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<1>
Accession Number
2007302182
Title
Autograft remodeling after the Ross procedure by cardiovascular magnetic
resonance imaging: Aortic stenosis versus insufficiency.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(2) (pp 578-587.e1),
2022. Date of Publication: February 2022.
Author
Lenoir M.; Emmott A.; Bouhout I.; Poirier N.; Tousch M.; El-Hamamsy I.;
Mongeon F.-P.
Institution
(Lenoir, Emmott, Bouhout, Poirier, Tousch, El-Hamamsy) Department of
Surgery, Montreal Heart Institute, Universite de Montreal, Montreal,
Quebec, Canada
(El-Hamamsy) Division of Cardiac Surgery, Sacre-Coeur Hospital, Universite
de Montreal, Montreal, Quebec, Canada
(Poirier) Division of Cardiac Surgery, Sainte-Justine University Hospital
Center, Universite de Montreal, Montreal, Quebec, Canada
(Mongeon) Divison of Noninvasive Cardiology, Department of Specialized
Medicine, Montreal Heart Institute, Universite de Montreal, Montreal,
Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Background: Studies suggest that patients undergoing the Ross procedure
for aortic insufficiency are at greater risk of autograft dilatation than
those with aortic stenosis. By using a tailored Ross technique to mitigate
autograft dilatation in patients with aortic insufficiency, we aimed to
compare the biomechanical and morphologic remodeling of the autograft at 1
year between patients with aortic insufficiency and patients with aortic
stenosis. Method(s): A total of 210 patients underwent a Ross
procedure (2011-2016). Of those, 86 patients (mean age 43 +/- 13 years;
32% were female) completed preoperative and postoperative cardiovascular
magnetic resonance imaging. A total of 71 studies were suitable for
analysis: 41 patients with aortic stenosis and 30 patients with aortic
insufficiency. Nine healthy adults were used as controls. Autograft root
dimensions, individual sinus volumes, and distensibility were measured
using cardiovascular magnetic resonance. Result(s): At 1 year, there
was no difference in autograft root dimensions between patients with
aortic stenosis (mean annulus 25.1 +/- 3.1 mm and sinus diameters 35 +/-
4.1 mm) and patients with aortic insufficiency (26.6 +/- 3 mm and 37.1 +/-
3.5 mm; P =.12 and.06, respectively). Relative sinus of Valsalva volumes
were symmetrical in the aortic stenosis (right 34.8% +/- 4%, left 33.7%
+/- 3.5%, noncoronary 31.4% +/- 3.2%) and aortic insufficiency groups
(34.8% +/- 3.9%, 33.8% +/- 2.8%, 31.3% +/- 3.7%, P =.85,.92, and.82), and
similar to those of healthy adults. Aortic root distensibility was reduced
in both groups compared with healthy adults (P =.003), but was similar
between aortic stenosis (3.12 +/- 1.58 x 10-3 mm
Hg-1) and aortic insufficiency (3.04 +/- 1.15 x 10-3
mm Hg-1; P =.9). Conclusion(s): Using a tailored
technique, there were no differences in the morphologic or biomechanical
remodeling of the autograft root 1 year after the Ross procedure between
patients with aortic stenosis and patients with aortic insufficiency.
However, autograft roots are stiffer than native aortic
roots. Copyright © 2020 The American Association for Thoracic
Surgery

<2>
Accession Number
637563420
Title
Cost-effectiveness analysis of a resource-intensive approach versus
minimally invasive strategy for high-risk transcatheter aortic valve
replacement patients.
Source
Journal of Comparative Effectiveness Research. 11(4) (pp 217-227), 2022.
Date of Publication: March 2022.
Author
Mayhew C.R.; Gallagher A.; Bensimhon A.; Dauerman H.L.; Tsai M.H.; Martin
J.A.
Institution
(Mayhew, Gallagher, Bensimhon, Tsai, Martin) Department of Anesthesiology
and Pain Medicine, University of Vermont Larner College of Medicine,
Burlington, VT 05401, United States
(Dauerman) Division of Cardiovascular Medicine, University of Vermont
Larner College of Medicine, Burlington, VT 05401, United States
(Tsai) Department of Orthopaedics and Rehabilitation, University of
Vermont Larner College of Medicine, Burlington, VT 05401, United States
Publisher
Future Medicine Ltd.
Abstract
Aortic stenosis has a high mortality rate in patients who do not receive
aortic valve replacement. Previously, transcatheter aortic valve
replacement (TAVR) was an intervention reserved for individuals deemed
high-risk for surgery. Since that time, TAVR has increasingly been offered
to lower risk patients, yet it is unclear whether TAVR will meet an
acceptable cost-effectiveness threshold in this group. In this
cost-effectiveness study, we employed a decision tree model with Monte
Carlo probability sensitivity analysis to determine the incremental cost
(in US$) per quality-Adjusted life year (QALY) and life year (LY) of
performing the TAVR procedure using the resource-intensive approach versus
the minimally invasive strategy in high-risk surgical
patients. Copyright © 2022 Future Medicine Ltd.

<3>
Accession Number
2017425819
Title
The Role of Pericardial Window Techniques in the Management of Penetrating
Cardiac Injuries in the Hemodynamically Stable Patient: Where Does It Fit
in the Current Trauma Algorithm.
Source
Journal of Surgical Research. 276 (pp 120-135), 2022. Date of Publication:
August 2022.
Author
Selvakumar S.; Newsome K.; Nguyen T.; McKenny M.; Bilski T.; Elkbuli A.
Institution
(Selvakumar, Newsome, Nguyen, McKenny, Elkbuli) Division of Trauma and
Surgical Critical Care, Department of Surgery, Kendall Regional Medical
Center, Miami, Florida, United States
(McKenny) Department of Surgery, University of South Florida, Florida,
Tampa
(Bilski) Division of Trauma and Surgical Critical Care, Department of
Surgery, Orlando Regional Medical Center, Florida, Orlando
Publisher
Academic Press Inc.
Abstract
Introduction: Penetrating cardiac injuries (PCIs) have high in-hospital
mortality rates. Guidelines regarding the use of pericardial window (PW)
for diagnosis and treatment of suspected PCIs are not universally
established. The objective of this review was to provide a critical
appraisal of the current literature to determine the effectiveness and
safety of PW as both a diagnostic and therapeutic technique for suspected
PCIs in patients with hemodynamic stability. Method(s): A review was
conducted using PubMed/MEDLINE, Google Scholar, and Embase to identify
literature evaluating the accuracy and therapeutic efficacy of PW and its
role in a hemodynamically stable patient with penetrating thoracic or
thoracoabdominal trauma. Result(s): Eleven studies evaluating
diagnostic PW and two studies evaluating therapeutic PW were included.
These studies ranged from (y) 1977 to 2018. Existing literature indicates
that PW is highly sensitive (92%-100%) and specific (96%-100%) for the
diagnosis of suspected PCIs. PW and drainage, when compared with
sternotomy, may be associated with decreased total hospital stay (4.1
versus 6.5 d; P < 0.001) and intensive care unit stay (0.25 versus 2.04 d;
P < 0.001) along with similar mortality and complication rates after the
management of hemopericardium. Conclusion(s): In a hemodynamically
stable patient presenting with penetrating cardiac trauma with a high
suspicion for PCI, PWs can (1) facilitate prompt diagnosis in the event of
equivocal ultrasonography findings and (2) serve as an effective
therapeutic modality with the benefit of potentially avoiding more
invasive procedures. Subxiphoid, transdiaphragmatic, and laparoscopic
approaches for PW have been shown to have similar efficacy and
safety. Copyright © 2022

<4>
Accession Number
2003536130
Title
Acupuncture: Could it be a treatment for angina pectoris?.
Source
European Journal of Preventive Cardiology. 28(14) (pp E3-E4), 2021. Date
of Publication: 01 Nov 2021.
Author
Teragawa H.; Oshita C.; Orita Y.; Kihara Y.
Institution
(Teragawa, Oshita, Orita) Department of Cardiovascular Medicine, Jr
Hiroshima Hospital, Japan
(Kihara) Department of Cardiovascular Medicine, Hiroshima University,
Graduate School of Biomedical and Health Sciences, Japan
Publisher
Oxford University Press

<5>
Accession Number
2011022301
Title
Randomized, placebo-controlled trial of orally administered vitamin K1 for
warfarin-associated coagulopathy in Chinese patients with mechanical heart
valves.
Source
European Journal of Clinical Pharmacology. 77(9) (pp 1333-1339), 2021.
Date of Publication: September 2021.
Author
Zhang H.; Li M.; Ao X.-L.; Dong Y.-J.; Dong L.
Institution
(Zhang, Li, Dong) Department of Cardiovascular Surgery, West China
Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu 610041,
China
(Ao) Department of Ultrasound, West China Hospital of Sichuan University,
Chengdu, China
(Dong) Department of Thoracic Neoplasm, West China Hospital of Sichuan
University, Chengdu, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Warfarin-associated coagulopathy commonly occurs in patients
undergoing treatment with this anticoagulant. This trial aimed to
determine the efficacy of using low-dose orally administered vitamin
K<inf>1</inf> to lower international normalized ratio (INR) values into
the target range in a cohort of Chinese patients with mechanical heart
valves. Method(s): This was a double-blind, placebo-controlled,
randomized trial. Chinese patients with mechanical heart valves who were
undergoing warfarin treatment and who had INR values from 4.0 to 10.0
without bleeding were the subjects of this study. These patients were
randomized into two treatment groups and were orally administered either
vitamin K<inf>1</inf> (2.5 mg) or placebo. Warfarin was discontinued in
both groups until INR values were <= 2.5. INR values on the day following
treatment were the primary study outcome, with INR values on the following
days and adverse clinical events over a 3-month follow-up serving as
secondary study outcomes. Result(s): In total, 80 patients were
enrolled in the present study, and 40 patients each were assigned to the
placebo and vitamin K1 treatment groups. Patients administered vitamin
K<inf>1</inf> exhibited a quick reduction in INR values relative to
patients administered placebo (29 of 40 [72.5%] vs. 0 of 44 [0%] patients
exhibiting INR values from 1.5-2.5 on the day following treatment,
respectively, p = 0.000). Lower bleeding incidence was observed among
patients administered vitamin K<inf>1</inf> relative to those administered
placebo during follow-up (4 [10%] vs. 12 [30%] patients, respectively, p =
0.045). There were no instances of thromboembolic complications or
warfarin resistance in either group. Conclusion(s): Low-dose oral
vitamin K<inf>1</inf> can be effectively administered to Chinese patients
with mechanical heart valves taking warfarin to rapidly reduce elevated
INR values. Copyright © 2021, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<6>
Accession Number
2017050034
Title
Prevalence and outcomes of concomitant cardiac amyloidosis and aortic
stenosis: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. 64 (pp 67-76), 2022. Date of Publication:
01 Mar 2022.
Author
Ho J.S.-Y.; Kor Q.; Kong W.K.; Lim Y.C.; Chan M.Y.-Y.; Syn N.L.; Ngiam
J.N.; Chew N.W.; Yeo T.-C.; Chai P.; Poh K.-K.; Wong R.C.; Lin W.; Sia
C.-H.
Institution
(Ho) Academic Foundation Programme, North Middlesex University Hospital
NHS Trust, United Kingdom
(Kor, Kong, Chan, Syn, Yeo, Chai, Poh, Wong, Lin, Sia) Department of
Medicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Kong, Lim, Chan, Chew, Yeo, Chai, Poh, Wong, Lin, Sia) Department of
Cardiology, National University Heart Centre Singapore, Singapore
(Ngiam) Internal Medicine Residency, University Medicine Cluster, National
University Health System, Singapore
Publisher
Hellenic Cardiological Society
Abstract
Objective: Cardiac amyloidosis (CA) is an increasingly recognised
condition in patients with aortic stenosis (AS). However, there is a large
variation in the reported prevalence figures, due to differences in
populations and diagnostic methods. We aimed to investigate the
prevalence, risk factors and outcomes of concomitant CA and AS.
 Method(s): We performed a systematic review and meta-analysis of the
literature searched on MEDLINE, Embase, Scopus and CENTRAL. We analysed
the prevalence of CA in patients with AS grouped according to the
diagnostic techniques, and the risk factors and outcomes of concomitant CA
and AS were analysed in AS patients referred for surgical or transcatheter
aortic valve replacement (AVR). Result(s): A total of 21 studies were
included, involving 4,243 patients. The pooled prevalence of CA in
patients with AS was 14.4%, with substantial heterogeneity. The pooled
prevalence of AS in patients CA was 8.7%, with substantial heterogeneity.
Patients with both AS and CA had higher all-cause mortality than those
with AS or CA alone. In AS patients requiring AVR, CA was associated with
increasing age, male sex, higher NT-proBNP levels, increased
interventricular septal end diastole (IVSd) thickness and lower left
ventricular ejection fraction. Concomitant AS and CA was associated with
increased all-cause mortality and pacemaker implantation post-procedure.
Study limitations included heterogeneity of the results and the fair to
good quality of the studies published. Conclusion(s): Overall, a
substantial proportion of patients with AS may have CA, and they have
poorer prognosis. A high degree of clinical suspicion is needed to
identify the "red flags" and perform appropriate diagnostic
imaging. Copyright © 2021 Hellenic Society of Cardiology

<7>
Accession Number
2015306848
Title
Renal Restrictive Index (RRI) Versus Urinary Neutrophil
Gelatinase-Associated Lipocalin (uNGAL) for early prediction of acute
kidney injury (AKI) in adults undergoing elective cardiac surgeries with
cardiopulmonary bypass: A prospective randomized observational study.
Source
Egyptian Journal of Anaesthesia. 38(1) (pp 166-173), 2022. Date of
Publication: 2022.
Author
Dawood H.F.A.; Abd Rabbih A.A.R.; Fouad H.A.; El-Shafei M.M.; Hussein H.W.
Institution
(Dawood) Anaesthesia and Surgical Intensive Care, Kafrelsheikh Faculty of
Medicine, Kafrelsheikh, Egypt
(Abd Rabbih, Fouad, Hussein) Anaesthesia and Surgical Intensive Care,
Alexandria Faculty of Medicine, Alexandria, Egypt
(El-Shafei) Radiology and Intervention, Alexandria Faculty of Medicine,
Alexandria, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Acute kidney injury (AKI) complicates most cardiac surgery
patients. This study assessed the accuracy of urine neutrophil
gelatinase-associated lipocalin (uNGAL) and Renal Resistive Index (RRI) to
early predict (AKI) after cardiopulmonary bypass (CPB). Method(s):
This work enrolled 57 cases of elective cardiac surgery with CPB. Urinary
NGAL and RRI were measured preoperatively and at 1, 6 and 24 h
postoperatively. The primary outcome was AKI, defined by Acute Kidney
Injury Network Classification (AKIN) System. The secondary aim was to
assess the diagnostic accuracy, cut-off point of uNGAL and RRI, and their
relation with AKI severity. AKI developed in 22 patients (38.5%), with 2
cases required dialysis. Mean uNGAL significantly increased by 10 folds at
1h and 15 folds at 6h postoperatively. Result(s): As regard uNGAL,the
1 h diagnostic accuracy was 94.8%, The area under the curve (AUC) was
0.888, using a cut-off value of 194.3 ng/ml. The 6 h diagnostic accuracy
was 96.5%, AUC was 0.995 at a cut-off value 67.1 ng/ml. The 1 and 6 h
uNGAL were unrelated to AKI severity. As regard RRI, AKI patients had
significantly higher 1 h and 6 h RRI. The diagnostic accuracy at 1 h was
93.0%, AUC was 0.991, using a cut-off value of 0.72. The diagnostic
accuracy at 6 h was 94.8%, AUC 0.995 at a cut-off value of 0.71. Values of
RRI were significantly related only to severe cases requiring dialysis.
 Conclusion(s): Urinary NGAL and RRI are early accurate indicators of
AKI. High RRI can predict dialysis-requirement. Copyright © 2022
The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<8>
Accession Number
637460966
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) (no pagination), 2022. Article Number: e056829. 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, Neefs, Van Den Berg, Meulendijks, Terpstra, Kawasaki,
Nariswari, Piersma, Van Boven, Driessen, De Groot) Heart Center,
Department of Clinical and Experimental Cardiology and Cardiothoracic
Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC Location AMC,
Noord-Holland, Amsterdam, Netherlands
Publisher
BMJ Publishing Group
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 2 years of follow-up. Results 121 patients
were included, of whom 35(29%) were women, age was 60.4+/-7.8 and 51% (62)
had at least one AF recurrence during 2 years of follow-up. LAECT was
longer in patients with versus without AF recurrence (182+/-43 ms vs
147+/-29 ms, 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 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.

<9>
Accession Number
637460948
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) (no pagination), 2022. Article Number: e054236. Date of
Publication: 09 Mar 2022.
Author
Christensen T.D.; Bendixen M.; Skaarup So.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 and 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
BMJ Publishing Group
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.

<10>
Accession Number
2015388464
Title
Primary and metastatic primitive neuroectodermal tumor of the heart: A
systematic review.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2022. Date of
Publication: 2022.
Author
Hajsadeghi S.; Iranpour A.; Amouei E.; Tehrani N.H.; Ghavidel A.; Ziaie
H.; Asadi O.; Moradians V.; Tayebi A.; Mestres C.-A.; Manqoutaei S.A.
Institution
(Hajsadeghi, Iranpour) Research Center for Prevention of Cardiovascular
Disease, Institute of Endocrinology & Metabolism, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Amouei, Ziaie, Manqoutaei) Department of Internal Medicine, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tehrani) East Metropolitan Health Services, Perth, Australia
(Ghavidel) Rajaie Cardiovascular Medical & Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Asadi) Endocrine Research Center, Institute of Endocrinology and
Metabolism, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Moradians) Department of Pulmonology and Critical Care, Iran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tayebi) Department of Surgery, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Mestres) Department of Cardiac Surgery, University Hospital Zurich,
Zurich, Switzerland
Publisher
SAGE Publications Inc.
Abstract
Objective: Primary and metastatic primitive neuroectodermal tumors of the
pericardium are uncommon. Two cases are presented and discussed.
 Method(s): The cases of a 17- and 38-year-old male patients with
neuroectodermal tumors of the pericardium are presented. In addition, a
systematic review was performed according to the Preferred Reporting Items
and checklist for Systematic reviews and Meta-Analyses (PRISMA). All
selected articles' quality assessment was done using the Joanna Briggs
Institute (JBI) Critical Appraisal Checklist for Case Reports.
 Result(s): The systematic review yielded 29 patients with primary or
metastatic PNET. Two patients underwent cardiac transplantation. It seems
that unlike considering total resection in other organs, pericardiectomy
in PNET patients with pericardial origin may lead to further invasion of
the lesions, and it is not recommended. The average disease-free follow-up
was 10 months. The combination of neoadjuvant and adjuvant chemotherapy
along with surgery and radiotherapy offered the best disease-free
outcomes. Conclusion(s): Neuroectodermal heart tumors are rare,
aggressive tumors requiring chemotherapy and radiotherapy in association
with tumor resection surgery to have the best disease-free
duration. Copyright © The Author(s) 2022.

<11>
Accession Number
2016755603
Title
HOMEFOOD randomised trial - Six-month nutrition therapy improves quality
of life, self-rated health, cognitive function, and depression in older
adults after hospital discharge.
Source
Clinical Nutrition ESPEN. 48 (pp 74-81), 2022. Date of Publication: April
2022.
Author
Blondal B.S.; Geirsdottir O.G.; Halldorsson T.I.; Beck A.M.; Jonsson P.V.;
Ramel A.
Institution
(Blondal, Geirsdottir, Halldorsson, Ramel) Faculty of Food Science and
Nutrition, School of Health, University of Iceland, Reykjavik, Iceland
(Beck) University College Copenhagen, Institute of Nursing and Nutrition,
Sigurdsgade 26, Copenhagen 2200, Denmark
(Beck) The Dietetic and Nutritional Research Unit, EFFECT, Herlev and
Gentofte University Hospital, Borgmester Ib Juuls Vej 50, Herlev 2730,
Denmark
(Jonsson) The Icelandic Gerontological Research Institute, Tungata 26,
Reykjavik 101, Iceland
(Jonsson) Faculty of Medicine, School of Health, University of Iceland,
Reykjavik, Iceland
(Jonsson) Department of Geriatrics, The National University Hospital of
Iceland, Reykjavik, Iceland
(Ramel) Matis Ohf, Vinlandslei 12, Reykjavik 113, Iceland
Publisher
Elsevier Ltd
Abstract
Background and aims: Malnutrition is common among older adults and is
related to quality of life, cognitive function, and depression. To what
extent nutrition interventions can improve these outcomes remains unclear.
The aim of this study was to investigate the effect of nutrition therapy
on health-related quality of life (EQ-5D), self-rated health, cognitive
function, and depression in community dwelling older adults recently
discharged from hospital. Method(s): Participants (>65 years) were
randomised into an intervention (n = 53) and a control group (n = 53). The
intervention group received individualised nutrition therapy based on the
nutrition care process including 5 home visits and 3 phone calls, in
combination with freely delivered energy- and protein-rich foods and oral
nutrition supplements for six months after hospital discharge. EQ-5D,
self-rated health, Mini-Mental-State-Examination (MMSE), and the Centre
for Epidemiologic Studies Depression - IOWA (CES-D) scale were measured at
baseline and at endpoint. Result(s): Two subjects dropped out, one
from each arm. The control group experienced an increase in depressive
symptoms and a decrease in self-rated health during the study period,
while the intervention group experienced increases in cognitive function,
self-rated health, and EQ-5D resulting in significant endpoint differences
between the groups: EQ-5D (0.102, P = 0.001); self-rated health: 15.876 (P
< 0.001); MMSE: 1.701 (P < 0.001); depressive symptoms: - 3.072 (P <
0.001); all in favour of the intervention group. Improvements during the
intervention in MMSE, self-rated health, and CES-D were significantly
related to body weight gain in a linear way. Conclusion(s): Cognitive
function and mental well-being worsen or stagnate in older adults who
receive standard care after hospital discharge. However, a six-month
nutrition therapy improves these outcomes leading to statistically and
clinically significant endpoint differences between the groups. As
improvements were related to body weight gain after hospital discharge, we
conclude that the increase in dietary intake, with focus on energy and
protein density, and changes in body weight might have contributed to
better cognitive function and mental well-being in older adults after the
intervention. Copyright © 2022 The Authors

<12>
Accession Number
603545017
Title
Impact of residual coronary artery disease on patients undergoing TAVI: A
meta-analysis of adjusted observational studies.
Source
International Journal of Cardiology. 181 (pp 77-80), 2015. Date of
Publication: 15 Feb 2015.
Author
Taha S.; Moretti C.; D'Ascenzo F.; Van Mieghem N.M.; Omede P.; Montefusco
A.; Ghany M.A.; Fouad D.; Demitry S.; Zoccai G.B.; Gaita F.
Institution
(Taha, Moretti, D'Ascenzo, Omede, Montefusco, Gaita) Citta della Salute e
della Scienza Hospital, Division of Cardiology 1, University of Turin,
Corso Bramante 88, Torino 10126, Italy
(Zoccai) Division of Cardiology, Rome, Italy
(Taha, Ghany, Fouad, Demitry) Assuit University Hospital, Egypt
(Van Mieghem) Department of Interventional Cardiology Thoraxcenter,
Erasmus Medical Center, Rotterdam, Netherlands
(Taha) Cardiology Department, Assuit University, Egypt
Publisher
Elsevier Ireland Ltd

<13>
Accession Number
2017330015
Title
Comment on: "The effect of delirium preventive measures on the occurrence
of postoperative cognitive dysfunction in older adults undergoing
cardiovascular surgery. The DelPOCD randomised controlled trial".
Source
Journal of Clinical Anesthesia. 79 (no pagination), 2022. Article Number:
110768. Date of Publication: August 2022.
Author
Chen D.X.
Institution
(Chen) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Elsevier Inc.

<14>
Accession Number
2015211525
Title
Major Aortopulmonary Collateral Arteries Requiring Percutaneous
Intervention Following the Arterial Switch Operation: A Case Series and
Systematic Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(2) (pp
146-154), 2022. Date of Publication: March 2022.
Author
Doulamis I.P.; Marathe S.P.; Oh N.A.; Saeed M.Y.; Muter A.; del Nido P.J.;
Nathan M.
Institution
(Doulamis, Marathe, Oh, Saeed, Muter, del Nido, Nathan) Department of
Cardiac Surgery, Boston Children's Hospital, Harvard Medical School,
Boston, MA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Dextro transposition of the great arteries (d-TGA) is the most
common critical congenital cardiac defect surgically treated in the
neonatal period by arterial switch operation (ASO). Major aortopulmonary
collaterals (MAPCAs) can be present in this population and may complicate
the early postoperative period. Our aim was to review our institutional
data and systematically review the available literature to provide further
insight on the clinical significance of MAPCAs during the early
postoperative course after ASO. Method(s): This is a retrospective
study of patients with simple d-TGA who underwent ASO between March 1998
and September 2020 at Boston Children's Hospital. The MEDLINE, Embase, and
Cochrane databases were searched from inception to June 2020.
 Result(s): Of the 671 d-TGA patients who underwent ASO at our center,
13 (1.9%) were diagnosed with MAPCAs. Five were diagnosed before ASO,
while eight were diagnosed after ASO. Of these, two patients required
catheterization for MAPCAs coiling during the same hospitalization on the
2nd and 11th postoperative days. The systematic review retrieved a total
of 34 articles after duplicates were removed. Finally, nine studies
reporting on 23 patients were deemed eligible for our analysis. The
average time to MAPCAs coiling was 12 days, while the mean hospital stay
was 36 days. Conclusion(s): MAPCAs should be included in the
differential diagnosis of ASO complicated by cardiac or respiratory
failure, or pulmonary hemorrhage acutely postoperatively. Once managed,
recovery of these patients is predictable, and mortality is low. Further
studies investigating the diagnostic value of echocardiography and the
long-term outcomes of these MAPCAs are necessary. Copyright © The
Author(s) 2021.

<15>
Accession Number
2017163830
Title
Impact of Systematic Whole-body 18F-Fluorodeoxyglucose PET/CT
on the Management of Patients Suspected of Infective Endocarditis: The
Prospective Multicenter TEPvENDO Study.
Source
Clinical Infectious Diseases. 73(3) (pp 393-403), 2021. Date of
Publication: 01 Aug 2021.
Author
Duval X.; Le Moing V.; Tubiana S.; Esposito-Farese M.; Ilic-Habensus E.;
Leclercq F.; Bourdon A.; Goehringer F.; Selton-Suty C.; Chevalier E.;
Boutoille D.; Piriou N.; Le Tourneau T.; Chirouze C.; Seronde M.-F.; Morel
O.; Piroth L.; Eicher J.-C.; Humbert O.; Revest M.; Thebault E.; Devillers
A.; Delahaye F.; Boibieux A.; Gregoire B.; Hoen B.; Laouenan C.; Iung B.;
Rouzet F.
Institution
(Duval, Tubiana, Esposito-Farese, Ilic-Habensus, Laouenan, Iung, Rouzet)
Inserm Cic 1425, Paris, France
(Duval, Duval, Tubiana, Esposito-Farese, Ilic-Habensus, Laouenan, Iung,
Rouzet) AP-HP, University Hospital of Bichat, Paris, France
(Tubiana, Laouenan, Iung, Rouzet) Inserm UMR-1137 Iame, Paris, France
(Duval, Laouenan, Iung, Rouzet) University Paris Diderot, Paris 7, Ufr de
Medecine-Bichat, Paris, France
(Le Moing) Department of Infectious Diseases, University Hospital of
Montpellier, Montpellier, France
(Esposito-Farese, Laouenan) Unite de Recherche Clinique, AP-HP, Hupnvs,
Hopital Universitaire Paris Nord-Val de Seine, Paris, France
(Leclercq) Department of Cardiology, University Hospital of Montpellier,
Montpellier, France
(Bourdon) Department of Nuclear Medicine, University Hospital of
Montpellier, Montpellier, France
(Goehringer, Hoen) Department of Infectious Diseases, University Hospital
of Nancy, Nancy, France
(Selton-Suty) Department of Cardiology, University Hospital of Nancy,
Nancy, France
(Chevalier) Department of Nuclear Medicine, University Hospital of Nancy,
Nancy, France
(Boutoille) Department of Infectious Diseases, Cic Uic 1413 Inserm,
University Hospital of Nantes, Nantes, France
(Piriou, Le Tourneau) Thorax Institute, Inserm, Umr 1087, University
Hospital of Nantes, Nantes, France
(Piriou) Department of Nuclear Medicine, Nantes University Hospital, G. et
R. Laennec Hospital, Nantes, France
(Chirouze) University Hospital of Besancon, Umr Cnrs 6249
Chrono-Environnement, Bourgogne University, Franche-Comte, Dijon, France
(Seronde) Department of Cardiology, University Hospital of Besancon,
Besancon, France
(Morel) Department of Nuclear Medicine, University Hospital of Besancon,
Besancon, France
(Piroth) Department of Infectious Diseases, University Hospital of Dijon,
Inserm Cic 1432 Chu, Dijon, France
(Eicher) Department of Cardiology, University Hospital of Dijon, Dijon,
France
(Humbert) Department of Nuclear Medicine, University Hospital of Dijon,
Dijon, France
(Revest) Infectious Diseases and Intensive Care Unit, University Hospital
of Rennes France, Inserm U1230 Chu, Rennes, France
(Revest, Thebault) Inserm Cic 1414, University Hospital of Rennes, France
(Devillers) Department of Nuclear Medicine, University Hospital of Rennes,
France
(Delahaye) Department of Cardiology, University Hospital of Lyon, Lyon,
France
(Boibieux) Department of Nuclear Medicine, University Hospital of Lyon,
Lyon, France
(Gregoire) Department of Infectious Diseases, University Hospital of Lyon,
Lyon, France
(Rouzet) Department of Nuclear Medicine, AP-HP, University Hospital of
Bichat, Paris, France
Publisher
Oxford University Press
Abstract
Background: Diagnostic and patients' management modifications induced by
whole-body 18F-FDG-PET/CT had not been evaluated so far in prosthetic
valve (PV) or native valve (NV) infective endocarditis (IE)-suspected
patients. Method(s): In sum, 140 consecutive patients in 8 tertiary
care hospitals underwent 18F-FDG-PET/CT. ESC-2015-modified Duke criteria
and patients' management plan were established jointly by 2 experts before
18F-FDG-PET/CT. The same experts reestablished Duke classification and
patients' management plan immediately after qualitative interpretation of
18F-FDG-PET/CT. A 6-month final Duke classification was established.
 Result(s): Among the 70 PV and 70 NV patients, 34 and 46 were
classified as definite IE before 18F-FDG-PET/CT. Abnormal perivalvular
18F-FDG uptake was recorded in 67.2% PV and 24.3% NV patients respectively
(P <. 001) and extracardiac uptake in 44.3% PV and 51.4% NV patients. IE
classification was modified in 24.3% and 5.7% patients (P =. 005) (net
reclassification index 20% and 4.3%). Patients' managements were modified
in 21.4% PV and 31.4% NV patients (P =. 25). It was mainly due to
perivalvular uptake in PV patients and to extra-cardiac uptake in NV
patients and consisted in surgery plan modifications in 7 patients,
antibiotic plan modifications in 22 patients and both in 5 patients.
Altogether, 18F-FDG-PET/CT modified classification and/or care in 40% of
the patients (95% confidence interval: 32-48), which was most likely to
occur in those with a noncontributing echocardiography (P <. 001) or IE
classified as possible at baseline (P =. 04), while there was no
difference between NV and PV. Conclusion(s): Systematic
18F-FDG-PET/CT did significantly and appropriately impact diagnostic
classification and/or IE management in PV and NV-IE suspected
patients. Copyright © 2020 The Author(s). Published by Oxford
University Press for the Infectious Diseases Society of America. All
rights reserved.

<16>
Accession Number
636681128
Title
Scientific Publishing Differences between Sexes in Cardiology, Cardiac,
and General Surgery.
Source
Thoracic and Cardiovascular Surgeon. 70(2) (pp 143-151), 2022. Date of
Publication: 01 Mar 2022.
Author
Farber G.; Alscher L.; Heyne E.; Doenst T.; Schwarzer M.
Institution
(Farber, Alscher, Heyne, Doenst, Schwarzer) Department of Cardiothoracic
Surgery, Jena University Hospital, Thuringen, Jena 07747, Germany
Publisher
Georg Thieme Verlag
Abstract
Background Research and scientific publications are important for the
advancement of science but also for the individual career development.
While women have become the majority of students in medicine we do not
know about female presence and scientific activity in cardiac surgery. We
thus aimed to compare scientific output of women and men in German
University departments of cardiac surgery with cardiology departments
focusing on the same organ and surgical departments not addressing the
heart (general surgery) of 34 universities in Germany. Methods Personnel
working at University departments was identified on the institutions
internet homepage in 2014. Publications in 2011 to 2013 on PubMed were
identified. Author and manuscript characteristics were determined. Results
A lower proportion of women were working in cardiac surgery (25%) compared
with cardiology (35%) and general (32%) surgery independent of executive
function or academic degree. Scientifically active women published fewer
manuscripts per capita than men both, in total and as first author.
Additionally, the mean and the cumulated journal impact factor of the
journals chosen was lower for women compared with men in cardiology but
not in cardiac and general surgery. Conclusion We conclude that the
differences in scientific activity between women and men are more
pronounced in cardiology compared with general and cardiac surgery,
indicating that a higher proportion of women in a field does not result in
reduced differences between sexes. The low number of women together with
the lower number of manuscripts in cardiac surgery may render the
appointment of women as directors challenging. Copyright © 2022
American Society of Civil Engineers (ASCE). All rights reserved.

<17>
Accession Number
636319349
Title
Long-term survival after coronary bypass surgery with multiple versus
single arterial grafts.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 61(4) (pp 925-933),
2022. Date of Publication: 24 Mar 2022.
Author
Thuijs D.J.F.M.; Davierwala P.; Milojevic M.; Deo S.V.; Noack T.;
Kappetein A.P.; Serruys P.W.; Mohr F.-W.; Morice M.-C.; Mack M.J.; Stahle
L.E.G.E.; Verberkmoes N.J.; Holmes D.R.; Head S.J.
Institution
(Thuijs, Milojevic, Kappetein, Head) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Davierwala, Noack, Mohr) University Department of Cardiac Surgery, Heart
Centre Leipzig, Leipzig, Germany
(Davierwala) Division of Cardiovascular Surgery, Peter Munk Cardiac
Centre, Toronto General Hospital, 15 University Health Network, Toronto,
ON, Canada
(Davierwala) Department of Surgery, University of Toronto, Toronto, Canada
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Deo) Department of Cardiovascular Surgery, Louis Stokes Cleveland VA
Medical Center, Cleveland, OH, USA
(Serruys) Department of Cardiology, National University of Ireland,
Galway, Ireland
(Morice) Department of Cardiology, Cardiovascular Institute Paris-Sud
(ICPS), Hopital prive Jacques Cartier, Generale de Sante Massy, France
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, TX, Dallas, United States
(Stahle) Department of Thoracic and Cardiovascular Surgery, University
Hospital, Uppsala, Sweden
(Verberkmoes) Department of Cardiothoracic Surgery, Catharina Hospital,
Eindhoven, Netherlands
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, MN, Rochester, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This study sought to evaluate the long-term differences in
survival between multiple arterial grafts (MAG) and single arterial grafts
(SAG) in patients who underwent coronary artery bypass grafting (CABG) in
the SYNTAX study. METHOD(S): The present analysis included the
randomized and registry-treated CABG patients (n=1509) from the SYNTAX
Extended Survival study (SYNTAXES). Patients with only venous (n=42) or
synthetic grafts (n=1) were excluded. The primary end point was all-cause
death at the longest follow-up. Multivariable Cox regression was used to
adjust for differences in baseline characteristics. Sensitivity analysis
using propensity matching with inverse probability for treatment weights
was performed. RESULT(S): Of the 1466 included patients, 465 (31.7%)
received MAG and 1001 (68.3%) SAG. Patients receiving MAG were younger and
at lower risk. At the longest follow-up of 12.6years, all-cause death
occurred in 23.6% of MAG and 40.0% of SAG patients [adjusted hazard ratio
(HR) 0.74, 95% confidence interval (CI) (0.55-0.98); P=0.038], which was
confirmed by sensitivity analysis. MAG in patients with the three-vessel
disease was associated with significant lower unadjusted and adjusted
all-cause death at 12.6years [adjusted HR 0.65, 95% CI (0.44-0.97);
P=0.033]. In contrast, no significance was observed after risk adjustment
in patients with the left main disease, with and without diabetes, or
among SYNTAX score tertiles. CONCLUSION(S): In the present post hoc
analysis of all-comers patients from the SYNTAX trial, MAG resulted in
markedly lower all-cause death at 12.6-year follow-up compared to a SAG
strategy. Hence, this striking long-term survival benefit of MAG over SAG
encourages more extensive use of multiple arterial grafting in selected
patients with reasonable life expectancy. TRIAL REGISTRATION: SYNTAXES
ClinicalTrials.gov reference: NCT03417050; SYNTAX ClinicalTrials.gov
reference: NCT00114972. Copyright © The Author(s) 2021. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<18>
Accession Number
636078527
Title
Combined heart and liver transplantation: an updated systematic review.
Source
Annals of the Royal College of Surgeons of England. 104(2) (pp 88-94),
2022. Date of Publication: 01 Feb 2022.
Author
Frountzas M.; Karampetsou N.; Nikolaou C.; Schizas D.; Tsapralis D.;
Avgerinos D.; Toutouzas K.
Institution
(Frountzas, Karampetsou, Nikolaou, Schizas, Toutouzas) National and
Kapodistrian University of Athens, Greece
(Tsapralis) General Hospital of Ierapetra, Greece
(Avgerinos) NewYork-Presbyterian Hospital, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Combined heart and liver transplantation (CHLT) is one of
the most complex procedures of surgery that has been implemented in the
last 35 years. The aim of our meta-analysis was to investigate the safety
and efficacy of CHLT. MATERIALS: The meta-analysis was designed according
to PRISMA (Preferred Reporting Items for Systematic reviews and
Meta-Analyses) and AMSTAR (A MeaSurement Tool to Assess systematic
Reviews) recommendations. A literature search was conducted up to April
2020 using the MEDLINE, SCOPUS, ClinicalTrials.gov, EmbaseTM, Cochrane
Central Register of Controlled Trials and Google ScholarTM databases.
 RESULT(S): Our meta-analysis included 16 studies with 860 patients.
The mortality rate following CHLT was 14.1%. One and five-year survival
rates were 85.3% and 71.4% while the heart and liver rejection rates were
6.1% and 9.1% respectively. The hospital stay was 25.8 days and the
intensive care unit stay was 9.9 days. Pooled values were also calculated
for cardiopulmonary bypass duration, units of transfused red blood cells
and fresh frozen plasma, postoperative infection rate, mechanical
ventilation rate and follow-up duration. CONCLUSION(S): Despite its
complexity, CHLT is a safe and effective procedure for the management of
lethal diseases that lead to progressive heart and/or liver failure.
Nevertheless, there must be strict adherence to the indications for
surgery, and future studies should compare CHLT with isolated cardiac and
hepatic transplantations.

