risk score from these variables (with good accuracy
C-index = 0.71) and calibration across observed and predicted tertiles of
risk. New-onset AF events rates increased steeply by increasing tertiles
of the risk-score. Compared to tertile 1, the risk of new-onset AF was
2.5-fold higher in tertile 2, and 6.3-fold higher in tertile 3.
Rivaroxaban had no effect in reducing new-onset AF. In time-updated
models, new-onset AF was associated with a higher risk of subsequent
all-cause death: HR (95%CI) 1.38 (1.11-1.73). Conclusion(s): A
well-calibrated risk-score identified patients at risk of new-onset AF in
the COMMANDER-HF trial. Patients who developed AF had a higher risk of
subsequent death. Graphic abstract: [Figure not available: see
fulltext.] Copyright © 2021, Springer-Verlag GmbH Germany, part
of Springer Nature.

<114>
Accession Number
2014999813
Title
Clinical Outcomes Following Isolated Transcatheter Tricuspid Valve Repair:
A Meta-Analysis and Meta-Regression Study.
Source
JACC: Cardiovascular Interventions. 14(20) (pp 2285-2295), 2021. Date of
Publication: 25 Oct 2021.
Author
Bocchino P.P.; Angelini F.; Vairo A.; Andreis A.; Fortuni F.; Franchin L.;
Frea S.; Raineri C.; Pidello S.; Conrotto F.; Montefusco A.; Alunni G.; De
Ferrari G.M.
Institution
(Bocchino, Angelini, Vairo, Andreis, Fortuni, Franchin, Frea, Raineri,
Pidello, Conrotto, Montefusco, Alunni, De Ferrari) Division of Cardiology,
Department of Medical Sciences, University of Turin, "Citta della Salute e
della Scienza" Hospital, Turin, Italy
(Fortuni) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to assess the pooled clinical and
echocardiographic outcomes of different isolated transcatheter tricuspid
valve repair (ITTVR) strategies for significant (moderate or greater)
tricuspid regurgitation (TR). Background(s): Significant TR is a
common valvular heart disease worldwide. Method(s): Published
research was systematically searched for studies evaluating the efficacy
and safety of ITTVR for significant TR in adults. The primary outcomes
were improvement in New York Heart Association (NYHA) functional class and
6-minute walking distance and the presence of severe or greater TR at the
last available follow-up of each individual study. Random-effect
meta-analysis was performed comparing outcomes before and after ITTVR.
 Result(s): Fourteen studies with 771 patients were included. The mean
age was 77 +/- 8 years, and the mean European System for Cardiac Operative
Risk Evaluation II score was 6.8% +/- 5.4%. At a weighted mean follow-up
of 212 days, 209 patients (35%) were in NYHA functional class III or IV
compared with 586 patients (84%) at baseline (risk ratio: 0.23; 95% CI:
0.13-0.40; P < 0.001). Six-minute walking distance significantly improved
from 237 +/- 113 m to 294 +/- 105 m (mean difference +50 m; 95% CI: +34 to
+66 m; P < 0.001). One hundred forty-seven patients (24%) showed severe or
greater TR after ITTVR compared with 616 (96%) at baseline (risk ratio:
0.29; 95% CI: 0.20-0.42; P < 0.001). Conclusion(s): Patients
undergoing ITTVR for significant TR experienced significant improvements
in NYHA functional status and 6-minute walking distance and a significant
reduction in TR severity at mid-term follow-up. Copyright © 2021
American College of Cardiology Foundation

