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<1>
Accession Number
2014776702
Title
Revascularization or medical therapy for stable coronary artery disease
patients with different degrees of ischemia: a systematic review and
meta-analysis of the role of myocardial perfusion.
Source
Therapeutic Advances in Chronic Disease. 13 (no pagination), 2022. Date of
Publication: January 2022.
Author
Yong J.; Tian J.; Zhao X.; Yang X.; Zhang M.; Zhou Y.; He Y.; Song X.
Institution
(Yong, Tian, Zhao, Yang, Zhang, Zhou) Department of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, Beijing, China
(He) Department of Radiology, Beijing Friendship Hospital, Capital Medical
University, Yongan Road 95, Beijing 100050, China
(Song) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Anzhen Road No. 2, Chaoyang District, Beijing 100029, China
Publisher
SAGE Publications Ltd
Abstract
Objective: This study explored the best treatment strategies for stable
coronary artery disease (SCAD) patients with differing levels of ischemic
severity. Method(s): We conducted a comprehensive search of the
PubMed, EMBASE, and Cochrane databases - searching for relevant articles
through 4 February 2021. We selected studies comparing different
treatments for patients with SCAD who had received ischemia assessments.
The primary outcome was death. The secondary outcomes were major adverse
cardiovascular events (MACEs) and myocardial infarction (MI).
 Result(s): A total of 11 studies, including 35,607 subjects, were
selected for this meta-analysis. Results showed that, compared with
medical therapy, revascularization could reduce MACE incidence (odds ratio
(OR) 0.73, 95% confidence interval (CI): 0.57-0.94, p < 0.05) in SCAD
patients with myocardial ischemia, but that it was not effective for
patients without ischemia. For mild ischemia, the incidence of death (OR
0.78, 95% CI: 0.59-1.01, p = 0.063), MACE (OR 0.91, 95% CI: 0.48-1.70, p =
0.762), or MI (OR 1.44, 95% CI: 0.94-2.19, p = 0.093) was the same whether
they were treated with revascularization or medical therapy. For moderate
to severe ischemia, revascularization reduced the incidence of MACE (OR
0.59, 95% CI: 0.42-0.83, p < 0.05) and MI (OR 0.83, 95% CI: 0.71-0.98, p <
0.05), but the incidence of death (OR 0.73, 95% CI: 0.47-1.12, p =.145)
was similar. For SCAD patients with severe ischemia, revascularization may
confer survival benefits (OR 0.46, 95% CI: 0.21-1.00, p = 0.05).
 Conclusion(s): For SCAD patients with moderate to severe ischemia,
revascularization reduces the MACE and MI incidences, but does not change
the incidence of death. Evaluation for myocardial ischemia is vital when
selecting a therapeutic strategy. Copyright © The Author(s),
2022.

<2>
Accession Number
2014718407
Title
Rapid deployment technology versus conventional sutured bioprostheses in
aortic valve replacement.
Source
Journal of Cardiac Surgery. 37(3) (pp 640-655), 2022. Date of Publication:
March 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.

<3>
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 ©

<4>
Accession Number
2016570733
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: 01 Jan
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,
Sun Yat-sen University, Guangzhou, China
Publisher
S. Karger AG
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. All rights reserved.

<5>
Accession Number
2012109410
Title
Erector spinae plane block in acute interventional pain management: A
systematic review.
Source
Scandinavian Journal of Pain. 21(4) (pp 671-679), 2021. Date of
Publication: 01 Oct 2021.
Author
Viderman D.; Dautova A.; Sarria-Santamera A.
Institution
(Viderman, Sarria-Santamera) Department of Biomedical Sciences, Nazarbayev
University School of Medicine (NUSOM), Kerei-Zhanibek Str. 5/1, Nur-Sultan
010000, Kazakhstan
(Dautova) Nazarbayev University Library, Nazarbayev University,
Nur-Sultan, Kazakhstan
Publisher
De Gruyter Open Ltd
Abstract
Erector Spinae Plane Block (ESPB) was described by Forero in 2016. ESPB is
currently widely used in acute postoperative pain management. The benefits
of ESPB include simplicity and efficacy in various surgeries. The aim of
this review was to conduct a comprehensive overview of available evidence
on erector spinae plane block in clinical practice. We included randomized
controlled trials and systematic reviews reporting the ESPB in human
subjects. The review was conducted in accordance with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines. Twenty-one articles including five systematic reviews and 16
randomized controlled trials were included and analyzed. ESPB appears to
be an effective, safe, and simple method for acute pain management in
cardiac, thoracic, and abdominal surgery. The incidence of side effects
has been reported to be rare. A critical issue is to make sure that new
evidence is not just of the highest quality, in form of well powered and
designed randomized controlled trials but also including a standardized
and homogeneous set of indicators that permit to assess the comparative
effectiveness of the application of ESPB in acute interventional pain
management. Copyright © 2021 Walter de Gruyter GmbH,
Berlin/Boston.

<6>
Accession Number
635749236
Title
A Systematic Review and Meta-analysis of Randomized Controlled Trials
Comparing Intraoperative Red Blood Cell Transfusion Strategies.
Source
Annals of surgery. 275(3) (pp 456-466), 2022. Date of Publication: 01 Mar
2022.
Author
Lenet T.; Baker L.; Park L.; Vered M.; Zahrai A.; Shorr R.; Davis A.;
McIsaac D.I.; Tinmouth A.; Fergusson D.A.; Martel G.
Institution
(Lenet, Baker, Park, Vered, Zahrai, Fergusson, Martel) Department of
Surgery, Ottawa Hospital, University of Ottawa, ON, Ottawa, Canada
(Lenet, Baker, McIsaac, Tinmouth, Fergusson, Martel) Clinical Epidemiology
Program, Ottawa Hospital Research Institute, ON, Ottawa, Canada
(Shorr, Davis) Library Services, Ottawa Hospital, ON, Ottawa, Canada
(McIsaac) Department of Anesthesiology, Ottawa Hospital, University of
Ottawa, ON, Ottawa, Canada
(Tinmouth, Fergusson) Department of Medicine, Ottawa Hospital, University
of Ottawa, ON, Ottawa, Canada
(Tinmouth, Fergusson) Canadian Blood Services, ON, Ottawa, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The objective of this work was to carry out a meta-analysis of
RCTs comparing intraoperative RBC transfusion strategies to determine
their impact on postoperative morbidity, mortality, and blood product use.
SUMMARY OF BACKGROUND DATA: RBC transfusions are common in surgery and
associated with widespread variability despite adjustment for casemix.
Evidence-based recommendations guiding RBC transfusion in the operative
setting are limited. METHOD(S): The search strategy was adapted from
a previous Cochrane Review. Electronic databases were searched from
January 2016 to February 2021. Included studies from the previous Cochrane
Review were considered for eligibility from before 2016. RCTs comparing
intraoperative transfusion strategies were considered for inclusion.
Co-primary outcomes were 30-day mortality and morbidity. Secondary
outcomes included intraoperative and perioperative RBC transfusion.
Meta-analysis was carried out using random-effects models. RESULT(S):
Fourteen trials (8641 patients) were included. One cardiac surgery trial
accounted for 56% of patients. There was no difference in 30-day mortality
[relative risk (RR) 0.96, 95% confidence interval (CI) 0.71-1.29] and
pooled postoperative morbidity among the studied outcomes when comparing
restrictive and liberal protocols. Two trials reported worse composite
outcomes with restrictive triggers. Intraoperative (RR 0.53, 95% CI
0.43-0.64) and perioperative (RR 0.70, 95% CI 0.62-0.79) blood
transfusions were significantly lower in the restrictive group compared to
the liberal group. CONCLUSION(S): Intraoperative restrictive
transfusion strategies decreased perioperative transfusions without added
postoperative morbidity and mortality in 12/14 trials. Two trials reported
worse outcomes. Given trial design and generalizability limitations,
uncertainty remains regarding the safety of broad application of
restrictive transfusion triggers in the operating room. Trials
specifically designed to address intraoperative transfusions are urgently
needed. Copyright © 2021 The Author(s). Published by Wolters
Kluwer Health, Inc.

<7>
Accession Number
632944068
Title
Clinical Burden and Unmet Need in Recurrent Pericarditis: A Systematic
Literature Review.
Source
Cardiology in review. 30(2) (pp 59-69), 2022. Date of Publication: 01 Mar
2022.
Author
Klein A.; Cremer P.; Kontzias A.; Furqan M.; Forsythe A.; Crotty C.;
Lim-Watson M.; Magestro M.
Institution
(Klein, Cremer, Furqan) From the Department of Cardiovascular Medicine,
Center for the Diagnosis and Treatment of Pericardial Diseases, Heart,
Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
(Kontzias) Department of Medicine, Division of Rheumatology, Allergy and
Immunology, Center of Autoinflammatory Diseases, State University of New
York Stonybrook, NY, NY
(Forsythe, Crotty) Purple Squirrel Economics, NY, NY
(Lim-Watson, Magestro) Value and Access, Kiniksa Pharmaceuticals Corp.,
MA, Lexington, United States
Publisher
NLM (Medline)
Abstract
Inflammation of the pericardium (pericarditis) is characterized by
excruciating chest pain. This systematic literature review summarizes
clinical, humanistic, and economic burdens in acute, especially recurrent,
pericarditis, with a secondary aim of understanding United States
treatment patterns and outcomes. Short-term clinical burden is well
characterized, but long-term data are limited. Some studies report
healthcare resource utilization and economic impact; none measure
health-related quality-of-life. Pericarditis is associated with infrequent
but potentially life-threatening complications, including cardiac
tamponade (weighted average: 12.7% across 10 studies), constrictive
pericarditis (1.84%; 9 studies), and pericardial effusion (54.7%; 16
studies). There are no approved pericarditis treatments; treatment
guidelines, when available, are inconsistent on treatment course or
duration. Most recommend first-line use of conventional treatments, for
example, nonsteroidal antiinflammatory drugs with or without colchicine;
however, 15-30% of patients experience recurrence. Second-line therapy may
involve conventional therapies plus long-term utilization of
corticosteroids, despite safety issues and the difficulty of tapering or
discontinuation. Other exploratory therapies (eg, azathioprine,
immunoglobulin, methotrexate, anakinra) present steroid-sparing options,
but none are supported by robust clinical evidence, and some present
tolerability challenges that may impact adherence. Pericardiectomy is
occasionally pursued in treatment-refractory patients, although data are
limited. This lack of an evidence-based treatment pathway for patients
with recurrent disease is reflected in readmission rates, for example,
12.2% at 30 days in 1 US study. Patients with continued recurrence and
inadequate treatment response need approved, safe, accessible treatments
to resolve pericarditis symptoms and reduce recurrence risk without
excessive treatment burden. Copyright © 2022 The Author(s).
Published by Wolters Kluwer Health, Inc.

<8>
Accession Number
637176190
Title
Influence of preoperative frailty on quality of life after cardiac
surgery: Protocol for a systematic review and meta-analysis.
Source
PloS one. 17(2) (pp e0262742), 2022. Date of Publication: 2022.
Author
Bezzina K.; Fehlmann C.A.; Guo M.H.; Visintini S.M.; Rubens F.D.; Wells
G.A.; Mazzola R.; McGuinty C.; Huang A.; Khoury L.; Boczar K.E.
Institution
(Bezzina, Huang, Khoury) Division of Geriatric Medicine, Ottawa Hospital,
Ottawa, ON, Canada
(Fehlmann, Wells, Mazzola, Boczar) School of Epidemiology and Public
Health, University of Ottawa, Ottawa, ON, Canada
(Fehlmann, Huang) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Fehlmann) Division of Emergency Medicine, Geneva University Hospitals,
Geneva, Switzerland
(Guo, Rubens) Department of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, United States
(Visintini) Berkman Library, University of Ottawa Heart Institute, Ottawa,
ON, Canada
(Wells) Research Methods Centre, University of Ottawa Heart Institute, ON,
Ottawa, Canada
(McGuinty, Boczar) University of Ottawa Heart Institute, Ottawa, ON,
Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Frailty has emerged as an important prognostic marker of
adverse outcomes after cardiac surgery, but evidence regarding its ability
to predict quality of life after cardiac surgery is currently lacking.
Whether frail patients derive the same quality of life benefit after
cardiac surgery as patients without frailty remains unclear.
 METHOD(S): This systematic review will include interventional studies
(RCT and others) and observational studies evaluating the effect of
preoperative frailty on quality-of-life outcomes after cardiac surgery
amongst patients 65 years and older. Studies will be retrieved from major
databases including the Cochrane Central Register of Controlled Trials,
Embase, and Medline. The primary exposure will be frailty status,
independent of the tool used. The primary outcome will be change in
quality of life, independent of the tool used. Secondary outcomes will
include readmission during the year following the index intervention,
discharge to a long-term care facility and living in a long-term care
facility at one year. Screening, inclusion, data extraction and quality
assessment will be performed independently by two reviewers. Meta-analysis
based on the random-effects model will be conducted to compare the
outcomes between frail and non-frail patients. The evidential quality of
the findings will be assessed with the GRADE profiler. CONCLUSION(S):
The findings of this systematic review will be important to clinicians,
patients and health policy-makers regarding the use of preoperative
frailty as a screening and assessment tool before cardiac surgery. STUDY
REGISTRATION: OSF registries (https://osf.io/vm2p8).

<9>
Accession Number
2015885807
Title
Dexmedetomidine Use in Intensive Care Unit Sedation and Postoperative
Recovery in Elderly Patients Post-Cardiac Surgery (DIRECT).
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(3) (pp 880-892),
2022. Date of Publication: March 2022.
Author
Chitnis S.; Mullane D.; Brohan J.; Noronha A.; Paje H.; Grey R.; Bhalla
R.K.; Sidhu J.; Klein R.
Institution
(Chitnis, Mullane, Brohan, Grey, Klein) Department of Anesthesiology and
Perioperative Care, Vancouver General and UBC Hospitals, Vancouver, BC,
Canada
(Chitnis) Department of Anaesthesia and Pain Medicine, Fiona Stanley
Hospital, Murdoch, Perth, WA, Australia
(Brohan) Department of Anaesthesia, Cork University Hospital, Wilton,
Cork, Ireland
(Noronha, Paje) Vancouver Coastal Health, Vancouver, BC, Canada
(Bhalla) Neuropsychology Service, Vancouver General Hospital, 899 W 12th
Avenue, Vancouver, BC V5Z 1M9, Canada
(Bhalla) Division of Psychiatry, University of British Columbia,
Vancouver, BC V6T 1Z4, Canada
(Sidhu) Department of Psychiatry, Vancouver General Hospital, Vancouver,
BC, Canada
Publisher
W.B. Saunders
Abstract
Objective: This study examined recovery, delirium, and neurocognitive
outcome in elderly patients receiving dexmedetomidine or propofol sedation
after undergoing cardiac surgery. Design(s): Open-label randomized
trial. Setting(s): Single center. Participant(s): A total of 70
patients older than 75 years without English language limitations and Mini
Mental State Examination scores >20. Intervention(s): Patients
received either propofol (group P) or dexmedetomidine (group D)
postoperatively until normothermic and hemodynamically stable.
 Measurements and Main Results: Quality of recovery (QoR) was measured
by the QoR-40 questionnaire on postoperative day (POD) three. Secondary
outcomes were incidence and duration of delirium, time to extubation,
length of hospital stay, hospital mortality rate, postoperative quality of
life (QoL; measured by SF-36 performed at baseline and six months
postoperatively), and neurocognitive disorder (measured by Minnesota
Cognitive Acuity Screen [MCAS] performed at baseline, POD5, and six months
postoperatively). A total of sixty-seven patients completed the trial.
There was no significant difference in QoR-40 scores (95% confidence
interval [CI], -7.6081-to-10.9781; p = 1.000), incidence of delirium
(group P, 42%; group D, 24%; p = 0.191), mean hospital stay (95% CI,
-5.4838-to-1.5444; p = 0.297), mean time to extubation (95% CI,
-19.2513-to-7.5561; p = 0.866), or mean duration of delirium (95% CI,
-4.3065-to-1.067; p = 0.206) between groups. No patients died in the
hospital. There were no significant differences in changes in SF-36 or
MCAS scores over time between groups. There was a decline in MCAS score
from preoperatively to POD5 in group P (95% CI, -8.95725-to- -2.61775; p =
0.0005), which was greater than that observed in group D.
 Conclusion(s): The authors' findings demonstrated that the use of
dexmedetomidine compared with propofol in elderly patients undergoing
cardiac surgery was unlikely to improve QoR/postoperative QoL. Although
the study was underpowered to detect secondary outcomes, the results
suggested no reductions in delirium, time to extubation, and hospital
stay, but a potential decrease in delayed neurocognitive
recovery. Copyright © 2021

<10>
Accession Number
2014271561
Title
Early Thromboembolic Stroke Risk of Postoperative Atrial Fibrillation
Following Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(3) (pp 807-814),
2022. Date of Publication: March 2022.
Author
Pierik R.; Zeillemaker-Hoekstra M.; Scheeren T.W.L.; Erasmus M.E.; Luijckx
G.-J.R.; Rienstra M.; Uyttenboogaart M.; Nijsten M.; van den Bergh W.M.
Institution
(Pierik, Nijsten, van den Bergh) Department of Critical Care, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(Zeillemaker-Hoekstra, Scheeren) Department of Anesthesiology, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(Erasmus) Department of Cardiac Surgery, University Medical Center
Groningen, University of Groningen, Groningen, Netherlands
(Luijckx, Uyttenboogaart) Department of Neurology, University Medical
Center Groningen, University of Groningen, Groningen, Netherlands
(Rienstra) Department of Cardiology, University Medical Center Groningen,
University of Groningen, Groningen, Netherlands
Publisher
W.B. Saunders
Abstract
Objective: The authors aimed to study the association between
postoperative atrial fibrillation (POAF) and thromboembolic stroke and to
determine risk factors for thromboembolic stroke after cardiac surgery.
 Design(s): The authors performed a secondary analysis from a
randomized controlled trial (GRIP-COMPASS). The patients with
thromboembolic stroke were compared with those without thromboembolic
stroke, and the difference in the incidence of POAF between these groups
was assessed. Odds ratios (OR) were calculated using logistic regression
analyses. Brain imaging was studied for the occurrence of thromboembolic
stroke during hospital admission, and POAF was monitored for seven days.
To assess which characteristics were associated with occurrence of
thromboembolic stroke, stepwise backward regression analysis was
performed. Participant(s): All adult consecutive cardiac surgery
patients admitted postoperatively to the intensive care unit.
 Setting(s): Academic tertiary care medical center.
 Intervention(s): None. Measurements and Main Results: Of the 910
patients included in this study, 26 patients (2.9%) had a thromboembolic
stroke during hospital admission. The incidence of POAF during the first
seven days after cardiac surgery in those with thromboembolic stroke was
65%, compared with 39% in those without thromboembolic stroke: adjusted OR
3.01 (95% confidence interval, 1.13-8.00). POAF, a history of peripheral
vascular disease, a higher EuroSCORE, and a longer duration of surgery
were associated with thromboembolic stroke. Conclusion(s): POAF
within seven days after cardiac surgery was associated with a three-fold
increased risk for a thromboembolic stroke during hospital admission.
Expeditious treatment of POAF may, therefore, reduce early stroke risk
after cardiac surgery. Copyright © 2021 The Authors

<11>
Accession Number
2013142657
Title
Ultrasound-Guided Long-Axis Versus Short-Axis Femoral Artery
Catheterization in Neonates and Infants Undergoing Cardiac Surgery: A
Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(3) (pp 677-683),
2022. Date of Publication: March 2022.
Author
Abdelbaser I.; Mageed N.A.; Elmorsy M.M.; Elfayoumy S.I.
Institution
(Abdelbaser, Mageed, Elmorsy) 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, Portsaid, Egypt
Publisher
W.B. Saunders
Abstract
Objective: The objective of the present study was to compare
ultrasound-guided long-axis (LAX) and short-axis (SAX) femoral artery
catheterization in neonates and infants undergoing cardiac surgery.
 Design(s): A single-center, prospective, randomized, single-blinded,
controlled study. Setting(s): This study was conducted in the
operating room and intensive care unit of the division of cardiac surgery,
Mansoura University Children's Hospital, Egypt. Participant(s):
Ninety neonates and infants undergoing elective cardiac surgery were
enrolled in this study and randomly allocated to ultrasound-guided LAX and
SAX groups. Intervention(s): Ultrasound-guided femoral artery
catheterization was done using either LAX (in-plane) or SAX (out-of-plane)
technique. Measurements and Main Results: The primary outcome measure
was the rate of a successful first puncture. The secondary outcome
measures were the rates of mechanical complications, failure rate, time to
a successful first, second, and third puncture, total time of
catheterization, and imaging time. The first puncture success rate was
significantly higher (p = 0.048) in the LAX group (34 of 41, 82.9%) than
in the SAX group (25 of 41, 60.9%). The mean time to a successful first
puncture was significantly shorter (p < 0.001) in the LAX group (153.1 +/-
30.1 seconds) than in the SAX group (227.2 +/- 48.8 seconds). The total
catheterization time was significantly shorter in the LAX group than in
the SAX group. There was no significant difference in the rate of
complication. Conclusion(s): With a single experienced operator
performing the ultrasound-guided femoral artery cannulation, the LAX
technique resulted in a higher first puncture success rate and shorter
time to cannulation than the SAX technique. Copyright © 2021
Elsevier Inc.

<12>
Accession Number
637181975
Title
ARE RENAL SPARING PROTOCOLS SAFE and EFFECTIVE in LIEU of RANDOMIZED
TRIALS in HEART TRANSPLANT?.
Source
Journal of Investigative Medicine. Conference: Western Medical Research
Conference, WMRC 2022. Carmel, CA United States. 70 (pp 277-278), 2021.
Date of Publication: 2021.
Author
Hu J.; Singer-Englar T.; Patel N.; Kim S.; Hamilton M.; Kobashigawa J.
Institution
(Hu) Western University of Health Sciences College of Osteopathic Medicine
of the Pacific-Northwest, Lebanon, OR, United States
(Singer-Englar, Patel, Kim, Hamilton, Kobashigawa) Cedars-Sinai Smidt
Heart Institute, Los Angeles, CA, United States
Publisher
BMJ Publishing Group
Abstract
Purpose of Study The calcineurin inhibitors (CNIs), including tacrolimus
and cyclosporine, have revolutionized outcomes of heart transplant (HTx)
patients but unfortunately have many side effects, which include
nephrotoxicity, hypertension, and malignancy. It has been recently
demonstrated through two large, randomized trials, the SCHEDULE Trial and
the MANDELA Trial, that weaning of CNIs has resulted in an increase of
rejection episodes. Most recently, many HTx centers have been using a
modified CNI wean protocol in order to prevent further nephrotoxicity and
to avoid kidney dialysis. It appears that an earlier (<2 years) renal
sparing protocol (RSP) may have more problems compared to later initiation
of the protocol (2-5 years after transplant). Therefore, we reviewed our
experience in CNI weaning. Methods Used Between 2010 and 2020, we assessed
34 HTx patients who underwent our RSP beginning after 6 months post-HTx
and divided them into those intiated <2 year and between 2-5 years after
heart transplant. Our protocol for CNI weaning is to decrease the CNI by
one-half for 2 weeks, then by an additional one-half for 2 weeks, and then
stop. Meanwhile, patients are also started on a proliferation signal
inhibitor (PSI), mostly sirolimus, beginning at 1 mg/day and the dose is
increased accordingly to maintain a PSI level between 4 and 8 ng/mL.
Endpoints included subsequent freedom from any treated rejection (ATR,
including acute cellular rejection [ACR], antibody-mediated rejection
[AMR], and biopsy-negative rejection [BNR]), survival, and freedom from
cardiac dysfunction (hemodynamic compromise rejection [HCR], defined as
left ventricular ejection fraction 40%) in the 1 year following RSP
initiation. As CNI wean has also been demonstrated to have beneficial
aspects, we also assessed the need for antihypertensive medications,
diabetes in terms of hemoglobin A1c, and glomerular filtration rate (GFR).
Summary of Results 89% of patients were successfully weaned off CNI at <2
years and 94% at 2-5 years after transplant. However, RSP was not
sustained in 50% of RSP <2 year patients and in 31% of 2-5 year patients.
The reasons included rejection, medication intolerance, and death. GFR for
both groups was markedly improved at 1-year post RSP initiation. There was
no difference between groups in anti-hypertension medications or
hemoglobin A1c levels. Conclusions CNI weaning at a large, single center
appears to be safe and efficacious for select patients but sustaining RSP
continues to be a challenge. Further development of other RSPs is
warranted.