<19>
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

<20>
Accession Number
637601914
Title
Incidence of post-transplant lymphoproliferative disease: A systematic
literature review.
Source
Blood. Conference: 63rd American Society of Hematology Annual Meeting and
Exposition, ASH 2021. Atlanta, GA United States. 138(SUPPL 1) (pp 4564),
2021. Date of Publication: November 2021.
Author
Thirumalai D.; Watson C.; Xun P.; Sadetsky N.; Schaible K.; Barlev A.
Publisher
American Society of Hematology
Abstract
Introduction: Post-transplant lymphoproliferative disease (PTLD) is an
ultra-rare lymphoma following allogeneic hematopoietic stem cell
transplant (HCT) or solid organ transplant (SOT). Incidence of PTLD varies
over time after transplant with majority of cases occurring within the
first year (yr) after HCT (Garcia-Cadenas, Eur J Haematol. 2019). In the
SOT setting, PTLD can occur up to 30 yrs post-transplant and is largely
dependent on the transplanted organ, the type and degree of
immunosuppression, and transplant recipient characteristics (Dierickx, N
Eng J Med. 2018; Trappe, J Clin Oncol. 2017). Published literature reports
wide ranges of epidemiological estimates due to variation in the follow-up
time, transplant type and sample size. We conducted a systematic
literature review (SLR) to summarize the incidence of PTLD to better
understand the reasons for such variation. Method(s): A SLR on the
burden of PTLD was conducted in accordance with the Preferred Reporting
Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines with
the scope defined in terms of Population, Intervention Comparators,
Outcomes and Study design (PICOS) criteria. Pertinent literature on
epidemiology of PTLD published between January 2010 to February 2020 and
relevant conference abstracts published between January 2018 to February
2020 were identified. Comprehensive literature searches were performed
using the Ovid platform to identify articles indexed in PubMed, Embase,
PsycINFO, and the National Health Service Economic Evaluation Database.
Study designs were limited to population/registry-based studies,
observational cohort studies (prospective/retrospective), and
cross-sectional studies. Studies reporting incidence of PTLD were limited
to those with at least 1000 total transplant recipients. All titles and
abstracts were reviewed by two independent researchers with any
discrepancies resolved by a third researcher. Incidence estimates were
calculated by data extractors when it was not directly reported in the
literature. Result(s): A total of 177 studies reporting
epidemiological data on PTLD were identified using pre-specified SLR
criteria. Most of the studies (n=150) were retrospective in design.
Incidence was reported in 114 studies. Majority of the studies reported
cumulative incidence (CI) over specified times such as 5-yr or 10-yr
incidence or proportion of patients (pts) with PTLD out of a sample of
transplanted pts. In the HCT setting, only CI was reported; twelve studies
reported CI ranging from 0.1% among 15094 pts receiving autologous HCT
over a 19-yr period to 4% in a cohort of 1021 pts receiving allogeneic HCT
over a 16-yr period. A total of 100 studies reported incidence of PTLD in
SOT pts which was highly influenced by the study population, EBV status at
the time of transplant and follow-up time. Of these, 12 reported incidence
rates ranging from 24 EBV negative PTLD cases per 100,000 person-years
(PY) within 1-5 yrs post-transplant to 3460 PTLD cases per 100,000 PY at
20 yrs post-transplant. Eighty studies reported CI, 19 of which reported
CI for various timepoints. In a group of 23171 heart transplant pts CI was
1% during a median follow-up of 4.3 yrs, while in a subgroup of four
pediatric multi-organ transplant recipients followed from 2003 to 2011 CI
was 25%. Across studies, CI at 1-yr post-transplant ranged from 0.1% to
4.9% and 5-yr CI ranged from 0.7% to 12.1% in select group of transplant
pts. Twenty-four studies reported CI by transplant organ type ranging from
0.2% in kidney transplant pts within the first year to 12.1% in lung
transplant pts over 7.5 yrs, with higher estimates reported in studies
with smaller sample sizes. Conclusion(s): Our SLR shows large
variation in the reported incidence of PTLD due to heterogeneity in the
methodology and the study populations in both HCT and SOT settings.
Published literature lacks the granularity to correctly interpret the
incidence of PTLD in the general transplant population. Thus, additional
methods and data considerations such as population type (HCT/SOT
transplants, adult/pediatric pts, etc.), representativeness (single
institutional data/multi-center/country level registry), unit of
measurement of risk (CI/incidence rate, etc.), type of study
(retrospective/prospective), length of follow-up, sample size, trends in
transplant and treatment landscape over time are needed to ensure accuracy
in the estimation of incidence of PTLD.

<21>
Accession Number
637598305
Title
Management strategies in persons with inherited hemophilia requiring
antithrombotic therapy: A scoping review.
Source
Blood. Conference: 63rd American Society of Hematology Annual Meeting and
Exposition, ASH 2021. Atlanta, GA United States. 138(SUPPL 1) (pp 3191),
2021. Date of Publication: November 2021.
Author
Uminski K.; Xu Y.; Zahrai A.; Hodgson A.; Duffett L.; Tinmouth A.; Khalife
R.
Publisher
American Society of Hematology
Abstract
Background: Cardiovascular disorders (CVD) and venous thromboembolism
(VTE) are increasingly reported in people with hemophilia (PWH) whose life
expectancy has improved dramatically over the past decades. While
management of thrombotic events among PWH requires navigating the delicate
balance between recurrent ischemic events and hemorrhage, current
practices are highly variable and largely informed by expert opinion.
 Objective(s): We sought to examine and summarize what is known about
the management, practice variation and outcomes of PWH requiring
antithrombotic therapy (ATT) for cardiovascular disorders (CVD) or venous
thromboembolism (VTE). We also aimed to identify current knowledge and
practice gaps in the management of CVD and VTE in PWH. Method(s): We
conducted a scoping review guided by Arksey and O'Malley (2002), and Levac
et al.'s (2010) methodological frameworks. We also adhered to the
Preferred Reporting Items for Systematic reviews and Meta-Analyses
extension for Scoping Reviews (PRISMAScR). A search strategy, developed
iteratively in collaboration with a medical librarian, was performed on
MEDLINE, EMBASE, and Scopus from inception to May 3, 2021. Studies of any
design, published in English or French, in full-text or abstract, were
included if they reported on more than two patients with inherited
hemophilia A or B requiring ATT for CVD or VTE. Following eligibility
assessment in duplicate, data from each study was charted by two
independent reviewers to report the type of research designs, population,
geographical location, interventions, and outcomes. Conflicts were
resolved by consensus. We conducted a descriptive analysis and narrative
synthesis to identify common themes and knowledge gaps. Result(s): We
screened 3929 articles and selected 38 studies for inclusion (23 full-text
and 15 abstracts). Published studies were largely retrospective (28/38,
73.7%), single center (25/38, 65.8%), and from Europe (25/38, 65.8%). A
total of 567 patients with hemophilia A or B were reported. Common
indications for ATT use included: coronary artery disease (26/38, 68.4%),
including a history of percutaneous coronary intervention or coronary
artery bypass procedures (14/38, 36.8%), atrial fibrillation (13/38,
34.2%), VTE treatment or prevention (10/38, 26.3%), cerebrovascular
disease (9/38, 23.7%) and valvular heart disease (7/38, 18.4%). ATT
included single antiplatelet therapy (28/38, 73.7%), heparins (21/38,
55.3%), dual antiplatelet therapy (19/38, 50%), vitamin K antagonists
(10/38, 26.3%), and direct oral anticoagulants (5/38, 13.2%). The use of
hemostatic therapies, either on-demand or prophylactically, was reported
in 36 studies (94.7%). Clotting factors concentrates were used in 35
studies (92.1%). Other agents included desmopressin (2/38, 5.2%) and
emicizumab (1/38, 2.6%). Only 19 studies (50%) reported target factor
levels (peak and/or trough) while on ATT. Outcomes related to bleeding
while on ATT were described in 36 studies (94.7%). Bleeding events
resulting in a change in hemostatic regimen occurred in 9 studies (25%),
while bleeding resulting in a change or discontinuation of ATT occurred in
10 studies (27.8%). In 10 studies (26.3%), no pathologic bleeding was
observed in PWH on ATT. Four key themes were generated iteratively to
describe the observed wide practice variation in the management of PWH
requiring ATT: (1) Deviation from established and evolving CVD/VTErelated
standards of care; (2) Difficulty weighing competing bleeding and
thrombotic risks; (3) Advocacy for individualized strategies and
multidisciplinary care; and (4) Absence of high-quality and long-term data
for PWH. Discussion and Conclusion(s): Our scoping review highlights
unmet needs in the management of an aging population of PWH with
increasing prevalence of CVD and VTE. Management patterns are inconsistent
and diverge from those of non-hemophilic patients. Current literature
provides limited information on key issues such as hemostatic regimen,
target factor levels, bleeding events and longterm outcomes. Prospective,
clinically actionable data are needed to inform optimal and evidence-based
management strategies of CVD and VTE in PWH. Higher quality data should
culminate in much needed guidelines co-produced with patient partners and
medical experts in hemophilia, CVD, and VTE.

<22>
Accession Number
637595955
Title
5 years mortality after non St segment elevation myocardial infarction
patients with or without diabetes.
Source
Endocrine Practice. Conference: AACE Cardiometabolic Conference and AACE
Communities Middle East Abstracts. Virtual. 27(12 SUPPL) (pp S1), 2021.
Date of Publication: December 2021.
Author
Tanwar S.
Institution
(Tanwar) HG SMS Hospital
Publisher
American Association of Clinical Endocrinologists
Abstract
Objective: Background: Major cause of death worldwide is coronary artery
disease. Epidemic of diabetes mellitus is increasing the burden of
cardiovascular disease, the leading cause of death among same.
 Objective(s): To evaluate the influence of diabetes on mortality
after non ST segment elevation myocardial infarction (NSTEMI).
 Method(s): Significant CAD patients presented NSTEMI in randomized
observational study from 2013 to 2015 were pooled, including 3287 in Group
A: n=1004, 30.5% with Diabetes type-2 and Group B: n=2283 without
diabetes. We divided into two sub groups A1: n=204 (PCI/CABG) 20.3% and
A2: n=800 (Medical treatment) with diabetes. Another subgroup B1: n=487
(PCI/CABG) 21.3% and B2 : n=1896 (Medical treatment) without diabetes.
Multivariable model was constructed to adjust for baseline
characteristics, aspects of NSTEMI presentation, and treatments for the
same event. Result(s): Mortality at 30 days was significantly higher
among patients with diabetes than without diabetes in PCI/CABG; group A1
vs B1(2.45% vs 1.64%, P < .03) and Medical treatment ;group A2 vs B2 (4.5%
vs 2.68%, P < .04). Diabetes was independently associated with higher
30-day mortality after NSTEMI in PCI/CABG group (odds ratio [OR], 1.50;
95% confidence interval [CI], 1.34-1.79) versus Medical treatment group
(OR, 1.70; 95% CI, 1.45-2.16). Diabetes with NSTEMI was associated with
significantly higher mortality after 12 months in PCI/CABG; group (hazard
ratio [HR], 1.23; 95% CI, 1.09-1.45)versus Medical treatment (HR, 1.56;
95% CI, 1.30-2.10). Mortality after 5 years was significantly higher with
diabetes than without diabetes in PCI/CABG; group A1 vs B1(11.27% vs
5.33%, P < .04) or Medical treatment; group A2 vs B2 (14.5% vs 7.22%, P <
.03). Discussion/Conclusion: Diabetes confers a significant adverse
prognosis with ischemic heart disease with two-fold increased mortality as
compared to euglycemic NSTEMI patients. Coronary revascularization may
have beneficiary role to reduce half risk of cardiac death after
significant CAD in diabetic patients.

<23>
Accession Number
637597624
Title
Magnesium sulfate as atrial fibrillation prophylaxis post coronary artery
bypass graft surgery: A meta-analysis.
Source
European Heart Journal, Supplement. Conference: 30th Annual Scientific
Meeting of Indonesian Heart Association, ASMIHA. Virtual. 23(SUPPL F) (pp
F19), 2021. Date of Publication: November 2021.
Author
Rismawanti R.I.; Rachmanadi M.B.
Institution
(Rismawanti, Rachmanadi) Faculty of Medicine,Public Health and Nursing,
Universitas Gadjah Mada, Yogyakarta, Indonesia
Publisher
Oxford University Press
Abstract
Background and Aims: Arrhythmia, especially atrial fibrillation (AF), is a
common complication post coronary artery bypass graft (CABG) surgery and a
major source of morbidity and mortality. This meta-analysis aims to
evaluate the use of magnesium sulfate (MgSO4) as AF prophylaxis post CABG
surgery. Method and Results: A total of 10 studies enrolled 1,371 patients
(1,114 males and 257 females) were retrieved from Pubmed, Cochrane, and
Medline until July 2021 to identify studies about the association between
MgSO4 and AF occurrence post CABG surgery. All suitable full text must
accomplish Jadad score >=2 for assessing study quality. Data were analyzed
using Review Manager 5.3. Mantel-Haenszel formula was used for dichotomous
variables to calculate the odds ratio (OR). Our results showed MgSO4 group
(n=711) compared to the placebo group (n=660) were at decreased odds of
having AF post CABG surgery (OR 0.59; 95%CI 0.39 to 0.91; p=0.03) with AF
occurrence in 134 patients and 188 patients, respectively. Data were
derived from the random-effects model due to the heterogenous result
between studies (Tau2=0.22, Chi2=18.99, df=9
[p=0.03], I2 = 53%). Conclusion(s): This meta-analysis showed that
administration of MgSO4 decreased the occurrence of AF occurrence post
CABG surgery. Further research is needed to determine the optimal MgSO4
dose and time of administration.

<24>
Accession Number
637612740
Title
A systematic review and meta-analysis of percutaneous coronary
intervention compared to coronary artery bypass grafting in
non-ST-elevation acute coronary syndrome.
Source
Scientific reports. 12(1) (pp 5138), 2022. Date of Publication: 24 Mar
2022.
Author
Kirov H.; Caldonazo T.; Rahouma M.; Robinson N.B.; Demetres M.; Serruys
P.W.; Biondi-Zoccai G.; Gaudino M.; Doenst T.
Institution
(Kirov, Caldonazo, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena 07747, Germany
(Rahouma, Robinson, Gaudino) Department of Cardiothoracic Surgery at New
York Presbyterian, Weill Cornell Medical Center, NY, United States
(Demetres) Weill Cornell Medicine, Samuel J. Wood Library and C.V. Starr
Biomedical Information Center, NY, NY, United States
(Serruys) Department of Cardiology, National University of Ireland, Galway
(NUIG), Galway, Ireland
(Serruys) CORRIB Corelab and Center for Research and Imaging, Galway,
Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) NaplesItaly
Publisher
NLM (Medline)
Abstract
Non-ST-elevation acute coronary syndrome (NSTE-ACS) affects millions of
patients. Although an invasive strategy can improve survival, the optimal
treatment [i.e., percutaneous coronary intervention (PCI) or coronary
artery bypass grafting (CABG)] is not clear. We performed a meta-analysis
of studies reporting outcomes between PCI and CABG in patients with
NSTE-ACS. MEDLINE, EMBASE and Cochrane Library were assessed. The primary
outcome was long-term mortality. Inverse variance method and random model
were performed. We identified 13 observational studies (48,891 patients).
No significant difference was found in the primary endpoint [CABG vs. PCI,
incidence rate ratio (IRR) 0.93, 95% confidence interval (CI) 0.70; 1.23].
CABG was associated with lower long-term major adverse cardiovascular
events (MACE) (IRR 0.64, 95% CI 0.54; 0.76) and lower long-term
re-revascularization (IRR 0.37, 95% CI 0.30; 0.47). There was no
significant difference in long-term myocardial infarction (CABG vs. PCI,
IRR 0.96, 95% CI 0.50; 1.84) and peri-operative mortality (CABG vs. PCI,
odds ratio 1.36, 95% CI 0.94; 1.95). For the treatment of NSTE-ACS, CABG
and PCI are associated with similar rates of long-term mortality and
myocardial infarction. CABG is associated with lower rates of long-term
MACE and re-revascularization. Randomized comparisons in this setting are
necessary. Copyright © 2022. The Author(s).

<25>
Accession Number
2017451115
Title
Design and baseline characteristics of participants in the COcoa
Supplement and Multivitamin Outcomes Study (COSMOS).
Source
Contemporary Clinical Trials. 116 (no pagination), 2022. Article Number:
106728. Date of Publication: May 2022.
Author
Rist P.M.; Sesso H.D.; Johnson L.G.; Aragaki A.K.; Wang L.; Rautiainen S.;
Hazra A.; Tobias D.K.; LeBoff M.S.; Schroeter H.; Friedenberg G.; Copeland
T.; Clar A.; Tinker L.F.; Hunt R.P.; Bassuk S.S.; Sarkissian A.; Smith
D.C.; Pereira E.; Carrick W.R.; Wion E.S.; Schoenberg J.; Anderson G.L.;
Manson J.E.
Institution
(Rist, Sesso, Hazra, Tobias, Friedenberg, Copeland, Clar, Bassuk,
Sarkissian, Smith, Pereira, Manson) Division of Preventive Medicine,
Brigham and Women's Hospital and Harvard Medical School, Boston, MA,
United States
(Rist, Sesso, Manson) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, United States
(Johnson, Aragaki, Tinker, Hunt, Carrick, Wion, Schoenberg, Anderson)
Division of Public Health Sciences, Fred Hutchinson Cancer Research
Center, Seattle, WA, United States
(Wang) Epidemiology, Janssen Research & Development, LLC, Titusville, NJ,
United States
(Rautiainen) Department of Global Public Health, Karolinska Institute,
Stockholm, Sweden
(LeBoff) Division of Endocrinology, Diabetes and Hypertension, Brigham and
Women's Hospital and Harvard Medical School, Boston, MA, United States
(Schroeter) Mars Inc., 6885 Elm St, McLean, VA 22101, United States
Publisher
Elsevier Inc.
Abstract
Background Cocoa extract and multivitamins have been proposed to reduce
the risk of cardiovascular disease (CVD) and cancer, respectively.
However, few randomized clinical trials have tested their long-term
effects on these outcomes. Methods The COcoa Supplement and Multivitamin
Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled,
2 x 2 factorial trial of a cocoa extract supplement and a multivitamin
supplement to reduce the risk of CVD and cancer. Here we describe the
pragmatic, hybrid design of the trial and baseline characteristics of the
trial participants. Results The nationwide study population includes
21,442 U.S. women aged >=65 years and men aged >=60 years without baseline
myocardial infarction (MI), stroke, or a recent (within the past 2 years)
cancer diagnosis. Participants were randomized in a 2 x 2 factorial design
to one of four groups: (1) cocoa extract (containing 500 mg/d flavanols,
including 80 mg (-)-epicatechin) and a multivitamin (Centrum
Silver©); (2) cocoa extract and multivitamin placebo; (3)
multivitamin and cocoa extract placebo; or (4) both placebos.
Randomization successfully distributed baseline demographic, clinical,
behavioral, and dietary characteristics across treatment groups. Baseline
biospecimens were collected from 6867 participants, with at least one
follow-up biospecimen from 2142 participants. The primary outcome for the
cocoa extract intervention is total CVD (a composite of MI, stroke,
cardiovascular mortality, coronary revascularization, unstable angina
requiring hospitalization, carotid artery surgery, and peripheral artery
surgery); the primary outcome for the multivitamin intervention is total
invasive cancer. Conclusion COSMOS will provide important information on
the health effects of cocoa extract and multivitamin supplementation in
older U.S. adults. Clinical Trials Registration: clinicaltrials.gov
#NCT02422745 Copyright © 2022 Elsevier Inc.

<26>
Accession Number
2016041488
Title
Infective Endocarditis by Moraxella Species: A Systematic Review.
Source
Journal of Clinical Medicine. 11(7) (no pagination), 2022. Article Number:
1854. Date of Publication: April-1 2022.
Author
Ioannou P.; Alexakis K.; Baliou S.; Kofteridis D.P.
Institution
(Ioannou, Alexakis, Baliou, Kofteridis) Department of Internal Medicine &
Infectious Diseases, University Hospital of Heraklion, Heraklion 71110,
Greece
Publisher
MDPI
Abstract
Moraxella catarrhalis is the most clinically relevant species among
Moraxella spp. For decades, it was considered to be part of the normal
human flora in the upper respiratory tract. However, since the late 1970s,
considerable evidence has proposed that M. catarrhalis is an important
pathogen in the human respiratory tract. Even though Infective
Endocarditis (IE) is rarely caused by Moraxella spp., these infections can
be problematic due to the lack of experience in their management. The aim
of this study was to systematically review all published cases of IE by
Moraxella spp. A systematic review of PubMed, Scopus and Cochrane library
(through 8 December 2021) for studies providing epidemiological, clinical,
microbiological data as well as treatment data and outcomes of IE by
Moraxella spp. was performed. A total of 27 studies, containing data for
31 patients, were included. A prosthetic valve was present in 25.8%.
Mitral valve was the most commonly infected site. Fever, sepsis and
embolic phenomena were the most common clinical presentations.
Cephalosporins, aminoglycosides, aminopenicillins and penicillin were the
most commonly used antimicrobials. Overall mortality was
12.9%. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<27>
Accession Number
2016038841
Title
Infective Endocarditis and Covid-19 Coinfection: An Updated Review.
Source
Acta Biomedica. 93(1) (no pagination), 2022. Article Number: e2022030.
Date of Publication: 14 Mar 2022.
Author
George A.A.; Venkataramanan S.V.A.; John K.J.; Mishra A.K.
Institution
(George, Venkataramanan) Department of Internal Medicine, Saint Vincent
Hospital, Worcester, MA, United States
(John) Department of Critical Care, Bangalore Baptist Hospital, Karnataka,
Hebbal, India
(Mishra) Department of Cardiovascular Medicine, Saint Vincent Hospital,
Worcester, MA, United States
Publisher
Mattioli 1885
Abstract
With the rising number of COVID-19 patients, there have been reports of
patients presenting with concomitant infective endocarditis. In this
retrospective review, we included all articles from Medline with COVID-19
and infective endocarditis coinfection. Ten articles were identified from
eight different countries over the world over the past 11 months. All
patients reported with the above coinfections were male with a mean age of
53 years. Clinical features of COVID-19 and the presence of ground-glass
opacity in CT thorax were predominant among patients with positive RT-PCR
for COVID-19. New-onset embolic infarct, pulmonary edema was a contributor
to the diagnosis of endocarditis in most patients. Involvement of the
aortic valve was most common. Delayed diagnosis and cardiac surgery were
contributors to increased morbidity. (www.actabiomedica.it). Copyright
© Mattioli 1885.

<28>
Accession Number
2015211773
Title
Leukocyte Filtration Improves Pulmonary Function and Reduces the Need for
Postoperative Non-Invasive Ventilation.
Source
International Journal of Artificial Organs. 35(9) (pp 679-688), 2012. Date
of Publication: September 2012.
Author
Rubino A.S.; Serraino G.F.; Marsico R.; Ventura V.; Foti D.; Gulletta E.;
Renzulli A.
Institution
(Rubino) Cardiac Surgery Unit, Ferrarotto Hospital, University of Catania,
Catania, Italy
(Serraino, Marsico, Renzulli) Department of Experimental and Clinical
Medicine, Cardiac Surgery Unit, Magna Graecia University of Catanzaro,
Catanzaro, Italy
(Ventura, Foti, Gulletta) Department of Experimental and Clinical
Medicine, Pathology Unit, Magna Graecia University of Catanzaro,
Catanzaro, Italy
Publisher
SAGE Publications Ltd
Abstract
Objectives: Leukocyte depletion (LD) has been reported to reduce
inflammatory damage during cardiopulmonary bypass (CPB). We evaluated the
role of LD in pulmonary function and inflammatory response.
 Method(s): Seventy consecutive CABG patients were randomized (1:1) to
receive LD on both arterial and cardioplegia lines (Filters) or standard
arterial filters (Controls) during CPB. Estimates of pulmonary function,
inflammatory and anti-inflammatory cytokines were collected pre-, intra-
and postoperatively. Result(s): Hospital mortality, intensive care
and in-hospital lengths of stay were similar. Although duration of
ventilation and incidence of pneumonia were comparable, leukodepleted
patients showed higher PaO <inf>2</inf>/FiO<inf>2</inf> (p-between groups
= 0.005; ICU arrival p = 0.023; 24 hours p = 0.039; 48 hours p<0.001) and
lower need for postoperative non-invasive ventilation (NIV), (p = 0.029).
Moreover, Filters showed lower inflammatory burst at 24 hours (IL-6
p<0.001; IL-8 p = 0.002) and 48 hours (IL-6 p = 0.015). This was
associated with a lower release of the anti-inflammatory IL-10 (p-between
groups = 0.030; ICU admission p = 0.002; 24 hours p = 0.003). Furthermore,
IL-2 concentration proved higher in Filters (p-between groups = 0.013; ICU
arrival p = 0.029; 24 hours p = 0.040; 48 hours p = 0.021) in association
with lower leukocyte and platelet counts at ICU admission.
 Conclusion(s): LD resulted in lower inflammatory burst and less need
for release of anti-inflammatory cytokines. Although hospital outcomes
were similar in terms of mortality and length of stay, improvements in
pulmonary function and reduced need for postoperative NIV support the use
of LD. Copyright © 2012 SAGE Publications.

<29>
Accession Number
637612802
Title
Postoperative outcomes in surgical patients with obstructive sleep apnoea
diagnosed by sleep studies: a meta-analysis and trial sequential analysis.
Source
Anaesthesia. (no pagination), 2022. Date of Publication: 24 Mar 2022.
Author
Pivetta B.; Sun Y.; Nagappa M.; Chan M.; Englesakis M.; Chung F.
Institution
(Pivetta, Sun) Department of Anaesthesia and Pain Medicine, University of
Toronto, ON, Toronto, Canada
(Nagappa) Department of Anaesthesia and Peri-Operative Medicine, London
Health Sciences Centre and St. Joseph Health Care, Schulich School of
Medicine and Dentistry, Western University, ON, London, Canada
(Chan) Department of Anaesthesia and Intensive Care, Chinese University of
Hong Kong, Hong Kong Special Administrative Region, China
(Englesakis) Library and Information Services, ON, University Health
Network, Toronto, Canada
(Chung) University of Toronto, ON, University Health Network, Toronto,
Canada
Publisher
NLM (Medline)
Abstract
Identifying surgical patients with obstructive sleep apnoea may assist
with anaesthetic management to minimise postoperative complications. Using
trial sequential analysis, we evaluated the impact of obstructive sleep
apnoea diagnosed by polysomnography or home sleep apnoea testing on
postoperative outcomes in surgical patients. Multiple databases were
systematically searched. Outcomes included: total postoperative
complications, systemic complications (cardiovascular, respiratory,
neurological, renal, infectious) and specific complications (atrial
fibrillation, myocardial infarction, combined hospital and intensive care
unit re-admission, mortality). The pooled odds ratios of postoperative
complications were evaluated by the Mantel-Haenszel method random-effects
model. Meta-analysis and meta-regression were conducted, and the GRADE
approach was used to evaluate the certainty of evidence. Twenty
prospective cohort studies with 3756 patients (2127 obstructive sleep
apnoea and 1629 non-obstructive sleep apnoea) were included (9 in
non-cardiac surgery and 11 in cardiac surgery). Postoperative
complications were almost two-fold higher with obstructive sleep apnoea,
OR (95%CI) 1.92 (1.52-2.42), p<0.001; certainty of evidence, moderate.
Obstructive sleep apnoea was associated with a 1.5 times increased risk of
postoperative cardiovascular complications, OR (95%CI) 1.56 (1.20-2.02),
p=0.001; certainty of evidence, moderate; an almost two-fold increase in
respiratory complications, OR (95%CI) 1.91 (1.39-2.62), p<0.001; certainty
of evidence, moderate; and hospital and ICU re-admission, OR (95%CI) 2.25
(1.21-4.19), p=0.01; certainty of evidence, low. Trial sequential analysis
showed adequate information size for postoperative complications. Baseline
confounding factors were adjusted by meta-regression, and the sub-group
analysis did not materially change our results. This increased risk
occurred especially in patients in whom obstructive sleep apnoea had been
newly diagnosed, emphasising the importance of pre-operative
screening. Copyright © 2022 Association of Anaesthetists.

<30>
Accession Number
637609146
Title
High Dose Preoperative Glucocorticoid for Prevention of Emergence and
Postoperative Delirium in Liver Resection: A Double-Blinded Randomised
Clinical Trial Substudy.
Source
Acta anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 24 Mar 2022.
Author
Awada H.N.; Steinthorsdottir K.J.; Schultz N.A.; Hillingso J.G.; Larsen
P.N.; Jans O.; Kehlet H.; Aasvang E.K.
Institution
(Awada, Steinthorsdottir, Jans, Aasvang) Department of Anesthesiology,
Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University
Hospital, Copenhagen 2100, Denmark
(Awada, Steinthorsdottir, Kehlet) Surgical Pathophysiology Unit,
Rigshospitalet, Copenhagen University Hospital, Copenhagen 2200, Denmark
(Schultz, Hillingso, Larsen) Centre for Cancer and Organ Diseases,
Rigshospitalet Copenhagen University Hospital, Department of
Gastrointestinal Surgery and Transplantation, Copenhagen 2100, Denmark
(Aasvang) Department of Clinical Medicine, Faculty of Health and Medical
Sciences, University of Copenhagen 2200
Publisher
NLM (Medline)
Abstract
BACKGROUND: Emergence delirium (ED) and postoperative delirium (POD) are
associated with increased morbidity and mortality and occur in up to
one-third of patients undergoing major non-cardiac surgery, where the
underlying pathogenesis is multifactorial, including increased
inflammation. We aimed to assess the effect of pre-operative high- vs.
low-dose glucocorticoid on the occurrence of ED and POD. METHOD(S):
This was a substudy from a randomized, double-blinded clinical trial.
Patients >=18 years, undergoing open liver resection were randomized 1:1
to high (HD, 10 mg/kg methylprednisolone) or low dose (LD, 8 mg
dexamethasone) glucocorticoid and assessed for ED and POD for a maximum of
4 days during hospitalization. The 3-minute Diagnostic Interview for
CAM-defined delirium (3D-CAM) was used for assessment, 15 and 90 minutes
after arrival in the post-anesthesia care unit (PACU), and subsequently
once daily in the ward. RESULT(S): Fifty-three patients were included
in this secondary substudy (26 HD-group and 27 LD-group). ED occurred in
n=5 HD- vs. n=6 LD patients 15 minutes after PACU arrival. At 90 minutes
after PACU arrival, 4 patients had ED, all from LD-group, and resulted in
significantly longer PACU admission, 273 minutes vs. 178 minutes in ED vs.
Non-ED patients. During the first 4 days in the ward, n=5 patients had at
least one occurrence of POD, all from LD-group. CONCLUSION(S): The
primary finding of the current substudy was a lower occurrence of ED/POD
in the PACU 90 minutes after arrival and during the first four
postoperative days in patients receiving high-dose glucocorticoid compared
with patients receiving low-dose glucocorticoid. The two study groups were
not evenly balanced concerning known explanatory factors, i.e., age and
size of surgery, which calls for larger studies to elucidate the
matter. Copyright This article is protected by copyright. All rights
reserved.S.

<31>
Accession Number
2010217649
Title
Enhanced recovery after cardiac surgery and its impact on outcomes: A
systematic review.
Source
Perfusion (United Kingdom). 37(2) (pp 162-174), 2022. Date of Publication:
March 2022.
Author
Zhang Y.; Chong J.H.; Harky A.
Institution
(Zhang) The London School of Medicine and Dentistry, London, United
Kingdom
(Chong) GKT School of Medical Education, King's College London, London,
United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Science,
University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Harky) Department of Cardiac Surgery, Alder Hey Children Hospital,
Liverpool, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background and Aim: Enhanced Recovery After Surgery (ERAS) protocols are a
series of perioperative interventions well-established in improving the
care and outcomes of patients. With recent emergence of studies on its
implementation in cardiac surgery, this paper represents the first
systematic review on current evidence of ERAS efficacy in this field.
 Method(s): Two reviewers independently searched through Pubmed,
Cochrane, Google Scholar, Web of Science, Embase and Scopus. Comparative
studies with controls that described the implementation of ERAS in all
types of cardiac operations from 2001 to 2020 were included. Data
extracted included patient demographics, components of ERAS protocol
described, types of cardiac surgery, and postoperative outcomes.
 Result(s): In the final analysis, nine studies were included, of
which there were one randomized controlled trial (RCT), one
quasi-experiment and seven retrospective/prospective studies. Significant
improvement in hospital and ICU length of stay, as well as reduction in
postoperative opioid consumption were demonstrated. No increase in
postoperative complications were reported. Conclusion(s): ERAS in
cardiac surgery has shown to be potentially safe and effective in
improving certain postoperative outcomes. However, the evidence is limited
by the lack of high-quality RCTs. We also found the lack of practice of
class 1 recommended interventions set forth by the ERAS Cardiac Society.
Furthermore, majority of studies only evaluated the immediate
postoperative outcomes of patients, and not the long-term outcomes. RCTs
that fully implement measures recommended by the ERAS Cardiac Society,
with assessments on both immediate and long-term outcomes, are
warranted. Copyright © The Author(s) 2021.

<32>
Accession Number
2014042394
Title
Sinus Node Sparing Hybrid Thoracoscopic Ablation Outcomes in Patients with
Inappropriate Sinus Tachycardia (SUSRUTA-IST) Registry.
Source
Heart Rhythm. 19(1) (pp 30-38), 2022. Date of Publication: January 2022.
Author
Lakkireddy D.; Garg J.; DeAsmundis C.; LaMeier M.; Romeya A.; Vanmeetren
J.; Park P.; Tummala R.; Koerber S.; Vasamreddy C.; Shah A.; Shivamurthy
P.; Frazier K.; Awasthi Y.; Chierchia G.B.; Atkins D.; Bommana S.; Di
Biase L.; Al-Ahmad A.; Natale A.; Gopinathannair R.
Institution
(Lakkireddy, Romeya, Vanmeetren, Park, Tummala, Koerber, Vasamreddy, Shah,
Shivamurthy, Atkins, Bommana, Gopinathannair) Kansas City Heart Rhythm
Institute, Overland Park, KS, United States
(Garg) Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda
University Health, Loma Linda, CA, United States
(DeAsmundis, Chierchia) Heart Rhythm Management Center, Postgraduate
Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis
Brussel - Vrije Universiteit Brussel, Brussels, Belgium
(LaMeier) Cardiac Surgery Department, Universitair Ziekenhuis Brussel -
Vrije Universiteit Brussel, Brussels, Belgium
(Frazier, Awasthi) AtriCure, Inc., Cincinnati, OH, United States
(Di Biase) Montefiore-Einstein Center for Heart and Vascular Care,
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
(Al-Ahmad, Natale) Texas Cardiac Arrhythmia Institute at St. David's
Medical Center, Austin, TX, United States
Publisher
Elsevier B.V.
Abstract
Background: Medical treatment of inappropriate sinus tachycardia (IST)
remains suboptimal. Radiofrequency sinus node (RF-SN) ablation has poor
success and higher complication rates. Objective(s): We aimed to
compare clinical outcomes of the novel SN sparing hybrid ablation
technique with those of RF-SN modification for IST management.
 Method(s): This is a multicenter prospective registry comparing the
SN sparing hybrid ablation strategy with RF-SN modification. The hybrid
procedure was performed using an RF bipolar clamp, isolating superior vena
cava/inferior vena cava with the creation of a lateral line across the
crista terminalis while sparing the SN region (identified by endocardial
3-dimensional mapping). RF-SN modification was performed by endocardial
and/or epicardial mapping and ablation at the site of earliest atrial
activation. Result(s): Of the 100 patients (hybrid ablation group, n
= 50; RF-SN group, n = 50), 82% were women, and the mean age was 22.8
years. Normal sinus rhythm and rate were restored in all patients in the
hybrid group (vs 84% in the RF-SN group; P =.006). Hybrid ablation was
associated with significantly better improvement in mean daily heart rate
and peak 6-minute walk heart rate compared with RF-SN ablation. The RF-SN
group had a significantly higher rate of redo procedures (100% vs 8%; P
<.001), phrenic nerve injury (14% vs 0%; P =.012), lower acute
pericarditis (48% vs 92%; P <.0001), permanent pacemaker implantation (50%
vs 4%; P <.0001) than did the hybrid ablation group. Conclusion(s):
The novel sinus node sparing hybrid ablation procedure appears to be more
efficacious and safer in patients with symptomatic drug-resistant IST with
long-term durability than RF-SN ablation. Copyright © 2021 Heart
Rhythm Society

<33>
Accession Number
2015208076
Title
Low Dose of Methylprednisolone for Pain and Immune Function After Thoracic
Surgery.
Source
Annals of Thoracic Surgery. 113(4) (pp 1325-1332), 2022. Date of
Publication: April 2022.
Author
Li X.; Song B.; Teng X.; Li Y.; Yang Y.; Zhu J.
Institution
(Li, Song, Teng, Li, Yang, Zhu) Department of Anesthesiology, Shengjing
Hospital of China Medical University, Liaoning, Shenyang, China
(Song) Department of Anesthesiology, Beijing Friendship Hospital of
Capital Medical University, Beijing, China
Publisher
Elsevier Inc.
Abstract
Background: This study evaluated the effects of single low-dose
preoperative methylprednisolone (MP) on the immunologic function and
postoperative pain of patients undergoing elective video-assisted
thoracoscopic surgery under general anesthesia. Method(s): The study
randomly assigned 81 patients who underwent elective video-assisted
thoracoscopic surgery to the MP group or the control group. The
T-lymphocyte subsets of CD3+, CD4+, and
CD8+, and the CD4+/CD8+ ratio at
T<inf>0</inf> (before anesthesia), T<inf>1</inf> (after operation), and
T<inf>2</inf> (24 hours after operation) were recorded. Also recorded were
postoperative rest and cough pain scores and postoperative adverse effects
and surgery complications. Result(s): Compared with T<inf>0</inf>,
the levels of CD3+ and CD4+ subsets and
CD4+/CD8+ were significantly decreased, and the
level of CD8+ was increased after surgery in both groups. There
was no significant difference in the variation of CD3+,
CD4+, CD8+, and CD4+/CD8+
between the MP group and the control group. The rest and cough pain of
patients in the MP group was significantly lower compared with the control
group at 2, 4, 6, and 24 hours after surgery. The incidences of nausea and
vomiting and dizziness were also significantly higher in the control group
than those in the MP group. Conclusion(s): A preoperative single low
dose of MP (1 mg/kg) had no effect on immune function but had effective
analgesic effects and could reduce the incidence of dizziness and
postoperative nausea and vomiting. Copyright © 2022 The Society
of Thoracic Surgeons

<34>
Accession Number
2015373884
Title
Cost comparison between transcatheter aortic valve implantation and
surgical valve replacement using individual data in a Spanish public
hospital.
Source
Cirugia Cardiovascular. 28(6) (pp 317-324), 2021. Date of Publication: 01
Nov 2021.
Author
Areces S.; Hernandez-Vaquero D.; Avanzas P.; Garcia-Aranda F.J.; Silva J.;
Moris C.
Institution
(Areces, Hernandez-Vaquero, Avanzas, Garcia-Aranda, Silva, Moris) Area del
Corazon, Hospital Universitario Central de Asturias, Oviedo, Spain
(Areces, Hernandez-Vaquero, Avanzas, Silva, Moris) Universidad de Oviedo,
Oviedo, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Background: Transcatheter aortic valve implantation has revolutionized the
management of aortic stenosis and is currently an alternative to surgical
aortic valve replacement. Some studies have found costs of percutaneous
procedure to be greater than those of surgical replacement. However, these
published studies are based on pooled data from clinical registries. The
objective of the present study was to compare costs of both treatments
during the hospital phase in a Spanish public hospital. Method(s): A
hospital phase cost study consisted of patients diagnosed and treated with
aortic stenosis in a Spanish tertiary hospital between 1st January 2019
and 29th February 2020. An individual analysis was conducted in relation
to real costs pertaining to materials, staffing and hospital stay. Several
baseline characteristics were controlled for. Result(s): Mean costs
per patient from procedure through to discharge were 26,684.1 in the
percutaneous group and 14,939.5 in the surgical group (p < 0.001).
Independent of comorbidities, the cost of transcatheter aortic valve
implantation was, on average, 8636.6 greater than that of surgical aortic
valve replacement (95% CI 6086.3-11,186.9; p < 0.001). Conclusion(s):
Aortic stenosis treatment costs in hospital phase were greater when
percutaneous option was used in comparison to surgery. Copyright
© 2021 Sociedad Espanola de Cirugia Cardiovascular y Endovascular

<35>
Accession Number
2006156290
Title
Subxiphoid versus intercostal video-assisted thoracic surgery for lung
resection: a meta-analysis.
Source
Minimally Invasive Therapy and Allied Technologies. 31(3) (pp 359-369),
2022. Date of Publication: 2022.
Author
Mei L.-X.; Wang Y.-Y.; Chen Y.; Dai L.; Chen M.-W.
Institution
(Mei, Wang, Chen, Dai, Chen) Department of Cardiothoracic Surgery, the
First Affiliated Hospital of GuangXi Medical University, Nanning, China
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: To systematically evaluate the safety and advantages of
subxiphoid approach video-assisted thoracic surgery (SA-VATS) compared
with intercostal approach video-assisted thoracic surgery (IA-VATS) for
lung resection, we conducted a meta-analysis of the current literature.
 Material(s) and Method(s): The literature search was conducted in
PubMed, Web of Science, Cochrane Library, Embase, and China National
Knowledge Infrastructure. RevMan 5.3 software was used to perform this
meta-analysis. Result(s): Eleven studies involving 934 patients were
included. Compared with patients in the IA-VATS group, those in the
SA-VATS group had lower pain scores on the day of the operation and at 24
h, 48 h and 72 h after the operation (p <.001) and suffered from less
postoperative paraesthesia at the first, third and sixth months after the
operation (p <.001). Moreover, there was no statistically significant
difference between the two groups regarding postoperative complications,
intraoperative blood loss, length of hospital stay, drainage amount, or
chest tube duration. However, SA-VATS had a longer operative time (p
<.001). Conclusion(s): SA-VATS is a safe surgical technique and has
superior postoperative outcomes over IA-VATS for lung resection in terms
of acute postoperative pain and chronic postoperative
paraesthesia. Copyright © 2020 Society of Medical Innovation and
Technology.