<115>
Accession Number
2015733714
Title
Microcirculatory Resistance Predicts Allograft Rejection and Cardiac
Events After Heart Transplantation.
Source
Journal of the American College of Cardiology. 78(24) (pp 2425-2435),
2021. Date of Publication: 14 Dec 2021.
Author
Ahn J.-M.; Zimmermann F.M.; Gullestad L.; Angeras O.; Karason K.; Russell
K.; Lunde K.; Okada K.; Luikart H.; Khush K.K.; Honda Y.; Pijls N.H.J.;
Lee S.E.; Kim J.-J.; Park S.-J.; Solberg O.-G.; Fearon W.F.
Institution
(Ahn, Lee, Kim, Park) Department of Cardiology, Asan Medical Center,
University of Ulsan College of Medicine, Seoul, South Korea
(Ahn, Zimmermann, Luikart, Khush, Honda, Fearon) Division of
Cardiovascular Medicine, Stanford University School of Medicine, Stanford
Cardiovascular Institute, Stanford, CA, United States
(Zimmermann, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Gullestad, Russell, Lunde, Solberg) Department of Cardiology, Oslo
University Hospital Rikshospitalet, Oslo, Norway
(Gullestad) KG Jebsen Center for Cardiac Research, University of Oslo,
Norway
(Gullestad) Center for Heart Failure Research, Oslo University Hospital,
Oslo, Norway
(Gullestad) Institute of Clinical Medicine, Faculty of Medicine,
University of Oslo, Oslo, Norway
(Angeras, Karason) Department of Cardiology, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Angeras, Karason) Department of Molecular and Clinical Medicine,
Institute of Medicine, Gothenburg University, Gothenburg, Sweden
(Okada) Division of Cardiology, Yokohama City University Medical Center,
Yokohama, Japan
(Fearon) VA Palo Alto Health Care System, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Single-center data suggest that the index of microcirculatory
resistance (IMR) measured early after heart transplantation predicts
subsequent acute rejection. Objective(s): The goal of this study was
to validate whether IMR measured early after transplantation can predict
subsequent acute rejection and long-term outcome in a large multicenter
cohort. Method(s): From 5 international cohorts, 237 patients who
underwent IMR measurement early after transplantation were enrolled. The
primary outcome was acute allograft rejection (AAR) within 1 year after
transplantation. A key secondary outcome was major adverse cardiac events
(MACE) (the composite of death, re-transplantation, myocardial infarction,
stroke, graft dysfunction, and readmission) at 10 years. Result(s):
IMR was measured at a median of 7 weeks (interquartile range: 3-10 weeks)
post-transplantation. At 1 year, the incidence of AAR was 14.4%. IMR was
associated proportionally with the risk of AAR (per increase of 1-U IMR;
adjusted hazard ratio [aHR]: 1.04; 95% confidence interval [CI]:
1.02-1.06; p < 0.001). The incidence of AAR in patients with an IMR >=18
was 23.8%, whereas the incidence of AAR in those with an IMR <18 was 6.3%
(aHR: 3.93; 95% CI: 1.77-8.73; P = 0.001). At 10 years, MACE occurred in
86 (36.3%) patients. IMR was significantly associated with the risk of
MACE (per increase of 1-U IMR; aHR: 1.02; 95% CI: 1.01-1.04; P = 0.005).
 Conclusion(s): IMR measured early after heart transplantation is
associated with subsequent AAR at 1 year and clinical events at 10 years.
Early IMR measurement after transplantation identifies patients at higher
risk and may guide personalized posttransplantation
management. Copyright © 2021

<116>
Accession Number
2015617731
Title
Does the solution used for cold static storage of hearts impact on heart
transplant survival?.
Source
Interactive Cardiovascular and Thoracic Surgery. 33(5) (pp 814-818), 2021.
Date of Publication: 01 Nov 2021.
Author
Pannekoek A.; Ali U.
Institution
(Pannekoek, Ali) Department of Clinical Services, Fiona Stanley Hospital,
Perth, WA, Australia
Publisher
Oxford University Press
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was For the [cold static
storage of donor hearts] does the [cardiac preservation solution] impact
on [heart transplant survival]? . Altogether 182 papers were found using
the reported search, of which 9 represented the best evidence to answer
the clinical question. The authors, journal, date and country of
publication, patient group studied, study type, relevant outcomes and
results of these papers are tabulated. A wide variety of both custom and
standardized cardiac preservation solutions are used for the procurement
and cold static storage of donor hearts. In heart transplants with shorter
cold ischaemic times, survival outcomes appear similar across many of the
common cardiac preservation solutions in the long term. However,
unspecified cardioplegia (with supraphysiological potassium concentration)
is not supported as the final storage solution as it was associated with
worse outcomes overall. In the short term, intracellular solutions (70
mEq/l sodium; including University of Wisconsin solution) may also have
better survival outcomes than extracellular solutions. Where extended
ischaemic times (4 h) are necessary or high-risk grafts obtained, the
evidence supports University of Wisconsin as the preferred solution. We
concluded that choice of cardiac preservation solution could impact both
survival and secondary outcomes. Copyright © 2021 Oxford
University Press. All rights reserved.

