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<1>
Accession Number
637198054
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: January-March 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
Wolters Kluwer Medknow Publications
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. Copyright © 2022 Annals of Cardiac Anaesthesia.

<2>
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.

<3>
Accession Number
2015377356
Title
Is this the prime time for transradial access left ventricular
endomyocardial biopsy?.
Source
Interventional Cardiology Review. 16 (no pagination), 2021. Date of
Publication: 2021.
Author
Tyler Z.; Guttmann O.P.; Savvatis K.; Jones D.; O'Mahony C.
Institution
(Tyler, Guttmann, Savvatis, Jones, O'Mahony) St Bartholomew's Hospital,
London, United Kingdom
(Guttmann, Savvatis, O'Mahony) UCL Centre for Heart Muscle Disease,
Institute of Cardiovascular Science, University College London, London,
United Kingdom
Publisher
Radcliffe Medical Media
Abstract
Left ventricular endomyocardial biopsy (EMB) is an essential tool in the
management of myocarditis and is conventionally performed via transfemoral
access (TFA). Transradial access EMB (TRA-EMB) is a novel alternative and
the authors sought to determine its safety and feasibility by conducting a
systematic review of the literature. Medline was searched in 2020, and
cohort demographics, procedural details and complications were extracted
from selected studies. Four observational studies with a combined total of
496 procedures were included. TRA-EMB was most frequently performed with a
sheathless MP1 guide catheter via the right radial artery. The most common
complication was pericardial effusion (up to 11% in one study), but
pericardial drainage for tamponade was rare (one reported case). Death and
mitral valve damage have not been reported. TRA-EMB was successful in
obtaining samples in 99% of reported procedures. The authors concluded
that TRA-EMB is a safe and feasible alternative to TFA-EMB and the most
common complication is uncomplicated pericardial effusion. Copyright
© 2021 Radcliffe Group Ltd. All rights reserved.

<4>
Accession Number
2013009866
Title
Cardiorespiratory parameters in intermittent positive pressure ventilation
versus spontaneous ventilation in under one-year-old pediatrics: A
randomized trial.
Source
Iranian Journal of Pediatrics. 31(3) (no pagination), 2021. Article
Number: e109382. Date of Publication: 2021.
Author
Zare A.; Ghanbari A.; Nasiri A.; Nooralishahi B.; Arani H.Z.
Institution
(Zare, Ghanbari, Nasiri, Arani) Young Researchers and Elite Club, Tehran
Medical Sciences, Islamic Azad University, Tehran, Iran, Islamic Republic
of
(Nooralishahi) Department of Anesthesia, Children's Medical Center, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Background: Cardiac catheterization is a useful method for determining the
anatomy and pressure in cardiac vessels and chambers. The use of
anesthesia methods with minimal hemodynamic and respiratory effects can
increase diagnostic accuracy. Objective(s): Since there are a few
exclusive pediatric angiography centers, scarce studies have been done in
this area. Accordingly, this study determined the effects of intermittent
positive pressure ventilation (IPPV) versus spontaneous ventilation on
cardiorespiratory parameters in less than one-year-old pediatric patients
undergoing angiography with general anesthesia. Method(s): In this
interventional study that was performed as a double-blind, randomized
clinical trial, 60 children younger than one year were enrolled. The
pulmonary, renal, hepatic, and metabolic background diseases, previous
cardiac and thoracic surgery, requiring over two ketamine doses, and
receiving sedative or anti-convulsant therapeutics were excluded. The
patients were randomly assigned to two groups, including IPPV and
spontaneous ventilation. Their vital signs were also recorded before and
after anesthesia induction and needling, as well as during measurements of
pulmonary parameters and systemic blood pressure. All measurements were
done by a single operator using the same device for each variable.
 Result(s): It was seen that SPO<inf>2</inf>, as well as
PCO<inf>2</inf> after anesthesia had significant alterations among the
study variables. Nausea and vomiting, pain, and agitation were not
different across the groups (P-value > 0.05). Conclusion(s): In this
study, we found that IPPV and spontaneous ventilation have the same
effects on respiration. Both techniques can be used in children with
different cardiovascular catheterization conditions to increase accuracy
and reduce alterations in cardiopulmonary parameters. Copyright ©
2021, Author(s).

<5>
Accession Number
2015178815
Title
Effect of high-flow nasal Oxygen on respiratory parameters and pulmonary
complications after early extubation following pediatric heart surgery.
Source
Journal of Comprehensive Pediatrics. 12(3) (no pagination), 2021. Article
Number: e116104. Date of Publication: August 2021.
Author
Enayati F.; Amini S.; Gerdrodbari M.G.; Jarahi L.; Ansari M.
Institution
(Enayati) Sabzevar University of Medical Sciences, Sabzevar, Iran, Islamic
Republic of
(Amini) Department of Anesthesia, School of Medicine, Mashhad University
of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Gerdrodbari, Ansari) Department of Nursing, Nursing & Midwifery School,
Sabzevar University of Medical Sciences, Sabzevar, Iran, Islamic Republic
of
(Jarahi) Community Medicine Department, Faculty of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Objectives: The aim of this study was to evaluate the effect of high-flow
nasal cannula (HFNC) after early extubation on children undergoing cardiac
surgery. Method(s): This randomized controlled clinical trial was
performed among 92 children aged 1 to 24 months undergoing cardiac surgery
from March 5 to August 30, 2020, in a pediatric post-cardiac surgery
intensive care unit (ICU). The patients were randomized to receive either
HFNC or conventional oxygen therapy after extubation. Arterial blood
samples were collected after anesthesia induction, after the end of the
surgery, at the time of entering the ICU while they were intubated, 6
hours after entering the ICU, before removing the endotracheal tube,
immediately after extubation, as well as 1, 6, 12, 24, and 36 hours after
extubation. The patients were compared regarding PaCO2, PaO2/FiO2 ratios,
respiratory failure, need for reintubation, development of atelectasis,
pneumothorax, pleural effusion, and length of ICU stay. Result(s):
The patients were similar regarding demographic characteristics, the
duration of surgery, and mechanical ventilation (P > 0.05). On the first
and second days after the surgery, the mean modified radiologic
atelectasis score (m-RAS) was lower in the HFNC group compared to the
conventional oxygen therapy group (P < 0.05). The frequency of respiratory
failure did not differ in the groups before and after the surgery (P >
0.05). PaCO2 was lower in the HFNC group than in the control group after
extubation (P < 0.001). PaO2/FIO2 ratio was significantly higher in the
HFNC group one hour after extubation and afterward in comparison to the
control group (P < 0.001). The need for re-intubation (P < 0.013) and the
length of ICU stay (P < 0.001) were significantly lower in the HFNC group
compared to the control group. Conclusion(s): It was found that HFNC
could improve the respiratory parameters and reduce postoperative
pulmonary complications in infants following a congenital heart
surgery. Copyright © 2021, Author(s).

<6>
Accession Number
637232474
Title
Comparison of dexmedetomidine and meperidine for the prevention of
shivering following coronary artery bypass graft: study protocol of a
randomised controlled trial.
Source
BMJ open. 12(2) (pp e053865), 2022. Date of Publication: 11 Feb 2022.
Author
Cao C.; Lv M.; Wei C.; Yan J.; Wang Y.; Gu C.
Institution
(Cao, Lv, Wei, Yan, Wang, Gu) Department of Anesthesiology and
Perioperative Medicine, First Affiliated Hospital of Shandong First
Medical University, Jinan, Shandong, China
(Cao, Yan) Shandong First Medical University, Jinan, Shandong, China
(Wang, Gu) Shandong Institute of Anesthesia and Respiratory Critical
Medicine, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
(Wang, Gu) Department of Anesthesiology and Perioperative Medicine,
Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan,
Shandong, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Shivering is a common complication in the postoperative
period. The incidence of shivering has been reported to range from 5% to
65% under general anaesthesia and as 33% during epidural anaesthesia.
Shivering can increase perioperative risk in patients. Both
dexmedetomidine and meperidine are effective agents for the prevention of
postanaesthetic shivering. However, few studies have compared the
anti-shivering effects of different agents following coronary artery
bypass graft (CABG). This study aims to compare the effects of
dexmedetomidine and meperidine on the incidence of shivering in patients
undergoing CABG. METHODS AND ANALYSIS: A total of 180 patients aged 18-75
years, with an American Society of Anesthesiologists (ASA) grade of II-IV,
undergoing elective CABG will be enrolled and randomly assigned to the
dexmedetomidine, meperidine and control groups (placebo) in an intended
1:1:1 allocation ratio. The patients will be followed up for 7days after
surgery. The primary outcome is the incidence of shivering within 24hours
postoperatively. The secondary outcomes are the number of remedial drugs
used after surgery, the incidence of postoperative hypotension and
bradycardia, sedation scores, endotracheal extubation time, intensive care
unit length of stay, incidence of postoperative delirium within 7days
after surgery, incidence of postoperative arrhythmias, incidence of
postoperative nausea and vomiting, average hospital length of stay and
mortality rate 30 days after surgery. ETHICS AND DISSEMINATION: The study
protocol was approved by the ethics committee of The First Affiliated
Hospital of Shandong First Medical University on 20 January 2021
(YXLL-KY-2021(002)) and registered at ClinicalTrials.gov. The results of
this study will be presented at national and international scientific
meetings and conferences. We plan to publish the data in peer-reviewed
international scientific journals. TRIAL REGISTRATION NUMBER:
NCT04735965. 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.

<7>
Accession Number
637231713
Title
Effect of trimetazidine on the functional capacity of ischemic heart
disease patients not suitable for revascularization: Meta-analysis of
randomized controlled trials.
Source
PloS one. 17(2) (pp e0263932), 2022. Date of Publication: 2022.
Author
Ajabnoor A.; Mukhtar A.
Institution
(Ajabnoor) Faculty of Pharmacy, Department of Pharmacy Practice, King
Abdulaziz University, Jeddah, Saudi Arabia
(Mukhtar) Pharmaceutical Care Division, King Faisal Specialist Hospital
and Research Center, Jeddah, Saudi Arabia
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To explore the effect of adding trimetazidine to other
anti-anginal drugs on the functional capacity of ischemic heart disease
(IHD) patients not suitable for revascularization when compared to
first-line antianginal drugs alone. METHOD(S): MEDLINE and EMBASE
databases were searched for English-language peer-reviewed randomized
controlled trials (RCTs) comparing trimetazidine with first-line
antianginal drugs alone or with placebo in IHD patients not suitable for
revascularization and were included in this review. Quality of studies
were assessed using the Cochrane collaboration "risk of bias" tool.
 RESULT(S): Six RCTs, three were crossover studies. A total of 312
participants were included in this review. Overall quality of studies was
moderate. Two studies found improvement in the 6-minute walking test
(6-MWT) [standardized mean differences (SMD) 1.75; 95% CI 1.35 to 2.14; p
<0.001], and two trials found improvement in the Canadian cardiovascular
society (CCS) grading of angina class (SMD -1.37; 95% CI -1.89 to -0.84)
in the trimetazidine group. Three of the better-quality trials found no
increase in total exercise duration (TED) (SMD 0.34; 95% CI -0.10 to 0.78;
p < 0.13). Significant heterogeneity was identified among trials
describing outcomes for the New York Heart Association (NYHA) functional
classification and left ventricular ejection fraction (LVEF %).
 CONCLUSION(S): Trimetazidine improve walking time and angina severity
in IHD patients not suitable for revascularization. Due to the
inconsistency of available evidence, RCTs targeting IHD patients with "no
option" to undergo coronary revascularization is required to clarify this
review question.

<8>
Accession Number
637231417
Title
The effects of preoperative supplementation with a combination of
beta-hydroxy-beta-methylbutyrate, arginine, and glutamine on inflammatory
and hematological markers of patients with heart surgery: a randomized
controlled trial.
Source
BMC surgery. 22(1) (pp 51), 2022. Date of Publication: 11 Feb 2022.
Author
Norouzi M.; Nadjarzadeh A.; Maleki M.; Khayyatzadeh S.S.; Hosseini S.;
Yaseri M.; Fattahi H.
Institution
(Norouzi) Department of Nutrition, International Campus of Shahid Sadoughi
University of Medical Science, Yazd, Iran, Islamic Republic of
(Norouzi, Nadjarzadeh, Khayyatzadeh) Nutrition and Food Security Research
Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,
Islamic Republic of
(Nadjarzadeh, Khayyatzadeh) Department of Nutrition, School of Public
Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,
Islamic Republic of
(Maleki) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Hosseini) Heart Valve Disease Research Center, Shahid Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Yaseri) Department of Epidemiology and Biostatistics, Tehran University
of Medical Science, Tehran, Iran, Islamic Republic of
(Fattahi) Cardiovascular Medical and Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac surgery is associated with a widespread inflammatory
response, by an additional release of free radicals. Due to the importance
of these patient's nutritional status, the present study was designed to
evaluate the effectiveness of supplementation with a combination of
glutamine, beta-hydroxy-beta-methylbutyrate (HMB) and arginine in patients
undergoing to the heart surgery. METHOD(S): The experiment was
performed in 1 month (30 days) before cardiac surgery. patients were asked
to take 2 sachets of Heallagen (a combination of 7 g L-arginine, 7 g
L-glutamine, and 1.5 g daily HMB) or placebo with identical appearance and
taste (maltodextrin) with 120 cc of water. Clinical and biochemical
factors were evaluated in the baseline and end of the study.
 RESULT(S): Totally, 60 preoperative patients (30 interventions and 30
placeboes) with a mean age of 53.13+/-14.35 years participated in the
study. Subjects in Heallagen group had a lower serum levels of
interleukin-6 (P=0.023), erythrocyte sedimentation rate (P<0.01), high
sensitivity C-reactive protein (P<0.01), and lymphocyte number (P=0.007)
compared to the placebo, at end of the study. CONCLUSION(S): In the
patients undergoing heart surgery, Heallagen significantly improved some
of the inflammatory factors and hematological parameters. These results
need to be confirmed in a larger trial. TRIAL REGISTRATION: The protocol
of the study was registered in the IRCT.ir with registration no.
IRCT20120913010826N31 at 13/10/2020. Copyright © 2022. The
Author(s).

<9>
Accession Number
2015005119
Title
Effects of 12-Week Supervised Early Resistance Training (SEcReT) Versus
Aerobic-Based Rehabilitation on Cognitive Recovery Following Cardiac
Surgery via Median Sternotomy: A Pilot Randomised Controlled Trial.
Source
Heart Lung and Circulation. 31(3) (pp 395-406), 2022. Date of Publication:
March 2022.
Author
Pengelly J.; Royse C.; Williams G.; Bryant A.; Clarke-Errey S.; Royse A.;
El-Ansary D.
Institution
(Pengelly, Royse, Royse, El-Ansary) Department of Nursing and Allied
Health, Swinburne University of Technology, Melbourne, Vic, Australia
(Pengelly) School of Science, Psychology and Sport, Federation University
Australia, Ballarat, Vic, Australia
(Royse, Royse, El-Ansary) Department of Surgery, University of Melbourne,
Melbourne, Vic, Australia
(Royse) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Vic, Australia
(Royse) Outcomes Research Consortium Cleveland Clinic, Cleveland, OH,
United States
(Williams, Bryant) Department of Physiotherapy, University of Melbourne,
Melbourne, Vic, Australia
(Clarke-Errey) Statistical Consulting Centre, University of Melbourne,
Melbourne, Vic, Australia
(Royse) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
Melbourne, Vic, Australia
(El-Ansary) Clinical Research Institute, Westmead Private Hospital,
Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Aims: To investigate the effects of a 12-week early moderate-intensity
resistance training program compared to aerobic-based rehabilitation on
postoperative cognitive recovery following cardiac surgery via median
sternotomy. Method(s): This was a multicentre, prospective,
pragmatic, non-blinded, pilot randomised controlled trial (1:1
randomisation) of two parallel groups that compared a 12-week early
moderate-intensity resistance training group to a control group, receiving
aerobic-based rehabilitation. English-speaking adults (>=18 years)
undergoing elective cardiac surgery via median sternotomy were randomised
using sealed envelopes, with allocation revealed before surgery. The
primary outcome was cognitive function, assessed using the Alzheimer's
Disease Assessment Scale-cognitive subscale (ADAS-cog), at baseline, 14
weeks and 6 months postoperatively. Result(s): The ADAS-cog score at
14 weeks was significantly better for the resistance training group (n=14,
7.2+/-1.4; 95% CI 4.3, 10.2, vs n=17, 9.2+/-1.3; 95% CI 6.6, 11.9,
p=0.010). At 14 weeks postoperatively, 53% of the aerobic-based
rehabilitation group (n=9/17) experienced cognitive decline by two points
or more from baseline ADAS-cog score, compared to 0% of the resistance
training group (n=0/14; p=0.001). Conclusion(s): Early resistance
training appears to be safe and may improve cognitive recovery compared to
standard, aerobic-based rehabilitation following cardiac surgery via
median sternotomy, however as this was a pilot study, the sample size was
small and further research is needed to determine a causal
relationship. Copyright © 2021 Australian and New Zealand Society
of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<10>
Accession Number
2014844898
Title
Myocardial Protection With Different Cardioplegia in Adult Cardiac
Surgery: A Network Meta-Analysis.
Source
Heart Lung and Circulation. 31(3) (pp 420-429), 2022. Date of Publication:
March 2022.
Author
Zhou K.; Zhang X.; Li D.; Song G.
Institution
(Zhou, Li) Department of Cardiac Surgery, Shengjing Hospital of China
Medical University, Shenyang, China
(Zhang, Song) Department of Ultrasound, Shengjing Hospital of China
Medical University, Shenyang, China
Publisher
Elsevier Ltd
Abstract
Aim: Cardioplegia is one of the most studied fields of myocardial
protection during cardiac surgery. However, the most effective
cardioplegia for protection in adult cardiac surgery remains unknown.
 Method(s): PubMed and other databases were searched and a network
meta-analysis with a Bayesian framework was performed. The primary
outcomes were the serum concentrations of creatine kinase-myocardial band
(CK-MB), cardiac troponin I, and cardiac troponin T (cTnT) at four time
points. Several clinical outcomes were evaluated, including low output
syndrome, myocardial infarction, and risk of early mortality. All studies
that involved crystalloid cardioplegia without reference to St Thomas
cardioplegia or histidine-tryptophan-ketoglutarate solution, and if the
cardioplegia was used at a temperature between 4degreeC and 16degreeC were
classified as cold crystalloid (cCCP) or cold blood cBCP cardioplegia.
Warm blood cardioplegia (wBCP) was defined as the blood cardioplegia used
at a temperature between 32degreeC and 37degreeC. Result(s):
Forty-seven (47) studies with a total of 4,175 patients were included.
Seven (7) cardioplegia solutions were used, including cold CCP or BCP, del
Nido solution, histidine-tryptophan-ketoglutarate solution, St Thomas
cardioplegia, wBCP and warm terminal blood cardioplegia (wtBCP). The serum
concentrations of CK-MB at 2 hours (mean difference [MD], 213.56; 95%
confidence interval [CI], -25.79 to -1.59) and cTnT at 24 hours of wBCP
(MD, -1.50; 95% CI, -2.69 to -0.31) were significantly lower than that of
cCCP. There were no significant differences in other outcomes of these six
cardioplegia solutions, when compared to cCCP. Conclusion(s): The
seven cardioplegia solutions analysed had similar myocardial protective
effects after adult cardiac surgery, although wBCP had a lower CK-MB at 2
hours and lower cTnT at 24 hours. Copyright © 2021 Australian and
New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the
Cardiac Society of Australia and New Zealand (CSANZ)

<11>
Accession Number
2011864941
Title
Distal Versus Proximal Radial Artery Access for Cardiac Catheterization
and Intervention: Design and Rationale of the DIPRA Trial.
Source
Cardiovascular Revascularization Medicine. 35 (pp 104-109), 2022. Date of
Publication: February 2022.
Author
Al-Azizi K.M.; Idris A.; Christensen J.; Hamandi M.; Hale S.;
Martits-Chalangari K.; Van Zyl J.S.; Ravindranathan P.; Banwait J.K.;
Mcckracken J.; Smith A.; Apakama G.; Swim J.; Dolton P.; Chionh K.; Dimaio
M.; Thomas S.; Szerlip M.; Sayfo S.; Dib C.; Mack M.; Potluri S.
Institution
(Al-Azizi) Interventional Cardiology and Structural Heart Disease, Texas
A&M University College of Medicine, The Heart Hospital - Plano, Baylor
Scott & White Health, 1100 Allied Dr, Plano, TX 75093, United States
(Idris, Christensen) The Heart Hospital Plano - Baylor Scott & White,
United States
(Hamandi, Hale, Martits-Chalangari, Van Zyl, Ravindranathan, Banwait,
Mcckracken, Smith, Apakama, Swim, Dolton, Chionh, Dimaio, Mack) Baylor
Research Institute, The Heart Hospital Plano - Baylor Scott & White,
United States
(Thomas, Szerlip, Sayfo, Potluri) Interventional Cardiology and Structural
Heart Disease, The Heart Hospital - Plano, Baylor Scott & White Health,
United States
(Dib) Interventional Cardiology, The Heart Hospital - Plano, Baylor Scott
& White Health, United States
Publisher
Elsevier Inc.
Abstract
Background: Radial artery (RA) catheterization is the access of choice
over femoral artery access for most interventional vascular procedures
given its safety and faster patient recovery. There has been growing
interest in distal radial artery (dRA) access as an alternative to the
conventional proximal radial artery (pRA) access. Preserving the RA is
important which serves as a potential conduit for future coronary artery
bypass surgery, dialysis conduit or preserve the artery for future
cardiovascular procedures. The dRA runs in close proximity to the radial
nerve, which raises the concern of potential detrimental effects on hand
function. Study design: The Distal versus Proximal Radial Artery Access
for cardiac catheterization and intervention (DIPRA) trial is a
prospective, randomized, parallel-controlled, open-label, single center
study evaluating the outcomes of hand function and effectiveness of dRA
compared to pRA access in patients undergoing cardiac catheterization. The
eligible subjects will be randomized to dRA and pRA access in a (1:1)
fashion. The primary end point is an evaluation of hand function at one
and twelve months follow-up. Secondary end points include rates of access
site hematoma, access site bleeding, other vascular access complications,
arterial access success rate, and RA occlusion at one and twelve months
follow up. Conclusion(s): Effects of dRA on hand function remains
unknown and it's use questionable in the presence of a widely accepted
pRA. DIPRA trial is designed to determine the safety and effectiveness of
dRA for diagnostic and interventional cardiovascular procedures compared
to the standard of care pRA. Copyright © 2021 Elsevier Inc.

<12>
Accession Number
2016871161
Title
Clinical outcomes of heart transplantation using hepatitis c-viremic
donors: A systematic review with meta-analysis.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2022. Date of
Publication: 2022.
Author
Villegas-Galaviz J.; Anderson E.; Guglin M.
Institution
(Villegas-Galaviz) Department of Medicine, Indiana University School of
Medicine, Indianapolis, IN, United States
(Anderson) Cardiothoracic Transplant, Indiana University Health Methodist
Hospital, Indianapolis, IN, United States
(Guglin) Heart Failure/Heart Transplantation/MCS Services, Krannert
Institute of Cardiology, Indiana University School of Medicine,
Indianapolis, IN, United States
Publisher
Elsevier Inc.
Abstract
Background: Heart transplantation (HTx) from hepatitis C virus
(HCV)-viremic donors to nonviremic recipients decreases mortality and
costs. Consequently, many transplant centers have reported their results
using this strategy. Hence, there is a need for an outcome analysis.
 Method(s): We performed a systematic review with meta-analysis. In
August 2020, we searched PubMed and EMBASE for publications containing
data of nonviremic recipients who underwent HTx from HCV-viremic donors
once direct-acting antiviral (DAA) therapy had become available (>=2014).
 Result(s): We identified 398 publications, 13 of which met inclusion
criteria, and analyzed the outcomes of 195 recipients. The
HCV-transmission rate was >97% but, the cure rate was 100% with DAA
therapy. The 6 and 12-month survival were 95.6% and 92.9%, respectively.
Of 10 deaths reported, none were associated with HCV infection. The acute
cellular rejection (ACR) rate was 31.1%. The overall DAA failure rate was
1.1%, defined as the need to alter the initial DAA therapy due to failure
to cure HCV. However, the DAA failure rate was 0% when the DAA therapy was
started within the first 2 weeks post-HTx. No statistically significant
differences in HCV cure rates, survivals, ACR rates, and DAA failure rates
were observed when outcomes were stratified by therapeutic approach type
(i.e., a prophylactic approach in which DAA was given to the recipient
before confirming HCV-transmission vs a reactive approach, in which DAA
was given to the recipient only after an HCV-transmission was confirmed).
 Conclusion(s): Excellent clinical outcomes have been observed in
nonviremic recipients of HTx from HCV-viremic donors since DAA had become
available. Copyright © 2022 International Society for Heart and
Lung Transplantation

<13>
Accession Number
2015626119
Title
Polycythaemia Vera and Coronary Artery Bypass Graft Surgery: A Systematic
Review of the Literature.
Source
Heart Lung and Circulation. 31(3) (pp 304-312), 2022. Date of Publication:
March 2022.
Author
Janmohamed I.K.; Sondh R.S.; Ahmed H.; Afzal M.B.; Tyson N.; Harky A.
Institution
(Janmohamed) University of Leeds, Faculty of Health and Medicine, UK,
Leeds, United Kingdom
(Sondh) St George's Hospital Medical School, University of London, UK,
London, United Kingdom
(Ahmed, Afzal) Imperial College London, Department of Medicine, UK,
London, United Kingdom
(Tyson) Nottingham University Hospitals, Department of Cardiac Surgery,
UK, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, UK, United Kingdom
Publisher
Elsevier Ltd
Abstract
Objectives: Polycythaemia vera (PV) is a condition that may potentially
put patients undergoing cardiac surgery at an increased risk of bleeding
and thrombosis; however, there is currently a paucity of literature
regarding the management of these patients. We aim to examine the
literature in this systematic review to indicate the interventions that
may be considered to minimise complications. Method(s): We conducted
a literature search using keywords and MeSH terms to identify articles
discussing PV and cardiac surgery. The studies were identified and
qualitatively analysed using the Preferred Reporting Items for Systematic
Reviews and Meta-analysis (PRISMA) protocol. Result(s): In total, 10
case reports representing 11 patients were identified for this systematic
review and were included in qualitative analysis. 63.6% of patients had
preoperative intermittent phlebotomy, and the majority of patients
received postoperative therapy that involved one antiplatelet agent and
one anticoagulant. Generous perioperative fluid management, phlebotomy,
preservation of core body temperature, early extubation, monitoring of
myocardial ischaemia, infarction and vascular events, intense chest
physiotherapy and patient mobilisation are important to consider to reduce
the risk of complications arising from surgery. Conclusion(s): These
considerations should be systematically discussed in a multidisciplinary
team, where the acute surgical need can be balanced appropriately against
the risk of haemorrhage and thrombosis. Copyright © 2021
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<14>
Accession Number
637234574
Title
Expanding the potential benefits of colchicine for preventing
postpericardiotomy syndrome and atrial fibrillation complications after
cardiac surgery: Meta-analysis of randomized controlled trials.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i113), 2021. Date of Publication:
May 2021.
Author
Putra B.P.; Putra F.N.
Institution
(Putra) Medical Doctor, Blitar, Indonesia
(Putra) Airlangga University, Surabaya, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Introduction: Postpericardiotomy syndrome (PPS) and atrial fibrillation
(AF) are complications occurred in one-third of cardiac surgery patients
that increase morbidity and mortality. Colchicine is an anti-inflammatory
drug for treating acute pericarditis and pericardial effusion. Previous
studies suggested that colchicine also may prevent PPS and AF after
cardiac surgery although the results were still inconsistent.
 Purpose(s): This study intends to determine the efficacy of
colchicine for preventing PPS and AF in post-cardiac surgery patients.
 Method(s): We conducted comprehensive literature searching in online
databases of Pubmed, EMBASE, ScienceDirect, and The Cochrane Library, to
include all relevant studies until November 2020. We included all
randomized controlled trials (RCTs) that access the incidence of PPS and
AF after cardiac surgery in patients who received colchicine before
cardiac surgery compared with placebo. We use revised Cochrane
risk-of-bias tool (RoB 2) for accessing the bias risk of included studies.
We performed analysis to provide pooled risk ratio (RR) with 95%
confidence interval (CI) using fixed-effect heterogeneity test.
 Result(s): We included 9 RCTs with total of 2,372 participants met
our inclusion criteria. The administration of colchicine before cardiac
surgery decreases the incidence of PPS significantly (pooled RR = 0.55,
95% CI 0.43 - 0.71, p < 0.00001. I2 = 0%). Besides, colchicine
also significantly lowers the incidence of postoperative AF compared with
placebo (pooled RR = 0.79, 95% CI 0.65 - 0.96, p = 0.02. I2 =
20%). Conclusion(s): Colchicine showed potential benefits for
preventing PPS and AF after cardiac surgery. However, further trials are
needed to establish the efficacies.

<15>
Accession Number
637234466
Title
Fit, female or fifty-is cardiac rehabilitation fit for purpose? A
systematic review and meta-analysis with meta-regression.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i318), 2021. Date of Publication:
May 2021.
Author
Smith M.; Orchard J.J.; La Gerche A.; Gallagher R.; Fitzpatrick J.
Institution
(Smith) Australasian College of Sports and Exercise Physicians, Melbourne,
Australia
(Orchard) University of Sydney, Charles Perkins Centre, Sydney, Australia
(La Gerche) Baker Heart and Diabetes Institute, Melbourne, Australia
(Gallagher) University of Sydney, Faculty of Medicine and Health, Sydney,
Australia
(Fitzpatrick) University of Melbourne, CHESM, Melbourne, Australia
Publisher
SAGE Publications Inc.
Abstract
Introduction: Cardiac rehabilitation (CR) is a multi-disciplinary,
evidence-based intervention, aimed to address modifiable risk factors for
coronary artery disease. It is recommended worldwide for patients
following myocardial infarction (MI), Percutaneous Coronary Intervention
(PCI) and cardiac surgery. A growing body of evidence points towards a
lack of uptake in CR in females and younger people. Purpose(s): To
examine the effectiveness of contemporary CR programs and assess whether
they cater for all patients regardless of age, gender and prior level of
fitness, via systematic review, meta-analysis and meta-regression.
 Method(s): MEDLINE was examined for studies involving exercise
prescription or CR following MI, PCI and cardiac surgery from January 2010
to May 2020. RCTs and cohort studies of >=10 patients were included for
programs delivering phase II or III CR. Primary outcome measures were
peakVO2max, 6-minute walk test (6MWT) and Metabolic Equivalent of Task
(METs). Data were extracted using random effects meta-analysis.
Epidemiological data were analysed for age, proportion of males to females
and prior level of fitness. Baseline level of fitness was assessed by
peakVO2max, 6MWT and METs values on entry into CR programs.
Meta-regression was then used to determine change in fitness and the
influence of age or gender. Result(s): Thirty-three of the 713
studies (13 RCT, 20 cohort) were eligible and included in the review.
Participants had a mean age of 60.0 years and 6/49 (12%) of study groups
had a mean age <55 years. Male participants comprised 81.9% of those who
completed CR and 41/58 (71%) participants were below average for
cardiorespiratory fitness (CRF) when compared to normative values for
those aged 60-69 years on entering CR. CRF improved in all study groups by
the end of CR programs (mean improvement in peakVO2 3.3mL/kg/min, 6MWT
90.8m and METs 1.7). Meta-regression analysis showed that males were more
likely to have an increase in 6MWT distance compared to females (mean
difference 3.16m (95% CI 0.44-5.89). However, gender and age did not
independently affect peakVO2max or METs. Conclusion(s): CR following
MI, PCI or cardiac surgery improved mean CRF in all study groups. While
males were more likely to show an improvement in 6MWT there was no
appreciable difference in effect in other outcomes after controlling for
age or gender differences. Females, younger people and those of average or
above CRF appear to be under-represented in data and attendance at cardiac
rehabilitation. Given that CR outcomes are equal across gender and age,
more effort should be made to encourage female and younger patients to
attend. A 'Precision Medicine' model of exercise prescription may assist
in this aim.

<16>
Accession Number
637234258
Title
Prehabilitation program for coronary artery bypass grafting patients and
perioperative myocardial injury.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i175), 2021. Date of Publication:
May 2021.
Author
Argunova Y.; Belik E.; Moskin E.; Gruzdeva O.; Pomeshkina S.; Barbarash O.
Institution
(Argunova, Belik, Moskin, Gruzdeva, Pomeshkina, Barbarash) Research
Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian
Federation
Publisher
SAGE Publications Inc.
Abstract
Purpose: To evaluate morphological and functional cardiac parameters and
to assess changes in markers of perioperative myocardial injury in
patients undergoing different prehabilitation program before elective
coronary artery bypass grafting (CABG). Method(s): 60 male patients
with stable coronary artery disease (CAD) underwent screening in the
preoperative period and were randomized into two groups. Group 1 (n = 30,
mean age 61.5 [56; 63]) underwent supervised treadmill exercises at
intensity corresponding to 80% of VO2 peak during the preoperative
management. Group 2 (n = 30, mean age 62.0 [56; 64]) patients did not
undergo any additional trainings. Patients underwent a standard
echocardiographic (ECHO-CG) study in the preoperative period and at days
5-7 after CABG. Serum markers of myocardial injury (troponin I, NT-proBNP)
were measured in both groups of patients in the preoperative period before
training (point 1), at the end of exercise training session (point 2) and
at days 5-7 (point 3) after CABG. Result(s): Left ventricular
end-systolic dimension (p = 0.039) and left ventricular end-systolic
volume (p = 0.039) increased by 8.5% and 18% in patients who underwent
supervised exercise trainings as compared to the baseline values. An
increase in these parameters was more pronounced in the control group (17%
(p = 0.00029) and 41% (p = 0.00028), respectively). Both groups were
comparable in troponin I levels at three study points. Troponin I values
were within the reference range. NT-proBNP levels showed a downward trend
in patients with prehabilitation at the end of the training sessions,
while in the control group NTproBNP levels increased. An increase in
NT-proBNP levels was reliable in patients without exercise trainings (p =
0.003) after CABG compared to the preoperative values. However, changes in
NT-proBNP levels were insignificant in patients who underwent
prehabilitation (p > 0.05). Conclusion(s): The safety of
high-intensity exercise trainings in the prehabilitation program for CABG
had been confirmed by laboratory markers indicative for myocardial injury.
The obtained data proved the efficiency of active prehabilitation for
optimizing morphological and functional cardiac parameters as well as
inducing cardioprotection.

<17>
Accession Number
637234215
Title
Effects of the use neuromuscular electrical stimulation of the lower
extremities in the prehabilitation of patients in a before cardiac
surgery.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i359-i360), 2021. Date of
Publication: May 2021.
Author
Oleinik P.; Sumin A.N.; Bezdenezhnykh A.V.
Institution
(Oleinik, Sumin, Bezdenezhnykh) Research Institute for Complex Issues of
Cardiovascular Diseases, Kemerovo, Russian Federation
Publisher
SAGE Publications Inc.
Abstract
Aim To evaluate the effects of neuromuscular electrostimulation in the
prehabilitation and prevention of muscle weakness in patients awaiting
cardiac surgery. Material(s) and Method(s): 122 patients waiting for
elective cardiac surgery were included. Exclusion criteria: age less than
25 and more than 80 years; emergency and urgent surgical interventions;
arthropathies; low pain threshold; rhabdomyolysis and other myopathies;
cognitive dysfunction. Routine laboratory and instrumental examinations
were performed in all patients upon admission to the hospital, as part of
a standard examination. 62 patients were randomly selected for the
preoperative NMES group, in addition to the standard preoperative
preparation and treatment program. The standard program included 60
control patients. Patients of the NMES group underwent quadriceps
stimulation for at least 5 sessions, lasting 90 minutes, daily before
surgery. Results.: The groups were comparable and did not have significant
differences in gender and age characteristics, according to the main
clinical and anamnestic data and types of operations. Initially, there
were no differences in the state of the muscles of the lower extremities,
the distance of the six-minute walking test (6MWT), and the strength of
the hand grip. After NMES, there was an increase in muscle strength
relative to the control group, both stimulated muscle groups and
unstimulated antagonist muscles, as well as a greater 6MWT distance and
hand compression force. All the differences were significant.
 Conclusion(s): The course of pre-rehabilitation of NMES before
surgery, allowed to maintain, and in some cases improve the condition of
the muscle frame of the lower extremities. A positive effect was observed
not only in stimulated muscle groups, but also in antagonist muscles.

<18>
Accession Number
637234123
Title
Association of type 2 diabetes mellitus and mortality after coronary
artery bypass graft surgery-a meta analysis.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i295), 2021. Date of Publication:
May 2021.
Author
Abdul Razzack A.; Pothuru S.; Adeel Hassan S.; Mandava S.; Theja Reddy K.;
Missael Rocha Castellanos D.; Rocha Castellanos D.; Lilian Contreras
Gallegos G.; Sanchez Alfaro A.; Arshad J.; Sattar Y.
Institution
(Abdul Razzack) Dr. N.T.R University of Health Sciences, Vijayawada,
Andhra Pradesh, India
(Pothuru) Ascension Via Christi Hospital, Department of Internal Medicine,
Kansas, United States
(Adeel Hassan) University of Louisville, School of Medicine, Louisville,
United States
(Mandava) Santa Barbara Cottage Hospital, California, United States
(Theja Reddy) UHS Southern California Medical Education Consortium,
Temecula, CA, United States
(Missael Rocha Castellanos) Tecnologico de Monterrey, Escuela de Medicina
y Ciencias de la Salud, Monterrey, Mexico
(Rocha Castellanos, Lilian Contreras Gallegos, Sanchez Alfaro) Facultad De
Medicina Universidad Autonoma de Tamaulipas, Matamoros, Mexico
(Arshad) Pakistan Institute of Medical Sciences, Islamabad, Pakistan
(Sattar) Icahn School of Medicine at Mount Sinai, New York, United States
Publisher
SAGE Publications Inc.
Abstract
Background-Recent studies have demonstrated the favorable cardiovascular
outcomes of coronary artery bypass graft surgery (CABG) among patients
with diabetes mellitus (DM). However, little is known regarding the impact
of T2DM in patients undergoing CABG. We aimed to compare the long-term
mortality following CABG in patients with and without T2DM.
Methods-Electronic databases ( PubMed, Embase, Scopus, Cochrane) were
searched from inception to December 15th, 2020. Unadjusted odds ratios
(OR) were calculated from dichotomous data using Mantel Haenszel (M-H)
random-effects with statistical significance to be considered if the
confidence interval excludes 1 and p < 0.05.The primary outcome was
all-cause mortality. Results-Sixteen studies with a total of 183,200
participants (DM = 51,474, Non-DM = 131,726) were included in our
analysis. Average follow up was 3 years. Mean age was 56.7 and 54.8 in the
DM and Non-DM groups respectively. A statistically significantly higher
rate of mortality was observed in patients with T2DM (OR 1.54; 95%CI
1.40-1.69; p < 0.00001, I2 = 36)as opposed to patients without T2DM.
Conclusion-Although CABG is the better revascularization strategy as
opposed to PCI, Type 2 DM is an independent predictor for long-term
mortality after CABG surgery.

