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<1>
Accession Number
624377409
Title
Randomized trial of the Carpentier-Edwards supra-annular prosthesis versus
the Medtronic Mosaic aortic prosthesis: 10-year results.
Source
European Journal of Cardio-thoracic Surgery. 54(2) (pp 281-287), 2018.
Date of Publication: 01 Aug 2018.
Author
Zibdeh O.; Bugg I.; Patel S.; Twine G.; Unsworth-White J.
Institution
(Zibdeh, Bugg, Patel) Plymouth University, Peninsula School of Medicine,
Plymouth, United Kingdom
(Twine, Unsworth-White) South West Cardiothoracic Unit, Derriford
Hospital, Plymouth PL6 8DH, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: We performed a prospective randomized study comparing the
clinical performance of the Carpentier-Edwards supraannular valve (CE-SAV)
(Edwards Lifesciences, Irvine, CA, USA) and the newer Mosaic (Medtronic
Corporation, Minneapolis, MN, USA) porcine bioprostheses in the aortic
position over a 10-year period. METHOD(S): Between January 2001 and
March 2005, 394 patients undergoing bioprosthetic aortic valve replacement
were randomized to receive either the CE-SAV (n = 191) or the Mosaic (n =
203) prosthesis. The preoperative demographics, EuroSCORE and
intraoperative characteristics concerning cardiopulmonary bypass of the 2
groups were comparable. All patients were followed annually for 10 years.
 RESULT(S): There were 77 (40.3%) deaths in the CE-SAV group and 93
(45.8%) deaths in the Mosaic group. The 10-year survival rate in the 2
groups was 59.7% and 54.2%, respectively (P = 0.27). There were no
statistically significant differences between the 2 groups in terms of
structural valve deterioration (P = 0.08), endocarditis (P = 0.95),
thromboembolism (P = 0.06) and major bleeds (P = 0.09). However, the
incidence of paravalvular leaks and valve-related reoperations were higher
in the Mosaic group, with 5 leaks and 6 reoperations when compared to none
in the CE-SAV group, (P=0.02) and (P = 0.01) respectively.
 CONCLUSION(S): At 10 years after implantation, freedom from
reoperation was greater in the CE-SAV group with no incidences of
paravalvular leaks. There were no other statistically significant
differences between CE-SAV and Mosaic aortic prostheses. Copyright
© The Author(s) 2018.

<2>
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.

<3>
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.

<4>
Accession Number
2014325495
Title
Transarterial Embolization for the Treatment of Chronic Musculoskeletal
Pain: A Systematic Review of Indications, Safety, and Efficacy.
Source
ACR Open Rheumatology. 4(3) (pp 209-217), 2022. Date of Publication: March
2022.
Author
Kishore S.; Sheira D.; Malin M.L.; Trost D.W.; Mandl L.A.
Institution
(Kishore) Palo Alto Veterans Affairs Healthcare System, Palo Alto, CA,
United States
(Kishore) Department of Radiology, Stanford University, Palo Alto, CA,
United States
(Kishore) Department of Radiology, Memorial Sloan Kettering Cancer Center,
New York, NY, United States
(Sheira, Mandl) Division of Rheumatology, Hospital for Special Surgery,
New York, NY, United States
(Malin) Wesleyan University, Middletown, CT, United States
(Trost) Department of Radiology, Weill Cornell Medicine, New York, United
States
(Mandl) Department of Medicine, Weill Cornell Medicine, New York, NY,
United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: The study objective was to evaluate the safety and efficacy of
transcatheter arterial "embolization" (TAE) in the treatment of chronic
"musculoskeletal pain" refractory to standard therapy. Method(s):
PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were
searched for original research articles evaluating TAE in patients with
musculoskeletal conditions from database inception to January 21, 2020.
Search terms employed were as follows: "embolization", "pain", "knee
osteoarthritis", joint replacement, epicondylitis, tenderness,
inflammation, WOMAC (Western Ontario and McMaster Universities
Osteoarthritis Index), microspheres, Embozene, geniculate artery,
neovascularity, transcatheter, embolic, imipenem/cilastatin sodium,
angiogenesis, and "musculoskeletal". Studies involving particle
"embolization" for painful musculoskeletal conditions were included.
Studies of TAE for hemarthrosis or malignancy-related "musculoskeletal
pain" were excluded. Result(s): The primary search yielded 1,099
sources; 7 articles and 4 abstracts were included for data extraction. All
were cohorts or case series, with low risk of bias and moderate to poor
level of evidence. Heterogeneity between studies was high, precluding
meta-analysis. The reviewed studies reported the safety and efficacy of
TAE for the treatment of "knee osteoarthritis"; adhesive capsulitis of the
shoulder; tendinopathy/enthesopathy of the knee, shoulder, elbow, and
ankle; and cervical myalgia. All TAEs were reported as technically
successful without major complications or subsequent serious adverse
events, including no reported osteonecrosis, cutaneous ulceration, limb
ischemia, cartilage degeneration, or myotendinous injury. TAE
significantly reduced pain and improved function for all of the treated
conditions, with durable response up to 24 months post procedure.
 Conclusion(s): TAE appears to be a safe and effective treatment for
some types of chronic refractory "musculoskeletal pain". Randomized
placebo-controlled studies are necessary to confirm these
findings. Copyright © 2021 The Authors. ACR Open Rheumatology
published by Wiley Periodicals LLC on behalf of American College of
Rheumatology.

<5>
Accession Number
2013997838
Title
Long-term follow-up after ultrathin vs. conventional 2nd-generation
drug-eluting stents: A systematic review and meta-analysis of randomized
controlled trials.
Source
European Heart Journal. 42(27) (pp 2643-2654), 2021. Date of Publication:
14 Jul 2021.
Author
Madhavan M.V.; Howard J.P.; Naqvi A.; Ben-Yehuda O.; Redfors B.; Prasad
M.; Shahim B.; Leon M.B.; Bangalore S.; Stone G.W.; Ahmad Y.
Institution
(Madhavan, Prasad, Leon) Columbia University Irving Medical Center,
NewYork-Presbyterian Hospital, New York, NY, United States
(Madhavan, Naqvi, Ben-Yehuda, Redfors, Shahim, Leon, Stone) Cardiovascular
Research Foundation, New York, NY, United States
(Howard) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Bangalore) New York University School of Medicine, New York, NY, United
States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Ahmad) Smidt Heart Institute, Cedars Sinai Medical Center, San Vicente
Boulevard, Los Angeles, CA 90048, United States
Publisher
Oxford University Press
Abstract
Aims: Contemporary 2nd-generation thin-strut drug-eluting stents (DES) are
considered standard of care for revascularization of patients undergoing
percutaneous coronary intervention. A previous meta-analysis of 10
randomized controlled trials (RCTs) with 11 658 patients demonstrated a
16% reduction in the 1-year risk of target lesion failure (TLF) with
ultrathin-strut DES compared with conventional 2nd-generation thin-strut
DES. Whether this benefit is sustained longer term is not known, and newer
trial data may inform these relative outcomes. We therefore sought to
perform an updated systematic review and meta-analysis of RCTs comparing
clinical outcomes with ultrathin-strut DES (<=70 mum strut thickness) with
conventional 2nd-generation thin-strut DES. Methods and Results: We
performed a random-effects meta-analysis of all RCTs comparing
ultrathin-strut DES to conventional 2nd-generation thin-strut DES. The
pre-specified primary endpoint was long-term TLF, a composite of cardiac
death, myocardial infarction (MI), or clinically driven target lesion
revascularization (CD-TLR). Secondary endpoints included the components of
TLF, stent thrombosis (ST), and all-cause death. There were 16 eligible
trials in which 20 701 patients were randomized. The weighted mean
follow-up duration was 2.5 years. Ultrathin-strut DES were associated with
a 15% reduction in long-term TLF compared with conventional 2nd-generation
thin-strut DES [relative risk (RR) 0.85, 95% confidence interval (CI)
0.76-0.96, P = 0.008] driven by a 25% reduction in CD-TLR (RR 0.75, 95% CI
0.62-0.92, P = 0.005). There were no significant differences between stent
types in the risks of MI, ST, cardiac death, or all-cause mortality.
 Conclusion(s): At a mean follow-up of 2.5 years, ultrathin-strut DES
reduced the risk of TLF, driven by less CD-TLR compared with conventional
2nd-generation thin-strut DES, with similar risks of MI, ST, cardiac
death, and all-cause mortality. Copyright © 2021 Published on
behalf of the European Society of Cardiology. All rights reserved.

<6>
Accession Number
2016977258
Title
Current perceptions and practices in lipid management: results of a
European Society of Cardiology/European Atherosclerosis Society Survey.
Source
European Journal of Preventive Cardiology. 28(18) (pp 2030-2037), 2021.
Date of Publication: 01 Dec 2021.
Author
Koskinas K.C.; Catapano A.L.; Baigent C.; Tokgozoglu L.; Mach F.
Institution
(Koskinas) Department of Cardiology, Bern University Hospital, Bern 3010,
Switzerland
(Catapano) Department of Pharmacological and Biomolecular Sciences,
University of Milan, Milan, Italy
(Baigent) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Tokgozoglu) Department of Cardiology, Hacettepe University, Ankara,
Turkey
(Mach) Department of Cardiology, Geneva University Hospital, Geneva,
Switzerland
Publisher
Oxford University Press
Abstract
Aims: We sought to evaluate physicians' opinions and practices in lipid
management. Methods and Results: A web-based survey by the European
Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) was
distributed to 70 696 individuals at two time points, before and after
publication of the 2019 ESC/EAS dyslipidaemia guidelines. Respondents
(1271 in the first and 1056 in the second part) were most commonly
cardiologists in Europe. More than 90% of participants reported that they
regularly measure lipid levels and discuss lipid-lowering treatment with
patients. More than 87% found the use of LDL-C goals useful or potentially
useful, although it was acknowledged that recommended goals are frequently
not achieved. Regarding the LDL-C goal according to the 2019 guidelines
(<1.4 mmol/L for very high-risk patients), more than 70% of respondents
felt that it is based on solid scientific evidence, but 31% noted that
implementation should also consider available local resources and patient
preferences. Statin intolerance was perceived as infrequent, affecting
1-5% of patients according to most respondents but was the main reason for
not prescribing a statin to secondary-prevention patients, followed by
patient non-adherence. Although most respondents reported that 11-20% of
secondary-prevention patients have an indication to add a non-statin
medication, fewer patients (<10% according to most respondents) receive
these medications. Conclusion(s): This survey shows a high level of
acceptance of the LDL-C treatment goals recommended by current ESC/EAS
guidelines. Although patient-related factors were the main reported
reasons for suboptimal lipid-lowering therapy, physician inertia to
intensify treatment cannot be excluded as an additional contributing
factor. Copyright © 2021 Published on behalf of the European
Society of Cardiology. All rights reserved.

<7>
Accession Number
2014446144
Title
U so care-the impact of cardiac ultrasound during cardiopulmonary
resuscitation: A prospective randomized simulator-based trial.
Source
Journal of Clinical Medicine. 10(22) (no pagination), 2021. Article
Number: 5218. Date of Publication: November-2 2021.
Author
Zollner K.; Sellmann T.; Wetzchewald D.; Schwager H.; Cleff C.; Thal S.C.;
Marsch S.
Institution
(Zollner, Wetzchewald, Schwager) Institution for Emergency Medicine,
Arnsberg 59755, Germany
(Sellmann) Department of Anaesthesiology and Intensive Care Medicine,
Bethesda Hospital, Duisburg 47053, Germany
(Sellmann, Thal) Department of Anaesthesiology 1, Witten/Herdecke
University, Witten 58455, Germany
(Cleff) Department of Anaesthesiology and Intensive Care Medicine,
University of Cologne, Cologne 50923, Germany
(Marsch) Department of Intensive Care, University Hospital, Basel 4031,
Switzerland
Publisher
MDPI
Abstract
Background: Actual cardiopulmonary resuscitation (CPR) guidelines
recommend point-of-care ultrasound (POCUS); however, data on POCUS during
CPR are sparse and conflicting. This randomized trial investigated the
effects of POCUS during CPR on team performance and diagnostic accuracy.
 Method(s): Intensive Care and Emergency Medicine residents performed
CPR with or without available POCUS in simulated cardiac arrests. The
primary endpoint was hands-on time. Data analysis was performed using
video recordings. Result(s): Hands-on time was 89% (87-91) in the
POCUS and 92% (89-94) in the control group (difference 3, 95% CI for
difference 2-4, p < 0.001). POCUS teams had delayed defibrillator
attachments (33 vs. 26 sec, p = 0.017) and first rhythm analysis (74 vs.
52 sec, p = 0.001). Available POCUS was used in 71%. Of the POCUS teams,
53 stated a POCUS-derived diagnosis, with 49 being correct and 42 followed
by a correct treatment decision. Four teams made a wrong diagnosis and two
made an inappropriate treatment decision. Conclusion(s): POCUS during
CPR resulted in lower hands-on times and delayed rhythm analysis. Correct
POCUS diagnoses occurred in 52%, correct treatment decisions in 44%, and
inappropriate treatment decisions in 2%. Training on POCUS during CPR
should focus on diagnostic accuracy and maintenance of high-quality
CPR. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<8>
Accession Number
2012049969
Title
Individualized positive end-expiratory pressure in patients undergoing
thoracoscopic lobectomy: a randomized controlled trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 71(5) (pp 565-571),
2021. Date of Publication: 01 Sep 2021.
Author
Zhang Y.; Zhang M.; Wang X.; Shang G.; Dong Y.
Institution
(Zhang, Zhang, Wang, Shang, Dong) Department of Anesthesiology, Shengjing
Hospital of China Medical University, Shenyang, China, Shengjing, China
Publisher
Elsevier Editora Ltda
Abstract
Background and objectives: With the intensive study of lung protective
ventilation strategies, people begin to advocate the individualized
application of positive end-expiratory pressure (PEEP). This study
investigated the optimal PEEP in patients during one-lung ventilation
(OLV) and its effects on pulmonary mechanics and oxygenation.
 Method(s): Fifty-eight patients who underwent elective thoracoscopic
lobectomy were randomly divided into two groups. Both groups received an
alveolar recruitment maneuver (ARM) after OLV. Patients in Group A
received optimal PEEP followed by PEEP decremental titration, while Group
B received standard 5 cmH<inf>2</inf>O PEEP until the end of OLV. Relevant
indexes of respiratory mechanics, pulmonary oxygenation and hemodynamics
were recorded after entering the operating room (T<inf>0</inf>), 10
minutes after intubation (T<inf>1</inf>), pre-ARM (T<inf>2</inf>), 20
minutes after the application of optimal PEEP (T<inf>3</inf>), at the end
of OLV (T<inf>4</inf>) and at the end of surgery (T<inf>5</inf>).
Postoperative outcomes were also assessed. Result(s): The optimal
PEEP obtained in Group A was 8.8 +/- 2.4 cmH<inf>2</inf>O, which
positively correlated with BMI and forced vital capacity (FVC). Group A
had a higher C<inf>PAT</inf> than Group B at T<inf>3</inf>, T<inf>4</inf>,
T<inf>5</inf> (p < 0.05) and a smaller DELTAP than Group B at
T<inf>3</inf>, T<inf>4</inf> (p < 0.01). At T<inf>4</inf>, PaO<inf>2</inf>
was significantly higher in Group A (p < 0.01). At T<inf>3</inf>, stroke
volume variation was higher in Group A (p < 0.01). Postoperative outcomes
did not differ between the two groups. Conclusion(s): Our findings
suggest that the individualized PEEP can increase lung compliance, reduce
driving pressure, and improve pulmonary oxygenation in patients undergoing
thoracoscopic lobectomy, with little effect on hemodynamics. Copyright
© 2021 Sociedade Brasileira de Anestesiologia

<9>
Accession Number
2010667182
Title
Music reduces patient-reported pain and anxiety and should be routinely
offered during flexible cystoscopy: Outcomes of a systematic review.
Source
Arab Journal of Urology. 19(4) (pp 480-487), 2021. Date of Publication:
2021.
Author
Gauba A.; Ramachandra M.N.; Saraogi M.; Geraghty R.; Hameed B.M.Z.;
Abumarzouk O.; Somani B.K.
Institution
(Gauba, Ramachandra, Saraogi, Geraghty, Somani) Department of Urology,
University Hospital Southampton NHS Trust, Southampton, United Kingdom
(Hameed) Department of Urology, Kasturba Medical College Manipal, Manipal
Academy of Higher Education, Manipal, India
(Abumarzouk) Department of Surgery, Hamad General Hospital, Hamad Medical
Corporation, Doha, Qatar
Publisher
Taylor and Francis Ltd.
Abstract
Objective: To conduct a systematic review of the literature to assess
whether music reduces the use of analgesics and anxiolytics during
flexible cystoscopy. Method(s): The systematic review was performed
in line with the Cochrane guidelines and Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) checklist. The databases
searched included the Medical Literature Analysis and Retrieval System
Online (MEDLINE), Scopus, Cumulative Index to Nursing and Allied Health
Literature (CINAHL), Clinicaltrials.gov, the Excerpta Medica dataBASE
(EMBASE), Cochrane library, Google Scholar, and Web of Science from
inception of the databases to February 2020. The primary outcome measure
was the effect of music on pain and anxiety, and secondary outcome
measures were patient heart rate and blood pressure. Result(s): The
initial search yielded 234 articles and after going through titles and
abstracts, four studies (399 patients, 199 in the music group and 200 in
no music group) were included for the final review. There were three
randomised controlled trials and one prospective study published between
2014 and 2017. These studies were done in China, the USA and Italy, with
the study duration between 9 and 24 months. All patients had 2% topical
lignocaine jelly given per-urethra before the procedure. The choice of
music was classical in three studies and a mixture of different music
types in one study. Three of the four studies showed significantly reduced
pain and anxiety with the use of music for flexible cystoscopy procedures.
Heart rate was noted to be higher for the no music group, reflecting a
higher pain perceived by these patients. Conclusion(s): The present
review showed that listening to music was associated with reduced anxiety
and pain during flexible cystoscopy. Listening to music is therefore
likely to increase procedural satisfaction and willingness to undergo the
procedure again, considering repeated flexible cystoscopy is often needed
for surveillance. As music is simple, inexpensive and easily accessible,
it should be routinely offered to patients for outpatient and office-based
urological procedures. Abbreviations: IQR: interquartile range; NRS:
numerical rating scale; PTSD: post-traumatic stress disorder; RCT:
randomised control trial; STAI: State-trait Anxiety Inventory; VAS: visual
analogue scale. Copyright © 2021 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<10>
Accession Number
634378951
Title
Ten-year all-cause mortality according to smoking status in patients with
severe coronary artery disease undergoing surgical or percutaneous
revascularization.
Source
European journal of preventive cardiology. 29(2) (pp 312-320), 2022. Date
of Publication: 11 Mar 2022.
Author
Takahashi K.; Thuijs D.J.F.M.; Gao C.; Ono M.; Holmes D.R.; Mack M.J.;
Morice M.-C.; Mohr F.-W.; Curzen N.; Davierwala P.M.; Milojevic M.;
Dawkins K.D.; Wykrzykowska J.J.; de Winter R.J.; McEvoy J.W.; Onuma Y.;
Head S.J.; Kappetein A.P.; Serruys P.W.
Institution
(Takahashi, Ono, Wykrzykowska, de Winter) Department of Cardiology,
Amsterdam Universities Medical Centers, Location Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Thuijs, Milojevic, Head, Kappetein) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Gao) Department of Cardiology, Radboud Medical Center, Nijmegen,
Netherlands
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, MN, Rochester, United States
(Mack) Department of Cardiothoracic Surgery, Baylor Scott & White Health,
TX, Dallas, United States
(Morice) Hopital prive Jacques Cartier, Generale de Sante Massy, Paris,
France
(Mohr, Davierwala) University Department of Cardiac Surgery, Heart Centre
Leipzig, Leipzig, Germany
(Curzen) Department of Cardiology, Coronary Research Group, University
Hospital Southampton NHS FT, Southampton, United Kingdom
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Dawkins) Shockwave Medical Inc, 5403 Betsy Ross Dr Santa Clara, CA 95054,
Santa Clara, CA, USA
(Wykrzykowska) Department of Cardiology, University Medical Centre
Groningen, University of Groningen, Groningen, Netherlands
(McEvoy, Onuma, Serruys) Department of Cardiology, National University of
Ireland, Galway (NUIG), Galway, Ireland
Publisher
NLM (Medline)
Abstract
AIMS: To evaluate the impact of various smoking status on 10-year
all-cause mortality and to examine a relative treatment benefit of
coronary artery bypass grafting (CABG) vs. percutaneous coronary
intervention (PCI) according to smoking habits. METHODS AND RESULTS: The
SYNTAX Extended Survival study evaluated vital status up to 10years in
1800 patients with de novo three-vessel disease and/or left main coronary
artery disease randomized to CABG or PCI in the SYNTAX trial. In the
present analysis, patients were divided into three groups (current,
former, or never smokers), and the primary endpoint of 10-year all-cause
mortality was assessed according to smoking status. Smoking status was
available in 1793 (99.6%) patients at the time of randomization, of whom
363 were current smokers, 798 were former smokers, and 632 were never
smokers. The crude rates of 10-year all-cause mortality were 29.7% in
current smokers, 25.3% in former smokers, and 25.9% in never smokers
(Log-rank P=0.343). After adjustment for imbalances in baseline
characteristics, current smokers had a significantly higher risk of
10-year all-cause mortality than never smokers [adjusted hazard ratio
(aHR): 2.29; 95% confidence interval (CI): 1.60-3.27; P<0.001], whereas
former smokers did not. PCI was associated with a higher risk of all-cause
mortality than CABG among current smokers (HR: 1.60; 95% CI: 1.09-2.35;
P=0.017), but it failed to show a significant interaction between
revascularization strategies and smoking status (Pinteraction=0.910).
 CONCLUSION(S): Current smokers had a higher adjusted risk of 10-year
all-cause mortality, whereas former smokers did not. The treatment effect
of CABG vs. PCI did not differ significantly according to smoking status.
CLINICAL TRIAL REGISTRATION: SYNTAX: ClinicalTrials.gov reference:
NCT00114972; SYNTAX Extended Survival. ClinicalTrials.gov reference:
NCT03417050. Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. © The Author(s) 2020. For
permissions, please email: journals.permissions@oup.com.

<11>
Accession Number
636664079
Title
Sublingual microcirculatory alterations during the immediate and early
postoperative period: A systematic review and meta-analysis.
Source
Clinical hemorheology and microcirculation. 80(3) (pp 253-265), 2022. Date
of Publication: 2022.
Author
Chalkias A.; Papagiannakis N.; Mavrovounis G.; Kolonia K.; Mermiri M.;
Pantazopoulos I.; Laou E.; Arnaoutoglou E.
Institution
(Chalkias, Kolonia, Mermiri, Laou, Arnaoutoglou) Department of
Anesthesiology, Faculty of Medicine, University of Thessaly, Larisa,
Greece
(Chalkias) Outcomes Research Consortium, Cleveland, OH, USA
(Papagiannakis) First Department of Neurology, National and Kapodistrian
University of Athens, Medical School, Athens, Greece
(Mavrovounis, Pantazopoulos) Department of Emergency Medicine, Faculty of
Medicine, University of Thessaly, Larisa, Greece
Publisher
NLM (Medline)
Abstract
BACKGROUND: The incidence of postoperative microcirculatory flow
alterations and their effect on outcome have not been studied extensively.
 OBJECTIVE(S): This systematic review and meta-analysis were designed
to investigate the presence of sublingual microcirculatory flow
alterations during the immediate and early postoperative period and their
correlation with complications and survival. METHOD(S): A systematic
search of PubMed, Scopus, Embase, PubMed Central, and Google Scholar was
conducted for relevant articles from January 2000 to March 2021.
Eligibility criteria were randomized controlled and non-randomized trials.
Case reports, case series, review papers, animal studies and non-English
literature were excluded. The primary outcome was the assessment of
sublingual microcirculatory alterations during the immediate and early
postoperative period in adult patients undergoing surgery. Risk of bias
was assessed with the Ottawa-Newcastle scale. Standard meta-analysis
methods (random-effects models) were used to assess the difference in
microcirculation variables. RESULT(S): Thirteen studies were
included. No statistically significant difference was found between
preoperative and postoperative total vessel density (p = 0.084;
Standardized Mean Difference (SMD): -0.029; 95%CI: -0.31 to 0.26; I2 =
22.55%). Perfused vessel density significantly decreased postoperatively
(p = 0.035; SMD: 0.344; 95%CI: 0.02 to 0.66; I2 = 65.66%), while perfused
boundary region significantly increased postoperatively (p = 0.031; SMD:
-0.415; 95%CI: -0.79 to -0.03; I2 = 37.21%). Microvascular flow index
significantly decreased postoperatively (p = 0.028; SMD: 0.587; 95%CI:
0.06 to 1.11; I2 = 86.09%), while no statistically significant difference
was found between preoperative and postoperative proportion of perfused
vessels (p = 0.089; SMD: 0.53; 95%CI: -0.08 to 1.14; I2 = 70.71%). The
results of the non-cardiac surgery post-hoc analysis were comparable
except that no statistically significant difference in perfused vessel
density was found (p = 0.69; SMD: 0.07; 95%CI: -0.26 to 0.39; I2 = 0%).
LIMITATIONS: The included studies investigate heterogeneous groups of
surgical patients. There were no randomized controlled trials.
 CONCLUSION(S): Significant sublingual microcirculatory flow
alterations are present during the immediate and early postoperative
period. Further research is required to estimate the correlation of
sublingual microcirculatory flow impairment with complications and
survival.

<12>
Accession Number
637033904
Title
A Systematized Review of Professional Employment Following Thoracic
Transplantation.
Source
Progress in transplantation (Aliso Viejo, Calif.). 32(1) (pp 55-66), 2022.
Date of Publication: 01 Mar 2022.
Author
Jobst S.; Schaefer J.; Kleiser C.; Kugler C.
Institution
(Jobst, Schaefer, Kleiser, Kugler) Institute of Nursing Science,
University of Freiburg, Freiburg, Germany
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Acknowledging the evolved landscape in thoracic
transplantation, professional employment becomes an important outcome
measure to quantify the success of this costly procedure.
 OBJECTIVE(S): We aimed to assess rates of and characterize factors
associated with professional employment in patients following thoracic
transplantation, and create an evidence-base on the relationship between
professional employment and relevant outcome parameters. METHOD(S):
We systematically searched Medline, Cinahl, and GoogleScholar to identify
studies published between 1998 and 2021 reporting on professional
employment following heart and lung transplantation. RESULT(S):
Twenty-two studies from 11 countries with varying sample sizes (N=27; 10
066) were included. Employment rates ranged from 19.7% to 69.4% for heart,
and from 7.4% to 50.8% for lung transplant recipients. Most frequently
reported positively associated factors with employment after transplant
were younger age, higher education, and history of pretransplant
employment. Longer duration of unemployment prior to transplantation and
Medicaid coverage were the most frequently reported negatively associated
factors. Relationships between professional employment and clinical
outcomes included lower rates of acute and chronic rejection, less
infection episodes, and better quality of life among working patients; one
study reported a lower 5-year-mortality rate. Reasons not to work were
"physical or mental health-related," "employment-related," "financial
reasons," and "lifestyle choices." DISCUSSION: Substantial proportions of
patients following thoracic transplantation are not professionally
employed, potentially diminishing the success of transplantation on
individual and societal levels. Considering adverse clinical outcomes in
employed transplant recipients were low, more efforts are needed to
identify modifiable factors for employment in these populations.

<13>
Accession Number
2017201361
Title
Clinical impact of del Nido cardioplegia in adult cardiac surgery: A
prospective randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Garcia-Suarez J.; Garcia-Fernandez J.; Martinez Lopez D.; Reques L.; Sanz
S.; Carballo D.; Martin C.E.; Ospina V.M.; Villar S.; Martin A.; Casado
M.; Villafranca A.; Gonzalez A.I.; Serrano S.; Forteza A.
Institution
(Garcia-Suarez, Garcia-Fernandez, Sanz, Carballo, Casado, Villafranca,
Gonzalez) Department of Anesthesiology and Critical Care, Puerta de Hierro
University Hospital, Madrid, Spain
(Martinez Lopez, Martin, Ospina, Villar, Serrano, Forteza) Department of
Cardiac Surgery, Puerta de Hierro University Hospital, Madrid, Spain
(Reques, Martin) Cardiac Surgery Perfusion Department, Puerta de Hierro
University Hospital, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Objective: The study objective was to assess the benefits of del Nido
cardioplegia compared with cold blood cardioplegia solution in terms of
myocardial protection during adult cardiac surgery. Method(s): A
total of 474 adult patients undergoing coronary artery bypass grafting,
heart valve surgery, thoracic aortic surgery, or combined procedures were
randomized to the del Nido cardioplegia group (n = 234) or the cold blood
cardioplegia solution group (n = 240) after provided informed consent. The
primary end points assessed inotropic support requirements, severe
cardiovascular events, and troponin trend within the first 48 hours of
intensive care unit stay. Reperfusion arrhythmias, aortic crossclamp and
cardiopulmonary bypass times, and other clinical perioperative variables
were considered as secondary end points. Result(s): No statistically
significant differences were found regarding postoperative inotropic
support requirements or the incidence of severe cardiovascular events. The
del Nido cardioplegia group showed a higher return to spontaneous sinus
rhythm (P < .001), a lower number of defibrillation attempts (P < .001),
and an earlier peak troponin value in the postoperative period. Peak blood
glucose levels and intravenous insulin requirements were significantly
lower in the del Nido cardioplegia group. We found no significant
differences regarding aortic crossclamp or cardiopulmonary bypass time. We
did observe a lower incidence of postoperative stroke in the del Nido
cardioplegia group (2.6% vs 6.7%; P = .035). Conclusion(s): del Nido
cardioplegia can be used safely and with comparable outcomes compared with
traditional cardioplegia solutions. Additional advantages over glycemic
control, reperfusion arrhythmias, and its comfortable redosing interval
make del Nido an interesting alternative for myocardial protection in
adult cardiac surgery. A significant decrease in postoperative stroke will
require further research to shed light on the results of this study. Video
Abstract: [Figure presented] Copyright © 2022 The American
Association for Thoracic Surgery

<14>
Accession Number
2017189256
Title
Influence of perioperative dexmedetomidine on the incidence of
postoperative delirium in adult patients undergoing cardiac surgery.
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Patel M.; Onwochei D.N.; Desai N.
Institution
(Patel, Onwochei, Desai) Department of Anaesthesia, Guy's and St Thomas'
NHS Foundation Trust, London, United Kingdom
(Onwochei, Desai) Honorary Senior Clinical, Lecturer, King's College
London, London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Delirium is a common neurocognitive complication after cardiac
surgery. The aim of this systematic review was to determine whether the
administration of dexmedetomidine in the perioperative period decreases
the incidence of postoperative delirium in adult patients undergoing
cardiac surgery. Method(s): Central, CINAHL, Ovid Embase, Ovid
Medline, and Web of Science databases were searched for RCTs of adult
patients undergoing cardiac surgery where participants received i.v.
dexmedetomidine or control in the perioperative period. The methods
included systematic review, meta-analysis, and trial sequential analysis.
The primary outcome was the incidence of postoperative delirium.
Dichotomous outcomes were presented as risk ratio (RR) using the
Mantel-Haenszel method, and continuous variables were presented as mean
difference with the inverse variance method. Result(s): Thirty
trials, comprising 4090 patients, were included. With unselected inclusion
of trials, dexmedetomidine vs control was associated with decreased
incidence of postoperative delirium (12.4% vs 16.2%; RR=0.62; 95%
confidence interval 0.44-0.86; P=0.005; I2=61%). If trials at
high risk of bias were excluded, the incidence of postoperative delirium
was not significantly different between groups (RR=0.71; 95% confidence
interval 0.49-1.03; P=0.070; I2=58%). Postoperative delirium
was not a reliably determined outcome across trials because of
methodological and reporting limitations, including the heterogeneity of
delirium diagnostic approach. Trial sequential analysis revealed that the
optimal information size was not reached, and the Z-curve did not cross
the trial sequential boundaries for benefit or futility. With respect to
safety concerns, dexmedetomidine was not significantly associated with
incident bradycardia or hypotension, or with the duration of mechanical
ventilation. Conclusion(s): When trials at high risk of bias were
excluded, the use of perioperative dexmedetomidine was not associated with
decreased incidence of postoperative delirium. PROSPERO registration
number: CRD 42021252779. Copyright © 2022 British Journal of
Anaesthesia

<15>
Accession Number
2011130748
Title
Intermittent levosimendan infusion in ambulatory patients with end-stage
heart failure: a systematic review and meta-analysis of 984 patients.
Source
Heart Failure Reviews. 27(2) (pp 493-505), 2022. Date of Publication:
March 2022.
Author
Elsherbini H.; Soliman O.; Zijderhand C.; Lenzen M.; Hoeks S.E.; Kaddoura
R.; Izham M.; Alkhulaifi A.; Omar A.S.; Caliskan K.
Institution
(Elsherbini, Zijderhand, Lenzen, Hoeks, Caliskan) Department of
Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands
(Elsherbini) Utrecht University of Applied Sciences, Utrecht, Netherlands
(Soliman) Department of Cardiology, National University of Ireland,
Galway, Ireland
(Kaddoura) Department of Clinical Pharmacy, Hamad Medical Corporation,
Doha, Qatar
(Izham) College of Pharmacy, QU Health, Qatar University, Doha, Qatar
(Alkhulaifi, Omar) Department of Cardiothoracic Surgery/Cardiac
Anaesthesia & ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
(Omar) Department of Critical Care Medicine, Beni Suef University, Beni
Suef, Egypt
(Omar) Department of Clinical Medicine, Weill Cornell Medical College,
Doha, Qatar
Publisher
Springer
Abstract
We sought to synthesize the available evidence regarding safety and
efficacy of intermittent levosimendan (LEVO) infusions in ambulatory
patients with end-stage heart failure (HF). Safety and efficacy of
ambulatory intermittent LEVO infusion in patients with end-stage HF are
yet not established. We systematically searched MEDLINE, EMBASE, SCOPUS,
Web of Science, and Cochrane databases, from inception to January 30, 2021
for studies reporting outcome of adult ambulatory patients with end-stage
HF treated with intermittent LEVO infusion. Fifteen studies (8 randomized
and 7 observational) comprised 984 patients (LEVO [N = 727] and controls
[N = 257]) met the inclusion criteria. LEVO was associated with improved
New York Heart Association (NYHA) functional class (weighted mean
difference [WMD] -1.04, 95%CI: -1.70 to -0.38, p < 0.001, 5 studies,
I2 = 93%), improved left ventricular (LV) ejection fraction
(WMD 4.0%, 95%CI: 2.8% to 5.3%, p < 0.001, 6 studies, I2 = 9%),
and reduced BNP levels (WMD -549 pg/mL, 95%CI -866 to -233, p < 0001, 3
studies, I2 = 66%). All-cause death was not different (RR 0.65,
95%CI: 0.38 to 1.093, p = 0.10, 6 studies, I2 = 0), but
cardiovascular death was lower on LEVO (RR 0.34, 95%CI: 0.13 to 0.87, p =
0.02, 3 studies, I2 = 0) compared to controls. Furthermore,
health-related quality of life (HRQoL) was improved alongside with reduced
LV size following LEVO infusions. Major adverse events were not different
between LEVO and placebo. In conclusion, intermittent LEVO infusions in
ambulatory patients with end-stage HF is associated with less frequent
cardiovascular death alongside with improved NYHA class, quality of life,
BNP levels, and LV function. However, the current evidence is limited by
heterogeneous and relatively small studies. Copyright © 2021, The
Author(s).