<117>
Accession Number
635289386
Title
The Efficacy of Resin Hemoperfusion Cartridge on Inflammatory Responses
during Adult Cardiopulmonary Bypass.
Source
Blood purification. 51(1) (pp 31-37), 2022. Date of Publication: 2022.
Author
He Z.; Lu H.; Jian X.; Li G.; Xiao D.; Meng Q.; Chen J.; Zhou C.
Institution
(He, Lu, Jian, Xiao, Meng, Chen, Zhou) Department of Cardiovascular
Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong
Provincial People's Hospital, Guangdong Academy of Medical Sciences,
Guangzhou, China
(Li) Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital
of Sun Yat-sen University, Guangzhou, China
Publisher
NLM (Medline)
Abstract
AIM: This study aimed to evaluate the efficacy of the resin hemoperfusion
device (HA380 hemoperfusion cartridge) on inflammatory responses during
adult cardiopulmonary bypass (CPB). METHOD(S): Sixty patients
undergoing surgical valve replacement were randomized into the HP group (n
= 30) with an HA380 hemoperfusion cartridge in the CPB circuit or the
control group (n = 30) with the conventional CPB circuit. The results of
routine blood tests, blood biochemical indexes, and inflammatory factors
were analyzed at V0 (pre-CPB), V1 (CPB 30 min), V2 (ICU 0 h), V3 (ICU 6
h), and V4 (ICU 24 h). RESULT(S): The HP group had significantly
lower levels of IL-6, IL-8, and IL-10. Significant estimation of group
differences in the generalized estimating equation (GEE) models was also
observed in IL-6 and IL-10. The HP group had significantly lower levels of
creatinine (Cr), aminotransferase (AST), and total bilirubin (TBil)
compared to the control group. The estimation of differences of Cr, AST,
and TBil all reached statistical significance in GEE results. The HP group
had significantly less vasopressor requirement and shorter mechanical
ventilation time and ICU stay time as compared to the control group.
 CONCLUSION(S): The HA380 hemoperfusion cartridge could effectively
reduce the systemic inflammatory responses and improve postoperative
recovery of patients during adult CPB. Copyright © 2021 S. Karger
AG, Basel.

<118>
Accession Number
2016536941
Title
The detection, treatment of parvovirus B19 infection induced anemia in
solid organ transplants: A case series and literature review of 194
patients.
Source
Transfusion Clinique et Biologique. (no pagination), 2022. Date of
Publication: 2022.
Author
Zhong Q.; Zeng J.; Lin T.; Song T.
Institution
(Zhong, Lin, Song) Urology Department, Urology research institute, West
China Hospital, Sichuan University, Chengdu, Sichuan, China
(Zhong, Lin, Song) Organ transplantation center, West China Hospital,
Sichuan University, Chengdu, Sichuan, China
(Zeng) Department of Transplantation Surgery, The Affiliated Hospital of
Guizhou Medical University, Guiyang, Guizhou, China
Publisher
Elsevier Masson s.r.l.
Abstract
Background: There are no optimal diagnostic, treatment and post-infection
surveillance strategies for parvovirus B19 infection in solid organ
transplantation (SOT) recipients. Method(s): We conducted a
retrospective review of all PVB19 infected cases confirmed by qPCR among
SOT recipients at our institution over a 3-year period and reviewed the
literature from 1990 to 2021. Result(s): Eight kidney and two heart
transplant patients with refractory anemia had PVB19 infection. The viral
DNA load in peripheral blood ranged from 2.62 x 102 to 8.31 x
106 copies/mL. Two patients with the lowest PVB19 DNA load only
reduced the use of immunosuppressants and anemia was relieved. Eight
received intravenous immunoglobulin (IVIG) (ranging from 0.25 to 0.5
g/kg/day). The median time to anemia improvement (hemoglobulin > 100 g/L)
was 16 days (8-70 days) after treatment. One patient had a PVB19 relapse
and viral DNA load > 1.00 x 108 copies/mL at diagnosis. A total
of 86 studies involving 194 SOTs were screened from the literature, and
the most common symptom was anemia and low reticulocyte count. PVB19 DNA
was detected in all cases. Of that, 91.4% of cases received IVIG, 53.8%
received IVIG and immunosuppression reduction, 6.5% of cases showed
reduced immunosuppression without IVIG, and 2.1% did not receive any
special treatment. The recurrence rate was 17.5%. Conclusion(s):
PVB19 infection is a cause of anemia after SOT, and treatment mainly
relies on IVIG and/or immunosuppression reduction. Copyright ©
2022 Societe francaise de transfusion sanguine (SFTS)

