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<1>
Accession Number
2017031030
Title
Timing of Intervention in Asymptomatic Aortic Stenosis.
Source
Circulation Journal. 86(3) (pp 376-382), 2022. Date of Publication: 2022.
Author
Lee S.-A.; Kang D.-H.
Institution
(Lee, Kang) Division of Cardiology, Asan Medical Center, College of
Medicine, University of Ulsan, Seoul, South Korea
Publisher
Japanese Circulation Society
Abstract
The decision to perform an intervention for asymptomatic severe aortic
stenosis (AS) requires careful weighing of the risks of early intervention
against those of watchful observation, and the optimal timing of
intervention remains controversial. With improvements in surgical and
postoperative care, long-term survival after surgical aortic valve (AV)
replacement (AVR) is excellent in low-risk patients, and the emergence of
transcatheter AVR may change the thresholds for early preemptive
intervention, although a durability issue has to be resolved. A watchful
observation strategy also has a risk of sudden death, irreversible
myocardial damage, and increase in operative risk while waiting for
symptoms to develop. We have been waiting for a prospective randomized
trial to solve the intense debate between early AVR and watchful
observation, and the RECOVERY (Randomized Comparison of Early Surgery
versus Conventional Treatment in Very Severe Aortic Stenosis) trial
provides the evidence to support early AVR for asymptomatic severe AS.
Risk assessment with severity of AS and staging classification may help to
facilitate the identification of patients who may benefit from early
intervention. Based on the results of the RECOVERY trial, early surgical
AVR is reasonable for asymptomatic patients with very severe AS (aortic
jet velocity >=4.5 m/s) and low surgical risk. Further evidence is
required to extend the indications of surgical AVR and to consider
transcatheter AVR in asymptomatic patients with severe AS. Copyright
© 2022 Japanese Circulation Society. All rights reserved.

<2>
Accession Number
2010642803
Title
Outcomes of Transcarotid Versus Trans-Subclavian Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 33 (pp 20-25), 2021. Date of
Publication: December 2021.
Author
Amer M.R.; Mosleh W.; Megaly M.; Shah T.; Ooi Y.S.; McKay R.G.
Institution
(Amer, Ooi) Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Mosleh) University of Connecticut, Farmington, CT, United States
(Megaly) Banner University Medical Center- UA College of Medicine,
Phoenix, AZ, United States
(Shah) St. Vincent's Hospital, Worcester, MA, United States
(McKay) Heart and Vascular Institute, Hartford Hospital, Hartford, CT,
United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study aimed to perform the first meta-analysis of studies
comparing transcarotid (TC) and trans-subclavian (TSc) transcatheter
aortic valve replacement (TAVR). Background(s): The safety and
feasibility of a TC and a TSc approach for performing TAVR in patients
with prohibitive femoral anatomy have been well described. The potential
advantage of one approach over the other is yet to be ascertained.
 Method(s): A computerized literature search of key medical databases
through September 2020 was performed. Randomized controlled trials (RCTs)
and observational studies comparing TC and TSc TAVR with reported 30-day
outcomes were considered. The primary endpoint was a composite of
all-cause mortality, stroke, life-threatening, and/or major bleeding or
major vascular complications. Statistical analysis using random-effects
models to report the odds ratio (OR) with 95% confidence interval (CI) was
performed. Result(s): A total of 5 observational studies inclusive of
4164 patients (TC = 1788 and TSc = 2376) met the eligibility criteria. The
average age of patients was 81.1 years. There was no difference in the
occurrence of the composite endpoint between the groups at 30-days. A
statistically insignificant trend towards higher rates of major vascular
complications (OR 1.65; 95% CI 0.94-2.89; P = 0.08; I2 = 0%)
and the need for permanent pacemaker placement was observed with the TSc
approach. Conclusion(s): This meta-analysis of studies comparing TC
and TSc TAVR showed similar 30-day outcomes between the 2 approaches. A
notable trend towards higher rates of major vascular complications and the
need for permanent pacemaker placement was observed with the TSc
approach. Copyright © 2021 Elsevier Inc.

<3>
Accession Number
2013446865
Title
Thoracic bone mineral density measured by quantitative computed tomography
in patients undergoing spine surgery.
Source
Spine Journal. 21(11) (pp 1866-1872), 2021. Date of Publication: November
2021.
Author
Salzmann S.N.; Okano I.; Jones C.; Basile E.; Iuso A.; Zhu J.; Reisener
M.-J.; Chiapparelli E.; Shue J.; Carrino J.A.; Girardi F.P.; Cammisa F.P.;
Sama A.A.; Hughes A.P.
Institution
(Salzmann, Okano, Jones, Basile, Iuso, Zhu, Reisener, Chiapparelli, Shue,
Carrino, Girardi, Cammisa, Sama, Hughes) Spine Care Institute, Hospital
for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York,
NY 10021, United States
Publisher
Elsevier Inc.
Abstract
BACKGROUND CONTEXT: The thoracic spine is a common location for vertebral
fractures as well as instrumentation failure after long spinal fusion
procedures. The association between those complications and bone mineral
density (BMD) are well recognized. Due to the overlying sternum and ribs
in the thoracic spine, projectional BMD assessment tools such as dual
energy x-ray absorptiometry (DXA) are limited to the lumbar spine.
Quantitative computed tomography circumvents several shortcomings of DXA
and allows for level-specific BMD measurements. Studies comprehensively
quantifying BMD of the entire thoracic spine in patients undergoing spine
surgery are limited. PURPOSE: The objective of this study was: (1) to
assess the reliability of thoracic QCT measurements, (2) to determine
possible level-specific BMD variation throughout the thoracic spine and
(3) to assess the correlation between BMDs of the T1-T12 spinal levels.
STUDY DESIGN/SETTING: Cross-sectional observation study. PATIENT SAMPLE:
Patients undergoing spine surgery from 2016-2020 at a single, academic
institution with available preoperative CT imaging of the thoracic spine
were included in this study. OUTCOME MEASURES: The outcome measure was BMD
measured by QCT. METHOD(S): Patients undergoing spine surgery from
2016-2020 at a single, academic institution with available preoperative CT
imaging of the thoracic spine were included in this study. Subjects with
previous instrumentation at any thoracic level, concurrent vertebral
fractures, a Cobb angle of more than 20 degrees, or incomplete thoracic
spine CT imaging were excluded. Asynchronous quantitative computed
tomography (QCT) measurements of T1-T12 were performed. To assess inter-
and intra-observer reliability, a validation study was performed on 120
vertebrae in 10 randomly selected patients. The interclass correlation
coefficient (ICC) was calculated. A pairwise comparison of BMD was
conducted and correlations between each thoracic level were evaluated. The
statistical significance level was set at p<.05. RESULT(S): 60
patients (men, 51.7%) met inclusion criteria. The study population was 90%
Caucasian with a mean age of 62.2 years and a mean BMI of 30.2
kg/m2. The inter- and intra-observer reliability of the
thoracic QCT measurements was excellent (ICC of 0.97 and 0.97,
respectively). The trabecular BMD was highest in the upper thoracic spine
and decreased in the caudal direction (T1 = 182.3 mg/cm3, T2 =
168.1 mg/cm3, T3 = 163.5 mg/cm3, T4 = 164.7
mg/cm3, T5 = 161.4 mg/cm3, T6 = 152.5
mg/cm3, T7 = 143.5 mg/cm3, T8 = 141.3
mg/cm3, T9 = 143.5 mg/cm3, T10 = 145.1
mg/cm3, T11 = 145.3 mg/cm3, T12 = 133.6
mg/cm3). The BMD of all thoracic levels cranial to T6 was
statistically higher than the BMD of all levels caudal to T6 (p <.001).
Nonetheless, significant correlations in BMD among all measured thoracic
levels were observed, with a Pearson's correlation coefficient ranging
from 0.74 to 0.97. CONCLUSION(S): There is significant regional BMD
variation in the thoracic spine depending on spinal level. This BMD
variation might contribute to several clinically relevant phenomena.
First, vertebral fractures occur most commonly at the thoracolumbar
junction including T12. In addition to mechanical reasons, these fractures
might be partially attributed to thoracic BMD that is lowest at T12.
Second, the optimal upper instrumented vertebra (UIV) for stopping long
fusions to the sacrum and pelvis is controversial. The BMD of surgically
relevant upper thoracic stopping points (T2-T4) was significantly higher
than the BMD of lower thoracic stopping points (T10-T12). Besides stress
concentration at the relatively mobile lower thoracic segments, the low
BMD at these levels might contribute to previously suggested higher rates
of junctional failures with short fusions. Copyright © 2021
Elsevier Inc.

<4>
Accession Number
635935221
Title
Percutaneous Coronary Intervention with Stenting versus Coronary Artery
Bypass Grafting in Stable Coronary Artery Disease.
Source
International Journal of Angiology. 30(3) (pp 221-227), 2021. Date of
Publication: 01 Sep 2021.
Author
Glenn I.C.; Iacona G.M.; Mangi A.A.
Institution
(Glenn) Department of Thoracic and Cardiovascular Surgery, Heart,
Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
(Iacona, Mangi) Medstar Health Cardiac Surgery, Heart and Vascular
Institute, Medstar Washington Hospital Center, 110 Irving Street
Northwest, Washington, DC 20010, United States
Publisher
Thieme Medical Publishers, Inc.
Abstract
The debate over coronary artery bypass grafting (CABG) or percutaneous
coronary intervention (PCI) with stent placement for the treatment of
stable multivessel coronary artery disease (CAD) continues in spite of
numerous studies investigating the issue. This paper reviews the most
recent randomized control trials (RCT) and meta-analyses of pooled RCT
data to help address this issue. General trends demonstrated that CABG was
superior in all-cause mortality and fulfilling the need for repeat
revascularization. These advantages tended to be more pronounced in
multivessel CAD and diabetes, and less so in left main CAD. PCI showed a
consistently lower rate of cerebrovascular events. CABG continues to offer
significant advantages over PCI, even as drug-eluting stent technology
continues to evolve. The ideal endpoint for comparing PCI and CABG remains
to be determined. Furthermore, additional research is required to further
refine patient selection criteria for each intervention. Copyright
© 2021. International College of Angiology. All rights reserved.

<5>
Accession Number
635866431
Title
Effect of Remote Ischemic Conditioning on Bleeding Complications in
Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Thrombosis and Hemostasis. 48(2) (pp 229-239), 2022. Date of
Publication: 01 Mar 2022.
Author
Krag A.E.; Hvas C.L.; Kiil B.J.; Hvas A.-M.
Institution
(Krag, Hvas) Thrombosis and Hemostasis Research Unit, Department of
Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
(Krag, Hvas) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
(Krag, Kiil) Department of Plastic and Breast Surgery, Aarhus University
Hospital, Denmark
(Hvas) Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Remote ischemic conditioning (RIC) is administered with an inflatable
tourniquet by inducing brief, alternating cycles of limb ischemia and
reperfusion. RIC possibly impacts the hemostatic system, and the
intervention has been tested as protective therapy against
ischemia-reperfusion injury and thrombotic complications in cardiac
surgery and other surgical procedures. In the present systematic review,
we aimed to investigate the effect of RIC on intraoperative and
postoperative bleeding complications in meta-analyses of randomized
controlled trials including adult patients undergoing surgery. A
systematic search was performed on November 7, 2020 in PubMed, Embase, and
the Cochrane Central Register of Controlled Trials. Randomized controlled
trials comparing RIC versus no RIC in adult patients undergoing surgery
that reported bleeding outcomes in English publications were included.
Effect estimates with 95% confidence intervals were calculated using the
random-effects model for intraoperative and postoperative bleeding
outcomes. Thirty-two randomized controlled trials with 3,804 patients were
eligible for inclusion. RIC did not affect intraoperative bleeding volume
(nine trials; 392 RIC patients, 399 controls) with the effect
estimate-0.95 [-9.90; 7.99] mL (p = 0.83). RIC significantly reduced
postoperative drainage volume (seven trials; 367 RIC patients, 365
controls) with mean difference-83.6 [-134.9;-32.4] mL (p = 0.001). The
risk of re-operation for bleeding was reduced in the RIC group (16 trials;
838 RIC patients, 839 controls), albeit not significantly, with the
relative risk 0.65 [0.39; 1.09] (p = 0.10). In conclusion, RIC reduced
postoperative bleeding measured by postoperative drainage volume in this
meta-analysis of adult patients undergoing surgery. Copyright ©
2021 Thieme. All rights reserved. Thieme Medical Publishers, Inc.

<6>
Accession Number
637426398
Title
Safety and efficacy of anti-inflammatory therapy in patients with coronary
artery disease: a systematic review and meta-analysis.
Source
BMC cardiovascular disorders. 22(1) (pp 84), 2022. Date of Publication: 04
Mar 2022.
Author
Niu Y.; Bai N.; Ma Y.; Zhong P.-Y.; Shang Y.-S.; Wang Z.-L.
Institution
(Niu, Bai, Ma, Zhong, Shang) First Clinical Medical College of Lanzhou
University, Lanzhou, China
(Wang) Department of Cardiology, First Hospital of Lanzhou University, No.
1 ,Donggang West Road ,Chengguan District, Lanzhou, Gansu 730000, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The inflammation hypothesis of atherosclerosis has been put
forward for more than 20 years. Although many animal experiments have
suggested that anti-inflammatory therapy can inhibit the atherosclerotic
process, the efficacy of anti-inflammatory therapy for patients with
coronary artery disease (CAD) is still controversial. Therefore, this
study aims to evaluate the safety and efficacy of anti-inflammatory drugs
in patients with CAD. METHOD(S): We conducted this systematic review
and meta-analysis of randomized controlled trials by searching PubMed,
EMBASE, web of science, and Cochrane Library database. The primary outcome
was a composite outcome of cardiovascular death, myocardial infarction
(MI), or stroke. The secondary outcomes included individual MI, coronary
revascularization, cardiovascular death, all-cause death, and stroke. The
relative risk (RR) and 95% confidence intervals (CI) for outcome events
were calculated by the fixed effects model, and trial sequential analysis
was applied to assess the results. RESULT(S): A total of ten
randomized controlled trials and 60,782 patients with CAD was included.
Compared with patients receiving placebo, anti-inflammatory therapy
significantly reduced the incidence of the primary outcome in patients
with CAD (RR 0.93, 0.89-0.98, P=0.007). In addition, the anti-inflammatory
therapy can also reduce the risk of MI (RR 0.90, 0.84-0.96, P=0.002) and
coronary revascularization (RR 0.74, 0.66-0.84, P<0.00001) remarkably.
However, there was no significant difference in the incidence of
cardiovascular death (RR 0.94, 0.86-1.02, P=0.14), all-cause death (RR
1.00, 0.94-1.07, P=0.98) and stroke (RR 0.96, 0.85-1.09, P=0.51) between
two groups. CONCLUSION(S): Anti-inflammatory therapy can reduce the
incidence of the primary outcome in patients with CAD, especially the risk
of MI and coronary revascularization. However, anti-inflammatory therapy
increases the risk of infection. (Registered by PROSPERO, CRD
420212291032). Copyright © 2022. The Author(s).

<7>
Accession Number
2017103678
Title
The Effect of Erector Spinae Plane Block and Combined Deep and Superficial
Serratus Anterior Plane Block on Acute Pain After Video-Assisted
Thoracoscopic Surgery: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Zengin M.; Sazak H.; Baldemir R.; Ulger G.; Alagoz A.
Institution
(Zengin, Sazak, Baldemir, Ulger, Alagoz) University of Health Sciences,
Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research
Hospital, Anesthesiology and Reanimation Clinic, Ankara, Turkey
Publisher
W.B. Saunders
Abstract
Objective: The study aimed to compare the analgesic effects of erector
spinae plane block (ESPB) and a combination of the deep and superficial
serratus anterior plane block (C-SAPB) methods in patients who underwent
video-assisted thoracoscopic surgery (VATS). Design(s): A
prospective, randomized study. Setting(s): At a single-center,
high-volume, tertiary thoracic surgery center. Participant(s): Adult
patients undergoing VATS. Intervention(s): Ultrasound-guided ESPB and
C-SAPB. Measurements and Main Results: Patients were assigned to ESPB
(group 1) or C-SAPB (group 2) groups according to the analgesia protocol.
All interventions were performed with single-needle insertion. Multimodal
analgesia was achieved via paracetamol, dexketoprofen, and intravenous
morphine for both study groups. Pain scores were assessed by the visual
analog scale (VAS). Morphine consumption, rescue analgesic requirements,
and side effects were recorded postoperatively for 24 hours. The primary
outcome was determined as VAS scores at rest and coughing. The secondary
outcomes of this study were postoperative morphine consumption and the
requirement of rescue analgesics. There was no statistically significant
difference between the groups in terms of VAS scores (p > 0.05). The
groups also were similar in terms of demographic characteristics, side
effects, morphine consumption, additional analgesic use, and duration of
block procedures (p > 0.05). There also were comparable results in terms
of hemodynamic variables (p > 0.05). Conclusion(s): Patients who
underwent VATS receiving ESPB or C-SAPB had similar pain scores, opioid
consumption, and side effects during the first postoperative 24 hours. At
the same time, the fact that the duration of the block procedure was
similar in both groups showed that multisite serratus anterior plane block
can be an effective alternative method in analgesic treatment after VATS,
considering that it easily can be applied. The authors here think that
C-SAPB can be a good alternative to ESPB because the outcomes of both
applications are similar, and C-SAPB easily can be seen and applied with
ultrasound. Copyright © 2022 Elsevier Inc.

<8>
Accession Number
2013824836
Title
Dual Filter Cerebral Embolic Protection (CEP) for Stroke Prevention During
Transcatheter Aortic Valve Implantation (TAVI): A Meta-Analysis.
Source
Heart Lung and Circulation. Conference: 69th CSANZ Annual Scientific
Meeting 43rd Annual Scientific Meeting of the International Society for
Heart Research ANZET 21. Virtual, Online. 30(Supplement 3) (pp S300),
2021. Date of Publication: January 2021.
Author
Mugde M.; Walton A.; Vriesendorp P.; Simmonds M.
Institution
(Mugde) THEMA Consulting, Pyrmont, NSW, Australia
(Walton, Vriesendorp) The Alfred, Melbourne, VIC, Australia
(Simmonds) Boston Scientific, Mascot, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Objectives: Stroke is a leading cause of disability in Australia [1], with
5.3% of deaths attributed to stroke in 2018 [2]. The Sentinel CEP System
is a dual-filter device used with TAVI in patients with aortic stenosis
(AS) to capture and remove embolic material dislodged during the
procedure, aiming to reduce peri-procedural ischaemic strokes. The
objective is to compare the clinical outcomes following TAVI when used
with CEP (TAVI+CEP) versus TAVI without the CEP. Method(s): A
systematic review was undertaken to identify all comparative trials of
TAVI+CEP and TAVI alone. The study limitations were assessed using the
GRADE (Grading of Recommendations, Assessment, Development and
Evaluations) approach. Peri-procedural outcomes, including stroke,
mortality, major vascular complications, and acute kidney injury (AKI)
were analysed using the random effects method. Result(s): Three
randomised controlled trials (SENTINEL IDE [3], CLEAN TAVI [4], MISTRAL-C
[5]) and two propensity score matched cohort studies (SENTINEL-Ulm [6],
Kroon 2019 [7]) were identified and included in the meta-analysis. A
statistically significant difference in peri-procedural 'all stroke' rates
was identified between TAVI+CEP (2.7%) and TAVI alone (4.7%) (OR; 95% CI:
0.49; 0.28, 0.85; p=0.01). Similarly, TAVI+CEP (0.55%) was associated with
a statistically significantly lower peri-procedural disabling stroke rate
compared with TAVI alone (2.1%) (0.30; 0.10, 0.92; p=0.04). No
statistically significant differences in peri-procedural rates of
non-disabling stroke, all-cause mortality, major vascular complications,
and AKI were detected. Conclusion(s): The results from this
meta-analysis suggest that TAVI+CEP is a safe procedure, and associated
with lower rates of peri-procedural stroke compared to TAVI
alone. Copyright © 2021

<9>
Accession Number
2013824776
Title
The Effect of Radiation Exposure on Cancer Development Among
Interventional Cardiologists: A Literature Review.
Source
Heart Lung and Circulation. Conference: 69th CSANZ Annual Scientific
Meeting 43rd Annual Scientific Meeting of the International Society for
Heart Research ANZET 21. Virtual, Online. 30(Supplement 3) (pp S207),
2021. Date of Publication: January 2021.
Author
Nair J.
Institution
(Nair) Townsville University Hospital, Townsville, Qld, Australia
Publisher
Elsevier Ltd
Abstract
Background: Cardiac catheterisation procedures including coronary
angiogram and angioplasty confer occupational health risks to performing
interventional cardiologists. The aim of this review is to investigate the
association between radiation exposure among interventional cardiologists
and development of cancer. Method(s): This systematic review was
conducted with reference to the Preferred Reporting Items for Systematic
reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE/PubMed (US National
Library of Medicine, MD, USA), PsychINFO and PROQUEST were searched with
the terms: malignancy, cancer, interventional cardiologists, radiation,
and exposure. Result(s): Two hundred and twenty-six studies were
identified, and 33 articles were evaluated against the eligibility
criteria. 7 eligible studies were included in this review. This review
demonstrates a potential link between cancer, particularly brain cancer
and radiation exposure, among interventional cardiologists (p<0.05). An
increased incidence of left-sided brain cancer among operators associated
with increased radiation exposure to the left side of the brain was found.
There was no evidence suggesting an association between radiation exposure
and other malignancies (thyroid and haematological) among interventional
cardiologists compared to the general population. Conclusion(s):
There is limited literature evaluating the relationship between exposure
to radiation and cancer development among interventional cardiologists.
Further research is warranted to study potential links between, radiation
exposure and different types of cancer; and secondly, the use of personal
protective equipment and other strategies in Australia to reduce exposure
of radiation among interventional cardiologists. Copyright © 2021

<10>
Accession Number
2013824718
Title
Systematic Review of Clinician Created Video in Patient Education.
Source
Heart Lung and Circulation. Conference: 69th CSANZ Annual Scientific
Meeting 43rd Annual Scientific Meeting of the International Society for
Heart Research ANZET 21. Virtual, Online. 30(Supplement 3) (pp S291),
2021. Date of Publication: January 2021.
Author
Bettler T.; Chow C.; Kim S.; McIntyre D.; Kulkarni R.; Thiagalingam A.
Institution
(Bettler, Chow, Kim, McIntyre, Kulkarni, Thiagalingam) Cardiology
Department Westmead Hospital, Westmead, NSW, Australia
(Bettler, Chow, McIntyre, Kulkarni, Thiagalingam) Westmead Applied
Research Centre (WARC), University of Sydney, Westmead, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Digital media is an emerging tool that clinicians can use to
empower patients and increase their engagement with disease management. In
particular, the use of clinician created video is emerging as a valuable
adjuvant in patient education. Aim(s): Assess the impact of clinician
created video on patient knowledge, markers of patient outcomes and
explore themes to inform future creation in cardiology-based content.
 Method(s): This review was conducted following the PRISMA statement
for systematic reviews. A search of the PubMed and Cochrane databases were
conducted using the terms 'video', 'patient' and 'education'. Randomised,
controlled studies that delivered clinician-created video as an adjuvant
to standard verbal education were included. A date-restriction was set
between 2015 and 2021. Result(s): The search identified 111 studies,
and 35 were included. Most were small (largest study n = 821), and single
centre. Patients were blinded in only a single study. Clinician-created
video significantly improved patient knowledge (Z = 7.22, p < 0.00001),
decreased periprocedural anxiety (Z = 2.60, p = 0.009), and increased
satisfaction with care (Z = 4.64, p < 0.00001). Interaction with
cardiovascular clinical outcomes were identified including increased
knowledge of cardiac conditions, reduction in anxiety prior to invasive
cardiac procedures, and improved symptom control and recovery following
myocardial infarction. Conclusion(s): Clinician-created video content
improves knowledge, anxiety, satisfaction and may have a significant
impact on cardiovascular clinical outcomes. Though given the small number
of studies in any one field, larger studies are needed to determine their
efficacy at scale within cardiology-based medicine. Copyright ©
2021

<11>
Accession Number
637428458
Title
Short term outcomes with mitraclip in women compared with men: Evidence
from a meta-analysis.
Source
Journal of the Hong Kong College of Cardiology. Conference: 28th Annual
Scientific Congress of the Hong Kong College of Cardiology. Virtual. 28(1)
(pp 41), 2020. Date of Publication: April 2020.
Author
Khalid Y.; Dasu N.; Dasu K.
Institution
(Khalid, Dasu) Rowan University, United States
(Dasu) Syracuse University, United States
Publisher
Medcom Limited
Abstract
Objectives: This study sought to examine short-term outcomes with
transcatheter mitraclip in women versus men. Background(s): MitraClip
is now approved for severe functional mitral regurgitation in high-risk
patients with contraindications to surgical mitral valve repair. Previous
studies have shown conflicting results with respect to sex differences in
outcomes with the MitraClip. Method(s): Electronic search was
performed until April 2020 for studies reporting outcomes with MitraClip
in women versus men. Random effects DerSimonian-Laird odds ratios were
calculated. Outcomes included all-cause mortality and major cardiovascular
events at short-term follow-up (in hospital or 30 days) as well as
complications. Result(s): Six studies (4 MitraClip registries; 2344
patients; 925 women) were analyzed. Women were older but exhibited fewer
comorbidities. At 30 days, men had more stroke (p<0.0347) and major
vascular complications (p<0.042), without a difference in all-cause and
cardiovascular mortality (OR 1.31, 0.67-2.57, p<0.43) compared with men.
There was no difference in pericardial effusion/cardiac tamponade
(p<0.311) or acute renal failure (p<0.805). However, for 4 of the studies,
female sex was associated with lower all-cause mortality at 1 year
(p=0.01), potentially caused by less moderate/severe aortic insufficiency
(p=0.001), and lower cardiovascular mortality (p=0.009). The female
survival advantage remained consistent across multiple secondary analyses.
The risk of stroke, moderate/severe aortic insufficiency, and all-cause
mortality seemed to vary based on the type of valve used; however, without
significant subgroup interactions. Conclusion(s): Despite conflicting
data, women experience better short-term outcomes with the MitraClip
repair.

<12>
Accession Number
637428457
Title
Transcatheter tricuspid valve replacement and repair: Pooled analysis of
the outcomes and complications of novel emerging treatments.
Source
Journal of the Hong Kong College of Cardiology. Conference: 28th Annual
Scientific Congress of the Hong Kong College of Cardiology. Virtual. 28(1)
(pp 41), 2020. Date of Publication: April 2020.
Author
Khalid Y.; Dasu N.; Dasu K.
Institution
(Khalid, Dasu) Rowan University, Stratford, United States
(Dasu) Syracuse University, Syracuse, United States
Publisher
Medcom Limited
Abstract
Background: Tricuspid regurgitation is a poor prognostic marker of
end-stage heart failure. Treatment options for severe tricuspid
regurgitation are currently limited because these procedures have the
highest mortality rates of all valve procedures. Transcatheter tricuspid
valve repair or replacement (collectively, TVTT), on the other hand, are
extremely promising interventions due to the minimally invasive nature of
these treatments. Objective(s): The aim of this study is to examine
the complications of these procedures from day 0 of procedure to up to 1
year of follow up. Method(s): Six studies were included from 3
registries (TriVALVE, TRILUMINATE, TRAMI), surveying a total of 336
patients. Complications following the procedures were pooled and analyzed.
 Result(s): From procedure to up to 1 year, there was 14.3% mortality
(49/342), 0.3% incidence of myocardial infarction and TIA/stroke (1/342),
2% device embolization and/or leaflet detachment (7/342), 5.2% major/minor
bleeding (18/342), 0.9% AKI (3/342), 1.1% infections and arrhythmias
(4/342). Conclusion(s): Despite a narrow sample size due to the
novelty of these procedures and varying lengths of follow-up (30 days to 1
year), trans-catheter tricuspid valve repair and replacement prove to be
promising interventions. Mortality was significant at 14.6%, but patients
with severe tricuspid regurgitation have a poor prognosis overall without
intervention along with higher comparative mortality rates. Research aimed
at further investigating TVTT procedures and prospective clinical trials
to establish these treatments as mainstays for severe tricuspid
regurgitation is necessary.

<13>
Accession Number
637428455
Title
Meta-analysis of cardiovascular outcomes in clinical trials on
apabetalone.
Source
Journal of the Hong Kong College of Cardiology. Conference: 28th Annual
Scientific Congress of the Hong Kong College of Cardiology. Virtual. 28(1)
(pp 40), 2020. Date of Publication: April 2020.
Author
Li H.L.; Fei Y.; Feng Q.; Cheung B.M.Y.
Institution
(Li, Fei, Feng, Cheung) Department of Medicine, University of Hong Kong,
Queen Mary Hospital, Hong Kong, Hong Kong
Publisher
Medcom Limited
Abstract
Background: Apabetalone is a novel drug that reduces inflammation and
thrombosis by inhibiting bromodomain and extra-terminal proteins (BET)
that regulate transcription. Three phase II trials suggested
cardiovascular benefits of apabetalone whereas a recent phase III trial,
BETonMACE (Ray et al. JAMA 2020 March 27), failed to show significant
benefit. To reconcile these inconsistencies, we performed a meta-analysis
of all trials on apabetalone. Method(s): MEDLINE, EMBASE, Cochrane
Library, and ClinialTrials. gov were searched for randomised controlled
trials of apabetalone up to May 05, 2020. The outcomes of interest were
major adverse cardiovascular events (MACE) and hospitalisation for heart
failure. The secondary outcomes were death, myocardial infarction (MI),
and coronary revascularisation. Risk ratios (RRs) and 95% confidence
intervals (CIs) were pooled with fixed-effects model using "meta" package
in R (version 3.6.3). Result(s): Four trials with altogether 3223
patients were finally included. All patients had documented coronary
artery disease and received standard statin therapy. The median follow-up
duration ranged from 12 weeks to 26.5 months. Apabetalone significantly
reduced MACE (RR 0.78, 95% CI: 0.63-0.96) and hospitalisation for heart
failure (RR 0.48, 95% CI: 0.33-0.70) compared to placebo. No statistically
significant difference was observed for death (RR 0.87, 95% CI:
0.63-1.21), MI (RR 0.82, 95% CI: 0.62-1.10), and coronary
revascularisation (RR 0.67, 95% CI: 0.31-1.49). There was no significant
heterogeneity among the included trials. Conclusion(s): Although the
BETonMACE trial failed to demonstrate significant benefits, our
meta-analysis incorporating evidence from three earlier trials shows that
apabetalone may reduce MACE and hospitalisation for heart failure in
patients with coronary artery disease. While it is too early to recommend
apabetalone for clinical use, larger outcome trials are urgently needed to
investigate the benefits of epigenetic modulation through BET protein
inhibition.

<14>
Accession Number
637428395
Title
28th Annual Scientific Congress Hong Kong College of Cardiology.
Source
Journal of the Hong Kong College of Cardiology. Conference: 28th Annual
Scientific Congress of the Hong Kong College of Cardiology. Virtual. 28(1)
(no pagination), 2020. Date of Publication: April 2020.
Author
Anonymous
Publisher
Medcom Limited
Abstract
The proceedings contain 65 papers. The topics discussed include: risk of
ventricular arrhythmia in improved left ventricular ejection fraction in
implantable cardioverter-defibrillator for primary prevention; total
aortic arch replacement and frozen elephant trunk: mid-term and second
stage surgery outcomes; what demographic factors influence participation
in a randomized controlled trial on prehabilitation for cardiac surgery?;
effect of homocysteine on the KCa channel family in human internal mammary
artery; influenza activity and ST-segment elevation myocardial infarction
incidence in Hong Kong; long term survival of one hundred left ventricular
assist device recipients in Hong Kong; and early clinical experience with
the rapid deployment intuity valve for surgical aortic valve replacement.

<15>
Accession Number
637428372
Title
What demographic factors influence participation in a randomised
controlled trial on prehabilitation for cardiac surgery?.
Source
Journal of the Hong Kong College of Cardiology. Conference: 28th Annual
Scientific Congress of the Hong Kong College of Cardiology. Virtual. 28(1)
(pp 19), 2020. Date of Publication: April 2020.
Author
Yau D.K.W.; Underwood M.J.; Joynt G.M.; Lee A.
Institution
(Yau, Joynt, Lee) Department of Anaesthesia and Intensive Care, Chinese
University of Hong Kong, Hong Kong, Hong Kong
(Underwood) Division of Cardiothoracic Surgery, Department of Surgery,
Chinese University of Hong Kong, Hong Kong, Hong Kong
(Yau, Joynt) Department of Anaesthesia and Intensive Care, Prince of Wales
Hospital, Hong Kong, Hong Kong
Publisher
Medcom Limited
Abstract
Background: The ongoing PREQUEL study examines the effect of a
hospital-based physical prehabilitation program before cardiac surgery to
improve frailty and hence postoperative recovery. The objective of this
sub-study was to assess the association between baseline factors and
successful study participation. Method(s): This is a stratified RCT
(ChiCTR1800016098) at a university hospital in Hong Kong. 153 pre-frail
and frail patients (Clinical Frailty Scale [CFS] 4-6) who met the
eligibility criteria were invited to participate in the trial between July
2018 and March 2020. Non-participants were defined as: inability to
regularly attend, or indecisive/refusal to participate. Mobility status
was classified as good (independent outdoor walker) or poor (homebound).
Driving distance from home to hospital was estimated using Google Maps
software. Demographic and baseline clinical data differences between
participation groups were analysed using appropriate univariate tests.
 Result(s): There were 81 (52.9%) participants and 72 (47.1%)
non-participants during the 21-month period. Study participation groups
were similar for mean age (P=0.29), gender (P=0.58), occupation (P=0.27),
education level (P=0.84), living alone (P=0.44), regular exercise habits
(P=0.24), types of surgery (P=0.73), median frailty level (P=0.42), median
left ventricular ejection fraction (P=0.75) and median number of
cardiovascular risk factors (P=0.11). Poor mobility status was associated
with the study participation, with no homebound participants recruited
into the study (P=0.047). Participation rates varied across districts
(33-100%), with 3 patients living across the border. For Hong Kong-based
patients, study participants lived closer to the hospital than
non-participants (n=150; median [IQR]: 21.8 km [7.5-32.0 km] vs 30.4 km
[13.3-34.8 km]; P=0.02). Patients who lived <=20 km of the hospital were
more likely to participate in RCT than those living >20 km away (RR: 1.49,
95% CI: 1.12-1.99). Conclusion(s): Good mobility status and closer
residential distance from the hospital were associated with successful RCT
participation. Recruitment strategies that address ambulatory and
transport difficulties may increase the participation of patients living
far away from the hospital.

<16>
Accession Number
2017071190
Title
The Outcomes of Patients Incidentally Confirmed with Covid-19 after
Cardiac Surgery.
Source
Heart Surgery Forum. 24(6) (pp E940-E946), 2021. Date of Publication:
2021.
Author
Uysal A.; Erturk E.; Abacilar A.F.; Duman U.; Dogan O.F.
Institution
(Uysal) Firat University, Medical Faculty, Cardiovascular Surgery Clinic,
Elazig, Turkey
(Erturk) The Health Science University, Mersin City Hospital, Department
of Cardiovascular Surgery, Mersin, Turkey
(Abacilar) The Private Izmir Su Hospital, Department of Cardiovascular
Surgery, Izmir, Turkey
(Duman) Private Tekirdag Hospital, Department of Cardiovascular Surgery,
Tekirdag, Turkey
(Dogan) Adiyaman University School of Medicine, Department of
Cardiovascular Surgery, Adiyaman, Turkey
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: The aim of this study was to investigate the clinical outcomes
of cardiac surgery in patients who were incidentally diagnosed with
Covid-19 in the postoperative period. Patients and Methods: We
performed 826 open cardiac surgeries in five tertiary centers. Most of the
surgeries were elective coronary artery bypass grafting (CABG) (93.8%). A
preoperative RT-PCR test and transcutaneous oxygen saturation were
routinely investigated prior to surgery. We also investigated whether the
patients already received Covid-19 treatment or had any contact with a
Covid-19 patient in the last two weeks. We analyzed high sensitive
C-reactive protein (hs-CRP), d-dimer, and fibrinogen, which plays a main
role in the activation of procoagulant state after surgeries.
 Result(s): Acute lung injury related to Covid-19 activation was
observed in 48 out of 826 patients (5.8%). The median age of 48 patients
was 63.9+/-12.4 years. Euro-Score and body mass index (BMI) were 6.1+/-1.1
and 29.2+/-4.1kg/m2 respectively. RT-PCR test results were
positive in 29 patients (60.4%). We performed thoracic computed tomography
(CT) in all patients with or without positive RT-PCR test results.
Thoracic CT images showed that there was a different degree of ARDS (mild,
moderate, and serious). The median time of extracorporeal circulation
(ECC) was 93.2+/-14.6 min. in on-pump surgery (IQR, 68-155 min.). Common
symptoms included dyspnea (N = 22; 45.8%) and fever (N = 12; 25%). Eleven
patients needed readmission to ICU. Compared with non-admitted to ICU
patients, ICU patients were higher comorbidities and severe laboratory
abnormalities (eg, high blood d-dimer and fibrinogen). We also detected
significantly low oxygen saturation, hypercapnia, and severe acidosis in
readmitted patients. Radiologic investigations showed that there were
severe ARDS with bilateral pneumonic infiltration resistant to medical
treatment in 6 out of 11 patients who died (54.5%). Conclusion(s):
Diffuse pneumonic infiltration related to Covid-19 may develop in
asymptomatic cardiac surgery patients with negative RT-PCR test results.
Immunologic disorders resulting from ECC, physiologic distress, and
anesthesia may activate Covid-19 during incubation period. We need
randomized clinical trials to explain Covid-19 activation in latent period
of the virus, and clinical outcomes in cardiac surgery. Copyright
© 2021 Forum Multimedia Publishing LLC. All rights reserved.

<17>
Accession Number
2015199578
Title
Network meta-analysis comparing blood cardioplegia, Del Nido cardioplegia
and custodiol cardioplegia in minimally invasive cardiac surgery.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Chan J.; Oo S.; Butt S.; Benedetto U.; Caputo M.; Angelini G.D.; Vohra
H.A.
Institution
(Chan, Oo, Benedetto, Angelini, Vohra) Department of Cardiac Surgery,
Bristol Heart Institute, Bristol, United Kingdom
(Butt) Department of Perfusion Sciences, St George's Hospital, London,
United Kingdom
(Caputo) Department of Cardiac Surgery, Bristol Royal Hospital for
Children, Bristol, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Introduction: Minimally invasive cardiac surgery has been evolving, with
the intention of reducing surgical trauma, improve cosmesis and patient
satisfaction. Single dose, crystalloid cardioplegia such as Del Nido
cardioplegia and Custoidol solution have been increasingly used to reduce
the interruption from repeating cardioplegia dosing to minimise the
cardiopulmonary bypass and cross clamp time. However, the best
cardioplegia for myocardial protection in adult minimally invasive cardiac
surgery remains controversial. We aimed to conduct a meta-analysis to
analyse the current evidence in the literature. Method(s): A
systematic review and meta-analysis was performed following the updated
2020 PRISMA guideline. Articles published in the five major electronic
databases up 1st of April 2021 were identified and reviewed. The primary
outcome was in-hospital or 30-day mortality. Traditional pairwise and
Bayesian network meta-analyses were conducted. Result(s): Nine
articles were included in this study. The use of Del Nido cardioplegia was
associated with a lower volume of cardioplegia used (Del Nido vs Blood,
1105.62 mL+/-123.47 vs 2569.46 mL+/-1515.52, p<0.001), cardiopulmonary
bypass (Del Nido vs Custoidol vs Blood: 91.67+/-14.78 vs 138.05 +/- 21.30
vs 119.38+/-26.91 minutes, p<0.001) and cross-clamp time (Del Nido vs
Custoidol vs Blood: 74.99+/-18.55 vs 82.01 +/- 17.28 vs 93.66+/-8.88
minutes, p < 0.001). No differences were observed in the incidence of
in-hospital/30-day mortality rate, new onset of atrial fibrillation and
stroke. Ranking analysis showed the Custoidol solution has the highest
probability to be the first ranked cardioplegia. Conclusion(s): No
differences were found between blood and crystalloid cardioplegia in adult
minimally invasive cardiac surgery in several clinical outcomes. The
cardioplegia of choice in minimally invasive cardiac surgery remains the
surgeons' decision and preference. Copyright © The Author(s)
2022.