<16>
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.

<17>
Accession Number
637362872
Title
Evaluation of volatile sedation in the postoperative intensive care of
patients recovering from heart valve surgery: Protocol for a randomised,
controlled, monocentre trial.
Source
BMJ Open. 12(2) (no pagination), 2022. Article Number: e057804. Date of
Publication: 23 Feb 2022.
Author
Flinspach A.N.; Herrmann E.; Raimann F.J.; Zacharowski K.; Adam E.H.
Institution
(Flinspach, Raimann, Zacharowski, Adam) Department of Anaesthesiology,
Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt,
Goethe University Frankfurt, Germany
(Herrmann) Department of Biostatistic and Mathematic Modeling, Goethe
University, Frankfurt, Germany
Publisher
BMJ Publishing Group
Abstract
Introduction Patients undergoing heart valve surgery are predominantly
transferred postoperatively to the intensive care unit (ICU) under
continuous sedation. Volatile anaesthetics are an increasingly used
treatment alternative to intravenous substances in the ICU. As subject to
inhalational uptake and elimination, the resulting pharmacological
benefits have been repeatedly demonstrated. Therefore, volatile
anaesthetics appear suitable to meet the growing demands of fast-track
cardiac surgery. However, their use requires special preparation at the
bedside and trained medical and nursing staff, which might limit the
pharmacological benefits. The aim of our work is to assess whether the
temporal advantages of recovery under volatile sedation outweigh the
higher effort of special preparation. Methods and analysis The study is
designed to evaluate the differences between intravenous sedatives (n=48)
and volatile sedatives (n=48) in continued intensive care sedation. This
study will be conducted as a prospective, randomised, controlled,
single-blinded, monocentre trial at a German university hospital in
consenting adult patients undergoing heart valve surgery at a university
hospital. This observational study will examine the necessary preparation
time, staff consultation and overall feasibility of the chosen sedation
method. For this purpose, the continuation of sedation in the ICU with
volatile sedatives is considered as one study arm and with intravenous
sedatives as the comparison group. Due to rapid elimination and quick
awakening after the termination of sedation, closer consultation between
the attending physician and the ICU nursing staff is required, in addition
to a prolonged setup time. Study analysis will include the required setup
time, time from admission to extubation as primary outcome and
neurocognitive assessability. In addition, possible operation-specific
(blood loss, complications), treatment parameters (catecholamine dosages,
lung function) and laboratory results (acute kidney injury, acid base
balance (lactataemia), liver failure) as influencing factors will be
collected. The study-relevant data will be extracted from the continuous
digital records of the patient data management system after the patient
has been discharged from the ICU. For statistical evaluation, 95% CIs will
be calculated for the median time to extubation and neurocognitive
assessability, and the association will be assessed with a Cox regression
model. In addition, secondary binary outcome measures will be evaluated
using Fisher's exact tests. Further descriptive and exploratory
statistical analyses are also planned. Copyright © Authors 2022

<18>
Accession Number
2014263134
Title
The new frontiers in valvular heart disease: From artificial intelligence
to new pharmacological targets in aortic stenosis.
Source
European Heart Journal. 42(30) (pp 2871-2875), 2021. Date of Publication:
07 Aug 2021.
Author
Crea F.
Institution
(Crea) Department of Cardiovascular Medicine, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Rome, Italy
(Crea) Department of Cardiovascular and Pulmonary Sciences, Catholic
University of the Sacred Heart, Rome, Italy
Publisher
Oxford University Press

<19>
Accession Number
2013223157
Title
Association of Sex with Outcome in Elderly Patients with Acute Coronary
Syndrome Undergoing Percutaneous Coronary Intervention.
Source
American Journal of Medicine. 134(9) (pp 1135-1141.e1), 2021. Date of
Publication: September 2021.
Author
De Rosa R.; Morici N.; De Luca G.; De Luca L.; Ferri L.A.; Piatti L.;
Tortorella G.; Grosseto D.; Franco N.; Misuraca L.; Sganzerla P.; Cacucci
M.; Antonicelli R.; Cavallini C.; Lenatti L.; Leuzzi C.; Murena E.; Ravera
A.; Ferrario M.; Corrada E.; Colombo D.; Prati F.; Piscione F.; Petronio
A.S.; Galasso G.; De Servi S.; Savonitto S.
Institution
(De Rosa, Ravera, Piscione, Galasso) University, Hospital "San Giovanni di
Dio e Ruggi d'Aragona,", Salerno, Italy
(De Rosa) Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
(Morici) ASST Grande Ospedale Metropolitano Niguarda, Milan, Department of
Clinical Sciences and Community Health, Universita degli Studi di Milano,
Milan, Italy
(De Luca) Azienda Ospedaliera Universitaria Maggiore della Carita, Eastern
Piedmont University, Novara, Italy
(De Luca) Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy
(Ferri) San Raffaele Scientific Institute, Milan, Italy
(Piatti, Lenatti, Savonitto) Manzoni Hospital, Lecco, Italy
(Tortorella) Ospedale Vaio, Fidenza, Italy
(Grosseto, Franco) Ospedale Infermi, Rimini, Italy
(Misuraca) Ospedale della Misericordia, Grosseto, Italy
(Sganzerla) ASST Bergamo ovest-ospedale di Treviglio, Treviglio, Italy
(Cacucci) Ospedale Maggiore, Crema, Italy
(Antonicelli) IRCCS Istituto Nazionale di Ricerca e Cura per l'Anziano,
Ancona, Italy
(Cavallini) Ospedale S. Maria della Misericordia, Perugia, Italy
(Leuzzi) IRCCS Arcispedale S. Maria Nuova, Reggio, United States
(Murena) Ospedale S. Maria delle Grazie, Pozzuoli, Italy
(Ferrario) IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy
(Corrada) Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
(Colombo) Clinical Pharmacology, Milan, Italy
(Prati) Ospedale S. Giovanni-Addolorata, Roma, Italy
(Petronio) Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
(De Servi) University of Pavia, Italy
Publisher
Elsevier Inc.
Abstract
Background: Worse outcomes have been reported for women, compared with
men, after an acute coronary syndrome (ACS). Whether this difference
persists in elderly patients undergoing similar invasive treatment has not
been studied. We investigated sex-related differences in 1-year outcome of
elderly acute coronary syndrome patients treated by percutaneous coronary
intervention (PCI). Method(s): Patients 75 years and older
successfully treated with PCI were selected among those enrolled in 3
Italian multicenter studies. Cox regression analysis was used to assess
the independent predictive value of sex on outcome at 12-month follow-up.
 Result(s): A total of 2035 patients (44% women) were included. Women
were older and most likely to present with ST-elevation myocardial
infarction (STEMI), diabetes, hypertension, and renal dysfunction; men
were more frequently overweight, with multivessel coronary disease, prior
myocardial infarction, and revascularizations. Overall, no sex disparity
was found about all-cause (8.3% vs 7%, P = .305) and cardiovascular
mortality (5.7% vs 4.1%, P = .113). Higher cardiovascular mortality was
observed in women after STEMI (8.8%) vs 5%, P = .041), but not after non
ST-elevation-ACS (3.5% vs 3.7%, P = .999). A sensitivity analysis
excluding patients with prior coronary events (N = 1324, 48% women) showed
a significantly higher cardiovascular death in women (5.4% vs 2.9%, P =
.025). After adjustment for baseline clinical variables, female sex did
not predict adverse outcome. Conclusion(s): Elderly men and women
with ACS show different clinical presentation and baseline risk profile.
After successful PCI, unadjusted 1-year cardiovascular mortality was
significantly higher in women with STEMI and in those with a first
coronary event. However, female sex did not predict cardiovascular
mortality after adjustment for the different baseline
variables. Copyright © 2021 Elsevier Inc.

<20>
Accession Number
2011555600
Title
Repeat Coronary Artery Bypass Grafting: A Meta-Analysis of Off-Pump versus
On-Pump Techniques in a Large Cohort of Patients.
Source
Heart Lung and Circulation. 30(9) (pp 1281-1291), 2021. Date of
Publication: September 2021.
Author
Tzoumas A.; Giannopoulos S.; Kakargias F.; Kokkinidis D.G.; Giannakoulas
G.; Faillace R.T.; Bakoyiannis C.; Doulamis I.P.; Avgerinos D.V.
Institution
(Tzoumas, Kakargias) Aristotle University of Thessaloniki, Thessaloniki,
Greece
(Giannopoulos) Division of Cardiology, Rocky Mountain Regional VA Medical
Center, University of Colorado, Denver, CO, United States
(Kokkinidis, Faillace) Department of Medicine, Jacobi Medical Center,
Albert Einstein College of Medicine, Bronx, NY, United States
(Giannakoulas) Department of Cardiology, Aristotle University of
Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
(Bakoyiannis) First Department of Surgery, National and Kapodistrian
University of Athens, Laikon General Hospital, Athens, Greece
(Doulamis) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
(Avgerinos) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York Presbyterian, New York, NY, United States
Publisher
Elsevier Ltd
Abstract
Background: Redo coronary artery bypass grafting (CABG) can be performed
with either the off-pump (OPCAB) or the on-pump (ONCAB) technique.
 Method(s): Following the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA), this meta-analysis compared the safety
and efficacy of OPCAB versus ONCAB redo CABG. Result(s): Twenty-three
(23) eligible studies were included (OPCAB, n=2,085; ONCAB, n=3,245).
Off-pump CABG significantly reduced the risk of perioperative death
(defined as in-hospital or 30-day death rate), myocardial infarction,
atrial fibrillation, and acute kidney injury. The two treatment approaches
were comparable regarding 30-day stroke and late all-cause mortality.
 Conclusion(s): Off-pump redo CABG resulted in lower perioperative
death and periprocedural complication rates. No difference was observed in
perioperative stroke rates and long-term survival between the two
techniques. Copyright © 2021 Australian and New Zealand Society
of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<21>
Accession Number
2013832787
Title
Risk factors for acute kidney injury after pediatric cardiac surgery: a
meta-analysis.
Source
Pediatric Nephrology. 37(3) (pp 509-519), 2022. Date of Publication: March
2022.
Author
Van den Eynde J.; Delpire B.; Jacquemyn X.; Pardi I.; Rotbi H.; Gewillig
M.; Kutty S.; Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, United States
(Van den Eynde, Delpire, Jacquemyn, Pardi, Gewillig) Department of
Cardiovascular Sciences, University Hospitals Leuven, KU Leuven,
Herestraat 49, Leuven 3000, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Department of Physiology, Radboud University Medical Center,
Radboud Institute for Health Sciences, Nijmegen, Netherlands
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Cardiac surgery-associated acute kidney injury (AKI) is
associated with increased morbidity and mortality in both adults and
children. Objective(s): This study aimed to identify clinical risk
factors for AKI following cardiac surgery in the pediatric population.
Data sources: PubMed/MEDLINE, Embase, Scopus, and reference lists of
relevant articles were searched for studies published by August 2020.
Study eligibility criteria: Studies were included if (1) the population
consisted of pediatric patients (< 18 years old), (2) patients underwent
cardiac surgery, (3) risk factors were compared between patients who
developed AKI and those who did not, and (4) studies were prospective or
retrospective observational studies or randomized controlled trials.
Participants and interventions: Children undergoing pediatric cardiac
surgery. Study appraisal and synthesis methods: Random-effects
meta-analysis was performed, comparing potential risk factors between
pediatric patients who developed CS-AKI and those who did not.
 Result(s): Sixty-one publications including a total of 19,680
participants (AKI: 7257 participants; no AKI: 12,423 participants) were
included from studies published between 2008 and 2020. The pooled
estimated incidence of AKI was 34.3% (95% confidence interval 30.0-38.8%,
I2 = 96.8%). Binary risk factors that were significantly and
consistently associated with AKI were the presence of pulmonary
hypertension, cyanotic heart disease, univentricular heart, risk
adjustment for congenital heart surgery 1 (RACHS-1) score >= 3,
vasopressor use, cardiopulmonary bypass use, reoperation, and sepsis.
Significant continuous risk factors included younger age, lower body
weight, lower preoperative creatinine, higher preoperative estimated
glomerular filtration rate (eGFR), higher RACHS-1 score, longer surgery
time, longer cardiopulmonary bypass time, longer aortic cross-clamp time,
and higher red blood cell transfusion volume. Limitation(s): Results
are limited by heterogeneity and potential residual confounding.
Conclusions and implications of key findings: Our meta-analysis identified
clinical risk factors that are associated with AKI in children undergoing
cardiac surgery. This might help clinicians anticipate and manage more
carefully this population and implement standardized preventive
strategies. Systematic review registration number: CRD42021262699.
Graphical abstract: A higher resolution version of the Graphical abstract
is available as Supplementary information. [Figure not available: see
fulltext.] Copyright © 2021, The Author(s), under exclusive
licence to International Pediatric Nephrology Association.

<22>
Accession Number
2017048257
Title
Transfemoral Tricuspid Valve Replacement in Patients With Tricuspid
Regurgitation: TRISCEND Study 30-Day Results.
Source
JACC: Cardiovascular Interventions. 15(5) (pp 471-480), 2022. Date of
Publication: 14 Mar 2022.
Author
Kodali S.; Hahn R.T.; George I.; Davidson C.J.; Narang A.; Zahr F.;
Chadderdon S.; Smith R.; Grayburn P.A.; O'Neill W.W.; Wang D.D.; Herrmann
H.; Silvestry F.; Elmariah S.; Inglessis I.; Passeri J.; Lim D.S.; Salerno
M.; Makar M.; Mack M.J.; Leon M.B.; Makkar R.
Institution
(Kodali, Hahn, George, Leon) Columbia University Irving Medical Center,
New York, NY, United States
(Hahn) Cardiovascular Research Foundation, New York, NY, United States
(Davidson, Narang) Northwestern University, Chicago, IL, United States
(Zahr, Chadderdon) Oregon Health and Science University, Portland, OR,
United States
(Smith, Grayburn, Mack) Baylor Scott and White The Heart Hospital Plano,
Plano, TX, United States
(O'Neill, Wang) Henry Ford Hospital, Detroit, MI, United States
(Herrmann, Silvestry) Hospital of the University of Pennsylvania,
Philadelphia, PA, United States
(Elmariah, Inglessis, Passeri) Massachusetts General Hospital, Boston, MA,
United States
(Lim, Salerno) University of Virginia, Charlottesville, VA, United States
(Makar, Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United
States
Publisher
Elsevier Inc.
Abstract
Objectives: The TRISCEND study (Edwards EVOQUE Tricuspid Valve
Replacement: Investigation of Safety and Clinical Efficacy after
Replacement of Tricuspid Valve with Transcatheter Device) is evaluating
the safety and performance of transfemoral transcatheter tricuspid valve
replacement in patients with clinically significant tricuspid
regurgitation (TR) and elevated surgical risk. Background(s):
Transcatheter valve replacement could lead to a paradigm shift in treating
TR and improving patient quality of life. Method(s): In the
prospective, single-arm, multicenter TRISCEND study, patients with
symptomatic moderate or greater TR, despite medical therapy, underwent
percutaneous transcatheter tricuspid valve replacement with the EVOQUE
system. A composite rate of major adverse events, echocardiographic
parameters, and clinical, functional, and quality-of-life measures were
assessed at 30 days. Result(s): Fifty-six patients (mean age of 79.3
years, 76.8% female, 91.1% TR severe or greater, 91.1% atrial
fibrillation, and 87.5% New York Heart Association functional class III or
IV) were treated. At 30 days, TR was reduced to mild or less in 98%. The
composite major adverse events rate was 26.8% at 30 days caused by 1
cardiovascular death in a patient with a failed procedure, 2
reinterventions after device embolization, 1 major access site or vascular
complication, and 15 severe bleeds, of which none were life-threatening or
fatal. No myocardial infarction, stroke, renal failure, major cardiac
structural complications, or device-related pulmonary embolism were
observed. New York Heart Association significantly improved to functional
class I or II (78.8%; P < 0.001), 6-minute walk distance improved 49.8 m
(P < 0.001), and Kansas City Cardiomyopathy Questionnaire score improved
19 points (P < 0.001). Conclusion(s): Early experience with the
transfemoral EVOQUE system in patients with clinically significant TR
demonstrated technical feasibility, acceptable safety, TR reduction, and
symptomatic improvement at 30 days. The TRISCEND II randomized trial
(NCT04482062) is underway. Copyright © 2022

<23>
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

<24>
Accession Number
2017046937
Title
The PARTNER 3 Bicuspid Registry for Transcatheter Aortic Valve Replacement
in Low-Surgical-Risk Patients.
Source
JACC: Cardiovascular Interventions. 15(5) (pp 523-532), 2022. Date of
Publication: 14 Mar 2022.
Author
Williams M.R.; Jilaihawi H.; Makkar R.; O'Neill W.W.; Guyton R.; Malaisrie
S.C.; Brown D.L.; Blanke P.; Leipsic J.A.; Pibarot P.; Hahn R.T.; Leon
M.B.; Cohen D.J.; Bax J.J.; Kodali S.K.; Mack M.J.; Lu M.; Webb J.G.
Institution
(Williams, Jilaihawi) NYU Langone Medical Center, New York, NY, United
States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(O'Neill) Center for Structural Heart Disease, Henry Ford Health System,
Detroit, MI, United States
(Guyton) Emory University Medical Center, Atlanta, GA, United States
(Malaisrie) Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Brown, Mack) Baylor Scott and White Health, Plano, TX, United States
(Blanke, Leipsic, Webb) St. Paul's Hospital, University of British
Columbia, Vancouver, BC, Canada
(Pibarot) Department of Medicine, Laval University, Quebec City, QC,
Canada
(Hahn, Leon, Kodali) Columbia University Irving Medical
Center/NewYork-Presbyterian Hospital, New York, NY, United States
(Hahn, Leon, Cohen) Cardiovascular Research Foundation, New York, NY,
United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Bax) Leiden University Medical Center, Leiden, Netherlands
(Lu) Edwards Lifesciences, Irvine, CA, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The study compared 1-year outcomes between transcatheter
aortic valve replacement (TAVR) patients with bicuspid aortic valve (BAV)
morphology and clinically similar patients having tricuspid aortic valve
(TAV) morphology. Background(s): There are limited prospective data
on TAVR using the SAPIEN 3 device in low-surgical-risk patients with
severe, symptomatic aortic stenosis and bicuspid anatomy. Method(s):
Low-risk, severe aortic stenosis patients with BAV were candidates for the
PARTNER 3 (Placement of Aortic Transcatheter Valves 3) (P3) bicuspid
registry or the P3 bicuspid continued access protocol. Patients treated in
these registries were pooled and propensity score matched to TAV patients
from the P3 randomized TAVR trial. Outcomes were compared between groups.
The primary endpoint was the 1-year composite rate of death, stroke, and
cardiovascular rehospitalization. Result(s): Of 320 total submitted
BAV patients, 169 (53%) were treated, and most were Sievers type 1. The
remaining 151 patients were excluded caused by anatomic or clinical
criteria. Propensity score matching with the P3 TAVR cohort (496 patients)
yielded 148 pairs. There were no differences in baseline clinical
characteristics; however, BAV patients had larger annuli and they
experienced longer procedure duration. There was no difference in the
primary endpoint between BAV and TAV (10.9% vs 10.2%; P = 0.80) or in the
rates of the individual components (death: 0.7% vs 1.4%; P = 0.58; stroke:
2.1% vs 2.0%; P = 0.99; cardiovascular rehospitalization: 9.6% vs 9.5%; P
= 0.96). Conclusion(s): Among highly select bicuspid aortic stenosis
low-surgical-risk patients without extensive raphe or subannular
calcification, TAVR with the SAPIEN 3 valve demonstrated similar outcomes
to a matched cohort of patients with tricuspid aortic
stenosis. Copyright © 2022 American College of Cardiology
Foundation

<25>
Accession Number
2015260958
Title
Comparison of Warfarin Initiation at 3 mg Versus 5 mg for Anticoagulation
of Patients with Mechanical Mitral Valve Replacement Surgery: A
Prospective Randomized Trial.
Source
Clinical Drug Investigation. (no pagination), 2022. Date of Publication:
2022.
Author
Sabry S.; El Wakeel L.M.; Saleh A.; Ahmed M.A.
Institution
(Sabry) The Cardiovascular Hospital, Ain Shams University, Cairo, Egypt
(El Wakeel, Ahmed) Department of Clinical Pharmacy, Faculty of Pharmacy,
Ain Shams University, 8/4 Badr Street from Al Gazaer Street, New Maadi,
Cairo, Egypt
(Saleh) Department of Cardiology, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
Publisher
Adis
Abstract
Background: The increased warfarin sensitivity observed after mechanical
mitral valve replacement (MVR) operations dictates clinical discretion in
warfarin dose initiation. Evidence is still lacking with regard to
anticoagulation management of MVR patients. Objective(s): This study
aimed to compare initiating warfarin at the recommended dosing regimen
versus empirically lowered doses intended to account for the variation in
warfarin sensitivity. Method(s): A prospective, single-blind,
randomized, comparative study was conducted in postoperative MVR patients.
Patients were randomly assigned to either the 5 mg group (n = 25) or the 3
mg group (n = 25) and were initiated on a 5 or 3 mg warfarin dose,
respectively. Time to target international normalized ratio (INR), time in
therapeutic range, occurrence of bleeding/thromboembolic events, and cost
of bridging with enoxaparin were assessed for both groups. Result(s):
Target INR was achieved earlier in the 5 mg group than in the 3 mg group
(p = 0.033), with a mean +/- SD of 5.3 +/- 2.0 and 6.6 +/- 2.0,
respectively (95% confidence interval of the mean difference 1.022-1.890).
Bleeding events did not differ significantly between the two groups. The
cost of enoxaparin consumption per patient was significantly higher in the
3 mg group versus the 5 mg group (p = 0.002). Conclusion(s): The
initiation of warfarin at a 5 mg dose in MVR patients was more efficacious
than the 3 mg dose in terms of time to reach the target INR. Moreover, the
cost of enoxaparin bridging was significantly reduced with a 5 mg warfarin
initiation dose. Bleeding events were comparable. ClinicalTrials.gov ID:
NCT04235569, 22 January 2020. Copyright © 2022, The Author(s).

<26>
[Use Link to view the full text]
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.

<27>
Accession Number
637470837
Title
Acquired von Willebrand's syndrome in congenital heart disease.
Source
Thoracic and Cardiovascular Surgeon. Conference: 54th Annual Meeting of
the German Society for Pediatric Cardiology, DGPK 2022. Online. 70(SUPPL
2) (no pagination), 2022. Date of Publication: January 2022.
Author
Icheva V.; Ebert J.; Budde U.; Wiegand G.; Schober S.; Engel J.; Kumpf M.;
Jaschonek K.; Neunhoeffer F.; Michel J.; Schlensak C.; Hofbeck M.; Magunia
H.
Institution
(Icheva, Schober) Universtiy Childrens' Hospital Tubingen, Tubingen,
Germany
(Ebert) Faculty of Medicine, Eberhard Karls University, Tubingen, Germany
(Budde) cMEDILYS Coagulation Lab mbH, Hamburg, Germany
(Wiegand, Kumpf) Department of Pediatric Cardiology, University of
Tuebingen, Tuebingen, Germany
(Engel, Michel) Department of Pediatric Cardiology, University Childrens'
Hospital Tubingen, Tuebingen, Germany
(Jaschonek) Department of Medical Oncology and Pneumology (Internal
Medicine VIII), University Hospital Tubingen, Tuebingen, Germany
(Neunhoeffer) Abteilung fur Kinderkardiologie, Pulmologie,Intensivmedizin,
Tubingen, Germany
(Schlensak) Hoppe-Seyler-Strase 3, Tabingen, Germany
(Hofbeck) Hoppe-Seyler-Str. 1, Tubingen, Germany
(Magunia) Department of Anesthesiology and Intensive Care Medicine,
Tubingen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: The aVWS (acquired von Willebrand's syndrome) has been
reported in association with congenital heart diseases (CHD) causing high
shear. Its incidence and impact on intraoperative bleeding have not been
systematically evaluated by now. This was also due to the lack of methods
for rapid testing under intraoperative conditions. Method(s): This
prospective observational single-center pilot trial searched for
appropriate diagnostic tools and predictors of aVWS in neonates and
infants with CHD undergoing cardiac surgery. The study aimed to clarify to
which extent aVWS contributes to intraoperative hemorrhage.
 Result(s): A total of 65 infants, categorized into four groups
according to the type of surgery, could be included in the study.
Intraoperative high molecular weight multimers (HMWM) ratio was inversely
correlated with duration of cardiopulmonary bypass (r = -0.55) and aortic
cross clamp time (r = -0.49) but showed weaker correlations with surrogate
bleeding parameters such as quantity of supplemented platelets (r =
-0.28), fibrinogen (r = -0.34), and fresh frozen plasma (r = -0.35). The
GP1bM/VWF:Ag ratio provided meaningful predictability of aVWS (AUC = 0.81)
with good correlation to HMWM ratio (r = 0.64). The aVWS positive patients
in the neonatal group had longer chest closure times compared with aVWS
negative patients (146 [118-174] vs. 95 [74-115] min, p = 0,016).
 Conclusion(s): CPB triggers aVWS in pediatric cardiac surgery. The
aVWS is not a major cause of bleeding after cardiac surgery, but its
correction might be beneficial in selected cases. The GP1bM/VWF:Ag ratio
is feasible for rapid aVWS diagnostics and should be implemented in the
routine hemostatic workup of complex CHD surgery. A cut-off value of 0.85
is proposed as a basis for further prospective randomized trials
evaluating the effect of von Willebrand's factor supplementation on
intraoperative bleeding.

<28>
Accession Number
2016981570
Title
Prediction models for treatment-induced cardiac toxicity in patients with
non-small-cell lung cancer: A systematic review and meta-analysis.
Source
Clinical and Translational Radiation Oncology. 33 (pp 134-144), 2022. Date
of Publication: March 2022.
Author
Tohidinezhad F.; Pennetta F.; van Loon J.; Dekker A.; de Ruysscher D.;
Traverso A.
Institution
(Tohidinezhad, Pennetta, van Loon, Dekker, de Ruysscher, Traverso)
Department of Radiation Oncology (Maastro Clinic), School for Oncology and
Developmental Biology (GROW), Maastricht University Medical Center,
Maastricht, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: To maximize the likelihood of positive outcome in
non-small-cell lung cancer (NSCLC) survivors, potential benefits of
treatment modalities have to be weighed against the possibilities of
damage to normal tissues, such as the heart. High-quality data-driven
evidence regarding appropriate risk stratification strategies is still
scarce. The aim of this review is to summarize and appraise available
prediction models for treatment-induced cardiac events in patients with
NSCLC. Method(s): A systematic search of MEDLINE was performed using
a Boolean combination of appropriate truncation and indexing terms related
to "NSCLC", "prediction models", "cardiac toxicity", and "treatment
modalities". The following exclusion criteria were applied: sample-size of
less than 100, no significant predictors in multivariate analysis, lack of
model specifications, and case-mix studies. The generic inverse variance
method was used to pool the summary effect estimate for each predictor.
The quality of the papers was assessed using the Prediction model Risk Of
Bias Assessment Tool. Result(s): Of the 3,056 papers retrieved, 28
prediction models were identified, including seven for
(chemo-)radiotherapy, one for immunotherapy, and 20 for surgical
resection. Forty-one distinct predictors were entered in the prediction
models. The pooled effect estimate of the mean heart dose (HR = 1.06,
95%CI:1.04-1.08) and history of cardiovascular diseases (HR = 3.1,
95%CI:1.8-5.36) were shown to significantly increase the risk of
developing late cardiac toxicity after (chemo-)radiotherapy. Summary
estimates of age (OR = 1.17, 95%CI:1.06-1.29), male gender (OR = 1.61,
95%CI:1.4-1.85), and advanced stage (OR = 1.34, 95%CI:1.06-1.69) were
significantly associated with higher risk of acute cardiac events after
surgery. Risk of bias varied across studies, but analysis was the most
concerning domain where none of the studies were judged to be low risk.
 Conclusion(s): This review highlights the need for a robust
prediction model which can inform patients and clinicians about expected
treatment-induced heart damage. Identified clues suggest incorporation of
detailed cardiac metrics (substructures' volumes and doses). Copyright
© 2022

<29>
Accession Number
637472869
Title
Associated Factors and Clinical Outcomes in Mechanical Circulatory Support
use in Patients Undergoing High Risk On-Pump Cardiac Surgery: Insights
from the LEVO-CTS trial.
Source
American heart journal. (no pagination), 2022. Date of Publication: 06
Mar 2022.
Author
Verma S.; Rathwell S.; Fremes S.; Zheng Y.; Mehta R.; Lopes R.D.;
Alexander J.H.; Goodman S.G.; Diepen S.V.
Institution
(Verma) Department of Critical Care Medicine, University of Alberta,
Edmonton, AB, Canada
(Rathwell, Zheng) Canadian VIGOUR Centre, University of Alberta, Edmonton,
AB, Canada
(Fremes) Sunnybrook Health Sciences Center, University of Toronto,
Toronto, ON, Canada
(Mehta, Lopes, Alexander) Duke Clinical Research Institute, Duke
University Medical Center, Durham, NC, United States
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton,
Alberta, Canada; Terrence Donnelly Heart Centre, Division of Cardiology,
St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
(Diepen) Department of Critical Care Medicine, University of Alberta,
Alberta, Edmonton, Canada; Canadian VIGOUR Centre, University of Alberta,
Edmonton, Alberta, Canada; Division of Cardiology, Department of Medicine,
University of Alberta, Edmonton, Alberta, Canada. Electronic address:
sv9@ualberta.ca
Publisher
NLM (Medline)
Abstract
BACKGROUND: We describe variables and outcomes associated with
peri-operative mechanical circulatory support (MCS) utilization among
patients enrolled in the Levosimendan in patients with Left Ventricular
Systolic Dysfunction Undergoing Cardiac Surgery Requiring Cardiopulmonary
Bypass (LEVO-CTS) trial. METHOD(S): In the LEVO-CTS trial, MCS
utilization (defined as intra-aortic balloon pump [IABP], extracorporeal
membrane oxygenation [ECMO], or surgical ventricular assist devise [VAD])
within 5 days of surgery was examined. The association between MCS use and
outcomes including 90-day mortality, 30-day renal-replacement therapy, and
hospital and critical stay length of stay (LOS) were determined.
 RESULT(S): Among the 849 patients from 70 centers randomized to
levosimendan or placebo, 85 (10.0%) patients were treated with MCS (71
IABP, 7 ECMO, 7 VAD); with 89.4% started on post-operative day zero.
Inter-institutional use ranged from 0 to 100%. Variables independently
associated with MCS utilization included combined coronary artery bypass
grafting and valve surgery (adjusted odds ratio [OR] 2.73, 95% confidence
interval [CI] 1.70-4.37, p<0.001), history of lung disease (OR 1.70, 95%
CI 1.06-2.70, p=0.029), and history of heart failure (OR 2.44, 95% CI
1.10-5.45, p=0.027). Adjusted 90-day mortality (22.4% vs 4.1%, hazard
ratio [HR] 6.11, 95% CI 3.95-9.44, p<0.001) was higher, and median
critical care LOS (8.0 vs 4.0 days, p<0.001) was longer in patients
managed with MCS. CONCLUSION(S): In a randomized controlled trial of
high-risk cardiac surgical patients in North America, we observed patient,
and surgical variables associated with MCS utilization. MCS use was
associated with a higher risk of post-operative mortality. Copyright
© 2022 Elsevier Ltd. All rights reserved.

