EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2014263143
Title
Eight-year outcomes for patients with aortic valve stenosis at low
surgical risk randomized to transcatheter vs. surgical aortic valve
replacement.
Source
European Heart Journal. 42(30) (pp 2912-2919), 2021. Date of Publication:
07 Aug 2021.
Author
Jorgensen T.H.; Thyregod H.G.Ho.; Ihlemann N.; Nissen H.; Petursson P.;
Kjeldsen B.J.; Steinbruchel D.A.; Olsen P.S.; Sondergaard L.
Institution
(Jorgensen, Sondergaard) Department of Cardiology, Heart Centre,
Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
(Thyregod, Olsen) Department of Cardiothoracic Surgery, Heart Centre,
Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
(Ihlemann, Nissen) Department of Cardiology, Odense University Hospital,
J. B. Winslows Vej 4, Odense 5000, Denmark
(Petursson) Department of Cardiology, Sahlgrenska University Hospital, Bla
straket 5, Gothenburg 41345, Sweden
(Kjeldsen) Department of Cardiothoracic and Vascular Surgery, Odense
University Hospital, J. B. Winslows Vej 4, Odense 5000, Denmark
(Steinbruchel) Department of Medicine, Nykoebing F Hospital and University
of Southern Denmark, J. B. Winslows Vej 4, Odense 5000, Denmark
Publisher
Oxford University Press
Abstract
Aims: The aims of the study were to compare clinical outcomes and valve
durability after 8 years of follow-up in patients with symptomatic severe
aortic valve stenosis at low surgical risk treated with either
transcatheter aortic valve implantation (TAVI) or surgical aortic valve
replacement (SAVR). <br/>Methods and Results: In the NOTION trial,
patients with symptomatic severe aortic valve stenosis were randomized to
TAVI or SAVR. Clinical status, echocardiography, structural valve
deterioration, and failure were assessed using standardized definitions.
In total, 280 patients were randomized to TAVI (n = 145) or SAVR (n =
135). Baseline characteristics were similar, including mean age of 79.1
+/- 4.8 years and a mean STS score of 3.0 +/- 1.7%. At 8-year follow-up,
the estimated risk of the composite outcome of all-cause mortality,
stroke, or myocardial infarction was 54.5% after TAVI and 54.8% after SAVR
(P = 0.94). The estimated risks for all-cause mortality (51.8% vs. 52.6%;
P = 0.90), stroke (8.3% vs. 9.1%; P = 0.90), or myocardial infarction
(6.2% vs. 3.8%; P = 0.33) were similar after TAVI and SAVR. The risk of
structural valve deterioration was lower after TAVI than after SAVR (13.9%
vs. 28.3%; P = 0.0017), whereas the risk of bioprosthetic valve failure
was similar (8.7% vs. 10.5%; P = 0.61). <br/>Conclusion(s): In patients
with severe aortic valve stenosis at low surgical risk randomized to TAVI
or SAVR, there were no significant differences in the risk for all-cause
mortality, stroke, or myocardial infarction, as well as the risk of
bioprosthetic valve failure after 8 years of follow-up. Clinical trial
registration: URL: http://www.ClinicalTrials.gov. Unique identifier:
NCT01057173.<br/>Copyright &#xa9; 2021 The Author(s) 2021. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<2>
Accession Number
636719662
Title
Safety of Normothermic Cardiopulmonary Bypass in Pediatric Cardiac
Surgery: A System Review and Meta-Analysis.
Source
Frontiers in Pediatrics. 9 (no pagination), 2021. Article Number: 757551.
Date of Publication: 14 Dec 2021.
Author
Xiong T.; Pu L.; Ma Y.-F.; Zhu Y.-L.; Cui X.; Li H.; Zhan X.; Li Y.-X.
Institution
(Xiong, Pu, Ma, Zhu, Cui, Li, Zhan, Li) Department of Cardiac Surgery,
Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical
University, Kunming, China
(Pu, Cui, Li, Zhan, Li) Cardiovascular Surgery, Institution of Yunnan,
Kunming, China
Publisher
Frontiers Media S.A.
Abstract
Objectives: Hypothermic cardiopulmonary bypass (HCPB) has been used
successfully in cardiac surgery for more than half a century, although
adverse effects have been reported with its use. Many studies on
temperature management during CPB published to date have shown that
normothermic CPB (NCPB) provides more benefits to children undergoing
cardiac surgery. The present meta-analysis investigated the effect of NCPB
on clinical outcomes based on results of randomized controlled trials and
observational studies on pediatric cardiac surgery. <br/>Method(s):
Databases such as PubMed, EMBASE, Cochrane Central Register of Controlled
Trials, and Clinical Trials.gov were searched from inception to May 2021
to identify relevant studies published in English. <br/>Result(s): The
present meta-analysis included 13 studies characterizing a total of 837
pediatric patients. The random effects model exhibited that the NCPB group
had reduced revision for postoperative bleeding [odds ratio (OR): 0.11;
95% confidence interval (CI): 0.01-0.89; I² = 0%, P = 0.04],
serum lactate 2-4 h after CPB (mean difference: -0.60; 95% CI: -1.09 to
-0.11; I² = 82%, P = 0.02), serum creatinemia 24 h after CPB
(mean difference: -2.73; 95% CI: -5.06 to -0.39; I² = 83%, P =
0.02), serum creatinemia 48 h after CPB (mean difference: -2.08; 95% CI:
-2.78 to -1.39; I² = 0%, P < 0.05), CPB time (mean difference:
-19.10, 95% CI: -32.03 to -6.18; I² = 96%, P = 0.04), and major
adverse events (OR: 0.37; 95% CI: 0.15-0.93; Z = 2.12, P = 0.03) after
simple congenital surgery compared with the HCPB group.
<br/>Conclusion(s): NCPB is as safe as HCPB in pediatric congenital heart
surgery. Moreover, NCPB provides more advantages than HCPB in simple
congenital heart surgery.<br/>Copyright &#xa9; 2021 Xiong, Pu, Ma, Zhu,
Cui, Li, Zhan and Li.

<3>
Accession Number
637726117
Title
The effect of dexmedetomidine on neuroprotection in pediatric cardiac
surgery patients: study protocol for a prospective randomized controlled
trial.
Source
Trials. 23(1) (pp 271), 2022. Date of Publication: 08 Apr 2022.
Author
Ji S.-H.; Kang P.; Song I.-S.; Jang Y.-E.; Lee J.-H.; Kim J.-T.; Kim
H.-S.; Kim E.-H.
Institution
(Ji, Kang, Song, Jang, Lee, Kim, Kim) Department of Anesthesiology and
Pain Medicine, Seoul National University Hospital, Seoul National
University College of Medicine, 101 Daehak-ro ,Jongno-gu, Seoul 03080,
South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Seoul National
University Hospital, Seoul National University College of Medicine, 101
Daehak-ro ,Jongno-gu, Seoul 03080, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Infants undergoing cardiac surgery under cardiopulmonary
bypass are vulnerable to postoperative neurodevelopmental delays.
Dexmedetomidine has been shown to have protective effects on the heart,
kidneys, and brain in animals and adults undergoing cardiac surgery with
cardiopulmonary bypass. We hypothesized that dexmedetomidine would have a
neuroprotective effect on infants undergoing cardiopulmonary bypass and
planned a prospective randomized controlled trial with postoperative
neurodevelopment measurements. <br/>METHOD(S): This is a single-center,
prospective, double-blinded, randomized controlled trial with 1:1
allocation. A cohort of 160 infants undergoing cardiac surgery with
cardiopulmonary bypass will be enrolled. After induction, dexmedetomidine
will be infused with a loading dose of 1mug/kg and a maintenance dose of
0.5mug/kg/h or the same amount of normal saline will be administered. Upon
initiation of cardiopulmonary bypass, an additional dose of
dexmedetomidine (0.01mug/cardiopulmonary priming volume) will be mixed
with the cardiopulmonary bypass circuit. The primary outcome will be the
proportion of infants who score lower than 85 in any of the cognitive,
language, or motor Bayley scales of infant development-III tests 1 year
after the surgery. Other feasible outcome measures will include
differences in plasma glial fibrillary acidic protein, troponin I,
interleukin-6, urinary neutrophil gelatinase-associated lipocalin, and
perioperative major adverse events. The results of the Bayley scales of
infant development-III test from the study group and the control group
will be compared using a chi-squared test under intention-to-treat
analysis. A generalized estimating equation will be used to analyze
repeated measurements over time. DISCUSSION: This study will enable us to
assess whether the use of dexmedetomidine can alter the early
neurodevelopmental outcome in infants undergoing cardiac surgery with
cardiopulmonary bypass and also estimate effects of dexmedetomidine on
other organs. TRIAL REGISTRATION: ClinicalTrials.gov NCT04484922.
Registered on 24 July 2020.<br/>Copyright &#xa9; 2022. The Author(s).

<4>
Accession Number
2015575936
Title
Ticagrelor versus aspirin 2 years after coronary bypass: Observational
analysis from the TARGET trial.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Kulik A.; Abreu A.M.; Boronat V.; Kouchoukos N.T.; Ruel M.
Institution
(Kulik, Abreu, Boronat) Division of Cardiac Surgery, Department of
Clinical Research, Boca Raton Regional Hospital, Florida Atlantic
University, Boca Raton, FL, United States
(Kouchoukos) Division of Cardiovascular and Thoracic Surgery, Missouri
Baptist Medical Center, St. Louis, MO, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Compared to conventional aspirin therapy, ticagrelor did not
improve vein graft patency 1 year after coronary bypass surgery (CABG) in
the ticagrelor antiplatelet therapy to reduce graft events and thrombosis
(TARGET) trial. However, it is unknown whether ticagrelor may impact graft
patency long-term following surgery. <br/>Method(s): In the TARGET
multicenter trial, 250 CABG patients were randomized to aspirin 81 mg or
ticagrelor 90 mg twice daily. In this observational analysis, 2 years
after surgery, vein graft occlusion and clinical events were compared
among subjects who agreed to a second year of double-blind study drug
administration (N = 156). <br/>Result(s): Two-year graft assessment was
performed for 142 patients (80 aspirin patients, 62 ticagrelor patients,
425 total grafts), with an overall 2-year graft occlusion rate of 10.6%.
Vein graft occlusion at 2 years, the primary outcome of this study, did
not significantly differ between the two groups (15.7% vs. 13.2%, aspirin
vs. ticagrelor, p =.71). The incidence of vein grafts with any disease
(stenosis or occlusion) did not significantly differ between the groups
(19.4% vs. 19.8%, aspirin vs. ticagrelor, p = 1.00), and the number of
patients with vein graft disease did not significantly differ between the
groups (30.0% vs. 29.0%, aspirin vs. ticagrelor, p = 1.00). Vein grafts
developing new disease did not significantly differ between the two groups
(1.5% vs. 3.8%, aspirin vs. ticagrelor, p =.41). Freedom from major
adverse cardiovascular events at 2 years was similar between the groups (p
=.75). <br/>Conclusion(s): Compared to conventional aspirin therapy,
ticagrelor did not significantly reduce vein graft disease 2 years after
CABG.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<5>
Accession Number
2017598638
Title
Prognostic impact of pre- and post- procedural renal dysfunction on late
all-cause mortality outcome following transcatheter edge-to-edge repair of
the Mitral Valve: A systematic review and Meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Safiriyu I.; Nagraj S.; Otulana R.; Saralidze T.; Kokkinidis D.G.;
Faillace R.
Institution
(Safiriyu, Nagraj, Saralidze, Faillace) Department of Medicine, Jacobi
Medical Center, Bronx, NY, United States
(Safiriyu, Nagraj, Saralidze, Faillace) Albert Einstein College of
Medicine, Bronx, NY, United States
(Otulana) Federal Medical Center, OG, Abeokuta, Nigeria
(Kokkinidis) Department of Cardiology, Yale University School of Medicine,
New Haven, CT, United States
(Faillace) Department of Cardiology, Jacobi Medical Center, Bronx, NY,
United States
Publisher
Elsevier Inc.
Abstract
Introduction: Impaired renal function, a well-recognized complication of
severe heart failure is associated with adverse outcomes following
cardiovascular interventions. There are conflicting data reported about
its impact on late all-cause mortality following transcatheter
edge-to-edge mitral valve repair (TEER) with MitraClip (MC) implantation.
<br/>Aim(s): To evaluate the impact of pre- and post- procedural renal
dysfunction on late (>=12 months) all-cause mortality following TEER with
MC. <br/>Method(s): Electronic databases PubMed, Embase, and Web of
Science were systematically reviewed from inception to February 2021 for
studies evaluating MC outcomes, according to the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses guidelines. A random-effects
model meta-analysis was performed and heterogeneity of the included
studies was assessed using I-squared test. <br/>Result(s): Out of 2606
articles, 15 studies with 19,545 patients were included. Pre-procedural
renal dysfunction i.e. chronic kidney disease (CKD) was independently
associated with higher late all-cause mortality (Hazard ratio [HR] 1.57,
95% CI 1.25-1.97, I² = 57%) after TEER with MC. A similar
association was observed irrespective of CKD severity (HR 1.62 95% CI
1.21-2.16, I² = 0% and HR 2.86, 95% CI 1.87-4.39, I²
= 26% for CKD stage 3 and >= stage 4 respectively). In addition, the
development of post-procedural renal dysfunction was independently
associated with higher late all-cause mortality (HR = 2.32, 95% CI
1.71-3.15, I² = 42%) after TEER with MC. <br/>Conclusion(s):
Pre- and post-procedural renal dysfunction is a strong independent
predictor of late all-cause mortality following TEER with MC and this
should be considered during periprocedural planning for these
patients.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<6>
Accession Number
2017586977
Title
Mechanisms of death in low risk patients after transcatheter or surgical
aortic valve replacement.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Ramlawi B.; Deeb G.M.; Yakubov S.J.; Markowitz A.H.; Hughes G.C.; Kiaii
R.B.; Huang J.; Kleiman N.S.; Reardon M.J.
Institution
(Ramlawi) Lankenau Heart Institute, 100 East Lancaster Ave., Suite 356,
Wynnewood, PA 19096, United States
(Deeb) Department of Cardiac Surgery, University of Michigan Hospitals,
1500 E. Medical Center Drive, 5144 Frankel Cardiovascular Center, SPC
#5864, Ann Arbor, MI 48109-5864, United States
(Yakubov) Department of Interventional Cardiology, OhioHealth-Riverside
Methodist Hospital, 3705 Olentangy River Rd Ste 100, Columbus, OH 43214,
United States
(Markowitz) Department of Cardiothoracic Surgery, University Hospitals
Cleveland Medical Center, 11100 Euclid Ave Ste 1800, Cleveland, OH 44106,
United States
(Hughes) Division of Thoracic and Cardiovascular Surgery, Duke University
Medical Center, 2301 Erwin Rd, Durham, NC 27707, United States
(Kiaii) Department of Cardiovascular and Thoracic Surgery, London Health
Sciences Centre, 800 Commissioners Rd E, London, ON N6A 5W9, Canada
(Huang) Department of Statistics, Medtronic, 8200 Coral Sea Street,
Minneapolis, MN 55112, United States
(Kleiman, Reardon) Department of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, 6550 Fannin Street, Suite 1401, Houston,
TX 77030, United States
Publisher
Elsevier Inc.
Abstract
Background: Death in high- and intermediate-risk patients after
self-expanding transcatheter (TAVR) and surgical aortic valve replacement
(surgery) differed in mechanisms and timing. In both risk groups, 1-year
all-cause mortality was lower in TAVR than in surgery patients. The
differences in mechanism and timing of death in low-risk patients has not
been studied. This report explores the mechanisms of death during 3 time
periods; 0 to 30 days (early), 31 to 120 days (recovery), and 121 to 365
days (late). <br/>Method(s): We retrospectively examined the mechanisms
and timing of death following TAVR or surgery in the randomized Evolut Low
Risk Trial. Patients were enrolled between March 2016 and November 2018
from 86 designated TAVR centers. Mechanisms of death were categorized as
due to technical reasons, failure to repair, complications linked to
death, failure to recover or other. <br/>Result(s): All-cause mortality at
1 year was 2.2% for TAVR and 2.8% for surgery, p = 0.44. Early deaths
included 3 TAVR patients, all due to technical reasons, and 8 surgery
patients (1 technical, 5 complications and 2 failed to recover). Recovery
period deaths included 6 TAVR patients (4 complications, 1 failed to
recover and 1 other), and 1 surgery patient from complications of valve
endocarditis. Late period deaths included 6 TAVR patients and 9 surgery
patients, primarily due to complications. <br/>Conclusion(s): In this
low-risk study cohort, no patient died from failure to repair the valve;
reduction in procedural complications in the TAVR and surgery groups
remain opportunities for further improvement in outcomes. Clinical Trial
Registrations (clinicaltrials.gov): NCT02701283 (Evolut Low
Risk).<br/>Copyright &#xa9; 2022