<18>
Accession Number
2015119868
Title
CABG in patients with liver cirrhosis: to pump or not to pump?.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2022. Date of
Publication: 2022.
Author
Jiang S.M.; Liblik K.; Baranchuk A.; Payne D.; El-Diasty M.
Institution
(Jiang, Payne, El-Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
(Liblik, Baranchuk) Department of Cardiology, Queen's University,
Kingston, ON, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Coronary artery bypass grafting in patients with established
liver cirrhosis is generally associated with poor outcomes. Avoiding
cardiopulmonary bypass (CPB) in these patients has not demonstrated any
advantage over the use of CPB. We review the current available literature
that compared the outcome of both on-pump (ONCABG) and off-pump (OPCAB)
techniques in cirrhotic patients in terms of morbidity and mortality.
Areas covered: A comprehensive search was conducted in the PubMed/MEDLINE
and EMBASE databases in January 2021. Articles that reported outcomes of
OPCAB and/or ONCABG in cirrhotic patients with no concomitant surgical
procedures were included. 829 unique abstracts were retrieved with title
and abstract screening completed independently by two reviewers. Two case
studies and six retrospective cohort studies were included. The largest
study comprised more than 98% of the total population, showing some
survival benefit for OPCAB over ONCABG. However, it was population-based
and did not report the severity of liver. The remaining studies reported
no clear difference in outcome between the two techniques. Expert opinion:
Surgical myocardial revascularisation carries high perioperative risk in
patients with liver cirrhosis irrespective of the surgical technique.
There is a lack of evidence to suggest that avoiding CPB in these patients
may be beneficial. Copyright © 2022 Informa UK Limited, trading
as Taylor & Francis Group.

<19>
Accession Number
637430955
Title
Risk of Perioperative Stroke in Patients with Patent Foramen Ovale: A
Systematic Review and Meta-Analysis.
Source
The Canadian journal of cardiology. (no pagination), 2022. Date of
Publication: 02 Mar 2022.
Author
Hobbes B.; Akseer S.; Pikula A.; Huszti E.; Devereaux P.J.; Horlick E.;
Abrahamyan L.
Institution
(Hobbes) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Akseer) Institute of Health Policy, Management and Evaluation (IHPME),
University of Toronto, Toronto, ON, Canada
(Pikula) Division of Neurology, ON, Toronto Western Hospital ,University
Health Network (UHN), Toronto, Canada
(Huszti) Institute of Health Policy, Management and Evaluation (IHPME),
University of Toronto, Toronto, Ontario, Canada; Biostatistics Research
Unit, UHN, Toronto, Ontario, Canada
(Devereaux) Population Health Research Institute, Hamilton, ON, Canada;
Departments of Medicine, and Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, ON, Canada
(Horlick) Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac
Centre (PMCC), UHN, Toronto, ON, Canada
(Abrahamyan) Institute of Health Policy, Management and Evaluation
(IHPME), University of Toronto, Toronto, Ontario, Canada; Toronto General
Hospital Research Institute, UHN, Toronto, Ontario, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patent foramen ovale (PFO) is a common congenital cardiac
abnormality. Risk of stroke increases perioperatively; however, the
association of PFO with perioperative stroke risk remains unclear. We
conducted a systematic review to inform the risk of perioperative stroke
in patients with PFO undergoing surgery. METHOD(S): EMBASE, MEDLINE,
and Cochrane databases were searched from inception to January 2020. We
described methods used for establishing PFO and perioperative stroke
diagnosis. We conducted meta-analyses to obtain pooled estimates for risk
of stroke in patients with and without PFO in different surgical
populations. RESULT(S): Ten articles with a total of 20,858,011
patients met the eligibility criteria. Prevalence of PFO ranged from
0.06-1.4% based on ICD code diagnosis and 10.4-40.4% based on
echocardiography diagnosis. Perioperative stroke was observed in 0-25% of
patients with PFO, and 0-16.7% without PFO. Studies that use
echocardiography to diagnose PFO found no association between PFO and
perioperative stroke. Studies that used ICD codes, found strong
association but were highly heterogenous. PFO was not associated with a
risk of perioperative stroke in cardiac and transplant surgeries. While
the adjusted odds ratios for stroke were substantial for orthopedic,
general, genitourinary, neuro, and thoracic surgeries (with PFO status
established based on ICD codes), data heterogeneity and quality of data
create significant uncertainty. CONCLUSION(S): In conclusion, PFO is
likely a risk factor for perioperative stroke in select types of
surgeries. However, this is based on a very low-quality evidence.
Rigorous, prospective studies are needed to further investigate this
relationship. Copyright © 2022. Published by Elsevier Inc.

<20>
Accession Number
637427466
Title
Continuous Titration of Inspired Oxygen Using Oxygen Reserve Index to
Decrease Oxygen Exposure During One-Lung Ventilation: A Randomized
Controlled Trial.
Source
Anesthesia and analgesia. (no pagination), 2022. Date of Publication: 03
Mar 2022.
Author
Yang M.; Kim J.A.; Ahn H.J.; Choi Y.S.; Park M.; Jeong H.; Kim K.; Lee
N.Y.
Institution
(Yang, Kim, Ahn, Park, Jeong, Lee) From the Departments of Anesthesiology
and Pain Medicine
(Choi) Thoracic and Cardiovascular Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, School of Dentistry,
Dankook University, Cheon-an, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: A high fraction of inspired oxygen (Fio2) is administered
during one-lung ventilation (OLV). However, a high Fio2 is not physiologic
and may lead to various complications. We hypothesized that continuous
titration of Fio2 using the oxygen reserve index (ORI) reduces oxygen
exposure compared to conventional management during OLV. METHOD(S):
In this randomized, double-blinded trial, patients undergoing thoracic
surgery were assigned to an ORI (n = 64) or a control group (n = 60). In
the ORI group, ORI was continuously displayed using multiwavelength pulse
co-oximetry (Masimo) between 0 and 1 (0, no reserve; 1, maximum reserve),
and Fio2 was titrated for a target ORI of 0.21 at 5-minute intervals
during OLV. In the control group, Fio2 was adjusted using arterial blood
gas analysis measured at 15 minutes after OLV initiation. The primary end
point was the time-weighted average Fio2 during OLV. RESULT(S):
Overall, time-weighted average Fio2 did not differ between the groups
(control versus ORI: median [interquartile range], 0.87 [0.73-1.00] vs
0.82 [0.68-0.93]; P = .09). However, in a subgroup analysis, the ORI group
reduced time-weighted average Fio2 after pulmonary vascular ligation
compared to the control group (control versus ORI: median [interquartile
range], 0.75 [0.70-1.00] vs 0.72 [0.59-0.89]; P = .0261). The incidence of
intraoperative hypoxia (arterial oxygen saturation [Spo2] <94%; control
versus ORI: 32% [19/60; 95% confidence interval (CI), 20-45] vs 19%
[12/64; 95% CI, 10-31]; P = .09), and postoperative complications within
the first 7 days did not differ between the groups. CONCLUSION(S):
ORI-guided continuous Fio2 titration does not reduce overall oxygen
exposure during OLV. Copyright © 2022 International Anesthesia
Research Society.

<21>
Accession Number
2017047111
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
Clinical Journal of Pain. (no pagination), 2022. Date of Publication:
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, Fayoum 63511, Egypt
(Abdelhady, Hassan) Department of Anesthesiology Faculty of Medicine,
Fayoum University, Fayoum, Egypt
(Boules) Department of Anesthesiology Faculty of Medicine, Fayoum
University, Cairo, Egypt
Publisher
Lippincott Williams and Wilkins
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 Lippincott Williams and
Wilkins. All rights reserved.

<22>
Accession Number
2010932808
Title
Efficacy and safety of non-vitamin K antagonist oral anticoagulants
combined with antiplatelet drugs for patients with peripheral artery
disease: A systematic review and meta-analysis of randomized controlled
trials.
Source
Vascular. 30(1) (pp 97-104), 2022. Date of Publication: February 2022.
Author
Lv M.; Jiang S.; Wu T.; Chen W.; Zhang J.
Institution
(Lv, Jiang, Wu, Chen, Zhang) Department of Pharmacy, Fujian Medical
University Union Hospital, Fuzhou, China
(Lv, Jiang, Wu, Chen, Zhang) College of Pharmacy, Fujian Medical
University, Fuzhou, China
Publisher
SAGE Publications Ltd
Abstract
Background: The efficacy and safety of non-vitamin K antagonist oral
anticoagulants (NOACs) combined with antiplatelet drugs in patients with
peripheral artery disease remain largely unknown. Objective(s): The
aim of this meta-analysis was to explore the effects of NOACs combined
with antiplatelet drugs versus antiplatelet drugs alone in this
population. Method(s): A comprehensive search of randomized
controlled trials published in PubMed, EMBASE, Web of Science, and the
Cochrane Library in 30 September 2020 and before. According to the
I2 statistic, a random or fixed-effect model was used to
analyze the safety and effectiveness of NOACs combined with antiplatelet
drugs in peripheral artery disease patients. Result(s): Three RCTs
met the inclusion criteria, with a total sample size of 11,761
participants. Compared with antiplatelet drugs alone, NOACs combined with
antiplatelet drugs resulted in lower risk of ischemic stroke events (OR =
0.75, 95%CI 0.57-0.98, p = 0.03), while other treatment effects were not
worse than those of single antiplatelet drugs (p >= 0.05). In addition,
although compared with single antiplatelet drugs alone, NOACs combined
with antiplatelet drugs had a higher risk of major bleeding and clinically
related nonmajor bleeding, their risk was not higher for intracranial
hemorrhage, which may endanger the life of patients, or for fatal
bleeding. Conclusion(s): In summary, for peripheral artery disease
patients, a combination of NOACs plus antiplatelet drugs may offer
additional benefit in reducing ischemic stroke outcome, yet it may
increase the risk of bleeding. Copyright © The Author(s) 2021.

<23>
Accession Number
2015094291
Title
Long-term Outcomes of Catheter Ablation for Ventricular Arrhythmias in
Post-Myocarditis Patients: Insights from a Meta-Analysis of Current Data.
Source
SN Comprehensive Clinical Medicine. 4(1) (no pagination), 2022. Article
Number: 62. Date of Publication: December 2022.
Author
Androulakis E.; Falconer D.; Briasoulis A.; Sohrabi C.; Lim W.-Y.; Siasos
G.; Ahluwalia N.; Graham A.; Papageorgiou N.
Institution
(Androulakis) Royal Brompton & Harefield NHS, Heart Imaging Centre,
London, United Kingdom
(Falconer) Cardiology department, Queens Hospital, Romford, United Kingdom
(Briasoulis) Section of Heart Failure and Transplant Division of
Cardiovascular Diseases, University of Iowa Hospitals and Clinics, Iowa
City, IA, United States
(Sohrabi, Lim, Ahluwalia, Graham, Papageorgiou) Electrophysiology
Department, Barts Heart Centre, St. Bartholomew's Hospital, West
Smithfield, London EC1A 7BE, United Kingdom
(Siasos) 3Rd Department of Cardiology, Sotiria Hospital University of
Athens Medical School Athens, Athens, Greece
(Papageorgiou) Institute of Cardiovascular Science, University College
London, London, United Kingdom
Publisher
Springer Nature
Abstract
Background: In the past decade, catheter ablation (CA) has become a
rapidly expanding treatment option for ventricular tachycardia (VT);
however it is not commonly utilised for patients with post-myocarditis VT.
We aimed to systematically review up-to-date evidence regarding
feasibility, effectiveness, and safety of CA, with a specific focus on
long-term relapse rate and procedural complications. Method(s): A
structured electronic database search (PubMed, Embase, Cochrane) of the
scientific literature was performed according to PRISMA guidelines for
studies describing outcomes at up to 7.3 years after CA. The primary
outcome measured was VT recurrence post-ablation. Procedural success was
defined as freedom of ventricular arrhythmias (at the end of follow-up
after an ablation procedure). The secondary outcome was significant
procedural complications which included procedural death, stroke, cardiac
tamponade, acute myocardial infarction, major vascular complications, and
major bleeding, assessed on a study-by-study basis. Result(s): A
total of 186 patients were included in analysis with most patients (88%)
being male. Over the follow-up period, there was a 18% relapse rate (n =
34) (confidence interval (CI); 0.12-0.24, I2=0, p = 0.77) with
the majority of patients remaining VT free for the duration of follow-up.
The overall procedural complication rate was 3.0% (n = 7) (CI; 0.01-0.07,
I2=0, p = 0.44), and of note, there were no peri-procedural
deaths or heart transplant surgeries reported. However, a single study
reported a mortality of 10% (n = 2) during the follow-up period.
 Conclusion(s): CA is an effective and durable long-term therapeutic
strategy for post-myocarditis VT patients with limited relapse rate and
very low complication rates based on these non-randomised data. Larger
randomised-controlled trials with standardised treatment and long
follow-up are required to compare CA versus conventional treatment in the
post-acute myocardial phase. Copyright © 2022, The Author(s),
under exclusive licence to Springer Nature Switzerland AG.

<24>
Accession Number
2014907942
Title
Systemic inflammatory response during cardiopulmonary bypass: Axial flow
versus radial flow oxygenators.
Source
International Journal of Artificial Organs. 45(3) (pp 278-283), 2022. Date
of Publication: March 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.

<25>
Accession Number
2013483742
Title
Glucocorticoid-induced leucine zipper (Gilz) in cardiovascular health and
disease.
Source
Cells. 10(8) (no pagination), 2021. Article Number: 2155. Date of
Publication: August 2021.
Author
Cappetta D.; Bereshchenko O.; Cianflone E.; Rossi F.; Riccardi C.; Torella
D.; Berrino L.; Urbanek K.; De Angelis A.; Bruscoli S.
Institution
(Cappetta, Rossi, Berrino, De Angelis) Department of Experimental
Medicine, University of Campania 'Luigi Vanvitelli', Naples 80138, Italy
(Bereshchenko) Department of Philosophy, Social Sciences and Education,
University of Perugia, Perugia 06123, Italy
(Cianflone) Department of Medical and Surgical Sciences, University 'Magna
Graecia' of Catanzaro, Catanzaro 88100, Italy
(Riccardi, Bruscoli) Department of Medicine and Surgery, Section of
Pharmacology, University of Perugia, Perugia 06156, Italy
(Torella, Urbanek) Department of Experimental and Clinical Medicine,
University 'Magna Graecia' of Catanzaro, Catanzaro 88100, Italy
Publisher
MDPI
Abstract
Glucocorticoids (GCs) are essential in regulating functions and
homeostasis in many biological systems and are extensively used to treat a
variety of conditions associated with immune/in-flammatory processes. GCs
are among the most powerful drugs for the treatment of autoimmune and
inflammatory diseases, but their long-term usage is limited by severe
adverse effects. For this reason, to envision new therapies devoid of
typical GC side effects, research has focused on expand-ing the knowledge
of cellular and molecular effects of GCs. GC-induced leucine zipper (GILZ)
is a GC-target protein shown to mediate several actions of GCs, including
inhibition of the NF-kappaB and MAPK pathways. GILZ expression is not
restricted to immune cells, and it has been shown to play a regulatory
role in many organs and tissues, including the cardiovascular system.
Research on the role of GILZ on endothelial cells has demonstrated its
ability to modulate the inflammatory cascade, resulting in a
downregulation of cytokines, chemokines, and cellular adhesion molecules.
GILZ also has the capacity to protect myocardial cells, as its deletion
makes the heart, after a deleterious stim-ulus, more susceptible to
apoptosis, immune cell infiltration, hypertrophy, and impaired function.
Despite these advances, we have only just begun to appreciate the
relevance of GILZ in cardiovascular homeostasis and dysfunction. This
review summarizes the current understanding of the role of GILZ in
modulating biological processes relevant to cardiovascular
biology. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<26>
Accession Number
634169065
Title
Patient values and preferences on valve replacement for aortic stenosis: A
systematic review.
Source
Heart. 107(16) (pp 1289-1295), 2021. Date of Publication: 01 Aug 2021.
Author
Heen A.F.; Lytvyn L.; Shapiro M.; Guyatt G.H.; Siemieniuk R.A.C.; Zhang
Y.; Manja V.; Vandvik P.O.; Agoritsas T.
Institution
(Heen) Department of Medicine, Innlandet Hospital Trust Gjovik Hospital,
Brumunddal, Norway
(Lytvyn, Guyatt, Siemieniuk, Zhang, Agoritsas) Department of Health
Research Methods, Evidence, and Impact, McMaster University Faculty of
Health Sciences, Hamilton, ON, Canada
(Shapiro) ChicagoILUnited States
(Manja) Department of Surgery, University of California Davis, Sacramento,
CA, United States
(Manja) Department of Medicine, Veterans Affairs Northern California
Health Care System, Mather, CA, United States
(Vandvik) Institute of Health and Society, University of Oslo, Oslo,
Norway
(Agoritsas) Division of General Internal Medicine, Department of Medicine,
University Hospitals of Geneva, Geneva, Switzerland
Publisher
BMJ Publishing Group
Abstract
The review aims to summarise evidence addressing patients' values,
preferences and practical issues on deciding between transcatheter aortic
valve insertion (TAVI) and surgical aortic valve replacement (SAVR) for
aortic stenosis. We searched databases and grey literature until June
2020. We included studies of adults with aortic stenosis eliciting values
and preferences about treatment, excluding medical management or
palliative care. Qualitative findings were synthesised using thematic
analysis, and quantitative findings were narratively described. Evidence
certainty was assessed using CERQual (Confidence in the Evidence from
Reviews of Qualitative Research) and GRADE (Grading of Recommendations
Assessment, Development and Evaluation). We included eight studies.
Findings ranged from low to very low certainty. Most studies only
addressed TAVI. Studies addressing both TAVI and SAVR reported on factors
affecting patients' decision-making along with treatment effectiveness,
instead of trade-offs between procedures. Willingness to accept risk
varied considerably. To improve their health status, participants were
willing to accept higher mortality risk than current evidence suggests for
either procedure. No study explicitly addressed valve reintervention, and
one study reported variability in willingness to accept shorter duration
of known effectiveness of TAVI compared with SAVR. The most common themes
were desire for symptom relief and improved function. Participants
preferred minimally invasive procedures with shorter hospital stay and
recovery. The current body of evidence on patients' values, preferences
and practical issues related to aortic stenosis management is of
suboptimal rigour and reports widely disparate results regarding patients'
perceptions. These findings emphasise the need for higher quality studies
to inform clinical practice guidelines and the central importance of
shared decision-making to individualise care fitted to each
patient. Copyright © 2021 BMJ Publishing Group. All rights
reserved.

<27>
Accession Number
2015274439
Title
Cardiovascular efficacy and safety of dipeptidyl peptidase-4 inhibitors: A
meta-analysis of cardiovascular outcome trials.
Source
World Journal of Cardiology. 13(10) (pp 585-592), 2021. Date of
Publication: 26 Oct 2021.
Author
Patoulias D.I.; Boulmpou A.; Teperikidis E.; Katsimardou A.; Siskos F.;
Doumas M.; Papadopoulos C.E.; Vassilikos V.
Institution
(Patoulias, Katsimardou, Siskos, Doumas) Second Propedeutic Department of
Internal Medicine, Aristotle University of Thessaloniki, Hippokration
General Hospital, Thessaloniki 54642, Greece
(Boulmpou, Teperikidis, Papadopoulos, Vassilikos) Third Department of
Cardiology, Aristotle University of Thessaloniki, Hippokration General
Hospital, Thessaloniki 54642, Greece
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Dipeptidyl peptidase-4 (DPP-4) inhibitors are a generally safe
and well tolerated antidiabetic drug class with proven efficacy in type 2
diabetes mellitus (T2DM). Recently, a series of large, randomized
controlled trials (RCTs) addressing cardiovascular outcomes with DPP-4
inhibitors have been published. AIM To pool data from the aforementioned
trials concerning the impact of DPP-4 inhibitors on surrogate
cardiovascular efficacy outcomes and on major cardiac arrhythmias. METHODS
We searched PubMed and grey literature sources for all published RCTs
assessing cardiovascular outcomes with DPP-4 inhibitors compared to
placebo until October 2020. We extracted data concerning the following
"hard" efficacy outcomes: fatal and non-fatal myocardial infarction, fatal
and non-fatal stroke, hospitalization for heart failure, hospitalization
for unstable angina, hospitalization for coronary revascularization and
cardiovascular death. We also extracted data regarding the risk for major
cardiac arrhythmias, such as atrial fibrillation, atrial flutter,
ventricular fibrillation and ventricular tachycardia. RESULTS We pooled
data from 6 trials in a total of 52520 patients with T2DM assigned either
to DPP-4 inhibitor or placebo. DPP-4 inhibitors compared to placebo led to
a non-significant increase in the risk for fatal and non-fatal myocardial
infarction [risk ratio (RR) = 1.02, 95%CI: 0.94-1.11, I2 = 0%],
hospitalization for heart failure (RR = 1.09, 95%CI: 0.92-1.29,
I2 = 65%) and cardiovascular death (RR = 1.02, 95%CI:
0.93-1.11, I2 = 0%). DPP-4 inhibitors resulted in a
non-significant decrease in the risk for fatal and non-fatal stroke (RR =
0.96, 95%CI: 0.85-1.08, I2 = 0%) and coronary revascularization
(RR = 0.99, 95%CI: 0.90-1.09, I2 = 0%), Finally, DPP-4
inhibitors demonstrated a neutral effect on the risk for hospitalization
due to unstable angina (RR = 1.00, 95%CI: 0.85-1.18, I2 = 0%).
As far as cardiac arrhythmias are concerned, DPP-4 inhibitors did not
significantly affect the risk for atrial fibrillation (RR = 0.95, 95%CI:
0.78-1.17, I2 = 0%), while they were associated with a
significant increase in the risk for atrial flutter, equal to 52% (RR =
1.52, 95%CI: 1.03-2.24, I2 = 0%). DPP-4 inhibitors did not have
a significant impact on the risk for any of the rest assessed cardiac
arrhythmias. CONCLUSION DPP-4 inhibitors do not seem to confer any
significant cardiovascular benefit for patients with T2DM, while they do
not seem to be associated with a significant risk for any major cardiac
arrhythmias, except for atrial flutter. Therefore, this drug class should
not be the treatment of choice for patients with established
cardiovascular disease or multiple risk factors, except for those cases
when newer antidiabetics (glucagon-like peptide-1 receptor agonists and
sodium-glucose co-transporter-2 inhibitors) are not tolerated,
contraindicated or not affordable for the patient. Copyright ©
The Author(s) 2021. Published by Baishideng Publishing Group Inc. All
rights reserved.

<28>
Accession Number
2015274438
Title
Patent hemostasis of radial artery: Comparison of two methods.
Source
World Journal of Cardiology. 13(10) (pp 574-584), 2021. Date of
Publication: 26 Oct 2021.
Author
Kyriakopoulos V.; Xanthopoulos A.; Papamichalis M.; Skoularigkis S.;
Tzavara C.; Papadakis E.; Patsilinakos S.; Triposkiadis F.; Skoularigis J.
Institution
(Kyriakopoulos, Papadakis, Patsilinakos) Department of Cardiology,
Konstantopoulio General Hospital, Athens 14233, Greece
(Xanthopoulos, Papamichalis, Skoularigkis, Triposkiadis, Skoularigis)
Department of Cardiology, University Hospital of Larissa, Larissa 41110,
Greece
(Tzavara) Department of Health, Medical School, University of Athens,
Athens 11527, Greece
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Radial artery obstruction is the most common complication of
coronary angiography performed via transradial access. Patent hemostasis
can significantly reduce the risk of radial artery occlusion. Previous
studies utilized sophisticated methods to evaluate radial artery patency.
Simplified and easily applicable methods for successful patent hemostasis
are currently lacking. AIM To determine which method (pulse oximeter vs
the traditional radial artery palpation) is better to achieve patent
hemostasis. METHODS This prospective, single center study included 299
consecutive patients who underwent coronary angiography or percutaneous
coronary intervention between November 2017 and July 2019. Patients less
than 18 years old, with a history of radial artery disease, or no palpable
artery pulse were excluded from the study. Patients were randomly assigned
to two groups. In the first group, radial artery flow was assessed by
palpation of the artery during hemostasis (traditional method). In the
second group, radial artery patency was estimated with the use of a pulse
oximeter. Two different compression devices were used for hemostasis (air
chamber and pressure valve). The primary study endpoint was the
achievement of successful patent hemostasis. RESULTS The two groups (pulse
oximeter vs artery palpation) had no significant differences in age, sex,
body mass index, risk factors, or comorbidities except for
supraventricular arrhythmias. The percentage of patients with successful
patent hemostasis was significantly higher in the pulse oximeter group
(82.2% vs 68.1%, P = 0.005). A lower percentage of patients with spasm was
recorded in the pulse oximeter group (9.9% vs 19.0%, P = 0.024). The
incidence of local complications, edema, bleeding, hematoma, vagotonia, or
pain did not differ between the two groups. In the multivariate analysis,
the use of a pulse oximeter (OR: 2.35, 95%CI: 1.34-4.13, P = 0.003) and
advanced age (OR: 1.04, 95%CI: 1.01-1.07, P = 0.006), were independently
associated with an increased probability of successful patent hemostasis.
The type of hemostatic device did not affect patent hemostasis (P =
0.450). CONCLUSION Patent hemostasis with the use of pulse oximeter is a
simple, efficient, and safe method that is worthy of further
investigation. Larger randomized studies are required to consider its
clinical implications. Copyright © The Author(s) 2021. Published
by Baishideng Publishing Group Inc. All rights reserved.

<29>
Accession Number
2014658113
Title
Effects of Glucocorticoids on Postoperative Delirium in Adult Patients
Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
Clinical Therapeutics. 43(9) (pp 1608-1621), 2021. Date of Publication:
September 2021.
Author
Liu W.; Wang Y.; Wang J.; Shi J.; Pan J.; Wang D.
Institution
(Liu, Wang, Wang, Shi, Pan, Wang) Department of Thoracic and
Cardiovascular Surgery, Affiliated Drum Tower Hospital of Nanjing
University Medical School, Institute of Cardiothoracic Vascular Disease,
Nanjing University, China
Publisher
Elsevier Inc.
Abstract
Purpose: Delirium is a common neurologic complication after cardiac
surgery and is associated with a poor prognosis. Several studies have
explored the effects of glucocorticoids on postoperative delirium (POD).
However, conclusion have been inconsistent. The purpose of this systematic
review and meta-analysis is to evaluate the effects of glucocorticoids on
POD in adult patients undergoing cardiac surgery. Method(s): A
systematic literature search was conducted using PubMed/MEDLINE, Embase,
Cochrane Library/Central, and Web of Science from inception to January 28,
2021. Randomized controlled trials evaluating the effects of perioperative
glucocorticoids administration on the incidence of POD in adults (>=18
years of age) undergoing cardiac surgery were included. The primary
outcome of incidence of POD was assessed using the risk ratio (RR) with a
fixed-effects model. Secondary analyses included the severity or duration
of delirium, mortality at 30 days, length of hospital and intensive care
unit (ICU) stay, duration of mechanical ventilatory support, the incidence
of myocardial injury, new atrial fibrillation, renal and respiratory
failure, postoperative infection and stroke, and the level of glucose and
inflammatory factors. Finding(s): A total 4 trials (n = 8448
patients) were included. Glucocorticoids did not significantly reduce the
incidence of POD (RR = 0.99; 95% CI, 0.86-1.14) but increased the risk of
myocardial injury (RR = 1.22; 95% CI, 1.08-1.38), decreased the duration
of mechanical ventilatory support (mean difference, -0.83; 95% CI, -1.32
to -0.34), and led to a tendency toward short length of ICU stay (mean
difference, -0.22; 95% CI, -0.47 to -0.03). No significant differences
were observed in other secondary outcomes. Implications: The perioperative
administration of glucocorticoids did not reduce the incidence of POD in
adult patients undergoing cardiac surgery but might be associated with
shorter duration of mechanical ventilatory support and a tendency toward a
shorter length of ICU stay. Furthermore, we found that glucocorticoids may
increase the rate of myocardial injury but have no effects on other
clinical outcomes. International Prospective Register of Systematic
Reviews identifier: CRD42021233458. Copyright © 2021

<30>
Accession Number
2014600509
Title
Heart valve surgery and the obesity paradox: A systematic review.
Source
Clinical Obesity. 12(2) (no pagination), 2022. Article Number: e12506.
Date of Publication: April 2022.
Author
EL-Andari R.; Bozso S.J.; Kang J.J.H.; Bedard A.M.A.; Adams C.; Wang W.;
Nagendran J.
Institution
(EL-Andari) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Bozso, Kang, Wang, Nagendran) Division of Cardiac Surgery, Department of
Surgery, University of Alberta, Edmonton, AB, Canada
(Bedard) Department of Biological Sciences, Faculty of Science, University
of Alberta, Edmonton, AB, Canada
(Adams) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin
Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB,
Canada
Publisher
John Wiley and Sons Inc
Abstract
Obesity has been associated with increased incidence of comorbidities and
shorter life expectancy, and it has generally been assumed that patients
with obesity should have inferior outcomes after surgery. Previous
literature has often demonstrated equivalent or even improved rates of
mortality after cardiac surgery when compared to their lower-weight
counterparts, coined the obesity paradox. Herein, we aim to review the
literature investigating the impact of obesity on surgical valve
interventions. PubMed and Embase were systematically searched for articles
published from 1 January 2000 to 15 October 2021. A total of 1315 articles
comparing differences in outcomes between patients of varying body mass
index (BMI) undergoing valve interventions were reviewed and 25 were
included in this study. Patients with higher BMI demonstrated equivalent
or reduced rates of postoperative myocardial infarction, stroke,
reoperation rates, acute kidney injury, dialysis and bleeding. Two studies
identified increased rates of deep sternal wound infection in patients
with higher BMI, although the majority of studies found no significant
difference in deep sternal wound infection rates. The obesity paradox has
described counterintuitive outcomes predominantly in coronary artery
bypass grafting and transcatheter aortic valve replacement. Recent
literature has identified similar trends in other heart valve
interventions. While the obesity paradox has been well characterized, its
causes are yet to be identified. Further study is essential in order to
identify the causes of the obesity paradox so patients of all body sizes
can receive optimal care. Copyright © 2021 World Obesity
Federation.

<31>
Accession Number
2011267283
Title
Graft Patency of a Second Conduit for Coronary Artery Bypass Surgery: A
Network Meta-Analysis of Randomized Controlled Trials.
Source
Seminars in Thoracic and Cardiovascular Surgery. 34(1) (pp 102-109), 2022.
Date of Publication: Spring 2022.
Author
Yokoyama Y.; Takagi H.; Kuno T.
Institution
(Yokoyama, Kuno) Department of Surgery, St. Luke's University Health
Network, Mount Sinai Beth Israel, Fountain Hill, PA, United States
(Kuno) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Takagi) Department of Medicine, Icahn School of Medicine at Mount Sinai,
New York, New York City
Publisher
W.B. Saunders
Abstract
It has been well documented that the use of the left internal thoracic
artery (LITA) to graft the left anterior descending (LAD) artery has a
significant benefit in coronary artery bypass graft (CABG) surgery.
However, what graft is the best as a second conduit to complement LITA-LAD
anastomosis remains uncertain. We thus conducted a network meta-analysis
of RCTs to compare graft patency of the radial artery (RA), the right
internal thoracic artery (RITA), the right gastroepiploic artery (RGEA),
conventional saphenous vein (C-SVG), and no-touch saphenous vein (NT-SVG)
as a second conduit in CABG. MEDLINE and EMBASE were searched through
August 31, 2020 to identify randomized controlled trials (RCTs) that
investigated graft patency of a second conduit in CABG. From each study,
we extracted the incidence rate ratios of the outcome. A total of 13 RCTs
were identified, including 3728 patients and 2773 angiographic results.
The graft failure rates were significantly lower in NT-SVG and RA compared
to C-SVG and RGEA. There was no significant difference among the other
comparisons. A sensitivity analysis restricting trials with >=3 years
angiographic follow-up time showed the graft failure rates were
significantly lower in NT-SVG and RA compared to C-SVG and RGEA, and a
sensitivity analysis restricting trials with >=5 years angiographic
follow-up time showed the graft failure rates were significantly lower in
NT-SVG and RA compared to C-SVG. In a network meta-analysis of the updated
outcomes from RCTs, NT-SVG and RA have better graft patency compared to
C-SVG and RGEA. Copyright © 2021 Elsevier Inc.

<32>
[Use Link to view the full text]
Accession Number
637421996
Title
Effects of perioperative erythropoietin administration on acute kidney
injury and red blood cell transfusion in patients undergoing cardiac
surgery: A systematic review and meta-analysis.
Source
Medicine. 101(9) (pp e28920), 2022. Date of Publication: 04 Mar 2022.
Author
Shin H.J.; Ko E.; Jun I.; Kim H.J.; Lim C.H.
Institution
(Shin, Ko, Jun, Lim) Department of Anesthesiology and Pain Medicine, Korea
University Anam Hospital, Korea University College of Medicine, Seoul,
South Korea
(Kim) Department of Preventive Medicine, Institute for Evidence-based
Medicine Cochrane Korea, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: The renoprotective effects of erythropoietin (EPO) are
well-known; however, the optimal timing of EPO administration remains
controversial. Red blood cell (RBC) transfusion is an independent risk
factor for cardiac surgery-associated acute kidney injury (CSA-AKI). We
aimed to evaluate the efficacy of EPO on CSA-AKI and RBC transfusion
according to the timing of administration. METHOD(S): We searched the
Cochrane Library, EMBASE, and MEDLINE databases for randomized controlled
trials. The primary outcome was the incidence of CSA-AKI following
perioperative EPO administration, and the secondary outcomes were changes
in serum creatinine, S-cystatin C, S-neutrophil gelatinase-associated
lipocalin, urinary neutrophil gelatinase-associated lipocalin, length of
hospital and intensive care unit (ICU) stay, volume of RBC transfusion,
and mortality. The subgroup analysis was stratified according to the
timing of EPO administration in relation to surgery. RESULT(S): Eight
randomized controlled trials with 610 patients were included in the study.
EPO administration significantly decreased the incidence of CSA-AKI (odds
ratio: 0.60, 95% confidence interval [CI]: 0.43-0.85, P = .004; I2 = 52%;
P for heterogeneity = .04), intra-operative RBC transfusion (standardized
mean difference: -0.30, 95% CI: -0.55 to -0.05, P = .02; I2 = 15%, P for
heterogeneity = .31), and hospital length of stay (mean difference: -1.54
days, 95% CI: -2.70 to -0.39, P = .009; I2 = 75%, P for heterogeneity =
.001) compared with control groups. Subgroup analyses revealed that
pre-operative EPO treatment significantly reduced the incidence of
CSA-AKI, intra-operative RBC transfusion, serum creatinine, and length of
hospital and ICU stay. CONCLUSION(S): Pre-operative administration of
EPO may reduce the incidence of CSA-AKI and RBC transfusion, but not in
patients administered EPO during the intra-operative or postoperative
period. Therefore, pre-operative EPO treatment can be considered to
improve postoperative outcomes by decreasing the length of hospital and
ICU stay in patients undergoing cardiac surgery. Copyright © 2022
the Author(s). Published by Wolters Kluwer Health, Inc.

<33>
[Use Link to view the full text]
Accession Number
637421906
Title
Evaluating the impact of personalized rehabilitation nursing intervention
on postoperative recovery of respiratory function among thoracic surgery
patients: A protocol for systematic review and meta-analysis.
Source
Medicine. 101(9) (pp e28776), 2022. Date of Publication: 04 Mar 2022.
Author
Liu A.; Li M.; Gao W.; Wen X.; Zhu H.; Chen Y.
Institution
(Liu, Li, Wen, Chen) Department of Cardiothoracic Surgery, Wuhan Puren
Hospital, Hubei Province, Wuhan, China
(Gao) Department of Neurosurgery, Wuhan Puren Hospital, Hubei Province,
Wuhan, China
(Zhu) Outpatient Department, Wuhan Puren Hospital, Hubei Province, Wuhan,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Owing to clinical developments and economic strain,
perioperative care has undergone considerable changes. Therefore, it is
important to review and critique the efficacy of existing practices in a
context that is placing increasing emphasis on better efficacy and
cost-containment. Considering that the objective involves devising
approaches to minimize postoperative complications and reduce medical
care, efforts should concentrate on postsurgical pulmonary complications
that are common. The present analysis aims to examine how customized
rehabilitation nursing intercession impacts the postsurgical restoration
of respiratory functions in thoracic surgery patients. METHOD(S):
Prespecified search strategies will be employed to perform a
methodological search of 6 databases namely EMBASE, Cochrane Library,
PubMed, Web of Science, WanFang Database, and China National Knowledge
Infrastructure. The analysis will comprise original publications that
evaluated how personalized rehabilitation nursing intervention impacts
postsurgical restoration of respiratory function in those who have
undergone thoracic surgery. All considered publications are before
December 25, 2021. Different authors will conduct an independent study
selection process to evaluate the quality of the publications and extract
required data. Based on the standardized mean difference and its 95%
confidence interval, we estimate the summary effects for each
meta-analyses. Based on heterogeneity in considered articles, the related
data will be pooled through either a random- or fixed-effect
meta-analysis. Lastly, the overall quality of evidence using appropriate
methods will be performed. RESULT(S): The results of this analysis
will systematically evaluate how customized rehabilitation nursing
interference impact postsurgical healing of respiratory functions in
patients who have undergone thoracic surgery by collecting the existing
evidence. ETHICS AND DISSEMINATION: Not required. OPEN SCIENCE FRAMEWORK
REGISTRATION NUMBER: 10.17605/OSF.IO/NBVYW. Copyright © 2022 the
Author(s). Published by Wolters Kluwer Health, Inc.