<30>
Accession Number
636124116
Title
Early computed tomography coronary angiography in patients with suspected
acute coronary syndrome: Randomised controlled trial.
Source
The BMJ. 374 (no pagination), 2021. Article Number: n2106. Date of
Publication: 29 Sep 2021.
Author
Gray A.J.; Roobottom C.; Smith J.E.; Goodacre S.; Oatey K.; O'Brien R.;
Storey R.F.; Curzen N.; Keating L.; Kardos A.; Felmeden D.; Lee R.J.;
Thokala P.; Lewis S.C.; Newby D.E.
Institution
(Gray, Oatey, Lee, Lewis, Newby) University of Edinburgh, Edinburgh,
United Kingdom
(Gray, O'Brien, Newby) Royal Infirmary of Edinburgh, NHS Lothian,
Edinburgh, United Kingdom
(Roobottom, Smith) University Hospitals Plymouth NHS Trust, Plymouth,
United Kingdom
(Roobottom) University of Plymouth, Plymouth, United Kingdom
(Goodacre, Storey, Thokala) University of Sheffield, Sheffield, United
Kingdom
(Curzen) University of Southampton, Southampton, United Kingdom
(Keating) Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
(Kardos) Milton Keynes University Hospital NHS Foundation Trust, Milton
Keynes, United Kingdom
(Kardos) University of Buckingham, Buckingham, United Kingdom
(Felmeden) Torbay and South Devon NHS Foundation Trust, Torquay, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
Objectives To establish if the use of early computed tomography (CT)
coronary angiography improves one year clinical outcomes in patients
presenting to the emergency department with acute chest pain and at
intermediate risk of acute coronary syndrome and subsequent clinical
events. Design Randomised controlled trial. Setting 37 hospitals in the
UK. Participants Adults with suspected or a provisional diagnosis of acute
coronary syndrome and one or more of previous coronary heart disease,
raised levels of cardiac troponin, or abnormal electrocardiogram.
Interventions Early CT coronary angiography and standard of care compared
with standard of care only. Main outcome measures Primary endpoint was all
cause death or subsequent type 1 or 4b myocardial infarction at one year.
Results Between 23 March 2015 and 27 June 2019, 1748 participants (mean
age 62 years (standard deviation 13), 64% men, mean global registry of
acute coronary events (GRACE) score 115 (standard deviation 35)) were
randomised to receive early CT coronary angiography (n=877) or standard of
care only (n=871). Median time from randomisation to CT coronary
angiography was 4.2 (interquartile range 1.6-21.6) hours. The primary
endpoint occurred in 51 (5.8%) participants randomised to CT coronary
angiography and 53 (6.1%) participants who received standard of care only
(adjusted hazard ratio 0.91 (95% confidence interval 0.62 to 1.35),
P=0.65). Invasive coronary angiography was performed in 474 (54.0%)
participants randomised to CT coronary angiography and 530 (60.8%)
participants who received standard of care only (adjusted hazard ratio
0.81 (0.72 to 0.92), P=0.001). There were no overall differences in
coronary revascularisation, use of drug treatment for acute coronary
syndrome, or subsequent preventive treatments between the two groups.
Early CT coronary angiography was associated with a slightly longer time
in hospital (median increase 0.21 (95% confidence interval 0.05 to 0.40)
days from a median hospital stay of 2.0 to 2.2 days). Conclusions In
intermediate risk patients with acute chest pain and suspected acute
coronary syndrome, early CT coronary angiography did not alter overall
coronary therapeutic interventions or one year clinical outcomes, but
reduced rates of invasive angiography while modestly increasing length of
hospital stay. These findings do not support the routine use of early CT
coronary angiography in intermediate risk patients with acute chest pain
and suspected acute coronary syndrome. Trial registration ISRCTN19102565,
NCT02284191. Copyright ©

<31>
Accession Number
2013554513
Title
Effect of dexmedetomidine on hemodynamics in patients undergoing
hysterectomy: a meta-analysis and systematic review.
Source
Journal of International Medical Research. 49(8) (no pagination), 2021.
Date of Publication: 2021.
Author
Li Z.; Li C.; Zhang M.
Institution
(Li) Surgical Anesthesia Center, Sanya Maternal and Child Health Hospital,
Sanya, Hainan, China
(Li) Department of Anesthesiology, Dongguan Houjie Hospital, Dongguan,
Guangdong, China
(Zhang) Department of Anesthesiology, People's Hospital of Ningxia Hui
Autonomous Region, Yinchuan, Ningxia, China
Publisher
SAGE Publications Ltd
Abstract
Objective: We conducted a meta-analysis and systematic review to evaluate
the effects of dexmedetomidine on the hemodynamics of patients undergoing
hysterectomy. Method(s): We searched the Medline, Embase, and
Cochrane Central Register of Controlled Trials databases for clinical
randomized controlled trials (RCTs) that allowed direct or indirect
comparisons of hemodynamic indicators. We also searched nine
English-language databases up to April 2021 to identify relevant research.
The Cochrane risk-of-bias tool for RCTs was applied to assess the
methodological quality of the eligible studies. The meta-analysis was
conducted using RevMan 5.4 software. Result(s): Nine trials were
included in this systematic review. The effect of dexmedetomidine on heart
rate during surgery was significantly smaller than that of other
sedatives. Intraoperative systolic and diastolic blood pressure and mean
arterial pressure were more stable in the dexmedetomidine group compared
with the control group. The postoperative modified Observer's Assessment
of Alertness Score was also better in the dexmedetomidine compared with
the control group. Conclusion(s): Dexmedetomidine increases
hemodynamic stability in patients undergoing hysterectomy, reduces the
cardiovascular stress response during surgery, and effectively prevents
postoperative adverse reactions, with good safety. Copyright ©
The Author(s) 2021.

<32>
Accession Number
2014151076
Title
Update on pulmonary ossifications in the differential diagnosis of
solitary pulmonary nodules.
Source
Journal of Clinical Medicine. 10(20) (no pagination), 2021. Article
Number: 4795. Date of Publication: October-2 2021.
Author
Gielis J.F.; Berzenji L.; Siozopoulou V.; Luijks M.; Van Schil P.E.Y.
Institution
(Gielis, Berzenji, Van Schil) Department of Thoracic and Vascular Surgery,
Antwerp University Hospital, University of Antwerp, Antwerp 2650, Belgium
(Siozopoulou) Department of Pathology, Antwerp University Hospital,
Antwerp 2650, Belgium
(Luijks) Department of Pathology, ZNA Stuivenberg, Antwerp 2060, Belgium
Publisher
MDPI
Abstract
Pulmonary ossifications have often been regarded as rare, post-mortem
findings without any clinical significance. We have investigated the
occurrence of pulmonary ossifications in patients undergoing thoracic
procedures, and how this may affect the differential diagnosis of solitary
pulmonary nodules. In addition, we have performed a literature search on
the occurrence and possible pathogenesis of these ossifications. From
January 2008 until August 2019, we identified pulmonary ossifications in
34 patients who underwent elective pulmonary surgery. Pre-operative
imaging was unable to differentiate these ossifications from solid tumors.
A definitive diagnosis was made by an experienced pathologist (VS, ML).
The PubMed database was researched in December 2019 with the search terms
"pulmonary ossifications"; "heterotopic ossifications"; and "solitary
pulmonary nodule". In total, 27 patients were male, with a mean age of 63
+/- 12 years (age 41 to 82 on diagnosis). All lesions were identified on
thoracic CT and marked for resection by a multidisciplinary team. A total
of 17 patients were diagnosed with malignancy concurrent with
ossifications. There was a clear predilection for the right lower lobe (12
cases, 35.3%) and most ossifications had a nodular form (70.6%). We could
not identify a clear association with any other pathology, either
cancerous or non-cancerous in origin. Oncologic or pulmonary comorbidities
did not influence patient survival. Pulmonary ossifications are not as
seldom as thought and are not just a curiosity finding by pathologists.
These formations may be mistaken for a malignant space-occupying lesion,
both pre-and perioperatively, as they are indistinguishable in imaging. We
propose these ossifications as an underestimated addition to the
differential diagnosis of a solitary pulmonary nodule. Copyright
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

<33>
Accession Number
2010850369
Title
Tidal volume during 1-lung ventilation: A systematic review and
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(4) (pp 1573-1585.e1),
2022. Date of Publication: April 2022.
Author
Peel J.K.; Funk D.J.; Slinger P.; Srinathan S.; Kidane B.
Institution
(Peel, Slinger) Department of Anesthesia, University of Toronto, Toronto,
ON, Canada
(Funk) Departments of Anesthesia and Medicine, University of Manitoba,
Winnipeg, MB, Canada
(Srinathan, Kidane) Section of Thoracic Surgery, Department of Surgery,
University of Manitoba, Winnipeg, MB, Canada
(Kidane) Department of Community Health Sciences, University of Manitoba,
Winnipeg, MB, Canada
(Kidane) Research Institute in Oncology and Hematology, Winnipeg, MB,
Canada
Publisher
Elsevier Inc.
Abstract
Background: The selection of tidal volumes for 1-lung ventilation remains
unclear, because there exists a trade-off between oxygenation and risk of
lung injury. We conducted a systematic review and meta-analysis to
determine how oxygenation, compliance, and clinical outcomes are affected
by tidal volume during 1-lung ventilation. Method(s): A systematic
search of MEDLINE and EMBASE was performed. A systematic review and
random-effects meta-analysis was conducted. Pooled mean difference
estimated arterial oxygen tension, compliance, and length of stay; pooled
odds ratio was calculated for composite postoperative pulmonary
complications. Risk of bias was determined using the Cochrane risk of bias
and Newcastle-Ottawa tools. Result(s): Eighteen studies were
identified, comprising 3693 total patients. Low tidal volumes (5.6
[+/-0.9] mL/kg) were not associated with significant differences in
partial pressure of oxygen (-15.64 [-88.53-57.26] mm Hg; P = .67),
arterial oxygen tension to fractional intake of oxygen ratio (14.71
[-7.83-37.24]; P = .20), or compliance (2.03 [-5.22-9.27] mL/cmH2O; P =
.58) versus conventional tidal volume ventilation (8.1 [+/-3.1] mL/kg).
Low versus conventional tidal volume ventilation had no significant impact
on hospital length of stay (-0.42 [-1.60-0.77] days; P = .49). Low tidal
volumes are associated with significantly decreased odds of pulmonary
complications (pooled odds ratio, 0.40 [0.29-0.57]; P < .0001).
 Conclusion(s): Low tidal volumes during 1-lung ventilation do not
worsen oxygenation or compliance. A low tidal volume ventilation strategy
during 1-lung ventilation was associated with a significant reduction in
postoperative pulmonary complications. Copyright © 2020 The
American Association for Thoracic Surgery

<34>
Accession Number
2007179352
Title
Nitric oxide delivery during cardiopulmonary bypass reduces acute kidney
injury: A randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(4) (pp 1393-1403.e9),
2022. Date of Publication: April 2022.
Author
Kamenshchikov N.O.; Anfinogenova Y.J.; Kozlov B.N.; Svirko Y.S.; Pekarskiy
S.E.; Evtushenko V.V.; Lugovsky V.A.; Shipulin V.M.; Lomivorotov V.V.;
Podoksenov Y.K.
Institution
(Kamenshchikov, Anfinogenova, Kozlov, Svirko, Pekarskiy, Evtushenko,
Lugovsky, Shipulin, Podoksenov) Cardiology Research Institute, Tomsk
National Research Medical Center, Russian Academy of Sciences, Tomsk,
Russian Federation
(Kozlov, Svirko, Shipulin, Podoksenov) Department of Cardiovascular
Surgery, Siberian State Medical University, Tomsk, Russian Federation
(Lomivorotov) Department of Anesthesiology and Critical Care, Meshalkin
National Medical Research Center, Novosibirsk, Russian Federation
Publisher
Elsevier Inc.
Abstract
Objective: Acute kidney injury (AKI) is a serious complication of cardiac
surgery with cardiopulmonary bypass (CPB). The aim of this study was to
evaluate the effects of nitric oxide (NO) supplementation to the CPB
circuit on the development of cardiac surgery-associated AKI.
 Method(s): This prospective randomized controlled study included 96
patients with moderate risk of renal complications who underwent elective
cardiac surgery with CPB. The study protocol was registered at
ClinicalTrials.gov (identifier NCT03527381). Patients were randomly
allocated to either NO supplementation to the CPB bypass circuit (NO
treatment group; n = 48) or usual care (control group; n = 48). In the NO
treatment group, 40-ppm NO was administered during the entire CPB period.
The primary outcome was the incidence of AKI. Result(s): NO treatment
was associated with a significant decrease in AKI incidence (10 cases
[20.8%] vs 20 cases [41.6%] in the control group; relative risk, 0.5; 95%
confidence interval, 0.26-0.95; P = .023) and a higher median urine output
during CPB (2.6 mL/kg/h [interquartile range (IQR), 2.1-5.08 mL/kg/h] vs
1.7 mL/kg/h [IQR, 0.80-2.50 mL/kg/h]; P = .0002). The median urinary
neutrophil gelatinase-associated lipocalin level at 4 hours after surgery
was significantly lower in the NO treatment group (1.12 ng/mL [IQR,
0.75-5.8 ng/mL] vs 4.62 ng/mL [IQR, 2.02-34.55 ng/mL]; P = .005). In the
NO treatment group, concentrations of NO metabolites were significantly
increased at 5 minutes postclamping, at 5 minutes after declamping, and at
the end of the operation. Concentrations of proinflammatory and
anti-inflammatory mediators and free plasma hemoglobin did not differ
significantly between the 2 groups. Conclusion(s): NO administration
in patients at moderate risk of renal complications undergoing elective
cardiac surgery with CPB was associated with a lower incidence of
AKI. Copyright © 2020 The American Association for Thoracic
Surgery

<35>
Accession Number
2015257705
Title
Off-pump versus on-pump coronary artery bypass grafting for octogenarians:
A meta-analysis involving 146 372 patients.
Source
Clinical Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Sun L.; Zhou M.; Ji Y.; Wang X.
Institution
(Sun, Ji, Wang, Wang) Department of Cardiovascular Surgery, The First
Affiliated Hospital of Nanjing Medical University, Nanjing, China
(Zhou) Department of Endocrine, The First Affiliated Hospital of Nanjing
Medical University, Nanjing, China
Publisher
John Wiley and Sons Inc
Abstract
There is an ongoing debate concerning the optimal surgical option of
myocardial revascularization for octogenarians. The current meta-analysis
aimed to compare clinical outcomes following off-pump coronary artery
bypass grafting (OPCABG) or conventional coronary artery bypass grafting
(CCABG) in octogenarians. PubMed, Cochrane, Web of Science, and EMBASE
databases were searched to identify eligible studies from inception to
March 2021. The analysis was performed using STATA 15.1. A literature
search yielded 18 retrospective studies involving 146 372 patients (OPCABG
= 44 522 vs. CCABG = 101 850). Pooled analysis showed a strong trend
toward reducing mortality risk in the OPCABG group (odds ratio: 0.75, 95%
confidence interval: 0.56-1.00, p =.05). However, it did not reach
statistical significance. The sensitive analysis demonstrated that OPCABG
was less likely to cause death than CCABG. There were comparable data in
myocardial infarction, renal failure, deep sternal wound infection, and
hospital stays between the two groups, although the incidence of stroke,
atrial fibrillation, prolonged ventilation, and reoperation for bleeding
was significantly lower in the OPCAGB group. OPCABG may be an effective
surgical strategy for myocardial revascularization, especially in reducing
the incidence of postoperative stroke, atrial fibrillation, prolonged
ventilation, and reoperation for bleeding. Copyright © 2022 The
Authors. Clinical Cardiology published by Wiley Periodicals LLC

<36>
Accession Number
637470522
Title
Right ventricular function, mechanical ventilation duration, and icu
length of stay in heart valve surgery patients underwent preoperative
inspiratory muscle training.
Source
Journal of the Hong Kong College of Cardiology. Conference: 8th Asian
Preventive Cardiology and Cardiac Rehabilitation Conference. Virtual.
28(2) (pp 82), 2020. Date of Publication: October 2020.
Author
Satoto H.H.; Paramitha A.; Baratha S.H.; Sugiri; Wahyudati S.; Sofia S.N.
Institution
(Satoto, Sugiri, Sofia) Department of Cardiology, Vascular Medicine
Faculty of Medicine, Diponegoro University-Dr. Kariadi General Hospital,
Semarang, Indonesia
(Paramitha, Baratha, Wahyudati) Department of Physical Medicine and
Rehabilitation, Faculty of Medicine Diponegoro University, Dr. Kariadi
General Hospital, Semarang, Indonesia
Publisher
Medcom Limited
Abstract
Background and Objectives: The reduction of right ventricular function
after heart valve surgery was associated with mortality and morbidity
after cardiac surgery, longer mechanical ventilation duration and ICU
length of stay (ICU LOS), which resulted in higher hospital cost.
Inspiratory muscle training can be considered for improving right
ventricular systolic function by optimalize afterload and cardiac
contractility. The objective of this study was to investigate the benefit
of preoperative inspiratory muscle training on right ventricular systolic
function by using echocardiography right ventricular fractional area
changes (RV FAC) measurement and it's impact on mechanical ventilation
duration and ICU LOS in heart valve surgery patients. Method(s):
Thirty patients scheduled for elective heart valve surgery on August-
November 2019 were randomized into conventional preoperative
rehabilitation group and conventional preoperative rehabilitation added
high intensity inspiratory muscle training at least 14 days before
surgery. Echocardiography examination were performed before preoperative
rehabilitation program and after cardiac surgery. Result(s): The
patients were randomized into 15 patients in control group and 15 patients
in intervention group. There were 12 patients on each group completed the
preoperative and postoperative echocardiography evaluations. Both groups
had no significant differences on RV FAC (44.3+/-4.1% vs 42.0+/-8.5%;
p=0.562) during the preoperative examination. We found significant
difference on RV FAC between intervention and control group (43.2+/-4.9%
vs 35.1+/-8.8; p=0.006) on postoperative evaluations. Although mechanical
ventilation in the intervention group was shorter than control group, it
wasn't statistically significant (16+/-9 vs 21+/-15 hours; p=0.38). The
ICU LOS in intervention group was significantly shorter than control group
(3.2+/-0.8 and 4.2+/-1.3 days; p=0.044). Conclusion(s): Patients
underwent conventional preoperative rehabilitation added inspiratory
muscle training had better right ventricular function postoperatively and
shorter ICU length of stay than patients in control group. However, there
was no significant difference on mechanical ventilation duration between
two groups.

<37>
Accession Number
637456929
Title
Pre-operative sildenafil for patients with pulmonary hypertension
undergoing mitral valve surgery: A systematic review and meta-analysis.
Source
Journal of the Hong Kong College of Cardiology. Conference: 27th Annual
Scientific Congress Hong Kong College of Cardiology. Hong Kong Hong Kong.
27(1) (pp 66), 2019. Date of Publication: April 2019.
Author
Villanueva D.L.
Institution
(Villanueva) Philippine General Hospital, Manila, Philippines
Publisher
Medcom Limited
Abstract
Background: Pulmonary hypertension is a usual complication of long
standing mitral valve disease. Perioperative pulmonary hypertension is a
risk factor for right ventricular failure and is an important cause of
morbidity and mortality in patients with pulmonary hypertension undergoing
mitral valve surgery. Phosphodiesterase 5-inhibitors particularly
Sildenafil citrate have proven clinical benefit for pulmonary arterial
hypertension but have shown discordant results in group 2 pulmonary
hypertension patients. We sought to determine the effect of pre-operative
Sildenafil on the intra-operative hemodynamic parameters of these
patients. Inclusion Criteria: Studies were included if they satisfied the
following criteria: 1) Randomized Controlled Trials; 2) Adult patients
with pulmonary hypertension scheduled for elective mitral valve surgery;
and 3) Reported data on changes in pre-, intra-, and post-operative
hemodynamic parameters. Method(s): Using PUBMED, Clinical Key,
Science Direct, and Cochrane databases, a search for eligible studies was
conducted from September 1 to December 31, 2018. The quality of each study
was evaluated using the Cochrane Risk of Bias Tool. The primary outcome of
interest is on the effect of pre-operative Sildenafil on the improvement
of intra-operative hemodynamic parameters such as systolic pulmonary
artery pressure, mean pulmonary arterial pressure, mean arterial pressure,
pulmonary and systemic greater than 1V. All but one patients had their
devices placed at the interventricular septum; the device was placed at
the right ventricular apex in the remaining patient. Conclusion(s):
The Micra Transcatheter system is safe in patients considered high risk
for traditional pacemakers. Implantation is successful with one attempt in
most patients. It achieves excellent pacing thresholds both acutely and at
one month. vascular resistances. We also investigated its effect on the
post-operative mortality, length of cardio-pulmonary bypass time,
ventilation time, and inotrope support requirement. Review Manager 5.3 was
utilized to perform analysis of random effects for continuous outcomes.
 Result(s): We identified 3 studies involving 153 patients with
pulmonary hypertension undergoing mitral valve surgery, showing that among
those who received pre-operative Sildenafil there is a significant
decrease in intra-operative systolic pulmonary arterial pressure [mean
difference -11.19 (95% CI, -20.23 to -2.15) p<0.05] and post-operative
systolic pulmonary artery pressure [mean difference -13.67 (95% CI, -19.56
to -7.78) p<0.05] without significantly affecting the mean arterial
pressure [mean difference 1.94 (95% CI, -5.49 to 9.37) p<0.05]. The
systemic and pulmonary vascular resistances were not affected as well.
 Conclusion(s): Administration of pre-operative Sildenafil to patients
with pulmonary hypertension undergoing mitral valve surgery decreases
intra-operative and post-operative systolic pulmonary arterial pressure
without significantly affecting other systemic hemodynamic parameters.

<38>
Accession Number
637456640
Title
Growth differentiation factor-15 predicts major adverse cardiac events in
patients undergoing percutaneous coronary intervention: a systematic
review and meta-analysis.
Source
Journal of the Hong Kong College of Cardiology. Conference: 27th Annual
Scientific Congress Hong Kong College of Cardiology. Hong Kong Hong Kong.
27(1) (pp 75), 2019. Date of Publication: April 2019.
Author
Liu L.; Chen J.; Liu Y.
Institution
(Liu, Chen, Liu) Guangdong Cardiovascular Institute, China
(Liu) Southern Medical University, China
(Liu, Chen, Liu) Guangdong Provincial People's Hospital, China
Publisher
Medcom Limited
Abstract
Background: Recent studies have shown Growth differentiation factor-15
(GDF-15) might be a potential predictive cytokine for the prognosis of
coronary heart disease (CHD). The aim of this study was to systematically
evaluate Major Adverse Cardiac Events (MACEs) following Percutaneous
Coronary Intervention (PCI) in patients with high GDF-15 through a
metaanalysis. Method(s): Publication searches of the Ovid MEDLINE,
EMBASE and Cochrane Central databases were performed without any time or
ethnicity restrictions. The inclusion and exclusion criteria were clearly
addressed. Two authors independently screened studies for inclusion,
consulting with a third author where necessary to resolve discrepancies.
Data analysis was performed by computing the hazard ratios (HR) with 95%
confidence interval (CI). Publication bias was tested using funnel plots
and the Egger test. Result(s): We identified five eligible studies
including a total of 8743 CHD patients undergoing PCI following the
inclusion criteria. The maximal duration of follow-up ranged from 6 months
to 5 years. Random effects models were used for the analysis and we found
that high GDF-15 was associated with a higher risk of the MACEs in
patients undergoing PCI (hazard ratios (HR), 1.69; 95% confidence interval
(CI), 1.26-2.28). Conclusion(s): Compared with low plasma GDF-15
levels, high plasma GDF- 15 levels are associated with an increased risk
of the MACEs in patients undergoing PCI. It suggests that plasma GDF-15
levels should be evaluated to prevent MACEs events after coronary
revascularization.

<39>
Accession Number
2017224723
Title
Acute haemothorax and pleuropulmonary blastoma: Two extremely rare
complications of extralobar pulmonary sequestration.
Source
Journal of Pediatric Surgery Case Reports. 80 (no pagination), 2022.
Article Number: 102238. Date of Publication: May 2022.
Author
Preziosi A.; Morandi A.; Galbiati F.; Scanagatta P.; Chiaravalli S.;
Fagnani A.M.; Di Cesare A.; Macchini F.; Leva E.
Institution
(Preziosi, Morandi, Galbiati, Fagnani, Di Cesare, Macchini, Leva)
Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale
Maggiore Policlinico, Milan, Italy
(Scanagatta) Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale
dei Tumori, Milan, Italy
(Chiaravalli) Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale
dei Tumori, Milan, Italy
Publisher
Elsevier Inc.
Abstract
Extralobar bronchopulmonary sequestration (eBPS) is a congenital lung
malformation characterized by non-functional lung tissue with no
connection with the bronchial tree, receiving systemic blood supply and
covered by its own visceral pleura. It is mostly asymptomatic, however it
can rarely get complicated with infections and neoplastic degeneration.
Its management is still debated: many authors suggest observation for
asymptomatic cases and intervention only in case of symptoms, others
advocate surgery even in asymptomatic patients. Pleuropulmonary blastoma
(PPB) is a rare malignant sarcomatous neoplasm, representing the most
common primary lung malignancy in children. Typically, PPB is associated
with congenital pulmonary airway malformation (CPAM). eBPS is rarely
associated with PPB. We report a case of a previously healthy
three-year-old boy presented to our emergency room with massive hemothorax
after a low-energy chest trauma. Imaging revealed active thoracic bleeding
by an anomalous artery arising from the celiac tripod, and an irregular
mass in the lower right hemithorax. After performing biopsy, pathologic
examination revealed a PPB. The patient underwent four cycles of
chemotherapy before surgery. The operative findings revealed a right
supradiaphragmatic extralobar mass, with no communication with the
bronchial tree, strictly adherent to the right middle lobe. After mass
excision, histological analysis confirmed the diagnosis of PPB type 2. The
patient underwent postoperative chemotherapy. No recurrence nor metastasis
were noted during the current follow-up. DICER-1 research revealed
biallelic mutation on the tumor and on the surrounding normal tissue. We
reviewed the literature concerning PPB and BPS. Based on these data, we
would recommend intervention even in case of asymptomatic
eBPS. Copyright © 2022 The Authors

<40>
Accession Number
637464750
Title
The effect of continuous intercostal nerve block vs. single shot on
analgesic outcomes and hospital stays in minimally invasive direct
coronary artery bypass surgery: a retrospective cohort study.
Source
BMC anesthesiology. 22(1) (pp 64), 2022. Date of Publication: 08 Mar 2022.
Author
Yao Y.; Xu M.
Institution
(Yao) Department of Anesthesiology, Peking University Third Hospital,
Beijing, China
(Xu) Department of Anesthesiology, Peking University Third Hospital,
Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Minimally invasive direct coronary artery bypass (MIDCAB)
grafting surgery is accompanied by severe pain. Although continuous
intercostal nerve block (CINB) has become one of the multimodal analgesic
techniques in single port thoracoscopic surgery, its effects on MIDCAB are
unclear. The purpose of this study was to compare the effects of CINB and
single shot on analgesic outcomes and hospital stays in patients
undergoing MIDCAB in a real-world setting. METHOD(S): A retrospective
cohort study was carried out at Peking University Third Hospital, China.
Two hundred and sixteen patients undergoing MIDCAB were divided into two
groups: a CINB group and a single block (SI) group. The primary outcome
was postoperative maximal visual analog scale (VAS); secondary outcomes
included the number of patients with maximal VAS<=3, the demand for and
consumed doses of pethidine and tramadol, and the length of intensive care
unit (ICU) and hospital stays. The above data and the area under the VAS
curve in the 70 h after extubation for the two subgroups (No. of grafts=1)
were also compared. RESULT(S): The maximum VAS was lower in the CINB
group, and there were more cases with maximum VAS<=3 in the CINB group:
CINB 52 (40%) vs. SI 17 (20%), P=0.002. The percentage of cases requiring
tramadol and pethidine was less in CINB, P=0.001. Among all patients, drug
doses were significantly lower in the CINB group [tramadol: CINB 0 (0-100)
mg vs. SI 100 (0-225) mg, P=0.0001; pethidine: CINB 0 (0-25) mg vs. SI 25
(0-50) mg, P=0.0004]. Further subgroup analysis showed that the area under
the VAS curve in CINB was smaller: 28.05 in CINB vs. 30.41 in SI, P=0.002.
Finally, the length of ICU stay was shorter in CINB than in SI: 20.5
(11.3-26.0) h vs. 22.0 (19.0-45.0) h, P=0.011. CONCLUSION(S): CINB is
associated with decreased demand for rescue analgesics and shorter length
of ICU stay when compared to single shot intercostal nerve block.
Additional randomized controlled trial (RCT) is needed to support these
findings. Copyright © 2022. The Author(s).