<19>
Accession Number
637234014
Title
Long-term prognosis after percutaneous or surgical revascularization in
patients with diabetes mellitus and complex coronary artery disease-a
systematic review and meta analysis.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i69), 2021. Date of Publication:
May 2021.
Author
Abdul Razzack A.; Mandava S.; Pothuru S.; Adeel Hassan S.; Missael Rocha
Castellanos D.; Fernando Perez Paz M.; Alsonso Elizarraras Aldrete O.;
Theja Reddy K.; Sattar Y.
Institution
(Abdul Razzack) Dr. N.T.R University of Health Sciences, Vijayawada,
Andhra Pradesh, India
(Mandava) Santa Barbara Cottage Hospital, CA, United States
(Pothuru) Ascension Via Christi Hospital, Department of Internal Medicine,
Kansas, United States
(Adeel Hassan) University of Louisville, School of Medicine, Louisville,
United States
(Missael Rocha Castellanos) Tecnologico de Monterrey, Escuela de Medicina
y Ciencias de la Salud, Monterrey, Mexico
(Fernando Perez Paz) Hospital General de Matamoros Dr. Alfredo Pumarejo H.
Matamoros, Tamaulipas, Mexico
(Alsonso Elizarraras Aldrete) Universidad De Monterrey, Monterrey, Mexico
(Theja Reddy) UHS Southern California Medical Educational Consortium,
Temecula, CA, United States
(Sattar) Icahn School of Medicine at Mount Sinai, New York, United States
Publisher
SAGE Publications Inc.
Abstract
Background-Whether Coronary artery bypass grafting (CABG) confers a
survival benefit in patients with diabetes mellitus(DM) and complex
coronary artery disease (CAD), including left main CAD and multivessel
coronary disease (MVD) after a follow up period >= 5 years remains
unknown. Methods-Electronic databases (PubMed, Embase, Scopus, Cochrane)
were searched from inception to December 12th 2020. Using a generic
invariance weighted random effects model, Hazard ratios (HRs) and their
95% confidence intervals (CIs) from individual studies were converted to
Log HRs and corresponding standard errors, which were then pooled. The
primary outcome of interest was all-cause mortality and major adverse
cardiac and cerebrovascular events (MACCE) which was defined as a
composite of death, myocardial reinfarction and stroke at >= 5 years.
Results-A total of 8 studies with 13336 participants(PCI = 6783, CABG =
6553)were included in our analysis. Mean age was 54.6 and 55.3 in the
PCI-DES and CABG groups respectively. The 5-yr follow-up outcomes
including all-cause mortality (HR 1.37; 95%CI 1.15-1.65; p = 0.0006, I2 =
0)and MACCE (HR 1.48; 95%CI 1.29-1.69; p < 0.00001, I2 = 0) were
significantly higher with PCI as compared to CABG. Furthermore, at >5 year
follow-up, all-cause mortality (HR 1.35; 95%CI 1.10-1.66; p = 0.004, I2 =
37) and MACCE (HR 1.98; 95%CI 1.85-2.12; p < 0.00001, I2 = 0) had similar
outcomes. Conclusion-Amongst patients with DM and Complex CAD ( left
main/MVD), CABG was associated with improved long-term mortality and
freedom from MACCEs as opposed to PCI-DES. CABG is the preferred
revascularization strategy in patients with complex anatomic disease and
concurrent diabetes.

<20>
Accession Number
637233997
Title
Patient adherence to statin therapy within 12 months after coronary
stenting depending on regular or remote monitoring.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i68), 2021. Date of Publication:
May 2021.
Author
Osokina A.; Filatova A.; Potekhina A.; Shchinova A.; Provatorov S.
Institution
(Osokina, Filatova, Potekhina, Shchinova, Provatorov) National Medical
Research Center of Cardiology, Moscow, Russian Federation
Publisher
SAGE Publications Inc.
Abstract
Background. Low adherence to statins remains a challenge in the treatment
of patients with cardiovascular diseases. Some patients who underwent
coronary stenting (CS) are unavailable for regular follow-up with
outpatient visits. The ability to remotely monitor patients after CS may
facilitate adherence to treatment, achieve target low density lipoprotein
(LDL) cholesterol levels and early detection of adverse events. We aimed
to evaluate the adherence to statin therapy in patients after CS receiving
remote monitoring or care with outpatient visits. Methods. We enrolled 279
consecutive stable CAD/silent myocardial ischemia patients (61.5 +/- 9.5
years) who underwent CS. The patients were randomized into groups of
regular outpatient visits (group 1, n = 96), remote monitoring (group 2, n
= 95) and control group (group 3, n = 88). The visits (cardio exam and
blood testing) and remote monitoring (videoconference, telephone care and
blood tests interpretation) were performed at 1, 3, 6 and 12 months after
CS for groups 1 and 2. Patients in the control group were cared by a
physician at the residence place, the contact with the study coordinator
was performed at baseline and 12 months after CS. Adherence to the
prescribed medical therapy based on the four-item Morisky Green Levine
Medication Adherence Scale was assessed at each contact with the study
coordinator. Results. Patient adherence to statin therapy 12 months after
CS was 53.6% for group 1, 55.8% for group 2 and 24.4% for group 3 (p <
0.05 for group 3 versus groups 1 and 2). In group 1
26.9/36.5/31.7/37.4*/41.3*% of patients achieved target LDL level at
baseline/1mo/3mo/6mo/ 12mo, respectively (p<0.05 vs. baseline). In group
2-35.8/36.8/40.0/51.6*/57.9*% of patients (p<0.05 vs. baseline). In group
3 25.5/28.2% of patients achieved target LDL level at baseline/12mo,
respectively. The significant decrease in LDL cholesterol levels between
baseline and 12mo values was observed in groups 1 and 2 (p < 0.05). No
differences were observed in group 3. Conclusion. The groups of patients
receiving remote monitoring or care with outpatient visits demonstrate the
same increase in the proportion of patients that achieved target LDL
cholesterol levels within 12 months after CS. The remote monitoring is a
safe strategy for improving and maintaining the adherence to statins in
patients after CS.

<21>
Accession Number
637233938
Title
Association between red blood cell transfusions and adverse effects after
transcatheter aortic valve replacement-a meta analysis.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i119-i120), 2021. Date of
Publication: May 2021.
Author
Abdul Razzack A.; Pothuru S.; Mandava S.; Adeel Hassan S.; Theja Reddy K.;
Missael Rocha Castellanos D.; Arshad J.; Sattar Y.
Institution
(Abdul Razzack) Dr. N.T.R University of Health Sciences, Vijayawada,
Andhra Pradesh, India
(Pothuru) Ascension Via Christi Hospital, Department of Internal Medicine,
Kansas, United States
(Mandava) Santa Barbara Cottage Hospital, California, United States
(Adeel Hassan) University of Louisville, School of Medicine, Louisville,
United States
(Theja Reddy) UHS Southern California Medical Education Consortium,
Temecula, CA, United States
(Missael Rocha Castellanos) Tecnologico de Monterrey, Escuela de Medicina
y Ciencias de la Salud, Monterrey, Mexico
(Arshad) Pakistan Institute of Medical Sciences, Islamabad, Pakistan
(Sattar) Icahn School of Medicine at Mount Sinai, New York, United States
Publisher
SAGE Publications Inc.
Abstract
Background-Transcatheter aortic valve replacement (TAVR) is associated
with periprocedural bleeding , mainly driven by vascular complications
leading to blood cell transfusion. Additionally, anemia is highly
prevalent in this population. The decision regarding the necessity for
blood transfusion in patients undergoing TAVR is challenging.
Methods-Electronic databases (Medline, Embase, Scopus, Cochrane) were
searched from inception to December 16th, 2020. Unadjusted odds ratios
(OR) were calculated from dichotomous data using Mantel Haenszel (M-H)
random-effects with statistical significance to be considered if the
confidence interval excludes 1 and p < 0.05.The primary outcomes of
interest were all-cause mortality, myocardial infarction( MI),
Stroke(CVA), and acute kidney injury(AKI). Results-A total of six studies
with 6701 participants (Transfusions = 1505, Non-Transfusions = 5196) were
included in our analysis. Average follow-up duration was 30 days. Mean age
was 82.4 and 81.5 in the Transfusions and Non-transfusions group
respectively. RBC transfusion was associated with higher 30-day mortality
(OR-4.08; 95%CI 2.29-7.27; p < 0.00001; I2 = 77) as well as increased risk
of acute kidney injury (AKI) (OR 2.97;95%CI 2.07-4.26; p < 0.00001; I2 =
77) and stroke (OR 2.44; 95%CI 1.78-3.34; p < 0.00001, I2 = 0) However,
there was no significant difference in the incidence of MI (OR 1.15;95%CI
0.50-2.64; p = 0.74, I2 = 0) Conclusion-RBC transfusion is a correlate and
an independent predictor of all-cause mortality, acute kidney injury and
stroke in this patient population and should be used with caution.

<22>
Accession Number
637233925
Title
Prevention The effect of omega-3 polyunsaturated fatty acids in prevention
of postoperative atrial fibrillation development in patients undergoing
coronary artery bypass graft surgery.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i5), 2021. Date of Publication:
May 2021.
Author
Rubanenko O.; Rubanenko A.
Institution
(Rubanenko, Rubanenko) Samara State Medical University, Samara, Russian
Federation
Publisher
SAGE Publications Inc.
Abstract
Purpose. To estimate the effect of omega-3 polyunsaturated fatty acids
(PUFAs) in prevention of postoperative atrial fibrillation (POAF) in
patients with coronary artery disease undergoing coronary artery bypass
graft (CABG) surgery. Methods. Studied were 306 patients who underwent
CABG. All the patients were divided into two groups depending on the
prescription of omega-3 PUFAs in the pre-and postoperative period by
randomization method: 1 group comprised 158 patients without PUFAs (82.7%
men, median age 63.0 (57.0;67.0) years, 2 group-148 patients with PUFAs
(89.3% men, median age 60.0 (57.0;64.0) years). PUFAs were prescribed 2000
mg daily starting with 5 days before CABG and 1000 mg daily after CABG for
21 days. In all the patients, we studied interleukin (IL)-6, IL-8, IL-10,
NT-proBNP, troponin, superoxide dismutase (SOD), malondialdehyde (MDA),
glutathione and omega-3 index. Results. During the observation period POAF
occurred in 29.7% patients of group 1, and in 16.9% patients of group 2 (p
= 0.009). In postoperative period patients of group 1 had median IL-6
level 39.3% higher (p = 0.001) and median IL-10 level-20.2% higher (p =
0.01) comparing with group 2. In patients of group 2 we found SOD median
level 78.9% lower (p<0.0001) and MDA median level 33.8% lower compared to
the patients of group 1 (p=0.03). In postoperative period in group 2 the
median level of docosahexaenoic acid was 55% higher (p = 0.03), and
omega-3 index-43.4% higher (h = 0.04) compared with group 1. Conclusion.
We found that patients with PUFAs had less activation of inflammation and
oxidative stress after CABG than patients without PUFAs. The patients with
PUFAs also had increased levels of docosahexaenoic acids and omega-3 index
compared to the patients without PUFAs. We also found a significant
decrease of the prevalence of POAF after CABG in patients with PUFAs.

<23>
Accession Number
637233917
Title
The Pandora's box of frailty assessments, which is the best for clinical
purpose? A critical review.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i396), 2021. Date of Publication:
May 2021.
Author
Baritello O.; Salzwedel A.; Suendermann S.; Niebauer J.; Voeller H.
Institution
(Baritello, Salzwedel, Voeller) University of Potsdam, Rehabilitation
Medicine, Potsdam, Germany
(Suendermann) Charite Universitatsmedizin Berlin, Cardiovascular Surgery,
Berlin, Germany
(Niebauer) Paracelsus Medical University, Institute of Sport Medicine,
Prevention, Rehabilitation and Research, Institute of Molecular Sports
Medicine and Rehabilitation, Salzburg, Austria
Publisher
SAGE Publications Inc.
Abstract
Introduction: Assessment of frailty is recommended for patients undergoing
elective transcatheter aortic valve implantation (TAVI) to appreciate
post-interventional prognosis. Several studies investigated frailty in
this population using single markers (e.g. gait speed), clinical judgment
scales (e.g. Rockwood) or composite indexes (e.g. Fried). However, there
is a lack of consensus on the most appropriate tool for assessment of
frailty in clinical practice. Purpose(s): To evaluate which frailty
assessment is the most used and meaningful for post-interventional
prognosis in older TAVI patients. Method(s): A systematic search was
performed in PubMed (May 2020). We included randomized controlled trials
or observational studies (prospective or retrospective) without time
restrictions investigating the association of frailty and 1-year all-cause
mortality in older (>=70 years) TAVI-patients. Result(s): 60 studies
(151,723 patients) were included. Studies heterogeneity (methods) was
considerable. 40 different frailty assessments were identified. The most
used single marker (Table) was gait speed (5-meter walk test),
investigated in 16 observational studies (8/8 prospective/ retrospective
with 5,747/40,535 patients). 11 studies found mortality prediction by
reduced gait speed, with hazard ratios (HR) between 1.36 (95% confidence
interval (CI) 1.23-1.50) and 14.71 (95%CI 6.50-33.30) as well as an Odds
Ratio (OR) of 2.34 (95%CI 1.03-5.32). Frailty in composite indexes (Table)
predicted mortality in 10 of 11 observational studies 4-items index: HR
1.84 (95%CI 1.23-2.69) to 3.05 (95%CI 1.24-7.46), 5-items index: OR 1.63
(95 CI 1.12-2.37) to 2.75 (95%CI 1.55-4.87). Conclusion(s):
Predominantly, single markers, especially gait speed, are used to assess
frailty in TAVI-patients. Composite indexes seem to be relieble as well
and should be considered for prediction of 1-year mortality.

<24>
Accession Number
637233913
Title
Effectiveness of a preoperative breathing exercises intervention on
patients undergoing cardiac surgery: A systematic review.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2021. Online. 28(SUPPL 1) (pp i332), 2021. Date of Publication:
May 2021.
Author
Nicola Martins Rodrigues S.F.; Henriques H.R.; Henriques M.A.
Institution
(Nicola Martins Rodrigues, Henriques, Henriques) Higher School of Nursing
of Lisbon, eNursing - Telenursing for aging people with chronic disease,
Lisbon, Portugal
Publisher
SAGE Publications Inc.
Abstract
Background: Postoperative pulmonary complications are a common cause of
morbidity and mortality in patients undergoing cardiac surgery, leading to
an increase of HLOS and health care costs. Purpose(s): This
systematic literature review aims to determine if patients undergoing
cardiac surgery submitted to a preoperative breathing exercises
intervention have better postoperative outcomes regarding respiratory
parameters, postoperative pulmonary complications, and HLOS.
 Method(s): Systematic searches were performed at CINAHL, Cochrane
Central Register of Controlled Trials, Cochrane Clinical Answers, Cochrane
Database of Systematic Reviews, MEDLINE and MedicLatina databases. Studies
were included if they examined adult patients scheduled for elective
cardiac surgery, who underwent a preoperative breathing exercises
intervention aimed at improving breathing parameters, preventing
postoperative pulmonary complications, and reducing HLOS. This review was
based on Cochrane and Prisma statement recommendations in the design,
literature search, analysis and reporting. Result(s): The search
yielded 608 records. Inclusion criteria was fulfilled by 11 studies. Ten
studies were RCT's and one was an observational cohort study. Through
these studies, data from 1240 participants was retrieved and meta-analysis
was performed whenever possible. Conclusion(s): A preoperative
breathing intervention on patients undergoing cardiac surgery may help
improve respiratory performance after surgery, prevent postoperative
pulmonary complications and reduce HLOS. However, more trials are needed
to support and strengthen the evidence found.

<25>
Accession Number
2014948330
Title
Distal radial approach between theory and clinical practice. Time to go
distal!.
Source
Egyptian Heart Journal. 74(1) (no pagination), 2022. Article Number: 8.
Date of Publication: December 2022.
Author
Sanhoury M.I.; Sobhy M.A.; Saddaka M.A.; Nassar M.A.; Elwany M.N.
Institution
(Sanhoury, Sobhy, Saddaka, Nassar, Elwany) Department of Cardiology and
Angiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Transradial access (TRA), which has a minimal risk of problems
such as radial artery occlusion (RAO), hemorrhage, spasm, and so on, is
now considered the standard procedure for cardiac catheterization. The aim
of the study is to present the distal transradial access (d-TRA) as a
possible promising novel technique in the field of cardiac coronary
interventions comparing it to the standard conventional TRA using primary
and secondary endpoints, exploring its benefits and drawbacks as a new
experience in Alexandria University. One hundred cases with variable
indications for coronary interventions were randomized to two arms using
systematic random sampling method, coronary interventions in the first one
were done via d-TRA (50 patients) and in the second arm via conventional
TRA group (50 patients). Result(s): Technically, there were highly
statistically significant differences between the two arms in favor of TRA
regarding procedural success, number of punctures taken, Access time,
Total procedural time, vasodilator used, and crossover to another access
site; meanwhile safety profile parameters have showed statistically
significant differences in favor of d-TRA regarding post-operative
hematoma, AV fistula, post-operative pain and compression time, and there
were no statistically significant differences regarding RAO although it
occurred more in TRA group. Conclusion(s): In the realm of cardiac
intervention, the distal radial approach is a promising technique. When
compared to TRA, we found it to be a viable and safe method for coronary
angiography and interventions and it could be a real option for the
interventionists in the near future, with a lower risk of radial artery
blockage and no significant differences in wrist hematoma and radial
artery spasm. The success rate of d-TRA is proportional to the steepness
of the operator's learning curve and the quality of the examples
chosen. Copyright © 2022, The Author(s).

<26>
Accession Number
2015634246
Title
Clinical Comparison of a Novel Balloon-Expandable Versus a Self-Expanding
Transcatheter Heart Valve for the Treatment of Patients with Severe Aortic
Valve Stenosis: The EVAL Registry.
Source
Journal of Clinical Medicine. 11(4) (no pagination), 2022. Article Number:
959. Date of Publication: February-2 2022.
Author
Barki M.; Ielasi A.; Buono A.; Maliandi G.; Pellicano M.; Bande M.;
Casilli F.; Messina F.; Uccello G.; Briguglia D.; Medda M.; Tespili M.;
Donatelli F.
Institution
(Barki, Ielasi, Buono, Maliandi, Pellicano, Bande, Casilli, Messina,
Uccello, Briguglia, Medda, Tespili) Clinical and Interventional Unit,
Istituto Clinico Sant'Ambrogio, Milan 20149, Italy
(Donatelli) Cardiac Surgery, Department of Cardiothoracic Center, Istituto
Clinico Sant'Ambrogio, University of Milan, Milan 20122, Italy
Publisher
MDPI
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an effective
treatment option for patients with severe, symptomatic AS, regardless of
the transcatheter heart valve (THV) implanted. Prior studies demonstrated
a higher device success with lower paravalvular leak (PVL) using the
balloon-expandable (BE) Sapien/XT THV vs. a self-expanding (SE) THV.
However, few data are available on the performance of a novel BE THV.
 Purpose(s): to compare early clinical performance and safety of the
newly available BE Myval THV (Myval, Meril Life Sciences Pvt. Ltd., India)
vs. the commonly used SE (Evolut R, Medtronic) THV. Method(s): A
single-center, retrospective cohort analysis was performed with 166
consecutive patients undergoing TAVR from March 2019 to March 2021 for
severe symptomatic AS treated with either the novel BE Myval or the SE
Evolut R (ER) bioprosthesis. The primary endpoint was device success at
day 30 according to the Valve Academic Research Consortium-3 (VARC-3).
Secondary endpoints included 30-day all-cause mortality, cardiovascular
mortality, more than mild PVL, permanent pacemaker implantation (PPI)
rates and a composite of all-cause mortality and disabling stroke at 6
months. Result(s): Among the 166 included patients, 108 patients
received the SE ER THV and 58 patients were treated with the BE Myval THV.
At baseline, the two groups showed comparable demographic characteristics.
The primary composite endpoint of early device success occurred in 55
patients (94.8%) in the BE Myval group and in 90 patients (83.3%) in the
SE ER group (OR 3.667, 95% CI 1.094-12.14; p = 0.048). At day 30, the BE
Myval THV group exhibited a significantly lower incidence of more than
mild PVL (BE Myval 3.45% vs. SE ER 14.8%, OR 0.2, 95% CI 0.05-0.8; p =
0.0338), along with a lower rate of PPI (BE Myval 11% vs. SE ER 24.2%, OR
0.38, 95% CI 0.15-0.99; p = 0.0535). At the 6-month follow-up, the
incidence of all-cause mortality and disabling stroke did not
significantly differ between the two groups, while the incidence of PPI
(BE Myval 11% vs. SE ER 27.5%, OR 0.32, CI 95% 0.1273-0.8; p = 0.02) and
>=moderate PVL (BE Myval 6.9% vs. SE ER 19.8%, OR 0.31, 95% CI 0.1-0.94; p
= 0.0396) was significantly lower in the BE Myval group.
 Conclusion(s): In patients with severe symptomatic AS undergoing
TAVR, the novel Myval BE THV provided a comparable performance to the
well-known ER SE THV, and it was associated with a lower rate of PPI and
>=moderate PVL within 30 days and 6 months after the procedure.
Randomized, head-to-head comparison trials are needed to confirm our
results. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<27>
Accession Number
2016882153
Title
Serum albumin in patients undergoing transcatheter aortic valve
replacement: A meta-analysis.
Source
Reviews in Cardiovascular Medicine. 20(3) (pp 161-169), 2019. Date of
Publication: 30 Sep 2019.
Author
Hsieh W.C.; Aboud A.; Henry B.M.; Omara M.; Lindner J.; Pirk J.
Institution
(Hsieh) First Faculty of Medicine, Charles University, Prague 1200,
Czechia
(Hsieh, Lindner) 2nd Department of Cardiovascular Surgery, First Faculty
of Medicine, Charles University, General University Hospital in Prague,
Prague 1200, Czechia
(Aboud) Department of Cardiac and Thoracic Vascular Surgery, University of
Schleswig-Holstein, Lubeck Campus, Lubeck 23562, Germany
(Henry) Division of Cardiology, Cincinnati Children's Hospital Medical
Center, Cincinnati, OH 45229, United States
(Omara) Department of Thoracic and Cardiovascular Surgery, Research
Institute, Cleveland Clinic, Cleveland, OH 44195, United States
(Pirk) Department of Cardiology and Cardiac Surgery, Institute of Clinical
and Experimental Medicine IKEM, Prague 14021, Czechia
Publisher
IMR Press Limited
Abstract
Transcatheter aortic valve replacement is becoming a more common
therapeutic option for the treatment of aortic stenosis in patients at
high risk for invasive surgery, but detecting which patients will benefit
clinically can be challenging. Hypoalbuminemia is a useful prognostic
marker for chronic inflammation in this population. We carried out a
systematic review and meta-analysis of studies evaluating the prognostic
value of serum albumin level in patients undergoing transcatheter aortic
valve replacement. A literature search of PubMed, Embase, ScienceDirect,
Web of Science, SciELO, BIOSIS, Wanfang, and CNKI databases was conducted.
Articles published between January 2000 and December 2017 reporting on the
prognostic value of low levels of serum albumin in patients undergoing
transcatheter aortic valve replacement were analyzed according to
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines. 11 studies including 6456 patients met inclusion criteria for
meta-analysis. A lower serum albumin level was associated with a lower
survival rate at follow-up in patients who underwent transcatheter aortic
valve replacement. A subgroup analysis of eight studies reporting adjusted
hazard ratios indicated that low serum albumin was independently
correlated with increased post-operative mortality. The hazard ratio of
mortality risk associated with each 1 g/dL increment in serum albumin
level was 0.46, suggesting a potential dose-response relationship between
increased serum albumin level and increased survival rate in patients
undergoing transcatheter aortic valve replacement. This meta-analysis
provides strong evidence for the utility of serum albumin as a prognostic
marker in aortic stenosis patients undergoing transcatheter aortic valve
replacement, with low serum albumin levels (2.5-3.5 g/dL) suggesting poor
prognosis. Copyright © 2019 Hsieh et al. Published by IMR Press.
All rights reserved.

<28>
[Use Link to view the full text]
Accession Number
2016744592
Title
Spontaneous Breathing Trial for Prediction of Extubation Success in
Pediatric Patients Following Congenital Heart Surgery: A Randomized
Controlled Trial.
Source
Pediatric Critical Care Medicine. 20(10) (pp 940-946), 2019. Date of
Publication: 01 Oct 2019.
Author
Ferreira F.V.; Sugo E.K.; Aragon D.C.; Carmona F.; Carlotti A.P.C.P.
Institution
(Ferreira, Sugo, Aragon, Carmona, Carlotti) Department of Pediatrics,
Division of Pediatric Critical Care, Ribeirao Preto Medical School,
University of Sao Paulo, Ribeirao Preto, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: To evaluate the usefulness of a spontaneous breathing trial
for predicting extubation success in pediatric patients in the
postoperative period after cardiac surgery compared with a physician-led
weaning. Study Design: Randomized, controlled trial. Setting(s):
PICU of a tertiary-care university hospital. Patient(s): A population
of pediatric patients following cardiac surgery for congenital heart
disease. Intervention(s): Patients on mechanical ventilation for more
than 12 hours after surgery who were considered ready for weaning were
randomized to the spontaneous breathing trial group or the control group.
The spontaneous breathing trial was performed on continuous positive
airway pressure with the pressure support of 10 cmH<inf>2</inf>O, the
positive end-expiratory pressure of 5 cmH<inf>2</inf>O, and the fraction
of inspired oxygen less than or equal to 0.5 for 2 hours. Patients in the
control group underwent ventilator weaning according to clinical judgment.
 Measurements and Main Results: The primary endpoint was extubation
success defined as no need for reintubation within 48 hours after
extubation. Secondary outcomes were PICU length of stay, hospital length
of stay, occurrence rate of ventilator-associated pneumonia, and
mortality. One hundred and ten patients with the median age of 8 months
were included in the study: 56 were assigned to the spontaneous breathing
trial group and 54 were assigned to the control group. Demographic and
clinical data and Risk Adjustment for Congenital Heart Surgery-1
classification were similar in both groups. Patients undergoing the
spontaneous breathing trial had greater extubation success (83% vs 68%, p
= 0.02) and shorter PICU length of stay (median 85 vs 367 hr, p < 0.0001)
compared with the control group, respectively. There was no significant
difference between groups in hospital length of stay, occurrence rate of
ventilator-associated pneumonia, and mortality. Conclusion(s):
Pediatric patients with congenital heart disease undergoing the
spontaneous breathing trial postoperatively had greater extubation success
and shorter PICU length of stay compared with those weaned according to
clinical judgment. Copyright © 2019 by the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies

<29>
Accession Number
2015002102
Title
Colchicine may become a new cornerstone therapy for coronary artery
disease: a meta-analysis of randomized controlled trials.
Source
Clinical Rheumatology. (no pagination), 2022. Date of Publication: 2022.
Author
Zhang H.; Chen Y.; Li M.; Luo W.; Liu Y.; Fu Y.; Xia H.; Xu C.; Jiang Y.;
Wu Y.
Institution
(Chen, Zhang, Chen, Li, Luo, Liu, Fu, Xia, Xu, Wu) Department of
Cardiovascular Medicine, Donghu District, The Second Affiliated Hospital
of Nanchang University, No. 1, Minde Road, Jiangxi, Nanchang 330006, China
(Jiang) Department of Cardiovascular Medicine, Donghu District, The First
Affiliated Hospital of Nanchang University, No. 17, Yongzhengwai Road,
Jiangxi, Nanchang 330006, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Colchicine is an ancient anti-inflammatory drug. In recent years,
an increasing number of studies have shown that colchicine improves the
prognosis of patients with coronary artery disease (CAD), while other
studies have reported the opposite. The aim of this study was to evaluate
the relative efficacy and safety of colchicine in treating CAD.
 Method(s): PubMed, EMBASE, the Cochrane Library, and
ClinicalTrials.gov were searched from inception to 20 October 2020 for
randomized controlled trials (RCTs) comparing colchicine and placebo in
patients with CAD. The primary outcomes were the primary composite
outcomes of cardiovascular death, myocardial infarction (MI), ischemic
stroke, or ischemia-driven coronary revascularization after colchicine
administration. The secondary outcomes were cardiovascular death, death
from any cause, noncardiac death, MI, ischemic stroke, coronary
revascularization, gastrointestinal (GI) symptoms, and the different
effects of colchicine in acute and chronic CAD. We assessed the pooled
odds ratio (OR) of all-cause and cardiovascular mortality for CAD in
fixed-effects models, the pooled risk ratio (RR) of the primary composite
outcomes, MI, ischemic stroke, and ischemia-driven coronary
revascularization in fixed-effects models and the pooled RR of GI symptoms
in random-effects models. The Cochrane risk of bias tool was used to
assess the risk of bias in the included RCTs. Finding(s): Eleven of
the 894 identified studies (n = 12,899 patients) were included (6501
subjects in the colchicine group; 6389 subjects in the control group). The
colchicine group had significantly lower pooled RRs of the primary
composite outcomes (0.73, 95% confidence interval (CI) 0.64-0.84, P <
0.0001), MI (0.77, 95% CI 0.64-0.92, P = 0.004), ischemic stroke (0.47,
95% CI 0.30-0.76, P = 0.002), and ischemia-driven coronary
revascularization (0.77, 95% CI 0.66-0.89, P = 0.0007), while the pooled
RR of adverse GI events (2.15 95% CI 1.40-3.31, P = 0.0005) was
significantly higher. Colchicine had a lower pooled RR of ischemic stroke
(0.28, 95% CI 0.12-0.65, P = 0.003) for patients with acute compared with
chronic CAD. Implications: Colchicine treatment significantly decreased
the risk of primary cardiovascular composite outcomes, MI, ischemic
stroke, and ischemia-driven coronary revascularization in CAD patients but
increased adverse GI events. There was no significant difference in
all-cause mortality, cardiovascular mortality, and non-cardiovascular
death between the colchicine and control groups. Colchicine performs
better in acute CAD patients with ischemic stroke than chronic CAD
patients. Colchicine might be a new treatment for patients with
CAD. Copyright © 2022, International League of Associations for
Rheumatology (ILAR).

<30>
Accession Number
637232697
Title
Stroke events after transcatheter aortic valve implantation: Temporal
relationships and affected brain regions.
Source
American heart journal. (no pagination), 2022. Date of Publication: 08
Feb 2022.
Author
Linder M.; Higgen F.L.; Voigtlander L.; Weimann J.; Ludwig S.; Waldschmidt
L.; Focke C.; Bhadra O.; Grundmann D.; Demal T.; von Zastrow A.; Schafer
A.; Schirmer J.; Reichenspurner H.; Blankenberg S.; Westermann D.; Schofer
N.; Conradi L.; Thomalla G.; Seiffert M.
Institution
(Linder, Weimann, Ludwig, Waldschmidt, Focke, Grundmann, von Zastrow,
Schofer) University Heart and Vascular Center Hamburg, Department of
Cardiology, Martinistrase 52, Hamburg 20246, Germany
(Higgen, Thomalla) Department of Neurology, University Medical Center
Hamburg-Eppendorf, Martinistrase 52, Hamburg 20246, Germany
(Voigtlander, Blankenberg, Westermann, Seiffert) University Heart and
Vascular Center Hamburg, Department of Cardiology, Martinistrase 52, 20246
Hamburg, Germany; German Center for Cardiovascular Research (DZHK),
Partner Site Hamburg/Lubeck/Kiel, Germany
(Bhadra, Demal, Schafer, Schirmer, Reichenspurner, Conradi) University
Heart and Vascular Center Hamburg, Department of Cardiovascular Surgery,
Martinistrase 52, Hamburg 20246, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Despite continuous improvements in transcatheter aortic valve
implantation (TAVI), periprocedural strokes remain a devastating
complication. Randomized controlled trials failed to demonstrate a
reduction in clinically apparent strokes or mortality after TAVI due to
cerebral embolic protection (CEP). To identify potential targets of CEP
strategies during TAVI, we evaluated affected brain regions and temporal
patterns of stroke onset in a routine clinical sample. METHODS AND
RESULTS: A total of 3,164 consecutive patients treated with TAVI from 2008
to 2019 at a single center were screened for cerebrovascular events.
Affected cerebral regions were determined according to clinical symptoms
and brain imaging. Rates of disabling stroke and non-disabling stroke at
30 days were 2.2% and 1.4%, respectively. The frequency of all strokes
decreased from 5.0% to 3.0% over time (p=0.012). Patients with impaired
left-ventricular function (OR 2.19), increased CHA2DS2-VASc (OR 1.39) and
moderate/severe spontaneous echo contrast (OR 3.60) had a higher stroke
risk. Acute symptom onset occurred during TAVI (19.4%), within 24 hours
(40.3%) or later (25.0%); 98.3% of strokes were of ischemic origin. In
intraprocedural strokes, 53.2% of lesions were found in locations
considered protected by current CEP devices and 37.5% of patients with
intraprocedural strokes were exclusively affected in these areas. Baseline
or procedural parameters were not associated with embolic distribution
patterns. CONCLUSION(S): Most strokes occurred early after TAVI - but
not necessarily during the procedure - and affected multiple brain regions
only partially protected by current CEP devices. Efficient prevention of
cerebrovascular events may require strategies beyond the TAVI procedure to
minimize stroke risk and additional randomized controlled trials will be
required to clarify the role of CEP in efficient stroke prevention during
TAVI. Copyright © 2022 Elsevier Ltd. All rights reserved.

<31>
Accession Number
2014064893
Title
Recruitment maneuvers in patients undergoing thoracic surgery: a
meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. 69(12) (pp 1553-1559), 2021.
Date of Publication: December 2021.
Author
Hu M.-C.; Yang Y.-L.; Chen T.-T.; Chen J.-T.; Tiong T.-Y.; Tam K.-W.
Institution
(Hu, Chen) Graduate Institute of Clinical Medicine, College of Medicine,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Hu, Chen) Division of Pulmonary Medicine, Department of Internal
Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City,
Taiwan (Republic of China)
(Yang) School of Respiratory Therapy, College of Medicine, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Yang) Department of Respiratory Therapy, Landseed International Hospital,
Taoyuan, Taiwan (Republic of China)
(Chen) Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical
University, New Taipei City, Taiwan (Republic of China)
(Chen) Department of Anesthesiology, School of Medicine, College of
Medicine, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Tiong) Division of Thoracic Surgery, Department of Surgery, Shuang Ho
Hospital, Taipei Medical University, New Taipei City, Taiwan (Republic of
China)
(Tam) Division of General Surgery, Department of Surgery, Shuang Ho
Hospital, Taipei Medical University, 291, Zhongzheng Road, Zhonghe
District, New Taipei City 23561, Taiwan (Republic of China)
(Tam) Division of General Surgery, Department of Surgery, School of
Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Tam) Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan (Republic
of China)
Publisher
Springer Japan
Abstract
Objective: Pulmonary atelectasis is a common postoperative complication
that may lead to intrapulmonary shunt, refractory hypoxemia, and
respiratory distress. Recruitment maneuvers may relieve pulmonary
atelectasis in patients undergoing thoracic surgery. This meta-analysis of
randomized controlled trials (RCTs) is to evaluate the effectiveness and
safety of recruitment maneuvers in patients undergoing thoracic surgery.
 Method(s): We performed a literature search on the PubMed, Embase,
and Cochrane Library databases and the ClinicalTrials.gov registry for
trials published before April 2021. We investigated postoperative
pulmonary atelectasis incidence, intrapulmonary shunt fraction, static
lung compliance, and mean arterial pressure. Result(s): Six RCTs
involving 526 patients were reviewed. Patients receiving a recruitment
maneuver exhibited a significant decrease in intrapulmonary shunt fraction
[weighted mean difference (WMD) - 0.02, 95% CI - 0.03 to - 0.01], improved
static lung compliance (WMD 2.16; 95% CI 1.14-3.18), and
PaO<inf>2</inf>/FIO<inf>2</inf> ratio (WMD 31.31; 95% CI 12.11-50.52)
without a significant difference in mean arterial pressure (WMD - 0.64;
95% CI - 4.92 to 3.64). The incidence pulmonary atelectasis favored
recruitment maneuver group, but was not statistically significant (RR
0.55; 95% CI 0.27-1.12). Conclusion(s): Recruitment maneuvers may be
a viable treatment for reducing intra-pulmonary shunt and improving static
lung compliance and PaO<inf>2</inf>/FIO<inf>2</inf> ratio without the
disturbance of hemodynamics in patients undergoing thoracic
surgery. Copyright © 2021, The Japanese Association for Thoracic
Surgery.

<32>
Accession Number
2007175054
Title
Role of Using a Thromboelastometry-Based Protocol for Transfusion
Management in Combined Coronary Artery Bypass Grafting and Valve Surgery:
A Randomized Clinical Trail.
Source
Indian Journal of Hematology and Blood Transfusion. 37(3) (pp 422-429),
2021. Date of Publication: July 2021.
Author
Khalaf-Adeli E.; Pourfathollah A.A.; Noohi F.; Alizadeh-Ghavidel A.;
Bakhshandeh-Abkenar H.; Shamriz R.; Alavi S.M.
Institution
(Khalaf-Adeli, Pourfathollah) Blood Transfusion Research Center, High
Institute for Research and Education in Transfusion Medicine, Tehran,
Iran, Islamic Republic of
(Pourfathollah) Departments of Immunology, Faculty of Medicine, Tarbiat
Modares University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Noohi) Cardiac Intervention Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Alizadeh-Ghavidel) Heart Valve Disease Research Center, Rajaie
Cardiovascular Medical and Research Center, University of Medical
Sciences, IranTehran, Iran, Islamic Republic of
(Bakhshandeh-Abkenar, Alavi) Rajaie Cardiovascular Medical and Research
Center, Iran University of Medical Sciences, Mellat park, Valiasr Avenue,
Tehran, Iran, Islamic Republic of
(Shamriz) Coagulation Laboratory, Iranian Blood Transfusion Organization,
Tehran, Iran, Islamic Republic of
Publisher
Springer
Abstract
The aim of this study was to evaluate the impact of using a
thromboelastometry-based protocol on transfusion requirements in patients
undergoing combined coronary artery bypass grafting (CABG) and valve
surgery. 80 adult patients scheduled for elective combined CABG and valve
surgery were included in this clinical trial study. Patients were randomly
allocated to the thromboelastometry (ROTEM) (n = 40) or control groups (n
= 40). In the ROTEM group, transfusion was directed according to a
thromboelastometry-based protocol. In the control group, transfusion was
conducted according to the routine practices including conventional
coagulation testing and clinical judgments. Finally, transfusion
requirements were compared between groups. Use of thromboelastometry-
based protocol resulted in 67% reduction in blood products units'
consumption as well as 23% in the percentage of patients transfused. This
reduction was especially evident in relation to fresh frozen plasma (FFP)
and platelet consumption. No significant differences were found both in
the percentage of patients receiving RBC and number of transfused RBC
units. Using thromboelastometry tests incorporated a protocol results in
reduction of transfusion requirements in patients undergoing elective
combined CABG and valve surgery. Copyright © 2020, Indian Society
of Hematology and Blood Transfusion.