<34>
[Use Link to view the full text]
Accession Number
637421722
Title
Tranexamic acid reduces postoperative blood loss in Chinese pediatric
patients undergoing cardiac surgery: A PRISMA-compliant systematic review
and meta-analysis.
Source
Medicine. 101(9) (pp e28966), 2022. Date of Publication: 04 Mar 2022.
Author
Zou Z.-Y.; He L.-X.; Yao Y.-T.
Institution
(Zou, He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular
Hospital, Yunnan Province, Kunming, China
(Yao) Anesthesia Center, Fuwai Hospital, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Tranexamic acid has been increasingly used for blood
conservation in cardiac surgery. However, the evidence supporting the
routine use of tranexamic acid in Chinese pediatric patients undergoing
cardiac surgery remains weak. This meta-analysis aimed to systematically
review the efficacy of tranexamic acid when applying to Chinese pediatric
patients undergoing cardiac surgery. PARTICIPANTS: Chinese pediatric
patients undergoing cardiac surgery. INTERVENTIONS: Tranexamic acid or
control drugs (saline/blank). METHOD(S): PUBMED, Cochrane Library,
EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang Data, and
VIP Data till May 4, 2021, database search was updated on August 1.
Primary outcomes of interest included postoperative bleeding, allogeneic
transfusion, and reoperation for bleeding. Secondary outcomes of interest
included postoperative recovery. For continuous/dichotomous variables,
treatment effects were calculated as weighted mean difference (WMD)/odds
ratio and 95% confidence interval. RESULT(S): A database search
yielded 15 randomized controlled trials including 1641 patients, where 8
studies were allocated into non-cyanotic congenital group, 5 were
allocated into cyanotic congenital group, and the other 2 were allocated
into combined cyanotic/non-cyanotic group. This meta-analysis demonstrate
that tranexamic acid administration can reduce the postoperative 24 hours
blood loss in non-cyanotic, cyanotic, and combined cyanotic/non-cyanotic
patients, the red blood cell transfusion in non-cyanotic and cyanotic
patients, and the fresh frozen plasma transfusion in non-cyanotic and
combined cyanotic/non-cyanotic patients. CONCLUSION(S): This
meta-analysis demonstrates that tranexamic acid is highly effective in
reducing the blood loss in Chinese pediatric cardiac surgery, but it
behaves poorly when it comes to the transfusion requirement. To further
confirm this, more well-designed and adequately-powered randomized trials
are needed. Copyright © 2022 the Author(s). Published by Wolters
Kluwer Health, Inc.

<35>
Accession Number
2017068619
Title
Coronary Chronic Total Occlusion (CTO): A Review.
Source
Reviews in Cardiovascular Medicine. 19(1) (pp 38-44), 2018. Date of
Publication: 30 Mar 2018.
Author
Koelbl C.O.; Nedeljkovic Z.S.; Jacobs A.K.
Institution
(Koelbl) Columbia University, Division of Cardiology, Mount Sinai Heart
Institute, 4300 Alton Road De Hirsch, Miami Beach, FL 33140, United States
(Nedeljkovic, Jacobs) Section of Cardiology, Boston Medical Center, 88
East Newton Street, Boston, MA 02118-2393, United States
Publisher
IMR Press Limited
Abstract
Coronary artery chronic total occlusions (CTO) are frequently encountered
during coronary angiography; however percutaneous recanalization has
historically been technically challenging and an important determinant for
referral to coronary artery bypass surgery or for medical therapy alone.
Recent advances in interventional equipment and innovative approaches to
crossing CTO have significantly increased the success rate of percutaneous
treatment. Although there is only one relevant randomized control trial
(RCT) performed to date, several large, nonrandomized studies have
consistently reported improvement in clinical outcomes, including improved
survival and relief of angina, when successful percutaneous treatment of
CTO was compared with unsuccessful revascularization. These positive
observational results have encouraged the initiation of several RCTs which
will provide more robust evidence on clinical outcomes of CTO-PCI compared
with guideline-directed medical therapy (GDMT) alone. Copyright
© 2019 Natalia et al.

<36>
Accession Number
637422666
Title
Early Mobilization Prescription in Patients Undergoing Cardiac Surgery:
Systematic Review.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2022. Date
of Publication: 03 Mar 2022.
Author
Borges M.G.B.; Borges D.L.; Ribeiro M.O.; Lima L.S.S.; Macedo K.C.M.; Nina
V.J.D.S.
Institution
(Borges, Borges) Department of Physiotherapy, Hospital Universitario da
Universidade Federal do Maranhao (UFMA), Sao Luis, Maranhao, Brazil
(Borges, Nina) Postgraduate Program in Health Sciences, Universidade
Federal do Maranhao (UFMA), Sao Luis, Maranhao, Brazil
(Ribeiro) Faculty of Physiotherapy, Faculdade Pitagoras, Sao Luis,
Maranhao, Brazil
(Lima) Multiprofessional Residency Program, Hospital Universitario da
Universidade Federal do Maranhao (UFMA), Sao Luis, Maranhao, Brazil
(Macedo) Department of Physiotherapy, Faculdade Pitagoras, Sao Luis,
Maranhao, Brazil
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Early mobilization of patients in the postoperative period
of cardiac surgery who are hospitalized in the intensive care unit (ICU)
is a practice that has a positive impact. METHOD(S): This is a
systematic review of studies published until September 2020 in the Medical
Literature Analysis and Retrieval System Online (or MEDLINE), Embase,
Physiotherapy Evidence Database (or PEDro), Scientific Electronic Library
Online (or SciELO), and Latin American and Caribbean Health Sciences
Literature (or LILACS) databases. Randomized clinical trials describing
mobilization protocols performed early in ICU patients after cardiac
surgery were included. RESULT(S): According to the eligibility
criteria, only 14 of the 1,128 articles found were included in the
analysis. Early mobilization protocols were initiated in the immediate
postoperative period or first postoperative day. The resources and
technics used were progressive mobilization, cycle ergometer, early bed
activities, walking protocols, resistance exercise, and virtual reality.
Intensity of the mobilization activities was determined using the Borg
scale and heart rate. CONCLUSION(S): Early mobilization protocols are
generalist (not individual), and low-intensity exercises are used, through
progressive mobilization, with two daily physical therapy sessions, during
10 to 30 minutes.

<37>
Accession Number
637422518
Title
Custodiol versus Blood Cardioplegia: Comparison of Myocardial
Immunohistochemical Analysis and Clinical Outcomes.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2022. Date
of Publication: 03 Mar 2022.
Author
Sen O.; Aydin U.; Kadirogullari E.; Guler S.; Gonca S.; Solakoglu S.;
Karacalilar M.; Timur B.; Onan B.
Institution
(Sen, Aydin, Kadirogullari, Karacalilar, Timur, Onan) Department of
Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and
Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
(Guler) Department of Cardiovascular Surgery, GATA, Ankara, Turkey
(Gonca) Department of Histology and Embryology, Kocaeli University School
of Medicine, Kocaeli, Turkey
(Solakoglu) Department of Histology and Embryology, Istanbul University
School of Medicine, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Custodiol (histidine-tryptophan-ketoglutarate) and
repetitive blood cardioplegia are the solutions for myocardial protection
and cardiac arrest. In this study, we aimed to compare immunohistochemical
analysis, clinical outcomes, and cardiac enzyme values of Custodiol and
blood cardioplegia groups. METHOD(S): This was a randomized
prospective study consisting of 2 groups and 20 patients, 10 patients for
each group, who underwent mitral and mitral/tricuspid valve surgery. Group
1 was formed for Custodiol cardioplegia and group 2 for blood
cardioplegia. Perioperative and postoperative cardiac events were
recorded, cardiac enzymes were analyzed with intervals, and myocardial
samples were taken for immunohistochemical analysis. Recorded data were
statistically evaluated. RESULT(S): There was no significant
difference for the Custodiol and blood cardioplegia groups in
perioperative and postoperative cardiac performance and adverse events.
Cardiac enzyme analysis showed no significant difference between groups.
However, two parameters (eNOS, Bcl-2) were in favor of the Custodiol group
in immunohistochemical studies. Custodiol performed better in cellular
oxidative stress resistance and cellular viability. CONCLUSION(S):
Clinical outcomes and cardiac enzyme analysis results were similar
regarding myocardial protection. However, Custodiol performed better in
the immunohistochemical analysis.

<38>
Accession Number
637420373
Title
Bariatric surgery and cardiovascular disease: a systematic review and
meta-analysis.
Source
European heart journal. (no pagination), 2022. Date of Publication: 04
Mar 2022.
Author
van Veldhuisen S.L.; Gorter T.M.; van Woerden G.; de Boer R.A.; Rienstra
M.; Hazebroek E.J.; van Veldhuisen D.J.
Institution
(van Veldhuisen, Hazebroek) Department of Surgery/Vitalys Clinic,
Rijnstate Hospital Arnhem, Arnhem, Netherlands
(van Veldhuisen) Department of Surgery, University of Amsterdam,
Amsterdam, Netherlands
(Gorter, van Woerden, de Boer, Rienstra, van Veldhuisen) Department of
Cardiology, University of Groningen, University Medical Centre Groningen,
PO Box 30.001, RB Groningen 9700, Netherlands
(Hazebroek) Division of Human Nutrition and Health, Wageningen University
& Research, Wageningen, Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: Obesity is a global health problem, associated with significant
morbidity and mortality, often due to cardiovascular (CV) diseases. While
bariatric surgery is increasingly performed in patients with obesity and
reduces CV risk factors, its effect on CV disease is not established. We
conducted a systematic review and meta-analysis to evaluate the effect of
bariatric surgery on CV outcomes, in accordance with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses guideline.
METHODS AND RESULTS: PubMed and Embase were searched for literature until
August 2021 which compared bariatric surgery patients to non-surgical
controls. Outcomes of interest were all-cause and CV mortality, atrial
fibrillation (AF), heart failure (HF), myocardial infarction, and stroke.
We included 39 studies, all prospective or retrospective cohort studies,
but randomized outcome trials were not available. Bariatric surgery was
associated with a beneficial effect on all-cause mortality [pooled hazard
ratio (HR) of 0.55; 95% confidence interval (CI) 0.49-0.62, P<0.001 vs.
controls], and CV mortality (HR 0.59, 95% CI 0.47-0.73, P<0.001). In
addition, bariatric surgery was also associated with a reduced incidence
of HF (HR 0.50, 95% CI 0.38-0.66, P<0.001), myocardial infarction (HR
0.58, 95% CI 0.43-0.76, P<0.001), and stroke (HR 0.64, 95% CI 0.53-0.77,
P<0.001), while its association with AF was not statistically significant
(HR 0.82, 95% CI 0.64-1.06, P=0.12). CONCLUSION(S): The present
systematic review and meta-analysis suggests that bariatric surgery is
associated with reduced all-cause and CV mortality, and lowered incidence
of several CV diseases in patients with obesity. Bariatric surgery should
therefore be considered in these patients. Copyright © The
Author(s) 2022. Published by Oxford University Press on behalf of European
Society of Cardiology.

<39>
Accession Number
628083447
Title
Recommendations for the management of MPS IVA: systematic evidence- and
consensus-based guidance.
Source
Orphanet Journal of Rare Diseases. 14(1) (no pagination), 2019. Article
Number: 137. Date of Publication: 13 Jun 2019.
Author
Akyol M.U.; Alden T.D.; Amartino H.; Ashworth J.; Belani K.; Berger K.I.;
Borgo A.; Braunlin E.; Eto Y.; Gold J.I.; Jester A.; Jones S.A.; Karsli
C.; Mackenzie W.; Marinho D.R.; McFadyen A.; McGill J.; Mitchell J.J.;
Muenzer J.; Okuyama T.; Orchard P.J.; Stevens B.; Thomas S.; Walker R.;
Wynn R.; Giugliani R.; Harmatz P.; Hendriksz C.; Scarpa M.
Institution
(Akyol) Department of Otolaryngology, Hacettepe University, Ankara, Turkey
(Alden) Department of Neurosurgery, Ann and Robert H. Lurie Children's
Hospital of Chicago, Northwestern University, Feinberg School of Medicine,
Chicago, IL, United States
(Amartino) Child Neurology Department, Hospital Universitario Austral,
Buenos Aires, Argentina
(Ashworth) Department of Paediatric Ophthalmology, Manchester Royal Eye
Hospital, Manchester University NHS Foundation Trust, Manchester, United
Kingdom
(Belani) Department of Anesthesiology, University of Minnesota,
Minneapolis, MN, United States
(Berger) Departments of Medicine and Neuroscience and Physiology, New York
University School of Medicine, Andre Cournand Pulmonary Physiology
Laboratory, Bellevue Hospital, New York, NY, United States
(Borgo) Orthopaedics Clinic, Padova University Hospital, Padova, Italy
(Braunlin) Division of Pediatric Cardiology, University of Minnesota,
Minneapolis, MN, United States
(Eto) Advanced Clinical Research Centre, Institute of Neurological
Disorders, Kanagawa, Japan
(Gold) Keck School of Medicine, Departments of Anesthesiology, Pediatrics,
and Psychiatry and Behavioural Sciences, Children's Hospital Los Angeles,
Department of Anesthesiology Critical Care Medicine, 4650 Sunset
Boulevard, Los Angeles, CA, United States
(Jester) Hand and Upper Limb Service, Department of Plastic Surgery,
Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
(Jones) Willink Biochemical Genetic Unit, Manchester Centre for Genomic
Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust,
Manchester, United Kingdom
(Karsli) Department of Anesthesiology and Pain Medicine, Hospital for Sick
Children, Toronto, Canada
(Mackenzie) Department of Orthopedics, Nemours/Alfred I, Dupont Hospital
for Children, Wilmington, DE, United States
(Marinho) Department of Ophthalmology, UFRGS, Ophthalmology Service, HCPA,
Porto Alegre, Brazil
(McFadyen) Isaac Foundation, Campbellford, ON, Canada
(McGill) Department of Metabolic Medicine, Queensland Children's Hospital,
Brisbane, Australia
(Mitchell) Division of Pediatric Endocrinology, Montreal Children's
Hospital, Montreal, QC, Canada
(Muenzer) Department of Pediatrics, School of Medicine, University of
North Carolina at Chapel Hill, Chapel Hill, NC, United States
(Okuyama) Department of Clinical Laboratory Medicine, National Centre for
Child Health and Development, Tokyo, Japan
(Orchard) Division of Blood and Marrow Transplantation, Department of
Pediatrics, University of Minnesota, Minneapolis, MN, United States
(Stevens, Thomas) MPS Society, Amersham, Buckinghamshire, United Kingdom
(Walker) Department of Paediatric Anaesthesia, Royal Manchester Children's
Hospital, Manchester, United Kingdom
(Wynn) Department of Paediatric Haematology, Royal Manchester Children's
Hospital, Manchester, United Kingdom
(Giugliani) Department of Genetics, UFRGS, Medical Genetics Service, HCPA,
Porto Alegre, Brazil
(Harmatz) UCSF Benioff Children's Hospital Oakland, Oakland, CA, United
States
(Hendriksz) Steve Biko Academic Hospital, University of Pretoria,
Pretoria, South Africa
(Scarpa) Center for Rare Diseases at Host Schmidt Kliniken, Wiesbaden,
Germany
(Eto) Department of Paediatrics/Gene Therapy, Tokyo Jikei University
School of Medicine, Tokyo, Japan
(Scarpa) Department of Paediatrics, University of Padova, Padova, Italy
Publisher
BioMed Central Ltd
Abstract
Introduction: Mucopolysaccharidosis (MPS) IVA or Morquio A syndrome is an
autosomal recessive lysosomal storage disorder (LSD) caused by deficiency
of the N-acetylgalactosamine-6-sulfatase (GALNS) enzyme, which impairs
lysosomal degradation of keratan sulphate and chondroitin-6-sulphate. The
multiple clinical manifestations of MPS IVA present numerous challenges
for management and necessitate the need for individualised treatment.
Although treatment guidelines are available, the methodology used to
develop this guidance has come under increased scrutiny. This programme
was conducted to provide evidence-based, expert-agreed recommendations to
optimise management of MPS IVA. Method(s): Twenty six international
healthcare professionals across multiple disciplines, with expertise in
managing MPS IVA, and three patient advocates formed the Steering
Committee (SC) and contributed to the development of this guidance.
Representatives from six Patient Advocacy Groups (PAGs) were interviewed
to gain insights on patient perspectives. A modified-Delphi methodology
was used to demonstrate consensus among a wider group of healthcare
professionals with experience managing patients with MPS IVA and the
manuscript was evaluated against the validated Appraisal of Guidelines for
Research and Evaluation (AGREE II) instrument by three independent
reviewers. Result(s): A total of 87 guidance statements were
developed covering five domains: (1) general management principles; (2)
recommended routine monitoring and assessments; (3) disease-modifying
interventions (enzyme replacement therapy [ERT] and haematopoietic stem
cell transplantation [HSCT]); (4) interventions to support respiratory and
sleep disorders; (5) anaesthetics and surgical interventions (including
spinal, limb, ophthalmic, cardio-thoracic and ear-nose-throat [ENT]
surgeries). Consensus was reached on all statements after two rounds of
voting. The overall guideline AGREE II assessment score obtained for the
development of the guidance was 5.3/7 (where 1 represents the lowest
quality and 7 represents the highest quality of guidance).
 Conclusion(s): This manuscript provides evidence- A nd
consensus-based recommendations for the management of patients with MPS
IVA and is for use by healthcare professionals that manage the holistic
care of patients with the intention to improve clinical- A nd
patient-reported outcomes and enhance patient quality of life. It is
recognised that the guidance provided represents a point in time and
further research is required to address current knowledge and evidence
gaps. Copyright © 2019 The Author(s).

<40>
Accession Number
636930910
Title
Movement-based mind-body interventions for cardiac rehabilitation: An
updated systematic review of randomized controlled trials.
Source
Tzu Chi Medical Journal. 34(1) (pp 49-54), 2022. Date of Publication: 01
Jan 2022.
Author
Huang C.-H.; Chao S.-F.; Cheng Y.-T.; Lai P.-C.; Lin I.-H.; Peng T.-C.
Institution
(Huang, Peng) Department of Nursing, Tzu Chi University, Hualien, Taiwan
(Republic of China)
(Chao) Department of Cardiovascular Surgery, Hualien Tzu Chi Hospital,
Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan (Republic of China)
(Chao, Cheng) School of Medicine, Tzu Chi University, Hualien, Taiwan
(Republic of China)
(Cheng) Department of Cardiovascular Surgery, Dalin Tzu Chi Hospital,
Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (Republic of China)
(Lai) Education Center, National Cheng Kung University Hospital and
College of Medicine, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
(Lin) Department of Post-Baccalaureate Chinese Medicine, Tzu Chi
University, Hualien, Taiwan (Republic of China)
Publisher
Wolters Kluwer Medknow Publications
Abstract
This study aimed to assess evidence for the effect of movement-based
mind-body interventions (MMBIs) for cardiac rehabilitation (CR). Six
databases were searched from January 1995 to September 2020. All
randomized controlled trials (RCTs) evaluated the effect of MMBIs on heart
disease (HD) patients' physical and psychological outcomes. Two reviewers
independently assessed the quality of all the included studies using the
revised Cochrane risk-of-bias tool for RCTs. Sixteen RCTs (5160
participants) published between 1996 and 2020 met all inclusion criteria.
In total, these studies investigated the effect of MMBIs for CR. Outcome
measures that emerged in these studies included physical and
psychological, and/or biochemical parameters to comprehensively evaluate
the effects of MMBIs on HD patients. Overall, these studies suggest that
MMBIs seem to be an alternative with the optimal CR option. Copyright
© 2021 Tzu Chi Medical Journal.

<41>
Accession Number
2015778771
Title
Atrial Mechanics in Hypertrophic Cardiomyopathy: Discriminating between
Ventricular Hypertrophy and Fibrosis.
Source
Arquivos Brasileiros de Cardiologia. 118(1) (pp 77-87), 2022. Date of
Publication: 2022.
Author
Marques-Alves P.; Ferreira J.A.; Freitas A.A.; Almeida J.P.; Baptista R.;
Castro G.; Martins R.; Donato P.; Ferreira M.J.; Goncalves L.
Institution
(Marques-Alves, Ferreira, Freitas, Almeida, Baptista, Castro, Martins,
Ferreira, Goncalves) Departamento de Cardiologia, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
(Baptista, Ferreira, Goncalves) ICBR Instituto de Investigacao Clinica e
Biomedica de Coimbra, Universidade de Coimbra, Coimbra, Portugal
(Marques-Alves, Baptista, Donato, Ferreira, Goncalves) Faculdade de
Medicina, Universidade de Coimbra, Coimbra, Portugal
(Donato) Departamento de Radiologia, Centro Hospitalar e Universitario de
Coimbra, Coimbra, Portugal
Publisher
Arquivos Brasileiros de Cardiologia
Abstract
Background: Hypertrophic cardiomyopathy (HCM) and left ventricular
hypertrophy (LVH) secondary to systemic hypertension (HTN) may be
associated with left atrial (LA) functional abnormalities.
 Objective(s): We aimed to characterize LA mechanics in HCM and HTN
and determine any correlation with the extent of left ventricular (LV)
fibrosis measured by cardiac magnetic resonance (CMR) in HCM patients.
 Method(s): Two-dimensional speckle tracking-derived longitudinal LA
function was acquired from apical views in 60 HCM patients, 60 HTN
patients, and 34 age-matched controls. HCM patients also underwent CMR,
with measurement of late gadolinium enhancement (LGE) extension.
Association with LA strain parameters was analyzed. Statistical
significance was set at p<0.05. Result(s): Mean LV ejection fraction
was not different between the groups. The E/e' ratio was impaired in the
HCM group and preserved in the control group. LA mechanics was
significantly reduced in HCM, compared to the HTN group. LA strain rate in
reservoir (LASRr) and in contractile (LASRct) phases were the best
discriminators of HCM, with an area under the curve (AUC) of 0.8, followed
by LA strain in reservoir phase (LASr) (AUC 0.76). LASRr and LASR-ct had
high specificity (89% and 91%, respectively) and LASr had sensitivity of
80%. A decrease in 2.79% of LA strain rate in conduit phase (LASRcd)
predicted an increase of 1cm in LGE extension (r2=0.42, beta
2.79, p=0.027). Conclusion(s): LASRr and LASRct were the best
discriminators for LVH secondary to HCM. LASRcd predicted the degree of LV
fibrosis assessed by CMR. These findings suggest that LA mechanics is a
potential predictor of disease severity in HCM. Copyright © 2022,
Arquivos Brasileiros de Cardiologia. All rights reserved.

<42>
Accession Number
2015670935
Title
Anticoagulation therapy in patients with post-operative atrial
fibrillation: Systematic review with meta-analysis.
Source
Vascular Pharmacology. 142 (no pagination), 2022. Article Number: 106929.
Date of Publication: February 2022.
Author
Neves I.A.; Magalhaes A.; Lima da Silva G.; Almeida A.G.; Borges M.; Costa
J.; Ferreira J.J.; Pinto F.J.; Caldeira D.
Institution
(Neves) Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
(Magalhaes, Lima da Silva, Almeida, Pinto, Caldeira) Centro Cardiovascular
da Universidade de Lisboa, CAML, Faculdade de Medicina da Universidade de
Lisboa, Portugal
(Magalhaes, Lima da Silva, Almeida, Pinto, Caldeira) Cardiology
Department, Hospital Santa Maria - Centro Hospitalar Universitario Lisboa
Norte (CHULN), Lisbon, Portugal
(Borges, Costa, Ferreira, Caldeira) Laboratory of Clinical Pharmacology
and Therapeutics, Faculty of Medicine, Universidade de Lisboa, Lisbon,
Portugal
(Borges, Costa, Ferreira) Instituto de Medicina Molecular Joao Lobo
Antunes, Faculdade de Medicina, Universidade de Lisboa, Portugal
(Ferreira) CNS - Neurological Senior Campus, Torres Vedras, Portugal
Publisher
Elsevier Inc.
Abstract
Background: Post-operative atrial fibrillation (POAF) is a relevant
complication after surgery. Several studies have shown that POAF has
important consequences for long-term morbidity and mortality, by
increasing the risk of thromboembolic events. However, the use of oral
anticoagulation (OAC) is not well established in this context.
 Method(s): We searched MEDLINE, CENTRAL, PsycInfo and Web of Science
for clinical trials and observational studies evaluating anticoagulation
vs. no anticoagulation in patients with POAF (after cardiac or non-cardiac
surgery). Data were screened and extracted by two independent reviewers.
We performed a random- effects model to estimate the pooled odds ratio
(OR) with 95% Confidence Intervals (CI), and heterogeneity was evaluated
by I2 statistics. The outcomes of interest were all-cause
mortality, thromboembolic events, and bleeding events. Result(s):
Overall, 10 observational retrospective studies were included: 5 studies
with 203,946 cardiac surgery POAF patients, and 5 studies with 29,566
patients with POAF after non-cardiac surgery. In cardiac surgery POAF, the
OAC use was associated with lower risk of thromboembolic events (OR 0.68;
95%CI 0.47-0.96, I2 = 31%; 4 studies) and the bleeding risk was
significantly increased (OR 4.30; 95%CI 3.69 to 5.02, 1 study). In
non-cardiac surgery POAF, OAC did not significantly reduce the risk of
thromboembolic events (OR 0.71, 95%CI 0.33-1.15; I2 = 79%; 5
studies) but was associated with increased risk of bleeding (OR 1.20,
95%CI 1.10-1.32, I2 = 0%; 3 studies). Mortality was not
significantly reduced in both cardiac and non-cardiac surgery POAF.
 Conclusion(s): Oral anticoagulation was associated with a lower risk
of thromboembolic events in patients with POAF following cardiac surgery
but not in non-cardiac surgery. Bleeding risk was increased in both
settings. The confidence on pooled results is at most low, and further
data, namely randomized controlled trials are necessary to derive robust
conclusions. Copyright © 2021 Elsevier Inc.

<43>
Accession Number
2015596573
Title
Distal versus conventional radial access for coronary angiography and
intervention: Design and rationale of DISCO RADIAL study.
Source
American Heart Journal. 244 (pp 19-30), 2022. Date of Publication:
February 2022.
Author
Aminian A.; Sgueglia G.A.; Wiemer M.; Gasparini G.L.; Kefer J.; Ruzsa Z.;
van Leeuwen M.A.H.; Vandeloo B.; Ungureanu C.; Kedev S.; Iglesias J.F.;
Leibundgut G.; Ratib K.; Bernat I.; Barriocanal I.; Borovicanin V.; Saito
S.
Institution
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Sgueglia) Division of Cardiology, Sant'Eugenio Hospital, Rome, Italy
(Wiemer) Department of Cardiology and Intensive Care, Johannes Wesling
University Hospital Ruhr University Bochum, Minden, Germany
(Gasparini) Humanitas Clinical and Research Center, IRCCS, Rozzano-Milan,
Italy
(Kefer) Division of Cardiology, Cliniques Universitaires Saint-Luc,
Brussels, Belgium
(Ruzsa) Department of Internal Medicine, Invasive Cardiology Division,
University of Szeged, Medical Faculty, Szeged, Hungary
(Ruzsa) Cardiology Division, Bacs-Kiskun County Hospital, Invasive
Cardiology, Kecskemet, Hungary
(van Leeuwen) Department of Cardiology, Isala Heart Center, Zwolle,
Netherlands
(Vandeloo) Department of Cardiology, Universitair Ziekenhuis Brussel,
Vrije Universiteit Brussel (VUB), Brussels, Belgium
(Ungureanu) Department of Cardiology, Jolimont Hospital, La Louviere,
Belgium
(Kedev) Interventional Cardiology Department, University Clinic of
Cardiology, Skopje, North Macedonia
(Iglesias) Department of Cardiology, Geneva University Hospital, Geneva,
Switzerland
(Leibundgut) Kantonsspital Baselland, Liestal, Switzerland
(Ratib) Centre for Prognosis Research, Keele Cardiovascular Research
Group, Institute for Primary Care and Health Sciences, Keele University,
United Kingdom
(Bernat) Department of Cardiology, University Hospital and Faculty of
Medicine Pilsen, Charles University, Pilsen, Czechia
(Barriocanal, Borovicanin) European Medical and Clinical Division, Terumo
Europe N.V., Leuven, Belgium
(Saito) Department of Cardiology, Shonan Kamakura General Hospital,
Kanagawa, Japan
Publisher
Elsevier Inc.
Abstract
Background: Transradial access (TRA) has become the default access method
for coronary diagnostic and interventional procedures. As compared to
transfemoral access, TRA has been shown to be safer, cost-effective and
more patient-friendly. Radial artery occlusion (RAO) represents the most
frequent complication of TRA, and precludes future coronary procedures
through the radial artery, the use of the radial artery as a conduit for
coronary artery bypass grafting or as arteriovenous fistula for patients
on hemodialysis. Recently, distal radial access (DRA) has emerged as a
promising alternative to TRA, yielding potential for minimizing the risk
of RAO. However, an international multicenter randomized comparison
between DRA, and conventional TRA with respect to the rate of RAO is still
lacking. Trial Design: DISCO RADIAL is a prospective, multicenter,
open-label, randomized, controlled, superiority trial. A total of 1300
eligible patients will be randomly allocated to undergo coronary
angiography and/or percutaneous coronary intervention (PCI) through DRA or
TRA using the 6 Fr Glidesheath Slender sheath introducer. Extended
experience with both TRA and DRA is required for operators' eligibility
and optimal evidence-based best practice to reduce RAO systematically
implemented by protocol. The primary endpoint is the incidence of forearm
RAO assessed by vascular ultrasound at discharge. Several important
secondary endpoints will also be assessed, including access-site
cross-over, hemostasis time, and access-site related complications. The
DISCO RADIAL trial will provide the first large-scale multicenter
randomized evidence comparing DRA to TRA in patients scheduled for
coronary angiography or PCI with respect to the incidence of RAO at
discharge. Copyright © 2021

<44>
Accession Number
2014434179
Title
COVID-19 Patients With Previous Coronary Artery By-Pass Graft Have a
Higher Mortality Risk.
Source
American Journal of Cardiology. 159 (pp 146-148), 2021. Date of
Publication: 15 Nov 2021.
Author
Zuin M.; Rigatelli G.; Bilato C.; Roncon L.; Zuliani G.
Institution
(Zuin, Zuliani) Department of Translational Medicine, University of
Ferrara, Ferrara, Italy
(Rigatelli, Roncon) Department of Cardiology, Rovigo General Hospital,
Rovigo, Italy
(Bilato) Department of Cardiology, West Vicenza Hospital, Arzignano, Italy
Publisher
Elsevier Inc.

<45>
Accession Number
2013137603
Title
Aortic valve myxoma-A systematic review of published cases.
Source
International Journal of Clinical Practice. 75(11) (no pagination), 2021.
Article Number: e14566. Date of Publication: November 2021.
Author
Sachdeva S.; Desai R.; Shamim S.; Gandhi Z.; Shrivastava A.; Patel D.;
Uzair Lodhi M.; Raina J.; Itare V.; Mahmood A.; Sachdeva R.; Kumar G.
Institution
(Sachdeva) Section of Cardiovascular Medicine, Department of Medicine,
Boston University School of Medicine, MA, United States
(Desai, Sachdeva, Kumar) Division of Cardiology, Atlanta VA Medical
Center, Decatur, GA, United States
(Shamim) Internal Medicine, AIM Medical Center, Snellville, GA, United
States
(Gandhi) Department of Medicine, C.U. Shah Medical College, Surendranagar,
Gujarat, India
(Shrivastava) Department of Pediatrics, Children's Hospital of
Michigan/Detroit Medical Center, Detroit, MI, United States
(Patel) Department of Internal Medicine, Texas Tech University Health
Sciences Center El Paso, El Paso, TX, United States
(Uzair Lodhi, Mahmood) Department of Internal Medicine, Eastern Idaho
Regional Medical Center, Idaho Falls, ID, United States
(Raina, Itare) Department of Internal Medicine, Brookdale University
Hospital and Medical Center, New York, NY, United States
(Kumar) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Aortic valve myxoma is the rarest location of the most common
primary tumour of cardiac origin. Because of the paucity of data, there is
little known about their clinical presentation, diagnosis and
complications. Method(s): PUBMED, EMBASE, SCOPUS and WEB OF SCIENCE
were systematically searched to identify all published cases of aortic
valve myxoma through October 2020. Descriptive statistics were used to
report the data. Result(s): Aortic valve myxomas were more prevalent
in young (mean age 41 years) male (75%) patients. It most commonly
involved the right coronary cusp (50%). Cerebrovascular events (25%),
dyspnoea (18.8%), and distal embolisation (18.8%) were found to be the
most frequent complications. Echocardiography remains the diagnostic
modality of choice in all cases, histopathology is used for confirmation.
Most cases were treated with surgical excision (94%); concomitant aortic
valve repair and mechanical aortic valve replacement were performed in 25%
and 37.5% cases respectively. Sudden cardiac death was noted in one
patient. Conclusion(s): Aortic valve myxomas are more often than not
discovered in the context of embolic phenomenon or dyspnoea. The most
feared complication is stroke, although mortality remains low in
surgically managed cases. Copyright © 2021 John Wiley & Sons Ltd

<46>
Accession Number
636748753
Title
Efficacy and safety of aprotinin in paediatric cardiac surgery: A
systematic review and meta-analysis.
Source
European journal of anaesthesiology. 39(4) (pp 352-367), 2022. Date of
Publication: 01 Apr 2022.
Author
Atasever A.G.; Eerens M.; Van den Eynde R.; Faraoni D.; Rex S.
Institution
(Atasever) From the Department of Anaesthesiology, University Hospitals of
the KU Leuven, Herestraat, Leuven, Belgium (AGA, ME, RVdE, SR). Arthur S.
Keats Division of Paediatric Cardiovascular Anesthesia. Department of
Anesthesiology, Peri-operative and Pain Medicine, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, USA (DF). And
Department of Cardiovascular Sciences, KU Leuven, Herestraat, Leuven,
Belgium (SR)
Publisher
NLM (Medline)
Abstract
BACKGROUND: The relicensing of aprotinin in Europe and Canada has
stimulated discussions on its usefulness in paediatric cardiac surgery.
 OBJECTIVE(S): To systematically evaluate the available evidence on
the efficacy and safety of aprotinin in paediatric cardiac surgery.
DESIGN: Systematic review of all randomised and observational studies
comparing aprotinin with tranexamic acid, epsilon aminocaproic acid,
placebo or no drug in paediatric cardiac surgery. Meta-analyses were
performed on efficacy and safety outcomes. DATA SOURCES: PubMed, Cochrane
Central Register of Controlled Trials, Web of Science and Embase were
searched from January 2000 to March 2021. ELIGIBILITY CRITERIA: Studies
that enrolled children under 18 years undergoing cardiac surgery with
cardiopulmonary bypass. RESULT(S): Thirty-two studies enrolling a
total of 63 894 paediatric cardiac procedures were included. Aprotinin
significantly reduced total blood loss [mean difference -4.70 ml kg-1, 95%
confidence interval (CI), -7.88 to -1.53; P = 0.004], postoperative
transfusion requirements and the incidence of surgical re-exploration for
bleeding [odds ratio (OR) 0.74, 95% CI, 0.56 to 0.97; P = 0.03]. Aprotinin
had no effects on 30-day mortality (OR 1.02, 95% CI, 0.93 to 1.11; P =
0.73) and on other safety outcomes, except for the incidence of renal
replacement therapy (RRT), which was significantly increased in patients
given aprotinin (OR 1.29, 95% CI, 1.08 to 1.54; P = 0.006). Findings from
observational and randomised controlled trials did not largely differ. A
sub-group analysis in neonates showed that aprotinin significantly reduced
packed red blood cell transfusions and the incidence of postoperative
surgical re-exploration for bleeding and/or tamponade. When compared with
lysine analogues, aprotinin was more effective at reducing bleeding and
transfusion without increasing the risk of side effects.
 CONCLUSION(S): This meta-analysis suggests that aprotinin is
effective and well tolerated in paediatric cardiac surgery. Given the
large heterogeneity of the results and the risk of selection bias in
observational studies, large randomised controlled trials are
warranted. Copyright © 2021 European Society of Anaesthesiology
and Intensive Care. Unauthorized reproduction of this article is
prohibited.

<47>
Accession Number
2011708714
Title
Efficacy, Safety, and Strategies for Recombinant-Activated Factor VII in
Cardiac Surgical Bleeding: A Narrative Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(4) (pp 1157-1168),
2022. Date of Publication: April 2022.
Author
Kidd B.; Sutherland L.; Jabaley C.S.; Flynn B.
Institution
(Kidd, Flynn) Division of Critical Care Medicine, Department of
Anesthesiology, University of Kansas Medical Center, KS, Kansas City
(Sutherland) Division of Critical Care Medicine, Department of
Anesthesiology, Columbia University, New York, NY, United States
(Jabaley) Division of Critical Care Medicine, Department of
Anesthesiology, Emory University, GA, Atlanta
(Jabaley) Emory Critical Care Center, GA, Atlanta
Publisher
W.B. Saunders
Abstract
As perioperative bleeding continues to be a major source of morbidity and
mortality in cardiac surgery, the search continues for an ideal hemostatic
agent for use in this patient population. Transfusion of blood products
has been associated both with increased costs and risks, such as
infection, prolonged mechanical ventilation, increased length of stay, and
decreased survival. Recombinant-activated factor VII (rFVIIa) first was
approved for the US market in 1999 and since that time has been used in a
variety of clinical settings. This review summarizes the existing
literature pertaining to perioperative rFVIIa, in addition to society
recommendations and current guidelines regarding its use in cardiac
surgery. Copyright © 2021 Elsevier Inc.

<48>
Accession Number
637411889
Title
Plasmalyte-A Based del Nido Cardioplegia Versus Plain Ringer Based del
Nido Cardioplegia: Double-Blind Randomized Trial.
Source
World journal for pediatric & congenital heart surgery. 13(2) (pp
187-195), 2022. Date of Publication: 01 Mar 2022.
Author
Talwar S.; Harshavardhan N.; Kapoor P.M.; Makhija N.; Rajashekar P.;
Sreenivas V.; Upadhyay A.D.; Sahu M.K.; Choudhary S.K.
Institution
(Talwar, Harshavardhan, Sahu, Choudhary) 422637All India Institute of
Medical Sciences Cardio-Thoracic Sciences Centre, New Delhi, India
(Kapoor, Makhija, Rajashekar, Sreenivas, Upadhyay) 28730All India
Institute of Medical Sciences, New Delhi, India
Publisher
NLM (Medline)
Abstract
Background: In this prospective randomized controlled trial, we compared
the standard del Nido cardioplegia solution (SDN) with the modified del
Nido cardioplegia solution (MDN) in which the base solution was the plain
Ringer solution. Method(s): A total of 80 patients aged < 12 years
undergoing intracardiac repair of Tetralogy of Fallot were randomized into
SDN (n=39) or MDN (n=41) groups. The primary outcome was a change in
cardiac index (CI). Secondary outcomes were ventricular arrhythmias after
the release of aortic-cross clamp, postoperative inotropic score (IS),
time to peripheral rewarming, duration of mechanical ventilation,
intensive care unit (ICU) length of stay, and hospital length of stay, and
electron microscopic differences between the 2 groups. Cardiac Troponin-I,
inflammatory markers tumor necrosis factor-alpha (TNF-alpha), and
interleukin-L (IL-6) were measured. Result(s): Applying the
noninferiority confidence interval approach, the difference between the
changes in CI between the 2 groups was -0.093 L/min/m2 (95% CI: -0.46-0.27
L/min/m2) which was within the noninferiority threshold of -0.5 indicating
that CI was similar in both SDN and MDN. Ventricular arrhythmias postclamp
release (P=.91), IS (P=.09), duration of mechanical ventilation (P=.27),
ICU length of stay (P=.50), hospital length of stay (P=.57), IL-6 (P=.19),
TNF-alpha (P=.17), Troponin-I (P=.15), electron microscopy changes (P>.05)
were not different between groups. Conclusion(s): MDN was shown to be
noninferior to the SDN cardioplegia in terms of preservation of cardiac
index. In addition, other metrics indicative of myocardial protection were
similar between groups. In developing nations where SDN is not available
or is expensive, MDN cardioplegia is an acceptable alternative.