<41>
Accession Number
637473864
Title
Intrapleural fibrinolysis and DNase versus video-assisted thoracic surgery
(VATS) for the treatment of pleural empyema (FIVERVATS): protocol for a
randomised, controlled trial - surgery as first-line treatment.
Source
BMJ open. 12(3) (pp e054236), 2022. Date of Publication: 09 Mar 2022.
Author
Christensen T.D.; Bendixen M.; Skaarup S.H.; Jensen J.-U.; Petersen R.H.;
Christensen M.; Licht P.; Neckelmann K.; Bibby B.M.; Moller L.B.; Bodtger
U.; Borg M.H.; Saghir Z.; Langfeldt S.; Harders S.M.W.; Bedawi E.O.; Naidu
B.; Rahman N.; Laursen C.B.
Institution
(Christensen) Department of Cardiothoracic and Vascular Surgery &
Department of Clinical Medicine, Aarhus University Hospital, Aarhus,
Denmark
(Bendixen) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Skaarup) Department of Respiratory Diseases and Allergy, Aarhus
University Hospital, Aarhus, Denmark
(Jensen, Saghir) Department of Internal Medicine, Respiratory Medicine
Section, Herlev and Gentofte Hospital, Copenhagen, Denmark
(Jensen, Petersen, Saghir) Institute for Clinical Medicine, Faculty of
Health Sciences, University of Copenhagen, Copenhagen, Denmark
(Petersen, Christensen) Department of Cardiothoracic Surgery, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Licht, Neckelmann) Department of Cardiothoracic Surgery, Odense
University Hospital, Odense, Denmark
(Bibby) Department of Public Health, Section for Biostatistics, Aarhus
University, Aarhus, Denmark
(Moller) Department of Cardiothoracic Surgery, Aalborg University
Hospital, Aalborg, Denmark
(Bodtger) Department of Internal Medicine & Department of Respiratory
Medicine, Zealand University Hospital, Naestved-Slagelse Hospital,
Naestved, Denmark
(Bodtger) Institute of Regional Health Research, University of Southern
Denmark, Odense, Denmark
(Borg) Department of Respiratory Medicine & Clinical Institute, Aalborg
University Hospital, Aalborg, Denmark
(Langfeldt) Department of Radiology, Aarhus University Hospital, Aarhus,
Denmark
(Harders) Department of Radiology, Odense University Hospital, Odense,
Denmark
(Bedawi, Rahman) NIHR Oxford Biomedical Research Centre, University of
Oxford, Oxford, United Kingdom
(Naidu) Department of Thoracic Surgery, Queen Elizabeth Hospital,
Birmingham, United Kingdom
(Naidu) Institute of Inflammation and Ageing, University of Birmingham,
Birmingham, United Kingdom
(Laursen) Department of Respiratory Medicine, Odense University Hospital,
Odense, Denmark
(Laursen) Odense Respiratory Research Unit (ODIN), Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Pleural empyema is a frequent disease with a high morbidity
and mortality. Current standard treatment includes antibiotics and
thoracic ultrasound (TUS)-guided pigtail drainage. Simultaneously with
drainage, an intrapleural fibrinolyticum can be given. A potential better
alternative is surgery in terms of video-assisted thoracoscopic surgery
(VATS) as first-line treatment. The aim of this study is to determine the
difference in outcome in patients diagnosed with complex parapneumonic
effusion (stage II) and pleural empyema (stage III) who are treated with
either VATS surgery or TUS-guided drainage and intrapleural therapy
(fibrinolytic (Alteplase) with DNase (Pulmozyme)) as first-line treatment.
METHODS AND ANALYSIS: A national, multicentre randomised, controlled
study. Totally, 184 patients with a newly diagnosed community acquired
complicated parapneumonic effusion or pleural empyema are randomised to
either (1) VATS procedure with drainage or (2) TUS-guided pigtail catheter
placement and intrapleural therapy with Actilyse and DNase. The total
follow-up period is 12 months. The primary endpoint is length of hospital
stay and secondary endpoints include for example, mortality, need for
additional interventions, consumption of analgesia and quality of life.
ETHICS AND DISSEMINATION: All patients provide informed consent before
randomisation. The research project is carried out in accordance with the
Helsinki II Declaration, European regulations and Good Clinical Practice
Guidelines. The Scientific Ethics Committees for Denmark and the Danish
Data Protection Agency have provided permission. Information about the
subjects is protected under the Personal Data Processing Act and the
Health Act. The trial is registered at www. CLINICALTRIALS: gov, and
monitored by the regional Good clinical practice monitoring unit. The
results of this study will be published in peer-reviewed journals and
presented at various national and international conferences. TRIAL
REGISTRATION NUMBER: NCT04095676. Copyright © Author(s) (or their
employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<42>
Accession Number
637473411
Title
Does left atrial epicardial conduction time reflect atrial fibrosis and
the risk of atrial fibrillation recurrence after thoracoscopic ablation?
Post hoc analysis of the AFACT trial.
Source
BMJ open. 12(3) (pp e056829), 2022. Date of Publication: 09 Mar 2022.
Author
Wesselink R.; Neefs J.; van den Berg N.W.E.; Meulendijks E.R.; Terpstra
M.M.; Kawasaki M.; Nariswari F.A.; Piersma F.R.; van Boven W.J.P.;
Driessen A.H.G.; de Groot J.R.
Institution
(Wesselink) Heart Center, Department of Clinical and Experimental
Cardiology and Cardiothoracic Surgery, Amsterdam Cardiovascular Sciences,
Amsterdam, Netherlands
(Neefs, van den Berg, Meulendijks, Terpstra, Kawasaki, Nariswari, Piersma,
van Boven, Driessen) Heart Center, Department of Clinical and Experimental
Cardiology and Cardiothoracic Surgery, Amsterdam Cardiovascular Sciences,
Amsterdam, Netherlands
(de Groot) Heart Center, Department of Clinical and Experimental
Cardiology and Cardiothoracic Surgery, Amsterdam Cardiovascular Sciences,
Amsterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To determine the association between left atrial epicardial
conduction time (LAECT), fibrosis and atrial fibrillation (AF) recurrence
after thoracoscopic surgical ablation of persistent AF. SETTING: Single
tertiary care centre in the Netherlands. PARTICIPANTS: Patients with
persistent AF from the randomised Atrial Fibrillation Ablation and
Autonomic Modulation via Thoracoscopic Surgery (AFACT)-trial were
included. Patients eligible for thoracoscopic AF ablation were included,
full inclusion and exclusion criteria were previously published. All
patients underwent thoracoscopic ablation, encompassing pulmonary vein
isolation with an additional roof and trigone lesion. In patients with
conduction block across the roof and trigone lesion, LAECT was measured.
LAECT was defined as the time to local activation at one side of the
roofline on pacing from the opposite side. Collagen fibre density was
quantified from left atrial appendage histology. OUTCOME MEASURES: Primary
outcome: AF recurrence during 2years of follow-up. RESULT(S): 121
patients were included, of whom 35(29%) were women, age was 60.4+/-7.8and
51% (62) had at least one AF recurrence during 2years of follow-up. LAECT
was longer in patients with versus without AF recurrence (182+/-43ms vs
147+/-29ms, p<0.001). LAECT was longer in older patients, in patients with
a higher body mass index (BMI) and in patients using class IC
antiarrhythmic drugs. LAECT was shorter in patients with higher collagen
fibre density. A previously failed catheter ablation, LAECT and BMI were
independently associated with AF recurrence. CONCLUSION(S): LAECT is
correlated with collagen fibre density and BMI and is independently
associated with AF recurrence in patients with persistent AF. In these
patients, LAECT appears to reflect substrate characteristics beyond
clinical AF type and left atrial volume. TRIAL REGISTRATION NUMBER:
NCT01091389. Copyright © Author(s) (or their employer(s)) 2022.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<43>
Accession Number
637473319
Title
Benefits and harms of direct oral anticoagulation and low molecular weight
heparin for thromboprophylaxis in patients undergoing non-cardiac surgery:
systematic review and network meta-analysis of randomised trials.
Source
BMJ (Clinical research ed.). 376 (pp e066785), 2022. Date of Publication:
09 Mar 2022.
Author
Marcucci M.; Etxeandia-Ikobaltzeta I.; Yang S.; Germini F.; Gupta S.;
Agarwal A.; Ventresca M.; Tang S.; Morgano G.P.; Wang M.; Ahmed M.M.;
Neumann I.; Izcovich A.; Criniti J.; Popoff F.; Devereaux P.J.; Dahm P.;
Anderson D.; Lavikainen L.I.; Tikkinen K.A.O.; Guyatt G.H.; Schunemann
H.J.; Violette P.D.
Institution
(Marcucci) Department of Health Research Methods, Evidence, McMaster
University, ON, and Impact, Hamilton, Canada
(Marcucci, Germini, Agarwal, Ahmed, Devereaux, Guyatt) Department of
Medicine, McMaster University, ON, Hamilton, Canada
(Marcucci, Devereaux) Population Health Research Institute, ON, Hamilton,
Canada
(Etxeandia-Ikobaltzeta, Germini, Ventresca, Morgano, Devereaux, Guyatt,
Schunemann, Violette) Department of Health Research Methods, Evidence,
McMaster University, ON, and Impact, Hamilton, Canada
(Yang) Department of Anaesthesia, Jewish General Hospital, QC, Montreal,
Canada
(Gupta) Department of Medicine, Kingston Health Sciences Centre, Queen's
University, ON, Kingston, Canada
(Agarwal) Department of Medicine, University of Toronto, ON, Toronto,
Canada
(Tang) Department of Epidemiology, Nanjing Medical University, Nanjing,
China
(Wang) Department of Science, McMaster University, ON, Hamilton, Canada
(Wang) Department of Mathematics, University of Waterloo, ON, Waterloo,
Canada
(Neumann) Department of Internal Medicine, Santiago de Chile, Pontificia
Universidad Catolica de Chile, Chile
(Izcovich, Criniti, Popoff) Department of Internal Medicine, Hospital
Aleman, Buenos Aires, Argentina
(Dahm) Minneapolis Veterans Affair Health Care System, Urology Section,
MN, Minneapolis, United States
(Dahm) University of Minnesota, Department of Urology, MN, Minneapolis,
United States
(Anderson) Faculty of Medicine, Dalhousie University, NS, Halifax, Canada
(Lavikainen) Faculty of Medicine, University of Helsinki, Helsinki,
Finland
(Tikkinen) Department of Urology, University of Helsinki and Helsinki
University Hospital, Helsinki, Finland
(Tikkinen) Department of Surgery, South Karelian Central Hospital,
Lappeenranta, Finland
(Schunemann) Michael DeGroote Cochrane Canada Centre-Department of
Medicine, McMaster University, ON, Hamilton, Canada
(Violette) Department of Surgery, McMaster University, ON, Hamilton,
Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To systematically compare the effect of direct oral
anticoagulants and low molecular weight heparin for thromboprophylaxis on
the benefits and harms to patients undergoing non-cardiac surgery. DESIGN:
Systematic review and network meta-analysis of randomised controlled
trials. DATA SOURCES: Medline, Embase, and the Cochrane Central Register
of Controlled Trials (CENTRAL), up to August 2021. REVIEW METHODS:
Randomised controlled trials in adults undergoing non-cardiac surgery were
selected, comparing low molecular weight heparin (prophylactic (low) or
higher dose) with direct oral anticoagulants or with no active treatment.
Main outcomes were symptomatic venous thromboembolism, symptomatic
pulmonary embolism, and major bleeding. Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for
network meta-analyses. Abstracts and full texts were screened
independently in duplicate. Data were abstracted on study participants,
interventions, and outcomes, and risk of bias was assessed independently
in duplicate. Frequentist network meta-analysis with multivariate random
effects models provided odds ratios with 95% confidence intervals, and
GRADE (grading of recommendations, assessment, development, and
evaluation) assessments indicated the certainty of the evidence.
 RESULT(S): 68 randomised controlled trials were included (51
orthopaedic, 10 general, four gynaecological, two thoracic, and one
urological surgery), involving 45445 patients. Low dose (odds ratio 0.33,
95% confidence interval 0.16 to 0.67) and high dose (0.19, 0.07 to 0.54)
low molecular weight heparin, and direct oral anticoagulants (0.17, 0.07
to 0.41) reduced symptomatic venous thromboembolism compared with no
active treatment, with absolute risk differences of 1-100 per 1000
patients, depending on baseline risks (certainty of evidence, moderate to
high). None of the active agents reduced symptomatic pulmonary embolism
(certainty of evidence, low to moderate). Direct oral anticoagulants and
low molecular weight heparin were associated with a 2-3-fold increase in
the odds of major bleeding compared with no active treatment (certainty of
evidence, moderate to high), with absolute risk differences as high as 50
per 1000 in patients at high risk. Compared with low dose low molecular
weight heparin, high dose low molecular weight heparin did not reduce
symptomatic venous thromboembolism (0.57, 0.26 to 1.27) but increased
major bleeding (1.87, 1.06 to 3.31); direct oral anticoagulants reduced
symptomatic venous thromboembolism (0.53, 0.32 to 0.89) and did not
increase major bleeding (1.23, 0.89 to 1.69). CONCLUSION(S): Direct
oral anticoagulants and low molecular weight heparin reduced venous
thromboembolism compared with no active treatment but probably increased
major bleeding to a similar extent. Direct oral anticoagulants probably
prevent symptomatic venous thromboembolism to a greater extent than
prophylactic low molecular weight heparin. SYSTEMATIC REVIEW REGISTRATION:
PROSPERO CRD42018106181. Copyright © Author(s) (or their
employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<44>
Accession Number
2015891199
Title
Colchicine for Prevention of Atrial Fibrillation after Cardiac Surgery in
the Early Postoperative Period.
Source
Journal of Clinical Medicine. 11(5) (no pagination), 2022. Article Number:
1387. Date of Publication: March-1 2022.
Author
Shvartz V.; Le T.; Kryukov Y.; Sokolskaya M.; Ispiryan A.; Khugaeva E.;
Yurkulieva G.; Shvartz E.; Petrosyan A.; Bockeria L.; Bockeria O.
Institution
(Shvartz, Le, Sokolskaya, Ispiryan, Khugaeva, Yurkulieva, Petrosyan,
Bockeria, Bockeria) Department of Surgical Treatment for Interactive
Pathology, Bakoulev Scientific Center for Cardiovascular Surgery, Moscow
121552, Russian Federation
(Kryukov) Department of Cardiovascular Surgery, Arrhythmology and Clinical
Electrophysiology, Bakoulev Scientific Center for Cardiovascular Surgery,
Moscow 121552, Russian Federation
(Shvartz) National Medical Research Center for Therapy and Preventive
Medicine, Moscow 101990, Russian Federation
Publisher
MDPI
Abstract
Background. Postoperative atrial fibrillation (POAF) is a common
complication of cardiac surgery. It has been proven to be associated with
an increase in the incidence of early complications and mortality, an
increase in the rate of hospital stay duration, and economic costs of
their treatment. One of the pharmaceutical drugs recommended by the
American College of Cardiology (ACC)/American Heart Association (AHA) for
preventing POAF is colchicine (class IIB). However, the results of
research on the efficacy and safety of colchicine are ambiguous and,
consequently, require further study. Objective. Evaluating the efficacy of
short-term colchicine administration in the prevention of POAF in patients
after open-heart surgery. Materials and methods. Double-blind, randomized,
placebo-controlled clinical trial. The subjects were randomly assigned to
two groups: treatment group (n = 50) with subjects receiving 1 mg of
colchicine 24 h before the surgery, as well as on days 2, 3, 4, and 5 in
the postoperative period; and the control group (n = 51), receiving
placebo on the same schedule. The primary endpoint was the frequency of
POAF in both groups within 7 days after surgery. Results. The study
included 101 patients (82 men, 19 women). Baseline clinical, laboratory,
instrumental, and intraoperative data did not differ statistically
significantly between the groups. POAF was detected in 9 patients (18%) of
the treatment group and 15 subjects (29.4%) of the control group, which
had no statistical significance (odds ratio, OR 0.527; 95% Cl 0.206-1.349;
p = 0.178). No statistically significant differences were revealed for
most secondary endpoints, as well as between the groups for all laboratory
parameters. There were statistically significant differences between the
groups solely in the frequency of diarrhea: 16 (32%) patients in the
treatment group and 6 (11.8%) subjects in the control group (OR 3.529; 95%
Cl 1.249-9.972; p = 0.010). Conclusions. We did not detect any statistical
differences between the groups in terms of primary endpoints, which could
be due to the insufficient volume of the sample of the study. However, we
detected some trends of statistical differences among the groups in terms
of some parameters. Clinical Trials Registration. ClinicalTrials. Unique
identifier: NCT04224545. Copyright © 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<45>
Accession Number
637362878
Title
Tranexamic acid versus placebo to reduce perioperative blood transfusion
in patients undergoing liver resection: Protocol for the haemorrhage
during liver resection tranexamic acid (HeLiX) randomised controlled
trial.
Source
BMJ Open. 12(2) (no pagination), 2022. Article Number: e058850. Date of
Publication: 24 Feb 2022.
Author
Karanicolas P.J.; Lin Y.; McCluskey S.; Roke R.; Tarshis J.; Thorpe K.E.;
Ball C.G.; Chaudhury P.; Cleary S.P.; Dixon E.; Eeson G.; Moulton C.-A.;
Nanji S.; Porter G.; Ruo L.; Skaro A.I.; Tsang M.; Wei A.C.; Guyatt G.
Institution
(Karanicolas) Department of Surgery, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Karanicolas, Moulton, Tsang) Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Molecular Diagnostics,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
(McCluskey) Department of Anesthesia and Pain Management, University
Health Network, Toronto, ON, Canada
(McCluskey) Department of Anesthesia, University of Toronto, Toronto, ON,
Canada
(Roke) Department of Evaluative Clinical Sciences, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Roke) Institute of Health Policy, Management and Evaluation, University
of Toronto, Toronto, ON, Canada
(Tarshis) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Thorpe) Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
(Ball, Dixon) Department of Surgery, Foothills Medical Centre, Calgary,
AB, Canada
(Ball) Department of Medicine, University of Calgary, Calgary, AB, Canada
(Chaudhury) Department of Surgery, McGill University Health Centre,
Montreal, QC, Canada
(Cleary) Department of Surgery, Mayo Clinic, Rochester, MN, United States
(Dixon) Department of Surgery, University of Calgary, Calgary, AB, Canada
(Eeson) Department of Surgery, Kelowna General Hospital, Kelowna, BC,
Canada
(Eeson) Department of Surgery, University of British Columbia, Vancouver,
BC, Canada
(Moulton) Department of Surgery, University Health Network, Toronto, ON,
Canada
(Nanji) Department of Surgery, Kingston General Hospital, Kingston, ON,
Canada
(Nanji) Department of Surgery, Queen's University, Kingston, ON, Canada
(Porter) Department of Surgery, Nova Scotia Health, Halifax, NS, Canada
(Porter) Department of Surgery, Dalhousie University, Halifax, NS, Canada
(Ruo) Department of Surgery, Juravinski Hospital and Cancer Centre,
Hamilton, ON, Canada
(Ruo) Deparment of Surgery, McMaster University, Hamilton, ON, Canada
(Skaro) Department of Surgery, London Health Sciences Centre, London, ON,
Canada
(Skaro) Department of Surgery, University of Western Ontario, Schulich
School of Medicine and Dentistry, London, ON, Canada
(Tsang) Division of General Surgery, St. Joseph's Health Centre, Unity
Health Toronto, Toronto, ON, Canada
(Wei) Department of Surgery, Memorial Sloan Kettering Cancer Center, New
York, NY, United States
(Guyatt) Department of Clinical Epidemiology and Biostatistics, McMaster
University, Hamilton, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Despite use of operative and non-operative interventions to
reduce blood loss during liver resection, 20%-40% of patients receive a
perioperative blood transfusion. Extensive intraoperative blood loss is a
major risk factor for postoperative morbidity and mortality and receipt of
blood transfusion is associated with serious risks including an
association with long-term cancer recurrence and overall survival. In
addition, blood products are scarce and associated with appreciable
expense; decreasing blood transfusion requirements would therefore have
health system benefits. Tranexamic acid (TXA), an antifibrinolytic, has
been shown to reduce the probability of receiving a blood transfusion by
one-third for patients undergoing cardiac or orthopaedic surgery. However,
its applicability in liver resection has not been widely researched.
Methods and analysis This protocol describes a prospective, blinded,
randomised controlled trial being conducted at 10 sites in Canada and 1 in
the USA. 1230 eligible and consenting participants will be randomised to
one of two parallel groups: experimental (2 g of intravenous TXA) or
placebo (saline) administered intraoperatively. The primary endpoint is
receipt of blood transfusion within 7 days of surgery. Secondary outcomes
include blood loss, postoperative complications, quality of life and
5-year disease-free and overall survival. Ethics and dissemination This
trial has been approved by the research ethics boards at participating
centres and Health Canada (parent control number 177992) and is currently
enrolling participants. All participants will provide written informed
consent. Results will be distributed widely through local and
international meetings, presentation, publication and ClinicalTrials.gov.
Trial registration number NCT02261415. Copyright ©

<46>
Accession Number
2016800696
Title
Meta-Analysis of Aortic Valve Replacement in Asymptomatic Patients With
Severe Aortic Stenosis.
Source
American Journal of Cardiology. 168 (pp 174-176), 2022. Date of
Publication: 01 Apr 2022.
Author
Mohamed M.M.G.; Taha M.; Kheiri B.; Osman M.
Institution
(Mohamed) Internal Medicine Department, SSM Health, St. Mary's
Hospital-St. Louis, Missouri
(Taha) Internal Medicine Department, University of Nevada, Nevada, Reno
(Kheiri, Osman) Knight Cardiovascular Institute, Oregon Health & Science
University, Oregon, Portland
Publisher
Elsevier Inc.

<47>
Accession Number
2016548013
Title
Meta-Analysis of Transcatheter Aortic Valve Implantation Using the Sapien
3 Versus Sapien 3 Ultra Valves.
Source
American Journal of Cardiology. 168 (pp 170-172), 2022. Date of
Publication: 01 Apr 2022.
Author
Abdelfattah O.M.; Sayed A.; Ghonim M.; Saleh Y.; Genereux P.; Goel S.S.;
Krishnaswamy A.; Yun J.; Kapadia S.R.
Institution
(Abdelfattah) Department of Internal Medicine
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(Sayed, Ghonim) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Saleh, Goel) Department of Cardiology, Houston Methodist Hospital, Texas,
Houston
(Krishnaswamy, Yun, Kapadia) Heart Vascular and Thoracic Institute,
Department of Cardiovascular Medicine, Cleveland Clinic, Ohio, Cleveland
(Saleh) Gagnon Cardiovascular Institute, Morristown Medical Center,
Atlantic Health System, New Jersey, Morristown, Egypt
Publisher
Elsevier Inc.

<48>
Accession Number
2017204219
Title
New-Onset Atrial Fibrillation After Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 15(6) (pp 603-613), 2022. Date of
Publication: 28 Mar 2022.
Author
Ryan T.; Grindal A.; Jinah R.; Um K.J.; Vadakken M.E.; Pandey A.; Jaffer
I.H.; Healey J.S.; Belley-Cote E.P.; McIntyre W.F.
Institution
(Ryan, Grindal, Jinah, Um, Healey, Belley-Cote, McIntyre) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Vadakken, Healey, Belley-Cote, McIntyre) Population Health Research
Institute, McMaster University, Hamilton, ON, Canada
(Pandey) Department of Medicine, University of Ottawa, Ottawa, ON, Canada
(Jaffer) Department of Surgery, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: The authors aimed to identify risk factors and outcomes
associated with new-onset atrial fibrillation (NOAF) after transcatheter
aortic valve replacement (TAVR). Background(s): NOAF is a common
complication after TAVR, although estimates of the precise occurrence are
variable. This study sought to quantify the occurrence of NOAF after TAVR
and to explore the outcomes and predictors associated with this
complication. Method(s): We searched Medline, EMBASE, and the
Cochrane database from 2016 to 2020 for articles that reported NOAF after
TAVR. We extracted data for studies published before 2016 from a previous
systematic review. We pooled data using a random effects model.
 Result(s): We identified 179 studies with 241,712 total participants
(55,271 participants with pre-existing atrial fibrillation (AF) were
excluded) that reported NOAF from 2008 to 2020. The pooled occurrence of
NOAF after TAVR was 9.9% (95% CI: 8.1%-12%). NOAF after TAVR was
associated with a longer index hospitalization (mean difference = 2.66
days; 95% CI: 1.05-4.27), a higher risk of stroke in the first 30 days
(risk ratio [RR]: 2.35; 95% CI: 2.12-2.61), 30-day mortality (RR: 1.76;
95% CI: 1.12-2.76), major or life-threatening bleeding (RR: 1.60; 95% CI:
1.39-1.84), and permanent pacemaker implantation (RR: 1.12; 95% CI:
1.05-1.18). Risk factors for the development of NOAF after TAVR included
higher Society of Thoracic Surgeons score, transapical access, pulmonary
hypertension, chronic kidney disease, peripheral vascular disease, and
severe mitral regurgitation, suggesting that the risk for NOAF is highest
in more comorbid TAVR patients. Conclusion(s): NOAF is common after
TAVR. Whether AF after TAVR is a causal factor or a marker of sicker
patients remains unclear. Copyright © 2022 American College of
Cardiology Foundation

<49>
Accession Number
2017197422
Title
Delayed peritoneal shunt catheter migration into the pulmonary artery with
indolent thrombosis: A case report and narrative review.
Source
Surgical Neurology International. 13 (no pagination), 2022. Article
Number: 77. Date of Publication: 2022.
Author
Patel M.S.; Zhang J.K.; Raza Khan A.S.; Alexopoulos G.; Khan M.Q.; Mercier
P.J.; Kemp J.M.
Institution
(Patel, Zhang, Alexopoulos, Mercier, Kemp) Department of Neurosurgery,
Saint Louis University School of Medicine, Saint Louis, MO, United States
(Raza Khan) Department of Neurosurgery, Texas Tech University Health
Sciences Center, Lubbock, TX, United States
(Khan) Department of Neurosurgery, Saint Louis University, Saint Louis,
MO, United States
Publisher
Scientific Scholar
Abstract
Background: Ventriculoperitoneal (VP) shunts are the preferred surgical
treatment for hydrocephalus, and rarely, these operations may be
complicated by catheter migration to ectopic sites. We present the case of
an asymptomatic VP shunt patient with delayed peritoneal catheter
migration into the pulmonary artery shunt catheter migration into the
pulmonary artery (SCMPA) complicated by knotting and indolent thrombosis,
necessitating open-heart surgery for system retrieval. Method(s): We
conducted a literature review in PubMed, Scopus, and Web of Science of
prior similar reported cases and present the results of 24 cases of SCMPA.
 Result(s): An asymptomatic 12-year-old male presented with SCMPA
noted on routine annual follow-up imaging. Preoperative CT angiogram
indicated extensive catheter looping into the pulmonary artery without
evidence of thrombosis. Less invasive attempts to retrieve the retained
catheter were unsuccessful, and open-heart surgery was required.
Intraoperatively, a nonocclusive pulmonary arterial thrombus surrounding
the knotted catheter was discovered that was lysed successfully before
system retrieval. Conclusion(s): VP shunt catheter migration into the
pulmonary artery (SCMPA) with concurrent large vessel thrombosis can
develop in pediatric patients incidentally without any clinical symptoms.
Our report suggests that preoperative CT angiogram may be insufficient to
detect arterial thrombosis in the presence of extensive intravascular
catheter knotting. An open-chest approach may be the only viable surgical
option for catheter retrieval in the presence of complex catheter coiling.
The use of anticoagulation following open-heart surgery for retrieval of a
migrated VP shunt catheter remains unclear, we here propose that
continuation of long-term therapeutic anticoagulation may successfully
prevent thrombus relapse. Copyright © 2022 Published by
Scientific Scholar on behalf of Surgical Neurology International.

<50>
Accession Number
2017181764
Title
effectiveness of endovascular versus open surgical repair for thoracic
aortic aneurysm: a systematic review and meta-analysis.
Source
Journal of Cardiovascular Surgery. 63(1) (pp 25-36), 2022. Date of
Publication: February 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, Heidari) Research Center for
evidence-Based Medicine, JBi Center of excellence, Tabriz university of
Medical sciences, Tabriz, Iran, Islamic Republic of
Publisher
Edizioni Minerva Medica
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. Copyright © 2022 Edizioni Minerva Medica. All rights
reserved.

<51>
Accession Number
2017181751
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
Journal of Cardiovascular Surgery. 63(1) (pp 60-68), 2022. Date of
Publication: February 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, Barros, Leite-Moreira) 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,
United Kingdom
(Cerqueira, Leite-Moreira) Department of Cardiothoracic Surgery, Sao Joao
University Hospital, Porto, Portugal
(Lourenco) Department of Anesthesiology, Sao Joao University Hospital,
Porto, Portugal
Publisher
Edizioni Minerva Medica
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). EVIDENCEACQUISITION:
Aliterature 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
CABGstrategy for these patients. Copyright © 2022 Edizioni
Minerva Medica. All rights reserved.

<52>
Accession Number
2017149519
Title
The effects of aromatherapy on patients undergoing coronary angiography: A
systematic review of clinical trials.
Source
Journal of HerbMed Pharmacology. 11(1) (pp 1-9), 2022. Date of
Publication: 2022.
Author
Amin A.; Amraei M.; Shahijan M.K.; Nadri S.; Moradifar N.
Institution
(Amin, Nadri, Moradifar) Cardiovascular Research Center, Lorestan
University of Medical Sciences, Khorramabad, Iran, Islamic Republic of
(Amraei) Department of Health Information Technology, School of
Paramedical Sciences, Lorestan University of Medical Sciences,
Khorramabad, Iran, Islamic Republic of
(Shahijan) Committee, Lorestan University of Medical Sciences,
Khorramabad, Iran, Islamic Republic of
Publisher
Nickan Research Institute
Abstract
As a diagnostic and therapeutic technique for coronary artery disease,
angiography is usually associated with some disorders and complications
such as fear, pain, discomfort, limited mobility, and anxiety. The present
study is a systematic review determining the effects of aromatherapy with
different plants in patients undergoing angiography. This review was
conducted according to the 06-PRISMA guideline and registered in the
CAMARADES-NC3Rs Preclinical Systematic Review and Meta-Analysis Facility
(SyRF) database. The English databases were Google Scholar, PubMed,
Scopus, Web of Science, EBSCO, and ScienceDirect to search articles
regarding the effects of aromatherapy with different plants in patients
experiencing angiography without a date limitation. The searched keywords
in this study were "aromatherapy", "angiography", "coronary artery
disease", "anxiety", "stress", and "cardiovascular diseases". Out of 1835
papers, 20 papers up to 2021, met the inclusion criteria for discussion in
this systematic review with the data extracted. Most studies were intended
to evaluate the effect of aromatherapy on patients anxiety with coronary
artery bypass graft surgery (11 papers, 55.0%). The most widely used
essential oil belonged to the lavender essential oil (13 papers, 65.0%).
The results of the current review confirmed that aromatherapy management
with lavender, damask rose, orange, and peppermint is able to
significantly decrease anxiety, pain, nausea and vomiting, sleep quality,
hemodynamic indices, blood pressure, etc. in patients with coronary
angiography. However, more investigation is required to confirm the
precise mechanisms and side effects of the alternative
treatment. Copyright © 2022 Nickan Research Institute. All rights
reserved.

<53>
Accession Number
2017141668
Title
Patient-reported quality of life after stand-alone and concomitant
arrhythmia surgery: a systematic review and meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 34(3) (pp 339-348), 2022.
Date of Publication: 01 Mar 2022.
Author
Maesen B.; Van Der Heijden C.A.J.; Bidar E.; Vos R.; Athanasiou T.;
Maessen J.G.
Institution
(Maesen, Van Der Heijden, Bidar, Maessen) Department of Cardiothoracic
Surgery, Maastricht University, Medical Centre, Postbus 5800, Maastricht
6202 AZ, Netherlands
(Maesen, Bidar, Maessen) Cardiovascular Research Institute Maastricht,
Maastricht, Netherlands
(Vos) Department of Methodology and Statistics, Maastricht University,
Maastricht, Netherlands
(Athanasiou) Department of Cardiothoracic Surgery, Imperial College
London, St Mary's Hospital, London, United Kingdom
Publisher
Oxford University Press
Abstract
OBJECTIVES: Patient-reported quality of life (QOL) has become an important
endpoint for arrhythmia surgery for atrial fibrillation (AF). While
studies specifically evaluating the effect of arrhythmia surgery on QOL
are scarce, we aimed to summarize current evidence of QOL following
concomitant and stand-alone arrhythmia surgery for AF. METHOD(S): All
studies reporting on QOL using questionnaires from patients undergoing
arrhythmia surgery for AF, both stand-alone and concomitant, were included
in this systematic review. A meta-analysis was performed on inter-study
heterogeneity of changes in QOL on 9 of 12 included studies that used the
Short-Form 36 tool and meta-regression based on rhythm outcome after 1
year was executed. Finally, differences in QOL following stand-alone
arrhythmia surgery and concomitant procedures were evaluated.
 RESULT(S): Overall, QOL scores improved 1 year after surgical
ablation for AF evaluated by several questionnaires. In stand-alone
arrhythmia procedures, meta-regression showed significant improvements in
those who were in sinus rhythm compared to those in AF after 1 year. This
association between an improved QOL and the procedural effectiveness was
also suggested in concomitant procedures. However, when comparing QOL of
patients undergoing cardiac surgery with and without add-on surgical
ablation for AF, only the variable 'physical role' demonstrated a
significant improvement. CONCLUSION(S): In patients with AF, QOL
improves after both stand-alone and concomitant arrhythmia surgery. In the
concomitant group, this improvement can be attributed to both the cardiac
procedure itself as well as the add-on arrhythmia surgery. However, both
in stand-alone and concomitant procedures, the improvement in QOL seems to
be related to the effectiveness of the procedure to maintain sinus rhythm
after 12 months. Copyright © The Author(s) 2021.