<36>
Accession Number
2017254028
Title
Exercise-based cardiac rehabilitation after myocardial revascularization:
a systematic review and meta-analysis.
Source
Reviews in Cardiovascular Medicine. 23(2) (no pagination), 2022. Article
Number: 074. Date of Publication: 01 Feb 2022.
Author
Campos H.O.; Rodrigues Q.T.; Drummond L.R.; Lima P.M.A.; Da Costa Monteiro
M.; Penna Wanner S.; Coimbra C.C.
Institution
(Campos) Department of Biological Sciences, University of the State of
Minas Gerais - Carangola Unit, Carangola 36800-000, Brazil
(Campos, Rodrigues, Drummond, Lima, Da Costa Monteiro, Coimbra) Department
of Physiology and Biophysics, Institute of Biological Sciences, Federal
University of Minas Gerais, Belo Horizonte 31270-901, Brazil
(Drummond) Department of Physical Education, State University of Minas
Gerais - Divinopolis Unit, Divinopolis 35501-170, Brazil
(Lima) Faculty of Medicine, University of Rio Verde, Aparecida de Goiania
74923-250, Brazil
(Penna Wanner) Department of Physical Education, Federal University of
Minas Gerais, Belo Horizonte 31270-901, Brazil
Publisher
IMR Press Limited
Abstract
Background: The present study aimed to analyze the effects of
exercise-based cardiac rehabilitation (CR) on physical performance after
myocardial revascularization. In addition, we compared the type and
duration of exercise-based CR protocols to determine which ones produced
the best performance improvements. Method(s): This systematic review
and meta-analysis was conducted and reported in accordance with PRISMA
statement. A systematic search of PubMed, Web of Science, SPORTDiscus and
ProQuest, was performed in July 2020. Studies that met the following
criteria were included: (i) participants submitted to myocardial
revascularization (i.e., coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI)), (ii) participants submitted to
exercise-based CR, and (iii) participants submitted to protocols for
assessing physical performance before and after the exercise-based CR.
 Result(s): Thirteen and eleven studies evaluating the effects of
exercise-based CR after myocardial revascularization were included in the
systematic review and meta-analysis, respectively. Exercise-based CR
increased physical performance after myocardial revascularization (mean
effect size (ES) 0.75;95% confidence interval (CI) 0.62, 0.88),
particularly when aerobic (ES 0.85;95% CI 0.68, 1.01) and combined
training (ES 1.04;95% CI 0.70, 1.38) lasting 8-12 weeks (ES 1.20;95% CI
0.87, 1.53) was prescribed. Conclusion(s): The present systematic
review and meta-analysis indicates that exercise-based CR increases
physical performance after myocardial revascularization. The prescription
of physical training for these patients should emphasize aerobic and
combined training lasting at least 8-12 weeks, which is more effective in
improving physical performance. Impact: Our findings demonstrate the
effectiveness of physical training in improving physical performance after
myocardial revascularization. Copyright © 2022 IMR Press Limited.
All rights reserved.

<37>
[Use Link to view the full text]
Accession Number
2017047111
Title
The Analgesic Effect of Ultrasound-guided Bilateral Pectointercostal
Fascial Plane Block on Sternal Wound Pain after Open Heart Surgeries: A
Randomized Controlled Study.
Source
Clinical Journal of Pain. 38(4) (pp 279-284), 2022. Date of Publication:
07 Apr 2022.
Author
Hamed M.A.; Abdelhady M.A.; Hassan A.A.S.M.; Boules M.L.
Institution
(Hamed, Abdelhady, Hassan, Boules) Department of Anesthesiology, Faculty
of Medicine, Fayoum University, Fayoum 63511, Egypt
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: We aimed to evaluate the analgesic efficacy of
ultrasound-guided bilateral pectointercostal fascial plane block after
open heart surgeries. Method(s): Seventy patients aged above 18 years
and scheduled for on-pump coronary artery bypass grafting or valve
replacement or both through median sternotomy were enrolled in this study.
Patients were randomly allocated into 2 groups of 35 (block group or
control group). The block group had the block performed through 20 ml of a
solution of 0.25% bupivacaine plus epinephrine (5 mcg/mL), and the control
group received dry needling. The primary outcome was the 24-hour
cumulative morphine consumption. The secondary outcomes were time to the
first analgesic request, pain score, quality of oxygenation, intensive
care unit stays, and hospital stay. Result(s): The cumulative
morphine consumption in the first 24 hours was significantly lower in the
block group, with a mean difference of -3.54 (95% confidence
interval=-6.55 to -0.53; P=0.015). In addition, the median estimate time
to the first analgesic request was significantly longer in the block group
than in the control group. Finally, during the postoperative period (4 to
24 h), mean sternal wound objective pain scores were, on average, 0.58
units higher in the block group. Conclusion(s): pectointercostal
fascial block is an effective technique in reducing morphine consumption
and controlling poststernotomy pain after cardiac surgeries. Also, it may
have a role in better postoperative respiratory outcomes. Copyright
© 2022 Lippincott Williams and Wilkins. All rights reserved.

<38>
Accession Number
637060835
Title
Topical antibiotic prophylaxis for surgical wound infections in clean and
clean-contaminated surgery: a systematic review and meta-analysis.
Source
BJS open. 5(6) (no pagination), 2021. Date of Publication: 09 Nov 2021.
Author
Chen P.-J.; Hua Y.-M.; Toh H.S.; Lee M.-C.
Institution
(Chen) Department of Emergency Medicine, Chi Mei Medical Center, Tainan,
Taiwan (Republic of China)
(Hua, Lee) Department of Pharmacy, Chi Mei Medical Center, Tainan, Taiwan
(Republic of China)
(Toh) Department of Intensive Care Medicine, Chi Mei Medical Center,
Tainan, Taiwan (Republic of China)
(Toh) Institute of Clinical Medicine, College of Medicine, National Cheng
Kung University, Tainan, Taiwan (Republic of China)
(Toh) Department of Health and Nutrition, Chia Nan University of Pharmacy
& Science, Tainan, Taiwan (Republic of China)
(Lee) Department of Public Health, College of Medicine, National Cheng
Kung University, Tainan, Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Topical antibiotics are widely prescribed as prophylaxis for
surgical site infection (SSI). Despite giving high drug concentrations at
local wound sites, their efficacy remains controversial. This study is a
systematic review and meta-analysis designed to compare the efficacy and
safety of topical antibiotics with non-antibiotic agents in preventing
SSI. METHOD(S): Randomized controlled trials (RCTs) comparing topical
antibiotics in patients with clean and clean-contaminated postsurgical
wounds were included. Relevant trials published before 30 September 2020,
were searched in the PubMed, Embase, and Cochrane databases, without
language restrictions. The primary outcome was the incidence of SSIs,
presented as the event rate. The secondary outcome was the incidence of
contact dermatitis (safety outcome). Data were synthesized using the
random-effects model, with the results expressed as risk ratio (RR) with
95 per cent confidence intervals (c.i.). RESULT(S): Thirteen RCTs
were included. The incidence of SSIs and contact dermatitis showed no
significant difference between topical antibiotics and non-antibiotic
agents (RR 0.89, 95 per cent c.i. 0.59 to 1.32 (P = 0.56, I2 = 48 per
cent); and RR 2.79, 95 per cent c.i. 0.51 to 15.19 (P = 0.24, I2 = 0 per
cent), respectively). In the subgroup analyses, a reduction in SSIs was
also not observed in dermatological (RR 0.77, 95 per cent c.i. 0.39 to
1.55; P = 0.46, I2 = 65 per cent), ocular (RR 0.08, 95 per cent c.i. 0.00
to 1.52; P = 0.09), spinal (RR 1.34, 95 per cent c.i. 0.65 to 2.77; P =
0.43, I2 = 0 per cent), orthopaedic (RR 0.69, 95 per cent c.i. 0.37 to
1.29; P = 0.25, I2 = 0 per cent), or cardiothoracic surgeries (RR 1.60, 95
per cent c.i. 0.79 to 3.25; P = 0.19). CONCLUSION(S): Given the
current evidence, the routine application of topical antibiotics to
surgical wounds did not reduce the incidence of SSI. Further trials are
needed to assess their effectiveness in high-risk surgeries or in selected
patient groups. Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of BJS Society Ltd.

<39>
Accession Number
635414964
Title
Effect of neridronate in osteopenic patients after heart, liver or lung
transplant: a multicenter, randomized, double-blind, placebo-controlled
study.
Source
Panminerva medica. 63(2) (pp 214-223), 2021. Date of Publication: 01 Jun
2021.
Author
Giannini S.; Poci C.; Fusaro M.; Egan C.G.; Marcocci C.; Vignali E.;
Cetani F.; Nannipieri F.; Loy M.; Gambino A.; Adami G.; Braga V.; Rossini
M.; Arcidiacono G.; Baffa V.; Sella S.
Institution
(Giannini) Department of Medicine (DIMED), University of Padua, Padua,
Italy
(Poci, Arcidiacono, Baffa, Sella) Department of Medicine (DIMED),
University of Padua, Padua, Italy
(Fusaro) National Research Council (CNR), Institute of Clinical Physiology
(IFC), Pisa, Italy
(Fusaro) Department of Medicine, University of Padua, Padua, Italy
(Egan) PisaItaly
(Marcocci, Vignali, Cetani) Unit of Endocrinology, Department of Clinical
and Experimental Medicine, University of Pisa, Pisa, Italy
(Nannipieri) Clinical Research, Pisa, Italy
(Loy) Unit of Thoracic Surgery, Department of Cardiac, Thoracic, Vascular
Sciences and Public Health, University of Padua, Padua, Italy
(Gambino) Unit of Cardiac Surgery, Department of Cardio-Thoracic Vascular
Sciences and Public Health, University of Padua, Padua, Italy
(Adami, Braga, Rossini) Unit of Rheumatology, Department of Medicine,
University of Verona, Verona, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transplantation (Tx) is an effective therapeutic option in
patients with end-stage organ failure and osteoporosis and related
fractures are a recognized complication in these patients. Aim of this
study was to evaluate the efficacy of neridronate in patients with reduced
bone mass after Tx of the heart, liver or lung. METHOD(S): In this
multicenter randomized double-blind controlled trial (RCT), 22 patients
were treated with neridronate (25 mg i.m./month) and 17 received placebo.
All patients received daily oral calcium (500 mg) and vitamin D (400 IU).
Dual-energy X-ray absorptiometry (DXA) was evaluated at 0, 6 and 12 months
and markers of bone turnover at 0, 3, 6, 9 and 12 months. RESULT(S):
Thirty-nine patients (11 heart Tx, 21 liver Tx, 7 lung Tx), aged
49.3+/-9.1 years, with a T-score <-2.0 SD at lumbar spine or femoral level
were included. In neridronate-treated patients, a significant increase in
lumbar bone mineral density (BMD) was observed after 12 months vs. placebo
control (0.92+/-0.13 g/cm2 vs. 0.84+/-0.08 g/cm2; P=0.005). Femur and hip
BMD remained unchanged between groups. Total alkaline phosphatase, bone
alkaline phosphatase and beta-cross-laps significantly decreased over the
12 months in neridronate-treated patients vs. placebo, respectively
(107.4+/-74 U/L vs. 157.6+/-107.1 U/L, P=0.002; 5.7+/-3.3 microg/L vs.
11.7+/-4.3 microg/L, P<0.001 and 0.25+/-0.13 ng/mL vs. 0.73+/-0.57 ng/mL,
P<0.001). No difference was observed between neridronate and placebo
groups regarding safety profile. CONCLUSION(S): This is the first RCT
that demonstrates the efficacy of neridronate in increasing bone density
and reducing bone turnover in organ Tx recipients with significant
skeletal morbidity.

<40>
Accession Number
2017404087
Title
Prognostic Value of Creatine Phosphate and Inflammatory Markers for Mitral
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Applied Bionics and Biomechanics. 2022 (no pagination), 2022. Article
Number: 1132452. Date of Publication: 2022.
Author
Zhu Y.; Zou C.; Zhang J.; Chen L.; Jia Y.
Institution
(Zhu, Jia) Department of Cardiac Surgery, Shandong Provincial Hospital,
Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021,
China
(Zhu, Zou, Zhang, Chen, Jia) Department of Cardiac Surgery, Shandong
Provincial Hospital Affiliated to Shandong First Medical University,
Jinan, Shandong 250021, China
Publisher
Hindawi Limited
Abstract
Purpose. The prognosis of mitral valve replacement is an important
clinical issue and may produce unexpected mortality rates if not properly
addressed. The postoperative examination results have important prognostic
implications. This study was designed to determine the prognostic value of
phosphocreatine and inflammatory markers after mitral valve replacement.
Method. Comparison and analysis of the data obtained using SPSS software.
The computer retrieved PubMed, Science Citation Index (SCI), Embase, VIP,
CNKI, CBM, and Wanfang database and manually retrieved randomized
controlled trials (RCTs) published at home and abroad on the central
muscle protection role of creatine phosphate in heart valve replacement,
and the search period was established until February 2018. Two random
literature reviewers independently screened the literature and extracted
data, using Review Manager (RevMan) (Computer program), version 5.3 (The
Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, 2014).
RevMan software version 5.0 assesses the risk of bias for inclusion in
studies. The software performs a meta-analysis of the obtained data.
Results. Ten RCTs with a total of 464 participants were enrolled. The
meta-analysis results showed that (1) elevated creatine kinase levels
often predict a better prognosis after mitral valve replacement (RR=1.36,
95% CI: 1.22 to 1.52, P<0.00001), (2) the creatine kinase isoenzyme level
in the venous blood of the phosphocreatine group after 24 h of aortic
blocking was significantly lower than that in the control group
(SMD=-2.90, 95% CI: -5.19 to -0.60, P=0.01), and (3) Troponin I levels
were significantly lower in the intravenous creatine group than in the
control group 24 h after opening of the aortic block (SMD=-1.49, 95% CI:
-2.02 to -0.97,P<0.00001). Conclusions. Creatine phosphate and
inflammatory factor have good predictive value for the prognosis of mitral
valve replacement. Copyright © 2022 Yanhui Zhu et al.

<41>
Accession Number
2017440522
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. 248 (pp 35-41), 2022. Date of Publication: June
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, Diepen) Department of Critical Care Medicine, University of
Alberta, Edmonton, AB, Canada
(Rathwell, Zheng, Goodman, Diepen) 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, NC, Durham
(Goodman) Terrence Donnelly Heart Centre, Division of Cardiology, St.
Michael's Hospital, University of Toronto, Toronto, ON, Canada
(Diepen) Division of Cardiology, Department of Medicine, University of
Alberta, Edmonton, AB, Canada
Publisher
Elsevier Inc.
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, extracorporeal membrane
oxygenation, or surgical ventricular assist device) 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 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 intra-aortic balloon pump, 7
extracorporeal membrane oxygenation, 7 ventricular assist device); with
89.4% started on post-operative day 0. 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
< .001), history of lung disease (OR 1.70, 95% CI 1.06-2.70, P = .029),
and history of heart failure (OR 2.44, 95% CI 1.10-5.45, P = .027).
Adjusted 90-day mortality (22.4% vs 4.1%, hazard ratio 6.11, 95% CI
3.95-9.44, P < .001) was higher, and median critical care length of stay
(8.0 vs 4.0 days, P < .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 Inc.

<42>
[Use Link to view the full text]
Accession Number
2017343127
Title
Traumatic mitral valve regurgitation: a case report and state-of-the-art
review.
Source
Journal of Cardiovascular Medicine. 20(10) (pp 709-717), 2019. Date of
Publication: 01 Oct 2019.
Author
Forteleoni A.; Montereggi F.; Sanna G.D.; Portoghese M.; Parodi G.
Institution
(Forteleoni, Montereggi, Sanna, Portoghese, Parodi) Sassari University
Hospital, Sassari, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Traumatic mitral valve regurgitation is a rare and often insidious
condition. Clinical presentation is variable and influenced by the
anatomic structures injured; when papillary muscles are damaged, the
clinical presentation is often acute, whereas, in the case of involvement
of other anatomic structures of the valvular apparatus (e.g. chordae
tendinae), the onset of symptoms may be delayed (days, weeks, or months).
Therefore, diagnosis may be belated because of the heterogeneous clinical
presentation. Traumatic mitral valve injury should be excluded in patients
admitted to the emergency services with blunt chest trauma, in particular
when signs or symptoms of acute heart failure occur. Echocardiography,
particularly with the transoesophageal approach, may play a pivotal role
in this setting. Herein, we present a case of severe mitral regurgitation
because of blunt chest trauma and a systematic review of the literature.
We examined 192 described cases, classified according to epidemiology,
aetiology, anatomic features, clinical presentation, diagnosis,
surgical/clinical management and prognosis. Copyright © 2019
Italian Federation of Cardiology - I.F.C.

<43>
Accession Number
2016009877
Title
Remote Ischaemic Preconditioning in Intra-Abdominal Cancer Surgery
(RIPCa): A Pilot Randomised Controlled Trial.
Source
Journal of Clinical Medicine. 11(7) (no pagination), 2022. Article Number:
1770. Date of Publication: April-1 2022.
Author
Papadopoulou A.; Dickinson M.; Samuels T.L.; Heiss C.; Hunt J.; Forni L.;
Creagh-Brown B.C.
Institution
(Papadopoulou) Department of Anaesthesia, King's College Hospital, London
SE5 9RS, United Kingdom
(Papadopoulou, Heiss, Hunt, Forni, Creagh-Brown) Department of Clinical
and Experimental Medicine, Faculty of Health and Medical Sciences,
University of Surrey, Guildford GU2 7XH, United Kingdom
(Dickinson) Department of Anaesthesia, Royal Surrey County Hospital,
Guildford GU2 7XX, United Kingdom
(Samuels) Department of Critical Care, Surrey and Sussex Healthcare NHS
Trust, Redhill RH2 5RH, United Kingdom
(Heiss) Vascular Department, Surrey and Sussex Healthcare NHS Trust,
Redhill RH2 5RH, United Kingdom
(Forni, Creagh-Brown) Department of Critical Care, Royal Surrey County
Hospital, Guildford GU2 7XX, United Kingdom
Publisher
MDPI
Abstract
There is limited evidence on the effect of remote ischaemic
preconditioning (RIPC) following non-cardiac surgery. The aim of this
study was to investigate the effect of RIPC on morbidity following
intra-abdominal cancer surgery. We conducted a double blinded pilot
randomised controlled trial that included 47 patients undergoing surgery
for gynaecological, pancreatic and colorectal malignancies. The patients
were randomized into an intervention (RIPC) or control group. RIPC was
provided by intermittent inflations of an upper limb tourniquet. The
primary outcome was feasibility of the study, and the main secondary
outcome was postoperative morbidity including perioperative troponin
change and the urinary biomarkers tissue inhibitor of metalloproteinases-2
and insulin-like growth factor-binding protein 7 (TIMP-2*IGFBP-7). The
recruitment target was reached, and the protocol procedures were followed.
The intervention group developed fewer surgical complications at 30 days
(4.5% vs. 33%), 90 days (9.5% vs. 35%) and 6 months (11% vs. 41%)
(adjusted p 0.033, 0.044 and 0.044, respectively). RIPC was a significant
independent variable for lower overall postoperative morbidity survey
(POMS) score, OR 0.79 (95% CI 0.63 to 0.99) and fewer complications at 6
months including pulmonary OR 0.2 (95% CI 0.03 to 0.92), surgical OR 0.12
(95% CI 0.007 to 0.89) and overall complications, OR 0.18 (95% CI 0.03 to
0.74). There was no difference in perioperative troponin change or
TIMP2*IGFBP-7. Our pilot study suggests that RIPC may improve outcomes
following intra-abdominal cancer surgery and that a larger trial would be
feasible. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<44>
Accession Number
2016017320
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. 11(6) (no pagination), 2022.
Article Number: e022937. Date of Publication: 15 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, United States
(Steg) Universite de Paris, AP-HP (Assistance Publique-Hopitaux de Paris),
Hopital Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM
U-1148, Paris, France
(Miller) Department of Medicine, University of Maryland School of
Medicine, Baltimore, MD, United States
(Brinton) Utah Lipid Center, Salt Lake City, UT, United States
(Jacobson, Ketchum, Juliano, Jiao, Doyle, Granowitz) Department of
Medicine, Office of Health Promotion and Disease Prevention, Emory
University School of Medicine, Atlanta, GA, United States
(Jacobson, Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc.
(Amarin), Bridgewater, NJ, United States
(Gibson, Pinto) Baim Clinical Research Institute, Boston, MA, United
States
(Budoff) David Geffen School of Medicine, Lundquist Institute, Torrance,
CA, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, QC, Canada
(Verma) Division of Cardiac Surgery, St Michael's Hospital, University of
Toronto, ON, Canada
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
Publisher
American Heart Association Inc.
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). CONCLUSION(S): 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. Copyright © 2022 The Authors.

<45>
Accession Number
2016019136
Title
Coronary Revascularization Versus Optimal Medical Therapy in Renal
Transplant Candidates With Coronary Artery Disease: A Systematic Review
and Meta-Analysis.
Source
Journal of the American Heart Association. 11(4) (no pagination), 2022.
Article Number: e023548. Date of Publication: 15 Feb 2022.
Author
Siddiqui M.U.; Junarta J.; Marhefka G.D.
Institution
(Siddiqui, Junarta) Department of Medicine, Thomas Jefferson University
Hospitals, Philadelphia, PA, United States
(Marhefka) Jefferson Heart Institute, Thomas Jefferson University
Hospitals, Philadelphia, PA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Coronary artery disease (CAD) is highly prevalent in patients
with chronic kidney disease and is a common cause of mortality in
end-stage renal disease. Thus, patients with end-stage renal disease are
routinely screened for CAD before renal transplantation. The usefulness of
revascularization before transplantation remains unclear. We hypothesize
that there is no difference in all-cause and cardiovascular mortality in
waitlisted renal transplant candidates with CAD who underwent
revascularization versus those treated with optimal medical therapy before
transplantation. METHODS AND RESULTS: This meta-analysis was reported
according to the Preferred Reporting Items for Systematic Review and
Meta-Analyses guidelines. MEDLINE, Scopus, and Cochrane Central Register
of Controlled Trials were systematically searched to identify relevant
studies. Risk of bias was assessed using the modified Newcastle-Ottawa
Scale and Cochrane risk of bias tool. The primary outcome of interest was
all-cause mortality. Eight studies comprising 945 patients were included
(36% women, mean age 56 years). There was no difference in all-cause
mortality (risk ratio [RR], 1.16 [95% CI, 0.63- 2.12), cardiovascular
mortality (RR, 0.75 [95% CI, 0.29-1.89]), or major adverse cardiovascular
events (RR, 0.78 [95% CI, 0.30- 2.07]) when comparing renal transplant
candidates with CAD who underwent revascularization versus those who were
on optimal medical therapy before renal transplant. CONCLUSION(S):
This meta-analysis demonstrates that revascularization is not superior to
optimal medical therapy in reducing all-cause mortality, cardiovascular
mortality, or major adverse cardiovascular events in waitlisted kidney
transplant candidates with CAD who eventually underwent kidney
transplantation. Copyright © 2022 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley. T.

<46>
Accession Number
2016019040
Title
Sex-Based Differences in Revascularization Outcomes: Is It Time for a
Dedicated Randomized Trial in Women?.
Source
Journal of the American Heart Association. 11(5) (no pagination), 2022.
Article Number: e024281. Date of Publication: 01 Mar 2022.
Author
Malick W.A.; Soriano K.; Stone G.W.
Institution
(Malick, Soriano, Stone) The Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Stone) Clinical Trials Center, Cardiovascular Research Foundation, New
York, NY, United States
Publisher
American Heart Association Inc.

<47>
Accession Number
2015389119
Title
Prospective validation of gas man simulations of sevoflurane in
O<inf>2</inf>/air over a wide fresh gas flow range.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2022. Date
of Publication: 2022.
Author
Candries E.; De Wolf A.M.; Hendrickx J.F.A.
Institution
(Candries) Faculty of Medicine and Health Sciences, UZ Gent, Ghent
University, Corneel Heymanslaan 10, Ghent 9000, Belgium
(De Wolf) Department of Anesthesiology, Feinberg School of Medicine,
Northwestern University, Chicago, IL, United States
(Hendrickx) Department of Anesthesiology, OLV Hospital, Aalst, Belgium
(Hendrickx) Department of Basic and Applied Medical Sciences, Ghent
University, Ghent, Belgium
(Hendrickx) Department of Anesthesiology, UZ Leuven, Leuven, Belgium
(Hendrickx) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
Publisher
Springer Science and Business Media B.V.
Abstract
The use of inhaled anesthetics has come under increased scrutiny because
of their environmental effects. This has led to a shift where sevoflurane
in O<inf>2</inf>/air has become the predominant gas mixture to maintain
anesthesia. To further reduce environmental impact, lower fresh gas flows
(FGF) should be used. An accurate model of sevoflurane consumption allows
us to assess and quantify the impact of the effects of lowering FGFs. This
study therefore tested the accuracy of the Gas Man model by determining
its ability to predict end-expired sevoflurane concentrations
(F<inf>ET</inf>sevo) in patients using a protocol spanning a wide range of
FGF and vaporizer settings. After IRB approval, 28 ASA I-II patients
undergoing a gynecologic or urologic procedure under general endotracheal
anesthesia were enrolled. Anesthesia was maintained with sevoflurane in
O<inf>2</inf>/air, delivered via a Zeus or FLOW-i workstation (14 patients
each). Every fifteen min, FGF was changed to randomly selected values
ranging from 0.2 to 6 L/min while the sevoflurane vaporizer setting was
left at the discretion of the anesthesiologist. The F<inf>ET</inf>sevo was
collected every min for 1 h. For each patient, a Gas Man simulation was
run using patient weight and the same FGF, vaporizer and minute
ventilation settings used during the procedure. For cardiac output, the
Gas Man default setting was used (= Brody formula). Gas Man's performance
was assessed by comparing measured with Gas Man predicted
F<inf>ET</inf>sevo using linear regression and Varvel's criteria [median
performance error (MDPE), median absolute performance error (MDAPE), and
divergence]. Additional analysis included separating performance for the
wash-in (0-15 min) and maintenance phase (15-60 min). For the FLOW-i,
MDPE, MDAPE and divergence were 1% [- 6, 8], 7% [3, 15] and - 0.96%/h [-
1.14, - 0.88], respectively. During the first 15 min, MDPE and MDAPE were
18% [1, 51] and 21% [8, 51], respectively, and during the last 45 min 0%
[- 7, 5] and 6% [2, 10], respectively. For the Zeus, MDPE, MDAPE and
divergence were 0% [- 5, 8], 6% [3, 12] and - 0.57%/h [- 0.85, - 0.16],
respectively. During the first 15 min, MDPE and MDAPE were 7% [- 6, 28]
and 13% [6, 32], respectively, and during the last 45 min - 1% [- 5, 5]
and 5% [2, 9], respectively. In conclusion, Gas Man predicts
F<inf>ET</inf>sevo in O<inf>2</inf>/air in adults over a wide range of FGF
and vaporizer settings using different workstations with both MDPE and
MDAPE < 10% during the first hour of anesthesia, with better relative
performance for simulating maintenance than wash-in. In the authors'
opinion, this degree of performance suffices for Gas Man to be used to
quantify the environmental impact of FGF reduction in real life practice
of the wash-in and maintenance period combined. Copyright © 2022,
The Author(s), under exclusive licence to Springer Nature B.V.

<48>
Accession Number
2015389102
Title
Intercostal lung herniation; a rare complication after mini-transthoracic
approach (TTA) for thoracic disc herniation. Two case reports and review
of literature.
Source
European Spine Journal. (no pagination), 2022. Date of Publication: 2022.
Author
De Vries S.E.N.; Arts M.P.; Van Huijstee P.J.
Institution
(Arts) Department of Neurosurgery, Haaglanden Medical Center, The Hague,
Netherlands
(De Vries, Van Huijstee) Department of General Surgery, Haga Medical
Center, The Hague, Netherlands
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Lung herniation is a rare condition, most often due to
thoracic injury, but has also been described as a complication following
cardiothoracic surgery. Here, we report two cases of post-surgical lung
herniation following a neurosurgical mini-transthoracic (mini-TTA) for
treatment of thoracic herniated discs. With this report we aim to make
surgeons aware of this rare complication, review existing literature on
surgical repairs and describe our novel correction technique using video
assisted thoracic surgery (VATS) and a combination of mesh covering the
muscle defect internally and nitinol rib plates for rib approximation on
the outside of the thoracic cavity. Case description: Patient A was an
85-year-old man who presented with a subcutaneous swelling at the site of
surgery following a left sided mini-TTA. Computed tomography (CT) revealed
pulmonary tissue herniation. He underwent VATS guided reconstruction.
Using two Ventralex meshes covering the defect on the inside and a
NiTi-rib H-plate for rib approximation. Patient B was a 73-year-old woman
who developed pulmonary complaints with a soft mass at the surgery site
after a left sided mini-TTA. She also underwent VATS guided
reconstruction. A large Sempramesh composite mesh and two NiTi-Rib
H-plates were used. Recovery was uncomplicated and follow-up revealed no
recurrence in both cases. Conclusion(s): These cases should make
surgeons aware of the possibility of post-surgical development of lung
herniation and describe successful correction using a combination of mesh
material and NiTi-Rib H-plates through a VATS technique. Copyright
© 2022, The Author(s).

<49>
Accession Number
637593570
Title
Identification of research priorities in CHD: empowering patients and
families through participation in the development of formal research
agendas.
Source
Cardiology in the young. (pp 1-6), 2022. Date of Publication: 24 Mar
2022.
Author
Burns J.; Basken A.; Acosta R.; Garnier-Villarreal M.; Kulkarni A.; Hayes
D.A.
Institution
(Burns) Cohen Children's Medical Center, Queens, NY, USA
(Basken) WI, Madison, United States
(Acosta) LLC, NV, Las Vegas, United States
(Garnier-Villarreal) Department of Sociology, Vrije Universiteit
Amsterdam, Amsterdam, Netherlands
(Kulkarni, Hayes) Department of Pediatric Cardiology, Cohen Children's
Medical Center, Queens, NY, USA
Publisher
NLM (Medline)
Abstract
BACKGROUND: Conquering CHD, formerly known as the Pediatric Congenital
Heart Association (PCHA), is the leading congenital heart disease (CHD)
patient advocacy organisation in the United States of America, and places
high priority on patient engagement in the research process. Participatory
design is an approach to problem-solving that utilises the knowledge and
opinions of groups of people to generate plans and new ideas. Utilising
this mode of patient engagement, patients and families engaged with
Conquering CHD assisted in developing a list of research priorities which
was then distributed to the larger membership with instructions to rank
the priorities in order of importance. Upon completion, these items were
compared to the current scientific literature to assess correlation with
current publications. This cross-sectional study and literature review
aimed to assess the priorities of patients and families in CHD research
and to determine the reflection of these areas in the current body of
scientific literature. METHOD(S): This cross-sectional study utilised
a survey asking participants to rank the importance of research items
within categories including "Technology Advances," "Genetic and Cellular
Research," "Broad Understanding of CHD," and "Psychosocial Outcomes" which
was distributed through social media and email to 43,168 accounts across
all platforms. Respondents were asked to place each item in a ranked order
in each category, with the value "1" representing the most preferred for
each participant. Anyone engaged with Conquering CHD was eligible to
complete the study, including patients and families. Subsequently, a
literature review of the largest medical databases including PubMed,
Scopus, and ScienceDirect was undertaken to determine the number of
articles published per each topic which was then assessed to determine if
there is a correlation between patient-ranked priorities and the current
body of literature. RESULT(S): The study generated a total response
of 527 participants. Regarding "Technology Advances," valve replacement
was the preferred topic (mean rank 2.07, IQR 2). Stem cell research was
the favoured topic in "Genetic and Cellular Research" (mean rank 2.53, IQR
2). Access to care was the priority in the "Broadening Understanding of
CHD" (mean rank 1.24, IQR 1). Pertaining to "Psychosocial Outcomes",
psychological/emotional effects was the highest ranked topic (mean rank
1.46, IQR 1). The literature review returned a total of 135,672 articles
in the areas of interest. For "Valve Replacement", 8361 articles resulted
reflecting a proportion of 0.097 of total articles. For "Stem Cell
Research", 9921 articles resulted reflecting a proportion of 0.115 of
total articles. For "Access to Care", 7845 articles resulted reflecting a
proportion of 0.091 of total articles. For "Psychological/Emotional
Effects", 6422 articles resulted reflecting a proportion of 0.074 of total
articles. A Spearman's correlation demonstrated no correlation between the
preferred domain of CHD research and the number of articles published for
that domain (rs = 0.02, p = 0.94). CONCLUSION(S): This process
demonstrates the effectiveness of participatory design, using a patient
and family network to determine the research items of concern to those
affected by CHD. The cross-sectional survey was effective in assessing
patient and family priorities but was limited by access to reliable
internet and delivery only in English. Though the study had a large
response rate, it was limited to patients already engaged with Conquering
CHD. For these reasons, it may not completely reflect the opinions of the
total population affected by CHD. However, this offers valuable insight
into patient-determined priorities and reveals that the current scientific
literature does not correlate with these items. These data serve to inform
individual and institutional research agendas to better reflect the needs
and desires of this population.

<50>
Accession Number
637580505
Title
Paediatric brain MRI findings following congenital heart surgery: a
systematic review.
Source
Archives of disease in childhood. (no pagination), 2022. Date of
Publication: 22 Mar 2022.
Author
Alablani F.J.; Chan H.S.A.; Beishon L.; Patel N.; Almudayni A.; Bu'Lock
F.; Chung E.M.
Institution
(Alablani, Chan, Beishon, Almudayni, Chung) Department of Cardiovascular
Sciences, University of Leicester, Leicester, United Kingdom
(Alablani, Almudayni) College of Applied Medical Sciences, Prince Sattam
bin Abdulaziz University, Saudi Arabia
(Patel) Department of Clinical Neuroscience, St George's University of
London, London, United Kingdom
(Bu'Lock) East Midlands Congenital Heart Centre, Glenfield Hospital,
Leicester, United Kingdom
(Chung) Faculty of Life Sciences and Medicine, King's College London,
London, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVE: This systematic review aimed to establish the relative
incidence of new postoperative brain MRI findings following paediatric
congenital cardiac surgery. DESIGN: To distinguish perioperative changes
from pre-existing MR findings, our systematic search strategy focused on
identifying original research studies reporting both presurgery and
postsurgery brain MRI scans. Patient demographics, study methods and brain
MR findings were extracted. RESULT(S): Twenty-one eligible
publications, including two case-control and one randomised controlled
trial, were identified. Pre-existing brain MRI findings were noted in 43%
(513/1205) of neonates prior to surgery, mainly white matter injuries
(WMI). Surgery was performed at a median age of 8 days with comparison of
preoperative and postoperative MR scans revealing additional new
postoperative findings in 51% (550/1075) of patients, mainly WMI. Four
studies adopted a brain injury scoring system, but the majority did not
indicate the severity or time course of findings. In a subgroup analysis,
approximately 32% of patients with pre-existing lesions went on to develop
additional new lesions postsurgery. Pre-existing findings were not found
to confer a higher risk of acquiring brain lesions postoperatively. No
evidence was identified linking new MR findings with later
neurodevelopmental delay. CONCLUSION(S): This systematic review
suggests that surgery approximately doubles the number of patients with
new brain lesions. 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.

<51>
Accession Number
637536258
Title
Effectiveness of implanted cardiac rhythm recorders with
electrocardiographic monitoring for detecting arrhythmias in peripartum
cardiomyopathy (PPCM).
Source
Cardiovascular Journal of Africa. Conference: Pan-African Society of
Cardiology Congress, PASCAR 2021. Mombasa Kenya. 33(SUPPL) (pp 17-18),
2021. Date of Publication: 2021.
Author
Hoevelmann J.; Viljoen C.; Chin A.; Briton O.; Sliwa K.
Institution
(Hoevelmann, Viljoen, Chin, Briton, Sliwa) Faculty of Health Sciences,
University of Cape Town, South Africa and Klinik fur Innere Medizin III,
Kardiologie, Angiologie und Internistische Intensivmedizin,
Universitatsklinikum des Saarlandes, Saarland University Hospital, Homburg
(Saar), Deutschland
Publisher
Clinics Cardive Publishing (PTY)Ltd
Abstract
Introduction: Peripartum cardiomyopathy (PPCM) is a form of dilated
cardiomyopathy that occurs within the last months of pregnancy or up to 5
months postpartum. Previous studies have shown that up to 30% of deaths in
PPCM are related to sudden cardiac death (SCD). However, little is known
about the burden of arrythmias in PPCM and their contribution to SCD.
 Purpose(s): We aimed to compare implantable loop recorder (ILR) plus
24-hour Holter monitoring to 24h Holter monitoring alone to assess its
utility in the detection of arrhythmias in PPCM. Method(s): In this
single-centre, prospective clinical trial, 20 consecutive patients with
PPCM were randomized to either standard care (SC cohort: ECG & 24-hour
Holter) or SC plus ILR (SC-ILR cohort: ECG, 24-hour Holter, ILR).
Follow-up included the first six months after ILR implantation.
 Result(s): The median age of this cohort was 31.7 years with a parity
of 2 (IQR 1-4). They presented with a median left ventricular ejection
fraction (LVEF) of 28% (IQR 24-35) and LVEDD of 60mm (IQR 55-66). The
12-lead ECG recorded sinus tachycardia in half of the patients, with
median heart rate of 90bpm (IQR 79-106) compared to 94.5bpm (IQR 85-99) on
24h-Holter-monitoring. The median QTc-interval was 464ms (IQR 424-494).
Ambulatory ECG monitoring detected major arrhythmias in three women (one
in SC cohort, two in SC-ILR cohort). One patient (5%) died shortly after
ILR implantation. Her ILR detected sinus arrest with an escape rhythm that
failed and resulted in an out of hospital cardiac arrest. Non-sustained
ventricular tachycardia (nsVT) occurred in two women (10%), one of which
was detected by Holter monitoring and the other on ILR. Both women
presented with acute heart failure with severely impaired systolic
function (LVEF 12% and 21% respectively). One of these patients had
persistent LV systolic dysfunction despite optimal medical therapy and
received an implantable cardioverter-defibrillator (ICD). The other
patient had intractable heart failure requiring recurrent intensive-care
treatment and underwent heart transplantation. There was no atrial
fibrillation or atrioventricular block detected in any patient by ECG,
Holter or ILR monitoring throughout the study period. Conclusion(s):
This study on ambulatory ECG monitoring in PPCM showed a high prevalence
of potentially fatal arrhythmias, which occurred predominantly in the
acute phase of the disease. Both Holter and ILR had a direct influence on
clinical decision making.

<52>
Accession Number
2003607205
Title
Circadian-timed quick-release bromocriptine lowers elevated resting heart
rate in patients with type 2 diabetes mellitus.
Source
Endocrinology, Diabetes and Metabolism. 3(1) (no pagination), 2020.
Article Number: e00101. Date of Publication: 01 Jan 2020.
Author
Chamarthi B.; Vinik A.; Ezrokhi M.; Cincotta A.H.
Institution
(Chamarthi, Ezrokhi, Cincotta) VeroScience LLC, Tiverton, RI, United
States
(Vinik) Eastern Virginia Medical School Strelitz Diabetes Center, Norfolk,
VA, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Sympathetic nervous system (SNS) overactivity is a risk factor
for insulin resistance and cardiovascular disease (CVD). We evaluated the
impact of bromocriptine-QR, a dopamine-agonist antidiabetes medication, on
elevated resting heart rate (RHR) (a marker of SNS overactivity in
metabolic syndrome), blood pressure (BP) and the relationship between
bromocriptine-QR's effects on RHR and HbA1c in type 2 diabetes subjects.
Design and Subjects: RHR and BP changes were evaluated in this post hoc
analysis of data from a randomized controlled trial in 1014 type 2
diabetes subjects randomized to bromocriptine-QR vs placebo added to
standard therapy (diet +/- <=2 oral antidiabetes medications) for 24 weeks
without concomitant antihypertensive or antidiabetes medication changes,
stratified by baseline RHR (bRHR). Result(s): In subjects with bRHR
>=70 beats/min, bromocriptine-QR vs placebo reduced RHR by -3.4 beats/min
and reduced BP (baseline 130/79; systolic, diastolic, mean arterial BP
reductions [mm Hg]: -3.6 [P =.02], -1.9 [P =.05], -2.5 [P =.02]). RHR
reductions increased with higher baseline HbA1c (bHbA1c) (-2.7 [P =.03],
-5 [P =.002], -6.1 [P =.002] with bHbA1c <=7, >7, >=7.5%, respectively] in
the bRHR >=70 group and more so with bRHR >=80 (-4.5 [P =.07], -7.8 [P
=.015], -9.9 [P =.005]). Subjects with bRHR <70 had no significant change
in RHR or BP. With bHbA1c >=7.5%, %HbA1c reductions with bromocriptine-QR
vs placebo were -0.50 (P =.04), -0.73 (P =.005) and -1.22 (P =.008) with
bRHR <70, >=70 and >=80, respectively. With bRHR >=70, the magnitude of
bromocriptine-QR-induced RHR reduction was an independent predictor of
bromocriptine-QR's HbA1c lowering effect. Conclusion(s):
Bromocriptine-QR lowers elevated RHR with concurrent decrease in BP and
hyperglycaemia. These findings suggest a potential sympatholytic mechanism
contributing to bromocriptine-QR's antidiabetes effect and potentially its
previously demonstrated effect to reduce CVD events. Copyright ©
2019 VeroScience Llc. Endocrinology, Diabetes & Metabolism published by
John Wiley & Sons Ltd.