<119>
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. Design(s):
Meta-analysis and systematic review of previously published studies.
 Setting(s): Each study was conducted in a surgical center or
intensive care unit. Participant(s): Studies investigating patients
<18 years without underlying hematologic disorders were included.
 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. 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. 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. Copyright © 2021
Elsevier Inc.

<120>
Accession Number
2015979180
Title
A clinical and cost-effectiveness analysis of the HeartMate 3 left
ventricular assist device for transplant-ineligible patients: A United
Kingdom perspective.
Source
Journal of Heart and Lung Transplantation. 41(2) (pp 174-186), 2022. Date
of Publication: February 2022.
Author
Lim H.S.; Shaw S.; Carter A.W.; Jayawardana S.; Mossialos E.; Mehra M.R.
Institution
(Lim) University Hospital Birmingham NHS Foundation Trust, Birmingham, UK,
United Kingdom
(Shaw) Manchester University NHS Foundation Trust, Manchester, UK, United
Kingdom
(Carter, Jayawardana, Mossialos) London School of Economics, London, UK,
United Kingdom
(Mehra) Brigham and Women's Hospital Heart and Vascular Center and Harvard
Medical School, Boston, Massachusetts
Publisher
Elsevier Inc.
Abstract
Background: The clinical and cost-effectiveness of left ventricular assist
device (LVAD) therapy for patients with advanced heart failure (HF) who
are ineligible for heart transplantation is debated in the UK. This study
develops an indirect comparison between the fully magnetically levitated
HeartMate 3 (HM 3) LVAD and medical therapy (MT) to evaluate expected
clinical and cost-effectiveness in the UK National Health Service (NHS)
context. Method(s): We performed an economic analysis comparing the
HM3 pump against the HeartMate II LVAD (MOMENTUM 3), and then another
analysis comparing MT with the first- and second-generation HeartMate XVE
pump LVAD and HeartMate II LVAD for the same patient population (REMATCH
and ROADMAP, respectively). By bridging those 2 analyses, an indirect
comparison between HM3 and MT in the form of a network meta-analysis was
developed. A literature search was performed to select the most
appropriate pair of studies for this purpose. Outcomes were adjusted to
produce Kaplan-Meier curves for the cost-effectiveness evaluation by using
a decision-analytic model. Data were extrapolated linearly over a 5-year
time horizon. Uncertainty and additional scenarios were addressed by
one-way and probabilistic sensitivity analysis. Local costs and health
utility were used from England, thereby representing the UK context.
 Result(s): The incremental cost-effectiveness ratio (ICER) for LVAD
vs MT in transplant ineligible patients with advanced HF was estimated to
be 47,361 per quality-adjusted life year gained, with a 97.1% probability
of being cost-effective at 50,000. In a subgroup of patients who are
inotropic therapy dependent (INTERMACS 1-3 severity profile), the ICER was
45,616, while for a population with less-ill ambulatory HF (INTERMACS
profile 4-7) the ICER changed to 64,051. Conclusion(s): This study
provides evidence that HM3 LVAD therapy in advanced HF patients ineligible
for heart transplantation may be cost-effective compared to MT in the NHS
UK-England context. The ICER is lowest for patients dependent on inotropic
support, but exceeds the willingness to pay threshold of 50,000 in
ambulatory noninotropic therapy dependent advanced HF
patients. Copyright © 2021 The Authors