<54>
Accession Number
637472518
Title
Amiodarone With or Without N-acetylcysteine for the Prevention of Atrial
Fibrillation After Thoracic Surgery: A Double-Blind, Randomized Trial.
Source
Anesthesiology. (no pagination), 2022. Date of Publication: 09 Mar 2022.
Author
Amar D.; Zhang H.; Chung M.K.; Tan K.S.; Desiderio D.; Park B.J.; Pedoto
A.; Roistacher N.; Isbell J.M.; Molena D.; Milne G.L.; Meyers B.F.;
Fischer G.W.; Rusch V.W.; Jones D.R.
Institution
(Amar, Zhang, Desiderio, Pedoto, Fischer) Department of Anesthesiology and
Critical Care Medicine, Memorial Sloan Kettering Cancer Center, NY
(Chung) Department of Cardiovascular Medicine, Heart, Vascular & Thoracic
Institute, Cleveland Clinic, Cleveland, OH, United States
(Tan) Department of Epidemiology and Biostatistics, Memorial Sloan
Kettering Cancer Center, NY
(Park, Isbell, Molena, Rusch, Jones) Thoracic Service, Department of
Surgery, Memorial Sloan Kettering Cancer Center, NY
(Roistacher) Department of Medicine, Memorial Sloan Kettering Cancer
Center, NY
(Milne) Department of Medicine, Division of Clinical Pharmacology,
Vanderbilt University Medical Center, Nashville, TN, United States
(Meyers) Department of Surgery, Washington University Medical Center,
Saint Louis, Missouri
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation (AF) may identify patients
at risk of subsequent AF, with its greater risk of stroke. We hypothesized
that N-acetylcysteine mitigates inflammation and oxidative stress to
reduce the incidence of postoperative AF. METHOD(S): In this
double-blind, placebo-controlled trial, patients at high risk of
postoperative AF scheduled to undergo major thoracic surgery were
randomized to N-acetylcysteine plus amiodarone or placebo plus amiodarone.
On arrival to the postanesthesia care unit, N-acetylcysteine or placebo
bolus (intravenous 50 mg/kg then 50 mg/kg/24 h x 48 h) was administered
plus amiodarone (intravenous 150 mg then 1 g/24 h x 48 h). The primary
outcome was sustained AF >30 s by telemetry (first 72 h) or symptoms
requiring intervention and confirmed by ECG within 7 days of surgery.
Systemic markers of inflammation (interleukin-6, interleukin-8, tumor
necrosis factor-alpha, C-reactive protein) and oxidative stress
(F2-isoprostane prostaglandin PGF2alpha [8-iso-PGF2alpha], isofuran) were
assessed immediately after surgery and on postoperative day 2. Patients
were phoned monthly to assess the occurrence of AF in year 1.
 RESULT(S): Among 154 patients included, postoperative AF occurred in
15 of 78 who received N-acetylcysteine (19%) and 13 of 76 who received
placebo (17%) (odds ratio, 1.24; 95.1% confidence interval, 0.53-2.88;
p=0.615). The trial was stopped at the interim analysis because of
futility. Three of the 28 patients with postoperative AF (11%) were
discharged in AF. Regardless of treatment at 1 year, 7 of 28 patients with
postoperative AF (25%) had recurrent episodes of AF. Inflammatory and
oxidative stress markers were similar between groups. CONCLUSION(S):
Dual therapy comprising N-acetylcysteine plus amiodarone did not reduce
the incidence of postoperative AF or markers of inflammation and oxidative
stress early after major thoracic surgery, compared with amiodarone alone.
Recurrent AF episodes are common among patients with postoperative AF
within 1 year of major thoracic surgery. Copyright © 2022, the
American Society of Anesthesiologists. All Rights Reserved.

<55>
Accession Number
637465852
Title
Treatment With Icosapent Ethyl to Reduce Ischemic Events in Patients With
Prior Percutaneous Coronary Intervention: Insights From REDUCE-IT PCI.
Source
Journal of the American Heart Association. (pp e022937), 2022. Date of
Publication: 09 Mar 2022.
Author
Peterson B.E.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson
T.A.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz C.;
Gibson C.M.; Pinto D.; Giugliano R.P.; Budoff M.J.; Tardif J.-C.; Verma
S.; Ballantyne C.M.
Institution
(Peterson, Bhatt, Giugliano) Brigham and Women's Hospital Heart and
Vascular Center Harvard Medical School Boston MA
(Steg) Universite de ParisAP-HP (Assistance Publique-Hopitaux de
Paris)Hopital BichatFACT (French Alliance for Cardiovascular Trials)INSERM
U-1148 Paris France, France
(Miller) Department of Medicine University of Maryland School of Medicine
Baltimore MD
(Brinton) Utah Lipid Center Salt Lake City UT
(Jacobson) Department of Medicine Office of Health Promotion and Disease
Prevention Emory University School of Medicine Atlanta GA
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc. (Amarin)
Bridgewater NJ
(Gibson, Pinto) Baim Clinical Research Institute Boston MA
(Budoff) David Geffen School of Medicine Lundquist Institute Torrance CA
(Tardif) Montreal Heart InstituteUniversite de Montreal Quebec Canada,
Canada
(Verma) Division of Cardiac Surgery St Michael's HospitalUniversity of
Toronto Ontario Canada, Canada
(Ballantyne) Department of Medicine Baylor College of MedicineCenter for
Cardiovascular Disease PreventionMethodist DeBakey Heart and Vascular
Center Houston TX
Publisher
NLM (Medline)
Abstract
Background Patients who undergo percutaneous coronary intervention (PCI)
are at increased risk for recurrent cardiovascular events despite
aggressive medical therapy. Methods and Results This post hoc analysis
focused on the subset of patients with prior PCI enrolled in REDUCE-IT
(Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention
Trial), a multicenter, randomized, double-blind, placebo-controlled trial
of icosapent ethyl versus placebo. Icosapent ethyl was added to statins in
patients with low-density lipoprotein cholesterol <100 mg/dL and fasting
triglycerides 135-499 mg/dL. The primary end point was a composite of
cardiovascular death, nonfatal myocardial infarction, nonfatal stroke,
coronary revascularization, or unstable angina requiring hospitalization.
There were 8179 patients randomized in REDUCE-IT followed for a median of
4.9 years, and 3408 (41.7%) of them had a prior PCI with a median
follow-up of 4.8 years. These patients were randomized a median of 2.9
years (11 days to 30.7 years) after PCI. Among patients treated with
icosapent ethyl versus placebo, there was a 34% reduction in the primary
composite end point (hazard ratio [HR], 0.66; 95% CI, 0.58-0.76; P<0.001;
number needed to treat4.8 years=12) and a 34% reduction in the key
secondary composite end point of cardiovascular death, nonfatal myocardial
infarction, or nonfatal stroke (HR, 0.66; 95% CI, 0.56-0.79; P<0.001;
NNT4.8 years=19) versus placebo. Similarly, large reductions occurred in
total coronary revascularizations and revascularization subtypes. There
was also a 39% reduction in total events (rate ratio, 0.61; 95% CI,
0.52-0.72; P<0.001). Conclusions Among patients treated with statins with
elevated triglycerides and a history of prior PCI, icosapent ethyl
substantially reduced the risk of recurrent events during an average of ~5
years of follow-up with a number needed to treat of only 12. Registration
URL: https://www.clinicaltrials.gov; Unique identifier: NCT01492361.

<56>
Accession Number
637464280
Title
Bi-level Positive Airway Pressure Versus Nasal CPAP for the Prevention of
Extubation Failure in Infants After Cardiac Surgery.
Source
Respiratory care. (no pagination), 2022. Date of Publication: 08 Mar
2022.
Author
Zheng Y.-R.; Lin W.-H.; Lin S.-H.; Xu N.; Cao H.; Chen Q.
Institution
(Zheng, Lin, Lin, Xu, Cao, Chen) Department of Cardiac Surgery, Fujian
Branch of Shanghai Children's Medical Center, Fuzhou, China; Fujian
Children's Hospital, Fuzhou, China; Fujian Maternity and Child Health
Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China;
and Fujian Key Laboratory of Women and Children's Critical Diseases
Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Extubation early in the postoperative period is beneficial to
the recovery and rehabilitation of patients. This study compared the
postoperative extubation failure rates among infants who received
postextubation respiratory support by either bi-level positive airway
pressure (BPAP) or nasal CPAP following cardiac surgery. METHOD(S):
This was a single-center randomized controlled trial registered at the
Chinese Clinical Trial Registry (number ChiCTR2000041453) and was
conducted between January 2020 and March 2021. Ventilated infants who
underwent cardiac surgery were randomized to either a BPAP or a nasal CPAP
group for ventilatory support following extubation. The primary outcome
measure was the extubation failure rate within 48 h. RESULT(S): The
analyses included 186 subjects. Treatment failure necessitating
re-intubation was noted in 14 of the 93 infants (15%) in the BPAP group
and in 11 of the 93 infants (12%) in the nasal CPAP group (P = .52).
Moreover, there were no statistically significant differences between the
2 groups regarding the duration of noninvasive ventilation (P = .54),
total enteral feeding time (P = .59), or complications (P = .85). We found
that both the BPAP group and the nasal CPAP group showed significantly
improved oxygenation and relief of respiratory distress after treatment.
However, the PaCO2 level within 24 h was significantly lower in the BPAP
group (P = .001) than in the CPAP group. Additionally, the PaO2 /FIO2 in
the BPAP group was significantly higher than in the nasal CPAP group at 6
h, 12 h, and 24 h after treatment (P < .001). CONCLUSION(S): The
introduction of BPAP for postextubation respiratory support was not
inferior to nasal CPAP in infants after cardiac surgery. Moreover, BPAP
was shown to be superior to nasal CPAP in improving oxygenation and carbon
dioxide clearance. Copyright © 2022 by Daedalus Enterprises.

<57>
Accession Number
2016980609
Title
The Art and Science of Mentorship in Cardiothoracic Surgery: A Systematic
Review of the Literature.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Odell D.D.; Edwards M.; Fuller S.; Loor G.; Antonoff M.B.
Institution
(Odell) Department of Surgery, Northwestern University Feinberg School of
Medicine, Illinois, Chicago
(Edwards) Department of Surgery, St. Joseph's Medical Center, Michigan,
Ann Arbor
(Fuller) Division of Cardiothoracic Surgery, Children's Hospital of
Philadelphia, Pennsylvania, Philadelphia
(Loor) Department of Surgery, Baylor College of Medicine, Houston, Texas,
United States
(Antonoff) Department of Thoracic and Cardiovascular Surgery, University
of Texas MD Anderson Cancer Center, Houston, Texas, United States
Publisher
Elsevier Inc.
Abstract
Background: As academic cardiothoracic surgeons focus on producing a new
generation of successful surgeon leaders, mentorship has emerged as one of
the most important variables influencing professional and personal success
and satisfaction. This review explores the literature to determine the
benefits, qualities, and features of the mentor relationship.
 Method(s): A comprehensive review was performed in February 2020 of
Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and the
SCOPUS Database using "'mentor"' as a primary search term. The titles and
abstracts of these publications were then reviewed by 2 of the authors to
identify relevant sources addressing topics related to mentorship in
cardiothoracic surgery and also to identify 4 specific areas of focus: (1)
the value of mentorship, (2) the skills needed to be an effective mentor,
(3) effective approaches for identifying and receiving mentorship, and (4)
the unique considerations associated with mentorship for traditionally
underrepresented populations in surgery. Result(s): Of 16,469
articles reviewed, 167 relevant manuscripts were identified, and 62 were
included. Conclusion(s): There is undeniable value in mentorship when
navigating a career in cardiothoracic surgery. By sharing the most
significant features and skills of both ideal mentors and mentees, this
review hoped to provide a framework to improve the quality of mentorship
from both sides. Copyright © 2022 The Society of Thoracic
Surgeons

<58>
Accession Number
2017201609
Title
Cerebral Embolic Protection during Transcatheter Aortic Valve
Implantation: Updated Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. (no pagination), 2022. Article Number:
101127. Date of Publication: 2022.
Author
Zahid S.; Ullah W.; Zia Khan M.; Faisal Uddin M.; Rai D.; Abbas S.; Usman
Khan M.; Hussein A.; Salama A.; Bandyopadhyay D.; Baibhav B.; Rao M.; Alam
M.; Alraies M.C.; Balla S.; Alkhouli M.; Depta J.P.
Institution
(Zahid, Faisal Uddin, Rai, Hussein, Salama, Baibhav, Rao, Depta)
Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, NY, United States
(Ullah, Usman Khan) Department of Cardiovascular Medicine, Thomas
Jefferson University Hospitals, Philadelphia, PA, United States
(Zia Khan, Balla) Division of Cardiovascular Medicine, West Virginia
University Heart & Vascular Institute, Morgantown, WV, United States
(Abbas) Department of Medicine, Dow Medical College, Karachi, Pakistan
(Bandyopadhyay) Division of Cardiovascular Medicine, Westchester Medical
Center at New York Medical College, Valhalla, New York, NY, United States
(Alam) Division of Cardiology, Baylor College of Medicine, Houston, TX,
United States
(Alraies) Division of Cardiology, Detroit Medical Center, Detroit, MI,
United States
(Alkhouli) Division of Interventional Cardiology, Mayo Clinic, Rochester,
MN, United States
Publisher
Elsevier Inc.
Abstract
In patient undergoing transcatheter aortic valve implantation (TAVI),
stroke remains a potentially devastating complication associated with
significant morbidity, and mortality. To reduce the risk of stroke,
cerebral protection devices (CPD) were developed to prevent debris from
embolizing to the brain during TAVI. We performed a systematic review and
meta-analysis to determine the safety and efficacy of CPD in TAVI. The
MEDLINE (PubMed, Ovid) and Cochrane databases were queried with various
combinations of medical subject headings to identify relevant articles.
Statistical analysis was performed using a random-effects model to
calculate unadjusted odds ratio (OR), including subgroup analyses based on
follow-up duration, study design, and type of CPD. Using a pooled
analysis, CPD was associated with a significant reduction in major adverse
cardiovascular events MACE (OR 0.75, 95% CI 0.70-0.81, P < 0.01),
mortality (OR 0.65, 95% CI 0.58-0.74, P < 0.01) and stroke (OR 0.84, 95%
CI 0.76-0.93, P < 0.01) in patients undergoing TAVI. Similarly, on MRI
volume per lesion were lower for patients with CPD use. No significant
difference was observed in acute kidney injury (OR 0.75, 95% CI 0.42-1.37,
P = 0.68), bleeding (OR 0.92, 95% CI 0.71-1.20, P = 0.55) or vascular
complications (OR 0.90, 95% CI 0.62-1.31, P = 0.6) for patients undergoing
TAVI with CPD. In conclusion, CPD device use in TAVI is associated with a
reduction of MACE, mortality, and stroke compared with patients undergoing
TAVI without CPD. However, the significant reduction in mortality is
driven mainly by observational studies. Copyright © 2022 Elsevier
Inc.

<59>
Accession Number
2017093925
Title
Association of preoperative vitamin D deficiency with the risk of
postoperative delirium and cognitive dysfunction: A meta-analysis.
Source
Journal of Clinical Anesthesia. 79 (no pagination), 2022. Article Number:
110681. Date of Publication: August 2022.
Author
Hung K.-C.; Wang L.-K.; Lin Y.-T.; Yu C.-H.; Chang C.-Y.; Sun C.-K.; Chen
J.-Y.
Institution
(Hung, Wang, Lin, Yu, Chen) Department of Anesthesiology, Chi Mei Medical
Center, Tainan City 71004, Taiwan (Republic of China)
(Hung, Wang, Lin) Department of Hospital and Health Care Administration,
College of Recreation and Health Management, Chia Nan University of
Pharmacy and Science, Tainan City 71710, Taiwan (Republic of China)
(Chang) Department of Neurology, Chi Mei Medical Center, Tainan City
71004, Taiwan (Republic of China)
(Chang) Center for General Education, Southern Taiwan University of
Science and Technology, Tainan 71004, Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung City
82445, Taiwan (Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan
(Republic of China)
Publisher
Elsevier Inc.
Abstract
Study objective: Despite vitamin D deficiency (VDD) associated with
cognitive dysfunction in the general population, the impacts of
preoperative VDD on postoperative delirium (POD) and cognitive dysfunction
(POCD) remain to be clarified. Design(s): Meta-analysis of cohort
studies. Setting(s): Postoperative care. Intervention(s):
Preoperative VDD as the prognostic factor. Patient(s): Adult patients
undergoing surgery. Measurements: Databases including MEDLINE, EMBASE,
Google scholar, and the Cochrane Library databases were searched from
inception to September 2021. Random-effects modeling was applied to the
pooling of results on the association between preoperative VDD and
POD/POCD. The primary outcome was the association of VDD with the risk of
POD/POCD, while the secondary outcomes included other prognostic factors
(e.g., hypertension) with the risk of POD/POCD. A prediction interval (PI)
was calculated to indicate the range of a true effect size of a future
study in 95% of all populations. Main Result(s): Meta-analysis of
seven observational studies involving 2673 patients showed that the pooled
incidence of POD/POCD was 29% (95% confidence interval (CI): 18% to 44%).
Our results demonstrated that preoperative VDD increased the risk of
POD/POCD [odds ratio (OR) = 1.54, 95% CI: 1.21-1.97, p < 0.01;
I2 = 29.2%, seven studies, 2673 patients; 95% PI: 0.89-2.67],
while vitamin D insufficiency was not associated with a higher risk of
POD/POCD (OR = 0.88, 95% CI: 0.49-1.57, p = 0.66; I2 = 62.6%,
four studies, 1410 patients; 95% PI: 0.09-8.79). The PI in our primary
outcome (i.e., 0.89 to 2.67) containing 1.0 suggested the possibility of
inconsistent results in future studies. Patients with POD/POCD were older
compared to those without. Hypertension, diabetes mellitus, male gender,
or smoking was not recognized as risk factors for POD/POCD.
 Conclusion(s): Our results demonstrated that preoperative vitamin D
deficiency was associated with postoperative cognitive impairment. Given
the prediction interval, more future studies are needed to elucidate
associations between VDD and POD/POCD. Copyright © 2022 Elsevier
Inc.

<60>
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)

<61>
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.

<62>
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.

<63>
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.

<64>
Accession Number
2016977254
Title
Efficacy and safety for the achievement of guideline-recommended lower
low-density lipoprotein cholesterol levels: a systematic review and
meta-analysis.
Source
European Journal of Preventive Cardiology. 28(18) (pp 2001-2009), 2021.
Date of Publication: 01 Dec 2021.
Author
Khan S.U.; Khan M.U.; Virani S.S.; Khan M.S.; Khan M.Z.; Rashid M.; Kalra
A.; Alkhouli M.; Blaha M.J.; Blumenthal R.S.; Michos E.D.
Institution
(Khan, Khan, Khan) Department of Medicine, West Virginia University, 1
Medical Center Drive, Morgantown, WV 26505, United States
(Virani) Michael E. DeBakey Veterans Affair Medical Center, Department of
Medicine, Baylor College of Medicine, 2002 Holcombe Blvd, Houston, TX
77030, United States
(Khan) Department of Medicine, John H Stroger Jr. Hospital of Cook County,
1969 Ogden Ave, Chicago, IL 60612, United States
(Rashid) Department of Cardiology, Keele Cardiovascular Research Group,
Keele University, Stoke-on-Trent, United Kingdom
(Kalra) Department of Cardiovascular Medicine, Heart and Vascular
Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United
States
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St
SW, Rochester, MN 55905, United States
(Blaha, Blumenthal, Michos) Division of Cardiology, Department of
Medicine, Johns Hopkins School of Medicine, 600 North Wolfe Street Blalock
524-D1, Baltimore, MD 21287, United States
(Blaha, Blumenthal, Michos) The Ciccarone Center for the Prevention of
Cardiovascular Disease, Johns Hopkins School of Medicine, 600 North Wolfe
Street, Blalock 524-D1, Baltimore, MD 21287, United States
Publisher
Oxford University Press
Abstract
Aim: The 2018 American Heart Association/American College of
Cardiology/Multi-Society Cholesterol Guidelines recommended the addition
of non-statins to statin therapy for high-risk secondary prevention
patients above a low-density lipoprotein cholesterol (LDL-C) threshold of
>=70 mg/dL (1.8 mmol/L). We compared effectiveness and safety of treatment
to achieve lower (<70) vs. higher (>=70 mg/dL) LDL-C among patients
receiving intensive lipid-lowering therapy (statins alone or plus
ezetimibe or proprotein convertase subtilisin/kexin type 9 inhibitors).
 Methods and Results: Eleven randomized controlled trials (130 070
patients), comparing intensive vs. less-intensive lipid-lowering therapy,
with follow-up >=6 months and sample size >=1000 patients were selected.
Meta-analysis was reported as random effects risk ratios (RRs) [95%
confidence intervals] and absolute risk differences (ARDs) as incident
cases per 1000 person-years. The median LDL-C levels achieved in lower
LDL-C vs. higher LDL-C groups were 62 and 103 mg/dL, respectively. At
median follow-up of 2 years, the lower LDL-C vs. higher LDL-C group was
associated with significant reduction in all-cause mortality [ARD -1.56;
RR 0.94 (0.89-1.00)], cardiovascular mortality [ARD -1.49; RR 0.90
(0.81-1.00)], and reduced risk of myocardial infarction, cerebrovascular
events, revascularization, and major adverse cardiovascular events (MACE).
These benefits were achieved without increasing the risk of incident
cancer, diabetes mellitus, or haemorrhagic stroke. All-cause mortality
benefit in lower LDL-C group was limited to statin therapy and those with
higher baseline LDL-C (>=100 mg/dL). However, the RR reduction in
ischaemic and safety endpoints was independent of baseline LDL-C or drug
therapy. Conclusion(s): This meta-analysis showed that treatment to
achieve LDL-C levels below 70 mg/dL using intensive lipid-lowering therapy
can safely reduce the risk of mortality and MACE. Copyright ©
2020 Published on behalf of the European Society of Cardiology. All rights
reserved.

<65>
Accession Number
2016976976
Title
Integration of FDG-PET/CT in the Diagnostic Workup for Staphylococcus
aureus Bacteremia: A Prospective Interventional Matched-cohort Study.
Source
Clinical Infectious Diseases. 73(11) (pp E3859-E3866), 2021. Date of
Publication: 01 Dec 2021.
Author
Ghanem-Zoubi N.; Kagna O.; Abu-Elhija J.; Mustafa-Hellou M.; Qasum M.;
Keidar Z.; Paul M.
Institution
(Ghanem-Zoubi, Paul) Infectious Diseases Institute, Rambam Health Care
Campus, Haifa, Israel
(Ghanem-Zoubi, Keidar, Paul) The Ruth and Bruce Rappaport Faculty of
Medicine, Technion, Israel Institute of Technology, Haifa, Israel
(Kagna, Keidar) Department of Nuclear Medicine, Rambam Health Care Campus,
Haifa, Israel
(Abu-Elhija, Mustafa-Hellou) Internal Medicine Department E, Rambam Health
Care Campus, Haifa, Israel
(Qasum) Internal Medicine Department D, Rambam Health Care Campus, Haifa,
Israel
Publisher
Oxford University Press
Abstract
Background: Staphylococcus aureus bacteremia (SAB) is uniquely
characterized by focal pyogenic complications that might not be apparent
clinically. We investigated the benefit of adding
fluorodeoxyglucose-positron emission tomography/computed tomography
(FDG-PET/CT) in the workup of patients with SAB. Method(s): In a
matched-cohort study patients with SAB (intervention group) were
prospectively recruited to undergo FDG-PET/CT 7-14 days after diagnosis.
Treatment was directed by FDG-PET/CT findings. Clinical outcomes were
compared with a control group of patients with SAB who had not undergone
FDG-PET/CT, matched by age, Charlson score, methicillin susceptibility,
and survival duration to FDG-PET/CT. The primary outcome was 90-day
mortality. Residual confounding was controlled through regression
analyses. Result(s): During the study period 149 patients with 151
separate episodes of SAB underwent FDG-PET/CT and were compared with 150
matched patients with 151 SAB episodes. Patients in the intervention group
acquired infections more frequently in the community and had less
frequently solid malignancies and more frequently high-risk SAB.
Ninety-day mortality in the intervention group was significantly lower
than in the control group (21/151 [13.9%] vs 43/151 [28.5%], P=.002). The
difference remained significant in a subgroup analysis of patients with
community-onset infections without malignancy and among patients with
low-risk SAB. Controlling for other risk factors for mortality, FDG-PET/CT
performance among all patients was independently associated with lower
mortality (OR,. 39; 95% CI,. 18-.84). Patients in the intervention group
had longer duration of treatment and more focus control procedures
performed compared with the control group. Conclusion(s): FDG-PET/CT
in patients with SAB seems to improve survival through guidance of
treatment duration and co-interventions. Copyright © 2020 The
Author(s) 2020. Published by Oxford University Press for the Infectious
Diseases Society of America. All rights reserved. For permissions, e-mail:
journals.permissions@oup.com.

<66>
Accession Number
2013079809
Title
Safety and efficacy of left atrial appendage closure using an epicardial
suture snaring device: Systematic review and current status.
Source
Journal of Cardiovascular Electrophysiology. 32(8) (pp 2189-2198), 2021.
Date of Publication: August 2021.
Author
Sabzwari S.R.A.; Mehta N.A.; Garg L.; Racharla L.; Kurtz E.; Afzal M.R.;
Turagam M.K.; Lakkireddy D.
Institution
(Sabzwari) Department of Electrophysiology, University of Colorado,
Aurora, CO, United States
(Mehta, Racharla) Department of Cardiology, Lehigh Valley Health Network,
Allentown, PA, United States
(Garg) Department of Electrophysiology, Hospital of the University of
Pennsylvania, PA, United States
(Kurtz) Department of Internal Medicine, Lehigh Valley Health Network,
Allentown, PA, United States
(Afzal) Department of Electrophysiology, Ohio State University, Columbus,
OH, United States
(Turagam) Department of Electrophysiology, The Mount Sinai Hospital, New
York City, NY, United States
(Lakkireddy) Department of Electrophysiology, Overland Park Regional
Medical Center, Overland Park, KS, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The LARIAT epicardial suture snaring device has been fraught
with technical challenges and procedural complications. Over time,
technique modification and improved operator experience have helped
overcome many of these challenges. Methods and Results: Studies
reporting left atrial appendage epicardial closure over a 12-year period
from 2009 to 2020 were evaluated. The primary efficacy outcome evaluated
was left atrial appendage closure with residual flow <=1 mm. Safety
outcomes evaluated were periprocedural and long term complications after
device placement. Nine studies consisting of 1430 patients were included
in this analysis, of which 1386 (97%) underwent successful device
placement. The mean age was 69.3 years, with a mean CHADS<inf>2</inf>-VASC
score of 3.78. Primary efficacy end point was achieved in 95.8% patients
immediately after device placement, and in 92.8% patients on long term
follow-up. Early procedural complications consisted of pericardial
effusion 5.6%, cardiac perforation 2.7%, pericarditis 2.6%, and need for
open heart surgery 1.5%. Long term complications consisted of all-cause
mortality 2.3%, stroke 1.5%, and left atrial appendage thrombus 2.3%.
Reduced complications were noted using micropuncture needles (2.20% vs.
10.14%; p <.0001), a longer duration pericardial drainage, and use of
anti-inflammatory medications (1.58% vs. 8.4%). Oral anticoagulation use
decreased from 44.7% to 22.9% post device implantation, and to 8.5% on
last clinical follow up. Conclusion(s): The LARIAT device is
effective in epicardial closure of the left atrial appendage. Improvement
in device techniques such as use of micropuncture needle, prophylactic
colchicine, and maintenance of a pericardial drain have helped improve
safety over time. Copyright © 2021 Wiley Periodicals LLC

<67>
Accession Number
2015132066
Title
The European bifurcation club Left Main Coronary Stent study: A randomized
comparison of stepwise provisional vs. systematic dual stenting strategies
(EBC MAIN).
Source
European Heart Journal. 42(37) (pp 3829-3839), 2021. Date of Publication:
01 Oct 2021.
Author
Hildick-Smith D.; Egred M.; Banning A.; Brunel P.; Ferenc M.; Hovasse T.;
Wlodarczak A.; Pan M.; Schmitz T.; Silvestri M.; Erglis A.; Kretov E.;
Lassen J.F.; Chieffo A.; Lefevre T.; Burzotta F.; Cockburn J.; Darremont
O.; Stankovic G.; Morice M.-C.; Louvard Y.
Institution
(Hildick-Smith, Cockburn) Sussex Cardiac Centre, Brighton and Sussex
University Hospitals, Brighton, United Kingdom
(Egred) Freeman Hospital, Newcastle upon Tyne, United Kingdom
(Banning) John Radcliffe Hospital, Oxford, United Kingdom
(Brunel) Hopital Prive, Dijon, France
(Ferenc) Universitats-Herzzentrum Bad Krozingem, Bad Krozingen, Germany
(Hovasse, Lefevre, Morice, Louvard) Institute Cardiovasculaire Paris Sud,
Massy, France
(Wlodarczak) Poland Miedziowe Centrum Zdrowia Lubin, Lubin, Poland
(Pan) Department of Cardiology, Reina Sofia Hospital, University of
Cordoba, Cordoba, Spain
(Schmitz) Elisabeth Hospital Essen, Essen, Germany
(Silvestri) Hopital Marseille, Marseille, France
(Erglis) Paul Stradins University Hospital, Riga, Latvia
(Kretov) Sibirskiy Federal Biomedical Research Center Novosibirsk,
Novosibirsk, Russian Federation
(Lassen) Rigshospitalet University of Copenhagen, Copenhagen, Denmark
(Chieffo) San Raffaele Scientific Institute, Milan, Italy
(Burzotta) Fondazione Policlinico Universitario A. Gemelli, Universita
Cattolica Del Sacro Cuore, Rome, Italy
(Darremont) Clinique Saint-Augustin - Elsan, 114 Avenue d'Ares, Bordeaux
33200, France
(Stankovic) Department of Cardiology, Clinical Centre of Serbia,
University of Belgrade, Belgrade, Serbia
Publisher
Oxford University Press
Abstract
Background: Patients with non-left-main coronary bifurcation lesions are
usually best treated with a stepwise provisional approach. However,
patients with true left main stem bifurcation lesions have been shown in
one dedicated randomized study to benefit from systematic dual stent
implantation. Methods and Results: Four hundred and sixty-seven
patients with true left main stem bifurcation lesions requiring
intervention were recruited to the EBC MAIN study in 11 European
countries. Patients were aged 71 +/- 10 years; 77% were male. Patients
were randomly allocated to a stepwise layered provisional strategy (n =
230) or a systematic dual stent approach (n = 237). The primary endpoint
(a composite of death, myocardial infarction, and target lesion
revascularization at 12 months) occurred in 14.7% of the stepwise
provisional group vs. 17.7% of the systematic dual stent group (hazard
ratio 0.8, 95% confidence interval 0.5-1.3; P = 0.34). Secondary endpoints
were death (3.0% vs. 4.2%, P = 0.48), myocardial infarction (10.0% vs.
10.1%, P = 0.91), target lesion revascularization (6.1% vs. 9.3%, P =
0.16), and stent thrombosis (1.7% vs. 1.3%, P = 0.90), respectively.
Procedure time, X-ray dose and consumables favoured the stepwise
provisional approach. Symptomatic improvement was excellent and equal in
each group. Conclusion(s): Among patients with true bifurcation left
main stem stenosis requiring intervention, fewer major adverse cardiac
events occurred with a stepwise layered provisional approach than with
planned dual stenting, although the difference was not statistically
significant. The stepwise provisional strategy should remain the default
for distal left main stem bifurcation intervention. Study registration:
http://clinicaltrials.gov NCT02497014. Copyright © 2021 Published
on behalf of the European Society of Cardiology. All rights reserved.