<53>
Accession Number
624872227
Title
The effect of remote ischemic preconditioning on the incidence of acute
kidney injury in patients undergoing coronary artery bypass graft surgery:
A randomized controlled trial.
Source
Iranian Journal of Medical Sciences. 43(6) (pp 587-595), 2018. Date of
Publication: November 2018.
Author
Bagheri S.; Shahbazi S.; Shafa M.; Borhani-Haghighi A.; Kiani M.; Sagheb
M.M.
Institution
(Bagheri, Kiani, Sagheb) Shiraz Nephro-Urology Research Center, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Shahbazi) Anesthesiology and Critical Care Research Center, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Shafa) Department of Cardiac Surgery, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Borhani-Haghighi) Clinical Neurology Research Center, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Shriaz University of Medical Sciences
Abstract
Background: Remote ischemic preconditioning (RIPC) protects other organs
from subsequent lethal ischemic injury, but uncertainty remains. We
investigated if RIPC could prevent acute kidney injury (AKI) in patients
undergoing coronary artery bypass graft (CABG) surgery. Method(s):
This parallel-group, double-blind, randomized, controlled trial was done
on adults undergoing elective or urgent on-pump CABG surgery from 2013 to
2017 in Shiraz, Iran. Patients were allocated to RIPC or control groups
through permuted blocking. The patients in the RIPC group received three
cycles of 5 min ischemia and 5 min reperfusion in the upper arm after
induction of anesthesia. We placed an uninflated cuff on the arm for 30
min in the control group. The study primary endpoint was an incidence of
AKI. Secondary endpoints included short-term clinical outcomes. We
compared categorical and continuous variables using Pearson
chi2 and unpaired t tests, respectively. P<0.05 was considered
significant. Result(s): Of the 180 patients randomized to RIPC (n=90)
and control (n=90) groups, 87 patients in the RIPC and 90 patients in the
control group were included in the analysis. There was no significant
difference in the incidence of AKI between the groups (38 patients [43.7%]
in the RIPC group and 41 patients [45.6%] in the control group; relative
risk, 0.96; 95% confidence interval, 0.69 to 1.33; P=0.80). No significant
differences were seen regarding secondary endpoints such as postoperative
liver function, atrial fibrillation, and inpatient mortality.
 Conclusion(s): RIPC did not reduce the incidence of AKI, neither did
it improve short-term clinical outcomes in patients undergoing on-pump
CABG surgery. Copyright © 2018, Shiraz University of Medical
Sciences. All rights reserved.

<54>
Accession Number
2015924388
Title
An Update on Patent Ductus Arteriosus and What is Coming Next.
Source
Turkish Archives of Pediatrics. 57(2) (pp 118-131), 2022. Date of
Publication: March 2022.
Author
Erdeve O.; Okulu E.; Singh Y.; Sindelar R.; Oncel M.Y.; Terrin G.;
Boscarino G.; Bulbul A.; Sallmon H.; Atasay B.; Ovali F.; Clyman R.I.
Institution
(Erdeve, Okulu, Atasay) Division of Neonatology, Department of Pediatrics,
Ankara University, Faculty of Medicine, Ankara, Turkey
(Singh) Division of Neonatology, Loma Linda University School of Medicine,
CA, United States
(Singh) Cambridge University Hospitals NHS Foundation Trust, Cambridge,
United Kingdom
(Sindelar) Department of Women's and Children's Health, Uppsala
University, Uppsala, Sweden
(Oncel) Division of Neonatology, Buca Seyfi Demirsoy Training and Research
Hospital, Izmir, Turkey
(Oncel) Division of Neonatology, Department of Pediatrics, Izmir Katip
Celebi University, Faculty of Medicine, Izmir, Turkey
(Terrin, Boscarino) Department of Maternal and Child Health, University of
Roma La Sapienza, Rome, Italy
(Bulbul) Division of Neonatology, Department of Pediatrics, University of
Health Science, Sisli Hamidiye Etfal Education and Research Hospital,
Istanbul, Turkey
(Sallmon) Department of Congenital Heart Disease/Pediatric Cardiology,
Charite-Universitatsmedizin Berlin and Deutsches Herzzentrum Berlin
(DHZB), Berlin, Germany
(Ovali) Division of Neonatology, Department of Pediatrics, Istanbul
Medeniyet University, Istanbul, Turkey
(Clyman) Department of Pediatrics and Cardiovascular Research Institute,
University of California San Francisco, San Francisco, CA, United States
Publisher
AVES
Abstract
Patent ductus arteriosus is the most common cardiovascular condition in
preterm infants. There is a significant uncertainty about when and how to
close ductus arteriosus in preterm infants due to a high spontaneous
closure rate even in very immature preterm infants. Diagnosis and
management of patent ductus arteriosus remain a challenge for both
neonatologists and pediatric cardiologists. Researchers have tried to
define a balance between an expectant approach and active treatment in
selected infants. This review aimed to focus on the pathophysiology and
management of patent ductus arteriosus and to make suggestions about
approaches thamight eliminate the association of morbidities with patent
ductus arteriosus. Copyright © 2022, AVES. All rights reserved.

<55>
Accession Number
637431594
Title
Effects of exercise-based prehabilitation in children undergoing elective
surgeries: A systematic review.
Source
F1000Research. 10 (no pagination), 2022. Article Number: 1262. Date of
Publication: 2022.
Author
Samuel S.; Noronha J.; Singh V.P.; Prabhu H.S.
Institution
(Noronha) Department of Physiotherapy, Kasturba Medical College, Manipal
Academy of Higher Education, Mangalore, Manipal, India
(Samuel) Department of Physiotherapy, Kasturba Medical College, Manipal
Academy of Higher Education, Mangalore, Manipal, India
(Singh) Department of Physiotherapy, Kasturba Medical College Mangalore,
Manipal Academy of Higher Education, Manipal, India
(Prabhu) Department of Surgery, Kasturba Medical College, Manipal Academy
of Higher Education, Mangalore, Manipal, India
Publisher
F1000 Research Ltd
Abstract
Background: Prehabilitation is a therapeutic strategy involving
preoperative physical exercises, nutritional support, and stress and
anxiety reduction. This approach has been gaining popularity and has been
seeing effective results in adults in terms of improving pre and
postoperative outcomes. The purpose of this review was to summarise the
evidence about the effects of exercise-based prehabilitation programs on
various outcome measures in children post elective surgeries.
 Method(s): PubMed, Scopus, Web of Science, PEDro, CINAHL/EBSCO and
EMBASE electronic databases were searched from inception to June 2021.
Based on the inclusion criteria, titles and abstracts were independently
screened by the authors. After that, a data extraction table of the
selected studies which included the participants, type, and details of
exercise intervention, outcome measures and results were analysed after
which the quality assessment of the studies was done. Result(s): The
search yielded 2219 articles of which three articles fulfilled the
inclusion criteria with two studies being randomized controlled trials and
one being a quasi-experimental pre-post type of study. One randomized
controlled trial was on the effects of exercise-based prehabilitation in
reducing pulmonary complications post cardiac surgeries in children and
the other two studies were on the effects of prehabilitation on functional
capacity & pulmonary function. All the three articles found that
exercise-based prehabilitation had a positive effect on children's
post-surgery. Conclusion(s): Although there is a paucity of
evidence-based literature, we conclude based on the existing literature
retrieved by our review that exercise-based prehabilitation improves
postoperative outcomes and helps in reducing postoperative complications
in children undergoing various surgeries. Copyright © 2022
Noronha J et al.

<56>
Accession Number
2017149407
Title
Transcatheter aortic valve replacement in mixed aortic valve disease: A
systematic review and meta-analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 8(2) (pp
169-176), 2022. Date of Publication: 01 Mar 2022.
Author
Guddeti R.R.; Gill G.S.; Garcia-Garcia H.M.; Alla V.M.
Institution
(Guddeti, Gill, Alla) Division of Cardiovascular Diseases, Creighton
University School of Medicine, Omaha, NE 68154, United States
(Guddeti) Division of Cardiovascular Diseases, Minneapolis Heart
Institute, Minneapolis, MN 55407, United States
(Garcia-Garcia) Department of Medicine, Georgetown University, Washington,
DC 20057, United States
(Garcia-Garcia) Division of Cardiovascular Medicine, MedStar Washington
Hospital Center, Washington, DC 20010, United States
Publisher
Oxford University Press
Abstract
Background: Utilization of transcatheter aortic valve replacement (TAVR)
has expanded from high-risk patients to intermediate- A nd select low-risk
candidates with severe aortic stenosis (AS). TAVR is currently not
indicated for patients with aortic insufficiency, and its outcomes in
mixed aortic valve disease (MAVD) are unclear. Method(s): A
systematic search of PubMed, Medline, CINHAL, and Cochrane databases was
performed to identify studies comparing TAVR outcomes in patients with AS
vs. MAVD. Primary outcomes included 30-day and late all-cause mortality,
and paravalvular regurgitation (PVR). Secondary outcomes were major
bleeding, vascular complications, device implantation success, permanent
pacemaker, and stroke. Pooled odds ratios (OR) and 95% confidence
intervals (CIs) were calculated using Der Simonian-Laird random-effects
model. Result(s): Six observational studies with 58 879 patients were
included in the analysis. There was no significant difference in 30-day
all-cause mortality [OR 1.03 (95% CI 0.92-1.15); P = 0.63], however, MAVD
group had higher odds of moderate-to-severe PVR [1.81 (1.41-2.31); P <
0.01]. MAVD patients had lower odds of device implantation success [0.60
(0.40-0.91); P = 0.02] while other secondary outcomes were similar in the
two groups. Conclusion(s): TAVR in MAVD is associated with increased
odds of paravalvular regurgitation and lower odds of device implantation
success when compared to severe aortic stenosis. Copyright © 2021
The Author(s). Published by Oxford University Press on behalf of the
European Society of Cardiology.

<57>
Accession Number
2016889800
Title
Intensive vs non-intensive statin pretreatment before percutaneous
coronary intervention in Chinese patients: A meta-analysis of randomized
controlled trials.
Source
World Journal of Clinical Cases. 10(5) (pp 1557-1571), 2022. Date of
Publication: 2022.
Author
Yang X.; Lan X.; Zhang X.L.; Han Z.L.; Yan S.M.; Wang W.X.; Xu B.; Ge W.H.
Institution
(Yang, Yan, Ge) Department of Pharmacy, Nanjing Drum Tower Hospital, The
Affiliated Hospital of Nanjing University Medical School, Jiangsu, Nanjing
210000, China
(Yang, Yan, Ge) Department of Pharmacy, Nanjing Medical Center for
Clinical Pharmacy, Jiangsu, Nanjing 210000, China
(Lan, Zhang, Han, Xu) Department of Cardiology, Nanjing Drum Tower
Hospital, The Affiliated Hospital of Nanjing University Medical School,
Jiangsu, Nanjing 210000, China
(Wang) Department of Pharmacy, The Affiliated Hospital of Qingdao
University, Shandong, Qingdao 266000, China
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND The results of intensive statin pretreatment before
percutaneous coronary intervention (PCI) is inconsistent between Chinese
and Western populations, and there are no corresponding meta-analyses
involving hard clinical endpoints in the available published literature.
AIM To evaluate the efficacy and safety of high-dose statin loading before
PCI in Chinese patients through a meta-analysis. METHODS Relevant studies
were identified by searching the electronic databases of PubMed, Embase
and Cochrane's Library to December 2019. The outcomes included an
assessment of major adverse cardiovascular event (MACE), non-fatal
myocardial infarction (MI), cardiac death, target vessel revascularization
(TVR), myalgia /myasthenia and abnormal alanine aminotransferase (ALT) in
all enrolled patients. Random effect model and fixed effect model were
applied to combine the data, which were further analyzed by chi2 test and
I2 test. The main outcomes were then analyzed through the use of relative
risks (RR) and its 95% confidence interval (95%CI). RESULTS Eleven studies
involving 3123 individuals were included. Compared with patients receiving
placebo or no statin treatment before surgery, intensive statin treatment
was associated with a clear reduction of risk of MACE (RR = 0.44, 95%CI:
0.31-0.61, P < 0.00001). However, compared with the patients receiving
moderateintensity statin before surgery, no advantage to intensive statin
treatment was seen (RR = 1.04, 95%CI: 0.82-1.31, P = 0.74). In addition,
no significant difference was observed between intensive statin therapy
and non-intensive statin therapy on the incidence of TVR (RR = 0.43,
95%CI: 0.18-1.02, P = 0.06), myalgia /myasthenia (RR = 1.35, 95%CI:
0.30-5.95, P = 0.69) and abnormal alanine aminotransferase (RR = 1.47,
95%CI: 0.54-4.02, P = 0.45) except non-fatal MI (RR = 0.54, 95%CI:
0.33-0.88, P = 0.01). CONCLUSION Compared with placebo or no statin
pretreatment, intensive statin before PCI displayed reduced incidence of
MACE. However, there was no significant benefit between high and
moderate-intensity statin. In addition, no significant difference was
observed between intensive statin therapy and non-intensive statin therapy
on the incidence of TVR, myalgia/myasthenia and abnormal alanine
aminotransferase except non-fatal MI. Copyright © The Author(s)
2021. Published by Baishideng Publishing Group Inc. All rights reserved.

<58>
Accession Number
2015250517
Title
Effects of transcutaneous electrical nerve stimulation on myocardial
protection in patients undergoing aortic valve replacement: a randomized
clinical trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 68. Date
of Publication: December 2022.
Author
Cho Y.J.; Jung D.-E.; Nam K.; Bae J.; Lee S.; Jeon Y.
Institution
(Cho, Jung, Nam, Bae, Lee, Jeon) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul 03080, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Cardiopulmonary bypass-related myocardial ischemia-reperfusion
injury is a major contributor to postoperative morbidity. Although
transcutaneous electrical nerve stimulation (TENS) has been found to have
cardioprotective effects in animal studies and healthy volunteers, its
effects on cardiac surgery under cardiopulmonary bypass patients have not
been evaluated. We investigated the effects of TENS on myocardial
protection in patients undergoing aortic valve replacement surgery using
cardiopulmonary bypass. Method(s): Thirty patients were randomized to
receive TENS or sham in three different anesthetic states -
pre-anesthesia, sevoflurane, or propofol (each n = 5). TENS was applied
with a pulse width of 385 mus and a frequency of 10 Hz using two surface
electrodes at the upper arm for 30 min. Sham treatment was provided
without stimulation. The primary outcome was the difference in myocardial
infarct size following ischemia-reperfusion injury in rat hearts perfused
with pre- and post-TENS plasma dialysate obtained from the patients using
Langendorff perfusion system. The cardioprotective effects of TENS were
determined by assessing reduction in infarct size following treatment.
 Result(s): There were no differences in myocardial infarct size
between pre- and post-treatment in any group (41.4 +/- 4.3% vs. 36.7 +/-
5.3%, 39.8 +/- 7.3% vs. 27.8 +/- 12.0%, and 41.6 +/- 2.2% vs. 37.8 +/-
7.6%; p = 0.080, 0.152, and 0.353 in the pre-anesthesia, sevoflurane, and
propofol groups, respectively). Conclusion(s): In our study, TENS did
not show a cardioprotective effect in patients undergoing aortic valve
replacement surgery. Trial registration: This study was registered at
clinicaltrials.gov (NCT03859115, on March 1, 2019). Copyright ©
2022, The Author(s).

<59>
Accession Number
2015211858
Title
Safety and efficacy of anti-inflammatory therapy in patients with coronary
artery disease: a systematic review and meta-analysis.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
84. Date of Publication: December 2022.
Author
Niu Y.; Bai N.; Ma Y.; Zhong P.-Y.; Shang Y.-S.; Wang Z.-L.
Institution
(Niu, Bai, Ma, Zhong, Shang) The First Clinical Medical College of Lanzhou
University, Lanzhou, China
(Wang) Department of Cardiology, The First Hospital of Lanzhou University,
No. 1, Donggang West Road, Chengguan District, Gansu, Lanzhou 730000,
China
Publisher
BioMed Central Ltd
Abstract
Background: The inflammation hypothesis of atherosclerosis has been put
forward for more than 20 years. Although many animal experiments have
suggested that anti-inflammatory therapy can inhibit the atherosclerotic
process, the efficacy of anti-inflammatory therapy for patients with
coronary artery disease (CAD) is still controversial. Therefore, this
study aims to evaluate the safety and efficacy of anti-inflammatory drugs
in patients with CAD. Method(s): We conducted this systematic review
and meta-analysis of randomized controlled trials by searching PubMed,
EMBASE, web of science, and Cochrane Library database. The primary outcome
was a composite outcome of cardiovascular death, myocardial infarction
(MI), or stroke. The secondary outcomes included individual MI, coronary
revascularization, cardiovascular death, all-cause death, and stroke. The
relative risk (RR) and 95% confidence intervals (CI) for outcome events
were calculated by the fixed effects model, and trial sequential analysis
was applied to assess the results. Result(s): A total of ten
randomized controlled trials and 60,782 patients with CAD was included.
Compared with patients receiving placebo, anti-inflammatory therapy
significantly reduced the incidence of the primary outcome in patients
with CAD (RR 0.93, 0.89-0.98, P = 0.007). In addition, the
anti-inflammatory therapy can also reduce the risk of MI (RR 0.90,
0.84-0.96, P = 0.002) and coronary revascularization (RR 0.74, 0.66-0.84,
P < 0.00001) remarkably. However, there was no significant difference in
the incidence of cardiovascular death (RR 0.94, 0.86-1.02, P = 0.14),
all-cause death (RR 1.00, 0.94-1.07, P = 0.98) and stroke (RR 0.96,
0.85-1.09, P = 0.51) between two groups. Conclusion(s):
Anti-inflammatory therapy can reduce the incidence of the primary outcome
in patients with CAD, especially the risk of MI and coronary
revascularization. However, anti-inflammatory therapy increases the risk
of infection. (Registered by PROSPERO, CRD 420212291032). Copyright
© 2022, The Author(s).

<60>
Accession Number
2015211515
Title
Plasmalyte-A Based del Nido Cardioplegia Versus Plain Ringer Based del
Nido Cardioplegia: Double-Blind Randomized Trial.
Source
World Journal for Pediatric and Congenital Heart Surgery. 13(2) (pp
187-195), 2022. Date of Publication: March 2022.
Author
Talwar S.; Harshavardhan N.; Kapoor P.M.; Makhija N.; Rajashekar P.;
Sreenivas V.; Upadhyay A.D.; Sahu M.K.; Choudhary S.K.
Institution
(Talwar, Harshavardhan, Sahu, Choudhary) All India Institute of Medical
Sciences Cardio-Thoracic Sciences Centre, New Delhi, India
(Kapoor, Makhija, Rajashekar, Sreenivas, Upadhyay) All India Institute of
Medical Sciences, New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Background: In this prospective randomized controlled trial, we compared
the standard del Nido cardioplegia solution (SDN) with the modified del
Nido cardioplegia solution (MDN) in which the base solution was the plain
Ringer solution. Method(s): A total of 80 patients aged < 12 years
undergoing intracardiac repair of Tetralogy of Fallot were randomized into
SDN (n = 39) or MDN (n = 41) groups. The primary outcome was a change in
cardiac index (CI). Secondary outcomes were ventricular arrhythmias after
the release of aortic-cross clamp, postoperative inotropic score (IS),
time to peripheral rewarming, duration of mechanical ventilation,
intensive care unit (ICU) length of stay, and hospital length of stay, and
electron microscopic differences between the 2 groups. Cardiac Troponin-I,
inflammatory markers tumor necrosis factor-alpha (TNF-alpha), and
interleukin-L (IL-6) were measured. Result(s): Applying the
noninferiority confidence interval approach, the difference between the
changes in CI between the 2 groups was -0.093 L/min/m2 (95% CI: -0.46-0.27
L/min/m2) which was within the noninferiority threshold of -0.5 indicating
that CI was similar in both SDN and MDN. Ventricular arrhythmias postclamp
release (P =.91), IS (P =.09), duration of mechanical ventilation (P
=.27), ICU length of stay (P =.50), hospital length of stay (P =.57), IL-6
(P =.19), TNF-alpha (P =.17), Troponin-I (P =.15), electron microscopy
changes (P >.05) were not different between groups. Conclusion(s):
MDN was shown to be noninferior to the SDN cardioplegia in terms of
preservation of cardiac index. In addition, other metrics indicative of
myocardial protection were similar between groups. In developing nations
where SDN is not available or is expensive, MDN cardioplegia is an
acceptable alternative. Copyright © The Author(s) 2022.

<61>
Accession Number
2017215400
Title
The effect of heparin concentration on results of venous blood gas of
patients admitted to cardiac intensive care unit: A double-blind clinical
trial.
Source
BioMedicine (Taiwan). 12(1) (pp 8-15), 2022. Date of Publication: 2022.
Author
Lakziyan R.; Shabani F.; Sarchahi Z.; Mazloomzadeh S.; Hadipourzadeh F.S.
Institution
(Lakziyan, Shabani, Mazloomzadeh) Rajaie Cardiovascular Medical and
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Sarchahi) Department of Nursing, Faculty of Nursing, Neyshabur University
of Medical Sciences, Neyshabur, Iran, Islamic Republic of
(Hadipourzadeh) Cardiac Anesthesia Department, Rajaie Cardiovascular,
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
China Medical University
Abstract
Background: The aim of the present study was to investigate the effect of
heparin (1000 IU/mL) in the blood sample on the results of venous blood
gases of patients admitted to the cardiac intensive care unit.
 Material(s) and Method(s): The present double-blind randomized
clinical trial study was performed on 282 samples from 141 patients
admitted to the cardiac intensive care unit. Insulin syringeswith heparin
(1000 IU/mL) and heparin (5000 IU/mL) and 1 cc of blood sample were taken
from the peripheral vein, then distributed in two syringes and given to
the analyzer. Result(s): In the present study, the mean age of the
samples was 49.96 +/- 9.58. There was a statistically significant
difference between the two groups in terms of values of partial pressure
of carbon dioxide (PCO2) (P < 0.001), partial pressure of oxygen (PaO2) (P
< 0.001), blood oxygen saturation (P < 0.001), bicarbonate ion (P <
0.001), excess base (P < 0.001), hemoglobin (P < 0.001), calcium (P <
0.001), potassium (P < 0.001), and sodium (P < 0.001) in the two groups.
 Conclusion(s): Overall, heparin (1000 IU/mL) led to a less disruption
in the results of venous blood gases, and since it has not significantly
increased the risk of clots, it is recommended to be used for venous blood
gas sampling. Copyright © 2022 EDP Sciences. All rights reserved.

<62>
Accession Number
2017160934
Title
Surgical data recording in the operating room: A systematic review of
modalities and metrics.
Source
British Journal of Surgery. 108(6) (pp 613-621), 2021. Date of
Publication: 01 Jun 2021.
Author
Levin M.; McKechnie T.; Kruse C.C.; Aldrich K.; Grantcharov T.P.;
Langerman A.
Institution
(Levin) Department of Otolaryngology, Head and Neck Surgery, University of
Toronto, Toronto, ON, Canada
(McKechnie) Division of General Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Kruse) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Aldrich, Langerman) Center for Medical Interoperability, Nashville, TN,
United States
(Grantcharov, Langerman) International Center for Surgical Safety, Li Ka
Shing Knowledge Institute, St. Michael's Hospital, ON, Canada
(Langerman) Department of Otolaryngology - Head and Neck Surgery,
Department of Radiology and Radiological Sciences, Surgical Analytics Lab,
Center for Biomedical Ethics and Society, Vanderbilt University Medical
Center, Nashville, TN, United States
Publisher
Oxford University Press
Abstract
Introduction: Operating room recording, via video, audio and sensor-based
recordings, is increasingly common. Yet, surgical data science is a new
field without clear guidelines. The purpose of this study is to examine
existing published studies of surgical recording modalities to determine
which are available for use in the operating room, as a first step towards
developing unified standards for this field. Method(s): Medline,
EMBASE, CENTRAL and PubMed databases were systematically searched for
articles describing modalities of data collection in the operating room.
Search terms included 'video-audio media', 'bio-sensing techniques',
'sound', 'movement', 'operating rooms' and others. Title, abstract and
full-text screening were completed to identify relevant articles.
Descriptive statistical analysis was performed for included studies.
 Result(s): From 3756 citations, 91 studies met inclusion criteria.
These studies described 10 unique data-collection modalities for 17
different purposes in the operating room. Data modalities included video,
audio, kinematic and eye-tracking among others. Datacollection purposes
described included surgical trainee assessment, surgical error, surgical
team communication and operating room efficiency. Conclusion(s):
Effective data collection and utilization in the operating room are
imperative for the provision of superior surgical care. The future
operating room landscape undoubtedly includes multiple modalities of data
collection for a plethora of purposes. This review acts as a foundation
for employing operating room data in a way that leads to meaningful
benefit for patient care. Copyright © 2021 John Wiley and Sons
Ltd. All rights reserved.

<63>
Accession Number
2017160570
Title
Effect of remote ischaemic preconditioning on mortality and morbidity
after non-cardiac surgery: Meta-analysis.
Source
BJS Open. 5(2) (no pagination), 2021. Article Number: zraa026. Date of
Publication: 01 Mar 2021.
Author
Wahlstrom K.L.; Bjerrum E.; Gogenur I.; Burcharth J.; Ekeloef S.
Institution
(Wahlstrom, Bjerrum, Gogenur, Burcharth, Ekeloef) Department of Surgery,
Centre for Surgical Science, Zealand University Hospital, Koege, Denmark
Publisher
Oxford University Press
Abstract
Background: Remote ischaemic preconditioning (RIPC) has been shown to have
a protective role on vital organs exposed to reperfusion injury. The aim
of this systematic review was to evaluate the effects of non-invasive RIPC
on clinical and biochemical outcomes in patients undergoing non-cardiac
surgery Methods: A systematic literature search of PubMed, EMBASE, Scopus,
and Cochrane databases was carried out in February 2020. RCTs
investigating the effect of non-invasive RIPC in adults undergoing
non-cardiac surgery were included. Meta-analyses and trial sequential
analyses (TSAs) were performed on cardiovascular events, acute kidney
injury, and short- and long-term mortality. Result(s): Some 43 RCTs
including 3660 patients were included. The surgical areas comprised
orthopaedic, vascular, abdominal, pulmonary, neurological, and urological
surgery. Meta-analysis showed RIPC to be associated with fewer
cardiovascular events in non-cardiac surgery (13 trials, 1968 patients,
421 events; odds ratio (OR) 0.68, 95 per cent c.i. 0.47 to 0.96; P=0.03).
Meta-analyses of the effect of RIPC on acute kidney injury (12 trials,
1208 patients, 211 events; OR 1.14, 0.78 to 1.69; P=0.50; I2 = 9 per
cent), short-term mortality (7 trials, 1239 patients, 65 events; OR 0.65,
0.37 to 1.12; P=0.12; I2 = 0 per cent), and long-term mortality (4 trials,
1167 patients, 9 events; OR 0.67, 0.18 to 2.55; P=0.56; I2 = 0 per cent)
showed no significant differences for RIPC compared with standard
perioperative care in non-cardiac surgery. However, TSAs showed that the
required information sizes have not yet been reached. Conclusion(s):
Application of RIPC to non-cardiac surgery might reduce cardiovascular
events, but not acute kidney injury or all-cause mortality, but currently
available data are inadequate to confirm or reject an assumed intervention
effect. Copyright © 2020 The Author(s).

<64>
Accession Number
2014359302
Title
Management of cardiovascular disease using an mHealth tool: a randomized
clinical trial.
Source
npj Digital Medicine. 4(1) (no pagination), 2021. Article Number: 165.
Date of Publication: December 2021.
Author
Kang S.-H.; Baek H.; Cho J.; Kim S.; Hwang H.; Lee W.; Park J.J.; Yoon
Y.E.; Yoon C.-H.; Cho Y.-S.; Youn T.-J.; Cho G.-Y.; Chae I.-H.; Choi
D.-J.; Yoo S.; Suh J.-W.
Institution
(Kang, Lee, Park, Yoon, Yoon, Youn, Cho, Chae, Choi, Suh) Division of
Cardiology, Department of Internal Medicine, Seoul National University and
Seoul National University Bundang Hospital, Seongnam, South Korea
(Baek, Cho, Kim, Hwang, Yoo) Healthcare Information and Communication
Technology Research Center, Office of eHealth Research and Businesses,
Seoul National University Bundang Hospital, Seongnam, South Korea
(Hwang) Department of Pediatrics, Seoul National University Bundang
Hospital, Seongnam, South Korea
(Cho) Department of Cardiology, Incheon Sejong Hospital, Incheon, South
Korea
Publisher
Nature Research
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of death
and morbidity worldwide. This randomized controlled, single-center,
open-label trial tested the impact of a mobile health (mHealth) service
tool optimized for ASCVD patient care. Patients with clinical ASCVD were
enrolled and randomly assigned to the intervention or control group.
Participants in the intervention group were provided with a smartphone
application named HEART4U, while a dedicated interface integrated into the
electronic healthcare record system was provided to the treating
physicians. A total of 666 patients with ASCVD were enrolled, with 333
patients in each group. The estimated baseline 10-year risk of
cardiovascular disease was 9.5% and 10.8% in the intervention and control
groups, respectively, as assessed by the pooled cohort risk equations. The
primary study endpoint was the change in the estimated risk at six months.
The estimated risk increased by 1.3% and 1.1%, respectively, which did not
differ significantly (P = 0.821). None of the secondary study endpoints
showed significant differences between the groups. A post-hoc subgroup
analysis showed the benefit was greater if a participant in the
intervention group accessed the application more frequently. The present
study demonstrated no significant benefits associated with the use of the
mHealth tool in terms of the predefined study endpoints in stable patients
with ASCVD. However, it also suggested that motivating patients to use the
mHealth tool more frequently may lead to greater clinical benefit. Better
design with a positive user experience needs to be considered for
developing future mHealth tools for ASCVD patient care. Trial
Registration: ClinicalTrials.gov NCT03392259 Copyright © 2021,
The Author(s).

<65>
Accession Number
2014072382
Title
Perioperative Neutrophil-Lymphocyte Ratio Predicts Mortality After Cardiac
Surgery: Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(5) (pp 1296-1303),
2022. Date of Publication: May 2022.
Author
Perry L.A.; Liu Z.; Loth J.; Penny-Dimri J.C.; Plummer M.; Segal R.; Smith
J.
Institution
(Perry, Liu, Loth, Segal) Department of Anaesthesia, Royal Melbourne
Hospital, Parkville, Australia
(Penny-Dimri, Smith) Department of Surgery, Monash University, Clayton,
Australia
(Penny-Dimri, Smith) School of Clinical Sciences, Monash Health, Clayton,
Australia
(Plummer) Intensive Care Unit, Royal Melbourne Hospital, Parkville,
Australia
(Plummer) Department of Critical Care, University of Melbourne, Parkville,
Australia
(Segal) Department of Medicine, University of Melbourne, Parkville,
Australia
Publisher
W.B. Saunders
Abstract
Objectives: Neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker
that has been evaluated across a variety of surgical disciplines and is
widely predictive of poor postoperative outcome, but its value in cardiac
surgery is unclear. The authors did this systematic review and
meta-analysis to determine the impact of elevated perioperative NLR on
survival after cardiac surgery. Design(s): Systematic review and
meta-analysis of study-level data. Setting(s): Multiple hospitals
involved in an international pool of studies. Participant(s): Adults
undergoing cardiac surgery. Intervention(s): None. Measurements
and Main Results: The authors searched multiple databases from inception
until November 2020. They generated summary hazard ratios (HR) and odds
ratios (OR) for the association of elevated preoperative NLR with
long-term and short-term mortality following cardiac surgery. They
separately reported on elevated postoperative NLR. Between-study
heterogeneity was explored using metaregression. The authors included 12
studies involving 13,262 patients undergoing cardiac surgery. Elevated
preoperative NLR was associated with worse long-term (>30 days) (hazard
ratio [HR] 1.56; 95% CI [confidence interval], 1.18-2.06; 8 studies) and
short-term (<30 days) mortality (OR 3.18; 95% CI, 1.90-5.30; 7 studies).
One study reported the association of elevated postoperative NLR with
long-term mortality (HR 8.58; 95% CI, 2.55-28.85). There was considerable
between-study heterogeneity for the analysis of long-term mortality
(I2 statistic 94.39%), which mostly was explained by
study-level variables, such as the number of variables adjusted for by
included studies and how many of these significantly increased the risk of
long-term mortality, high risk of bias, and number of study centers, as
well as participant level factors, such as average participant age and
hypertension prevalence. Conclusion(s): Perioperative NLR is an
independent predictor of short-term and long-term postoperative mortality
following cardiac surgery. Further research is required to determine which
patient-level factors modify the prognostic value of NLR and to evaluate
its role in routine clinical practice. Copyright © 2021 Elsevier
Inc.

<66>
Accession Number
2013682146
Title
Efficacy of Erector Spinae Plane Block for Analgesia in Thoracic Surgery:
A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(5) (pp 1387-1395),
2022. Date of Publication: May 2022.
Author
Koo C.-H.; Lee H.-T.; Na H.-S.; Ryu J.-H.; Shin H.-J.
Institution
(Koo, Lee, Na, Ryu, Shin) Department of Anesthesiology & Pain Medicine,
Seoul National University Bundang Hospital, Seongnam, South Korea
(Ryu) Department of Anesthesiology & Pain Medicine, Seoul National
University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: The objective of this study was to determine whether erector
spinae plane block (ESPB) can provide an effective analgesia for managing
pain after thoracic surgery and compare the efficacy of ESPB with that of
other regional analgesic techniques. Design(s): Systematic review and
meta-analysis of randomized controlled trials. Setting(s): PubMed,
EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science were searched.
 Participant(s): Patients undergoing thoracic surgeries.
 Intervention(s): Erector spinae plane block with local anesthetics
for postoperative analgesia. Measurement and Main Results: Seventeen
studies, including 1,092 patients, were included in the final analysis.
Erector spinae plane block reduced 24-hour postoperative opioid
consumption (mean difference [MD] -17.49, 95% CI -26.87 to -8.12), pain
score at rest (MD -0.82, 95% CI -1.31 to -0.33), and pain score at
movement (MD -0.77, 95% CI -1.20 to -0.3) compared to no block. Compared
with other regional blocks, various results have been observed. Although
statistical results showed that ESPB is inferior to thoracic paravertebral
block and intercostal nerve block and superior to serratus anterior plan
block in postoperative analgesia, clinical differences remain unclear. The
incidence of hematoma was lower in the ESPB group than in the other groups
(odds ratio 0.19, 95% CI 0.05-0.73). Conclusion(s): Erector spinae
plane block may provide effective analgesia after thoracic surgery.
Compared with other techniques, it is a safer method, without clinically
important differences, for postoperative pain control. Therefore, ESPB may
be considered as a valuable option for postoperative pain management after
thoracic surgery. Copyright © 2021 Elsevier Inc.

<67>
Accession Number
2015094045
Title
Serum biomarkers of brain injury after uncomplicated cardiac surgery:
Secondary analysis from a randomized trial.
Source
Acta Anaesthesiologica Scandinavica. 66(4) (pp 447-453), 2022. Date of
Publication: April 2022.
Author
Barbu M.; Jonsson K.; Zetterberg H.; Blennow K.; Kolsrud O.; Ricksten
S.-E.; Dellgren G.; Bjork K.; Jeppsson A.
Institution
(Barbu, Dellgren, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Barbu) Department of Cardiology, Blekinge Hospital, Karlskrona, Sweden
(Jonsson, Kolsrud, Dellgren, Bjork, Jeppsson) Department of Cardiothoracic
Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
(Zetterberg, Blennow) Clinical Neurochemistry Laboratory, Sahlgrenska
University Hospital, Molndal, Sweden
(Zetterberg, Blennow) Department of Psychiatry and Neurochemistry,
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University
of Gothenburg, Molndal, Sweden
(Zetterberg) Department of Neurodegenerative Disease, UCL Institute of
Neurology, London, United Kingdom
(Zetterberg) UK Dementia Research Institute at UCL, London, United Kingdom
(Ricksten) Department of Cardiothoracic Anesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Ricksten) Department of Anesthesiology and Intensive Care, Institute of
Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Postoperative cognitive dysfunction is common after cardiac
surgery. Postoperative measurements of brain injury biomarkers may
identify brain damage and predict cognitive dysfunction. We describe the
release patterns of five brain injury markers in serum and plasma after
uncomplicated cardiac surgery. Method(s): Sixty-one elective cardiac
surgery patients were randomized to undergo surgery with either a
dextran-based prime or a crystalloid prime. Blood samples were taken
immediately before surgery, and 2 and 24 h after surgery. Concentrations
of the brain injury biomarkers S100B, glial fibrillary acidic protein
(GFAP), tau, neurofilament light (NfL) and neuron-specific enolase (NSE))
and the blood-brain barrier injury marker beta-trace protein were
analyzed. Concentrations of brain injury biomarkers were correlated to
patients' age, operation time, and degree of hemolysis. Result(s): No
significant difference in brain injury biomarkers was observed between the
prime groups. All brain injury biomarkers increased significantly after
surgery (tau +456% (25th-75th percentile 327%-702%), NfL +57% (28%-87%),
S100B +1145% (783%-2158%), GFAP +17% (-3%-43%), NSE +168% (106%-228%),
while beta-trace protein was reduced (-11% (-17-3%). Tau, S100B, and NSE
peaked at 2h, NfL and GFAP at 24 h. Postoperative concentrations of brain
injury markers correlated to age, operation time, and/or hemolysis.
 Conclusion(s): Uncomplicated cardiac surgery with cardiopulmonary
bypass is associated with an increase in serum/plasma levels of all the
studied injury markers, without signs of blood-brain barrier injury. The
biomarkers differ markedly in their levels of release and time course.
Further investigations are required to study associations between
perioperative release of biomarkers, postoperative cognitive function and
clinical outcome. Copyright © 2022 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<68>
[Use Link to view the full text]
Accession Number
637421996
Title
Effects of perioperative erythropoietin administration on acute kidney
injury and red blood cell transfusion in patients undergoing cardiac
surgery: A systematic review and meta-analysis.
Source
Medicine. 101(9) (pp e28920), 2022. Date of Publication: 04 Mar 2022.
Author
Shin H.J.; Ko E.; Jun I.; Kim H.J.; Lim C.H.
Institution
(Shin, Ko, Jun, Lim) Department of Anesthesiology and Pain Medicine, Korea
University Anam Hospital, Korea University College of Medicine, Seoul,
South Korea
(Kim) Department of Preventive Medicine, Institute for Evidence-based
Medicine Cochrane Korea, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: The renoprotective effects of erythropoietin (EPO) are
well-known; however, the optimal timing of EPO administration remains
controversial. Red blood cell (RBC) transfusion is an independent risk
factor for cardiac surgery-associated acute kidney injury (CSA-AKI). We
aimed to evaluate the efficacy of EPO on CSA-AKI and RBC transfusion
according to the timing of administration. METHOD(S): We searched the
Cochrane Library, EMBASE, and MEDLINE databases for randomized controlled
trials. The primary outcome was the incidence of CSA-AKI following
perioperative EPO administration, and the secondary outcomes were changes
in serum creatinine, S-cystatin C, S-neutrophil gelatinase-associated
lipocalin, urinary neutrophil gelatinase-associated lipocalin, length of
hospital and intensive care unit (ICU) stay, volume of RBC transfusion,
and mortality. The subgroup analysis was stratified according to the
timing of EPO administration in relation to surgery. RESULT(S): Eight
randomized controlled trials with 610 patients were included in the study.
EPO administration significantly decreased the incidence of CSA-AKI (odds
ratio: 0.60, 95% confidence interval [CI]: 0.43-0.85, P = .004; I2 = 52%;
P for heterogeneity = .04), intra-operative RBC transfusion (standardized
mean difference: -0.30, 95% CI: -0.55 to -0.05, P = .02; I2 = 15%, P for
heterogeneity = .31), and hospital length of stay (mean difference: -1.54
days, 95% CI: -2.70 to -0.39, P = .009; I2 = 75%, P for heterogeneity =
.001) compared with control groups. Subgroup analyses revealed that
pre-operative EPO treatment significantly reduced the incidence of
CSA-AKI, intra-operative RBC transfusion, serum creatinine, and length of
hospital and ICU stay. CONCLUSION(S): Pre-operative administration of
EPO may reduce the incidence of CSA-AKI and RBC transfusion, but not in
patients administered EPO during the intra-operative or postoperative
period. Therefore, pre-operative EPO treatment can be considered to
improve postoperative outcomes by decreasing the length of hospital and
ICU stay in patients undergoing cardiac surgery. Copyright © 2022
the Author(s). Published by Wolters Kluwer Health, Inc.