<13>
Accession Number
633426322
Title
The effects of surgery on plasma/serum vitamin C concentrations: A
systematic review and meta-analysis.
Source
British Journal of Nutrition. 127(2) (pp 233-247), 2022. Date of
Publication: 28 Jan 2022.
Author
Travica N.; Ried K.; Hudson I.; Scholey A.; Pipingas A.; Sali A.
Institution
(Travica, Hudson, Scholey, Pipingas) Centre for Human Psychopharmacology,
Swinburne University of Technology, Melbourne, VIC 3122, Australia
(Travica, Ried, Sali) National Institute of Integrative Medicine,
Melbourne, VIC 3122, Australia
(Ried) Discipline of General Practice, University of Adelaide, Adelaide,
SA 5005, Australia
(Ried) Torrens University, Melbourne, VIC 3000, Australia
(Hudson) Department of Mathematical Sciences, School of Science, College
of Science, Engineering and Health, Royal Melbourne Institute of
Technology (RMIT), Melbourne, VIC 3001, Australia
(Hudson) School of Mathematical and Physical Science, University of
Newcastle, Newcastle, NSW 2308, Australia
Publisher
Cambridge University Press
Abstract
Vitamin C (ascorbic acid) is a water-soluble vitamin with an array of
biological functions. A number of proposed factors contribute to the
vitamin's plasma bioavailability and ability to exert optimal
functionality. The aim of this review was to systematically assess plasma
vitamin C levels post-surgery compared with pre-surgery/the magnitude and
time frame of potential changes in concentration. We searched the PUBMED,
SCOPUS, SciSearch and the Cochrane Library databases between 1970 and
April 2020 for relevant research papers. Prospective studies, control
groups and true placebo groups derived from controlled trials that
reported means and standard deviations of plasma vitamin C concentrations
pre- and postoperatively were included into the meta-analysis. Data were
grouped into short-term (<=7 d) and long-term (>7 d) postoperative
follow-up. Twenty-three of thirty-one studies involving 642 patients
included in the systematic review were suitable for meta-analysis. Pooled
data from the meta-analysis revealed a mean depletion of plasma vitamin C
concentration of -17.99 Amol/l (39 % depletion) (CI -22.81, -13.17) (trial
arms = 25, n 565, P < 0.001) during the first postoperative week and
-18.80 Amol/l (21 % depletion) (CI -25.04, -12.56) (trial arms = 6, n 166,
P < 0.001) 2-3 months postoperatively. Subgroup analyses revealed that
these depletions occurred following different types of surgery; however,
high heterogeneity was observed amongst trials assessing concentration
change during the first postoperative week. Overall, our results warrant
larger, long-term investigations of changes in postoperative plasma
vitamin C concentrations and their potential effects on clinical
symptomology. Copyright © The Author(s) 2020.

<14>
Accession Number
2016535173
Title
Long-term 5-year outcome of the randomized IMPRESS in severe shock trial:
Percutaneous mechanical circulatory support vs. intra-aortic balloon pump
in cardiogenic shock after acute myocardial infarction.
Source
European Heart Journal: Acute Cardiovascular Care. 10(9) (pp 1009-1015),
2021. Date of Publication: 01 Dec 2021.
Author
Karami M.; Eriksen E.; Ouweneel D.M.; Claessen B.E.; Vis M.M.; Baan J.;
Beijk M.; Packer E.J.S.; Sjauw K.D.; Engstrom A.; Vlaar A.; Lagrand W.K.;
Henriques J.P.S.
Institution
(Karami, Ouweneel, Claessen, Vis, Baan, Beijk, Engstrom, Henriques)
Department of Interventional Cardiology, Heart Center, Amsterdam
Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam,
Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
(Eriksen, Packer) Department of Heart Disease, Haukeland University
Hospital, Jonas Lies vei 65, Bergen 5021, Norway
(Claessen) Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar,
Netherlands
(Sjauw) Department of Cardiology, Medical Center Leeuwarden, Henri
Dunantweg 2, Leeuwarden 8934 AD, Netherlands
(Engstrom) Department of Cardiology, Erasmus MC, Rotterdam, Netherlands
(Vlaar, Lagrand) Department of Intensive Care, Amsterdam UMC, University
of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
Publisher
Oxford University Press
Abstract
Aims: To assess differences in long-term outcome and functional status of
patients with cardiogenic shock (CS) treated by percutaneous mechanical
circulatory support (pMCS) and intra-aortic balloon pump (IABP).
 Methods and Results: Long-term follow-up of the multicentre,
randomized IMPRESS in Severe Shock trial (NTR3450) was performed 5-year
after initial randomization. Between 2012 and 2015, a total of 48 patients
with severe CS from acute myocardial infarction (AMI) with ST-segment
elevation undergoing immediate revascularization were randomized to pMCS
by Impella CP (n = 24) or IABP (n = 24). For the 5-year assessment,
all-cause mortality, functional status, and occurrence of major adverse
cardiac and cerebrovascular event (MACCE) were assessed. MACCE consisted
of death, myocardial re-infarction, repeat percutaneous coronary
intervention, coronary artery bypass grafting, and stroke. Five-year
mortality was 50% (n = 12/24) in pMCS patients and 63% (n = 15/24) in IABP
patients (relative risk 0.87, 95% confidence interval 0.47-1.59, P =
0.65). MACCE occurred in 12/24 (50%) of the pMCS patients vs. 19/24 (79%)
of the IABP patients (P = 0.07). All survivors except for one were in New
York Heart Association Class I/II [pMCS n = 10 (91%) and IABP n = 7
(100%), P = 1.00] and none of the patients had residual angina. There were
no differences in left ventricular ejection fraction between the groups
(pMCS 52 +/- 11% vs. IABP 48 +/- 10%, P = 0.53). Conclusion(s): In
this explorative randomized trial of patients with severe CS after AMI,
there was no difference in long-term 5-year mortality between pMCS and
IABP-treated patients, supporting previously published short-term data and
in accordance with other long-term CS trials. Copyright © 2021
The Author(s) 2021.

<15>
Accession Number
2016535167
Title
Acute kidney injury in patients with acute coronary syndrome undergoing
invasive management treated with bivalirudin vs. unfractionated heparin:
Insights from the MATRIX trial.
Source
European Heart Journal: Acute Cardiovascular Care. 10(10) (pp 1170-1179),
2021. Date of Publication: 01 Dec 2021.
Author
Landi A.; Branca M.; Ando G.; Russo F.; Frigoli E.; Gargiulo G.; Briguori
C.; Vranckx P.; Leonardi S.; Gragnano F.; Calabro P.; Campo G.; Ambrosio
G.; Santucci A.; Varbella F.; Zaro T.; Heg D.; Windecker S.; Juni P.;
Pedrazzini G.; Valgimigli M.
Institution
(Landi, Pedrazzini, Valgimigli) Division of Cardiology, Cardiocentro
Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 48,
Lugano CH-6900, Switzerland
(Branca, Frigoli, Heg) CTU Bern, University of Bern, Bern, Switzerland
(Ando) Department of Clinical and Experimental Medicine, Azienda
Ospedaliera Universitaria Policlinico Gaetano Martino, University of
Messina, Messina, Italy
(Russo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Gargiulo) Department of Advanced Biomedical Science, University of Naples
Federico II, Naples, Italy
(Briguori) Interventional Cardiology Unit, Mediterranea Cardiocentro,
Naples, Italy
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, University of Hasselt,
Hasselt, Belgium
(Leonardi) Coronary Care Unit, Department of Molecular Medicine,
University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
(Gragnano, Calabro) Division of Cardiology, Sant'Anna e San Sebastiano
Hospital, Caserta, Italy
(Gragnano, Calabro) Department of Translational Medicine, University of
Campania Luigi Vanvitelli, Caserta, Italy
(Campo) Cardiology Unit, Cardiovascular Institute, Azienda
Ospedaliero-Universitaria di Ferrara, Cona, Italy
(Ambrosio, Santucci) Department of Cardiology, Azienda
Ospedaliero-Universitaria S. Maria della Misericordia, Perugia, Italy
(Varbella) Cardiology Unit, Ospedali Riuniti di Rivoli, ASL Torino 3,
Turin, Italy
(Varbella) Cardiology Unit, Azienda Ospedaliera Universitaria San Luigi
Gonzaga Orbassano, Turin, Italy
(Zaro) Cardiology Division, A.O. Ospedale Civile di Vimercate (MB),
Vimercate, Italy
(Windecker, Valgimigli) Department of Cardiology, University of Bern,
Bern, Switzerland
(Juni) Department of Medicine, Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, ON, Canada
Publisher
Oxford University Press
Abstract
Aims: Acute kidney injury (AKI) is a critical complication among patients
with acute coronary syndrome (ACS) undergoing invasive management. The
value of adjunctive antithrombotic strategies, such as bivalirudin or
unfractionated heparin (UFH) on the risk of AKI is unclear. Methods
and Results: Among 7213 patients enrolled in the MATRIX-Antithrombin and
Treatment Duration study, 128 subjects were excluded due to incomplete
information on serum creatinine (sCr) or end-stage renal disease on
dialysis treatment. The primary endpoint was AKI defined as an absolute
(>0.5 mg/dL) or a relative (>25%) increase in sCr. AKI occurred in 601
patients (16.9%) treated with bivalirudin and 616 patients (17.4%) treated
with UFH [odds ratio (OR): 0.97; 95% confidence interval (CI): 0.85-1.09;
P = 0.58]. A >25% sCr increase was observed in 597 patients (16.8%) with
bivalirudin and 616 patients (17.4%) with UFH (OR: 0.96; 95% CI:
0.85-1.08; P = 0.50), whereas a >0.5 mg/dL absolute sCr increase occurred
in 176 patients (5.0%) with bivalirudin vs. 189 patients (5.4%) with UFH
(OR: 0.92; 95% CI: 0.75-1.14; P = 0.46). By implementing the Kidney
Disease Improving Global Outcomes (KDIGO) criteria, the risk of AKI was
not significantly different between bivalirudin and UFH groups (OR: 0.88;
95% CI: 0.72-1.07; P = 0.21). Subgroup analyses of the primary endpoint
suggested a benefit with bivalirudin in patients randomized to femoral
access. Conclusion(s): Among ACS patients undergoing invasive
management, the risk of AKI was not significantly lower with bivalirudin
compared with UFH. Copyright © 2021.

<16>
Accession Number
637056051
Title
Son of a Lesser God: The Case of Cell Therapy for Refractory Angina.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 709795. Date of Publication: 2021.
Author
Bassetti B.; Rurali E.; Gambini E.; Pompilio G.
Institution
(Bassetti, Rurali, Gambini, Pompilio) Unita di Biologia Vascolare e
Medicina Rigenerativa, Centro Cardiologico Monzino-Istituto di Ricovero e
Cura a Carattere Scientifico (IRCCS), Milan, Italy
(Gambini) Oloker Therapeutics S.r.l, Bari, Italy
(Pompilio) Dipartimento di Scienze Biomediche, Chirurgiche e
Odontoiatriche, Universita degli Studi di Milano, Milan, Italy
Publisher
Frontiers Media S.A.
Abstract
In the last decades, various non-pharmacological solutions have been
tested on top of medical therapy for the treatment of patients affected by
refractory angina (RA). Among these therapeutics, neuromodulation,
external counter-pulsation and coronary sinus constriction have been
recently introduced in the guidelines for the management of RA in United
States and Europe. Notably and paradoxically, although a consistent body
of evidence has proposed cell-based therapies (CT) as safe and salutary
for RA outcome, CT has not been conversely incorporated into current
international guidelines yet. As a matter of fact, published randomized
controlled trials (RCT) and meta-analyses (MTA) cumulatively indicated
that CT can effectively increase perfusion, physical function and
well-being, thus reducing angina symptoms and drug assumption in RA
patients. In this review, we (i) provide an updated overview of novel
non-pharmacological therapeutics included in current guidelines for the
management of patients with RA, (ii) discuss the Level of Evidence stemmed
from available clinical trials for each recommended treatment, and (iii)
focus on evidence-based CT application for the management of
RA. Copyright © 2021 Bassetti, Rurali, Gambini and Pompilio.

<17>
Accession Number
2013626947
Title
Intravenous versus inhalational maintenance of anesthesia for quality of
recovery in adult patients undergoing non-cardiac surgery: A systematic
review with meta-analysis and trial sequential analysis.
Source
PLoS ONE. 16(7 July) (no pagination), 2021. Article Number: e0254271. Date
of Publication: July 2021.
Author
Shui M.; Xue Z.; Miao X.; Wei C.; Wu A.
Institution
(Shui, Xue, Miao, Wei, Wu) Department of Anesthesiology, Beijing Chaoyang
Hospital, Capital Medical University, Beijing, China
Publisher
Public Library of Science
Abstract
Background Intravenous and inhalational agents are commonly used in
general anesthesia. However, it is still controversial which technique is
superior for the quality of postoperative recovery. This meta-analysis
aimed at comparing impact of total intravenous anesthesia (TIVA) versus
inhalational maintenance of anesthesia on the quality of recovery in
patients undergoing non-cardiac surgery. Methods We systematically
searched EMBASE, PubMed, and Cochrane library for randomized controlled
trials (RCTs), with no language or publication status restriction. Two
authors independently performed data extraction and assessed risk of bias.
The outcomes were expressed as mean difference (MD) with 95% confidence
interval (CI) based on a random-effect model. We performed trial
sequential analysis (TSA) for total QoR-40 scores and calculated the
required information size (RIS) to correct the increased type I error.
Results A total of 156 records were identified, and 9 RCTs consisting of
922 patients were reviewed and included in the meta-analysis. It revealed
a significant increase in total QoR-40 score on the day of surgery with
TIVA (MD, 5.91 points; 95% CI, 2.14 to 9.68 points; P = 0.002;
I2 = 0.0%). The main improvement was in four dimensions,
including "physical comfort", "emotional status", "psychological support"
and "physical independence". There was no significant difference between
groups in total QoR-40 score (P = 0.120) or scores of each dimension on
POD1. The TSA showed that the estimated required information size for
total QoR-40 scores was not surpassed by recovered evidence in our
meta-analysis. And the adjusted Z-curves did not cross the conventional
boundary and the TSA monitoring boundary. Conclusion Low-certainty
evidence suggests that propofol-based TIVA may improve the QoR-40 score on
the day of surgery. But more evidence is needed for a firm conclusion and
clinical significance. Copyright © 2021 Shui et al. This is an
open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<18>
Accession Number
637164975
Title
The effect of preoperative chest physiotherapy on oxygenation and lung
function in cardiac surgery patients: a randomized controlled study.
Source
Annals of Saudi medicine. 42(1) (pp 8-16), 2022. Date of Publication: 01
Jan 2022.
Author
Shahood H.; Pakai A.; Rudolf K.; Bory E.; Szilagyi N.; Sandor A.; Zsofia
V.
Institution
(Shahood, Pakai, Zsofia) From the Doctoral School of Health Sciences,
University of Pecs Medical School, Pecs, Hungary
(Rudolf, Bory, Szilagyi, Sandor, Zsofia) From the Heart Institute Medical
School, University of Pecs Medical School, Pecs, Hungary
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative pulmonary complications in patients who undergo
open heart surgery are serious life-threatening conditions. Few studies
have investigated the potentially beneficial effects of preoperative
physiotherapy in patients undergoing cardiac surgery. OBJECTIVE(S):
Assess the effects of preoperative chest physiotherapy on oxygenation and
lung function in patients undergoing open heart surgery. DESIGN:
Randomized, controlled. SETTING: University hospital. PATIENTS AND
METHODS: Patients with planned open heart surgery were randomly allocated
into an intervention group of patients who underwent a preoperative home
chest physiotherapy program for one week in addition to the traditional
postoperative program and a control group who underwent only the
traditional postoperative program. Lung function was assessed daily from
the day before surgery until the seventh postoperative day. MAIN OUTCOME
MEASURES: Differences in measures of respiratory function and oxygen
saturation. Length of postoperative hospital stay was a secondary outcome.
SAMPLE SIZE: 100 patients (46 in intervention group, 54 in control group).
 RESULT(S): Postoperative improvements in lung function and oxygen
saturation in the intervention group were statistically significant
compared with the control group. The intervention group also had a
statistically significant shorter hospital stay (P<.01).
 CONCLUSION(S): Preoperative chest physiotherapy is effective in
improving respiratory function following open heart surgery. LIMITATIONS:
Relatively small number of patients.None. REGISTRATION: ClinicalTrials.gov
(NCT04665024).

<19>
Accession Number
2016756225
Title
Meta-Analysis of Mitral Valve Repair Versus Replacement for Rheumatic
Mitral Valve Disease.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Liao Y.-W.B.; Wang T.K.M.; Wang M.T.M.; Ramanathan T.; Wheeler M.
Institution
(Liao, Wang, Wang, Ramanathan, Wheeler) Green Lane Cardiovascular Service,
Auckland City Hospital, Auckland, New Zealand
(Wang, Wang) Department of Medicine, University of Auckland, Auckland, New
Zealand
Publisher
Elsevier Ltd
Abstract
Background: Rheumatic heart disease remains one of the leading causes of
heart valve disease worldwide despite being a preventable condition.
Mitral valve repair is superior to replacement in severe degenerative
mitral valve disease, however its role in rheumatic valve disease remains
controversial. This meta-analysis compared mitral valve repair and
replacement in rheumatic heart disease. Method(s): Medline, EMBASE,
Cochrane and Scopus were searched from January 1980 to June 2016 for
original studies reporting outcomes of both mitral valve repair and
replacement in rheumatic heart disease in adults, children or both. Two
(2) authors independently assessed studies for inclusion, followed by data
extraction and analysis. Result(s): The search yielded 930 articles,
with 98 full-texts reviewed after initial screening and 13 studies
subsequently included for analysis, totalling 2,410 mitral valve repairs
and 3,598 replacements. Pooled rates and odds ratio (95% confidence
interval) for operative mortality of repair versus replacement was 3.2% vs
4.3%, 0.68 (0.50-0.92 p=0.01). Pooled odds ratios (95% confidence
interval) were for long-term mortality 0.41 (0.30-0.56 p<0.001);
reoperation 3.02 (1.72-5.31 p<0.001); and bleeding 0.26 (0.11-0.63
p=0.003). There was a trend towards lower thrombo-embolism 0.42 (0.17-1.03
p=0.06), and no significant difference in endocarditis (p=0.76), during
follow-up. Conclusion(s): Mitral valve repair is associated with
reduction in operative and long-term mortality and bleeding, so is
recommended in rheumatic mitral valve disease where feasible, but it does
entail a higher rate of reoperation during follow-up. Copyright ©
2021

<20>
[Use Link to view the full text]
Accession Number
2016681962
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 (United States). 101(3) (pp E28494), 2022. Date of Publication:
21 Jan 2022.
Author
Li C.-Y.; Liang W.; He Y.-Q.; Han Q.
Institution
(Li, Liang, He, Han) First People's Hospital of Jiangxia District, Hubei
Province, Wuhan, China
Publisher
Lippincott Williams and Wilkins
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. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<21>
Accession Number
2016795362
Title
Autonomic Neuromodulation for Atrial Fibrillation Following Cardiac
Surgery: JACC Review Topic of the Week.
Source
Journal of the American College of Cardiology. 79(7) (pp 682-694), 2022.
Date of Publication: 22 Feb 2022.
Author
Zafeiropoulos S.; Doundoulakis I.; Farmakis I.T.; Miyara S.; Giannis D.;
Giannakoulas G.; Tsiachris D.; Mitra R.; Skipitaris N.T.; Mountantonakis
S.E.; Stavrakis S.; Zanos S.
Institution
(Zafeiropoulos, Miyara) Elmezzi Graduate School of Molecular Medicine,
Northwell Health, Manhasset, NY, United States
(Zafeiropoulos, Miyara, Giannis, Zanos) Feinstein Institutes for Medical
Research at Northwell Health, Manhasset, NY, United States
(Doundoulakis) Department of Cardiology, 424 General Military Training
Hospital, Thessaloniki, Greece
(Doundoulakis, Tsiachris) Athens Heart Center, Athens Medical Center,
Athens, Greece
(Farmakis, Giannakoulas) Department of Cardiology, AHEPA University
Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
(Mitra) Division of Electrophysiology, Department of Cardiology, North
Shore University Hospital, Northwell Health, Manhasset, NY, United States
(Skipitaris, Mountantonakis) Department of Cardiology, Lenox Hill
Hospital, Northwell Health, New York City, New York, United States
(Stavrakis) Heart Rhythm Institute, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
Publisher
Elsevier Inc.
Abstract
Autonomic neuromodulation therapies (ANMTs) (ie, ganglionated plexus
ablation, epicardial injections for temporary neurotoxicity, low-level
vagus nerve stimulation [LL-VNS], stellate ganglion block, baroreceptor
stimulation, spinal cord stimulation, and renal nerve denervation)
constitute an emerging therapeutic approach for arrhythmias. Very little
is known about ANMTs' preventive potential for postoperative atrial
fibrillation (POAF) after cardiac surgery. The purpose of this review is
to summarize and critically appraise the currently available evidence.
Herein, the authors conducted a systematic review of 922 articles that
yielded 7 randomized controlled trials. In the meta-analysis, ANMTs
reduced POAF incidence (OR: 0.37; 95% CI: 0.25 to 0.55) and burden (mean
difference [MD]: -3.51 hours; 95% CI: -6.64 to -0.38 hours), length of
stay (MD: -0.82 days; 95% CI: -1.59 to -0.04 days), and interleukin-6 (MD:
-79.92 pg/mL; 95% CI: -151.12 to -8.33 pg/mL), mainly attributed to LL-VNS
and epicardial injections. Moving forward, these findings establish a base
for future larger and comparative trials with ANMTs, to optimize and
expand their use. Copyright © 2022 American College of Cardiology
Foundation

<22>
Accession Number
2015563122
Title
Human Tissue Analysis of Left Atrial Adipose Tissue and Atrial
Fibrillation after Cox Maze Procedure.
Source
Journal of Clinical Medicine. 11(3) (no pagination), 2022. Article Number:
826. Date of Publication: February-1 2022.
Author
Kim J.-H.; Song J.-Y.; Shim H.-S.; Lee S.; Youn Y.-N.; Joo H.-C.; Yoo
K.-J.; Lee S.-H.
Institution
(Kim, Song, Lee, Youn, Joo, Yoo, Lee) Division of Cardiovascular Surgery,
Department of Thoracic and Cardiovascular Surgery, Severance
Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei
University Health System, Seoul 03722, South Korea
(Shim) Department of Pathology, Severance Hospital, Yonsei University
College of Medicine, Seoul 03722, South Korea
Publisher
MDPI
Abstract
Cardiac adipose tissue is a well-known risk factor for the recurrence of
atrial fibrillation (AF) after radiofrequency catheter ablation, but its
correlation with maze surgery remains unknown. The aim of this study was
to investigate the correlation between the recurrence of AF and the
adipose component of the left atrium (LA) in patients who underwent a
modified Cox maze (CM) III procedure. We reviewed the pathology data of
resected LA tissues from 115 patients, including the adipose tissue from
CM-III procedures. The mean follow-up duration was 30.05 +/- 23.96 months.
The mean adipose tissue component in the AF recurrence group was 16.17%
+/- 14.32%, while in the non-recurrence group, it was 9.48% +/- 10.79% (p
= 0.021), and the cut-off value for the adipose component for AF
recurrence was 10% (p = 0.010). The rates of freedom from AF recurrence at
1, 3, and 5 years were 84.8%, 68.8%, and 38.6%, respectively, in the
high-adipose group (>=10%), and 96.3%, 89.7%, and 80.3%, respectively, in
the low-adipose group (<10%; p = 0.002). A high adipose component (>=10%)
in the LA is a significant risk factor for AF recurrence after CM-III
procedures. Thus, it may be necessary to attempt to reduce the
perioperative adipose portion of the cardiac tissue using a statin in a
randomized study. Copyright © 2022 by the authors. Licensee MDPI,
Basel, Switzerland.

<23>
Accession Number
2016659566
Title
Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney
Injury during Percutaneous Cardiovascular Procedures.
Source
CardioRenal Medicine. (no pagination), 2022. Date of Publication: 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, University of North Texas, Health
Sciences Center, School of Medicine, Dallas, TX, United States
(Noiri) Department of Nephrology and Endocrinology, The University of
Tokyo Hospital, Tokyo, Japan
(Noiri) National Center Biobank Network, National Center for Global Health
and Medicine, Tokyo, Japan
(Sugaya) Timewell Medical, Tokyo, Japan
(Sugaya) St. Marianna University, School of Medicine, Kawasaki, Japan
(Dahlen) Hikari Dx, Inc., San Diego, CA, United States
Publisher
S. Karger AG
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.