<68>
Accession Number
2016891607
Title
Post-stenting fractional flow reserve vs coronary angiography for
optimization of percutaneous coronary intervention (TARGET-FFR).
Source
European Heart Journal. 42(45) (pp 4656-4668), 2021. Date of Publication:
01 Dec 2021.
Author
Collison D.; Didagelos M.; Aetesam-Ur-Rahman M.; Copt S.; McDade R.;
McCartney P.; Ford T.J.; McClure J.; Lindsay M.; Shaukat A.; Rocchiccioli
P.; Brogan R.; Watkins S.; McEntegart M.; Good R.; Robertson K.; O'Boyle
P.; Davie A.; Khan A.; Hood S.; Eteiba H.; Berry C.; Oldroyd K.G.
Institution
(Collison, Didagelos, Aetesam-Ur-Rahman, McDade, McCartney, Lindsay,
Shaukat, Rocchiccioli, Brogan, Watkins, McEntegart, Good, Robertson,
O'Boyle, Davie, Khan, Hood, Eteiba, Berry, Oldroyd) West of Scotland
Regional Heart & Lung Centre, Golden Jubilee National Hospital, Agamemnon
Street, Clydebank G81 4DY, United Kingdom
(Collison, McCartney, Ford, McClure, Watkins, McEntegart, Good, Eteiba,
Berry, Oldroyd) Institute of Cardiovascular & Medical Sciences, University
of Glasgow, 126 University Place, Glasgow G12 8TA, United Kingdom
(Copt) University of Geneva, 24 rue de General-Dufour, Geneve 4 1211,
Switzerland
Publisher
Oxford University Press
Abstract
Aims A fractional flow reserve (FFR) value >=0.90 after percutaneous
coronary intervention (PCI) is associated with a reduced risk of adverse
cardiovascular events. TARGET-FFR is an investigator-initiated,
single-centre, randomized controlled trial to determine the feasibility
and efficacy of a post-PCI FFR-guided optimization strategy vs. standard
coronary angiography in achieving final post-PCI FFR values >=0.90.
Methods and results After angiographically guided PCI, patients were
randomized 1:1 to receive a physiology-guided incremental optimization
strategy (PIOS) or a blinded coronary physiology assessment (control
group). The primary outcome was the proportion of patients with a final
post-PCI FFR >=0.90. Final FFR <=0.80 was a prioritized secondary outcome.
A total of 260 patients were randomized (131 to PIOS, 129 to control) and
68.1% of patients had an initial post-PCI FFR <0.90. In the PIOS group,
30.5% underwent further intervention (stent post-dilation and/or
additional stenting). There was no significant difference in the primary
endpoint of the proportion of patients with final post-PCI FFR >=0.90
between groups (PIOS minus control 10%, 95% confidence interval -1.84 to
21.91, P = 0.099). The proportion of patients with a final FFR <=0.80 was
significantly reduced when compared with the angiography-guided control
group (-11.2%, 95% confidence interval -21.87 to -0.35], P = 0.045).
Conclusion Over two-thirds of patients had a physiologically suboptimal
result after angiography-guided PCI. An FFR-guided optimization strategy
did not significantly increase the proportion of patients with a final FFR
>=0.90, but did reduce the proportion of patients with a final FFR
<=0.80. Copyright © The Author(s) 2021. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<69>
Accession Number
2014592485
Title
Preserving the endothelial glycocalyx in patients undergoing
cardiopulmonary bypass: a prospective randomised interventional pilot
study of lidocaine and doxycycline (LiDEG trial) [version 1; peer review:
3 approved with reservations, 1 not approved].
Source
F1000Research. 9 (pp 1-16), 2021. Date of Publication: 2021.
Author
Pannekoek A.; Johnson M.; Buggy D.; Pavey W.
Institution
(Pannekoek, Johnson, Pavey) Fiona Stanley and Fremantle Hospitals, Perth,
WA, Australia
(Johnson, Buggy) School of Medicine and Medical Science, University
College Dublin, Dublin D4, Ireland
(Johnson, Pavey) University of Western Australia, Perth, WA, Australia
Publisher
F1000 Research Ltd
Abstract
Background: During major surgery, particularly heart surgery, an element
of the lining of blood vessels, known as the endothelial glycocalyx (EG),
can be damaged. This can lead to swelling, low oxygenlevels, kidney
failure and other problems, which delay recovery. There are laboratory
studies that show lidocaine (a local anaesthetic) and doxycycline (an
antibiotic) may help protect this lining. The study agents are widely
available, cheap and safe drugs. Trial design and objective: This is a
phase IV, single centre, prospective, unblinded, randomised,
parallel-group trial. The objectives of the trial are to investigate the
role of doxycycline and lidocaine as potential agents to reduce EG
shedding and correlate with early postoperative outcomes. Method(s):
60 adult patients undergoing heart surgery requiring cardiopulmonary
bypass (CPB) will be randomly assigned to one of three groups: doxycycline
group (oral doxycycline, 200mg preoperatively); lidocaine group
(perioperative intravenous lidocaine,1.5mg/kg bolus at induction followed
by 2mg/kg/hr infusion for the duration of surgery); and control group
(standard care). The randomisation will be undertaken using a sealed
opaque envelope method. The primary outcome will be the relative
difference in the biochemical marker of EG injury, syndecan-1, at
different timepoints in the intraoperative and early post-operative
period. Secondary endpoints include vasopressor requirements, markers of
organ dysfunction (lung, kidney, brain, arrhythmia), coagulation and
inflammation. Discussion(s): EG injury is ubiquitous in patients
undergoing CPB. Maintaining homeostasis of this delicate layer would
appear to be a valuable therapeutic target. To date no agents have been
shown to be effective in protecting the EG. Our study agents have shown
some promise in the preclinical setting and would represent a novel
therapeutic approach should they show a protective effect. Trial
registration: Australian New Zealand Clinical Trials Registry,
ACTRN12619000621112 (26th April 2019) Copyright ©
2020. Pannekoek A et al. This is an open access article distributed under
the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited

<70>
Accession Number
2013894802
Title
Comparison of outcomes of direct-acting oral anticoagulants vs. vitamin K
antagonists in patients with bioprosthetic heart valves or valve repair: A
systematic review and meta-analysis.
Source
European Review for Medical and Pharmacological Sciences. 25(15) (pp
5006-5017), 2021. Date of Publication: 2021.
Author
Tang L.-L.; Liang S.-W.; Shi H.-L.; Ye J.-J.
Institution
(Tang, Liang, Shi, Ye) Department of Pharmacy, XinChang County Hospital of
Traditional Chinese Medicine, Zhejiang Province, Shaoxing, China
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: To compare the outcomes between direct-acting oral
anticoagulants and vitamin K antagonists, particularly for risk of stroke
and bleeding, among patients with atrial fibrillation (AF) and
bioprosthetic heart valve replacement or repair. MATERIALS AND METHODS: A
systematic search was conducted in the PubMed, Scopus, Cochrane Database
of Systematic Reviews and Google scholar databases. Studies that were done
in patients with AF who underwent bioprosthetic heart valve replacement or
repair and that compared the outcomes between the use of direct-acting
oral anticoagulants (DOACs) and vitamin K antagonists were eligible for
inclusion. Studies that were preferably randomized controlled trials or
adopted a cohort approach or retrospective data-based studies were
considered for inclusion. The strength of association was presented in the
form of pooled hazards risk (HR). Statistical analysis was done using
STATA version 16.0. RESULT(S): A total of 8 articles were included in
the meta-analysis. There were no significant differences in the risk of
"all-cause stroke" [HR 0.72, 95% CI: 0.39, 1.34] and ischemic stroke [HR
0.79, 95% CI: 0.49, 1.29] between the two groups. The risk of "any
bleeding" [HR 0.74, 95% CI: 0.64, 0.87], major bleeding [HR 0.60, 95% CI:
0.42, 0.86] and intra-cranial bleeding [HR 0.54, 95% CI: 0.36, 0.81] was
much lower in those that received DOAC compared to warfarin. Compared to
those receiving warfarin, those on DOACs had substantially reduced risk of
any clinical thromboembolic events [HR 0.52, 95% CI: 0.39, 0.70]. No
significant differences were noted for all-cause mortality [HR 0.88, 95%
CI: 0.74, 1.05], cardiovascular events/myocardial infarction (MI) [HR
0.58, 95% CI: 0.33, 1.04] and and readmission rates [HR 0.85, 95% CI:
0.62, 1.18]. CONCLUSION(S): Findings suggest that the use DOACs in
patients with AF with bioprosthetic valve replacement or repair is
comparatively better than vitamin K antagonists in reducing the risk of
bleeding and thrombo-embolic events. Future studies with a randomized
design and larger sample sizes are needed to further substantiate these
findings. Copyright © 2021 Verduci Editore s.r.l. All rights
reserved.

<71>
Accession Number
2014177750
Title
Culprit lesion location and outcomes in patients with multivessel disease
and infarct-related cardiogenic shock: A core laboratory analysis of the
CULPRIT-SHOCK trial.
Source
EuroIntervention. 17(5) (pp E418-E424), 2021. Date of Publication: August
2021.
Author
Hauguel-Moreau M.; Barthelemy O.; Farhan S.; Huber K.; Rouanet S.;
Zeitouni M.; Guedeney P.; Hage G.; Vicaut E.; Zeymer U.; Desch S.; Thiele
H.; Montalescot G.
Institution
(Hauguel-Moreau, Barthelemy, Zeitouni, Guedeney, Hage, Montalescot)
Sorbonne Universite, ACTION Study Group, INSERM UMRS-1166, Institut de
Cardiologie (AP-HP), Paris, France
(Farhan) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Huber) 3rd Department of Medicine, Cardiology and Intensive Care
Medicine, Wilhelminen Hospital, Sigmund Freud University, Medical School,
Vienna, Austria
(Rouanet) Statistician Unit, StatEthic, Levallois-Perret, France
(Vicaut) ACTION Study Group, Unite de Recherche Clinique, Hopital
Lariboisiere (AP-HP), Paris, France
(Zeymer) Department of Cardiology, Heart Centre Ludwigshafen,
Ludwigshafen, Germany
(Desch, Thiele) Heart Center Leipzig, University of Leipzig, Leipzig Heart
Institute, Leipzig, Germany
Publisher
Europa Group
Abstract
Background: Critical culprit lesion locations (CCLL) such as left main
(LM) and proximal left anterior descending (LAD) are associated with worse
clinical outcome in myocardial infarction without cardiogenic shock (CS).
 Aim(s): We aimed to assess whether CCLL identify a subgroup of
patients with poorer prognosis when presenting with CS. Method(s): In
the CULPRIT-SHOCK trial, a core laboratory reviewed all coronary
angiograms to identify CCLL. A CCLL was defined as a culprit lesion with a
>70% diameter stenosis of the LM, LM equivalent (>70% diameter stenosis of
both proximal LAD and proximal circumflex), proximal LAD or last remaining
vessel. We evaluated the primary study endpoint of the CULPRIT-SHOCK trial
according to CCLL. Result(s): A total of 269 (43%) out of 626
patients eligible for this analysis had a CCLL. Death or renal replacement
therapy within 30 days, death within 30 days and death within one year
were significantly higher in the CCLL than in the non-CCLL group (58.4% vs
43.4%, p<0.001, 55.8% vs 39.5%, p<0.001, 61.0% vs 44.5%, p<0.001,
respectively). This was consistent after adjustment for baseline and
angiographic characteristics. No interaction with the randomisation group
(culprit lesion-only or immediate multivessel PCI) was found.
 Conclusion(s): CCLL is frequent in CS and independently associated
with worse clinical outcomes irrespective of the revascularisation
strategy. Trial registration: www.clinicaltrials.gov
NCT01927549. Copyright © Europa Digital & Publishing 2021. All
rights reserved.

<72>
Accession Number
2013627775
Title
The effects of high-intensity interval training, Nordic walking and
moderate-to-vigorous intensity continuous training on functional capacity,
depression and quality of life in patients with coronary artery disease
enrolled in cardiac rehabilitation: A randomized controlled trial (CRX
study).
Source
Progress in Cardiovascular Diseases. 70 (pp 73-83), 2022. Date of
Publication: 01 Jan 2022.
Author
Reed J.L.; Terada T.; Cotie L.M.; Tulloch H.E.; Leenen F.H.; Mistura M.;
Hans H.; Wang H.-W.; Vidal-Almela S.; Reid R.D.; Pipe A.L.
Institution
(Reed, Terada, Mistura, Hans, Vidal-Almela) Exercise Physiology and
Cardiovascular Health Lab, University of Ottawa Heart Institute, 40 Ruskin
Street, Ottawa, ON K1Y 4W7, Canada
(Reed) School of Epidemiology and Public Health, Faculty of Medicine,
University of Ottawa, Ottawa, Canada
(Reed, Vidal-Almela) School of Human Kinetics, Faculty of Health Sciences,
University of Ottawa, Ottawa, Canada
(Reed, Terada, Cotie, Tulloch, Mistura, Hans, Vidal-Almela, Reid, Pipe)
Division of Cardiac Prevention and Rehabilitation, University of Ottawa
Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Tulloch, Leenen, Reid, Pipe) School of Medicine, Faculty of Medicine,
University of Ottawa, Ottawa, Canada
(Leenen, Wang) Brain and Heart Research Group, University of Ottawa Heart
Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Vidal-Almela) Institut du savoir Montfort, Hopital Montfort, Ottawa,
Canada
Publisher
W.B. Saunders
Abstract
Background: Coronary artery disease (CAD) patients undergoing
revascularization procedures often experience ongoing, diminished
functional capacity, high rates of depression and markedly low quality of
life (QoL). In CAD patients, studies have demonstrated that high-intensity
interval training (HIIT) is superior to traditional moderate-to-vigorous
intensity continuous training (MICT) for improving functional capacity,
whereas no differences between Nordic walking (NW) and MICT have been
observed. Mental health is equally as important as physical health, yet
few studies have examined the impact of HIIT and NW on depression and QoL.
The purpose of this randomized controlled trial (RCT) was to compare the
effects of 12 weeks of HIIT, NW and MICT on functional capacity in CAD
patients. The effects on depression severity, brain-derived neurotrophic
factor (BDNF) and QoL were also examined. Method(s): CAD patients who
underwent coronary revascularization procedures were randomly assigned to:
(1) HIIT (4 x 4-min of high-intensity work periods at 85%-95% peak heart
rate [HR]), (2) NW (resting HR [RHR] + 20-40 bpm), or (3) MICT (RHR +
20-40 bpm) twice weekly for 12 weeks. Functional capacity (six-min walk
test [6MWT]), depression (Beck Depression Inventory-II [BDI-II]), BDNF
(from a blood sample), and general (Short-Form 36 [SF-36]) and
disease-specific (HeartQoL) QoL were measured at baseline and follow-up.
Linear mixed-effects models for repeated measures were used to test the
effects of time, group and time x group interactions. Result(s): N =
135 CAD patients (aged 61 +/- 7 years; male: 85%) participated. A
significant time x group interaction (p = 0.042) showed greater increases
in 6MWT distance (m) for NW (77.2 +/- 60.9) than HIIT (51.4 +/- 47.8) and
MICT (48.3 +/- 47.3). BDI-II significantly improved (HIIT: -1.4 +/- 3.7,
NW: -1.6 +/- 4.0, MICT: -2.3 +/- 6.0 points, main effect of time: p <
0.001) whereas BDNF concentrations did not change (HIIT: -2.5 +/- 9.6, NW:
-0.4 +/- 7.7, MICT: -1.2 +/- 6.4 ng/mL, main effect of time: p > 0.05).
Significant improvements in SF-36 and HeartQoL values were observed (main
effects of time: p < 0.05). HIIT, NW and MICT participants attended 17.7
+/- 7.5, 18.3 +/- 8.0 and 16.1 +/- 7.3 of the 24 exercise sessions,
respectively (p = 0.387). Conclusion(s): All exercise programmes
(HIIT, NW, MICT) were well attended, safe and beneficial in improving
physical and mental health for CAD patients. NW was, however,
statistically and clinically superior in increasing functional capacity, a
predictor of future cardiovascular events. Copyright © 2021
Elsevier Inc.

<73>
Accession Number
2015146759
Title
Risk of Pneumothorax Requiring Pleural Drainage after Drainless VATS
Pulmonary Wedge Resection: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 17(1) (pp 14-24), 2022. Date of Publication: January 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, Zuyderland Medical
Center, Heerlen, Netherlands
Publisher
SAGE Publications Ltd
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; I
2 = 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; I 2 = 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 (I 2 = 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; I 2 = 92%) and postoperative day 2 (SMD =
-1.28, 95% CI: -2.55 to -0.01, P = 0.05; I 2 = 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. Copyright © The
Author(s) 2022.

<74>
Accession Number
2015140023
Title
Efficacy of bilateral PECS II block in postoperative analgesia for
ultrafast track pediatric cardiac anesthesia.
Source
Egyptian Journal of Anaesthesia. 38(1) (pp 150-157), 2022. Date of
Publication: 2022.
Author
Kamal F.; Abd El-Rahman A.; Hassan R.M.; Helmy A.F.
Institution
(Kamal, Abd El-Rahman, Hassan, Helmy) Pain Management Department. Faculty
of Medicine, Ain Shams University, Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Effective analgesia after cardiac surgery contributes to fast
recovery, and discharge from the critical care unit. Aim(s): This
study was conducted to evaluate PECS II block for controlling
post-sternotomy pain in pediatric population in ultrafast track cardiac
surgery. Method(s): In this double-blind, randomized control trial,
40 children, 1-5 years old, underwent cardiac surgery via median
sternotomy, Group (A) control: Analgesics were administered intravenously.
Group (B): received 0.25% bupivacaine at 0.5 ml/kg divided equally to both
sides for PECS block. Result(s): PECS group had lower median Modified
Objective Pain Score (MOPS) immediately, two, four, and 6 h
postoperatively. PECS group had lower median fentanyl utilization by 35%
than the control group with median utilization of 2.72 (95% CI
2.490-2.960) mic/kg/in the first 24 hours in contrast to 4.17 (95% CI
3.834-4.516) mic/kg/in the first 24 hours in the control group (P <
0.001). First rescue analgesia was later in PECS group compared to the
control group with median time (7 hours) and (2 hours), respectively.
Furthermore, Pediatric Anesthesia Emergence Agitation (PAED) score was
lower in the intervention group with median 9.5 and 12 in the control
group (P < 0.001). PECS group had shorter ICU stay than the control group
(P < 0.05), with mean ICU stay 52 hours (95% CI 43.522-62.378) compared to
80.40 hours (95% CI 64.310-96.490). Conclusion(s): PECS block is an
efficient technique that can be implemented as an integral part of
fast-track cardiac surgery. Copyright © 2022 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<75>
Accession Number
2015865219
Title
Effect of Thoracic Paravertebral Nerve Block on Blood Coagulation in
Patients After Thoracoscopic Lobectomy: A Prospective Randomized
Controlled Clinical Trial.
Source
Journal of Pain Research. 15 (pp 633-641), 2022. Date of Publication:
2022.
Author
Yuan B.; Liu D.; Zhu Z.; Hao Y.; He K.; Deng S.
Institution
(Yuan, Liu, Zhu, Hao, He, Deng) Department of Anesthesiology, The First
Affiliated Hospital of Chongqing Medical University, Chongqing, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Ultrasound-guided thoracic paravertebral block (TPVB) has become
increasingly popular for postoperative analgesia after thoracic surgery.
We designed this prospective, randomized, double-blind, placebo-controlled
trial to investigate the effect of TPVB on blood coagulation in patients
after thoracoscopic lobectomy. Patients and Methods: Sixty patients
scheduled for thoracoscopic lobectomy were randomly allocated to two
groups. Patients underwent ultrasound-guided TPVB with 0.33% ropivacaine
(T group) or 0.9% saline (C group) at the end of the surgery under general
anesthesia. Patient-controlled intravenous analgesia (PCIA) was
administered for both group after the surgery. The primary outcome was the
thromboelastogram (TEG) parameters before anesthesia (T0), at the end of
operation (T1) and in 1 day (T2) and 2 days (T3) after the operation, the
second outcomes were the analgesic effect and the amount of intraoperative
opioid consumption, operation time, infusion volume, blood loss and urine
volume. Result(s): The visual analog scale (VAS) scores in group T
were lower than group C (P < 0.05). In group T, compared with T0, the R
value at T1 and T2 is significantly reduced, and the K value at T1 were
significantly shortened, the alpha-angle and MA value at T1 were
significantly increased (P < 0.05). In group C, compared with T0, the R
value and K value were significantly shortened, the alpha-angle and MA
value were significantly increased at all postoperative time points (P <
0.05). Compared with group C at the same time point, the R and K values of
group T were significantly longer, and the alpha-angle and MA values were
significantly reduced at T2 and T3 points, with statistically significant
differences (P<0.05). Conclusion(s): TPVB is beneficial to improve
postoperative hypercoagulability and promote postoperative rehabilitation
of patients after thoracoscopic lobectomy. Copyright © 2022 Yuan
et al.

<76>
Accession Number
637423324
Title
Use of Electronic Auscultation in Full Personal Protective Equipment to
Detect Ventilation Status in Selective Lung Ventilation: A Randomized
Controlled Trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 851395.
Date of Publication: 21 Feb 2022.
Author
Wei T.-J.; Hsiung P.-Y.; Liu J.-H.; Lin T.-C.; Kuo F.-T.; Wu C.-Y.
Institution
(Wei, Hsiung, Liu, Lin, Kuo, Wu) Department of Anesthesiology, National
Taiwan University Hospital, Taipei, Taiwan (Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Chest auscultation is the first procedure performed to detect endotracheal
tube malpositioning but conventional stethoscopes do not conform to the
personal protective equipment (PPE) protocol during the COVID-19 pandemic.
This double-blinded randomized controlled trial evaluated the feasibility
of using ear-contactless electronic stethoscope to identify endobronchial
blocker established selective lung ventilation, simulating endobronchial
intubation during thoracic surgery with full PPE. Conventional and
electronic auscultation was performed without and with full PPE,
respectively, of 50 patients with selective lung ventilation. The rates of
correct ventilation status detection were 86 and 88% in the conventional
and electronic auscultation groups (p = 1.00). Electronic auscultation
revealed a positive predictive value of 87% (95% CI 77 to 93%), and a
negative predictive value of 91% (95% CI 58 to 99%), comparable to the
results for conventional auscultation. For detection of the true
unilateral lung ventilation, the F1 score and the phi were 0.904 and
0.654, respectively for conventional auscultation; were 0.919 and 0.706,
respectively for electronic auscultation. Furthermore, the user experience
questionnaire revealed that the majority of participant anesthesiologists
(90.5%) rated the audio quality of electronic lung sounds as comparable or
superior to that of conventional acoustic lung sounds. In conclusion,
electronic auscultation assessments of ventilation status as examined
during thoracic surgery in full PPE were comparable in accuracy to
corresponding conventional auscultation assessments made without PPE.
Users reported satisfactory experience with the electronic
stethoscope. Copyright © 2022 Wei, Hsiung, Liu, Lin, Kuo and Wu.

<77>
Accession Number
637387653
Title
Diagnostic features, management and prognosis of type 2 myocardial
infarction compared to type 1 myocardial infarction: A systematic review
and meta-analysis.
Source
BMJ Open. 12(2) (no pagination), 2022. Article Number: e055755. Date of
Publication: 17 Feb 2022.
Author
White K.; Kinarivala M.; Scott I.
Institution
(White, Kinarivala, Scott) Internal Medicine and Clinical Epidemiology,
Princess Alexandra Hospital, Woolloongabba, QLD, Australia
(White, Scott) School of Clinical Medicine, University of Queensland,
Brisbane, QLD, Australia
Publisher
BMJ Publishing Group
Abstract
Importance Distinguishing type 2 (T2MI) from type 1 myocardial infarction
(T1MI) in clinical practice can be difficult, and the management and
prognosis for T2MI remain uncertain. Objective To compare precipitating
factors, risk factors, investigations, management and outcomes for T2MI
and T1MI. Data sources Medline and Embase databases as well as reference
list of recent articles were searched January 2009 to December 2020 for
term type 2 myocardial infarction'. Study selection Studies were included
if they used a universal definition of MI and reported quantitative data
on at least one variable of interest. Data extraction and synthesis Data
were pooled using random-effect meta-analysis. Risk of bias was assessed
using Newcastle-Ottawa quality assessment tool. Preferred Reporting Items
for Systematic Reviews and Meta-analyses guidelines were followed. All
review stages were conducted by two reviewers. Main outcomes and measures
Risk factors, presenting symptoms, cardiac investigations such as troponin
and angiogram, management and outcomes such as mortality. Results 40
cohort studies comprising 98 930 patients with T1MI and 13 803 patients
with T2MI were included. Compared with T1MI, patients with T2MI were: more
likely to have pre-existing chronic kidney disease (OR 1.87; 95% CI 1.53
to 2.28) and chronic heart failure (OR 2.35; 95% CI 1.82 to 3.03), less
likely to present with typical cardiac symptoms of chest pain (OR 0.19;
95% CI 0.13 to 0.26) and more likely to present with dyspnoea (OR 2.64;
95% CI 1.86 to 3.74); more likely to demonstrate non-specific ST-T wave
changes on ECG (OR 2.62; 95% CI 1.81 to 3.79) and less likely to show ST
elevation (OR 0.22; 95% CI 0.17 to 0.28); less likely to undergo coronary
angiography (OR 0.09; 95% CI 0.06 to 0.12) and percutaneous coronary
intervention (OR 0.06; 95% CI 0.04 to 0.10) or receive cardioprotective
medications, such as statins (OR 0.25; 95% CI 0.16 to 0.38) and
beta-blockers (OR 0.45; 95% CI 0.33 to 0.63). T2MI had greater risk of all
cause 1-year mortality (OR 3.11; 95% CI 1.91 to 5.08), with no differences
in short-term mortality (OR 1.34; 95% CI 0.63 to 2.85). Conclusion and
relevance This review has identified clinical, management and survival
differences between T2MI and T1MI with greater precision and scope than
previously reported. Differential use of coronary revascularisation and
cardioprotective medications highlight ongoing uncertainty of their
utility in T2MI compared with T1MI. Copyright ©

<78>
Accession Number
2017079091
Title
Current Status of Malignant Tumors after Organ Transplantation.
Source
BioMed Research International. 2022 (no pagination), 2022. Article Number:
5852451. 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
Hindawi Limited
Abstract
Objective. To analyze the diagnosis and treatment of patients with
concomitant malignant tumors after organ transplantation by compiling data
from organ transplantation patients. Methods. By searching CNKI and PubMed
databases, we made a systematic analysis of the studies of postorgan
transplantation complicating malignant tumors in the last decade. Results.
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. Conclusions. 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.

<79>
Accession Number
2015199630
Title
Prophylactic dexmedetomidine use did not decrease the incidence of
delirium in patients undergoing cardiac surgery: A meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Li W.; Liu H.; Yang C.
Institution
(Li, Liu, Yang) Department of Cardiovascular Medicine, Affiliated Hospital
of Shandong University of Traditional Chinese Medicine, Shandong, Jinan,
China
Publisher
SAGE Publications Ltd
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. Copyright © The Author(s) 2022.

<80>
Accession Number
2015145984
Title
Infective endocarditis by Serratia species: a systematic review.
Source
Journal of Chemotherapy. (no pagination), 2022. Date of Publication:
2022.
Author
Ioannou P.; Alexakis K.; Spentzouri D.; Kofteridis D.P.
Institution
(Ioannou, Alexakis, Spentzouri, Kofteridis) Department of Internal
Medicine & Infectious Diseases, University Hospital of Heraklion,
Heraklion, Greece
Publisher
Taylor and Francis Ltd.
Abstract
Serratia species are facultative anaerobes, non-spore-forming, motile
Gram-negative bacteria. Serratia spp. are currently thought to cause a
variety of infections, such as bacteremia, urinary tract infections, and
pneumonia, as well as other, less common infections, including ocular
infections or skin and soft tissue infections. On the other hand,
Infective Endocarditis (IE) is an infrequent disease with notable
morbidity and mortality. Even though IE is rarely caused by Serratia spp.,
these infections can be quite problematic due to the lack of experience in
their management. This study aimed to systematically review all published
cases of IE by Serratia spp. in the literature. A systematic review of
PubMed, Scopus, and Cochrane library (through 13th May 2021)
for studies providing epidemiological, clinical, microbiological data as
well as data on treatment and outcomes of IE by Serratia spp. was
performed. In total, 50 studies, containing data for 72 patients, were
included. A prosthetic valve was present in 18.1%. The mitral valve was
the most commonly infected site, followed by the aortic valve. The
diagnosis was facilitated by transthoracic echocardiography in 34.7%,
while the diagnosis was set at autopsy in 22.4%. Fever, sepsis, and
embolic phenomena were the most common clinical presentations, followed by
heart failure. Aminoglycosides, cephalosporins, and carbapenems were the
most commonly used antimicrobials. Clinical cure was noted only in 53.5%,
while overall mortality was 47.2%. Having surgery along with antimicrobial
treatment was independently associated with reduced overall mortality. IE
by Serratia spp. was more likely to be associated with intravenous drug
use, and to present with heart failure and embolic phenomena compared to
IE by other non-HACEK Gram-negative bacilli, while mortality was also
higher in IE by Serratia spp. Copyright © 2022 Edizioni Scientifi
che per l'Informazione su Farmaci e Terapia.

<81>
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.