<121>
Accession Number
636679785
Title
Limb Remote Ischemic Preconditioning Applied During Sevoflurane Anesthesia
Does Not Protect the Lungs in Patients Undergoing Adult Heart Valve
Surgery.
Source
The heart surgery forum. 24(5) (pp E916-E924), 2021. Date of Publication:
21 Oct 2021.
Author
Li T.; Zeng Q.-S.; She S.-Z.
Institution
(Li) Department of Anesthesiology, First Affiliated Hospital of Nanchang
University, Nanchang, Jiangxi, China
(Zeng) Department of Anesthesiology, Guangdong General Hospital,
Guangzhou, Guangdong, China
(She) Department of Anesthesiology, Guangzhou First People's Hospital,
Guangzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Two consistent overall cell protective preconditioning
treatments should provide more protection. We hypothesized that limb
remote ischemic preconditioning (RIPC, second preconditioning stimulus)
applied during sevoflurane inhalation (first preconditioning stimulus)
would provide more protection to the lungs of patients undergoing adult
heart valve surgery. METHOD(S): In this randomized,
placebo-controlled, double-blind trial, 50 patients were assigned to the
RIPC group or the placebo group (1:1). Patients in the RIPC group received
three 5-min cycles of 300 mmHg cuff inflation/deflation of the left-side
lower limb before aortic cross-clamping. Anesthesia consisted of opioids
and propofol for induction and sevoflurane for maintenance. The primary
end point was comparison of the postoperative arterial-alveolar oxygen
tension ratio (a/A ratio) between groups. Secondary end points included
comparisons of pulmonary variables, postoperative morbidity and mortality
and regional and systemic inflammatory cytokines between groups.
 RESULT(S): In the RIPC group, the a/A ratio and other pulmonary
variables exhibited no significant differences throughout the study period
compared with the placebo group. No significant differences in either
plasma or bronchoalveolar lavage levels of TNF- alpha were noted between
the groups at 10 min after anesthetic induction and 1 h after cross-clamp
release. The percentage of neutrophils at 12 h postoperation was
significantly increased in the RIPC group compared with the placebo group
(91.34+/-0.00 vs. 89.42+/-0.10, P = 0.023). CONCLUSION(S): Limb RIPC
applied during sevoflurane anesthesia did not provide additional
significant pulmonary protection following adult valvular cardiac surgery.

<122>
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. 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. 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. 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). Copyright ©
2021. The Author(s).