<7>
[Use Link to view the full text]
Accession Number
2017432072
Title
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization:
Executive Summary: A Report of the American College of Cardiology/American
Heart Association Joint Committee on Clinical Practice Guidelines.
Source
Circulation. 145(3) (pp E4-E17), 2022. Date of Publication: 18 Jan 2022.
Author
Lawton J.S.; Tamis-Holland J.E.; Bangalore S.; Bates E.R.; Beckie T.M.;
Bischoff J.M.; Bittl J.A.; Cohen M.G.; Dimaio J.M.; Don C.W.; Fremes S.E.;
Gaudino M.F.; Goldberger Z.D.; Grant M.C.; Jaswal J.B.; Kurlansky P.A.;
Mehran R.; Metkus T.S.; Nnacheta L.C.; Rao S.V.; Sellke F.W.; Sharma G.;
Yong C.M.; Zwischenberger B.A.
Publisher
Lippincott Williams and Wilkins
Abstract
Aim: The executive summary of the American College of Cardiology/American
Heart Association/Society for Cardiovascular Angiography and Interventions
coronary artery revascularization guideline provides the top 10 items
readers should know about the guideline. In the full guideline, the
recommendations replace the 2011 coronary artery bypass graft surgery
guideline and the 2011 and 2015 percutaneous coronary intervention
guidelines. This summary offers a patient-centric approach to guide
clinicians in the treatment of patients with significant coronary artery
disease undergoing coronary revascularization, as well as the supporting
documentation to encourage their use. <br/>Method(s): A comprehensive
literature search was conducted from May 2019 to September 2019,
encompassing studies, reviews, and other evidence conducted on human
subjects that were published in English from PubMed, EMBASE, the Cochrane
Collaboration, CINHL Complete, and other relevant databases. Additional
relevant studies, published through May 2021, were also considered.
Structure: Recommendations from the earlier percutaneous coronary
intervention and coronary artery bypass graft surgery guidelines have been
updated with new evidence to guide clinicians in caring for patients
undergoing coronary revascularization. This summary includes
recommendations, tables, and figures from the full guideline that relate
to the top 10 take-home messages. The reader is referred to the full
guideline for graphical flow charts, supportive text, and tables with
additional details about the rationale for and implementation of each
recommendation, and the evidence tables detailing the data considered in
the development of this guideline.<br/>Copyright &#xa9; 2022 Lippincott
Williams and Wilkins. All rights reserved.

<8>
[Use Link to view the full text]
Accession Number
2017431040
Title
Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic
Severe Aortic Stenosis: The AVATAR Trial.
Source
Circulation. 145(9) (pp 648-658), 2022. Date of Publication: 01 Mar 2022.
Author
Banovic M.; Putnik S.; Penicka M.; Doros G.; Deja M.A.; Kockova R.; Kotrc
M.; Glaveckaite S.; Gasparovic H.; Pavlovic N.; Velicki L.; Salizzoni S.;
Wojakowski W.; Van Camp G.; Nikolic S.D.; Iung B.; Bartunek J.
Institution
(Banovic, Putnik) Belgrade Medical School, University of Belgrade, Serbia
(Banovic) Cardiology Department, University Clinical Center of Serbia,
Pasterova 2, Belgrade, Serbia
(Putnik) Cardiac-Surgery Department, University Clinical Center of Serbia,
Belgrade, Serbia
(Penicka, Van Camp, Bartunek) Cardiovascular Center, OLV Hospital, Aalst,
Belgium
(Doros) Boston University, School of Public Health, Department of
Biostatistics, MA, United States
(Deja) Department of Cardiac Surgery, Medical University of Silesia,
Katowice, Poland
(Kockova, Kotrc) Department of Cardiology, Institute for Clinical and
Experimental Medicine, Prague, Czechia
(Glaveckaite) Clinic of Cardiac and Vascular Diseases, Institute of
Clinical Medicine, Faculty of Medicine, Vilnius University, Lithuania
(Gasparovic) Department of Cardiac Surgery, University of Zagreb, School
of Medicine, University Hospital Center Zagreb, Croatia
(Pavlovic) University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
(Velicki) Faculty of Medicine, University of Novi Sad, Serbia
(Velicki) Institute of Cardiovascular Diseases Vojvodina, Sremska
Kamenica, Serbia
(Salizzoni) Division of Cardiosurgery, Cardiovascular and Thoracic
Department, Citta della Salute e della Scienza Hospital, University of
Turin, Italy
(Wojakowski) Division of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Nikolic) CorDynamix, Redwood City, CA, United States
(Iung) Cardiology Department, Bichat Hospital APHP, Universite de Paris,
France
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Surgical aortic valve replacement (SAVR) represents a class I
indication in symptomatic patients with severe aortic stenosis (AS).
However, indications for early SAVR in asymptomatic patients with severe
AS and normal left ventricular function remain debated. <br/>Method(s):
The AVATAR trial (Aortic Valve Replacement Versus Conservative Treatment
in Asymptomatic Severe Aortic Stenosis) is an investigator-initiated
international prospective randomized controlled trial that evaluated the
safety and efficacy of early SAVR in the treatment of asymptomatic
patients with severe AS, according to common criteria (valve area <=1
cm²with aortic jet velocity >4 m/s or a mean transaortic
gradient >=40 mm Hg), and with normal left ventricular function. Negative
exercise testing was mandatory for inclusion. The primary hypothesis was
that early SAVR would reduce the primary composite end point of all-cause
death, acute myocardial infarction, stroke, or unplanned hospitalization
for heart failure compared with a conservative strategy according to
guidelines. The trial was designed as event-driven to reach a minimum of
35 prespecified events. The study was performed in 9 centers in 7 European
countries. <br/>Result(s): Between June 2015 and September 2020, 157
patients (mean age, 67 years; 57% men) were randomly allocated to early
surgery (n=78) or conservative treatment (n=79). Follow-up was completed
in May 2021. Overall median follow-up was 32 months: 28 months in the
early surgery group and 35 months in the conservative treatment group.
There was a total of 39 events, 13 in early surgery and 26 in the
conservative treatment group. In the early surgery group, 72 patients
(92.3%) underwent SAVR with operative mortality of 1.4%. In an
intention-to-treat analysis, patients randomized to early surgery had a
significantly lower incidence of primary composite end point than those in
the conservative arm (hazard ratio, 0.46 [95% CI, 0.23-0.90]; P=0.02).
There was no statistical difference in secondary end points, including
all-cause mortality, first heart failure hospitalizations, major bleeding,
or thromboembolic complications, but trends were consistent with the
primary outcome. <br/>Conclusion(s): In asymptomatic patients with severe
AS, early surgery reduced a primary composite of all-cause death, acute
myocardial infarction, stroke, or unplanned hospitalization for heart
failure compared with conservative treatment. This randomized trial
provides preliminary support for early SAVR once AS becomes severe,
regardless of symptoms. Registration: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT02436655.<br/>Copyright &#xa9; 2022 Lippincott
Williams and Wilkins. All rights reserved.

<9>
Accession Number
634554655
Title
A systematic review on the application of the hybrid operating room in
surgery: experiences and challenges.
Source
Updates in surgery. 74(2) (pp 403-415), 2022. Date of Publication: 01 Apr
2022.
Author
Jin H.; Lu L.; Liu J.; Cui M.
Institution
(Jin) Second Department of General Surgery, Zhuhai People's Hospital
(Zhuhai Hospital Affiliated with Jinan University), China
(Lu) Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan
University), Guangdong Province, No. 79 of Kangning Road 519000, China
(Liu) Zhuhai Health Bureau, Guangdong Province, No. 351 of east Meihua
Road 519000, China
(Cui) China's Communist Party Committee, Zhuhai People's Hospital (Zhuhai
Hospital Affiliated with Jinan University), Guangdong Province, No. 79 of
Kangning Road 519000, China
Publisher
NLM (Medline)
Abstract
The hybrid operating room has been widely applied in different surgery
sub-specialties. We aim to identify the advantages of hybrid operating
rooms by focusing on intraoperative imaging and explore what to do for
further improving its application. We searched related literature in
websites including Pubmed, MEDLINE, Web of science, using the keywords
("hybrid operating room" or "integrated operating room" or
"multifunctional operating room") and ("surgery" or "technique" or
"intervention" or "radiology"). All the searched papers were screened and
underwent quality evaluation. A total of 30 literature was eventually
identified after full-text screening. These articles covered 10 countries
and presented data for 15,558 individuals. The median sample size was 536
(range 8-12,804). Application of the hybrid operating room in general
surgery, neurosurgery, thoracic surgery, urology, gynaecologic and
obstetrics surgery, cardiovascular surgery, was summarized. Four different
operative indicators were applied (operative duration, mortality rate,
operation success rate and complication rate). A hybrid OR could
significantly increase the operation success rate and reduce operative
duration, mortality rates, and complication rates. Further efforts could
be made to reduce radiation exposure in the hybrid operating room and
increase its cost-effectiveness ratio.<br/>Copyright &#xa9; 2021. Italian
Society of Surgery (SIC).

<10>
Accession Number
636663915
Title
Predictors of cognitive dysfunction after cardiac surgery: a systematic
review.
Source
European journal of cardiovascular nursing. 21(3) (pp 192-204), 2022. Date
of Publication: 09 Apr 2022.
Author
Bowden T.; Hurt C.S.; Sanders J.; Aitken L.M.
Institution
(Bowden, Hurt, Aitken) School of Health Sciences, City, University of
London, Northampton Square, London EC1V 0HB, UK
(Sanders) St Bartholomew's Hospital, Barts Health NHS Trust, West
Smithfield, London EC1V 0HB, UK
(Sanders) William Harvey Research Institute, Queen Mary University London,
Barts & the London School of Medicine & DentistryCharterhouse Square,
London EC1M 6BQ, United Kingdom
(Aitken) School of Nursing and Midwifery, Griffith University, 170 Kessels
Road ,Nathan, Australia
Publisher
NLM (Medline)
Abstract
AIMS: Postoperative cognitive dysfunction (POCD) is often experienced by
cardiac surgery patients; however, it is not known if some groups of
patients experience this more frequently or severely than others.The aim
of this systematic review was to identify preoperative and postoperative
predictors of cognitive dysfunction in adults following cardiac surgery.
METHODS AND RESULTS: Eight bibliographic databases were searched (January
2005 to March 2021) in relation to cardiac surgery and cognition. Studies
including adult patients who had undergone open cardiac surgery and using
a validated measurement of cognitive function were included. Full-text
review for inclusion, quality assessment, and data extraction were
undertaken independently by two authors. A total of 2870 papers were
identified, of which 36 papers met the inclusion criteria and were
included in the review. The majority were prospective observational
studies [n=28 (75.7%)]. In total, 61 independent predictors (45
preoperative and 16 postoperative) were identified as significant in at
least one study; advancing age and education level appear important. Age
has emerged as the most common predictor of cognitive outcome.
<br/>CONCLUSION(S): Although a number of predictors of POCD have been
identified, they have inconsistently been reported as significantly
affecting cognitive outcome. Consistent with previous research, our
findings indicate that older patients and those with lower educational
levels should be prioritized when developing and trialling interventions
to improve cognitive function. These findings are less than surprising if
we consider the methodological shortcomings of included studies. It is
evident that further high-quality research exploring predictors of POCD is
required. REGISTRATION: This review was registered on Prospero,
CRD42020167037.<br/>Copyright &#xa9; The Author(s) 2021. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<11>
Accession Number
637709381
Title
Application of Different Ventilation Modes Combined with AutoFlow
Technology in Thoracic Surgery.
Source
Journal of healthcare engineering. 2022 (pp 2507149), 2022. Date of
Publication: 2022.
Author
Lixian W.; Yanfang Y.; Chengzong C.; Ning J.; Yufeng G.
Institution
(Lixian, Yanfang, Chengzong, Ning, Yufeng) Cangzhou Central Hospital,
Cangzhou, China
Publisher
NLM (Medline)
Abstract
To investigate the effect of AutoFlow on airway pressure and hemodynamics
in mechanical ventilation constant volume-control ventilation mode, 100
patients receiving mechanical ventilation were randomly divided into
observation group (SIMV-PSV-PEEP+AutoFlow) and control group
(SIMV-PSV-PEEP). The results showed that the peak airway pressure and
average airway pressure decreased with different flow rate settings and
automatic flow conversion (P < 0.05). The peak airway pressure and mean
airway pressure decreased with different resistance settings (P < 0.05).
With different compliance settings, the peak airway pressure and average
airway pressure decreased after being assisted with an automatic converter
(P < 0.05). Adding AutoFlow on the basis of SIMV-PSV mode can
significantly reduce peak inspiratory pressure (PIP), mean airway pressure
(Pmean), and airway resistance (R). There was no significant difference in
hemodynamic monitoring results between the observation group and the
control group. It is proved that the SIMV constant volume-controlled
ventilation mode combined with AutoFlow can not only ensure tidal volume
but also avoid excessive airway pressure, which has little effect on
hemodynamics.<br/>Copyright &#xa9; 2022 Wang Lixian et al.