<33>
Accession Number
2013859948
Title
Management of ganciclovir resistance cytomegalovirus infection with CMV
hyperimmune globulin and leflunomide in seven cardiothoracic transplant
recipients and literature review.
Source
Transplant Infectious Disease. 24(1) (no pagination), 2022. Article
Number: e13733. Date of Publication: February 2022.
Author
Santhanakrishnan K.; Yonan N.; Iyer K.; Callan P.; Al-aloul M.;
Venkateswaran R.
Institution
(Santhanakrishnan, Yonan, Iyer, Callan, Al-aloul, Venkateswaran)
Transplant Department, Wythenshawe Hospital, Manchester University NHS
Foundation Trust, Manchester, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Cytomegalovirus (CMV) disease caused by genetically resistant CMV poses a
major challenge in solid organ transplant recipients, and the development
of resistance is associated with increased morbidity and mortality.
Antiviral resistance affects 5%-12% of patients following ganciclovir
(GCV) therapy, but is more common in individuals with specific underlying
risk factors. These include the CMV D+R- serostatus, type of transplanted
organ, dose and duration of (Val)GCV ([V]GCV) prophylaxis, peak viral
loads, and the intensity of immunosuppressive therapy. Guideline
recommendations for the management of GCV resistance (GanR) in solid organ
transplant recipients are based on expert opinion as there is a lack of
data from controlled trials. Second-line options to treat GanR include
foscarnet (FOS) and cidofovir (CDV), but these drugs are often poorly
tolerated due to high rates of toxicity, such as renal dysfunction and
neutropenia. Here, we report seven cardiothoracic transplant recipients
with GCV resistance CMV infection from our centre treated with CMV
immunoglobulin (CMVIG) +/- leflunomide (LEF) and reviewed the literature
on the use of these agents in this therapeutic setting. Copyright
© 2021 Wiley Periodicals LLC

<34>
Accession Number
2015424534
Title
The coronary arteries in adults after arterial switch: A systematic
review.
Source
International Journal of Cardiology Congenital Heart Disease. Conference:
31st International Symposium on ACHD. Toronto Canada. 5 (no pagination),
2021. Article Number: 100252. Date of Publication: October 2021.
Author
Engele L.; Mulder B.J.M.; Schoones J.; Kies P.; Egorova A.D.; Vliegen
H.W.; Hazekamp M.G.; Bouma B.J.; Jongbloed M.R.M.
Institution
(Engele, Mulder, Bouma) Center for Congenital Heart Disease
Amsterdam-Leiden (CAHAL), Department of Clinical and Experi-mental
Cardiology, Amsterdam Cardiovascular Sciences, Heart Centre, Amsterdam
UMC, University of Amsterdam, Amsterdam, Netherlands
(Kies, Egorova, Vliegen, Jongbloed) Center for Congenital Heart Disease
Amsterdam-Leiden (CAHAL), the Netherlands. Department of Cardiology,
Leiden University Medical Center, Leiden, Netherlands
(Schoones) Directorate of Research Policy (formerly: Walaus Library),
Leiden University Medical Center, Leiden, Netherlands
(Hazekamp) Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL),
Department of Cardiothoracic Surgery, Leiden, University Medical Center,
Leiden, Netherlands
(Jongbloed) Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL),
Department of Anatomy and Embry-ology, Leiden, University Medical Center,
Leiden, Netherlands
Publisher
Elsevier B.V.
Abstract
Background: Coronary artery status in adults longterm after the arterial
switch operation (ASO) is unclear. As a consequence, current follow-up
strategies for coronary assessment remain controversial. We conducted a
systemic review to provide an overview of coronary complications during
adulthood and to evaluate the value of coronary imaging in adults after
ASO, in light of current guidelines. Material(s) and Method(s):
Studies describing coronary complications or coronary imaging after ASO in
adults were considered eligible for review and analysis. Articles were
screened for the inclusion of adult ASO patients and data on coronary
complications and findings of coronary imaging were collected. In cohort
studies with both adults (>=18 years) and non-adults (<18 years) only
outcomes in identifiable adults were analyzed. Result(s): A total of
993 adults were followed with a median follow-up of 2.0 years after
reaching adulthood. Myocardial ischemia was suspected in 16/192 patients
(6.8%). The number of coronary interventions was 4 (0.4%) and coronary
death was reported in 4 (0.4%) patients. The following coronary
abnormalities were found by routine coronary computer tomography CT (cCT):
stenosis (4%), acute angle (40%), kinking (24%) and interarterial course
(11%). No coronary events were reported during pregnancy (n= 45).
 Conclusion(s): The reported number of coronary interventions (0.4%)
and of coronary death (0.4%) during a median follow-up of 2 years in 993
ASO adults is low. Coronary abnormalities including acute angle, kinking
and interarterial course were commonly found by cCT. The 2020 European
Society of Cardiology (ESC) guidelines state that routine screening for
coronary pathologies is questionable. However, based on current findings
and in line with the 2018 American ACC/AHA guidelines we suggest a
baseline assessment of the coronary arteries in all adult ASO patients.
Thereafter, an individualized coronary follow-up strategy, based upon
coronary findings, is advisable. Copyright © 2021

<35>
Accession Number
2015422169
Title
Tricuspid valve intervention at the time of pulmonary valve replacement: A
systematic review and meta-analysis.
Source
International Journal of Cardiology Congenital Heart Disease. Conference:
31st International Symposium on ACHD. Toronto Canada. 5 (no pagination),
2021. Article Number: 100257. Date of Publication: October 2021.
Author
Van Den Eynde J.; Callahan C.; Lo Rito M.; Hussein N.; Carvajal H.;
Ruhparwar A.; Weymann A.; Budts W.; Gewillig M.; Sa M.P.B.O.
Institution
(Van Den Eynde) Helen B. Taussig Heart Center, Johns Hopkins Hospital,
Baltimore, United States
(Van Den Eynde, Budts, Gewillig) Department of Cardiovascular Diseases,
University Hospitals Leuven, Leuven, Belgium
(Callahan) Division of Cardiovascular Surgery, The Hospital for Sick
Children, Toronto, Canada
(Lo Rito) Department of Congenital Cardiac Surgery, IRCCS Policlinico San
Donato, Milanese, Italy
(Hussein) Department of Congenital Cardiac Surgery, Yorkshire Heart
Centre, Leeds General Infirmary, Leeds, United Kingdom
(Carvajal) Section of Pediatric Cardiothoracic Surgery, Department of
Surgery, Washington University School of Medicine in St. Louis/St. Louis
Children's Hospital, Saint Louis, United States
(Ruhparwar, Weymann) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
(Sa) Division of Cardiovascular Surgery of Pronto Socorro Cardiologico de
Pernambuco, PROCAPE, University of Pernambuco, Recife, Brazil
Publisher
Elsevier B.V.
Abstract
Background: Tricuspid regurgitation (TR) is a common finding in adults
with congenital heart disease referred for pulmonary valve replacement
(PVR). However, indications for combined valve surgery remain
controversial. This study aimed to evaluate early results of concomitant
tricuspid valve intervention (TVI) at the time of PVR. Material(s)
and Method(s): Observational studies comparing TVI+PVR and isolated PVR
were identified by a systematic search of published research.
Random-effects meta-analysis was performed, comparing outcomes between the
two groups. Result(s): Six studies involving 749 patients (TVI+PVR:
278 patients; PVR: 471 patients) met the eligibility criteria. In the
pooled analysis, both TVI+PVR and PVR reduced TR grade, pulmonary
regurgitation (PR) grade, right ventricular end-diastolic volume (RVEDV),
and right ventricular end-systolic volumes (RVESV). TVI+PVR, but not PVR,
was associated with a significant decrease in tricuspid valve annulus size
(mean difference [MD] -6.43, 95% confidence interval [CI] -10.59, -2.27,
p=0.010). Furthermore, TVI+PVR was associated with a significantly larger
reduction in TR grade compared to PVR (MD -0.40, 95% CI -0.75;-0.05,
p=0.031) and echocardiographic assessment of right ventricular dilatation
(MD -0.14, 95% CI -0.19;-0.08, p=0.020). No effects on right ventricular
ejection fraction or echocardiographic assessment of right ventricular
dysfunction could be observed. There was no difference in hospital
mortality nor reoperation for TR. Conclusion(s): While both
strategies are effective in reducing TR and right ventricular volumes,
routine TVI+PVR can reduce TR grade to a larger extent than isolated PVR.
Further studies are needed to identify the subgroups of patients who would
benefit most from combined valve surgery. Copyright © 2021

<36>
Accession Number
2015422168
Title
Outcomes of balloon valvuloplasty versus surgical valvotomy in congenital
aortic stenosis: A systematic review and meta-analysis.
Source
International Journal of Cardiology Congenital Heart Disease. Conference:
31st International Symposium on ACHD. Toronto Canada. 5 (no pagination),
2021. Article Number: 100243. Date of Publication: October 2021.
Author
Amir T.; Alraddadi H.; Barron D.; Honjo O.
Institution
(Amir) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, Canada
(Alraddadi) Division of Cardiac Surgery, McMaster University, Hamilton,
Canada
(Barron, Honjo) Division of Cardiovascular Surgery, The Labatt Family
Heart Centre, The Hospital for Sick Children, Toronto, Canada
(Barron, Honjo) Department of Surgery, University of Toronto, Toronto,
Canada
Publisher
Elsevier B.V.
Abstract
Background: The debate regarding the best therapeutic approach for
congenital aortic stenosis (AS) has persisted for decades due to equivocal
evidence. Historically, the selection of interventions, primarily surgical
aortic valvotomy (SAV) versus balloon aortic valvuloplasty (BAV), has
depended on individual/institutional preferences. Recent single-centre
studies demonstrate better outcomes with SAV; however, their results were
attributed to improved surgical techniques. In this study, we perform a
contemporary systematic review and meta-analysis to compare the effects of
BAV and SAV on patient morbidity and mortality. Material(s) and
Method(s): We searched MEDLINE and EMBASE from inception to March 2021 for
studies comparing BAV versus SAV for critical congenital AS in patients
younger than age 18. We performed title and abstract screening, full-text
review, risk of bias assessment using the CLARITY tool, and data
collection independently and in duplicate. We pooled data using the
random-effects model and the Mantel-Haensel statistical method. We
evaluated the overall quality of evidence using the GRADE framework.
 Result(s): 12 studies (n=1214) comparing outcomes for BAV and SAV in
the pediatric population were included. Differences in mortality at 30-day
and at longest follow-up were not statistically significant between the
two groups (RR 0.66, 95% CI [0.34, 1.27] and 0.74, 95% CI [0.35, 1.56],
respectively). Postprocedural aortic insufficiency was more common after
BAV but failed to reach statistical significance (RR 1.5, 95% CI [0.99 -
2.99]). Reintervention favoured surgical repair at the longest follow-up
but did not reach statistical significance (RR 1.11, 95% CI [0.89, 1.38]).
 Conclusion(s): In pediatric patients with congenital AS, surgical
valvotomy did not offer additional advantages over balloon valvuloplasty.
There was a trend towards increased post-procedural AI and rate of
reintervention with BAV. However, the quality of evidence is very low; an
appropriately powered study is required to adequately address the risks
and benefits of the two interventions. Copyright © 2021

<37>
Accession Number
637226926
Title
Efficacy of prothrombin complex concentrate (PCC) versus fresh frozen
plasma (FFP) in reducing perioperative blood loss in cardiac surgery:
study protocol for a non-inferiority, randomised controlled trial.
Source
BMJ open. 12(2) (pp e051072), 2022. Date of Publication: 10 Feb 2022.
Author
Pei L.; Sun C.; Lv H.; Zhang Y.; Shi J.
Institution
(Pei, Sun) Department of Anaesthesiology, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences & Peking Union Medical
College, Beijing, China
(Pei) Outcomes Research Consortium, Cleveland, OH, United States
(Lv, Shi) Department of Anaesthesiology, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular
Diseases, Chinese Academy of Medical Sciences & Peking Union Medical
College, Beijing, China
(Zhang) Medical Research Center, Peking Union Medical College Hospital,
Chinese Academy of Medical Sciences & Peking Union Medical College,
Beijing, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To explore whether prothrombin complex concentrate (PCC) is not
inferior to fresh frozen plasma (FFP) with regard to reducing
perioperative blood loss in patients undergoing cardiac surgery under
cardiopulmonary bypass (CPB). SETTING: Fu Wai Hospital, and Peking Union
Medical College Hospital in China. PARTICIPANTS: Patients undergoing
elective coronary artery bypass grafting, valve replacement or
valvuloplasty under CPB, between 18 and 80 years old, will be included.
DESIGN: This study is a non-inferiority, randomised controlled clinical
trial. A total of 594 subjects will be randomly assigned to two groups
(group PCC and group FFP) and given corresponding interventions when at
least one of the following criteria is met: (1) international normalised
ratio >1.7 measured 20min after CPB, (2) prolonged prothrombin time or
activated partial thromboplastin time (>1.5 times baseline) measured 20min
after CPB and (3) excessive bleeding observed. 4-factor PCC (15IU/kg) and
FFP (10mL/kg) will be given to group PCC and group FFP, respectively.
Preoperative management, anaesthetic and surgical techniques will be
standardised for both groups. PRIMARY AND SECONDARY OUTCOME MEASURES: The
primary outcome is the volume of blood loss during and within 24 hours
after surgery. The secondary outcomes include (1) the total units of
allogeneic red blood cells transfused during and within 7days after
surgery, (2) re-exploration due to postoperative bleeding within 7days
after surgery, (3) adverse events and serious adverse events within 30
days after surgery and (4) length of intensive care unit stay and hospital
stay. TRIAL REGISTRATION NUMBER: Registered under NCT04244981 at
ClinicalTrials.gov on 28 January 2020,
https://clinicaltrials.gov/ct2/show/NCT04244981?cond=NCT04244981&draw=2&ra
nk=1. ETHICS AND DISSEMINATION: This study has been approved by the
Institutional Review Board of Peking Union Medical College Hospital
(ZS-2242). 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.

<38>
Accession Number
2016849409
Title
The burden of perioperative hypertension/ hypotension: A systematic
review.
Source
PLoS ONE. 17(2 February) (no pagination), 2022. Article Number: e0263737.
Date of Publication: February 2022.
Author
Lizano-Diez I.; Poteet S.; Burniol-Garcia A.; Cerezales M.
Institution
(Lizano-Diez) Ferrer, Barcelona, Spain
(Poteet, Burniol-Garcia, Cerezales) Axentiva Solutions SL, Barcelona,
Spain
Publisher
Public Library of Science
Abstract
Study objective Our goal is to review the outcomes of acute
hypertensive/hypotensive episodes from articles published in the past 10
years that assessed the short- and long-term impact of acute
hypertensive/hypotensive episodes in the perioperative setting. Methods We
conducted a systematic peer review based upon PROSPERO and Cochrane
Handbook protocols. The following study characteristics were collected:
study type, author, year, population, sample size, their definition of
acute hypertension, hypotension or other measures, and outcomes
(probabilities, odds ratio, hazard ratio, and relative risk) and the
p-values; and they were classified according to the type of surgery
(cardiac and non-cardiac). Results A total of 3,680 articles were
identified, and 66 articles fulfilled the criteria for data extraction.
For the perioperative setting, the number of articles varies by outcome:
20 mortality, 16 renal outcomes, 6 stroke, 7 delirium and 34 other
outcomes. Hypotension was reported to be associated with mortality (OR
1.02-20.826) as well as changes from the patient's baseline blood pressure
(BP) (OR 1.02-1.36); hypotension also had a role in the development of
acute kidney injury (AKI) (OR 1.03-14.11). Postsurgical delirium was found
in relation with BP lability (OR 1.018-1.038) and intra- and postsurgical
hypotension (OR 1.05-1.22), and hypertension (OR 1.44-2.34). Increased OR
(37.67) of intracranial hemorrhage was associated to postsurgical systolic
BP >130 mmHg. There was a wide range of additional diverse outcomes
related to hypo-, hypertension and BP lability. Conclusions The
perioperative management of BP influences short- and long-term effects of
surgical procedures in cardiac and non-cardiac interventions; these
findings support the burden of BP fluctuations in this
setting. Copyright: © 2022 Lizano-Diez 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.

<39>
Accession Number
2015629232
Title
Comparison of Perioperative Active or Routine Temperature Management on
Postoperative Quality of Recovery in PACU in Patients Undergoing
Thoracoscopic Lobectomy: A Randomized Controlled Study.
Source
International Journal of General Medicine. 15 (pp 429-436), 2022. Date of
Publication: 2022.
Author
Ji J.; Gu X.; Xiao C.
Institution
(Ji, Xiao) Anesthesiology Department, The First Affiliated Hospital of
Soochow University, Jiangsu, Suzhou, China
(Gu) Anesthesiology Department, The No.2 People's Hospital of Suzhou
Xiangcheng District, Jiangsu, Suzhou, China
(Xiao) Anesthesiology Department, The First Affiliated Hospital of Soochow
University, 899 Pinghai Road, Gusu District, Jiangsu, Suzhou 215000, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Whether intraoperative temperature management can help
patients recover quickly in the postanesthesia care unit (PACU) still
remains to be investigated. This study aimed to investigate the effect of
intraoperative temperature management on the quality of postoperative
recovery of patients who underwent pulmonary lobectomy in the PACU.
 Method(s): Totally, 98 patients aged 45-60 years with a body mass
index of 20-25 kg/m2 who underwent elective thoracoscopic
lobectomy were enrolled. Patients were categorized into two groups using a
random number table: the conventional group received routine intervention
to maintain normothermia (Group C, n = 49) and the aggressive group
received integrated interventions (Group A, n = 49). In Group C,
normothermic fluid was infused intravenously, the heating blanket was
turned on when the intraoperative temperature was <35.0 degreeC, and the
warming was stopped when the temperature reached 36.5 degreeC. In Group A,
the fluid heated to 37 degreeC was infused intravenously, and the heating
blanket was used intraoperatively. When the body temperature was >37
degreeC, the heating blanket was turned off, and when the body temperature
was <36.5 degreeC, the heating blanket was turned on to continue heating.
 Result(s): Steward awakening scores at 1 min and 5 min after
extubation and PaO<inf>2</inf> levels at 15 min after extubation were
higher in Group A than in Group C (P < 0.05); incidence of chills, nausea,
and vomiting in the PACU was lower in Group A than in Group C (P < 0.05);
and length of stay in the PACU was shorter in Group A than in Group C (P <
0.05). Conclusion(s): Aggressive intraoperative temperature
management of patients undergoing thoracoscopic lobectomy can improve the
quality of postoperative recovery in the PACU through a safe and smooth
transition compared with routine insulation measures. Copyright ©
2022 Ji et al.

<40>
Accession Number
2016365359
Title
Meta-Analysis of Surgical Left Atrial Appendage Occlusion During Cardiac
Surgery.
Source
American Journal of Cardiology. 166 (pp 145-146), 2022. Date of
Publication: 01 Mar 2022.
Author
Eagle G.E.; Whitlock R.P.; Belley-Cote E.P.
Institution
(Eagle) McMaster University, Hamilton, Ontario, Canada
(Whitlock) Faculty of Health Science, McMaster University, Hamilton,
Ontario, Canada
(Belley-Cote) Department of Surgery, McMaster University, Hamilton,
Ontario, Canada
Publisher
Elsevier Inc.

<41>
Accession Number
2016340857
Title
Meta-Analysis of 5-Year Risk of All-Cause Death or Stroke After
Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve
Replacement.
Source
American Journal of Cardiology. 166 (pp 146-147), 2022. Date of
Publication: 01 Mar 2022.
Author
Yokoyama Y.; Kuno T.; Ando T.; Sugiura T.; Latib A.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Pennsylvania, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York
(Ando) Department of Cardiology, Kawasaki Saiwai Hospital, Kawasaki, Japan
(Sugiura) Division of Cardiothoracic Surgery, Montefiore Medical Center,
Albert Einstein College of Medicine, New York
Publisher
Elsevier Inc.

<42>
Accession Number
2015645347
Title
A Prospective Randomized Controlled Research to Assess the Outcome of
Oxiport Laryngoscope Blade Versus Miller Laryngoscope Blade for Intubation
in Neonates and Infants During General Anesthesia.
Source
International Journal of Pharmaceutical and Clinical Research. 14(1) (pp
254-260), 2022. Date of Publication: 2022.
Author
Kumar S.; Kumar J.; Kumar R.R.; Kashyap B.K.
Institution
(Kumar, Kumar, Kumar, Kashyap) Department of Anesthesiology & Critical
Care, Patna Medical College & Hospital, Bihar, Patna, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: Comparative study of oxiport laryngoscope blade versus miller
laryngoscope blade for intubation in neonates and infants during general
anesthesia. Method(s): This prospective, randomised, controlled
interventional single-blind study conducted in the Department of
Anesthesiology & Critical Care Patna Medical College & Hospital, Patna,
Bihar, India for 1 year. 80 neonates/infants in groups of 40 each posted
for surgery in paediatric operation theatre (OT) over a period of 6 months
were included in the study. Full-term neonates and infants up to 6 months
of age of either sex requiring general anaesthesia with endotracheal
intubation for elective as well as emergency surgery were included in the
study. Result(s): Out of the 80 patients 40 patients in Miller group
and 40 patients in Oxiport group were included. Both groups were
comparable with respect to age, sex, weight, mean time to intubation (P =
0.57) and anaesthesiologist performing the laryngoscopy (P = 0.72). Mean
lowest SpO2 recorded was 96.1% +/- 4.75% in Miller group and 98.15% +/-
2.83% in Oxiport group. This difference was statistically significant (P =
0.041). The incidence of mild desaturation (SpO2 up to 90%) was 87.5% in
Miller group and 95% in Oxiport group. The incidence of moderate
desaturation (SpO2 between 85% and 92.5%) was 2.5% in Miller group and 5%
in Oxiport group. Incidence of severe desaturation (SpO2 <85%) was 15% in
Miller group and 0 in Oxiport group (Chi-square test P = 0.04).
Correlation between time to intubation and SpO2 in Miller group (Pearson's
R2 = -0.12) was statistically not significant at P = 0.41. Correlation
between time to intubation and SpO2 in Oxiport group (Pearson's R2 =
-0.42) was statistically significant at P = 0.001. Both groups were
comparable with respect to the type of surgery (abdominal, thoracic,
miscellaneous) (P = 0.71). Abdominal surgeries were associated with a
higher number of severe desaturations (70%) compared to thoracic (15%) and
miscellaneous (15%) surgeries. Conclusion(s): In this study, apnoeic
laryngeal oxygen insufflation with Oxiport laryngoscope blade decreased
the incidence of severe desaturation while intubating neonates and
infants. This was easily done as it was non-cumbersome and did not
increase the overall cost of anaesthesia. Copyright © 2022, Dr
Yashwant Research Labs Pvt Ltd. All rights reserved.

<43>
[Use Link to view the full text]
Accession Number
2016744591
Title
The Effect of Levosimendan Versus Milrinone on the Occurrence Rate of
Acute Kidney Injury Following Congenital Heart Surgery in Infants: A
Randomized Clinical Trial.
Source
Pediatric Critical Care Medicine. 20(10) (pp 947-956), 2019. Date of
Publication: 01 Oct 2019.
Author
Thorlacius E.M.; Suominen P.K.; Wahlander H.; Keski-Nisula J.; Vistnes M.;
Ricksten S.-E.; Synnergren M.; Romlin B.S.; Castellheim A.
Institution
(Thorlacius, Ricksten, Romlin, Castellheim) Department of Anesthesiology
and Intensive Care Medicine, Sahlgrenska Academy, University of
Gothenburg, Queen Silvia Children's Hospital, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Suominen, Keski-Nisula) Department of Anesthesia and Intensive Care,
Children's Hospital, Helsinki University Central Hospital, Helsinki,
Finland
(Wahlander) Department of Pediatric Cardiology, Sahlgrenska Academy,
University of Gothenburg, Queen Silvia Children's Hospital, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Vistnes) Department of Internal Medicine, Diakonhjemmet Hospital,
Institute for Experimental Medical Research, Oslo University Hospital,
University of Oslo, Oslo, Norway
(Synnergren) Department of Pediatric Thoracic Surgery, Queen Silvia
Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: It has been shown that, in contrast to other inotropic agents,
levosimendan improves glomerular filtration rate after adult cardiac
surgery. The aim of this study was to investigate the efficacy of
levosimendan, compared with milrinone, in preventing acute kidney
dysfunction in infants after open-heart surgery with cardiopulmonary
bypass. Design(s): Two-center, double-blinded, prospective,
randomized clinical trial. Setting(s): The study was performed in two
tertiary pediatric centers, one in Sweden (Gothenburg) and one in Finland
(Helsinki). Patient(s): Infants between 1 and 12 months old,
diagnosed with Tetralogy of Fallot, complete atrioventricular septal
defect or nonrestrictive ventricular septal defect, undergoing total
corrective cardiac surgery with cardiopulmonary bypass.
 Intervention(s): Seventy-two infants were randomized to receive a
perioperative infusion of levosimendan (0.1 microg/kg/min) or milrinone
(0.4 microg/kg/min). The infusion was initiated at the start of
cardiopulmonary bypass and continued for 26 hours. Measurements and
Main Results: The primary outcome variable was the absolute value of serum
creatinine data on postoperative day 1. Secondary outcomes included the
following: 1) acute kidney injury according to the serum creatinine
criteria of the Kidney Diseases: Improving Global Outcomes; 2) acute
kidney injury with serum creatinine corrected for fluid balance; 3) plasma
neutrophil gelatinase-associated lipocalin; 4) cystatin C; 5) urea; 6)
lactate; 7) hemodynamic variables; 8) use of diuretics in the PICU; 9)
need of dialysis; 10) length of ventilator therapy; and 11) length of PICU
stays. There was no significant difference in postoperative serum
creatinine between the treatment groups over time (p = 0.65). The
occurrence rate of acute kidney injury within 48 hours was 46.9% in the
levosimendan group and 39.5% in the milrinone group (p = 0.70). There were
no significant differences in other secondary outcome variables between
the groups. Conclusion(s): Levosimendan compared with milrinone did
not reduce the occurrence rate of acute kidney injury in infants after
total corrective heart surgery for atrioventricular septal defect,
ventricular septal defect, or Tetralogy of Fallot. Copyright ©
2019 by the Society of Critical Care Medicine and the World Federation of
Pediatric Intensive and Critical Care Societies

<44>
Accession Number
2016884193
Title
Effect of Volatile Anesthetics on Myocardial Infarction After Coronary
Artery Surgery: A Post Hoc Analysis of a Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Zangrillo A.; Lomivorotov V.V.; Pasyuga V.V.; Belletti A.; Gazivoda G.;
Monaco F.; Nigro Neto C.; Likhvantsev V.V.; Bradic N.; Lozovskiy A.; Lei
C.; Bukamal N.A.R.; Silva F.S.; Bautin A.E.; Ma J.; Yong C.Y.; Carollo C.;
Kunstyr J.; Wang C.Y.; Grigoryev E.V.; Riha H.; Wang C.; El-Tahan M.R.;
Scandroglio A.M.; Mansor M.; Lembo R.; Ponomarev D.N.; Bezerra F.J.L.;
Ruggeri L.; Chernyavskiy A.M.; Xu J.; Tarasov D.G.; Navalesi P.;
Yavorovskiy A.; Bove T.; Kuzovlev A.; Hajjar L.A.; Landoni G.
Institution
(Zangrillo, Belletti, Monaco, Scandroglio, Lembo, Ruggeri, Landoni)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Zangrillo, Landoni) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Lomivorotov, Ponomarev, Chernyavskiy) Department of Anesthesiology and
Intensive Care, E. Meshalkin National Medical Research Center,
Novosibirsk, Russian Federation
(Lomivorotov) Department of Anesthesiology and Intensive Care, Novosibirsk
State University, Novosibirsk, Russian Federation
(Pasyuga) Department of Anesthesiology and Intensive Care, Federal Center
for Cardiovascular Surgery Astrakhan, Astrakhan, Russian Federation
(Gazivoda) Department of Anaesthesia and Intensive Care, Cardiovascular
Institute Dedinje, Belgrade, Serbia
(Nigro Neto, Bezerra) Anesthesia Section, Department of Cardiovascular
Surgery, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Likhvantsev) Department of Anesthesiology and Intensive Care, First
Moscow State Medical University, Moscow, Russian Federation
(Likhvantsev, Kuzovlev) V. Negovsky Reanimatology Research Institute,
Moscow, Russian Federation
(Bradic) Department of Cardiovascular Anesthesiology and Intensive Care
Medicine, Clinical Department of Anesthesiology, Resuscitation and
Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia
(Bradic) Department of Biomedical Sciences, University North, Varazdin,
Croatia
(Lozovskiy) Department of Anesthesia and Intensive Care, Ural Institute of
Cardiology, Ekaterinburg, Russian Federation
(Lei) Department of Anesthesiology and Perioperative Medicine, Xijing
Hospital, Shaanxi, Xi'an, China
(Bukamal) Cardiothoracic ICU and Anesthesia Department, Mohammed Bin
Khalifa Cardiac Center, Riffa, Bahrain
(Silva) Department of Anaesthesiology, Hospital de Santa Maria, Lisboa,
Portugal
(Bautin) Laboratory for Anesthesiology and Intensive Care, Almazov
National Medical Research Center, Saint Petersburg, Russian Federation
(Ma, Wang) Center for Anesthesiology, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China
(Yong) Department of Anaesthesiology and Intensive Care, Hospital Pulau
Pinang, Pulau Pinang, Malaysia
(Carollo, Navalesi) Institute of Anesthesia and Intensive Care, Padua
University Hospital, Padua, Italy
(Kunstyr) Department of Anesthesiology and Intensive Care, First Faculty
of Medicine Charles University and General University Hospital, Prague,
Czechia
(Wang, Mansor) Department of Anaesthesiology, Faculty of Medicine,
University of Malaya, Kuala Lumpur, Malaysia
(Grigoryev) Intensive Care Unit, Scientific Research Institute for Complex
Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
(Riha) Cardiothoracic Anesthesiology and Intensive Care Medicine,
Department of Anesthesiology and Intensive Care Medicine, Institute for
Clinical and Experimental Medicine, Prague, Czechia
(El-Tahan) Department of Anesthesiology, Imam Abdulrahman Bin Faisal
University, Dammam, Saudi Arabia
(Xu) Department of Anesthesiology, The Second Xiangya Hospital of Central
South University, Changsha, China
(Tarasov) Department of Cardiac Surgery, Federal Center for Cardiovascular
Surgery Astrakhan, Astrakhan, Russian Federation
(Navalesi) Department of Medicine, University of Padua, Padua, Italy
(Yavorovskiy) Federal Research and Clinical Center of Resuscitation and
Rehabilitation, Moscow, Russian Federation
(Bove) Department of Medicine (DAME), University of Udine, Udine, Italy
(Bove) Department of Anesthesia and Intensive Care Medicine, ASUFC
University-Hospital of Central Friuli, Udine, Italy
(Hajjar) Department of Cardiopneumology, Instituto do Coracao,
Universidade de Sao Paulo, Sao Paulo, Brazil
(Hajjar) Intensive Care Unit, Hospital SirioLibanes, Sao Paulo, Brazil
Publisher
W.B. Saunders
Abstract
Objective: To investigate the effect of volatile anesthetics on the rates
of postoperative myocardial infarction (MI) and cardiac death after
coronary artery bypass graft (CABG). Design(s): A post hoc analysis
of a randomized trial. Setting(s): Cardiac surgical operating rooms.
 Participant(s): Patients undergoing elective, isolated CABG.
 Intervention(s): Patients were randomized to receive a volatile
anesthetic (desflurane, isoflurane, or sevoflurane) or total intravenous
anesthesia (TIVA). The primary outcome was hemodynamically relevant MI (MI
requiring high-dose inotropic support or prolonged intensive care unit
stay) occurring within 48 hours from surgery. The secondary outcome was
1-year death due to cardiac causes. Measurements and Main Results: A
total of 5,400 patients were enrolled between April 2014 and September
2017 (2,709 patients randomized to the volatile anesthetics group and
2,691 to TIVA). The mean age was 62 +/- 8.4 years, and the median baseline
ejection fraction was 57% (50-67), without differences between the 2
groups. Patients in the volatile group had a lower incidence of MI with
hemodynamic complications both in the per-protocol (14 of 2,530 [0.6%] v
27 of 2,501 [1.1%] in the TIVA group; p = 0.038) and as-treated analyses
(16 of 2,708 [0.6%] v 29 of 2,617 [1.1%] in the TIVA group; p = 0.039),
but not in the intention-to-treat analysis (17 of 2,663 [0.6%] v 28 of
2,667 [1.0%] in the TIVA group; p = 0.10). Overall, deaths due to cardiac
causes were lower in the volatile group (23 of 2,685 [0.9%] v 40 of 2,668
[1.5%] than in the TIVA group; p = 0.03). Conclusion(s): An
anesthetic regimen, including volatile agents, may be associated with a
lower rate of postoperative MI with hemodynamic complication in patients
undergoing CABG. Furthermore, it may reduce long-term cardiac
mortality. Copyright © 2022 Elsevier Inc.

<45>
Accession Number
2016871051
Title
Ultrasound-guided versus anatomic landmark-guided vascular access in
cardiac electrophysiology procedures: A systematic review and
meta-analysis.
Source
Indian Pacing and Electrophysiology Journal. (no pagination), 2022. Date
of Publication: 2022.
Author
Triantafyllou K.; Karkos C.D.; Fragakis N.; Antoniadis A.P.; Meletidou M.;
Vassilikos V.
Institution
(Triantafyllou, Fragakis, Antoniadis, Meletidou, Vassilikos) 3rd
Cardiology Department, Hippokration General Hospital of Thessaloniki,
Aristotle University of Thessaloniki, Greece
(Karkos) Vascular Unit, 5th Surgery Department, Hippokration General
Hospital of Thessaloniki, Aristotle University of Thessaloniki, Greece
Publisher
Indian Pacing and Electrophysiology Group
Abstract
Introduction: Electrophysiology (EP) procedures are nowadays the
gold-standard method for tachyarrhythmia treatment with impressive success
rates, but also with a considerable risk of complications, mainly
vascular. A systematic review and meta-analysis was performed to evaluate
the safety of ultrasound (US)-guided femoral vein access in EP procedures
compared to the traditional anatomic landmark-guided method.
 Method(s): We searched Pubmed (MEDLINE), Embase, Web of Science, and
Cochrane electronic databases for relevant entries, dated from January
1st, 2000 to June 30th, 2021. Only observational studies and randomized
controlled trials were included in this analysis. Data extraction included
study details, patient characteristics, procedure details, and all types
of vascular complications. Complications were classified as major if any
intervention, prolongation of hospitalization, or readmission was
required. Result(s): 9 studies (1 randomized controlled trial and 8
observational), with 7858 participants (3743 in the US-guided group, 4115
in the control group), were included in the meta-analysis. Overall
vascular complication rates were significantly decreased in the US-guided
group compared to the control group (1.2 versus 3.2%, RR = 0.38, 95% CI,
0.27-0.53), in all EP procedures. Sub-group analysis of AF ablation
procedures yielded similar results (RR 0.41, 95% CI, 0.29-0.58, p <
0.00001). The event reduction effect was significant for both major and
minor vascular complications. Conclusion(s): US-guided vascular
access in EP procedures is associated with significantly reduced vascular
complications, compared to the standard anatomic landmark-guided approach,
regardless of procedure complexity. Copyright © 2022 Indian Heart
Rhythm Society

<46>
Accession Number
637226099
Title
Does early extubation after cardiac surgery lead to a reduction in
intensive care unit length of stay?.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2022.
Date of Publication: 10 Feb 2022.
Author
Taylor M.; Apparau D.; Mosca R.; Nwaejike N.
Institution
(Taylor, Apparau, Nwaejike) Department of Cardiothoracic Surgery,
Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital,
Manchester, United Kingdom
(Mosca) Department of Cardiothoracic Anaesthesia, Manchester University
Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, United
Kingdom
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was whether early extubation
(EE) after cardiac surgery leads to a reduction in intensive care unit
(ICU) length of stay (LOS)? A total of 564 papers were found using the
reported search, of which 4 were randomized trials and hence represented
the best evidence to answer the clinical question. The authors, journal,
date and country of publication, patient group studied, study type,
relevant outcomes and results of these papers are tabulated. EE was
defined as extubation in theatre (n = 2), within 6 h of surgery (n = 1)
and within 8 h of surgery (n = 1). EE was associated with significantly
reduced ICU LOS in all studies. Despite the Society of Thoracic Surgeons
using extubation <6 h after surgery as a measure of quality, this study
has demonstrated that no standardized definition for EE currently exists.
The body of evidence identified in this work has demonstrated that for
appropriately selected patients (avoiding patients with multiple
comorbidities, advanced age and undergoing complex non-elective surgery)
early tracheal extubation is associated with a reduction in ICU LOS
without an increase in the rate of postoperative
complications. Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<47>
Accession Number
2013594206
Title
Diagnostic performance of computed tomography-based fraction flow reserve
in identifying myocardial ischemia caused by coronary artery stenosis: A
meta-analysis.
Source
Hellenic Journal of Cardiology. 63 (pp 1-7), 2022. Date of Publication: 01
Jan 2022.
Author
Luo Y.; Mao M.; Xiang R.; Han B.; Chang J.; Zuo Z.; Wu F.; Ma K.
Institution
(Luo, Mao, Xiang, Han, Chang, Zuo, Wu, Ma) Department of Cardiology, The
First Affiliated Hospital of Chongqing Medical University, Chongqing
400016, China
Publisher
Hellenic Cardiological Society
Abstract
Background: As a new noninvasive diagnostic technique, computed tomography
(CT)-based fraction flow reserve (FFR) has been used to identify
hemodynamically significant coronary artery stenosis. This meta-analysis
used invasive FFR as the standard to evaluate the diagnostic performance
of FFRCT. Method(s): We searched the PubMed, Cochrane library, and
EMBASE for articles published between January 2009 and January 2021. The
synthesized sensitivity and specificity of invasive FFR and FFRCT were
analyzed at both the patient and vessel levels. We generated a summary
receiver operating characteristic curve (SROC) and then calculated the
area under the curve (AUC). Result(s): We included a total of 23
studies, including 2,178 patients and 3,029 vessels or lesions. Analysis
at each patient level demonstrated a synthesized sensitivity of 88%,
specificity of 79%, LR+ of 4.16, LR-of 0.15, and AUC of 0.89 for FFRCT.
Analysis at the level of each vessel or lesion showed a synthesized
sensitivity of 85%, specificity of 81%, LR+ of 4.44, LR-of 0.19, and AUC
of 0.87 for FFRCT. Conclusion(s): Our research reveals that FFRCT has
high diagnostic performance in patients with coronary artery stenosis,
regardless of whether it is at the patient level or the vessel
level. Copyright © 2021 Hellenic Society of Cardiology

<48>
Accession Number
2013481500
Title
Short- and long-term outcomes after heart transplantation in cardiac
sarcoidosis and giant-cell myocarditis: a systematic review and
meta-analysis.
Source
Clinical Research in Cardiology. 111(2) (pp 125-140), 2022. Date of
Publication: February 2022.
Author
Bobbio E.; Bjorkenstam M.; Nwaru B.I.; Giallauria F.; Hessman E.; Bergh
N.; Polte C.L.; Lehtonen J.; Karason K.; Bollano E.
Institution
(Bobbio, Bjorkenstam, Bergh, Karason, Bollano) Department of Cardiology,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Bobbio, Bjorkenstam, Bergh, Polte, Karason, Bollano) Institute of
Medicine At Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Nwaru) Krefting Research Centre, Institute of Medicine, University of
Gothenburg, Gothenburg, Sweden
(Nwaru) Wallenberg Centre for Molecular and Translational Medicine,
University of Gothenburg, Gothenburg, Sweden
(Giallauria) Department of Translational Medical Sciences, 'Federico II'
University of Naples, Naples, Italy
(Hessman) Biomedical Library, Gothenburg University Library, University of
Gothenburg, Gothenburg, Sweden
(Polte) Departments of Clinical Physiology and Radiology, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Lehtonen) Heart and Lung Centre, Helsinki University and Helsinki
University Hospital, Helsinki, Finland
(Karason) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Heart transplantation (HTx) is a valid therapeutic option for end-stage
heart failure secondary to cardiac sarcoidosis (CS) or giant-cell
myocarditis (GCM). However, post-HTx outcomes in patients with
inflammatory cardiomyopathy (ICM) have been poorly investigated. We
searched PubMed, Scopus, Science Citation Index, EMBASE, and Google
Scholar, screened the gray literature, and contacted experts in the field.
We included studies comparing post-HTx survival, acute cellular rejection,
and disease recurrence in patients with and without ICM. Data were
synthesized by a random-effects meta-analysis. We screened 11,933
articles, of which 14 were considered eligible. In a pooled analysis,
post-HTx survival was higher in CS than non-CS patients after 1 year (risk
ratio [RR] 0.88, 95% confidence interval [CI] 0.60-1.17; I2 =
0%) and 5 years (RR 0.72, 95% CI 0.52-0.91; I2 = 0%), but
statistically significant only after 5 years. During the first-year
post-HTx, the risk of acute cellular rejection was similar for patients
with and without CS, but after 5 years, it was lower in those with CS (RR
0.38, 95% CI 0.03-0.72; I2 = 0%). No difference in post-HTx
survival was observed between patients with and without GCM after 1 year
(RR 1.16, 95% CI 0.05-2.28; I2 = 0%) or 5 years (RR 0.98, 95%
CI 0.42-1.54; I2 = 0%). During post-HTx follow-up, recurrence
of CS and GCM occurred in 5% and 8% of patients, respectively. Post-HTx
outcomes in patients with CS and GCM are comparable with cardiac
recipients with other heart failure etiologies. Patients with ICM should
not be disqualified from HTx. Graphic abstract: [Figure not available: see
fulltext.]. Copyright © 2021, The Author(s).