<69>
[Use Link to view the full text]
Accession Number
637421722
Title
Tranexamic acid reduces postoperative blood loss in Chinese pediatric
patients undergoing cardiac surgery: A PRISMA-compliant systematic review
and meta-analysis.
Source
Medicine. 101(9) (pp e28966), 2022. Date of Publication: 04 Mar 2022.
Author
Zou Z.-Y.; He L.-X.; Yao Y.-T.
Institution
(Zou, He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular
Hospital, Yunnan Province, Kunming, China
(Yao) Anesthesia Center, Fuwai Hospital, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Tranexamic acid has been increasingly used for blood
conservation in cardiac surgery. However, the evidence supporting the
routine use of tranexamic acid in Chinese pediatric patients undergoing
cardiac surgery remains weak. This meta-analysis aimed to systematically
review the efficacy of tranexamic acid when applying to Chinese pediatric
patients undergoing cardiac surgery. PARTICIPANTS: Chinese pediatric
patients undergoing cardiac surgery. INTERVENTIONS: Tranexamic acid or
control drugs (saline/blank). METHOD(S): PUBMED, Cochrane Library,
EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang Data, and
VIP Data till May 4, 2021, database search was updated on August 1.
Primary outcomes of interest included postoperative bleeding, allogeneic
transfusion, and reoperation for bleeding. Secondary outcomes of interest
included postoperative recovery. For continuous/dichotomous variables,
treatment effects were calculated as weighted mean difference (WMD)/odds
ratio and 95% confidence interval. RESULT(S): A database search
yielded 15 randomized controlled trials including 1641 patients, where 8
studies were allocated into non-cyanotic congenital group, 5 were
allocated into cyanotic congenital group, and the other 2 were allocated
into combined cyanotic/non-cyanotic group. This meta-analysis demonstrate
that tranexamic acid administration can reduce the postoperative 24 hours
blood loss in non-cyanotic, cyanotic, and combined cyanotic/non-cyanotic
patients, the red blood cell transfusion in non-cyanotic and cyanotic
patients, and the fresh frozen plasma transfusion in non-cyanotic and
combined cyanotic/non-cyanotic patients. CONCLUSION(S): This
meta-analysis demonstrates that tranexamic acid is highly effective in
reducing the blood loss in Chinese pediatric cardiac surgery, but it
behaves poorly when it comes to the transfusion requirement. To further
confirm this, more well-designed and adequately-powered randomized trials
are needed. Copyright © 2022 the Author(s). Published by Wolters
Kluwer Health, Inc.

<70>
Accession Number
637036461
Title
Hybrid coronary revascularization in multivessel coronary artery disease:
a systematic review.
Source
Future cardiology. 18(3) (pp 219-234), 2022. Date of Publication: 01 Mar
2022.
Author
Nenna A.; Nappi F.; Spadaccio C.; Greco S.M.; Pilato M.; Stilo F.;
Montelione N.; Catanese V.; Lusini M.; Spinelli F.; Chello M.
Institution
(Nenna, Greco, Stilo, Montelione, Catanese, Lusini, Spinelli, Chello)
Cardiovascular Surgery, Universita Campus Bio-Medico di Roma, Via Alvaro
del Portillo 200, Rome, Italy
(Nappi) Cardiac Surgery, Centre Cardiologique du Nord, Rue des Moulins
Gemeaux 32, Saint Denis, Paris, France
(Spadaccio) Cardiac Surgery, Golden Jubilee National Hospital, Agamemnon
St, Clydebank, G814DY, Glasgow, UK
(Greco, Pilato) Cardiac Surgery, Via Ernesto Tricomi 5, Palermo, Italy
Publisher
NLM (Medline)
Abstract
Aim: Hybrid coronary revascularization (HCR) for multivessel coronary
artery disease (CAD) integrates coronary artery bypass grafting (CABG) and
percutaneous intervention in a planned revascularization strategy. This
systematic review summarizes the state of this art of this technique.
 Method(s): Major databases searched until October 2021.
 Result(s): The available literature on HCR includes three randomized
trials, ten meta-analysis and 27 retrospective studies. The greatest
benefits are observed in patients with low-to-intermediate risk and less
complex coronary anatomy; highly complex disease and the presence of risk
factors favored conventional CABG in terms of adverse events and survival.
 Conclusion(s): HCR is an interesting approach for multivessel CAD but
should not be considered a 'one-size-fits-all' procedure. Further studies
will specify the subset of patients likely to benefit most from this
hybrid approach.

<71>
Accession Number
2010496735
Title
Aspirin Versus Dual Antiplatelet Therapy in Patients Undergoing
Trans-Catheter Aortic Valve Implantation, Updated Meta-Analysis.
Source
Cardiovascular Drugs and Therapy. 36(2) (pp 279-283), 2022. Date of
Publication: April 2022.
Author
Alkhalil M.; Edwards R.; Puri R.; Kalra A.; Zaman A.; Das R.
Institution
(Alkhalil, Edwards, Zaman, Das) Department of Cardiothoracic Services,
Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, United Kingdom
(Puri, Kalra) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Zaman) Newcastle University, Newcastle-upon-Tyne, United Kingdom
(Das) Northumbria University, Newcastle upon Tyne, United Kingdom
Publisher
Springer
Abstract
Background: The Antiplatelet Therapy for Patients Undergoing Transcatheter
Aortic-Valve Implantation (POPular TAVI) trial reported comparable
composite endpoints of ischemic events using aspirin compared to dual
antiplatelet therapy (DAPT). However, this trial was not powered to detect
individual differences in ischemic events. We sought to conduct a
meta-analysis to compare aspirin to DAPT on ischemic and bleeding events
following TAVI. Method(s): The MEDLINE database was searched from
inception until September 2020 and only randomized clinical trials of
patients receiving antiplatelet therapy following TAVI were included. The
treatment effect was reported as rate ratios (RRs) with 95% confidence
intervals. Result(s): Four randomized clinical trials of 1086 TAVI
patients were included. There was a 51% reduction in major or
life-threatening bleeding with aspirin compared with DAPT [RR 0.49, (95%CI
0.31 to 0.78)]. Aspirin was not associated with an increased risk of death
[RR 1.01, (95%CI 0.62 to 1.65)], cardiovascular death [RR 1.15, (95%CI
0.56 to 2.36)], ischemic stroke [RR 0.93, (95%CI 0.51 to 1.70)], or MI [RR
0.53, (95%CI 0.18 to 1.57)]. Conclusion(s): This meta-analysis
supports the use of aspirin as the optimal antiplatelet strategy following
TAVI procedures in reducing bleeding without an increase in ischemic
events compared with dual antiplatelet therapy. Copyright © 2021,
Springer Science+Business Media, LLC, part of Springer Nature.

<72>
Accession Number
2010472486
Title
Aspirin Alone Versus Dual Antiplatelet Therapy after Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Drugs and Therapy. 36(2) (pp 271-278), 2022. Date of
Publication: April 2022.
Author
Lin X.; Wang S.; Wang L.; Guan Y.; Huang J.
Institution
(Lin, Guan) Zhejiang Chinese Medical University, Hangzhou, China
(Lin, Wang, Wang, Guan, Huang) Affiliated Hangzhou First People's
Hospital, Zhejiang University School of Medicine, Stress: No. 261, Huansha
Road, Hangzhou 310006, China
Publisher
Springer
Abstract
Background: The current American College of Cardiology and American Heart
Association (ACC/AHA) guidelines recommend dual antiplatelet therapy
(DAPT) with aspirin and clopidogrel for 6 months followed by lifelong
aspirin after transcatheter aortic valve replacement (TAVR). However,
studies that have DAPT with aspirin following TAVR have questioned this
recommendation as DAPT has been associated with more bleeding events
compared to aspirin. We performed a systematic review and meta-analysis of
all the RCTs comparing DAPT (aspirin plus clopidogrel) with aspirin alone
as antithrombotic treatment following transcatheter aortic valve
replacement. Method(s): The databases of Embase, PubMed, and Cochrane
library were searched from inception to Oct 1, 2020, and randomized
controlled trials (RCTs) reporting aspirin plus clopidogrel with aspirin
alone as antithrombotic treatment after TAVI were included. Revman 5.3 was
used to conduct the analysis. Result(s): After screening 152
articles, four studies involving 1086 patients (541 patients in the
aspirin group and 545 patients in the DAPT group) were included. The
results demonstrated that, at 30 days follow-up, compared with DAPT,
aspirin was not associated with a statistically significant difference in
the rate of bleeding events (RR = 1.22, 95% CI 0.62 to 2.39, P = 0.57),
all-cause mortality (RR = 1.21, 95% CI 0.52 to 2.84, P = 0.66), stroke (RR
= 0.81, 95% CI 0.24 to 2.79, P = 0.74), and MI (RR = 4.00, 95% CI 0.45 to
35.22, P = 0.21). However, at the 6 to 12 months follow-up, DAPT appeared
to increase the risk of bleeding events compared with aspirin alone (RR =
1.67, 95% CI 1.24 to 2.24, P < 0.001), and there was no significant
difference in the rate of all-cause mortality (RR = 0.89, 95% CI 0.53 to
1.48, P = 0.65), stroke (RR = 1.04, 95% CI 0.57 to 1.92, P = 0.90), and MI
(RR = 1.65, 95% CI 0.52 to 5.26, P = 0.40) among the two groups.
 Conclusion(s): Our systematic review and meta-analysis suggested that
aspirin alone could decrease the risk of bleeding and was not associated
with higher risk of mortality, stroke or myocardial infarction compared
with DAPT. Copyright © 2021, Springer Science+Business Media,
LLC, part of Springer Nature.

<73>
Accession Number
636860390
Title
Tricuspid Valve Intervention at the Time of Pulmonary Valve Replacement in
Adults With Congenital Heart Disease: A Systematic Review and
Meta-Analysis.
Source
Journal of the American Heart Association. 10(24) (pp e022909), 2021. Date
of Publication: 21 Dec 2021.
Author
Van den Eynde J.; Callahan C.P.; Lo Rito M.; Hussein N.; Carvajal H.;
Guariento A.; Ruhparwar A.; Weymann A.; Budts W.; Gewillig M.; Sa M.P.;
Kutty S.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart CenterThe Johns Hopkins
Hospital and School of Medicine Baltimore MD
(Van den Eynde) Department of Cardiovascular Sciences Department of
Cardiovascular Diseases KU Leuven, University Hospitals Leuven Leuven
Belgium, Belgium
(Callahan, Guariento) Division of Cardiovascular Surgery The Hospital for
Sick Children Toronto Canada, Canada
(Lo Rito) Department of Congenital Cardiac Surgery IRCCS Policlinico San
Donato San Donato Milanese Italy, Italy
(Hussein) Department of Congenital Cardiac Surgery Yorkshire Heart
CentreLeeds General Infirmary England United Kingdom, United Kingdom
(Carvajal) Section of Pediatric Cardiothoracic Surgery Department of
Surgery Washington University School of Medicine in St. Louis/St. Louis
Children's Hospital Saint Louis MO
(Ruhparwar, Weymann) Department of Thoracic and Cardiovascular Surgery
West German Heart and Vascular Center Essen University Hospital of
EssenUniversity Duisburg-Essen Essen Germany, Germany
(Budts) Department of Cardiovascular Sciences Congenital and Structural
Cardiology Catholic University Leuven, University Hospitals Leuven Leuven
Belgium, Belgium
(Gewillig) Pediatric Cardiology University Hospitals Leuven Leuven
Belgium, Belgium
(Sa) Department of Cardiac Surgery Lankenau Heart InstituteMain Line
Health Wynnewood PA
(Sa) Department of Cardiac Surgery Research Lankenau Institute for Medical
ResearchMain Line Health Wynnewood PA
Publisher
NLM (Medline)
Abstract
Background Tricuspid regurgitation (TR) is a common finding in adults with
congenital heart disease referred for pulmonary valve replacement (PVR).
However, indications for combined valve surgery remain controversial. This
study aimed to evaluate early results of concomitant tricuspid valve
intervention (TVI) at the time of PVR. Methods and Results Observational
studies comparing TVI+PVR and isolated PVR were identified by a systematic
search of published research. Random-effects meta-analysis was performed,
comparing outcomes between the 2 groups. Six studies involving 749
patients (TVI+PVR, 278 patients; PVR, 471 patients) met the eligibility
criteria. In the pooled analysis, both TVI+PVR and PVR reduced TR grade,
pulmonary regurgitation grade, right ventricular end-diastolic volume, and
right ventricular end-systolic volumes. TVI+PVR, but not PVR, was
associated with a decrease in tricuspid valve annulus size (mean
difference, -6.43 mm, 95% CI, -10.59 to -2.27; P=0.010). Furthermore,
TVI+PVR was associated with a larger reduction in TR grade compared with
PVR (mean difference, -0.40; 95% CI, -0.75 to -0.05; P=0.031). No evidence
could be established for an effect of either treatment on right
ventricular ejection fraction or echocardiographic assessment of right
ventricular dilatation and dysfunction. There was no evidence for a
difference in hospital mortality or reoperation for TR. Conclusions While
both strategies are effective in reducing TR and right ventricular
volumes, routine TVI+PVR can reduce TR grade to a larger extent than
isolated PVR. Further studies are needed to identify the subgroups of
patients who might benefit most from combined valve surgery.

<74>
Accession Number
2017070146
Title
Do non-vitamin K antagonist oral anticoagulants increase the risk of
myocardial infarction?.
Source
Kardiologia Polska. 80(1) (pp 16-24), 2022. Date of Publication: 2022.
Author
Grajek S.; Kaluzna-Oleksy M.
Institution
(Grajek, Kaluzna-Oleksy) 1st Department of Cardiology, Poznan University
of Medical Sciences, Poznan, Poland
Publisher
Via Medica
Abstract
Non-vitamin K antagonist oral anticoagulants (NOACs), compared with
warfarin, have a favorable risk-benefit profile. However, in the RE-LY
study in patients with atrial fibrillation (AF), the number of patients
with MI was higher in the dabigatran group as compared to the warfarin
group. Many meta-analyses showed that dabigatran treatment led to an
increased risk of myocardial infarction (MI). Large real-world data (RWD)
did not confirm an increase in the risk of MI during dabigatran treatment.
In our meta-analysis we excluded RWD, and each of the four drugs was
evaluated in two key-phase III randomized controlled trials: in patients
with AF and patients with AF and chronic coronary syndrome or acute
coronary syndrome treated with percutaneous coronary interventions. In
each study, warfarin was the comparator for NOACs. In this homogeneous
group of patients, dabigatran, in direct comparison with warfarin,
significantly increased the risk of MI by about 30%. Moreover, the risk of
MI was also significantly higher than the opposite effect of activated
factor (F) X inhibitors (FXa inhibitors) vs. warfarin. In our network
meta-analysis, considering individual NOACs in recommended doses, we found
an increased risk of MI compared to warfarin only in patients treated with
dabigatran 150 mg twice a day and, in particular, 110 mg twice a day. In
this review we present evidence supporting our opinion that in patients
with AF and coronary stenting, the choice of NOACs (direct FXa vs.
thrombin inhibitors) is equally as important as choosing the optimal
antiplatelet therapy (single or dual antiplatelet therapy). Copyright
by the Author(s), 2022

<75>
Accession Number
2017070131
Title
Efficacy and safety of coronary computed tomography angiography in
patients with a high clinical likelihood of obstructive coronary artery
disease.
Source
Kardiologia Polska. 80(1) (pp 49-55), 2022. Date of Publication: 2022.
Author
Rudzinski P.N.; Kruk M.; Demkow M.; Oleksiak A.; Schoepf J.U.; Mach M.;
Dzielinska Z.; Pregowski J.; Witkowski A.; Ruzyllo W.; Kepka C.
Institution
(Rudzinski, Kruk, Demkow, Oleksiak, Dzielinska, Pregowski, Witkowski,
Ruzyllo, Kepka) National Institute of Cardiology, Warszawa, Poland
(Schoepf) Division of Cardiovascular Imaging, Department of Radiology and
Radiological Science, Medical University of South Carolina, Charleston,
SC, United States
(Schoepf) Division of Cardiology, Department of Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Mach) Division of Cardiac Surgery, Department of Surgery, Vienna General
Hospital, Vienna, Austria
Publisher
Via Medica
Abstract
Background: The CAT-CAD trial showed that coronary computed tomography
angiography (CTA) in patients with a high prevalence of coronary artery
disease (CAD) and indications for invasive coronary angiography (ICA)
reduces the number of patients undergoing ICA by two-thirds and nearly
eradicates non-actionable ICAs. However, the long-term benefits of this
non-invasive strategy remain unknown. Aim(s): To evaluate the
long-term efficacy and safety of a non-invasive strategy employing
coronary CTA vs. ICA as the first-line imaging test in stable patients
with a high clinical likelihood of obstructive CAD. Method(s): The
long-term outcomes were evaluated for 36 months following randomization
and included the efficacy outcome (analyzed as the composite of major
adverse cardiovascular events (MACE): all-cause death, acute coronary
syndrome, unplanned coronary revascularization, urgent hospitalization for
a cardiovascular reason, a stroke) and the safety outcome (analyzed as a
cumulative incidence of serious adverse events). Result(s): One
hundred and twenty participants at a mean age of 60.6 (7.9) years (female,
35.0%) were randomized with an allocation ratio of 1:1 to coronary CTA and
direct ICA as the first-line anatomical test for suspected obstructive
CAD. There were no significant differences between both diagnostic
strategies neither in terms of the long-term efficacy (MACE occurrence:
15.5% in coronary CTA group vs. 16.7% in ICA group; log-rank P = 0.89) nor
the long-term safety (cumulative number of serious adverse events: 36 vs.
38; P = 0.79, respectively). Conclusion(s): Long-term follow-up of
the randomized CAT-CAD trial confirms t hat t he s trategy employing
coronary CTA is an effective and safe, non-invasive, outpatient-based
alternative to ICA for patients with a high clinical likelihood of
obstructive CAD. Copyright by the Author(s), 2022

<76>
Accession Number
2015924381
Title
Transcatheter Aortic Valve Implantation in Bicuspid Aortic Valve with
Aortic Stenosis: a Meta-Analysis and Trial Sequential Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 37(1) (pp 88-98), 2022. Date
of Publication: 2022.
Author
Chan J.S.K.; Singh S.; Eriksen P.; Tsui L.H.; Harky A.
Institution
(Chan) Division of Cardiology, Department of Medicine and Therapeutics,
Prince of Wales Hospital, Shatin, New Territories, Hong Kong
(Chan, Singh) Faculty of Medicine, The Chinese University of Hong Kong,
Shatin, New Territories, Hong Kong
(Eriksen) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
(Tsui) Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong
Kong
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, United Kingdom
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objectives: Bicuspid aortic valve (BAV) is an important aetiology of
aortic stenosis and the use of transcatheter aortic valve implantation
(TAVI) has not been fully explored in this cohort. This systematic review
and meta-analysis compared the outcomes of TAVI in stenotic BAV against
tricuspid aortic valve (TAV). Method(s): An electronic literature
search was performed in PubMed, MEDLINE, EMBASE, and Scopus to identify
all studies comparing TAVI in stenotic BAV versus TAV. Only studies
comparing TAVI in BAV versus TAV were included, without any limit on the
study date. Primary endpoints were 30-day and 1-year mortality, while
secondary endpoints were postoperative rates of stroke, acute kidney
injury (AKI), and permanent pacemaker (PPM) requirement. A trial
sequential analysis (TSA) was performed for all endpoints to understand
their significance. Result(s): Thirteen studies met the inclusion
criteria (917 BAV and 3079 TAV patients). The BAV cohort was younger
(76.8+/-7.43 years vs. 78.5+/-7.12 years, P=0.02), had a higher
trans-aortic valve gradient (P=0.02), and larger ascending aortic
diameters (P<0.0001). No significant difference was shown for primary
(30-day mortality [P=0.45] and 1-year mortality [P=0.41]) and secondary
endpoints (postoperative stroke [P=0.49], AKI [P=0.14], and PPM
requirement [P=0.86]). The BAV group had a higher rate of significant
postoperative aortic regurgitation (P=0.002). TSA showed that there was
sufficient evidence to conclude the lack of difference in PPM
requirements, and 30-day and 1-year mortality between the two cohorts.
 Conclusion(s): TAVI gives satisfactory outcomes for treating stenotic
BAV and should be considered clinically. Copyright © 2022,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<77>
Accession Number
2016077360
Title
Rationale and design of the safe and timely antithrombotic removal -
ticagrelor (STAR-T) trial: A prospective, multi-center, double-blind,
randomized controlled trial evaluating reductions in postoperative
bleeding with intraoperative removal of ticagrelor by the drugsorbTM-ATR
device in patients undergoing cardiothoracic surgery within 48 hours from
last ticagrelor dose.
Source
American Heart Journal. 245 (pp 19-28), 2022. Date of Publication: March
2022.
Author
Gibson C.M.; Mack M.J.; Lee V.T.; Schneider D.J.; Sellke F.W.; Ohman E.M.;
Thourani V.H.; Doros G.; Kroger H.; Cutlip D.E.; Deliargyris E.N.
Institution
(Gibson, Doros, Cutlip) The Baim Institute and Harvard Medical School,
Boston, MA, United States
(Mack) Baylor Scott & White Health, Baylor Scott & White Research
Institute, Dallas, TX, United States
(Lee, Kroger, Deliargyris) CytoSorbents Inc, Princeton, NJ, United States
(Schneider) Department of Medicine and Cardiovascular Research Institute,
University of Vermont, Burlington, VT, United States
(Sellke) Division of Cardiothoracic Surgery, Alpert Medical School of
Brown University, Providence, RI, United States
(Ohman) Duke Clinical Research Institute, Duke Program for Advanced
Coronary Disease, Duke University Medical Center, Durham, NC, United
States
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart Institute, Atlanta, GA, United States
(Doros) Boston University School of Public Health, Boston, MA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Ticagrelor is often administered to patients with acute
coronary syndromes. However, when these patients require urgent or
emergent cardiothoracic (CT) surgery the presence of ticagrelor
significantly increases surgical bleeding. The goal of the current trial
is to evaluate the effectiveness and safety of the DrugSorb-ATR
hemoadsorption device for the intraoperative removal of ticagrelor to
reduce postoperative bleeding in the above patient population. The Safe
and Timely Antithrombotic Removal - Ticagrelor (STAR-T) Trial is a
multi-center, double-blind, randomized, controlled trial enrolling
patients who require cardiothoracic surgery on cardiopulmonary bypass
(CPB) within 48 hours of last ticagrelor dose. Method(s): Subjects
will be randomized 1:1 to receive either the DrugSorb-ATR device or an
identical sham device during CPB. The study will enroll up to 120 subjects
at 20 U.S centers, and the primary outcome is the composite of fatal
perioperative bleeding, moderate/severe/massive bleeding according to the
Universal Definition of Perioperative Bleeding in Cardiac Surgery (UDPB),
and 24 hours chest tube drainage. The components of the composite are
hierarchically ranked according to clinical significance and the primary
analysis will utilize the Win Ratio method. Percent change in ticagrelor
levels before and after CPB (drug removal) will be the key secondary
endpoint. An independent Clinical Events Committee will adjudicate all
clinical endpoints including safety endpoints relating to postoperative
thrombotic events. Subjects will be followed through 30 days after the
index operation. Conclusion(s): The results from STAR-T, if positive,
will potentially support FDA market approval for DrugSorb-ATR, and provide
a solution to an important unmet clinical need. Copyright © 2021
The Author(s)

<78>
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 ©

<79>
Accession Number
2014505130
Title
Prognostic Importance of NT-proBNP and Effect of Empagliflozin in the
EMPEROR-Reduced Trial.
Source
Journal of the American College of Cardiology. 78(13) (pp 1321-1332),
2021. Date of Publication: 28 Sep 2021.
Author
Januzzi J.L.; Zannad F.; Anker S.D.; Butler J.; Filippatos G.; Pocock
S.J.; Ferreira J.P.; Sattar N.; Verma S.; Vedin O.; Schnee J.; Iwata T.;
Cotton D.; Packer M.
Institution
(Januzzi) Cardiology Division, Massachusetts General Hospital, Boston, MA,
United States
(Januzzi) Harvard Medical School, Boston, MA, United States
(Januzzi) Baim Institute for Clinical Research, Boston, MA, United States
(Zannad) Universite de Lorraine, Inserm Investigation Network
Initiative-Cardiovascular and Renal Clinical Trialists, Centre Hospitalier
Regional Universitaire, Nancy, France
(Anker) Department of Cardiology and Berlin Institute of Health Center for
Regenerative Therapies, German Centre for Cardiovascular Research Partner
Site Berlin, Charite Universitatsmedizin, Berlin, Germany
(Butler) Department of Medicine, University of Mississippi School of
Medicine, Jackson, MS, United States
(Filippatos) National and Kapodistrian University of Athens School of
Medicine, Athens University Hospital Attikon, Athens, Greece
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Ferreira) Universite de Lorraine, Inserm, Centre d'Investigation Clinique
Plurithematique 1433, Centre Hospitalier Regional Universitaire de Nancy,
French Clinical Research Infrastructure Network, Investigation Network
Initiative-Cardiovascular and Renal Clinical Trialists, Nancy, France
(Sattar) British Heart Foundation Glasgow Cardiovascular Research Centre,
University of Glasgow, Glasgow, United Kingdom
(Verma) Division of Cardiac Surgery, St Michael's Hospital and University
of Toronto, Toronto, ON, Canada
(Vedin) Boehringer Ingelheim AB, Stockholm, Sweden
(Schnee, Cotton) Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield,
CT, United States
(Iwata) Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany
(Packer) Baylor Heart and Vascular Institute, Baylor University Medical
Center, Dallas, TX, United States
(Packer) Imperial College, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: The relationship between the benefits of empagliflozin in
heart failure with reduced ejection fraction (HFrEF) and N-terminal
pro-B-type natriuretic peptide (NT-proBNP) has not been reported.
 Objective(s): The authors sought to evaluate the relationship between
NT-proBNP and empagliflozin effects in EMPEROR-Reduced (Empagliflozin
Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection
Fraction). Method(s): Patients with HFrEF were randomly assigned to
placebo or empagliflozin 10 mg daily. NT-proBNP was measured at baseline,
4 weeks, 12 weeks, 52 weeks, and 100 weeks. Patients were divided into
quartiles of baseline NT-proBNP. Result(s): Incidence rates for each
study outcome were 4- to 6-fold higher among those in the highest versus
lowest NT-proBNP quartiles (>=3,480 vs <1,115 pg/mL). Study participants
with higher NT-proBNP had 2- to 3-fold total hospitalizations higher than
the lowest NT-proBNP quartile. Empagliflozin reduced risk for major
cardiorenal events without heterogeneity across NT-proBNP quartiles
(primary endpoint P<inf>interaction</inf> = 0.94; renal composite endpoint
P<inf>interaction</inf> = 0.71). Empagliflozin treatment significantly
reduced NT-proBNP at all timepoints examined; by 52 weeks, the adjusted
mean difference from placebo was 13% (P < 0.001). An NT-proBNP in the
lowest quartile (<1,115 pg/mL) 12 weeks after randomization was associated
with lower risk for subsequent cardiovascular death or heart failure
hospitalization regardless of baseline concentration. Treatment with
empagliflozin resulted in 27% higher adjusted odds of an NT-proBNP
concentration of <1,115 pg/mL by 12 weeks compared with placebo (P =
0.01). Conclusion(s): In EMPEROR-Reduced, higher baseline NT-proBNP
concentrations were associated with greater risk for adverse heart failure
or renal outcomes, but empagliflozin reduced risk regardless of baseline
NT-proBNP concentration. The NT-proBNP concentration after treatment with
empagliflozin better informs subsequent prognosis than pretreatment
concentrations. (Empagliflozin Outcome Trial in Patients With Chronic
Heart Failure With Reduced Ejection Fraction [EMPEROR-Reduced];
NCT03057977) Copyright © 2021 The Authors

<80>
Accession Number
2006161266
Title
Hostility predicts mortality but not recurrent acute coronary syndrome.
Source
European Journal of Cardiovascular Nursing. 20(2) (pp 132-137), 2021. Date
of Publication: 01 Feb 2021.
Author
Vitori T.K.; Frazier S.K.; Biddle M.J.; Mudd-Martin G.; Pelter M.M.;
Dracup K.; Moser D.K.
Institution
(Vitori) University of Tennessee, College of Nursing, United States
(Frazier, Biddle, Mudd-Martin, Moser) University of Kentucky, College of
Nursing, United States
(Pelter, Dracup) University of California, San Francisco, United States
Publisher
Oxford University Press
Abstract
Background Hostility is associated with greater risk for cardiac disease,
cardiac events and dysrhythmias. Investigators have reported equivocal
findings regarding the association of hostility with acute coronary
syndrome (ACS) recurrence and mortality. Given mixed results on the
relationship between hostility and cardiovascular outcomes, further
research is critical. Aims The aim of our study was to determine whether
hostility was a predictor of ACS recurrence and mortality. Methods We
performed a secondary analysis of data (N = 2321) from a large randomized
clinical trial of an intervention designed to reduce pre-hospital delay
among patients who were experiencing ACS. Hostility was measured at
baseline with the Multiple Adjective Affect Checklist (MAACL) and patients
were followed for 24 months for evaluation of ACS recurrence and all-cause
mortality. We used Cox proportional hazards modeling to determine whether
hostility was predictive of time to ACS recurrence or all-cause mortality.
Results The majority of patients were married (73%), Caucasian (97%), men
(68%), and had a mean age of 67 +/- 11 years. Fifty-seven percent of
participants scored as hostile based on the established MAACL cut point
(mean score = 7.56 +/- 3.8). Hostility was an independent predictor of
all-cause mortality (p = < 0.039), but was not a predictor of ACS
recurrence (p = 0.792). Conclusion Hostility is common in patients with
ACS and its relationship to clinical outcomes is important to the design
of future interventions to improve long-term ACS mortality. Copyright
© 2021 SAGE Publications Inc.. All rights reserved.

<81>
Accession Number
2016680202
Title
Outcomes in Patients With Asymptomatic Aortic Stenosis (from the Evolut
Low Risk Trial).
Source
American Journal of Cardiology. 168 (pp 110-116), 2022. Date of
Publication: 01 Apr 2022.
Author
Merhi W.M.; Heiser J.; Deeb G.M.; Yakubov S.J.; Lim D.S.; Bladergroen M.;
Tadros P.; Zorn G.; Byrne T.; Kirshner M.; Huang J.; Reardon M.J.
Institution
(Merhi, Heiser) Departments of Cardiothoracic Surgery and Interventional
Cardiology, Spectrum Health Hospitals, Grand Rapids, MI, United States
(Deeb) Departments of Cardiac Surgery and Interventional Cardiology,
University of Michigan Hospitals, Ann Arbor, MI, United States
(Yakubov) Department of Cardiology, Ohio Health Riverside Methodist
Hospital, Columbus, OH, United States
(Lim) Department of Cardiology, University of Virginia Health,
Charlottesville, VA, United States
(Bladergroen) Department of Thoracic Surgery, Bon Secours Saint Mary's
Hospital, Virginia, Richmond
(Tadros, Zorn) Departments of Thoracic Surgery and Interventional
Cardiology, The University of Kansas Hospital, Kansas, Kansas City
(Byrne, Kirshner) Department of Cardiology, Abrazo Arizona Heart Hospital,
Arizona, Phoenix
(Huang) Statistical Services, Medtronic, Minneapolis, MN, United States
(Reardon) Department of Cardiothoracic Surgery and Interventional
Cardiology, Methodist DeBakey Heart and Vascular Center, Houston
Methodist, Texas, Houston
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) has comparable outcomes
with surgical aortic valve replacement (SAVR) in symptomatic patients with
severe aortic stenosis, including those at low risk for surgery. Less is
known about TAVI outcomes in asymptomatic patients. This analysis compares
clinical, hemodynamic, and quality of life (QOL) outcomes after TAVI or
SAVR for low-risk asymptomatic patients. The randomized Evolut Low Risk
trial enrolled asymptomatic patients treated with TAVI (n = 76) and SAVR
(n = 62). New York Heart Association functional class I identified
patients without symptoms. Clinical outcomes, echocardiographic findings,
and QOL in both groups were compared 30 days and 12 months after AVR.
Asymptomatic patients had a mean Society of Thoracic Surgeons score of 1.7
+/- 0.6, 73% were men, and mean age was 74.2 +/- 5.8 years. The composite
end point of all-cause mortality or disabling stroke was similar at 12
months in patients with TAVI (1.3%) and SAVR (6.5%; p = 0.11), although
patients with SAVR tended to have higher rates of all-cause mortality
(4.8%) compared with patients with TAVI (0.0%, p = 0.05). Patients with
TAVI had lower mean aortic valve gradients (8.1 +/- 3.2 mm Hg) and larger
mean effective orifice area (2.3 +/- 0.6 mm Hg) than patients with SAVR
(10.8 +/- 3.8; p <0.001 and 1.9 +/- 0.6; p = 0.001, respectively), and
showed significant improvement in Kansas City Cardiomyopathy Questionnaire
scores from baseline to 30 days (12.1 +/- 23.6; p <0.001), whereas
patients with SAVR did not (2.2 +/- 20.3; p = 0.398). Patients with TAVI
and SAVR had a significant improvement in QOL by 12 months compared with
baseline. In conclusion, low risk asymptomatic patients with severe aortic
stenosis who underwent TAVI had comparable clinical outcomes to SAVR, with
superior valve performance and faster QOL improvement. Copyright
© 2022 Elsevier Inc.

<82>
Accession Number
637549313
Title
Effects of early rehabilitation on functional outcomes in patients after
coronary artery bypass graft surgery: a randomized controlled trial.
Source
The Journal of international medical research. 50(3) (pp
3000605221087031), 2022. Date of Publication: 01 Mar 2022.
Author
Han P.; Yu H.; Xie F.; Li M.; Chen X.; Yu X.; Li J.; Shao B.; Liu J.; Liu
Y.; Liu Z.; Liu X.; Guo Q.
Institution
(Han, Li, Yu, Guo) Shanghai University of Medicine and Health Sciences
Affiliated Zhoupu Hospital, Shanghai, China
(Han, Chen, Li, Liu, Shao, Liu, Liu, Liu, Liu, Guo) TEDA International
Cardiovascular Hospital, Tianjin, China
(Yu) Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
(Xie) Shanghai Jiangwan Hospital, Shanghai, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: This study evaluated the effectiveness, feasibility, and safety
of early rehabilitation for patients after coronary artery bypass graft
(CABG) surgery. METHOD(S): In a three-arm randomized controlled
trial, patients who underwent CABG from January 2018 to June 2018 were
randomly assigned to one of three groups: (i) usual care (UC group); (ii)
UC+single general ward rehabilitation (SGR group); and (iii) UC+general
ward rehabilitation and intensive care unit (ICU) rehabilitation (IGR
group). The primary outcome was the Barthel Index scores. RESULT(S):
The Barthel Index score for UC (75.3+/-12.1) was significantly lower than
that of both SGR (86.2+/-14.1) and IGR (89.1+/-15.5). There was no
significant difference in the Barthel Index scores between the SGR and IGR
groups. Statistically significant differences were found in the length of
ICU stay and post-operative hospital stay but not in post-operative
pulmonary complications (PPC) or atrial fibrillation between the three
groups. CONCLUSION(S): Early rehabilitation implemented during ICU
stay and on the general ward resulted in significant improvements in
functional independence and could be a safe part of routine care
post-CABG.