<24>
Accession Number
637048051
Title
Concomitant Tricuspid Repair in Patients with Degenerative Mitral
Regurgitation.
Source
New England Journal of Medicine. 386(4) (pp 327-339), 2022. Date of
Publication: 27 Jan 2022.
Author
Gammie J.S.; Chu M.W.A.; Falk V.; Overbey J.R.; Moskowitz A.J.; Gillinov
M.; Mack M.J.; Voisine P.; Krane M.; Yerokun B.; Bowdish M.E.; Conradi L.;
Bolling S.F.; Miller M.A.; Taddei-Peters W.C.; Jeffries N.O.; Parides
M.K.; Weisel R.; Jessup M.; Rose E.A.; Mullen J.C.; Raymond S.; Moquete
E.G.; O'Sullivan K.; Marks M.E.; Iribarne A.; Beyersdorf F.; Borger M.A.;
Geirsson A.; Bagiella E.; Hung J.; Gelijns A.C.; O'Gara P.T.; Ailawadi G.
Institution
(Gammie) Division of Cardiac Surgery, Johns Hopkins School of Medicine,
Baltimore, MD, United States
(Miller, Taddei-Peters) Division of Cardiovascular Sciences, National
Institutes of Health, Bethesda, MD, United States
(Jeffries) National Heart, Lung, and Blood Institute, National Institutes
of Health, Bethesda, MD, United States
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, ON, Canada
(Weisel) Division of Cardiovascular Surgery, Toronto General Hospital,
University of Toronto, Toronto, Canada
(Voisine) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, QC, Canada
(Mullen) Cardiovascular and Thoracic Surgery, Department of Surgery,
University of Alberta, Edmonton, Canada
(Falk) Department of Cardiothoracic and Vascular Surgery, Deutsche
Herzzentrum Berlin, Germany
(Beyersdorf) Department of Cardiovascular Surgery, Charite
Universitatsmedizin Berlin, DZHK (German Center for Cardiovascular
Research), Berlin, Germany
(Krane) Technical University of Munich, School of Medicine and Health,
Department of Cardiovascular Surgery, Institute Insure (Institute for
Translational Cardiac Surgery), German Heart Center Munich, DZHK, Munich,
Germany
(Conradi) Department of Cardiovascular Surgery, University Heart Center
Hamburg, Hamburg, Germany
(Bagiella) Department of Cardiovascular Surgery, University Heart Center
Freiburg, Albert Ludwigs University Freiburg, Freiburg, Germany
(Borger) Leipzig Heart Center, University of Leipzig, Leipzig, Germany
(Overbey, Moskowitz, Rose, Raymond, Moquete, O'Sullivan, Marks, Bagiella,
Gelijns) Department of Population Health Science and Policy, Icahn School
of Medicine, Mount Sinai, NY, United States
(Parides) Department of Cardiothoracic and Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, New York, United
States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, United States
(Mack) Department of Cardiac and Thoracic Surgery, Baylor Scott and White
Health, Plano, TX, United States
(Jessup) American Heart Association, Dallas, TX, United States
(Krane, Geirsson) Department of Surgery, Division of Cardiac Surgery, Yale
School of Medicine, New Haven, CT, United States
(Yerokun) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University, Durham, NC, United States
(Bowdish) Departments of Surgery and Population and Public Health
Sciences, Keck School of Medicine, University of Southern California, Los
Angeles, United States
(Bolling, Ailawadi) Department of Cardiac Surgery, University of Michigan
Health System, Ann Arbor, United States
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
Lebanon, NH, United States
(Hung) Division of Cardiology, Massachusetts General Hospital, Boston,
United States
(O'Gara) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Tricuspid regurgitation is common in patients with severe
degenerative mitral regurgitation. However, the evidence base is
insufficient to inform a decision about whether to perform tricuspid-valve
repair during mitral-valve surgery in patients who have moderate tricuspid
regurgitation or less-than-moderate regurgitation with annular dilatation.
METHODS We randomly assigned 401 patients who were undergoing mitral-valve
surgery for degenerative mitral regurgitation to receive a procedure with
or without tricuspid annuloplasty (TA). The primary 2-year end point was a
composite of reoperation for tricuspid regurgitation, progression of
tricuspid regurgitation by two grades from baseline or the presence of
severe tricuspid regurgitation, or death. RESULTS Patients who underwent
mitral-valve surgery plus TA had fewer primary-end-point events than those
who underwent mitral-valve surgery alone (3.9% vs. 10.2%) (relative risk,
0.37; 95% confidence interval [CI], 0.16 to 0.86; P=0.02). Two-year
mortality was 3.2% in the surgery-plus-TA group and 4.5% in the
surgery-alone group (relative risk, 0.69; 95% CI, 0.25 to 1.88). The
2-year prevalence of progression of tricuspid regurgitation was lower in
the surgery-plus-TA group than in the surgery-alone group (0.6% vs. 6.1%;
relative risk, 0.09; 95% CI, 0.01 to 0.69). The frequencies of major
adverse cardiac and cerebrovascular events, functional status, and quality
of life were similar in the two groups at 2 years, although the incidence
of permanent pacemaker implantation was higher in the surgery-plus-TA
group than in the surgery-alone group (14.1% vs. 2.5%; rate ratio, 5.75;
95% CI, 2.27 to 14.60). CONCLUSIONS Among patients undergoing mitral-valve
surgery, those who also received TA had a lower incidence of a
primary-end-point event than those who underwent mitral-valve surgery
alone at 2 years, a reduction that was driven by less frequent progression
to severe tricuspid regurgitation. Tricuspid repair resulted in more
frequent permanent pacemaker implantation. Whether reduced progression of
tricuspid regurgitation results in long-term clinical benefit can be
determined only with longer follow-up. Copyright © 2021
Massachusetts Medical Society.

<25>
Accession Number
637029656
Title
Addition of topical airway anaesthesia to conventional induction
techniques to reduce haemodynamic instability during the induction period
in patients undergoing cardiac surgery: Protocol for a randomised
controlled study.
Source
BMJ Open. 12(1) (no pagination), 2022. Article Number: e053337. Date of
Publication: 25 Jan 2022.
Author
Chen T.T.; Lv M.; Wang J.H.; Wei C.S.; Gu C.P.; Wang Y.L.
Institution
(Chen, Lv, Wang, Wei, Gu, Wang) Department of Anesthesiology, First
Affiliated Hospital of Shandong First Medical University, Shandong,
Ji'nan, China
(Chen) Shandong First Medical University, Shandong, Ji'nan, China
Publisher
BMJ Publishing Group
Abstract
Introduction The aim of this prospective study is to evaluate the effects
of combining topical airway anaesthesia with intravenous induction on
haemodynamic variables during the induction period in patients undergoing
cardiac surgery. Methods and analysis This randomised, double-blind,
controlled, parallel-group, superiority study from 1 March 2021 to 31
December 2021 will include 96 participants scheduled for cardiac surgery.
Participants will be screened into three blocks (ASA II, ASA III, ASA IV)
according to the American Society of Anesthesiologists (ASA) grade and
then randomly allocated into two groups within the block in a 1:1 ratio.
Concealment of allocation will be maintained using opaque, sealed
envelopes generated by a nurse according to a computer-generated
randomisation schedule. In addition to general intravenous anaesthetics,
participants will receive supraglottic and subglottic topical anaesthesia.
Changes in arterial blood pressure and heart rate in both groups will be
recorded by an independent investigator at the start of anaesthesia
induction until the skin incision. If vasopressors are used during this
period, the frequency, dosage and types of vasopressors will be recorded.
The incidence and severity of participants' postoperative hoarseness and
sore throat will also be assessed. Ethics and dissemination This study was
approved by the Ethics Committee of Qianfoshan Hospital of Shandong
Province (registration number: YXLL-KY-2021(003)). The results will be
disseminated through a peer-reviewed publication and in conferences or
congresses. Trial registration number NCT04744480. Copyright ©
Author(s) (or their employer(s)) 2022.

<26>
Accession Number
637167121
Title
Impact of the Southern Thoracic Surgical Association James W. Brooks
Scholarship.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 31 Jan 2022.
Author
Kim M.P.; Mavroudis C.; Jacobs J.P.; Yang S.C.
Institution
(Kim) Division of Thoracic Surgery, Department of Surgery, Houston
Methodist Hospital, TX, Houston
(Mavroudis) Pediatric Cardiothoracic Surgery, Peyton Manning Children's
Hospital, IN, Indianapolis, United States
(Jacobs) Division of Cardiovascular Surgery, Department of Surgery,
University of Florida, FL, Gainesville, United States
(Yang) Division of Thoracic Surgery, Department of Surgery, Johns Hopkins
Medical Institutions, MD, Baltimore, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Medical students and general surgery residents often do not
get exposure to cardiothoracic surgery (CTS) due to decreased emphasis of
CTS rotations during their training. The Southern Thoracic Surgical
Association (STSA) began offering the Brooks Scholarship to medical
students in 2010 and general surgery residents in 2014 to promote CTS.
This study examines the impact of the scholarship. METHOD(S): We
examined the history of the award and how STSA administers the award.
Next, we examined the impact of the award by evaluating the number of
medical students and residents who are tracked to complete a CTS program.
Finally, we performed an analysis of the academic output of the awardees
who have completed or tracked to complete a CTS program. RESULT(S):
The scholarship was developed to honor the memory of past STSA President
Dr. James W. Brooks. It is administered through the STSA scholarship
committee, and it provides medical students and residents funds to attend
the STSA annual meeting and the opportunity to spend time with a mentor
during the meeting. 88% of the medical student recipients (21 out of 24)
and 100% of general surgery resident recipients (15 out of 15) have
completed or are on track to complete a CTS program. The 36 recipients
going into CTS have published a total of 823 papers and 9240 articles have
cited those papers. CONCLUSION(S): The STSA medical student and
general surgery Brooks scholarship awards were associated with completing
or pursuing a career in CTS. STSA should continue the Brooks scholarship
to attract talented medical students and residents to CTS. Copyright
© 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc.
All rights reserved.

<27>
Accession Number
637150101
Title
Low-Dose Versus Standard Warfarin After Mechanical Mitral Valve
Replacement: A Randomized Controlled Trial.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 28 Jan 2022.
Author
Chu M.W.A.; Ruel M.; Graeve A.; Gerdisch M.W.; Damiano R.J.; Smith R.L.;
Keeling W.B.; Wait M.A.; Hagberg R.C.; Quinn R.D.; Sethi G.K.; Floridia
R.; Barreiro C.J.; Pruitt A.L.; Accola K.D.; Dagenais F.; Markowitz A.H.;
Ye J.; Sekela M.E.; Tsuda R.Y.; Duncan D.A.; Swistel D.G.; Harville L.E.;
DeRose J.J.; Lehr E.J.; Puskas J.D.
Institution
(Chu) London Health Sciences Centre, Western University, ON, London,
Canada
(Ruel) University of Ottawa Heart Institute, ON, Ottawa, Canada
(Graeve) MultiCare Health System, Tacoma, WA, United States
(Gerdisch) Franciscan St. Francis Health, IN, Indianapolis, United States
(Damiano) Washington University SL, St. Louis, MO
(Smith) Heart Hospital Baylor Plano, TX, Plano, United States
(Keeling) Emory University Hospital Midtown, Atlanta, United States
(Wait) UT Southwestern Medical Center (St. Paul's), TX, Dallas, United
States
(Hagberg) CT, Hartford Hospital, Hartford, United States
(Quinn) Maine Medical Center, ME, Portland, Jamaica
(Sethi) University of Arizona, Tucson Heart Center, AZ, Tucson, United
States
(Floridia) Loma Linda University Medical Center, Loma Linda, CA
(Barreiro) Sentara Norfolk General Hospital, VA, Norfolk
(Pruitt) St. Joseph Mercy Hospital, MI, Ann Arbor, United States
(Accola) Florida Hospital, FL, Orlando, United States
(Dagenais) Institut universitaire de cardiologie et de pneumologie de
Quebec (IUCPQ), QC, Quebec City, Canada
(Markowitz) University Hospitals-Cleveland, Cleveland, OH
(Ye) St. Paul's and Vancouver General Hospital, Vancouver, Canada
(Sekela) University of Kentucky, KY, Lexington, United States
(Tsuda) Southern Arizona VA Medical Center, AZ, Tucson, United States
(Duncan) Novant Clinical Research Institute, Winston-Salem
(Swistel) NYU Langone Hospitals, NY, NY
(Harville) University of Oklahoma Health Sciences Center, Oklahoma City,
United States
(DeRose) Montefiore Medical Center, Bronx, NY
(Lehr) Swedish Medical Center, Seattle, WA
(Puskas) Mount Sinai Saint Luke's, NY, NY
Publisher
NLM (Medline)
Abstract
BACKGROUND: Current guidelines recommend a target international normalized
ratio (INR) range of 2.5 to 3.5 in patients with a mechanical mitral
prosthesis. The Prospective Randomized On-X Anticoagulation Clinical Trial
(PROACT) Mitral randomized controlled trial assessed the safety and
efficacy of warfarin at doses lower than currently recommended, in
patients with an On-X mechanical mitral valve. METHOD(S): After On-X
mechanical mitral valve replacement followed by at least 3 months of
standard anticoagulation, 401 patients at 44 North American centers were
randomized to low-dose warfarin (target INR 2.0 to 2.5) or standard-dose
warfarin (target INR 2.5 to 3.5). All patients were prescribed aspirin 81
mg daily and encouraged to use home INR testing. The primary endpoint was
the sum of the linearized rates of thromboembolism, valve thrombosis, and
bleeding events. Secondary endpoints included death, valve-related events,
New York Heart Association classification, and valve hemodynamics.
 RESULT(S): Mean patient follow-up was 4.1 years. Mean INR was 2.47
and 2.92 (P <.001) in the low-dose and standard-dose warfarin groups,
respectively. Primary endpoint rates were 11.9%/patient-year in the
low-dose group and 12.0%/patient-year in the standard-dose group (P =
.97). The -0.07% difference (95% confidence interval: -0.07, -0.06) was
noninferior (<1.5% margin). Individual rates (expressed as %/patient-year)
of thromboembolism (2.3% vs 2.5%), valve thrombosis (0.5% vs 0.5%), and
major bleeding (4.9% vs 4.3%) were also similar and noninferior.
 CONCLUSION(S): Low-dose warfarin was noninferior to standard-dose
warfarin in patients with an On-X mechanical mitral prosthesis, following
>3 postoperative months of standard anticoagulation therapy. (PROACT
Clinicaltrials.gov number, NCT00291525). Copyright © 2022 The
Society of Thoracic Surgeons. Published by Elsevier Inc. All rights
reserved.

<28>
Accession Number
2014841234
Title
Kinetics of tissue oxygenation index during fast and slow cardiopulmonary
bypass initiation.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Turra J.; Bauer A.; Mobius A.; Wojdyla J.; Eisner C.
Institution
(Turra, Mobius) Department of Cardiothoracic Surgery, University Hospital
Heidelberg, Heidelberg, Germany
(Bauer) Department of Cardiovascular Surgery, Mediclin Heartcenter Coswig,
Coswig, Germany
(Wojdyla) Department of Cardiothoracic Surgery, Sunnyside Medical Center,
OR, United States
(Eisner) Department of Anesthesiology, University Hospital Heidelberg,
Heidelberg, Germany
Publisher
SAGE Publications Ltd
Abstract
Introduction: Despite being a daily clinical application in cardiac
operating theaters, an evidence-based approach on how to optimally
initiate the heart-lung machine (HLM) to prevent critical phases of
cerebral ischemia is still lacking. We therefore designed a study
comparing two different initiation times for starting the cardiopulmonary
bypass (CPB). Method(s): We conducted a monocentric, randomized, and
prospective study comparing the impact of two initiation times, a rapid
initiation of 15 s and a slow initiation of 180 s to reach the full target
flow rate of 2.5 L/min/m2 times the body surface area, on
cerebral tissue oxygenation by near infrared spectroscopy measurements.
 Result(s): The absolute values in tissue oxygenation index (TOI)
showed no difference between the groups before and after the CPB with a
10% drop in oxygenation index in both groups due to the hemodilution
through the HLM priming. Looking at the kinetics a rapid initiation of CPB
produced a higher negative rate of change in TOI with a total of 21% in
critical oxygenation readings compared to 6% in the slow initiation group.
 Conclusion(s): In order to avoid critical phases of cerebral ischemia
during the initiation of CPB for cardiac procedures, we propose an
initiation time of at least 90 s to reach the 100% of target flow rate of
the HLM. Copyright © The Author(s) 2022.

<29>
Accession Number
2015094425
Title
Repetitive use of LEvosimendan in Ambulatory Heart Failure patients
(LEIA-HF) - The rationale and study design.
Source
Advances in Medical Sciences. 67(1) (pp 18-22), 2022. Date of Publication:
March 2022.
Author
Tycinska A.; Gierlotka M.; Bartus S.; Gasior M.; Glowczynska R.; Grzesk
G.; Jaguszewski M.; Kasprzak J.D.; Kubica J.; Legutko J.; Leszek P.;
Nessler J.; Pacileo G.; Ponikowski P.; Sobkowicz B.; Stepinska J.;
Straburzynska-Migaj E.; Wojakowski W.; Zawislak B.; Zymlinski R.
Institution
(Tycinska, Sobkowicz) Department of Cardiology, Medical University of
Bialystok, Bialystok, Poland
(Gierlotka) Department of Cardiology, Institute of Medical Sciences,
University of Opole, Opole, Poland
(Bartus) Department of Cardiology, Jagiellonian University Medical
College, Krakow, Poland
(Gasior) Third Department of Cardiology, School of Medicine with the
Division of Dentistry in Zabrze, Medical University in Katowice, Silesian
Center for Heart Diseases, Zabrze, Poland
(Glowczynska) First Chair and Department of Cardiology, Medical University
of Warsaw, Warsaw, Poland
(Grzesk) Department of Cardiology and Clinical Pharmacology, Faculty of
Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus
University in Torun, Bydgoszcz, Poland
(Jaguszewski) First Department of Cardiology, Medical University of
Gdansk, Gdansk, Poland
(Kasprzak) First Department and Chair of Cardiology, Medical University of
Lodz, Lodz, Poland
(Kubica) Department of Cardiology and Internal Medicine, Collegium Medicum
in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
(Legutko) Department of Interventional Cardiology, Institute of
Cardiology, Jagiellonian University Medical College, The John Paul II
Hospital, Krakow, Poland
(Leszek) Department of Heart Failure and Transplantology, National
Institute of Cardiology, Warsaw, Poland
(Nessler) Department of Coronary Disease and Heart Failure, Institute of
Cardiology, Jagiellonian University, Medical College, Krakow, Poland
(Pacileo) Heart Failure and Cardiac Rehabilitation Unit, Department of
Cardiology, AORN dei Colli-Monaldi Hospital, Naples, Italy
(Ponikowski, Zymlinski) Department of Heart Diseases, Wroclaw Medical
University, Wroclaw, Poland
(Stepinska) Department of Intensive Cardiac Therapy, National Institute of
Cardiology, Warsaw, Poland
(Straburzynska-Migaj) First Department of Cardiology, University of
Medical Sciences, Poznan, Poland
(Wojakowski) Division of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Zawislak) Intensive Cardiac Care Unit, University Hospital Krakow,
Krakow, Poland
Publisher
Medical University of Bialystok
Abstract
Purpose: Clinical practice forces the necessity to conduct a clinical
trial concerning the group of outpatients with chronically advanced heart
failure in III or IV NYHA functional class, frequently requiring
hospitalizations due to HF exacerbation, and often left without any
additional therapeutic option. The current trial aims to determine the
efficacy and safety of repeated levosimendan infusions in the group of
severe outpatients with reduced ejection fraction (HFrEF).
 Material(s) and Method(s): LEIA-HF (LEvosimendan In Ambulatory Heart
Failure Patients) is a multicentre, randomized, double-blind,
placebo-controlled, phase 4 clinical trial to determine whether the
repetitive use of levosimendan reduces the incidence of adverse
cardiovascular events in ambulatory patients with chronic, advanced HFrEF.
A total of 350 patients will be randomized in a 1:1 ratio to receive
either levosimendan or placebo, which will be administered as continuous
24 h infusions, every 4 weeks for 48 weeks (12 infusions in total - phase
I), and followed by double-blind 6 visits, every 4 weeks (phase II of the
trial including the option of restarting levosimendan or placebo, based on
the fulfillment of additional criteria). The primary endpoint for efficacy
assessment will be death from any cause or unplanned hospitalization for
HF assessed together, whichever occurs first, in a 12-month follow-up
period. Conclusion(s): A well-designed study with a consistent
protocol, including the drug side effects, comprehensive clinical
assessment, appropriate definition of endpoints, and monitoring therapy,
may provide a complete overview of the effectiveness and safety profile of
the repetitive levosimendan administration in ambulatory severe HFrEF
patients. Copyright © 2021

<30>
Accession Number
2016141013
Title
Selection of the best of 2021 in structural interventional cardiology.
Source
REC: CardioClinics. 57(Supplement 1) (pp S65-S70), 2022. Date of
Publication: 03 Jan 2022.
Author
Romaguera R.; Ojeda S.; Cruz-Gonzalez I.; Moreno R.
Institution
(Romaguera) Servicio de Cardiologia, Hospital de Bellvitge-IDIBELL,
Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
(Ojeda) Servicio de Cardiologia, Hospital Universitario Reina
Sofia-IMIBIC, Universidad de Cordoba, Cordoba, Spain
(Cruz-Gonzalez) Departamento de Cardiologia, Hospital Clinico de
Salamanca, Salamanca, Spain
(Moreno) Servicio de Cardiologia, Hospital Universitario La Paz-IDIPAZ,
Madrid, Spain
(Moreno) Centro de Investigacion Biomedica en Red Enfermedades
Cardiovaculares (CIBERCV), Spain
Publisher
Elsevier Espana S.L.U
Abstract
This article is a systematic review of the most relevant articles on
aortic, mitral, tricuspid or atrial appendage intervention from September
15, 2020 to September 15, 2021 indexed in Medline and Scopus, as well as
abstracts of randomized clinical trials or large multicenter prospective
registries presented at the most relevant conferences. Copyright
© 2021 Sociedad Espanola de Cardiologia

<31>
Accession Number
2014298183
Title
Cefazolin-induced hemolytic anemia: a case report and systematic review of
literature.
Source
European Journal of Medical Research. 26(1) (no pagination), 2021. Article
Number: 133. Date of Publication: December 2021.
Author
Mause E.; Selim M.; Velagapudi M.
Institution
(Mause) Creighton University School of Medicine, Omaha, NE, United States
(Selim) Department of Internal Medicine, Creighton University, Omaha, NE,
United States
(Velagapudi) Department of Infectious Disease, Creighton University,
Omaha, NE, United States
Publisher
BioMed Central Ltd
Abstract
Background: Cefazolin is a first-generation cephalosporin commonly used
for skin and soft tissue infections, abdominal and orthopedic surgery
prophylaxis, and methicillin-sensitive staph aureus. Cephalosporins as a
whole are known potential inducers of hemolytic anemia; however, mechanism
of action is primarily autoimmune, and compared to other drugs, cefazolin
is the least common. Method(s): A rare case report of
cefazolin-induced hemolytic anemia "CIHA" and a systematic review of CIHA
articles in English literature. Two authors performed review of
publications and articles were selected based on inclusion and exclusion
criteria. A systematic search of the literature yielded 768 entries with
five case reports on cefazolin-induced hemolytic anemia. Case
presentation/results: An 80-year-old female with methicillin-sensitive
Staphylococcus aureus "MSSA" endocarditis. The patient was started on
intravenous "IV" cefazolin that that resulted in hemolytic anemia and
eosinophilia. Switching to vancomycin improved hemoglobin level and
resolved eosinophilia. Four cefazolin-induced hemolytic anemia case
reports and one population-based article with a case reported were
analyzed with respect to direct antiglobulin test "DAT" (also known as the
direct Coombs test) results, prior penicillin sensitivity, and acute
anemia causes exclusion. Conclusion(s): CIHA is a rare cause of
clinically significant anemia. The diagnosis of drug-induced anemia is one
of exclusion. It is important to consider DAT results and prior penicillin
sensitivity when evaluating a patient for cefazolin-induced hemolytic
anemia. However, the frequency of cefazolin use and resultant anemia
necessitates early recognition of hemolytic anemia and prompt
discontinuation of cefazolin, especially with long-term use. Copyright
© 2021, The Author(s).