<49>
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.

<50>
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.

<51>
Accession Number
2013177737
Title
Angiotensin-converting enzyme inhibitor for post-transcatheter aortic
valve implantation patients: study protocol for a multicenter randomized,
open-label blinded endpoint control trial.
Source
Trials. 22(1) (no pagination), 2021. Article Number: 462. Date of
Publication: December 2021.
Author
Liao Y.B.; Xia C.; Cheng Y.; Li Q.; Wei X.; Ou Y.; Chen F.; Li Y.; Liu Q.;
Xiong T.; Zhao Z.; Peng Y.; Wei J.; Feng Y.; Chen M.
Institution
(Liao, Xia, Cheng, Li, Wei, Ou, Chen, Li, Liu, Xiong, Zhao, Peng, Wei,
Feng, Chen) Department of Cardiology, West China Hospital, Sichuan
University, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: With the expanded utilization of transcatheter aortic valve
implantation (TAVI) to younger and lower surgical risk patients with
severe aortic stenosis (AS), optimal medical therapy after TAVI procedure
has become the main concern. Renin-angiotensin system inhibitors (RASi)
are widely utilized in the area of cardiovascular disease including heart
failure and myocardial infarction and revealed the ability to reverse left
ventricular (LV) remodeling. Interests have, thus, been drawn in
investigating whether the prescription of RASi after the TAVI procedure
can prevent or reverse cardiac remodeling and improve long-term clinical
outcomes. No recommendation regarding the prescription of RASi after TAVI
is proposed yet due to the lack of evidence from randomized controlled
trials, especially in the Chinese population. We, therefore, designed this
randomized controlled trial to explore the effect of adding fosinopril to
standard care in patients who underwent a successful TAVI procedure on the
LV remodeling. Method(s): A total of 200 post-TAVI patients from
seven academic hospitals across China will be recruited and randomized
with a ratio of 1:1 to receive standard care or standard care plus
fosinopril. Follow-up visits will take place at 30 days, 3 months, 6
months, 12 months, and 24 months from randomization to assess the clinical
symptoms, any adverse events, cardiac function, and quality of life.
Cardiac magnetic resonance will be performed at baseline and repeated at
the 24-month follow-up visit to assess LV remodeling. Discussion(s):
This study will provide evidence regarding medical therapy for AS patients
who underwent TAVI and filling the gap in the Chinese population. Trial
registration: Chinese Clinical Trial Registry ChiCTR2100042266. Registered
on 17 January 2021. Copyright © 2021, The Author(s).

<52>
Accession Number
2015124711
Title
A Tale of Two Centrifugal-Flow Ventricular Assist Devices As Bridge to
Heart Transplant.
Source
Annals of Thoracic Surgery. 113(3) (pp 757-762), 2022. Date of
Publication: March 2022.
Author
Alwair H.; Whitehouse K.; Slaughter M.S.; Trivedi J.R.
Institution
(Alwair, Whitehouse, Slaughter, Trivedi) Department of Cardiovascular and
Thoracic Surgery, University of Louisville School of Medicine, Kentucky,
Louisville
Publisher
Elsevier Inc.
Abstract
Background: Use of continuous-flow left ventricular assist devices (LVAD)
has increased over the years as a bridge to transplant. The HeartWare HVAD
(Medtronic, Minneapolis, MN) and HeartMate III (HM3, Abbott, Abbott Park,
IL) are currently approved centrifugal-flow devices used for bridge to
transplant. We sought to evaluate outcomes of the patients listed and who
received a transplant after receiving these 2 devices. Method(s): The
United Network of Organ Sharing thoracic transplant database was queried
after August 23, 2017, until December 2018 to identify patients aged older
than 18 years listed for heart transplant and supported by the HVAD or
HM3. Patient characteristics were evaluated at the time of listing and
transplant. The primary study end point was 1-year mortality after LVAD
implantation. Nonparametric tests were used to evaluate the device groups.
 Result(s): Of 569 patients listed for heart transplant during the
study period, 226 had HM3 and 343 had HVAD. The HM3 group had more men
(82% vs 74%, P =.02), patients with diabetes (38% vs 29%, P =.02), and the
body mass index was higher (28 vs 27 kg/m2, P =.04) at listing.
Between the HM3 and HVAD groups, the 1-year mortality was 20% vs 17%,
respectively (log-rank P =.28; Figure 1), and the posttransplant survival
at 1 year was 97% and 94%, respectively (P =.1). Conclusion(s): In a
relatively well-matched group of patients listed for heart transplant with
a centrifugal-flow LVAD, the 6-month and 1-year mortality on the waiting
list as well as after transplant were not statistically different.
Additional real-world experience or a randomized trial would be needed to
determine whether one LVAD is superior. Copyright © 2022 The
Society of Thoracic Surgeons

<53>
Accession Number
2013718101
Title
10-Year Results of Mitral Repair and Coronary Bypass for Ischemic
Regurgitation: A Randomized Trial.
Source
Annals of Thoracic Surgery. 113(3) (pp 816-822), 2022. Date of
Publication: March 2022.
Author
Fattouch K.; Dioguardi P.; Guccione F.; Nogara A.; Salardino M.;
Sampognaro R.; Bacarella D.; Moscarelli M.
Institution
(Fattouch, Dioguardi, Guccione, Nogara, Salardino, Sampognaro, Bacarella,
Moscarelli) GVM Care & Research, Department of Cardiovascular Surgery,
Maria Eleonora Hospital, Palermo, Italy
(Fattouch, Moscarelli) GVM Care & Research, Department of Cardiovascular
Surgery, Maria Cecilia Hospital, Cotignola, Italy
Publisher
Elsevier Inc.
Abstract
Background: The decision to treat moderate ischemic mitral regurgitation
(IMR) at the time of coronary artery bypass surgery (CABG) remains
controversial. We previously conducted a prospective randomized trial that
showed a benefit of adding restricted annuloplasty to bypass surgery
(CABG-Ring group) in terms of IMR grade, New York Heart Association
classification, and left ventricle reverse remodeling. Here, we present
the long-term (>10 years) follow-up data from this randomized trial.
 Method(s): The original trial arms accounted for 54 patients in the
CABG-alone and 48 in the CABG-Ring group; patients were re-contacted for
follow-up to obtain relevant clinical and echocardiographic information.
 Result(s): The mean follow-up was 160.4 +/- 45.5 months. Survival
probabilities in the CABG-alone and CABG-Ring groups were 96% vs 93% at 3
years, 85% vs 89% at 6 years, 79% vs 85% at 9 years, 77% vs 83% at 12
years, and 72% vs 80% at 15 years, respectively (P = .18) Freedom from at
least moderate IMR or reintervention at last follow-up was also higher in
the CABG-Ring group (P < .001). Compared with the CABG-alone group, the
CABG-Ring group had a higher degree of left ventricular reverse remodeling
(54.7 +/- 6.9 mm vs 51.6 +/- 6 mm, respectively; P = .03), lower New York
Heart Association class (P < .001), and a lower rate of rehospitalization
(P = .002). Conclusion(s): Long-term follow-up data from our
randomized trial further support the utility of performing restricted
annuloplasty at the time of CABG to prevent further progression of IMR,
mitral reintervention, and left ventricle remodeling. Untreated IMR was
associated with significantly higher New York Heart Association class and
rehospitalization. Copyright © 2022 The Society of Thoracic
Surgeons

<54>
Accession Number
2012015301
Title
Pulmonary Valve Replacement in Tetralogy of Fallot: An Updated
Meta-Analysis.
Source
Annals of Thoracic Surgery. 113(3) (pp 1036-1046), 2022. Date of
Publication: March 2022.
Author
Van den Eynde J.; Sa M.P.B.O.; Vervoort D.; Roever L.; Meyns B.; Budts W.;
Gewillig M.; Ruhparwar A.; Zhigalov K.; Weymann A.
Institution
(Van den Eynde, Meyns) Unit of Cardiac Surgery, Department of
Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
(Sa) Division of Cardiovascular Surgery of Pronto Socorro Cardiologico de
Pernambuco, PROCAPE, University of Pernambuco, Pernambuco, Recife, Brazil
(Vervoort) Johns Hopkins Bloomberg School of Public Health, Maryland,
Baltimore
(Roever) Department of Clinical Research, Federal University of
Uberlandia, Minas Gerais, Uberlandia, Brazil
(Budts) Congenital and Structural Cardiology University Hospitals Leuven
and Department of Cardiovascular Sciences, Catholic University Leuven,
Leuven, Belgium
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Ruhparwar, Zhigalov, Weymann) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center, Essen, Germany
Publisher
Elsevier Inc.
Abstract
Background: The benefits of pulmonary valve replacement (PVR) for
pulmonary insufficiency in patients with repaired tetralogy of Fallot are
still incompletely understood, and optimal timing remains challenging.
 Method(s): We systematically reviewed databases (PubMed/MEDLINE,
Embase, Cochrane Central Register of Controlled Trials /Cochrane
Controlled Trials Register, ClinicalTrials.gov, Scientific Electronic
Library Online, Literatura Latino Americana em Ciencias da Saude, and
Google Scholar) and reference lists of relevant articles for studies about
PVR in repaired tetralogy of Fallot patients that reported any of the
following outcomes: mortality and redo PVR rates, right ventricular (RV)
and left ventricular measures, QRS duration, cardiopulmonary exercise test
results, or brain natriuretic peptide. In addition to calculating the
pooled treatment effects using a random-effects meta-analysis, we
evaluated the effect of preoperative measures on PVR outcomes using
meta-regressions. Result(s): Eighty-four studies involving 7544
patients met the eligibility criteria. Pooled mortality at 30 days, 5
years, and 10 years after PVR was 0.87% (63 of 7253 patients, 80 studies),
2.7% (132 of 4952 patients, 37 studies), and 6.2% (510 of 2765 patients,
15 studies), respectively. Pooled 5- and 10-year redo PVR rates were 3.7%
(141 of 3755 patients, 23 studies) and 16.8% (172 of 3035 patients, 16
studies), respectively. The results of the previous meta-analysis could be
confirmed. In addition, we demonstrated that after PVR (1) QRS duration,
cardiopulmonary exercise test results, and RV and left ventricular
measures longitudinal strain do not significantly change; (2) brain
natriuretic peptide decreases; and (3) greater indexed RV end-diastolic
and end-systolic volumes are associated with lower chances of RV volume
normalization after PVR. Conclusion(s): This updated meta-analysis
provides evidence about the benefits of PVR. Copyright © 2022 The
Society of Thoracic Surgeons

<55>
Accession Number
2007651176
Title
Investigation of myocardial protection during pediatric CPB: Practical
experience in 100 Chinese hospitals.
Source
Perfusion (United Kingdom). 37(1) (pp 5-13), 2022. Date of Publication:
January 2022.
Author
Zhang P.; Liu J.; Tong Y.; Guo S.; Bai L.; Jin Y.; Feng Z.; Zhao J.; Li Y.
Institution
(Zhang, Liu, Tong, Guo, Bai, Jin, Feng, Zhao, Li) State Key Laboratory of
Cardiovascular Disease, Department of Cardiopulmonary Bypass, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
Publisher
SAGE Publications Ltd
Abstract
Many measures have been proposed for myocardial protection in pediatric
congenital heart surgeries, but little data is available for China. This
study investigates myocardial protection strategies in pediatric
cardiopulmonary bypass (CPB) throughout China. Online questionnaires were
delivered to 100 hospitals in 27 provinces. The number of yearly on-pump
pediatric cardiovascular surgeries in these hospitals varied greatly.
About 91.0% of respondents believe that each surgery should have at least
two perfusionists, while only 64.0% of hospitals actually met this
requirement. For pediatric patients, crystalloid cardioplegia was more
prevalent than blood-based cardioplegia.
Histidine-tryptophan-ketoglutarate solution and St. Thomas crystalloid
solution were dominant among crystalloid cardioplegia. Del Nido
cardioplegia and St. Thomas blood-based cardioplegia ranked the top two in
the popularity of blood-based cardioplegia. Dosages varied among different
kinds of cardioplegia. In the choice of different cardioplegia,
perfusionists mainly focused on myocardial protective effect and cost.
Hypothermia of cardioplegia solution was maintained by ice buckets in 3/4
of the hospitals in this survey. In conclusion, the essence of myocardial
protection management during pediatric CPB was cardiac arrest induced by
cardioplegia under systemic hypothermia. However, there is no uniform
standard for the type of cardioplegia, or dosages. Therefore,
well-designed multicenter randomized controlled trials are warranted to
provide tangible evidence for myocardial protection of cardioplegia in
pediatric CPB. Copyright © The Author(s) 2020.

<56>
Accession Number
2007545157
Title
Remote ischemic preconditioning effects on inflammatory markers and
myocardial protection in coronary artery bypass graft surgery.
Source
Perfusion (United Kingdom). 37(1) (pp 56-61), 2022. Date of Publication:
January 2022.
Author
Gorjipour F.; Saeedzadeh T.; Toloueitabar Y.; Kachoueian N.; Bahlouli
Ghashghaei S.; Mortazian M.; Dehghani Firoozabadi M.; Jadbabaie A.;
Tirgarfakheri K.; Motamednejad A.; Totonchi Z.
Institution
(Gorjipour, Kachoueian, Jadbabaie) Department of Cardiac Surgery, Imam
Hossein Educational Hospital, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Gorjipour) Iranian Scientific Society of Extracorporeal Technology,
Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Saeedzadeh) Department of Biological Sciences, North Tehran Branch,
Islamic Azad University, Tehran, Iran, Islamic Republic of
(Toloueitabar, Bahlouli Ghashghaei, Tirgarfakheri, Motamednejad, Totonchi)
Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Mortazian) AJA University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Dehghani Firoozabadi) Department of Anesthesiology, Tehran Heart Center,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
SAGE Publications Ltd
Abstract
Background: Induction of short episodes of ischemia to remote organs,
namely upper or lower limbs, literally known as remote ischemic
preconditioning (RIPC) has been suggested as a preconditioning approach to
ameliorate ischemia/reperfusion injury (IRI). RIPC has been demonstrated
to effectively protect various vital organs, including heart, against the
next ischemic events in preclinical studies. However, human studies are
required to approve its clinical applicability. Present study was
performed to evaluate the effect of RIPC on the myocardial protection and
inflammatory response markers in patients undergoing coronary artery
bypass graft surgery Methods: In this randomized clinical trial, 43
coronary artery bypass graft (CABG) patients from Imam Hossein educational
hospital were allocated in two groups, RIPC (21 patients) and control (22
patients). Serum level of interleukin (IL)-4, IL-8, and IL-10, interferon
(IFN)-gamma and Cardiac Troponin-I (cTnI) were measured in (1) after
induction of anesthesia (before incision of skin), (2) after separation
from CPB and (3) 24 hours after ICU arrival. Result(s): increase pack
cell transfusions were observed in control group in ICU. Serum level of
IL-10 at 24 hours after ICU admission was significantly higher in the RIPC
group. Significantly lower amounts of IL-8 at post-CPB time were observed
in the RIPC group in comparison with control. Conclusion(s): RIPC
regulates the circulatory inflammatory cytokines, IL-8 decrement and IL-10
elevation, which could be translated into protection against IRI. However,
further studies with larger sample sizes with careful consideration of
parameters such as use of propofol as an anesthetic in the patients should
be conducted to consolidate the findings from the current
study. Copyright © The Author(s) 2020.

<57>
Accession Number
2007236979
Title
Sutureless versus transcatheter aortic valves in elderly patients with
aortic stenosis at intermediate risk: A multi-institutional study.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(3) (pp 925-935.e5),
2022. Date of Publication: March 2022.
Author
Muneretto C.; Solinas M.; Folliguet T.; Di Bartolomeo R.; Repossini A.;
Laborde F.; Rambaldini M.; Santarpino G.; Di Bacco L.; Fischlein T.
Institution
(Muneretto, Repossini, Di Bacco) University of Brescia, Brescia, Italy
(Solinas) Monasterio Foundation Heart Hospital, Massa, Italy
(Folliguet) Centre Hospitalo-universitaire Brabois ILCV, Vandoeuvre les
Nancy, France
(Di Bartolomeo) University of Bologna, Bologna, Italy
(Laborde) Institut Mutualiste Montsouris, Paris, France
(Rambaldini) Carlo Poma Hospital of Mantova, Mantova, Italy
(Santarpino, Fischlein) Universitatsklinik der Paracelsus Medizinischen
Privatuniversitat, Nuremberg, Germany
Publisher
Elsevier Inc.
Abstract
Objective: This multi-institutional study compares the long-term outcome
of elderly patients with severe aortic stenosis and an intermediate risk
profile undergoing sutureless versus transcatheter aortic valve
implantation. Method(s): From 2008 to 2015, 967 elderly patients (>75
years) with intermediate risk (Society of Thoracic Surgeons score 4%-8%)
and isolated aortic stenosis were included in the study (sutureless valve
= 481; transcatheter aortic valve implantation = 486). After propensity
score matching, 2 matched groups of 291 patients were obtained.
Transcatheter valves implanted in patients were the CoreValve (Medtronic,
Minneapolis, Minn), Edwards SAPIEN-XT (Edwards Lifesciences, Irvine,
Calif), and Acurate-TA (Symetis, Lausanne, Switzerland). Primary end
points included all-cause death at 30 days and 5 years. Secondary end
points included early and 5-year incidence of composite adverse events
(major adverse cardiovascular events: all-cause death, stroke, pacemaker
implant, myocardial infarction, paravalvular leak >=II, and reoperation).
 Result(s): After matching, there were no substantial differences
between groups. The 30-day mortality was significantly lower in the
sutureless valve group (sutureless valve = 1.7% vs transcatheter aortic
valve implantation = 5.5%; P = .024) and the rate of permanent pacemaker
implantation (sutureless valve = 5.5% vs transcatheter aortic valve
implantation = 10.7%, P = .032). Stroke/transient ischemic attack
cumulative incidence at 5 years was 1.4% in the sutureless valve group and
5.3% in the transcatheter aortic valve implantation group (P = .010). The
incidence of perivalvular leak grade II or greater was 1.3% in the
sutureless valve group and 9.8% in the transcatheter aortic valve
implantation group (P < .001). At 60 months follow-up, the all-cause death
rate was lower in the sutureless valve group than in the transcatheter
aortic valve implantation group (sutureless valve = 16.1% +/- 4.1% vs
transcatheter aortic valve implantation = 28.9% +/- 5.3%, P = .006), and
the major adverse cardiovascular event rate was lower in the sutureless
valve group (sutureless valve = 23.5% +/- 4.1% vs transcatheter aortic
valve implantation = 39.0% +/- 5.6%, P = .002). Multivariable Cox
regression identified transcatheter aortic valve implantation as an
independent predictor for 5-year mortality and major adverse
cardiovascular events (hazard ratio, 1.86; confidence interval, 1.09-3.18;
P = .022) (hazard ratio, 1.73; confidence interval, 1.13-2.73; P = .010).
 Conclusion(s): Sutureless valves improved the outcomes of aortic
stenosis in elderly patients with an intermediate risk profile when
compared with transcatheter aortic valve implantation. The use of
transcatheter aortic valve implantation in this subset population should
be evaluated in further controlled randomized trials with sutureless valve
use in a comparative cohort. Copyright © 2020 The American
Association for Thoracic Surgery

<58>
Accession Number
635811916
Title
Efficacy and Safety of Tranexamic Acid for the Control of Surgical
Bleeding in Patients Under Liposuction.
Source
Aesthetic plastic surgery. 46(1) (pp 258-264), 2022. Date of Publication:
01 Feb 2022.
Author
Rodriguez-Garcia F.A.; Sanchez-Pena M.A.; de Andrea G.T.;
Villarreal-Salgado J.L.; Alvarez-Trejo H.J.; Medina-Quintana V.M.;
Garcia-Valenzuela S.E.; Morfin-Meza K.E.; Fierro-Rodriguez D.A.;
Dorado-Hernandez E.; Bonilla-Catalan P.V.; Ramos-Maciel J.; Romero-Algara
E.; Jimenez-Pavon K.E.; Torres-Salazar Q.L.
Institution
(Rodriguez-Garcia, Villarreal-Salgado, Alvarez-Trejo, Medina-Quintana,
Garcia-Valenzuela, Morfin-Meza, Fierro-Rodriguez, Dorado-Hernandez,
Bonilla-Catalan, Ramos-Maciel, Romero-Algara, Jimenez-Pavon) Instituto de
Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital
Regional "Dr. Valentin Gomez Farias", Av. Soledad Orozco 203, El Capullo,
45100, Zapopan, Guadalajara, Jalisco, Mexico
(Sanchez-Pena, de Andrea) Hospital INNOVARE, Av. Verona 7412, Zapopan,
Jalisco, Mexico
(Torres-Salazar) Universidad Juarez del Estado de Durango, Calle Paloma
No.806, Colonia Fatima, Durango 34060, Mexico
Publisher
NLM (Medline)
Abstract
Liposuction remains one of the most frequently performed cosmetic surgical
procedures and its popularity is increasing every year. However, since its
inception, justified concerns regarding patient safety have placed limits
on the volume of fat that can be aspirated, influenced by hemodynamic
fluctuations and blood loss during liposuction. Tranexamic acid (TXA) is
an antifibrinolytic agent that competitively inhibits the conversion of
plasminogen to plasmin, thus preventing the binding and degradation of
fibrin. Despite the existence of evidence of the effectiveness of TXA in
orthopedic and cardiac surgeries, there is little evidence of its use in
liposuction. The objective of this study was to evaluate the efficacy and
safety of tranexamic acid in the control of surgical bleeding in patients
undergoing liposuction, through a prospective, open, randomized and
controlled clinical trial. Two groups of 25 participants each were formed
to whom the application of TXA in a tumescent solution prior to
liposuction or liposuction with the traditional technique was randomly
assigned. The results showed a decrease in blood loss reflected by the
differences in the final hematocrit values, as well as decrease in the
same per aspirated volume (p = 0.003). No adverse events were found
related with the TXA application and no blood transfusions were required
in this group, in contrast to the control group where the need for blood
transfusion was present in 20% of the intervened participants. LEVEL OF
EVIDENCE II: This journal requires that authors assign a level of evidence
to each article. For a full description of these Evidence-Based Medicine
ratings, please refer to the Table of Contents or the online Instructions
to Authors www.springer.com/00266. Copyright © 2021. Springer
Science+Business Media, LLC, part of Springer Nature and International
Society of Aesthetic Plastic Surgery.

<59>
Accession Number
635292235
Title
P2Y12 inhibitor monotherapy or dual antiplatelet therapy after coronary
revascularisation: Individual patient level meta-analysis of randomised
controlled trials.
Source
The BMJ. 373 (no pagination), 2021. Article Number: n1332. Date of
Publication: 16 Jun 2021.
Author
Valgimigli M.; Gragnano F.; Branca M.; Franzone A.; Baber U.; Jang Y.;
Kimura T.; Hahn J.-Y.; Zhao Q.; Windecker S.; Gibson C.M.; Kim B.-K.;
Watanabe H.; Song Y.B.; Zhu Y.; Vranckx P.; Mehta S.; Hong S.-J.; Ando K.;
Gwon H.-C.; Serruys P.W.; Dangas G.D.; McFadden E.P.; Angiolillo D.J.; Heg
D.; Juni P.; Mehran R.
Institution
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Valgimigli, Windecker) Department of Cardiology, Bern University
Hospital, University of Bern, Bern, Switzerland
(Gragnano) Department of Translational Medical Sciences, University of
Campania Luigi Vanvitelli, Caserta, Italy
(Branca, Heg) Clinical Trials Unit, Bern, Switzerland
(Franzone) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Baber, Dangas, Mehran) Icahn School of Medicine at Mount Sinai, New York,
NY, United States
(Jang, Kim, Hong) Severance Cardiovascular Hospital, Yonsei University
College of Medicine, Seoul, South Korea
(Kimura, Watanabe) Department of Cardiovascular Medicine, Kyoto
University, Graduate School of Medicine, Kyoto, Japan
(Hahn, Song, Gwon) Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Zhao, Zhu) Department of Cardiovascular Surgery, Ruijin Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Gibson) Division of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Belgium
(Mehta) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Mehta) Hamilton Health Sciences, Hamilton, ON, Canada
(Ando) Kokura Memorial Hospital, Department of Cardiology, Kitakyushu,
Japan
(Serruys) Department of Cardiology, National University of Ireland Galway,
Galway, Ireland
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(McFadden) Cardialysis Core Laboratories and Clinical Trial Management,
Rotterdam, Netherlands
(McFadden) Department of Cardiology, Cork University Hospital, Cork,
Ireland
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Juni) Applied Health Research Centre, Li Ka Shing Knowledge Institute,
Department of Medicine, St Michael's Hospital, University of Toronto,
Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objective To assess the risks and benefits of P2Y 12 inhibitor monotherapy
compared with dual antiplatelet therapy (DAPT) and whether these
associations are modified by patients' characteristics. Design Individual
patient level meta-analysis of randomised controlled trials. Data sources
Searches were conducted in Ovid Medline, Embase, and three websites
(www.tctmd.com, www.escardio.org, www.acc.org/cardiosourceplus) from
inception to 16 July 2020. The primary authors provided individual
participant data. Eligibility criteria Randomised controlled trials
comparing effects of oral P2Y 12 monotherapy and DAPT on centrally
adjudicated endpoints after coronary revascularisation in patients without
an indication for oral anticoagulation. Main outcome measures The primary
outcome was a composite of all cause death, myocardial infarction, and
stroke, tested for non-inferiority against a margin of 1.15 for the hazard
ratio. The key safety endpoint was Bleeding Academic Research Consortium
(BARC) type 3 or type 5 bleeding. Results The meta-analysis included data
from six trials, including 24 096 patients. The primary outcome occurred
in 283 (2.95%) patients with P2Y 12 inhibitor monotherapy and 315 (3.27%)
with DAPT in the per protocol population (hazard ratio 0.93, 95%
confidence interval 0.79 to 1.09; P=0.005 for non-inferiority; P=0.38 for
superiority; tau 2 =0.00) and in 303 (2.94%) with P2Y 12 inhibitor
monotherapy and 338 (3.36%) with DAPT in the intention to treat population
(0.90, 0.77 to 1.05; P=0.18 for superiority; tau 2 =0.00). The treatment
effect was consistent across all subgroups, except for sex (P for
interaction=0.02), suggesting that P2Y 12 inhibitor monotherapy lowers the
risk of the primary ischaemic endpoint in women (hazard ratio 0.64, 0.46
to 0.89) but not in men (1.00, 0.83 to 1.19). The risk of bleeding was
lower with P2Y 12 inhibitor monotherapy than with DAPT (97 (0.89%) v 197
(1.83%); hazard ratio 0.49, 0.39 to 0.63; P<0.001; tau 2 =0.03), which was
consistent across subgroups, except for type of P2Y 12 inhibitor (P for
interaction=0.02), suggesting greater benefit when a newer P2Y 12
inhibitor rather than clopidogrel was part of the DAPT regimen.
Conclusions P2Y 12 inhibitor monotherapy was associated with a similar
risk of death, myocardial infarction, or stroke, with evidence that this
association may be modified by sex, and a lower bleeding risk compared
with DAPT. Copyright © 2019 Author(s). Published by BMJ.

<60>
Accession Number
624628505
Title
Morphine and Ticagrelor Interaction in Primary Percutaneous Coronary
Intervention in ST-Segment Elevation Myocardial Infarction:
ATLANTIC-Morphine.
Source
American Journal of Cardiovascular Drugs. 19(2) (pp 173-183), 2019. Date
of Publication: 08 Apr 2019.
Author
Lapostolle F.; van't Hof A.W.; Hamm C.W.; Stibbe O.; Ecollan P.; Collet
J.-P.; Silvain J.; Lassen J.F.; Bolognese L.; Cantor W.J.; Cequier A.;
Chettibi M.; Goodman S.G.; Hammett C.J.; Huber K.; Janzon M.; Merkely B.;
Storey R.F.; ten Berg J.; Zeymer U.; Licour M.; Tsatsaris A.; Bougherbal
R.; Bouafia M.T.; Nibouche D.; Moklati A.; Benalia A.; Kaid O.; Krim M.;
Hammett C.; Garraby P.; Jayasinghe R.; Rashford S.; Neunteufl T.; Brussee
H.; Alber H.; Weidinger F.; Brunner M.; Sipoetz J.; Prause G.; Baubin M.;
Sebald D.; Vijayaraghavan R.; Bata I.; Lavoie A.; Ravkilde J.; Jensen
L.O.; Christensen A.M.; Toftegaard M.; Kohler D.; Montalescot G.; Ducrocq
G.; Danchin N.; Henry P.; Livarek B.; Berthier R.; Hovasse T.; Garot P.;
Payot L.; Benamer H.; Esteve J.B.; Elhadad S.; Teiger E.; Bonnet J.L.;
Paganelli F.; Cottin Y.; Schiele F.; Thuaire C.; Cayla G.; Coste P.;
Ohlmann P.; Cudraz E.B.; Lantelme P.; Perret T.; Tron C.; De Labriolle A.;
Aptecar E.; Beliard O.; Varenne O.; Mahmoud R.E.; Filippi-Codaccioni E.;
Angoulvant D.; Peycher P.; Poitrineau O.; Tabone X.; Broche C.; Lambert
Y.; Briole N.; Beruben A.; Porcher N.; Auffray J.-P.; Freysz M.; Depardieu
F.; Poubel D.; De La Cousaye J.-E.; Bartier J.-C.; Jardel B.; Boulanger
B.; Labourel H.; Soulat L.-C.; Julie V.; Thicoipe M.; Capel O.; Carli P.;
Tazarourte K.; Alcouffe F.; Aboucaya D.; Aubert G.; Kierzek G.;
Cahun-Giraud S.; Hamm C.; Dengler T.; Prondzinsky R.; Biever P.M.; Schafer
A.; Seyfarth M.; Lemke B.; Werner G.; Nef H.; Steiger H.; Leschke M.;
Munzel T.; Orto M.C.D.; Loges C.; Schinke M.; Koberne F.; Reiffen H.P.;
Tiroch K.; Wierich D.; Kneussel M.; Little S.; Sauer H.;
Laufenberg-Feldmann R.; Ungi I.; Horvath I.; Edes I.; Martai I.; Berti S.;
Chiarella F.; Calabria P.; Fineschi M.; Galvani M.; Valgimigli M.; Moretti
L.; Tespili M.; Mando M.; Bermano F.; Biagioni R.; Fabbri A.; Ricciardelli
A.; Petroni M.R.; Vatteroni U.R.; Palumbo F.; Willems F.F.; mafragi A.A.;
Heestermans T.A.A.C.M.; Van Eck M.J.; Heutz W.M.J.M.; Meppelder H.H.; Jong
A.R.-D.; Van de Pas H.; Fillat A.C.; Tenas M.S.; Ferrer J.M.; Penaranda
A.S.; Ferrer J.A.; Del Blanco B.G.; Guardiola F.M.; Nodar J.M.R.; Romo
A.I.; Gonzalez N.V.; Nouche R.T.; De La Llera L.D.; Garcia J.M.H.;
Rivero-Crespo F.; Hernandez F.H.; Gomez J.L.Z.; Farega X.J.; Fernandez
G.A.; Toboso J.L.; Carrasco M.; Barreiro V.; Vazquez J.A.I.; del Mar Ruiz
Montero M.; Ortiz F.R.; Escudero G.G.; Ingelmo V.S.-B.; Garcia A.L.;
Oldgren J.; Calais F.; Kastberg R.; Bergsten P.-A.; Blomberg H.; Thorn K.;
Skoog G.; Zaman A.; Gerber R.; Ryding A.; Spence M.; Swanson N.; Been M.;
Grosser K.; Schofield P.; Mackin D.; Fell P.; Foster T.Q.T.; McManus D.;
Carson A.
Institution
(Lapostolle) SAMU 93 - UF Recherche-Enseignement-Qualite, Universite Paris
13, Sorbonne Paris Cite, Inserm U942, Hopital Avicenne, 125, rue de
Stalingrad, Bobigny 93009, France
(van't Hof) Department of Cardiology, Isala Clinics, Zwolle, Netherlands
(Hamm) Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad
Nauheim, Germany
(Stibbe) Service Medical d'Urgence, Brigade de Sapeurs-Pompiers de Paris,
Paris, France
(Ecollan, Collet, Silvain, Montalescot) Sorbonne Universite, ACTION Study
Group, Hopital Pitie-Salpetriere (AP-HP), 47 boul de l'Hopital, Paris
75013, France
(Lassen) Department of Cardiology B, Aarhus University Hospital, Skejby,
Aarhus N, Denmark
(Heutz) Regionale Ambulance Voor ziening Gelderland-Midden, Arnhem,
Netherlands
(Bolognese) Cardiovascular and Neurological Department, Azienda
Ospedaliera Arezzo, Arezzo, Italy
(Cantor) Southlake Regional Health Centre, University of Toronto,
Newmarket, ON, Canada
(Cequier) Heart Disease Institute, Hospital Universitario de Bellvitge,
University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
(Chettibi) Centre Hospito-universitaire Frantz Fanon, Blida, Algeria
(Goodman) Division of Cardiology, Canadian Heart Research Centre, St
Michael's Hospital, University of Toronto, Toronto, Canada
(Hammett) Department of Cardiology, Royal Brisbane and Women's Hospital,
Brisbane, QLD, Australia
(Huber) 3rd Department of Medicine, Cardiology and Intensive Care
Medicine, Wilhelminenhospital, Sigmund Freud University, Medical School,
Vienna, Austria
(Janzon) Department of Cardiology and Department of Medical and Health
Sciences, Linkoping University, Linkoping, Sweden
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Storey) Department of Infection, Immunity and Cardiovascular Disease,
University of Sheffield, Sheffield, United Kingdom
(ten Berg) Department of Cardiology, St Antonius Hospital Nieuwegein,
Nieuwegein, Netherlands
(Zeymer) Klinikum Ludwigshafen and Institut fur Herzinfarktforschung
Ludwigshafen, Ludwigshafen, Germany
(Licour, Tsatsaris) AstraZeneca, Rueil Malmaison, France
(van't Hof) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
Publisher
Adis
Abstract
Background: Morphine adversely impacts the action of oral adenosine
diphosphate (ADP)-receptor blockers in ST-segment elevation myocardial
infarction (STEMI) patients, and is possibly associated with differing
patient characteristics. This retrospective analysis investigated whether
interaction between morphine use and pre-percutaneous coronary
intervention (pre-PCI) ST-segment elevation resolution in STEMI patients
in the ATLANTIC study was associated with differences in patient
characteristics and management. Method(s): ATLANTIC was an
international, multicenter, randomized study of treatment in the acute
ambulance/hospital setting where STEMI patients received ticagrelor 180 mg
+/- morphine. Patient characteristics, cardiovascular history, risk
factors, management, and outcomes were recorded. Result(s): Opioids
(97.6% morphine) were used in 921 out of 1862 patients (49.5%). There were
no significant differences in age, sex or cardiovascular history, but more
morphine-treated patients had anterior myocardial infarction and left-main
disease. Time from chest pain to electrocardiogram and ticagrelor loading
was shorter with morphine (both p = 0.01) but not total ischemic time.
Morphine-treated patients more frequently received glycoprotein IIb/IIIa
inhibitors (p = 0.002), thromboaspiration and stent implantation (both p <
0.001). No significant difference between the two groups was found
regarding pre-PCI >= 70% ST-segment elevation resolution, death,
myocardial infarction, stroke, urgent revascularization and definitive
acute stent thrombosis. More morphine-treated patients had an absence of
pre-PCI Thrombolysis in Myocardial Infarction (TIMI) 3 flow (85.8% vs.
79.7%; p = 0.001) and more had TIMI major bleeding (1.1% vs. 0.1%; p =
0.02). Conclusion(s): Morphine-treatment was associated with
increased GP IIb/IIIa inhibitor use, less pre-PCI TIMI 3 flow, and more
bleeding. Judicious morphine use is advised with non-opioid analgesics
preferred for non-severe acute pain. Trial Registration:
clinicaltrials.gov identifier: NCT01347580. Copyright © 2018,
Springer Nature Switzerland AG.