<82>
Accession Number
2013593990
Title
Transcatheter Aortic Valve Replacement in Low-Risk Bicuspid and Tricuspid
Patients: Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 33 (pp 1-6), 2021. Date of
Publication: December 2021.
Author
Medranda G.A.; Rogers T.; Doros G.; Zhang C.; Case B.C.; Yerasi C.; Shults
C.C.; Waksman R.
Institution
(Medranda, Rogers, Doros, Zhang, Case, Yerasi, Waksman) Section of
Interventional Cardiology, MedStar Washington Hospital Center, Washington,
DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung and Blood Institute, National Institutes of Health, Bethesda,
MD, United States
(Shults) Department of Cardiac Surgery, MedStar Washington Hospital
Center, Washington, DC, United States
Publisher
Elsevier Inc.
Abstract
Background: Most pivotal transcatheter aortic valve replacement (TAVR)
trials have excluded patients with bicuspid aortic stenosis (AS). This
study compared TAVR in low-risk patients with bicuspid AS to those with
tricuspid AS, incorporating data from prospective trials. Method(s):
We selected prospective US low-risk TAVR trials containing a bicuspid arm
for this meta-analysis, examining outcomes at 30 days. Study results were
pooled using a hierarchical Bayesian random-effects model. Result(s):
Included were 3 Food and Drug Administration (FDA)-approved
investigational device exemption (IDE) trials that enrolled a total of
1810 low-risk patients with symptomatic severe AS for TAVR. We compared
380 bicuspid patients with 1430 tricuspid patients. Event rates at 30 days
overall were low, with similar mortality (odds ratio [OR], 0.38; 95%
credible interval [CrI]: 0.08, 1.78; I2, 0%), non-disabling
stroke (OR, 0.45; 95% CrI: 0.15, 1.07; I2, 9%), and permanent
pacemaker implantation (OR, 0.86; 95% CrI: 0.41, 1.47; I2,
59%). There were statistically significant differences in disabling stroke
(OR, 0.16; 95% CrI: 0.01, 0.90; I2, NA) and coronary
obstruction (OR, 0.21; 95% CrI: 0.05, 0.91) that disappeared after
sensitivity analysis by adding a single event to the tricuspid arm.
Hemodynamics were similar at 30 days. Conclusion(s): Preliminary data
from the FDA-approved IDE trials of low-risk patients with bicuspid AS
undergoing TAVR demonstrated 30-day outcomes comparable to low-risk
tricuspid patients, except for a trend toward higher stroke in bicuspid
patients. Randomized trials are warranted to reassure the safety and
long-term outcome of TAVR in patients with severe bicuspid
AS. Copyright © 2021

<83>
Accession Number
2013469863
Title
Comparison of Ticagrelor Versus Clopidogrel on Cerebrovascular
Microembolic Events and Platelet Inhibition during Transcatheter Aortic
Valve Implantation.
Source
American Journal of Cardiology. 154 (pp 78-85), 2021. Date of Publication:
01 Sep 2021.
Author
Vavuranakis M.A.; Kalantzis C.; Voudris V.; Kosmas E.; Kalogeras K.;
Katsianos E.; Oikonomou E.; Siasos G.; Aznaouridis K.; Toutouzas K.;
Stasinopoulou M.; Tountopoulou A.; Bei E.; Moldovan C.M.; Vrachatis D.;
Iakovou I.; Papaioannou T.G.; Tousoulis D.; Leucker T.M.; Vavuranakis M.
Institution
(Vavuranakis, Kalantzis, Kalogeras, Oikonomou, Siasos, Aznaouridis,
Toutouzas, Bei, Moldovan, Papaioannou, Tousoulis, Vavuranakis) Department
of Cardiology, National and Kapodistrian University of Athens,
Hippokration Hospital, Athens, Greece
(Voudris, Kosmas, Iakovou) Onassis Cardiac Surgery Center, Kallithea,
Greece
(Kalogeras, Katsianos, Oikonomou, Siasos, Vavuranakis) Department of
Cardiology, National and Kapodistrian University of Athens, Sotiria
Hospital, Athens, Greece
(Stasinopoulou) Agios Savvas - Anticancer Hospital, Athens, Greece
(Tountopoulou) Aiginiteio University Hospital, Athens, Greece
(Vrachatis) General Hospital of Athens "G. Gennimatas", Athens, Greece
(Vavuranakis, Leucker) Division of Cardiology, Department of Medicine,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
The impact of the antiplatelet regimen and the extent of associated
platelet inhibition on cerebrovascular microembolic events during
transcatheter aortic valve implantation (TAVI) are unknown. Our aim was to
evaluate the effects of ticagrelor versus clopidogrel and of platelet
inhibition on the number of cerebrovascular microembolic events in
patients undergoing TAVI. Patients scheduled for TAVI were randomized
previous to the procedure to either aspirin and ticagrelor or to aspirin
and clopidogrel. Platelet inhibition was expressed in P2Y12 reaction units
(PRU) and percentage of inhibition. High intensity transient signals
(HITS) were assessed with transcranial Doppler (TCD). Safety outcomes were
recorded according to the VARC-2 definitions. Among 90 patients
randomized, 6 had an inadequate TCD signal. The total number of procedural
HITS was lower in the ticagrelor group (416.5 [324.8, 484.2]) (42
patients) than in the clopidogrel group (723.5 [471.5, 875.0]) (42
patients), p <0.001. After adjusting for the duration of the procedure,
diabetes, extra-cardiac arteriopathy, BMI, hypertension, aortic valve
calcium content, procedural ACT, and pre-implantation balloon
valvuloplasty, patients on ticagrelor had on average 256.8 (95% CI:
[-335.7, -176.5]) fewer total procedural HITS than patients on
clopidogrel. Platelet inhibition was greater with ticagrelor 26 [10, 74.5]
PRU than with clopidogrel 207.5 (120 to 236.2) PRU, p <0.001, and
correlated significantly with procedural HITS (r = 0.5, p <0.05). In
conclusion, ticagrelor resulted in fewer procedural HITS, compared with
clopidogrel, in patients undergoing TAVI, while achieving greater platelet
inhibition. Copyright © 2021

<84>
Accession Number
2013110474
Title
Effect of strict intraoperative blood pressure management strategy on
postoperative acute kidney injury in non-cardiac surgery: A meta-analysis
of randomised controlled trials.
Source
International Journal of Clinical Practice. 75(11) (no pagination), 2021.
Article Number: e14570. Date of Publication: November 2021.
Author
Tu M.-Y.; Hong S.; Lu J.; Liu Y.-H.; Deng M.
Institution
(Tu, Hong, Liu, Deng) Department of Anesthesiology, Huashan Hospital of
Fudan University, Shanghai, China
(Lu) Department of Anesthesiology, Huashan Hospital North Affiliated to
Fudan University, Shanghai, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Acute kidney injury (AKI) is one of the most serious
perioperative complications. 20% to 40% of high-risk patients who undergo
non-cardiac surgery have AKI and those with AKI are eight-times more
likely to die within 30 days after surgery. It may be related to
intraoperative hypotension, which is mainly caused by vasodilatory and
cardiodepressant effects of anaesthesia, and/or hypovolemia. Strict
intraoperative blood pressure management strategy (strict BP management)
is a potential option to prevent postoperative AKI. This strategy refers
to additional administration of vasoactive agents under the premise of a
protocolised fluid delivery. The efficacy of strict BP management for
preventing postoperative AKI in non-cardiac surgery patients was assessed
by a meta-analysis. Method(s): We systematically retrieved randomised
controlled trials (RCTs) and compared strict BP management with
conventional therapy control on effect of postoperative AKI in non-cardiac
surgery patients, which were published on PubMed, EMBASE, Cochrane library
and Web of Science databases before October 5, 2020. Ultimately, a
meta-analysis of all RCTs eligible for inclusion criteria was performed.
 Result(s): Five RCTs, comprising 1485 patients, were included in the
meta-analysis. Strict BP management was associated with a reduced
incidence of postoperative AKI [relative risk (RR) = 0.73, 95% confidence
interval (CI): 0.58-0.92, P =.007]. No significant difference was found
between strict BP management group and conventional therapy control in
mortality at longest follow-up available (RR = 0.92, 95% CI: 0.68-1.25, P
=.60). In the subset analysis, the studies using supranormal BP management
target was significantly lower in the incidence of postoperative AKI (RR =
0.65, 95% CI: 0.51-0.82, P =.0003). Conclusion(s): Strict BP
management is significantly more effective than conventional therapy for
the prevention of postoperative AKI. Supranormal target of intraoperative
BP management may be considered a more appealing option for the prevention
of AKI. Copyright © 2021 John Wiley & Sons Ltd

<85>
Accession Number
2012840618
Title
Association between perioperative chlorhexidine oral care and
postoperative pneumonia in non-cardiac surgical patients: A systematic
review and meta-analysis.
Source
Surgery (United States). 170(5) (pp 1418-1431), 2021. Date of Publication:
November 2021.
Author
Liang S.; Zhang X.; Hu Y.; Yang J.; Li K.
Institution
(Liang, Zhang, Hu, Li) West China School of Nursing, West China Hospital,
Sichuan University, Chengdu, China
(Yang) Department of Gastrointestinal Surgery, West China School of
Nursing, West China Hospital, Sichuan University, Chengdu, China
Publisher
Elsevier Inc.
Abstract
Background: Postoperative pneumonia is the third most common complication
after surgery, and its occurrence is associated with a poor prognosis in
patients. Perioperative chlorhexidine oral care has been reported to
reduce the incidence of postoperative pneumonia in patients undergoing
cardiac surgery. However, whether perioperative chlorhexidine oral care
can reduce the incidence of postoperative pneumonia in noncardiac surgical
patients is still unknown. The aim of this systematic review and
meta-analysis was to determine the association between perioperative
chlorhexidine oral care and postoperative pneumonia in noncardiac surgical
patients. Method(s): A comprehensive systematic search of PubMed,
Ovid Embase, Web of Science, the Cochrane Library, Wanfang Database, and
the China National Knowledge Infrastructure was conducted to include
studies from the inception of each database through March 2021. The
reference lists of all included studies were also searched by hand.
Eligible studies were published and unpublished randomized controlled
trials and observational studies evaluating the effect of perioperative
chlorhexidine oral care on the reported incidence of postoperative
pneumonia. Relative risks or odds ratio with their 95% confidence
intervals were calculated and risk of bias was assessed for eligible
studies. Result(s): Seven randomized controlled trials with a total
of 1,773 patients and 3 observational studies with a total of 12,528
noncardiac surgical patients were included. A total of 621 and 5,904
patients received perioperative chlorhexidine oral care in randomized
controlled trials and observational studies, respectively. Six (85%)
randomized controlled trials had a high risk of bias, and 2 (67%)
observational studies had a high quality. Perioperative chlorhexidine oral
care significantly reduced the incidence of postoperative pneumonia in
randomized controlled trials (relative risk, 0.60; 95% confidence
interval, 0.44-0.80; P < .001) and observational studies (odds ratio,
0.26; 95% confidence interval, 0.08-0.90; P = .03). Conclusion(s):
Perioperative chlorhexidine oral care led by a nurse significantly
decreases the incidence of postoperative pneumonia in noncardiac surgical
patients and may be more convenient and economical compared with dental
professional-led perioperative oral care. Copyright © 2021
Elsevier Inc.

<86>
Accession Number
633261873
Title
Atrial nitroso-redox balance and refractoriness following on-pump cardiac
surgery: a randomized trial of atorvastatin.
Source
Cardiovascular research. 118(1) (pp 184-195), 2022. Date of Publication:
07 Jan 2022.
Author
Jayaram R.; Jones M.; Reilly S.; Crabtree M.J.; Pal N.; Goodfellow N.;
Nahar K.; Simon J.; Carnicer R.; DeSilva R.; Ratnatunga C.; Petrou M.;
Sayeed R.; Roalfe A.; Channon K.M.; Bashir Y.; Betts T.; Hill M.; Casadei
B.
Institution
(Jayaram, Reilly, Crabtree, Pal, Goodfellow, Nahar, Simon, Carnicer,
Channon, Casadei) Division of Cardiovascular Medicine, Radcliffe
Department of Medicine, University of Oxford, West Wing, Oxford OX3 9DU,
United Kingdom
(Jones, Bashir, Betts) Cardiology, Oxford Heart Centre, Oxford University
Hospitals NHS Foundation Trust, Oxford, United Kingdom
(DeSilva, Ratnatunga, Petrou, Sayeed) Cardiothoracic Surgery, Oxford Heart
Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United
Kingdom
(Roalfe) Nuffield Department of Primary Care Health Sciences, University
of Oxford, Oxford, United Kingdom
(Hill) Clinical Trial Service Unit, Nuffield Department of Population
Health, University of Oxford, Oxford, United Kingdom
Publisher
NLM (Medline)
Abstract
AIMS: Systemic inflammation and increased activity of atrial
NOX2-containing NADPH oxidases have been associated with the new onset of
atrial fibrillation (AF) after cardiac surgery. In addition to lowering
LDL-cholesterol, statins exert rapid anti-inflammatory and antioxidant
effects, the clinical significance of which remains controversial. METHODS
AND RESULTS: We first assessed the impact of cardiac surgery and
cardiopulmonary bypass (CPB) on atrial nitroso-redox balance by measuring
NO synthase (NOS) and GTP cyclohydrolase-1 (GCH-1) activity, biopterin
content, and superoxide production in paired samples of the right atrial
appendage obtained before (PRE) and after CPB and reperfusion (POST) in
116 patients. The effect of perioperative treatment with atorvastatin
(80mg once daily) on these parameters, blood biomarkers, and the
post-operative atrial effective refractory period (AERP) was then
evaluated in a randomized, double-blind, placebo-controlled study in 80
patients undergoing cardiac surgery on CPB. CPB and reperfusion led to a
significant increase in atrial superoxide production (74% CI 71-76%, n=46
paired samples, P<0.0001) and a reduction in atrial tetrahydrobiopterin
(BH4) (34% CI 33-35%, n=36 paired samples, P<0.01), and in GCH-1 (56% CI
55-58%, n=26 paired samples, P<0.001) and NOS activity (58% CI 52-67%,
n=20 paired samples, P<0.001). Perioperative atorvastatin treatment
prevented the effect of CPB and reperfusion on all parameters but had no
significant effect on the postoperative right AERP, troponin release, or
NT-proBNP after cardiac surgery. CONCLUSION(S): Perioperative statin
therapy prevents post-reperfusion atrial nitroso-redox imbalance in
patients undergoing on-pump cardiac surgery but has no significant impact
on postoperative atrial refractoriness, perioperative myocardial injury,
or markers of postoperative LV function. CLINICAL TRIAL REGISTRATION:
https://clinicaltrials.gov/ct2/show/NCT01780740. Copyright © The
Author(s) 2020. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<87>
Accession Number
2017123210
Title
Randomised open-label trial comparing intravenous iron and an
erythropoiesis-stimulating agent versus oral iron to treat preoperative
anaemia in cardiac surgery (INITIATE trial).
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Kong R.; Hutchinson N.; Hill A.; Ingoldby F.; Skipper N.; Jones C.;
Bremner S.; Bruce C.; Wright J.; Lewis M.; Newman S.; Chevassut T.;
Hildick-Smith D.
Institution
(Kong, Hutchinson, Hill) Department of Anaesthesia, Royal Sussex County
Hospital, UK, Brighton, United Kingdom
(Ingoldby, Skipper) University Hospitals Sussex NHS Foundation Trust,
Clinical Research Facility, Cardiac Research, UK, Brighton, United Kingdom
(Jones, Bremner, Bruce) Brighton and Sussex Clinical Trials Unit, Brighton
& Sussex Medical School, University of Sussex, UK, Brighton, United
Kingdom
(Wright) Brighton and Sussex Medical School, UK, Brighton, United Kingdom
(Lewis) Department of Cardiac Surgery, Royal Sussex County Hospital, UK,
Brighton, United Kingdom
(Newman) School of Health Sciences, University of London, UK, London,
United Kingdom
(Chevassut) Department of Haematology, Royal Sussex County Hospital, UK,
Brighton, United Kingdom
(Hildick-Smith) Department of Cardiology, Royal Sussex County Hospital,
UK, Brighton, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Preoperative anaemia is a risk factor for adverse
postoperative outcomes after cardiac surgery. Iron deficiency is a
frequent cause of low preoperative haemoglobin. An effective treatment for
preoperative anaemia associated with iron deficiency has not been
determined. Method(s): We conducted a single-centre, open-label,
pragmatic randomised trial, enrolling 156 elective cardiac surgery
patients who had low preoperative haemoglobin (100-130 g L-1)
with iron deficiency (serum ferritin <100 mug L-1 or
transferrin saturation <30%) to compare intravenous ferric derisomaltose
1000 mg and darbepoetin 200 mug subcutaneously (intervention group) with
oral ferrous sulphate 600 mg daily (control group). The primary outcome
was transfusion of at least one unit of allogeneic red cells during
surgery and within the following 5 days. Secondary outcomes included the
change in haemoglobin concentration between randomisation and surgery, red
cell transfusion volume, postoperative blood loss, pre-specified
postoperative complications, length of hospital stay, and in-hospital
death. Result(s): The odds of red cell transfusion were lower in the
intervention group compared with the control group (adjusted odds
ratio=0.33; 95% confidence interval [CI], 0.15-0.75; P=0.008). Of the
secondary outcomes, the only significant difference was the increase in
haemoglobin between randomisation and surgery, intervention vs control 9.5
g L-1 (95% CI, 6.8-12.2; P<0.001). Conclusion(s): In
patients with a low preoperative haemoglobin and iron deficiency,
preoperative treatment with a single dose of ferric derisomaltose and
darbepoetin decreased the proportion of participants who received a
perioperative blood transfusion as a consequence of a greater increase in
haemoglobin compared with treatment with oral ferrous sulphate. Clinical
trial registration: ISRCTN Number: 41421863; EUDRACT number:
2011-003695-36. Copyright © 2022 British Journal of Anaesthesia

<88>
Accession Number
637036757
Title
In low-risk patients aged >70-75 with severe aortic stenosis, is
transcatheter superior to surgical aortic valve replacement in terms of
reported cardiovascular composite outcomes and survival?.
Source
Interactive cardiovascular and thoracic surgery. 34(1) (pp 40-44), 2022.
Date of Publication: 06 Jan 2022.
Author
Magro P.L.; Sousa-Uva M.
Institution
(Magro, Sousa-Uva) Department of Cardiothoracic Surgery, Hospital de Santa
Cruz, Carnaxide, Portugal
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was: In low-risk patients aged
>70-75 with severe aortic stenosis, is transcatheter superior to surgical
aortic valve replacement in terms of reported composite outcomes and
survival? More than 73 papers were found using the reported search, of
which 8 represented the best evidence to answer the clinical question. The
authors, journal, date and country of publication, patient group studied,
study type, relevant outcomes and results of these papers were tabulated.
The only low-risk randomized control trial to date [Nordic Aortic Valve
Intervention (NOTION)] regarding an elderly population did not show a
statistically significant difference between the 2 approaches regarding
the composite endpoint of death, stroke or myocardial infarction. A
subgroup analysis of elderly patients in the 2 main low-risk randomized
control trials did not yield statistically different results from those of
the overall population; the results indicated the superiority of
transcatheter aortic valve implantation regarding the composite of death,
stroke or rehospitalization at 1year [The Safety and Effectiveness of the
SAPIEN 3 Transcatheter Heart Valve in Low Risk Patients With Aortic
Stenosis (PARTNER 3)] and non-inferiority regarding a composite of death
or stroke at 2years [Medtronic Evolut Transcatheter Aortic Valve
Replacement in Low-Risk Patients (Evolut LR)]. The results from lower
evidence studies are largely consistent with these findings. Overall,
there is no compelling evidence indicating that older age should be an
isolated criterion for the choice between transcatheter aortic valve
replacement and surgical aortic valve replacement in otherwise low-risk
patients. The superiority of either technique regarding the aforementioned
composite short-term outcomes in this particular subgroup of patients is
unclear. Copyright © The Author(s) 2021. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<89>
Accession Number
637428742
Title
Effect of surgery on cardiac structure and function in mild primary
hyperparathyroidism.
Source
Osteoporosis International. Conference: World Congress on Osteoporosis,
Osteoarthritis and Musculoskeletal Diseases, WCO-IOF-ESCEO 2021. London
United Kingdom. 32(SUPPL 1) (pp S133), 2022. Date of Publication: 2022.
Author
Zidrou C.; Beletsiotis A.
Institution
(Zidrou, Beletsiotis) 2nd Orthopaedic Dept., G. Papageorgiou General
Hospital, Thessaloniki, Greece
Publisher
Springer London
Abstract
Objective: The cardiovascular (CV) risk profile is worsened in primary
hyperparathyroidism (PHPT), and CV mortality is related to serum calcium
levels. It is unknown whether CV mortality is increased in the most common
form of PHPT and whether the increased CV risk is reversible after
surgery. The purpose of this study is to investigate the morbidity of
parathyroidectomy compared with observation without operation in patients
with mild primary hyperparathyroidism. Furthermore, the study researches
for recording simultaneously reversibility of echocardiographic changes in
mild primary hyperparathyroidism after surgery treatment. Method(s):
From January 2012 to December 2019, 30 patients were involved, of which 15
were randomized to observation (1st subgroup) and 15 for parathyroidectomy
(2nd subgroup). The inclusion criteria were mild PHPT without the
appearance of symptoms, corrected calcium levels for albumin between
2.60-2.85 mmol/l, age between 50-80 y, without taking other drugs that
affect calcium metabolism. At baseline and after 2 y, a biochemist and
echocardiographic control was conducted. Result(s): In the 2-y
follow-up, the corrected calcium levels and those of PTH were
significantly lower in the 2nd subgroup. Instead, there seemed no
significant differences in blood pressure, heart rate, BMI, inflammatory
markers, cholesterol and other cardiovascular risk markers. The
echocardiography did not show significant differences between subgroups in
heart function and dimensions, except a marginal reduction in left
ventricular mass and the mass ratio of the left ventricle in the 2nd
subgroup, suggesting reversibility of left ventricular hypertrophy even in
mild PHPT. Simultaneously, to the 2nd subgroup, a decrease of septum size
was found. Unlike other studies, no correlation was observed between
vitamin D and echocardiographic variables. Conclusion(s): It is safe
to observe without surgery patients with mild PHPT for a few years and
suggest that longer follow-up may yield larger and clinically important
differences.

<90>
Accession Number
2013824671
Title
The Effect of Supervised Early Resistance Training Versus Aerobic-Based
Rehabilitation on Cognitive Recovery Following Cardiac Surgery via Median
Sternotomy (SEcReT): A Pilot Randomised Controlled Trial.
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 S93), 2021.
Date of Publication: January 2021.
Author
Pengelly J.; Royse C.; Williams G.; Bryant A.; Clarke-Errey S.; Royse A.;
El-Ansary D.
Institution
(Pengelly, Royse, Royse, El-Ansary) Department of Nursing and Allied
Health, Swinburne University Of Technology, Hawthorn, Vic, Australia
(Pengelly) School of Science, Psychology and Sport, Federation University
Australia, Ballarat, Vic, Australia
(Royse, Royse, El-Ansary) Department of Surgery, University of Melbourne,
Parkville, Vic, Australia
(Royse) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Parkville, Vic, Australia
(Royse) Australian Director, Outcomes Research Consortium Cleveland
Clinic, Cleveland, OH, United States
(Williams, Bryant) Department of Physiotherapy, University of Melbourne,
Parkville, Vic, Australia
(Clarke-Errey) Statistical Consulting Centre, University of Melbourne,
Parkville, Vic, Australia
(Royse) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
Parkville, Vic, Australia
(El-Ansary) Clinical Research Institute, Westmead Private Hospital,
Westmead, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Post-operative cognitive impairment remains the most prevalent
adverse outcome following cardiac surgery. This study aimed to investigate
the effects of a 12-week early moderate-intensity resistance training
program compared to aerobic-based rehabilitation on post-operative
cognitive recovery following cardiac surgery via median sternotomy.
 Method(s): This was a multicentre, prospective, pragmatic,
non-blinded, pilot randomised controlled trial of two parallel groups that
compared a 12-week early moderate-intensity resistance training program
performed on CAM-based machines (n=14) to a control group, receiving
aerobic-based rehabilitation (n=17). 31 adults undergoing elective cardiac
surgery via median sternotomy were randomised 1:1 using sealed envelopes,
with allocation revealed after surgery. The primary outcome was cognitive
function, assessed using the Alzheimer's Disease Assessment Scale-
cognitive subscale (ADAS-cog), at baseline, 14 weeks, and 6 months
post-operatively. Result(s): ADAS-cog score at 14 weeks was
significantly better for the resistance training group (n=14, 7.2+/-1.4;
95% CI 4.3, 10.2, vs. n=17, 9.2+/-1.3; 95% CI 6.6, 11.9, p=0.010). At
14-weeks post-operatively, 53% of the aerobic-based rehabilitation group
(n= 9/17) experienced cognitive decline by 2-points or more from baseline
ADAS-cog score, compared to 0% of the resistance training group (n=0/14;
p=0.001). No major adverse cardiovascular or cerebral events or serious
adverse events were experienced for the duration of the study.
 Conclusion(s): Early resistance training improves cognitive recovery,
and appears to have a protective cognitive effect, when compared to
standard, aerobic-based rehabilitation following cardiac surgery via
median sternotomy. Trial registration: Prospectively registered with the
Australian New Zealand Clinical Trials Registry (ID: ACTRN12617001430325p)
on 9 October 2017. Copyright © 2021

<91>
Accession Number
2013824609
Title
In Patients Undergoing Open Thoracic Aortic Surgery Does Frailty
Assessment Predict Cardiovascular Events or Mortality?.
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 S255-S256),
2021. Date of Publication: January 2021.
Author
Sharma A.; Seevanayagam S.
Institution
(Sharma, Seevanayagam) University of Melbourne, Melbourne, Vic, Australia
(Seevanayagam) Austin Hospital, Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Aims: With a globally ageing population, frailty and its impact on
clinical outcomes is increasingly recognised in preoperative risk
stratification. Open thoracic aortic surgery is often considered a
high-risk procedure and existing risk stratification models (e.g.,
EuroScore/STS score) fail to incorporate frailty. In this study, we aimed
to critically review existing literature about whether frailty assessment
in open thoracic aortic surgery patients predicts cardiovascular events or
mortality. Method(s): We performed a systematic review of the
literature, searching MEDLINE and EMBASE (Ovid platform) using MeSH terms.
We followed PRISMA guidelines - 153 titles/abstracts screened,16 full
texts reviewed, 7 full texts included. Studies discussing frailty
exclusively in interventional cardiology procedures were excluded.
 Result(s): Sarcopenia, a marker of frailty, correlated negatively
with overall survival (HR:2.59) and post-operative cardiac complications
occurred at higher rates in the sarcopenic group (p=0.006). Gait speed,
another surrogate marker for frailty, was found to be a preoperative
indicator for postoperative events, including in-hospital mortality
(OR:2.09). Studies using a frailty scale combining age, BMI, anaemia,
nutritional status, sarcopenia, stroke history +/- renal dysfunction found
frailty to be an independent predictor for 1-year mortality (OR:4.5) and
reported on significant differences in late term survival between frail vs
non-frail groups (p=0.0001). Conclusion(s): There is a paucity of
literature regarding frailty assessment in open thoracic aortic surgery.
Our review concludes that frailty assessment can be of predictive value
for post-operative harm. It may therefore have an important role to play
in patient risk stratification and preoperative workup. Copyright
© 2021

<92>
Accession Number
2013824410
Title
Effect of Empagliflozin on Total Events of Myocardial Infarctions by
Subtype in the EMPA-REG OUTCOME Trial.
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 S220-S221),
2021. Date of Publication: January 2021.
Author
Hamilton A.; Fitchett D.; Zinman B.; Inzucchi S.; Wanner C.; Anker S.;
Pocock S.; Kaspers S.; Mattheus M.; Vedin O.; Hantel S.; Lund S.
Institution
(Hamilton) Nightingale Cardiology, Adelaide, SA, Australia
(Fitchett) St Michael's Hospital, Division of Cardiology, University of
Toronto, Toronto, ON, Canada
(Zinman) Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital,
University of Toronto, Toronto, ON, Canada
(Inzucchi) Section of Endocrinology, Yale University School of Medicine,
New Haven, CT, United States
(Wanner) Wurzburg University Clinic, Wurzburg, Germany
(Anker) Charite University, Berlin, Germany
(Pocock) Department of Medical Statistics, London School of Hygiene &
Tropical Medicine, London, United Kingdom
(Kaspers, Lund) Boehringer Ingelheim International GmbH, Ingelheim,
Germany
(Mattheus) Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
(Vedin) Boehringer Ingelheim AB, Stockholm, Sweden
(Hantel) Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
Publisher
Elsevier Ltd
Abstract
Introduction: In EMPA-REG OUTCOME, empagliflozin (EMPA) reduced the risk
of myocardial infarction (MI) in patients with type 2 diabetes and
established atherosclerotic cardiovascular disease. Here we report the
effects of EMPA on the total number of MIs by subtype. Method(s):
Patients were randomised to EMPA 10 mg, 25 mg, or placebo. We assessed the
effect of pooled EMPA (10/25 mg) versus placebo on total (first+recurrent)
events of fatal and non-fatal MI using a negative binomial model.
Post-hoc, we analysed established MI subtypes: Type 1: Plaque-rupture or
thrombus related; Type 2: Supply-demand; Type 3: Sudden-death related
(i.e., fatal MI); Type 4: Percutaneous coronary intervention related; Type
5: Coronary artery bypass graft related. MIs were centrally adjudicated
and could be assigned to more than one subtype. Result(s): Among
7,020 patients, there were 421 total MI events; 299, 86, 26, 19, and 1
were classified as type 1, 2, 3, 4, and 5, respectively. EMPA reduced the
risk of total MI events by 21% versus placebo (rate ratio (RR) [95% CI],
EMPA versus placebo: 0.79 [0.620; 0.998], p=0.0486; each MI only counted
once). The overall reduction in total MI events by EMPA was driven by type
1, 2 and 3 MIs (RR 0.67-0.79 across subtypes; p>0.05 for all), with
limited number of type 4 (n=19) (RR 1.84; p=0.2780), and 5 (n=1) (no
statistical analysis) MIs. Conclusion(s): EMPA reduced the risk of
total MI events with consistent effects across the most common MI
aetiologies: type 1 (plaque-rupture or thrombus) and 2
(supply-demand). Copyright © 2021

<93>
Accession Number
2013824356
Title
Sex Differences in Mortality After Coronary Artery Bypass Graft Surgery: A
Systematic Review and 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 S259),
2021. Date of Publication: January 2021.
Author
Matthews S.; O'Neil A.; Sanders J.; Buttery A.; Maraosco S.; Fredericks
S.; Martorella G.; Keenan N.; Ganes A.; Wynne R.
Institution
(Matthews, Buttery) The National Heart Foundation of Australia, Melbourne,
Vic, Australia
(Matthews) University of Melbourne, Parkville, Vic, Australia., 3. Deakin
University, Geelong, Vic, Australia
(O'Neil, Wynne) Queen Mary University of London, London, United Kingdom
(Sanders) Monash University, Melbourne, Vic, Australia
(Maraosco) Ryerson University, Toronto, ON, Canada
(Fredericks) Florida State University, Tallahassee, FL, United States
(Martorella, Wynne) Western Sydney University, Penrith, NSW, Australia
(O'Neil, Ganes) Barwon Health, Geelong, Vic, Australia
(Matthews) The Royal Melbourne Hospital, Parkville, Vic, Australia
(Maraosco) The Alfred Hospital, Prahran, Vic, Australia
(Keenan) St. James Hospital, Dublin, Ireland, 13. St Bartholomew's
Hospital, London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Evidence describing and quantifying sex-based differences in
cardiac surgical techniques and outcomes is scant. The aim of this review
was to determine whether there is contemporary evidence for short and
longer-term differences in sex-based mortality after CABGs.
 Method(s): EMBASE, CINAHL, Medline and the Cochrane Library database
were searched from January 2010 to April 2020. Inclusion criteria were
English language, randomised controlled trials from 2010, where isolated
CABGs was compared to an alternative strategy for revascularisation in
adult patients, with subgroup analyses comparing sex-based differences in
mortality. Covidence software was used to manage screening, data
extraction and quality assessment. The Cochrane RoB2 tool and the CONSORT
checklist were used for risk of bias and quality assessments. PROSPERO
Registration ID: CRD42020181673. Result(s): The search yielded 4,459
citations, 352 duplicates were removed; 4,107 titles and abstracts were
screened. Full text review of 29 articles revealed 9 eligible for
inclusion. Women were poorly represented (23.2%, +/- 6.98%) and there was
variability in time to follow-up between trials. Sex-based mortality
differences at 30 days (RR 0.82, 95% CI 0.66-1.02), 1-2 years (RR 1.07,
95% CI 0.69-1.64), 2-5 years (RR 1.25, 95% CI 1.03-1.53) and 10 years (RR
0.81, 95% CI 0.69-0.95) did not differ. Conclusion(s): Meta-analysis
did not support sex-based differences in mortality outcomes after CABGS.
Findings must be interpreted with caution secondary to heterogeneity in
results and poor representation of women in trial recruitment. Trials with
sex-based stratification are required to ensure appropriate
sex-differentiated treatment options for coronary artery
revascularisation. Copyright © 2021

<94>
Accession Number
637443968
Title
A Bayesian Spatial-temporal Modelling Approach for Prevalence Estimation
of a VRE Outbreak in a Tertiary Care Hospital.
Source
Open Forum Infectious Diseases. Conference: Infectious Diseases Week,
IDWeek 2021. Virtual. 8(SUPPL 1) (pp S493), 2021. Date of Publication:
November 2021.
Author
Atkinson A.; Ellenberger B.; Endrich O.; Kaspar T.; Hardegger M.; Steiger
W.; Piezzi V.; Leichtle A.; Marschall J.
Institution
(Atkinson, Ellenberger, Endrich, Kaspar, Hardegger, Steiger, Piezzi,
Leichtle) Bern University Hospital, Bern, Switzerland
(Marschall) University of Bern, Bern, Switzerland
Publisher
Oxford University Press
Abstract
Background. There was a nosocomial outbreak of vancomycin-resistant
enterococci (VRE) in our hospital group from 2018-19. The goals of the
study were to describe the prevalence trajectory and explore risk factors
associated with putative room colonization during the outbreak. Methods.
We performed a room centric analysis of 12 floors (floors F to R, 264
rooms) of the main bed tower of the hospital, including data on 37'458
patients (23'050 person weeks) over the 104 week period. Patients were
assumed to be colonized in the week prior to their first positive test,
and thereafter throughout the remainder of their stay until discharge.
Poisson Bayesian Hierarchical models were fitted to estimate prevalence
per room, including both spatial (conditional autoregressive) and temporal
(random walk) random effects terms. Model M1 estimated prevalence for each
floor and then used meta-analysis to combine the estimates, whereas model
M2 estimated prevalence for "all-floors" simultaneously. Results. The
oncology department, where the outbreak was thought to have started,
experienced slightly higher prevalence (floors O and R; adjusted incidence
rate ratio (aIRR) 4.8 [2.6, 8.9], p< 0.001; reference is general medicine;
see Figure Panel A), as did both the cardiac surgery (floors G, N, O; aIRR
3.8 [2.0, 7.3], p< 0.001) and abdominal surgery departments (floors H and
Q; 3.7 [1.8, 7.6], p< 0.001). There was no discernible difference in
prevalence between floors with single and multiple department occupancy.
Furthermore, departments spread across multiple floors had similar
prevalence on all constituent floors - perhaps indicating transmission by
people or devices moving between floors. The "single floor meta-analysis"
model (M1) more closely followed the estimated trajectory for the crude
prevalence, whereas the "all floors" model (M2) dampened the amplitude of
the peaks somewhat, but better estimated periods of low prevalence (Figure
Panel B). Conclusion. We applied a room centric approach that took into
account spatial and temporal dependencies apparent in the nosocomial VRE
outbreak. Despite additional complexity, Bayesian Hierarchical Models
provide a more flexible platform for studying transmission dynamics and
performing hypothesis testing, compared to more traditional methods.