<12>
Accession Number
637725367
Title
Utility of a smartphone application in assessing palmar circulation prior
to radial artery harvesting for coronary artery bypass grafting: rationale
and design of the randomised CAPITAL iRADIAL-CABG trial.
Source
BMJ open. 12(4) (pp e055580), 2022. Date of Publication: 08 Apr 2022.
Author
Goh C.Y.; Parlow S.; Di Santo P.; Simard T.; Jung R.; Ahmed Z.;
Verreault-Julien L.; Kuhar P.; Chan V.; Al-Atassi T.; Toeg H.; Bernick J.;
Wells G.A.; Ruel M.; Hibbert B.
Institution
(Goh, Parlow, Di Santo, Jung, Ahmed, Verreault-Julien, Hibbert) CAPITAL
Research Group, Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Di Santo, Wells) School of Epidemiology and Public Health, University of
Ottawa, Ottawa, ON, Canada
(Simard) Department of Cardiovascular Diseases, Mayo Clinic School of
Medicine, Rochester, MN, United States
(Jung, Hibbert) Department of Cellular and Molecular Medicine, University
of Ottawa, Ottawa, ON, Canada
(Kuhar) Azumio Inc, Redwood City, San Francisco, USA
(Chan, Al-Atassi, Toeg, Ruel) Division of Cardiac Surgery, University of
Ottawa Heart Institute, Ottawa, ON, Canada
(Bernick, Wells) Cardiovascular Research Methods Centre, University of
Ottawa Heart Institute, Ottawa, ON, Canada
Publisher
NLM (Medline)
Abstract
INTRODUCTION: There is emerging evidence supporting the use of the radial
artery (RA) as a preferred secondary conduit for coronary artery bypass
grafting (CABG) as it is associated with higher rates of graft patency at
5 years when compared with saphenous vein grafts (SVG). The modified
Allen's test (MAT) is traditionally regarded as the standard of care in
the assessment of ulnar artery (UA) patency prior to RA harvesting.
Unfortunately, due to high false-positive rates, a substantial number of
pre-CABG patients are found to have an abnormal MAT despite normal UA
patency, resulting in inappropriate exclusion from RA harvesting. The SVG
is generally used in its place when this occurs, resulting in potentially
lower rates of long-term graft patency. METHODS AND ANALYSIS: The CAPITAL
iRADIAL-CABG trial is currently enrolling participants 18 years of age or
older undergoing CABG for whom the treating physician is considering the
use of an RA conduit. Eligible patients will be randomised in a 1:1
fashion to MAT or smartphone-based photoplethysmography application
assessment to assess collateral palmar circulation prior to RA harvesting.
The primary outcome of the trial is the use of the RA as a conduit during
CABG. The primary safety outcome is postoperative palmar ischaemia as
determined by clinical assessment or requirement of vascular intervention.
Secondary outcomes include vascular complications, early graft failure,
need for rescue percutaneous coronary intervention during the index
hospitalisation and a composite cardiovascular outcome of myocardial
infarction, stroke and cardiovascular death prior to discharge from
hospital. A total of 236 participants are planned to be recruited. ETHICS
AND DISSEMINATION: The study was approved by the Ottawa Heart Science
Network Research Ethics Board (approval number 20180865-01H). The study
results will be disseminated via conference presentations and
peer-reviewed publications. TRIAL REGISTRATION NUMBER:
NCT03810729.<br/>Copyright &#xa9; 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.

<13>
Accession Number
637725302
Title
Dexmedetomidine after Cardiac Surgery for Prevention of Delirium (EXACTUM)
trial protocol: a multicentre randomised, double-blind, placebo-controlled
trial.
Source
BMJ open. 12(4) (pp e058968), 2022. Date of Publication: 08 Apr 2022.
Author
Gargadennec T.; Oilleau J.-F.; Rozec B.; Nesseler N.; Lasocki S.; Futier
E.; Amour J.; Durand M.; Bougle A.; Kerforne T.; Consigny M.; Eddi D.;
Huet O.
Institution
(Gargadennec, Oilleau, Huet) Departement d'Anesthesie et Reanimation
Chirurgicale, CHU Brest, Brest, France
(Gargadennec, Oilleau, Huet) Universite de Bretagne Occidentale, Brest,
France
(Rozec) Intensive Care Unit, Anesthesia and Critical Care Department,
Hopital Laennec, University Hospital Centre Nantes, Nantes, France
(Rozec) CNRS, INSERM, l'institut du thorax, Universite de Nantes, Nantes,
France
(Nesseler) Anaesthesia and Intensive Care Unit, Centre Hospitalier
Universitaire de Rennes, Rennes, France
(Lasocki) Departement Anesthesie Reanimation, CHU Angers, Angers, France
(Lasocki) Universite Angers Faculte des Sciences, Angers, France
(Futier) Departement de Medecine Perioperatoire, Anesthesie Reanimation,
Hopital Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France
(Futier) CNRS, Inserm U-1103, Universite Clermont Auvergne,
Clermont-Ferrand, France
(Amour) Critical Care Medicine and Anesthesiology in Cardiothoracic
Surgery (IPRA), Jacques Cartier Private Hospital, Massy, France
(Durand) Pole Anesthesie-Reanimation, CHU Grenoble Alpes, Grenoble, France
(Bougle) Sorbonne Universite, Paris, France
(Bougle) Department of Anesthesiology and Critical Care Medicine,
Institute of Cardiology, Pitie-Salpetriere Hospital, APHP, Paris, France
(Kerforne) INSERM U1082, Ischemie Reperfusion en Transplantation
Modelisation et Innovations Therapeutiques, Universite de Poitiers,
Faculte de Medecine, Poitiers, France
(Kerforne) Service d'Anesthesie, Reanimation et Medecine Peri-Operatoire,
CHU Poitiers, Poitiers, France
(Consigny, Eddi) Direction de la Recherche Clinique et de l'Innovation
(DRCI), CHU Brest, Brest, France
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Incidence of delirium after cardiac surgery remains high and
delirium has a significant burden on short-term and long-term outcomes.
Multiple causes can trigger delirium occurence, and it has been
hypothesised that sleep disturbances can be one of them. Preserving the
circadian rhythm with overnight infusion of low-dose dexmedetomidine has
been shown to lower the occurrence of delirium in older patients after
non-cardiac surgery. However, these results remain controversial. The aim
of this study was to demonstrate the usefulness of sleep induction by
overnight infusion of dexmedetomidine to prevent delirium after cardiac
surgery. METHODS AND ANALYSIS: Dexmedetomidine after Cardiac Surgery for
Prevention of Delirium is an investigator-initiated, randomised,
placebo-controlled, parallel, multicentre, double-blinded trial. Nine
centres in France will participate in the study. Patients aged 65 years or
older and undergoing cardiac surgery will be enrolled in the study. The
intervention starts on day 0 (the day of surgery) until intensive care
unit (ICU) discharge; the treatment is administered from 20:00 to 08:00 on
the next day. Infusion rate is modified by the treating nurse or the
clinician with an objective of Richmond Agitation and Sedation Scale score
from -1 to +1. The primary outcome is delirium occurrence evaluated with
confusion assessment method for the ICU two times per day during 7days
following surgery. Secondary outcomes include incidence of agitation
related events, self-evaluated quality of sleep, cognitive evaluation 3
months after surgery and quality of life 3 months after surgery. The
sample size is 348. ETHICS AND DISSEMINATION: The study was approved for
all participating centers by the French Central Ethics Committee (Comite
de Protection des Personnes Ile de France VI, registration number
2018-000850-22). The results will be submitted for publication in
peer-reviewed journals. TRIAL REGISTRATION NUMBER:
NCT03477344.<br/>Copyright &#xa9; 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.

<14>
Accession Number
637262131
Title
Meta-Analysis Comparing Direct Oral Anticoagulants Versus Vitamin K
Antagonists in Patients With Atrial Fibrillation Who Underwent
Bioprosthetic Valve Replacement.
Source
The American journal of cardiology. 169 (pp 148-149), 2022. Date of
Publication: 15 Apr 2022.
Author
Shaikh S.; Mohamed M.M.G.; Osman M.; Kheiri B.
Institution
(Shaikh, Mohamed) Internal Medicine Department, SSM Health St. Mary's
Hospital-St. Louis, St Louis, MO, United States
(Osman, Kheiri) Knight Cardiovascular Institute, Oregon Health & Science
University, Portland, Oregon
Publisher
NLM (Medline)

<15>
Accession Number
637262077
Title
Meta-Analysis Investigating the Efficacy and Safety of the MANTA Versus
ProGlide Vascular Closure Devices After Transcatheter Aortic Valve
Implantation.
Source
The American journal of cardiology. 169 (pp 151-154), 2022. Date of
Publication: 15 Apr 2022.
Author
Al-Abcha A.; Saleh Y.; Halboni A.; Wang E.; Salam M.F.; Abela G.
Institution
(Al-Abcha, Wang, Salam) Department of Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Saleh) Department of Cardiology, Houston Methodist DeBakey Heart &
Vascular Center, Houston, Texas; Department of Cardiology, Alexandria
University, Alexandria, Egypt. Electronic address: alabchaa@msu.edu
(Halboni) Department of Internal Medicine, Wayne State University/Detroit
Medical Center, Detroit, MI, United States
(Abela) Department of Cardiology, Michigan State University, East Lansing,
MI, United States
Publisher
NLM (Medline)

<16>
Accession Number
637119224
Title
ABCDEF pulmonary rehabilitation program can improve the mid-term lung
function of lung cancer patients after thoracoscopic surgery: A randomized
controlled study.
Source
Geriatric nursing (New York, N.Y.). 44 (pp 76-83), 2022. Date of
Publication: 01 Mar 2022.
Author
Zou H.; Qin Y.; Gong F.; Liu J.; Zhang J.; Zhang L.
Institution
(Zou, Qin, Gong) Department of Nursing, Hunan Provincial People's
Hospital, First Affiliated Hospital of Hunan Normal University, Changsha
410005, China
(Liu, Zhang) Medical College of Hunan Normal University, Changsha 410013,
China
(Zhang) Department of Cardiothoracic, Hunan Provincial People's Hospital,
First Affiliated Hospital of Hunan Normal University, Changsha 410005,
China
Publisher
NLM (Medline)
Abstract
Background Pulmonary rehabilitation is recommended for most patients with
lung diseases. However, some previous studies have shown that pulmonary
rehabilitation has no obvious effect on short-term lung function in
patients with lung cancer. Objective The purpose of this study was to
evaluate the effect of the ABCDEF pulmonary rehabilitation program on lung
cancer patients who have undergone surgery. Design This was a randomized
controlled trial with repeated measures. Settings The study was conducted
in the Cardiothoracic Surgery Department of a 4000-bed comprising training
and research hospital from 2019 to 2020. Participants A total of 90
patients who underwent thoracoscopic pneumonectomy were divided into two
groups of 45, using a completely randomized model. Methods Patients in the
experimental group participated in an ABCDEF program (Acapella positive
vibration pressure training, breathing exercise, cycling training, dance
in the square, education, and follow-up) after surgery. In contrast, the
regular care provided to the control group focused on breathing and
expectoration guidance. The study outcomes were the first second (FEV1),
forced vital capacity (FVC), FEV1/FVC ratio, 6 min walking distance, Borg
score, incidence of postoperative complications, length of indwelling
chest tube, and length of postoperative stay. Generalized estimating
equation models were used to compare the changes in the outcomes between
the groups over time. Results The ABCDEF pulmonary rehabilitation program
for patients who underwent thoracoscopic pneumonectomy was found to be
more effective in increasing lung function at 3 months after discharge
(p<0.05). However, there was no statistically significant difference on
the day of discharge (p>0.05). Exercise tolerance was different at both
time points (p<0.05). The incidence of postoperative complications in the
experimental group was lower than that in the control group (p<0.05). The
length of postoperative stay in the experimental group was also shorter
(p<0.05), however, the length of the indwelling chest tube was not
significantly different between the intervention and control groups
(p>0.05). Conclusions This study showed that the ABCDEF pulmonary
rehabilitation program could effectively improve mid-term lung function
and exercise tolerance in patients after thoracoscopic pneumonectomy, and
reduce the incidence of postoperative complications along with the length
of postoperative hospital stay.<br/>Copyright &#xa9; 2022 Elsevier Inc.
All rights reserved.

<17>
Accession Number
637726373
Title
The Wattson temporary pacing guidewire for transcatheter heart valve
implantation.
Source
Future Cardiology. 18(4) (pp 275-283), 2022. Date of Publication: April
2022.
Author
Carey J.; Buckley A.; O'Connor S.; Hensey M.
Institution
(Carey, Buckley, O'Connor, Hensey) St James's Hospital, James St, Dublin,
Ireland
Publisher
Future Medicine Ltd.
Abstract
Transcatheter aortic valve implantation and implantation of other
transcatheter heart valves, generally requires insertion of a temporary
venous pacemaker. Implantation of a temporary venous pacemaker adds
complexity, time and risk to the procedure. Guidewire modification to
allow pacing is increasingly popular, however it requires technical
expertise and provides unipolar pacing resulting in high thresholds and
potential capture loss. The Wattson temporary pacing guidewire is a novel
device which offers guidewire support for valve delivery and concomitant
bipolar pacing. It may offer a safe and effective solution to guidewire
pacing for transcatheter aortic valve implantation and other transcatheter
heart valve implantations. Herein, we review the literature surrounding
left ventricular guidewire pacing along with the features and clinical
data of the Wattson wire. <br/>Copyright &#xa9; 2021 Future Medicine Ltd.

<18>
Accession Number
637726207
Title
Hybrid coronary revascularization in multivessel coronary artery disease:
A systematic review.
Source
Future Cardiology. 18(3) (pp 219-234), 2022. Date of Publication: March
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 00128, Italy
(Nappi) Cardiac Surgery, Centre Cardiologique du Nord, Rue des Moulins
Gemeaux 32, Saint Denis, Paris 93200, France
(Spadaccio) Cardiac Surgery, Golden Jubilee National Hospital, Agamemnon
St, Clydebank, Glasgow G814DY, United Kingdom
(Greco, Pilato) Cardiac Surgery, ISMETT-IRCCS, Via Ernesto Tricomi 5,
Palermo 90127, Italy
Publisher
Future Medicine Ltd.
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.
<br/>Method(s): Major databases searched until October 2021.
<br/>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.
<br/>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.<br/>Copyright &#xa9; 2022 Future Medicine Ltd.