<61>
Accession Number
608827005
Title
Effect of Pre-Hospital Ticagrelor during the First 24 h after Primary
Percutaneous Coronary Intervention in Patients with ST-Segment Elevation
Myocardial Infarction the ATLANTIC-H24 Analysis.
Source
JACC: Cardiovascular Interventions. 9(7) (pp 646-656), 2016. Date of
Publication: 11 Apr 2016.
Author
Montalescot G.; Van 'T Hof A.W.; Bolognese L.; Cantor W.J.; Cequier A.;
Chettibi M.; Collet J.-P.; Goodman S.G.; Hammett C.J.; Huber K.; Janzon
M.; Lapostolle F.; Lassen J.F.; Licour M.; Merkely B.; Salhi N.; Silvain
J.; Storey R.F.; Ten Berg J.M.; Tsatsaris A.; Zeymer U.; Vicaut E.; Hamm
C.W.; Bougherbal R.; Bouafia M.T.; Nibouche D.; Moklati A.; Benalia A.;
Kaid O.; Krim M.; Hammett C.; Garrahy P.; Jayasinghe R.; Rashford S.;
Neunteufl T.; Brussee H.; Alber H.; Weidinger F.; Brunner M.; Sipoetz J.;
Prause G.; Baubin M.; Sebald D.; Vijayaraghavan R.; Bata I.; Lavoie A.;
Ravkilde J.; Jensen L.O.; Christensen A.Mo.; Toftegaard M.; Kohler D.;
Ducrocq G.; Danchin N.; Henry P.; Livarek B.; Berthier R.; Hovasse T.;
Garot P.; Payot L.; Benamer H.; Esteve J.B.; Elhadad S.; Teiger E.; Bonnet
J.L.; Paganelli F.; Cottin Y.; Schiele F.; Thuaire C.; Cayla G.; Coste P.;
Ohlmann P.; Cudraz E.B.; Lantelme P.; Perret T.; Tron C.; De Labriolle A.;
Aptecar E.; Beliard O.; Varenne O.; El Mahmoud R.; Filippi-Codaccioni E.;
Angoulvant D.; Peycher P.; Poitrineau O.; Tabone X.; Ecollan P.; Broche
C.; Lambert Y.; Briole N.; Beruben A.; Porcher N.; Auffray J.-P.; Freysz
M.; Depardieu F.; Poubel D.; De La Cousaye J.-E.; Bartier J.-C.; Jardel
B.; Boulanger B.; Labourel H.; Soulat L.-C.; Julie V.; Thicoipe M.; Capel
O.; Stibbe O.; Carli P.; Tazarourte K.; Alcouffe F.; Aboucaya D.; Aubert
G.; Kierzek G.; Cahun-Giraud S.; Hamm C.; Dengler T.; Prondzinsky R.;
Biever P.M.; Schafer A.; Seyfarth M.; Lemke B.; Werner G.; Nef H.; Steiger
H.; Leschke M.; Munzel T.; Dell Orto M.C.; Loges C.; Schinke M.; Koberne
F.; Reiffen H.P.; Tiroch K.; Wierich D.; Kneussel M.; Little S.; Sauer H.;
Laufenberg-Feldmann R.; Ungi I.; Horvath I.; Edes I.; Martai I.; Berti S.;
Chiarella F.; Calabria P.; Fineschi M.; Galvani M.; Valgimigli M.; Moretti
L.; Tespili M.; Mando M.; Bermano F.; Biagioni R.; Fabbri A.; Ricciardelli
A.; Petroni M.R.; Vatteroni U.R.; Palumbo F.; Willems F.F.; Al Mafragi A.;
Heestermans T.A.A.C.M.; Van Eck M.J.; Heutz W.M.J.M.; Meppelder H.H.; Jong
A.R.-D.; Van De Pas H.; Fillat A.C.; Tenas M.S.; Ferrer J.M.; Penaranda
A.S.; Ferrer J.A.; Del Blanco B.G.; Guardiola F.M.; Ruiz Nodar J.M.; Romo
A.I.; Gonzalez N.V.; Nouche R.T.; De La Llera L.D.; Hernandez Garcia J.M.;
Rivero-Crespo F.; Hernandez F.H.; Zamorano Gomez J.L.; Farega X.J.;
Fernandez G.A.; Toboso J.L.; Carrasco M.; Barreiro V.; Iglesias Vazquez
J.A.; Montero M.D.M.R.; Ortiz F.R.; Escudero G.G.; Ingelmo V.S.-B.; Garcia
A.L.; Oldgren J.; Calais F.; Kastberg R.; Bergsten P.-A.; Blomberg H.;
Thorn K.; Skoog G.; Zaman A.; Gerber R.; Ryding A.; Spence M.; Swanson N.;
Been M.; Grosser K.; Schofield P.; Mackin D.; Fell P.; Quinn T.; Foster
T.; McManus D.; Carson A.
Institution
(Montalescot, Collet, Silvain) Universite Paris 6, ACTION Study Group,
Institut de Cardiologie (AP-HP), Centre Hospitalier Universitaire
Pitie-Salpetriere, INSERM UMRS 1166, 47 Boulevard de lHopital, Paris
75013, France
(Van 'T Hof) Department of Cardiology, Isala Clinics, Zwolle, Netherlands
(Bolognese) Cardiovascular and Neurological Department, Azienda
Ospedaliera Arezzo, Arezzo, Italy
(Cantor) Southlake Regional Health Centre, University of Toronto,
Newmarket, ON, Canada
(Cequier) Heart Disease Institute, Hospital Universitario de Bellvitge,
University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
(Chettibi) Centre Hospito-Universitaire Frantz Fanon, Blida, Algeria
(Goodman) Canadian Heart Research Centre, Division of Cardiology, St.
Michael's Hospital, University of Toronto, Toronto, Canada
(Hammett) Department of Cardiology, Royal Brisbane and Women's Hospital,
Brisbane, QLD, Australia
(Huber) 3rd Department of Medicine, Cardiology and Intensive Care
Medicine, Wilhelminenhospital, Vienna, Austria
(Janzon) Department of Cardiology, Linkoping University, Linkoping, Sweden
(Lapostolle) SAMU 93 Hopital Avicenne, Bobigny, France
(Lassen) Department of Cardiology B, Aarhus University Hospital, Aarhus N,
Denmark
(Licour, Tsatsaris) AstraZeneca, Rueil Malmaison, France
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Salhi) AstraZeneca, Luton, United Kingdom
(Storey) Department of Cardiovascular Science, University of Sheffield,
Sheffield, United Kingdom
(Ten Berg) Department of Cardiology, St. Antonius Hospital Nieuwegein,
Nieuwegein, Netherlands
(Zeymer) Klinikum Ludwigshafen, Institut fur Herzinfarktforschung
Ludwigshafen, Ludwigshafen, Germany
(Vicaut) Unite de Recherche Clinique, Universite Paris 7, Hopital
Lariboisiere, ACTION Study Group, Paris, France
(Hamm) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim,
Germany
Publisher
Elsevier Inc.
Abstract
Objectives The aim of this landmark exploratory analysis,
ATLANTIC-H24, was to evaluate the effects of pre-hospital
ticagrelor during the first 24 h after primary percutaneous coronary
intervention (PCI) in the ATLANTIC (Administration of Ticagrelor in the
cath Lab or in the Ambulance for New ST elevation myocardial infarction to
open the Coronary artery) study. Background The ATLANTIC trial in patients
with ongoing ST-segment elevation myocardial infarction showed that
pre-hospital ticagrelor was safe but did not improve pre-PCI coronary
reperfusion compared with in-hospital ticagrelor. We hypothesized that the
effect of pre-hospital ticagrelor may not have manifested until after PCI
due to the rapid transfer time (31 min). Methods The
ATLANTIC-H24 analysis included 1,629 patients who underwent
PCI, evaluating platelet reactivity, Thrombolysis In Myocardial Infarction
flow grade 3, >=70% ST-segment elevation resolution, and clinical
endpoints over the first 24 h. Results Following PCI, largest
between-group differences in platelet reactivity occurred at 1 to 6 h;
coronary reperfusion rates numerically favored pre-hospital ticagrelor,
and the degree of ST-segment elevation resolution was significantly
greater in the pre-hospital group (median, 75.0% vs. 71.4%; p = 0.049). At
24 h, the composite ischemic endpoint was lower with pre-hospital
ticagrelor (10.4% vs. 13.7%; p = 0.039), as were individual endpoints of
definite stent thrombosis (p = 0.0078) and myocardial infarction (p =
0.031). All endpoints except death (1.1% vs. 0.2%; p = 0.048) favored
pre-hospital ticagrelor, with no differences in bleeding events.
Conclusions The effects of pre-hospital ticagrelor became apparent after
PCI, with numerical differences in platelet reactivity and immediate
post-PCI reperfusion, associated with reductions in ischemic endpoints,
over the first 24 h, whereas there was a small excess of mortality.
(Administration of Ticagrelor in the cath Lab or in the Ambulance for New
ST elevation myocardial infarction to open the Coronary artery [ATLANTIC,
NCT01347580]) Copyright © 2016 American College of Cardiology
Foundation.

<62>
Accession Number
2016672498
Title
Clinical assessment of efficacy of poly-L-lactide sternal pin on sternal
stability and post-operative pain: a prospective randomized trial in
cardiovascular surgery.
Source
Journal of Thoracic Disease. 14(1) (pp 76-89), 2022. Date of Publication:
January 2022.
Author
Takahara S.; Sasaki K.; Saito T.; Sakuma K.; Fujiwara H.; Yoshioka I.;
Kumagai K.; Sun W.; Takase K.; Saiki Y.
Institution
(Takahara, Sasaki, Saito, Sakuma, Fujiwara, Yoshioka, Saiki) Division of
Cardiovascular Surgery, Tohoku University Graduate School of Medicine,
Sendai, Japan
(Kumagai, Saiki) Research Division of Science for Aortic diseases, Tohoku
University Graduate School of Medicine, Sendai, Japan
(Sun, Takase) Department of Diagnostic Radiology, Tohoku University
Graduate School of Medicine, Sendai, Japan
Publisher
AME Publishing Company
Abstract
Background: Although the incident rate is low, sternal dislocation and
dehiscence due to unstable sternal fixation after cardiovascular surgery
could cause potentially lethal complications. Thus, to enforce the
stability of closed sternum, the sternal pins have been utilized at
surgeon's discretion. However, there is no randomized clinical trial to
test whether these pins are effective to stabilize a sternum. Hence, this
study aimed to examine the clinical efficacy of bioabsorbable
poly-L-lactide (PLLA) sternal pins in reinforcing sternal stability and
preventing instability of the sternum after full sternotomy.
 Method(s): We conducted a single institutional, prospective,
randomized, single-blinded clinical study involving 100 patients who
underwent an initial cardiovascular surgery via sternotomy. Patients were
randomly allocated into two groups: with (group P) and without (group N)
PLLA sternal pins, at 1:1 ratio from November 2013 to April 2016. Sternal
deviation and stability were assessed with postoperative computed
tomography (CT) at two postures to put shear stress on the sternum.
Additionally, information on patient demographic indices was obtained
prospectively, and patient's pain intensity was assessed with numerical
rating scoring system during rehabilitation. Furthermore, propensity score
matching was performed for further comparative sub-analysis.
 Result(s): Ninety-one patients (43 in group P and 48 in group N) were
analyzed using the intention-to-treat method. Group N had a significantly
higher proportion of males (P=0.015) and ischemic disease as a primary
diagnosis (P=0.040) than group P. Postoperative CT showed that the degree
of sternal deviation and stability were comparable between the groups.
Similarly, the numerical rating score of pain during rehabilitation showed
no difference between the groups. Even after adjusting for patient
characteristics using propensity score matching method, no significant
differences in sternal gaps, stability, and numerical rating score of pain
were observed. Of note, no material-related adverse event such as wound
infection was found. Conclusion(s): We could not identify the
efficacy of the sternal pin in enforcing sternal stability based on CT
measurements with mild shear stress on sternum after cardiovascular
surgery. Nevertheless, our results with no adverse events might encourage
further investigations with a more specific cohort who is susceptible to
infection but requires an additional sternal fixation. Trial Registration:
This study was registered in University Hospital Medical Information
Network Clinical Trial Registry (UMIN000017357). Copyright ©
Journal of Thoracic Disease. All rights reserved.

<63>
Accession Number
2016672495
Title
Negative pressure wound therapy for massive subcutaneous emphysema: a
systematic review and case series.
Source
Journal of Thoracic Disease. 14(1) (pp 43-53), 2022. Date of Publication:
January 2022.
Author
Janssen N.; Laven I.E.W.G.; Daemen J.H.T.; Hulsewe K.W.E.; Vissers Y.L.J.;
de Loos E.R.
Institution
(Janssen, Laven, Daemen, Hulsewe, Vissers, de Loos) Department of Surgery,
Division of General Thoracic Surgery, Zuyderland Medical Centre, Heerlen,
Netherlands
Publisher
AME Publishing Company
Abstract
Background: Massive subcutaneous emphysema can cause considerable
morbidity with respiratory distress. To resolve this emphysema in
short-term, negative pressure wound therapy could be applied as added
treatment modality. However, its use is sparsely reported, and a variety
of techniques are being described. This study provides a systematic review
of the available literature on the effectiveness of negative pressure
wound therapy as treatment for massive subcutaneous emphysema. In
addition, our institutional experience is reported through a case-series.
 Method(s): The PubMed, Embase and Cochrane Library were
systematically searched for publications on the use of negative pressure
wound therapy for subcutaneous emphysema following thoracic surgery,
trauma or spontaneous pneumothorax. Moreover, patients treated at our
institution between 2019 and 2021 were retrospectively identified and
analyzed. Result(s): The systematic review provided 10 articles
presenting 23 cases. Studies demonstrated considerable heterogeneity
regarding the location of incision, creation of prepectoral pocket, and
surgical safety margin. Also closed incision negative pressure wound
therapy and PICO© device were discussed. Despite the
apparent heterogeneity, all techniques provided favorable outcomes. No
complications, reinterventions or recurrences were documented.
Furthermore, retrospective data of 11 patients treated at our clinic
demonstrated an immediate response to negative pressure wound therapy and
a full remission of the subcutaneous emphysema at the end of negative
pressure wound therapy. No recurrence requiring intervention or
complications were observed. Conclusion(s): The findings of this
study suggest that negative pressure wound therapy, despite the varying
techniques employed, is associated with an immediate regression of
subcutaneous emphysema and full remission at the end of therapy. Given the
relatively low sample size, no technique of choice could be identified.
However, in general, negative pressure wound therapy appears to provide
fast regression of subcutaneous emphysema and release of symptoms in all
cases. Copyright © Journal of Thoracic Disease. All rights
reserved.

<64>
Accession Number
2014577291
Title
Ticagrelor versus aspirin and vein graft patency after coronary bypass: A
randomized trial.
Source
Journal of Cardiac Surgery. 37(3) (pp 563-570), 2022. Date of Publication:
March 2022.
Author
Kulik A.; Abreu A.M.; Boronat V.; Kouchoukos N.T.; Ruel M.
Institution
(Kulik, Abreu, Boronat) Division of Cardiac Surgery, Boca Raton Regional
Hospital and Florida Atlantic University, Boca Raton, FL, United States
(Kouchoukos) Division of Cardiac Surgery, Missouri Baptist Medical Center,
St. Louis, MO, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Antiplatelet therapy prevents saphenous vein graft (SVG)
occlusion and improves outcomes after coronary artery bypass graft surgery
(CABG). However, the optimal postoperative antiplatelet regimen remains
unclear. The goal of the Ticagrelor Antiplatelet Therapy to Reduce Graft
Events and Thrombosis (TARGET) trial was to assess whether early
postoperative ticagrelor reduces SVG occlusion compared to conventional
aspirin therapy. Method(s): In this multi-center double-blind
randomized trial, 250 patients who had CABG with SVG were randomized to
receive either aspirin 81 mg twice daily or ticagrelor 90 mg twice daily.
The primary outcome was SVG occlusion at 1 year. Result(s):
Altogether, 123 patients were randomized to aspirin and 127 received
ticagrelor. One-year graft assessment was performed in 202 patients
(80.8%), examining 588 grafts, yielding an overall graft occlusion rate of
10.9%. The primary outcome, SVG occlusion at 1 year, did not significantly
differ between the two groups (17.4% vs. 13.2%, aspirin vs. ticagrelor, p
=.30). The incidence of vein grafts with any disease (stenosis or
occlusion) did not significantly differ between the groups (21.5% vs.
22.3%, aspirin vs. ticagrelor, p =.90), and the number of patients with
vein graft disease did not significantly differ between the groups (29.4%
vs. 28.0%, aspirin vs. ticagrelor, p =.88). Freedom from major adverse
cardiovascular events at 1 year was similar between the groups (p =.60).
 Conclusion(s): Compared to conventional aspirin therapy, ticagrelor
did not significantly reduce vein graft occlusion 1 year after CABG.
Further study will assess the impact of ticagrelor on 2-year graft patency
for this cohort. Copyright © 2021 Wiley Periodicals LLC

<65>
Accession Number
2015569443
Title
Recent Advances in the Rheumatic Fever and Rheumatic Heart Disease
Continuum.
Source
Pathogens. 11(2) (no pagination), 2022. Article Number: 179. Date of
Publication: February 2022.
Author
Rwebembera J.; Nascimento B.R.; Minja N.W.; de Loizaga S.; Aliku T.; Dos
Santos L.P.A.; Galdino B.F.; Corte L.S.; Silva V.R.; Chang A.Y.; Dutra
W.O.; Nunes M.C.P.; Beaton A.Z.
Institution
(Rwebembera) Department of Adult Cardiology (JR), Uganda Heart Institute,
Kampala 37392, Uganda
(Nascimento, Dos Santos, Galdino, Corte, Silva, Nunes) Departamento de
Clinica Medica, Faculdade de Medicina da Universidade Federal de Minas
Gerais, MG, Belo Horizonte 30130-100, Brazil
(Nascimento, Nunes) Servico de Cardiologia e Cirurgia Cardiovascular e
Centro de Telessaude, Hospital das Clinicas da Universidade Federal de
Minas Gerais, Avenida Professor Alfredo Balena 110, 1st Floor, MG, Belo
Horizonte 30130-100, Brazil
(Minja) Rheumatic Heart Disease Research Collaborative in Uganda, Uganda
Heart Institute, Kampala 37392, Uganda
(de Loizaga, Beaton) School of Medicine, University of Cincinnati,
Cincinnati, OH 45229, United States
(Aliku) Department of Paediatric Cardiology (TA), Uganda Heart Institute,
Kampala 37392, Uganda
(Chang) Department of Epidemiology and Population Health, Stanford
University School of Medicine, Stanford, CA 94305, United States
(Dutra) Laboratory of Cell-Cell Interactions, Institute of Biological
Sciences, Department of Morphology, Federal University of Minas Gerais,
MG, Belo Horizonte 30130-100, Brazil
(Dutra) National Institute of Science and Technology in Tropical Diseases
(INCT-DT), BA, Salvador 40170-970, Brazil
(Beaton) Cincinnati Children's Hospital Medical Center, The Heart
Institute, Cincinnati, OH 45229, United States
Publisher
MDPI
Abstract
Nearly a century after rheumatic fever (RF) and rheumatic heart disease
(RHD) was eradicated from the developed world, the disease remains endemic
in many low-and middle-income countries (LMICs), with grim health and
socioeconomic impacts. The neglect of RHD which persisted for a
semi-centennial was further driven by competing infectious diseases,
particularly the human immunodeficiency virus (HIV) pandemic. However,
over the last two-decades, slowly at first but with building momentum,
there has been a resurgence of interest in RF/RHD. In this narrative
review, we present the advances that have been made in the RF/RHD
continuum over the past two decades since the re-awakening of interest,
with a more concise focus on the last decade's achievements. Such primary
advances include understanding the genetic predisposition to RHD, group A
Streptococcus (GAS) vaccine development, and improved diagnostic
strategies for GAS pharyngitis. Echocardiographic screening for RHD has
been a major advance which has unearthed the prevailing high burden of RHD
and the recent demonstration of benefit of secondary antibiotic
prophylaxis on halting progression of latent RHD is a major step forward.
Multiple befitting advances in tertiary management of RHD have also been
realized. Finally, we summarize the research gaps and provide illumination
on profitable future directions towards global eradication of
RHD. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<66>
Accession Number
2007179059
Title
Application of the Hybrid Operating Room in Surgery: A Systematic Review.
Source
Journal of Investigative Surgery. 35(2) (pp 378-389), 2022. Date of
Publication: 2022.
Author
Jin H.; Liu J.
Institution
(Jin) The Second Department of General Surgery, Zhuhai People's Hospital
(Zhuhai Hospital Affiliated with Jinan University), Guangdong, Zhuhai,
China
(Liu) Zhuhai Health Bureau, Guangdong, Zhuhai, China
Publisher
Taylor and Francis Ltd.
Abstract
Background and objective: The hybrid operating room has been widely
applied in surgery, including neurology, general surgery, gynecology, and
obstetrics. By reviewing application of the hybrid operating room in
different categories of surgery, we aim to summarize both advantages and
disadvantages of the hybrid operating room and discuss what to do for
further improving the application of it. Method(s): We searched
related literature in websites including Pubmed, MEDLINE, Web of science,
using the keywords "hybrid operating room", "surgery", "technique",
"intervention", and "radiology". All the searched papers were screened and
underwent quality evaluation. The eventually selected papers were
carefully read, with related information extracted and summarized.
 Result(s): After screening and assessment, a total of 29 literature
was collected. Application of the hybrid operating room in general
surgery, neurosurgery, thoracic surgery, urology, gynecologic and
obstetrics surgery, and cardiovascular surgery was summarized. Both
advantages and disadvantages of the hybrid operating room were discussed
in order to improve application of the hybrid operating room in surgery.
 Conclusion(s): Surgeries performed in the hybrid operating room take
advantages over those conventional operating rooms mainly in terms of
higher procedure accuracy, less operative time, and less risk of
hemorrhage during the transportation between radiology departments and
operating suites. Further efforts should be made to reduce radiation
exposure from imaging systems equipped in the hybrid operating room and
increase cost-effectiveness ratio of the hybrid operating
room. Copyright © 2022 Taylor & Francis Group, LLC.

<67>
Accession Number
2013627977
Title
Efficacy and safety of dexmedetomidine in maintaining hemodynamic
stability in pediatric cardiac surgery: a systematic review and
meta-analysis.
Source
Jornal de Pediatria. 98(1) (pp 15-25), 2022. Date of Publication: 01 Jan
2022.
Author
Wang Q.; Chen C.; Wang L.
Institution
(Wang, Chen) Hainan Women and Children's Medical Center, Department of
Anesthesiology, Haikou, China
(Wang) The First Hospital of Hebei Medical University, Department of
Anesthesiology, Shijiazhuang, China
Publisher
Elsevier Editora Ltda
Abstract
Objectives: Dexmedetomidine (DEX) is a highly selective alpha-2 adrenergic
receptor agonist, which is the main sedative in the intensive care unit.
This study aims to investigate the effectiveness and adverse events of DEX
in maintaining hemodynamic stability in pediatric cardiac surgery.
Sources: Databases such as PubMed, Cochrane, Web of Science, WANFANG STATA
and China National Knowledge Infrastructure were searched for articles
about the application of DEX in maintaining hemodynamic stability during
and after pediatric cardiac surgery up to 18th Feb. 2021. Only randomized
controlled trials were included and random-effects model meta-analysis was
applied to calculate the standardized mean deviation (SMD), odds ratio
(OR) and 95% confidence interval (CI). Summary of the findings: Fifteen
articles were included for this meta-analysis, and 9 articles for
qualitative analysis. The results showed that preoperative prophylaxis and
postoperative recovery of DEX in pediatric patients undergoing cardiac
surgery were effective in maintaining systolic blood pressure (SBP), mean
arterial pressure (MAP), diastolic blood pressure (DBP) and reducing heart
rate (HR) (SBP: SMD = -0.35,95% CI: -0.72, 0.01; MAP: SMD = -0.83, 95% CI:
-1.87,0.21; DBP: SMD = -0.79,95% CI: -1.66,0.08; HR: SMD = -1.71,95% CI:
-2.29, -1.13). In addition, the frequency of Junctional Ectopic
Tachycardia in the DEX treatment group was lower than that in the placebo
group. Conclusion(s): The application of DEX for preoperative
prophylaxis and postoperative recovery in pediatric cardiac surgery
patients are effective in maintaining hemodynamic stability, and the
clinical dose of DEX is not significantly related to the occurrence of
pediatric adverse events which may be related to individual
differences. Copyright © 2021 Sociedade Brasileira de Pediatria

<68>
Accession Number
2013716636
Title
Safety and efficacy of less-invasive ventricular enhancement procedure
with the transcatheter Revivent TCTM system in patients with
left ventricular aneurysm: A systematic review.
Source
Reviews in Cardiovascular Medicine. 22(2) (pp 445-452), 2021. Date of
Publication: 30 Jun 2021.
Author
Brinza C.; Cinteza M.; Popa I.V.; Burlacu A.
Institution
(Brinza, Popa, Burlacu) Department of Internal Medicine, 'Grigore T. Popa'
University of Medicine and Pharmacy, Iasi 700115, Romania
(Brinza, Burlacu) Department of Interventional Cardiology, Cardiovascular
Diseases Institute, Iasi 700503, Romania
(Cinteza) Department of Internal Medicine, 'Carol Davila' University of
Medicine and Pharmacy, Bucharest 050474, Romania
(Burlacu) Research Department, Academy of Medical Sciences, Bucharest
030167, Romania
Publisher
IMR Press Limited
Abstract
Left ventricular (LV) aneurysm following acute myocardial infarction (MI)
represents a less common complication, but with worse clinical outcomes.
Ventricular surgical reconstruction is not always the intervention of
choice due to high surgical risk. There were proposed less invasive LV
aneurysm exclusion techniques such as the less invasive ventricular
enhancement (LIVE) procedure. Our paper represents the first systematic
approach to investigate the efficacy and safety of LIVE procedure using
Revivent TCTM anchor system for LV aneurysm exclusion. Studies
were considered if they reported original data regarding LIVE procedure's
efficacy and/or safety using the Revivent TCTM system in
patients with LV aneurysms. Five studies met the inclusion criteria. The
procedure is associated with a reduction in LV volumes and an improvement
in LV ejection fraction (LVEF). The means of preoperative LVEF varied
between 22.8% and 35.6%, while postoperative LVEF means ranged between 34%
and 45.9% (P < 0.005) across studies. All included papers reported a
significant difference between preoperative and postoperative LV
end-systolic volume index (P <= 0.001) and LV end-diastolic volume index
(P <= 0.001). Three out of four studies achieved statistical significance
(P <= 0.001) when comparing preoperative (means range: 2.6-3.4) and
postoperative (means range: 1.4-1.9) New York Heart Association (NYHA)
class. One study reported a survival rate of 90.6 (95% CI, 84.6-97.0) at
12 months following the procedure. LIVE appears to be a promising and
appropriate treatment strategy for a complex condition, which could extend
the indication of LV aneurysm exclusion in the future. Copyright
© 2021 The Author(s). Published by IMR Press.

<69>
Accession Number
2013659571
Title
Efficacy and safety of liraglutide in type 2 diabetes mellitus patients
complicated with coronary artery disease: A systematic review and
meta-analysis of randomized controlled trials.
Source
Pharmacological Research. 171 (no pagination), 2021. Article Number:
105765. Date of Publication: September 2021.
Author
Wang L.; Xin Q.; Wang Y.; Chen Z.; Yuan R.; Miao Y.; Zhang G.; Cong W.
Institution
(Wang, Wang, Chen, Zhang) Xiyuan Hospital, China Academy of Chinese
Medical Sciences, Beijing 100091, China
(Xin, Yuan, Miao, Cong) Laboratory of Cardiovascular Diseases, Xiyuan
Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
(Xin, Yuan, Miao, Cong) National Clinical Research Center for Chinese
Medicine Cardiology, Beijing 100091, China
(Chen, Zhang) Institute of Endocrinology, Xiyuan Hospital, China Academy
of Chinese Medical Sciences, Beijing 100091, China
Publisher
Academic Press
Abstract
To evaluate the efficacy and safety of liraglutide in patients with Type 2
Diabetes Mellitus (T2DM) complicated with Coronary Artery Disease (CAD),
we searched PubMed, Cochrane Library, Embase, China National Knowledge
Infrastructure (CNKI), Chinese VIP Information (VIP), Wanfang Database and
Chinese Biomedical Literature database (CBM) for relevant randomized
controlled trials (RCTs) from inception to 7 October 2020. A total of 18
RCTs including 1557 patients with T2DM complicated with CAD were included.
Meta-analysis revealed liraglutide reduced hemoglobin A1c (HbA1c) (WMD =
-0.67; 95% CI[-0.94 to -0.39]; P < 0.00001), fasting plasma glucose (FPG)
(WMD = -0.80; 95% CI[-1.06 to -0.54]; P < 0.00001) and 2 h plasma glucose
(2hPG) (WMD = -1.64; 95% CI[-2.12 to -1.16]; P0.00001); improved left
ventricular ejection fraction(LVEF) (WMD = 4.79; 95% CI[4.08-5.51]; P <
0.00001), left ventricular end-diastolic diameter (LVEDD) (WMD = -5.70;
95% CI[-6.67 to -4.72]; P0.00001), E/A (WMD = 0.13; 95% CI[0.11-0.14]; P <
0.00001) and left ventricular posterior wall thickness (LVPWT) (WMD =
-1.86; 95% CI[-2.16 to -1.55]; P < 0.00001); reduced total cholesterol
(TC) (WMD = -0.48; 95% CI[-0.56 to -0.39]; P < 0.00001), triglycerides
(TG) (WMD = -0.42; 95% CI[-0.59 to -0.26]; P < 0.00001), low-density
lipoprotein cholesterol (LDL-C) (WMD = -0.41; 95% CI[-0.55 to -0.26]; P <
0.00001), and increased high-density lipoprotein cholesterol (HDL-C) (WMD
= -0.19; 95% CI[0.13-0.24]; P = 0.0005). As for safety assessment,
liraglutide did not increase the incidence of hypoglycemia (OR = 0.75, 95%
CI[0.32-1.77], P = 0.51) and gastrointestinal (OR = 1.15, 95%
CI[0.72-1.85], P = 0.55) events. Consequently, liraglutide had favorable
effects on blood glucose, cardiac function, lipid profile and an
acceptable safety profile. Copyright © 2021

<70>
Accession Number
636600293
Title
The Efficacy and Safety of Ultrasound-Guided, Bi-Level, Erector Spinae
Plane Block With Different Doses of Dexmedetomidine for Patients
Undergoing Video-Assisted Thoracic Surgery: A Randomized Controlled Trial.
Source
Frontiers in Medicine. 8 (no pagination), 2021. Article Number: 577885.
Date of Publication: 25 Nov 2021.
Author
Gao X.; Zhao T.; Xu G.; Ren C.; Liu G.; Du K.
Institution
(Gao, Zhao, Xu, Ren, Liu) Department of Anesthesiology, Liaocheng People's
Hospital, Liaocheng, China
(Du) Department of Thoracic Surgery, Liaocheng People's Hospital,
Liaocheng, China
Publisher
Frontiers Media S.A.
Abstract
Background: The anesthetic characteristics of ultrasound-guided bi-level
erector spinae plane block (ESPB) plus dexmedetomidine (Dex) remain
unclear. We compared the efficacy and safety of ultrasound-guided bi-level
ESPB plus different doses of Dex in patients undergoing video-assisted
thoracic surgery (VATS). Method(s): One-hundred eight patients
undergoing VATS were randomized into three groups: R group (n = 38, 15 ml
of 0.375% ropivacaine with 0.1 mg/kg dexamethasone), RD1 group (n = 38, 15
ml of 0.375% ropivacaine plus 0.5 mug/kg DEX with 0.1 mg/kg dexamethasone)
and RD2 group (n = 38, 15 ml of 0.375% ropivacaine plus 1.0 mug/kg DEX
with 0.1 mg/kg dexamethasone). The primary outcome was the pain 12 h after
surgery. Secondary outcomes included the Prince Henry Hospital Pain Score;
hemodynamics; consumption of sufentanil; anesthetized dermatomal
distribution; recovery time; rescue analgesia; satisfaction scores of
patients and surgeon; quick recovery index; adverse effects; the
prevalence of chronic pain and quality of recovery. Result(s): The
visual analog scale (VAS) and the Prince Henry pain score were
significantly lower in both the RD1 and RD2 groups during the first 24 h
after surgery (P < 0.05). Both VAS with coughing and the Prince Henry pain
score were significantly lower in the RD2 group than in the RD1 group 8-24
h after surgery (P < 0.05). Both heart rate and mean arterial pressure
were significantly different from T2 to T6 in the RD1 and RD2 groups (P <
0.05). The receipt of remifentanil, propofol, Dex, and recovery time was
significantly reduced in the RD2 group (P < 0.05). The requirement for
sufentanil during the 8-72 h after surgery, less rescue medication, and
total press times were significantly lower in the RD2 group (P < 0.05).
The time to the first dose of rescue ketorolac was significantly longer in
the RD2 group (P < 0.05). Further, anal exhaust, removal of chest tubes,
and ambulation were significantly shorter in the RD2 group (P < 0.05). The
incidence of tachycardia, post-operative nausea and vomiting, and chronic
pain was significantly reduced in the RD2 group, while the QoR-40 score
was significantly higher in the RD2 group (P < 0.05). Conclusion(s):
Pre-operative bi-level, single-injection ESPB plus 1 mug/kg DEX provided
superior pain relief and long-term post-operative recovery for patients
undergoing VATS. Clinical Trial Registration:
http://www.chictr.org.cn/searchproj.aspx. Copyright © 2021 Gao,
Zhao, Xu, Ren, Liu and Du.

<71>
Accession Number
636306110
Title
Levosimendan to Facilitate Weaning From Cardiorespiratory Support in
Critically Ill Patients: A Meta-Analysis.
Source
Frontiers in Medicine. 8 (no pagination), 2021. Article Number: 741108.
Date of Publication: 12 Oct 2021.
Author
Luo J.-C.; Zheng W.-H.; Meng C.; Zhou H.; Xu Y.; Tu G.-W.; Luo Z.; Huang
H.-B.
Institution
(Luo, Tu, Luo) Department of Critical Care Medicine, Zhongshan Hospital,
Fudan University, Shanghai, China
(Zheng) Department of Critical Care Medicine, The Second People's
Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
(Meng, Zhou, Xu, Huang) Department of Critical Care Medicine, School of
Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua
University, Beijing, China
(Luo) Department of Critical Care Medicine, Xiamen Branch, Zhongshan
Hospital, Fudan University, Xiamen, China
Publisher
Frontiers Media S.A.
Abstract
Background: Cardiopulmonary support, as extracorporeal membrane
oxygenation (ECMO) or mechanical ventilation (MV), is crucial for ICU
patients. However, some of these patients are difficult to wean.
Therefore, we aimed to assess the efficacy and safety of levosimendan in
facilitating weaning from cardiorespiratory support in this patient
population. Method(s): We searched for potentially relevant articles
in PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and
the Cochrane database from inception up to Feb 30, 2021. Studies focusing
on weaning data in MV/ECMO adult patients who received levosimendan
compared to controls were included. We used the Cochrane risk of bias tool
or the Newcastle-Ottawa Quality Assessment Scale to evaluate the study
quality. The primary outcome was the weaning rate from MV/ECMO. Secondary
outcomes were mortality, duration of MV, and ICU stay. Subgroup analysis,
sensitivity analysis, and publication bias were also conducted.
 Result(s): Eighteen studies with 2,274 patients were included. The
quality of the included studies was low to moderate. Overall, levosimendan
effectively improved weaning rates from MV/ECMO [odds ratio (OR) = 2.32;
95%CI, 1.60-3.36; P < 0.00001, I2 = 68%]. Subgroup analyses
confirmed the higher successful weaning rates in ventilated patients with
low left ventricular ejection fractions (OR = 4.06; 95%CI, 2.16-7.62),
patients with ECMO after cardiac surgery (OR = 2.04; 95%CI, 1.25-3.34),
and patients with ECMO and cardiogenic shock (OR = 1.98; 95%CI,
1.34-2.91). However, levosimendan showed no beneficial effect on patients
with MV weaning difficulty (OR = 2.28; 95%CI, 0.72-7.25). Additionally, no
differences were found concerning the secondary outcomes between the
groups. Conclusion(s): Levosimendan therapy significantly increased
successful weaning rates in patients with cardiopulmonary support,
especially patients with combined cardiac insufficiency. Large-scale,
well-designed RCTs will be needed to define the subgroup of patients most
likely to benefit from this strategy. © Copyright © 2021
Luo, Zheng, Meng, Zhou, Xu, Tu, Luo and Huang.

<72>
[Use Link to view the full text]
Accession Number
2015249946
Title
Prehabilitation before elective coronary artery bypass grafting surgery: A
scoping review protocol.
Source
JBI Evidence Synthesis. 19(2) (pp 469-476), 2021. Date of Publication: 16
Feb 2021.
Author
Olsen D.B.; Pedersen P.U.; Noergaard M.W.
Institution
(Olsen) Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Pedersen, Noergaard) Danish Centre of Systematic Reviews, A JBI Centre of
Excellence, Centre of Clinical Guidelines, Faculty of Medicine, Aalborg
University, Aalborg, Denmark
(Noergaard) Department of Cardiology, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
Objective:The objective of this scoping review is to identify and map
existing preoperative interventions, referred to as prehabilitation, in
adult patients at home awaiting coronary bypass grafting (CABG) surgery.
This scoping review also seeks to examine the feasibility and patient
experiences in order to inform clinical practice and underpin a future
systematic review.Introduction:As patients age, comorbidities become more
common. Strategies to improve postoperative outcomes and to accelerate
recovery are required in patients undergoing CABG. Prehabilitation refers
to a proactive process of increasing functional capacity before surgery to
improve the patient's capacity to withstand upcoming physiologic stress
and thus avoid postoperative complications.Inclusion criteria:This scoping
review will consider any studies including adult patients at home awaiting
CABG surgery. Studies will provide information on any prehabilitation
intervention to optimize preoperative physical and psychological health
status. Studies conducted in any setting will be included.
 Method(s):The methodology will follow the JBI recommendations for
scoping reviews. Any published or unpublished source of information will
be considered. Studies published in English, German, Danish, Swedish, and
Norwegian will be included, with no geographical or cultural limitations.
Retrieved papers will be screened by two independent reviewers, and a
standardized tool will be used to extract data from each included source.
The results will be presented as a map of the data extracted in a tabular
form together with a narrative summary to provide a description of the
existing evidence. Copyright © 2021 JBI. All Rights Reserved.