<49>
Accession Number
637411807
Title
Major Aortopulmonary Collateral Arteries Requiring Percutaneous
Intervention Following the Arterial Switch Operation: A Case Series and
Systematic Review.
Source
World journal for pediatric & congenital heart surgery. 13(2) (pp
146-154), 2022. Date of Publication: 01 Mar 2022.
Author
Doulamis I.P.; Marathe S.P.; Oh N.A.; Saeed M.Y.; Muter A.; Del Nido P.J.;
Nathan M.
Institution
(Doulamis, Marathe, Oh, Saeed, Muter, Del Nido, Nathan) Department of
Cardiac Surgery, 1862Boston Children's Hospital, Harvard Medical School,
MA, Boston, United States
Publisher
NLM (Medline)
Abstract
Background: Dextro transposition of the great arteries (d-TGA) is the most
common critical congenital cardiac defect surgically treated in the
neonatal period by arterial switch operation (ASO). Major aortopulmonary
collaterals (MAPCAs) can be present in this population and may complicate
the early postoperative period. Our aim was to review our institutional
data and systematically review the available literature to provide further
insight on the clinical significance of MAPCAs during the early
postoperative course after ASO. Method(s): This is a retrospective
study of patients with simple d-TGA who underwent ASO between March 1998
and September 2020 at Boston Children's Hospital. The MEDLINE, Embase, and
Cochrane databases were searched from inception to June 2020.
 Result(s): Of the 671 d-TGA patients who underwent ASO at our center,
13 (1.9%) were diagnosed with MAPCAs. Five were diagnosed before ASO,
while eight were diagnosed after ASO. Of these, two patients required
catheterization for MAPCAs coiling during the same hospitalization on the
2nd and 11th postoperative days. The systematic review retrieved a total
of 34 articles after duplicates were removed. Finally, nine studies
reporting on 23 patients were deemed eligible for our analysis. The
average time to MAPCAs coiling was 12 days, while the mean hospital stay
was 36 days. Conclusion(s): MAPCAs should be included in the
differential diagnosis of ASO complicated by cardiac or respiratory
failure, or pulmonary hemorrhage acutely postoperatively. Once managed,
recovery of these patients is predictable, and mortality is low. Further
studies investigating the diagnostic value of echocardiography and the
long-term outcomes of these MAPCAs are necessary.

<50>
Accession Number
2016939828
Title
2-Year Outcomes After Transcatheter Versus Surgical Aortic Valve
Replacement in Low-Risk Patients.
Source
Journal of the American College of Cardiology. 79(9) (pp 882-896), 2022.
Date of Publication: 08 Mar 2022.
Author
Forrest J.K.; Deeb G.M.; Yakubov S.J.; Rovin J.D.; Mumtaz M.; Gada H.;
O'Hair D.; Bajwa T.; Sorajja P.; Heiser J.C.; Merhi W.; Mangi A.; Spriggs
D.J.; Kleiman N.S.; Chetcuti S.J.; Teirstein P.S.; Zorn G.L.; Tadros P.;
Tchetche D.; Resar J.R.; Walton A.; Gleason T.G.; Ramlawi B.; Iskander A.;
Caputo R.; Oh J.K.; Huang J.; Reardon M.J.
Institution
(Forrest, Mangi) Department of Internal Medicine (Cardiology), Yale
University School of Medicine, New Haven, CT, United States
(Forrest, Mangi) Department of Surgery (Cardiac Surgery), Yale University
School of Medicine, New Haven, CT, United States
(Deeb, Chetcuti) Department of Interventional Cardiology, University of
Michigan Hospitals, Ann Arbor, MI, United States
(Deeb, Chetcuti) Department of Cardiovascular Surgery, University of
Michigan Hospitals, Ann Arbor, MI, United States
(Yakubov) Department of Interventional Cardiology, Riverside
Methodist-OhioHealth, Columbus, OH, United States
(Rovin, Spriggs) Department of Cardiac Surgery, Morton Plant Hospital,
Clearwater, FL, United States
(Mumtaz, Gada) Department of Interventional Cardiology, University of
Pittsburgh Medical Center Pinnacle, Wormleyburg, PA, United States
(Mumtaz, Gada) Department of Cardiovascular and Thoracic Surgery,
University of Pittsburgh Medical Center Pinnacle, Wormleyburg, PA, United
States
(O'Hair, Bajwa) Department of Interventional Cardiology, Aurora St. Luke's
Medical Center, Milwaukee, WI, United States
(O'Hair, Bajwa) Department of Cardiovascular Surgery, Aurora St. Luke's
Medical Center, Milwaukee, WI, United States
(Sorajja) Department of Interventional Cardiology, Minneapolis Heart
Institute-Abbott Northwestern Hospital, Minneapolis, MN, United States
(Heiser, Merhi) Department of Interventional Cardiology, Spectrum Health,
Grand Rapids, MI, United States
(Heiser, Merhi) Department of Cardiothoracic Surgery, Spectrum Health,
Grand Rapids, MI, United States
(Kleiman, Reardon) Department of Interventional Cardiology, Houston
Methodist-DeBakey Heart and Vascular Center, Houston, TX, United States
(Kleiman, Reardon) Department of Cardiothoracic Surgery, Houston
Methodist-DeBakey Heart and Vascular Center, Houston, TX, United States
(Teirstein) Department of Interventional Cardiology, Scripps Clinic, La
Jolla, CA, United States
(Zorn, Tadros) Department of Interventional Cardiology, University of
Kansas, Kansas City, KS, United States
(Zorn, Tadros) Department of Cardiac Surgery, University of Kansas, Kansas
City, KS, United States
(Tchetche) Department of Interventional Cardiology, Clinique Pasteur,
Toulouse, France
(Resar) Department of Interventional Cardiology, Johns Hopkins Hospital,
Baltimore, MD, United States
(Walton) Department of Interventional Cardiology, Alfred Hospital,
Melbourne, VIC, Australia
(Gleason) Department of Cardiac Surgery, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Ramlawi) Department of Cardiovascular Surgery, Valley Health System,
Winchester, Virginia, United States
(Iskander, Caputo) Department of Interventional Cardiology, Saint Joseph's
Hospital Health Center, Syracuse, NY, United States
(Iskander, Caputo) Department of Cardiovascular Surgery, Saint Joseph's
Hospital Health Center, Syracuse, NY, United States
(Oh) Division of Cardiovascular Ultrasound, Mayo Clinic, Rochester, MN,
United States
(Huang) Department of Statistics, Medtronic, Minneapolis, MN, United
States
Publisher
Elsevier Inc.
Abstract
Background: The Evolut Low Risk Trial (Medtronic Evolut Transcatheter
Aortic Valve Replacement in Low Risk Patients) showed that transcatheter
aortic valve replacement (TAVR) with a supra-annular, self-expanding valve
was noninferior to surgery for the primary endpoint of all-cause mortality
or disabling stroke at 2 years. This finding was based on a Bayesian
analysis performed after 850 patients had reached 1 year of follow-up.
 Objective(s): The goal of this study was to report the full 2-year
clinical and echocardiographic outcomes for patients enrolled in the
Evolut Low Risk Trial. Method(s): A total of 1,414 low-surgical risk
patients with severe aortic stenosis were randomized to receive TAVR or
surgical AVR. An independent clinical events committee adjudicated adverse
events, and a central echocardiographic core laboratory assessed
hemodynamic endpoints. Result(s): An attempted implant was performed
in 730 TAVR and 684 surgical patients from March 2016 to May 2019. The
Kaplan-Meier rates for the complete 2-year primary endpoint of death or
disabling stroke were 4.3% in the TAVR group and 6.3% in the surgery group
(P = 0.084). These rates were comparable to the interim Bayesian rates of
5.3% with TAVR and 6.7% with surgery (difference: -1.4%; 95% Bayesian
credible interval: -4.9% to 2.1%). All-cause mortality rates were 3.5% vs
4.4% (P = 0.366), and disabling stroke rates were 1.5% vs 2.7% (P =
0.119), respectively. Between years 1 and 2, there was no convergence of
the primary outcome curves. Conclusion(s): The complete 2-year
follow-up from the Evolut Low Risk Trial found that TAVR is noninferior to
surgery for the primary endpoint of all-cause mortality or disabling
stroke, with event rates that were slightly better than those predicted by
using the Bayesian analysis. (Medtronic Evolut Transcatheter Aortic Valve
Replacement in Low Risk Patients [Evolut Low Risk Trial];
NCT02701283) Copyright © 2022

<51>
Accession Number
2015172304
Title
Preoperative Anemia and Risk for Perioperative Neurocognitive Dysfunction
in Cardiac Surgery Patients: A Retrospective Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(4) (pp 1056-1063),
2022. Date of Publication: April 2022.
Author
Shayan S.; Okocha O.; Srdanovic N.; Balmert L.; Grafman J.; Madhan A.S.;
Samra S.S.; Brown I.C.H.; Sweitzer B.; Hogue C.W.
Institution
(Shayan, Okocha, Sweitzer, Hogue) Department of Anesthesiology,
Northwestern University Feinberg School of Medicine, IL, Chicago
(Srdanovic, Balmert) Department of Preventative Medicine, Northwestern
University Feinberg School of Medicine, IL, Chicago
(Grafman) Department of Physical Medicine & Rehabilitation, Neurology,
Cognitive Neurology and Alzheimer's Center, Department of Psychiatry,
Feinberg School of Medicine & Department of Psychology, Weinberg College
of Arts and Sciences, Northwestern University, IL, Chicago
(Madhan, Samra) Northwestern University Feinberg School of Medicine
(Brown) Department of Anesthesiology & Critical Care Medicine, The Johns
Hopkins University School of Medicine, MD, Baltimore
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate whether there is a relationship between
preoperative anemia and domain-specific cognitive performance in patients
undergoing cardiac surgery. Design(s): Retrospective analysis of data
collected from a randomized study. Setting(s): Tertiary care
university hospital. Participant(s): A total of 436 patients age >=55
years undergoing cardiac surgery. Intervention(s): None.
 Measurements and Main Results: Neuropsychological testing was
performed before and one month after surgery, using a standard battery.
Individual Z-scores calculated from the mean and standard deviation of
tests at baseline were combined into domain-specific scores. Anemia
(hemoglobin <130 g/L for men, <120 g/L for women) was present in 41% of
patients. Preoperative anemia had little impact on preoperative cognition.
There were no differences in the change in cognitive performance one month
after surgery from baseline between patients with and without preoperative
anemia. However, in a sensitivity analysis using multiple imputation for
missing cognitive test scores, significant associations were observed
between preoperative anemia and change in postoperative processing speed
(p = 0.016), change in executive function (p = 0.049), and change in fine
motor speed (p = 0.016). Nadir hemoglobin during cardiopulmonary bypass,
which was lower in anemic than nonanemic patients, was associated with
decrements in performance on tests of verbal fluency (p = 0.007),
processing speed (p = 0.042), and executive function (p = 0.10) one month
after surgery but not delayed neurocognitive recovery (p = 0.06).
 Conclusion(s): Preoperative anemia may be associated with impairment
of selective cognitive domains after surgery. Any effect of preoperative
anemia may have on cognition after surgery might be related to lower nadir
hemoglobin during cardiopulmonary bypass. Copyright © 2021

<52>
Accession Number
2014755582
Title
Association of Metformin with the Mortality and Incidence of
Cardiovascular Events in Patients with Pre-existing Cardiovascular
Diseases.
Source
Drugs. 82(3) (pp 311-322), 2022. Date of Publication: February 2022.
Author
Li T.; Providencia R.; Jiang W.; Liu M.; Yu L.; Gu C.; Chang A.C.Y.; Ma H.
Institution
(Li, Jiang, Liu, Ma) Department of Physiology and Pathophysiology, Fourth
Military Medical University, No. 169 Changle West Rd, Xi'an 710032, China
(Providencia) Barts Heart Centre, St. Bartholomew's Hospital, London,
United Kingdom
(Yu) Department of Pathology, Xijing Hospital, Fourth Military Medical
University, Xi'an 710032, China
(Gu) Department of Cardiovascular Surgery, Xijing Hospital, Fourth
Military Medical University, Xi'an 710032, China
(Chang) Department of Cardiology and Shanghai Institute of Precision
Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai 211125, China
Publisher
Adis
Abstract
Introduction: Whether metformin reduces all-cause cardiovascular mortality
and the incidence of cardiovascular events in patients with pre-existing
cardiovascular diseases (CVD) remains inconclusive. Some randomised
controlled trials (RCTs) and cohort studies have shown that metformin is
associated with an increased risk of mortality and cardiovascular events.
 Method(s): We conducted a pooling synthesis to assess the effects of
metformin in all-cause cardiovascular mortality and incidence of
cardiovascular events in patients with CVD. Studies published up to
October 2021 in PubMed or Embase with a registration in PROSPERO
(CRD42020189905) were collected. Both RCT and cohort studies were
included. Hazard ratios (HR) with 95% CI were pooled across various trials
using the random-effects model. Result(s): This study enrolled 35
published studies (in 14 publications) for qualitative synthesis and
identified 33 studies (published in 26 publications) for quantitative
analysis. We analysed a total of 61,704 patients, among them 58,271
patients were used to calculate all-cause mortality while 12,814 patients
were used to calculate cardiovascular mortality. Compared with
non-metformin control, metformin usage is associated with a reduction in
all-cause mortality (HR: 0.90; 95% CI 0.83, 0.98; p = 0.01),
cardiovascular mortality (HR: 0.89; 95% CI 0.85, 0.94; p < 0.0001),
incidence of coronary revascularisation (HR: 0.79; 95% CI 0.64, 0.98; p =
0.03), and heart failure (HR: 0.90; 95% CI 0.87, 0.94; p < 0.0001) in
patients with pre-existing cardiovascular diseases. Conclusion(s):
Metformin use is associated with a reduction in all-cause mortality,
cardiovascular mortality, incidence of coronary revascularisation, and
heart failure in patients with CVD; however, metformin usage was not
associated with reduction in the incidence of myocardial infarction,
angina, or stroke. Copyright © 2022, The Author(s), under
exclusive licence to Springer Nature Switzerland AG.

<53>
Accession Number
637391083
Title
Postnatal outcome in patients with aortic stenosis undergoing fetal aortic
valvuloplasty: A systematic review and meta-analysis.
Source
Zeitschrift fur Geburtshilfe und Neonatologie. Conference: 30. Kongress
der Deutschen Gesellschaft fur Perinatale Medizin. Virtual. 225(SUPPL 1)
(pp e50), 2021. Date of Publication: November 2021.
Author
Axt-Fliedner R.
Institution
(Axt-Fliedner) Justus-Liebig Universitat Giessen, Abteilung fuer Pranatale
Medizin and Fetale Therapie, Giessen, Germany
Publisher
Thieme Medical Publishers, Inc.
Abstract
Critical fetal aortic stenosis (AS) leads to stunted growth of the left
ventricle (LV) and progresses to hypoplastic left heart syndrome (HLHS) if
left untreated. To preserve the growth potential of the LV, fetal aortic
valvuloplasty (FAV) became the treatment of choice at selected centers
around the world. To this date, however, it is unclear in how many
patients undergoing FAV worldwide, a biventricular circulation is
ultimately achieved. The goal of this systematic review/metaanalysis is to
determine whether there is sufficient clinical evidence to predict
postnatal outcome in patients with AS following FAV to provide adequate
prenatal counseling for this patient cohort. Methods The methodology
published by the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) statement was applied. A systematic search on peri-
and postnatal outcome in patients with AS following FAV was performed
using MEDLINE, EMBASE, Web of Science and Cochrane Library. Results An
electronic search identified 579 studies, of which seven were considered
eligible for analysis. A total of 266 fetuses underwent FAV with a
follow-up ranging from 12 months to 13.2 years. There were no maternal
deaths and only one FAV related maternal complication. Hydrops was present
in 25 (9%) patients. Pooled prevalence of BV and UV among all live-born
patients were 46%, 44%, respectively. Pooled prevalence of each secondary
outcome was, technical successful procedures 82%; fetal deaths 16%, TOP
6%, live-births 79%, NND 9% comfort care 4%, late death 10%. Pooled
prevalence for BV and UV among live-born patients that underwent technical
successful procedures were 52% and 39.8%, respectively. Conclusion
Maternal FAV-related complications are rare and the majority of fetuses
undergoing FAV are born alive. BVC following successful fetal intervention
can be achieved in 52% of live-born patients compared to UVC. In summary,
the current available published information can serve for prenatal
parental counseling in this patient cohort. However,.

<54>
Accession Number
637409878
Title
Transcatheter Aortic Valve Replacement in Nonagenarians: A Systematic
Review and Meta-Analysis.
Source
The Journal of invasive cardiology. 34(3) (pp E226-E236), 2022. Date of
Publication: 01 Mar 2022.
Author
Demir O.M.; Curio J.; Pagnesi M.; Rahman H.; Mitomo S.; Colombo A.; Chau
M.; Prendergast B.; Latib A.
Institution
(Demir) Department of Cardiology, St Thomas' Hospital, London SE1 7EH,
United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Nonagenarians represent only a small proportion of patients
included in large transcatheter aortic valve replacement (TAVR) trials,
but will become a relevant future population in need of treatment due to
demographic change. Thus, this study sought to evaluate outcomes of TAVR
for the treatment of severe aortic stenosis (AS) in nonagenarian patients.
 METHOD(S): We screened Medline/Pubmed for studies that stated
specific outcomes for nonagenarians undergoing TAVR. A weighted
meta-analysis was conducted, calculating pooled estimate rates using a
binary random-effects model for dichotomous variables, and comparing
non-dichotomous outcomes with a continuous random-effects model.
 RESULT(S): Data from 23 studies including 16,094 nonagenarians were
merged; 53.4% were women. Despite reasonable rates of comorbidities,
Society of Thoracic Surgeons mortality risk score was 10.2 +/- 5.4. Pooled
estimate rate of procedural success was 94.1% (95% confidence interval
[CI], 91.7-96.6), with major vascular complications occurring in 6.3% (95%
CI, 2.7-9.8) and at least moderate postprocedural paravalvular leak in
7.5% (95% CI, 4.4-10.6). The rate of periprocedural stroke or transient
ischemic attack was 2.6% (95% CI, 2.0-3.2). At 30 days, the pooled
estimate of mortality was 6.1% (95% CI, 4.7-7.4) and a permanent pacemaker
was implanted in 12.6% (95% CI, 7.6-17.6). After 1 year, the mortality
rate was 20.5% (95% CI, 15.9-25.1). CONCLUSION(S): TAVR in
nonagenarians is an effective and safe procedure, with encouraging
outcomes given the general life expectancy of these patients. Currently,
only selected nonagenarians are undergoing TAVR, but their number will
grow as life expectancy continues to increase in the developed world.
Specific research to identify ideal candidates and techniques in this
cohort is needed.

<55>
Accession Number
637409695
Title
Clinically Significant Incidental Findings on CT Imaging During TAVI
Work-up: A Systematic Review and Meta-Analysis.
Source
The Journal of invasive cardiology. 34(3) (pp E218-E225), 2022. Date of
Publication: 01 Mar 2022.
Author
Ko K.; Zwetsloot P.-P.; Voskuil M.; Stella P.; Leiner T.; Kraaijeveld A.
Institution
(Kraaijeveld) Department of Cardiology, University Medical Centre Utrecht,
Heidelberglaan 100, CX Utrecht 3584, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: The transcatheter aortic valve implantation (TAVI) population
is mostly elderly and frail. Clinically significant incidental findings
(SIFs) are commonly encountered in the work-up of TAVI patients. This is a
systematic review of current literature on the occurrence of SIFs on
computed tomography (CT) imaging preceding TAVI and their association with
mortality, delayed planning, and procedure cancellation. METHOD(S): A
systematic search on Medline, Embase, and Cochrane resulted in 19
retrospective studies (published from 2010-2020) reporting SIFs in the
work-up for TAVI. A total of 6358 individuals from 19 studies were
analyzed, with mean age of 80 years and sex equally divided. A
random-effects meta-analysis was performed, with weighting based on study
size. RESULT(S): Pooled prevalence of patients with SIF was 22.2%
(95% confidence interval [CI], 17.8-26.6) and most findings (48.3%) were
found in the lungs. Pooled prevalence of new malignancies was 3.4% (95%
CI, 2.5-4.4). Higher mortality in patients with SIF was only found in
studies with a follow-up period >4 years (hazard ratio, 1.5-1.7). TAVI was
more frequently cancelled in patients with SIF vs those with no SIF
(ranges, 10.1%-47.1% vs 5.2%-37.0%, respectively). SIF did not delay time
to TAVI (ranges, 6-91 days in SIF patients vs 4-81 days in non-SIF
patients). CONCLUSION(S): SIFs are common in patients screened for
TAVI. SIF is associated with a higher risk of TAVI cancellation and with
increased mortality risk over the long term, which should be taken into
consideration in decision making. These findings may help inform patients
and aid patient selection.

<56>
Accession Number
2015752913
Title
Efficacy of Levobupivacaine Alone Versus Levobupivacaine with Ketamine in
Subcutaneous Infiltration for Postoperative Analgesia in Lower Segment
Cesarean Section.
Source
International Journal of Pharmaceutical and Clinical Research. 14(2) (pp
92-99), 2022. Date of Publication: 2022.
Author
Verma R.
Institution
(Verma) Department of Anaesthesiology, Patna Medical College and Hospital,
Bihar, Patna, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: The aim of the present study to comparison of levobupivacaine alone
versus levobupivacaine with ketamine in subcutaneous infiltration for
postoperative analgesia in lower segment cesarean section.
 Material(s) and Method(s): A randomized double blind controlled study
conducted in the Department of Anaesthesiology, Patna Medical College and
Hospital, Patna, Bihar, India for 1 year. A total of 30 parturients were
randomly assigned to two groups (each with 15) based on computer-generated
random numbers kept in sealed and numbered envelopes. Parturients in Group
A received a subcutaneous surgical wound infiltration with a 0.5 percent
levobupivacaine solution diluted with normal saline to a total of 32 ml at
2 mg/kg body weight to a maximum of 150 mg. Parturients in Group B
received a subcutaneous surgical wound infiltration with a solution of 0.5
percent levobupivacaine 2 mg/kg body weight diluted with normal saline to
a total volume of 32 ml, plus ketamine 1 mg/kg body weight diluted with
normal saline to a total volume of 150 mg. The VAS scale and total
analgesic use throughout the 24-hour postoperative period were used to
assess the primary outcome, postoperative pain alleviation.
 Result(s): The mean heart rates at zero hour (baseline) were
comparable in groups A and B (P=0.871). Except at the 4th and 6th hour
post-operative, the mean heart rate of group A was greater than that of
group B, which was statistically insignificant at the majority of time
periods. Conclusion(s): In terms of greater pain relief, reduced need
for rescue opioid analgesia, and no serious side effects, the study
concluded that ketamine is a viable adjunct modality to levobupivacaine
for local wound infiltration. Copyright © 2022, Dr Yashwant
Research Labs Pvt Ltd. All rights reserved.

<57>
Accession Number
2015144258
Title
CeRebrUm and CardIac Protection with ALlopurinol in Neonates with Critical
Congenital Heart Disease Requiring Cardiac Surgery with Cardiopulmonary
Bypass (CRUCIAL): study protocol of a phase III, randomized,
quadruple-blinded, placebo-controlled, Dutch multicenter trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 174. Date of
Publication: December 2022.
Author
Stegeman R.; Nijman M.; Breur J.M.P.J.; Groenendaal F.; Haas F.; Derks
J.B.; Nijman J.; van Beynum I.M.; Taverne Y.J.H.J.; Bogers A.J.J.C.;
Helbing W.A.; de Boode W.P.; Bos A.F.; Berger R.M.F.; Accord R.E.; Roes
K.C.B.; de Wit G.A.; Jansen N.J.G.; Benders M.J.N.L.
Institution
(Stegeman, Nijman, Groenendaal, Benders) Department of Neonatology,
Wilhelmina Children's Hospital, University Medical Center (UMC) Utrecht,
Utrecht University, KE 04.123.1, PO Box 85909, AB, Utrecht 3508,
Netherlands
(Stegeman, Nijman, Breur) Department of Pediatric Cardiology, Wilhelmina
Children's Hospital, UMC Utrecht, Utrecht University, Utrecht, Netherlands
(Stegeman, Nijman, Jansen) Department of Pediatric Intensive Care,
Wilhelmina Children's Hospital, UMC Utrecht, Utrecht University, Utrecht,
Netherlands
(Stegeman, Haas) Congenital Cardiothoracic Surgery, Wilhelmina Children's
Hospital, UMC Utrecht, Utrecht University, Utrecht, Netherlands
(Stegeman, Nijman, Groenendaal) Utrecht Brain Center, UMC Utrecht, Utrecht
University, Utrecht, Netherlands
(Derks) Department of Obstetrics, Wilhelmina Children's Hospital, UMC
Utrecht, Utrecht University, Utrecht, Netherlands
(van Beynum, Helbing) Department of Pediatrics, Division of Pediatric
Cardiology, Academic Center for Congenital Heart Disease, Erasmus Medical
Center (MC) - Sophia Children's Hospital, Rotterdam, Netherlands
(Taverne, Bogers) Department of Cardiothoracic Surgery, Erasmus MC,
Erasmus University Rotterdam, Rotterdam, Netherlands
(Helbing) Department of Pediatrics, Division of Pediatric Cardiology,
Academic Center for Congenital Heart Disease, Radboudumc - Amalia
Children's Hospital, Nijmegen, Netherlands
(de Boode) Department of Neonatology, Radboudumc, Radboud Institute for
Health Sciences, Amalia Children's Hospital, Nijmegen, Netherlands
(Bos) Division of Neonatology, Beatrix Children's Hospital, UMC Groningen,
University of Groningen, Groningen, Netherlands
(Berger) Center for Congenital Heart Diseases, Pediatric Cardiology,
Beatrix Children's Hospital, UMC Groningen, University of Groningen,
Groningen, Netherlands
(Accord) Center for Congenital Heart Diseases, Department of
Cardiothoracic Surgery, UMC Groningen, University of Groningen, Groningen,
Netherlands
(Roes) Department of Health Evidence, Section Biostatistics, Radboudumc,
Radboud University Nijmegen, Nijmegen, Netherlands
(de Wit) Julius Center for Health Sciences and Primary Care, UMC Utrecht,
Utrecht University, Utrecht, Netherlands
(Jansen) Department of Pediatrics, Beatrix Children's Hospital, UMC
Groningen, University of Groningen, Groningen, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Neonates with critical congenital heart disease (CCHD)
undergoing cardiac surgery with cardiopulmonary bypass (CPB) are at risk
of brain injury that may result in adverse neurodevelopment. To date, no
therapy is available to improve long-term neurodevelopmental outcomes of
CCHD neonates. Allopurinol, a xanthine oxidase inhibitor, prevents the
formation of reactive oxygen and nitrogen species, thereby limiting cell
damage during reperfusion and reoxygenation to the brain and heart. Animal
and neonatal studies suggest that allopurinol reduces hypoxic-ischemic
brain injury and is cardioprotective and safe. This trial aims to test the
hypothesis that allopurinol administration in CCHD neonates will result in
a 20% reduction in moderate to severe ischemic and hemorrhagic brain
injury. Method(s): This is a phase III, randomized,
quadruple-blinded, placebo-controlled, multicenter trial. Neonates with a
prenatal or postnatal CCHD diagnosis requiring cardiac surgery with CPB in
the first 4 weeks after birth are eligible to participate. Allopurinol or
mannitol-placebo will be administered intravenously in 2 doses early
postnatally in neonates diagnosed antenatally and 3 doses perioperatively
of 20 mg/kg each in all neonates. The primary outcome is a composite
endpoint of moderate/severe ischemic or hemorrhagic brain injury on early
postoperative MRI, being too unstable for postoperative MRI, or mortality
within 1 month following CPB. A total of 236 patients (n = 188 with
prenatal diagnosis) is required to demonstrate a reduction of the primary
outcome incidence by 20% in the prenatal group and by 9% in the postnatal
group (power 80%; overall type 1 error controlled at 5%, two-sided),
including 1 interim analysis at n = 118 (n = 94 with prenatal diagnosis)
with the option to stop early for efficacy. Secondary outcomes include
preoperative and postoperative brain injury severity, white matter injury
volume (MRI), and cardiac function (echocardiography); postnatal and
postoperative seizure activity (aEEG) and regional cerebral oxygen
saturation (NIRS); neurodevelopment at 3 months (general movements);
motor, cognitive, and language development and quality of life at 24
months; and safety and cost-effectiveness of allopurinol.
 Discussion(s): This trial will investigate whether allopurinol
administered directly after birth and around cardiac surgery reduces
moderate/severe ischemic and hemorrhagic brain injury and improves cardiac
function and neurodevelopmental outcome in CCHD neonates. Trial
registration: EudraCT 2017-004596-31. Registered on November 14, 2017.
ClinicalTrials.gov NCT04217421. Registered on January 3,
2020 Copyright © 2022, The Author(s).

<58>
Accession Number
2017063276
Title
Incidence of readmission to the ICU after cardiac surgery: a systematic
review and meta-analysis.
Source
Journal of Thoracic Disease. 14(2) (pp 414-422), 2022. Date of
Publication: February 2022.
Author
Lv H.; Meng Z.; Yu C.; Chen Q.; Wang Y.; Xiao Y.
Institution
(Lv, Yu) Department of Cardiac Surgery, Hainan General Hospital, Hainan
Affiliated Hospital of Hainan Medical University, Haikou, China
(Meng, Chen, Wang) Department of Critical Medicine, Danzhou People's
Hospital, Danzhou, China
(Xiao) Department of Cardiovascular Operating Room, The Second Affiliated
Hospital of Hainan Medical University, Haikou, China
Publisher
AME Publishing Company
Abstract
Background: Due to the complexity of cardiac surgery, almost all patients
need to be admitted to the intensive care unit (ICU) for postoperative
care after surgery. After being discharged from the ICU, some patients
need to be readmitted due to disease deterioration during hospitalization.
We conducted a meta-analysis of the literature to investigate the
incidence of readmission to the ICU in patients undergoing cardiac
surgery. Method(s): The PubMed, Medline, and Elsevier databases were
searched using the keywords "cardiac surgery," "readmission," "intensive
care unit," and "ICU" to retrieve English-language articles published from
January 2000 to January 2021. The articles were screened, and their
quality was evaluated. A meta-analysis was performed on the outcomes of
patients after readmission to the ICU using Stata16.0 software.
 Result(s): Ultimately, 9 articles were included in the meta-analysis,
comprising 32,825 cardiac surgery cases, of whom 1,302 were readmitted to
the ICU. The incidence of readmission to the ICU was 3.97%. Among the
direct reasons for readmission to the ICU, respiratory failure accounted
for 13.6-48.6%, while hemodynamic instability accounted for 21.6-51.9%.
The results of the meta-analysis showed that the mortality rate of
patients readmitted to the ICU was significantly higher than that of
patients not readmitted to the ICU [risk difference (RD) =8.05, 95%
confidence interval (CI): 5.10-12.69, Z=8.965; P<0.0001], as was the
length of hospital stay [standard mean difference (SMD) =3.17, 95% CI:
1.40-4.94, Z=3.504; P<0.001], and the incidence of complications (odds
ratio =1.97, 95% CI: 1.35-2.87, Z=3.507; P<0.001). Conclusion(s):
Nine articles were included in this meta-analysis on the incidence rate of
readmission to the ICU of patients undergoing cardiac surgery. The results
showed that the proportion of readmission to the ICU was 3.97%. Patients
readmitted to the ICU had a higher rate of complications, longer hospital
stay, and higher mortality rate than those not readmitted. Copyright
© Journal of Thoracic Disease. All rights reserved.

<59>
Accession Number
637409554
Title
TEA Clinical Profile of Infective Endocarditis in Patients with Recent
COVID-19: A Systematic Review.
Source
The American journal of the medical sciences. (no pagination), 2022. Date
of Publication: 27 Feb 2022.
Author
Quintero-Martinez J.A.; Hindy J.-R.; Mahmood M.; Gerberi D.J.; DeSimone
D.C.; Baddour L.M.
Institution
(Quintero-Martinez) Division of Infectious Diseases, Departments of
Medicine and Cardiovascular Diseases, Mayo Clinic College of Medicine and
Science, Rochester, MN, United States
(Hindy, Mahmood, DeSimone, Baddour) Division of Infectious Diseases,
Departments of Medicine and Cardiovascular Diseases, Mayo Clinic College
of Medicine and Science, Rochester, MN, United States
(Gerberi) Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) can progress to
cardiovascular complications which are linked to higher in-hospital
mortality rates. Infective endocarditis (IE) can develop in patients with
recent COVID-19 infections, however, characterization of IE following
COVID-19 infection has been lacking. To better characterize this disease,
we performed a systematic review with descriptive analysis of the clinical
features and outcomes of these patients. METHOD(S): Our search was
conducted in 8 libraries for all published reports of probable or definite
IE in patients with a prior COVID-19 confirmed diagnosis. After ensuring
an appropriate inclusion of the articles, we extracted data related to
clinical characteristics, modified duke criteria, microbiology, outcomes,
and procedures. RESULT(S): Searches generated a total of 323
published reports, and 20 articles met our inclusion criteria. The mean
age of patients was 52.2 +/- 16.9 years and 76.2% were males.
Staphylococcus aureus was isolated in 8 (38.1%) patients, Enterococcus
faecalis in 3 patients (14.3%) and Streptococcus mitis/oralis in 2 (9.5%)
patients. The mean time interval between COVID-19 and IE diagnoses was
16.7 +/- 15 days. Six (28.6%) patients required critical care due to IE, 7
patients (33.3%) underwent IE-related cardiac surgery and 5 patients
(23.8%) died during their IE hospitalization. CONCLUSION(S): Our
systematic review provides a profile of clinical features and outcomes of
patients with a prior COVID-19 infection diagnosis who subsequently
developed IE. Due to the ongoing COVID-19 pandemic, it is essential that
clinicians appreciate the possibility of IE as a unique complication of
COVID-19 infection. Copyright © 2022. Published by Elsevier Inc.

<60>
Accession Number
637224763
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) (no pagination), 2022. Article Number: e051072. 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
BMJ Publishing Group
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 20 min after CPB, (2) prolonged prothrombin time or
activated partial thromboplastin time (>1.5 times baseline) measured 20
min after CPB and (3) excessive bleeding observed. 4-factor PCC (15 IU/kg)
and FFP (10 mL/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 7 days after
surgery, (2) re-exploration due to postoperative bleeding within 7 days
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 ©

<61>
Accession Number
2016994049
Title
Effects of positive end-expiratory pressure on pulmonary atelectasis after
paediatric laparoscopic surgery as assessed by ultrasound: A randomised
controlled study.
Source
Anaesthesia Critical Care and Pain Medicine. 41(2) (no pagination), 2022.
Article Number: 101034. Date of Publication: April 2022.
Author
Lee H.-M.; Min J.Y.; Lee J.-R.; Lee M.H.; Byon H.-J.
Institution
(Lee) Department of Anaesthesiology and Pain Medicine, Yonsei University
College of Medicine, Yongin Severance Hospital, 363,
Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do 169995, South
Korea
(Lee, Lee, Lee, Byon) Anaesthesia and Pain Research Institute, Yonsei
University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722,
South Korea
(Min) Department of Anaesthesiology and Pain Medicine, The Catholic
University College of Medicine, Eunpyeong St. Mary's Hospital, 1021,
Tongil-ro, Eunpyeong-gu, Seoul 03312, South Korea
(Lee, Lee, Byon) Department of Anaesthesiology and Pain Medicine, Yonsei
University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722,
South Korea
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Positive end-expiratory pressure (PEEP) following alveolar
recruitment manoeuvre (RM) can effectively prevent anaesthesia-induced
atelectasis in children. We aimed to evaluate the individual effect of
PEEP following RM on atelectasis at the end of laparoscopic surgery in
infants and small children. Method(s): Children undergoing
laparoscopic inguinal hernia repair aged 5 weeks to 2 years were randomly
allocated to either the PEEP or control group. A progressive RM was
performed after intubation in all cases. The PEEP group received PEEP of 5
cmH<inf>2</inf>O until the end of mechanical ventilation, while the
control group did not receive any PEEP. Lung ultrasonography was performed
to compare the number of atelectatic regions between the two groups after
anaesthesia induction, after RM, and at the end of surgery in 12 thoracic
regions. Result(s): Overall, 432 ultrasonographic images were
acquired from 36 children. At the end of surgery, the number of
atelectatic regions (median [interquartile range]) was significantly lower
in the PEEP group compared to the control group (2.0 [1.0-3.0] versus 4.0
[3.0-4.0] out of 12 regions, respectively; p = 0.02). While no difference
was observed between the number of atelectatic regions after induction and
at the end of surgery in the control group (p = 0.30), a decrease was
observed in the PEEP group (3.0 [2.0-4.0] to 2.0 [1.0-3.0], respectively;
p = 0.02). Conclusion(s): RM followed by a PEEP of 5 cmH<inf>2</inf>O
can effectively reduce the regions of pulmonary atelectasis at the end of
laparoscopic surgery in infants and small children. Copyright ©
2022 Societe francaise d'anesthesie et de reanimation (Sfar)

<62>
[Use Link to view the full text]
Accession Number
2016817985
Title
Saphenous vein harvesting techniques for coronary artery bypass grafting:
A systematic review and meta-analysis.
Source
Coronary Artery Disease. 33(2) (pp 128-136), 2022. Date of Publication: 01
Mar 2022.
Author
Vuong N.L.; Elfaituri M.K.; Eldoadoa M.; Karimzadeh S.; Mokhtar M.A.; Eid
P.S.; Nam N.H.; Mostafa M.R.; Radwan I.; Zaki M.M.M.; Al Khudari R.;
Kassem M.; Huy N.T.
Institution
(Vuong) Department of Cardiovascular and Thoracic Surgery, Faculty of
Medicine
(Vuong) Department of Medical Statistics and Informatics, Faculty of
Public Health, University of Medicine, Pharmacy at Ho Chi Minh City, Ho
Chi Minh City, Vietnam
(Elfaituri, Eldoadoa, Karimzadeh, Mokhtar, Eid, Nam, Mostafa, Radwan,
Zaki, Al Khudari, Kassem) Online Research Club, School of Tropical
Medicine and Global Health, Nagasaki University, Nagasaki, Japan
(Elfaituri) Faculty of Medicine, University of Tripoli, Tripoli, Libyan
Arab Jamahiriya
(Eldoadoa) Milton Keynes University Hospital, Milton Keynes, United
Kingdom
(Karimzadeh) School of Medicine, Sabzevar University of Medical Sciences,
Sabzevar, Iran, Islamic Republic of
(Mokhtar) Faculty of Medicine, Sohag University, Sohag, Egypt
(Eid, Radwan) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Nam) Division of Hepato-Biliary-Pancreatic Surgery and Transplantation,
Department of Surgery, Graduate School of Medicine, Kyoto University,
Kyoto, Japan
(Mostafa) School of Medicine, Tanta University, Tanta, Egypt
(Zaki) Faculty of Clinical Pharmacy, Fayoum University, Fayoum, Egypt
(Al Khudari) Pediatric Department, Children's University Hospital,
Damascus University, Damascus, Syrian Arab Republic
(Kassem) Department of Medical Oncology, Ohio State University, Wexner
Medical Center, Columbus, OH, United States
(Huy) School of Tropical Medicine and Global Health, Nagasaki University,
1-12-4 Sakamoto, Nagasaki 852-8523, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
The great saphenous vein (GSV) graft remains a frequently used conduit for
coronary artery bypass graft (CABG) surgery. The optimal technique for GSV
harvesting has been the subject of on-going controversy. We therefore
sought to conduct a systematic review and meta-analysis of all available
GSV harvesting techniques in CABG. A systematic search of 12 electronic
databases was performed to identify all randomized controlled trials
(RCTs) of any GSV harvesting technique, including conventional vein
harvesting (CVH), no-touch, standard bridging technique (SBT) and
endoscopic vein harvesting (EVH) techniques. We investigated safety and
long-term efficacy outcomes. All outcomes were analyzed using the
frequentist network meta-analysis. A total of 6480 patients from 34 RCTs
were included. For safety outcomes, EVH reduced 91% and 77% risk of wound
infection compared to no-touch and CVH, respectively. EVH and SBT also
significantly reduced the risk of sensibility disorder and postoperative
pain. The techniques were not significantly different regarding long-term
efficacy outcomes, including mortality, myocardial infarction and graft
patency. For GSV harvesting for CABG, EVH techniques are the most
favorable, but in case of using an open technique, no-touch is more
recommended than CVH. More effective and safer procedures should be
investigated for GSV harvesting in CABG. Copyright © 2022
Lippincott Williams and Wilkins. All rights reserved.