<19>
Accession Number
2017574401
Title
Effects of Pre-Surgical Education and Physical Therapy Training for
Dyspnea Prevention in Patients Undergoing Valvular Cardiac Surgery.
Source
Pakistan Journal of Medical and Health Sciences. 16(2) (pp 518-520), 2022.
Date of Publication: February 2022.
Author
Ibrar I.; Shabbir S.; Ahmad H.; Zafar M.; Hassan T.; Waheed M.
Institution
(Ibrar) The University of Faisalabad. Consultant physiotherapist at
mahfooz clinic and kidney care center, Pakistan
(Shabbir) Fcps-1 Mass Vaccination Center, Faisalabad, Pakistan
(Ahmad) Fcps-1 COVID Vaccination, Chiniot, Pakistan
(Zafar) Department of anesthesia Mayo hospital, Lahore, Pakistan
(Hassan) Government College University Faisalabad, In Government College
University, Faisalabad, Pakistan
(Waheed) Department of anesthesia Mayo hospital, Lahore, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Objective: To evaluate the Effects of Pre-operative education and physical
therapy training for dyspnea prevention in patients undergoing valvular
cardiac surgery. <br/>Method(s): A Prospective RCT was performed on sample
size of 40 patients of cardiac valvular disease that were obtain from
Faisalabad Institute of cardiology. At the time of admission, all patients
were tested by baseline dyspnea index then the subjects were randomly
assigned into two groups by computerized random generator. Both groups
were having education but treatment group were having additional breathing
exercises and functional tasks for 10 minutes in 1st week regularly and 1
hour in 2nd week regularly. Each group were tested again by BDI after the
treatment on second post-op day. Tracheal extubation and eye-opening time
were also noted as outcome measures of study. Results were compiled on
SPSS.20 for finding post-operative dyspnea. <br/>Result(s): Pre-operative
and post-operative findings showed that the patients of treatment group
performed better than control group as the effects of pre-operative
treatment on dyspnea by total baseline dyspnea index is significant
(p<0.05) as well as the treatment group had significant reduction in
eye-opening and tracheal extubation time in comparison of control group
having (p<0.05). <br/>Conclusion(s): The results shows that in patients of
valvular cardiac surgery, pre-surgical education and physical therapy
training showed significant reduction in post-surgical dyspnea, tracheal
extubation and eye-opening time.<br/>Copyright &#xa9; 2022 Lahore Medical
And Dental College. All rights reserved.

<20>
Accession Number
2017658816
Title
Design of a pragmatic clinical trial embedded in the Electronic Health
Record: The VA's Diuretic Comparison Project.
Source
Contemporary Clinical Trials. 116 (no pagination), 2022. Article Number:
106754. Date of Publication: May 2022.
Author
Ishani A.; Leatherman S.M.; Woods P.; Hau C.; Klint A.; Lew R.A.; Taylor
A.A.; Glassman P.A.; Brophy M.T.; Fiore L.D.; Ferguson R.E.; Cushman W.C.
Institution
(Ishani) Minneapolis VA Health Care System, Department of Medicine,
University of Minnesota, Minneapolis, MN, United States
(Leatherman, Woods, Hau, Klint) Boston Cooperative Studies Program
Coordinating Center, VA Boston Healthcare System, Boston, MA, United
States
(Lew) Boston Cooperative Studies Program Coordinating Center, VA Boston
Healthcare System, Boston University School of Public Health, Boston, MA,
United States
(Taylor) Michael E. DeBakey VA Medical Center, Baylor College of Medicine,
Houston, TX, United States
(Glassman) Pharmacy Benefits Management Services, Department of Veterans
Affairs, VA Greater Los Angeles Healthcare System, David Geffen School of
Medicine at UCLA, Los Angeles, CA, United States
(Brophy, Fiore, Ferguson) Boston Cooperative Studies Program Coordinating
Center, VA Boston Healthcare System, Boston University School of Medicine,
Boston, MA, United States
(Cushman) Department of Preventive Medicine, University of Tennessee
Health Science Center, United States
Publisher
Elsevier Inc.
Abstract
Background: Recent US guidelines recommend chlorthalidone over other
thiazide-type diuretics for the treatment of hypertension based on its
long half-life and proven ability to reduce CVD events. Despite
recommendations most clinicians prescribe hydrochlorothiazide (HCTZ) over
chlorthalidone (CTD). No randomized controlled data exist comparing these
two diuretics on cardiovascular outcomes. <br/>Method(s): The Diuretic
Comparison Project (DCP) is a multicenter, two-arm, parallel, Prospective
Randomized Open, Blinded End-point (PROBE) trial testing the primary
hypothesis that CTD is superior to HCTZ in the prevention of non-fatal CVD
events and non-cancer death. Patients with hypertension taking HCTZ 25 or
50 mg were randomly assigned to either continue their current HCTZ or
switch to an equipotent dose of CTD. The primary outcome is time to the
first occurrence of a composite outcome consisting of a non-fatal CVD
event (stroke, myocardial infarction, urgent coronary revascularization
because of unstable angina, or hospitalization for acute heart failure) or
non-cancer death. The trial randomized 13,523 patients at 72 VA medical
centers. The study is conducted by a centralized research team with site
procedures embedded in the electronic health record and all data collected
through administrative claims data, with no study related visits for
participants. The trial will have 90% power to detect an absolute
reduction in the composite event rate of 2.4%. <br/>Result(s): Enrollment
ended in November 2021. There are 4128 participting primary care providers
and 16,595 patients individually consented to participate, 13,523 of whom
were randomized. <br/>Conclusion(s): DCP should provide much needed
evidence as to whether CTD is superior to HCTZ in preventing
cardiovascular events in hypertensive patients. Clinical trial
registration: NCT02185417
[https://clinicaltrials.gov/ct2/show/NCT02185417].<br/>Copyright &#xa9;
2022

<21>
Accession Number
2017484823
Title
Evaluation of the Preventive Effect of Selenium on Acute Kidney Injury
Following On-pump Cardiac Surgery.
Source
Iranian Red Crescent Medical Journal. 23(9) (no pagination), 2021. Article
Number: e377. Date of Publication: 14 Sep 2021.
Author
Zeraati A.A.; Amini S.; Samadi M.; Mortazi H.; Zeraati T.; Samadi K.
Institution
(Zeraati, Samadi, Samadi) Kidney Transplantation Complications Research
Center, Department of Internal Medicine, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Amini, Mortazi, Zeraati) Lung Research Center, Imam Reza Hospital, School
of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,
Islamic Republic of
Publisher
ZamenPub
Abstract
Background: Patients undergoing on-pump cardiac surgery are at risk of
postoperative acute kidney injury (AKI). This is mainly due to some
ischemic events and also pre-and postoperative stress responses which can
result in postoperative organ dysfunction. Selenium (Se) as an antioxidant
may help reduce inflammation and subsequent related complications.
<br/>Objective(s): This study aimed to test if administration of oral Se
complement before and after the on-pump cardiac surgery can reduce the
incidence or severity of AKI following the operation. <br/>Method(s): In
this randomized double-blind trial, the patients who were a candidate for
on-pump cardiac surgery were randomly divided into two groups of
intervention and control who received Se (n=60) or nothing (n=60),
respectively. In the Se group, 500 mug of Se was administrated orally 14
and 2 h before surgery and every 12 h postoperatively for 2 days (overall
3000 mug), while the control group only received the routine and standard
care. The patients were closely observed for the incidence and severity of
postoperative AKI, using both Risk/Injury/Failure/Loss/End-stage (RIFLE)
and the Acute Kidney Injury Network (AKIN) criteria. <br/>Result(s): The
study sample included 46 (38.3%) males and 74 (61.7%) females with a
mean+/-SD age of 52.8+/-16.7 years. Both groups were similar in terms of
demographic characteristics, comorbidities, and Euro-SCORE. According to
the RIFLE criteria, AKI occurred in 11 (17.9%) and 13 (21.4%) patients in
the Se and control group, respectively. However, based on AKIN criteria,
there were 17 (28.6%) and 21 (35.7%) cases of AKI in the Se and the
control group, respectively (P=0.73). The most frequent stage of AKI among
patients was the first stage in both groups and the highest rate of AKI
was observed within 3-4 days after the surgery in both groups.
<br/>Conclusion(s): The obtained results did not approve the effect of Se
in AKI prevention in coronary artery bypass grafting
patients.<br/>Copyright &#xa9; 2021 Author(s).

<22>
Accession Number
2017549955
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. (no pagination), 2022. Date of Publication:
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, United States
(Basken) Conquering Chd, Madison, WI, United States
(Acosta) A+J Patient Advocacy, Llc, Las Vegas, NV, 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, United States
Publisher
Cambridge University Press
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; The Author(s), 2022.
Published by Cambridge University Press.

<23>
Accession Number
637729832
Title
Efficacy and safety of Triiodothyronine (T3) treatment in Cardiac Surgery
or Cardiovascular Diseases - a Systematic Review and Meta-analysis of
Randomized Controlled Trials.
Source
Thyroid : official journal of the American Thyroid Association. (no
pagination), 2022. Date of Publication: 10 Apr 2022.
Author
Tharmapoopathy M.; Thavarajah A.; Kenny R.P.; Pingitore A.; Iervasi G.;
Dark J.; Bano A.; Razvi S.
Institution
(Tharmapoopathy, Thavarajah, Dark) Newcastle University Faculty of Medical
Sciences, 12186, Newcastle upon Tyne, Newcastle upon Tyne , United Kingdom
of Great Britain and Northern Ireland;
(Kenny) Newcastle University, 5994, Newcastle upon Tyne, Tyne and Wear,
United Kingdom of Great Britain and Northern Ireland;
(Pingitore) IFC CNR, 117072, Pisa, Toscana, Italy; pingi@ifc.cnr.it
(Iervasi) C.N.R., Clinical Physiology Institute, Via Moruzzi 1, Pisa,
Italy, 56100;
(Bano) University of Bern, 27210, Institute of Social and Preventive
Medicine, Mittelstrasse 43, Bern, BE, Switzerland, 3012;
(Razvi) Newcastle University, 5994, Translational and Clinical Research
Institute, East Wing, International Centre for Life, Central Square,
Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland,
NE1 3BZ;
Publisher
NLM (Medline)
Abstract
BACKGROUND: Low levels of the active thyroid hormone triiodothyronine (T3)
in cardiac patients are associated with worse outcomes. The aim of this
analysis was to assess if T3 treatment is beneficial and safe in patients
undergoing cardiac surgery or those with cardiovascular diseases in whom
there is observed or expected reduction in serum T3 levels.
<br/>METHOD(S): A systematic review and meta-analysis of randomized
controlled trials (RCTs) was performed as per the PRISMA guidelines.
Pubmed, Embase and Web of Science databases were searched for RCTs
published between 1st January 1960 and 30th March 2022 that evaluated the
effects of T3 therapy in patients undergoing cardiac surgery or with
cardiovascular diseases. The primary outcomes were measures of cardiac
function. Weighted mean difference (MD) or relative risk were calculated
using a random effects model. PROSPERO registration no. CRD42020211966
Results: Of the 3181 full-text articles screened, 34 studies with 2547
participants (number ranging between 13 to 223, mean ages between 0.5 to
73 years, mean percentage of women between 7 to 64%) were included. In 12
RCTs with 1093 adults undergoing cardiac surgery T3 therapy was associated
with improvement in cardiac index (MD [95% CI], 0.24 [0.08 to 0.40]
L/min/m2, I2=74%). The quality of evidence was high to moderate. In 3 RCTs
with 188 children undergoing cardiac surgery, 3 RCTs with 131 adult
cardiac donors, 3 RCTs with 83 adult patients with heart failure, and 2
RCTs with 89 adults with acute myocardial infarction, T3 therapy did not
improve cardiac index or left ventricular function; the quality of
evidence ranged from high (paediatric cardiac surgery) to low (other
groups). No detrimental effect of T3 therapy was observed on heart rate,
risk of in-hospital atrial fibrillation or mortality. <br/>CONCLUSION(S):
Short-term T3 therapy is safe and trials in adults undergoing cardiac
surgical procedures to evaluate longer term clinical endpoints are
required. Current data does not support the routine use of T3 therapy in
children undergoing cardiac surgery or in cardiac donors. Adequately
designed trials are required to determine if T3 therapy improves cardiac
function and clinical outcomes in patients with heart failure or acute
myocardial infarction.

<24>
Accession Number
637719536
Title
Incorporating Insulin Growth Factor-1 into Regenerative and Personalized
Medicine for Cardiovascular Disease: A Systematic Review.
Source
Current stem cell research & therapy. (no pagination), 2022. Date of
Publication: 07 Apr 2022.
Author
Gan Q.F.; Lim Y.T.; Foo C.N.; Yu C.W.; Woon C.K.; Cheong S.K.; Leong P.P.
Institution
(Gan, Leong) Pre-clinical Department, Faculty of Medicine and Health
Science, UTAR Sg Long Campus, Selangor, Malaysia
(Lim) Intensive Care Unit, Assunta Hospital, Jalan Templer, Petaling Jaya,
Selangor, Malaysia
(Foo) Population Medicine Department, Faculty of Medicine and Health
Science, UTAR Sg Long Campus, Selangor, Malaysia
(Yu) Faculty of Allied Health Science, Bedong, Kedah, Malaysia
(Woon) Department of Anatomy, Faculty of Medicine, Sungai Buloh,
Universiti Teknologi MARA, Selangor, Malaysia
(Cheong) Medicine Department, Faculty of Medicine and Health Sciences,
UTAR Sg Long Campus, Selangor, Malaysia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiovascular disease (CVD) is one of the world's leading
causes of increased morbidity and mortality. Current interventions for
CVD, including percutaneous transluminal coronary angioplasty (PTCA) and
coronary artery bypass grafting (CABG), carry certain risks and
complications which may also affect the patient's quality of life. It is
important to minimize those risks and complications while speeding up the
recovery. Insulin Growth Factor-1 (IGF-1) is a growth factor responsible
for cellular migration, proliferation, differentiation, and angiogenesis,
which supports cardiovascular regeneration. <br/>METHOD(S): In light of
the current trend of regenerative medicine, the present review aims to
pool data relating to the incorporation of IGF-1 in regenerative medicine
and provide input on the current research gaps and concerns arising on
translating this approach from benchwork into clinical settings.
<br/>RESULT(S): Using the keywords IGF-1 'OR' Insulin Growth Factor 1
'AND' Mesenchymal Stem Cells 'AND' Tissue Healing from 2009 up to present
2020, we identified 160 and 52 from Medline and PubMed, screening out 202
articles due to non-fulfilment of the inclusion criteria.
<br/>CONCLUSION(S): Incorporating IGF-1 into regenerative and personalized
medicine may be promising for treating CVD; however, the concerns include
the role of IGF-1 in inducing cancer growth and its ability tomigrate to
the specific site of injury, especially for those who present with
multiple pathologies should be address prior to its translation from bench
work into clinical settings.<br/>Copyright&#xa9; Bentham Science
Publishers; For any queries, please email at epub@benthamscience.net.