<32>
Accession Number
634854501
Title
A meta-analysis of optimal medical therapy with or without percutaneous
coronary intervention in patients with stable coronary artery disease.
Source
Coronary artery disease. 33(2) (pp 91-97), 2022. Date of Publication: 01
Mar 2022.
Author
Shah R.; Nayyar M.; Le F.K.; Labroo A.; Nasr A.; Rashid A.; Davis D.A.;
Weintraub W.S.; Boden W.E.
Institution
(Shah, Nayyar) Department of Medicine, University of Tennessee, Memphis,
TN, United States
(Shah, Le, Labroo, Davis) Department of Cardiology, Gulf Coast Medical
center, Alabama University of Osteopathic Medicine, Panama City, FL,
United States
(Nasr) Department of Biology, University of Memphis, Memphis, TN, United
States
(Rashid) Department of Cardiology, University of Tennessee, Jackson, TN,
United States
(Weintraub) Department of Medicine, MedStar Washington Hospital Center,
DC, WA
(Boden) Department of Medicine, Veterans Affairs (VA) New England
Healthcare System, Boston University, United Kingdom
(Boden) Department of Medicine, Boston University School of Medicine,
Boston, MA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether percutaneous coronary intervention (PCI) improves
clinical outcomes in patients with chronic angina and stable coronary
artery disease (CAD) has been a continuing area of investigation for more
than two decades. The recently reported results of the International Study
of Comparative Health Effectiveness with Medical and Invasive Approaches,
the largest prospective trial of optimal medical therapy (OMT) with or
without myocardial revascularization, provides a unique opportunity to
determine whether there is an incremental benefit of revascularization in
stable CAD patients. METHOD(S): Scientific databases and websites
were searched to find randomized clinical trials (RCTs). Pooled risk
ratios were calculated using the random-effects model. RESULT(S):
Data from 10 RCTs comprising 12125 patients showed that PCI, when added to
OMT, were not associated with lower all-cause mortality (risk ratios,
0.96; 95% CI, 0.87-1.08), cardiovascular mortality (risk ratios, 0.91; 95%
CI, 0.79-1.05) or myocardial infarction (MI) (risk ratios, 0.90; 95% CI,
0.78-1.04) as compared with OMT alone. However, OMT+PCI was associated
with improved anginal symptoms and a lower risk for revascularization
(risk ratios, 0.52; 95% CI, 0.37-0.75). CONCLUSION(S): In patient
with chronic stable CAD (without left main disease or reduced ejection
fraction), PCI in addition to OMT did not improve mortality or MI compared
to OMT alone. However, this strategy is associated with a lower rate of
revascularization and improved anginal symptoms. Copyright © 2021
Wolters Kluwer Health, Inc. All rights reserved.

<33>
Accession Number
635125223
Title
Saphenous vein harvesting techniques for coronary artery bypass grafting:
a systematic review and meta-analysis.
Source
Coronary artery disease. 33(2) (pp 128-136), 2022. Date of Publication: 01
Mar 2022.
Author
Vuong N.L.; Elfaituri M.K.; Eldoadoa M.; Karimzadeh S.; Mokhtar M.A.; Eid
P.S.; Nam N.H.; Mostafa M.R.; Radwan I.; Zaki M.M.M.; Al Khudari R.;
Kassem M.; Huy N.T.
Institution
(Vuong) Department of Cardiovascular and Thoracic Surgery, Faculty of
Medicine
(Vuong) Department of Medical Statistics and Informatics, Faculty of
Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho
Chi Minh City, Vietnam
(Elfaituri, Eldoadoa, Karimzadeh, Mokhtar, Eid, Nam, Mostafa, Radwan,
Zaki, Al Khudari, Kassem) Online Research Club
(http://www.onlineresearchclub.org), School of Tropical Medicine and
Global Health, Nagasaki University, Nagasaki, Japan
(Elfaituri) Faculty of Medicine - University of Tripoli, Tripoli, Libyan
Arab Jamahiriya
(Eldoadoa) Milton Keynes University Hospital, Milton Keynes, United
Kingdom
(Karimzadeh) School of Medicine, Sabzevar University of Medical Sciences,
Sabzevar, Iran, Islamic Republic of
(Mokhtar) Faculty of Medicine, Sohag University, Sohag, Egypt
(Eid, Radwan) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Nam) Division of Hepato-Biliary-Pancreatic Surgery and Transplantation,
Department of Surgery, Graduate School of Medicine, Kyoto University,
Kyoto, Japan
(Mostafa) School of Medicine, Tanta University
(Zaki) Faculty of Clinical Pharmacy, Fayoum university, Egypt
(Al Khudari) Pediatric Department, Children's University Hospital,
Damascus University, Damascus, Syrian Arab Republic
(Kassem) Department of Medical Oncology, Ohio State University Wexner
Medical Center, Columbus, OH, United States
(Huy) School of Tropical Medicine and Global Health, Nagasaki University,
Nagasaki, Japan
Publisher
NLM (Medline)
Abstract
The great saphenous vein (GSV) graft remains a frequently used conduit for
coronary artery bypass graft (CABG) surgery. The optimal technique for GSV
harvesting has been the subject of on-going controversy. We therefore
sought to conduct a systematic review and meta-analysis of all available
GSV harvesting techniques in CABG. A systematic search of 12 electronic
databases was performed to identify all randomized controlled trials
(RCTs) of any GSV harvesting technique, including conventional vein
harvesting (CVH), no-touch, standard bridging technique (SBT) and
endoscopic vein harvesting (EVH) techniques. We investigated safety and
long-term efficacy outcomes. All outcomes were analyzed using the
frequentist network meta-analysis. A total of 6480 patients from 34 RCTs
were included. For safety outcomes, EVH reduced 91% and 77% risk of wound
infection compared to no-touch and CVH, respectively. EVH and SBT also
significantly reduced the risk of sensibility disorder and postoperative
pain. The techniques were not significantly different regarding long-term
efficacy outcomes, including mortality, myocardial infarction and graft
patency. For GSV harvesting for CABG, EVH techniques are the most
favorable, but in case of using an open technique, no-touch is more
recommended than CVH. More effective and safer procedures should be
investigated for GSV harvesting in CABG. Copyright © 2021 Wolters
Kluwer Health, Inc. All rights reserved.

<34>
Accession Number
2016787826
Title
RAVAL trial: Protocol of an international, multi-centered, blinded,
randomized controlled trial comparing robotic-assisted versus
video-assisted lobectomy for earlystage lung cancer.
Source
PLoS ONE. 17(2 February) (no pagination), 2022. Article Number: e0261767.
Date of Publication: February 2022.
Author
Patel Y.S.; Hanna W.C.; Fahim C.; Shargall Y.; Waddell T.K.; Yasufuku K.;
Machuca T.N.; Pipkin M.; Baste J.-M.; Xie F.; Shiwcharan A.; Foster G.;
Thabane L.
Institution
(Patel, Hanna, Fahim, Shargall) Division of Thoracic Surgery, Department
of Surgery, McMaster University, Hamilton, ON, Canada
(Waddell, Yasufuku) Division of Thoracic Surgery, Department of Surgery,
University of Toronto, Toronto, ON, Canada
(Machuca, Pipkin) Division of Thoracic and Cardiovascular Surgery,
Department of Surgery, University of Florida, Gainesville, FL, United
States
(Baste) Division of Thoracic Surgery, Department of Surgery, Rouen
Normandy University, Rouen Cedex, France
(Xie, Foster, Thabane) Department of Epidemiology and Biostatistics,
McMaster University, Hamilton, ON, Canada
(Shiwcharan) Funding Reform and Case Costing, St. Joseph's Healthcare
Hamilton, Hamilton, ON, Canada
Publisher
Public Library of Science
Abstract
Background Retrospective data demonstrates that robotic-assisted
thoracoscopic surgery provides many benefits, such as decreased
postoperative pain, lower mortality, shorter length of stay, shorter chest
tube duration, and reductions in the incidence of common postoperative
pulmonary complications, when compared to video-assisted thoracoscopic
surgery. Despite the potential benefits of robotic surgery, there are two
major barriers against its widespread adoption in thoracic surgery: Lack
of high-quality prospective data, and the perceived higher cost of it.
Therefore, in the face of these barriers, a prospective randomized
controlled trial comparing robotic- to video-assisted thoracoscopic
surgery is needed. The RAVAL trial is a two-phase, international,
multi-centered, blinded, parallel, randomized controlled trial that is
comparing robotic- to video-assisted lobectomy for early-stage non-small
cell lung cancer that has been enrolling patients since 2016. Methods The
RAVAL trial will be conducted in two phases: Phase A will enroll 186
early-stage nonsmall cell lung cancer patients who are candidates for
minimally invasive pulmonary lobectomy; while Phase B will continue to
recruit until 592 patients are enrolled. After consent, participants will
be randomized in a 1:1 ratio to either robotic- or video-assisted
lobectomy, and blinded to the type of surgery they are allocated to.
Health-related quality of life questionnaires will be administered at
baseline, postoperative day 1, weeks 3, 7, 12, months 6, 12, 18, 24, and
years 3, 4, 5. The primary objective of the RAVAL trial is to determine
the difference in patient-reported health-related quality of life outcomes
between the roboticand video-assisted lobectomy groups at 12 weeks.
Secondary objectives include determining the differences in
cost-effectiveness, and in the 5-year survival data between the two arms.
The results of the primary objective will be reported once Phase A has
completed accrual and the 12-month follow-ups are completed. The results
of the secondary objectives will be reported once Phase B has completed
accrual and the 5-year follow-ups are completed. Discussion If
successfully completed, the RAVAL Trial will have studied patient-reported
outcomes, cost-effectiveness, and survival of robotic- versus
video-assisted lobectomy in a prospective, randomized, blinded fashion in
an international setting. Copyright © 2022 Patel et al. This is
an open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<35>
Accession Number
2016787678
Title
Prognostic value of cardiac magnetic resonance in patients with aortic
stenosis: A systematic review and meta-analysis.
Source
PLoS ONE. 17(2 February) (no pagination), 2022. Article Number: e0263378.
Date of Publication: February 2022.
Author
Zhang C.; Liu J.; Qin S.
Institution
(Zhang, Qin) Department of Cardiology, The First Affiliated Hospital,
Chongqing Medical University, Yuzhong District, Chongqing, China
(Liu) Chongqing Municipal Health Supervision Bureau, Chongqing, China
Publisher
Public Library of Science
Abstract
Background The timing of surgery for aortic stenosis (AS) is imperfect,
and the management of moderate AS and asymptomatic severe AS is still
challenging. Myocardial fibrosis (MF) is the main pathological basis of
cardiac decompensation in patients with AS and can be detected by
cardiovascular magnetic resonance (CMR). The aim of this study was to
evaluate the prognostic value of MF measured by CMR in patients with AS,
which can provide a reference for the timing of aortic valve replacement
(AVR). Methods We searched Medline, Embase, and Web of Science to include
all studies that investigated the prognostic value of CMR in patients with
AS. The search deadline is March 31, 2021. The pooled relative risk (RR)
or hazard ratio (HR) and 95% confidence intervals (CI) of the biomarkers
including late gadolinium enhancement (LGE), Native T1 or extracellular
volume (ECV) were calculated to evaluate the prognostic value. Results 13
studies and 2,430 patients with AS were included in this study, the mean
or medium follow- up duration for each study was ranged from 6 to 67.2
months. Meta-analysis showed the presence of LGE was associated with an
increased risk for all-cause mortality (pooled RR: 2.14, 95% CI:
1.67-2.74, P < 0.001), cardiac mortality (pooled RR: 3.50, 95% CI: 2.32-
5.30, P < 0.001), and major adverse cardiovascular events (MACEs) (pooled
RR: 1.649, 95% CI: 1.23-2.22, P = 0.001). Native T1 was significantly
associated with MACEs (pooled RR: 2.23, 95% CI: 1.00-4.95; P = 0.049), and
higher ECV was associated with a higher risk of cardiovascular events
(pooled HR: 1.69, 95% CI: 1.11-2.58; P = 0.014). Conclusion The use of CMR
to detect MF has a good prognostic value in patients with AS. LGE, Native
T1 and ECV measured by CMR can contribute to risk stratification of AS,
thereby helping to optimize the timing of AVR. Copyright © 2022
Zhang et al. This is an open access article distributed under the terms of
the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<36>
Accession Number
2014711499
Title
Stress exercise haemodynamic performance and opening reserve of a stented
bovine pericardial aortic valve bioprosthesis.
Source
Journal of Cardiac Surgery. 37(3) (pp 618-627), 2022. Date of Publication:
March 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

<37>
Accession Number
2014656457
Title
Cardiac transplantation after heparin-induced thrombocytopenia: A
systematic review.
Source
Clinical Transplantation. 36(2) (no pagination), 2022. Article Number:
e14567. Date of Publication: February 2022.
Author
Jimenez D.C.; Warner E.D.; Ahmad D.; Rosen J.L.; Al-Rawas N.; Morris R.J.;
Alvarez R.; Rame J.E.; Entwistle J.W.; Massey H.T.; Tchantchaleishvili V.
Institution
(Jimenez, Warner, Ahmad, Rosen, Morris, Entwistle, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Al-Rawas) Department of Anesthesiology, Thomas Jefferson University,
Philadelphia, PA, United States
(Alvarez, Rame) Division of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Purpose: Heparin-induced thrombocytopenia (HIT) presents a unique
challenge in patients requiring orthotopic heart transplantation (OHT). We
sought to pool the existing evidence in a systematic review.
 Method(s): Electronic search was performed to identify all relevant
studies on OHT in patients with HIT. Patient-level data for 33 patients
from 21 studies were extracted for statistical analysis. Result(s):
Median patient age was 51 [IQR 41, 55] years, with 75.8% (25/33) males.
All patients had a clinical diagnosis of HIT, and anti-PF4/Heparin
antibodies were positive in 87.9% (29/33). Median lowest reported platelet
count was 46 x 109/L [27.2, 73.5]. Intraoperatively, 61%
(20/33) of patients were given unfractionated heparin (UFH), while 39%
(13/33) were given alternative anticoagulants. The alternative agent
subgroup required more antifibrinolytics [54% (7/13) vs 10% (2/20), P
=.02] and clotting factors [69.2% (9/13) vs 15.0% (3/20), P <.01].
Perioperative thrombosis occurred more [53.8% (7/13) vs 0% (0/20, P <.01)
in alternate agent subgroup. More patients in the alternate agent subgroup
required post-operative transfusions [54% (7/13) vs 0% (0/20), P <.01].
Thirty-day mortality of 15.2% (5/33) was comparable between the subgroups.
 Conclusion(s): Heparin use during OHT may be associated with less
adverse effects compared to use of other anticoagulants with no difference
in 30-day mortality. Copyright © 2021 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd.

<38>
Accession Number
637151625
Title
Effect of Moderate Hypothermia vs Normothermia on 30-Day Mortality in
Patients With Cardiogenic Shock Receiving Venoarterial Extracorporeal
Membrane Oxygenation: A Randomized Clinical Trial.
Source
JAMA. 327(5) (pp 442-453), 2022. Date of Publication: 01 Feb 2022.
Author
Levy B.; Girerd N.; Amour J.; Besnier E.; Nesseler N.; Helms J.; Delmas
C.; Sonneville R.; Guidon C.; Rozec B.; David H.; Bougon D.; Chaouch O.;
Walid O.; Herve D.; Belin N.; Gaide-Chevronnay L.; Rossignol P.; Kimmoun
A.; Duarte K.; Slutsky A.S.; Brodie D.; Fellahi J.-L.; Ouattara A.; Combes
A.
Institution
(Levy, Kimmoun) Medecine Intensive et Reanimation, CHRU Nancy,
Vandoeuvre-les-Nancy, France
(Levy) INSERM U1116, Vandoeuvre-les-Nancy, Faculte de Medecine, France
(Levy) Universite de Lorraine, Nancy, France
(Girerd) Universite de Lorraine, INSERM, Centre d'Investigations Cliniques
Plurithematique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et
des Vaisseaux, Nancy, Frances
(Girerd) INI-CRCT (Cardiovascular and Renal Clinical Trialists) F-CRIN
Network, Nancy, France
(Amour) Institut de Perfusion, de Reanimation et d'Anesthesie de Chirurgie
Cardiaque Paris Sud, Hopital Prive Jacques Cartier, Massy, France
(Besnier) Department of Anaesthesiology and Critical Care, Rouen
University Hospital, Rouen, France
(Besnier) Normandie University, UNIROUEN, INSERM U1096, Rouen, France
(Nesseler) Department of Anesthesia and Critical Care, Pontchaillou,
University Hospital of Rennes, Rennes, France
(Nesseler) University Rennes, CHU de Rennes, Inra, INSERM, Rennes, CIC
1414 (Centre d'Investigation Clinique de Rennes), France
(Helms) Universite de Strasbourg, Hopitaux Universitaires de Strasbourg,
Service de Medecine Intensive-Reanimation, Nouvel Hopital Civil, Faculte
de Medecine, Strasbourg, France
(Delmas) Intensive Cardiac Care Unit, Rangueil University Hospital,
Toulouse, France
(Sonneville) AP-HP, Bichat Hospital, Medical and infectious diseases ICU,
Paris, France
(Guidon) Pole Anesthesie-Reanimation, Marseille, France
(Rozec) Service d'Anesthesie-Reanimation, Hopital G&R Laennec CHU de
Nantes, Nantes, France
(Rozec) L'institut du Thorax INSERM, CNRS, CHU Nantes, UNIV Nantes,
Nantes, France
(David) Department of Anesthesiology and Critical Care Medicine, Arnaud de
Villeneuve Hospital, CHU Montpellier, Montpellier, France
(David) Montpellier University, INSERM, CNRS, PhyMedExp, Montpellier,
France
(Bougon, Rossignol) Service de Reanimation, Centre Hospitalier Annecy,
France
(Chaouch) Hopital Europeen Georges Pompidou, AP-HP, Department of
Anesthesiology and Critical Care Medicine, Universite Paris Descartes,
Paris, France
(Walid) Service d'Anesthesie-Reanimation et Medecine peri-Operatoire,
Nouvel Hopital Civil, Hopitaux Universitaires de Strasbourg, Strasbourg,
France
(Herve) Vasculaire et Respiratoire, CHU Amiens Picardie, Amiens, France
(Belin) Service de Reanimation Medicale, CHU Besancon, Besancon, France
(Gaide-Chevronnay) Unite de Reanimation Cardiovasculaire et Thoracique,
Pole Anesthesie Reanimation, CHU de Grenoble Alpes, Grenoble, France
(Duarte) Centre d'Investigations Cliniques Plurithematique, Institut
Lorrain du Coeur et des Vaisseaux, Universite de LorraineCHRU de Nancy,
Nancy, France
(Slutsky) Keenan Research Center, Li Ka Shing Knowledge Institute, St
Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
(Slutsky) Department of Medicine, Surgery, Biomedical Engineering,
University of Toronto, Toronto, ON, Canada
(Brodie) Department of Medicine, College of Physicians and Surgeons,
Columbia University, the Center for Acute Respiratory Failure, New
York-Presbyterian Hospital/Columbia University Medical Center, NY
(Fellahi) Service d'Anesthesie-Reanimation, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
(Fellahi) Laboratoire CarMeN, INSERM 1060, Universite Lyon 1 Claude
Bernard, Lyon, France
(Ouattara) CHU Bordeaux, Department of Anaesthesia and Critical Care,
Magellan Medico-Surgical Centre, Bordeaux, France
(Ouattara) University Bordeaux, INSERM, Biology of Cardiovascular
Diseases, Pessac, France
(Combes) Sorbonne Universite, INSERM, Institute of Cardiometabolism and
Nutrition, Paris, France
(Combes) Service de Medecine Intensive-Reanimation, Institut de
Cardiologie, Paris, France
Publisher
NLM (Medline)
Abstract
Importance: The optimal approach to the use of venoarterial extracorporeal
membrane oxygenation (ECMO) during cardiogenic shock is uncertain.
 Objective(s): To determine whether early use of moderate hypothermia
(33-34 degreeC) compared with strict normothermia (36-37 degreeC) improves
mortality in patients with cardiogenic shock receiving venoarterial ECMO.
 Design, Setting, and Participant(s): Randomized clinical trial of
patients (who were eligible if they had been endotracheally intubated and
were receiving venoarterial ECMO for cardiogenic shock for <6 hours)
conducted in the intensive care units at 20 French cardiac shock care
centers between October 2016 and July 2019. Of 786 eligible patients, 374
were randomized. Final follow-up occurred in November 2019.
 Intervention(s): Early moderate hypothermia (33-34 degreeC; n=168)
for 24 hours or strict normothermia (36-37 degreeC; n=166). Main
Outcomes and Measures: The primary outcome was mortality at 30 days. There
were 31 secondary outcomes including mortality at days 7, 60, and 180; a
composite outcome of death, heart transplant, escalation to left
ventricular assist device implantation, or stroke at days 30, 60, and 180;
and days without requiring a ventilator or kidney replacement therapy at
days 30, 60, and 180. Adverse events included rates of severe bleeding,
sepsis, and number of units of packed red blood cells transfused during
venoarterial ECMO. Result(s): Among the 374 patients who were
randomized, 334 completed the trial (mean age, 58 [SD, 12] years; 24%
women) and were included in the primary analysis. At 30 days, 71 patients
(42%) in the moderate hypothermia group had died vs 84 patients (51%) in
the normothermia group (adjusted odds ratio, 0.71 [95% CI, 0.45 to 1.13],
P=.15; risk difference, -8.3% [95% CI, -16.3% to -0.3%]). For the
composite outcome of death, heart transplant, escalation to left
ventricular assist device implantation, or stroke at day 30, the adjusted
odds ratio was 0.61 (95% CI, 0.39 to 0.96; P=.03) for the moderate
hypothermia group compared with the normothermia group and the risk
difference was -11.5% (95% CI, -23.2% to 0.2%). Of the 31 secondary
outcomes, 30 were inconclusive. The incidence of moderate or severe
bleeding was 41% in the moderate hypothermia group vs 42% in the
normothermia group. The incidence of infections was 52% in both groups.
The incidence of bacteremia was 20% in the moderate hypothermia group vs
30% in the normothermia group. Conclusions and Relevance: In this
randomized clinical trial involving patients with refractory cardiogenic
shock treated with venoarterial ECMO, early application of moderate
hypothermia for 24 hours did not significantly increase survival compared
with normothermia. However, because the 95% CI was wide and included a
potentially important effect size, these findings should be considered
inconclusive. Trial Registration: ClinicalTrials.gov Identifier:
NCT02754193.

<39>
Accession Number
637166112
Title
The Association Between Preoperative Frailty and Postoperative Delirium: A
Systematic Review and Meta-analysis.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 37(1) (pp 53-62), 2022. Date of
Publication: 01 Feb 2022.
Author
Liu C.-Y.; Gong N.; Liu W.
Institution
(Liu) Second Department of Anesthesiology, Affiliated Zhongshan Hospital
of Dalian University, Dalian, Liaoning, China
(Gong) Second Affiliated Hospital and Yuying Children's Hospital of
Wenzhou Medical University, Wenzhou, Zhejiang, China
(Liu) School of Nursing, Liaoning University of Traditional Chinese
Medicine, Shenyang, Liaoning, China
Publisher
NLM (Medline)
Abstract
PURPOSE: Identifying factors that place patients at high risk for
developing postoperative delirium is an important first step to reduce
incidence. Frailty is associated with poor postoperative outcomes. This
meta-analysis aims to determine the association between preoperative
frailty and postoperative delirium. DESIGN: This is a systematic review
and meta-analysis. METHOD(S): We used PubMed, Scopus, Embase, CINAHL,
Cochrane, and Web of Science as databases for the search up to April 23,
2020. We included cohort studies that assessed postoperative delirium as
the outcome and described the prevalence of delirium among participants
during the postoperative period. Odds ratio and 95% confidence interval
were calculated to examine the association. FINDINGS: Twenty cohort
studies met our inclusion criteria, which included a total of 4,568
patients. We found that preoperative frailty was significantly associated
with an increased risk of postoperative delirium (crude odds ratio: 3.28;
95% confidence interval: 2.51 to 4.28; I2 = 46.7%) (adjusted odds ratio:
2.45; 95% confidence interval: 1.58 to 3.81; I2 = 88.6%).
 CONCLUSION(S): This meta-analysis showed that preoperative frailty is
an independent risk factor for postoperative delirium. In patients
undergoing cardiovascular surgery, there is a lower association between
frailty and postoperative delirium. In patients with other types of
surgery, preoperative frailty is closely related to postoperative
delirium. Copyright © 2020 American Society of PeriAnesthesia
Nurses. Published by Elsevier Inc. All rights reserved.