<63>
Accession Number
2015748079
Title
Cardio-psycho-metabolic outcomes of bariatric surgery: design and baseline
of the WAS trial.
Source
Endocrine Connections. 11(2) (no pagination), 2022. Article Number:
e210338. Date of Publication: Feb 2022.
Author
Koschker A.-C.; Warrings B.; Morbach C.; Seyfried F.; Rickert N.; Jung P.;
Geier A.; Dischinger U.; Krauthausen M.; Herrmann M.J.; Stier C.; Frantz
S.; Malzahn U.; Stork S.; Fassnacht M.
Institution
(Koschker, Dischinger, Stier, Fassnacht) Division of Endocrinology and
Diabetology, Department of Internal Medicine I, University Hospital,
University of Wurzburg, Wurzburg, Germany
(Koschker, Warrings, Morbach, Frantz, Stork, Fassnacht) Comprehensive
Heart Failure Center, University & University Hospital Wurzburg, Wurzburg,
Germany
(Warrings, Herrmann) Department of Psychiatry, Psychosomatics and
Psychotherapy, University Hospital, University of Wurzburg, Wurzburg,
Germany
(Morbach, Frantz, Stork) Division of Cardiology, Department of Internal
Medicine I, University Hospital, University of Wurzburg, Wurzburg, Germany
(Seyfried, Stier) Department of General, Visceral, Transplant, Vascular,
and Pediatric Surgery, University Hospital, University of Wurzburg,
Wurzburg, Germany
(Rickert) Department of Radiology, University Hospital, University of
Wurzburg, Wurzburg, Germany
(Jung) Division of Pneumology, Department of Internal Medicine I,
University Hospital, University of Wurzburg, Wurzburg, Germany
(Geier) Division of Hepatology, Department of Internal Medicine II,
University Hospital, University of Wurzburg, Wurzburg, Germany
(Krauthausen) Department of General Practice, University Hospital,
University of Wurzburg, Wurzburg, Germany
(Malzahn) Center for Clinical Trials, University Hospital, University of
Wurzburg, Wurzburg, Germany
Publisher
BioScientifica Ltd.
Abstract
Obesity is a rapidly emerging health problem and an established risk
factor for cardiovascular diseases. Bariatric surgery profoundly reduces
body weight and mitigates sequelae of obesity. The open, randomized
controlled Wurzburg Adipositas Studie (WAS) trial compares the effects of
Roux-en-Y gastric bypass (RYGB) vs psychotherapy-supported lifestyle
modification in morbidly obese patients. The co-primary endpoint addresses
1-year changes in cardiovascular function (peak VO<inf>2</inf> during
cardiopulmonary exercise testing) and the quality of life (QoL)
(Short-Form-36 physical functioning scale). Prior to randomization, all
included patients underwent a multimodal anti-obesity treatment for 6-12
months. Thereafter, the patients were randomized and followed through
month 12 to collect the primary endpoints. Afterwards, patients in the
lifestyle group could opt for surgery, and final visit was scheduled for
all patients 24 months after randomization. Sample size calculation
suggested to enroll 90 patients in order to arrive at minimally 22
patients per group evaluable for the primary endpoint. Secondary
objectives were to quantify changes in body weight, left ventricular
hypertrophy, systolic and diastolic function (by echocardiography and
cardiac MRI), functional brain MRI, psychometric scales, and endothelial
and metabolic function. WAS enrolled 93 patients (72 women, median age 38
years, BMI 47.5 kg/m2) exhibiting a relevantly compromised
exercise capacity (median peakVO<inf>2</inf> 18.3 mL/min/kg) and the QoL
(median physical functioning scale 50). WAS is the first randomized
controlled trial focusing on the effects of RYGB on cardiovascular
function beyond hypertension. In addition, it will provide a wealth of
high-quality data on the cerebral, psychiatric, hepatic, and metabolic
function in obese patients after RYGB. Copyright © 2022 The
authors Published by Bioscientifica Ltd.

<64>
Accession Number
2015741824
Title
Cardiovascular and Renal Effectiveness of GLP-1 Receptor Agonists vs.
Other Glucose-Lowering Drugs in Type 2 Diabetes: A Systematic Review and
Meta-Analysis of Real-World Studies.
Source
Metabolites. 12(2) (no pagination), 2022. Article Number: 183. Date of
Publication: February 2022.
Author
Caruso I.; Cignarelli A.; Sorice G.P.; Natalicchio A.; Perrini S.; Laviola
L.; Giorgino F.
Institution
(Caruso, Cignarelli, Sorice, Natalicchio, Perrini, Laviola, Giorgino)
Department of Emergency and Organ Transplantation Section of Internal
Medicine, Endocrinology, Andrology and Metabolic Diseases, University of
Bari Aldo Moro, Bari 70124, Italy
Publisher
MDPI
Abstract
Cardiovascular outcome trials (CVOT) showed that treatment with
glucagon-like peptide-1 receptor agonists (GLP-1RA) is associated with
significant cardiovascular benefits. However, CVOT are scarcely
representative of everyday clinical practice, and real-world studies could
provide clini-cians with more relatable evidence. Here, literature was
thoroughly searched to retrieve real-world studies investigating the
cardiovascular and renal outcomes of GLP-1RA vs. other glucose-lowering
drugs and carry out relevant meta-analyses thereof. Most real-world
studies were conducted in populations at low cardiovascular and renal
risk. Of note, real-world studies investigating cardio-renal outcomes of
GLP-1RA suggested that initiation of GLP-1RA was associated with a greater
benefit on composite cardiovascular outcomes, MACE (major adverse
cardiovascular events), all-cause mortality, myocardial infarction,
stroke, cardiovascular death, peripheral artery disease, and heart failure
compared to other glucose-lowering drugs with the exception of
sodium-glucose transporter-2 inhibitors (SGLT-2i). Initiation of SGLT-2i
and GLP-1RA yielded similar effects on composite cardiovascular outcomes,
MACE, stroke, and myocardial infarction. Conversely, GLP-1RA were less
effective on heart failure prevention compared to SGLT-2i. Finally, the
few real-world studies addressing renal outcomes suggested a significant
benefit of GLP-1RA on estimated glomerular filtration rate (eGFR)
reduction and hard renal outcomes vs. active comparators except SGLT-2i.
Further real-world evidence is needed to clarify the role of GLP-1RA in
cardio-renal protection among available glucose-lowering
drugs. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<65>
Accession Number
2016940544
Title
The effect of delirium preventive measures on the occurrence of
postoperative cognitive dysfunction in older adults undergoing
cardiovascular surgery. The DelPOCD randomised controlled trial.
Source
Journal of Clinical Anesthesia. 78 (no pagination), 2022. Article Number:
110686. Date of Publication: June 2022.
Author
Olotu C.; Ascone L.; Wiede J.; Manthey J.; Kuehn S.; Scherwath A.;
Kiefmann R.
Institution
(Olotu, Wiede, Manthey, Kiefmann) Department of Anaesthesiology,
University Medical Centre Hamburg, Germany
(Ascone) Department of Psychiatry and Psychotherapy, University Medical
Centre Hamburg, Germany
(Kuehn, Scherwath) Institute of Medical Psychology, University Medical
Centre Hamburg, Germany
(Scherwath) Department of Stem Cell Transplantation, University Medical
Centre Hamburg, Germany
Publisher
Elsevier Inc.
Abstract
Study objective: This trial examines the effect of delirium preventive
measures on the incidence of postoperative cognitive dysfunction in older
adults. Design(s): In a randomised approach, a delirium prevention
and a standard care group were compared regarding manifestation of
postoperative cognitive dysfunction at seven days, three and twelve months
postoperatively (primary outcome). To correct for practice effects and
age-depended cognitive decline, a control group of age-matched healthy
subjects was included. Setting(s): The trial was conducted at the
University Medical Centre Hamburg between 2014 and 2018, data assessment
took place in the Anaesthesia Outpatient Clinic and on the surgical ward.
 Patient(s): A total of 609 patients >=60 years scheduled for
cardiovascular surgery were enrolled, allocated treatment was received by
284 patients in the delirium prevention and 274 patients in the standard
care group. Intervention(s): The intervention consisted of a delirium
prevention bundle including reorientation measures, sleeping aids and
early mobilisation. Measurements: Cognitive functions were assessed via
neuropsychological testing of attention, executive functions including
word fluency, and verbal memory utilizing a computerised test of
attentional performance, the trail making test, the digit span subtest
from the Wechsler Adult Intelligence Scale-IV, the verbal learning and
memory test, and the Regensburg Word Fluency Test. Assessments were
performed preoperatively and at three time points postoperatively (one
week, three months and 12 months). Main Result(s): Postoperative
cognitive dysfunction was defined as a clinically meaningful decline in at
least two out of nine chosen test parameters compared to the preoperative
level (reliable change index <= - 1.96). The rates of postoperative
cognitive dysfunction were 25.9% (delirium prevention group, n = 284) vs.
28.1% (standard care group, n = 274) [X2(1,n = 433) = 0.245;p =
0.621] at postoperative day seven and declined to 7.8% vs. 6.8%
[X2(1,n = 219) = 0.081;p = 0.775] and 1.3% vs. 5.6% (p = 0.215,
Fisher's exact test) at three and 12 months following surgery,
respectively. The postoperative delirium rates did not differ between the
two groups (delirium prevention group: 13.4% vs. standard care group:
17.3%). Attentional performance was impaired shortly after surgery,
whereas verbal delayed recall was most frequently affected over the whole
postoperative period. Conclusion(s): These findings suggest that an
intervention combining specific measures extracted from established
postoperative delirium prevention programs did not reduce the rate of
postoperative cognitive dysfunction in older adults. Copyright ©
2022 Elsevier Inc.

<66>
Accession Number
2015627842
Title
Mechanical active compression-decompression versus standard mechanical
cardiopulmonary resuscitation: A randomised haemodynamic out-of-hospital
cardiac arrest study.
Source
Resuscitation. 170 (pp 1-10), 2022. Date of Publication: January 2022.
Author
Berve P.O.; Hardig B.M.; Skalhegg T.; Kongsgaard H.; Kramer-Johansen J.;
Wik L.
Institution
(Berve, Kramer-Johansen) Institute of Clinical Medicine, University of
Oslo, Oslo, Norway
(Berve, Kongsgaard, Kramer-Johansen, Wik) Norwegian National Advisory Unit
on Prehospital Emergency Medicine, Oslo University Hospital, Oslo, Norway
(Berve, Skalhegg, Kramer-Johansen, Wik) Air Ambulance Department, Division
of Prehospital Services, Oslo University Hospital, Oslo, Norway
(Berve, Wik) Department of Anaesthesiology, Oslo University Hospital,
Oslo, Norway
(Hardig) Clinical Sciences, Helsingborg, Section II, Faculty of Medicine,
Lund University, Sweden
(Hardig) Stryker/Jolife AB, Lund, Sweden
Publisher
Elsevier Ireland Ltd
Abstract
Background: Active compression-decompression cardiopulmonary resuscitation
(ACD-CPR) utilises a suction cup to lift the chest-wall actively during
the decompression phase (AD). We hypothesised that mechanical ACD-CPR
(Intervention), with AD up to 30 mm above the sternal resting position,
would generate better haemodynamic results than standard mechanical CPR
(Control). Method(s): This out-of-hospital adult non-traumatic
cardiac arrest trial was prospective, block-randomised and non-blinded. We
included intubated patients with capnography recorded during mechanical
CPR. Exclusion criteria were pregnancy, prisoners, and prior chest
surgery. The primary endpoint was maximum tidal carbon dioxide partial
pressure (p<inf>MT</inf>CO<inf>2</inf>) and secondary endpoints were
oxygen saturation of cerebral tissue (SctO<inf>2</inf>), invasive arterial
blood pressures and CPR-related injuries. Intervention device lifting
force performance was categorised as Complete AD (>=30 Newtons) or
Incomplete AD (<=10 Newtons). Haemodynamic data, analysed as one
measurement for each parameter per ventilation (Observation Unit, OU) with
non-linear regression statistics are reported as mean (standard
deviation). A two-sided p-value < 0.05 was considered as statistically
significant. Result(s): Of 221 enrolled patients, 210 were deemed
eligible (Control 109, Intervention 101). The Control vs. Intervention
results showed no significant differences for
p<inf>MT</inf>CO<inf>2</inf>: 29(17) vs 29(18) mmHg (p = 0.86), blood
pressures during compressions: 111(45) vs. 101(68) mmHg (p = 0.93) and
decompressions: 21(20) vs. 18(18) mmHg (p = 0.93) or for
SctO<inf>2</inf>%: 55(36) vs. 57(9) (p = 0.42). The 48 patients who
received Complete AD in > 50% of their OUs had higher SctO<inf>2</inf>
than Control patients: 58(11) vs. 55(36)% (p < 0.001). Conclusion(s):
Mechanical ACD-CPR provided similar haemodynamic results to standard
mechanical CPR. The Intervention device did not consistently provide
Complete AD. Clinical trial registration: ClinicalTrials.gov identifier
(NCT number): NCT02479152. The Haemodynamic Effects of Mechanical Standard
and Active Chest Compression-decompression During Out-of-hospital
CPR. Copyright © 2021 Elsevier B.V.

<67>
Accession Number
2015017876
Title
Economic impact of powered stapler in video-assisted thoracic surgery
lobectomy for lung Cancer in a Chinese tertiary hospital: a
cost-minimization analysis.
Source
Health Economics Review. 12(1) (no pagination), 2022. Article Number: 12.
Date of Publication: December 2022.
Author
Cao Y.; Xiong F.; Xia X.; Gu P.; Wang Q.; Wu A.; Zhan H.; Chen W.; Qian Z.
Institution
(Cao, Xiong, Xia, Gu, Wang, Wu, Qian) Xiangya Hospital, Central South
University, Changsha, China
(Zhan) Changsha Normin Health Technology Ltd, Changsha, China
(Chen) Normin Health Consulting Ltd, Toronto, Canada
Publisher
BioMed Central Ltd
Abstract
Background: To assess the economic impact of powered stapler use in
video-assisted thoracic surgery (VATS) lobectomy for lung cancer in a
Chinese tertiary care hospital. Method(s): This study identified 388
patients who received VATS lobectomy using the ECHELON powered stapler (n
= 296) or the ECHELON manual stapler (n = 92) for lung cancer in a Chinese
tertiary hospital. Multiple generalized linear regression analyses were
conducted using data on hospital costs and patient characteristics to
develop predictive equations for hospital costs in a cost-minimization
analysis (CMA) model comparing hospital costs associated with the ECHELON
powered stapler and the ECHELON manual stapler. CMA model was used to
conduct scenario analysis to compare the ECHELON powered stapler with
another manual stapler (Victor Medical). Result(s): The multiple
generalized linear regression analyses identified that using the ECHELON
powered stapler in VATS lobectomy for lung cancer was associated with
significantly lower drug costs than using the ECHELON manual stapler
(coefficient - 0.256, 95% confidence interval: - 0.375 to - 0.139). The
CMA model estimated that the ECHELON powered stapler could save hospital
costs by 1653 when compared with the ECHELON manual stapler (65,531 vs.
67,184). The use of the ECHELON powered stapler also saved hospital costs
by 4411 when compared with the Victor Medical manual stapler (65,531 vs.
69,942) in the scenario analysis. Conclusion(s): Compared to the two
manual staplers used for VATS lobectomy for lung cancer in a Chinese
tertiary hospital, the ECHELON powered stapler had 100% probability to
save total hospital costs under present prices of the three staplers
according to the CMA. Copyright © 2022, The Author(s).

<68>
Accession Number
2011014952
Title
Role of preoperative erythropoietin in the optimization of preoperative
anemia among surgical patients - A systematic review and meta-analysis.
Source
Hematology, Transfusion and Cell Therapy. 44(1) (pp 76-84), 2022. Date of
Publication: 01 Jan 2022.
Author
Ali S.M.E.; Hafeez M.H.; Nisar O.; Fatima S.; Ghous H.; Rehman M.
Institution
(Ali, Fatima) Dr Ruth KM Pfau Civil Hospital, Karachi, Pakistan
(Hafeez, Nisar) Shalamar Medical and Dental College (SMDC), Lahore,
Pakistan
(Ghous) Lady Dufferin Hospital, Karachi, Pakistan
(Rehman) Jinnah Medical and Dental College (JMDC), Karachi, Pakistan
Publisher
Elsevier Editora Ltda
Abstract
Preoperative anemia is a common finding. Preoperative allogeneic
transfusion, iron therapy, vitamin supplementation and erythropoietin
therapy are the current management strategies for preoperative anemia.
Previous reviews regarding erythropoietin were limited to specialties,
provided little evidence regarding the benefits and risks of
erythropoietin in managing preoperative anemia and included non-anemic
patients. The purpose of our systematic review was to determine the role
of erythropoietin solely in preoperatively anemic patients and to
investigate the complications of this treatment modality to produce a
guideline for preoperative management of anemic patients for all surgical
specialties. The PubMed/Medline, Google Scholar, and Cochrane Library were
searched for randomized trials evaluating the efficacy of erythropoietin
in preoperative anemia. The risk ratio (RR) and standardized mean
difference (SMD) was used to pool the estimates of categorical and
continuous outcomes, respectively. Allogeneic transfusion and
complications and the 90-day mortality were the primary outcomes, while
the postoperative change in hemoglobin, bleeding in milliliters and the
number of red blood cell (RBC) packs transfused were the secondary
outcomes. Result(s): Eight studies were included, comprising 734 and
716 patients in the erythropoietin group and non-erythropoietin group,
respectively. The pooled estimate by RR for allogeneic transfusion was
0.829 (p = 0.049), while complications and the 90-day mortality were among
the 1,318 (p = 0.18) patients. Conclusion(s): Preoperative
erythropoietin provides better outcomes, considering the optimization of
preoperative anemia for elective surgical procedures. The benefits of
erythropoietin are significantly higher, compared to the control group,
while the risks remain equivocal in both groups. We recommend preoperative
erythropoietin in anemic patients. Copyright © 2021 Associacao
Brasileira de Hematologia, Hemoterapia e Terapia Celular

<69>
Accession Number
2012844376
Title
Perioperative implications of newer generation drug-eluting coronary
stents: A narrative review.
Source
Anaesthesia and Intensive Care. 49(5) (pp 338-348), 2021. Date of
Publication: September 2021.
Author
Milder D.A.; Kam P.C.A.
Institution
(Milder) Department of Anaesthesia, Concord Repatriation General Hospital,
Concord, Australia
(Kam) Department of Anaesthetics, Royal Prince Alfred Hospital,
Camperdown, Australia
(Kam) Sydney Medical School, Faculty of Medicine and Health, University of
Sydney, Sydney, Australia
Publisher
SAGE Publications Inc.
Abstract
Newer generation drug-eluting stents are the most commonly inserted stent
in the setting of percutaneous coronary intervention. This narrative
review focuses on the evidence underpinning the perioperative management
of patients with newer generation drug-eluting stents undergoing
non-cardiac surgery. Six studies reported the incidence of major adverse
cardiovascular events according to the time interval from percutaneous
coronary intervention to non-cardiac surgery, and the comparative risks of
newer and first generation drug-eluting stents. No study demonstrated an
increased risk of major adverse cardiovascular events once three months
had elapsed between stent implantation and non-cardiac surgery. Only one
study included patients with third and fourth generation drug-eluting
stents. Seven studies analysed the relationship between antiplatelet
therapy, major adverse cardiovascular events and perioperative bleeding.
The risks of major adverse cardiovascular events do not appear to be
increased if antiplatelet therapy is ceased for less than seven days but
are increased if it is discontinued for more than seven days. Most studies
reported no differences in the incidence of major bleeding associated with
antiplatelet therapy. The risk of perioperative major adverse
cardiovascular events in non-cardiac surgery does not appear to be
increased after three months following implantation with newer generation
drug-eluting stents. However, the possibility of increased risk cannot be
excluded as most studies were inadequately powered. The thrombotic risk is
substantially reduced in patients with fourth (polymer free) generation
drug-eluting stents, and urgent non-cardiac surgery can be considered one
month after percutaneous coronary intervention. Larger multicentre studies
are needed to define the optimal window for non-cardiac surgery after
percutaneous coronary intervention and provide definitive perioperative
strategies for patients presenting for non-cardiac surgery after the
implantation of newer generation drug-eluting stents. Copyright ©
The Author(s) 2021.

<70>
Accession Number
2016891569
Title
Efficacy and safety of low-dose colchicine in patients with coronary
disease: a systematic review and meta-analysis of randomized trials.
Source
European Heart Journal. 42(28) (pp 2765-2775), 2021. Date of Publication:
21 Jul 2021.
Author
Fiolet A.T.L.; Opstal T.S.J.; Mosterd A.; Eikelboom J.W.; Jolly S.S.;
Keech A.C.; Kelly P.; Tong D.C.; Layland J.; Nidorf S.M.; Thompson P.L.;
Budgeon C.; Tijssen J.G.P.; Cornel J.H.
Institution
(Fiolet) Department of Cardiology, University Medical Centre Utrecht,
Utrecht, Netherlands
(Fiolet, Mosterd, Cornel) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Opstal, Cornel) Department of Cardiology, Northwest Clinics, Alkmaar,
Netherlands
(Opstal, Cornel) Department of Cardiology, Radboud University Medical
Centre, Nijmegen, Netherlands
(Mosterd) Department of Cardiology, Meander Medical Centre, Amersfoort,
Netherlands
(Mosterd) Julius Centre for Health Sciences and Primary Care, Utrecht
University Medical Centre, Utrecht, Netherlands
(Eikelboom) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Jolly) Division of Cardiology, Department of Medicine, Population Health
Research Institute, McMaster University, Hamilton, ON, Canada
(Keech) Sydney Medical School, National Health and Medical Research
Council (NHMRC) Clinical Trials Centre, University of Sydney, Australia
(Kelly) Mater University and Health Research Board (HRB) Stroke Clinical
Trials Network Ireland, University College Dublin, Ireland
(Tong, Layland) Cardiology, Department of Medicine, Peninsula Health,
Peninsula Clinical School, Central Clinical School, Monash University,
VIC, Australia
(Tong, Layland) Department of Cardiology, St. Vincent's Hospital,
Melbourne, VIC, Australia
(Layland) Peninsula Clinical School, Central Clinical School, Monash
University, VIC, Australia
(Nidorf, Thompson) Heart and Vascular Research Institute of Western
Australia, Perth, Australia
(Nidorf) GenesisCare Western Australia, Perth, Australia
(Thompson) Sir Charles Gairdner Hospital, Perth, Australia
(Thompson, Budgeon) School of Population and Global Health, University of
Western Australia, Perth, Australia
(Tijssen) Department of Cardiology, Amsterdam University Medical Centre,
Amsterdam, Netherlands
(Tijssen) Cardialysis BV, Rotterdam, Netherlands
Publisher
Oxford University Press
Abstract
Aims Recent randomized trials demonstrated a benefit of low-dose
colchicine added to guideline-based treatment in patients with recent
myocardial infarction or chronic coronary disease. We performed a
systematic review and meta-analysis to obtain best estimates of the
effects of colchicine on major adverse cardiovascular events (MACE).
Methods and results We searched the literature for randomized clinical
trials of long-term colchicine in patients with atherosclerosis published
up to 1 September 2020. The primary efficacy endpoint was MACE, the
composite of myocardial infarction, stroke, or cardiovascular death. We
combined the results of five trials that included 11 816 patients. The
primary endpoint occurred in 578 patients. Colchicine reduced the risk for
the primary endpoint by 25% [relative risk (RR) 0.75, 95% confidence
interval (CI) 0.61-0.92; P = 0.005], myocardial infarction by 22% (RR
0.78, 95% CI 0.64-0.94; P = 0.010), stroke by 46% (RR 0.54, 95% CI
0.34-0.86; P = 0.009), and coronary revascularization by 23% (RR 0.77, 95%
CI 0.66-0.90; P < 0.001). We observed no difference in all-cause death (RR
1.08, 95% CI 0.71-1.62; P = 0.73), with a lower incidence of
cardiovascular death (RR 0.82, 95% CI 0.55-1.23; P = 0.34) counterbalanced
by a higher incidence of non-cardiovascular death (RR 1.38, 95% CI
0.99-1.92; P = 0.060). Conclusion Our meta-analysis indicates that
low-dose colchicine reduced the risk of MACE as well as that of myocardial
infarction, stroke, and the need for coronary revascularization in a broad
spectrum of patients with coronary disease. There was no difference in
all-cause mortality and fewer cardiovascular deaths were counterbalanced
by more non-cardiovascular deaths. Copyright Published on behalf of
the European Society of Cardiology. All rights reserved. © The
Author(s) 2021.

<71>
Accession Number
2015741082
Title
Clinical Characteristics of Individuals Having Spinal Anaesthesia with
Intrathecal Bupivacaine and Clonidine, as well as Intrathecal Bupivacaine
and Fentanyl.
Source
International Journal of Pharmaceutical and Clinical Research. 13(3) (pp
53-58), 2021. Date of Publication: 2021.
Author
Saurav S.; Bhurer S.C.; Kashyap B.K.
Institution
(Saurav) Department of Anaesthesiology and Critical Care, Patna Medical
College and Hospital, Bihar, Patna, India
(Bhurer) Department of Anaesthesiology and Critical Care, Patna Medical
College and Hospital, Bihar, Patna, India
(Kashyap) Department of Anaesthesiology and Critical Care, Patna Medical
College and Hospital, Bihar, Patna, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: The aim of this study is to assess the clinical profile of patients
undergoing spinal anesthesia with intrathecal bupivacaine with clonidine
and intrathecal bupivacaine with fentanyl. Method(s): A prospective
double blind randomized controlled study was conducted in the Department
of Anaesthesiology and Critical Care, Patna Medical College and Hospital,
Patna, Bihar, India for a period of 1 year. 100 adult patients were
randomly divided on an alternative basis into two groups of 50 each. Group
"A"-Bupivacaine plus clonidine group. Group "B"-Bupivacaine plus fentanyl
group. Patients with ASA grade 1and 2 and age group of 18-70yrs were
included in the study. Those patients scheduled to undergo elective lower
abdominal, lower extremity, gynaecological or urological surgeries under
subarachnoid block were included in this study. Patients in group 'A'
received 3 ml (15 mg) of hyperbaric bupivacaine 0.5% plus 1
microg.kg-1 of clonidine. Patients in group 'B' received 3 ml
(15 mg) of hyperbaric bupivacaine 0.5% plus (25 microg) of fentanyl. After
injection, patient was immediately turned to supine position.
 Result(s): Majority of patients in both the groups belonged were in
the age group of 35 to 45 years. The number of males was 45% and females
55%. Majority of female patients in the both the groups have the heights
in the range of 160 to 170 cms and males 171 to 175 cms. Samples were
height matched. 42 percent of the patients underwent gynaecological
surgery followed by lower limb surgeries 34 percent and Lower Abdominal
Surgeries 24 percent. Conclusion(s): The administration of local
anaesthetics in combination with opioids intrathecally is an established
technique for managing postoperative pain following abdominal, pelvic,
thoracic, or orthopaedic procedures on lower extremities. Local
anaesthetics with opioids demonstrate significant improvement in the
post-operative pain and decrease the requirement of rescue
analgesia. Copyright © 2021, Dr Yashwant Research Labs Pvt Ltd.
All rights reserved.

<72>
Accession Number
635539573
Title
Multivessel PCI guided by FFR or angiography for myocardial infarction.
Source
New England Journal of Medicine. 385(4) (pp 297-308), 2021. Date of
Publication: 22 Jul 2021.
Author
Puymirat E.; Cayla G.; Simon T.; Steg P.G.; Montalescot G.; Durand-Zaleski
I.; Le Bras A.; Gallet R.; Khalife K.; Morelle J.-F.; Motreff P.; Lemesle
G.; Dillinger J.-G.; Lhermusier T.; Silvain J.; Roule V.; Labeque J.-N.;
Range G.; Ducrocq G.; Cottin Y.; Blanchard D.; Nelson A.C.; De Bruyne B.;
Chatellier G.; Danchin N.
Institution
(Puymirat, Blanchard, Danchin) Assistance Publique-Hopitaux de Paris
(AP-HP), Department of Cardiology, Hopital Europeen Georges Pompidou,
Universite de Paris, INSERM, Paris Centre de Recherche Cardiovasculaire
(Simon) AP-HP, Hopital Saint Antoine, Department of Clinical Pharmacology
and Unite de Recherche Clinique, Sorbonne Universite, INSERM Unite 698
(Steg) Universite de Paris, INSERM Unite 1148, Hopital Bichat, AP-HP
(Montalescot, Silvain) Sorbonne Universite, ACTION Study Group, Institut
de Cardiologie (AP-HP), INSERM UMRS 1166, Hopital Pitie-Salpetriere
(Durand-Zaleski, Le Bras) Clinical Research Unit Eco Ile de France,
Hopital Hotel Dieu, AP-HP
(Dillinger) Department of Cardiology, Hopital Lariboisiere, AP-HP, INSERM
Unite 942, Universite de Paris
(Ducrocq) Department of Cardiology, Hopital Bichat, AP-HP, French Alliance
for Cardiovascular Trials, INSERM Unite 1148, Laboratory for Vascular
Translational Science, Universite de Paris
(Nelson, Chatellier) Clinical Research Unit, Centre d'Investigation
Clinique 1418 INSERM, George Pompidou European Hospital, AP-HP
(Lemesle, Ducrocq, Blanchard, Danchin) French Alliance for Cardiovascular
Trials, Paris, France
(Cayla) Centre Hospitalier Universitaire (CHU) de Nimes, Nimes, France
(Gallet) Service de Cardiologie, AP-HP, Universite de Paris Est Creteil,
Hopitaux Universitaires Henri Mondor, Creteil, Unite 955-Mondor Institute
for Biomedical Research, Equipe 03, INSERM, Ecole Nationale Veterinaire
d'Alfort, Maisons-Alfort, France
(Khalife) Hopital du Bon Secours, Metz, France
(Morelle) Clinique St. Martin, Caen University Hospital, Caen, France
(Roule) Cardiology Department, Caen University Hospital, Caen, France
(Motreff) Department of Cardiology, CHU Clermont-Ferrand, CNRS UMR 6602,
Universite Clermont Auvergne, Clermont-Ferrand, France
(Lhermusier) Intensive Cardiac Care Unit, Department of Cardiology,
Rangueil University Hospital, The Medical School, Toulouse III Paul
Sabatier University, Toulouse, France
(Labeque) Groupement de Cooperation Saintaire de Cardiologie de la Cote
Basque, Centre Hospitalier de la Cote Basque, Bayonne, France
(Range) Cardiology Department, Hopitaux de Chartres, Chartres, France
(Cottin) Physiopathologie et Epidemiologie Cerebro-Cardiovasculaires,
Equipe d'Accueil (EA 7460), University of Bourgogne Franche-Comte,
Cardiology Department, University Hospital Center of Dijon Bourgogne,
Dijon, France
(De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(De Bruyne) Department of Cardiology, Lausanne University Center Hospital,
Lausanne, Switzerland
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND In patients with ST-elevation myocardial infarction (STEMI) who
have multivessel disease, percutaneous coronary intervention (PCI) for
nonculprit lesions (complete revascularization) is superior to treatment
of the culprit lesion alone. However, whether complete revascularization
that is guided by fractional flow reserve (FFR) is superior to an
angiography-guided procedure is unclear. METHODS In this multicenter
trial, we randomly assigned patients with STEMI and multivessel disease
who had undergone successful PCI of the infarct-related artery to receive
complete revascularization guided by either FFR or angiography. The
primary outcome was a composite of death from any cause, nonfatal
myocardial infarction, or unplanned hospitalization leading to urgent
revascularization at 1 year. RESULTS The mean (+/-SD) number of stents
that were placed per patient for nonculprit lesions was 1.01+/-0.99 in the
FFR-guided group and 1.50+/-0.86 in the angiographyguided group. During
follow-up, a primary outcome event occurred in 32 of 586 patients (5.5%)
in the FFR-guided group and in 24 of 577 patients (4.2%) in the
angiography-guided group (hazard ratio, 1.32; 95% confidence interval,
0.78 to 2.23; P = 0.31). Death occurred in 9 patients (1.5%) in the
FFR-guided group and in 10 (1.7%) in the angiography-guided group;
nonfatal myocardial infarction in 18 (3.1%) and 10 (1.7%), respectively;
and unplanned hospitalization leading to urgent revascularization in 15
(2.6%) and 11 (1.9%), respectively. CONCLUSIONS In patients with STEMI
undergoing complete revascularization, an FFR-guided strategy did not have
a significant benefit over an angiography-guided strategy with respect to
the risk of death, myocardial infarction, or urgent revascularization at 1
year. However, given the wide confidence intervals for the estimate of
effect, the findings do not allow for a conclusive interpretation. (Funded
by the French Ministry of Health and Abbott; FLOWER-MI ClinicalTrials.gov
number, NCT02943954.) Copyright © 2021 Massachusetts Medical
Society.

<73>
Accession Number
2015186748
Title
Representation of racial minorities in cardiac surgery randomized clinical
trials.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Cancelli G.; Audisio K.; Perezgrovas-Olaria R.; Soletti G.J.; Chadow D.;
Rahouma M.; Robinson N.B.; Gaudino M.
Institution
(Cancelli, Audisio, Perezgrovas-Olaria, Soletti, Chadow, Rahouma,
Robinson, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Racial minorities account for 39.9% of the population in the
United States, but are often underrepresented in clinical research.
Results from studies predominantly enrolling White patients may not apply
to racial minorities. The aim of this analysis is to assess the
representation of racial minorities in cardiac surgery randomized clinical
trials (RCTs). Method(s): A systematic search of the literature was
performed. All RCTs published from 2000 to 2020 including at least 100
patients and comparing two or more adult cardiac surgery procedures were
included. Meta-analytic estimates were calculated. Result(s): Among
51 cardiac surgery RCTs published between 2000 and 2020, only 9 (17.6%)
reported the race of patients and were included in the final analysis. All
of them were multicentric, with a mean of 33 centers included. Six RCTs
enrolled patients undergoing coronary artery bypass grafting (66.7%),
while the remaining three were on valve surgery (33.3%). Overall, 9193
patients were included; of them, 8034 (87.4%) were White and 1026 (11.2%)
nonWhite (386 [4.2%] Black, 191 [2.1%] Hispanic, 274 [3.0%] from other
races, and 175 [1.9%] nonWhite patients of unspecified race). The
proportion of nonWhite patients did not change over time.
 Conclusion(s): Only 9 (17.6%) of the 51 cardiac surgery RCTs
published between 2000 and 2020 reported the race of the patients enrolled
and only 11.2% of them were nonWhite patients. Given the association
between race and clinical outcomes, future RCTs should either guarantee a
balanced inclusion of racial minorities or be designed to specifically
enroll them. Copyright © 2022 Wiley Periodicals LLC.

<74>
Accession Number
2015104354
Title
Evaluating the efficacy and safety of calcium channel blockers as
adjunctive analgesics to opioid therapy: a literature review.
Source
Journal of Pharmacy Practice and Research. 52(1) (pp 7-18), 2022. Date of
Publication: February 2022.
Author
Reinert J.P.; Tiemann A.R.; Barlow M.L.; Veronin M.A.
Institution
(Reinert, Tiemann, Barlow, Veronin) Ben and Maytee Fisch College of
Pharmacy, The University of Texas at Tyler, Tyler, TX, United States
(Reinert) Bon Secours Mercy Health St Vincent Medical Center, Toledo, OH,
United States
Publisher
John Wiley and Sons Inc
Abstract
Calcium channel blockers have been postulated as opioid adjuncts, due to
their complementary mechanism of action, which may reduce pain signal
transduction. The purpose of this study was to conduct a literature review
regarding the safety and efficacy of calcium channel blockers alongside
opioids in pain management. From August 2020 to January 2021, PubMed,
Scopus, and ProQuest were searched using the following terminology:
calcium channel blocker OR verapamil OR diltiazem OR amlodipine OR
nicardipine OR nimodipine OR nifedipine AND analgesia. Studies included
were those with adult human subjects that had reported efficacy and safety
outcomes for calcium channel blocker use as opioid adjuncts. Exclusion
criteria for the analysis were articles including pregnant patients, those
not readily translatable to English and those detailing the use of calcium
channel blockers for an alternative diagnosis or indication. Ten studies
were included in this review. Five were randomised controlled trials, one
involving verapamil, one addressing diltiazem, one including nifedipine
and three examining nimodipine. A sixth clinical trial involving
verapamil, diltiazem and nimodipine was reviewed. The seventh and final
clinical trial included nimodipine or nifedipine use during aorto-coronary
bypass surgery. One conclusive study addressed nimodipine's use in cancer
patients treated with morphine and the other nifedipine's morphine adjunct
potential postoperatively. Currently, there is insufficient data to
support the use of calcium channel blockers as adjuncts to opioid therapy
in pain management. When compared, the studies came to varying conclusions
and demonstrated conflicting data indicating the need for more research
regarding this topic. Copyright © 2022 The Society of Hospital
Pharmacists of Australia.

<75>
Accession Number
2014782537
Title
Conventional Versus Minimally Invasive Aortic Valve Replacement Surgery: A
Systematic Review, Meta-Analysis, and Meta-Regression.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 17(1) (pp 3-13), 2022. Date of Publication: January 2022.
Author
Almeida A.S.; Ceron R.O.; Anschau F.; de Oliveira J.B.; Leao Neto T.C.;
Rode J.; Rey R.A.W.; Lira K.B.; Delvaux R.S.; de Souza R.O.R.R.
Institution
(Almeida, de Oliveira, Leao Neto, de Souza) Postgraduate Studies Program
in Minimally Invasive Cardiovascular Surgery, Goiania, Brazil
(Almeida, Ceron, Anschau, Rode, Rey, Lira, Delvaux) Cardiothoracic Surgery
Division, Hospital Nossa Senhora da Conceicao, Grupo Hospitalar Conceicao,
Porto Alegre, Brazil
(Almeida, Anschau) Health Technology Assessment Center (NATS), Grupo
Hospitalar Conceicao, Porto Alegre, Brazil
(Anschau) Postgraduate Program in Technology Assessment for SUS
(PPGATSUS/GHC), Grupo Hospitalar Conceicao, Porto Alegre, Brazil
(de Oliveira, Leao Neto, de Souza) Cardiothoracic Surgery Division,
Hospital Ruy Azeredo, Goiania, Brazil
Publisher
SAGE Publications Ltd
Abstract
Objective: To assess the potential benefits of minimally invasive aortic
valve replacement (MIAVR) compared with conventional AVR (CAVR) by
examining short-term outcomes. Method(s): A systematic search
identified randomized trials comparing MIAVR with CAVR. To assess study
limitations and quality of evidence, we used the Cochrane Risk of Bias
tool and GRADE and performed random-effects meta-analysis. We used
meta-regression and sensitivity analysis to explore reasons for diversity.
 Result(s): Thirteen studies (1,303 patients) were included. For the
comparison of MIAVR and CAVR, the risk of bias was judged low or unclear
and the quality of evidence ranged from very low to moderate. No
significant difference was observed in mortality, stroke, acute kidney
failure, infectious outcomes, cardiac events, intubation time, intensive
care unit stay, reoperation for bleeding, and blood transfusions. Blood
loss (mean difference [MD] = -130.58 mL, 95% confidence interval [CI] =
-216.34 to -44.82, I2 = 89%) and hospital stay (MD = -0.93
days, 95% CI = -1.62 to -0.23, I2 = 81%) were lower with MIAVR.
There were shorter aortic cross-clamp (MD = 5.99 min, 95% CI = 0.99 to
10.98, I2 = 93%) and cardiopulmonary bypass (CPB) times (MD =
7.75 min, 95% CI = 0.27 to 15.24, I2 = 94%) in the CAVR group.
In meta-regression analysis, we found that age was the variable with the
greatest influence on heterogeneity. Conclusion(s): MIAVR seems to be
an excellent alternative to CAVR, reducing hospital stay and incidence of
hemorrhagic events. Despite significantly greater aortic cross-clamp and
CPB times with MIAVR, this did not translate into adverse effects, with no
changes in the results found with CAVR. Copyright © The Author(s)
2022.