<25>
Accession Number
637719520
Title
Aggressive intraoperative warming versus routine thermal management during
non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority
trial.
Source
Lancet (London, England). (no pagination), 2022. Date of Publication: 01
Apr 2022.
Author
Sessler D.I.; Pei L.; Li K.; Cui S.; Chan M.T.V.; Huang Y.; Wu J.; He X.;
Bajracharya G.R.; Rivas E.; Lam C.K.M.
Institution
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, USA; Population Health Research
Institute, McMaster University, ON, Canada. Electronic address: DS@OR.org
(Pei) Department of Anesthesiology, Peking Union Medical College Hospital,
Beijing, China
(Li, Cui) China-Japan Union Hospital of Jilin University, Jilin, China
(Chan) Chinese University of Hong Kong, Hong Kong Special Administrative
Region, China
(Huang) Department of Anesthesiology, Peking Union Medical College
Hospital, Beijing, China
(Wu) Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai,
China
(He) West China Hospital, Sichuan University, Sichuan, China
(Bajracharya) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, USA
(Rivas) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, USA; Department of Anesthesia, Hospital
Clinic of Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
(Lam) Tuen Mun Hospital, Hong Kong Special Administrative Region, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Moderate intraoperative hypothermia promotes myocardial
injury, surgical site infections, and blood loss. Whether aggressive
warming to a truly normothermic temperature near 37degreeC improves
outcomes remains unknown. We aimed to test the hypothesis that aggressive
intraoperative warming reduces major perioperative complications.
<br/>METHOD(S): In this multicentre, parallel group, superiority trial,
patients at 12 sites in China and at the Cleveland Clinic in the USA were
randomly assigned (1:1) to receive either aggressive warming to a target
core temperature of 37degreeC (aggressively warmed group) or routine
thermal management to a target of 35.5degreeC (routine thermal management
group) during non-cardiac surgery. Randomisation was stratified by site,
with computer-generated, randomly sized blocks. Eligible patients (aged
>=45 years) had at least one cardiovascular risk factor, were scheduled
for inpatient non-cardiac surgery expected to last 2-6 h with general
anaesthesia, and were expected to have at least half of the anterior skin
surface available for warming. Patients requiring dialysis and those with
a body-mass index exceeding 30 kg/m2 were excluded. The primary outcome
was a composite of myocardial injury (troponin elevation, apparently of
ischaemic origin), non-fatal cardiac arrest, and all-cause mortality
within 30 days of surgery, as assessed in the modified intention-to-treat
population. This study is registered with ClinicalTrials.gov, NCT03111875.
FINDINGS: Between March 27, 2017, and March 16, 2021, 5056 participants
were enrolled, of whom 5013 were included in the intention-to-treat
population (2507 in the aggressively warmed group and 2506 in the routine
thermal management group). Patients assigned to aggressive warming had a
mean final intraoperative core temperature of 37.1degreeC (SD 0.3) whereas
the routine thermal management group averaged 35.6degreeC (SD 0.3). At
least one of the primary outcome components (myocardial injury after
non-cardiac surgery, cardiac arrest, or mortality) occurred in 246 (9.9%)
of 2497 patients in the aggressively warmed group and in 239 (9.6%) of
2490 patients in the routine thermal management group. The common effect
relative risk of aggressive versus routine thermal management was an
estimated 1.04 (95% CI 0.87-1.24, p=0.69). There were 39 adverse events in
patients assigned to aggressive warming (17 of which were serious) and 54
in those assigned to routine thermal management (30 of which were
serious). One serious adverse event, in an aggressively warmed patient,
was deemed to be possibly related to thermal management. INTERPRETATION:
The incidence of a 30-day composite of major cardiovascular outcomes did
not differ significantly in patients randomised to 35.5degreeC and to
37degreeC. At least over a 1.5degreeC range from very mild hypothermia to
full normothermia, there was no evidence that any substantive outcome
varied. Keeping core temperature at least 35.5degreeC in surgical patients
appears sufficient. FUNDING: 3M and the Health and Medical Research Fund,
Food and Health Bureau, Hong Kong. TRANSLATION: For the Chinese
translation of the abstract see Supplementary Materials
section.<br/>Copyright &#xa9; 2022 Elsevier Ltd. All rights reserved.

<26>
Accession Number
2017264256
Title
Pocket hematoma after pacemaker or defibrillator surgery: Direct oral
anticoagulants versus vitamin K antagonists.
Source
IJC Heart and Vasculature. 39 (no pagination), 2022. Article Number:
101005. Date of Publication: April 2022.
Author
de Heide J.; van der Graaf M.; Holl M.J.; Bhagwandien R.E.; Theuns
D.A.M.J.; de Wit A.; Zijlstra F.; Szili-Torok T.; Lenzen M.J.; Yap S.-C.
Institution
(de Heide, van der Graaf, Holl, Bhagwandien, Theuns, de Wit, Zijlstra,
Szili-Torok, Lenzen, Yap) Department of Cardiology, Erasmus MC, University
Medical Center Rotterdam, Rotterdam, the Netherlands. All authors take
responsibility for all aspects of the reliability and freedom from bias of
the data presented and their discussed interpretation
Publisher
Elsevier Ireland Ltd
Abstract
Background: Direct oral anticoagulants (DOACs) are the preferred choice of
oral anticoagulation in patients with atrial fibrillation (AF). Randomized
trials have demonstrated the efficacy and safety of DOAC in patients
undergoing a cardiac implantable electronic device procedure (CIED);
however, there is limited real-world data. <br/>Objective(s): To evaluate
the outcome of patients undergoing an elective CIED procedure in a
tertiary referral center with an interrupted DOAC or continued vitamin K
antagonist (VKA) regimen. <br/>Method(s): This was a retrospective
single-center study of consecutive patients with AF undergoing an elective
CIED procedure between January 2016 and June 2019. The primary endpoint
was a clinically significant pocket hematoma < 30 days after surgery. The
secondary endpoint was any systemic thromboembolic complication < 30 days
after surgery. <br/>Result(s): Of a total of 1,033 elective CIED
procedures, 283 procedures were performed in patients with AF using oral
anticoagulation. One-third of the procedures were performed under DOAC (N
= 81, 29%) and the remainder under VKA (N = 202, 71%). The DOAC group was
younger, had less chronic renal disease, more paroxysmal AF and a lower
HAS-BLED score. The VKA group more often underwent a generator change only
in comparison to the DOAC group. Clinically significant pocket hematoma
occurred in 5 patients (2.5%) in the VKA group and did not occur in the
DOAC group (P = 0.33). There were no thromboembolic events reported.
<br/>Conclusion(s): In patients with AF undergoing an elective CIED
procedure, the risk of a pocket hematoma and a systemic thromboembolic
event is comparably low when using either continued VKA or interrupted
DOAC.<br/>Copyright &#xa9; 2022 The Author(s)

<27>
Accession Number
2015496045
Title
Comparison of left double lumen tube and y-shaped and double-ended
bronchial blocker for one lung ventilation in thoracic surgery-a
randomised controlled clinical trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 92. Date
of Publication: December 2022.
Author
Risse J.; Szeder K.; Schubert A.-K.; Wiesmann T.; Dinges H.-C.; Feldmann
C.; Wulf H.; Meggiolaro K.M.
Institution
(Risse) Center of Emergency Medicine, University Hospital Essen, Essen,
Germany
(Risse, Szeder, Schubert, Wiesmann, Dinges, Feldmann, Wulf, Meggiolaro)
Department of Anesthesiology and Intensive Care Medicine,
Philipps-University, Marburg, Germany
(Wiesmann) Department of Anesthesiology and Operative Intensive Care
Medicine, Diakoneo Diak Hospital Schwabisch Hall gGmbH, Schwabisch Hall,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Double lumen tube (DLT) intubation is the most commonly used
technique for one lung ventilation. Bronchial blockers (BB) are an
alternative, especially for difficult airways. The EZ-bronchial blocker
(EZB) is an innovative y-shaped and double-ended device of the BB family.
<br/>Method(s): A randomised, controlled trial was conducted in 80
patients undergoing elective thoracic surgery using DLT or EZB for one
lung ventilation (German Clinical Trial Register DRKS00014816). The
objective of the study was to compare the clinical performance of EZB with
DLT. Primary endpoint was total time to obtain successful one lung
ventilation. Secondary endpoints were time subsections, quality of lung
collapse, difficulty of intubation, any complications during the
procedure, incidence of objective trauma of the oropharynx and
supraglottic space and intubation-related subjective symptoms.
<br/>Result(s): 74 patients were included, DLT group (n = 38), EZB group
(n = 36). Median total time to obtain one lung ventilation [IQR] in the
DLT group was 234 s [207 to 294] versus 298 s [243 to 369] in the EZB
group (P = 0.007). Median total time was relevantly influenced by
different preparation times. Quality of lung collapse was equal in both
groups, DLT group 89.5% were excellent vs. 83.3% in the EZB group (P =
0.444). Inadequate lung collapse in five patients of the EZB group
resulted in unsuccessful repositioning attempts and secondary DLT
placement. Endoscopic examinations revealed significantly more carina
trauma (P = 0.047) and subglottic haemorrhage (P = 0.047) in the DLT
group. Postoperative subjective symptoms (sore throat, hoarseness) were
more common in the DLT group, as were speech problems. <br/>Conclusion(s):
Using EZB prima facie results in prolonged time to obtain one lung
ventilation with equal quality of lung collapse for the thoracic surgeon.
If preparation times are omitted in the analysis, the time difference is
statistically and clinically not relevant. Our data showed only little
evidence for reducing objective airway trauma as well as subjective
complaints. In summary both procedures were comparable in terms of times
and clinical applicability. Therefore decisions for DLT or EZB should
depend more on individual experience, in-house equipment and the
individual patient, than on any times that are neither clinically
significant nor relevant. Trial registration: German Clinical Trial
Register DRKS00014816, prospectively registered on
07.06.2018<br/>Copyright &#xa9; 2022, The Author(s).

<28>
Accession Number
2014939157
Title
Steroid Use for Recovery of advanced atrioVentricular block Immediately
after VALvular surgery (SURVIVAL): A preliminary randomized clinical
trial.
Source
Journal of Cardiovascular Electrophysiology. 33(4) (pp 575-585), 2022.
Date of Publication: April 2022.
Author
Ghodsi S.; Masoudkabir F.; Hosseini Z.; Davarpasand T.; Yavari N.; Mohebi
M.; Talasaz A.H.; Jalali A.; Ahmadi-Tafti S.H.; Bagheri J.; Hasanzadeh H.
Institution
(Ghodsi, Masoudkabir, Hosseini, Yavari, Mohebi, Jalali) Cardiac Primary
Prevention Research Center, Tehran Heart Center, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Masoudkabir, Davarpasand, Talasaz) Department of Cardiology, Tehran Heart
Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Ahmadi-Tafti, Bagheri, Hasanzadeh) Department of Cardiac Surgery, Tehran
Heart Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Atrioventricular block (AVB) is an important complication
following valvular surgery. Several factors including
inflammation-mediated injury might trigger AVB. <br/>Method(s): Patients
with advanced postoperative AVB were randomly assigned to receive either
dexamethasone (0.4 mg/kg, maximum 30 mg/day) intravenously for 3 days or
conservative care only. Primary endpoint was recovery rate in Day 5 since
randomization. Secondary endpoints were recovery rate in Day 7 and Day 10,
cumulative AVB time, permanent pacemaker (PPM) implantation rate, length
of stay in critical care units, and postoperative major adverse events
(MAE). <br/>Result(s): We enrolled 139 subjects (48.9% male) with mean age
of 59.9 years randomly allocated to intervention group (n = 69) and
control group (n = 70). Dexamethasone led to higher recovery rates at Day
5 (82.6% vs. 62.9%, p =.009) and Day 7 (88.4% vs. 61.4%, p <.0001)
respectively. This benefit ceased at Day 10 (83.05% vs. 78.6%, p =.547).
Median cumulative AVB time was shorter in dexamethasone group compared
with control group (41 h vs. 64 h, p =.044). PPM implantation rates were
similar between the dexamethasone and control groups (15.9% vs. 17.1%,
respectively, p =.849). Median length of stay in intensive care unit (ICU)
(10 days vs. 12 days, p =.03) and MAE (17.4% vs. 25.7%, p =.133) tended to
be lower with dexamethasone. <br/>Conclusion(s): Dexamethasone may serve
as a safe and effective medication to help hasten recovery of advanced AVB
after valvular surgery.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<29>
Accession Number
2015942951
Title
Role of pre-operative transthoracic echocardiography in predicting
post-operative atrial fibrillation after cardiac surgery: A systematic
review of the literature and meta-analysis.
Source
Europace. 23(11) (pp 1731-1743), 2021. Date of Publication: 01 Nov 2021.
Author
Kawczynski M.J.; Gilbers M.; Van De Walle S.; Schalla S.; Crijns H.J.;
Maessen J.G.; Schotten U.; Maesen B.; Bidar E.
Institution
(Kawczynski, Gilbers, Van De Walle, Maessen, Maesen, Bidar) Department of
Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University
Medical Centre, Professor Debyelaan 25, Maastricht 6229 HX, Netherlands
(Kawczynski, Gilbers, Maessen, Schotten, Maesen, Bidar) Department of
Physiology, Maastricht University, Maastricht, Netherlands
(Schalla, Crijns) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Schalla, Crijns) Department of Cardiology, Heart and Vascular Centre,
Maastricht University Medical Centre, Maastricht, Netherlands
(Schalla) Department of Radiology, Maastricht University Medical Centre,
Maastricht, Netherlands
Publisher
Oxford University Press
Abstract
Aims: This systematic review and meta-analysis aims to evaluate the role
of pre-operative transthoracic echocardiography in predicting
post-operative atrial fibrillation (POAF) after cardiac surgery.
<br/>Methods and Results: Electronic databases were searched for studies
reporting on pre-operative echocardiographic predictors of POAF in PubMed,
Cochrane library, and Embase. A meta-analysis of echocardiographic
predictors of POAF that were identified by at least five different
publications was performed. Forty-three publications were included in this
systematic review. Echocardiographic predictors for POAF included
surrogate parameters for total atrial conduction time (TACT), structural
cardiac changes, and functional disturbances. Meta-analysis showed that
prolonged pre-operative PA-TDI interval [5 studies, Cohen's d = 1.4, 95%
confidence interval (CI) 0.9-1.9], increased left atrial volume indexed
for body surface area (LAVI) (23 studies, Cohen's d = 0.8, 95% CI
0.6-1.0), and reduced peak atrial longitudinal strain (PALS) (5 studies,
Cohen's d = 1.4, 95% CI 1.0-1.8), were associated with POAF incidence.
Left atrial volume indexed for body surface was the most important
predicting factor in patients without a history of AF. These parameters
remained important predictors of POAF in heterogeneous populations with
variable age and comorbidities such as coronary artery disease and
valvular disease. <br/>Conclusion(s): This meta-analysis shows that
increased TACT, increased LAVI, and reduced PALS are valuable parameters
for predicting POAF in the early post-operative phase in a large variety
of patients.<br/>Copyright &#xa9; 2021 Published on behalf of the European
Society of Cardiology. All rights reserved.