<40>
Accession Number
637162127
Title
The connection between Down syndrome and Alzheimer disease.
Source
Alzheimer's & dementia : the journal of the Alzheimer's Association.
17(Supplement 7) (pp e050215), 2021. Date of Publication: 01 Dec 2021.
Author
Battaglino L.B.; Rodrigues A.B.
Institution
(Battaglino, Rodrigues) Bridgewater State University, MA, Bridgewater,
United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Individuals with Down syndrome (DS) face unique aging issues.
Often the serious consequences of Alzheimer's disease in individuals with
DS are misunderstood and inadequately addressed due to a lack of
understanding and sparse resources. This presentation explores research in
medical advances, education, programming, housing, and transitioning.
 METHOD(S): This presentation is a review of literature and research
examining the relationship between Down syndrome (DS) and Alzheimer's
disease. RESULT(S): Over the past 40 years the life expectancy of
people with Down syndrome has more than doubled from 25 years in 1983 to
60 years in 2020 due to advances in cardiac surgery, medications, updated
treatments, and the elimination of inhumane institutionalization. As a
result, ever increasing numbers of people deal with the issues faced when
people with DS experience premature age related changes. While memory loss
is an early predictor of AD in the general population, according to the
Alzheimer's Association (2020) people with DS are more likely to
experience other symptoms such as a reduction in being social, decreased
enthusiasm for usual activities, a decline in focusing ability, sadness,
fearfulness or anxiety, irritability, uncooperativeness or aggression,
sleep disturbances, adult onset seizures, changes in coordination, and or
increased excitability. CONCLUSION(S): Implications for professionals
include becoming knowledgeable of the signs of AD in clients with DS.
Essential to the planning and implementation of effective medical
interventions as well as programing is the development of medications,
strategies and behavioral supports to ease transitions, the creation of
resources for families and care givers, and the recognition of the growing
demands of older adults with DS. Families are frequently ill prepared for
the increased demands put upon them as a result of AD symptoms in their
loved one with DS. Accessing state, federal, and privately funded services
may be unknown, unavailable, and/or difficult. In addition, proper
diagnosis and reliable information may not be readily available. These
families are often in dire need of sound medical advice, financial,
emotional, respite care, and physical assistance. Copyright ©
2021 the Alzheimer's Association.

<41>
Accession Number
2016750925
Title
Effect of Intensive vs Moderate Alveolar Recruitment Strategies Added to
Lung Protective Ventilation on Postoperative Pulmonary Complications.
Source
Pakistan Journal of Medical and Health Sciences. 16(1) (pp 290-292), 2022.
Date of Publication: January 2022.
Author
Naseer M.; Tabassum R.; Furqan A.
Institution
(Naseer) CMH Lahore Medical and Dental College, Pakistan
(Tabassum) Peoples University of Medical and Health Sciences, Nawabshah,
Pakistan
(Furqan) Dept. of Anaesthesia and ICU, Chaudhry Pervaiz Ellahi Institute
of Cardiology (CPEIC), Multan, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Aim: to establish the effects of intensive alveolar recruitment therapy in
decreasing the post-operative pulmonary complications. Methodology: A
randomized multi centered study was performed with patients in ICU having
hypoxemia after a cardiac surgery. Patients were allocated to two groups
(intensive vs moderate recruitment strategy) with ventilation having small
tidal volume. Severity of post-operative pulmonary complications was
primary outcome. Secondary outcome was duration of stay in hospital and
ICU, hospital mortality and the rate of barotrauma. Result(s): The
pulmonary complication severity score of the intensive and moderate group
patients was 1.58+/-0.91 and 2.10+/-1.01 respectively. The mean ICU stay,
hospital stay and mechanical ventilation in ICU mean of the intensive
group patients was 4.06+/-2.12 days, 10.10+/-3.21 days and 11.26+/-2.80
respectively. While, the mean ICU stay, hospital stay and mechanical
ventilation in ICU mean of the moderate group patients was 4.70+/-2.04
days, 14.09+/-2.99 days and 12.15+/-2.08 respectively. Conclusion(s):
Patients having hypoxemia after a cardiac surgery, intensive alveolar
recruitment therapy proves to be more helpful in decreasing the severity
and occurrence of post-operative pulmonary complications as compared to
moderate alveolar recruitment therapy. Copyright © 2022 Lahore
Medical And Dental College. All rights reserved.

<42>
Accession Number
636989276
Title
24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk.
Source
New England Journal of Medicine. 386(3) (pp 252-263), 2022. Date of
Publication: 20 Jan 2022.
Author
Ma Y.; He F.J.; Sun Q.; Yuan C.; Kieneker L.M.; Curhan G.C.; MacGregor
G.A.; Bakker S.J.L.; Campbell N.R.C.; Wang M.; Rimm E.B.; Manson J.E.;
Willett W.C.; Hofman A.; Gansevoort R.T.; Cook N.R.
Institution
(Ma, Sun, Curhan, Wang, Rimm, Manson, Willett, Hofman, Cook) Departments
of Epidemiology, Brigham and Women's Hospital and Harvard Medical School,
Boston, United States
(Sun, Yuan, Rimm, Willett) Departments of Nutrition, Brigham and Women's
Hospital and Harvard Medical School, Boston, United States
(Sun, Curhan, Rimm, Manson, Willett) The Department of Medicine, And
Channing Division of Network Medicine, Harvard T.H. Chan School of Public
Health, Boston, United States
(Curhan) The Department of Medicine, Renal Division, Brigham and Women's
Hospital and Harvard Medical School, Boston, United States
(Campbell, Manson) The Division of Preventive Medicine, Brigham and
Women's Hospital and Harvard Medical School, Boston, United States
(He, MacGregor) The Wolfson Institute of Population Health, St.
Bartholomew's Hospital and London School of Medicine and Dentistry, Queen
Mary University of London, London, United Kingdom
(Kieneker, Bakker, Gansevoort) The Department of Nephrology, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(Campbell) Departments of Medicine, Community Health Sciences, and
Physiology and Pharmacology, O'Brien Institute of Public Health and Libin
Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB,
Canada
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND The relation between sodium intake and cardiovascular disease
remains controversial, owing in part to inaccurate assessment of sodium
intake. Assessing 24-hour urinary excretion over a period of multiple days
is considered to be an accurate method. METHODS We included
individual-participant data from six prospective cohorts of generally
healthy adults; sodium and potassium excretion was assessed with the use
of at least two 24-hour urine samples per participant. The primary outcome
was a cardiovascular event (coronary revascularization or fatal or
nonfatal myocardial infarction or stroke). We analyzed each cohort using
consistent methods and combined the results using a random-effects
meta-analysis. RESULTS Among 10,709 participants, who had a mean (SD) age
of 51.5}12.6 years and of whom 54.2% were women, 571 cardiovascular events
were ascertained during a median study follow-up of 8.8 years (incidence
rate, 5.9 per 1000 person-years). The median 24-hour urinary sodium
excretion was 3270 mg (10th to 90th percentile, 2099 to 4899). Higher
sodium excretion, lower potassium excretion, and a higher
sodium-to-potassium ratio were all associated with a higher cardiovascular
risk in analyses that were controlled for confounding factors (P<=0.005
for all comparisons). In analyses that compared quartile 4 of the urinary
biomarker (highest) with quartile 1 (lowest), the hazard ratios were 1.60
(95% confidence interval [CI], 1.19 to 2.14) for sodium excretion, 0.69
(95% CI, 0.51 to 0.91) for potassium excretion, and 1.62 (95% CI, 1.25 to
2.10) for the sodium-to-potassium ratio. Each daily increment of 1000 mg
in sodium excretion was associated with an 18% increase in cardiovascular
risk (hazard ratio, 1.18; 95% CI, 1.08 to 1.29), and each daily increment
of 1000 mg in potassium excretion was associated with an 18% decrease in
risk (hazard ratio, 0.82; 95% CI, 0.72 to 0.94). CONCLUSIONS Higher sodium
and lower potassium intakes, as measured in multiple 24-hour urine
samples, were associated in a dose-response manner with a higher
cardiovascular risk. These findings may support reducing sodium intake and
increasing potassium intake from current levels. (Funded by the American
Heart Association and the National Institutes of Health.). Copyright
© 2021 Massachusetts Medical Society.

<43>
Accession Number
636989232
Title
Fractional flow reserve-guided PCI as compared with coronary bypass
surgery.
Source
New England Journal of Medicine. 386(2) (pp 128-137), 2022. Date of
Publication: 13 Jan 2022.
Author
Fearon W.F.; Zimmermann F.M.; de Bruyne B.; Piroth Z.; van Straten A.H.M.;
Szekely L.; Davidavicius G.; Kalinauskas G.; Mansour S.; Kharbanda R.;
Ostlund-Papadogeorgos N.; Aminian A.; Oldroyd K.G.; Al-Attar N.; Jagic N.;
Jan-Henk E.D.; Kala P.; Angeras O.; MacCarthy P.; Wendler O.; Casselman
F.; Witt N.; Mavromatis K.; Miner S.E.S.; Sarma J.; Engstrom T.;
Christiansen E.H.; Tonino P.A.L.; Reardon M.J.; Lu D.; Ding V.Y.;
Kobayashi Y.; Hlatky M.A.; Mahaffey K.W.; Desai M.; Woo Y.J.; Yeung A.C.;
Pijls N.H.J.
Institution
(Fearon) Stanford University School of Medicine, 300 Pas- teur Dr., H2103,
Stanford, CA 94305, United States
(Fearon, Hlatky, Yeung) Division of Cardiovascular Medicine, Stanford
Cardiovascular Institute, United States
(Lu, Ding, Desai) The Quantitative Sciences Unit
(Hlatky) Departments of Health Policy
(Woo) Cardiotho- racic Surgery
(Mahaffey) Stanford University, Stanford Center for Clinical Research,
Department of Medicine, Stanford University School of Medicine, United
States
(Fearon) VA Palo Alto Health Care System, Palo Alto, CA, United States
(Zimmermann, van Straten, Tonino) Catharina Hospital, Eindhoven,
Netherlands
(Jan-Henk, Pijls) Isala Hospital, Zwolle, Netherlands
(de Bruyne, Casselman) Cardio- vascular Center Aalst, Aalst, Belgium
(Aminian) Centre Hospitalier Universitaire de Charleroi, Charleroi,
Belgium
(de Bruyne) Lausanne University Center Hospital, Lausanne, Switzerland
(Piroth, Szekely) Gottsegen National Cardiovascular Center, Budapest,
Hungary
(Davidavicius, Kalinauskas) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Vilnius University, Vilnius University
Hospi- tal Santaros Klinikos, Vilnius, Lithuania
(Mansour) Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
(Davidavicius, Kalinauskas) Southlake Regional Health Centre, Newmarket,
ON, Canada
(Mansour) Oxford University Hospitals NHS Foundation Trust, Oxford, United
Kingdom
(Miner) Golden Jubilee National Hospital, Glasgow, United Kingdom
(Kharbanda) Wythenshawe Hospital, Manchester, United Kingdom
(Oldroyd, Al-Attar) Danderyd University Hospital, Sweden
(Sarma) Karolinska Institutet, Solna, Sweden
(Ostlund-Papadogeorgos) Sahlgrenska University Hospital, Gothenburg,
Sweden
(Ostlund-Papadogeorgos, Witt) Clinical Hospital Centre Zemun, University
of Belgrade, Belgrade, Serbia
(Angeras) Medical Faculty of Masaryk University and University Hospital
Brno, Brno, Czechia
(Jagic) Kings College Hospital, London, United Kingdom
(Kala) The Atlanta VA Healthcare System, Decatur, United States
(MacCarthy, Wendler) Rigshospitalet, Copenhagen, Denmark
(Mavromatis) Aarhus University Hospital, Aarhus, Denmark
(Engstrom) Houston Methodist Hospital, Houston, United States
(Christiansen) Montefiore Medical Center, New York, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Patients with three-vessel coronary artery disease have been
found to have better outcomes with coronary-artery bypass grafting (CABG)
than with percutaneous coronary intervention (PCI), but studies in which
PCI is guided by measurement of fractional flow reserve (FFR) have been
lacking. METHODS In this multicenter, international, noninferiority trial,
patients with three-vessel coronary artery disease were randomly assigned
to undergo CABG or FFR-guided PCI with current-generation
zotarolimus-eluting stents. The primary end point was the occurrence
within 1 year of a major adverse cardiac or cerebrovascular event, defined
as death from any cause, myocardial infarction, stroke, or repeat
revascularization. Noninferiority of FFR-guided PCI to CABG was
prespecified as an upper boundary of less than 1.65 for the 95% confidence
interval of the hazard ratio. Secondary end points included a composite of
death, myocardial infarction, or stroke; safety was also assessed. RESULTS
A total of 1500 patients underwent randomization at 48 centers. Patients
assigned to undergo PCI received a mean (+/-SD) of 3.7+/-1.9 stents, and
those assigned to undergo CABG received 3.4+/-1.0 distal anastomoses. The
1-year incidence of the composite primary end point was 10.6% among
patients randomly assigned to undergo FFR-guided PCI and 6.9% among those
assigned to undergo CABG (hazard ratio, 1.5; 95% confidence interval [CI],
1.1 to 2.2), findings that were not consistent with noninferiority of
FFR-guided PCI (P=0.35 for noninferiority). The incidence of death,
myocardial infarction, or stroke was 7.3% in the FFR-guided PCI group and
5.2% in the CABG group (hazard ratio, 1.4; 95% CI, 0.9 to 2.1). The
incidences of major bleeding, arrhythmia, and acute kidney injury were
higher in the CABG group than in the FFR-guided PCI group. CONCLUSIONS In
patients with three-vessel coronary artery disease, FFR-guided PCI was not
found to be noninferior to CABG with respect to the incidence of a
composite of death, myocardial infarction, stroke, or repeat
revascularization at 1 year. (Funded
byMedtronicandAbbottVascular;FAME3ClinicalTrials.govnumber,NCT02100722.)Copyright © 2022 BMJ Publishing Group. All rights reserved.

<44>
Accession Number
636989169
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) (no pagination), 2022. Article Number: e058216. 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 and Communications, Medical University of
Vienna, Wien, Austria
(Treskatsch, Berger) Department of Anesthesiology and Intensive Care
Medicine, Charite Universitatsmedizin Berlin, Berlin, Germany
Publisher
BMJ Publishing Group
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.

<45>
Accession Number
2015495483
Title
Modalities of Exercise Training in Patients with Extracorporeal Membrane
Oxygenation Support.
Source
Journal of Cardiovascular Development and Disease. 9(2) (no pagination),
2022. Article Number: 34. Date of Publication: February 2022.
Author
Kourek C.; Nanas S.; Kotanidou A.; Raidou V.; Dimopoulou M.; Adamopoulos
S.; Karabinis A.; Dimopoulos S.
Institution
(Kourek, Nanas, Kotanidou, Raidou, Dimopoulou, Dimopoulos) Clinical
Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care
Medicine Department, Evangelismos Hospital, National and Kapodistrian
University of Athens, Athens 106 76, Greece
(Adamopoulos) Heart Failure and Transplant Unit, Onassis Cardiac Surgery
Center, Athens 176 74, Greece
(Karabinis, Dimopoulos) Cardiac Surgery Intensive Care Unit, Onassis
Cardiac Surgery Center, Athens 176 74, Greece
Publisher
MDPI
Abstract
The aim of this qualitative systematic review is to summarize and analyze
the different modalities of exercise training and its potential effects in
patients on extracorporeal membrane oxygenation (ECMO) support. ECMO is an
outbreaking, life-saving technology of the last decades which is being
used as a gold standard treatment in patients with severe cardiac,
respiratory or combined cardiorespiratory failure. Critically ill patients
on ECMO very often present intensive care unit-acquired weakness (ICU-AW);
thus, leading to decreased exercise capacity and increased mortality
rates. Early mobilization and physical therapy have been proven to be safe
and feasible in critically ill patients on ECMO, either as a bridge to
lung/heart transplantation or as a bridge to recovery. Rehabilitation has
beneficial effects from the early stages in the ICU, resulting in the
prevention of ICU-AW, and a decrease in episodes of delirium, the duration
of mechanical ventilation, ICU and hospital length of stay, and mortality
rates. It also improves functional ability, exercise capacity, and quality
of life. Rehabilitation requires a very careful, multi-disciplinary
approach from a highly specialized team from different specialties.
Initial risk assessment and screening, with appropriate physical therapy
planning and exercise monitoring in patients receiving ECMO therapy are
crucial factors for achieving treatment goals. However, more randomized
controlled trials are required in order to establish more appropriate
individualized exercise training protocols. Copyright © 2022 by
the authors. Licensee MDPI, Basel, Switzerland.

<46>
Accession Number
2016739382
Title
Sex is a critical factor in the timing of surgical intervention in men and
women with severe carotid artery disease: Protocol for a systematic review
and meta-analysis.
Source
Italian Journal of Vascular and Endovascular Surgery. 28(4) (pp 125-130),
2021. Date of Publication: 2021.
Author
Sancho C.; Maheswaran M.; Gasbarrino K.; Di Iorio D.; Hales L.; MacKenzie
K.S.; Daskalopoulou S.S.
Institution
(Sancho, Maheswaran, Gasbarrino, Di Iorio, Daskalopoulou) Vascular Health
Unit, Research Institute of the McGill University Health Centre,
Department of Medicine, Faculty of Medicine, McGill University, Montreal,
QC, Canada
(Hales) Medical Library, McGill University Health Centre, Montreal, QC,
Canada
(MacKenzie) Division of Vascular Surgery, Department of Surgery, McGill
University Health Centre, Montreal, QC, Canada
Publisher
Edizioni Minerva Medica
Abstract
Stroke is a leading cause of mortality worldwide among men and women. Sex
differences exist in stroke incidence, mortality, long-term functional
outcomes, and treatment responses. Timing of carotid surgical intervention
is essential in the prevention of strokes, particularly among women.
However, it remains unclear whether sex is a critical factor that
influences surgical wait times. In this protocol we outlined a systematic
review and meta-analysis regarding sex differences in the timing of
surgical intervention among men and women with severe carotid artery
disease, as well as secondary analyses assessing the impact of delayed
intervention on perioperative and postoperative clinical outcomes. Various
electronic databases will be searched: Medline, Embase, The Cochrane
Library, PubMed, CINAHLPlus, Scopus, grey literature, and trial
registries. Search strategies will be designed to identify human (>=18
years) controlled trials, cohort studies, case-control studies, and
cross-sectional studies concerning "sex differences in the timing of
surgical intervention in men and women with severe carotid artery
disease."Apreliminary search strategy was developed for Medline (1946 to
August 3rd, 2020). For primary outcomes, data must involve timing spanning
from symptom onset to surgical intervention in symptomatic individuals, or
timing spanning from first medical contact to surgical intervention in
asymptomatic individuals. Secondary outcomes include effect estimates for
peri-operative and post-operative cardiovascular (including
cerebrovascular) morbidity and mortality, based on timing of intervention.
Pooled analyses will be conducted using the random-effects model.
Publication bias will be assessed by visual inspection of funnel plots and
by Begg's and Egger's statistical tests. Between-studies heterogeneity
will be measured using the I2 test (P<0.10). Sources of heterogeneity will
be explored by sensitivity, subgroup, and meta-regression analyses.
Findings will be shared through scientific conferences and societies,
social media, and consumer advocacy groups. Results will be used to inform
current guidelines for carotid disease management and stroke prevention in
men and women. Copyright © 2021 EDIZIONI MINERVA MEDICA.

<47>
Accession Number
637126971
Title
Evaluation of Rhomboid Intercostal Block in Video-Assisted Thoracic
Surgery: Comparing Three Concentrations of Ropivacaine.
Source
Frontiers in Pharmacology. 12 (no pagination), 2021. Article Number:
774859. Date of Publication: 17 Jan 2022.
Author
Deng W.; Jiang C.-W.; Qian K.-J.; Liu F.
Institution
(Deng, Qian, Liu) Department of Critical Medicine, The First Affiliated
Hospital of Nanchang University, Nanchang, China
(Deng, Qian, Liu) Medical Innovation Center, First Affiliated Hospital of
Nanchang University, Nanchang, China
(Jiang) Department of Anesthesiology and Pain Medicine, The Affiliated
Hospital of Jiaxing University, Jiaxing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Ultrasound-guided rhombic intercostal block (RIB) is a novel
regional block that provides analgesia for patients who have received
video-assisted thoracoscopic surgery (VATS). The anesthetic
characteristics of ultrasound-guided RIB with different concentrations of
ropivacaine are not known. This research primarily hypothesizes that
ultrasound-guided RIB, given in combination with the same volume of
different concentrations of ropivacaine, would improve the whole quality
of recovery-40 (QoR-40) among patients with VATS. Approaches: This
double-blinded, single-center, prospective, and controlled trial
randomized 100 patients undergoing VATS to receive RIB. One hundred
patients who have received elective VATS and satisfied inclusion standards
were fallen into four groups randomly: control group with no RIB and
R<inf>0.2%</inf>, R<inf>0.3%</inf>, and R<inf>0.4%</inf>; they underwent
common anesthesia plus the RIB with ropivacaine at 0.2%, 0.3%, and 0.4% in
a volume of 30 ml. Outcome(s): Groups R<inf>0.2%</inf>,
R<inf>0.3%</inf>, and R<inf>0.4%</inf> displayed great diversities in the
overall QoR-40 scores and QoR-40 dimensions (in addition to psychological
support) by comparing with the control group (Group C) (p < 0.001 for all
contrasts). Groups R<inf>0.3%</inf> and R<inf>0.4%</inf> displayed great
diversities in the overall QoR-40 scores and QoR-40 dimensions (in
addition to psychological support) by comparing with the R<inf>0.2%</inf>
group (p < 0.001 for all contrasts). The overall QoR-40 scores and QoR-40
dimensions [physical comfort (p = 0.585)] did not vary greatly between
Groups R<inf>0.3%</inf> and R<inf>0.4%</inf> (p > 0.05 for all contrasts).
Groups R<inf>0.2%</inf>, R<inf>0.3%</inf>, and R<inf>0.4%</inf> showed
significant differences in numerical rating scales (NRS) score region
under the curve (AUC) at rest and on movement in 48 h when compared with
the Group C (p < 0.001 for all contrasts). Groups R<inf>0.3%</inf> and
R<inf>0.4%</inf> displayed great diversities in NRS score AUC at rest and
on movement in 48 h when compared with the R<inf>0.2%</inf> group (p <
0.001 for all contrasts). The NRS mark AUC at rest and, on movement in 48
h, did not vary greatly between the Group R<inf>0.3%</inf> and
R<inf>0.4%</inf> (p > 0.05 for all contrasts). Conclusion(s): In this
study it was found that a dose of 0.3% ropivacaine is the best
concentration for RIB for patients undergoing VATS. Through growing
ropivacaine concentration, the analgesia of the RIB was not improved
greatly. Clinicaltrials.gov Registration: https://clinicaltrials.gov/,
identifier ChiCTR2100046254. Copyright © 2022 Deng, Jiang, Qian
and Liu.

<48>
Accession Number
2016673212
Title
New Perspectives in the Treatment of Acute and Chronic Heart Failure with
Reduced Ejection Fraction.
Source
Journal of Cardiovascular Emergencies. 7(4) (pp 88-99), 2021. Date of
Publication: 01 Dec 2021.
Author
Statescu C.; Sascau R.; Clement A.; Anghel L.
Institution
(Statescu, Sascau, Clement, Anghel) Prof. Dr. George I.M. Georgescu
Cardiovascular Diseases Institute, Iasi, Romania
(Statescu, Sascau, Anghel) Grigore T. Popa University of Medicine and
Pharmacy, Iasi, Romania
Publisher
De Gruyter Open Ltd
Abstract
Acute and chronic heart failure with reduced ejection fraction (HFrEF) is
a major public health problem, studies showing a 25% survival rate at 5
years after hospitalization. If left untreated, it is a common and
potentially fatal disease. In recent years, the medical and device
therapies of patients with HFrEF have significantly improved. The aim of
our review is to provide an evidence-based update on new therapeutic
strategies in acute and chronic settings, to prevent hospitalization and
death in patients with HFrEF. We performed a systematic literature search
on PubMed, EMBASE, and the Cochrane Database of Systemic Reviews, and we
included a number of 23 randomized controlled trials published in the last
30 years. The benefit of beta-blockers and renin-angiotensin-aldosterone
system inhibitors in patients with HFrEF is well known. Recent
developments, such as sodium-glucose cotransporter 2 inhibitors,
vericiguat, transcatheter mitral valve repair, wireless pulmonary artery
pressure monitor and cardiac contractility modulation, have also proven
effective in improving prognosis. In addition, other new therapeutic
agents showed encouraging results, but they are currently being studied.
The implementation of personalized disease management programs that
directly target the cause of HFrEF is crucial in order to improve
prognosis and quality of life for these patients. Copyright ©
2021 Cristian Statescu., published by Sciendo.