<76>
Accession Number
2014077915
Title
Safety of direct oral anticoagulants in solid organ transplant recipients:
A meta-analysis.
Source
Clinical Transplantation. 36(3) (no pagination), 2022. Article Number:
e14513. Date of Publication: March 2022.
Author
Zakko J.; Ganapathi A.M.; Whitson B.A.; Mokadam N.A.; Henn M.C.; Lampert
B.; Kahwash R.; Franco V.; Haas G.; Emani S.; Hasan A.; Vallakati A.
Institution
(Zakko) Department of Surgery, The Ohio State University Wexner Medical
Center, Columbus, OH, United States
(Ganapathi, Whitson, Mokadam, Henn) Department of Surgery, Division of
Cardiac Surgery, The Ohio State University Wexner Medical Center,
Columbus, OH, United States
(Lampert, Kahwash, Franco, Haas, Emani, Hasan, Vallakati) Department of
Internal Medicine, Division of Cardiology, The Ohio State University
Wexner Medical Center, Columbus, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
There is limited evidence comparing direct oral anticoagulants (DOACs) and
warfarin in solid organ transplant (SOT) recipients. We performed a pooled
analysis to study the safety and efficacy of DOACs in this patient
population. We searched PubMed, Embase, and Scopus databases using the
search terms "heart transplant" or "lung transplant" or "liver transplant"
or "kidney transplant" or "pancreas transplant" and "direct oral
anticoagulant" for literature search. Random effects model with
Mantel-Haenszel method was used to pool the outcomes. Pooled analysis
included 489 patients, of which 259 patients received DOACs and 230
patients received warfarin. When compared to warfarin, the use of DOACs
was associated with decreased risk of composite bleed (RR.49, 95%
CI.32-.76, p =.002). There were no differences in rates of major bleeding
(RR.55, 95% CI.20-1.49, p =.24) or venous thromboembolism (RR.65, 95%
CI.25-1.70, p =.38) between the two groups. Evidence from pooled analysis
suggests that DOACs are comparable to warfarin in terms of safety in SOT
recipients. Further research is warranted to conclusively determine
whether DOACs are safe alternatives to warfarin for anticoagulation in SOT
recipients. Copyright © 2021 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<77>
Accession Number
2013158667
Title
The use of diflunisal for transthyretin cardiac amyloidosis: a review.
Source
Heart Failure Reviews. 27(2) (pp 517-524), 2022. Date of Publication:
March 2022.
Author
Ibrahim M.; Saint Croix G.R.; Lacy S.; Fattouh M.; Barillas-Lara M.I.;
Behrooz L.; Mechanic O.
Institution
(Ibrahim, Behrooz) Department Medicine, Division of Cardiovascular
Medicine, Boston University Hospital, 801 Massachusetts Avenue Suite 400,
Boston, MA 02118, United States
(Saint Croix, Mechanic) Division of Cardiology At Mount Sinai Medical
Center, Columbia University, 4300 Alton Rd, Miami Beach, FL 33140, United
States
(Lacy) Department of Medicine, University of Miami Miller School of
Medicine, 1120 NW 14th Street, Clinical Research Building, Miami, FL
33136, United States
(Fattouh, Barillas-Lara) Department of Internal Medicine Boston Medical
Center, Boston University School of Medicine, 72 East Concord St, Boston,
MA 02118, United States
Publisher
Springer
Abstract
Transthyretin cardiac amyloidosis (ATTR-CM) is caused by the accumulation
of misfolded transthyretin (TTR) protein in the myocardium. Diflunisal, an
agent that stabilizes TTR, has been used as an off-label therapeutic for
ATTR-CM. Given limited data surrounding the use of diflunisal, a
systematic review of the literature is warranted. We searched the PubMed,
MEDLINE, and Embase databases for studies that reported on the use of
diflunisal therapy for patients with ATTR-CM. We included English language
studies which assessed the effect of diflunisal in adult patients with
ATTR-CM who received diflunisal as primary treatment and reported clinical
outcomes with emphasis on studies that noted the safety and efficacy of
diflunisal in cardiac manifestations of ATTR amyloidosis. We excluded
studies which did not use diflunisal therapy or used diflunisal therapy
for non-cardiac manifestations of TTR amyloidosis. We also excluded case
reports, abstracts, oral presentations, and studies with fewer than 10
subjects. Our search yielded 316 records, and we included 6 studies
reporting on 400 patients. Non-comparative single-arm small non-randomized
trials for diflunisal comprised 4 of the included studies. The 2 studies
that compared diflunisal versus no treatment found improvements in TTR
concentration, left atrial volume index, cardiac troponin I, and global
longitudinal strain. Overall, diflunisal use was associated with decreased
mortality and number of orthotopic heart transplant in ATTR-CM patients.
Although a smaller number of patients had to stop treatment due to
gastrointestinal side effects and transient renal dysfunction, there were
no severe reactions reported in the studies included in our review. This
systematic review supports the use of diflunisal for ATTR-CM. Additional
long-term analyses and randomized clinical trials are needed to confirm
these results. Copyright © 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<78>
Accession Number
2017063403
Title
The effectiveness and safety of pulmonary autograft as living tissue in
Ross procedure: A systematic review.
Source
Translational Pediatrics. 11(2) (pp 280-297), 2022. Date of Publication:
February 2022.
Author
Nappi F.; Iervolino A.; Singh S.S.A.
Institution
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord,
Saint-Denis 93200, France
(Iervolino) Department of Internal Medicine, Federico II University,
Naples, Italy
(Singh) Department of Cardiothoracic Surgery, Golden Jubilee National
Hospital, Glasgow, United Kingdom
Publisher
AME Publishing Company
Abstract
Background: Reports on effectiveness and safety after the implant of
pulmonary autograft (PA) living tissue in Ross procedure, to treat both
congenital and acquired disease of the aortic valve and left ventricular
outflow tract (LVOT), show variable durability results. We undertake a
quantitative systematic review of evidence on outcome after the Ross
procedure with the aim to improve insight into outcome and potential
determinants. Method(s): A systematic search of reports published
from October 1979 to January 2021 was conducted (PubMed, Ovid Medline,
Ovid Embase and Cochrane library) reporting outcomes after the Ross
procedure in patients with diseased aortic valve with or without LVOT.
Inclusion criteria were observational studies reporting on mortality
and/or morbidity after autograft aortic valve or root replacement,
completeness of follow-up >90%, and study size n>=30. Forty articles
meeting the inclusion criteria were allocated to two categories: Pediatric
patient series and young adult patient series. Results were tabulated for
a clearer presentation. Result(s): A total of 342 studies were
evaluated of which forty studies were included in the final analysis as
per the eligibility criteria. A total of 8,468 patients were included
(7,796 in pediatric cohort and young adult series and 672 in pediatric
series). Late mortality rates were remarkably low alongside similar
age-matched mortality with the general population in young adults. There
were differences in implantation techniques as regard the variability in
stress and the somatic growth that recorded conflicting outcomes regarding
the miniroot vs the subcoronary approach. Discussion(s): The
adaptability of lung autograft to allow for both stress variability and
somatic growth make it an ideal conduit for Ross's operation. The use of
the miniroot technique over subcoronary implantation for better
adaptability to withstand varying degrees of stress is perhaps more
applicable to different patient subgroups. Copyright © 2022 AME
Publishing Company. All rights reserved.

<79>
Accession Number
2017046944
Title
Propensity-Matched 1-Year Outcomes Following Transcatheter Aortic Valve
Replacement in Low-Risk Bicuspid and Tricuspid Patients.
Source
JACC: Cardiovascular Interventions. 15(5) (pp 511-522), 2022. Date of
Publication: 14 Mar 2022.
Author
Deeb G.M.; Reardon M.J.; Ramlawi B.; Yakubov S.J.; Chetcuti S.J.; Kleiman
N.S.; Mangi A.A.; Zahr F.; Song H.K.; Gada H.; Mumtaz M.; Heiser J.; Merhi
W.; Murrah C.P.; Noel T.; Kirshner M.; Byrne T.; Ito S.; Huang J.; Forrest
J.K.
Institution
(Deeb) Department of Cardiac Surgery, University of Michigan Hospitals,
Ann Arbor, MI, United States
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist DeBakey
Heart and Vascular Institute, Houston, TX, United States
(Ramlawi) Department of Cardiothoracic Surgery, Valley Health, Winchester,
Virginia, United States
(Yakubov) Department of Interventional Cardiology, Riverside
Methodist-OhioHealth, Columbus, OH, United States
(Chetcuti) Department of Interventional Cardiology, University of Michigan
Hospitals, Ann Arbor, MI, United States
(Kleiman) Department of Interventional Cardiology, Houston Methodist
DeBakey Heart and Vascular Institute, Houston, TX, United States
(Mangi) Department of Surgery (Cardiac Surgery), Yale University School of
Medicine, New Haven, CT, United States
(Zahr) Department of Interventional Cardiology, Oregon Health and Science
University, Portland, OR, United States
(Song) Department of Cardiothoracic Surgery, Oregon Health and Science
University, Portland, OR, United States
(Gada) Department of Interventional Cardiology, University of Pittsburgh
Pinnacle, Wormsleyburg, Pennsylvani, United States
(Mumtaz) Department of Cardiothooracic Surgery, University of Pittsburgh
Pinnacle, Wormsleyburg, PA, United States
(Heiser) Department of Cardiothoracic Surgery, Spectrum Health, Grand
Rapids, MI, United States
(Merhi) Department of Interventional Cardiology, Spectrum Health, Grand
Rapids, MI, United States
(Murrah) Department of Cardiothoracic Surgery, Tallahassee Research
Institute, Tallahassee, FL, United States
(Noel) Department of Interventional Cardiology, Tallahassee Research
Institute, Tallahassee, FL, United States
(Kirshner) Department of Cardiothoracic Surgery, Abrazo Arizona Heart
Hospital, Phoenix, AZ, United States
(Byrne) Department of Interventional Cardiology, Abrazo Arizona Heart
Hospital, Phoenix, AZ, United States
(Ito) Division of Cardiovascular Ultrasound, Mayo Clinic, Rochester, MN,
United States
(Huang) Department of Statistics, Medtronic, Minneapolis, MN, United
States
(Forrest) Department of Internal Medicine (Cardiology), Yale University
School of Medicine, New Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to compare 1-year outcomes after
transcatheter aortic valve replacement (TAVR) in low surgical risk
patients with bicuspid aortic stenosis to patients with tricuspid aortic
stenosis. Background(s): The pivotal TAVR trials excluded patients
with bicuspid aortic valves. The Low Risk Bicuspid Study 30-day primary
endpoint of death or disabling stroke was 1.3%. Method(s): The Low
Risk Bicuspid Study is a prospective, single-arm, TAVR trial that enrolled
patients from 25 U.S. sites. A screening committee confirmed bicuspid
anatomy and valve classification on computed tomography using the Sievers
classification. Valve sizing was by annular measurements. An independent
clinical events committee adjudicated all serious adverse events, and an
independent core laboratory assessed all echocardiograms. The 150 patients
from the Low Risk Bicuspid Study were propensity matched to the TAVR
patients in the randomized Evolut Low Risk Trial using the 1:1 5-
to-1-digit greedy method, resulting in 145 pairs. Result(s):
All-cause mortality or disabling stroke at 1 year was 1.4% in the bicuspid
and 2.8% in the tricuspid group (P = 0.413). A pacemaker was implanted in
16.6% of bicuspid and 17.9% of tricuspid patients (P = 0.741). The
effective orifice area was similar between groups at 1 year (2.2 +/- 0.7
cm2 vs 2.3 +/- 0.6 cm2, P = 0.677) as was the mean
gradient (8.7 +/- 3.9 mm Hg vs 8.5 +/- 3.1 mm Hg, P = 0.754). Fewer
patients in the bicuspid group had mild or worse paravalvular leak (21.3%
vs 42.6%, P < 0.001). Conclusion(s): There were no significant
differences in clinical or forward flow hemodynamic outcomes between the
propensity-matched groups at 1 year. Copyright © 2022 American
College of Cardiology Foundation

<80>
Accession Number
2017081945
Title
Clinical, Microbiological, and Imaging Characteristics of Infective
Endocarditis in Latin America: A Systematic Review.
Source
International Journal of Infectious Diseases. 117 (pp 312-321), 2022. Date
of Publication: April 2022.
Author
Urina-Jassir M.; Jaimes-Reyes M.A.; Martinez-Vernaza S.; Quiroga-Vergara
C.; Urina-Triana M.
Institution
(Urina-Jassir, Jaimes-Reyes, Urina-Triana) Fundacion del Caribe para la
Investigacion Biomedica, Barranquilla, Atlantico, Colombia, Full postal
address: Carrera 50 # 80 - 216 Office 201, Atlantico, Barranquilla,
Colombia
(Martinez-Vernaza, Quiroga-Vergara) Unidad de Infectologia, Hospital
Universitario San Ignacio, Bogota D.C., Colombia, Full postal address:
Calle 41 #13-06 Piso 2, D.C., Bogota, Colombia
(Urina-Triana) Facultad de Ciencias de la Salud, Universidad Simon
Bolivar, Barranquilla, Atlantico, Colombia, Full postal address: Carrera
59 # 59 - 65, Atlantico, Barranquilla, Colombia
Publisher
Elsevier B.V.
Abstract
Objectives: We aimed to describe the clinical, microbiological, and
imaging characteristics of patients with infective endocarditis (IE) in
studies from Latin America (LATAM). Method(s): A systematic search
through PubMed, EMBASE, LILACS, and SciELO from inception until February
2021 was conducted. We included observational studies that assessed adults
with IE from LATAM and reported data on clinical, microbiological, or
imaging characteristics. Data were independently extracted by 2 authors
and the risk of bias was evaluated by study design with its respective
tool. Findings were summarized using descriptive statistics.
 Result(s): Forty-four studies were included. Most cases were male
(68.5%), had a predisposing condition including valve disease (24.3%), or
had a prosthetic valve (23.4%). Clinical manifestations included fever
(83.9%), malaise (63.2%), or heart murmur (57.7%). A total of 36.4% and
27.1% developed heart failure or embolism, respectively. Blood cultures
were negative in 23.9% and S. aureus (18.6%) and the viridans group
streptococci (17.8%) were the most common isolates. Most cases were native
valve IE (67.3%) affecting mainly left-sided valves. Echocardiographic
findings included vegetations (84.3%) and regurgitation (75.9%).
In-hospital mortality was 25.1%. Conclusion(s): This is the first
systematic review that evaluated the characteristics of IE in LATAM
patients. A lack of multicenter studies reflects the need for these
studies in LATAM. Copyright © 2022 The Author(s)

<81>
Accession Number
2017027785
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: 01 Mar
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
Oxford University Press
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 >= 65 years. 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 40 042 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 © 2021 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.

<82>
Accession Number
2017043742
Title
Direct aortic route versus transaxillary route for transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
PeerJ. 8 (no pagination), 2020. Article Number: e9102. Date of
Publication: May 2020.
Author
Lee H.-A.; Su I.-L.; Chen S.-W.; Wu V.C.-C.; Chen D.-Y.; Chu P.-H.; Chou
A.-H.; Cheng Y.-T.; Lin P.-J.; Tsai F.-C.
Institution
(Lee, Su, Chen, Cheng, Lin, Tsai) Department of Thoracic and
Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou Medical
Center, Chang Gung University, Taoyuan, Taiwan (Republic of China)
(Wu, Chen, Chu) Department of Cardiology, Chang Gung Memorial Hospital,
Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan (Republic of
China)
(Chou) Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou
Medical Center, Chang Gung University, Taoyuan, Taiwan (Republic of China)
Publisher
PeerJ Inc.
Abstract
Background: The transfemoral route is contraindicated in nearly 10% of
transcatheter aortic valve replacement (TAVR) candidates because of
unsuitable iliofemoral vessels. Transaxillary (TAx) and direct aortic
(DAo) routes are the principal nonfemoral TAVR routes; however, few
studies have compared their outcomes. Method(s): We performed a
systematic review and meta-analysis to compare the rates of mortality,
stroke, and other adverse events of TAx and DAo TAVR. The study was
prospectively registered with PROSPERO (registration number:
CRD42017069788). We searched Medline, PubMed, Embase, and Cochrane
databases for studies reporting the outcomes of DAo or TAx TAVR in at
least 10 patients. Studies that did not use the Valve Academic Research
Consortium definitions were excluded. We included studies that did not
directly compare the two approaches and then pooled rates of events from
the included studies for comparison. Result(s): In total, 31 studies
were included in the quantitative meta-analysis, with 2,883 and 2,172
patients in the DAo and TAx TAVR groups, respectively. Compared with TAx
TAVR, DAo TAVR had a lower Society of Thoracic Surgery (STS) score,
shorter fluoroscopic time, and less contrast volume use. The 30-day
mortality rates were significantly higher in the DAo TAVR group (9.6%, 95%
confidence interval (CI) = [8.4-10.9]) than in the TAx TAVR group (5.7%,
95% CI = [4.8-6.8]; P for heterogeneity <0.001). DAo TAVR was associated
with a significantly lower risk of stroke in the overall study population
(2.6% vs. 5.8%, P for heterogeneity <0.001) and in the subgroup of studies
with a mean STS score of >=8 (1.6% vs. 6.2%, P for heterogeneity = 0.005).
DAo TAVR was also associated with lower risks of permanent pacemaker
implantation (12.3% vs. 20.1%, P for heterogeneity = 0.009) and valve
malposition (2.0% vs. 10.2%, P for heterogeneity = 0.023) than was TAx
TAVR. Conclusion(s): DAo TAVR increased 30-day mortality rate
compared with TAx TAVR; by contrast, TAx TAVR increased postoperative
stroke, permanent pacemaker implantation, and valve malposition risks
compared with DAo TAVR. Copyright © 2020 Lee et al.

<83>
Accession Number
2016967979
Title
Meta-Analysis Comparing Risk Factors, Incidence, and Outcomes of Patients
With Versus Without Prosthesis-Patient Mismatch Following Transcatheter
Aortic Valve Implantation.
Source
American Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Lim O.Z.H.; Mai A.S.; Ng C.H.; Tang A.; Chin Y.H.; Kong G.; Ho Y.J.; Ong
J.; Tay E.; Kuntjoro I.; Chew N.W.; Lim Y.
Institution
(Lim, Mai, Ng, Tang, Chin, Kong, Ho, Kuntjoro, Lim) Yong Loo Lin School of
Medicine, National University of Singapore, Singapore
(Ong, Tay, Kuntjoro, Chew, Lim) Department of Cardiology, National
University Heart Centre, Singapore
Publisher
Elsevier Inc.
Abstract
Current guidelines on the management of patients with aortic valvular
disease have widened the use of transcatheter aortic valve implantation
(TAVI) with an emphasis on avoidance of prosthesis-patient mismatch (PPM).
This study sought to examine the incidence, risk factors, and all-cause
mortality of PPM after TAVI. Medline and Embase databases were searched
from inception to August 10, 2021. Patients were compared along 2 arms:
(1) any degree of PPM and those without PPM, (2) severe PPM, and nonsevere
PPM. A total of 22 articles involving 115,442 patients after TAVI were
included. Pooled incidence for any degree of PPM was 30.1% and 10.7% in
severe PPM. Incidence was significantly higher (p <0.001) for any degree
of PPM in Europe (33.1%) and North America (34.4%) compared with Asia
(10.4%). Incidence of severe PPM was higher (p = 0.015) in older
generation (13.6%) compared with current-generation valves (6.3%). Severe
PPM increased the risk of all-cause mortality relative to nonsevere PPM
(hazard ratio: 1.86, 95% confidence interval: 1.05 to 3.29, p = 0.034).
Patients of younger age, increased body surface area, lower left
ventricular ejection fraction, and classified New York Heart Association
Class III/IV were at greater risk of both any degree and severe PPM.
Smaller prosthesis size increased the risk of any degree of PPM, whereas
postdilation and larger prostheses were protective factors. In conclusion,
all-cause mortality was significantly affected in severe PPM compared with
nonsevere cases, whereas this excess mortality was not observed between
those with any degree of PPM and those without. Closer attention to
patient and bioprosthetic valve factors is required to minimize the
occurrence of severe PPM. Copyright © 2022 Elsevier Inc.

<84>
Accession Number
2017050034
Title
Prevalence and outcomes of concomitant cardiac amyloidosis and aortic
stenosis: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Ho J.S.-Y.; Kor Q.; Kong W.K.; Lim Y.C.; Chan M.Y.-Y.; Syn N.L.; Ngiam
J.N.; Chew N.W.; Yeo T.-C.; Chai P.; Poh K.-K.; Wong R.C.; Lin W.; Sia
C.-H.
Institution
(Ho) Academic Foundation Programme, North Middlesex University Hospital
NHS Trust, United Kingdom
(Kor, Kong, Chan, Syn, Yeo, Chai, Poh, Wong, Lin, Sia) Department of
Medicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Kong, Lim, Chan, Chew, Yeo, Chai, Poh, Wong, Lin, Sia) Department of
Cardiology, National University Heart Centre Singapore, Singapore
(Ngiam) Internal Medicine Residency, University Medicine Cluster, National
University Health System, Singapore
Publisher
Hellenic Cardiological Society
Abstract
Objective: Cardiac amyloidosis (CA) is an increasingly recognised
condition in patients with aortic stenosis (AS). However, there is a large
variation in the reported prevalence figures, due to differences in
populations and diagnostic methods. We aimed to investigate the
prevalence, risk factors and outcomes of concomitant CA and AS.
 Method(s): We performed a systematic review and meta-analysis of the
literature searched on MEDLINE, Embase, Scopus and CENTRAL. We analysed
the prevalence of CA in patients with AS grouped according to the
diagnostic techniques, and the risk factors and outcomes of concomitant CA
and AS were analysed in AS patients referred for surgical or transcatheter
aortic valve replacement (AVR). Result(s): A total of 21 studies were
included, involving 4,243 patients. The pooled prevalence of CA in
patients with AS was 14.4%, with substantial heterogeneity. The pooled
prevalence of AS in patients CA was 8.7%, with substantial heterogeneity.
Patients with both AS and CA had higher all-cause mortality than those
with AS or CA alone. In AS patients requiring AVR, CA was associated with
increasing age, male sex, higher NT-proBNP levels, increased
interventricular septal end diastole (IVSd) thickness and lower left
ventricular ejection fraction. Concomitant AS and CA was associated with
increased all-cause mortality and pacemaker implantation post-procedure.
Study limitations included heterogeneity of the results and the fair to
good quality of the studies published. Conclusion(s): Overall, a
substantial proportion of patients with AS may have CA, and they have
poorer prognosis. A high degree of clinical suspicion is needed to
identify the "red flags" and perform appropriate diagnostic
imaging. Copyright © 2021 Hellenic Society of Cardiology

<85>
Accession Number
2017049955
Title
Role of Hypothermia in Adult Cardiac Surgery Patients: A Systematic Review
and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Abbasciano R.G.; Koulouroudias M.; Chad T.; Mohamed W.; Leeman I.; Pellowe
C.; Kunst G.; Klein A.; Murphy G.J.
Institution
(Abbasciano, Koulouroudias, Chad, Mohamed, Murphy) Department of
Cardiovascular Sciences, Clinical Sciences Wing, Glenfield Hospital,
University of Leicester, Leicester, United Kingdom
(Leeman, Pellowe) National Cardiac Surgery Clinical Trials Initiative,
Case Study Group 5 -Organ Protection, University of Leicester, Leicester,
United Kingdom
(Kunst) Department of Anaesthetics and Pain Medicine, King's College
Hospital NHS Foundation Trust, School of Cardiovascular Medicine &
Sciences, King's College London British Heart Foundation Centre of
Excellence, London, United Kingdom
(Klein) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital, Cambridge, United Kingdom
Publisher
W.B. Saunders
Abstract
Objective: To review studies that assessed systemic hypothermia as an
organ protection strategy in adults undergoing cardiac surgery with
cardiopulmonary bypass. Design(s): A systematic review and
meta-analysis. Setting and Participants: Randomized controlled trials,
irrespective of blinding, language, publication status, and date of
publication, were identified by searching the Cochrane Central register of
Controlled Trials, MEDLINE, and Embase until November 2020. Risk of bias
assessment was performed according to Cochrane methodology. Treatment
effects were expressed as risk ratios and 95% confidence intervals.
Heterogeneity was expressed as I2. Intervention(s):
Systemic hypothermia. Measurements and Main Results: Forty-eight
trials enrolling 6,690 patients were included in the analysis.
Methodologic quality of the studies included was low, mostly due to
insufficient allocation concealment or blinding. Random-effects
meta-analysis did not resolve uncertainty as to the risks and benefits for
hypothermia versus normothermia for key primary and secondary outcomes,
including mortality (1.21, 0.94 to 1.56, I2 = 0%) and brain
injury (0.87, 0.67 to 1.14, I2 = 0%). Sensitivity analyses
restricted to trials at low risk of important bias demonstrated higher
mortality with hypothermia (1.70, 1.05 to 2.75, I2 = 0%), with
little or no treatment effect on brain injury (1.01, 0.69 to 1.49,
I2 = 0%). There was no interaction between cardioplegia
temperature and the effects of cardiopulmonary bypass temperature on
outcomes. There was insufficient evidence to assess the effects of
hypothermia in noncoronary artery bypass graft surgery.
 Conclusion(s): The existing evidence for an organ-protective effect
of hypothermia in adult cardiac surgery is of low quality and
inconsistent. Copyright © 2022 Elsevier Inc.

<86>
Accession Number
637386253
Title
Current Status of Malignant Tumors after Organ Transplantation.
Source
BioMed research international. 2022 (pp 5852451), 2022. Date of
Publication: 2022.
Author
Shen B.; Cen Z.; Tan M.; Song C.; Wu X.; Wang J.; Huang M.
Institution
(Shen, Cen, Tan, Song, Wu, Wang, Huang) Thoracic Surgery, Foshan Clinical
Medical School of Guangzhou University of Chinese Medicine, Guangdong
Province, China
Publisher
NLM (Medline)
Abstract
Objective: To analyze the diagnosis and treatment of patients with
concomitant malignant tumors after organ transplantation by compiling data
from organ transplantation patients. Method(s): By searching CNKI and
PubMed databases, we made a systematic analysis of the studies of
postorgan transplantation complicating malignant tumors in the last
decade. Result(s): There were 10 articles on malignant tumors after
renal transplantation, 8 articles on liver transplantation, 2 articles on
heart transplantation, and 1 article on lung transplantation. The
incidence of malignant tumors complicating renal transplantation is 10.4%
in Europe, with skin cancer and Kaposi's sarcoma being common; the
incidence in the United States is 3.4%, with PTLD having the highest
incidence; the incidence of malignant tumors is relatively lowest in Asia,
with gastrointestinal malignancies being the main ones. The mean time to
complication of malignancy after renal transplantation is 3.83 years. The
incidence of concurrent malignancies after liver transplantation is 8.8%
in Europe, where skin cancer and Kaposi's sarcoma are common; 5.6% in
Asia, where gastrointestinal tract tumors are prevalent; and 4.5% in the
United States, where gastrointestinal tract tumors, PTLD, and hematologic
diseases are predominant. The mean time to complication of malignancy
after liver transplantation is 4.79 years. The incidence of malignancy
after heart transplantation is 6.8-10.7%. The incidence of malignancy
after lung transplantation is about 10.1%. Minimization of
immunosuppression or modification of immunosuppression regimens may be a
key component of cancer prevention. mTOR inhibitors and phenolate (MMF)
reduce the incidence of de novo malignancies in patients after solid organ
transplantation. Surgical treatment improves survival in patients with
early malignancies. The use of external beam radiation therapy in the
treatment of hepatocellular carcinoma is limited due to the risk of
radiation liver disease. Conclusion(s): The risk of concomitant
malignancy needs to be guarded for 5 years of immunosuppressive therapy
after organ transplantation surgery. Adjusting the immunosuppressive
treatment regimen is an effective way to reduce concurrent malignancies.
Systemic chemotherapy or radiotherapy requires vigilance against the toxic
effects of drug metabolism kinetics on the transplanted
organ. Copyright © 2022 Bairu Shen et al.

<87>
Accession Number
2015143224
Title
Umbrella Meta-analysis Evaluating the Effectiveness of ViV-TAVI vs Redo
SAVR.
Source
SN Comprehensive Clinical Medicine. 4(1) (no pagination), 2022. Article
Number: 63. Date of Publication: December 2022.
Author
Aedma S.K.; Khan N.; Altamimi A.; Ali N.; Jain S.; Raol K.; Madireddy S.;
Rakholiya J.; Raheem A.; Desai R.; Patel U.K.; Rabbani R.; Pothuru S.
Institution
(Aedma) Department of Internal Medicine, Carle Illinois College of
Medicine, Urbana, IL, United States
(Khan) Department of Internal Medicine, Jinnah Sindh Medical University,
Sindh, Pakistan
(Altamimi) Department of Emergency Medicine, Amiri Hospital, Sharq, Kuwait
(Ali) Liaquat University of Medical Health and Science, Sindh, Pakistan
(Jain) Department of Internal Medicine, Gujarat Medical Education and
Research Society Medical College, Gujarat, Gotri, India
(Raol) Department of Internal Medicine, Gujarat Medical Education and
Research Society Medical College and General Hospital, Gujarat,
Gandhinagar, India
(Madireddy) Department of Internal Medicine, Mamata Medical College,
Telangana, Khammam, India
(Rakholiya) Department of Internal Medicine, Mayo Clinic, Rochester, MN,
United States
(Raheem) Department of Internal Medicine, Texas Tech University Health
Sciences Center at Permian Basin, Odessa, TX, United States
(Desai) Department of Internal Medicine, University of North Carolina
Cardiology at Nash, Rocky Mount, NC, United States
(Patel) Department of Public Health and Neurology, Icahn School of
Medicine at Mount Sinai, Gustave L. Levy Pl, New York, NY 10029, United
States
(Rabbani) Temple University Hospital, Philadelphia, PA, United States
(Pothuru) Department of Internal Medicine, Ascension Via Christi Hospital,
Manhattan, KS, United States
Publisher
Springer Nature
Abstract
Since almost a decade, the use of bioprosthetic valves (BPV) has been
increasing for the replacement of stenosed aortic valves. With the
increasing use, a rise in the BPV failure is noted considering their
limited durability. Redo-surgical aortic valve replacement (rSAVR) is by
far the only gold standard treatment modality for replacement of
deteriorated BPV. Recently, valve in valve-transcatheter aortic valve
replacement (ViV-TAVR) is explored as the alternative minimally invasive
procedure compared to the gold standard rSAVR. However, its efficacy
remains the major concern. Hence, we aimed to conduct the
meta-meta-analysis to evaluate the safety and efficacy of ViV-TAVI
compared to redo-SAVR. Following PRISMA guidelines, we searched for a
meta-analysis comparing the safety and efficacy of ViV-TAVR vs rSAVR from
PubMed and included 9 analyses which compared the two modalities
head-to-head in terms of outcomes and complications. We included various
complications and outcomes like 30-day mortality, long-term mortality,
procedural mortality, hospital readmission, and complications including
acute MI, stroke, major bleeding, vascular complications, acute kidney
injury, and new pacemaker implantation. We carried out a
meta-meta-analysis by obtaining pooled odds ratio, 95% CI using random
effect models. We found out that there was a significantly low risk of
30-day mortality (pooled OR:0.60; 95%CI:0.53-0.68; p < 0.00001) with no
heterogeneity (p = 0.53; I2 = 0%) with ViV-TAVR vs rSAVR. Also,
there was a reduced risk of procedural mortality (pooled OR:0.52;
95%CI:0.27-0.98; p = 0.04) with 0% heterogeneity with ViV-TAVR vs rSAVR.
ViV-TAVI is associated with significantly reduced risk of 30-day mortality
compared to rSAVR. Our meta-meta-analysis reinforces the safety and
efficacy of ViV-TAVR as the procedure of choice for failed bioprosthetic
(BP) valves in high-risk candidates. Copyright © 2022, The
Author(s), under exclusive licence to Springer Nature Switzerland AG.

<88>
Accession Number
2015120015
Title
Clinical outcomes of patients with hepatic insufficiency undergoing
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
67. Date of Publication: December 2022.
Author
Jiang W.; Cheng Z.; Tu S.; Wang X.; Xiang C.; Zhou W.; Chen L.
Institution
(Jiang, Tu, Wang) The First Clinical Medical College of Lanzhou
University, No.222, Tianshui Road (South), Chengguan District, Gansu
Province, Lanzhou City 730000, China
(Cheng) Department of Cardiac Surgery, Ruijin Hospital affiliated to
School of Medicine, Shanghai Jiao Tong University, No.197, Ruijin Road
(Second), Shanghai City 200025, China
(Xiang) The Second Clinical Medical College of Lanzhou University, No.222,
Tianshui Road (South), Chengguan District, Gansu Province, Lanzhou City
730000, China
(Zhou) Department of General Surgery, The First Hospital of Lanzhou
University, No. 1, Donggangxi Road, Chengguan District, Gansu Province,
Lanzhou City 730000, China
(Chen) Department of Infectious Diseases, The First Hospital of Lanzhou
University, No. 1, Donggangxi Road, Chengguan District, Gansu Province,
Lanzhou City 730000, China
Publisher
BioMed Central Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is currently a
common treatment in high-risk aortic stenosis patients, but the impact of
hepatic insufficiency on prognosis after TAVI is debatable and whether
TAVI is superior to surgical aortic valve replacement (SAVR) in patients
with hepatic insufficiency is uncertain. Objective(s): To investigate
the effect of abnormal liver function on the outcome and safety after TAVI
and whether TAVI is superior to SAVR in patients with hepatic
insufficiency. Method(s): PubMed, Embase, the Cochrane Library and
Web of Science were systematically searched from inception up to 26
November 2021. Studies were eligible if mortality and complications after
TAVI in patients with and without hepatic insufficiency, or mortality and
complications for TAVI versus SAVR in patients with hepatic insufficiency
were reported. The Newcastle-Ottawa scale (NOS) was used to evaluate the
quality of each study. This meta-analysis was registered with PROSPERO
(CRD42021253423) and was carried out by using RevMan 5.3 and Stata 14.0.
 Result(s): This meta-analysis of 21 studies assessed a total of
222,694 patients. Hepatic insufficiency was associated with higher
short-term (in-hospital or 30-day) mortality [OR = 1.62, 95% CI (1.18 to
2.21), P = 0.003] and 1-2 years mortality [HR = 1.64, 95% CI (1.42 to
1.89), P < 0.00001] after TAVI. Between TAVI and SAVR in patients with
hepatic insufficiency, there was a statistically significant difference in
in-hospital mortality [OR = 0.46, 95% CI (0.27 to 0.81), P = 0.007], the
occurrence rate of blood transfusions [OR = 0.29, 95% CI (0.22 to 0.38), P
< 0.00001] and the occurrence rate of acute kidney injury [OR = 0.55, 95%
CI (0.33 to 0.91), P = 0.02]. Conclusion(s): TAVI patients with
hepatic insufficiency may have negative impact both on short-term
(in-hospital or 30-day) and 1-2-years mortality. For patients with hepatic
insufficiency, TAVI could be a better option than SAVR. Copyright
© 2022, The Author(s).

<89>
Accession Number
637400699
Title
Prophylactic dexmedetomidine use did not decrease the incidence of
delirium in patients undergoing cardiac surgery: A meta-analysis.
Source
Perfusion. (pp 2676591211066232), 2022. Date of Publication: 01 Mar 2022.
Author
Li W.; Liu H.; Yang C.
Institution
(Li, Liu, Yang) Department of Cardiovascular Medicine, 159393Affiliated
Hospital of Shandong University of Traditional Chinese Medicine, Jinan,
Shandong, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The benefits of prophylactic dexmedetomidine use in patients
undergoing cardiac surgery remain controversial. The aim of this
meta-analysis was to investigate the short-term clinical outcomes of
dexmedetomidine use versus non-dexmedetomidine use. METHOD(S):
Systematic searches using PubMed, Embase, and the Cochrane Library were
carried out for English articles published from inception to 23 September
2021. This was followed by a meta-analysis investigating delirium, the
length of delirium, mortality, bradycardia, hypotension, the length of
intensive care unit (ICU) and hospital stay, and the duration of
mechanical ventilation. RESULT(S): Ten randomized controlled trials
(RCTs) totaling 2550 patients were included. In the dexmedetomidine group
incidence of delirium was 13.5%, compared with 16.1% in the control group.
The risk ratio (RR) for the comparison was 0.69 (95% CI, 0.47 - 1.00; p =
.052). In addition, there were no differences in mortality (RR, 0.56; 95%
CI, 0.27 - 1.14; p = .109), the incidence of bradycardia (RR, 1.20; 95%
CI, 0.91 - 1.57; p = .201), the incidence of hypotension (RR, 0.90; 95%
CI, 0.57 - 1.44; p = .674), and the length of delirium mean difference
(MD, -0.99; 95% CI, -2.20 to 0.21; p = .106). However, prophylactic
dexmedetomidine use significantly reduced the duration of mechanical
ventilation (MD, -2.03; 95% CI, -3.35 to -0.70; p = .003), length of ICU
stay (MD, -3.17; 95% CI, -5.10 to -1.24; p = .001), and length of hospital
stay (MD, -1.76; 95% CI, -2.88 to -0.66; p = .002). CONCLUSION(S):
Prophylactic dexmedetomidine use did not decrease the incidence of
delirium in patients undergoing cardiac surgery, but significantly reduced
the duration of mechanical ventilation, length of ICU stay, and length of
hospital stay.