<30>
Accession Number
2017578666
Title
Meta-Analysis of Percutaneous Coronary Intervention Versus Coronary Artery
Bypass Grafting for Left Main Narrowing.
Source
American Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Chew N.W.S.; Ng C.-H.; Kong G.; Lee K.-S.; Tan D.J.H.; Lim O.Z.-H.; Chin
Y.H.; Tai B.C.; Gu T.; Park S.-J.; Park D.-W.; Morice M.-C.; Kofidis T.;
Yip J.W.L.; Loh P.-H.; Chan K.-H.; Low A.F.; Lee C.-H.; Yeo T.-C.; Tan
H.-C.; Chan M.Y.
Institution
(Chew, Yip, Loh, Chan, Low, Lee, Yeo, Tan, Chan) Department of Cardiology,
National University Heart Centre, National University Health System,
Singapore
(Ng, Kong, Tan, Lim, Chin, Kofidis, Yip, Loh, Chan, Low, Lee, Yeo, Tan,
Chan) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
(Lee) Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Tai, Gu) Biostatistics & Modelling Domain, Saw Swee Hock School of Public
Health, National University of Singapore
(Park, Park) Division of Cardiology, Asan Medical Center, University of
Ulsan College of Medicine, Seoul, South Korea
(Morice) Cardiovascular European Research Center, Massy, France
(Kofidis) Department of Cardiac, Thoracic, Vascular Surgery, National
University Heart Centre, Singapore
Publisher
Elsevier Inc.
Abstract
Randomized controlled trials (RCTs) comparing percutaneous coronary
intervention (PCI) with drug-eluting stents and coronary artery bypass
grafting (CABG) for patients with left main coronary artery disease
(LMCAD) have reported conflicting results. We performed a systematic
review up to May 23, 2021, and 1-stage reconstructed individual patient
data meta-analysis (IPDMA) to compare outcomes between both groups. The
primary outcome was 10-year all-cause mortality. Secondary outcomes
included myocardial infarction (MI), stroke, and unplanned
revascularization at 5 years. We performed individual patient data
meta-analysis using published Kaplan-Meier curves to provide individual
data points in coordinates and numbers at risk were used to increase the
calibration accuracy of the reconstructed data. Shared frailty model or,
when proportionality assumptions were not met, a restricted mean survival
time model were fitted to compare outcomes between treatment groups. Of
583 articles retrieved, 5 RCTs were included. A total of 4,595 patients
from these 5 RCTs were randomly assigned to PCI (n = 2,297) or CABG (n =
2,298). The cumulative 10-year all-cause mortality after PCI and CABG was
12.0% versus 10.6%, respectively (hazard ratio [HR] 1.093, 95% confidence
interval [CI] 0.925 to 1.292; p = 0.296). PCI conferred similar time-to-MI
(restricted mean survival time ratio 1.006, 95% CI 0.992 to 1.021,
p=0.391) and stroke (restricted mean survival time ratio 1.005, 95% CI
0.998 to 1.013, p = 0.133) at 5 years. Unplanned revascularization was
more frequent after PCI than CABG (HR 1.807, 95% CI 1.524 to 2.144, p
<0.001) at 5 years. This meta-analysis using reconstructed
participant-level time-to-event data showed no statistically significant
difference in cumulative 10-year all-cause mortality between PCI versus
CABG in the treatment of LMCAD.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<31>
Accession Number
636992871
Title
Ivabradine and Atrial Fibrillation: A Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of cardiovascular pharmacology. 79(4) (pp 549-557), 2022. Date of
Publication: 01 Apr 2022.
Author
Wang Z.; Wang W.; Li H.; Zhang A.; Han Y.; Wang J.; Hou Y.
Institution
(Wang, Wang, Wang, Hou) Department of Cardiology, First Affiliated
Hospital of Shandong First Medical University and Shandong Provincial
Qianfoshan Hospital, Shandong Province, Jinan, China
(Li, Zhang) Cheeloo College of Medicine, Shandong University, Jinan,
Shandong Province, PR China; and
(Han) Department of Pharmacy, First Affiliated Hospital of Shandong First
Medical University and Shandong Provincial Qianfoshan Hospital, Shandong
Province, Jinan, China
Publisher
NLM (Medline)
Abstract
ABSTRACT: This was a meta-analysis of randomized control trials (RCTs) to
evaluate the effect of ivabradine on the risk of atrial fibrillation (AF)
and its effect on the ventricular rate in patients with AF. The PubMed,
EMBASE, Cochrane Controlled Trials Register, and other databases were
searched for RCTs on ivabradine. Thirteen trials with 37,533 patients met
the inclusion criteria. The incidence of AF was significantly higher in
the ivabradine treatment group than in the control group [odds ratio (OR),
1.23; 95% confidence interval (CI), 1.08-1.41], although it was reduced
after cardiac surgery (OR, 0.70; 95% CI, 0.23-2.12). Regarding left
ventricular ejection fraction (LVEF), ivabradine increased the risk of AF
in both LVEF >40% (OR, 1.42; 95% CI, 1.24-1.63) and LVEF <=40% subgroups
(OR, 1.16; 95% CI, 0.98-1.37). The risk of AF was increased by both small
and large cumulative doses of ivabradine (small cumulative dose: OR, 3.00;
95% CI, 0.48-18.93; large cumulative dose: OR, 1.05; 95% CI, 0.83-1.34).
Furthermore, ivabradine may reduce the ventricular rate in patients with
AF. In conclusion, we found that both large and small cumulative doses of
ivabradine were associated with an increased incidence of AF, and the
effect was more marked in the LVEF >40% subgroup. Nevertheless, ivabradine
therapy is beneficial for the prevention of postoperative AF. Furthermore,
ivabradine may be effective in controlling the ventricular rate in
patients with AF, although more RCTs are needed to support this
conclusion.<br/>Copyright &#xa9; 2022 Wolters Kluwer Health, Inc. All
rights reserved.

<32>
Accession Number
637713758
Title
Individual contributions of the KDIGO AKI care bundle's components for the
prevention of postoperative acute kidney injury (AKI).
Source
Critical Care. Conference: 41st International Symposium on Intensive Care
and Emergency Medicine. Brussels Belgium. 26(SUPPL 1) (no pagination),
2022. Date of Publication: 2022.
Author
Von Groote T.C.; Ostermann M.; Forni L.G.; Meersch M.; Zarbock A.; Weiss
R.
Institution
(Von Groote, Meersch, Zarbock, Weiss) University Hospital Munster,
Department of Anaesthesiology, Intensive Care and Pain Medicine, Munster,
Germany
(Ostermann) King's College London, Guy's and St Thomas' NHS Foundation
Hospital, Department of Intensive Care, London, United Kingdom
(Forni) University of Surrey, Department of Clinical and Experimental
Medicine, Guildford, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Introduction: The incidence and severity of postoperative acute kidney
injury (AKI) can be reduced by implementing an AKI care bundle as
developed by the Kidney Disease Improving Global Outcomes (KDIGO)
guidelines. However, the impact of each individual component of this
bundle was unclear and was therefore investigated in this analysis.
<br/>Method(s): Data of the two PrevAKI-trials were combined, together
including 554 cardiac surgery patients at high risk for AKI, as identified
by elevated urinary biomarkers TIMP-2 IGFBP7 [1, 2]. Patients were
randomized to standard of care versus implementation of the care bundle.
Univariate logistic regression of the bundle's components was performed as
a risk factor analysis of the whole cohort. Following this, individual
treatment effects were analyzed, using the same method for the
intervention group only. <br/>Result(s): Hypotension, low cardiac index,
and use of radiocontrast agents significantly increased the risk for AKI.
Similarly, optimizing the hemodynamic situation (i.e. avoiding hypotension
or a low cardiac output state) was the most important individual component
for the prevention of AKI. However, this was not the case for avoidance of
radiocontrast. Avoidance of nephrotoxic drugs was identified as an
important component in the individual treatment effect analysis, however
this finding showed wide confidence intervals (Table 1).
<br/>Conclusion(s): Our findings demonstrate the importance of maintaining
adequate systemic blood pressure and cardiac output. If hypotension or low
cardiac index occurs, timely hemodynamic optimization should be performed
to prevent AKI. Whilst our analyses suggested a possible role for
radiocontrast agents and nephrotoxic drugs, these factors had wide
confidence intervals, indicating low certainty of these findings. Besides
hemodynamic optimization, other bundle components had little or no impact
on the bundle's overall effectiveness. (Table Presented).

<33>
Accession Number
637713640
Title
Weight-adjusted dosing of fibrinogen concentrate and cryoprecipitate in
the treatment of hypofibrinogenemic bleeding adult cardiac surgical
patients: a post hoc analysis of the FIBRES randomized controlled trial.
Source
Critical Care. Conference: 41st International Symposium on Intensive Care
and Emergency Medicine. Brussels Belgium. 26(SUPPL 1) (no pagination),
2022. Date of Publication: 2022.
Author
Bartoszko J.; Devine C.; Callum J.; Karkouti K.
Institution
(Bartoszko, Karkouti) Women's College Hospital, University of Toronto,
Department of Anesthesia and Pain Management, Toronto, Canada
(Devine) University of Ottawa, Department of Anesthesiology and Pain
Medicine, Ottawa, Canada
(Callum) Kingston Health Sciences Centre, Kingston, Canada
Publisher
BioMed Central Ltd
Abstract
Introduction: While empiric dosing of fibrinogen replacement is widely
utilized and well-tolerated, it may be suboptimal in some cardiac surgery
patients, leading to inadequate bleeding control due to acquired
hypofibrinogenemia. This may lead to additional transfusion requirements,
impacting clinical outcomes. Our aim was to compare the efficacy and
safety of weight-adjusted vs. empiric dosing of fibrinogen replacement.
<br/>Method(s): This post-hoc analysis of the FIBRES randomized controlled
trial included adults experiencing clinically significant bleeding and
hypofibrinogenemia after cardiac surgery at 11 Canadian centers and
utilized empiric dosing of fibrinogen concentrate (FC; Fibryga,
Octapharma; 4 g) or cryoprecipitate (10 IU) [1]. Patients were grouped
into quartiles based on increasing weight-adjusted dosing of either
product. The primary outcome was the number of red blood cell (RBC) units
transfused within 24 h of cardiopulmonary bypass (CPB). <br/>Result(s):
The median weight-adjusted FC dose was 52 mg/kg (IQR 45-61; n = 372) and
1.30 U/10 kg (IQR 1.11-1.54; n = 363) for cryoprecipitate. In patients
receiving a single dose of either product where plasma fibrinogen level
was measured pre and post dosing, the increase in plasma fibrinogen was
higher with FC (0.96 g/l, IQR 0.74-1.28; n = 252) vs. cryoprecipitate
(0.78 g/l, IQR 0.52-1.00; n = 225; p < 0.0001). There was no difference
between patients in the quartile receiving the lowest weight-adjusted
doses compared to higher quartiles in the number of RBCs (Table 1) or
allogenic transfusions received within 24 h of CPB, return to the
operating room, or thromboembolic/ischemic complications within 28 days.
<br/>Conclusion(s): Transfusion and safety outcomes for low and high
weight-adjusted doses of fibrinogen replacement were comparable.
Weight-adjusted dosing does not appear to offer advantages over fixed
dosing in hypofibrinogenemic bleeding adult cardiac surgical patients.
(Table Presented).

<34>
[Use Link to view the full text]
Accession Number
2017432073
Title
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A
Report of the American College of Cardiology/American Heart Association
Joint Committee on Clinical Practice Guidelines.
Source
Circulation. 145(3) (pp E18-E114), 2022. Date of Publication: 18 Jan 2022.
Author
Lawton J.S.; Tamis-Holland J.E.; Bangalore S.; Bates E.R.; Beckie T.M.;
Bischoff J.M.; Bittl J.A.; Cohen M.G.; Dimaio J.M.; Don C.W.; Fremes S.E.;
Gaudino M.F.; Goldberger Z.D.; Grant M.C.; Jaswal J.B.; Kurlansky P.A.;
Mehran R.; Metkus T.S.; Nnacheta L.C.; Rao S.V.; Sellke F.W.; Sharma G.;
Yong C.M.; Zwischenberger B.A.
Publisher
Lippincott Williams and Wilkins
Abstract
AIM: The guideline for coronary artery revascularization replaces the 2011
coronary artery bypass graft surgery and the 2011 and 2015 percutaneous
coronary intervention guidelines, providing a patient-centric approach to
guide clinicians in the treatment of patients with significant coronary
artery disease undergoing coronary revascularization as well as the
supporting documentation to encourage their use. <br/>METHOD(S): A
comprehensive literature search was conducted from May 2019 to September
2019, encompassing studies, reviews, and other evidence conducted on human
subjects that were published in English from PubMed, EMBASE, the Cochrane
Collaboration, CINHL Complete, and other relevant databases. Additional
relevant studies, published through May 2021, were also considered.
STRUCTURE: Coronary artery disease remains a leading cause of morbidity
and mortality globally. Coronary revascularization is an important
therapeutic option when managing patients with coronary artery disease.
The 2021 coronary artery revascularization guideline provides
recommendations based on contemporary evidence for the treatment of these
patients. The recommendations present an evidence-based approach to
managing patients with coronary artery disease who are being considered
for coronary revascularization, with the intent to improve quality of care
and align with patients' interests.<br/>Copyright &#xa9; 2022 Lippincott
Williams and Wilkins. All rights reserved.