<83>
Accession Number
2017308085
Title
DUAL VERSUS SINGLE ANTIPLATELET THERAPY AFTER CORONARY ARTERY BYPASS
GRAFTING: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 1114), 2022. Date of
Publication: 08 Mar 2022.
Author
Agrawal A.; Kumar A.; Wang T.K.M.
Institution
(Agrawal, Kumar, Wang) Cleveland Clinic Foundation, Cleveland, OH, United
States
Publisher
Elsevier Inc.
Abstract
Background The optimal antiplatelet regimen after coronary artery bypass
grafting (CABG) remains unclear, including one or two antiplatelet agents.
This meta-analysis compares the cardiovascular and bleeding outcomes of
dual antiplatelet therapy (DAPT) versus single antiplatelet therapy (SAPT)
following CABG. Methods The PRISMA guidelines were followed for this
study, with literature search conducted on Pubmed until 9/30/2021. Studies
were included if they reported death, cardiovascular and/or bleeding
outcomes in DAPT and SAPT patients separately after CABG, and data pooled
using Revman (Version 5.4). Results A total of 24 studies (9 randomized
and 15 cohort studies) were included, combining 28,250 DAPT and 34,933
SAPT CABG patients. DAPT was associated with reduced death (pooled odds
ratio (OR)=0.58, 95% confidence interval (CI) 0.43-0.78; p=0.0003),
reduced cardiovascular death (OR=0.53, 95% CI 0.32-0.88; p=0.01) and
reduced total graft occlusion summing venous and arterial grafts,
(OR=0.59, 95% CI 0.40-0.86; p=0.006). Major (OR=1.33, 95% CI 1.05-1.69;
p=0.02) and minor (OR=1.67, 95% CI 1.06-2.65; p=0.03) bleeding events were
significantly lower in the SAPT cohort (Table). There were no significant
differences in myocardial infarction, stroke and revascularization.
Conclusion DAPT was associated with significant lower rates of all-cause
death, cardiovascular death, and graft occlusion after CABG with higher
rates of major and minor bleeding. [Formula presented] Copyright
© 2022 American College of Cardiology Foundation

<84>
Accession Number
2017308022
Title
A META-ANALYSIS COMPARING TRANSCAROTID VERSUS TRANSFEMORAL ACCESS IN
TRANSCATHETER AORTIC VALVE REPLACEMENT.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 787), 2022. Date of
Publication: 08 Mar 2022.
Author
Abraham B.; Sedhom R.; Sous M.; Roman S.; Megaly M.; Fortuin F.D.
Institution
(Abraham, Sedhom, Sous, Roman, Megaly, Fortuin) Mayo Clinic Hospital,
Phoenix, AZ, United States
Publisher
Elsevier Inc.
Abstract
Background: Transfemoral (TF) access is not always feasible for
transcatheter aortic valve replacement (TAVR). Transcarotid access (TC)
has been introduced as a possible alternative to TF in patients with
severe femoral atherosclerosis. We aimed to compare TC to TF accesses in
patients undergoing TAVR Methods: We performed a systematic review and
meta-analysis including all published studies from 1996 to June 2021 that
comparing TC vs. TF accesses in patients undergoing TAVR. The main
outcomes were: major vascular complications, major bleeding,
cerebrovascular accidents (CVA), permanent pacemaker placement (PPM),
myocardial infarction (MI), acute kidney injury (AKI) and death. Outcomes
were reported in the first 30 days post procedure Results: We included 13
observational studies with a total of 18006 patients. Transcarotid access
arm included 2023 patients and TF access arm included 15983 patients.
Patients underwent TC-TAVR were younger age (80.9+/-7.5 vs. 82.6+/-7.2,
p<0.001) and had higher STS score (6.1+/-3.9 vs. 5.7+/-3.7, p=0.02)
compared to TF-TAVR. There was no difference in procedure success rate
(97.2% vs. 96.1%, p=0.28), and procedure time (70+/-17 minutes vs.
71+/-19, p=0.25) between both groups. Patients underwent TC-TAVR had lower
major vascular complications (1.9% vs. 6.4%, odds ratio (OR) 0.53, 95% CI
[0.32, 0.89], p=0.02) compared to TF-TAVR. However, they had higher CVA
(3.6% vs. 2.1%, OR 1.64, 95% CI [1.23, 2.18], p<0.001), MI (0.6% vs. 0.3%,
OR 2.1, 95% CI [1.04, 4.21], p=0.04), AKI (4.2% vs. 3.2%, OR 1.43, 95% CI
[1.04, 1.97], p=0.03), and death (3.8% vs. 3.4%, OR 1.32, 95% CI [1.01,
1.72], p=0.04). There was no difference in PPM placement (16.1% vs. 15.6%,
p=0.74), and major bleeding (7.8% vs. 4.6%, p=0.36) between both groups.
 Conclusion(s): Compared to TF-TAVR, patients who underwent TC-TAVR
had higher STS score. There was no significant difference between both
groups in procedure success rate. Transcarotid TAVR was associated with
less vascular complications, but higher CVA, MI, AKI and death in the
first 30 days post procedure. Copyright © 2022 American College
of Cardiology Foundation

<85>
Accession Number
2017307988
Title
TAVR IN PATIENTS WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION AND
SEVERE OR NON-SEVERE AORTIC STENOSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 655), 2022. Date of
Publication: 08 Mar 2022.
Author
Ludwig S.; Schofer N.; Jean G.; Kim W.-K.; Renker M.; Hamm C.W.; Alcazar
M.U.; Abdel-Wahab M.; Thiele H.; Van Mieghem N.M.; Ooms J.; Wiessmann M.;
Kornowski R.; Dahl J.S.; Mogensen J.; Longere B.; Coisne A.; Walid B.A.;
Clavel M.-A.
Institution
(Ludwig, Schofer, Jean, Kim, Renker, Hamm, Alcazar, Abdel-Wahab, Thiele,
Van Mieghem, Ooms, Wiessmann, Kornowski, Dahl, Mogensen, Longere, Coisne,
Walid, Clavel) University Heart and Vascular Center Hamburg, Hamburg,
Germany
(Ludwig, Schofer, Jean, Kim, Renker, Hamm, Alcazar, Abdel-Wahab, Thiele,
Van Mieghem, Ooms, Wiessmann, Kornowski, Dahl, Mogensen, Longere, Coisne,
Walid, Clavel) Institut Universitaire de Cardiologie et de Pneumologie,
Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Background: Patients with reduced left ventricular ejection fraction
(LVEF), small aortic valve area and low gradient (LG) (<40 mmHg) may have
severe or moderate aortic stenosis (AS). The impact of transcatheter
aortic valve replacement (TAVR) is controversial in this population.
 Method(s): Patients with LG AS and LVEF<50% were included in a
multinational TAVR registry (ATLAS TAVI). AS severity was assessed by TTE
and non-contrast CT. Survival was investigated for the subgroups of
TAVR-LG-severe AS and TAVR-LG-non-severe AS. TAVR-high-gradient AS
patients and moderate AS patients on medical management (Medical-Mod AS)
were included as control groups. Result(s): Among a total of 1,568
patients, 1047 underwent TAVR (TAVR-high-gradient AS, N=313;
TAVR-LG-severe AS, N=527; TAVR-LG-non-severe AS, N=207) and 521 patients
continued medical management (Medical-Mod AS). After adjustment, all TAVR
groups showed superior survival compared to Medical-Mod AS patients (all
p<0.001). TAVR-LG-severe and TAVR-LG-non-severe AS patients showed similar
survival (p=0.84). After inverse propensity weighting between
TAVR-LG-non-severe AS and Medical-Mod AS patients, TAVR was associated
with improved survival (IPW-HR: 0.57 [0.34-0.94]; p=0.03).
 Conclusion(s): Among patients with low LVEF AS, TAVR was a major
predictor of survival in both severe and non-severe LG AS patients, thus,
reinforcing the need of a randomized controlled trial comparing TAVR
versus medical management in non-severe AS patients with low LVEF.
[Formula presented] Copyright © 2022 American College of
Cardiology Foundation

<86>
Accession Number
2017307908
Title
TO THIN OR NOT TO THIN: A "NOVEL" CASE OF SPONTANEOUS HEMORRHAGIC
PERICARDIAL TAMPONADE COMPLICATED BY ACUTE CVA WITH INTRACARDIAC THROMBUS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 2311), 2022. Date of
Publication: 08 Mar 2022.
Author
McCurdy M.C.; Hemyari B.A.; Haider S.; Dawson J.; Kazimuddin M.; Singh A.
Institution
(McCurdy, Hemyari, Haider, Dawson, Kazimuddin, Singh) University of
Kentucky College of Medicine Bowling Green Campus, Bowling Green, KY,
United States
Publisher
Elsevier Inc.
Abstract
Background: The NOACs have become favorable with less drug interactions,
lack of dietary effects, and lower risk of intracranial hemorrhage
compared with other therapies, i.e. Warfarin[3]. They are well
studied in CVA prevention in non-valvular afib, as well as treatment of
thromboembolism. NOACs are rarely known for spontaneous hemorrhage, such
as intracranial, pericardial, or pleural; however, there are a limited
number of case reports showing just that[2,6,7]. Case: 73 yo
female with one week of dyspnea. PMH of CAD, afib (on Eliquis) s/p DCCV,
modified MAZE with LAA amputation, and bioprosthetic MVR (4 months prior).
Initial presentation of shock, without improvement on fluid resuscitation.
TTE revealed effusion with tamponade. Pericardiocentesis performed with
sanguineous drainage. Etiology of effusion unclear, as workup was
nondiagnostic. Unfortunately, patient experienced ACS event, with LHC
exhibiting nonobstructive CAD. Repeat TTE revealed newly reduced LVEF
(30%) with MV and LA thrombus (19 cm3). MRI brain revealed
small CVA suggestive of embolic source. Initiated on Rivaroxaban. 6 week
follow-up confirmed resolution of prior thrombus without MACE or adverse
bleeding. Decision-making: We believe it unlikely hemorrhagic effusion was
due to prior intervention, as procedure was >4 months prior with benign
TEE <1 month prior. Thus, this may represent spontaneous bleeding on
Apixaban. Review of literature showed increased rates of intracranial
bleeding with Warfarin, and Rivaroxaban, compared to
Apixaban[1,3]. Yet, there are no large studies verifying
efficacy, and safety, of Apixaban for non-valvular afib[4].
Furthermore, the RIVER trial demonstrated in afib with bioprosthetic MV,
Rivaroxaban was noninferior to warfarin with respect to death, MACE, and
major bleeding at 12 months[5]. Ultimately, risk of bleeding
was overshadowed by potential benefit of Rivaroxaban. Conclusion(s):
In conclusion, chronic anticoagulation with Apixaban has been shown safe
and effective, with few reports of spontaneous bleeding when compared to
Warfarin and Rivaroxaban; however, special consideration should still be
given to the treatment of high-risk populations with non-valvular
A-fib[1,3]. Copyright © 2022 American College of
Cardiology Foundation

<87>
Accession Number
2017307727
Title
PROSTHETIC VALVE ENDOCARDITIS IN PATIENTS UNDERGOING TAVR: A
STATE-OF-THE-ART SYSTEMATIC REVIEW.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 692), 2022. Date of
Publication: 08 Mar 2022.
Author
Jaiswal V.; Song D.; Lnu K.; Jaiswal A.; Lo K.B.; Patel N.; Vadiyala M.R.;
Mitra S.; Pandey S.; Lin X.; Mukherjee D.; Sethi P.
Institution
(Jaiswal, Song, Lnu, Jaiswal, Lo, Patel, Vadiyala, Mitra, Pandey, Lin,
Mukherjee, Sethi) Larkin Community Hospital, Miami, FL, United States
(Jaiswal, Song, Lnu, Jaiswal, Lo, Patel, Vadiyala, Mitra, Pandey, Lin,
Mukherjee, Sethi) Icahn School of Medicine at Mount Sinai, Elmhurst, NY,
United States
Publisher
Elsevier Inc.
Abstract
Background: Infective endocarditis (IE) post TAVR is not well studied in
literature. This is the first systematic review with more than 100,000
patients for IE post TAVR. Method(s): Databases were queried with
various keyword combinations to find applicable articles. The following
keywords were used: infective endocarditis, prosthetic valve endocarditis,
and transcatheter aortic valve replacement Results: A total of 21 studies
were included in the final analysis, with a total of 1,76,288 patients
that underwent TAVR. 1.22% (n=2340) of the patients had post-TAVR IE. The
common comorbidities included diabetes (n=611, 26.11%), COPD (n=456,
19.48%) and history of previous stroke (n=184, 7.9%). 12 studies reported
the use of antibiotics for prophylaxis, with beta-lactams being the most
commonly used. Twenty studies reported the type of bacteria isolated in
cultures; all the studies reported finding enterococcus species (n= 415,
18%) and staphylococcus species (n= 656, 28.03%), whereas streptococcus
species (n= 171, 7.30%) was isolated in sixteen of the studies. Most
common complications included HF (n=405, 17.30%), AKI (n= 370, 15.81%),
septic shock (n=264,11.3%) and stroke (n= 98, 4.2%). Among patients with
IE the length of hospital stay was noted to be 14.96 +/-11.28 days and the
overall mortality rate was estimated to be 24%. Conclusion(s):
Incidence of IE post-TAVR is low but is associated with higher rate of
mortality and morbidity. As a result, aggressive management is needed to
prevent complications [Formula presented] Copyright © 2022
American College of Cardiology Foundation

<88>
Accession Number
2017307667
Title
ANGIOTENSIN-CONVERTING ENZYME INHIBITORS (ACEIS) OR ANGIOTENSIN RECEPTOR
BLOCKERS (ARBS) AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR): A
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 780), 2022. Date of
Publication: 08 Mar 2022.
Author
Bhat V.; Kumar A.; Kalra A.
Institution
(Bhat, Kumar, Kalra) St. John's Medical College, Bangalore, India
(Bhat, Kumar, Kalra) Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Persistent left ventricular hypertrophy after TAVR has been
associated with poor outcomes. Angiotensin Converting Enzyme Inhibitors
(ACEIs) and Angiotensin Receptor Blockers (ARBs), due to their favorable
effects on ventricular remodeling, have been hypothesized to improve
outcomes post TAVR. Method(s): We performed a literature search on
PubMed until 30th September 2021, and included all studies
comparing clinical outcomes between patients given ACEIs/ARBs and those
not given ACEIs/ARBs, after TAVR. We used Mantel-Haenszel method with
Paule-Mandel estimator of Tau2 with Hartung-Knapp adjustment for small
study effect, to calculate risk ratios (RR) and corresponding 95%
confidence interval (CI). All analysis was carried out using R version
4.0.3. Result(s): We included 7 studies on the use of ACEIs/ARBs post
TAVR, with all-cause mortality as the primary outcome. Patients on
ACEIs/ARBS had similar risk of all-cause mortality (RR: 0.90, CI:
0.75-1.07, I2=27%, chi2 p-value=0.22) and cardiovascular mortality (RR:
0.94, CI: 0.86-1.03, I2 = 27%, chi2 p-value = 0.89). They had lower risk
of heart failure (RR: 0.83, CI: 0.70-0.99, I2 = 22%, chi2 p-value = 0.27),
and similar risk of new pacemaker implantation, aortic regurgitation,
mitral regurgitation, MI, and stroke. Conclusion(s): Patients on
ACEIs/ARBs have similar outcomes compared to those not on ACEIs/ARBs, post
TAVR, other than heart failure. Randomized trials are needed to explore
the benefits of ACEIs/ARBs post-TAVR. [Formula presented] Copyright
© 2022 American College of Cardiology Foundation

<89>
Accession Number
2017307616
Title
TOTAL CARDIOVASCULAR AND LIMB EVENTS WITH TICAGRELOR AND CLOPIDOGREL IN
PATIENTS WITH SYMPTOMATIC PAD IN THE EUCLID TRIAL.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 1744), 2022. Date of
Publication: 08 Mar 2022.
Author
Szarek M.; Hess C.N.; Patel M.R.; Jones W.S.; Berger J.S.; Baumgartner I.;
Katona B.; Mahaffey K.W.; Norgren L.; Blomster J.; Rockhold F.; Hsia J.A.;
Fowkes F.G.; Bonaca M.P.
Institution
(Szarek, Hess, Patel, Jones, Berger, Baumgartner, Katona, Mahaffey,
Norgren, Blomster, Rockhold, Hsia, Fowkes, Bonaca) CPC Clinical Research,
Aurora, CO, United States
(Szarek, Hess, Patel, Jones, Berger, Baumgartner, Katona, Mahaffey,
Norgren, Blomster, Rockhold, Hsia, Fowkes, Bonaca) University of Colorado
School of Medicine, Aurora, CO, United States
Publisher
Elsevier Inc.
Abstract
Background Peripheral artery disease (PAD) is associated with increased
risk for major adverse limb and cardiovascular (CV) events, but data on
total burden of risk in stable PAD, and the association with polyvascular
disease, is limited. Methods In EUCLID, 13,885 patients with symptomatic
PAD (LER >30 days prior to randomization or ABI <= 0.80) were randomized
1:1 to ticagrelor or clopidogrel. Treatment effects on total events (CV
death; non-fatal myocardial infarction and ischemic stroke; acute limb
ischemia, unstable angina, and transient ischemic attack requiring
hospitalization; coronary, carotid, and peripheral revascularizations; and
amputation for symptomatic PAD) are summarized by events per 100
patient-years (p-y) of follow-up, overall and by number of affected
vascular beds at baseline. Results A total of 7600 events (3878 first,
3722 subsequent) occurred during a median 2.7 years of follow-up,
translating to 20.5 and 21.3 events per 100 p-y for the ticagrelor and
clopidogrel groups, respectively. Event rates and associated risk
reductions with ticagrelor were greater among patients with disease in
multiple vascular beds (Figure). Conclusion Patients with stable PAD have
nearly double the number of total events than first events, with rates
reflecting the number of affected vascular beds. These findings highlight
the clinical relevance of quantifying total disease burden in terms of
total events and the need for long-term preventive treatments in high-risk
patient populations. [Formula presented] Copyright © 2022
American College of Cardiology Foundation

<90>
Accession Number
2017307483
Title
IMPACT OF RENIN-ANGIOTENSIN SYSTEM INHIBITORS ON CLINICAL OUTCOMES IN
PATIENTS WITH SEVERE SYMPTOMATIC AORTIC STENOSIS UNDERGOING TRANSCATHETER
AORTIC VALVE REPLACEMENT WITH A SELF-EXPANDING BIOPROSTHESIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 776), 2022. Date of
Publication: 08 Mar 2022.
Author
Goel S.S.; Kleiman N.S.; Chetcuti S.J.; Deeb G.M.; Yakubov S.J.; Boatman
S.V.; Van Mieghem N.M.; Reardon M.J.
Institution
(Goel, Kleiman, Chetcuti, Deeb, Yakubov, Boatman, Van Mieghem, Reardon)
Houston Methodist DeBakey Heart and Vascular Institute, Houston, TX,
United States
Publisher
Elsevier Inc.
Abstract
Background: Growing evidence suggests renin-angiotensin system (RAS)
inhibition is associated with clinical benefit following surgery or TAVR
in patients with severe symptomatic aortic stenosis. We investigated the
impact of RAS inhibitor (RASi) therapy on clinical outcomes after TAVR
with a self-expanding bioprosthesis. Method(s): Data from patients
undergoing TAVR were pooled from the CoreValve US Pivotal Extreme Risk
trial, CoreValve US Pivotal High Risk randomized clinical trial (RCT),
SURTAVI Intermediate Risk RCT, and the associated continued access
programs. Implants took place from Dec 2010 to Jul 2017. Patients were
stratified by RASi use, defined as angiotensin converting enzyme inhibitor
or angiotensin II receptor blocker therapy at baseline. Unadjusted
outcomes were reported at 2 years. Result(s): The analysis included
852 RASi and 1189 non-RASi patients. The RASi group had higher prevalence
of diabetes (45.9% vs 31.8%), hypertension (98.1% vs 87.8%), and prior
coronary artery bypass surgery (27.6% vs 22.7%) at baseline. All-cause
mortality was significantly lower at 2 years in the RASi group (15.8% vs
20.6%; p=0.0076). Additional outcomes are shown in the Table.
 Conclusion(s): RASi therapy in patients undergoing TAVR was
associated with significantly lower risk of all-cause mortality at 2
years. However, differences in prognostic baseline covariates were
observed and may limit interpretation of this result. Adjusted analyses
are planned to account for potential confounders. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<91>
Accession Number
2017307266
Title
CLINICAL OUTCOMES OF REVASCULARIZATION STRATEGY WITH PERCUTANEOUS CORONARY
INTERVENTION (PCI) PRIOR TO TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR):
A COMPREHENSIVE META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 763), 2022. Date of
Publication: 08 Mar 2022.
Author
Altibi A.; Ghanem F.H.; Hammad F.; Ramu V.K.; Lantz G.; Song H.K.; Golwala
H.; Zahr F.E.; Rahmouni H.
Institution
(Altibi, Ghanem, Hammad, Ramu, Lantz, Song, Golwala, Zahr, Rahmouni)
Oregon Health & Science University, portland, OR, United States
Publisher
Elsevier Inc.
Abstract
Background: Two-thirds of patients undergoing TAVR has concomitant
coronary artery disease (CAD). Evidence regarding the role of PCI in
patients undergoing TAVR remains insufficient to make guideline
recommendations. Method(s): We searched electronic databases to
identify studies reporting on clinical outcomes in patients who underwent
TAVR with or without PCI prior to that. Random-effects meta-analyses with
the inverse variance method were used to estimate the effect size.
 Result(s): We included 23 reports comprising 15,638 TAVR patients
with underlying CAD in the meta-analysis: 20 observational studies, 2
administrative databases, and 1 clinical trial. The pooled 30-day
mortality was 6.3% vs. 6.1% and 1-year mortality was 18.4% vs. 19.3% in
the PCI and no-PCI groups, respectively. There was no difference between
PCI versus no-PCI groups in 30-day mortality (OR 1.07, 95% CI: 0.77-1.48,
p-value= 0.06), 1-year mortality (OR 1.13, 95% CI: 0.96-1.32, p-value=
0.99), 30-day stroke (OR 1.10, 95% CI: 0.75-1.62, p-value= 0.62), 30-day
myocardial infarction (OR 1.29, 95% CI: 0.64-2.58, p-value= 0.48). PCI
prior to TAVR was associated with increased risk for life-threatening
bleeding (OR 1.50, 95% CI: 1.1-2.01, p-value= 0.01). Conclusion(s):
In CAD patient population undergoing TAVI for severe AS, pre-TAVR PCI was
not associated with an improvement in shortand long-term mortality
outcomes, myocardial infarction, or stroke. However, pre-TAVR PCI was
associated an increased risk of life-threatening bleeding. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<92>
Accession Number
2017307134
Title
REVIEW OF POST-TAVR ANNULAR INJURY AND FISTULA FORMATION.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 764), 2022. Date of
Publication: 08 Mar 2022.
Author
Ebrahimi A.; Merrin C.; Patel T.R.; Alkhayru A.; Swe N.C.; Jabbar A.A.
Institution
(Ebrahimi, Merrin, Patel, Alkhayru, Swe, Jabbar) HCA Northside GME/USF
Morsani College of Medicine, St. Petersburg, FL, United States
Publisher
Elsevier Inc.
Abstract
Background: Annular injury after TAVR is a feared complication that
carries a high mortality rate. It is not well reported in most randomized
clinical trials and registry reported incidence is less than 1%, however,
this rate is likely underestimated. Post TAVR annular injury is a spectrum
that encompasses different procedural-related injuries in the region of
the aortic root and the left ventricular outflow tract during
transcatheter aortic valve replacement. Method(s): We conducted a
literature search for case-reports and case-series on annular injuries
post trans-catheter aortic valve replacement in MEDLINE, PubMed, and
Google Scholar. All articles published from 2009 through 2019 were
included in our search. Patients' procedural outcomes and follow-up were
compared when reported. The literature search was conducted between June
2019 and May 2020. Result(s): 45% of the patients were Male, 47% were
Female, with 7% of the patients not having gender available for review.
The mean age of patients included in the analysis was 81 years of age at
the time of review. 40% of patients underwent implantation of an Edwards
Sapien-XT valve, 31% underwent implantation with an Edwards Sapien valve,
10% underwent implantation with an Edwards Sapien-3 valve, 14% underwent
implantation with a Corevalve prosthesis, and 5% were unknown during the
review. 50% of patient cases involved a fistula or communication with the
right ventricle, 50% involved a ventricular septal defect, and 16% cases
of communications to alternative sites. The mean follow-up interval
reported was 9.5 months, with a median follow-up period of 6 months based
on the reported data. There was a 45% reported in-hospital survival rate
based on the pooled data, a 19% in-hospital mortality rate, and an unknown
outcome in 35% of included patient cases Conclusion(s): Post TAVR
annular injuries are uncommon but frequently missed complications. A
multi- modality imaging is needed to define the extent and location of
these defects. When intervention is needed, percutaneous device closure
appears to be safe and feasible in most patients. Open surgery should be
reserved for those with associated aortic root injuries. Copyright
© 2022 American College of Cardiology Foundation

<93>
Accession Number
2017305061
Title
OPTIMAL ANTITHROMBOTIC THERAPY AFTER TRANSCATHETER AORTIC VALVE
REPLACEMENT - A NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 670), 2022. Date of
Publication: 08 Mar 2022.
Author
Singh A.; Hiltner E.P.; Hakeem A.; Kassotis J.; Russo M.; Sethi A.
Institution
(Singh, Hiltner, Hakeem, Kassotis, Russo, Sethi) Rutgers-Robert Wood
Johnson Medical School, New Brunswick, NJ, United States
(Singh, Hiltner, Hakeem, Kassotis, Russo, Sethi) Robert Wood Johnson
University Hospital Somerset, Somerville, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background: Despite the widespread acceptance of transcatheter aortic
valve replacement (TAVR) for the treatment of native aortic valve
stenosis, the optimal antithrombotic therapy post-TAVR remains a matter of
debate. Method(s): We systematically searched electronic databases
for randomized controlled trials comparing antithrombotic therapies
post-TAVR for aortic stenosis without an established indication for oral
anticoagulation. A frequentist random effect network meta-analysis was
performed to compile direct and indirect evidence comparing various
regimens. Result(s): We identified ten studies with 4,125 patients
comparing six antithrombotic regimens. Aspirin (ASA) alone was associated
with a lower risk of the Valve Academic Research Consortium defined major
or life-threatening bleeding when compared to ASA combined with either
clopidogrel, apixaban or rivaroxaban at the longest available follow up.
There was no difference in major or life-threatening bleeding between ASA
alone or combined with either warfarin or ticagrelor. There was no
difference in the rates of ischemic stroke, cardiovascular or total
mortality among the different regimens. Conclusion(s): ASA alone may
be the safest antithrombotic treatment regimen post-TAVR. Further studies
comparing single antithrombotic agents to ASA are needed. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<94>
Accession Number
2017304826
Title
CONDUCTION SYSTEM PACING IN PATIENTS WITH PROSTHETIC HEART VALVES.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 67), 2022. Date of
Publication: 08 Mar 2022.
Author
Shah K.; Williamson B.D.; Kutinsky I.B.; Bhardwaj R.; Contractor T.;
Mandapati R.; Lakkireddy D.R.; Garg J.
Institution
(Shah, Williamson, Kutinsky, Bhardwaj, Contractor, Mandapati, Lakkireddy,
Garg) Beaumont hospital, Royal Oak, MI, United States
(Shah, Williamson, Kutinsky, Bhardwaj, Contractor, Mandapati, Lakkireddy,
Garg) Loma Linda University, Loma Linda, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: There has been increasing interest in physiologic pacing
techniques that directly activate the specialized conduction system. We
aimed to assess outcomes of conduction system pacing (CSP) in patients
with prosthetic heart valves. Method(s): This systematic review was
performed according to PRISMA guidelines. Freeman Tukey double arcsine
transformation with random effect model was used to summarize the data.
Outcomes studied were - (1) implant success; (2) lead parameters at
implant and follow-up; (3) procedure related complications.
 Result(s): 246 patients in 6 studies (92 HBP and 154 LBBAP) with
prosthetic heart valves (54%TAVR) were included. There was no difference
in overall success rate in HBP vs LBBAP (80.16% vs 94.10%, p=0.12),
however, LBBAP had a significantly higher success rate compared to HBP
(93.69 vs 68.39%, p<0.001) in TAVR patients (Figure). HBP thresholds were
higher compared to LBBAP at implant (1.36 @ 1.0ms vs 0.62 @ 0.4ms, p<0.01)
and at a mean follow up of 11.3+/-7.6 months (1.23 @ 1.0ms vs 0.64 @
0.4ms, p<0.01). R wave sensing was significantly better (11.91 mV vs. 4.67
mV, p<0.01), with no difference in mean paced QRS duration with LBBAP
compared to HBP (117 ms vs. 121 ms, p=0.51). There was no significant
difference in mean procedure and fluoroscopy times. There were no acute
complications. Conclusion(s): CSP is safe and feasible in patients
with prosthetic heart valves, with better success rate and lead parameters
with LBBAP compared to HBP, especially in TAVR patients. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<95>
Accession Number
2017304808
Title
DISEASE-SPECIFIC QUALITY OF LIFE FOLLOWING CORONARY ARTERY BYPASS GRAFTING
VERSUS PERCUTANEOUS CORONARY INTERVENTION: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 985), 2022. Date of
Publication: 08 Mar 2022.
Author
Dimagli A.; Spadaccio C.; Myers A.; Demetres M.; Fremes S.E.
Institution
(Dimagli, Spadaccio, Myers, Demetres, Fremes) Ruth Masterson Creber, Weill
Cornell Medicine, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Coronary artery bypass grafting (CABG) and percutaneous
coronary intervention (PCI) are the primary revascularization strategies
for ischemic heart disease. While we know CABG has longer-term survival
than PCI, we do not know whether there is also a quality of life (QoL)
benefit of CABG over PCI. Methods We performed a systematic review and
meta-analysis of randomized clinical trials to compare the effect of CABG
vs PCI on QoL. The primary outcome was Seattle Angina Questionnaire (SAQ),
including three subscales Angina Frequency (AF), QoL, and Physical
Limitations (PL). The mean differences of scores from baseline to 1-year
were computed for CABG and PCI and the "mean gain", the difference between
the mean changes, was pooled using a random-effects model with an inverse
variance method. Results 2,586 studies were screened, and 4 randomized
trials were included in the meta-analysis. There was a significantly
higher gain in QoL scores from before surgery to 1 year post-operatively
in CABG patients for the SAQ AF (1.97; 95%CI 0.68-3.26), and SAQ QoL
(3.30; 95%CI 1.78-4.82).When the metanalytic estimates were regressed on
age, sex and diabetes, we did not find any statistically significant
effect modifiers. There was no evidence of publication bias or small study
effect. Conclusion CABG was associated with a higher improvement in
disease-specific QoL compared to PCI. [Formula presented] Copyright
© 2022 American College of Cardiology Foundation

<96>
Accession Number
2017304729
Title
CLINICAL OUTCOMES OF THE BALLOON-EXPANDABLE VS SELF-EXPANDABLE VALVES IN
PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT - A
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 685), 2022. Date of
Publication: 08 Mar 2022.
Author
Gan E.; Keh Y.S.; Fei G.; Ewe S.H.; Amanullah M.R.; Chao V.; Lim S.T.; Ho
K.W.; Yap J.
Institution
(Gan, Keh, Fei, Ewe, Amanullah, Chao, Lim, Ho, Yap) National Heart Centre
Singapore, Singapore, Singapore
Publisher
Elsevier Inc.
Abstract
Background: This study compares the short and long-term clinical outcomes
of balloon-expandable (BEV) versus self-expandable (SEV) valves in TAVI
patients via a meta-analysis. Method(s): A systematic PubMed
literature review was performed up to Apr 2020. Clinical outcomes (see
Table 1) were divided into 30d, 1y and >=3y. Studies with n<100 were
excluded. Meta-analysis using a fixed effects model was done and
heterogeneity assessed. Result(s): 52 studies were included (29704
BEV vs 27945 SEV patients). At 30d, mortality favored BEV (OR 0.85 (95%CI
0.75-0.96), p = 0.009). BEV had higher AV MPG but lower rates of pacemaker
and paravalvular aortic regurgitation (all p<0.05). At 1y, no significant
differences were observed in mortality, stroke, and major bleeding (all
p>0.05). BEV had smaller AVA (mean difference -0.22 (-0.36 to -0.08), p
<0.01), higher AV MPG (MD 5.29 (0.63-9.95), p = 0.03) but lower pacemaker
rates (OR 0.44 (0.37-0.52), p<0.01). At 3y, there were no differences in
mortality (p=0.16). See Table 1. Conclusion(s): At 1 year, SEV showed
better valve hemodynamics but higher pacemaker rates compared to BEV. No
significant differences in long-term mortality were noted. Better
understanding of these differences will allow specific tailoring of valve
type to the individual patient profile. [Formula presented] Copyright
© 2022 American College of Cardiology Foundation

<97>
Accession Number
2017304713
Title
NON-VITAMIN K ANTAGONISTS VS. WARFARIN IN PATIENTS WITH ATRIAL
FIBRILLATION AND TRANSCATHETER AORTIC VALVE REPLACEMENT: A SYSTEMATIC
REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 676), 2022. Date of
Publication: 08 Mar 2022.
Author
Ternes C.M.P.; Justino G.B.; Justino L.B.; Fernandes A.; Fernandes G.;
Graffunder F.P.; Cardoso R.
Institution
(Ternes, Justino, Justino, Fernandes, Fernandes, Graffunder, Cardoso)
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
Publisher
Elsevier Inc.
Abstract
Background: In the recent GALILEO trial, rivaroxaban increased the risk of
death or thromboembolic complications in patients with transcatheter
aortic valve replacement (TAVR) without an indication for anticoagulation,
calling into question the safety of non-vitamin K antagonists (NOACs) in
the TAVR population. Method(s): We aimed to perform a systematic
review and meta-analysis of studies comparing NOACs to warfarin in
patients with atrial fibrillation (AF) and TAVR for efficacy and safety
endpoints. We searched PubMed, Scopus, and Cochrane databases. A fixed or
random-effects model was used in studies with low and high heterogeneity,
respectively. Result(s): We included 1 randomized controlled trial
and 5 observational studies with 4,124 patients, of whom 1,780 (43.2%)
received a NOAC. Mean follow-up ranged from 3 months to 2.3 years. In the
pooled analysis, all-cause mortality (OR 0.93; 95% CI 0.63-1.38; p=0.72;
Fig. 1A); cardiovascular mortality (OR 1.11; 95% CI 0.78-1.57); stroke (OR
0.96; 95% CI 0.66-1.40; p=0.84; Fig. 1B); hemorrhagic stroke (OR 0.63; 95%
CI 0.21-1.87); and major bleeding (OR 1.00; 95% CI 0.71-1.41; p=0.99;
figure 1C) were not significantly different between groups.
 Conclusion(s): In patients with TAVR and AF, there were no
differences between NOACs and warfarin in mortality, thromboembolic, and
hemorrhagic outcomes. [Formula presented] Copyright © 2022
American College of Cardiology Foundation

<98>
Accession Number
2017304627
Title
META-ANALYSIS OF THE OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION PRIOR
TO TAVR VERSUS TAVR ALONE IN PATIENTS WITH SEVERE AORTIC STENOSIS AND
SIGNIFICANT CORONARY ARTERY DISEASE.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 890), 2022. Date of
Publication: 08 Mar 2022.
Author
Jhand A.; Alraies M.C.; Brilakis E.S.; Mamas M.A.; Abbott J.D.; Bhatt
D.L.; Velagapudi P.
Institution
(Jhand, Alraies, Brilakis, Mamas, Abbott, Bhatt, Velagapudi) University of
Nebraska Medical Center, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Background: The role of percutaneous coronary intervention (PCI) for
significant coronary artery disease (CAD) in severe aortic stenosis (AS)
prior to transcatheter aortic valve replacement (TAVR) remains
controversial. We performed a meta-analysis to study outcomes of PCI
performed prior to TAVR compared with TAVR alone in this patient
population. Method(s): We searched major electronic databases for
studies comparing a strategy of PCI vs. no PCI prior to TAVR in patients
with severe AS and stable significant CAD. Our co-primary outcomes of
interest were short term (<= 30 days) and 1 year mortality. Other outcomes
of interest were short term incidence of stroke, myocardial infarction
(MI), acute kidney injury (AKI), and major bleeding. Risk ratios (RR) and
95 % confidence intervals (CI) were calculated using a random effects
model. Result(s): 8 studies (1 randomized and 7 observational) met
our inclusion criteria comprising a total of 2585 patients (PCI: 1169, No
PCI: 1416). The mean Eurosore and STS scores were comparable between the
two groups. We found no difference in short-term (RR: 0.92, 95% CI = 0.67
- 1.28, p = 0.63) or 1-year mortality (RR: 1.09, 95% CI = 0.87 - 1.38, p =
0.44), or the incidence of short-term stroke, MI, and AKI between the two
groups. However, major bleeding was higher in the PCI group (RR: 1.50, 95%
CI = 1.09 - 2.07, p = 0.01). Conclusion(s): Our analysis demonstrates
that PCI prior to TAVR is not associated with improved clinical outcomes
among patients with severe AS and stable CAD undergoing TAVR. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<99>
Accession Number
2017304617
Title
A META-ANALYSIS COMPARING TRANSCAROTID VERSUS TRANSAXILLARY/TRANSUBCLAVIAN
AND TRANSAPICAL ACCESS IN TRANSCATHETER AORTIC VALVE REPLACEMENT.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 708), 2022. Date of
Publication: 08 Mar 2022.
Author
Abraham B.; Sous M.; Sedhom R.; Roman S.; Megaly M.; Fortuin F.D.
Institution
(Abraham, Sous, Sedhom, Roman, Megaly, Fortuin) Mayo Clinic Hospital,
Phoenix, AZ, United States
Publisher
Elsevier Inc.
Abstract
Background: Transaxillary/transubclavian (TAx/TS) and transapical access
(TA) are considered alternative access for transcatheter aortic valve
replacement (TAVR) in patients who are not candidates for transfemoral
access. We aimed to compare transcarotid (TC) access to TAx/TS and TA
access in patients undergoing TAVR. Method(s): We performed a
systematic review and meta-analysis including all published studies from
1996 to June 2021 that comparing TC vs. TAx/TS or TA access in patients
undergoing TAVR. The main outcomes were: major vascular complications,
cerebrovascular accidents (CVA), permanent pacemaker placement (PPM),
myocardial infarction (MI), acute kidney injury (AKI) and all-cause
mortality. Outcomes were reported in the first 30 days post procedure.
 Result(s): Eight observational studies compared TC-TAVR vs.
TAx/TS-TAVR with a total of 4796 patients, 2198 in TC arm, and 2598
patients in TAx/TS arm. Compared to patients who underwent TAx/TS-TAVR,
the patient who underwent TC-TAVR had lower major vascular complications
(2% vs. 2.3%, OR 0.62, 95% CI [0.39, 0.97], p=0.04). There was no
statistically significant difference between both groups in hospital
length of stay, CVA, all-cause mortality, acute kidney injury, or
permanent pacemaker placement. Six observational studies compared TC-TAVR
to TA-TAVR with a total of 607 patients, 209 patients in TC-TAVR arm, and
398 patients in TA-TAVR arm. Patients who underwent TC-TAVR had lower
major bleeding, CVA, and all-cause mortality; however, it did not reach
the statistical significant point. Conclusion(s): Patient who
underwent TC-TAVR had lower vascular complications compared with
TAx/TS-TAVR with no difference between both groups in CVA and death. There
was no statistically significant difference in outcomes between patients
underwent TC-TAVR and TA-TAVR. Copyright © 2022 American College
of Cardiology Foundation

<100>
Accession Number
2017304499
Title
IMPACT OF CHRONIC KIDNEY DISEASE ON THE OUTCOMES OF MITRACLIP.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 887), 2022. Date of
Publication: 08 Mar 2022.
Author
Abdelghany M.; Vyas V.; Saad M.; Elbadawi A.; Shah S.
Institution
(Abdelghany, Vyas, Saad, Elbadawi, Shah) Boston Medical Center, Boston
University, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Significant mitral regurgitation (MR) is associated with
higher mortality among patients with chronic kidney disease (CKD). We
studied the outcomes of transcatheter mitral valve repair using MitraClip
in patients with vs without CKD. Method(s): We searched PubMed,
SCOPUS, EMBASE, and Google Scholar for studies comparing MitraClip
outcomes in patients with vs without CKD. Primary outcome was all-cause
mortality at 30 days and 1 year. Secondary outcomes included procedural
success, heart failure (HF) readmission, and stroke. Result(s): Six
studies with a total of 5,854 patients met the inclusion criteria. At a
weighted average follow-up duration of 329.3 days, all-cause mortality at
30 days (RR 1.69, 95% CI 1.21 - 2.36, p = 0.002) and 1 year (RR 1.83, 95%
CI 1.46 - 2.30, p <= 0.001) following MitraClip was significantly higher
in patients with versus without CKD. On subgroup analysis by severity of
CKD, patients with GFR <30 ml/min suffered higher all-cause mortality at
30 days (RR 2.60, 95% CI 1.69 - 3.99, p <= 0.001) and 1 year (RR 2.43, 95%
CI 1.94 - 3.06, p <= 0.001) compared with patients without CKD. This was
not observed in patients with GFR of 30-59 ml/min (30-day mortality RR
1.38, 95% CI 0.97 - 1.98, p = 0.08; and 1-year mortality RR 1.51, 95% CI
0.92 - 2.48, p = 0.10). The risk of procedural failure, HF readmission,
and stroke was similar in the two groups. Conclusion(s): Patients
with advanced renal failure (GFR <30 ml/min) undergoing MitraClip have a
significantly higher risk of all-cause mortality at 30 days and 1 year.
[Formula presented] Copyright © 2022 American College of
Cardiology Foundation

<101>
Accession Number
2017304439
Title
PROGRESSIVE MAVD - WHEN TO BITE THE BULLET?.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 3241), 2022. Date of
Publication: 08 Mar 2022.
Author
Mealy S.; Radhakrishnan A.U.
Institution
(Mealy, Radhakrishnan) Allegheny General Hospital, Pittsburgh, PA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Mixed aortic valve disease (MAVD) refers to the presence of
aortic regurgitation (AR) and aortic stenosis (AS). Current guidelines
indicate aortic valve replacement (AVR) for asymptomatic AS and AR when
peak velocity is >4.0 m/s and ejection fraction (EF) is <50%. We present a
challenging case of asymptomatic severe MAVD whom has been followed
clinically for 7 years and is currently enrolled in Early TAVR trial.
Case: A 75-year-old woman presented to our clinic for severe AS.
Echocardiogram revealed aortic valve (AV) mean gradient (MG) of 56mmHg
with AV area of 0.8cm2 and EF of 65%. She was asymptomatic, confirmed with
exercise stress testing (ETT) where she reached 8METS. Over a few years,
her MG peaked at 65mmHg, pressure half-time of 280msec, AV area of 0.8cm2,
and EF of 65%. She was referred to surgery since she met IIa indication
for AVR. She was enrolled in Early TAVR trial and randomized to the
clinical surveillance arm. She progressed to develop atrial fibrillation,
moderate mitral regurgitation, and worsening left atrial pressures.
Although because she remained asymptomatic, no intervention has been
performed. Decision-making: While valve guidelines are descriptive on
imaging and clinical surveillance with asymptomatic AS, they are lacking
in patients with MAVD. This case demonstrates an asymptomatic patient with
progressive MAVD and adverse left sided remodeling. Although per the trial
criteria, no intervention was performed since she is clinically
asymptomatic. Conclusion(s): Studies have shown patients with MAVD
have rapid pathologic remodeling and hemodynamic compromise. This leads to
more heart failure admissions and worse mortality after delayed AVR when
compared to isolated AS patients. Pursuing earlier intervention may be
favorable in this population to prevent irreversible remodeling and
long-term consequences of LV overload. We argue that our patient should
have had a TAVR earlier, and that TAVR trials should exclude all MAVD
patients as they have vastly different hemodynamics. Our case highlights
the need for further research and guidelines to help manage this complex
patient population. Copyright © 2022 American College of
Cardiology Foundation

<102>
Accession Number
2017304157
Title
TRANSCATHETER AORTIC VALVE REPLACEMENT FOR BICUSPID AORTIC VALVES -
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 734), 2022. Date of
Publication: 08 Mar 2022.
Author
Gupta R.; Mahmoudi E.; Vyas A.V.; Combs W.G.; Patel N.C.
Institution
(Gupta, Mahmoudi, Vyas, Combs, Patel) Lehigh Valley Health Network,
Allentown, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Bicuspid aortic valve (BAV) is present in 0.5-2% of the
general population, causing significant aortic stenosis in 12-37% of
affected individuals. There is a lack of evidence behind the safety and
efficacy of Transcatheter Aortic Valve Replacement (TAVR) in BAV. This
study is conducted to compare TAVR outcomes in patients with BAV versus
other morphologies. Method(s): A comprehensive systematic search was
performed in PubMed, Web of Science, and Cochrane. Studies were included
if they had two groups of adult cases with stenotic BAV and non-BAV
undergoing TAVR. Meta-analysis was performed by both random-effect and
fixed-effect model using RevMan and Stata software. Result(s): 38
trials with a total of 260,748 patients (15,947 BAV and 233,381 non-BAV)
were included. TAVR in BAV resulted in higher incidence of stroke,
conversion to open surgery, moderate or severe paravalvular leak,
increased transaortic pressure gradient and need for re-intervention.
However, there was no statistical difference in the incidence of 30-day or
in-hospital mortality, acute kidney injury, major or life-threatening
bleed, major vascular events, myocardial infarction or need for permanent
pacemaker. Conclusion(s): TAVR is a feasible option in selected
patients with BAV. A proper pre-procedural assessment of valve anatomy and
burden of calcification may improve the safety and efficacy of TAVR in
this setting. [Formula presented] Copyright © 2022 American
College of Cardiology Foundation