<49>
Accession Number
637168381
Title
Serum biomarkers of brain injury after uncomplicated cardiac surgery:
Secondary analysis from a randomized trial.
Source
Acta anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 04 Feb 2022.
Author
Barbu M.; Jonsson K.; Zetterberg H.; Blennow K.; Kolsrud O.; Ricksten
S.-E.; Dellgren G.; Bjork K.; Jeppsson A.
Institution
(Barbu, Dellgren, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Barbu) Department of Cardiology, Blekinge Hospital, Karlskrona, Sweden
(Jonsson, Kolsrud, Dellgren, Bjork, Jeppsson) Department of Cardiothoracic
Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
(Zetterberg, Blennow) Clinical Neurochemistry Laboratory, Sahlgrenska
University Hospital, Molndal, Sweden
(Zetterberg, Blennow) Department of Psychiatry and Neurochemistry,
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University
of Gothenburg, Molndal, Sweden
(Zetterberg) Department of Neurodegenerative Disease, UCL Institute of
Neurology, London, United Kingdom
(Zetterberg) UK Dementia Research Institute at UCL, London, United Kingdom
(Ricksten) Department of Cardiothoracic Anesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Ricksten) Department of Anesthesiology and Intensive Care, Institute of
Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative cognitive dysfunction is common after cardiac
surgery. Postoperative measurements of brain injury biomarkers may
identify brain damage and predict cognitive dysfunction. We describe the
release patterns of five brain injury markers in serum and plasma after
uncomplicated cardiac surgery. METHOD(S): Sixty-one elective cardiac
surgery patients were randomized to undergo surgery with either a
dextran-based prime or a crystalloid prime. Blood samples were taken
immediately before surgery, and 2 and 24 hours after surgery.
Concentrations of the brain injury biomarkers S100B, glial fibrillary
acidic protein (GFAP), tau, neurofilament light (NfL) and neuron-specific
enolase (NSE)) and the blood-brain barrier injury marker beta-trace
protein were analyzed. Concentrations of brain injury biomarkers were
correlated to patients' age, operation time, and degree of hemolysis.
 RESULT(S): No significant difference in brain injury biomarkers was
observed between the prime groups. All brain injury biomarkers increased
significantly after surgery (tau +456% (25th-75th percentile 327%-702%),
NfL +57% (28%-87%), S100B +1145% (783%-2158%), GFAP +17% (-3%-43%), NSE
+168% (106%-228%), while beta-trace protein was reduced (-11% (-17-3%).
Tau, S100B and NSE peaked at 2h, NfL and GFAP at 24h. Postoperative
concentrations of brain injury markers correlated to age, operation time,
and/or hemolysis. CONCLUSION(S): Uncomplicated cardiac surgery with
cardiopulmonary bypass is associated with an increase in serum/plasma
levels of all the studied injury markers, without signs of blood-brain
barrier injury. The biomarkers differ markedly in their levels of release
and time course. Further investigations are required to study associations
between perioperative release of biomarkers, postoperative cognitive
function and clinical outcome. Copyright This article is protected by
copyright. All rights reserved.

<50>
Accession Number
2014459740
Title
Application effect of dexmedetomidine combined with flurbiprofen axetil
and flurbiprofen axetil monotherapy in radical operation of lung cancer
and evaluation of the immune function.
Source
Journal of B.U.ON.. 26(4) (pp 1432-1439), 2021. Date of Publication: July
2021.
Author
Zong S.; Du J.; Chen Y.; Tao H.
Institution
(Zong, Du, Chen, Tao) Department of Anesthesiology, Tengzhou Central
People's Hospital, Tengzhou, China
Publisher
Zerbinis Publications
Abstract
Purpose: To explore the effect of dexmedetomidine combined with
flurbiprofen axetil on postoperative analgesia and immune function in
patients with lung cancer after radical operation. Method(s): 60 lung
cancer patients undergoing open chest radical surgery were selected and
randomly divided into D & F Group (dexmedetomidine combined with
flurbiprofen axetil) and F Group (flurbiprofen axetil), with 30 cases in
each group. Before induction of general anesthesia, Group F was
administered intravenous flurbiprofen axetil, and in D & F group,
dexmedetomidine and erfuorbiprofen axetil were injected. Result(s):
At T2 (intubation) and T3 (extubation), map and HR in D & F group were
significantly lower than those in F group (p<0.05). The extubation quality
score of D & F group was significantly lower than that of F group
(p<0.05). At 6 h and 12 h after operation, visual analogue scale (VAS)
score and Bruggrmann comfort scale (BCS) score of D & F group were
significantly lower than that of F group (p<0.05). The dosage of
sufentanil and the times of pressing analgesia pump in group D & F were
significantly less than those in group F (p<0.05). NK cells, CD3 + T cells
and CD4 + / CD8 + in the D & F group were significantly higher than those
in F group at 12h, 24h, 48 h and 1 week after operation (p<0.05).
 Conclusion(s): Flurbiprofen axetil can improve postoperative pain,
but combined with dexmedetomidine better effect, postoperative comfort and
immune function of patients were significantly improved. Copyright
© 2021 Zerbinis Publications. All rights reserved.

<51>
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
©

<52>
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.

<53>
[Use Link to view the full text]
Accession Number
2016509269
Title
Effect of Perioperative Intravenous Iron Supplementation for Complex
Cardiac Surgery on Transfusion Requirements: A Randomized, Double-blinded
Placebo-controlled Trial.
Source
Annals of Surgery. 275(2) (pp 232-239), 2022. Date of Publication: 01 Feb
2022.
Author
Song J.W.; Soh S.; Shim J.-K.; Lee S.; Lee S.H.; Kim H.B.; Kim M.-Y.; Kwak
Y.L.
Institution
(Song, Soh, Shim, Kim, Kim, Kwak) Department of Anesthesiology and Pain
Medicine, Seoul, South Korea
(Song, Soh, Shim, Kim, Kwak) Anesthesia and Pain Research Institute,
Seoul, South Korea
(Lee, Lee) Department of Thoracic and Cardiovascular Surgery, Yonsei
University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, South
Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives:We investigated whether routine perioperative intravenous iron
replenishment reduces the requirement for packed erythrocytes (pRBC)
transfusion.Summary of Background Data:Patients undergoing complex cardiac
surgery are at high risk of developing postoperative iron deficiency
anemia, thus requiring transfusion, which is associated with adverse
outcomes. Method(s):Patients were randomized to receive either ferric
derisomaltose 20 mg/kg (n = 103) or placebo (n = 101) twice during the
perioperative period: 3 days before and after the surgery. The primary
endpoint was the proportion of patients who received pRBC transfusion
until postoperative day (POD) 10. Hemoglobin, reticulocyte count, serum
iron profile, hepcidin, and erythropoietin were serially measured.
 Result(s):pRBC was transfused in 60.4% and 57.2% of patients in the
control and iron group, respectively (P = 0.651). Hemoglobin concentration
at 3 weeks postoperatively was higher in the iron group than in the
control group (11.6 +/- 1.5 g/dL vs 10.9 +/- 1.4 g/dL, P < 0.001). The
iron group showed higher reticulocyte count [205
(150-267)x103/muL vs 164 (122-207)x103/muL, P =
0.003] at POD 10. Transferrin saturation and serum ferritin were
significantly increased in the iron group than in the control group (P <
0.001). Serum hepcidin was higher in the iron group than in the control
group at POD 3 [106.3 (42.9-115.9) ng/mL vs 39.3 (33.3-43.6) ng/mL, P <
0.001]. Erythropoietin concentration increased postoperatively in both
groups (P = 0.003), with no between-group difference.
 Conclusion(s):Intravenous iron supplementation during index
hospitalization for complex cardiac surgery did not minimize pRBC
transfusion despite replenished iron store and augmented erythropoiesis,
which may be attributed to enhanced hepcidin expression. Copyright
© 2022 Lippincott Williams and Wilkins. All rights reserved.

<54>
Accession Number
2016560130
Title
Direct Oral Anticoagulants in Patients with Atrial Fibrillation and
Bioprosthetic Valves A Systematic Review and Meta-Analysis.
Source
Journal of Innovations in Cardiac Rhythm Management. 12(12) (pp
4797-4805), 2021. Date of Publication: December 2021.
Author
Ruzieh M.; Wolbrette D.L.; Naccarelli G.V.
Institution
(Ruzieh) Division of Cardiovascular Medicine, University of Florida
College of Medicine, 4037 NW 86th Terrace, Gainesville, FL 32606, United
States
(Wolbrette, Naccarelli) Division of Cardiology, Penn State Heart and
Vascular Institute, Penn State College of Medicine, Hershey, PA, United
States
Publisher
MediaSphere Medical LLC
Abstract
Oral anticoagulation is recommended for patients with atrial fibrillation
and an elevated stroke risk. Direct oral anticoagulants (DOACs) are
generally preferred over vitamin K antagonists. Nonetheless, there
controversy persists regarding whether DOACs should be used in patients
with atrial fibrillation and bioprosthetic valves. Therefore, we conducted
this systematic review and meta-Analysis to assess the safety and efficacy
of DOACs compared to warfarin in this patient population. We performed a
systematic search of the MEDLINE and PubMed Central databases for relevant
articles. The incidence rate and risk ratio (RR) of all-cause mortality,
cardiovascular mortality, ischemic stroke/systemic thromboembolism,
hemorrhagic stroke/ intracranial bleeding, major bleeding, and minor
bleeding were calculated. A total of eight studies were included,
including 5,300 patients (stratified as 1,638 patients in the DOAC arm and
3,662 patients in the warfarin arm). There was no significant difference
in the rate of stroke/systemic thromboembolism [RR: 0.85; 95% confidence
interval (CI): 0.43 1.69], all-cause mortality (RR: 0.77; 95% CI: 0.53
1.11), or cardiovascular death (RR: 0.81; 95% CI: 0.40 1.63) between DOACs
and warfarin. Major bleeding and hemorrhagic stroke/intracranial bleeding
were similar between both treatment arms (RR: 0.61; 95% CI: 0.35 1.06 and
RR: 0.27; 95% CI: 0.06 1.13, respectively). In conclusion, DOACs are safe
and effective in patients with atrial fibrillation and bioprosthetic
valves. Future large-scale randomized studies are warranted to confirm
this observation. Copyright © 2021 MediaSphere Medical LLC. All
Rights Reserved.

<55>
Accession Number
2016559805
Title
Effect of Pentoxifylline on Claudication Distances And Lipid Profile In
Patients With Occlusive Peripheral Arterial Disease.
Source
JK Practitioner. 26(2) (pp 44-51), 2021. Date of Publication: April 2021.
Author
Singh S.; Singh G.
Institution
(Singh) Department of Clinical Pharmacology, SKIMS, Srinagar, India
(Singh) Department of Cardiothoracic and Vascular surgery, GMC Jammu,
India
Publisher
JK Practitioner
Abstract
Objective: To study the efficacy and tolerability of pentoxifylline in
patients with moderately severe peripheral arterial disease.
 Method(s): This is a prospective, randomized, open-label, parallel
study conducted at the Postgraduate Department of Pharmacology and
Therapeutics in collaboration with Cardiothoracic and Vascular Surgery
department Govt. Medical College Jammu for a period of one year. After
fulfilling the eligibility criteria, patients were divided into groups
after proper randomization; one group was administered tablet
pentoxifylline 400mg three times a day whereas another was assigned
matched tablet of placebo. Clinical evaluation was carried out by complete
history, general physical examination, systemic examination, baseline
investigations and lipid profile. Special investigations like color
Doppler study and angiography of lower limb vessels was also done.
Patients were followed up at every 2, 4, 6, 8, 10 and 12 weeks.
 Result(s): Out of 51 patients, 26 were administered pentoxifylline
400mg three times a day and 25 were administered placebo. Pentoxifyllne
significantly raised both initial as well as absolute claudication
distances, which remained well sustained throughout all the weeks of
follow up, whereas, placebo raised the claudication distances for initial
few weeks, but decreased it below the baseline subsequently. There was
almost no statistically significant difference between patient's
assessment and physician's assessment between two groups, and except for
pharyngitis, which was significantly more in pentoxifylline treated
patients, there was no significant difference in other side effects
between two groups. Conclusion(s): Pentoxifylline can be an effective
treatment for patients of peripheral arterial disease with claudication.
However, long term controlled randomized trials on large scale are
recommended to further substantiate our findings. Copyright ©
2021 JK Practitioner. All rights reserved.

<56>
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.

<57>
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

<58>
Accession Number
635885650
Title
A Systematic Review and Pooled Prevalence of Delirium in Critically Ill
Children.
Source
Critical care medicine. 50(2) (pp 317-328), 2022. Date of Publication: 01
Feb 2022.
Author
Semple D.; Howlett M.M.; Strawbridge J.D.; Breatnach C.V.; Hayden J.C.
Institution
(Semple, Howlett, Strawbridge) Pharmacy Department, Children's Health
Ireland, Crumlin, Dublin, Ireland
(Semple, Howlett, Hayden) School of Pharmacy and Biomolecular Sciences,
Royal College of Surgeons in Ireland, Dublin, Ireland
(Breatnach) Department of Intensive Care, Children's Health Ireland,
Crumlin, Dublin, Ireland
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Pediatric delirium is a neuropsychiatric disorder with
disrupted cerebral functioning due to underlying disease and/or critical
care treatment. Pediatric delirium can be classified as hypoactive,
hyperactive, and mixed. This systematic review was conducted to estimate
the pooled prevalence of pediatric delirium using validated assessment
tools in children (Cornell Assessment of Pediatric Delirium, Pediatric
Confusion Assessment Method for the ICU, PreSchool Confusion Assessment
Method for the ICU, Pediatric Confusion Assessment Method for the ICU
Severity Scale, and Sophia Observation Withdrawal Symptoms Pediatric
Delirium scale), identify modifiable and nonmodifiable risk factors, and
explore the association of pediatric delirium with clinical outcomes. DATA
SOURCES: A systematic search of PubMed, EMBASE, and CINAHL databases was
undertaken for full articles pertaining to pediatric delirium prevalence.
STUDY SELECTION: No language or date barriers were set. Studies were
included where the following eligibility criteria were met: study design
aimed to estimate pediatric delirium prevalence arising from treatment in
the intensive care setting, using a validated tool. Only randomized
controlled trials, cross-sectional studies, or cohort studies allowing an
estimate of the prevalence of pediatric delirium were included. DATA
EXTRACTION: Data were extracted by the primary researcher (D.S.) and
accuracy checked by coauthors. DATA SYNTHESIS: A narrative synthesis and
pooled prevalence meta-analysis were undertaken. CONCLUSION(S):
Pediatric delirium, as determined by the Cornell Assessment of Pediatric
Delirium score, is estimated to occur in 34% of critical care admissions.
Eight of 11 studies reporting on subtype identified hypoactive delirium as
most prevalent (46-81%) with each of the three remaining reporting either
hyperactive (44%), mixed (57%), or equal percentages of hypoactive and
mixed delirium (43%) as most prevalent. The development of pediatric
delirium is associated with cumulative doses of benzodiazepines, opioids,
the number of sedative classes used, deep sedation, and cardiothoracic
surgery. Increased time mechanically ventilated, length of stay,
mortality, healthcare costs, and associations with decreased quality of
life after discharge were also found. Multi-institutional and longitudinal
studies are required to better determine the natural history, true
prevalence, long-term outcomes, management strategies, and financial
implications of pediatric delirium. Copyright © 2021 by the
Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All
Rights Reserved.

<59>
Accession Number
637015901
Title
Transcatheter Aortic Valve Implantation With or Without Predilation: A
Meta-Analysis.
Source
The Journal of invasive cardiology. 34(2) (pp E104-E113), 2022. Date of
Publication: 01 Feb 2022.
Author
Conrotto F.; D'Ascenzo F.; Franchin L.; Bruno F.; Mamas M.A.; Toutouzas
K.; Cuisset T.; Leclercq F.; Dumonteil N.; Latib A.; Nombela-Franco L.;
Schaefer A.; Anderson R.D.; Marruncheddu L.; Gallone G.; De Filippo O.; La
Torre M.; Rinaldi M.; Omede P.; Salizzoni S.; De Ferrari G.M.
Institution
(D'Ascenzo) Division of Cardiology, Department of Medical Science,
University of Turin, Corso Bramante 88/90, Turin, Italy
Publisher
NLM (Medline)
Abstract
AIMS: To evaluate the impact of systematic predilation with balloon aortic
valvuloplasty (BAV) on transcatheter aortic valve implantation (TAVI).
METHODS AND RESULTS: We performed a systematic meta-analysis investigating
patients undergoing TAVI with systematic BAV vs no BAV in RCT or in
adjusted studies. Device success was the primary endpoint, while all-cause
mortality, 30-day moderate/severe aortic regurgitation (AR), stroke,
permanent pacemaker implantation (PPI) and acute kidney injury (AKI) were
the secondary endpoints. Subanalysis according to design of the study (RCT
and adjusted analysis) and to the type of valve (balloon-expandable [BE]
vs self-expanding [SE]) were conducted. We obtained data from 15 studies,
comprising 16,408 patients: 10,364 undergoing BAV prior to TAVI and 6,044
in which direct TAVI has been performed. At 30-day follow-up, BAV did not
improve the rate of device success in the overall population (OR, 1.09;
95% CI, 0.90-1.31), both in SE (OR, 0.93; 95% CI, 0.60-1.45) and in BE
(OR, 1.16; 95% CI, 0.88-1.52) valves. Between BAV and direct TAVI, no
differences in secondary outcomes were observed neither in overall
population nor according to valve type between BAV and direct TAVI
strategies. All endpoints results were consistent between RCTs and
adjusted studies except for postdilation rate that did not differ in
observational studies (OR, 0.70; 95% CI, 0.47-1.04), while it was lower in
BAV when only RCTs were included in the analysis (OR, 0.48; 95% CI,
0.24-0.97). CONCLUSION(S): Direct TAVI is feasible and safe compared
to predilation approach with similar device success rates and clinical
outcomes. Direct TAVI could represent a first-choice approach in
contemporary TAVI procedures.

<60>
Accession Number
637009311
Title
Restrictive or liberal transfusion for cardiac surgery: Spanish results of
a randomized multicenter international parallel open-label clinical trial.
Source
Medicina intensiva. 46(1) (pp 53-57), 2022. Date of Publication: 01 Jan
2022.
Author
Galan J.; Mateo E.; Carmona P.; Gajate L.; Mazer C.D.; Martinez-Zapata
M.J.
Institution
(Galan) Department of Anesthesia, Hospital de la Santa Creu I Sant Pau,
Barcelona, Spain
(Mateo) Department of Anesthesia, Consorcio Hospital General de Valencia,
Valencia, Spain
(Carmona) Department of Anesthesia, Hospital Universitario y Politecnico
La Fe de Valencia, Valencia, Spain
(Gajate) Department of Anesthesia, Hospital Ramon y Cajal, Madrid, Spain
(Mazer) Department of Anesthesia and LKSKI of Saint Michael's Hospital,
University of Toronto, Toronto, Canada
(Martinez-Zapata) Iberoamerican Cochrane-Centre-Clinical Epidemiology and
Health Service.IIB Sant Pau. CIBERESP, Barcelona, Spain
Publisher
NLM (Medline)

<61>
Accession Number
2014636633
Title
Commentary: Prevention of saphenous vein graft disease remains elusive.
Source
Journal of Cardiac Surgery. 37(3) (pp 571-573), 2022. Date of Publication:
March 2022.
Author
Hays N.M.; Balsam L.B.
Institution
(Hays) Department of Surgery, University of Massachusetts Chan Medical
School, Worcester, MA, United States
(Balsam) Division of Cardiac Surgery, UMass Memorial Medical Center,
Worcester, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
One-year outcomes of Ticagrelor Antiplatelet Therapy to Reduce Graft
Events and Thrombosis (TARGET), a randomized double-blinded clinical trial
comparing post-coronary artery bypass surgery antiplatelet therapy with
ticagrelor versus aspirin are published in this issue of the Journal.
Although the authors did not detect statistically significant differences
in their primary outcome (saphenous vein graft patency at 1 year) and
major adverse cardiovascular events, their findings must be interpreted
with caution given important limitations in the design and execution of
the trial. Copyright © 2022 Wiley Periodicals LLC

<62>
Accession Number
2014419930
Title
Effect of physical manipulation pulmonary rehabilitation on lung cancer
patients after thoracoscopic lobectomy.
Source
Thoracic Cancer. 13(3) (pp 308-315), 2022. Date of Publication: February
2022.
Author
Zhou T.; Sun C.
Institution
(Zhou) Thoracic surgery Department, Beijing Hospital, National Center of
Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
(Sun) Nursing Department, Beijing Hospital, National Center of
Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: To introduce a new postoperative pulmonary rehabilitation
program named physical manipulation pulmonary rehabilitation (PMPR) and to
explore the effect of perioperative management, including PMPR, on
patients with non-small cell lung cancer (NSCLC) after thoracoscopic
lobectomy. Method(s): A randomized controlled trial was conducted
between April and June 2021 at the Department of Thoracic Surgery, Beijing
Hospital. Adult patients with NSCLC who had undergone thoracoscopic
lobectomy were allocated to the treatment and control groups using a
random number table. The treatment group received both conventional
pulmonary rehabilitation (CVPR) and 14 days of PMPR after surgery; the
control group patients received CVPR only. PMPR included relaxing and
exercising the intercostal muscles, thoracic costal joint and abdominal
breathing muscles. Pulmonary function tests and the 6-min walk test were
conducted preoperatively and 7, 14, 21 and 28 days postoperatively. The
postoperative length of hospital stay, chest tube retention time and
postoperative pulmonary complications were recorded. The baseline data,
pulmonary function parameters and prognosis were compared with t- and
chi-square tests between the two groups. Result(s): A total of 86
patients were enrolled, and 44 patients were allocated to the treatment
group. There were no significant differences in the baseline data for age,
sex, body mass index, basic disease, surgical plan or preoperative
pulmonary function between the two groups (all p > 0.05). The peak
expiratory flow of patients in the treatment group was higher than that of
those in the control group 21 days after surgery (316 +/- 95 vs. 272 +/-
103 l/min, respectively, p = 0.043), and forced expiratory volume in the
first second on day 28 after surgery was greater than that in the control
group (2.1 +/- 0.2 vs. 1.9 +/- 0.3 L, respectively, p < 0.001). There were
no significant differences in forced vital capacity or 6-min walk test
scores (both p > 0.05). There were no significant differences in the
incidences of pneumonia and atelectasis between the two groups (both p >
0.05). The postoperative length of hospital stay (3.3 +/- 1.3 vs. 3.9 +/-
1.5 days, p = 0.043) and chest tube retention time (66 +/- 30 vs. 81 +/-
35 h, p = 0.036) in the treatment group were shorter than those in the
control group. Conclusion(s): We determined that PMPR could improve
early lung function in patients with NSCLC after thoracoscopic lobectomy,
and that chest tube retention time and length of hospital stay were
shortened. Copyright © 2021 The Authors. Thoracic Cancer
published by China Lung Oncology Group and John Wiley & Sons Australia,
Ltd.