<35>
[Use Link to view the full text]
Accession Number
2017432065
Title
Comparison of a Pure Plug-Based Versus a Primary Suture-Based Vascular
Closure Device Strategy for Transfemoral Transcatheter Aortic Valve
Replacement: The CHOICE-CLOSURE Randomized Clinical Trial.
Source
Circulation. 145(3) (pp 170-183), 2022. Date of Publication: 18 Jan 2022.
Author
Abdel-Wahab M.; Hartung P.; Dumpies O.; Obradovic D.; Wilde J.; Majunke
N.; Boekstegers P.; Muller R.; Seyfarth M.; Vorpahl M.; Kiefer P.; Noack
T.; Leontyev S.; Sandri M.; Rotta Detto Loria J.; Kitamura M.; Borger
M.A.; Funkat A.-K.; Hohenstein S.; Desch S.; Holzhey D.; Thiele H.
Institution
(Abdel-Wahab, Hartung, Dumpies, Obradovic, Wilde, Majunke, Sandri, Rotta
Detto Loria, Kitamura, Desch, Thiele) Department Of Cardiology, Heart
Center Leipzig At University Of Leipzig, Germany
(Boekstegers, Muller) Department Of Cardiology, Helios Klinikum Siegburg,
Germany
(Boekstegers, Seyfarth, Vorpahl, Holzhey) Witten Herdecke University,
Germany
(Seyfarth, Vorpahl) Department Of Cardiology, Helios University Hospital
Wuppertal, Germany
(Kiefer, Noack, Leontyev, Borger, Holzhey) University Department Of
Cardiac Surgery, Heart Center Leipzig, Germany
(Funkat, Hohenstein) Leipzig Heart Institute, Germany
(Holzhey) Department Of Cardiac Surgery, Helios University Hospital
Wuppertal, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Transcatheter aortic valve replacement is an established
treatment option for patients with severe symptomatic aortic stenosis and
is most commonly performed through the transfemoral access route.
Percutaneous access site closure can be achieved using dedicated
plug-based or suture-based vascular closure device (VCD) strategies, but
randomized comparative studies are scarce. <br/>Method(s): The
CHOICE-CLOSURE trial (Randomized Comparison of Catheter-based Strategies
for Interventional Access Site Closure during Transfemoral Transcatheter
Aortic Valve Implantation) is an investigator-initiated, multicenter
study, in which patients undergoing transfemoral transcatheter aortic
valve replacement were randomly assigned to vascular access site closure
using either a pure plug-based technique (MANTA, Teleflex) with no
additional VCDs or a primary suture-based technique (ProGlide, Abbott
Vascular) potentially complemented by a small plug. The primary end point
consisted of access site- or access-related major and minor vascular
complications during index hospitalization, defined according to the Valve
Academic Research Consortium-2 criteria. Secondary end points included the
rate of access site- or access-related bleeding, VCD failure, and time to
hemostasis. <br/>Result(s): A total of 516 patients were included and
randomly assigned. The mean age of the study population was 80.5+/-6.1
years, 55.4% were male, 7.6% of patients had peripheral vascular disease,
and the mean Society of Thoracic Surgeons score was 4.1+/-2.9%. The
primary end point occurred in 19.4% (50/258) of the pure plug-based group
and 12.0% (31/258) of the primary suture-based group (relative risk, 1.61
[95% CI, 1.07-2.44], P=0.029). Access site- or access-related bleeding
occurred in 11.6% versus 7.4% (relative risk, 1.58 [95%CI: 0.91-2.73],
P=0.133) and device failure in 4.7% versus 5.4% (relative risk, 0.86, [95%
CI, 0.40-1.82], P=0.841) in the respective groups. Time to hemostasis was
significantly shorter in the pure plug-based group (80 [32-180] versus 240
[174-316] seconds, P<0.001). <br/>Conclusion(s): Among patients treated
with transfemoral transcatheter aortic valve replacement, a pure
plug-based vascular closure technique using the MANTA VCD is associated
with a higher rate of access site- or access-related vascular
complications but a shorter time to hemostasis compared with a primary
suture-based technique using the ProGlide VCD.<br/>Copyright &#xa9; 2022
Lippincott Williams and Wilkins. All rights reserved.

<36>
[Use Link to view the full text]
Accession Number
2017431019
Title
Cost-Effectiveness of Coronary Artery Bypass Surgery Versus Medicine in
Ischemic Cardiomyopathy: The STICH Randomized Clinical Trial.
Source
Circulation. 145(11) (pp 819-828), 2022. Date of Publication: 15 Mar 2022.
Author
Chew D.S.; Cowper P.A.; Al-Khalidi H.; Anstrom K.J.; Daniels M.R.;
Davidson-Ray L.; Li Y.; Michler R.E.; Panza J.A.; Pina I.L.; Rouleau J.L.;
Velazquez E.J.; Mark D.B.
Institution
(Chew, Cowper, Al-Khalidi, Anstrom, Daniels, Davidson-Ray, Li, Mark) Duke
Clinical Research Institute, Duke University, Durham, NC, United States
(Al-Khalidi, Anstrom) Department of Biostatistics and Bioinformatics, Duke
University, Durham, NC, United States
(Chew) Department of Cardiac Sciences, Libin Cardiovascular Institute,
University of Calgary, AL, Canada
(Chew) O'Brien Institute for Public Health, University of Calgary, AL,
Canada
(Michler) Department of Cardiothoracic and Vascular Surgery, Montefiore
Medical Center, Bronx, NY, United States
(Panza) Department of Cardiology, Westchester Medical Center, Westchester
Medical Center Health Network, Valhalla, NY, United States
(Pina) Department of Medicine, Wayne State University, Detroit, MI, United
States
(Rouleau) Institut de Cardiologie de Montreal, Universite de Montreal,
Canada
(Velazquez) Section of Cardiovascular Medicine, Yale School of Medicine,
New Haven, CT, United States
(Chew) Division of Cardiology, Department of Medicine, Duke University
Medical Center, Durham, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The STICH Randomized Clinical Trial (Surgical Treatment for
Ischemic Heart Failure) demonstrated that coronary artery bypass grafting
(CABG) reduced all-cause mortality rates out to 10 years compared with
medical therapy alone (MED) in patients with ischemic cardiomyopathy and
reduced left ventricular function (ejection fraction <=35%). We examined
the economic implications of these results. <br/>Method(s): We used a
decision-analytic patient-level simulation model to estimate the lifetime
costs and benefits of CABG and MED using patient-level resource use and
clinical data collected in the STICH trial. Patient-level costs were
calculated by applying externally derived US cost weights to resource use
counts during trial follow-up. A 3% discount rate was applied to both
future costs and benefits. The primary outcome was the incremental
cost-effectiveness ratio assessed from the US health care sector
perspective. <br/>Result(s): For the CABG arm, we estimated 6.53
quality-adjusted life-years (95% CI, 5.70-7.53) and a lifetime cost of
$140 059 (95% CI, $106 401 to $180 992). For the MED arm, the
corresponding estimates were 5.52 (95% CI, 5.06-6.09) quality-adjusted
life-years and $74 894 lifetime cost (95% CI, $58 372 to $93 541). The
incremental cost-effectiveness ratio for CABG compared with MED was $63
989 per quality-adjusted life-year gained. At a societal
willingness-to-pay threshold of $100 000 per quality-adjusted life-year
gained, CABG was found to be economically favorable compared with MED in
87% of microsimulations. <br/>Conclusion(s): In the STICH trial, in
patients with ischemic cardiomyopathy and reduced left ventricular
function, CABG was economically attractive relative to MED at current
benchmarks for value in the United States. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT00023595.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<37>
Accession Number
2017552589
Title
Long-term survival after coronary bypass surgery with multiple versus
single arterial grafts.
Source
European Journal of Cardio-thoracic Surgery. 61(4) (pp 925-933), 2022.
Date of Publication: 01 Apr 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, United States
(Serruys) Department of Cardiology, National University of Ireland,
Galway, Ireland
(Morice) Department of Cardiology, Cardiovascular Institute Paris-Sud
(ICPS), Hopital Prive Jacques Cartier, Gene rale de Sante Massy, Ramsay,
France
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, Dallas, TX, 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, Rochester, MN, United States
Publisher
European Association for Cardio-Thoracic Surgery
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. <br/>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. <br/>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 12.6 years,
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 12.6 years [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.
<br/>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. <br/>Copyright &#xa9; 2021 The Author(s) 2021.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<38>
[Use Link to view the full text]
Accession Number
2017500137
Title
American Society for Enhanced Recovery and Perioperative Quality
Initiative-4 Joint Consensus Statement on Persistent Postoperative Opioid
Use: Definition, Incidence, Risk Factors, and Health Care System
Initiatives.
Source
Anesthesia and Analgesia. 129(2) (pp 543-552), 2019. Date of Publication:
August 2019.
Author
Kent M.L.; Hurley R.W.; Oderda G.M.; Gordon D.B.; Sun E.; Mythen M.;
Miller T.E.; Shaw A.D.; Gan T.J.; Thacker J.K.M.; McEvoy M.D.
Institution
(Kent, Miller) Department of Anesthesiology, Duke University Medical
Center, Durham, NC, United States
(Hurley) Departments of Anesthesiology and Public Health Sciences, Wake
Forest University School of Medicine, Winston Salem, NC, United States
(Oderda) College of Pharmacy, University of Utah, Salt Lake City, UT,
United States
(Gordon) Department of Anesthesiology and Pain Medicine, University of
Washington, Seattle, WA, United States
(Sun) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University, Palo Alto, CA, United States
(Mythen) University College London, National Institute of Health Research
(NIHR), Biomedical Research Centre, London, United Kingdom
(Shaw) Department of Anesthesiology and Pain Medicine, University of
Alberta, Edmonton, AB, Canada
(Gan) Department of Anesthesiology, Stony Brook School of Medicine, Stony
Brook, NY, United States
(Thacker) Division of Advanced Oncologic and Gastrointestinal Surgery,
Duke University Medical Center, Durham, NC, United States
(McEvoy) Department of Anesthesiology, Vanderbilt University Medical
Center, Nashville, TN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Persistent postoperative opioid use is thought to contribute to the
ongoing opioid epidemic in the United States. However, efforts to study
and address the issue have been stymied by the lack of a standard
definition, which has also hampered efforts to measure the incidence of
and risk factors for persistent postoperative opioid use. The objective of
this systematic review is to (1) determine a clinically relevant
definition of persistent postoperative opioid use, and (2) characterize
its incidence and risk factors for several common surgeries. Our approach
leveraged a group of international experts from the Perioperative Quality
Initiative-4, a consensus-building conference that included representation
from anesthesiology, surgery, and nursing. A search of the medical
literature yielded 46 articles addressing persistent postoperative opioid
use in adults after arthroplasty, abdominopelvic surgery, spine surgery,
thoracic surgery, mastectomy, and thoracic surgery. In opioid-naive
patients, the overall incidence ranged from 2% to 6% based on
moderate-level evidence. However, patients who use opioids preoperatively
had an incidence of >30%. Preoperative opioid use, depression, factors
associated with the diagnosis of substance use disorder, preoperative
pain, and tobacco use were reported risk factors. In addition, while
anxiety, sex, and psychotropic prescription are associated with persistent
postoperative opioid use, these reports are based on lower level evidence.
While few articles addressed the health policy or prescriber
characteristics that influence persistent postoperative opioid use,
efforts to modify prescriber behaviors and health system characteristics
are likely to have success in reducing persistent postoperative opioid
use.<br/>Copyright &#xa9; 2019 International Anesthesia Research Society

<39>
Accession Number
2010397108
Title
Cardiohelp System use in school age children and adolescents at a center
with interfacility mobile extracorporeal membrane oxygenation capability.
Source
International Journal of Artificial Organs. 45(2) (pp 134-139), 2022. Date
of Publication: February 2022.
Author
Ignat T.; Desai A.; Hoschtitzky A.; Smith R.; Jackson T.; Frall D.; Evans
E.; Trimlett R.; Ledot S.; Chan-Dominy A.
Institution
(Ignat, Desai, Frall, Evans, Chan-Dominy) Pediatric Intensive Care Unit,
Royal Brompton Harefield NHS Foundation Trust, London, United Kingdom
(Hoschtitzky) Department of Congenital Heart Surgery, Royal Brompton
Harefield NHS Foundation Trust, London, United Kingdom
(Smith, Jackson) Department of Perfusion, Royal Brompton Harefield NHS
Foundation Trust, London, United Kingdom
(Trimlett) Department of Cardiothoracic Surgery, Royal Brompton Harefield
NHS Foundation Trust, London, United Kingdom
(Trimlett, Ledot, Chan-Dominy) Department of Cardiothoracic Critical Care
and Anesthesia, Royal Brompton Harefield NHS Foundation Trust, London,
United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Cardiohelp System use for pediatric extracorporeal membrane oxygenation
(ECMO) beyond the transport setting is sparsely described in literature.
We report the use of Getinge's Cardiohelp System in children and
integrated utilization of Mobile ECMO Retrieval Team (MERT) at an all-age
specialized cardiorespiratory center. Electronic database of all patients
under 16 years of age who received ECMO with use of the Cardiohelp System
between January 2018 and March 2020 was retrospectively reviewed and
analyzed for demographics, set-up, complications, and outcomes. Out of 41
patients, seven patients (four in middle childhood, three in early
teenage) with median age of 10 years (range 8.8-15.6) were supported with
use of Cardiohelp System. Median weight and height were 34 kg (range
28-53) and 145 cm (range 134-166) respectively. Initial ECMO deployment
was veno-arterial (V-A) in five patients and veno-venous (V-V) in two.
There were three interhospital transfers by our MERT, and 12 intrahospital
transfers for interventions or imaging. The median ECMO therapy was 7 days
(range 4-25), with standard 3/8-inch tubing and ECMO flow rate range at
56-100 mL/kg/min (1.89-5.0 LPM). There were two circuit changes and three
reconfigurations of support. Two patients received continuous veno-venous
hemofiltration via ECMO circuit. The 90-day and 180-day survival rates
were 100% (including two heart transplants at day 7 and day 8). There were
no transport-related or circuit-related complications during the 1750 h of
Cardiohelp use. Cardiohelp System use is safe in pediatric patients for
diverse application of ECMO support including inter- and intrahospital
transfers.<br/>Copyright &#xa9; The Author(s) 2021.

<40>
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.
<br/>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.
<br/>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. <br/>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.<br/>Copyright &#xa9; 2021 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<41>
Accession Number
2014907942
Title
Systemic inflammatory response during cardiopulmonary bypass: Axial flow
versus radial flow oxygenators.
Source
International Journal of Artificial Organs. 45(3) (pp 278-283), 2022. Date
of Publication: March 2022.
Author
Yildirim F.; Amanvermez Senarslan D.; Yersel S.; Bayram B.; Taneli F.;
Tetik O.
Institution
(Yildirim, Amanvermez Senarslan, Bayram, Tetik) Cardiovascular Surgery,
Manisa Celal Bayar University, Manisa, Turkey
(Yersel) Manisa Celal Bayar University, Manisa, Turkey
(Yersel) Munich Heart Center, Munich, Germany
(Taneli) Biochemistry, Manisa Celal Bayar University, Manisa, Turkey
Publisher
SAGE Publications Ltd
Abstract
Background: The objective of this study was to investigate the
inflammatory effects of different oxygenator flow pattern types in
patients undergoing coronary artery bypass graft surgery with
cardiopulmonary bypass. <br/>Method(s): We designed this randomized,
single-blind, prospective study of patients with coronary artery disease.
We compared the systemic inflammatory effects of oxygenators with two
types of flow: axial flow and radial flow. Therefore, we divided the
patients into two groups: 24 patients in the axial group and 28 patients
in the radial group. IL-1, IL-6, IL-10, and TNF-alpha were examined for
cytokine activation leading to a systemic inflammatory reaction. The
samples were collected at three different time intervals: T1, T2, and T3
(T1 was taken before cardiopulmonary bypass, T2 just 1 h after CPB onset,
and T3 was taken 24 h after the surgery). <br/>Result(s): There were no
significant differences in demographic characteristics between the two
groups. We observed that there were notably lower levels of humoral
inflammatory response parameters (IL-1, IL-6, and TNF-alpha) in the radial
flow oxygenator group than in the axial flow group at the specific
sampling times. For IL-10, there was no significant difference for any
time period. <br/>Conclusion(s): It might be advantageous to use a
radial-flow-patterned oxygenator to limit the inflammatory response
triggered by the oxygenators in cardiopulmonary bypass.<br/>Copyright
&#xa9; The Author(s) 2022.