<73>
Accession Number
2015617725
Title
Prediction of right ventricular failure after left ventricular assist
device implantation in patients with heart failure: A meta-analysis
comparing echocardiographic parameters.
Source
Interactive Cardiovascular and Thoracic Surgery. 33(5) (pp 784-792), 2021.
Date of Publication: 01 Nov 2021.
Author
Chriqui L.-E.; Monney P.; Kirsch M.; Tozzi P.
Institution
(Chriqui) Department of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland
(Monney) Service of Cardiology, Lausanne University Hospital (CHUV),
Lausanne, Switzerland
(Kirsch, Tozzi) Service of Cardiovascular Surgery, Lausanne University
Hospital (CHUV), Lausanne, Switzerland
Publisher
Oxford University Press
Abstract
OBJECTIVES: Between 10% and 40% of patients who receive a left ventricular
assistance device (LVAD) suffer from right ventricular failure (RVF)
shortly after the device is implanted. Patients with post-LVAD RVF tend to
have poor outcomes. Only a few predictive factors concerning the right
ventricle (RV) have been investigated. Our goal was to search for
non-invasive variables that correlate with RV function, focusing on
echocardiographic parameters of the RV. METHOD(S): We selected 3
parameters: tricuspid annular plane systolic excursion, right ventricular
fractional area change and right ventricular global longitudinal strain.
We searched the literature and pooled relevant studies in a meta-analysis.
Finally, we performed a statistical analysis to confirm whether each
parameter was a reliable predictor of RVF after LVAD implantation.
 RESULT(S): We retained 19 articles involving a total of 1561
patients. We found a pooled standardized mean deviation of -0.13 cm for
the tricuspid annular plane systolic excursion, with the lower and upper
tails of -0.21 and -0.04 cm, respectively. Concerning the right
ventricular fractional area change, the averaged standardized mean
deviation was equal to -2.61%, with the lower and upper extremities of
-4.12% and -1.09%, respectively. Finally, regarding the global
longitudinal strain, the standardized mean deviation was equal to -2.06%
with an uncertainty value between -3.23% and -0.88%. CONCLUSION(S):
The tricuspid annular plane systolic excursion could be a reliable
parameter in RVF prediction. The right ventricular fractional area change
and global longitudinal strain are likely to be stronger predictors of RVF
after LVAD implantation. Prospective studies should be carried out to
confirm this observation. Copyright © 2021 The Author(s) 2021.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<74>
Accession Number
2015585473
Title
Abdominal and thoracic cavity closure: damage control surgery's
cinderella.
Source
Colombia Medica. 52(2) (no pagination), 2021. Article Number: e4144777.
Date of Publication: 2021.
Author
Rodriguez-Holguin F.; Hadad A.G.; Mejia D.; Garcia A.; Cevallos C.;
Himmler A.N.; Caicedo Y.; Salcedo A.; Serna J.J.; Herrera M.A.; Pino L.F.;
Parra M.W.; Ordonez C.A.
Institution
(Rodriguez-Holguin, Garcia, Salcedo, Serna, Ordonez) Fundacion Valle del
Lili, Department of Surgery. Division of Trauma and Acute Care Surgery,
Cali, Colombia
(Hadad, Garcia, Salcedo, Serna, Herrera, Pino, Ordonez) Universidad del
Valle, Facultad de Salud, Escuela de Medicina, Department of Surgery,
Division of Trauma and Acute Care Surgery, Cali, Colombia
(Hadad, Salcedo, Serna, Herrera, Pino) Hospital Universitario del Valle,
Department of Surgery, Division of Trauma and Acute Care Surgery, Cali,
Colombia
(Hadad) Centro Medico Imbanaco, Cali, Colombia
(Mejia) Hospital Pablo Tobon Uribe, Department of Surgery, Medellin,
Colombia
(Mejia) Universidad de Antioquia, Department of Surgery, Medellin,
Colombia
(Garcia, Salcedo, Serna) Universidad Icesi, Cali, Colombia
(Cevallos) Hospital Vicente Corral Moscoso, Department of Surgery.
Division of Trauma and Acute Care Surgery, Cuenca, Ecuador
(Cevallos) Universidad de Cuenca, Cuenca, Ecuador
(Himmler) Medstar Georgetown University Hospital and Washington Hospital
Center. Department of Surgery, Washington, D.C., United States
(Caicedo, Ordonez) Fundacion Valle del Lili, Centro de Investigaciones
Clinicas (CIC), Cali, Colombia
(Parra) Broward General Level I Trauma Center, Department of Trauma
Critical Care, Fort Lauderdale, FL, United States
Publisher
Facultad de Salud de la Universidad del Valle
Abstract
Damage control surgery principles allow delayed management of traumatic
lesions and early metabolic resuscitation by performing abbreviated
procedures and prompt resuscitation maneuvers in severely injured trauma
patients. However, the initial physiological response to trauma and
surgery, along with the hemostatic resuscitation efforts, causes important
side effects on intracavitary organs such as tissue edema, increased
cavity pressure, and hemodynamic collapse. Consequently, different
techniques have been developed over the years for a delayed cavity
closure. Nonetheless, the optimal management of abdominal and thoracic
surgical closure remains controversial. This article aims to describe the
indications and surgical techniques for delayed abdominal or thoracic
closure following damage control surgery in severely injured trauma
patients, based on the experience obtained by the Trauma and Emergency
Surgery Group (CTE) of Cali, Colombia. We recommend negative pressure
dressing as the gold standard technique for delayed cavity closure,
associated with higher wall closure success rates and lower complication
and mortality rates. Copyright © 2021 Universidad del Valle.

<75>
Accession Number
2015593501
Title
Non-Vitamin K Antagonists Versus Warfarin in Patients with Atrial
Fibrillation and Bioprosthetic Valves: A Systematic Review and
Meta-Analysis.
Source
American Journal of Medicine. 135(2) (pp 228-234.e1), 2022. Date of
Publication: February 2022.
Author
Cardoso R.; Ternes C.M.P.; Justino G.B.; Fernandes A.; Rocha A.V.; Knijnik
L.; d'Avila A.; Lopes R.D.
Institution
(Cardoso) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Mass, Boston
(Ternes, Justino) Department of Medicine, Federal University of Santa
Catarina, Florianopolis, Brazil
(Ternes, d'Avila) Cardiac Arrhythmia Service, Hospital SOS Cardio,
Florianopolis, Brazil
(Fernandes, Knijnik) Division of Medicine, University of Miami, Fla, Miami
(Rocha) Division of Medicine, Federal University of Goias, Brazil
(d'Avila) Harvard-Thorndike Electrophysiology Institute, Beth Israel
Deaconess Medical Center, Harvard Medical School, Mass, Boston
(Lopes) Duke Clinical Research Institute, Duke University School of
Medicine, NC, Durham
Publisher
Elsevier Inc.
Abstract
Background: Patients with atrial fibrillation and bioprosthetic valves are
at high risk for thromboembolic events. The pooled efficacy and safety of
non-vitamin K oral anticoagulants (NOACs), as a class, relative to
warfarin in this population is not well-known. We aimed to compare the
efficacy and safety of NOACs relative to warfarin in patients with
bioprosthetic valves or valve repair. Method(s): We systematically
searched EMBASE, PubMed, and Cochrane databases for randomized controlled
trials comparing NOACs to warfarin in patients with atrial fibrillation
and bioprosthetic valves or valve repair. We pooled outcomes for stroke or
systemic embolism, ischemic stroke, hemorrhagic stroke, and major
bleeding. Result(s): We included 4 trials with 1379 patients, of whom
723 (52.4%) received a NOAC. Mean follow-up ranged from 90 days to 2.8
years. In the pooled analysis, stroke or systemic embolism was
significantly lower in patients treated with NOACs (1.9%) compared with
warfarin (3.7%) (odds ratio [OR] 0.43; 95% confidence interval [CI]
0.22-0.85; P =.02). Ischemic stroke (OR 0.72; 95% CI 0.18-2.93),
hemorrhagic stroke (OR 0.18; 95% CI 0.03-1.05), cardiovascular death (OR
0.78; 95% CI 0.38-1.62), and all-cause mortality (OR 0.94; 95% CI
0.55-1.62) were not significantly different among groups. Major bleeding
was significantly lower in patients treated with NOAC (2.8%) compared with
warfarin (4.7%) (OR 0.49; 95% CI 0.28-0.88; P =.02). Conclusion(s):
In patients with atrial fibrillation and bioprosthetic valves or valve
repair, NOACs are associated with a reduced incidence of thromboembolic
events and major bleeding as compared with warfarin. Thus, NOACs may be
considered a preferred option for this patient population. Copyright
© 2021

<76>
Accession Number
2015506449
Title
Inconsistent Methodology as a Barrier to Meaningful Research Outputs From
Studies of Atrial Fibrillation After Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(3) (pp 739-745),
2022. Date of Publication: March 2022.
Author
Campbell N.G.; Wollborn J.; Fields K.G.; Lip G.Y.H.; Ruetzler K.;
Muehlschlegel J.D.; O'Brien B.
Institution
(Campbell) Division of Cardiovascular Sciences, University of Manchester,
Manchester Academic Health Science Centre, Manchester, United Kingdom
(Wollborn, Fields, Muehlschlegel) Department of Anesthesiology,
Perioperative and Pain Medicine, Brigham, and Women's Hospital, Harvard
Medical School, Boston, MA
(Lip) Liverpool Centre for Cardiovascular Science, University of Liverpool
and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
(Lip) Department of Clinical Medicine, Aalborg University, Aalborg,
Denmark
(Ruetzler) Anesthesiology Institute, Departments of Outcomes Research and
General Anesthesiology, Cleveland Clinic, Cleveland, OH
(Ruetzler, O'Brien) Outcomes Research Consortium, Cleveland, OH
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, German Heart Center Berlin, Berlin, Germany
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, Charite Universitatsmedizin, Berlin, Germany
(O'Brien) Department of Perioperative Medicine, St. Bartholomew's
Hospital, London, United Kingdom
Publisher
W.B. Saunders
Abstract
Atrial fibrillation after cardiac surgery (AFACS) is a serious
postoperative complication. There is significant research interest in this
field but also relevant heterogeneity in reported AFACS definitions and
approaches used for its identification. Few data exist on the extent of
this variation in clinical studies. The authors reviewed the literature
since 2001 and included manuscripts reporting outcomes of AFACS in adults.
They excluded smaller studies and studies in which patients did not
undergo a sternotomy. The documented protocol in each manuscript was
analyzed according to six different categories to determine how AFACS was
defined, which techniques were used to identify it, and the inclusion
and/or exclusion criteria. They also noted when a category was not
described in the documented protocol. The authors identified 302 studies,
of which 92 were included. Sixty-two percent of studies were randomized
controlled trials. There was significant heterogeneity in the manuscripts,
including the exclusion of patients with preoperative AF, the definition
and duration of AF needed to meet the primary endpoint, the type of
screening approach (continuous, episodic, or opportunistic), the duration
of monitoring during the study period in days, the diagnosis with
predefined electrocardiogram criteria, and the requirement for independent
confirmation by study investigators. Furthermore, the definitions of these
criteria frequently were not described. Consistent reporting standards for
AFACS research are needed to advance scientific progress in the field. The
authors here propose pragmatic standards for trial design and reporting
standards. These include adequate sample size estimation, a clear
definition of the AFACS endpoints, and a protocol for AFACS
detection. Copyright © 2021 Elsevier Inc.

<77>
Accession Number
2015371370
Title
Autologous pericardium for adult and elderly patients undergoing aortic
valve replacement: A systematic review.
Source
Cirugia Cardiovascular. 29(1) (pp 25-30), 2022. Date of Publication: 01
Jan 2022.
Author
Dilawar I.; Putra M.A.; Makdinata W.; Billy M.; Paat R.K.
Institution
(Dilawar, Putra, Makdinata, Billy, Paat) Division of Adult Cardiac
Surgery, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas
Indonesia, Indonesia
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Ozaki et al. first performed aortic valve replacement using autologous
pericardium in 2007. Compared to mechanical and bioprosthetic valves which
have apparent disadvantages, this technique has been an alternative with a
promising safety and efficacy result. A comprehensive search was carried
out in 4 databases (Pubmed, Cochrane Library, Proquest, Scopus) from
February to March 2021 using search terms "autologous pericardium",
"aortic valve replacement", and "aortic valve reconstruction". Outcomes
measured in this study were mortality, freedom of operation,
thromboembolic and endocarditis event, and echocardiography finding. Risk
bias of all studies was measured using MINORS criteria. A total of 12
studies involving 1427 subjects were included. The mean age was 64.95
years and 52.1% subjects were male. Mortality due to cardiac and
noncardiac cause was 1.75%. Reoperation was needed in 1.12% subjects.
Thromboembolic and endocarditis events occurred in 0.21% and 0.91%
respectively. All studies reported lower average peak pressure gradient
after surgery. Aortic valve replacement using autologous pericardium has a
tolerable safety and efficacy. Copyright © 2021 Sociedad Espanola
de Cirugia Cardiovascular y Endovascular

<78>
Accession Number
2015172289
Title
Colchicine - new horizons for an ancient drug. Review based on the highest
hierarchy of evidence.
Source
European Journal of Internal Medicine. 96 (pp 34-41), 2022. Date of
Publication: February 2022.
Author
Schattner A.
Institution
(Schattner) The Faculty of Medicine, Hebrew University and Hadassah
Medical School, Jerusalem, Israel
Publisher
Elsevier B.V.
Abstract
Colchicine is an old, inexpensive, and relatively safe anti-inflammatory
drug traditionally used in gout and over the last 50 years in familial
Mediterranean fever. A search of all high-hierarchy studies (randomized
controlled trials [RCTs], systematic reviews and meta-analysis of RCTs)
over the last 20 years revealed myriad other evidence-based applications.
Colchicine seems efficacious in the treatment of acute pericarditis and
prevention of recurrences and in the prevention of postcardiac injury
syndrome and atrial fibrillation following cardiac surgery or percutaneous
interventions. In patients already fully treated with statins and
antiplatelet agents following acute coronary syndromes or stable coronary
disease, adding low-dose colchicine achieved secondary prevention of major
cardiovascular events (myocardial infarction, stroke, or cardiovascular
death) with pooled risk reduction 0.75. Colchicine may also be useful in
Behcet's syndrome and most recently, in improving outcomes of COVID-19
infection. Colchicine in the low doses used in most trials (<= 1 mg/d) was
generally safe and well-tolerated, excepting diarrhea (approximately 10%)
which sometimes led to drug discontinuation. Further RCTs are required to
confirm these results, and will likely lead to expanding indications for
low-dose colchicine. Increasing numbers of patients will be treated with
colchicine in the near future, with improved health outcomes, as long as
basic caveats are heeded. Copyright © 2021

<79>
Accession Number
2015124708
Title
Effect of Levosimendan Treatment in Pediatric Patients With Cardiac
Dysfunction: An Update of a Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(3) (pp 657-664),
2022. Date of Publication: March 2022.
Author
Silvetti S.; Belletti A.; Bianzina S.; Momeni M.
Institution
(Silvetti, Bianzina) Neonatal and Pediatric Intensive Care Unit,
Department of Critical Care and Perinatal Medicine, IRCCS Istituto
Giannina Gaslini, Genova, Italy
(Belletti) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Momeni) Department of Anesthesiology, Cliniques Universitaires Saint Luc,
Universite Catholique de Louvain, Institut de Recherche Experimentale et
Clinique (IREC), Brussels, Belgium
Publisher
W.B. Saunders
Abstract
Levosimendan increasingly has been used to treat heart failure and cardiac
dysfunction in pediatric patients. Currently, there is only limited
evidence that this drug positively affects outcomes. The authors' aim was
to investigate the effects of levosimendan on hemodynamic parameters and
outcomes in pediatric patients in all clinical settings. The study design
was a systematic review of randomized and nonrandomized studies.
Randomized clinical trials (RCTs) were included in a meta-analysis. The
primary outcome of the meta-analysis was the effect of levosimendan on
central venous oxygen saturation (ScvO<inf>2</inf>) and lactate values as
surrogate markers of low-cardiac-output syndrome. The study setting was
any acute care setting. Study participants were pediatric patients (age
<18 years) receiving levosimendan, and the intervention was levosimendan
versus any control treatment. The authors identified 44 studies published
from 2004 to 2020, including a total of 1,131 pediatric patients. Nine
studies (enrolling 547 patients) were RCTs, all performed in a pediatric
cardiac surgery setting. Three RCTs were judged to carry a low risk of
bias. In the RCTs, levosimendan administration was associated with a
significant improvement of ScvO<inf>2</inf> (p = 0.03) and a trend toward
lower postoperative lactate levels (p = 0.08). No differences could be
found for secondary outcomes. Levosimendan use in pediatric patients is
not associated with major side effects and may lead to hemodynamic
improvement after cardiac surgery. However, its impact on major clinical
outcomes remains to be determined. Overall, the quality of evidence for
levosimendan use in pediatric patients is low, and further high-quality
RCTs are needed. Copyright © 2021 Elsevier Inc.

<80>
Accession Number
2014877896
Title
Treatment of Bicuspid Aortic Valve Stenosis with TAVR: Filling Knowledge
Gaps Towards Reducing Complications.
Source
Current Cardiology Reports. 24(1) (pp 33-41), 2022. Date of Publication:
January 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.

<81>
Accession Number
2016064757
Title
Postoperative Transfusion Guidelines in Aneurysmal Cerebral Subarachnoid
Hemorrhage: A Systematic Review and Critical Summary of Available
Evidence.
Source
World Neurosurgery. 158 (pp 234-243.e5), 2022. Date of Publication:
February 2022.
Author
Mofor P.; Oduguwa E.; Tao J.; Barrie U.; Kenfack Y.J.; Montgomery E.;
Edukugho D.; Rail B.; Hicks W.H.; Pernik M.N.; Adeyemo E.; Caruso J.; El
Ahmadieh T.Y.; Bagley C.A.; De Oliveira Sillero R.; Aoun S.G.
Institution
(Mofor, Oduguwa, Tao, Barrie, Kenfack, Montgomery, Rail, Hicks, Pernik,
Adeyemo, Caruso, Bagley, De Oliveira Sillero, Aoun) Department of
Neurological Surgery, University of Texas Southwestern Medical Center,
Dallas, Texas, United States
(Edukugho) Department of Neurological Surgery, Boonshoft School of
Medicine, Wright State University, Dayton, Ohio, United States
(El Ahmadieh) Department of Neurological Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Objective: Surgical management of aneurysmal subarachnoid hemorrhage (SAH)
often involves red blood cell (RBC) transfusion, which increases the risk
of postoperative complications. RBC transfusion guidelines report on
chronically critically ill patients and may not apply to patients with
SAH. Our study aims to synthesize the evidence to recommend RBC
transfusion thresholds among adult patients with SAH undergoing surgery.
 Method(s): A systematic review was conducted using PubMed, Google
Scholar, and Web of Science electronic databases according to the PRISMA
(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
guidelines to critically assess primary articles discussing RBC
transfusion thresholds and describe complications secondary to RBC
transfusion in adult patients with SAH in the perioperative period.
 Result(s): Sixteen articles meeting our search strategy were
reviewed. Patients with SAH who received blood transfusion were older,
female, had World Federation of Neurosurgical Societies grade IV-V and
modified Fisher grade 3-4 scores, and presented with more comorbidities
such as hypertension, diabetes, and cardiovascular and pulmonary diseases.
In addition, transfusion was associated with multiple postoperative
complications, including higher rates of vasospasms, surgical site
infections, cardiovascular and respiratory complications, increased
postoperative length of stay, and 30-day mortality. Analysis of transfused
patients showed that a higher hemoglobin (>10 g/dL) goal after SAH was
safe and that patients may benefit from a higher whole hospital stay
hemoglobin nadir, as shown by a reduction in risk of cerebral vasospasm
and improvement in clinical outcomes (level B class II).
 Conclusion(s): Among patients with SAH, the benefits of reducing
cerebral ischemia and anemia are shown to outweigh the risks of
transfusion-related complications. Copyright © 2021 Elsevier Inc.

<82>
Accession Number
2005726487
Title
Influence of lipoproteins and antiplatelet agents on vein graft patency 1
year after coronary artery bypass grafting.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(3) (pp 1030-1039.e4),
2022. Date of Publication: March 2022.
Author
Zhu J.; Zhu Y.; Zhang M.; Xue Q.; Hu J.; Liu H.; Wang R.; Wang X.; Zhao Q.
Institution
(Zhu, Zhu, Zhao) Department of Cardiovascular Surgery, Ruijin Hospital
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Zhang) Department of Cancer Control and Prevention, Shanghai Municipal
Center for Disease Control and Prevention, Shanghai, China
(Xue) Department of Cardiovascular Surgery, Changhai Hospital of Shanghai,
Shanghai, China
(Hu) Department of Cardiovascular Surgery, Fuwai Central China
Cardiovascular Hospital, Zhengzhou, China
(Liu) Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai Jiao
Tong University School of Medicine, Shanghai, China
(Wang) Department of Cardiovascular Surgery, Nanjing First Hospital,
Nanjing, China
(Wang) Department of Cardiovascular Surgery, Jiangsu Province Hospital,
Nanjing, China
Publisher
Elsevier Inc.
Abstract
Objective: It remains unclear whether aggressive low-density lipoprotein
cholesterol (LDL-C) management (<1.8 mmol/L) can slow the process of vein
graft stenosis. This study aimed to explore the impact of baseline LDL-C
levels on vein graft patency in patients on ticagrelor with or without
aspirin 1 year after coronary artery bypass grafting (CABG).
 Method(s): This was a post hoc analysis of the DACAB (Different
Antiplatelet Therapy Strategy After Coronary Artery Bypass Graft Surgery)
trial (NCT02201771), a randomized controlled trial (ticagrelor + aspirin
or ticagrelor vs aspirin) of patients undergoing CABG in China. The study
subjects were stratified as LDL-low (baseline LDL-C <1.8 mmol/L, 148
patients with 430 vein grafts) versus LDL-high (baseline LDL-C >=1.8
mmol/L, 352 patients with 1030 vein grafts). The primary outcome was the
1-year vein graft patency (Fitzgibbon grade A) assessed by coronary
computed tomographic angiography or coronary angiography. Result(s):
Baseline/1-year LDL-C were 1.4/1.6 and 2.6/2.4 mmol/L in the LDL-low and
LDL-high subgroups, respectively. Regardless of antiplatelet regimen, no
significant inter-subgroup difference was observed for 1-year graft
patency (LDL-low: 83.8% [359/430 grafts]; LDL-high: 82.3% [848/1030
grafts]; adjusted OR for non-patency [OR<inf>adj</inf>], 0.96; 95%
confidence interval [CI], 0.62-1.50, P = .857). For both subgroups, the
1-year graft patency rates were greater with ticagrelor + aspirin versus
aspirin (LDL-low: OR<inf>adj</inf>, 0.41; 95% CI, 0.17-0.97; LDL-high:
OR<inf>adj</inf>, 0.38; 95% CI, 0.20-0.71; inter P = .679).
 Conclusion(s): In general, baseline LDL-C is not associated with
1-year vein graft patency after CABG. Regardless of the baseline LDL-C
levels, ticagrelor + aspirin was superior to aspirin alone in maintaining
vein graft patency. The primary factor causing early vein graft disease
might not be atherosclerosis but thrombosis. Copyright © 2020 The
American Association for Thoracic Surgery

<83>
Accession Number
635635561
Title
The short- and long-term effects of dietary patterns on cardiometabolic
health in adults aged 65 years or older: a systematic review.
Source
Nutrition reviews. 80(3) (pp 329-350), 2022. Date of Publication: 10 Feb
2022.
Author
Luong R.; Ribeiro R.V.; Cunningham J.; Chen S.; Hirani V.
Institution
(Luong, Ribeiro, Cunningham, Chen, Hirani) School of Life and
Environmental Sciences, Charles Perkins Centre, University of Sydney, NSW,
Australia
Publisher
NLM (Medline)
Abstract
CONTEXT: Cardiometabolic diseases are leading causes of death and
morbidity. Aging increases the risk of disease development. Diet has
protective and causal effects on cardiometabolic health.
 OBJECTIVE(S): To consolidate the current evidence on the short- and
long-term effects of dietary patterns on cardiometabolic health in adults
aged >=65years. DATA SOURCES: The Medline, Embase, Cochrane Central
Register of Controlled Trials, Cochrane Database of Systematic Reviews,
Database of Abstracts of Reviews of Effects, Cumulative Index to Nursing
and Allied Health Literature, Web of Science, Scopus, Global Health, and
Pre-Medline databases, along with ClinicalTrials.gov and the World Health
Organization International Clinical Trials Registry Platform were
searched. DATA EXTRACTION: A total of 40042 records were identified.
Quality assessment involved using the revised Cochrane risk-of-bias tool
for randomized trials and Joanna Briggs Institute checklists. The
certainty of evidence was assessed using Grading of Recommendations,
Assessment, Development, and Evaluation. RESULT(S): Thirteen articles
were included (n = 5 cohort studies and n = 3 randomized controlled
trials). The low-fat dietary pattern reduced adiposity; however, no
effects were evident for hypertension incidence, composite coronary heart
disease incidence (including myocardial infarction, coronary heart
disease, and coronary revascularization), high-density lipoprotein
cholesterol level, and increased blood pressure in the long term. The
Mediterranean dietary pattern resulted in reduced triglyceride levels and
systolic blood pressure, and had no effects on diastolic blood pressure
and glucose in the short term. Other dietary patterns had inconclusive
effects. CONCLUSION(S): The Mediterranean dietary pattern showed the
most benefits without harm on cardiometabolic health in older adults. The
current body of evidence is small, indicating the need for more research
to confirm these findings at a high certainty of evidence, and to include
dietary patterns combined with other dietary components, subgroups with
cardiometabolic disease or risk factors, longer follow-up, and outcomes
that have not yet been investigated. Studies including these factors may
help identify the most effective dietary pattern for cardiometabolic
health benefits in older adults, to inform future guidelines. SYSTEMATIC
REVIEW REGISTRATION: PROSPERO registration no.
CRD42020141400. Copyright © The Author(s) 2021. Published by
Oxford University Press on behalf of the International Life Sciences
Institute. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<84>
[Use Link to view the full text]
Accession Number
635322405
Title
Impact of Comorbidities and Antiplatelet Regimen on Platelet Reactivity
Levels in Patients Undergoing Transcatheter Aortic Valve Implantation.
Source
Journal of cardiovascular pharmacology. 78(3) (pp 463-473), 2021. Date of
Publication: 01 Sep 2021.
Author
Trejo-Velasco B.; Tello-Montoliu A.; Cruz-Gonzalez I.; Moreno R.;
Baz-Alonso J.A.; Salvadores P.J.; Romaguera R.; Molina-Navarro E.;
Paredes-Galan E.; Fernandez-Barbeira S.; Ortiz-Saez A.; Bastos-Fernandez
G.; De Miguel-Castro A.; Figueiras-Guzman A.; Iniguez-Romo A.;
Jimenez-Diaz V.A.
Institution
(Trejo-Velasco, Cruz-Gonzalez) Cardiology Department, Hospital
Universitario de Salamanca, Instituto de Investigacion Biomedica de
Salamanca (IBSAL), Salamanca, Spain
(Tello-Montoliu) Cardiology Department, Hospital Universitario Virgen de
la Arrixaca, IMIB-Arrixaca, Murcia, Spain
(Tello-Montoliu, Cruz-Gonzalez, Moreno, Iniguez-Romo, Jimenez-Diaz) Centro
de Investigacion en Red de Enfermedades Cardiovasculares (Network Research
Center for Cardiovascular Diseases), Madrid, Spain
(Moreno) Interventional Cardiology, Instituto de Investigacion del
Hospital La Paz (IDIPAZ), University Hospital La Paz, Madrid, Spain
(Baz-Alonso, Paredes-Galan, Fernandez-Barbeira, Ortiz-Saez,
Bastos-Fernandez, De Miguel-Castro, Iniguez-Romo, Jimenez-Diaz) Cardiology
Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo,
Spain
(Salvadores, Jimenez-Diaz) Cardiovascular Research Unit, Cardiology
Department, Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo,
Spain
(Salvadores, Jimenez-Diaz) Cardiovascular Research Group, Galicia Sur
Health Research Institute (IIS Galicia Sur), Vigo, Spain
(Romaguera) Cardiology Department, Hospital Universitario de Bellvitge,
Barcelona, Spain
(Molina-Navarro) Cardiology Department, Hospital Universitario Virgen de
las Nieves, Granada, Spain; and
(Figueiras-Guzman) Departamento de Medicina Preventiva y Salud Publica,
Facultad de Medicina, Universidad de Santiago de Compostela
Publisher
NLM (Medline)
Abstract
ABSTRACT: The aim of our study is to assess the impact of anemia, chronic
kidney disease, and diabetes mellitus on platelet reactivity (PR) in
patients with severe aortic stenosis, both at baseline and after
transcatheter aortic valve implantation (TAVI). This study is a
prespecified subanalysis of the REAC-TAVI prospective, multicenter trial
that included patients pretreated with aspirin + clopidogrel before TAVI.
PR was measured at baseline and at 5 different time points after TAVI with
the VerifyNow assay (Accriva Diagnostics, San Diego, CA), over a 3-month
follow-up period. Patients with high PR (HPR) at baseline, before TAVI (n
= 48) were randomized to aspirin + clopidogrel or aspirin + ticagrelor for
3 months, whereas those with normal PR (NPR) (n = 20) were continued on
aspirin + clopidogrel. A "raiser response" in PR was defined as an
increase in PR units >20% of baseline after TAVI. Patients with HPR before
TAVI presented concomitant anemia and chronic kidney disease more
frequently than their counterparts with NPR. Anemia and higher body mass
index were independently associated with HPR to clopidogrel at baseline.
Moreover, anemic patients with baseline HPR who were continued on
clopidogrel presented higher PR after TAVI than patients with HPR switched
to ticagrelor. All patients with baseline NPR presented a "raiser
response" after TAVI, which was nonexistent among patients with HPR
managed with ticagrelor. In summary, anemia seems as a relevant factor
associated with baseline HPR and higher PR after TAVI in patients with
baseline HPR randomized to clopidogrel, whereas ticagrelor proved more
effective than clopidogrel at attaining sustained reductions in PR during
follow-up, regardless of baseline comorbidities. Copyright © 2021
Wolters Kluwer Health, Inc. All rights reserved.

<85>
Accession Number
637209469
Title
Effectiveness of implanted cardiac rhythm recorders with
electrocardiographic monitoring for detecting arrhythmias in peripartum
cardiomyopathy (PPCM).
Source
Cardiovascular Journal of Africa. Conference: 15th Pan African Society of
Cardiology, PASCAR 2021. Mombasa Kenya. 32(SUPPL) (pp 17-18), 2021. Date
of Publication: 2021.
Author
Hoevelmann J.; Viljoen C.; Chin A.; Briton O.; Sliwa K.
Institution
(Hoevelmann, Viljoen, Chin, Briton, Sliwa) Faculty of Health Sciences,
University of Cape Town, South Africa
Publisher
Clinics Cardive Publishing (PTY)Ltd
Abstract
Introduction: Peripartum cardiomyopathy (PPCM) is a form of dilated
cardiomyopathy that occurs within the last months of pregnancy or up to 5
months postpartum. Previous studies have shown that up to 30% of deaths in
PPCM are related to sudden cardiac death (SCD). However, little is known
about the burden of arrythmias in PPCM and their contribution to SCD.
 Purpose(s): We aimed to compare implantable loop recorder (ILR) plus
24-hour Holter monitoring to 24h Holter monitoring alone to assess its
utility in the detection of arrhythmias in PPCM. Method(s): In this
single-centre, prospective clinical trial, 20 consecutive patients with
PPCM were randomized to either standard care (SC cohort: ECG & 24-hour
Holter) or SC plus ILR (SC-ILR cohort: ECG, 24-hour Holter, ILR).
Follow-up included the first six months after ILR implantation.
 Result(s): The median age of this cohort was 31.7 years with a parity
of 2 (IQR 1-4). They presented with a median left ventricular ejection
fraction (LVEF) of 28% (IQR 24-35) and LVEDD of 60mm (IQR 55-66). The
12-lead ECG recorded sinus tachycardia in half of the patients, with
median heart rate of 90bpm (IQR 79-106) compared to 94.5bpm (IQR 85-99) on
24h-Holter-monitoring. The median QTc-interval was 464ms (IQR 424-494).
Ambulatory ECG monitoring detected major arrhythmias in three women (one
in SC cohort, two in SC-ILR cohort). One patient (5%) died shortly after
ILR implantation. Her ILR detected sinus arrest with an escape rhythm that
failed and resulted in an out of hospital cardiac arrest. Non-sustained
ventricular tachycardia (nsVT) occurred in two women (10%), one of which
was detected by Holter monitoring and the other on ILR. Both women
presented with acute heart failure with severely impaired systolic
function (LVEF 12% and 21% respectively). One of these patients had
persistent LV systolic dysfunction despite optimal medical therapy and
received an implantable cardioverter-defibrillator (ICD). The other
patient had intractable heart failure requiring recurrent intensive-care
treatment and underwent heart transplantation. There was no atrial
fibrillation or atrioventricular block detected in any patient by ECG,
Holter or ILR monitoring throughout the study period. Conclusion(s):
This study on ambulatory ECG monitoring in PPCM showed a high prevalence
of potentially fatal arrhythmias, which occurred predominantly in the
acute phase of the disease. Both Holter and ILR had a direct influence on
clinical decision making.

<86>
Accession Number
2016828092
Title
Comparison of Balloon-Blowing Exercise and Incentive Spirometry after
Thoracotomy.
Source
Pakistan Journal of Medical and Health Sciences. 16(1) (pp 486-489), 2022.
Date of Publication: January 2022.
Author
Ghani H.M.; Obaid S.; Bhatti Z.M.; Razzaq M.; Niaz A.; Waris S.
Institution
(Ghani, Razzaq) Bakhtawar Amin College of Rehabilitation Sciences BAMDC,
Multan, Pakistan
(Obaid) Riphah International University-, Islamabad, Pakistan
(Bhatti) Principal Bakhtawar Amin College of Rehabilitation Sciences
BAMDC, Multan, Pakistan
(Razzaq) Abasyn University, Islamabad Campus, Pakistan
(Niaz) College of Rehabilitation Sciences BAMDC, Multan, Pakistan
(Waris) University of Management and Technology, Sialkot Campus, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Objective: The objective of this study is to compare effect of balloon
blowing exercise & incentive spirometer on Chest expansion, Improvement in
lung volumes and capacities, Level of dyspnoea, and on Improvement in
progression of walk in post-thoracotomy stable patients. Study
Design: Randomized Controlled Trial Place and Duration of Study: Study was
conducted in thoracic surgical ICU of Gulab Devi Hospital, Lahore for the
period of 6 months from September 2018 - February 2019. Patients and
Methods: The sample size was calculated through Open Epi, and it was 48.
24 subjects were assigned to control group A and 24 to experimental group
B through non-purposive random sampling technique. Data was collected at
base line, 3rd and 5th day after exercise therapy on above stated outcome
measures, by using Tape Measure, Digital Spirometer, RPE Scale and
Pedometer respectively, from non-critical postthoracotomy patients.
Control Group-A performed routine respiratory physiotherapy + incentive
spirometry and Experimental Group- B performed routine respiratory
physiotherapy + balloon blowing exercise. Result(s): BBE + routine
respiratory physiotherapy was found equally effective on mentioned outcome
measure as Incentive Spirometry + routine respiratory physiotherapy in
stated patients. (P >0.05) Conclusion(s): Based upon statistical
analysis, it can be concluded that incentive spirometer can be replaced
with balloon-blowing exercise with conventional/routine respiratory
physiotherapy in thoracotomy patients who have lung surgeries, to overcome
post-op pulmonary complications or to achieve the same outcomes as that of
incentive spirometer. Copyright © 2022 Lahore Medical And Dental
College. All rights reserved.

<87>
Accession Number
2016809282
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 February) (no pagination), 2022. Article Number: e0262742.
Date of Publication: February 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, The 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, Canada
(Visintini) Berkman Library, University of Ottawa Heart Institute, Ottawa,
ON, Canada
(Wells) Research Methods Centre, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(McGuinty, Boczar) University of Ottawa Heart Institute, Ottawa, ON,
Canada
Publisher
Public Library of Science
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. Methods 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 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. Copyright: © 2022 Bezzina 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.

<88>
[Use Link to view the full text]
Accession Number
2016779907
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) Pharmacy Department, Children's Health Ireland Crumlin,
Dublin, Ireland
(Semple, Howlett, Strawbridge, 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
Lippincott Williams and Wilkins
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.

<89>
Accession Number
2016785759
Title
The Effect of Classic Chest Physiotherapy on Postoperative Pain Scores and
Hospital Stay in Patients Undergoing Off-Pump Coronary Artery
BypassGraftSurgery:ARandomizedClinicalTrial.
Source
Galen Medical Journal. 7 (no pagination), 2018. Article Number: e838. Date
of Publication: 31 Mar 2018.
Author
Zolfaghari M.; Mirhosseini S.J.; Baghbeheshti M.; Bauer B.A.
Institution
(Zolfaghari, Baghbeheshti) Student Research Committee, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Mirhosseini) Department of Cardiovascular Surgery, Afshar Hospital,
Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic
Republic of
(Bauer) Complementary and Integrative Medicine, Division General Internal
Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United
States
Publisher
Shriaz University of Medical Sciences
Abstract
Background: Background: Chest physiotherapy (CPT) is a care that increases
the mobilization of several structures from both muscle and subcutaneous
tissue. We planned to investigate the effect of classic CPT on pain,
fatigue, satisfaction, and hospital length of stay (LOS) in patients
undergoing off-pump coronary artery bypass graft (CABG). Material(s)
and Method(s): This study was a randomized controlled trial that conducted
on 50 patients undergoing elective off-pump CABG. The patients have been
randomly divided into two groups; in the group A (n=25) patients received
physiotherapy at a single session of classic CPT, 4 times during 2nd to
5th days for 15 minutes in every session, in the group B (n=25) patients
had not protocol of this exercise therapy (control). Result(s):The
average age of all participants was 62.08 +/-9.08 years. Of the 50
patients, 33 (66%) was male. Classic CPT significantly decreased pain
(P=0.04), hospital LOS (P=0.010) and could increase in patients'
satisfaction (P<0.001). However, it had no considerable effect on fatigue
(P=0.725). Conclusion(s): According to our findings, classic CPT
could improve postoperative care after off-pump CABG
surgery. Copyright© 2018, Galen Medical Journal.