<90>
Accession Number
637398915
Title
Prophylactic Penehyclidine Inhalation for Prevention of Postoperative
Pulmonary Complications in High-risk Patients: A Double-blind Randomized
Trial.
Source
Anesthesiology. (no pagination), 2022. Date of Publication: 28 Feb 2022.
Author
Yan T.; Liang X.-Q.; Wang G.-J.; Wang T.; Li W.-O.; Liu Y.; Wu L.-Y.; Yu
K.-Y.; Zhu S.-N.; Wang D.-X.; Sessler D.I.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative pulmonary complications are common. Aging and
respiratory disease provoke airway hyperresponsiveness, high-risk surgery
induces diaphragmatic dysfunction, and general anesthesia contributes to
atelectasis and peripheral airway injury. This study therefore tested the
hypothesis that inhalation of penehyclidine, a long-acting muscarinic
antagonist, reduces the incidence of pulmonary complications in high-risk
patients over the initial 30 postoperative days. METHOD(S): This
single-center double-blind trial enrolled 864 patients age over 50 yr who
were scheduled for major upper-abdominal or noncardiac thoracic surgery
lasting 2 h or more and who had an Assess Respiratory Risk in Surgical
Patients in Catalonia score of 45 or higher. The patients were randomly
assigned to placebo or prophylactic penehyclidine inhalation from the
night before surgery through postoperative day 2 at 12-h intervals. The
primary outcome was the incidence of a composite of pulmonary
complications within 30 postoperative days, including respiratory
infection, respiratory failure, pleural effusion, atelectasis,
pneumothorax, bronchospasm, and aspiration pneumonitis. RESULT(S): A
total of 826 patients (mean age, 64 yr; 63% male) were included in the
intention-to-treat analysis. A composite of pulmonary complications was
less common in patients assigned to penehyclidine (18.9% [79 of 417]) than
those receiving the placebo (26.4% [108 of 409]; relative risk, 0.72; 95%
CI, 0.56 to 0.93; P = 0.010; number needed to treat, 13). Bronchospasm was
less common in penehyclidine than placebo patients: 1.4% (6 of 417) versus
4.4% (18 of 409; relative risk, 0.327; 95% CI, 0.131 to 0.82; P = 0.011).
None of the other individual pulmonary complications differed
significantly. Peak airway pressures greater than 40 cm H2O were also less
common in patients given penehyclidine: 1.9% (8 of 432) versus 4.9% (21 of
432; relative risk, 0.381; 95% CI, 0.171 to 0.85; P = 0.014). The
incidence of other adverse events, including dry mouth and delirium, that
were potentially related to penehyclidine inhalation did not differ
between the groups. CONCLUSION(S): In high-risk patients having major
upper-abdominal or noncardiac thoracic surgery, prophylactic penehyclidine
inhalation reduced the incidence of pulmonary complications without
provoking complications. Copyright © 2022, the American Society
of Anesthesiologists. All Rights Reserved.

<91>
Accession Number
637398637
Title
Ticagrelor Monotherapy or Dual Antiplatelet Therapy After Drug-Eluting
Stent Implantation: Per-Protocol Analysis of the GLOBAL LEADERS Trial.
Source
Journal of the American Heart Association. (pp e024291), 2022. Date of
Publication: 01 Mar 2022.
Author
Gragnano F.; Zwahlen M.; Vranckx P.; Heg D.; Schmidlin K.; Hamm C.; Steg
P.G.; Gargiulo G.; McFadden E.P.; Onuma Y.; Chichareon P.; Benit E.;
Mollmann H.; Janssens L.; Leonardi S.; Zurakowski A.; Arrivi A.; Van Geuns
R.J.; Huber K.; Slagboom T.; Calabro P.; Serruys P.W.; Juni P.; Valgimigli
M.; Windecker S.
Institution
(Gragnano, Windecker) Department of Cardiology, Inselspital University of
Bern Switzerland, Switzerland
(Gragnano, Calabro) Department of Translational Medical Sciences
University of Campania "Luigi Vanvitelli" Naples Italy, Italy
(Zwahlen, Schmidlin) Institute of Social and Preventive Medicine,
University of Bern, Switzerland
(Vranckx) Department of Cardiology and Critical Care Medicine Hartcentrum
Hasselt, Jessa Ziekenhuis Hasselt Belgium, Belgium
(Vranckx) Faculty of Medicine and Life Sciences University of Hasselt
Hasselt Belgium, Belgium
(Heg) Clinical Trials Unit University of Bern Bern Switzerland,
Switzerland
(Hamm) Heart Center Campus Kerckhoff of Justus-Liebig-University Giessen
Germany
(Hamm) German Center for Cardiovascular Research (DZHK), Partner Site
Rhine-Main Germany, Germany
(Steg) Universite de ParisFrench Alliance for Cardiovascular Trials
AP-HPHopital Bichat, Institut National de la Sante et de la Recherche
Medicale UMR1148 Paris France, France
(Gargiulo) Department of Advanced Biomedical Sciences Federico II
University of Naples Naples Italy, Italy
(McFadden) Cardialysis Core Laboratories and Clinical Trial Management
Rotterdam the Netherlands, Netherlands
(McFadden) Department of Cardiology Cork University Hospital Cork Ireland,
Ireland
(Onuma) Department of Cardiology National University of Ireland Galway
Galway Ireland, Ireland
(Chichareon) Department of Internal Medicine Faculty of Medicine
Cardiology Unit Prince of Songkla University Songkhla Thailand, Thailand
(Benit) Department of Cardiology Jessa Hospital Hasselt Belgium, Belgium
(Mollmann) Department of Cardiology St. Johannes Hospital Dortmund
Germany, Germany
(Janssens) Heart Center Imelda Ziekenhuis Bonheiden Belgium, Belgium
(Leonardi) University of Pavia and Fondazione IRCCS Policlinico San Matteo
Pavia Italy, Italy
(Zurakowski) rzej Frycz Modrzewski Krakow University Krakow Poland, Poland
(Zurakowski) American Heart of Poland Chrzanow Poland, Poland
(Arrivi) Department of Cardiology Azienda Ospedaliera S. Maria Terni
Italy, Italy
(Van Geuns) Department of Cardiology Radboudumc, Netherlands
(Huber) Wilhelminenhospital III Department of Medicine, Cardiology and
Intensive Care MedicineVienna Austria, Austria
(Huber) Medical Faculty Sigmund Freud University Vienna Austria, Austria
(Slagboom) Onze Lieve Vrouwe Gasthuis Amsterdam the Netherlands
(Serruys) National Heart and Lung InstituteImperial College London London
United Kingdom, United Kingdom
(Serruys) Department of Cardiology National University of Ireland Galway
Ireland, Ireland
(Juni) Department of Medicine Applied Health Research Centre Li Ka Shing
Knowledge Institute of St Michael's HospitalUniversity of Toronto Ontario
Canada, Canada
(Valgimigli) Cardiocentro Ticino InstituteEnte Ospedaliero Cantonale
Lugano Switzerland, Switzerland
Publisher
NLM (Medline)
Abstract
Background In the GLOBAL LEADERS trial, ticagrelor monotherapy beyond 1
month compared with standard antiplatelet regimens after coronary stent
implantation did not improve outcomes at intention-to-treat analysis.
Considerable differences in treatment adherence between the experimental
and control groups may have affected the intention-to-treat results. In
this reanalysis of the GLOBAL LEADERS trial, we compared the experimental
and control treatment strategies in a per-protocol analysis of patients
who did not deviate from the study protocol. Methods and Results Baseline
and postrandomization information were used to classify whether and when
patients were deviating from the study protocol. With logistic
regressions, we derived time-varying inverse probabilities of nondeviation
from protocol to reconstruct the trial population without protocol
deviation. The primary end point was a composite of all-cause mortality or
nonfatal Q-wave myocardial infarction at 2 years. At 2-year follow-up,
1103 (13.8%) of 7980 patients in the experimental group and 785 (9.8%) of
7988 patients in the control group qualified as protocol deviators. At
per-protocol analysis, the rate ratio for the primary end point was 0.88
(95% CI, 0.75-1.03; P=0.10) on the basis of 274 versus 325 events in the
experimental versus control group. The rate ratio for the key safety end
point of major bleeding was 1.00 (95% CI, 0.79-1.26; P=0.99). The
per-protocol and intention-to-treat effect estimates were overall
consistent. Conclusions Among patients who complied with the study
protocol in the GLOBAL LEADERS trial, ticagrelor plus aspirin for 1 month
followed by ticagrelor monotherapy was not superior to 1-year standard
dual antiplatelet therapy followed by aspirin alone at 2 years after
coronary stenting. Registration URL: https://www.clinicaltrials.gov;
Unique identifier: NCT01813435.

<92>
Accession Number
637395205
Title
Reply to left atrial appendage closure during cardiac surgery for atrial
fibrillation: A meta-analysis.
Source
Cardiovascular revascularization medicine : including molecular
interventions. (no pagination), 2022. Date of Publication: 22 Feb 2022.
Author
Eagle G.E.; Whitlock R.P.; Belley-Cote E.P.
Institution
(Eagle, Whitlock) McMaster University, Hamilton, Ontario, Canada
(Belley-Cote) McMaster University, Hamilton, Ontario, Canada. Electronic
address: Emilie.Belley-Cote@phri.ca
Publisher
NLM (Medline)

<93>
Accession Number
637392711
Title
Association of Annual N-Terminal Pro-Brain Natriuretic Peptide
Measurements with Clinical Events in Patients with Asymptomatic Nonsevere
Aortic Stenosis: A Post Hoc Substudy of the SEAS Trial.
Source
JAMA Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Hadziselimovic E.; Greve A.M.; Sajadieh A.; Olsen M.H.; Kesaniemi Y.A.;
Nienaber C.A.; Ray S.G.; Rossebo A.B.; Willenheimer R.; Wachtell K.;
Nielsen O.W.
Institution
(Greve) Department of Clinical Biochemistry 3011, Rigshospitalet,
Copenhagen, Denmark
(Sajadieh, Nielsen) Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Olsen) Department of Cardiology, Holbaek Hospital, Holbaek, Denmark
(Olsen) Department of Regional Health Research, University of Southern
Denmark, Odense, Denmark
(Kesaniemi) Research Unit of Internal Medicine, Medical Research Center
Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
(Nienaber) Royal Brompton and Harefield NHS Foundation Trust, Imperial
College, London, United Kingdom
(Ray) Manchester Academic Health Sciences Centre, Manchester, United
Kingdom
(Rossebo) Department of Cardiology, Oslo University Hospital, Ulleval,
Oslo, Norway
(Willenheimer) Lund University, Heart Health Group, Malmo, Sweden
(Wachtell) Department of Cardiology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
Publisher
American Medical Association
Abstract
Importance: Recent studies have questioned the presumed low-risk status of
patients with asymptomatic nonsevere aortic stenosis (AS). Whether annual
N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements are
useful for risk assessment is unknown. Objective(s): To assess the
association of annual NT-proBNP measurements with clinical outcomes in
patients with nonsevere AS. Design, Setting, and Participant(s):
Analysis of annual NT-proBNP concentrations in the multicenter,
double-blind Simvastatin and Ezetimibe in Aortic Stenosis (SEAS)
randomized clinical trial was performed. SEAS was conducted from January
6, 2003, to April 1, 2008. Blood samples were analyzed in 2016, and data
analysis was performed from February 10 to October 10, 2021. SEAS included
1873 patients with asymptomatic AS not requiring statin therapy with
transaortic maximal flow velocity from 2.5 to 4.0 m/s and preserved
ejection fraction. This substudy included 1644 patients (87.8%) with
available blood samples at baseline and year 1. Exposures: Increased age-
and sex-adjusted NT-proBNP concentrations at year 1 and a 1.5-fold or
greater relative NT-proBNP concentration change from baseline to year 1.
Moderate AS was defined as baseline maximal flow velocity greater than or
equal to 3.0 m/s. Main Outcomes and Measures: Aortic valve events
(AVEs), which are a composite of aortic valve replacement, cardiovascular
death, or incident heart failure due to AS progression, were noted.
Landmark analyses from year 1 examined the association of NT-proBNP
concentrations with outcomes. Result(s): Among 1644 patients, 996
were men (60.6%); mean (SD) age was 67.5 (9.7) years. Adjusted NT-proBNP
concentrations were within the reference range (normal) in 1228 of 1594
patients (77.0%) with NT-proBNP values available at baseline and in 1164
of 1644 patients (70.8%) at year 1. During the next 2 years of follow-up,
the AVE rates per 100 patient-years for normal vs increased adjusted
NT-proBNP levels at year 1 were 1.39 (95% CI, 0.86-2.23) vs 7.05 (95% CI,
4.60-10.81) for patients with mild AS (P <.01), and 10.38 (95% CI,
8.56-12.59) vs 26.20 (95% CI, 22.03-31.15) for those with moderate AS (P
<.01). Corresponding all-cause mortality rates were 1.05 (95% CI,
0.61-1.81) vs 4.17 (95% CI, 2.42-7.19) for patients with mild AS (P <.01),
and 1.60 (95% CI, 0.99-2.57) vs 4.78 (95% CI, 3.32-6.87) for those with
moderate AS (P <.01). In multivariable Cox proportional hazards regression
models, the combination of a 1-year increased adjusted NT-proBNP level and
1.5-fold or greater NT-proBNP level change from baseline was associated
with the highest AVE rates in both patients with mild AS (hazard ratio,
8.12; 95% CI, 3.53-18.66; P <.001) and those with moderate AS (hazard
ratio, 4.05; 95% CI, 2.84-5.77; P <.001). Conclusions and Relevance:
The findings of this study suggest that normal NT-proBNP concentrations at
1-year follow-up are associated with low AVE and all-cause mortality rates
in patients with asymptomatic nonsevere AS. Conversely, an increased
1-year NT-proBNP level combined with a 50% or greater increase from
baseline may be associated with high AVE rates. Trial Registration:
ClinicalTrials.gov Identifier: NCT00092677. Copyright © 2019
American Medical Association. All rights reserved.

<94>
Accession Number
2013135232
Title
Effectiveness of cervicothoracic and thoracic manual physical therapy in
managing upper quarter disorders-a systematic review.
Source
Journal of Manual and Manipulative Therapy. 30(1) (pp 46-55), 2022. Date
of Publication: 2022.
Author
Schenk R.; Donaldson M.; Parent-Nichols J.; Wilhelm M.; Wright A.; Cleland
J.A.
Institution
(Schenk, Donaldson, Parent-Nichols, Wilhelm, Wright, Cleland) Department
of Public Health and Community Medicine, Program in Physical Therapy,
Tufts University School of Medicine, Boston, MA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Study Design: Systematic review. Background(s): Physical therapists
often use cervicothoracic and thoracic manual techniques to treat
musculoskeletal disorders of the upper quarter,however, the overall
effectiveness of this approach remains to be elucidated.
 Objective(s): This systematic review explored studies that examined
the short- and long-term effectiveness of manual physical therapy directed
at the cervicothoracic and thoracic region in the management of upper
quarter musculoskeletal conditions. Method(s): The electronic
databases MEDLINE, AMED, CINAHL, and Embase were searched from their
inception through 30 October 2020. Eligible clinical trials included those
where human subjects treated with cervicothoracic and/or thoracic manual
procedures were compared with a control group or other interventions. The
methodological quality of individual studies was assessed using the PEDro
scale. Result(s): The initial search returned 950 individual
articles. After the screening of titles and abstracts, full texts were
reviewed by two authors, with 14 articles determined to be eligible for
inclusion. PEDro scores ranged from 66 to 10 (out of a maximum score of
10). In the immediate to 52-week follow-up period, studies provided
limited evidence that cervicothoracic and thoracic manual physical therapy
may reduce pain and improve function when compared to control/sham or
other treatments. Conclusion(s): Evidence provides some support for
the short-termeffectiveness of cervicothoracic and thoracic manual
physical therapy in reducing pain and improving function in people
experiencing upper quarter musculoskeletal disorders. Evidence is lacking
for long-term effectiveness as only two studies explored outcomes beyond
26 weeks and this was for patient-perceived improvement. Prospero ID:
CRD42020219456. Copyright © 2021 Informa UK Limited, trading as
Taylor & Francis Group.

<95>
Accession Number
2013413565
Title
Effect of cardioplegia for myocardial protection in pediatric cardiac
surgery: A network meta-analysis.
Source
Congenital Heart Disease. 16(6) (pp 609-645), 2021. Date of Publication:
2021.
Author
Zhou K.; Li D.; Zhang X.; Wang W.; Li S.; Song G.
Institution
(Zhou, Li, Wang, 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
Tech Science Press
Abstract
Cardioplegia has been widely used to reduce myocardial injury during
pediatric cardiac surgery; however, which cardioplegia solution has the
best protective effect has not been established. Thus, we compared the
myocardial protective effects of different cardioplegia solutions used in
pediatric cardiac surgery. Seven databases were searched to identify the
relevant randomized controlled trials. A network meta-analysis with a
Bayesian framework was conducted. The outcomes included the following
biochemical and clinical outcomes: Serum concentrations of the creatine
kinase-myocardial band at 6 h postoperatively; cardiac troponin I (cTnI)
at 4, 12, and 24 h postoperatively; spontaneous beating after declamping;
postoperative arrhythmias; inotropic support percentage and duration;
mechanical ventilation hours; intensive care unit stay in days; hospital
stay in days; and mortality. The group treated with cold crystalloid
cardioplegia (cCCP) was chosen as the control group. The 22 studies
involved 1529 patients. Six types of cardioplegia solutions were described
in these studies, including cold blood cardioplegia, cCCP, del Nido,
histidine-tryptophan-ketoglutarate (HTK), terminal warm blood
cardioplegia, and warm blood cardioplegia (wBCP). The serum concentrations
of the 24-h cTnI with wBCP (MD = -2.52, 95% CI: -4.74 to -0.27) was
significantly lower than cCCP. The serum concentrations of the 24-h cTnI
with HTK (MD = 4.91, 95% CI: 2.84-7.24) was significantly higher than
cCCP. There was no significant difference in other biochemical and
clinical outcomes when compared to cCCP. In conclusion, wBCP may have a
superior myocardial protective effect with lower 24-h cTnI levels
postoperatively and similar clinical outcomes after pediatric cardiac
surgery. Copyright © 2021, Tech Science Press. All rights
reserved.

<96>
Accession Number
2016891506
Title
European position paper on the management of patients with patent foramen
ovale. Part II - Decompression sickness, migraine, arterial deoxygenation
syndromes and select high-risk clinical conditions.
Source
European Heart Journal. 42(16) (pp 1545-1553), 2021. Date of Publication:
21 Apr 2021.
Author
Pristipino C.; Germonpre P.; Toni D.; Sievert H.; Meier B.; Berti S.;
Onorato E.M.; Bedogni F.; Mas J.-L.; Scacciatella P.; Hildick-Smith D.;
Gaita F.; Kyrle P.A.; Thomson J.; Derumeaux G.; Sibbing D.; Chessa M.;
Hornung M.; Zamorano J.; Dudek D.; D'Ascenzo F.; Omede P.; Ballocca F.;
Barbero U.; Giordana F.; Gili S.; Iannaccone M.; Akagi T.; Anzola G.;
Carroll J.; Dalvi B.; De Angelis C.; Junbo G.; Kasner S.E.; Michel-Behnke
I.; Musumeci G.; Sondergaard L.; Tarantini G.; Biondi-Zoccai G.G.L.;
Capodanno D.; Valgimigli M.; Byrne R.; Kunadian V.
Institution
(Pristipino) S. Filippo Neri Hospital ASL Roma 1, Rome, Italy
(Germonpre) Military Hospital, Brussels, Belgium
(Toni) Hospital Policlinico Umberto, Sapienza University, Rome, Italy
(Sievert, Hornung) CardioVascular Center Frankfurt (CVC Frankfurt),
Frankfurt, Germany
(Sievert) Anglia Ruskin University, Chelmsford, United Kingdom
(Sievert) University California San Francisco (UCSF), San Francisco, CA,
United States
(Meier, Valgimigli) University Hospital, Bern, Switzerland
(D'Ascenzo, Gaita, D'Ascenzo, Omede) Citta della Salute e della Scienza
Hospital, University of Turin, Turin, Italy
(Berti, Gili) Heart Hospital, Massa, Italy
(Onorato) Centro Cardiologico Monzino, IRCCS, Milan, Italy
(Bedogni, Chessa) IRCCS Policlinico San Donato, San Donato Milanese,
Milan, Italy
(Mas) Hopital Sainte-Anne, Universite Paris Descartes, Paris, France
(Scacciatella) UParini Hospital, Aosta, Italy
(Hildick-Smith) Sussex Cardiac Centre, Brighton and Sussex University
Hospitals, Brighton, United Kingdom
(Kyrle) Medical University, Vienna, Austria
(Thomson) Leeds General Infirmary, Leeds, United Kingdom
(Derumeaux) Hopital Henri Mondor, Faculte de Medecine de Creteil, Creteil,
France
(Sibbing) Privatklinik Lauterbacher Muhle Am Ostersee, Iffeldorf and
Ludwig-Maximilians-Universitat (LMU) Munchen, Munich, Germany
(Zamorano) University Hospital Ramon y Cajal, Madrid, Spain
(Dudek) Jagiellonian University Medical College, Krakow, Poland
(Dudek) Maria Cecilia Hospital, GVM Care and Research, Cotignola (RA),
Italy
(Ballocca) Ospedale Maria Vittoria, Turin, Italy
(Barbero) Ospedale Civile SS. Annunziata, Savigliano, Italy
(Giordana) Ospedale Santa Croce e Carle, Cuneo, Italy
(Iannaccone) Ospedale San Giovanni Bosco, Turin, Italy
(Akagi) Okayama University Hospital, Okayama, Japan
(Anzola) Brescia University, Brescia, Italy
(Carroll) University of Colorado Hospital, Denver, CO, United States
(Dalvi) Glenmark Cardiac Centre, Mumbai, India
(De Angelis) Italian Air Force HQ, Rome, Italy
(Junbo) Shanghai Institute of Cardiovascular Disease, Shanghai, China
(Kasner) University of Pennsylvania, Philadelphia, PA, United States
(Michel-Behnke) University Hospital for Children and Adolescents, Medical
University Vienna, Vienna, Austria
(Musumeci) Mauriziano Hospital, Turin, Italy
(Sondergaard) Rigshospitalet, Copenhagen, Denmark
(Tarantini) Padua University Hospital, Padua, Italy
(Biondi-Zoccai) Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Naples, Italy
(Capodanno) Azienda Ospedaliero-Universitaria "policlinico-Vittorio
Emanuele", University of Catania, Catania, Italy
(Byrne) RCSI University of Medicine and Health Sciences, Dublin, Ireland
(Kunadian) Newcastle University and Freeman Hospital, Newcastle Upon Tyne
Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
Publisher
Oxford University Press
Abstract
Patent foramen ovale (PFO) is implicated in the pathogenesis of a number
of medical conditions but to date only one official position paper related
to left circulation thromboembolism has been published. This
interdisciplinary paper, prepared with the involvement of eight European
scientific societies, reviews the available evidence and proposes a
rationale for decision making for other PFO-related clinical conditions.
In order to guarantee a strict evidence-based process, we used a modified
grading of recommendations, assessment, development, and evaluation
(GRADE) methodology. A critical qualitative and quantitative evaluation of
diagnostic and therapeutic procedures was performed, including assessment
of the risk/benefit ratio. The level of evidence and the strength of the
position statements were weighed and graded according to predefined
scales. Despite being based on limited and observational or low-certainty
randomised data, a number of position statements were made to frame PFO
management in different clinical settings, along with suggestions for new
research avenues. This interdisciplinary position paper, recognising the
low or very low certainty of existing evidence, provides the first
approach to several PFO-related clinical scenarios beyond left circulation
thromboembolism and strongly stresses the need for fresh high-quality
evidence on these topics. Copyright © The Author(s), 2021.

<97>
Accession Number
2017049591
Title
Pericardial Involvement in Sarcoidosis.
Source
American Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Mahalwar G.; Kumar A.; Agrawal A.; Bhat A.; Furqan M.; Yesilyaprak A.;
Verma B.R.; Chan N.; Schleicher M.; Neto M.L.R.; Xu B.; Jellis C.L.; Klein
A.L.
Institution
(Mahalwar, Kumar, Agrawal, Bhat, Furqan, Yesilyaprak, Verma, Chan, Xu,
Jellis, Klein) Center for the Diagnosis and Treatment of Pericardial
Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular
Medicine, Heart, Vascular, and Thoracic Institute
(Neto) Department of Pulmonary Medicine, Respiratory Institute
(Yesilyaprak) Department of Internal Medicine, Wayne State University,
Detroit, Michigan, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland,
Ohio, United States
Publisher
Elsevier Inc.
Abstract
Pericardial disease secondary to sarcoidosis is a rare clinical entity
with no observational studies in previous research. Therefore, we
evaluated reported cases of pericarditis because of sarcoidosis to further
understand its diagnosis and management. We performed a systematic review
of previous research until December 16, 2020 in MEDLINE, Embase, Scopus,
Cochrane Central Register of Controlled Trials, and Web of Science. Case
reports and case series demonstrating pericardial involvement in
sarcoidosis were included. Fourteen reports with a total of 27 patients
were identified. Dyspnea (82%) was the most common presentation, with the
lungs being the primary site of sarcoidosis in most patients (77%). The
most frequently encountered pericardial manifestations were pericardial
effusion (89%), constrictive pericarditis and cardiac tamponade (48%).
Management of these patients included use of corticosteroids (82%),
colchicine (11%), and nonsteroidal anti-inflammatory agents (7%). Similar
to the general population, the most common intervention in these patients
was pericardiocentesis (59%), pericardial window (30%), and
pericardiectomy (19%). Overall, the majority of this population (70%)
achieved clinical improvement during median follow-up time of 8 months. In
conclusion, the prevalence and incidence of sarcoid-induced pericarditial
disease remain unclear. Clinical manifestations of pericardial involvement
are variable, though many patients present with asymptomatic pericardial
effusions. No consensus exists on the treatment of this special
population, but corticosteroids and combination therapies are considered
first-line therapies because of their efficacy in suppressing pericardial
inflammation and underlying sarcoidosis. Patients with refractory cases of
pericarditis may also benefit therapeutically from the addition of
nonsteroidal anti-inflammatory agents, colchicine, and/or
biologics. Copyright © 2022 Elsevier Inc.

<98>
Accession Number
636744223
Title
Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic
Severe Aortic Stenosis: The AVATAR Trial.
Source
Circulation. 145(9) (pp 648-658), 2022. Date of Publication: 01 Mar 2022.
Author
Banovic M.; Putnik S.; Penicka M.; Doros G.; Deja M.A.; Kockova R.; Kotrc
M.; Glaveckaite S.; Gasparovic H.; Pavlovic N.; Velicki L.; Salizzoni S.;
Wojakowski W.; Van Camp G.; Nikolic S.D.; Iung B.; Bartunek J.
Institution
(Banovic, Putnik) Belgrade Medical School, University of Belgrade, Serbia
(Banovic) Cardiology Department (M.B.), University Clinical Center of
Serbia, Belgrade, United States
(Putnik) Cardiac-Surgery Department (S.P.), University Clinical Center of
Serbia, Belgrade, United States
(Penicka, Van Camp, Bartunek) Cardiovascular Center, OLV Hospital, G.V.C.,
Aalst, Belgium
(Doros) Boston University School of Public Health, Department of
Biostatistics
(Deja) Department of Cardiac Surgery, Medical University of Silesia,
Poland (M.A.D.), Katowice, Poland
(Kockova, Kotrc) Department of Cardiology, Institute for Clinical and
Experimental Medicine, Czech Republic (R.K., Prague, United States
(Glaveckaite) Clinic of Cardiac and Vascular Diseases, Institute of
Clinical Medicine, Faculty of Medicine, Vilnius University, Lithuania
(Gasparovic) Department of Cardiac Surgery, University of Zagreb School of
Medicine and University Hospital Center Zagreb, Croatia
(Pavlovic) University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
(Velicki) Faculty of Medicine, University of Novi Sad, Serbia
(Velicki) Institute of Cardiovascular Diseases Vojvodina, Sremska
Kamenica, Serbia
(Salizzoni) Cardiovascular and Thoracic Department, Citta della Salute e
della Scienza Hospital and University of Turin, Italy
(Wojakowski) Division of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Poland (W.W.), Katowice, Poland
(Nikolic) Redwood CityUnited States
(Iung) Cardiology Department, Bichat Hospital APHP and Universite de
Paris, France
Publisher
NLM (Medline)
Abstract
BACKGROUND: Surgical aortic valve replacement (SAVR) represents a class I
indication in symptomatic patients with severe aortic stenosis (AS).
However, indications for early SAVR in asymptomatic patients with severe
AS and normal left ventricular function remain debated. METHOD(S):
The AVATAR trial (Aortic Valve Replacement Versus Conservative Treatment
in Asymptomatic Severe Aortic Stenosis) is an investigator-initiated
international prospective randomized controlled trial that evaluated the
safety and efficacy of early SAVR in the treatment of asymptomatic
patients with severe AS, according to common criteria (valve area <=1 cm2
with aortic jet velocity >4 m/s or a mean transaortic gradient >=40 mm
Hg), and with normal left ventricular function. Negative exercise testing
was mandatory for inclusion. The primary hypothesis was that early SAVR
would reduce the primary composite end point of all-cause death, acute
myocardial infarction, stroke, or unplanned hospitalization for heart
failure compared with a conservative strategy according to guidelines. The
trial was designed as event-driven to reach a minimum of 35 prespecified
events. The study was performed in 9 centers in 7 European countries.
 RESULT(S): Between June 2015 and September 2020, 157 patients (mean
age, 67 years; 57% men) were randomly allocated to early surgery (n=78) or
conservative treatment (n=79). Follow-up was completed in May 2021.
Overall median follow-up was 32 months: 28 months in the early surgery
group and 35 months in the conservative treatment group. There was a total
of 39 events, 13 in early surgery and 26 in the conservative treatment
group. In the early surgery group, 72 patients (92.3%) underwent SAVR with
operative mortality of 1.4%. In an intention-to-treat analysis, patients
randomized to early surgery had a significantly lower incidence of primary
composite end point than those in the conservative arm (hazard ratio, 0.46
[95% CI, 0.23-0.90]; P=0.02). There was no statistical difference in
secondary end points, including all-cause mortality, first heart failure
hospitalizations, major bleeding, or thromboembolic complications, but
trends were consistent with the primary outcome. CONCLUSION(S): In
asymptomatic patients with severe AS, early surgery reduced a primary
composite of all-cause death, acute myocardial infarction, stroke, or
unplanned hospitalization for heart failure compared with conservative
treatment. This randomized trial provides preliminary support for early
SAVR once AS becomes severe, regardless of symptoms. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT02436655.

<99>
Accession Number
637385448
Title
Risk of Pneumothorax Requiring Pleural Drainage after Drainless VATS
Pulmonary Wedge Resection: A Systematic Review and Meta-Analysis.
Source
Innovations (Philadelphia, Pa.). 17(1) (pp 14-24), 2022. Date of
Publication: 01 Jan 2022.
Author
Laven I.E.W.G.; Daemen J.H.T.; Janssen N.; Franssen A.J.P.M.; Gronenschild
M.H.M.; Hulsewe K.W.E.; Vissers Y.L.J.; de Loos E.R.
Institution
(Laven, Daemen, Janssen, Franssen, Hulsewe, Vissers, de Loos) Department
of Surgery, Division of General Thoracic Surgery, Zuyderland Medical
Center, Heerlen, Netherlands
(Gronenschild) Department of Respiratory Medicine, 3802Zuyderland Medical
Center, Heerlen, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Omitting pleural drainage after video-assisted thoracic surgery
(VATS) for pulmonary wedge resections has been shown to be a safe approach
to enhance recovery. However, major concerns remain regarding the risk of
postoperative pneumothoraces requiring surgical interventions. Therefore,
our objective was to provide conclusive evidence whether chest tube
omission after VATS wedge resection is safe and does not increase the risk
of pneumothoraces requiring pleural drainage. METHOD(S): Five
scientific databases were searched. Studies comparing patients with (CT
group) and without chest tube drainage (NCT group) after VATS wedge
resection were evaluated. Outcomes included radiographically diagnosed
pneumothoraces and pneumothoraces requiring pleural drainage,
postoperative complications, hospitalization, and pain scores.
 RESULT(S): Overall, 9 studies (3 randomized controlled trials) were
included (N=928). Meta-analysis showed significantly more radiographically
diagnosed pneumothoraces in the NCT group (risk ratio [RR]=2.58, 95%
confidence interval [CI]: 1.56 to 4.29, P<0.001; I2=0%). However, no
significant differences were found in postoperative pneumothoraces
requiring pleural drainage (RR=1.72, 95% CI: 0.63 to 4.74, P=0.29; I2=0%)
or complications (RR=0.77, 95% CI: 0.39 to 1.52, P=0.46; I2=0%).
Furthermore, the NCT group showed significantly shorter hospitalization
(mean difference=-1.26, 95% CI: -1.56 to -0.95, P<0.001) with high
heterogeneity (I2=58%, P=0.02), and lower pain scores on postoperative day
1 (standard mean difference [SMD]=-0.98, 95% CI: -1.71 to -0.25, P=0.009;
I2=92%) and postoperative day 2 (SMD=-1.28, 95% CI: -2.55 to -0.01,
P=0.05; I2=96%) compared with the CT group. CONCLUSION(S): VATS wedge
resection without routine chest tube placement is suggested as a safe and
less invasive approach in selected patients that does not increase the
risk of a pneumothorax requiring pleural drainage.

<100>
Accession Number
2015177334
Title
Effects of changes in position, positive end-expiratory pressure and mean
arterial pressure on renal, portal and hepatic Doppler ultrasound
perfusion indices: a randomized crossover study in cardiac surgery
patients.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2022. Date
of Publication: 2022.
Author
Hermansen J.L.; Norskov J.; Juhl-Olsen P.
Institution
(Hermansen, Norskov, Juhl-Olsen) Department of Cardiothoracic- and
Vascular Surgery, Anaesthesia Section, Aarhus University Hospital, Palle
Juul-Jensens, Boulevard 99, Aarhus 8200, Denmark
(Hermansen, Juhl-Olsen) Department of Clinical Medicine, Aarhus
University, Palle Juul-Jensens Boulevard 82, Aarhus 8200, Denmark
Publisher
Springer Science and Business Media B.V.
Abstract
Point-of-care ultrasound perfusion indices can be used for detection of
AKI and venous congestion. Patients in the postoperative- and intensive
care units are frequently exposed to alternating treatment and loading
conditions. We aimed to study the effects of changes in preload (patient
positioning), positive end-expiratory pressure (PEEP) and afterload
(phenylephrine) on renal, portal and hepatic ultrasound indices. We
hypothesized that renal resistive index was not influenced by changes in
PEEP and patient positioning. This was a single-site, randomized,
crossover study. Patients above 18 years scheduled for elective open-heart
surgery at Aarhus University Hospital, Denmark, were available for
inclusion. Patients were randomized to a sequence of six combinations of
PEEP and position in addition to an increase in mean arterial pressure by
phenylephrine. Thirty-one patients participated in the study. Resistive
index was influenced by positional change (P = 0.007), but not by change
in PEEP (P = 0.50) (Table 1). Renal venous stasis index and portal
pulsatility fraction increased in the raised legs position (P <= 0.019),
but not with increases in PEEP. Renal venous flow pattern and hepatic
venous flow pattern were affected by position (P <= 0.019), but not by
PEEP. None of the ultrasound indices were significantly changed by
infusion of phenylephrine. Doppler perfusion indices were significantly
affected by changes in preload, but not by changes in PEEP or afterload.
Although the changes in the Doppler ultrasound indices were significant,
they were small in absolute numbers. Therefore, from a clinical
perspective, the ultrasound indices were robust. Trial registration
Registered at clinicaltrials.com, first posted online June 5th 2020,
identifier: NCT04419662. Copyright © 2022, The Author(s), under
exclusive licence to Springer Nature B.V.

<101>
Accession Number
2014763658
Title
Hematinic and Iron Optimization in Peri-operative Anemia and Iron
Deficiency.
Source
Current Anesthesiology Reports. 12(1) (pp 65-77), 2022. Date of
Publication: March 2022.
Author
Miles L.F.; Richards T.
Institution
(Miles) Department of Critical Care, Faculty of Medicine, Dentistry and
Health Sciences, The University of Melbourne, Melbourne, Australia
(Miles) Department of Anaesthesia, Austin Health, Melbourne, Australia
(Miles, Richards) Division of Surgery, Faculty of Health and Medical
Science, The University of Western Australia, Perth, Australia
Publisher
Springer
Abstract
Purpose of Review: Preoperative anemia is independently associated with
worse postoperative outcomes following cardiac and noncardiac surgery.
This article explores the current understanding of perioperative anemia
and iron deficiency with reference to definition, diagnosis, and
treatment. Recent Findings: Iron deficiency is the most common cause of
anemia. It can arise from reduced iron intake, poor absorption, or excess
iron loss. Inflammation throughout the preoperative period can drive iron
sequestration, leading to a functional deficiency of iron and the
development of what was referred to until recently as the "anemia of
chronic disease." Current best practice guidance supports the routine
administration of preoperative intravenous iron to treat anemia despite
limited evidence. This "one size fits all" approach has been called into
question following results from a recent large, randomized trial (the
PREVENTT trial) that assessed the use of a single dose of intravenous iron
compared to placebo 10-42 days before major abdominal surgery. Although
there were no improvements in patient-centered outcomes apparent during
the initial hospital stay, secondary endpoints of this trial suggested
there may be some late benefit after discharge from the hospital (8 weeks
postoperatively). This trial raises questions on (1) the mechanisms of
iron deficiency in the perioperative patient; (2) the need to reassess our
opinions on generic anemia management; and (3) the need to address patient
outcomes after discharge from hospital. Summary: Despite the known
associations between preoperative anemia (particularly iron deficiency
anemia) and poor postoperative outcome, recent evidence suggests that
administering intravenous iron relatively close to surgery does not yield
a tangible short-term benefit. This is made more complex by the interplay
between iron and innate immunity. Iron deficiency irrespective of
hemoglobin concentration may also impact postoperative outcomes.
Therefore, further research into associations between iron deficiency and
postoperative outcomes, and between postoperative anemia, delayed outcomes
(hospital readmission), and the efficacy of postoperative intravenous iron
is required. Copyright © 2022, The Author(s).

<102>
Accession Number
2014727343
Title
Valve replacement or repair in native mitral valve infective
endocarditis-Which is better? A meta-analysis and systematic review.
Source
Journal of Cardiac Surgery. 37(4) (pp 1004-1015), 2022. Date of
Publication: April 2022.
Author
He K.; Song J.; Luo H.; Su H.; Liang W.; Bian L.; Yue H.; Wu Z.
Institution
(He, Song, Luo, Liang, Bian, Yue, Wu) Department of Cardiovascular
Surgery, West China Hospital of Sichuan University, Sichuan, Chengdu,
China
(Su) Department of Cardiovascular Surgery, West China (Sanya) Hospital,
Sichuan University, Hainan, Sanya, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Native mitral valve infective endocarditis (IE) plagues
patients and surgeons alike because of its high mortality and recurrence
rates as well as poor prognosis. Mitral valve repair (MVP) and mitral
valve replacement (MVR) are two main surgical methods. However, the
question of which benefits patients more remains controversial. Thus, we
conducted a meta-analysis to systematically review the two approaches,
focusing on the early survival rate and long-term outcomes.
 Method(s): A meta-analysis and systematic review were conducted using
studies sourced from the PubMed, Embase, and Cochrane literature databases
to compare MVP and MVR, with data extracted for baseline characteristics,
mortality, survival, recurrent endocarditis, and valve reoperation. Risk
ratio (RR) or hazard ratio (HR) values were calculated, and publication
bias was tested. Result(s): A total of 17 relevant publications with
a total population of 3759 patients, with 1180 patients having undergone
MVP and 2579 patients having undergone MVR, respectively, were analyzed.
Patients who underwent MVP may benefit from a lower risk of early
mortality (RR, 0.51; 95% confidence interval [CI], 0.39-0.66; p <.00001),
a higher long-term survival rate (HR, 0.69; 95% CI, 0.58-0.81; p <.001;
I2 = 0%), and a lower risk of recurrence (RR, 0.66; 95% CI,
0.40-1.09; p =.10; I2 = 0%). However, a similar risk of
reoperation was observed for both groups (RR, 1.02; 95% CI, 0.36-2.91; p
=.96; I2 = 43%). Conclusion(s): This meta-analysis
suggests that MVP may lead to better outcomes compared to MVR. Among
patients with mitral valve IE, MVP can reduce in-hospital mortality,
improve long-term survival, and has a lower risk of recurrent
endocarditis. As a result, MVP may be suitable as a primary treatment
choice and should be considered whenever possible in most IE
patients. Copyright © 2022 Wiley Periodicals LLC.