<103>
Accession Number
2017304046
Title
RESECTION MITRAL VALVE REPAIR WITH SMALL ANNULOPLASTY IS AT HIGHER RISK OF
FUNCTIONAL MITRAL STENOSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 1710), 2022. Date of
Publication: 08 Mar 2022.
Author
Hibino M.; Pandey A.K.; Dhingra N.; Chan V.; Mazer C.D.; Teoh H.; Quan A.;
Leong-Poi H.M.; Connelly K.A.; Verma S.
Institution
(Hibino, Pandey, Dhingra, Chan, Mazer, Teoh, Quan, Leong-Poi, Connelly,
Verma) Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto,
Canada
(Hibino, Pandey, Dhingra, Chan, Mazer, Teoh, Quan, Leong-Poi, Connelly,
Verma) University of Toronto, Toronto, Canada
Publisher
Elsevier Inc.
Abstract
Background Mitral valve repair is the gold standard for the treatment of
degenerative mitral regurgitation (DMR), commonly performed with leaflet
resection or preservation. Functional mitral stenosis (FMS) is the
narrowing of the mitral valve orifice after repair and is observed
especially upon physiologic stress. It is not known whether repair
strategy influences FMS. Herein, we conducted the Canadian Mitral Research
Alliance CardioLink-2 study and compared post-repair outcomes including
mid-term functional tests. Methods In the randomized control trial, 104
patients with DMR from posterior leaflet prolapse were allocated to either
leaflet resection (n=54) or preservation (n=50) at 7 Canadian cardiac
centers. Stress echocardiograms at 12 months were analyzed at a core
laboratory in a blinded fashion. In addition, functional status including
6-minute walking test at 12 months was compared. Results Between the two
groups, there was no significant difference in the baseline demographics
and echocardiographic findings following randomized allocation. There was
no conversion to mitral replacement. Mitral annuloplasty prosthesis size
was similar in the resection and preservation group (33.0+/-3.0 vs
33.6+/-3.4, p=0.42). Furthermore, sizing strategy (diameter to
annuloplasty size ratio) were deemed fair between the groups (both
0.8+/-0.1, p=0.75). There were no readmissions for heart failure nor
deaths during the 12-month follow-up. In the NYHA class at 12 months, the
resection group were more symptomatic (p=0.01). The exercise capacity at
12 months was not significantly different but smaller rate pressure
product in exercise test (20197 vs 21270 p=0.38) and shorter 6-minute walk
distance (451 vs 481meter, p=0.27) were found in the resection group. At
12 months, increase of mean mitral gradient with smaller annuloplasty size
was prominent in the resection group both at rest (p=0.027) and at peak
exercise (p=0.005) in the linear regression model. Conclusion Resection
repair with small annuloplasty is at a higher risk of FMS. For patients
who requires small annuloplasty such as 30mm or less, preservation
strategy may reduce the risk of FMS with wider mitral
opening. Copyright © 2022 American College of Cardiology
Foundation

<104>
Accession Number
2017303764
Title
MONITORED ANESTHESIA CARE VS GENERAL ANESTHESIA OUTCOMES IN TRANSCATHETER
AORTIC VALVE IMPLANTATION-A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 727), 2022. Date of
Publication: 08 Mar 2022.
Author
Hanif H.; Shrivastava S.; Naseer R.; Affan M.; Saqib N.U.; Pir M.S.;
Sothwal A.
Institution
(Hanif, Shrivastava, Naseer, Affan, Saqib, Pir, Sothwal) The Wright Center
for Graduate Medical Education, Scranton, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is
traditionally performed under general anesthesia (GA). However, monitored
anesthesia care (MAC) is being widely adopted for its efficiency and cost
effectiveness with increasing popularity of the procedure. Method(s):
Extensive search on PubMed and Google Scholar database were conducted and
assessed till October 2021. Studies were independently evaluated by 3
physicians. 42 studies comparing TAVI performed under MAC vs GA met our
inclusion criteria. As a guide, an I2 > 30% was considered an
indicator of statistical heterogeneity among the studies. A study-level
analysis was done using Review manager 5.3. A Mantel-Haenszel Fixed
effects model was used to calculate the Odds Ratio for homogeneous
endpoints. A p value <0.05 was considered significant. Result(s):
30-day all-cause mortality in patients undergoing TAVI under GA was
significantly higher as compared to MAC [Odds Ratio 0.68 (0.61-0.76);
p<0.000 (A)]. No differences were seen in incidence of stroke [Odds Ratio
0.96 (0.82-1.12); p=0.57 (B)], AKI [Odds Ratio 0.92 (0.77-1.09); p=0.34
(C)] and MI [Odds Ratio 1.06 (0.76-1.47); p=0.74 (D)] following TAVI in
both groups. Conclusion(s): GA has significantly higher all-cause
mortality at 1 month compared to MAC. This highlights the need for close
short-term monitoring among patients undergoing TAVI. Further studies are
needed to identify possible confounding factors driving mortality
difference. [Formula presented] Copyright © 2022 American College
of Cardiology Foundation

<105>
Accession Number
2017303725
Title
IMPACT OF CHRONIC THROMBOCYTOPENIA ON CLINICAL OUTCOMES AFTER TAVR:
INSIGHTS FROM THE BRAVO-3 RANDOMIZED TRIAL.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 745), 2022. Date of
Publication: 08 Mar 2022.
Author
Feldman D.; Cao D.; Razuk V.; Nicolas J.; Hengstenberg C.; Zhang Z.;
Sartori S.; Beerkens F.; Pivato C.A.; Chiarito M.; Jones D.B.; Satish M.;
Roumeliotis A.; Power D.; Camaj A.; Jeger R.V.; Violini R.; Ferrari M.;
Mehran R.; Dangas G.D.
Institution
(Feldman, Cao, Razuk, Nicolas, Hengstenberg, Zhang, Sartori, Beerkens,
Pivato, Chiarito, Jones, Satish, Roumeliotis, Power, Camaj, Jeger,
Violini, Ferrari, Mehran, Dangas) The Zena and Michael A. Wiener
Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Chronic thrombocytopenia (CTP) has been shown to be a
predictor of bleeding following transcatheter aortic valve replacement
(TAVR). Managing peri-procedural anticoagulation can be difficult in this
population because of the increased risk of bleeding. This analysis aims
to evaluate the effect of CTP on clinical outcomes following TAVR and the
interaction between CTP and periprocedural anticoagulation.
 Method(s): The BRAVO-3 randomized trial compared the use of
bivalirudin versus unfractionated Heparin (UFH) in 802 high-risk patients
undergoing transfemoral TAVR for severe symptomatic aortic stenosis.
Patients were stratified according to the presence or absence of chronic
thrombocytopenia, defined as platelets 100-150 x 103, as well
as periprocedural anticoagulation. The primary outcome was net adverse
cardiac events (NACE), a composite of all-cause mortality, myocardial
infarction, stroke, or bleeding as well as major bleeding (Bleeding
Academic Research Consortium >=3b) while hospitalized and at 30 days.
 Result(s): Among the 796 patients with data on baseline platelet
counts, 130 (16.3%) had CTP, of whom 66 (50.7%) received bivalirudin.
There was no difference in the primary outcomes in those with CTP compared
to those without CTP both in hospital and at 30 days (OR = 1.21, 95% CI
0.71-1.98 for NACE and OR = 1.06, 95% CI 0.54-1.94 for bleeding). Amongst
only those with CTP, there was no difference in the primary outcomes for
those who received bivalirudin as compared to UFH (OR = 1.50, 95% CI
0.60-3.91 for NACE and OR = 1.15, 95% CI 0.36-3.76 for major bleeding).
There was a trend toward a higher rate of vascular complications while
hospitalized for patients with CTP who received bivalirudin as compared to
UFH (OR = 4.04, 95% CI 1.35-14.9; p-interaction= 0.056). In patients with
normal platelet counts there was a trend towards a decrease risk of NACE
while hospitalized in those who received bivalirudin as compared to UFH
(OR = 0.58, 95% CI 0.34-0.97; p-interaction= 0.071). Conclusion(s):
Chronic thrombocytopenia was not associated with a higher risk of NACE or
major bleeding after TAVR. Periprocedural anticoagulation with bivalirudin
versus UFH had no treatment effect on NACE or major
bleeding. Copyright © 2022 American College of Cardiology
Foundation

<106>
Accession Number
2017303670
Title
THE ASSOCIATION OF RIGHT HEART CATHETERIZATION TIMING AND OUTCOMES OF
PATIENTS WITH CARDIOGENIC SHOCK.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 247), 2022. Date of
Publication: 08 Mar 2022.
Author
Elzanaty A.; Maraey A.M.; Khalil M.; Nazir S.; Elsharnoby H.R.; Harhash
A.; Moukarbel G.V.
Institution
(Elzanaty, Maraey, Khalil, Nazir, Elsharnoby, Harhash, Moukarbel)
University of Toledo, Toledo, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Recent studies showed mortality benefit with right heart
catheterization (RHC) use in cardiogenic shock (CS) with AHA/ACC giving it
class IC recommendation. The optimal timing of RHC in those patients is
unknown owing to lack of available data. Method(s): The Nationwide
Readmission Database 2016-2018 was queried for hospitalizations with CS.
We excluded patients who presented with cardiac arrest, a history of
ventricular assisted devices, or heart transplantation. Complex samples
multi-variable regression models were used to determine the association
between RHC timing (<=24 hours [early RHC] vs > 24 hours [late RHC]) and
in-hospital outcomes (mortality, acute kidney injury [AKI], mechanical
circulatory support use [MCD], length of stay [LOS], hospital charges),
and all cause 30-day readmission rates. Result(s): A total of 46,963
hospitalizations [18,632 in the early group and 28,332 in the late group]
were included in this analysis. RHC was mainly performed in large teaching
hospitals. Patients in the early RHC group had lower incidence of AKI,
higher rate of MCD, shorter LOS (abeta: -5.50; CI -5.92to-5.08;p<0.01),
lower hospital charges charges (Adjusted beta [abeta]:-62,129$; CI:-70,939
to -53,320;p<0.01), and lower readmission rates compared to late RHC
group(figure). Conclusion(s): Early RHC was associated with decreased
incidence of AKI, decreased LOS, total charges, and readmission rate with
no effect on survival. Further randomized-controlled trials are needed to
validate these results [Formula presented] Copyright © 2022
American College of Cardiology Foundation

<107>
Accession Number
2017303475
Title
PERIPHERAL VASCULAR ACCESS FOR TRANSCATHETER AORTIC VALVE REPLACEMENT: A
NETWORK META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 688), 2022. Date of
Publication: 08 Mar 2022.
Author
Yokoyama Y.; Takagi H.; Kuno T.
Institution
(Yokoyama, Takagi, Kuno) St. Luke's University Health Network, Bethlehem,
PA, United States
Publisher
Elsevier Inc.
Abstract
Background: The choice of an alternative access for transcatheter aortic
valve replacement (TAVR) remains controversial when transfemoral (TF)
access is contraindicated. Method(s): MEDLINE and EMBASE were
searched through August 2021 to identify studies that investigated
outcomes in patients who underwent TAVR via TF, transcarotid (TC),
trans-subclavian (Tsc), and transcaval (Tcav). Outcomes of interests were
30-day mortality, rates of access failure, major vascular complication,
major or life-threatening bleeding, myocardial infarction, new permanent
pacemaker implantation, grade> 2 postoperative aortic regurgitation and
late mortality. Result(s): Our analysis included 30 studies that
enrolled a total of 29,284 patients. were similar among the groups. The
rates of major vascular complication were lower via TC compared with TF
and Tsc. Major or life-threatening bleeding was more frequent via TC
compared with TF. Stroke was less frequent via TF compared with Tsc. The
risk of myocardial infarction was higher via TC compared with TF and Tsc.
30-day mortality, the rates of access failure, new permanent pacemaker
implantation, grade> 2 postoperative aortic regurgitation, and late
mortality were similar among the groups. Conclusion(s): Although TC
was associated with lower rates of major vascular complication compared
with TF and Tsc, major or life-threatening bleeding and myocardial
infarction were more frequent via TC. Tsc was associated with higher risk
of stroke compared with TF. [Formula presented] Copyright © 2022
American College of Cardiology Foundation

<108>
Accession Number
2017303460
Title
EFFICACY AND SAFETY OF VITAMIN K ANTAGONISTS VERSUS DIRECT ORAL
ANTICOAGULANTS FOR ATRIAL FIBRILLATION AFTER TRANSCATHETER AORTIC VALVE
REPLACEMENT: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 729), 2022. Date of
Publication: 08 Mar 2022.
Author
Selvaraj V.; Khan M.S.; Contos A.; Jindal A.; Kazimuddin M.; Abdul-Waheed
M.; Saad M.; Hyder O.; Aronow H.D.; Abbott J.D.
Institution
(Selvaraj, Khan, Contos, Jindal, Kazimuddin, Abdul-Waheed, Saad, Hyder,
Aronow, Abbott) The Miriam Hospital, Providence, RI, United States
(Selvaraj, Khan, Contos, Jindal, Kazimuddin, Abdul-Waheed, Saad, Hyder,
Aronow, Abbott) Warren Alpert Medical School of Brown University,
Providence, RI, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients undergoing transcatheter aortic valve replacement
(TAVR) with concomitant atrial fibrillation (AF) are at high risk for
thromboembolic and bleeding events. The optimal anticoagulation strategy
in AF patients post-TAVR remains unclear. We sought to determine the
comparative efficacy and safety of direct oral anticoagulants (DOAC) and
oral vitamin K antagonists (VKA) in these patients. Method(s):
Pubmed, Cochrane and Embase databases were searched for relevant
observational and randomized controlled trials (RCTs). Outcomes assessed
were 1) all-cause mortality 2) stroke 3) major/life-threatening bleeding.
Odds ratios (ORs) were calculated for each outcome and random effects
model was used to pool data. Result(s): Six studies with 3,947
patients were included in the analysis. Pooled analysis showed no
significant difference in all-cause mortality (OR: 0.79, 95% CI:
0.53-1.17, p=0.24), stroke (OR: 0.94, 95% CI 0.65-1.35, p=0.73) and
major/life-threatening bleeding (OR 0.86, 95% CI: 0.53-1.39, p=0.53) in
patients that received DOAC compared to oral VKA (Figure).
 Conclusion(s): In patients undergoing TAVR with a concomitant
indication for anticoagulation for AF, all -cause mortality, stroke and
major/life-threatening bleeding, outcomes were similar between DOACs and
oral VKA. DOACs may be a safe alternative anticoagulation strategy to oral
VKA in patients post-TAVR, although individual bleeding risks should be
carefully risk stratified to select optimal agents. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<109>
Accession Number
2017303458
Title
A LABOUR OF LOVE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF LONG-TERM (>1
YEAR) CARDIAC OUTCOMES OF PERIPARTUM CARDIOMYOPATHY.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 1965), 2022. Date of
Publication: 08 Mar 2022.
Author
Koerber D.; Khan S.; Kirubarajan A.; Spivak A.; Wine R.; Matelski J.;
Sobel M.
Institution
(Koerber, Khan, Kirubarajan, Spivak, Wine, Matelski, Sobel) University of
Alberta, Edmonton, Canada
(Koerber, Khan, Kirubarajan, Spivak, Wine, Matelski, Sobel) University of
Toronto, Toronto, Canada
Publisher
Elsevier Inc.
Abstract
Background: Peripartum cardiomyopathy (PPCM) is the development of heart
failure towards the end of pregnancy or within five months following
delivery. Given that patients are young at time of diagnosis,
understanding the long-term prognosis of their condition is particularly
important. As such, this study was performed to summarize current evidence
surrounding the long-term cardiac outcomes (> 1 year) of PPCM.
 Method(s): We conducted a systematic review and meta-analysis in
accordance with Preferred Reporting Items for Systematic Reviews and
Meta-Analysis guidelines (PRISMA). We searched MEDLINE, Embase, Cochrane,
and CINAHL from database inception to May 2021 for original studies that
reported on the long-term cardiac and all-cause mortality outcomes of
patients diagnosed with PPCM. A metaregression was performed using a
random effects model. Result(s): A total of 62 studies, involving
4318 PPCM patients and an average follow-up of 4.46 +/- 2.93 years were
included from the 2936 records eligible for title and abstract screening.
The average age of participants was 30.35 +/- 2.68 and most were
multiparous (58.09 +/- 19.89%). The mean LVEF was 27.88 +/- 6.06% at
diagnosis and 47.57 +/- 9.17% at time of last follow-up. The average LVEDD
was 62.15 +/- 8.60 at diagnosis and 53.06 +/- 5.63 at time of last
follow-up. The overall frequency of ICD, LVAD implantation, and heart
transplantation was 12.3%, 7.4%, and 10.6%, respectively. The most common
threshold used to define myocardial recovery was an LVEF > 50% (n = 21),
and 47.1% of patients achieved myocardial recovery. By the time of the
last follow-up, the prevalence of MACE was 3.0% (1.2 - 7.3), and overall
all-cause mortality was 9.0%. Predictors of myocardial recovery included
higher baseline LVEF (reported in 17 papers), and reduced baseline
LVEDD/LVESD (13 papers). Conclusion(s): Peripartum cardiomyopathy is
associated with significant long term morbidity and mortality. Many
patients with PPCM require cardiac intervention, and the majority do not
experience myocardial recovery. Copyright © 2022 American College
of Cardiology Foundation

<110>
Accession Number
2017303368
Title
IMPACT OF CORONARY ARTERY DISEASE ON CLINICAL OUTCOMES AFTER TAVR:
INSIGHTS FROM THE BRAVO-3 RANDOMIZED TRIAL.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 726), 2022. Date of
Publication: 08 Mar 2022.
Author
Feldman D.; Cao D.; Nicolas J.; Hengstenberg C.; Zhang Z.; Sartori S.;
Beerkens F.; Pivato C.A.; Chiarito M.; Satish M.; Jones D.B.; Iyer D.;
Power D.; Chen H.; Camaj A.; Razuk V.; Roumeliotis A.; Jeger R.V.; Violini
R.; Ferrari M.; Mehran R.; Dangas G.D.
Institution
(Feldman, Cao, Nicolas, Hengstenberg, Zhang, Sartori, Beerkens, Pivato,
Chiarito, Satish, Jones, Iyer, Power, Chen, Camaj, Razuk, Roumeliotis,
Jeger, Violini, Ferrari, Mehran, Dangas) The Zena and Michael A. Wiener
Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery disease (CAD) is a common co-morbidity amongst
patients undergoing transcatheter aortic valve replacement (TAVR) and
studies provide conflicting data on its prognostic impact. In addition,
the optimal periprocedural anticoagulation in patients with CAD undergoing
TAVR remains unknown. This analysis aims to evaluate the effect of CAD on
clinical outcomes following TAVR and the interaction between CAD and
different periprocedural anticoagulants. Method(s): The BRAVO-3
randomized trial compared the use of bivalirudin versus unfractionated
heparin (UFH) in 802 high-risk patients undergoing transfemoral TAVR for
severe symptomatic aortic stenosis. Patients were stratified according to
the presence or absence of CAD as well as periprocedural anticoagulation.
The primary outcome was net adverse cardiac events (NACE), a composite of
all-cause mortality, myocardial infarction, stroke, or bleeding as well as
major bleeding (Bleeding Academic Research Consortium >=3b) at 30 days.
 Result(s): Among 801 patients with data on history of CAD, 405
(50.6%) had CAD of whom 209 (51.6%) received bivalirudin. Those with CAD
were more likely to be male, have a higher EuroSCORE, and more
comorbidities including anemia, peripheral artery disease, prior CABG and
MI, and a lower LVEF. There were no significant differences in NACE and
major bleeding in those with CAD compared to those without CAD (adjusted
OR= 0.99, 95% CI 0.64 - 1.52 for NACE and adjusted OR= 0.82, 95% CI 0.49 -
1.39 for major bleeding) and there was no treatment effect based on
anticoagulant used (p-interaction = 0.837 for NACE, p-interaction = 0.430
for major bleeding). However, those with CAD had a higher rate of
myocardial infarction at 30 days (n=8 vs n=0, p= N/A) compared to those
without CAD. Amongst only those with CAD, there was no difference in NACE
and major bleeding for those who received bivalirudin as compared to UFH
(adjusted OR= 0.77, 95% CI 0.44 - 1.35 for NACE and adjusted OR= 0.65, 95%
CI 0.31 - 1.390 for bleeding). Conclusion(s): CAD was not associated
with a higher risk of NACE or major bleeding at 30 days after TAVR.
Periprocedural anticoagulation with bivalirudin versus unfractionated
heparin had no treatment effect. Copyright © 2022 American
College of Cardiology Foundation

<111>
Accession Number
2017303339
Title
DIRECT ORAL ANTICOAGULATION THERAPY IN TRANSCATHETER AORTIC VALVE
REPLACEMENT IN PATIENTS WITH CONCURRENT INDICATION FOR ANTICOAGULATION; AN
UPDATED META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 728), 2022. Date of
Publication: 08 Mar 2022.
Author
Iskandarani M.E.; Khalid M.; Paul T.K.
Institution
(Iskandarani, Khalid, Paul) St Mary Regional Medical Center, Lewiston, ME,
United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal antithrombotic regimen in patients after
transcatheter aortic valve replacement (TAVR) in the setting of concurrent
anticoagulation indications remains controversial. Recently multiple
studies have investigated the role of direct oral anticoagulation therapy
(DOAC) in comparison to Vitamin K antagonist (VKA) in this category of
patients. Therefore, we conducted a systematic review and meta-analysis to
evaluate the efficacy and safety of this approach. Method(s):
Unrestricted searches of the PubMed, EMBASE, and Cochrane databases from
inception till 30 September 2021 for studies comparing DOAC with VKA in
TAVR patients with anticoagulation indications. Relevant data were
extracted and analyzed using Revman 5.3 software. Relative Risk (RR) and
95% Confidence interval (CI) were calculated using the random-effects
model. Result(s): A total of 9 studies (8 Observational, and 2
Randomized clinical trial) were included examining 14,544 TAVR patients
(4,393 DOAC vs 10,151 VKA). There was no difference between DOAC and VKA
in terms of all-cause mortality RR 0.82 (95% CI 0.58-1.16), bleeding
events RR 0.81 (95% CI 0.58-1.13), and stroke risk RR 1.42 (95% CI
0.96-2.11). Conclusion(s): DOAC therapy is probably safe and
effective alternative to VKA in TAVR patients with concurrent indications
for anticoagulation therapy. [Formula presented] Copyright © 2022
American College of Cardiology Foundation

<112>
Accession Number
2017303047
Title
COMPARING THE EFFICACY AND SAFETY OF DIRECT ORAL ANTICOAGULANTS AND
STANDARD OF CARE IN PATIENTS WITH ATRIAL FIBRILLATION AFTER SUCCESSFUL
TRANSCATHETER AORTIC-VALVE REPLACEMENT.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 716), 2022. Date of
Publication: 08 Mar 2022.
Author
Vaz I.; Tangri A.; Ceron C.; Singh H.; Llanos-Chea F.; Silberman H.B.
Institution
(Vaz, Tangri, Ceron, Singh, Llanos-Chea, Silberman) UTRGV, Edinburg, TX,
United States
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) is a common complication after
transcatheter aortic valve replacement (TAVR) and is reported to occur in
approximately one third of the patients. Vitamin K antagonists (VKA) is
currently the standard of care for thromboembolic events prophylaxis in
this population, however, there is a question about the efficacy and
safety of using direct oral anticoagulation (DOAC). Method(s): We
conducted our study using the PRISMA guidelines. A systematized search of
Medline, Embase, and Cochrane Register of clinical trials databases from
inception until September 2021 was conducted for randomized clinical
trials comparing the use of VKA and DOAC for patients with AF after
successful TAVR. Result(s): The search yielded 383 results and 3
studies met our inclusion criteria. The Mantel Haenszel random-effects
model was used to calculate relative risk (RR) and 95% confidence
intervals (CI). Our analysis showed higher rates of thromboembolic events
(RR - 1.17; 95% CI - 1.01-1.37; p = 0.04 - Panel A) and bleeding (RR
-1.32; 95% 1.07-1.62, p = 0.009 - Panel B). Conclusion(s): There is
no significant difference in the thromboembolic events rate between DOAC
and the standard of care. However, the DOAC group was associated with a
higher incidence of major bleeding. The current data raises the potential
concern for increased bleeding in the DOAC group with AF post TAVR and
warrants further investigation. [Formula presented] Copyright ©
2022 American College of Cardiology Foundation

<113>
Accession Number
2017303013
Title
META-ANALYSIS OF DUAL ANTIPLATELET REGIMENS INVOLVING CLOPIDOGREL VERSUS
TICAGRELOR OR PRASUGREL AFTER CORONARY ARTERY BYPASS GRAFTING.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 1054), 2022. Date of
Publication: 08 Mar 2022.
Author
Agrawal A.; Kumar A.; Wang T.K.M.
Institution
(Agrawal, Kumar, Wang) Cleveland Clinic Foundation, Cleveland, OH, United
States
Publisher
Elsevier Inc.
Abstract
Background The preferred antiplatelet therapy strategy after coronary
artery bypass grafting (CABG) remains controversial, including which P2Y12
inhibitor to select as part of dual antiplatelet therapy (DAPT). We
compared the efficacy and safety outcomes of aspirin and ticagrelor (A+T)
or aspirin and prasugrel (A+P), against aspirin and clopidogrel (A+C), in
this meta-analysis. Methods Using the PRISMA guidelines, Pubmed database
was searched until 9/30/2021 for eligible studies reporting mortality,
vascular and bleeding outcomes separately for CABG patients receiving DAPT
of A+T/A+P or A+C. Data was pooled using Reman (version 5.4). Results Five
studies (4 randomized trial and 1 cohort study) were included, totaling
1111 CABG patients receiving A+T/A+P, and 1049 CABG patients receiving
A+C. The table summarizes the main results of the meta-analyses. All-cause
mortality (pooled odds ratio (OR)=0.42, 95% confidence interval
(CI)=0.28-0.63; p=<0.0001) and cardiovascular death (OR=0.44,
CI=0.24-0.80; p=0.008) were significantly lower in the A+T/A+P group as
compared to A+C cohort, with no significant differences in all other
vascular or bleeding outcomes studied. Conclusion A+T/A+P therapy is
associated with significantly lower all-cause and cardiovascular mortality
after CABG, without a notable penalty in bleeding risk, and is, therefore,
the preferred DAPT option to CABG patients. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<114>
Accession Number
2017302961
Title
PROGNOSTIC IMPACT OF PRE-PROCEDURAL PULMONARY HYPERTENSION ON LATE
ALL-CAUSE MORTALITY OF TRANSCATHETER MITRAL VALVE REPAIR USING MITRACLIP:
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 859), 2022. Date of
Publication: 08 Mar 2022.
Author
Adebolu O.; Safiriyu I.; Lao N.; Lim J.; Idowu A.; Eromosele O.
Institution
(Adebolu, Safiriyu, Lao, Lim, Idowu, Eromosele) Akron General Medical
Center, Akron, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter Mitral Valve Repair (TMVR) with MitraClip (MC)
is increasingly being used in the management of high-risk patients with
grade III/IV chronic mitral regurgitation. However, there is insufficient
data on the impact of pre-procedural pulmonary hypertension (PHTN) on the
late outcome of TMVR with MC Methods: A Comprehensive search of PubMed,
Embase, and Web of Science was done. Pre-specified outcomes of interest
were late (>1 year) all-cause mortality, composite of late all-cause
mortality and heart failure re-admission after TMVR with MC implantation
in patients with pre-procedural PHTN. Random-effects model meta-analysis
was performed and heterogeneity was assessed using I2test.
 Result(s): Out of 1794 studies, 8 studies including 5504 patients
were included in the meta-analysis. On pooled univariate and multivariate
analysis: Pre-procedural PHTN was a significant predictor of high late
all-cause mortality [Univariate - HR: 1.72, CI: 1.09- 2.70, I2:
69%] (Multivariate - HR: 1.92, 95% CI: 1.20- 3.06, I2: 58%)
(Fig. 1) and it also significantly increased the risk of composite of late
all-cause mortality and heart failure re-admission after TMVR using MC
(HR: 1.34, 95% CI: 1.16-1.55, I2: 22%) (Fig. 2)
 Conclusion(s): Pre-procedural PHTN is a predictor of poor late
outcome after TMVR with MC. Further studies is needed to evaluate the
severity of PHTN that drove this increase in mortality. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<115>
Accession Number
2017302942
Title
LEFT VENTRICULAR OUTFLOW TRACT CALCIFICATION AND TRANSCATHETER AORTIC
VALVE REPLACEMENT PROCEDURAL OUTCOMES: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 715), 2022. Date of
Publication: 08 Mar 2022.
Author
Techorueangwiwat C.; Kanitsoraphan C.; Kuniyoshi J.; Shah P.; Huang R.;
Techasatian W.; Kanjanauthai S.
Institution
(Techorueangwiwat, Kanitsoraphan, Kuniyoshi, Shah, Huang, Techasatian,
Kanjanauthai) University of Hawaii Internal Medicine Residency Program,
Honolulu, HI, United States
(Techorueangwiwat, Kanitsoraphan, Kuniyoshi, Shah, Huang, Techasatian,
Kanjanauthai) Division of Cardiovascular Medicine, Keck School of Medicine
of University of Southern California, Los Angeles, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Previous studies suggested that left ventricular outflow tract
(LVOT) calcification may increase risks of poor outcomes after
transcatheter aortic valve replacement (TAVR). However, the association
remains unclear, especially with newer generation devices. Method(s):
A literature search was conducted through October 2021 using MEDLINE and
EMBASE. We included studies comparing post-TAVR outcomes of interest in
patients with or without LVOT calcification. We calculated pooled odds
ratio (OR) with 95% confidence intervals (CI) and I2 statistic
using the random-effects model. Result(s): Eleven studies from 2014
to 2021, involving 5,554 patients who underwent TAVR, were included in
this meta-analysis. LVOT calcification is significantly associated with
increased risks of paravalvular regurgitation (OR 2.07, 95% CI 1.09-3.92),
permanent pacemaker (PPM) implantation (OR 1.46, 95% CI 1.12-1.91), and
30-day mortality (OR 1.97, 95% CI 1.10-3.55) after TAVR (Figure 1).
Subgroup analysis of only new-generation devices (SAPIEN 3, Evolut R/Pro,
ACURATE neo, Lotus, or Portico) shows that LVOT calcification is
significantly associated with increased risk of PPM implantation, but not
paravalvular regurgitation or 30-day mortality. Conclusion(s): LVOT
calcification is associated with increased risks of paravalvular
regurgitation, PPM implantation, and 30-day mortality after TAVR. Among
newer generation devices, LVOT calcification is associated with an
increased risk of PPM implantation. [Formula presented] Copyright
© 2022 American College of Cardiology Foundation

<116>
Accession Number
2017302912
Title
DAYS ALIVE OUT OF HOSPITAL FOR PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION
AND CORONARY ARTERY DISEASE TREATED WITH CORONARY ARTERY BYPASS SURGERY OR
MEDICAL THERAPY: FINDINGS FROM THE STICH TRIAL.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 1058), 2022. Date of
Publication: 08 Mar 2022.
Author
Faridi K.; Huang H.; Parise H.; Ahmad T.; Mori M.; Chung M.; Yeh R.W.;
Velazquez E.J.
Institution
(Faridi, Huang, Parise, Ahmad, Mori, Chung, Yeh, Velazquez) Yale School of
Medicine, New Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Background Days alive out of hospital (DAOH) is an emerging
patient-centered outcome that helps capture the impact of treatment
choices on morbidity and mortality. DAOH for patients with coronary artery
disease and left ventricular dysfunction have not been well described.
Methods We evaluated DAOH and percent time spent alive and out of hospital
(%DAOH) for patients randomized to coronary artery bypass surgery (CABG)
vs. medical therapy in the STICH trial with 10 years of follow-up.
Hospital days were determined based on total time spent hospitalized and
mortality days were defined as time from death to 10-year follow-up.
Results At 10 years, mean DAOH for patients randomized to CABG (2306,
standard deviation [SD] 1059) and medical therapy (2176 [SD 1310]) were
similar (p = 0.08). There were fewer mortality days with CABG (1320 [SD
1399]) compared with medical therapy (1465 [SD 1373]; p = 0.04). There
were more hospital days in the CABG group (34 [SD 46] vs. 23 [SD 40]; p <
0.001) due to hospital days from the index CABG, with similar non-CABG
related hospital days (Figure). Mean %DAOH was similar between groups
(63.8% [95% CI 60.8-66.7%] with CABG vs. 60.2% [95% CI 57.3-63.1%] with
medical therapy). Conclusion Patients with left ventricular dysfunction
and coronary artery disease randomized to CABG in the STICH trial had
similar DAOH compared with medical therapy after 10 years, though DAOH
lost due to death were lower with CABG. These findings help quantify the
potential benefits of CABG in this population. [Formula
presented] Copyright © 2022 American College of Cardiology
Foundation

<117>
Accession Number
2017302699
Title
SYNCHRONIZED VERSUS STAGED PERCUTANEOUS CORONARY INTERVENTION (PCI)
REVASCULARIZATION STRATEGY PRIOR TO TRANSCATHETER AORTIC VALVE REPLACEMENT
(TAVR): A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 758), 2022. Date of
Publication: 08 Mar 2022.
Author
Altibi A.; Ghanem F.H.; Al-Taweel O.; Hammad F.; Alshami M.; Rahmouni H.
Institution
(Altibi, Ghanem, Al-Taweel, Hammad, Alshami, Rahmouni) Oregon Health &
Science University, Portland, OR, United States
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery disease (CAD) and severe aortic stenosis
coexist in about half of patients undergoing TAVR. Significant CAD is
usually treated with percutaneous coronary interventions (PCI) prior to
TAVR (staged PCI) or concomitantly with TAVR (synchronized PCI).
 Method(s): We searched the literature to identify studies reporting
on patients with significant CAD undergoing TAVR. We identified studies
comparing two PCI revascularization strategies: (i) PCI synchronized with
TAVR, (ii) staged PCI prior to TAVR. Random-effects meta-analyses with the
inverse variance method were used to estimate the effect size.
 Result(s): We identified 6 studies reporting on 750 TAVR patients who
underwent revascularization with either staged PCI (n= 423) or
synchronized PCI (n= 327). Mean age was 81.3 +/- 5.7 years, 45.5% were
males, and ejection fraction was 51 +/- 13.5. The pooled 30-day all-cause
mortality was 5.4% in staged PCI versus 2.8% in synchronized PCI. There
was no statistically significant difference between staged versus
synchronized PCI groups in 30-day mortality (OR 0.90, 95% CI: 0.37-2.16,
p-value= 0.81). There was no statistically significant difference between
two groups in life-threatening bleeding (OR 0.83, 95% CI: 0.41-1.69,
p-value= 0.62). Conclusion(s): In CAD patients undergoing
revascularization with PCI prior to TAVR, data did not show significant
difference in short-term mortality outcomes or in life-threatening
bleeding between staged PCI prior to TAVR and synchronized PCI with TAVR.
[Formula presented] Copyright © 2022 American College of
Cardiology Foundation

<118>
Accession Number
2017302595
Title
TRANSCATHETER AORTIC VALVE REPLACEMENT IS SAFE IN PATIENTS WITH ANOMALOUS
ORIGIN OF CORONARY ARTERIES.
Source
Journal of the American College of Cardiology. Conference: ACC 22.
Washington, DC United States. 79(9 Supplement) (pp 782), 2022. Date of
Publication: 08 Mar 2022.
Author
Wolfe S.; Langer N.B.; Hedgire S.S.; Passeri J.J.; Yucel E.; Dal-Bianco
J.; Inglessis-Azuaje I.; Kolte D.S.; Patel N.K.; Michel E.; Sakhuja R.;
Elmariah S.; Jassar A.S.
Institution
(Wolfe, Langer, Hedgire, Passeri, Yucel, Dal-Bianco, Inglessis-Azuaje,
Kolte, Patel, Michel, Sakhuja, Elmariah, Jassar) Massachusetts General
Hospital, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is becoming an
option for increasingly broad patient populations. Aberrant anatomy such
as anomalous origin of coronary arteries (AOCA) present unique challenges
when preparing for surgery. We aimed to review our experience in patients
with AOCA who underwent TAVR evaluation. Method(s): CT scans of
patients who underwent TAVR evaluation were reviewed to identify patients
with AOCA. Chart review was performed to collect pre/intraoperative
characteristics and postoperative outcomes. Result(s): Of 1,871
patients who underwent TAVR evaluation, 13 were found to have AOCA. Six
patients had anomalous origins of the left coronary artery (CA) and seven
of the right CA. Nine patients underwent TAVR, 3 underwent SAVR, and 1
declined aortic valve replacement. Four (44%) TAVR patients had AOCA with
an intramural course and one (11%) left circumflex CA coursed immediately
posterior to the aortic annulus. Indications for SAVR included concomitant
anomalous coronary unroofing, randomization to SAVR in the low-risk trial,
and patient preference. Mean left and right coronary height was 12.7 and
16.0 mm, respectively. Balloon expandable valve (median size = 23 mm) was
used in 6 patients and self-expandable valve (median size =29 mm) was used
in 3 patients. There were no complications or mortalities within 30-days
of surgery. Conclusion(s): With appropriate perioperative planning,
TAVR can be performed safely in patients with anomalous origins of
coronary arteries. [Formula presented] Copyright © 2022 American
College of Cardiology Foundation

<119>
Accession Number
637536937
Title
Mediastinal ectopic parathyroid adenoma causing malignant hypercalcaemia
in a young female-a case report and review of literature.
Source
British Journal of Surgery. Conference: ASiT Surgical Innovation Summit -
Future Surgery Show. London United Kingdom. 109(SUPPL 1) (pp i14), 2022.
Date of Publication: March 2022.
Author
Bell A.; Razzaq Z.; Mustafa H.; Redmond H.P.
Institution
(Bell, Razzaq, Mustafa, Redmond) Cork University Hospital, Cork, Ireland
Publisher
John Wiley and Sons Ltd
Abstract
Ectopic parathyroid tissue can pose difficulties in diagnosis and
management of patients with hyperparathyroidism. Due to the embryological
origins of the inferior parathyroid glands from the 3rd pharyngeal arch
where they develop with the thymus; they can have variable anatomical
locations, including the anterior mediastinum. While the incidence of
ectopic parathyroid glands varies in the literature mediastinal
parathyroid tissue is extremely rare. This anatomical variation has
important diagnostic and surgical ramifications for patients and is an
important topic for trainees in medical endocrinology, endocrine surgery,
and cardiothoracic surgery to be aware of. We present the case of a
22-year-old woman who presented as an emergency with severe
hypercalcaemia. Who was subsequently found to have an ectopic mediastinal
parathyroid adenoma. She underwent surgery within days of her initial
presentation providing her with an immediate cure and restoring her
calcium homeostasis. Despite diagnostic and operative challenges, combined
care from our endocrine and cardio-thoracic surgical teams ensured an
uneventful post-operative recovery for this patient.