<90>
Accession Number
2016834672
Title
Five-Year Outcomes of Concomitant Maze Procedure Using Nitrous Oxide vs
Argon-Based Cryoablation.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Park I.; Jeong D.S.; Ahn J.H.; Park P.W.
Institution
(Park) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Jeong, Ahn) Biostatistics and Clinical Epidemiology Center, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Park) Department of Thoracic and Cardiovascular Surgery, Incheon Sejong
Hospital, Incheon, South Korea
Publisher
Elsevier Inc.
Abstract
Background: Cryoablation is effective for not only ablating the
myocardium, but also maintaining the structure of the ablated tissue.
However, data comparing nitrous oxide (N<inf>2</inf>O)-based and argon
gas-based cryoprobes are limited. Method(s): This study was a
follow-up study of a single-center, prospective, randomized controlled
trial in which 60 patients were randomly allocated to either the
N<inf>2</inf>O group or the argon group. The primary endpoint of this
study was sinus rhythm maintenance, and the key secondary endpoint was a
composite of major adverse cardiovascular and cerebrovascular events
(MACCEs) (ie, cardiac death, stroke, major bleeding, and readmission for
heart failure). Result(s): The baseline and operative characteristics
of the patients in the N<inf>2</inf>O and argon groups were comparable. At
the 5-year follow-up, the rate of sinus rhythm maintenance was 81.8% in
the N<inf>2</inf>O group, whereas it was 78.5% in the argon group (P >
.999). No significant differences in the rate of freedom from MACCEs
(80.6% in the N<inf>2</inf>O group vs 81.9% in the argon group; P = .978)
were observed at the 5-year follow-up. The left atrial volume index
decreased over time from 114.65 mL/m2 to 65.74 mL/m2
(P < .0001) and reached similar values in the 2 groups (P = .279) at the
5-year follow-up. Conclusion(s): Both N<inf>2</inf>O- and argon
gas-based cryoprobes showed similar rates of sinus rhythm maintenance and
freedom from MACCEs at the 5-year follow-up. Both cryoprobes might have
similar efficacy and safety in the arrested heart in the long
term. Copyright © 2022 The Society of Thoracic Surgeons

<91>
Accession Number
2014907942
Title
Systemic inflammatory response during cardiopulmonary bypass: Axial flow
versus radial flow oxygenators.
Source
International Journal of Artificial Organs. (no pagination), 2022. Date
of Publication: 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
SAGE Publications Ltd
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 1 h after CPB onset,
and T3 was taken 24 h 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. Copyright
© The Author(s) 2022.

<92>
Accession Number
2014876338
Title
Epidemiology of infective endocarditis: novel aspects in the twenty-first
century.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2022. Date of
Publication: 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, Rochester, MN, United States
(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
Taylor and Francis Ltd.
Abstract
Introduction: The epidemiology of infective endocarditis (IE) in this
millennium has changed with emergence of new risk factors and reemergence
of others. This, coupled with modifications in national guidelines in the
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,
epidemiological 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. Copyright © 2022 Informa UK Limited,
trading as Taylor & Francis Group.

<93>
Accession Number
637206720
Title
Do non-vitamin K antagonist oral anticoagulants increase the risk of
myocardial infarction?.
Source
Kardiologia polska. 80(1) (pp 16-24), 2022. Date of Publication: 2022.
Author
Grajek S.; Kaluzna-Oleksy M.
Institution
(Grajek, Kaluzna-Oleksy) 1st Department of Cardiology, Poznan University
of Medical Sciences, Poznan, Poland
Publisher
NLM (Medline)
Abstract
Non-vitamin K antagonist oral anticoagulants (NOACs), compared with
warfarin, have a favorable risk-benefit profile. However, in the RE-LY
study in patients with atrial fibrillation (AF), the number of patients
with MI was higher in the dabigatran group as compared to the warfarin
group. Many meta-analyses showed that dabigatran treatment led to an
increased risk of myocardial infarction (MI). Large real-world data (RWD)
did not confirm an increase in the risk of MI during dabigatran treatment.
In our meta-analysis we excluded RWD, and each of the four drugs was
evaluated in two key-phase III randomized controlled trials: in patients
with AF and patients with AF and chronic coronary syndrome or acute
coronary syndrome treated with percutaneous coronary interventions. In
each study, warfarin was the comparator for NOACs. In this homogeneous
group of patients, dabigatran, in direct comparison with warfarin,
significantly increased the risk of MI by about 30%. Moreover, the risk of
MI was also significantly higher than the opposite effect of activated
factor (F) X inhibitors (FXa inhibitors) vs. warfarin. In our network
meta-analysis, considering individual NOACs in recommended doses, we found
an increased risk of MI compared to warfarin only in patients treated with
dabigatran 150 mg twice a day and, in particular, 110 mg twice a day. In
this review we present evidence supporting our opinion that in patients
with AF and coronary stenting, the choice of NOACs (direct FXa vs.
thrombin inhibitors) is equally as important as choosing the optimal
antiplatelet therapy (single or dual antiplatelet therapy).

<94>
Accession Number
637197988
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 - Journal of the American Medical Association. 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, Pole
Cardio-Medico-Chirurgical, Vandoeuvre-les-Nancy 54511, France
(Levy) INSERM U1116, Faculte de Medecine, Vandoeuvre-les-Nancy, 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, France
(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, EnVi, Rouen,
France
(Nesseler) Department of Anesthesia and Critical Care, Pontchaillou,
University Hospital of Rennes, Rennes, France
(Nesseler) University Rennes, CHU de Rennes, Inra, INSERM, Institut
NUMECAN, UMR_A 1341, UMR_S 1241, CIC 1414, Centre d'Investigation Clinique
de Rennes, Rennes, France
(Helms) Universite de Strasbourg, Faculte de Medecine, Hopitaux
Universitaires de Strasbourg, Service de Medecine Intensive-Reanimation,
Nouvel Hopital Civil, 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 GandR 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,
Genevois, 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) Reanimation Medico-Chirurgicale Cardio-Thoracique, 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) Universite de Lorraine, Centre d'Investigations Cliniques
Plurithematique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et
des Vaisseaux, 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, and 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, New York,
NY, United States
(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, UMR 1034, Biology of
Cardiovascular Diseases, Pessac, France
(Combes) Sorbonne Universite, INSERM, UMRS_1166-ICAN, Institute of
Cardiometabolism and Nutrition, Paris, France
(Combes) Service de Medecine Intensive-Reanimation, Institut de
Cardiologie, APHP Sorbonne Universite, Hopital Pitie-Salpetriere, Paris,
France
Publisher
American Medical Association
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. Copyright © 2022 American Medical Association. All
rights reserved.

<95>
Accession Number
637212779
Title
Comparison the Effect of Etomidate vsThiopentone on Left Ventricular
Strain and Strain Rate at the Time of Anesthesia Induction in Patients
Undergoing Elective Coronary Artery Bypass Surgery: A Randomized Double
Blind Controlled Trial.
Source
Journal of Cardiac Critical Care. 5(3) (pp 201-207), 2021. Article Number:
2190005. Date of Publication: 01 Dec 2021.
Author
Singh U.; Choudhury M.; Choudhury A.; Hote M.P.; Kapoor P.M.
Institution
(Singh) Department of Cardiac Surgical Intensive Care, All India Institute
of Medical Sciences, New Delhi, India
(Choudhury, Choudhury, Kapoor) Department of Cardiac Anaesthesia and
Critical Care, All India Institute of Medical Sciences, New Delhi 110029,
India
(Hote) Department of Cardiothoracic and Vascular Surgery, All India
Institute of Medical Sciences, New Delhi, India
Publisher
Thieme India
Abstract
Myocardial strain imaging with speckle tracking echocardiography (STE) is
getting popularity because it does not depends on insonation angle and has
shown good correlation with intraoperative and postoperative ventricular
function in patients with coronary artery disease. The impact of
thiopentone and etomidate induction on myocardial function was studied and
compared on sixty patients undergoing elective coronary artery bypass
grafting. Three loops for each views (apical 4 chamber, apical 2 chamber,
and apical long axis) were acquired at base line (T0) and 1 minute (T1)
after induction for offline analysis. In Group T, significant increase in
HR from the base line values (67.8 +/- 13.8 vs 79.2 +/- 15.6, p = 0.001)
occurred post induction, where as in Group E it remain near to the base
line (71.7 +/- 8.3 vs 70.1+/- 8.9, p = 0.345). A reduction in mean
arterial pressure (MAP) was noted in both the groups after the injection
of the allocated drug. There was no significant difference in the index of
contractility (ICON) (T0 vs T1: 48.7 +/- 10.6 vs 47.0 +/- 11.7, p = 0.120)
in Group E where as in Group T there was a reduction in the ICON value (T0
vs T1: 45.0 +/- 10.7 vs 41.0 +/- 8.4, p = 0.005). A similar picture was
also noted in systemic vascular resistance index. A significant decrease
in cardiac index (CI) was seen in Group E (T0 vs T1: 2.7 +/- 0.4 vs 2.5
+/- 0.4, p = 0.027), however it remain near to the base line in Group T.
There occurred no changes in stroke index (SI) in Group E (T0 vs T1: 38.7
+/- 6 vs 37.0+/- 5.3, p = 0.134), where as a significant decrease was
noted after injection of thiopental (T0 vs T1: 38.0 +/- 6.2 vs 36.1+/-
4.9, p = 0.049). A significant decline in cardiac performance index (CPI)
was also recorded in Group E (T0 vs T1: 0.57 +/- 0.15 vs 0.52 +/- 0.12, p
= 0.032), and not in Group T. There was decrease in left ventricular
ejection fraction (LVEF) after the injection of both the drugs (Group E,
T0 vs T1: 57 +/- 3.7 vs 54+/- 3.7, p= 0.001; and Group T, T0 vs T1: 57 +/-
3.7 vs 54+/- 3.7, p = 0.001). In Group E, global longitudinal peak
systolic strain (GLPSS) showed no change after the injection of the drug
(T0 vs T1: -13.2 +/- 2.2 vs -13.1+/- 2.3, p = 0.631). However, a
significant decrease in GLPSS (T0 vs T1: -13.5 +/- 1.5 vs - 10 +/- 1.8, p
= 0.001) after injection of thiopental. Longitudinal peak systolic strain
rate (LPSSR) was significantly decreased in all echocardiographic views
after the injection of respective drugs. However, the decrease in LPSSR
was significantly less in Group E in comparison to Group T. To conclude,
STE provides accurate and reliable real time quantitative regional and
global LV assessment. Use of thiopentone for anesthesia induction is
associated with more profound impairment of LV function in comparison to
etomidate as assessed by a decreased longitudinal peak systolic strain
rate and global longitudinal peak systolic strain. Further studies are
warranted to understand the exact clinical impact, which may influence the
choice of intravenous induction agent based upon preoperative patient
characteristics. Copyright © 2021 Thieme India. All rights
reserved.

<96>
Accession Number
637208213
Title
Long-term clinical impact of permanent pacemaker implantation in patients
undergoing transcatheter aortic valve implantation: a systematic review
and meta-analysis.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2022. Date of Publication: 09 Feb 2022.
Author
Zito A.; Princi G.; Lombardi M.; D'Amario D.; Vergallo R.; Aurigemma C.;
Romagnoli E.; Pelargonio G.; Bruno P.; Trani C.; Burzotta F.; Crea F.
Institution
(Zito, Princi, Lombardi, D'Amario, Vergallo, Aurigemma, Romagnoli,
Pelargonio, Bruno, Trani, Burzotta, Crea) Department of Cardiovascular and
Thoracic Sciences, Universita Cattolica del Sacro Cuore, L.go A. Gemelli
1, Rome 00168, Italy
(D'Amario, Vergallo, Aurigemma, Romagnoli, Pelargonio, Bruno, Trani,
Burzotta, Crea) Department of Cardiovascular Medicine, Fondazione
Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Publisher
NLM (Medline)
Abstract
AIMS: The aims of this study is to assess by an updated meta-analysis the
clinical outcomes related to permanent pacemaker implantation (PPI) after
transcatheter aortic valve implantation (TAVI) at long-term (>=12 months)
follow-up (LTF). METHODS AND RESULTS: A comprehensive literature research
was performed on PubMed and EMBASE. The primary endpoint was all-cause
death. Secondary endpoints were rehospitalization for heart failure,
stroke, and myocardial infarction. A subgroup analysis was performed
according to the Society of Thoracic Surgeon-Predicted Risk of Mortality
(STS-PROM) score. This study is registered with PROSPERO (CRD42021243301).
A total of 51 069 patients undergoing TAVI from 31 observational studies
were included. The mean duration of follow-up was 22 months. At LTF, PPI
post-TAVI was associated with a higher risk of all-cause death [risk ratio
(RR) 1.18, 95% confidence interval (CI) 1.10-1.25; P < 0.001] and
rehospitalization for heart failure (RR 1.32, 95% CI 1.13-1.52; P <
0.001). In contrast, the risks of stroke and myocardial infarction were
not affected. Among the 20 studies that reported procedural risk, the
association between PPI and all-cause death risk at LTF was statistically
significant only in studies enrolling patients with high STS-PROM score
(RR 1.25, 95% CI 1.12-1.40), although there was a similar tendency of the
results in those at medium and low risk. CONCLUSION(S): Patients
necessitating PPI after TAVI have a higher long-term risk of all-cause
death and rehospitalization for heart failure as compared to those who do
not receive PPI. Copyright Published on behalf of the European Society
of Cardiology. All rights reserved. © The Author(s) 2022. For
permissions, please email: journals.permissions@oup.com.

<97>
Accession Number
637207556
Title
Prognostic impact of secondary prevention after coronary artery bypass
grafting-insights from the TiCAB trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 09 Feb 2022.
Author
Heer T.; von Scheidt M.; Boening A.; Heyken C.; Gusmini F.; de Waha A.;
Kuna C.; Fach A.; Grothusen C.; Oberhoffer M.; Knosalla C.; Walther T.;
Danner B.C.; Misfeld M.; Wimmer-Greinecker G.; Siepe M.; Grubitzsch H.;
Joost A.; Schaefer A.; Conradi L.; Cremer J.; Hamm C.; Lange R.; Radke
P.W.; Schulz R.; Laufer G.; Grieshaber P.; Attmann T.; Schmoeckel M.;
Meyer A.; Ziegelhoffer T.; Hambrecht R.; Sandner S.E.; Kastrati A.;
Schunkert H.; Zeymer U.
Institution
(Heer) Department of Cardiology, Munich, Germany
(von Scheidt, Heyken, Gusmini, de Waha, Kuna, Kastrati, Schunkert)
Department of Cardiology, Deutsches Herzzentrum Munchen, Technische
Universitat Munchen, Munich, Germany
(von Scheidt, Kastrati, Schunkert) DZHK (German Center for Cardiovascular
Research), Partner Site Munich Heart Alliance, Munich, Germany
(Boening) Department of Cardiovascular Surgery, Justus-Liebig University
Giesen, Giesen, Germany
(Fach, Hambrecht) Department of Cardiology and Angiology, Klinikum Links
der Weser, Bremen, Germany
(Grothusen, Cremer, Attmann) Department of Cardiac Surgery,
Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Oberhoffer) Department of Cardiac Surgery, Klinik und Poliklinik fur
Herz- und Gefaschirurgie, Universitatsmedizin der Johannes
Gutenberg-Universitat Mainz, Mainz, Germany
(Knosalla, Meyer) Department of Cardiothoracic and Vascular Surgery,
German Heart Institute Berlin, Berlin, Germany
(Knosalla, Meyer) DZHK (German Center for Cardiovascular Research),
Partner Site Berlin, Berlin, Germany
(Walther) Department of Cardiac Surgery, Universitatsklinikum Frankfurt,
Frankfurt am Main, Germany
(Danner) Department of Thoracic and Cardiovascular Surgery, University
Medical Center, Gottingen, Germany
(Misfeld) University Department of Cardiac Surgery, Leipzig Heart Center,
Leipzig, Germany
(Wimmer-Greinecker) Department for Cardiothoracic Surgery, Heart and
Vessel Center Bad Bevensen, Bad Bevensen, Germany
(Siepe) Department of Cardiovascular Surgery, Heart Centre Freiburg
University, University of Freiburg, Freiburg, Germany
(Grubitzsch) Department of Cardiovascular Surgery, Charite
Universitatsmedizin Berlin, Berlin, Germany
(Joost) Department of Cardiology, Angiology and Intensive Care Medicine,
University Hospital Schleswig-Holstein, Medical Clinic II, Lubeck, Germany
(Schaefer, Conradi) Department of Cardiovascular Surgery, University Heart
Center Hamburg, Hamburg, Germany
(Hamm) Department of Cardiology, Justus-Liebig University Giesen,
Kerckhoff Campus ,Giesen, Germany
(Hamm) DZHK (German Center for Cardiovascular Research), Rhein-Main,
Partner Site Rhein-Main, Germany
(Lange) Department of Cardiovascular Surgery, Deutsches Herzzentrum
Munchen, Technische Universitat Munchen, Munich, Germany
(Radke) Department of Internal Medicine-Cardiology, Schon Klinik Neustadt
SE & Co. KG, Neustadt, Germany
(Schulz) Institute of Physiology, Justus-Liebig University Giesen, Giesen,
Germany
(Laufer, Sandner) Division of Cardiac Surgery, Medical University Vienna,
Wien, Austria
(Grieshaber) Department of Cardiovascular Surgery, University of
Heidelberg, Heidelberg, Germany
(Schmoeckel) Department of Cardiac Surgery, Asklepios Klinik St. Georg,
Hamburg, Germany
(Ziegelhoffer) Department of Cardiac Surgery, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Zeymer) Ludwigshafen, Germany
Publisher
NLM (Medline)
Abstract
OBJECTIVES: There are disparities in the adherence to
guideline-recommended therapies after coronary artery bypass graft (CABG).
We therefore sought to evaluate the effect of guideline-adherent medical
secondary prevention on 1-year outcome after CABG. METHOD(S): Data
were taken from the randomized 'Ticagrelor in CABG' trial. From April 2013
until April 2017, patients who underwent CABG were included. For the
present analysis, we compared patients who were treated with optimal
medical secondary prevention with those where 1 or more of the recommended
medications were missing. RESULT(S): Follow-up data at 12 months were
available in 1807 patients. About half (54%) of them were treated with
optimal secondary prevention. All-cause mortality [0.5% vs 3.5%, hazard
ratio (HR) 0.14 (0.05-0.37), P < 0.01], cardiovascular mortality [0.1% vs
1.7%, HR 0.06 (0.01-0.46), P = 0.007] and major adverse events [6.5% vs
11.5%, HR 0.54 (0.39-0.74), P < 0.01] were significantly lower in the
group with optimal secondary prevention. The multivariable model for the
primary end point based on binary concordance to guideline recommended
therapy identified 3 independent factors: adherence to guideline
recommended therapy [HR 0.55 (0.39-0.78), P < 0.001]; normal renal
function [HR 0.99 (0.98-0.99), P = 0.040]; and off-pump surgery [HR 2.06
(1.02-4.18), P = 0.045]. CONCLUSION(S): Only every second patient
receives optimal secondary prevention after CABG. Guideline adherent
secondary prevention therapy is associated with lower mid-term mortality
and less adverse cardiovascular events after 12 months. Copyright
© The Author(s) 2022. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<98>
Accession Number
637207161
Title
Intravenous Lidocaine for the Management of Traumatic Rib Fractures: A
Double-Blind Randomized Controlled Trial (INITIATE Program of Research).
Source
The journal of trauma and acute care surgery. (no pagination), 2022. Date
of Publication: 07 Feb 2022.
Author
Patton P.; Vogt K.; Priestap F.; Parry N.; Ball I.M.
Institution
(Patton) Department of Medicine, Canada Department of Surgery, Canada
Trauma Program, London Health Sciences Centre, Canada Office of Academic
Military Medicine, Canada. Department of Epidemiology and Biostatistics,
Western University, London, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Traumatic rib fractures (TRFs) are common with a 10% incidence
in all trauma patients and are associated with significant morbidity and
mortality. Adequate analgesia is paramount for preventing pulmonary
complications and death. Evidence exists for intravenous (IV) lidocaine's
effectiveness and safety in post-operative thoracic and abdominal surgery
and we hypothesized it would be effective in patients with TRFs.
 METHOD(S): We conducted a single-centre, double-blind, randomized
control trial comparing IV lidocaine plus usual analgesics to placebo
infusion plus usual analgesics for 72-96 hours. Participants were adult
trauma patients diagnosed with two or more TRFs requiring hospital
admission. The primary outcome was mean pain score at rest and with
movement, as measured on the Visual Analog Scale (VAS). Secondary outcomes
included patient satisfaction and opioid requirements (standardized total
morphine equivalents (TME)). The study was powered to detect a 20%
reduction in pain scores, which has been deemed clinically meaningful.
 RESULT(S): 36 patients were enrolled and randomized to IV lidocaine
or placebo. Comparison of the mean VAS pain scores demonstrated
significant pain reduction with movement in the lidocaine group compared
to placebo (7.05 +/- 1.72 vs 8.22 +/- 1.28, p = 0.042). Although pain
scores at rest were reduced in the lidocaine group, this difference was
not statistically significant (3.37 +/- 2.00 vs 3.82 +/- 1.97, p = 0.519).
Patient satisfaction was higher in the lidocaine group than the placebo
group, though this did not reach statistical significance (8.3 (IQR 7.0,
9.6) vs 6.3 (IQR 5.2, 7.1), p = 0.105). TMEs were lower in the lidocaine
group than the placebo group, but this difference did not reach
statistical significance (167 (IQR 60, 340) vs 290 (IQR 148, 390), p =
0.194). CONCLUSION(S): These results demonstrate that lidocaine has a
beneficial analgesic effect in patients with TRFs. Future work is needed
to evaluate lidocaine's ability to reduce patient important consequences
of inadequate analgesia. LEVEL OF EVIDENCE: Level 2: RCT with significance
and only 1 negative criterion (Missing >20% data). Copyright ©
2022 Lippincott Williams & Wilkins, Inc.

<99>
Accession Number
637207132
Title
Mechanical versus biological valve prostheses for left-sided infective
endocarditis.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 07 Feb 2022.
Author
Kahrovic A.; Angleitner P.; Herkner H.; Kocher A.; Ehrlich M.; Laufer G.;
Andreas M.
Institution
(Kahrovic, Angleitner, Kocher, Ehrlich, Laufer, Andreas) Department of
Cardiac Surgery, Medical University of Vienna, Vienna, Austria
(Herkner) Department of Emergency Medicine, Medical University of Vienna,
Vienna, Austria
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Our aim was to analyse outcomes after implantation of
mechanical versus biological valve prostheses in patients presenting with
left-sided infective endocarditis. METHOD(S): We conducted a
retrospective single-centre cohort study, analysing adults requiring valve
surgery for left-sided infective endocarditis between January 2009 and
December 2018 at the Department of Cardiac Surgery, Medical University of
Vienna. The primary outcome variable was all-cause mortality. Secondary
outcome variables included the occurrence of a combined event (death,
stroke, intracerebral bleeding or reoperation) and the risk of
re-endocarditis. RESULT(S): Among 220 patients, 76 (34.5%) underwent
mechanical valve replacement, while 144 (65.5%) underwent biological valve
replacement. Recipients of mechanical valve prostheses were younger at the
time of surgery and presented with lower European System for Cardiac
Operative Risk Evaluation II values. In patients <55 years of age,
implantation of a mechanical valve prosthesis was independently associated
with significantly lower risk of all-cause mortality (adjusted hazard
ratio 0.35, 95% confidence interval 0.15-0.80, P = 0.013). Moreover, this
group was at significantly lower risk of a combined event (adjusted hazard
ratio 0.38, 95% confidence interval 0.19-0.76, P = 0.006). Implantation of
a mechanical valve prosthesis was not associated with increased risk of
re-endocarditis. The presence of an annular abscess significantly
increased the risk of re-endocarditis (adjusted hazard ratio 3.06, 95%
confidence interval 1.40-6.71, P = 0.005). CONCLUSION(S): In patients
presenting with left-sided infective endocarditis <55 years of age,
implantation of a mechanical valve prosthesis is associated with superior
outcomes. A prospective randomized controlled trial is warranted to
confirm these results. Copyright © The Author(s) 2022. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<100>
Accession Number
637205618
Title
Concomitant Mitral Regurgitation in Patients Undergoing Surgical Aortic
Valve Replacement for Aortic Stenosis: A Systematic Review.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. (no
pagination), 2022. Date of Publication: 09 Feb 2022.
Author
Cheung F.P.; He C.; Eaton P.R.; Dimitriou J.; Newcomb A.E.
Institution
(Cheung, He, Eaton, Dimitriou, Newcomb) Department of Cardiothoracic
Surgery, St Vincent's Hospital Melbourne, VIC, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Concomitant mitral regurgitation (MR) is frequently seen in
patients undergoing surgical aortic valve replacement (AVR) for severe
aortic stenosis (AS). When the severity of MR is moderate or less, the
decision to undertake simultaneous mitral valve intervention can be
challenging. METHOD(S): A systematic search of Medline, PubMed
(NCBI), Embase and Cochrane Library was conducted to qualitatively assess
the current evidence for concomitant mitral valve intervention for MR in
patients with AS undergoing AVR. The primary outcome for this systematic
review was the postoperative change in the severity of MR and other
outcomes of interest included factors that predict improvement or
persistence of MR and long-term impacts of residual MR. RESULT(S): A
total of 17 studies were included. The percentage of patients
demonstrating improvement in MR severity following AVR ranged from 17.2%
to 72%; the studies that exclusively included patients with moderate
functional MR and reported longer term echocardiographic follow-up of
greater than 12 months demonstrated an improvement in MR severity of 45%
to 72%. CONCLUSION(S): This systematic review demonstrates that a
proportion of patients can exhibit an improvement in MR following isolated
surgical AVR, but whether this confers any long-term morbidity and
mortality benefit remains unclear.

<101>
Accession Number
637204944
Title
Bibliometric Analysis of 50 Most Cited Articles Comparing Lobectomy with
Sublobar Resection.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2022. Date of
Publication: 08 Feb 2022.
Author
Tekneci A.K.; Ozgur G.K.; Akcam T.I.; Cagirici U.
Institution
(Tekneci, Ozgur, Akcam, Cagirici) Department of Thoracic Surgery, Ege
University School of Medicine, Izmir, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Recent years have seen an increase in the number of studies
of the sublobar resection approach in non-small cell lung cancer (NSCLC)
surgery. The purpose of this bibliometric analysis is to assess the
significance and impact of articles comparing sublobar resection and
lobectomy in NSCLC surgery. MATERIAL AND METHODS: The Web of Science
database was searched to identify studies comparing sublobar resection and
lobectomy in NSCLC surgery published between 2005 and 2020 (accessed:
September 11, 2020). The 50 most cited articles were analyzed by years,
countries, authors, authors' affiliations, journals, journals' addresses,
and impact factors. RESULT(S): The bibliometric analysis revealed
that the most cited article had 443 citations, while the total number of
citations of all articles was 2,820. The mean number of citations, in
turn, was 56.4+/-75.62 (1-443) times. The highest number of publications
over the past 15 years was in 2016, with eight articles. The Annals of
Thoracic Surgery (n=10; 20%) had the highest number of publications on the
list. The articles included in the present study were mostly (n=35, 70%)
published in U.S. journals. While multiple subject matters and analyses
were presented by many studies, survival was the topic of greatest
interest, with 37 (74%) studies. CONCLUSION(S): This study revealed
that interest in studies comparing sublobar resection with lobectomy has
increased in recent years. It also presents both quantitative and
qualitative analyses of the most cited articles in the literature on this
topic. Therefore, it can serve as a guide for researchers. Copyright
Thieme. All rights reserved.

<102>
Accession Number
637202835
Title
The Analgesic Effect of Ultrasound-guided Bilateral Pecto-intercostal
Fascial Plane Block on Sternal Wound Pain after Open Heart Surgeries: A
Randomized Controlled Study.
Source
The Clinical journal of pain. (no pagination), 2022. Date of Publication:
08 Feb 2022.
Author
Hamed M.A.; Abdelhady M.A.; Hassan A.A.S.M.; Boules M.L.
Institution
(Hamed) Department of Anesthesiology, Faculty of Medicine, Fayoum
University, Egypt Department of Anesthesiology Faculty of Medicine -
Fayoum University, Cairo 63511, Egypt
Publisher
NLM (Medline)
Abstract
OBJECTIVES: We aimed to evaluate the analgesic efficacy of
ultrasound-guided bilateral pecto-intercostal fascial plane block after
open-heart surgeries. METHOD(S): Seventy patients aged above 18 years
and scheduled for on-pump coronary artery bypass grafting or valve
replacement or both through median sternotomy were enrolled in this study.
Patients were randomly allocated into two groups of each 35 (block group
or control group): Block group, which had the block performed through
twenty milliliters of a solution of 0.25% bupivacaine plus epinephrine
(5mcg/mL), and Control group, dry needling was done. The primary outcome
was the 24-hour cumulative morphine consumption. The secondary outcomes
were time to the first analgesic request, pain score, quality of
oxygenation, ICU stays, and hospital stay. RESULT(S): The cumulative
morphine consumption in the first 24 hours was significantly lower in the
block group, with a mean difference of -3.54 (95% CI=-6.55 to -0.53;
P=0.015). In addition, the median estimate time to the first analgesic
request was significantly longer in the block group than in the control
group. Finally, during the postoperative period (4-24h), mean sternal
wound Objective pain scores were, on average, 0.58 units higher in the
block group. CONCLUSION(S): PIFB is an effective technique in
reducing morphine consumption and controlling post-sternotomy pain after
cardiac surgeries. Also, it may have a role in better postoperative
respiratory outcomes. Copyright © 2022 Wolters Kluwer Health,
Inc. All rights reserved.

<103>
Accession Number
637202326
Title
Coronary Revascularization Versus Optimal Medical Therapy in Renal
Transplant Candidates With Coronary Artery Disease: A Systematic Review
and Meta-Analysis.
Source
Journal of the American Heart Association. (pp e023548), 2022. Date of
Publication: 08 Feb 2022.
Author
Siddiqui M.U.; Junarta J.; Marhefka G.D.
Institution
(Siddiqui, Junarta) Department of Medicine Thomas Jefferson University
Hospitals Philadelphia PA
(Marhefka) Jefferson Heart Institute Thomas Jefferson University Hospitals
Philadelphia PA
Publisher
NLM (Medline)
Abstract
Background Coronary artery disease (CAD) is highly prevalent in patients
with chronic kidney disease and is a common cause of mortality in
end-stage renal disease. Thus, patients with end-stage renal disease are
routinely screened for CAD before renal transplantation. The usefulness of
revascularization before transplantation remains unclear. We hypothesize
that there is no difference in all-cause and cardiovascular mortality in
waitlisted renal transplant candidates with CAD who underwent
revascularization versus those treated with optimal medical therapy before
transplantation. Methods and Results This meta-analysis was reported
according to the Preferred Reporting Items for Systematic Review and
Meta-Analyses guidelines. MEDLINE, Scopus, and Cochrane Central Register
of Controlled Trials were systematically searched to identify relevant
studies. Risk of bias was assessed using the modified Newcastle-Ottawa
Scale and Cochrane risk of bias tool. The primary outcome of interest was
all-cause mortality. Eight studies comprising 945 patients were included
(36% women, mean age 56 years). There was no difference in all-cause
mortality (risk ratio [RR], 1.16 [95% CI, 0.63-2.12), cardiovascular
mortality (RR, 0.75 [95% CI, 0.29-1.89]), or major adverse cardiovascular
events (RR, 0.78 [95% CI, 0.30-2.07]) when comparing renal transplant
candidates with CAD who underwent revascularization versus those who were
on optimal medical therapy before renal transplant. Conclusions This
meta-analysis demonstrates that revascularization is not superior to
optimal medical therapy in reducing all-cause mortality, cardiovascular
mortality, or major adverse cardiovascular events in waitlisted kidney
transplant candidates with CAD who eventually underwent kidney
transplantation.

<104>
Accession Number
637201789
Title
Meta-Analysis of Aortic Valve Replacement in Asymptomatic Patients With
Severe Aortic Stenosis.
Source
The American journal of cardiology. (no pagination), 2022. Date of
Publication: 04 Feb 2022.
Author
Mohamed M.M.G.; Taha M.; Kheiri B.; Osman M.
Institution
(Mohamed) Internal Medicine Department, SSM Health, St. Mary's
Hospital-St. Louis, MO
(Taha) Internal Medicine Department, University of Nevada, Reno, NV,
United States
(Kheiri, Osman) Knight Cardiovascular Institute, Oregon Health & Science
University, Portland, Oregon
Publisher
NLM (Medline)

<105>
Accession Number
637200345
Title
Evaluation of Citation Inaccuracies in Surgical Literature by Journal
Type, Study Design, and Level of Evidence: Towards Safeguarding the
Peer-Review Process.
Source
The American surgeon. (pp 31348211067993), 2022. Date of Publication: 07
Feb 2022.
Author
Sauder M.; Newsome K.; Zagales I.; Autrey C.; Das S.; Ang D.; Elkbuli A.
Institution
(Sauder, Das) 2814NSU NOVA Southeastern University, Dr Kiran, C. Patel
College of Allopathic Medicine, FL, Fort Lauderdale, United States
(Newsome, Zagales, Autrey) 5450Florida International University, FL,
Miami, United States
(Ang, Elkbuli) Departments of Surgery and Surgical Education, 23703Orlando
Regional Medical Center, FL, Orlando, United States
(Ang) University of Central Florida, FL, Ocala, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Accurate citation practices are key to furthering knowledge in
an efficient and valid manner. The aim of this study is to investigate the
prevalence of citation inaccuracies in original research from the
top-ranked surgical journals and to evaluate the impact level of evidence
has on citation inaccuracy. METHOD(S): A retrospective study
evaluating the citation accuracy of the top 10 ranked surgical journals
using the SJCR indicators. For each year between 2015 and 2020, the top 10
cited studies were selected, totaling 60 studies from each journal. From
each individual study, 10 citations were randomly selected and evaluated
for accuracy. Categories of inaccuracy included fact not found, study not
found, contradictory conclusion, citation of a citation, and inaccurate
population. RESULT(S): A total of 5973 citations were evaluated for
accuracy. Of all the citations analyzed, 15.2% of them had an inaccuracy.
There was no statistically significant difference in citations inaccuracy
rates among the years studied (P = .38) or study level of evidence (P =
.21). Annals of Surgery, Plastic and Reconstructive Surgery and Annals of
Surgical Oncology had significantly more citation inaccuracies than other
journals evaluated (P < .05). JAMA Surgery, The Journal of Endovascular
Therapy and The Journal of Thoracic and Cardiovascular Surgery had
significantly fewer citation inaccuracies. CONCLUSION(S): Although
84.8% of citations from 2015-2020 were determined to be accurate, citation
inaccuracies continue to be prevalent throughout highly-ranked surgical
literature. There were no significant differences identified in citation
inaccuracy rates between the years evaluated or based on study level of
evidence.

<106>
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.

<107>
Accession Number
2014561270
Title
Clinical characteristics, management strategies, and outcomes of non-
st-segment- elevation myocardial infarction patients with and without
prior coronary artery bypass grafting.
Source
Journal of the American Heart Association. 10(20) (no pagination), 2021.
Article Number: e018823. Date of Publication: 19 Oct 2021.
Author
Shoaib A.; Rashid M.; Berry C.; Curzen N.; Kontopantelis E.; Timmis A.;
Ahmad A.; Kinnaird T.; Mamas M.A.
Institution
(Shoaib, Rashid, Ahmad, Mamas) Keele Cardiovascular Research Group, Centre
for Prognosis Research, Institute for Primary Care and Health Sciences,
Keele University, Stoke-on-Trent, United Kingdom
(Berry) Institute of Cardiovascular & Medical Sciences, University of
Glasgow, United Kingdom
(Curzen) Cardiothoracic Department, University Hospital Southampton &
Faculty of Medicine, University of Southampton, United Kingdom
(Kontopantelis) Division of Informatics, Imaging and Data Sciences,
University of Manchester, United Kingdom
(Timmis) Barts & the London School of Medicine and Dentistry, Queen Mary
University London, London, United Kingdom
(Kinnaird) University Hospital of Wales, Cardiff, United Kingdom
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: There are limited data on the management strategies, temporal
trends and clinical outcomes of patients who present with non- ST-segment-
elevation myocardial infarction and have a prior history of CABG. METHODS
AND RESULTS: We identified 287 658 patients with non- ST-segment-
elevation myocardial infarction between 2010 and 2017 in the United
Kingdom Myocardial Infarction National Audit Project database. Clinical
and outcome data were ana-lyzed by dividing into 2 groups by prior history
of coronary artery bypass grafting (CABG): group 1, no prior CABG (n=262
362); and group 2, prior CABG (n=25 296). Patients in group 2 were older,
had higher GRACE (Global Registry of Acute Coronary Events) risk scores
and burden of comorbid illnesses. More patients underwent coronary
angiography (69% versus 63%) and revascularization (53% versus 40%) in
group 1 compared with group 2. Adjusted odds of receiving inpatient
coronary angiogram (odds ratio [OR], 0.91; 95% CI, 0.88- 0.95; P<0.001)
and revascularization (OR, 0.73; 95% CI, 0.70- 0.76; P<0.001) were lower
in group 2 compared with group 1. Following multivariable logistic
regression analyses, the OR of in-hospital major adverse cardiovascular
events (composite of inpatient death and reinfarction; OR, 0.97; 95% CI,
0.90-1.04; P=0.44), all-cause mortality (OR, 0.96; 95% CI, 0.88-1.04;
P=0.31), reinfarction (OR, 1.02; 95% CI, 0.89-1.17; P=0.78), and major
bleeding (OR, 1.01; 95% CI, 0.90-1.11; P=0.98) were similar across groups.
Lower adjusted risk of inpatient mortality (OR, 0.67; 95% CI, 0.46-0.98;
P=0.04) but similar risk of bleeding (OR,1.07; CI, 0.79-1.44; P=0.68) and
reinfarction (OR, 1.13; 95% CI, 0.81-1.57; P=0.47) were observed in group
2 patients who underwent percutaneous coronary intervention compared with
those man-aged medically. CONCLUSION(S): In this national cohort,
patients with non- ST-segment- elevation myocardial infarction with prior
CABG had a higher risk profile, but similar risk-adjusted in-hospital
adverse outcomes compared with patients without prior CABG. Patients with
prior CABG who received percutaneous coronary intervention had lower
in-hospital mortality compared with those who received medical
management. Copyright © 2021 The Authors. Published on behalf of
the American Heart Association, Inc., by Wiley.