<123>
[Use Link to view the full text]
Accession Number
2016531207
Title
Plasma and Platelet Transfusions Strategies in Neonates and Children
Undergoing Cardiac Surgery With Cardiopulmonary Bypass or Neonates and
Children Supported by Extracorporeal Membrane Oxygenation: From the
Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding.
Source
Pediatric Critical Care Medicine. 23 (pp E25-E36), 2022. Date of
Publication: 01 Jan 2022.
Author
Cholette J.M.; Muszynski J.A.; Ibla J.C.; Emani S.; Steiner M.E.; Vogel
A.M.; Parker R.I.; Nellis M.E.; Bembea M.M.
Institution
(Cholette) Department of Pediatrics, University of Rochester, Golisano
Children's Hospital, Rochester, NY, United States
(Muszynski) Department of Pediatrics, Division of Critical Care Medicine,
Nationwide Children's Hospital, Columbus, OH, United States
(Ibla) Division of Cardiac Anesthesia, Department of Anesthesiology,
Critical Care and Pain Medicine, Boston Children's Hospital, Harvard
Medical School, Boston, MA, United States
(Emani) Department of Cardiac Surgery, Boston Children's Hospital, Boston,
MA, United States
(Steiner) Divisions of Critical Care and Hematology, Department of
Pediatrics, University of Minnesota, Masonic Children's Hospital,
Minneapolis, MN, United States
(Vogel) Division of Pediatric Surgery, Department of Surgery, Texas
Children's Hospital, Baylor College of Medicine, Houston, TX, United
States
(Parker) Department of Pediatrics, Hematology/Oncology, Renaissance School
of Medicine, SUNY at Stony Brook, Stony Brook, NY, United States
(Nellis) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, NY Presbyterian Hospital, Weill Cornell Medicine, New York,
NY, United States
(Bembea) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University, School of Medicine, Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: To present the recommendations and consensus statements with
supporting literature for plasma and platelet transfusions in critically
ill neonates and children undergoing cardiac surgery with cardiopulmonary
bypass or supported by extracorporeal membrane oxygenation from the
Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding.
DESIGN: Systematic review and consensus conference of international,
multidisciplinary experts in platelet and plasma transfusion management of
critically ill children. SETTING: Not applicable. PATIENTS: Critically ill
neonates and children following cardiopulmonary bypass or supported by
extracorporeal membrane oxygenation. INTERVENTIONS: None. MEASUREMENTS AND
MAIN RESULTS: A panel of nine experts developed evidence-based and, when
evidence was insufficient, expert-based statements for plasma and platelet
transfusions in critically ill neonates and children following
cardiopulmonary bypass or supported by extracorporeal membrane
oxygenation. These statements were reviewed and ratified by the 29
Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding
experts. A systematic review was conducted using MEDLINE, EMBASE, and
Cochrane Library databases, from inception to December 2020. Consensus was
obtained using the Research and Development/University of California, Los
Angeles Appropriateness Method. Results were summarized using the Grading
of Recommendations Assessment, Development, and Evaluation method. We
developed one good practice statement, two recommendations, and three
expert consensus statements. CONCLUSION(S): Whereas viscoelastic
testing and transfusion algorithms may be considered, in general, evidence
informing indications for plasma and platelet transfusions in neonatal and
pediatric patients undergoing cardiac surgery with cardiopulmonary bypass
or those requiring extracorporeal membrane oxygenation support is
lacking. Copyright © 2022 by the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies

<124>
Accession Number
2016562090
Title
Evaluating the effect of ultrasound-guided superficial serratus plane
block, deep serratus plane block and thoracic epidural analgesia in cancer
patients undergoing thoracotomy: A randomized controlled trial.
Source
Anaesthesia, Pain and Intensive Care. 25(6) (pp 713-721), 2021. Date of
Publication: 01 Dec 2021.
Author
Abdelrahman A.S.; Al Wasseef M.M.; Hassan M.E.; Abdelghafar E.M.
Institution
(Abdelrahman, Al Wasseef, Hassan, Abdelghafar) National Cancer Institute,
Cairo University, Cairo, Egypt
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & objective: The serratus anterior plane block (SAPB) is a
recent technique providing effective perioperative analgesia in thoracic
surgeries. This study compared the intra-operative hemodynamics and the
perioperative analgesic efficacy of superficial SAPB, to deep SAPB, and to
thoracic epidural analgesia in thoracotomies. Methodology: One hundred and
eighty lung cancer patients scheduled for thoracotomy were randomly
allocated to three groups; TEA group, which received thoracic epidural
analgesia, SSPB group receiving ultrasound-guided superficial serratus
plane block and DSPB group which received US-guided deep serratus plane
block. Baseline and intra-operative hemodynamics and total consumption of
intraoperative fentanyl and postoperative morphine was noted.
 Result(s): Intra-operative mean arterial pressure (MAP) significantly
decreased in the TEA group compared to baseline values, whereas no
significant changes were found in either SSPB or DSPB groups. Heart rate
(HR) did not show significant changes in any group. The time to
postoperative analgesic demand was significantly longer in the SSPB and
DSPB groups than in the TEA group (p < 0.001). In the first postoperative
hour, TEA group had significantly higher visual analogue scale (VAS)
scores than SSPB or DSPB groups at rest and with cough. The total
consumption of intraoperative fentanyl and postoperative morphine was
comparable among all groups. Conclusion(s): Pre-operative SSPB and
DSPB can provide adequate perioperative analgesia without hemodynamic
instability when compared to TEA in thoracotomies. Copyright ©
2021 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights
reserved.

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