<63>
Accession Number
2014325523
Title
Improving respiratory outcomes after pediatric cardiac surgery: New uses
for nitric oxide.
Source
Journal of Cardiac Surgery. 37(3) (pp 552-554), 2022. Date of Publication:
March 2022.
Author
Scharoun J.H.
Institution
(Scharoun) Department of Anesthesiology, Weill Cornell Medicine, New
York-Presbyterian Hospital, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: This month's issue of Journal of Cardiac Surgery features a
retrospective study on the effect of combining inhaled nitric oxide with
high frequency oscillator ventilation to rescue infants who have failed
conventional ventilation after congenital heart surgery. Aim(s): This
commentary aims to place that study within the context of available
published literature on the topic. Material(s) and Method(s): The
PubMed database was queried for all English-language entries between 1995
and 2021 with the terms nitric oxide, congenital heart disease,
oscillator, and respiratory failure. The results were then assessed for
relevance and impact by the author. Result(s): From these results, 15
articles were selected for use in this review. The cost of prolonged
mechanical ventilation is described. The use of nitric oxide has been used
to improve outcomes in hypoxic respiratory failure. High-frequency
oscillator ventilation has also been studied in pediatric patients with
ARDS. To date, no studies have been published showing the benefit of
combining these two modalities in pediatric cardiac surgical patients.
 Discussion(s): The results of this month's study on nitric oxide and
high frequency oscillator ventilation are placed in the context of current
literature and suggestions for further study are presented.
 Conclusion(s): Pediatric patients with hypoxic respiratory failure
following congenital heart surgery have a new treatment strategy that
appears effective. Further studies to confirm this should be
undertaken. Copyright © 2021 Wiley Periodicals LLC

<64>
Accession Number
2013353695
Title
Myocardial protective and anti-inflammatory effects of dexmedetomidine in
patients undergoing cardiovascular surgery with cardiopulmonary bypass: a
systematic review and meta-analysis.
Source
Journal of Anesthesia. 36(1) (pp 5-16), 2022. Date of Publication:
February 2022.
Author
Chen M.; Li X.; Mu G.
Institution
(Chen, Li) Department of Anesthesiology, Shehong People's Hospital, NO.
19, Guanghan road, Sichuan, Shehong 629200, China
(Mu) Department of Anesthesiology, Zigong Fourth People's Hospital,
Sichuan, Zigong, China
Publisher
Springer Japan
Abstract
Cardiopulmonary bypass (CPB) technology provides potential for cardiac
surgery, but it is followed by myocardial injury and inflammation related
to ischemia-reperfusion. This meta-analysis aimed to systematically
evaluate the cardioprotective effect of dexmedetomidine on cardiac surgery
under CPB and its effect on accompanied inflammation. PubMed, Cochrane
Library, EMBASE and Web of Science databases were comprehensively searched
for all randomized controlled trials (RCTs) published before April 1st,
2021 that explored the application of dexmedetomidine in cardiac surgery.
Compared with the control group (group C), the concentrations of CK-MB in
the perioperative period and cTn-I at 12 h and 24 h after operation in
dexmedetomidine group (group D) were significantly decreased (P < 0.05).
In addition, in group D, the levels of interleukin-6 at 24 h after
operation, tumor necrosis factor-a at the 12 h and 24 h after operation
were significantly decreased (P < 0.05). At the same time, the length of
Intensive Care Unit stay in group D was significantly shorter than group C
(P < 0.05). However, there was no significant difference in interleukin-10
level, C reactive protein level, the time on ventilator and length of
hospital stay between the two groups (P > 0.05). The application of
dexmedetomidine in cardiac surgery with CPB can reduce CK-MB and cTn-I
concentration and interleukin-6, tumor necrosis factor-alpha levels to a
certain extent and shorten the length of Intensive Care Unit stay, but it
has no significant effect on IL-10 level, C reactive protein level, the
time on ventilator and length of hospital stay. Copyright © 2021,
Japanese Society of Anesthesiologists.

<65>
Accession Number
635517497
Title
Geographical variations in left main coronary artery revascularisation: a
prespecified analysis of the EXCEL trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
17(13) (pp 1081-1090), 2022. Date of Publication: 28 Jan 2022.
Author
Myat A.; Hildick-Smith D.; de Belder A.J.; Trivedi U.; Crowley A.; Morice
M.-C.; Kandzari D.E.; Lembo N.J.; Brown W.M.; Serruys P.W.; Kappetein
A.P.; Sabik J.F.; Stone G.
Institution
(Myat, Hildick-Smith, de Belder, Trivedi) Sussex Cardiac Centre, Brighton
and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
(Myat) Division of Clinical and Experimental Medicine, Brighton and Sussex
Medical School, Brighton, United Kingdom
(Crowley, Lembo, Stone) Clinical Trials Centre, Cardiovascular Research
Foundation, NY, NY, United States
(Morice) Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Kandzari, Brown) Piedmont Heart Institute, Atlanta, United States
(Lembo) NewYork-Presbyterian Hospital/Columbia University Medical Center,
NY, NY, United States
(Serruys) Department of Cardiology, National University of Ireland Galway
(NUIG), Galway, Ireland
(Serruys) Department of Cardiology, Imperial College London, London,
United Kingdom
(Kappetein) Thoraxcentre, Erasmus Medical Centre, Rotterdam, Netherlands
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
USA
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, NY, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The EXCEL trial reported similar five-year rates of the
primary composite outcome of death, myocardial infarction (MI), or stroke
after percutaneous coronary intervention (PCI) compared with coronary
artery bypass grafting (CABG) for treatment of obstructive left main
coronary artery disease (LMCAD). AIMS: We sought to determine whether
these outcomes remained consistent regardless of geography of enrolment.
 METHOD(S): We performed a prespecified subgroup analysis based on
regional enrolment. RESULT(S): Among 1,905 patients randomised to PCI
(n=948) or CABG (n=957), 1,075 (56.4%) were recruited at 52 European Union
(EU) centres, and 752 (39.5%) were recruited at 67 North American (NA)
centres. EU versus NA patients varied according to numerous baseline
demographics, anatomy, pharmacotherapy and procedural characteristics.
Nonetheless, the relative rates of the primary endpoint after PCI versus
CABG were consistent across EU versus NA centres at 30 days and 5 years.
However, NA participants had substantially higher late rates of
ischaemia-driven revascularisation (IDR) after PCI, driven predominantly
by the need for greater target vessel and lesion revascularisation. This
culminated in a significant difference in the relative risk of the
secondary composite outcome of death, MI, stroke, or IDR at 5 years
(pinteraction=0.02). CONCLUSION(S): In the EXCEL trial, the relative
risks for the 30-day and five-year primary composite outcome of death, MI
or stroke after PCI versus CABG were consistent irrespective of geography.
However, five-year rates of IDR after PCI were significantly higher in NA
centres, a finding the Heart Team and patients should consider when making
treatment decisions. ClinicalTrials.gov identifier: NCT01205776.

<66>
Accession Number
637143425
Title
Eligibility criteria perpetuate disparities in enrollment and
participation in pancreatic cancer clinical trials.
Source
Cancer Epidemiology Biomarkers and Prevention. Conference: 14th AACR
Conference on the Science of Cancer Health Disparities in Racial/Ethnic
Minorities and the Medically Underserved. Virtual. 31(1 SUPPL) (no
pagination), 2022. Date of Publication: January 2022.
Author
Riner A.N.; Girma S.; Skoro N.; Gal T.S.; Herremans K.M.; Mukhopadhyay N.;
Vudatha V.; Raman S.; George T.; Trevino J.G.
Institution
(Riner, Herremans, George) University of Florida, Gainesville, FL, United
States
(Girma, Skoro, Gal, Mukhopadhyay, Vudatha, Raman, Trevino) Virginia
Commonwealth University, Richmond, VA, United States
Publisher
American Association for Cancer Research Inc.
Abstract
Introduction: Clinical trials determine efficacy and safety of cancer
therapeutics and set the standard of care. Inequitable representation of
participants leaves gaps in our knowledge, limits opportunities to
investigational therapeutics and subsequently perpetuates disparities in
survivorship. Clinical trial eligibility criteria have been postulated to
differentially impact certain racial/ethnic groups which have higher
prevalence of infectious and chronic diseases. We aimed to determine the
impact of eligibility criteria on disparities in pancreatic cancer
clinical trial candidacy. Method(s): Common eligibility criteria for
Phase 2 and 3 pancreatic cancer trials listed in clinicaltrials.gov were
compiled for simulation of a clinical trial screening process. Patients
with pancreatic ductal adenocarcinoma who sought care at VCU Massey Cancer
Center (Richmond, VA) from 2010-2019 were included. Clinical variables
pertaining to eligibility criteria were obtained from billing codes and
discrete values in the medical record. Inclusion/exclusion criteria were
applied to determine overall eligibility and for individual criterion.
Chi-squared tests were utilized to identify statistically significant
differences in patient eligibility between racial groups. Result(s):
A total of 676 patients with pancreatic cancer were identified, with Black
(42%) and White (52%) patients comprising the majority of the patient
population. Black patients were significantly more likely than White
patients to be deemed ineligible based on Creatinine (6.08% vs 2.27%, p =
0.036), HIV (3.136% vs 0.286%, p = 0.01), Hepatitis B (1.742% vs 0%, p =
0.043), and Hepatitis C (9.06 vs 3.43%, p = 0.005). Black patients were
also more likely to be ineligible based on Albumin (12.45% vs 7.47%, p =
0.076), history of coronary stenting in the past 6 months (1.39% vs 0%, p
= 0.087), and uncontrolled diabetes (8.96% vs 6.07%, p = 0.244), although
differences in these criteria did not achieve statistical significance at
5% level. History of prior cancer treatment was the only variable that
excluded less Black patients than White patients (9.06% vs 14.0%, p =
0.072) and was attributable to more White patients initiating neoadjuvant
chemotherapy for their pancreatic cancer prior to seeking care at VCU.
After applying all criteria, Black patients were more likely to be
ineligible for participation compared to White patients (42.0% vs 33.3%, p
= 0.039). Conclusion(s): Standard pancreatic cancer clinical trial
eligibility criteria differentially exclude Black patients from
participating in clinical trials. These criteria perpetuate racial
disparities, limit generalizability to real world clinical scenarios, and
are often not medically justifiable. Alternative eligibility criteria can
improve representation of diverse participants, provide more equitable
access to investigational therapeutics and reduce disparities in
survivorship, without compromising patient safety or study results.

<67>
Accession Number
2016698747
Title
Evaluation of systemic inflammation in response to remote ischemic
preconditioning in patients undergoing transcatheter aortic valve
replacement (TAVR).
Source
Reviews in Cardiovascular Medicine. 23(1) (no pagination), 2022. Article
Number: 20. Date of Publication: 20 Jan 2022.
Author
Zhang K.; Troeger W.; Kuhn M.; Wiedemann S.; Ibrahim K.; Pfluecke C.;
Sveric K.M.; Winzer R.; Fedders D.; Ruf T.F.; Strasser R.H.; Linke A.;
Quick S.; Heidrich F.M.
Institution
(Zhang) Department of Internal Medicine and Cardiology, Campus
Virchow-Klinikum, Charite-Universitatsmedizin Berlin, Berlin 13353,
Germany
(Zhang) Berlin Health Institute, Berlin 10178, Germany
(Zhang) DZHK (German Centre for Cardiovascular Research), partner site
Berlin, Berlin 10785, Germany
(Troeger, Pfluecke, Sveric, Linke, Quick, Heidrich) Department of Internal
Medicine and Cardiology, Faculty of Medicine Carl Gustav Carus, Technische
Universitat Dresden, Herzzentrum Dresden, Dresden 01307, Germany
(Troeger) Department of Anesthesiology and Critical Care Medicine, Medical
University of Innsbruck, Innsbruck 6020, Austria
(Kuhn) Institute for Medical Informatics and Biometry, Faculty of Medicine
Carl Gustav Carus, Technische Universitat Dresden, Dresden 01307, Germany
(Wiedemann) Department of Internal Medicine and Cardiology, HELIOS
Klinikum Pirna, Pirna 01796, Germany
(Ibrahim, Quick) Department of Cardiology, Faculty of Medicine Carl Gustav
Carus, Technische Universitat Dresden, Klinikum Chemnitz, Chemnitz 09116,
Germany
(Pfluecke) Department of Internal Medicine I, Faculty of Medicine Carl
Gustav Carus, Technische Universitat Dresden, Klinikum Gorlitz, Gorlitz
02828, Germany
(Winzer, Fedders) Department of Radiology, Faculty of Medicine Carl Gustav
Carus, Technische Universitat Dresden, Universitatsklinikum Dresden,
Dresden 01307, Germany
(Ruf) Center for Cardiology I, Heart Valve Center Mainz, University
Medical Center Mainz, Mainz 55131, Germany
(Strasser) Faculty of Medicine Carl Gustav Carus, Technische Universitat
Dresden, Dresden 01307, Germany
Publisher
IMR Press Limited
Abstract
Background: Systemic inflammation can occur after transcatheter aortic
valve replacement (TAVR) and correlates with adverse outcome. The impact
of remote ischemic preconditioning (RIPC) on TAVR associated systemic
inflammation is unknown and was focus of this study. Method(s): We
performed a prospective controlled trial at a single center and included
66 patients treated with remote ischemic preconditioning (RIPC) prior to
TAVR, who were matched to a control group by propensity score. RIPC was
applied to the upper extremity using a conventional tourniquet. Definition
of systemic inflammation was based on leucocyte count, C-reactive protein
(CRP), procalcitonin (PCT) and interleukin-6 (IL-6), assessed in the first
5 days following the TAVR procedure. Mortality was determined within 6
months after TAVR. RIPC group and matched control group showed comparable
baseline characteristics. Result(s): Systemic inflammation occurred
in 66% of all patients after TAVR. Overall, survival after 6 months was
significantly reduced in patients with systemic inflammation. RIPC, in
comparison to control, did not significantly alter the plasma levels of
leucocyte count, CRP, PCT or IL-6 within the first 5 days after TAVR.
Furthermore, inflammation associated survival after 6 months was not
improved by RIPC. Of all peri-interventional variables assessed, only the
amount of the applied contrast agent was connected to the occurrence of
systemic inflammation. Conclusion(s): Systemic inflammation
frequently occurs after TAVR and leads to increased mortality after 6
months. RIPC neither reduces the incidence of systemic inflammation nor
improves inflammation associated patient survival within 6
months. Copyright: © 2022 The Author(s).

<68>
Accession Number
2015557057
Title
Prospective randomized study comparing outcome of myocardial protection
with Del-Nido Cardioplegia versus Saint Thomas Cardioplegia in adult
cardiac surgical patients.
Source
Pakistan Journal of Medical Sciences. 38(3) (pp 699-704), 2022. Date of
Publication: March-April 2022.
Author
Rizvi M.F.A.; Yousuf S.M.A.; Younas A.; Baig M.A.R.
Institution
(Rizvi, Yousuf, Younas) Bahawal Victoria Hospital, Bahawalpur, Pakistan
(Baig) Clinical Perfusionist, Hail Cardiac Center, Hail, Saudi Arabia
Publisher
Professional Medical Publications
Abstract
Objectives: To compare the effectiveness of Del-Nido cardioplegia as
myocardial protective agent with Saint Thomas cardioplegia in adult
cardiac surgical patients. Method(s): This prospective randomized
study was conducted in cardiac surgery department of Bahawal Victoria
hospital Bahawalpur, from October 2020 to March 2021. Eighty adult
patients who underwent primary Isolated coronary artery bypass grafting
(CABG) or isolated Valve surgery requiring cardiopulmonary bypass were
randomly divided into Del Nido (DN, n=40) and Saint Thomas (ST, n=40)
groups. Data regarding operative and post-operative variables such as
cardiopulmonary bypass (CPB) and aortic cross clamp (AXC) times, inotropic
requirements, resumption of sinus rhythm, need for electrical
defibrillation, postoperative CKMB, blood requirement and ICU stay were
noted. Result(s): CPB and AXC times were statistically
insignificantly different. Resumption of Sinus rhythm was seen
significantly in more patients of DN group (95%) than in ST group (72.5%)
[p-value 0.05]. Less patients of DN group (5%) were candidates of
electrical defibrillation than ST group (17.5%) [p-value <0.001).
Post-operative CKMB values were significantly lower in DN group as
compared to ST group (30.5+/-22.6 IU vs 50.5+/-50.28 IU, p value.008).
Blood transfusion was significantly lower in DN group; 50% versus 80% in
ST group (p-value 0.005). Ventilation time was significantly less in DN
group than ST group (165.95+/-48.09 minutes versus 165.95+/-48.09 minutes
respectively, p-value 0.03). While ICU stay was also less in DN group;
5.2+/-0.8 days versus 6.05+/-1.6 days in ST group (p-value 0.003).
 Conclusion(s): Del-Nido cardioplegia is a reliable and better
myocardial protective agent than Saint Thomas cardioplegia in adult
cardiac surgical procedures. Copyright © 2022, Professional
Medical Publications. All rights reserved.

<69>
Accession Number
2014877896
Title
Treatment of Bicuspid Aortic Valve Stenosis with TAVR: Filling Knowledge
Gaps Towards Reducing Complications.
Source
Current Cardiology Reports. (no pagination), 2022. Date of Publication:
2022.
Author
Yeats B.B.; Yadav P.K.; Dasi L.P.; Thourani V.H.
Institution
(Yeats, Dasi) Department of Biomedical Engineering, Georgia Institute of
Technology and Emory University, Atlanta, GA, United States
(Yadav) Department of Cardiology, Piedmont Heart Institute, Marcus Valve
Center, Atlanta, GA, United States
(Thourani) Department of Cardiovascular Surgery, Piedmont Heart Institute,
Marcus Valve Center, Atlanta, GA, United States
Publisher
Springer
Abstract
Purpose of Review: Bicuspid aortic valve (BAV) disease is the most common
congenital heart defect worldwide. When severe, symptomatic aortic
stenosis ensues, the treatment has increasingly become transcatheter
aortic valve replacement (TAVR). The purpose of this review is to identify
BAV classification and imaging methods, outline TAVR outcomes in BAV
anatomy, and discuss how computational modeling can enhance TAVR treatment
in BAV patients. Recent Findings: TAVR use in BAV patients, when compared
to use in tricuspid aortic valves, showed lower device success rate, and
there remains no long-term randomized trial data. It has been reported
that BAV patients with severe calcification increase the rate of
complications. Additionally, the asymmetrical morphology of BAVs often
results in asymmetric stent geometries which have implications for
increased thrombosis risk and decreased durability. These adverse outcomes
are currently very difficult to predict from routine pre-procedural
imaging alone. Recently developed patient specific experimental and
computational techniques have the potential to assist in filling knowledge
gaps in the mechanisms of these complications and provide more information
during preclinical planning for better TAVR selection in low surgical risk
BAV patients. Summary: Efficacy of TAVR for irregular BAV anatomies
remains concerning due to the lack of a long-term randomized trial data,
their increased rate of short-term complications, and signs that long-term
durability could be an issue. More knowledge on identifying which BAV
anatomies are at greater risk for these adverse outcomes can potentially
improve patient selection for TAVR versus SAVR in low surgical risk BAV
patients. Copyright © 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<70>
Accession Number
637119145
Title
Assessment of stress response attenuation with caudal morphine using a
surrogate marker during pediatric cardiac surgery.
Source
Annals of cardiac anaesthesia. 25(1) (pp 61-66), 2022. Date of
Publication: 01 Jan 2022.
Author
Maddali M.M.; Al Shamsi F.; Arora N.R.; Venkatachlam R.; Sathiya P.M.
Institution
(Maddali, Arora, Venkatachlam) Department of Cardiac Anesthesia, National
Heart Center, Royal Hospital, Muscat, Oman
(Al Shamsi) Anesthesia Residency Training Program, Oman Medical Specialty
Board, Muscat, Oman
(Sathiya) Department of Studies and Research, Oman Medical Specialty
Board, Muscat, Oman
Publisher
NLM (Medline)
Abstract
Background: Measurement of biomarkers representing sympathetic tone and
the surgical stress response are helpful for objective comparison of
anesthetic protocols. Aim(s): The primary aim was to compare changes
in chromogranin A levels following pump pediatric cardiac surgery between
children who received bolus caudal morphine and those who received a
conventional intravenous narcotic-based anesthesia regime. The secondary
objectives were to compare hemodynamic responses to skin incision and the
magnitude of the rise in blood sugar values between the groups. Settings
and Design: A prospective observational study at a tertiary cardiac
center. Measurements and Methods: Sixty pediatric cardiac surgical
patients were randomized to Group I [n= 30] to receive intravenous
narcotic-based anesthesia and Group II [n = 30] to receive single-shot
caudal morphine. Baseline and postoperative chromogranin A levels, the
hemodynamic response to skin incision, changes in blood sugar levels, and
the total intravenous narcotic dose administered were recorded for each
participant. Statistical Analysis: Pearson's Chi-squared test was used for
comparison of categorized variables, and Mann-Whitney test was used for
the analysis of continuous data. Result(s): Changes in chromogranin A
levels and blood sugar levels were comparable in both groups. Group II
received a lower narcotic dosage (P <= 0.001), and the response to skin
incision as reflected by systolic pressure rise was less (P = 0.006).
 Conclusion(s): Surgical stress response attenuation was similar to
caudal morphine as compared with intravenous narcotic-based anesthesia
techniques as reflected by a similar increase in chromogranin A levels.

<71>
Accession Number
637125044
Title
Long-term impact of permanent cardiac pacing after surgical aortic valve
replacement: systematic review and meta-analysis.
Source
Expert review of cardiovascular therapy. (no pagination), 2022. Date of
Publication: 26 Jan 2022.
Author
Servito M.; Khoury W.; Payne D.; Baranchuk A.; El Diasty M.
Institution
(Servito, Khoury) Faculty of Medicine, Queen's University, ON, Kingston,
Canada
(Payne, El Diasty) Division of Cardiac Surgery, Kingston Health Sciences
Centre, ON, Kingston, Canada
(Baranchuk) Division of Cardiology, Kingston Health Sciences Centre, ON,
Kingston, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Permanent pacemaker (PPM) implantation after surgical aortic
valve (SAVR) is associated with short- and long-term complications.
However, the impact of PPM implantation on long-term mortality has not
been fully established. The aim of this meta-analysis was to determine
whether PPM post-SAVR increases the risk of mortality. METHOD(S): We
searched Cochrane, MEDLINE and EMBASE from inception to December 2020 for
studies comparing mortality between patients who received PPM post-SAVR
and those who did not. Random effects meta-analysis was performed to
determine the effect of PPM on early and late mortality. The effect sizes
were reported as hazard ratio (HR) with 95% confidence intervals.
 RESULT(S): Three studies met criteria, which yielded a total of 9,105
patients. The most common indication was post-operative complete
atrioventricular block. While there was no difference in early mortality
between the PPM and no PPM groups (RR 1.19; 95%CI 0.20-7.08; I2=23%), PPM
implantation was shown to significantly increase late mortality (RR 1.49;
95%CI 1.25-1.77; I2=0%). CONCLUSION(S): The need for permanent
pacemaker after surgical isolated aortic valve replacement is associated
with increased risk of long-term mortality. This warrants further
exploration on the effect of PPM on long-term mortality in patients
receiving sutureless prostheses or transcatheter aortic valve implants.

<72>
Accession Number
637117463
Title
Leaflet Resection vs Preservation for Degenerative Mitral Regurgitation:
Functional Outcomes and Mitral Stenosis at 12 months in a Randomized
Trial.
Source
The Canadian journal of cardiology. (no pagination), 2022. Date of
Publication: 21 Jan 2022.
Author
Hibino M.; Pandey A.; Chan V.; Mazer C.D.; Dhingra N.K.; Bonneau C.; Verma
R.; Quan A.; Teoh H.; Cheema A.; Yanagawa B.; Leong-Poi H.; Connelly K.A.;
Bisleri G.; Verma S.
Institution
(Hibino, Yanagawa, Bisleri) Division of Cardiac Surgery, Li Ka Shing
Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada;
Department of Surgery, University of Toronto, ON, Canada
(Pandey) Michael G. DeGroote School of Medicine, McMaster University, ON,
Hamilton, Canada
(Chan) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada; School of Epidemiology, Public Health and Preventive
Medicine, University of Ottawa, Ottawa, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute of St.
Michael's Hospital, Toronto, ON, Canada; Department of Anesthesiology and
Pain Medicine, University of Toronto, ON, Canada; Department of
Physiology, University of Toronto, Toronto, ON, Canada
(Dhingra, Quan) Division of Cardiac Surgery, Li Ka Shing Knowledge
Institute of St. Michael's Hospital, ON, Toronto, Canada
(Bonneau) Division of Cardiac Surgery, McGill University, QC, Montreal,
Canada
(Verma) Royal College of Surgeon in Ireland, Dublin, Ireland
(Teoh) Division of Cardiac Surgery, Li Ka Shing Knowledge Institute of St.
Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology and
Metabolism, Li Ka Shing Knowledge Institute of St. Michael's Hospital,
Toronto, ON, Canada
(Cheema) Division of Cardiology, Southlake Regional Health Centre, ON,
Newmarket, Canada
(Leong-Poi) Division of Cardiology, Li Ka Shing Knowledge Institute of St.
Michael's Hospital, Toronto, ON, Canada; Department of Medicine,
University of Toronto, ON, Canada
(Connelly) Department of Physiology, University of Toronto, Toronto, ON,
Canada; Division of Cardiology, Li Ka Shing Knowledge Institute of St.
Michael's Hospital, Toronto, ON, Canada; Department of Medicine,
University of Toronto, ON, Canada
(Verma) Division of Cardiac Surgery, Li Ka Shing Knowledge Institute of
St. Michael's Hospital, Toronto, ON, Canada; Department of Surgery,
University of Toronto, ON, Canada; Department of Pharmacology and
Toxicology, University of Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Mitral valve repair is the gold standard treatment for
degenerative mitral regurgitation (MR). The Canadian Mitral Research
Alliance (CAMRA) CardioLink-2 trial showed no significant association
between repair strategy, leaflet resection versus preservation, and risk
of functional mitral stenosis. In this sub-analysis, we compare outcomes
and functional tests at 12 months. METHOD(S): CAMRA CardioLink-2 was
a multi-center randomized controlled trial that allocated patients with
degenerative MR patients and posterior leaflet prolapse to either leaflet
resection (n=54) or preservation (n=50). Stress echocardiography and
functional status assessments including the 6-minute walk test were
compared 12 months post-repair. RESULT(S): Baseline demographics,
stress echocardiographic findings, and mitral annuloplasty prosthesis size
(33.0+/-3.0 vs 33.6+/-3.4, p=0.4) were similar between the two groups.
There were no readmissions for heart failure or deaths during the
follow-up period. At 12 months, a larger percentage of patients were NYHA
functional class >=2 in the resection group compared to the preservation
group (p=0.01). Exercise capacity, rate pressure product, 6-minute walk
distance and mean mitral valve gradients were not significantly different
between the groups at 12 months. A more prominent increase in mean mitral
gradient with smaller annuloplasty sizes was observed in the resection
group both at rest (p=0.03) and peak exercise (p=0.005) in the linear
regression model. CONCLUSION(S): At 12 months, there was no
significant difference in mitral valve gradient, exercise capacity and
6-minute walk test between repair strategies. Leaflet preservation may
offer a larger mitral valve orifice with improved gradients in patients
requiring smaller annuloplasty sizes. Copyright © 2022. Published
by Elsevier Inc.