<108>
Accession Number
2012931208
Title
COVID-19 in heart transplant recipients during February-August 2020: A
systematic review.
Source
Clinical Transplantation. 35(9) (no pagination), 2021. Article Number:
e14390. Date of Publication: September 2021.
Author
Diaz-Arocutipa C.; Carvallo-Castaneda D.; Luis-Ybanez O.; Pariona M.;
Rivas-Lasarte M.; Alvarez-Garcia J.
Institution
(Diaz-Arocutipa) Vicerrectorado de Investigacion, Universidad San Ignacio
de Loyola, Lima, Peru
(Diaz-Arocutipa) Programa de Atencion Domiciliaria (PADOMI) - EsSalud,
Lima, Peru
(Diaz-Arocutipa, Carvallo-Castaneda, Luis-Ybanez) Asociacion para el
Desarrollo de la Investigacion Estudiantil en Ciencias de la Salud
(ADIECS), Lima, Peru
(Carvallo-Castaneda) Puesto de Salud Pacaycasa, Ministerio de Salud,
Ayacucho, Peru
(Luis-Ybanez) Facultad de Medicina de San Fernando, Universidad Nacional
Mayor de San Marcos, Lima, Peru
(Pariona) Departamento de Cardiologia, Hospital Nacional Edgardo
Rebagliati Martins, Lima, Peru
(Rivas-Lasarte) Unidad de Insuficiencia Cardiaca Avanzada y Trasplante
Cardiaco, Hospital Universitario Puerta de Hierro, Madrid, Spain
(Rivas-Lasarte, Alvarez-Garcia) Centro de Investigacion Biomedica en Red
de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
(Alvarez-Garcia) Unidad de Insuficiencia Cardiaca Avanzada. Servicio de
Cardiologia del Hospital Universitario Ramon y Cajal, Madrid, Spain
(Alvarez-Garcia) Universidad Autonoma de Barcelona, Barcelona, Spain
Publisher
John Wiley and Sons Inc
Abstract
The coronavirus disease 2019 (COVID-19) pandemic represents a major
concern in immunosuppressed patients such as heart transplant recipients.
Therefore, we performed a systematic review to summarize the clinical
features, treatment, and outcomes of heart transplant recipients with
COVID-19. We searched electronic databases from inception to January 11,
2021. Thirty-nine articles (22 case reports and 17 cohorts) involving 415
patients were included. The mean age was 59.9 +/- 15.7 years and 77% of
patients were men. In cohort studies including outpatients and inpatients,
the hospitalization rate was 77%. The most common symptoms were fever
(70%) and cough (67%). Inflammatory biomarkers (C-reactive protein and
procalcitonin) were above the normal range. Forty-eight percent of
patients presented with severe or critical COVID-19. Hydroxychloroquine
(54%), azithromycin (14%), and lopinavir/ritonavir (14%) were the most
commonly used drugs. Forty-nine percent of patients discontinued the
baseline regimen of antimetabolites. In contrast, 59% and 73% continued
the same regimen of calcineurin inhibitors and corticosteroids,
respectively. Short-term mortality among cohorts limited to inpatients was
25%. Our review suggests that heart transplant recipients with COVID-19
exhibited similar demographic and clinical features to the general
population. However, the prognosis was poor in these
patients. Copyright © 2021 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<109>
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.

<110>
Accession Number
634682544
Title
Efficacy and safety of colchicine for the prevention of major
cardiovascular and cerebrovascular events in patients with coronary artery
disease: a systematic review and meta-analysis on 12 869 patients.
Source
European journal of preventive cardiology. 28(17) (pp 1916-1925), 2022.
Date of Publication: 03 Feb 2022.
Author
Andreis A.; Imazio M.; Piroli F.; Avondo S.; Casula M.; Paneva E.; De
Ferrari G.M.
Institution
(Andreis, Imazio, Piroli, Avondo, Casula, Paneva, De Ferrari) Department
of Cardiovascular and Thoracic, University Cardiology, A.O.U. Citta della
Salute e della Scienza di Torino ,Corso Bramante 88, Turin 10126, Italy
Publisher
NLM (Medline)
Abstract
AIMS: The key role of inflammation in the pathogenesis of coronary artery
disease (CAD) is an urgent call for innovative treatments. Several trials
have proposed colchicine as a therapeutic option for secondary prevention
in CAD patients but its utilization is hampered by fears about
drug-related adverse events (DAEs) and conflicting evidences. The aim of
this meta-analysis was to consolidate evidence on the efficacy and safety
of colchicine for secondary prevention in patients with CAD. METHODS AND
RESULTS: A systematic search in electronic bibliographic databases of
Medline, Scopus, Embase, and the Cochrane Library was performed to
identify randomized controlled trials (RCTs) assessing the cardiovascular
effects of colchicine in CAD patients, compared with placebo. Outcomes of
interest were the occurrence of major adverse cardiovascular and
cerebrovascular events (MACCE) and DAEs. Estimates were pooled using
inverse-variance random-effects model. A total of 11 RCTs, including 12
869 patients, were identified as eligible. A total of 6501 patients
received colchicine, while 6368 received placebo. After a median follow-up
of 6months (interquartile range, 1-16), patients receiving colchicine had
a lower risk of MACCE [6% vs. 8.8%, relative risk (RR) = 0.67, 95%
confidence interval (CI) 0.56-0.80, I2=19%], myocardial infarction (3.3%
vs. 4.3%, RR=0.76, 95% CI 0.61-0.96, I2=17%), coronary revascularization
(2.9% vs. 4.2%, RR=0.61, 95% CI 0.42-0.89, I2=40%), stroke (0.4% vs. 0.9%,
RR=0.48, 95% CI 0.30-0.77, I2=0%), hospitalization for cardiovascular
cause (0.9% vs. 2.9%, RR=0.32, 95% CI 0.12-0.87, I2=0%). Colchicine was
associated with an increased risk of gastrointestinal DAEs (11% vs. 9.2%,
RR=1.67, 95% CI 1.20-2.34, I2=76%), myalgia (18% vs. 16%, RR = 1.16, 95%
CI 1.02-1.32, I2=0%) and DAEs-related discontinuation (4.1% vs. 3%, RR =
1.54, 95% CI 1.02-2.32, I2=65%). However, gastrointestinal DAEs and
discontinuation may be prevented with a lower daily dose. Colchicine did
not increase the risk of cardiovascular death (0.7% vs. 1%, RR=0.73, 95%
CI 0.45-1.21, I2=14%), all-cause death (2% vs. 1.9%, RR=1.01, 95% CI
0.71-1.43, I2=16%), or other DAEs. CONCLUSION(S): The use of
colchicine in patients with CAD is safe and efficacious for MACCE
prevention. Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. © The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<111>
Accession Number
636921924
Title
Efficacy and safety of coronary computed tomography angiography in
patients with a high clinical likelihood of obstructive coronary artery
disease.
Source
Kardiologia polska. 80(1) (pp 56-63), 2022. Date of Publication: 2022.
Author
Rudzinski P.N.; Kruk M.; Demkow M.; Oleksiak A.; Schoepf J.U.; Mach M.;
Dzielinska Z.; Pregowski J.; Witkowski A.; Ruzyllo W.; Kepka C.
Institution
(Rudzinski) National Institute of Cardiology, Warszawa, Poland
(Kruk, Demkow, Oleksiak, Dzielinska, Pregowski, Witkowski, Ruzyllo, Kepka)
National Institute of Cardiology, Warszawa, Poland
(Schoepf) Division of Cardiovascular Imaging, Department of Radiology and
Radiological Science, Medical University of South Carolina, SC,
Charleston, United States
(Schoepf) Division of Cardiology, Department of Medicine, Medical
University of South Carolina, SC, Charleston, United States
(Mach) Division of Cardiac Surgery, Department of Surgery, Vienna General
Hospital, Vienna, Austria
Publisher
NLM (Medline)
Abstract
BACKGROUND: The CAT-CAD trial showed that coronary computed tomography
angiography (CTA) in patients with a high prevalence of coronary artery
disease (CAD) and indications for invasive coronary angiography (ICA)
reduces the number of patients undergoing ICA by two-thirds and nearly
eradicates non-actionable ICAs. However, the long-term benefits of this
non-invasive strategy remain unknown. AIMS: To evaluate the long-term
efficacy and safety of a non-invasive strategy employing coronary CTA vs.
ICA as the first-line imaging test in stable patients with a high clinical
likelihood of obstruc-tive CAD. METHOD(S): The long-term outcomes
were evaluated for 36 months following randomization and included the
efficacy outcome (analyzed as the composite of major adverse
cardiovascular events (MACE): all-cause death, acute coronary syndrome,
unplanned coronary revascularization, urgent hospitalization for a
cardiovascular reason, a stroke) and the safety outcome (analyzed as a
cumulative incidence of serious adverse events). RESULT(S): One
hundred and twenty participants at a mean age of 60.6 (7.9) years (female,
35.0%) were randomized with an allocation ratio of 1:1 to coronary CTA and
direct ICA as the first-line anatomical test for suspected obstructive
CAD. There were no significant differences between both diagnostic
strategies neither in terms of the long-term efficacy (MACE occurrence:
15.5% in coronary CTA group vs. 16.7% in ICA group; log-rank P = 0.89) nor
the long-term safety (cumulative number of serious adverse events: 36 vs.
38; P = 0.79, respectively). CONCLUSION(S): Long-term follow-up of
the randomized CAT-CAD trial confirms that the strategy employing coronary
CTA is an effective and safe, non-invasive, outpatient-based alternative
to ICA for patients with a high clinical likelihood of obstructive CAD.

<112>
Accession Number
637150174
Title
Combined heart and liver transplantation: an updated systematic review.
Source
Annals of the Royal College of Surgeons of England. 104(2) (pp 88-94),
2022. Date of Publication: 01 Feb 2022.
Author
Frountzas M.; Karampetsou N.; Nikolaou C.; Schizas D.; Tsapralis D.;
Avgerinos D.; Toutouzas K.
Institution
(Frountzas, Karampetsou, Nikolaou, Schizas, Toutouzas) National and
Kapodistrian University of Athens, Greece
(Tsapralis) General Hospital of Ierapetra, Greece
(Avgerinos) NewYork-Presbyterian Hospital, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Combined heart and liver transplantation (CHLT) is one of
the most complex procedures of surgery that has been implemented in the
last 35 years. The aim of our meta-analysis was to investigate the safety
and efficacy of CHLT. MATERIALS: The meta-analysis was designed according
to PRISMA (Preferred Reporting Items for Systematic reviews and
Meta-Analyses) and AMSTAR (A MeaSurement Tool to Assess systematic
Reviews) recommendations. A literature search was conducted up to April
2020 using the MEDLINE, SCOPUS, ClinicalTrials.gov, EmbaseTM, Cochrane
Central Register of Controlled Trials and Google ScholarTM databases.
 RESULT(S): Our meta-analysis included 16 studies with 860 patients.
The mortality rate following CHLT was 14.1%. One and five-year survival
rates were 85.3% and 71.4% while the heart and liver rejection rates were
6.1% and 9.1% respectively. The hospital stay was 25.8 days and the
intensive care unit stay was 9.9 days. Pooled values were also calculated
for cardiopulmonary bypass duration, units of transfused red blood cells
and fresh frozen plasma, postoperative infection rate, mechanical
ventilation rate and follow-up duration. CONCLUSION(S): Despite its
complexity, CHLT is a safe and effective procedure for the management of
lethal diseases that lead to progressive heart and/or liver failure.
Nevertheless, there must be strict adherence to the indications for
surgery, and future studies should compare CHLT with isolated cardiac and
hepatic transplantations.

<113>
Accession Number
2014071889
Title
Maintenance of Serum Potassium Levels >=3.6 mEq/L Versus >=4.5 mEq/L After
Isolated Elective Coronary Artery Bypass Grafting and the Incidence of
New-Onset Atrial Fibrillation: Pilot and Feasibility Study Results.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(3) (pp 847-854),
2022. Date of Publication: March 2022.
Author
Campbell N.G.; Allen E.; Montgomery H.; Aron J.; Canter R.R.; Dodd M.;
Sanders J.; Sturgess J.; Elbourne D.; O'Brien B.
Institution
(Campbell) Division of Cardiovascular Sciences, School of Medical
Sciences, Manchester Academic Health Science Centre, University of
Manchester, Manchester, United Kingdom
(Campbell) Wythenshawe Hospital, Manchester University Foundation NHS
Trust, Manchester, United Kingdom
(Allen, Canter, Dodd, Sturgess, Elbourne) Clinical Trials Unit, London
School of Hygiene & Tropical Medicine, London, United Kingdom
(Montgomery) UCL Division of Medicine and Institute for Sport, Exercise,
and Health, London, United Kingdom
(Aron) St. George's Hospital, London, United Kingdom
(Sanders, O'Brien) St. Bartholomew's Hospital, Barts Health NHS Trust,
West Smithfield, London, United Kingdom
(O'Brien) German Heart Center, Department of Cardiac Anesthesiology and
Intensive Care Medicine, Berlin, Germany
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, Charite Berlin, Berlin, Germany
(O'Brien) Outcomes Research Consortium, Cleveland, OH
Publisher
W.B. Saunders
Abstract
Objective: Serum potassium levels frequently are maintained at high levels
(>=4.5 mEq/L) to prevent atrial fibrillation after cardiac surgery
(AFACS), with limited evidence. Before undertaking a noninferiority
randomized controlled trial to investigate the noninferiority of
maintaining levels >=3.6 mEq/L compared with this strategy, the authors
wanted to assess the feasibility, acceptability, and safety of recruiting
for such a trial. Design(s): Pilot and feasibility study of full
trial protocol. Setting(s): Two university tertiary-care hospitals.
 Participant(s): A total of 160 individuals undergoing first-time
elective isolated coronary artery bypass grafting. Intervention(s):
Randomization (1:1) to protocols aiming to maintain serum potassium at
either >=3.6 mEq/L or >=4.5 mEq/L after arrival in the postoperative care
facility and for 120 hours or until discharge from the hospital or AFACS
occurred, whichever happened first. Measurements and Main Results:
Primary outcomes: (1) whether it was possible to recruit and randomize 160
patients for six months (estimated 20% of those eligible); (2) maintaining
supplementation protocol violation rate <=10% (defined as potassium
supplementation being inappropriately administered or withheld according
to treatment allocation after a serum potassium measurement); and (3)
retaining 28-day follow-up rates >=90% after surgery. Between August 2017
and April 2018, 723 patients were screened and 160 (22%) were recruited.
Potassium protocol violation rate = 9.8%. Follow-up rate at 28 days =
94.3%. Data on planned outcomes for the full trial also were collected.
 Conclusion(s): It is feasible to recruit and randomize patients to a
study assessing the impact of maintaining serum potassium concentrations
at either >=3.6 mEq/L or >=4.5 mEq/L on the incidence of
AFACS. Copyright © 2021

<114>
[Use Link to view the full text]
Accession Number
2010671704
Title
Perioperative Spinal Cord Ischemia After Cardiac Surgery Not Involving the
Aorta: A Review of the Literature.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(3) (pp 776-784),
2022. Date of Publication: March 2022.
Author
Wanat-Hawthorne A.; Akorede R.; Floyd T.
Institution
(Wanat-Hawthorne, Akorede, Floyd) Department of Anesthesiology and Pain
Management, UT Southwestern, Dallas, TX
Publisher
W.B. Saunders
Abstract
Spinal cord ischemia (SCI) associated with aortic surgery is
well-described; however, SCI after cardiac surgery not involving the aorta
is an unusual and underappreciated phenomenon. The authors reviewed the
literature and found 54 case reports of perioperative spinal cord ischemia
in nonaortic surgery. The severity of its implications is evidenced by the
fact that 14 patients died, 22 had no recovery, and seven had only partial
recovery. Various types of cardiac surgery have reported this complication
including coronary artery bypass grafting (CABG), off-pump CABG, valve
surgeries, combination valve and CABG surgeries, and transcatheter aortic
valve procedures. Patient comorbidities, such as high blood pressure,
hypercholesterolemia, diabetes, and peripheral vascular disease, also may
play a role in the development of this adverse outcome. The authors review
the literature to define further possible mechanisms, surgical techniques,
and patient factors that could contribute to the risk of perioperative SCI
after cardiac surgery. Copyright © 2020 Elsevier Inc.

<115>
[Use Link to view the full text]
Accession Number
637189726
Title
The effect of oral versus nasal intubation on feeding outcomes in neonates
requiring cardiac surgery.
Source
Critical Care Medicine. Conference: 51st Society of Critical Care Medicine
Critical Care Congress, SCCM 2022. San Juan Puerto Rico. 50(1 SUPPL) (pp
192), 2022. Date of Publication: January 2022.
Author
Yildirim M.; Castro B.; McNaull P.; Rafael J.; Sharma R.; Spaeder M.;
Vizzini S.; Frank D.
Institution
(Yildirim) University of Virginia, Charlottesville, VA, United States
(Castro, McNaull, Rafael, Sharma, Spaeder, Vizzini, Frank) University of
Virginia
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: Patients who require cardiac surgery in the neonatal period
frequently encounter difficulties reaching full volume oral feeds. These
difficulties are related to developmental features, perioperative events,
and postoperative oral aversion symptoms. Patients who struggle with oral
feeding require longer hospitalizations and frequently require invasive
devices for stable nutrition at discharge. We hypothesize that nasal
intubation for neonatal cardiac surgery may reduce time to full oral feeds
and decrease the proportion of patients requiring discharge feeding tubes.
 METHOD(S): This is a single-center, prospective randomized control
trial of patients less than 2 weeks of age who undergo endotracheal
intubation at the time of cardiac surgery. We exclude patients who were <
37 weeks corrected gestational age (GA) at surgery, had orofacial or
gastrointestinal anomalies, required >5 days of intubation before surgery,
or required ECMO or >5 minutes of CPR at any time during the
hospitalization. Patients are randomized to nasal (NI) or oral intubation
(OI). RESULT(S): 57 subjects have been recruited to date (26 NI, 31
OI). We perform an "as treated" analysis for anticipated NI failures,
which occurred in 3 subjects. Clinical characteristics between the NI and
OI groups are similar: mean GA at birth (39 2/7 vs 38 5/7 weeks),
birthweight (3460 vs 3230 grams), STAT score (3.9 vs 4.1), systemic to
pulmonary shunt placement (35% vs 41%), bypass time (179 vs 181 minutes),
and cross clamp time (113 vs 110 minutes). Median time from extubation to
feeding tube removal is 5 days in the NI group and 8 days in the OI group.
4% of subjects in the NI group and 21% in the OI group were discharged
with a feeding tube. CONCLUSION(S): In this cohort, nasally intubated
patients reach full oral feeds more quickly and are less likely to require
supplemental tube feeding at hospital discharge in comparison to the
orally intubated patients. This may be due to less oral aversion in the
nasally intubated group. The limitations of this study include the
relatively small sample size and single-center nature. In the future, a
large multi-center trial may be beneficial to establish recommendations
for intubation route in neonates requiring cardiac surgery.

<116>
[Use Link to view the full text]
Accession Number
637188715
Title
Mechanical complications of the double-lumen tube.
Source
Critical Care Medicine. Conference: 51st Society of Critical Care Medicine
Critical Care Congress, SCCM 2022. San Juan Puerto Rico. 50(1 SUPPL) (pp
508), 2022. Date of Publication: January 2022.
Author
Chemtob E.; Kauffman D.; Nguyen C.; Hu A.; Pla R.; Heinz E.
Institution
(Chemtob, Kauffman, Nguyen, Hu) George Washington University, School of
Medicine and Health Sciences
(Pla, Heinz) George Washington University
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION/HYPOTHESIS: The Double Lumen Tube (DLT) is commonly used to
facilitate one-lung ventilation in thoracic surgery, in which several
mechanical complications have been noted by previous studies. The goal of
our study is to identify the frequency of mechanical complications with
the DLT at each anatomical location and classify the injuries using a
severity score. From this study, we aim to inform patients and
anesthesiologists on the risks associated with the DLT. METHOD(S): We
independently and systematically searched the literature using PubMed
using the following search term: complications; double lumen tube;
one-lung ventilation; injury. This resulted in 251 studies. The following
filters were then applied in Covidence: English language; human subjects;
adult subjects (age >= 18 years). Forty-one studies met our specified
inclusion and exclusion criteria, ten of which were randomized controlled
trials. We organized the injuries by anatomical location and created an
injury severity classification system to determine the frequency of minor
to severe injuries graded I to IV; I as minor and IV as severe.
 RESULT(S): We included 10 randomized control trials that met our
inclusion criteria with a total of 2,554 participants. 1591 were males and
963 were females. The average age of participants was 56, average height
was 168 cm, average weight was 67 kg, and average BMI was 23.7. Of the
participants, 772 met criteria for American Society of Anesthesiologists
(ASA) physical status classification of I, 1169 for ASA II, 390 for ASA
III, and 5 for ASA IV. Of the 2,554 participants across the ten studies,
we found that 64% experienced an oropharynx injury, 42% experienced a
laryngeal or vocal cord injury, 31% experienced a tracheal injury, and 47%
experienced a bronchial injury. CONCLUSION(S): Our results show that
the DLT can cause injury to the oropharynx, larynx and vocal cords,
trachea, and the bronchi, with oropharynx injuries occurring the most
frequently. We found that grade I injuries occurred more frequently than
grade IV injuries at each anatomic location. However, severe injuries from
the DLT can lead to morbidity and mortality, so a larger-scale
observational study is needed to analyze predictors and risk factors
associated with severe injury.

<117>
[Use Link to view the full text]
Accession Number
637188631
Title
Caution for calcium use during pediatric CPR: Do selected resuscitation
scenarios benefit?.
Source
Critical Care Medicine. Conference: 51st Society of Critical Care Medicine
Critical Care Congress, SCCM 2022. San Juan Puerto Rico. 50(1 SUPPL) (pp
693), 2022. Date of Publication: January 2022.
Author
Cashen K.; Meert K.; Reeder R.; Berg R.; Cooper K.; Wesley Diddle J.;
Graham K.; Horvat C.; Kirkpatrick T.; Morgan R.; Nadkarni V.; Page K.;
Danna Q.; Wolfe H.; Yates A.; Sutton R.
Institution
(Cashen) DMC Childrens Hospital of Michigan, Durham, NC, United States
(Meert) Children's Hospital of Michigan, Merion Station, PA, United States
(Reeder, Page) University of Utah, Merion Station, PA, United States
(Berg) Children's Hospital of Philadelphia, Merion Station, PA, United
States
(Cooper, Graham, Wolfe, Sutton) Children's Hospital of Philadelphia,
Philadelphia, PA, United States
(Wesley Diddle) Childrens National Health Systems, Philadelphia, PA,
United States
(Horvat) Children's Hospital of Pittsburgh of UPMC, Philadelphia, PA,
United States
(Kirkpatrick) Mattell Childrens Hospital/UCLA, Philadelphia, PA, United
States
(Morgan) Childrens Hospital of Philadelphia, Philadelphia, PA, United
States
(Nadkarni) University of Pennsylvania Perelman, School of Medicine, CHOP,
Philadelphia, PA, United States
(Danna) Nationwide Children's Hospital, Ohio State University,
Philadelphia, PA, United States
(Yates) Nationwide Children's Hospital
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: Calcium is frequently used during pediatric in-hospital
cardiac arrest (p-IHCA) despite studies associating calcium use with no
benefit or potential harm. Previous work could not evaluate specific
subgroup populations where clinical benefit of calcium is observed
anecdotally at the bedside. Our primary objective was to evaluate the
association between calcium use and outcomes among specific subgroup
populations hypothesized to have clinical benefit. METHOD(S):
Included were children <=18 years old and >=37 weeks corrected gestational
age who received any duration of chest compressions admitted to one of 18
ICUs of The ICU-RESUScitation Project (NCT028374497), a prospective,
multicenter, cluster randomized interventional trial. In this secondary
analysis, detailed patient and event characteristics, pre-arrest
laboratory values (-2 to -6 hours prior to IHCA), and congenital heart
disease classification information were available. In a propensity score
weighted cohort, the relationship between calcium use and outcomes was
assessed in subjects with: 1) documented hyperkalemia (>6 mmol/L) 2)
cardiac surgery the day of arrest 3) sepsis 4) renal insufficiency and 5)
specific cardiac diagnoses hypothesized as "calcium avid" (interrupted
aortic arch, tetralogy of Fallot, or truncus arteriosus). The primary
outcome was ROSC. RESULT(S): of 1100 CPR events, average age was 3.7
years; ROSC was achieved in 773 (70%); 450 (41%) had calcium use. Among
the weighted cohort, calcium use was not associated with ROSC (aOR:1.06,
CI95 0.81-1.39, p=0.7), but was associated with lower survival to hospital
discharge (aOR:0.73; CI95 0.56-0.96, p=0.02.) Among pre-specified
subgroups, calcium use compared to no calcium use was associated with
significantly higher rates of ROSC only in patients with sepsis (aOR:1.97,
CI95 1.07-3.66, p=0.03) and "calcium-avid" heart disease (aOR:3.16, CI95
1.36-7.52, p< 0.01), and was not associated with improved survival to
hospital discharge in any subgroup. CONCLUSION(S): In this
multicenter cohort study of p-IHCA, calcium use was common and was
associated with lower rates of survival to hospital discharge among all
patients. In prespecified subgroup analyses of patients with sepsis or
select congenital heart disease diagnoses, calcium use was associated with
higher rates of ROSC, but not survival.

<118>
[Use Link to view the full text]
Accession Number
2016750942
Title
Successful subclavian transcatheter aortic valve replacement in a
nonagenarian patient: Case report and review of literature.
Source
Medicine (United States). 101(4) (pp E28702), 2022. Date of Publication:
28 Jan 2022.
Author
Oh S.; Kim J.H.; Hyun D.Y.; Cho K.H.; Kim M.C.; Sim D.S.; Hong Y.J.; Ahn
Y.; Jeong M.H.; Jung Y.; Lee K.S.
Institution
(Oh, Kim, Hyun, Cho, Kim, Sim, Hong, Ahn, Jeong) Department of Cardiology,
Chonnam National University Hospital, Gwangju, South Korea
(Kim, Kim, Sim, Hong, Ahn, Jeong) Department of Cardiology, Chonnam
National University, Medical School, Gwangju, South Korea
(Jung, Lee) Department of Thoracic Cardiovascular Surgery, Chonnam
National University Hospital, Gwangju, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Rationale:In super-aged patients with severe symptomatic aortic stenosis,
transcatheter aortic valve replacement (TAVR) is a good treatment option,
and the number of TAVR-eligible elderly patients is expected to grow
exponentially. We present the case of a nonagenarian woman with severe
aortic stenosis who underwent successful subclavian TAVR.Patient
concerns:A 90-year-old Korean woman was brought to our department with
dyspnea. On physical examination, a grade IV systolic murmur was
auscultated in both the upper sternal borders and the left lower sternal
border.Diagnosis:A transthoracic echocardiogram showed heavy calcification
of the aortic valve with an increase in both peak velocity (4.36 m/s) and
mean pressure (44.8 mm Hg), indicating severe symptomatic aortic stenosis.
 Intervention(s):After a heart team conference involving
interventional cardiologists, cardiac surgeons, and anesthesiologists,
subclavian TAVR was performed. Using the left subclavian artery, we
successfully deployed a self-expandable valve prosthesis
(CoreValveTMEvolut RTM, Medtronic Inc., Minneapolis,
MN). Outcome(s):After TAVR, transthoracic echocardiogram showed a
decline in both peak velocity (2.06-2.14 m/s) and mean pressure (7.42-7.95
mm Hg) with an increase in the aortic valve area (1.12 cm2).
The patient's dyspnea symptoms improved dramatically.Lessons:In addition
to femoral TAVR, subclavian TAVR may be feasible and safe in super-aged
patients. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<119>
Accession Number
637134860
Title
Evaluation of low-dose colchicine in patients with cardiopulmonary bypass:
Study protocol for a randomised controlled trial.
Source
BMJ Open. 12(2) (no pagination), 2022. Article Number: e050577. Date of
Publication: 01 Feb 2022.
Author
Zhang H.; Han X.; Pan T.; Zhang H.-T.; Zhong K.; Li Z.-S.; Jiang X.; Pan
J.; Wang D.-J.
Institution
(Zhang, Pan, Zhang, Li, Jiang, Wang) Department of Cardio-Thoracic
Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences,
Peking Union Medical College, Graduate School of Peking, Union Medical
College, Beijing, China
(Han) Department of Epidemiology, Harvard University, T H Chan School of
Public Health, Boston, MA, United States
(Han) Program in Genetic Epidemiology and Statistical Genetics, Harvard
University, T H Chan School of Public Health, Boston, MA, United States
(Pan, Pan, Wang) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, The Affiliated Hospital, Nanjing University Medical School,
Nanjing University Medical School, Affiliated Nanjing Drum Tower Hospital,
Jiangsu, Nanjing, China
(Zhong) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, Nanjing Medical University, Nanjing Medical University, Jiangsu,
Nanjing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Inflammation and myocardial damage caused by cardiovascular
surgery with cardiopulmonary bypass (CPB) have been shown to be the major
contributors to postoperative morbidity and mortality. Colchicine can
reduce myocardial ischaemia-reperfusion injury in patients with chronic
coronary artery disease. However, there is a lack of evidence whether
colchicine could reduce myocardial injury after cardiovascular surgery. In
this study, we aim to evaluate the effect of low-dose colchicine on
myocardial protection during perioperative period in patients who undergo
cardiovascular surgery with CPB. Methods and analysis In this randomised
controlled trial, a total of 132 patients will be recruited from the
Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital.
Patients will be randomised into the colchicine treatment group and
control group with a ratio of 1:1. Patients in the colchicine treatment
group will receive 0.5 mg of colchicine daily for 3 days before surgery
and 0.5 mg of colchicine daily for 5 days after surgery. Patients in the
control group will receive placebo instead of colchicine for the same
schedule. Level of postoperative myocardial injury will be assessed as the
primary outcome. The secondary outcomes are biomarker levels for
myocardial injury (such as creatine kinase-MB, cardiac troponin I,
myohaemoglobin, type B natriuretic peptide, D-dimer) and inflammatory
response markers (white blood cell, procalcitonin, interleukin-6, C
reactive protein) for 5 consecutive days after surgery and poor
postoperative outcomes. Ethics and dissemination This study has been
approved by Medical Ethics Committee of Affiliated Nanjing Drum Tower
Hospital, Nanjing University Medical College (approval number:
2020-293-01). Study results will be disseminated through publication in an
open access journal. Trial registration number
ChiCTR2000040129. Copyright © 2022 BMJ Publishing Group. All
rights reserved.

<120>
Accession Number
2014928015
Title
Surgical Treatment of Primary Cardiac Tumors in Children Systematic Review
and Meta-analysis.
Source
Pediatric Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Svobodov A.A.; Glushko L.A.; Ergashov A.Y.
Institution
(Svobodov, Glushko, Ergashov) Bakoulev Scientific Center for
Cardiovascular Surgery Moskva, Rublevskoe shosse 135, Moscow 121552,
Russian Federation
Publisher
Springer
Abstract
This systematic review sought to investigate the current evidence
regarding surgical management of primary cardiac tumors in children.
Twenty-four studies were deemed eligible, reporting on 713 pediatric
patients. Cumulative 30-day mortality rate was 5.5% and 7.5% after
surgery. It was revealed a statistically lower mortality rate in the group
of patients below 1 year of age, justifying a more aggressive surgical
approach for primary cardiac tumors, except for rhabdomyoma that can
regress spontaneously. Copyright © 2022, The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<121>
Accession Number
637192783
Title
Goal-directed perfusion for reducing acute kidney injury in cardiac
surgery: A systematic review and meta-analysis.
Source
Perfusion. (pp 2676591211073783), 2022. Date of Publication: 06 Feb 2022.
Author
Gao P.; Liu J.; Zhang P.; Bai L.; Jin Y.; Li Y.
Institution
(Gao, Liu, Zhang, Bai, Jin, Li) Department of Cardiopulmonary Bypass,
Fuwai Hospital, National Center for Cardiovascular Diseases, 34736Peking
Union Medical College and Chinese Academy of Medical Sciences, Beijing,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Acute kidney injury (AKI) is a common complication following
cardiopulmonary bypass (CPB) which can affect morbidity and mortality.
Goal-directed perfusion (GDP) intended to avoid the nadir oxygen delivery
index below the critical value is associated with reduced postoperative
AKI. However, current studies suggested that GDP can only decrease the
incidence of AKI stage 1 but showed no effects on AKI stages 2-3 and
mortality. The objective of the present meta-analysis is to deter the
effects of GDP on postoperative AKI in any stage and mortality following
cardiac surgery. METHOD(S): MEDLINE, Embase, and the Cochrane Library
were searched to identify all clinical trials comparing GDP with control
(standard care) during cardiopulmonary bypass conducting in adults
undergoing cardiac surgery. The primary outcome was postoperative acute
kidney injury. Secondary outcomes included postoperative mortality and
length of ICU stay. Data synthesis was obtained by using risk ratio with
95% confidence interval by a random-effects model. RESULT(S): From
1094 potential studies, 3 trials enrolling 777 patients were included.
Meta-analysis suggested the GDP strategy based on DO2i reduced
postoperative AKI compared with standard CPB management (RR = 0.52; 95%
CI: 0.38-0.70; p < .0001), especially in AKI stage I (RR = 0.47; 95% CI:
0.33-0.66; p < .0001). But the GDP strategy did not reduce the incidence
of severe AKI (stages 2-3) and postoperative mortality.
 CONCLUSION(S): The GDP strategy based on DO2i during CPB obviously
reduces AKI stage 1 and thus reduces overall AKI incidence. But it shows
no effects on severe AKI (stages 2-3) and mortality.

<122>
Accession Number
637191823
Title
Cerebral Embolic Protection during Transcatheter Aortic Valve
Implantation: Updated Systemic Review and Meta-Analysis.
Source
Current problems in cardiology. (pp 101127), 2022. Date of Publication:
03 Feb 2022.
Author
Zahid S.; Ullah W.; Zia Khan M.; Faisal Uddin M.; Rai D.; Abbas S.; Usman
Khan M.; Hussein A.; Salama A.; Bandyopadhyay D.; Bhaibhav B.; Rao M.;
Alam M.; Alraies C.; Balla S.; Alkhouli M.; Depta J.P.
Institution
(Zahid, Faisal Uddin, Rai, Hussein, Salama, Bhaibhav, Rao)
Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, NY, USA
(Ullah, Usman Khan) Department of Cardiovascular Medicine, Thomas
Jefferson University Hospitals, PA, Philadelphia, United States
(Zia Khan, Balla) Division of Cardiovascular Medicine, West Virginia
University Heart & Vascular Institute, Morgantown, United States
(Abbas) Department of Medicine, Dow Medical College, Karachi, Pakistan
(Bandyopadhyay) Division of Cardiovascular Medicine, Westchester Medical
Center at New York Medical College, Valhalla, NY, United States
(Alam) Division of Cardiology, Baylor College of Medicine, TX, Houston
(Alraies) Division of Cardiology, Detroit Medical Center, MI, Detroit,
United States
(Alkhouli) Division of Interventional Cardiology, Mayo Clinic, MN,
Rochester, United States
(Depta) Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, NY, USA. Electronic address: salmannazar1312@gmail.com
Publisher
NLM (Medline)
Abstract
BACKGROUND: In patient undergoing transcatheter aortic valve implantation
(TAVI), stroke remains a potentially devastating complication associated
with significant morbidity and mortality. To reduce the risk of stroke,
cerebral protection devices (CPD) were developed to prevent debris from
embolizing to the brain during TAVI. METHODS AND RESULTS: We performed a
systemic review and meta-analysis to determine the safety and efficacy of
CPD in TAVI. The MEDLINE (PubMed, Ovid) and Cochrane databases were
queried with various combinations of medical subject headings to identify
relevant articles. Statistical analysis was performed using a
random-effects model to calculate unadjusted odds ratio (OR), including
subgroup analyses based on follow-up duration, study design, and type of
CPD. Using a pooled analysis, CPD was associated with a significant
reduction in major adverse cardiovascular events MACE (OR 0.75, 95% CI
0.70-0.81, p<0.01), mortality (OR 0.65, 95% CI 0.58-0.74, p<0.01) and
stroke (OR 0.84, 95% CI 0.76-0.93, p<0.01) in patients undergoing TAVI.
Similarly, on MRI volume per lesion were lower for patients with CPD use.
No significant difference was observed in acute kidney injury (OR 0.75,
95% CI 0.42-1.37, p=0.68), bleeding (OR 0.92, 95% CI 0.71-1.20, p=0.55) or
vascular complications (OR 0.90, 95% CI 0.62-1.31, p=0.6) for patients
undergoing TAVI with CPD. CONCLUSION(S): In conclusion, CPD device
use in TAVI is associated with a reduction of MACE, mortality and stroke
compared with patients undergoing TAVI without CPD. However, the
significant reduction in mortality is driven mainly by observational
studies. Copyright © 2022 Elsevier Ltd. All rights reserved.

<123>
Accession Number
637184677
Title
Clinical Characteristics of a Zoonotic Occupational Disease- Brucella
endocarditis with Review of Literature.
Source
Indian Journal of Cardiovascular Disease in Women - WINCARS. (no
pagination), 2022. Date of Publication: 2022.
Author
Anilet V.K.; Tammiraju I.; Koduri M.
Institution
(Anilet, Tammiraju, Koduri) ASRAM Medical College, Andhra Pradesh, Eluru
534005, India
Publisher
Georg Thieme Verlag
Abstract
Background Brucellosis is a zoonotic bacterial infection caused by a
gram-negative aerobic coccobacillus. It can have varied presentation. Most
severe complications include neurological and cardiovascular involvement
(most commonly in the form of infective endocarditis). Aortic valve is
most commonly involved (75%). Blood culture is highly specific, while
serologic tests are more sensitive for diagnosing brucellosis.
Transthoracic and transesophageal echocardiography plays a major role in
diagnosing infective endocarditis. Treatment of Brucella endocarditis
includes combination of antibiotic therapy and surgical valve replacement.
We are presenting here a case series of seven cases of B. endocarditis
with different presentations and varied underlying cardiac conditions.
Materials and Methods Total seven cases of B. endocarditis were reported.
The age group ranges from 22 to 45 years. Majority of them were from
agriculture and dairy industry. All have presented with fever and three
patients had severe breathlessness. Three cases were rheumatic valve
diseases, one was bicuspid aortic valve, and one was congenital heart
disease with prosthetic valve. Six patients had native valve endocarditis
(four had predisposing cardiac condition with diseased valves, two had
normal valves), whereas one had prosthetic valve endocarditis. Four had
aortic valve involvement and three had mitral involvement. All cases were
diagnosed using blood culture, serology, and echocardiography. Conclusion
All were treated initially with antibiotics and valve replacement was done
in five cases. Mortality was the outcome in two cases on conservative
treatment and before surgery. Other five patients recovered after
surgery. Copyright © 2022 American Medical Association. All
rights reserved.

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