<95>
Accession Number
637443673
Title
Use of Dalbavancin in Gram-positive Infective Endocarditis: Review of
Current Literature.
Source
Open Forum Infectious Diseases. Conference: Infectious Diseases Week,
IDWeek 2021. Virtual. 8(SUPPL 1) (pp S446), 2021. Date of Publication:
November 2021.
Author
Fazili T.; Bansal E.; De La Espriella M.G.; Garner D.C.
Institution
(Fazili, Bansal) Virginia Tech Carilion School of Medicine, Roanoke, VA,
United States
(De La Espriella) Carilion Clinic, Virginia Tech, Blacksburg, VA, United
States
(Garner) Virginia Tech Carilion School of Medicine, Carilion Clinic,
Roanoke, VA, United States
Publisher
Oxford University Press
Abstract
Background. Dalbavancin is a long acting, semisynthetic derivative of
teicoplanin that is currently approved for treatment of acute bacterial
skin and skin structure infections. Its efficacy and role of in the
treatment of invasive infections, in particular infective endocarditis, is
not well known. Methods. We reviewed the English-language literature for
the use of Dalbavancin in the treatment of endocarditis due to
Gram-positive organisms, using Pubmed. Results. 15 publications were
reviewed. All the publications were retrospective in nature, with
relatively small numbers of patients, including a few case reports. A
total of 159 patients received Dalbavancin for endocarditis. The mean age
was 47 years. The main reasons for using Dalbavancin were non-feasibility
of a standard outpatient regimen (mainly due to drug use) or the need for
a simpler regimen. 75 patients had infection of a native valve, 44 of a
prosthetic valve and 19 of a cardiac device. The type of infection for the
rest of the patients was not specified. The tricuspid valve was the most
frequently reported. The etiologic organisms causing endocarditis were
Staphylococcus species, followed by Streptococcus species and Enterococcus
species, with Staphylococcus aureus being the most common. All, but one,
patients received Dalbavancin as sequential therapy, after receiving other
intravenous antibiotics initially. The duration of antibiotics received
prior to initiation of Dalbavancin was variable, with the median being 3
weeks. The median duration of Dalbavancin use was 2.7 weeks. The dosage
regimens varied, with the more common ones using a loading dose of either
1500 mg or 1000 mg, followed by one or more weekly doses of 500 mg. The
overall clinical efficacy was around 89%. Adverse events were mild,
including nausea, vomiting, rash, headache and reversible acute kidney
injury. None of the patients had to discontinue the drug because of
adverse events. Two publications evaluated the cost effectiveness of
Dalbavancin and found it to save about $9000 per patient, the saving being
mainly due to reduced length of hospital stay. Conclusion. Dalbavancin
appears to be an efficacious, safe and cost-effective option for
sequential treatment of endocarditis caused by Staph aureus and other
Gram-positive organisms.

<96>
Accession Number
637443046
Title
137 Hospital Cluster-Randomized Trial of Mupirocin-Chlorhexidine vs
Iodophor-Chlorhexidine for Universal Decolonization in Intensive Care
Units (ICUs) (Mupirocin Iodophor Swap Out Trial).
Source
Open Forum Infectious Diseases. Conference: Infectious Diseases Week,
IDWeek 2021. Virtual. 8(SUPPL 1) (pp S3-S4), 2021. Date of Publication:
November 2021.
Author
Huang S.S.; Septimus E.; Kleinman K.; Heim L.; Moody J.; Avery T.R.;
McLean L.E.; Rashid S.; Haffenreffer K.; Shimelman L.; Staub-Juergens W.;
Spencer-Smith C.; Sljivo S.; Rosen E.; Poland R.; Coady M.H.; Blanchard
E.J.; Reddish K.; Hayden M.K.; Weinstein R.A.; Carver B.; Smith K.N.;
Hickok J.; Lolans K.; Khan N.; Sturdevant S.G.; Reddy S.; Jernigan J.A.;
Sands K.; Perlin J.B.; Platt R.
Institution
(Huang) University of California, Irvine, Irvine, CA, United States
(Septimus, Platt) Harvard Medical School, Houston, TX, United States
(Kleinman) University of Massachusetts, Amherst, MA, United States
(Heim, Rashid) UC Irvine School of Medicine, Irvine, CA, United States
(Moody, McLean, Staub-Juergens, Spencer-Smith, Poland, Blanchard, Reddish,
Carver, Smith, Sands, Perlin) HCA Healthcare, Nashville, TN, United States
(Avery) Harvard Pilgrim Healthcare Institute, Boston, MA, United States
(Haffenreffer, Sljivo, Rosen, Coady) Harvard Pilgrim Health Care
Institute, Boston, MA, United States
(Shimelman) Massachusetts Bay Transportation Authority, Boston, MA, United
States
(Hayden, Weinstein, Lolans) Rush University Medical Center, Chicago, IL,
United States
(Hickok) Ondine, Nashville, TN, United States
(Khan) Emory University Rollins School of Public Health, Decatur, GA,
United States
(Sturdevant) NIH, Baltimore, MD, United States
(Reddy, Jernigan) Centers for Disease Control and Prevention, Atlanta, GA,
United States
Publisher
Oxford University Press
Abstract
Background. ICU universal decolonization with daily chlorhexidine (CHG)
baths plus mupirocin nasal decolonization reduces all-cause bloodstream
infections (BSI) and MRSA clinical cultures. We assessed nasal iodophor,
an antiseptic less susceptible to resistance, in place of mupirocin.
Methods. We conducted a cluster randomized non-inferiority trial in ICUs,
comparing universal decolonization with: 1) Mupirocin-CHG: daily CHG baths
and 5 days of twice daily nasal mupirocin, to 2) Iodophor-CHG: same
regimen, substituting twice daily 10% povidone-iodine for mupirocin. All
adult ICUs in a hospital were assigned to the same strategy. We compared
each hospital's outcomes during the 18-month intervention (Nov 2017-Apr
2019) to its own baseline (May 2015-Apr 2017), during which all hospitals
used mupirocin-CHG. The primary outcome was ICUattributable S. aureus
clinical isolates. Secondary outcomes included ICU-attributable MRSA
clinical isolates and all-cause BSI. As randomized and as treated analyses
used unadjusted proportional hazards models assessing differences in
outcomes between baseline and intervention periods across the two groups,
accounting for clustering by hospital and patient. Results. We randomized
137 hospitals with 233 ICUs in 18 states. There were 442,544 admissions in
the baseline period and 349,262 in the intervention period. Median ICU
length of stay was 4 days. ICU types included mixed medical surgical
(56%), medical (9%), surgical (11%), cardiac (15%), and neurologic (9%).
CHG adherence was similar in both arms (85%), but adherence was greater
for mupirocin (90%) than iodophor (82%). Primary as-randomized results
(Table, Figure) exceeded the non-inferiority margin in favor of mupirocin,
for S. aureus clinical cultures (21% superiority, P< 0.001) and for MRSA
clinical cultures (20% superiority, P< 0.001). The regimens had similar
BSI hazards. Analyses of fully adherent patients are in progress.
Conclusion. Universal iodophor-CHG was equivalent to mupirocin-CHG for ICU
BSI prevention. Mupirocin-CHG was superior to iodophor-CHG for S. aureus
and MRSA clinical isolates, potentially due to greater adherence to
mupirocin.

<97>
Accession Number
2015242471
Title
Fractional Flow Reserve to Guide Treatment of Patients With Multivessel
Coronary Artery Disease.
Source
Journal of the American College of Cardiology. 78(19) (pp 1875-1885),
2021. Date of Publication: 09 Nov 2021.
Author
Rioufol G.; Roubille F.; Perret T.; Motreff P.; Angoulvant D.; Cottin Y.;
Meunier L.; Cetran L.; Cayla G.; Harbaoui B.; Wiedemann J.-Y.; Van Belle
E.; Pouillot C.; Noirclerc N.; Soto F.-X.; Caussin C.; Bertrand B.;
Lefevre T.; Dupouy P.; Lesault P.-F.; Albert F.; Koning R.; Leborgne L.;
Barnay P.; Chapon P.; Lafont A.; Piot C.; Amaz C.; Vaz B.; Benyahya L.;
Varillon Y.; Ovize M.; Mewton N.; Finet G.; Fournier A.; Jarry G.; Leleu
F.; Malaquin D.; Mirode A.; Belle L.; Mangin L.; Hirsch J.-L.; Metge M.;
Pansiery M.; Soto F.; Boge A.; HadjHamou K.; Miliani I.; Molins G.; Mourot
S.; Pelletier M.; Ressencourt O.; Schaad F.; Coste P.; Chasseriaud W.;
Poustis P.; Morelle J.-F.; Demicheli T.; Range G.; Thuaire C.;
Barber-Chamoux N.; Combaret N.; Malcles G.; Souteyrand G.; Buffet P.;
Gudjonvick A.; L'Huillier I.; Lorgis L.; Richard C.; Baronne-Rochette G.;
Bouvaist H.; Marliere S.; Ormezzano O.; Vanzetto G.; Trouillet C.; Valy
Y.; VanBelle E.; Bauters C.; Delhaye C.; Lemesle G.; Rihani R.; Graux P.;
Lemahieu J.-M.; Besnard C.; Courand P.-Y.; Dauphin R.; Lantelme P.;
Caignault J.-R.; Dubreuil O.; Ranc S.; Ritz B.; Bergerot C.; Bochaton T.;
Bonnefoy-Cudraz E.; Bresson D.; Dementhon J.; Derimay F.; Green L.; Prieur
C.; Sanchez I.; Zouaghi O.; Armero S.; Ben-Amer H.; Chevalier B.; Garot
P.; Hovasse T.; Louvard Y.; Morice M.-C.; Tavolaro O.; Unterseeh T.; Cung
D.; Macia J.-C.; Levy G.; Roth O.; Jacquemin L.; Cornillet L.; Ledermann
B.; Schmutz L.; Karam N.; Rahal S.; Amabile N.; Girard P.; Veugeois A.;
Barthelemy O.; Collet J.-P.; Montalescot G.; Berland J.; Godin M.;
Landolff Q.; Zoghlami B.; Bougrini K.; Geyer C.; Glanenapp J.; Mascarel
P.; Rambaud G.; ViFane R.; Desveaux B.; Ivanes F.; Pacouret G.; Quilliet
L.-E.; SaintEtienne C.; Bretelle C.; Champin S.
Institution
(Rioufol, Derimay, Finet) Hopital Cardiologique et Pneumologique Louis
Pradel, Hospices Civils de Lyon, Bron, France
(Roubille) Hopital Arnaud de Villeneuve, Montpellier, France
(Perret) Centre Hospitalier Saint Joseph-Saint Luc, Lyon, France
(Motreff) Hopital Gabriel Montpied, Clermont-Ferrand, France
(Angoulvant) EA4245 T2i, Hopital Trousseau, CHRU de Tours, Universite de
Tours, Tours, France
(Cottin) Hopital du Bocage Central, Dijon, France
(Meunier) Centre Hospitalier de La Rochelle, La Rochelle, France
(Cetran) Hopital Cardiologique, Centre Hospitalo-Universitaire de
Bordeaux, Universite de Bordeaux, Bordeaux, France
(Cayla) Service de cardiologie, Hopital Caremeau, Universite de
Montpellier, Nimes, France
(Harbaoui) Hopital de la Croix-Rousse, Hospices Civils de Lyon, Lyon,
France
(Wiedemann) Centre Hospitalier de Mulhouse, Mulhouse, France
(Van Belle) Hopital Cardiologique Calmette, Lille, France
(Pouillot) Clinique Sainte Clotilde, La Reunion, France
(Noirclerc) Centre Hospitalier Annecy-Genevois, Annecy, France
(Morelle) Clinique Saint Martin, Caen, France
(Soto) Centre Hospitalier d'Auxerre, Auxerre, France
(Caussin) Institut Mutualiste de Montsouris, Paris, France
(Bertrand) Hopital Michallon, Grenoble, France
(Lefevre) Institut Hospitalier Jacques Cartier, Massy, France
(Dupouy) Clinique Les Fontaines, Melun, France
(Lesault) Hopital Prive de l'Estuaire, Le Havre, France
(Albert) Centre Hospitalier General, Chartres, France
(Barthelemy) Hopital de La Pitie-Salpetriere, Assistance Publique-Hopitaux
de Paris, Paris, France
(Koning) Clinique Saint Hilaire, Rouen, France
(Leborgne) Centre Hospitalier Amiens-Picardie, Hopital Sud, Amiens, France
(Barnay) Hopital Henri Duffaut, Avignon, France
(Chapon) Centre Hospitalier de Valence, Valence, France
(Armero) Hopital Europeen, Marseille, France
(Lafont) Hopital Europeen George Pompidou, Assistance Publique-Hopitaux de
Paris, Paris, France
(Piot) Clinique Le Millenaire, Montpellier, France
(Amaz, Vaz, Benyahya, Varillon, Ovize, Mewton) Centre d'investigation
clinique de Lyon, INSERM 1407, Hopital Cardiologique et Pneumologique
Louis Pradel, Hospices Civils de Lyon, Bron, France
Publisher
Elsevier Inc.
Abstract
Background: There is limited evidence that fractional flow reserve (FFR)
is effective in guiding therapeutic strategy in multivessel coronary
artery disease (CAD) beyond prespecified percutaneous coronary
intervention or coronary graft surgery candidates. Objective(s): The
FUTURE (FUnctional Testing Underlying coronary REvascularization) trial
aimed to evaluate whether a treatment strategy based on FFR was superior
to a traditional strategy without FFR in the treatment of multivessel CAD.
 Method(s): The FUTURE trial is a prospective, randomized, open-label
superiority trial. Multivessel CAD candidates were randomly assigned (1:1)
to treatment strategy based on FFR in all stenotic (>=50%) coronary
arteries or to a traditional strategy without FFR. In the FFR group,
revascularization (percutaneous coronary intervention or surgery) was
indicated for FFR <=0.80 lesions. The primary endpoint was a composite of
major adverse cardiac or cerebrovascular events at 1 year. Result(s):
The trial was stopped prematurely by the data safety and monitoring board
after a safety analysis and 927 patients were enrolled. At 1-year
follow-up, by intention to treat, there were no significant differences in
major adverse cardiac or cerebrovascular events rates between groups
(14.6% in the FFR group vs 14.4% in the control group; hazard ratio: 0.97;
95% confidence interval: 0.69-1.36; P = 0.85). The difference in all-cause
mortality was nonsignificant, 3.7% in the FFR group versus 1.5% in the
control group (hazard ratio: 2.34; 95% confidence interval: 0.97-5.18; P =
0.06), and this was confirmed with a 24 months' extended follow-up. FFR
significantly reduced the proportion of revascularized patients, with more
patients referred to exclusively medical treatment (P = 0.02).
 Conclusion(s): In patients with multivessel CAD, we did not find
evidence that an FFR-guided treatment strategy reduced the risk of
ischemic cardiovascular events or death at 1-year follow-up. (Functional
Testing Underlying Coronary Revascularisation; NCT01881555) Copyright
© 2021 American College of Cardiology Foundation

<98>
Accession Number
2005790163
Title
Long-term outcome of perioperative low cardiac output syndrome in cardiac
surgery: 1-year results of a multicenter randomized trial.
Source
Journal of Critical Care. 58 (pp 89-95), 2020. Date of Publication: August
2020.
Author
Zangrillo A.; Lomivorotov V.V.; Pisano A.; Calabro M.G.; Belletti A.;
Brazzi L.; Grigoryev E.V.; Guarracino F.; Monaco F.; Garofalo E.;
Crivellari M.; Likhvantsev V.V.; Fominskiy E.V.; Paternoster G.;
Yavorovskiy A.; Pasyuga V.V.; Oriani A.; Lembo R.; Bianchi A.; Scandroglio
A.M.; Abubakirov M.N.; Di Tomasso N.; Landoni G.
Institution
(Zangrillo, Calabro, Belletti, Monaco, Crivellari, Fominskiy, Oriani,
Lembo, Scandroglio, Di Tomasso, Landoni) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Zangrillo, Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Lomivorotov, Abubakirov) Department of Anesthesiology and Intensive Care,
E. Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Lomivorotov) Novosibirsk State University, Novosibirsk, Russian
Federation
(Pisano) Division of Cardiac Anesthesia and Intensive Care Unit, AORN dei
Colli - Monaldi Hospital, Naples, Italy
(Brazzi) Department of Anesthesia, Intensive Care and Emergency, Citta
della Salute e della Scienza Hospital, Turin, Italy
(Brazzi) Department of Surgical Sciences, University of Turin, Turin,
Italy
(Grigoryev) Intensive Care Unit, Scientific Research Institute for Complex
Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
(Guarracino) Division of Cardiothoracic Anesthesia and Intensive Care,
Department of Anesthesia and Critical Care Medicine, AOU Pisana, Pisa,
Italy
(Garofalo) Department of Anesthesia and Intensive Care, AOU Mater Domini
Germaneto, Catanzaro, Italy
(Likhvantsev, Yavorovskiy) Department of Anesthesiology and Intensive
Care, First Moscow State Medical University, Moscow, Russian Federation
(Likhvantsev) V. Negovsky Reanimatology Research Institute, Moscow,
Russian Federation
(Paternoster) Department of Anesthesia and Intensive Care, San Carlo
Hospital, Potenza, Italy
(Pasyuga) Department of Anesthesiology and Intensive Care, Federal Center
for Cardiovascular Surgery Astrakhan, Astrakhan, Russian Federation
(Bianchi) Department of Cardiovascular Anesthesia and Intensive Care, AO
Ordine Mauriziano, Turin, Italy
Publisher
W.B. Saunders
Abstract
Purpose: Perioperative myocardial dysfunction occurs frequently in cardiac
surgery, and is a risk factor for morbidity and mortality. Levosimendan
has been suggested to reduce mortality of patients with perioperative
myocardial dysfunction. However, long-term outcome data on its efficacy in
cardiac surgery are lacking. Material(s) and Method(s): Cardiac
surgery patients with perioperative myocardial dysfunction were randomized
to levosimendan or placebo, in addition to standard inotropic care.
One-year mortality data were collected. Result(s): We randomized 506
patients (248 to levosimendan 258 to placebo). At 1-year follow-up, 41
patients (16.5%) died in the levosimendan group, while 47 (18.3%) died in
the placebo group (absolute risk difference -1.8; 95% CI -8.4 to 4.9; P
=.60). Female sex, history of chronic obstructive pulmonary disease,
previous myocardial infarction, serum creatinine, hematocrit, mean
arterial pressure, and duration of cardiopulmonary bypass were
independently associated with 1-year mortality. Conclusion(s):
Levosimendan administration does not improve 1-year survival in cardiac
surgery patients with perioperative myocardial dysfunction. One-year
mortality in these patients is 17%. Six predictive factors for long-term
mortality were identified. Study registration number: NCT00994825
(ClinicalTrials.gov). Copyright © 2020 Elsevier Inc.

<99>
Accession Number
2015117200
Title
Diagnostic accuracy of coronary computed tomography angiography for the
evaluation of obstructive coronary artery disease in patients referred for
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
European Radiology. (no pagination), 2022. Date of Publication: 2022.
Author
Gatti M.; Gallone G.; Poggi V.; Bruno F.; Serafini A.; Depaoli A.; De
Filippo O.; Conrotto F.; Darvizeh F.; Faletti R.; De Ferrari G.M.; Fonio
P.; D'Ascenzo F.
Institution
(Gatti, Poggi, Serafini, Depaoli, Faletti, Fonio) Department of Surgical
Sciences, Radiology Unit, University of Turin, Via Genova 3, Turin 10126,
Italy
(Gallone, Bruno, De Filippo, Conrotto, De Ferrari, D'Ascenzo) Division of
Cardiology, Department of Medical Science, University of Turin, Turin,
Italy
(Darvizeh) School of Medicine, Vita-Salute San Raffaele University, Milan
20121, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To evaluate the diagnostic accuracy of coronary computed
tomography angiography (CCTA) for the evaluation of obstructive coronary
artery disease (CAD) in patients referred for transcatheter aortic valve
implantation (TAVI). Method(s): EMBASE, PubMed/MEDLINE, and CENTRAL
were searched for studies reporting accuracy of CCTA for the evaluation of
obstructive CAD compared with invasive coronary angiography (ICA) as the
reference standard. QUADAS-2 tool was used to assess the risk of bias. A
bivariate random effects model was used to analyze, pool, and plot the
diagnostic performance measurements across studies. Pooled sensitivity,
specificity, positive (+ LR) and negative (-LR) likelihood ratio,
diagnostic odds ratio (DOR), and hierarchical summary ROC curve (HSROC)
were evaluated. Prospero registration number: CRD42021252527.
 Result(s): Fourteen studies (2533 patients) were included. In the
intention-to-diagnose patient-level analysis, sensitivity and specificity
for CCTA were 97% (95% CI: 94-98%) and 68% (95% CI: 56-68%), respectively,
and + LR and -LR were 3.0 (95% CI: 2.1-4.3) and 0.05 (95% CI: 0.03 -
0.09), with DOR equal to 60 (95% CI: 30-121). The area under the HSROC
curve was 0.96 (95% CI: 0.94-0.98). No significant difference in
sensitivity was found between single-heartbeat and other CT scanners (96%
(95% CI: 90 - 99%) vs. 97% (95% CI: 94-98%) respectively; p = 0.37),
whereas the specificity of single-heartbeat scanners was higher (82% (95%
CI: 66-92%) vs. 60% (95% CI: 46 - 72%) respectively; p < 0.0001). Routine
CCTA in the pre-TAVI workup could save 41% (95% CI: 34 - 47%) of ICAs if a
disease prevalence of 40% is assumed. Conclusion(s): CCTA proved an
excellent diagnostic accuracy for assessing obstructive CAD in patients
referred for TAVI; the use of single-heartbeat CT scanners can further
improve these findings. Key Points: * CCTA proved to have an excellent
diagnostic accuracy for assessing obstructive CAD in patients referred for
TAVI. * Routine CCTA in the pre-TAVI workup could save more than 40% of
ICAs. * Single-heartbeat CT scanners had higher specificity than others in
the assessment of obstructive CAD in patients referred for
TAVI. Copyright © 2022, The Author(s).

<100>
Accession Number
2015115347
Title
Non-vitamin K oral anticoagulants versus vitamin K antagonists in post
transcatheter aortic valve replacement patients with clinical indication
for oral anticoagulation: A meta-analysis.
Source
Clinical Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Chen Y.-F.; Liu F.; Li X.-W.; Zhang H.-J.; Liu Y.-G.; Lin L.
Institution
(Chen, Li, Zhang, Liu, Lin) Department of Pharmacy, Xiamen Cardiovascular
Hospital of Xiamen University, School of Medicine, Xiamen University,
Xiamen, China
(Liu) Department of Cardiovascular Surgery, Xiamen Cardiovascular Hospital
of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Current guidelines recommend oral anticoagulation (OAC)
following transcatheter aortic valve replacement (TAVR) in patients with
clinical indication, but the optimal antithrombotic regimen remains
uncertain. We aimed to compare the efficacy and safety of non-vitamin K
oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in
patients undergoing TAVR with concomitant indication of OAC. Hypothesis:
Comparing with VKAs therapy, NOACs are similar in reducing the all-cause
mortality and major bleeding in post-TAVR patients requiring OAC
medication. Method(s): We searched the databases of PubMed, Embase,
and Cochrane library databases to identify studies that investigated NOACs
versus VKAs after TAVR in patients with another indication of OAC, which
were published before 28th September 28, 2021. The effectiveness of
outcomes was all-cause mortality and stroke or systemic embolism, while
the main safety outcome was major and/or life-threatening bleeding. The
hazard ratio (HR) with 95% confidence interval (CI) was used as a measure
of treatment effect. Result(s): Our search identified eight studies.
We included 4947 post-TAVR patients with another indication of OAC
allocated to the NOAC (n = 2146) or VKA groups (n = 2801). There were no
significant differences in the all-cause mortality (HR: 0.91, 95% CI:
0.77-1.08, p =.29, I2 = 47%), stroke or systemic embolism (HR:
0.96, 95% CI: 0.68-1.37, p =.84, I2 = 0%), and major and/or
life-threatening bleeding (HR: 1.09, 95% CI: 0.89-1.32, p =.40,
I2 = 30%) in both groups. Conclusion(s): Among post-TAVR
patients who required OAC therapy, NOACs therapy compared to VKAs is
similar in reducing the all-cause mortality, stroke or systemic embolism,
and major and/or life-threatening bleeding events. Copyright ©
2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.

<101>
Accession Number
637426853
Title
Genome-wide association study reveals novel genetic loci: a new polygenic
risk score for mitral valve prolapse.
Source
European heart journal. (no pagination), 2022. Date of Publication: 04
Mar 2022.
Author
Roselli C.; Yu M.; Nauffal V.; Georges A.; Yang Q.; Love K.; Weng L.-C.;
Delling F.N.; Maurya S.R.; Schrolkamp M.; Tfelt-Hansen J.; Hagege A.;
Jeunemaitre X.; Debette S.; Amouyel P.; Guan W.; Muehlschlegel J.D.; Body
S.C.; Shah S.; Samad Z.; Kyryachenko S.; Haynes C.; Rienstra M.; Le
Tourneau T.; Probst V.; Roussel R.; Wijdh-Den Hamer I.J.; Siland J.E.;
Knowlton K.U.; Jacques Schott J.; Levine R.A.; Benjamin E.J.; Vasan R.S.;
Horne B.D.; Muhlestein J.B.; Benfari G.; Enriquez-Sarano M.; Natale A.;
Mohanty S.; Trivedi C.; Shoemaker M.B.; Yoneda Z.T.; Wells Q.S.; Baker
M.T.; Farber-Eger E.; Michelena H.I.; Lundby A.; Norris R.A.; Slaugenhaupt
S.A.; Dina C.; Lubitz S.A.; Bouatia-Naji N.; Ellinor P.T.; Milan D.J.
Institution
(Roselli, Nauffal, Weng, Guan, Lubitz, Ellinor) Cardiovascular Disease
Initiative, Broad Institute of MIT and Harvard, Cambridge MA 02142, United
States
(Roselli, Rienstra, Siland) Department of Cardiology, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
(Yu, Georges, Hagege, Jeunemaitre, Kyryachenko, Bouatia-Naji) Universite
de Paris, PARCC, Inserm, Paris F-75015, France
(Nauffal) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, MA, Boston, United States
(Yang, Vasan) School of Public Health, Boston University, MA, Boston,
United States
(Love, Weng, Guan, Lubitz, Ellinor, Milan) Cardiovascular Research Center,
Massachusetts General Hospital, MA, Boston, United States
(Delling) Division of Cardiology, University of California San Francisco,
San Francisco, CA, USA
(Maurya, Schrolkamp, Lundby) Department of Biomedical Sciences, Faculty of
Health and Medical Sciences, University of Copenhagen, Denmark
(Tfelt-Hansen) Department of Cardiology, Heart Centre, Rigshospitalet,
Copenhagen University Hospital, Copenhagen, Denmark
(Tfelt-Hansen) Department of Forensic Medicine, Faculty of Medical
Sciences, University of Copenhagen, Copenhagen, Denmark
(Hagege, Jeunemaitre) Departments of Cardiology and Genetics, Hopital
Europeen Georges Pompidou, Assistance Publique-Hopitaux de Paris, Paris
75015, France
(Debette) Bordeaux Population Health Research Center, Inserm Center U1219,
University of Bordeaux, Bordeaux, France
(Debette) Department of Neurology, Bordeaux University Hospital, Inserm
U1219, Bordeaux, France
(Amouyel) Univ. Lille, Inserm, Centre Hosp. Univ Lille, Institut Pasteur
de Lille, UMR1167 - RID-AGE- Risk factors and molecular determinants of
aging-related diseases, Lille F-59000, France
(Guan, Lubitz, Ellinor) Demoulas Center for Cardiac Arrhythmias,
Massachusetts General Hospital, MA, Boston, United States
(Muehlschlegel) Department of Anesthesiology, Perioperative and Pain
Medicine, Brigham and Women's Hospital, MA, Boston, United States
(Body) Department of Anesthesiology, Boston University School of Medicine,
MA, Boston, United States
(Shah, Haynes) Duke Molecular Physiology Institute, Duke University,
Durham, United States
(Shah, Samad) Division of Cardiology, Department of Medicine, Duke
University School of Medicine, Durham, United States
(Samad) Department of Medicine, Aga Khan University, Karachi, Pakistan
(Le Tourneau, Probst, Jacques Schott, Dina) l'institut du thorax, INSERM,
CNRS, Univ Nantes, CHU Nantes, Nantes, France
(Le Tourneau) l'institut du thorax, CHU Nantes, Nantes, France
(Roussel) Cordeliers Research Centre, INSERM, Universite de Paris, Paris,
France
(Roussel) Hopital Bichat-Claude-Bernard, APHP, Department of Diabetology,
Paris, France
(Wijdh-Den Hamer) Department of Cardiothoracic Surgery, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
(Knowlton, Horne, Muhlestein) Intermountain Medical Center Heart
Institute, UT, Salt Lake City, United States
(Knowlton) Division of Cardiovascular Medicine, Department of Medicine,
University of California San Diego, San Diego, CA, USA
(Levine) Cardiac Ultrasound Laboratory, Harvard Medical School,
Massachusetts General Hospital, MA, Boston, United States
(Benjamin, Vasan) National Heart, Lung, Framingham Heart Study, MA,
Framingham, United States
(Benjamin) Section of Cardiovascular Medicine, Boston University School of
Medicine, MA, Boston, United States
(Benjamin) Department of Epidemiology, Boston University School of Public
Health, MA, Boston, United States
(Vasan) School of Medicine, Boston University, MA, Boston, United States
(Horne) Division of Cardiovascular Medicine, Department of Medicine,
Stanford University, Stanford, CA, USA
(Muhlestein) Cardiology Division, Department of Internal Medicine,
University of Utah, UT, Salt Lake City, United States
(Benfari, Enriquez-Sarano, Michelena) Department of Cardiovascular
Medicine, Mayo Clinic, MN, Rochester, United States
(Natale, Mohanty, Trivedi) Texas Cardiac Arrhythmia Institute, St David's
Medical Center, TX, Austin, United States
(Shoemaker, Yoneda) Department of Medicine, Division of Cardiovascular
Diseases, Vanderbilt University Medical Center, TN, Nashville, United
States
(Wells, Baker, Farber-Eger) Department of Medicine, Vanderbilt University
Medical Center, TN, Nashville, United States
(Wells) Department of Pharmacology, Vanderbilt University Medical Center,
TN, Nashville, United States
(Wells) Department of Biomedical Informatics, Vanderbilt University
Medical Center, TN, Nashville, United States
(Lundby) Novo Nordisk Foundation Center for Protein Research, Faculty of
Health and Medical Sciences, University of Copenhagen, Denmark
(Norris) Cardiovascular Developmental Biology Center, Department of
Regenerative Medicine and Cell Biology, Medical University of South
Carolina, SC, Charleston, United States
(Slaugenhaupt) Center for Genomic Medicine and Department of Neurology,
Massachusetts General Hospital Research Institute and Harvard Medical
School, MA, Boston, United States
(Milan) Leducq Foundation, Boston, United States
Publisher
NLM (Medline)
Abstract
AIMS: Mitral valve prolapse (MVP) is a common valvular heart disease with
a prevalence of >2% in the general adult population. Despite this high
incidence, there is a limited understanding of the molecular mechanism of
this disease, and no medical therapy is available for this disease. We
aimed to elucidate the genetic basis of MVP in order to better understand
this complex disorder. METHODS AND RESULTS: We performed a meta-analysis
of six genome-wide association studies that included 4884 cases and 434649
controls. We identified 14 loci associated with MVP in our primary
analysis and 2 additional loci associated with a subset of the samples
that additionally underwent mitral valve surgery. Integration of
epigenetic, transcriptional, and proteomic data identified candidate MVP
genes including LMCD1, SPTBN1, LTBP2, TGFB2, NMB, and ALPK3. We created a
polygenic risk score (PRS) for MVP and showed an improved MVP risk
prediction beyond age, sex, and clinical risk factors. CONCLUSION(S):
We identified 14 genetic loci that are associated with MVP. Multiple
analyses identified candidate genes including two transforming growth
factor-beta signalling molecules and spectrin beta. We present the first
PRS for MVP that could eventually aid risk stratification of patients for
MVP screening in a clinical setting. These findings advance our
understanding of this common valvular heart disease and may reveal novel
therapeutic targets for intervention. KEY QUESTION: Expand our
understanding of the genetic basis for mitral valve prolapse (MVP).
Uncover relevant pathways and target genes for MVP pathophysiology.
Leverage genetic data for MVP risk prediction. KEY FINDING: Sixteen
genetic loci were significantly associated with MVP, including 13 novel
loci. Interesting target genes at these loci included LTBP2, TGFB2, ALKP3,
BAG3, RBM20, and SPTBN1. A risk score including clinical factors and a
polygenic risk score, performed best at predicting MVP, with an area under
the receiver operating characteristics curve of 0.677. TAKE-HOME MESSAGE:
Mitral valve prolapse has a polygenic basis: many genetic variants
cumulatively influence pre-disposition for disease. Disease risk may be
modulated via changes to transforming growth factor-beta signalling, the
cytoskeleton, as well as cardiomyopathy pathways. Polygenic risk scores
could enhance the MVP risk prediction. Copyright © The Author(s)
2022. Published by Oxford University Press on behalf of European Society
of Cardiology. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

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