<103>
Accession Number
2013080682
Title
Influence of fractional flow reserve on grafts patency: Systematic review
and patient-level meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(3) (pp 730-735),
2022. Date of Publication: February 15, 2022.
Author
G. Toth G.; Collet C.; Langhoff Thuesen A.; Mizukami T.; Casselman F.;
Riber L.P.; Van Praet F.; Junker A.; Nagumo S.; De Bruyne B.; Okkels
Jensen L.; Barbato E.
Institution
(G. Toth) Division of Cardiology, University Heart Center Graz, Medical
University of Graz, Graz, Austria
(Collet, Mizukami, Nagumo, De Bruyne, Barbato) Cardiovascular Center
Aalst, OLV Clinic, Aalst, Belgium
(Langhoff Thuesen, Riber) Department of Cardiothoracic Surgery, Odense
University Hospital, Odense, Denmark
(Langhoff Thuesen, Junker, Okkels Jensen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Mizukami) Clinical Research Institute for Clinical Pharmacology and
Therapeutics, Showa University, Tokyo, Japan
(Casselman, Van Praet) Departement of Cardiovascular and Thoracic Surgery,
OLV Hospital Aalst, Aalst, Belgium
(Nagumo) Division of Cardiology, Department of Internal medicine, Showa
University Fujigaoka Hospital, Kanagawa, Japan
(De Bruyne) Department of Cardiology, Universtiy Hospital Center Lausanne,
Lausanne, Switzerland
(Barbato) Department of Advanced Biomedical Sciences, University Federico
II, Naples, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objective: To investigate the impact of invasive functional guidance for
coronary artery bypass graft surgery (CABG) on graft failure.
 Background(s): Data on the impact of fractional flow reserve (FFR) in
guiding CABG are still limited. Method(s): Systematic review and
individual patient data meta-analysis were performed. Primary objective
was the risk of graft failure, stratified by FFR. Risk estimates are
reported as odds ratios (ORs) derived from the aggregated data using
random-effects models. Individual patient data were analyzed using mixed
effect model to assess relationship between FFR and graft failure. This
meta-analysis is registered in PROSPERO (CRD42020180444). Result(s):
Four prospective studies comprising 503 patients referred for CABG, with
1471 coronaries, assessed by FFR were included. Graft status was available
for 1039 conduits at median of 12.0 [IQR 6.6; 12.0] months. Risk of graft
failure was higher in vessels with preserved FFR (OR 5.74, 95% CI
1.71-19.29). Every 0.10 FFR units decrease in the coronaries was
associated with 56% risk reduction of graft failure (OR 0.44, 95% CI 0.34
to 0.59). FFR cut-off to predict graft failure was 0.79.
 Conclusion(s): Surgical grafting of coronaries with functionally
nonsignificant stenoses was associated with higher risk of graft
failure. Copyright © 2021 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<104>
Accession Number
2005221502
Title
Intravenous regular insulin is an efficient and safe procedure for
obtaining high-quality cardiac 18F-FDG PET images: an
open-label, single-center, randomized controlled prospective trial.
Source
Journal of Nuclear Cardiology. 29(1) (pp 239-247), 2022. Date of
Publication: February 2022.
Author
Chen Y.C.; Wang Q.Q.; Wang Y.H.; Zhuo H.L.; Dai R.Z.
Institution
(Chen, Wang, Wang) Department of Nuclear Medicine, Quanzhou First Hospital
Affiliated to Fujian Medical University, Quanzhou 362000, China
(Chen) Medical College, Huaqiao University, South Anji Road 1028#, Fengze
District, Quanzhou 362000, China
(Zhuo, Dai) Department of Cardiology, Quanzhou First Hospital Affiliated
to Fujian Medical University, Quanzhou 362000, China
Publisher
Springer
Abstract
Background: An open-label, single-center, randomized controlled
prospective trial was performed to assess the efficiency and safety of an
insulin loading procedure to obtain high-quality cardiac
18F-FDG PET/CT images for patients with coronary artery disease
(CAD). Method(s): Between November 22, 2018 and August 15, 2019, 60
patients with CAD scheduled for cardiac 18F-FDG PET/CT imaging
in our department were randomly allocated in a 1:1 ratio to receive an
insulin or standardized glucose loading procedure for cardiac
18F-FDG imaging. The primary outcome was the ratio of
interpretable images (high-quality images defined as myocardium-to-liver
ratios >= 1). The secondary outcome was the patient preparation time (time
interval between administration of insulin/glucose and 18F-FDG
injection). Hypoglycemia events were recorded. Result(s): The ratio
of interpretable cardiac PET images in the insulin loading group surpassed
the glucose loading group (30/30 vs. 25/30, P = 0.026). Preparation time
was 71+/-2 min shorter for the insulin loading group than for the glucose
loading group (P < 0.01). Two and six hypoglycemia cases occurred in the
insulin and glucose loading groups, respectively. Conclusion(s): The
insulin loading protocol was a quicker, more efficient, and safer
preparation for gaining high-quality cardiac 18F-FDG
images. Copyright © 2020, American Society of Nuclear Cardiology.

<105>
Accession Number
637325606
Title
Cost Analysis From a Randomized Comparison of Immediate Versus Delayed
Angiography After Cardiac Arrest.
Source
Journal of the American Heart Association. 11(5) (pp e022238), 2022. Date
of Publication: 01 Mar 2022.
Author
Camaro C.; Bonnes J.L.; Adang E.M.; Spoormans E.M.; Janssens G.N.; van der
Hoeven N.W.; Jewbali L.S.; Dubois E.A.; Meuwissen M.; Rijpstra T.A.;
Bosker H.A.; Blans M.J.; Bleeker G.B.; Baak R.; Vlachojannis G.J.;
Eikemans B.J.; van der Harst P.; van der Horst I.C.; Voskuil M.; van der
Heijden J.J.; Beishuizen B.; Stoel M.; van der Hoeven H.; Henriques J.P.;
Vlaar A.P.; Vink M.A.; van den Bogaard B.; Heestermans T.A.; de Ruijter
W.; Delnoij T.S.; Crijns H.J.; Jessurun G.A.; Oemrawsingh P.V.; Gosselink
M.T.; Plomp K.; Magro M.; Elbers P.W.; van de Ven P.M.; Lemkes J.S.; van
Royen N.
Institution
(Camaro, Bonnes, van Royen) Department of Cardiology Radboud University
Medical Center Nijmegen the Netherlands, Netherlands
(Adang) Department of Health EvidenceRadboudumc Technology Center for
Health Economics Nijmegen the Netherlands, Netherlands
(Spoormans, Janssens, van der Hoeven, Lemkes, van Royen) Department of
Cardiology Amsterdam University Medical Centerlocation VUmc Amsterdam the
Netherlands, Netherlands
(Jewbali, Dubois) Department of Cardiology and Intensive Care Medicine
Erasmus Medical Centre Rotterdam the Netherlands, Netherlands
(Meuwissen) Department of Cardiology Amphia Hospital Breda the
Netherlands, Netherlands
(Rijpstra) Department of Intensive Care Medicine Amphia Hospital Breda the
Netherlands, Netherlands
(Bosker) Department of Cardiology Rijnstate Hospital Arnhem the
Netherlands, Netherlands
(Blans) Department of Intensive Care Medicine Rijnstate Hospital Arnhem
the Netherlands, Netherlands
(Bleeker) Department of Cardiology HAGA Hospital Den Haag the Netherlands,
Netherlands
(Baak) Department of Intensive Care Medicine HAGA Hospital Den Haag the
Netherlands, Netherlands
(Vlachojannis) Department of Cardiology Maasstad Hospital Rotterdam and
University Medical Centre Utrecht Utrecht the Netherlands, Netherlands
(Eikemans) Department of Intensive Care Medicine Maasstad Hospital
Rotterdam the Netherlands, Netherlands
(van der Harst) Department of Cardiology University Medical Center
Groningen and University Medical Centre Utrecht Groningen and Utrecht the
Netherlands, Netherlands
(van der Horst) Department of Critical Care University Medical Center
Groningen and Maastricht University Medical Center+ Groningen and
Maastricht the Netherlands, Netherlands
(van der Horst, Delnoij) Department of Intensive Care Medicine Maastricht
University Medical Center+ Maastricht the Netherlands, Netherlands
(Voskuil) Department of Cardiology University Medical Center Utrecht
Utrecht the Netherlands, Netherlands
(van der Heijden) Department of Intensive Care Medicine University Medical
Center Utrecht Utrecht the Netherlands, Netherlands
(Beishuizen) Department of Intensive Care Medicine Medisch Spectrum Twente
Enschede The Netherlands, Netherlands
(Stoel) Department of Cardiology Medisch Spectrum Twente Enschede The
Netherlands, Netherlands
(van der Hoeven) Department of Intensive Care Medicine Radboud University
Medical Center Nijmegen the Netherlands, Netherlands
(Henriques) Department of Cardiology Amsterdam University Medical
Centerlocation AMC Amsterdam the Netherlands, Netherlands
(Vlaar) Department of Intensive Care Medicine Amsterdam University Medical
Centerlocation AMC Amsterdam the Netherlands, Netherlands
(Vink) Department of Cardiology OLVG Amsterdam the Netherlands,
Netherlands
(van den Bogaard) Department of Intensive Care Medicine OLVG Amsterdam the
Netherlands, Netherlands
(Heestermans) Department of Cardiology Noord West Ziekenhuisgroep Alkmaar
the Netherlands, Netherlands
(de Ruijter) Department of Intensive Care Medicine Noord West
Ziekenhuisgroep Alkmaar the Netherlands, Netherlands
(Delnoij, Crijns) Department of Cardiology Maastricht University Medical
Center+ Maastricht the Netherlands, Netherlands
(Jessurun) Department of Cardiology Scheper Hospital Emmen the
Netherlands, Netherlands
(Oemrawsingh) Department of Cardiology Haaglanden Medical Center Den Haag
the Netherlands, Netherlands
(Gosselink) Department of Cardiology Isala Hospital Zwolle the
Netherlands, Netherlands
(Plomp) Department of Cardiology Tergooi Hospital Blaricum the
Netherlands, Netherlands
(Magro) Department of Cardiology Elisabeth-Tweesteden Hospital Tilburg the
Netherlands, Netherlands
(Elbers) Department of Intensive Care Medicine Amsterdam University
Medical Centerlocation VUmc Amsterdam the Netherlands, Netherlands
(van de Ven) Department of Epidemiology and Data Science Amsterdam
University Amsterdam the Netherlands, Netherlands
Publisher
NLM (Medline)
Abstract
Background In patients with out-of-hospital cardiac arrest without
ST-segment elevation, immediate coronary angiography did not improve
clinical outcomes when compared with delayed angiography in the COACT
(Coronary Angiography After Cardiac Arrest) trial. Whether 1 of the 2
strategies has benefits in terms of health care resource use and costs is
currently unknown. We assess the health care resource use and costs in
patients with out-of-hospital cardiac arrest. Methods and Results A total
of 538 patients were randomly assigned to a strategy of either immediate
or delayed coronary angiography. Detailed health care resource use and
cost-prices were collected from the initial hospital episode. A
generalized linear model and a gamma distribution were performed. Generic
quality of life was measured with the RAND-36 and collected at 12-month
follow-up. Overall total mean costs were similar between both groups (EUR
33 575+/-19 612 versus EUR 33 880+/-21 044; P=0.86). Generalized linear
model: (beta, 0.991; 95% CI, 0.894-1.099; P=0.86). Mean procedural costs
(coronary angiography and percutaneous coronary intervention, coronary
artery bypass graft) were higher in the immediate angiography group (EUR
4384+/-3447 versus EUR 3028+/-4220; P<0.001). Costs concerning intensive
care unit and ward stay did not show any significant difference. The
RAND-36 questionnaire did not differ between both groups. Conclusions The
mean total costs between patients with out-of-hospital cardiac arrest
randomly assigned to an immediate angiography or a delayed invasive
strategy were similar during the initial hospital stay. With respect to
the higher invasive procedure costs in the immediate group, a strategy
awaiting neurological recovery followed by coronary angiography and
planned revascularization may be considered. Registration URL:
https://trialregister.nl; Unique identifier: NL4857.

<106>
Accession Number
637319198
Title
Sex-Based Differences in Revascularization Outcomes: Is It Time for a
Dedicated Randomized Trial in Women?.
Source
Journal of the American Heart Association. 11(5) (pp e024281), 2022. Date
of Publication: 01 Mar 2022.
Author
Malick W.A.; Soriano K.; Stone G.W.
Institution
(Malick, Soriano, Stone) Zena and Michael A. Wiener Cardiovascular
Institute Icahn School of Medicine at Mount Sinai New York NY
(Stone) Clinical Trials Center Cardiovascular Research Foundation New York
NY
Publisher
NLM (Medline)

<107>
Accession Number
637065826
Title
Aortic valve repair for the treatment of rheumatic aortic valve disease: a
systematic review and meta-analysis.
Source
Scientific reports. 12(1) (pp 674), 2022. Date of Publication: 13 Jan
2022.
Author
Zhao M.; Tang Y.; Li L.; Dai Y.; Lu J.; Liu X.; Zhou J.; Wu Y.
Institution
(Zhao, Tang, Li, Dai, Liu, Zhou, Wu) Department of Cardiovascular Surgery,
First Affiliated Hospital of Nanjing Medical University, Jiangsu Province,
Nanjing 210029, China
(Lu) Department of Cardiology, First Affiliated Hospital of Nanjing
Medical University, Nanjing, Jiangsu, China
Publisher
NLM (Medline)
Abstract
Valvuloplasty for rheumatic aortic valve disease remains controversial. We
conducted this study to explore whether aortic valvuloplasty is
appropriate for the rheumatic population. A comprehensive search was
conducted, and 7 eligible retrospective studies were identified from
PubMed, Embase, Medline and Cochrane (up to April 7, 2020) according to
the inclusion and exclusion criteria. The data for hospital mortality,
5-year survival, 5-year reoperation, aortic insufficiency grade (AIG) and
aortic valve gradient (AVG) were extracted by 2 independent reviewers and
were analysed to evaluate the safety and availability of aortic
valvuloplasty for rheumatic patients. The heterogeneity of the results was
estimated using the Q test and I2 statistics. The fixed pooling model was
used when I2<=50%; otherwise, the random pooling model was selected. 7
articles with 418 patients were included. The pooled hospital mortality,
5-year survival and 5-year reoperation rates were 3.2%, 94.5% and 9.9%,
respectively. The heterogeneities of the weighted mean differences (WMD)
values of the AIG and AVG between preoperation and postoperation were
extremely high (I2=81.5%, p<0.001 in AIG, I2=97.6%, p=0.003 in AVG).
Subgroup analysis suggested that the AIG and AVG were improved by 3.03
grades (I2=0%, p<0.001) and 3.16 mmHg (I2=0%, p<0.001) in the European
group, respectively. In the Asian group, the AIG and AVG were improved by
2.57 grades (I2=0%, p<0.001) and 34.39 mmHg (I2=0%, p<0.001),
respectively. Compared with the values at discharge, the AIG was increased
by 0.15 grades (I2=0%, p=0.031) and the AVG was still decreased by 2.07
mmHg (I2=0%, p=0.031) at the time of follow up. Valvuloplasty is safe and
effective to treat rheumatic aortic insufficiency and stenosis, and the
duration of maintenance required to improve stenosis was longer than that
of insufficiency. Copyright © 2022. The Author(s).

<108>
Accession Number
637064262
Title
Aortic regurgitation management: a systematic review of clinical practice
guidelines and recommendations.
Source
European heart journal. Quality of care & clinical outcomes. 8(2) (pp
113-126), 2022. Date of Publication: 02 Mar 2022.
Author
Galusko V.; Thornton G.; Jozsa C.; Sekar B.; Aktuerk D.; Treibel T.A.;
Petersen S.E.; Ionescu A.; Ricci F.; Khanji M.Y.
Institution
(Galusko) Department of Cardiology, King's College Hospital, London SE5
9RS, United Kingdom
(Thornton, Jozsa, Aktuerk, Treibel, Petersen, Khanji) Barts Heart Centre,
Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
(Thornton, Treibel) Institute of Cardiovascular Science, University
College London, London WC1E 6DD, United Kingdom
(Jozsa, Khanji) Department of Cardiology, Newham University Hospital,
Barts Health NHS Trust, Glen Road, London E13 8SL, United Kingdom
(Sekar) Department of Cardiology, Gloucestershire Hospitals NHS Foundation
Trust, Gloucester GL1 3NN, United Kingdom
(Petersen, Khanji) NIHR Barts Biomedical Research Centre, William Harvey
Research Institute, Queen Mary University of London, London EC1A 7BE,
United Kingdom
(Ionescu) Morriston Hospital, UK Cardiac Regional Centre, Swansea Bay
Health Board, Swansea SA6 6NL, United Kingdom
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences,
'G.d'Annunzio' University of Chieti-Pescara, Chieti 66100, Italy
(Ricci) Department of Clinical Sciences, Lund University, Jan Waldenstroms
gata 35, Malmo -205 02, Sweden
(Ricci) Casa di Cura Villa Serena, 65013 Citta Sant'Angelo, Pescara, Italy
Publisher
NLM (Medline)
Abstract
Guidelines for the diagnosis and management of aortic regurgitation (AR)
contain recommendations that do not always match. We systematically
reviewed clinical practice guidelines and summarized similarities and
differences in the recommendations as well as gaps in evidence on the
management of AR. We searched MEDLINE and Embase (1 January 2011 to 1
September 2021), Google Scholar, and websites of relevant organizations
for contemporary guidelines that were rigorously developed as assessed by
the Appraisal of Guidelines for Research and Evaluation II tool. Three
guidelines met our inclusion criteria. There was consensus on the
definition of severe AR and use of echocardiography and of multimodality
imaging for diagnosis, with emphasis on comprehensive assessment by the
heart valve team to assess suitability and choice of intervention. Surgery
is indicated in all symptomatic patients and aortic valve replacement is
the cornerstone of treatment. There is consistency in the frequency of
follow-up of patients, and safety of non-cardiac surgery in patients
without indications for surgery. Discrepancies exist in recommendations
for 3D imaging and the use of global longitudinal strain and biomarkers.
Cut-offs for left ventricular ejection fraction and size for recommending
surgery in severe asymptomatic AR also vary. There are no specific AR
cut-offs for high-risk surgery and the role of percutaneous intervention
is yet undefined. Recommendations on the treatment of mixed valvular
disease are sparse and lack robust prospective data. Copyright ©
The Author(s) 2022. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<109>
Accession Number
636762233
Title
A systematic review and meta-analysis of randomized controlled studies
comparing off-pump versus on-pump coronary artery bypass grafting in the
elderly.
Source
The Journal of cardiovascular surgery. 63(1) (pp 60-68), 2022. Date of
Publication: 01 Feb 2022.
Author
Machado R.J.; Saraiva F.A.; Mancio J.; Sousa P.; Cerqueira R.J.; Barros
A.S.; Lourenco A.P.; Leite-Moreira A.F.
Institution
(Machado, Saraiva, Mancio, Sousa, Barros) Department of Surgery and
Physiology and Cardiovascular Research, Development Center, Faculty of
Medicine, University of Porto, Porto, Portugal
(Mancio) Department of Intensive Care and Perioperative Medicine, Royal
Brompton and Harefield & Guys and St. Thomas NHS Foundation Trust,
London, UK
(Cerqueira, Leite-Moreira) Department of Cardiothoracic Surgery, Sao Joao
University Hospital, Porto, Portugal
(Lourenco) Department of Anesthesiology, Sao Joao University Hospital,
Porto, Portugal
(Leite-Moreira) Department of Surgery and Physiology and Cardiovascular
Research, Development Center, Faculty of Medicine, University of Porto,
Porto, Portugal
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Comparison of short and mid-term outcomes between off-pump
CABG (OPCAB) and on-pump CABG (ONCAB) in patients older than 65 throughout
a meta-analysis of randomized clinical trials (RCTs). EVIDENCE
ACQUISITION: A literature search was conducted using 3 databases. RCTs
reporting mortality outcomes of OPCAB versus ONCAB among the elderly were
included. Data on myocardial infarction, stroke, re-revascularization,
renal failure and composite endpoints after CABG were also collected.
Random effects models were used to compute statistical combined measures
and 95% confidence intervals (CI). EVIDENCE SYNTHESIS: Five RCTs
encompassing 6221 patients were included (3105 OPCAB and 3116 ONCAB).
There were no significant differences on mid-term mortality (pooled HR:
1.02, 95%CI: 0.89-1.17, P=0.80) and composite endpoint incidence (pooled
HR: 0.98, 95%CI: 0.88-1.09, P=0.72) between OPCAB and ONCAB. At 30-day,
there were no differences in mortality, myocardial infarction, stroke and
renal complications. The need for early re-revascularization was
significantly higher in OPCAB (pooled OR: 3.22, 95%CI: 1.28-8.09, P=0.01),
with a higher percentage of incomplete revascularization being reported
for OPCAB in trials included in this pooled result (34% in OPCAB vs. 29%
in ONCAB, P<0.01). CONCLUSION(S): Data from RCTs in elderly patients
showed that OPCAB and ONCAB provide similar mid-term results. OPCAB was
associated with a higher risk of early re-revascularization. As CABG on
the elderly is still insufficiently explored, further RCTs, specifically
designed targeting this population, are needed to establish a better CABG
strategy for these patients.

<110>
Accession Number
636760393
Title
Transcatheter aortic valve replacement in mixed aortic valve disease: a
systematic review and meta-analysis.
Source
European heart journal. Quality of care & clinical outcomes. 8(2) (pp
169-176), 2022. Date of Publication: 02 Mar 2022.
Author
Guddeti R.R.; Gill G.S.; Garcia-Garcia H.M.; Alla V.M.
Institution
(Guddeti, Gill, Alla) Division of Cardiovascular Diseases, Creighton
University School of Medicine, Omaha, NE 68154, USA
(Guddeti) Division of Cardiovascular Diseases, Minneapolis Heart
Institute, Minneapolis, United States
(Garcia-Garcia) Department of Medicine, Georgetown University, WA DC
20057, United States
(Garcia-Garcia) Division of Cardiovascular Medicine, MedStar Washington
Hospital Center, WA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Utilization of transcatheter aortic valve replacement (TAVR)
has expanded from high-risk patients to intermediate- and select low-risk
candidates with severe aortic stenosis (AS). TAVR is currently not
indicated for patients with aortic insufficiency, and its outcomes in
mixed aortic valve disease (MAVD) are unclear. METHOD(S): A
systematic search of PubMed, Medline, CINHAL, and Cochrane databases was
performed to identify studies comparing TAVR outcomes in patients with AS
vs. MAVD. Primary outcomes included 30-day and late all-cause mortality,
and paravalvular regurgitation (PVR). Secondary outcomes were major
bleeding, vascular complications, device implantation success, permanent
pacemaker, and stroke. Pooled odds ratios (OR) and 95% confidence
intervals (CIs) were calculated using Der Simonian-Laird random-effects
model. RESULT(S): Six observational studies with 58 879 patients were
included in the analysis. There was no significant difference in 30-day
all-cause mortality [OR 1.03 (95% CI 0.92-1.15); P = 0.63], however, MAVD
group had higher odds of moderate-to-severe PVR [1.81 (1.41-2.31); P <
0.01]. MAVD patients had lower odds of device implantation success [0.60
(0.40-0.91); P = 0.02] while other secondary outcomes were similar in the
two groups. CONCLUSION(S): TAVR in MAVD is associated with increased
odds of paravalvular regurgitation and lower odds of device implantation
success when compared to severe aortic stenosis. Copyright © The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<111>
Accession Number
635563068
Title
Effectiveness of endovascular versus open surgical repair for thoracic
aortic aneurysm: a systematic review and meta-analysis.
Source
The Journal of cardiovascular surgery. 63(1) (pp 25-36), 2022. Date of
Publication: 01 Feb 2022.
Author
Mahboub-Ahari A.; Sadeghi-Ghyassi F.; Heidari F.
Institution
(Mahboub-Ahari) Tabriz Health Services Management Research Center, School
of Management and Medical Informatics, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Mahboub-Ahari, Sadeghi-Ghyassi) Research Center for Evidence-Based
Medicine: a JBI Center of Excellence, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Heidari) Research Center for Evidence-Based Medicine: a JBI Center of
Excellence, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Since the approval, the thoracic endovascular aortic repair
(TEVAR) is widely used for the repair of thoracic aortic aneurysm.
However, the long-term mortality and re-intervention rates compared to
open surgical repair (OSR) are unclear. We aimed to compare the
effectiveness of TEVAR with OSR specifically for thoracic aortic
aneurysms. EVIDENCE ACQUISITION: We conducted a comprehensive search in
MEDLINE, PubMed, EMBASE, CINAHL, PROSPERO, Centre for Reviews and
Dissemination, and the Cochrane Library up to November 2020. The main
outcomes were early mortality, mid-to-long-term survival, and
re-intervention. The quality of the evidence was assessed using the GRADE
methodology. All analyses were performed using RevMan with the random
effect model and Comprehensive Meta-Analysis software. EVIDENCE SYNTHESIS:
One systematic review and 15 individual studies were included. Pooled
analysis showed that 30-day mortality, stroke, renal failure, and
pulmonary complications were significantly lower in TEVAR versus open
surgery. The pooled rate of re-intervention significantly favored the OSR.
The long-term survival and mortality favored TEVAR and OSR in one and two
studies, respectively, but was non-significant in seven analyzes.
 CONCLUSION(S): Early clinical outcomes including the 30-day
mortality, stroke, renal failure, and pulmonary complications
significantly favored the TEVAR. However, the mid-to-long-term
re-intervention rate favored the OSR and long-term survival was
inconsistent among the studies. The quality of evidence was very low. More
studies with longer follow-ups are needed. The use of TEVAR should be
decided by taking into account other factors including patient
characteristics and preferences, cost, and surgeon expertise.

<112>
Accession Number
2017000005
Title
Adding objectivity to submaximal exercise testing by assessment of heart
rate recovery in healthy volunteers (SEARCH-II).
Source
British Journal of Anaesthesia. Conference: Association for Cardiothoracic
Anaesthesia & Critical Care annual scientific meeting, Grand Central
Hotel. Glasgow United Kingdom. 128(3) (pp e252-e253), 2022. Date of
Publication: March 2022.
Author
Minhas H.; Morton C.; Shaw M.; Shelley B.
Institution
(Minhas, Morton, Shaw, Shelley) Academic Unit of Anaesthesia, Pain and
Critical Care, University of Glasgow, Glasgow, United Kingdom
(Shelley) Department of Cardiothoracic Anaesthesia, Golden Jubilee
National Hospital, Glasgow, United Kingdom
Publisher
Elsevier Ltd
Abstract
Submaximal exercise tests (SETs) offer a cheaper, easier to conduct, and
better tolerated alternative to 'maximal' cardiopulmonary exercise testing
as a preoperative risk assessment tool.1 Quantifying HR
recovery (HRR) is a potentially objective method for assessing
cardiopulmonary fitness after SETs. HRR1 and HRR2 (calculated as HR on
exercise cessation minus HR at 1 and 2 min of rest) are commonly used
methods for quantifying HRR. Impaired HRR1 after SETs has been shown to be
an independent predictor of cardiovascular complications after thoracic
surgery.2 However, previous work indicates HRR1/HRR2 are
dependent on modality of exercise3 and so lack reproducibility
in a clinical setting. This study assessed the reproducibility of HRR1,
HRR2, and a novel area under the curve (AUC) method (Fig. 3) for
quantifying HRR across different modalities of SET. Ethical approval was
granted by the Golden Jubilee Research Institute and written informed
consent was obtained from all volunteers. Thirty-one healthy volunteers
underwent three SETs of differing modalities in a randomised order: cycle
ergometry, step test, and shuttle walk. Individuals on beta blockers or
with contraindications for exercise testing were excluded. HR was measured
at 30 s intervals for 6 min of rest after cessation of exercise. HRR was
quantified using HRR1, HRR2, and AUC. Reproducibility was assessed by
calculating Pearson's correlation coefficient (r) and the intra-class
correlation coefficient (ICC). The median age of the study population was
26 (range 18-74) yr with 16.1% of the population possessing chronic
comorbidities. Mean effort across all exercise tests was 63.8% (95%
confidence interval: 62-65.7%) of age predicted maximal HR. HRR1 and HRR2
demonstrated poor reproducibility (ICC<=0.45 and r<=0.53 and ICC<=0.29 and
r<=0.47, respectively) and AUC demonstrated moderate reproducibility
(ICC>=0.52 and r>=0.75) across all comparisons. HRR1/HRR2 demonstrated
poor reproducibility and weak to moderate correlation across different
modalities exercise testing suggesting they are influenced by the modality
of exercise. The AUC method, however, demonstrates moderate
reproducibility and strong positive correlation despite differing exercise
modality, suggesting it may be a superior and more objective method for
quantifying HRR after SET. For SETs to become standardised perioperative
risk assessment tools, further work is required to assess the utility of
the AUC method in perioperative risk prediction in patients undergoing
thoracic surgery. References 1. Noonan V, Dean E. Phys Ther 2000; 80:
782-807 2. Ha D, Choi H, Zell K, et al. J Thorac Cardiovasc Surg 2015;
149: 1168-73 3. Maeder MT, Ammann P, Rickli H, et al. Eur J Appl Physiol
2009; 105: 247-55 [Formula presented] Copyright © 2021

<113>
Accession Number
2016977232
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), 2021.
Date of Publication: 01 Dec 2021.
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
Oxford University Press
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 6 months (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 © 2021
Published on behalf of the European Society of Cardiology. All rights
reserved.

<114>
Accession Number
2015117362
Title
Cerebral near-infrared spectroscopy monitoring (NIRS) in children and
adults: a systematic review with meta-analysis.
Source
Pediatric Research. (no pagination), 2022. Date of Publication: 2022.
Author
Hansen M.L.; Hyttel-Sorensen S.; Jakobsen J.C.; Gluud C.; Kooi E.M.W.;
Mintzer J.; Fumagalli M.; Alarcon A.; Alderliesten T.; Greisen G.; Austin
T.; Bruckner M.; de Boode W.P.; Dempsey E.; Ergenekon E.; Gucuyener K.;
Levy P.T.; Liem K.D.; Martini S.; Naulaers G.; Neunhoeffer F.; Pellicer
A.; Pichler G.; Roehr C.C.; Roll C.; Schwarz C.E.; Szczapa T.; Urlesberger
B.; Wolf M.; Wong F.; Rhee C.J.; Lemmers P.
Institution
(Hansen, Greisen) Department of Neonatology, Copenhagen University
Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
(Hyttel-Sorensen) Department of Intensive Care, Copenhagen University
Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
(Jakobsen, Gluud) Copenhagen Trial Unit, Centre for Clinical Intervention
Research, The Capital Region, Copenhagen University Hospital -
Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
(Jakobsen, Gluud) Department of Regional Health Research, The Faculty of
Health Sciences, University of Southern Denmark, Odense, Denmark
(Kooi) Division of Neonatology, University of Groningen, University
Medical Center Groningen, Beatrix Children's Hospital, Groningen,
Netherlands
(Mintzer) Department of Pediatrics, Division of Newborn Medicine,
Mountainside Medical Center, Montclair, NJ, United States
(de Boode, de Boode) Division of Neonatology, Department of Pediatrics,
Radboud University Medical Center, Radboud Institute for Health Sciences,
Amalia Children's Hospital, Nijmegen, Netherlands
(Fumagalli) Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Milan, Via Francesco Sforza 35, Milano 20122, Italy
(Fumagalli) Department of Clinical Sciences and Community Health,
University of Milan, Via Festa del Perdono 7, Milano 20122, Italy
(Alarcon) Department of Neonatology, Hospital Sant Joan de Deu, Passeig de
Sant Joan de Deu 2, Barcelona, Esplugues de Llobregat 08950, Spain
(Alderliesten) Department of Neonatology, University Medical Center
Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
(Austin) Topun Austin, Neonatal Intensive Care Unit, Cambridge University
Hospitals NHS Foundation Trust, Cambridge, United Kingdom
(Bruckner) Research Unit for Neonatal Micro- and Macrocirculation,
Department of Pediatrics and Adolescent Medicine, Medical University of
Graz, Graz, Austria
(Dempsey, Schwarz) Department of Paediatrics and Child Health, INFANT
Centre, University College Cork, Cork, Ireland
(Ergenekon) Division of Newborn Medicine, Department of Pediatrics, Gazi
University Hospital, Ankara, Turkey
(Gucuyener) Department of Pediatric Neurology, Gazi University Hospital,
Ankara, Turkey
(Levy) Boston Children's Hospital, Harvard Medical School, Harvard
University, Boston, MA, United States
(Liem) Department of Neonatology, Radboud University Medical Center,
Radboud Institute for Health Sciences, Amalia Children's Hospital,
Nijmegen, Netherlands
(Martini) Department of Medical and Surgical Sciences, Neonatal Intensive
Care Unit, S. Orsola-Malpighi University Hospital, University of Bologna,
Bologna, Italy
(Naulaers) Department of Development and Regeneration, Woman and Child, KU
Leuven, Leuven, Belgium
(Neunhoeffer) Department of Pediatric Cardiology, Pulmonology and
Pediatric Intensive Care Medicine, University Children's Hospital
Tubingen, Tubingen, Germany
(Pellicer) Department of Neonatology, La Paz University Hospital, Madrid,
Spain
(Pichler) Department of Pediatrics, Medical University of Graz, Graz,
Austria
(Roehr) Newborn Services, Southmead Hospital, North Bristol Trust,
Bristol, United Kingdom
(Roehr) National Perinatal Epidemiology Unit Clinical Trials Unit,
Nuffield Department of Population Health, Medical Sciences Division,
University of Oxford, Oxford, United Kingdom
(Roehr) Faculty of Health Sciences, University of Bristol, Bristol, United
Kingdom
(Roll) Department of Neonatology, Pediatric Intensive Care, Sleep
Medicine, Vest Children's Hospital Datteln, University Witten-Herdecke,
Datteln, Germany
(Schwarz) Department of Neonatology, University Children's Hospital
Tubingen, Tubingen, Germany
(Szczapa) Department of Neonatology, Biophysical Monitoring and
Cardiopulmonary Therapies Research Unit, Poznan University of Medical
Sciences, Poznan, Poland
(Urlesberger) Division of Neonatology, Department of Pediatrics and
Adolescent Medicine, Medical University of Graz, Graz, Austria
(Wolf) Biomedical Optics Research Laboratory, Department of Neonatology,
University Hospital Zurich, Zurich, Switzerland
(Wong) Monash Newborn, Monash Children's Hospital, Hudson Institute of
Medical Research, Department of Paediatrics, Monash University, Melbourne,
VIC, Australia
(Rhee) Section of Neonatology, Baylor College of Medicine, Texas
Children's Hospital, Houston, TX, United States
(Lemmers) Department of Neonatology, Wilhelmina Children's Hospital,
University Medical Center, Utrecht, Netherlands
Publisher
Springer Nature
Abstract
Background: Cerebral oxygenation monitoring utilising near-infrared
spectroscopy (NIRS) is increasingly used to guide interventions in
clinical care. The objective of this systematic review with meta-analysis
and Trial Sequential Analysis is to evaluate the effects of clinical care
with access to cerebral NIRS monitoring in children and adults versus care
without. Method(s): This review conforms to PRISMA guidelines and was
registered in PROSPERO (CRD42020202986). Methods are outlined in our
protocol (doi: 10.1186/s13643-021-01660-2). Result(s): Twenty-five
randomised clinical trials were included (2606 participants). All trials
were at a high risk of bias. Two trials assessed the effects of NIRS
during neonatal intensive care, 13 during cardiac surgery, 9 during
non-cardiac surgery and 1 during neurocritical care. Meta-analyses showed
no significant difference for all-cause mortality (RR 0.75, 95% CI
0.51-1.10; 1489 participants; I2 = 0; 11 trials; very low
certainty of evidence); moderate or severe, persistent cognitive or
neurological deficit (RR 0.74, 95% CI 0.42-1.32; 1135 participants;
I2 = 39.6; 9 trials; very low certainty of evidence); and
serious adverse events (RR 0.82; 95% CI 0.67-1.01; 2132 participants;
I2 = 68.4; 17 trials; very low certainty of evidence).
 Conclusion(s): The evidence on the effects of clinical care with
access to cerebral NIRS monitoring is very uncertain. Impact: The evidence
of the effects of cerebral NIRS versus no NIRS monitoring are very
uncertain for mortality, neuroprotection, and serious adverse events.
Additional trials to obtain sufficient information size, focusing on
lowering bias risk, are required.The first attempt to systematically
review randomised clinical trials with meta-analysis to evaluate the
effects of cerebral NIRS monitoring by pooling data across various
clinical settings.Despite pooling data across clinical settings, study
interpretation was not substantially impacted by heterogeneity.We have
insufficient evidence to support or reject the clinical use of cerebral
NIRS monitoring. Copyright © 2022, The Author(s).

<115>
Accession Number
637379347
Title
Serum Lactate and Mortality during Pediatric Admissions: Is 2 Really the
Magic Number?.
Source
Journal of Pediatric Intensive Care. (no pagination), 2022. Date of
Publication: 2022.
Author
Loomba R.S.; Farias J.S.; Villarreal E.G.; Flores S.
Institution
(Loomba) Division of Pediatric Cardiac Critical Care, Advocate Children's
Hospital, Oak Lawn, IL, United States
(Loomba) Department of Pediatrics, Chicago Medical School, Rosalind
Franklin University of Medicine and Science, Chicago, IL, United States
(Farias, Villarreal) Tecnologico de Monterrey, Escuela de Medicina y
Ciencias de la Salud, Avenue Morones Prieto 3000, Colonia Los Doctores,
Nuevo Leon, Monterrey 64710, Mexico
(Flores) Section of Critical Care Medicine and Cardiology, Texas
Children's Hospital, Houston, TX, United States
(Flores) Department of Pediatrics, Baylor College of Medicine, Houston,
TX, United States
Publisher
Georg Thieme Verlag
Abstract
The primary objective of this study was to determine if serum lactate
level at the time of hospital admission can predict mortality in pediatric
patients. A systematic review was conducted to identify studies that
assessed the utility of serum lactate at the time of admission to predict
mortality in pediatric patients. The areas under the curve from the
receiver operator curve analyses were utilized to determine the pooled
area under the curve. Additionally, standardized mean difference was
compared between those who survived to discharge and those who did not. A
total of 12 studies with 2,099 patients were included. Out of these, 357
(17%) experienced mortality. The pooled area under the curve for all
patients was 0.74 (0.67-0.80, p < 0.01). The pooled analyses for all
admissions were higher in those who experienced mortality (6.5 vs. 3.3
mmol/L) with a standardized mean difference of 2.60 (1.74-3.51, p < 0.01).
The pooled area under the curve for cardiac surgery patients was 0.63
(0.53-0.72, p < 0.01). The levels for cardiac surgery patients were higher
in those who experienced mortality (5.5 vs. 4.1 mmol/L) with a
standardized mean difference of 1.80 (0.05-3.56, p = 0.04). Serum lactate
at the time of admission can be valuable in identifying pediatric patients
at greater risk for inpatient mortality. This remained the case when only
cardiac surgery patients were included. Copyright © 2022 Georg
Thieme Verlag. All rights reserved.

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