<73>
Accession Number
637142049
Title
Systemic inflammatory response during cardiopulmonary bypass: Axial flow
versus radial flow oxygenators.
Source
The International journal of artificial organs. (pp 3913988221075043),
2022. Date of Publication: 31 Jan 2022.
Author
Yildirim F.; Amanvermez Senarslan D.; Yersel S.; Bayram B.; Taneli F.;
Tetik O.
Institution
(Yildirim, Amanvermez Senarslan, Bayram, Tetik) Cardiovascular Surgery,
Manisa Celal Bayar University, Manisa, Turkey
(Yersel) Manisa Celal Bayar University, Manisa, Turkey
(Yersel) Munich Heart Center, Munich, Germany
(Taneli) Biochemistry, Manisa Celal Bayar University, Manisa, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: The objective of this study was to investigate the
inflammatory effects of different oxygenator flow pattern types in
patients undergoing coronary artery bypass graft surgery with
cardiopulmonary bypass. METHOD(S): We designed this randomized,
single-blind, prospective study of patients with coronary artery disease.
We compared the systemic inflammatory effects of oxygenators with two
types of flow: axial flow and radial flow. Therefore, we divided the
patients into two groups: 24 patients in the axial group and 28 patients
in the radial group. IL-1, IL-6, IL-10, and TNF-alpha were examined for
cytokine activation leading to a systemic inflammatory reaction. The
samples were collected at three different time intervals: T1, T2, and T3
(T1 was taken before cardiopulmonary bypass, T2 just 1h after CPB onset,
and T3 was taken 24h after the surgery). RESULT(S): There were no
significant differences in demographic characteristics between the two
groups. We observed that there were notably lower levels of humoral
inflammatory response parameters (IL-1, IL-6, and TNF-alpha) in the radial
flow oxygenator group than in the axial flow group at the specific
sampling times. For IL-10, there was no significant difference for any
time period. CONCLUSION(S): It might be advantageous to use a
radial-flow-patterned oxygenator to limit the inflammatory response
triggered by the oxygenators in cardiopulmonary bypass.

<74>
Accession Number
637139525
Title
Triiodothyronine Supplementation in Infants Undergoing Cardiopulmonary
Bypass: A Randomized Controlled Trial.
Source
Seminars in thoracic and cardiovascular surgery. (no pagination), 2022.
Date of Publication: 27 Jan 2022.
Author
Portman M.A.; Slee A.E.; Roth S.J.; Radman M.; Olson A.K.; Mainwaring
R.D.; Kamerkar A.; Nuri M.; Hastings L.
Institution
(Portman, Radman, Olson) Seattle Children's Research Institute and
Department of Pediatrics, University of Washington, Seattle, WA
(Slee) New Arch Consulting, Seattle, WA
(Roth) Department of Cardiology and Critical Care, Lucile Packard
Children's Hospital, Palo Alto, CA
(Mainwaring) Department of Cardiothoracic Surgery, Lucile Packard
Children's Hospital, Palo Alto, CA
(Kamerkar) Department of Critical Care, Los Angeles Children's Hospital,
Los Angeles, CA
(Nuri) Division of Cardiothoracic Surgery at Children's Hospital of
Philadelphia, PA, Philadelphia, United States
(Hastings) Levine Children's Hospital, Charlotte, Saint Vincent and the
Grenadines
Publisher
NLM (Medline)
Abstract
Cardiopulmonary bypass (CPB) profoundly suppresses circulating thyroid
hormone levels in infants. We performed a multicenter randomized placebo
controlled trial to determine if triiodothyronine (T3) supplementation
improves reduces time to extubation (TTE) in infants after CPB. Infants
(n=220) undergoing cardiac surgery with CPB and stratified into two age
cohorts: <=30 days and > 30 days to < 152 days were randomization to
receive either intravenous triiodothyronine or placebo bolus followed by
study drug infusion until extubated or at 48 hours, whichever preceded. T3
did not significantly alter the primary endpoint, TTE (hazard ratio for
chance of extubation (1.08, 95% CI: 0.82 to 1.43, p=0.575) in the entire
randomized population with censoring at 21 days. T3 showed no significant
effect on TTE (HR 0.82, 95% CI:0.55 to 1.23, p=0.341) in the younger
subgroup or in the older (HR 1.38, 95% CI:0.95 to 2.2, p=0.095). T3 also
did not significantly impact TTE during the first 48 hours while T3 levels
were maintained (HR 1.371, 95% CI:0.942 to 1.95, p=0.099) No significant
differences occurred for arrhythmias or other sentinel adverse events in
the entire cohort or in the subgroups. This trial showed no significant
benefit on TTE in the entire cohort. T3 supplementation appears safe as it
did not cause an increase in adverse events. The study implementation and
analysis were complicated by marked variability in surgical risk, although
risk categories were balanced between treatment groups. Copyright
© 2022. Published by Elsevier Inc.

<75>
Accession Number
637137951
Title
Editorial comments on 'Effects of ischaemic postconditioning in aortic
valve replacement: a multicenter randomized controlled trial'.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 29 Jan 2022.
Author
Podesser B.K.; Kiss A.
Institution
(Podesser, Kiss) Ludwig Boltzmann Institute for Cardiovascular Research at
the Center for Biomedical Research and Translational Surgery, Medical
University of Vienna, Vienna, Austria
(Podesser) Department of Cardiac Surgery, University Hospital St. Poelten,
Austria
Publisher
NLM (Medline)

<76>
Accession Number
2010470560
Title
Effect of Renin-Angiotensin System Inhibitors on Acute Kidney Injury Among
Patients Undergoing Cardiac Surgery: A Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33(4) (pp 1014-1022),
2021. Date of Publication: Winter 2021.
Author
Zhou H.; Xie J.; Zheng Z.; Ooi O.C.; Luo H.
Institution
(Zhou) School of Management, University of Science and Technology of
China, Hefei, China
(Xie) School of Management, Technical University of Munich, Heilbronn,
Germany
(Zheng) Lee Kong Chian School of Business, Singapore Management
University, Singapore
(Ooi, Luo) Department of Cardiac, Thoracic & Vascular Surgery, National
University Hospital, Singapore
Publisher
W.B. Saunders
Abstract
Acute kidney injury (AKI) is a frequent complication of cardiac surgery,
which can lead to higher mortality and long-term renal function
impairment. The effect of perioperative renin-angiotensin system
inhibitors (RASi) therapy on AKI incidence in patients undergoing cardiac
surgery remains controversial. We reviewed related studies in PubMed,
Scopus, and Cochrane Library from inception to February 2020. Two
randomized controlled trials and 21 cohort studies were included in the
meta-analysis, involving 76,321 participants. The pooled odds ratio and
95% confidence interval were calculated using the DerSimonian and Laird
random-effects model. The results showed no significant association
between perioperative RASi therapy and postoperative AKI in patients
undergoing cardiac surgery. We highlighted the limitations of existing
studies and called for well-designed large-scale randomized controlled
trials to verify the conclusion. Copyright © 2020 Elsevier Inc.

<77>
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.

<78>
Accession Number
636664333
Title
Effect of Positive Expiratory Pressure Therapy on Lung Volumes and Health
Outcomes in Adults With Chest Trauma: A Systematic Review and
Meta-Analysis.
Source
Physical therapy. 102(1) (no pagination), 2022. Date of Publication: 01
Jan 2022.
Author
Saliba K.A.; Blackstock F.; McCarren B.; Tang C.Y.
Institution
(Saliba, Blackstock, Tang) Physiotherapy Department, School of Health
Sciences, Western Sydney University, NSW, Australia
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The purposes of this study were to evaluate the effect of
positive expiratory pressure (PEP) therapy on lung volumes and health
outcomes in adults with chest trauma and to investigate any adverse
effects and optimal dosages leading to the greatest positive impact on
lung volumes and recovery. METHOD(S): Data sources were
MEDLINE/PubMed, Embase, Cochrane Library, Physiotherapy Evidence Database,
CINAHL, Open Access Thesis/Dissertations, EBSCO Open Dissertations, and
OpenSIGLE/Open Grey. Randomized controlled trials investigating PEP
therapy compared with usual care or other physical therapist interventions
were included. Participants were>18 years old and who were admitted to the
hospital with any form of chest trauma, including lung or cardiac surgery,
blunt chest trauma, and rib fractures. Methodological quality was assessed
using the Physiotherapy Evidence Database Scale, and the level of evidence
was downgraded using the Grading of Recommendations Assessment,
Development and Evaluation approach. RESULT(S): Eleven studies
involving 661 participants met inclusion eligibility. There was very
low-level evidence that PEP improved forced vital capacity (standardized
mean difference=-0.50; 95% CI=-0.79 to -0.21), forced expiratory volume in
1 second (standardized mean difference =-0.38; 95% CI=-0.62 to -0.13), and
reduced the incidence of pneumonia (relative risk=0.16; 95% CI=0.03 to
0.85). Respiratory muscle strength also significantly improved in all 3
studies reporting this outcome. There was very low-level evidence that PEP
did not improve other lung function measures, arterial blood gases,
atelectasis, or hospital length of stay. Both PEP devices and dosages
varied among the studies, and no adverse events were reported.
 CONCLUSION(S): PEP therapy is a safe intervention with very low-level
evidence showing improvements in forced vital capacity, forced expiratory
volume in 1 second, respiratory muscle strength, and incidence of
pneumonia. It does not improve arterial blood gases, atelectasis, or
hospital length of stay. Because the evidence is very low level, more
rigorous physiological and dose-response studies are required to
understand the true impact of PEP on the lungs after chest trauma. IMPACT:
There is currently no strong evidence for physical therapists to routinely
use PEP devices following chest trauma. However, there is no evidence of
adverse events; therefore, in specific clinical situations, PEP therapy
may be considered. Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of the American Physical Therapy
Association. All rights reserved. For permissions, please email:
journals.permissions@oup.com.

<79>
Accession Number
635756199
Title
The efficacy of three-dimensional video-assisted thoracic surgery on
treating lung cancer: An exploratory meta-analysis.
Source
Asian journal of surgery. 44(11) (pp 1400-1401), 2021. Date of
Publication: 01 Nov 2021.
Author
Lin H.-H.; Zhou K.; Peng Z.-Y.; Mei J.-D.
Institution
(Lin, Zhou, Peng, Mei) Department of Thoracic Surgery, West China
Hospital, Sichuan University, Chengdu, 610041, PR China; Western China
Collaborative Innovation Center for Early Diagnosis and Multidisciplinary
Therapy of Lung Cancer, Sichuan University, Chengdu, China
Publisher
NLM (Medline)

<80>
Accession Number
637119359
Title
Clinical application of viscoelastic point-of-care tests of
coagulation-shifting paradigms.
Source
Annals of cardiac anaesthesia. 25(1) (pp 1-10), 2022. Date of Publication:
01 Jan 2022.
Author
Nath S.S.; Pandey C.K.; Kumar S.
Institution
(Nath, Kumar) Department of Anaesthesiology and Critical Care, Dr. Ram
Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
(Pandey) Anaesthesia Services, Medanta Hospital, Lucknow, Uttar Pradesh,
India
Publisher
NLM (Medline)
Abstract
Bleeding during cardiac surgery, liver transplant, trauma and post partum
hemorrhage are often multifactorial and these factors are dynamic as new
factors crop up during the course of management. Conventional tests of
coagulation offer information of a part of the coagulation system and also
is time consuming. Viscoelastic point of care tests (VE POCTs) like
rotational thromboelastometry, thromboelastogram and Sonoclot, are based
on analysis of the viscoelastic properties of clotting blood and provide
information for the entire coagulation pathway. In this comprehensive
review being presented here, we have examined the pros and cons of VE
POCTs including clinical, cost and survival benefits. The recommendations
of the various guidelines regarding use of VE POCTs in various scenarios
have been discussed. The review also tried to offer suggestions as to
their optimal role in management of bleeding during cardiac surgeries,
extracorporeal membrane oxygenation, left ventricular assist devices,
liver transplant and briefly in trauma and postpartum hemorrhage.

<81>
Accession Number
2015521016
Title
Fungal Infection Testing in Pediatric Intensive Care Units-A Single Center
Experience.
Source
International Journal of Environmental Research and Public Health. 19(3)
(no pagination), 2022. Article Number: 1716. Date of Publication:
February-1 2022.
Author
Klepacka J.; Zakrzewska Z.; Czogala M.; Wojtaszek-Glowka M.; Krzysztofik
E.; Czogala W.; Skoczen S.
Institution
(Klepacka, Czogala, Skoczen) Department of Microbiology, University
Children's Hospital, Wielicka 265, Krakow 30-663, Poland
(Zakrzewska, Czogala, Czogala, Skoczen) Department of Oncology and
Hematology, University Children's Hospital, Wielicka 265, Krakow 30-663,
Poland
(Czogala) Department of Pediatric Oncology and Hematology, Institute of
Pediatrics, Jagiellonian University Medical College, Krakow 30-663, Poland
(Wojtaszek-Glowka, Krzysztofik) Student Scientific Group of Pediatric
Oncology and Hematology, Jagiellonian University Medical College, Krakow
30-663, Poland
Publisher
MDPI
Abstract
Mycoses are diseases caused by fungi that involve different parts of the
body and can generate dangerous treatment complications. This study aims
to analyze fungal infection epidemiology in intensive care units
(Pediatric and Cardiac Surgery Intensive Care Units-PCICU) and the
Neonatal Intensive Care Unit (NICU) in one large pediatric center in the
period 2015-2020 compared with 2005. The year 2005 was randomly selected
as a historical time reference to notice possible changes. In 2005 and
2015-2020, 23,334 mycological tests were performed in intensive care
units. A total of 4628 tests (19.8%) were performed in the intensive care
units. Microbiological diagnostics involved mycological and serological
testing. Of the 458 children hospitalized in the NICU, positive results in
the mycological tests in the studied years were found in 21-27% of the
children and out of 1056 PCICU patients, positive results were noticed in
18-29%. In both departments, the main detected pathogen was Candida
albicans which is comparable with data published in other centers. Our
experience indicates that blood cultures as well as the detection of
antifungal antibodies do not add important information to mycological
diagnostics. For the years of observation, only a few positive results
were detected, even in patients with invasive fungal diseases. To our
knowledge, this is one of a few similar studies over recent years and it
provides contemporary reports of mycoses in pediatric ICU
patients. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<82>
Accession Number
2016697681
Title
Topical Vancomycin and Risk of Sternal Wound Infections: A Double-Blind
Randomized Controlled Trial.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Servito M.; Khani-Hanjani A.; Smith K.-M.; Tsuyuki R.T.; Mullen J.C.
Institution
(Servito) School of Medicine, Faculty of Health Sciences, Queen's
University, Kingston, Ontario, Canada
(Khani-Hanjani) Division of Cardiac Surgery, Royal University Hospital,
University of Saskatchewan, Saskatoon, Saskatchewan, Canada
(Smith, Mullen) Division of Cardiac Surgery, Faculty of Medicine and
Dentistry, University of Alberta, Edmonton, AB, Canada
(Tsuyuki) Department of Pharmacology, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, AB, Canada
(Tsuyuki) Division of Cardiology, Department of Medicine, Faculty of
Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
Publisher
Elsevier Inc.
Abstract
Background: The use of topical vancomycin in the reduction of sternal
wound infection (SWI) risk has become a point of contention. The earlier
literature consists of observational studies and 1 unblinded trial. Hence,
the objective of this study was to assess whether vancomycin reduces the
incidence of SWI in a double-blind randomized controlled trial.
 Method(s): Patients were randomized 1:1 to either vancomycin-soaked
(vancomycin) or saline-soaked (control) sponges. The sponges were applied
once the sternum was opened and were removed just before sternal closure.
Patients were followed up at 3 months and at 1 year postoperatively to
determine the incidence of SWI in each group. Results were analyzed
according to the modified intention-to-treat principle. Result(s):
This study assessed 1038 patients for eligibility and enrolled 1037
patients. There were 517 patients randomized to the vancomycin group and
520 patients randomized to the control group. Analysis was performed on
1021 patients. At 3 months postoperatively, there was no significant
difference in the incidence of SWI between the vancomycin and control
groups (2.7% vs 4.1%; P = .23). There was also no significant difference
between the vancomycin and control groups in the risk of superficial,
deep, and organ-space infections. Similar findings were observed 1 year
postoperatively. The most common organism isolated was coagulase-negative
Staphylococcus. Conclusion(s): The use of vancomycin applied to the
sternum during cardiac surgery does not reduce the incidence of
SWI. Copyright © 2021 The Society of Thoracic Surgeons

<83>
Accession Number
637125080
Title
Coronary Revascularization for Patients with Diabetes Mellitus: A
Contemporary Systematic Review and Meta-Analysis.
Source
Annals of surgery. (no pagination), 2022. Date of Publication: 25 Jan
2022.
Author
El-Andari R.; Bozso S.J.; Fialka N.M.; Kang J.J.; Nagendran J.
Institution
(El-Andari) Faculty of Medicine and Dentistry, Canada Division of Cardiac
Surgery, Department of Surgery, University of Alberta, Edmonton, AB,
Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVE: This systematic review and meta-analysis aims to review the
contemporary literature comparing CABG and PCI in diabetic patients
providing an up-to-date perspective on the differences between the
interventions. BACKGROUND: Diabetes is common and diabetic patients are at
a 2-to-4-fold increased risk of developing coronary artery disease.
Approximately 75% of diabetic patients die of cardiovascular disease.
Previous literature has identified CABG as superior to PCI for
revascularization in diabetic patients with complex coronary artery
diseas. METHOD(S): PubMed and Medline were systematically searched
for articles published from January 1, 2015 to April 15, 2021. This
systematic review included all retrospective, prospective, and randomized
trial studies comparing CABG and PCI in diabetic patients. 1552 abstracts
were reviewed and 25 studies were included in this review. The data was
analyzed using the RevMan 5.4 software. RESULT(S): Diabetic patients
undergoing CABG experienced significantly reduced rates of 5-year
mortality, major adverse cardiovascular and cerebrovascular events,
myocardial infarction, and required repeat revascularization. Patients who
underwent PCI experienced improved rates of stroke that trended toward
significance. CONCLUSION(S): Previous literature regarding coronary
revascularization in diabetic patients has consistently demonstrated
superior outcomes for patients undergoing CABG over PCI. The development
of 1st and 2nd generation DES have narrowed the gap between CABG and PCI,
but CABG continues to be superior. Continued investigation with large
randomized trials and retrospective studies including long term follow-up
comparing CABG and 2nd generation DES is necessary to confirm the optimal
intervention for diabetic patients. Copyright © 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<84>
Accession Number
637124416
Title
Epidemiology of infective endocarditis: novel aspects in the twenty-first
century.
Source
Expert review of cardiovascular therapy. (no pagination), 2022. Date of
Publication: 27 Jan 2022.
Author
Arshad V.; Talha K.M.; Baddour L.M.
Institution
(Arshad, Talha) Division of Infectious Diseases, Department of Medicine,
Mayo Clinic College of Medicine and Science
(Baddour) Department of Cardiovascular Disease, Mayo Clinic School of
Medicine and Science, Rochester, MN, United States
(Baddour) Division of Infectious Diseases, Department of Medicine, Mayo
Clinic School of Medicine and Science, Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The epidemiology of infective endocarditis (IE) in this
millennium has changed with emergence of new risk factors and re-emergence
of others. This, coupled with modifications in national guidelines in the
recent setting of a pandemic, prompted an address of the topic. AREAS
COVERED: Our goal is to provide a contemporary review of IE epidemiology
considering changing incidence of rheumatic heart disease (RHD), cardiac
device implantation, and injection drug use (IDU), with SARS-CoV-2
pandemic as the backdrop. METHOD(S): PubMed and Google Scholar were
used to identify studies of interest. EXPERT OPINION: Our experience over
the past two decades verifies the notion that there is not one "textbook"
profile of IE. Multiple factors have dramatically impacted IE
epidemiology, and these factors differ, based, in part on geography. RHD
has declined in many areas of the World whereas implanted cardiovascular
devices related IE has grown exponentially. Perhaps the most influential,
at least in areas of the United States, is injection drug use complicating
the opioid epidemic. Healthy younger individuals contracting a potentially
life-threatening infection has been tragic. In the past year,
epidemiologic changes due to the COVID-19 pandemic have also occurred. No
doubt, changes will characterize IE in the future and serial review of the
topic is warranted.

<85>
Accession Number
637119224
Title
ABCDEF pulmonary rehabilitation program can improve the mid-term lung
function of lung cancer patients after thoracoscopic surgery: A randomized
controlled study.
Source
Geriatric nursing (New York, N.Y.). 44 (pp 76-83), 2022. Date of
Publication: 21 Jan 2022.
Author
Zou H.; Qin Y.; Gong F.; Liu J.; Zhang J.; Zhang L.
Institution
(Zou, Qin, Gong) Department of Nursing, Hunan Provincial People's
Hospital, First Affiliated Hospital of Hunan Normal University, Changsha
410005, China
(Liu, Zhang) Medical College of Hunan Normal University, Changsha 410013,
China
(Zhang) Department of Cardiothoracic, Hunan Provincial People's Hospital,
First Affiliated Hospital of Hunan Normal University, Changsha 410005,
China
Publisher
NLM (Medline)
Abstract
Background Pulmonary rehabilitation is recommended for most patients with
lung diseases. However, some previous studies have shown that pulmonary
rehabilitation has no obvious effect on short-term lung function in
patients with lung cancer. Objective The purpose of this study was to
evaluate the effect of the ABCDEF pulmonary rehabilitation program on lung
cancer patients who have undergone surgery. Design This was a randomized
controlled trial with repeated measures. Settings The study was conducted
in the Cardiothoracic Surgery Department of a 4000-bed comprising training
and research hospital from 2019 to 2020. Participants A total of 90
patients who underwent thoracoscopic pneumonectomy were divided into two
groups of 45, using a completely randomized model. Methods Patients in the
experimental group participated in an ABCDEF program (Acapella positive
vibration pressure training, breathing exercise, cycling training, dance
in the square, education, and follow-up) after surgery. In contrast, the
regular care provided to the control group focused on breathing and
expectoration guidance. The study outcomes were the first second (FEV1),
forced vital capacity (FVC), FEV1/FVC ratio, 6 min walking distance, Borg
score, incidence of postoperative complications, length of indwelling
chest tube, and length of postoperative stay. Generalized estimating
equation models were used to compare the changes in the outcomes between
the groups over time. Results The ABCDEF pulmonary rehabilitation program
for patients who underwent thoracoscopic pneumonectomy was found to be
more effective in increasing lung function at 3 months after discharge
(p<0.05). However, there was no statistically significant difference on
the day of discharge (p>0.05). Exercise tolerance was different at both
time points (p<0.05). The incidence of postoperative complications in the
experimental group was lower than that in the control group (p<0.05). The
length of postoperative stay in the experimental group was also shorter
(p<0.05), however, the length of the indwelling chest tube was not
significantly different between the intervention and control groups
(p>0.05). Conclusions This study showed that the ABCDEF pulmonary
rehabilitation program could effectively improve mid-term lung function
and exercise tolerance in patients after thoracoscopic pneumonectomy, and
reduce the incidence of postoperative complications along with the length
of postoperative hospital stay. Copyright © 2022 Elsevier Inc.
All rights reserved.

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