<120>
Accession Number
2017248442
Title
A scoping review of artificial intelligence applications in thoracic
surgery.
Source
European Journal of Cardio-thoracic Surgery. 61(2) (pp 239-248), 2022.
Date of Publication: 01 Feb 2022.
Author
Seastedt K.P.; Moukheiber D.; Mahindre S.A.; Thammineni C.; Rosen D.T.;
Watkins A.A.; Hashimoto D.A.; Hoang C.D.; Kpodonu J.; Celi L.A.
Institution
(Seastedt, Watkins) Department of Surgery, Beth Israel Deaconess Medical
Center, Harvard Medical School, Chest Disease Center, 185 Pilgrim Road,
Suite 201, Boston, MA 02215, United States
(Moukheiber) Laboratory for Computational Physiology, Massachusetts
Institute of Technology, Cambridge, MA, United States
(Mahindre) Institute for Computational and Data Sciences, University at
Buffalo, State University of New York, Buffalo, NY, United States
(Thammineni) HILS Laboratory, University at Buffalo, State University of
New York, Buffalo, NY, United States
(Rosen) Department of Medicine, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
(Hashimoto) Surgical AI & Innovation Laboratory, Department of Surgery,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Hoang) Thoracic Surgery Branch, National Cancer Institute, National
Institutes of Health, Bethesda, MD, United States
(Kpodonu) Division of Cardiac Surgery, Department of Surgery, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, MA, United
States
(Celi) Division of Pulmonary, Critical Care and Sleep Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Machine learning (ML) has great potential, but there are few
examples of its implementation improving outcomes. The thoracic surgeon
must be aware of pertinent ML literature and how to evaluate this field
for the safe translation to patient care. This scoping review provides an
introduction to ML applications specific to the thoracic surgeon. We
review current applications, limitations and future directions.
 METHOD(S): A search of the PubMed database was conducted with
inclusion requirements being the use of an ML algorithm to analyse patient
information relevant to a thoracic surgeon and contain sufficient details
on the data used, ML methods and results. Twenty-two papers met the
criteria and were reviewed using a methodological quality rubric.
 RESULT(S): ML demonstrated enhanced preoperative test accuracy,
earlier pathological diagnosis, therapies to maximize survival and
predictions of adverse events and survival after surgery. However, only 4
performed external validation. One demonstrated improved patient outcomes,
nearly all failed to perform model calibration and one addressed fairness
and bias with most not generalizable to different populations. There was a
considerable variation to allow for reproducibility. CONCLUSION(S):
There is promise but also challenges for ML in thoracic surgery. The
transparency of data and algorithm design and the systemic bias on which
models are dependent remain issues to be addressed. Although there has yet
to be widespread use in thoracic surgery, it is essential thoracic
surgeons be at the forefront of the eventual safe introduction of ML to
the clinic and operating room. Copyright © 2021 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<121>
Accession Number
2015986073
Title
The Analgesic Efficacy of Ultrasound-Guided Bilateral Transversus Thoracic
Muscle Plane Block After Open-Heart Surgeries: A Randomized Controlled
Study.
Source
Journal of Pain Research. 15 (pp 675-682), 2022. Date of Publication:
2022.
Author
Hamed M.A.; Boules M.L.; Sobhy M.M.; Abdelhady M.A.
Institution
(Hamed, Boules, Sobhy, Abdelhady) Department of Anesthesiology, Faculty of
Medicine, Fayoum University, Fayoum, Egypt
Publisher
Dove Medical Press Ltd
Abstract
Background: We aimed to evaluate the analgesic efficacy of
ultrasound-guided bilateral transversus thoracic muscle plane block after
open-heart surgeries. Method(s): Seventy patients aged above 18 years
and scheduled for valve replacement or adult congenital via median
sternotomy were enrolled in this study. Patients were divided into two
groups, randomized by computer-generated random numbers: the block group,
which had the ultrasound-guided bilateral transversus thoracic muscle
plane block, and the control group, which had a sham block. The primary
outcome was total fentanyl consumption in the first 24-hours. The
secondary outcomes were pain score, time to the first analgesic request,
time to extubation, ICU stays, and hospital stay. Result(s): The
total fentanyl consumption in the first 24 hours was significantly lower
in the block group, with a mean difference of -158.286 (95% CI = (-179.271
to -137.300; p =<0.0001)). The time to the first analgesic request was
statistically significantly shorter in the non-block group (median 3
hours) than the block group (median 14 hours). During the postoperative
period (0.5-24 hours), at-rest pain scores were 1.86 units lower in the
block group (the estimate was -1.80, 95% CI = -2.14 to -1.45, t = -10.323
with p < 0.0001). Likewise, pain scores with cough were 3.29 units lower
in the block group (the estimate was -3.29, 95% CI = -3.80 to -2.77, t =
-12.703, p < 0.0001). Conclusion(s): Bilateral transversus thoracic
muscle plane block is a promising and effective technique in reducing
opioid consumption and controlling post-sternotomy pain after open-heart
surgery via median sternotomy. Copyright © 2022 Hamed et al.

<122>
Accession Number
2015985323
Title
Infusion Versus Bolus Esmolol on Hemodynamic Responses to Intubation in
Patients Undergoing Coronary Artery Bypasses Grafting: a Randomized
Clinical Trial.
Source
Journal of Advances in Medical and Biomedical Research. 30(139) (pp
101-108), 2022. Date of Publication: March-April 2022.
Author
Tashakkor M.; Akbari H.; Mahdian M.; Tobeiha M.
Institution
(Tashakkor) Dept. of Anesthesiology, Faculty of Medicine, Kashan
University of Medical Sciences, Kashan, Iran, Islamic Republic of
(Akbari) Social Determinants of Health Research Center, Kashan University
of Medical Sciences, Kashan, Iran, Islamic Republic of
(Mahdian) Trauma Research Center, Kashan University of Medical Sciences,
Kashan, Iran, Islamic Republic of
(Tobeiha) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
Publisher
Zanjan University of Medical Sciences and Health Services
Abstract
Background & Objective: Perioperative myocardial ischemia remains one of
the most serious complications of cardiac surgery. This study aimed to
evaluate the effect of bolus esmolol versus its infusion on hemodynamic
responses after laryngoscopy and intubation in patients undergoing
coronary artery bypass grafting (CABG). Material(s) and Method(s):
This double-blind randomized clinical trial was conducted on 75 patients
that were allocated into three groups. In the infusion group, 10 minutes
prior to laryngoscopy 0.5 mg/kg esmolol was injected, and then, 200
microg/kg/minute esmolol was infused. In the bolus group, 2 minutes prior
to the laryngoscopy 1.5 mg/kg bolus dose of esmolol was injected
intravenously. In the control group, a bolus dose of normal saline was
administered. Heart rate (HR), Systolic (SBP) and diastolic (DBP) blood
pressures and mean arterial pressure (MAP), were recorded every one minute
from 10 minutes prior to laryngoscopy to 10 minutes after intubation.
Repeated measure ANOVA was applied as statistical analysis.
 Result(s): SBP was at the lowest rate since laryngoscopy was started
until 10 minutes after intubation in the esmolol infusion group (P=
0.029). From the initiation of laryngoscopy to 6 minutes after the
intubation, DBP was at the lowest rate in the infusion group. There was a
significant difference between the groups regarding DBP changes during the
measurement. ANOVA model showed that interaction between time and groups
on SBP, MAP, and HR (P< 0.05). Conclusion(s): According to our
results, the exact doses of esmolol infusion significantly reduced the
level of SBP during intubation, compared with bolus esmolol. Copyright
© The Authors.

<123>
Accession Number
2015983045
Title
Effect of Music Intervention on Lung Expansion Exercises after
Cardiothoracic Surgery.
Source
Journal of Clinical Medicine. 11(6) (no pagination), 2022. Article Number:
1589. Date of Publication: March-2 2022.
Author
Chen G.-Y.; Guo L.-Y.; Chuang I.-C.; Kuo H.-C.; Tsai Y.-C.; Liu S.-F.
Institution
(Chen, Kuo, Tsai, Liu) Department of Respiratory Therapy, Kaohsiung Chang
Gung Memorial Hospital, Kaohsiung 833, Taiwan (Republic of China)
(Guo) Department of Sports Medicine, College of Medicine, Kaohsiung
Medical University, Kaohsiung 807, Taiwan (Republic of China)
(Guo) Department of Medical Research, Kaohsiung Medical University
Hospital, Kaohsiung 807, Taiwan (Republic of China)
(Guo) College of Humanities and Social Sciences, National Pingtung
University of Science and Technology, Pingtung 912, Taiwan (Republic of
China)
(Chuang) Department of Respiratory Therapy, Kaohsiung Medical University,
Kaohsiung 807, Taiwan (Republic of China)
(Kuo) Department of Paediatrics, Kaohsiung Chang Gung Memorial Hospital,
Kaohsiung 833, Taiwan (Republic of China)
(Kuo, Liu) Medical Department, College of Medicine, Chang Gung University,
Taoyuan 333, Taiwan (Republic of China)
(Liu) Division of Pulmonary and Critical Care Medicine, Department of
Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833,
Taiwan (Republic of China)
Publisher
MDPI
Abstract
Background: Music intervention can reduce anxiety. This study analyzed the
physiological changes from using music intervention after cardiothoracic
surgery. Method(s): Subjects were randomly assigned to the music
group or the control group. The maximal inspiratory pressure/maximal
expiratory pressure (MIP/MEP), pulse oximeter oxygen saturation (SpO2),
visual analogue scale (VAS) for pain, and State-Trait Anxiety Inventory
(STAI) were compared. Result(s): Compared to the control group (n =
9), the music group (n = 9) had higher MIP and MEP during the overall test
(p < 0.05), with significant differences in the changes and time (p <
0.001). However, only MEP was significant in terms of the interaction
between music intervention and time (p < 0.001). In terms of the groups,
SpO2 and VAS were significant (p < 0.05). SBP, SpO2, and VAS over time
showed significant differences between the two groups (p < 0.05). In terms
of the interaction between music intervention and time, only SpO2 was
significant (p < 0.05). The STAI-S scale decreased by -5.7 +/- 5.8 in the
music group vs. -0.47 +/- 9.37 in control group and the STAI-T scale
increased by 4.17 +/- 12.31 in the music group vs. 1.9 +/- 9.29 in the
control group, but showed no significance. Conclusion(s): Music
intervention with nature sounds has a positive physiological impact and
can reduce postoperative pain and anxiety in cardiothoracic surgery
patients. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<124>
Accession Number
2015323677
Title
Efficacy and safety of rhomboid intercostal block for analgesia in breast
surgery and thoracoscopic surgery: a meta-analysis.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 71. Date
of Publication: December 2022.
Author
Chen R.; Su S.; Shu H.
Institution
(Chen, Shu) Department of Anesthesiology, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Second
Road, Yuexiu District, Guangdong, Guangzhou 510080, China
(Chen, Su, Shu) The Second School of Clinical Medicine, Southern Medical
University, 106 Zhongshan Second Road, Yuexiu District, Guangdong,
Guangzhou 510080, China
Publisher
BioMed Central Ltd
Abstract
Background: Rhomboid intercostal block (RIB) is a new regional anesthesia
technique that provides postoperative analgesia for breast surgery and
thoracoscopic surgery. The published papers are not yet fully integrated
and do not adequately address the impact and safety of the RIB on
postoperative pain. Method(s): The PubMed, Web of Science and Embase
were searched from 2016 to 2021 for all available randomized controlled
trials (RCTs) that evaluated the analgesic efficacy and safety of RIB
after thoracic surgery and breast surgery. Random and fixed-effects
meta-analytical models were used where indicated, and between-study
heterogeneity was assessed. The primary outcome was Postoperative
Numerical Rating Scale (NRS) scores of patients at rest recorded 0-1, 6-8,
24 h after surgery. The secondary outcomes included rate of postoperative
nausea and vomiting (PONV), postoperative fentanyl consumption and
presence of complications of the block. Result(s): From 81 records
identified, four studies met our inclusion criteria, including 216
patients (RIB:108 patients; no block: 108 patients). In the primary
outcome, RIB group showed significantly lower postoperative NRS at rest at
first 0-1 h and 6-8 h (weighted mean difference [WMD] = -1.55; 95%
confidence internal [CI] = -2.92 to -0.19; p < 0.05), (WMD = -0. 69; 95%
CI = -1.29 to -0. 09; p < 0. 05). And there was no significant difference
between groups in NRS at rest at 24 h (WMD = -0.78; 95% CI = -1.64 to
-0.08; p = 0.77). Also, RIB group showed significantly lower postoperative
NRS of breast surgery and thoracoscopic surgery at 0-1 h (WMD = -3.00; 95%
CI = -3.13 to -2.87; p < 0.01), (WMD = -1.08; 95% CI = -1.98 to -0.18; p <
0.05). In the secondary outcome, the analysis also showed RIB group had
significant lower of POVN rates (summary relative risk (RR) = 0.212;95%CI
= 0.10 to 0.45; p < 0. 01) and the postoperative consumption of fentanyl
(WMD = -57.52;95%CI = -106.03 to -9.02; p < 0. 05). Conclusion(s):
This review shows that RIB was more effective in controlling acute pain
after breast surgery and thoracoscopic surgery than general analgesia. And
it is a trend that RIB may be a kind of effective and safe nerve bock
technology and it requires further studies. Copyright © 2022, The
Author(s).

<125>
Accession Number
2015354507
Title
A systematic review and meta-analysis of the cerebrovascular event
incidence after transcatheter aortic valve implantation.
Source
Clinical Research in Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Meertens M.M.; Macherey S.; Asselberghs S.; Lee S.; Schipper J.H.; Mees
B.; Eitel I.; Baldus S.; Frerker C.; Schmidt T.
Institution
(Meertens, Macherey, Lee, Schipper, Baldus) Department III of Internal
Medicine, University Hospital of Cologne, Cologne, Germany
(Asselberghs, Mees) Department of Pathology, Cardiovascular Research
Institute Maastricht, Maastricht University Medical Center, Maastricht,
Netherlands
(Meertens, Asselberghs, Mees) Department of Vascular Surgery, Maastricht
University Medical Center, Maastricht, Netherlands
(Eitel, Frerker, Schmidt) Department of Cardiology, Angiology and
Intensive Care Medicine, University Heart Center Lubeck, University
Hospital Schleswig-Holstein, Ratzeburger Allee 160, Lubeck 23538, Germany
(Eitel, Frerker, Schmidt) DZHK (German Centre for Cardiovascular
Research), Partner Site Hamburg/Kiel/Lubeck, Lubeck, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: Periinterventional stroke is one of the most feared potential
complication, among patients treated with transcatheter aortic valve
implantation (TAVI). The purpose of this review was to investigate the
incidence of cerebrovascular events and the influence of
postinterventional neurologic check-up in patients undergoing TAVI.
 Method(s): A systematic review and meta-analysis were conducted
according to the PRISMA guideline. Three separate electronic searches of
the public domains Medline and Clinicaltrials.gov were performed to
identify the 30-day incidence of stroke within randomized controlled
trials (RCTs) and registries for patients undergoing a TAVI procedure. A
meta-analysis was conducted to evaluate the 30-day incidence of stroke
within RCTs. Furthermore, we pooled the RCTs in which a scheduled
neurological check-up was conducted or not to investigate the effect of
this intervention. Result(s): Twenty-three studies including
399,532,491 TAVI patients were included, 6370 from RCTs, 857,833 from
cerebral-embolic protection device RCTs and 392,288 were adopted from
registries. The mean 30-day incidence of stroke among all reviewed studies
was 2.33%. In RCTs evaluating TAVI the pooled stroke incidence was 3.86%,
among RCTs focused CEP the incidence was 6.4436% and in registries the
incidence was 2.29%. Ten RCTs conducted scheduled neurological check-ups,
the incidence in these was 4.03% and among the remaining RCTs it was
2.47%. In the meta-analysis, the pooled 30-day stroke incidence was 3.61%
(95% CI 2.57-4.79%). Conclusion(s): This systematic review
demonstrates that the stroke incidences following TAVI differ strongly
according to the study design and neurological follow-up. Intense
neurological testing increases the incidence of a stroke after TAVI.
Graphical abstract: [Figure not available: see fulltext.] Copyright
© 2022, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany.

<126>
Accession Number
637534925
Title
Serratus anterior plane block and erector spinae plane block in
postoperative analgesia in thoracotomy: A randomised controlled study.
Source
Indian Journal of Anaesthesia. 66(2) (pp 119-125), 2022. Date of
Publication: February 2022.
Author
Hassan M.E.; Alfattah Wadod M.A.
Institution
(Hassan, Alfattah Wadod) Department of Anesthesia, Surgical Intensive Care
Unit and Pain Management, National Cancer Institute, Cairo University,
Cairo, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Managing pain after thoracic surgery is crucial and
the traditional methods have many adverse effects. We aimed to evaluate
serratus anterior plane block (SAPB) and erector spinae plane block (ESPB)
in acute pain control in thoracic cancer surgeries. Method(s): This
randomised controlled, triple-blind study was performed on 90 patients,
between 18 and 70 years old, scheduled for elective thoracic cancer
surgery. Patients were allocated into three equal groups: Control group:
received sham ESPB and sham SAPB. SAPB group received SAPB (20 ml
bupivacaine 0.5%) and sham ESPB. ESBP group received ESPB (20 ml
bupivacaine 0.5%) and sham SAPB. Result(s): Postoperative morphine
consumption was significantly lower in ESBP and SAPB groups than control
group [ESPB (8.52 +/- 4.29 mg) < SAPB (19.57 +/- 7.63 mg) < control (36.37
+/- 8.27 mg)] (P < 0.001). Numerical rating scale pain score was
comparable among the groups at rest, but was significantly lower at 30
min, 2, 4 h in ESPB and SAPB groups, than control group on coughing. The
scores were better in SAPB compared to control group till 4 h. At 8, 12,
24 h, the difference between control and SAPB groups became insignificant,
but it remained the least in ESPB group. Postoperative forced vital
capacity and forced expiratory volume in the first second after 24 h were
the best in ESPB group and better in SAPB group compared to the control
group. Conclusion(s): Both ESPB and SAPB reduced intraoperative and
postoperative opioid consumptions and postoperative dynamic pain scores
with improved postoperative pulmonary functions in thoracic surgery with
the ESPB being superior. Copyright © 2022 Indian Journal of
Anaesthesia.

<127>
Accession Number
637552171
Title
Intraarterial Papaverine For Relief of Catheter Induced Peripheral
Arterial Vasospasm During Pediatric Cardiac Surgery: A Randomized
Double-Blind Controlled Trial.
Source
Paediatric anaesthesia. (no pagination), 2022. Date of Publication: 19
Mar 2022.
Author
Gautam N.K.; Griffin E.; Hubbard R.; Pawelek O.; Edmonds K.; Rydalch E.;
Xu Z.; Sharma S.; Hoffmann C.
Institution
(Gautam, Griffin, Hubbard, Pawelek, Edmonds, Rydalch, Xu, Hoffmann)
Department of Anesthesiology, McGovern Medical School, UT Health Houston,
TX, United States
(Sharma) Clinical Research Trainee, Mayo Clinic, Scottsdale, AZ, United
States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Maintaining the patency of peripheral arterial lines in
pediatric patients during surgery can be challenging due to multiple
factors, and catheter-related arterial vasospasm is a potentially
modifiable cause. Papaverine, a potent vasodilator, improves arterial line
patency when used as a continuous infusion in the pediatric intensive care
setting, but this method is not convenient during surgery. AIM:
Extrapolating from the benefit seen in the intensive care unit, the
authors hypothesize that a small volume intraarterial bolus of papaverine
immediately after arterial line placement will reduce vasospasm-related
arterial line malfunction. METHOD(S): This was a prospective,
randomized, double-blind study. Patients less than 17 years of age
undergoing cardiac surgery were enrolled. Patients were randomized into
the heparin or papaverine groups. Immediately after arterial line
insertion, an intraarterial bolus of heparin (2units/mL, 1mL) or
papaverine (0.12mg/mL, 1mL) was administered (T1, Figure 1). An optimal
waveform was defined as the ease of aspirating a standardized blood sample
within 30 secs, absence of cavitation when sampling, absence of color
change at the catheter site during injection, and presence of a dicrotic
notch. The primary outcome evaluated was the presence of an optimal
arterial waveform at 5 minutes after the first randomized dose (T1+5mins).
The secondary outcomes were the presence of optimal arterial waveform an
hour after the first dose and the ability of papaverine to rescue
suboptimal waveforms. RESULT(S): A total of 100 patients were
enrolled in the study. Twelve patients were excluded from the analysis
(Figure 2). Complete datasets after randomization were available in 88
patients (heparin group, n= 46; papaverine group, n= 42). At baseline,
groups were similar for age, weight, arterial vessel size, and arterial
line patency (Table 1). At T1+5 mins, an improvement in the waveform
characteristics was observed in the papaverine group [heparin,39% (8/46)
vs. papaverine, 64% (27/42); p=0.02; odds ratio, 2.8; 95% CI, 1.2 to 6.6,
Figure 3, Table 2]. At the end of one hour, both groups showed continued
improvement in arterial line patency. After the second dose, a higher
number of patients in the heparin group had sub-optimal waveforms and were
treated with papaverine [heparin,37% (17/46) vs. papaverine,17% (7/42),
p=0.05]. Patients in the heparin group treated with papaverine showed
significant improvement in patency (13/17 vs. 3/7, p=0.01). No serious
adverse events were reported. CONCLUSION(S): In pediatric patients,
papaverine injection immediately after peripheral arterial catheter
placement was associated with relief of vasospasm and improved initial
arterial line patency. Further, papaverine can be used as a rescue to
improve and maintain arterial line patency. Copyright This article is
protected by copyright. All rights reserved.

<128>
Accession Number
637551844
Title
Predictors of permanent pacemaker insertion after mitral valve
replacement: a systematic review.
Source
Pacing and clinical electrophysiology : PACE. (no pagination), 2022. Date
of Publication: 19 Mar 2022.
Author
Ghauri H.; Iqbal R.; Ahmed S.; Ashraf A.; Khan M.S.Q.; Malik J.; Zaidi
S.M.J.; Almas T.
Institution
(Ghauri, Malik) Department of Cardiology, Rawalpindi Institute of
Cardiology, Rawalpindi, Pakistan
(Iqbal) Department of Cardiology, Wah Medical College, Pakistan
(Ahmed) Department of Cardiology, DHQ Hospital, Chakwal, Pakistan
(Ashraf) Department of Medicine, Military Hospital, Rawalpindi, Pakistan
(Khan) Department of Cardiology, Armed Forces Institute of Cardiology,
Rawalpindi, Pakistan
(Zaidi) Department of Medicine, Rawalpindi Medical University, Rawalpindi,
Pakistan
(Almas) Department of Medicine, Royal College of Surgeons in Ireland,
Dublin, Ireland
Publisher
NLM (Medline)
Abstract
OBJECTIVE: As the established surgical mitral valve replacement (MVR)
expands towards various contemporary techniques and access routes, the
predictors and burden of procedure-related complications including the
need for permanent pacemaker (PPM) implantation need to be identified.
 METHOD(S): Digital databases were searched systematically to identify
studies reporting the incidence of PPM implantation after MVR. Detailed
study and patient-level baseline characteristics including the type of
study, sample size, follow-up, number of post-MVR PPM implantations, age,
gender, and baseline ECG abnormalities were abstracted. RESULT(S): A
total of 12 studies, recruiting 37,124 patients were included in the final
analysis. Overall, 2,820 (7.6%) patients required a PPM with the net rate
ranging from 1.7% to 10.96%. Post-MVR atrioventricular (AV) block was the
most commonly observed indication for PPM, followed by sinoatrial (SA)
node dysfunction, and bradycardia. Age, male gender, pre-existing comorbid
conditions, prior CABG, history of arrhythmias or using anti-arrhythmic
drugs, AF ablation, and double valve replacement were predictors of PPM
implantation post-MVR. CONCLUSION(S): Age, male gender, comorbid
conditions like diabetes and renal impairment, prior CABG, double valve
replacement, and anti-arrhythmic drugs served as positive predictors of
PPM implantation in patients undergoing MVR. This article is protected by
copyright. All rights reserved.

<129>
Accession Number
637541316
Title
American College of Gastroenterology-Canadian Association of
Gastroenterology Clinical Practice Guideline: Management of Anticoagulants
and Antiplatelets During Acute Gastrointestinal Bleeding and the
Periendoscopic Period.
Source
The American journal of gastroenterology. (no pagination), 2022. Date of
Publication: 17 Mar 2022.
Author
Abraham N.S.; Barkun A.N.; Sauer B.G.; Douketis J.; Laine L.; Noseworthy
P.A.; Telford J.J.; Leontiadis G.I.
Institution
(Abraham) Division of Gastroenterology and Hepatology, Department of
Medicine, Mayo Clinic, Scottsdale, AZ, United States
(Barkun) Division of Gastroenterology, Department of Medicine, McGill
University, Montreal, QC, Canada
(Sauer) Division of Gastroenterology and Hepatology, University of
Virginia, Charlottesville, VA, United States
(Douketis) Department of Medicine, St. Joseph's Healthcare Hamilton and
McMaster University, Hamilton, Ontario, Canada
(Laine) Yale School of Medicine, New Haven, Connecticut, USA, and Virginia
Connecticut Healthcare System, West Haven, Connecticut, USA
(Noseworthy) Department of Cardiovascular Diseases, Electrophysiology,
Mayo Clinic, Rochester, MN, United States
(Telford) Division of Gastroenterology, Department of Medicine, St. Paul's
Hospital, University of British Columbia, Vancouver, BC, Canada
(Leontiadis) Division of Gastroenterology and Farncombe Family Digestive
Health Research Institute, Department of Medicine, McMaster University,
Hamilton, Ontario, Canada
Publisher
NLM (Medline)
Abstract
We conducted systematic reviews of predefined clinical questions and used
the GRADE approach to develop recommendations for the periendoscopic
management of anticoagulant and antiplatelet drugs during acute
gastrointestinal (GI) bleeding and the elective endoscopic setting. The
following recommendations target patients presenting with acute GI
bleeding: For patients on warfarin, we suggest against giving fresh frozen
plasma or vitamin K; if needed, we suggest prothrombin complex concentrate
(PCC) compared with fresh frozen plasma administration; for patients on
direct oral anticoagulants (DOACs), we suggest against PCC administration;
if on dabigatran, we suggest against the administration of idarucizumab,
and if on rivaroxaban or apixaban, we suggest against andexanet alfa
administration; for patients on antiplatelet agents, we suggest against
platelet transfusions; and for patients on cardiac acetylsalicylic acid
(ASA) for secondary prevention, we suggest against holding it, but if the
ASA has been interrupted, we suggest resumption on the day hemostasis is
endoscopically confirmed. The following recommendations target patients in
the elective (planned) endoscopy setting: For patients on warfarin, we
suggest continuation as opposed to temporary interruption (1-7 days), but
if it is held for procedures with high risk of GI bleeding, we suggest
against bridging anticoagulation unless the patient has a mechanical heart
valve; for patients on DOACs, we suggest temporarily interrupting rather
than continuing these; for patients on dual antiplatelet therapy for
secondary prevention, we suggest temporary interruption of the P2Y12
receptor inhibitor while continuing ASA; and if on cardiac ASA monotherapy
for secondary prevention, we suggest against its interruption. Evidence
was insufficient in the following settings to permit recommendations. With
acute GI bleeding in patients on warfarin, we could not recommend for or
against PCC administration when compared with placebo. In the elective
periprocedural endoscopy setting, we could not recommend for or against
temporary interruption of the P2Y12 receptor inhibitor for patients on a
single P2Y12 inhibiting agent. We were also unable to make a
recommendation regarding same-day resumption of the drug vs 1-7 days after
the procedure among patients prescribed anticoagulants (warfarin or DOACs)
or P2Y12 receptor inhibitor drugs because of insufficient
evidence. Copyright © 2022 The Author(s). Published by Wolters
Kluwer Health, Inc. on behalf of The American College of Gastroenterology.

<130>
Accession Number
637540331
Title
Two-lung ventilation or one-lung ventilation for esophagectomy: maybe the
more is better from the evidence of meta-analysis.
Source
Updates in surgery. (no pagination), 2022. Date of Publication: 16 Mar
2022.
Author
Deng H.-Y.; Zhang Y.; Ren Y.; Xu Y.; Tang X.
Institution
(Deng, Tang) Lung Cancer Center, West China Hospital, Sichuan University,
No. 37 Guoxue Street, Chengdu, Sichuan 610041, China
(Zhang, Xu) Department of Anesthesiology, West China Hospital, Sichuan
University and The Research Units of West China (2018RU012), Chinese
Academy of Medical Sciences, Chengdu 610041, China
(Ren) Department of Outpatient, West China Hospital, Sichuan University,
Chengdu 610041, China
Publisher
NLM (Medline)
Abstract
One-lung ventilation (OLV) is the most commonly used ventilation strategy
during esophagectomy. However, two-lung ventilation (TLV) with artificial
pneumothorax has been applied in recent years during esophagectomy. It is
unclear whether TLV takes advantages over OLV for esophagectomy. Here, we
conducted a meta-analysis to compare the effects of TLV and OLV for
esophagectomy. We searched relevant studies from the Cochrane Central
Register of Controlled Trials, Pubmed, and Embase in November 2020. We
included studies that compared the effects of TLV with OLV in
esophagectomy and provided sufficient perioperative and postoperative
data. We extracted data of postoperative outcomes (postoperative pulmonary
complications, anastomotic leak, hospital stay) and surgical variables
(thoracic phrase time, blood loss, the number of total resected thoracic
lymph nodes). We calculated the risk ratio (RR) for dichotomous data and
the weighted mean differences (WMDs) for continuous data. Six studies with
1725 patients were included in this meta-analysis. TLV was associated with
significantly lower incidence of postoperative pulmonary complications
[RR=0.714; 95% confidence interval (CI)=(0.534, 0.956); P=0.023], shorter
hospital stay [WMD=-0.148; 95% CI=(-0.246,-0.051); P=0.003], less blood
loss [WMD=-0.352; 95% CI=(-0.528,-0.176); P<0.001] and more resected
thoracic lymph nodes [WMD=0.207; 95% CI=(0.003, 0.4120); P=0.047] than
OLV. Moreover, TLV consumed similar time for thoracic phrase [WMD=-0.289;
95% CI=(-0.661, 0.083); P=0.128], and yielded a comparable rate of
anastomotic leak [RR=1.086; 95% CI=(0.842, 1.400); P=0.525] compared with
OLV. TLV with artificial pneumothorax resulted in less trauma than OLV.
TLV with artificial pneumothorax is safe and could be a choice of
ventilation strategy for esophagectomy. Copyright © 2022. Italian
Society of Surgery (SIC).

<131>
Accession Number
637540005
Title
Effect of cocoa flavanol supplementation for prevention of cardiovascular
disease events: The COSMOS randomized clinical trial.
Source
The American journal of clinical nutrition. (no pagination), 2022. Date
of Publication: 16 Mar 2022.
Author
Sesso H.D.; Manson J.E.; Aragaki A.K.; Rist P.M.; Johnson L.G.;
Friedenberg G.; Copeland T.; Clar A.; Mora S.; Moorthy M.V.; Sarkissian
A.; Carrick W.R.; Anderson G.L.
Institution
(Sesso, Manson, Rist, Friedenberg, Copeland, Clar, Mora, Moorthy,
Sarkissian) Division of Preventive Medicine, Brigham and Women's Hospital
and Harvard Medical School, MA, Boston, United States
(Sesso, Manson, Rist) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, MA, Boston, United States
(Aragaki, Johnson, Carrick, Anderson) Division of Public Health Sciences,
Fred Hutchinson Cancer Research Center, Seattle, WA, USA
(Mora) Division of Cardiovascular Medicine, Brigham and Women's Hospital
and Harvard Medical School, MA, Boston, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cocoa extract is a source of flavanols that favorably
influence vascular risk factors in small and short-term trials, yet
effects on clinical cardiovascular events are untested. OBJECTIVE(S):
We examined whether cocoa extract supplementation decreases total
cardiovascular disease (CVD) among older adults. METHOD(S): We
conducted a randomized, double-blind, placebo-controlled, two-by-two
factorial trial of cocoa extract supplementation and multivitamins for
prevention of CVD and cancer among 21,442 U.S. adults (12,666 women aged
>= 65 years and 8,776 men aged >= 60 years) free of major CVD and recently
diagnosed cancer. Intervention phase was June 2015 through December 2020.
This article reports on the cocoa extract intervention. Participants were
randomly assigned to a cocoa extract supplement (500 mg/d flavanols,
including 80 mg (-)-epicatechins) or placebo. The primary outcome was a
composite of confirmed incident total cardiovascular events, including
myocardial infarction (MI), stroke, coronary revascularization,
cardiovascular death, carotid artery disease, peripheral artery surgery,
and unstable angina. RESULT(S): During a median follow-up of 3.6
years, 410 participants taking cocoa extract and 456 taking placebo had
confirmed total cardiovascular events (hazard ratio [HR], 0.90; 95%
confidence interval [CI], 0.78, 1.02; P = 0.11). For secondary endpoints,
HRs were 0.73 (95% CI, 0.54, 0.98) for CVD death, 0.87 (95% CI, 0.66,
1.16) for MI, 0.91 (95% CI, 0.70, 1.17) for stroke, 0.95 (95% CI, 0.77,
1.17) for coronary revascularization, neutral for other individual
cardiovascular endpoints, and 0.89 (95% CI, 0.77, 1.03) for all-cause
mortality. Per-protocol analyses censoring follow-up at nonadherence
supported a lower risk of total cardiovascular events (HR, 0.85; 95% CI,
0.72, 0.99). There were no safety concerns. CONCLUSION(S): Cocoa
extract supplementation did not significantly reduce total cardiovascular
events among older adults but reduced CVD death by 27%. Potential
reductions in total cardiovascular events were supported in per-protocol
analyses. Additional research is warranted to clarify whether cocoa
extract may reduce clinical cardiovascular events. Copyright ©
The Author(s) 2022. Published by Oxford University Press on behalf of the
American Society for Nutrition.

<132>
Accession Number
637532022
Title
A Randomized Clinical Trial of Perfusion Modalities in Pediatric
Congenital Heart Surgery Patients.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 12 Mar 2022.
Author
Undar A.; Patel K.; Holcomb R.M.; Clark J.B.; Ceneviva G.D.; Young C.A.;
Spear D.; Kunselman A.R.; Thomas N.J.; Myers J.L.
Institution
(Undar) Penn State Hershey Pediatric Cardiovascular Research Center,
Department of Pediatrics, Penn State College of Medicine, Penn State
Health Children's Hospital, Hershey, PA, USA; Department of Surgery, Penn
State College of Medicine, Penn State Health Children's Hospital, Hershey,
PA, USA; Department of Biomedical Engineering, Penn State College of
Medicine, Penn State Health Children's Hospital, Hershey, PA, USA.
Electronic address: aundar@pennstatehealth.psu.edu
(Patel, Holcomb, Clark, Myers) Penn State Hershey Pediatric Cardiovascular
Research Center, Department of Pediatrics, Penn State College of Medicine,
Penn State Health Children's Hospital, Hershey, PA, USA; Department of
Surgery, Penn State College of Medicine, Penn State Health Children's
Hospital, Hershey, PA, USA
(Ceneviva, Young, Spear) Penn State Hershey Pediatric Cardiovascular
Research Center, Department of Pediatrics, Penn State College of Medicine,
Penn State Health Children's Hospital, Hershey, PA, USA; Division of
Pediatric Critical Care Medicine, Penn State College of Medicine, Penn
State Health Children's Hospital, Hershey, PA, USA
(Kunselman, Thomas) Penn State Hershey Pediatric Cardiovascular Research
Center, Department of Pediatrics, Penn State College of Medicine, Penn
State Health Children's Hospital, Hershey, PA, USA; Department of Public
Health Sciences, Penn State College of Medicine, Penn State Health
Children's Hospital, Hershey, PA, USA
Publisher
NLM (Medline)
Abstract
BACKGROUND: The objective of this randomized clinical trial was to
investigate the effects of perfusion modalities on cerebral hemodynamics,
vital organ injury, quantified by the Pediatric Logistic Organ
Dysfunction-2 (PELOD-2) Score, and clinical outcomes in risk-stratified
congenital cardiac surgery patients. METHOD(S): This randomized
clinical trial included 159 consecutive congenital cardiac surgery
patients using either pulsatile (n=83) or non-pulsatile (n=76) perfusion.
Cerebral hemodynamics were assessed using Transcranial Doppler ultrasound.
Multiple organ injury was quantified using the PELOD-2 score at 24, 48,
and 72 hours. Clinical outcomes, including intubation time, ICU length of
stay (LOS), hospital LOS and mortality, were also evaluated.
 RESULT(S): Pulsatility Index at the middle cerebral artery and in the
arterial line during aortic cross-clamping was consistently better
maintained in the pulsatile group. Demographics/cardiopulmonary bypass
characteristics were similar between the two groups. While risk
stratification with STAT Mortality Categories was similar between the
groups, Mortality Categories 1-3 demonstrated more patients than Mortality
Categories 4-5. There were no differences in clinical outcomes between the
groups. The PELOD-2 scores showed a progressive improvement from 24 hours
to 72 hours, but the results were not statistically different between the
groups. CONCLUSION(S): Pulsatillity Index for pulsatile group
demonstrated a more physiologic pattern compared to the non-pulsatile
group. While pulsatile perfusion did not increase plasma-free hemoglobin
levels or microemboli delivery, it also did not demonstrate any
improvements in clinical outcomes or PELOD-2 scores, suggesting that while
pulsatile perfusion is a safe modality, it not a "magic bullet" for
congenital cardiac surgeries. Copyright © 2022 The Society of
Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

<133>
Accession Number
637530711
Title
Pacemaker implantation after sutureless or stented valve: results from a
controlled randomized trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 15 Mar 2022.
Author
Lorusso R.; Ravaux J.M.; Pollari F.; Folliguet T.A.; Kappert U.; Meuris
B.; Shrestha M.L.; Roselli E.E.; Bonaros N.; Fabre O.; Corbi P.; Troise
G.; Andreas M.; Pinaud F.; Pfeiffer S.; Kueri S.; Tan E.; Voisine P.;
Girdauskas E.; Rega F.; Garcia-Puente J.; Fischlein T.
Institution
(Lorusso, Ravaux) Cardio-Thoracic Surgery Department, Heart & Vascular
Centre, Maastricht University Medical Center+ (MUMC+), Maastricht,
Netherlands
(Lorusso, Ravaux) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Pollari, Pfeiffer, Fischlein) Department of Cardiac Surgery,
Cardiovascular Center, Paracelsus Medical University-Klinikum Nurnberg,
Nuremberg, Germany
(Folliguet) Department of Cardiac Surgery & Transplantation, Assistance
Publique, Hopital Henri Mondor, Paris, France
(Kappert) Department of Cardiac Surgery, Dresden Heart Centre University
Hospital, Dresden University of Technology, Dresden, Germany
(Meuris, Rega) Cardiac Surgery Department, Universitaire Ziekenhuizen
Leuven, Leuven, Belgium
(Shrestha) Department of Thoracic and Cardiovascular Surgery, Hannover
Medical School, Hannover, Germany
(Roselli) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, USA
(Bonaros) Department of Cardiac Surgery, Innsbruck Medical University,
Innsbruck, Austria
(Fabre) Department of Cardiac Surgery of Artois, Hospital Center of Lens,
Lens, France
(Fabre) Department of Cardiac Surgery, Bois Bernard Private Hospital,
Ramsay Generale de Sante, Lens, France
(Corbi) Department of Thoracic and Cardiovascular Surgery, Cardio-Vascular
Center, University Hospital of Poitiers, Poitiers, France
(Troise) Division of Cardiac Surgery, Poliambulanza Foundation, Brescia,
Italy
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Pinaud) Department of Cardiac Surgery, CHU d'Angers, University Hospital
Angers, Angers, France
(Kueri) Department of Cardiovascular Surgery, University Heart Center
Freiburg Bad Krozingen, Bad Krozingen, Germany
(Kueri) Department of Cardiovascular Surgery, University Heart Center,
Albert-Ludwigs-Universitat Freiburg, Bad Krozingen, Germany
(Tan) Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven,
Netherlands
(Voisine) Department of Surgery, Universite Laval, QC, Quebec, Canada
(Voisine) Division of Cardiac Surgery, Department of Cardiology, Institut
Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), QC,
Quebec, Canada
(Girdauskas) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, Hamburg, Germany
(Rega) Division of Experimental Cardiac Surgery, Department of
Cardiovascular Sciences, University of Leuven, Leuven, Belgium
(Garcia-Puente) Department of Cardiac Surgery, Hospital Universitario
Virgen de la Arraixaca, Murcia, Spain
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Sutureless aortic valves demonstrated non-inferiority to
standard stented valves for major cardiovascular and cerebral events at 1
year after aortic valve replacement. We aim to assess the factors
correlating with permanent pacemaker implantation (PPI) in both cohorts.
 METHOD(S): PERSIST-AVR is a prospective, randomized, open-label
trial. Patients undergoing aortic valve replacement were randomized to
receive a sutureless aortic valve replacement (Su-AVR) or stented sutured
bioprosthesis (SAVR). Multivariable analysis was performed to identify
possible independent risk factors associated with PPI. A logistic
regression analysis was performed to estimate the risk of PPI associated
to different valve size. RESULT(S): The 2 groups (Su-AVR; n = 450,
SAVR n = 446) were well balanced in terms of preoperative risk factors.
Early PPI rates were 10.4% in the Su-AVR group and 3.1% in the SAVR. PPI
prevalence correlated with valve size XL (P = 0.0119) and preoperative
conduction disturbances (P = 0.0079) in the Su-AVR group. No predictors
were found in the SAVR cohort. Logistic regression analysis showed a
significantly higher risk for PPI with size XL compared to each individual
sutureless valve sizes [odds ratio (OR) 0.272 vs size S (95%confidence
interval 0.07-0.95), 0.334 vs size M (95% CI 0,16-0; 68), 0.408 vs size L
(95% CI 0,21-0.81)] but equivalent risk of PPI rates for all other
combination of valve sizes. CONCLUSION(S): Su-AVR is associated with
higher PPI rate as compared to SAVR. However, the increased PPI rate
appears to be size-dependent with significant higher rate only for size
XL. The combination of preoperative conduction disorder and a size XL can
lead to a higher probability of early PPI in Su-AVR. CLINICAL TRIAL
REGISTRATION NUMBER: NCT02673697. Copyright © The Author(s) 2022.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

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