<42>
Accession Number
2013051933
Title
Comparison of transradial versus transfemoral diagnostic coronary
angiography in terms of oxidative stress: Which option is more
physiological?.
Source
European Journal of Inflammation. 19 (no pagination), 2021. Date of
Publication: 2021.
Author
Oktay V.; Keskin B.; Serin E.; Oksen D.; Kaya A.; Ozkan A.A.
Institution
(Oktay, Keskin, Serin, Oksen, Ozkan) Department of Cardiology, Istanbul
University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey
(Kaya) Deparment of Biochemistry, Istanbul University Cerrahpasa,
Institute of Cardiology, Istanbul, Turkey
Publisher
SAGE Publications Inc.
Abstract
In this randomized, single-center, clinical study we aimed to compare the
oxidative stress response in patients undergoing diagnostic transradial or
transfemoral elective coronary angiography. Sixty patients with stable
angina pectoris undergoing elective coronary angiography to either
transradial (n = 30) or transfemoral (n = 30) approach were included. The
levels of plasma total oxidative status (TOS) were measured and compared
just before and immediately after the procedure in both groups. The
clinical and laboratory findings were compatible between the two groups.
Although the levels of plasma total oxidative status after coronary
angiography were increased in both groups (TF pTOS 20. +/- :3; 34 +/- 3 vs
TR pTOS 18 +/- 2; 23 +/- 4), this was more pronounced in the transfemoral
group as compared with the transradial group (DELTApTOS: 11 +/- 4 vs 4 +/-
3, p < 0.001) In correlation analysis, TOS levels and white blood cell
counts (r = 0.25, p = 0.042), total cholesterol levels (r = 0.267, p =
0.041), triglyceride levels (r = 0.253, p = 0.049), serum creatinine
levels (r = 0.260, p = 0.043) were found to be moderately positively
correlated. This study showed that oxidative stress response associated
with heart catheterization is more evident in patients undergoing
transfemoral coronary angiography versus transradial coronary
angiography.<br/>Copyright &#xa9; The Author(s) 2021.

<43>
Accession Number
2010475566
Title
Association of Obstructive Sleep Apnea With the Risk of Repeat Adverse
Cardiovascular Events in Patients With Newly Diagnosed Acute Coronary
Syndrome: A Systematic Review and Meta-Analysis.
Source
Ear, Nose and Throat Journal. 100(4) (pp 260-270), 2021. Date of
Publication: May 2021.
Author
Yang S.-H.; Xing Y.-S.; Wang Z.-X.; Liu Y.-B.; Chen H.-W.; Ren Y.-F.; Chen
J.-L.; Li S.-B.; Wang Z.-F.
Institution
(Yang, Liu, Wang) Department of Cardiology, Xinxiang Central Hospital, The
Fourth Clinical College of Xinxiang Medical University, Henan Province,
China
(Xing, Wang, Chen, Ren, Chen, Li) Department of Intensive Care Unit,
Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical
University, Henan Province, China
Publisher
SAGE Publications Ltd
Abstract
Background: The impact of obstructive sleep apnea (OSA) on subsequent
cardiovascular events in patients with acute coronary syndrome (ACS)
remains inconclusive. <br/>Aim(s): Our aim was to systematically assess
the relationship between preexisting OSA and adverse cardiovascular events
in patients with newly diagnosed ACS by conducting a systematic review and
meta-analysis. <br/>Method(s): We systematically searched PubMed, EMBASE,
and Cochrane library for studies published up to May 1, 2020, that
reported any association between OSA and cardiovascular events in patients
with newly diagnosed ACS. The main outcomes were a composite of all-cause
or cardiovascular death, recurrent myocardial infarction, stroke, repeat
revascularization, or heart failure. We conducted a pooled analysis using
the random-effects model. We also performed subgroup, sensitivity,
heterogeneity analysis, and the assessment of publication bias.
<br/>Result(s): We identified 10 studies encompassing 3350 participants.
The presence of OSA was associated with increased risk of adverse
cardiovascular events in newly prognosed ACS (risk ratio [RR] 2.18, 95%
confidence interval [CI]: 1.45-3.26, P <.001, I² = 64%).
Between-study heterogeneity was partially explained by a multicenter study
(9 single-center studies, RR 2.33 95% CI 1.69-3.19, I² =18%),
and I² remarkably decreased from 64% to 18%. Moreover, OSA
significantly increased the incidence of repeat revascularization (8
studies) and heart failure (6 studies) in patients with newly diagnosed
ACS. <br/>Conclusion(s): Patients with preexisting OSA are at greater risk
of subsequent cardiovascular events after onset of ACS. Further studies
should investigate the treatment of OSA in patient with ACS.<br/>Copyright
&#xa9; The Author(s) 2021.

<44>
Accession Number
2005891748
Title
Validation and comparison of drug eluting stent to bare metal stent for
restenosis rates following vertebral artery ostium stenting: A
single-center real-world study.
Source
Interventional Neuroradiology. 26(5) (pp 629-636), 2020. Date of
Publication: 01 Oct 2020.
Author
Li L.; Wang X.; Yang B.; Wang Y.; Gao P.; Chen Y.; Zhu F.; Ma Y.; Chi H.;
Zhang X.; Bai X.; Feng Y.; Dmytriw A.A.; Hong T.; Hua Y.; Jiao L.; Ling F.
Institution
(Li, Wang, Yang, Wang, Gao, Chen, Ma, Zhang, Bai, Feng, Hong, Jiao, Ling)
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University,
Beijing, China
(Gao, Zhu, Jiao, Ling) Department of Interventional Neuroradiology, Xuanwu
Hospital, Capital Medical University, Beijing, China
(Chi) Department of Neurology, Dalian University Affiliated Xinhua
Hospital, Dalian, China
(Dmytriw) Division of Neuroradiology, Department of Medical Imaging,
Toronto Western Hospital, University of Toronto, Toronto, Canada
(Hua) Department of Vascular Ultrasonography, Xuanwu Hospital, Capital
Medical University, Beijing, China
Publisher
SAGE Publications Inc.
Abstract
Background and purpose: While drug-eluting stents (DES) have been widely
applicated in coronary stenosis, uncertainty persists concerning the
relative performance and clinical benefit in patients undergoing vertebral
artery stenting when compared with a bare metal stent (BMS). We sought to
compare in-stent restenosis (ISR) rates of DES and BMS in the treatment of
vertebral artery ostium (VAO) stenosis. <br/>Material(s) and Method(s):
This study analyzed a single-center prospective cohort. Over 1.5-year
period (January 2014-June 2015), 137 consecutive patients underwent VAO
stenting involving deployment of 76 DES and 74 BMS. Patient demographics,
comorbidities, stenosis severity, stent diameters and lengths,
periprocedural complications, imaging and duplex ultrasonography follow-up
and recurrent symptoms were assessed. <br/>Result(s): Technical success
was achieved in all patients. Mean VAO stenosis at presentation were 82.4
+/- 7.2% in the DES group and 83.3 +/- 7.5% in the BMS group and were
reduced to 12.5 +/- 4.5% and 11.3 +/- 4.0%. Mean stent diameter was 3.53
+/- 0.40 mm in DES and 5.05 +/- 0.40 mm in BMS (p < 0.0001). Mean
follow-up was 12.3 months for DES and 11.7 months for BMS. The use of DES
was associated with significant lower ISR rates compared with BMS (18.4%
vs. 31.1%; OR = 2.628, p = 0.021). Recurrent symptoms rates were similar
in DES vs. BMS (2.6% vs 2.7%, p = 0.680). Stent type and stent diameter
were independent risk factors for ISR (P = 0.026). <br/>Conclusion(s): Our
results suggest superior efficacy of deploying DES for the treatment of
VAO stenosis with lower ISR rates as compared to BMS, but do not support
significant differences in periprocedural risk and recurrent symptoms
rate.<br/>Copyright &#xa9; The Author(s) 2020.

<45>
Accession Number
2005741763
Title
Safety of stent-assisted coiling for the treatment of wide-necked ruptured
aneurysm: A systematic literature review and meta-analysis of prevalence.
Source
Interventional Neuroradiology. 26(5) (pp 547-556), 2020. Date of
Publication: 01 Oct 2020.
Author
Bsat S.; Bsat A.; Tamim H.; Chanbour H.; Alomari S.O.; Houshiemy M.N.E.;
Moussalem C.; Omeis I.
Institution
(Bsat, Alomari, Houshiemy, Moussalem, Omeis) Department of Neurosurgery,
American University of Beirut Medical Center, Beirut, Lebanon
(Bsat, Chanbour) Faculty of Medicine, Lebanese University, Beirut, Lebanon
(Tamim) Department of Internal Medicine, American University of Beirut
Medical Center, Beirut, Lebanon
(Omeis) Department of Neurosurgery, Baylor College of Medicine, Houston,
TX, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Stent-assisted coil embolization of ruptured wide-necked
aneurysms is a controversial treatment modality due to concerns on the
peri-procedural safety of anti-platelet therapy in the setting of acute
subarachnoid hemorrhage. Our aim was to systematically review the
literature on stent-assisted coil embolization of acutely ruptured
wide-neck aneurysms to calculate the pooled prevalence of clinical
outcome, thromboembolic and hemorrhagic complication rates and overall
mortality. <br/>Method(s): We searched PubMed and Google Scholar for
articles published between 2009 and 2019 and stratified selected articles
based on risk of publication bias. Data on thromboembolic and hemorrhagic
complications, clinical outcomes and mortality rates were analyzed using
quality-effects model and double arcsine transformation. <br/>Result(s):
24 articles were included featuring a total of 1582 patients.
Thromboembolic and hemorrhagic complication rates were witnessed in 9.1%
[95% CI: 6.0% - 12.7%; I² = 72.8%] and 8.7% [95% CI: 5.4 -
12.6%; I² = 77.2%] of patients, respectively. 245 patients
received external ventricular drains, of which 33 (13.5%) had EVD-related
hemorrhages. Total complication rate was 20.8% [95% CI: 14.2 - 28.1%;
I² = 87.0%]. 57% of aneurysms were completely occluded and a
favorable clinical outcome was reported in 74.7% [95% CI: 66.4 - 82.2%;
I² = 86.0] of patients. Overall mortality rate came at 7.8%
[95% CI: 4.8 - 11.6%; I² = 76.9%]. <br/>Conclusion(s):
Stent-assisted coiling of ruptured intracranial aneurysm is a technically
feasible procedure with controlled thromboembolic complication rate but
may be associated with higher hemorrhagic and total complication rates
compared to coiling alone. While stent-assisted coiling of ruptured
wide-necked aneurysm seems to yield a lower rate of favorable clinical
outcome, overall mortality is comparable to that of endovascular coiling
alone.<br/>Copyright &#xa9; The Author(s) 2020.

<46>
Accession Number
2005089038
Title
Application of flow diverters in the treatment of aneurysms in the
internal carotid artery bifurcation region.
Source
Neuroradiology Journal. 33(4) (pp 297-305), 2020. Date of Publication: 01
Aug 2020.
Author
Mahmoud M.; Farag A.; Farid M.; Elserwi A.; Abdelsamad A.; Guergues W.;
Hassan F.
Institution
(Mahmoud, Farag, Farid, Elserwi, Abdelsamad, Guergues) Radiology
Department, Ain Shams University Hospital, Egypt
(Hassan) Radiology Department, Cairo University, Egypt
Publisher
SAGE Publications Inc.
Abstract
Introduction: The treatment of aneurysms in the internal carotid
bifurcation region (ICABR), including aneurysms of the true internal
carotid artery (ICA) terminus, those inclined on the proximal A1 or M1
segments or at the most distal pre-bifurcation (ICA) segment, is often
challenging in microsurgical clipping and endovascular surgery. Few
reports had discussed flow diversion as a therapeutic option for this
group. <br/>Method(s): This was a retrospective study analysing flow
diversion in treating ICABR aneurysms. Seven patients harbouring eight
aneurysms in the ICABR were treated with flow diversion. Five aneurysms
were inclined on the proximal A1 segment, and three were located at the
most distal pre-bifurcation segment. Patients' demographics, presentation,
procedure technical description, angiographic and clinical follow-up were
recorded. PubMed and Ovid MEDLINE were also reviewed for articles
published in English, including case series or case reports, for ICABR
aneurysms treated with flow diverters. <br/>Result(s): All patients except
one underwent angiographic follow-up. The Karman-Byrne occlusion scale was
used to determine the occlusion rate. All six patients with documented
angiographic follow-up had a class IV occlusion score. No permanent or
transient neurological or non-neurological complications were encountered
in this study. <br/>Conclusion(s): Treating ICABR aneurysms using flow
diversion is feasible, with a promising angiographic occlusion rate.
Further studies are needed to analyse long-term clinical and angiographic
results.<br/>Copyright &#xa9; The Author(s) 2020.

<47>
Accession Number
2004247942
Title
Extracorporeal membrane oxygenation without therapeutic anticoagulation in
adults: A systematic review of the current literature.
Source
International Journal of Artificial Organs. 43(9) (pp 570-578), 2020. Date
of Publication: 01 Sep 2020.
Author
Fina D.; Matteucci M.; Jiritano F.; Meani P.; Lo Coco V.; Kowalewski M.;
Maessen J.; Guazzi M.; Ballotta A.; Ranucci M.; Lorusso R.
Institution
(Fina, Ballotta, Ranucci) Department of Cardiovascular Anesthesia and ICU,
IRCCS Policlinico San Donato, Milan, Italy
(Fina, Matteucci, Jiritano, Meani, Lo Coco, Kowalewski, Maessen, Lorusso)
Department of Cardiothoracic Surgery, Maastricht University Medical
Centre, Maastricht, Netherlands
(Matteucci) Department of Cardiac Surgery, Circolo Hospital, University of
Insubria, Varese, Italy
(Jiritano) Department of Cardiac Surgery, Magna Graecia University of
Catanzaro, Catanzaro, Italy
(Kowalewski) Thoracic Research Centre, Nicolaus Copernicus University,
Collegium Medicum in Bydgoszcz, Innovative Medical Forum, Bydgoszcz,
Poland
(Guazzi) IRCCS Policlinico San Donato, University of Milan, Milan, Italy
(Lorusso) Cardiovascular Research Institute, Maastricht University,
Maastricht, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Extracorporeal membrane oxygenation is essential for the treatment of
refractory cardiopulmonary failure. Its use may be complicated by worse
haemorrhagic complications exacerbated by extracorporeal membrane
oxygenation-related therapeutic anticoagulation. Progressive technological
advancements have made extracorporeal membrane oxygenation components less
thrombogenic, potentially allowing its application with temporary
avoidance of systemic anticoagulants. A systematic review of all the
available experiences, reporting the use of extracorporeal membrane
oxygenation without systemic anticoagulation in the published literature
was performed. Only patient series were included, irrespective of the
clinical indication. The survival, extracorporeal membrane oxygenation
system-related dysfunction and complications rates, as well as in-hospital
outcome, were analysed. Six studies were selected for the analysis.
Veno-arterial extracorporeal membrane oxygenation was used in 84% of
patients, while veno-venous extracorporeal membrane oxygenation was
applied in the remaining cases. Anticoagulation was avoided because of the
high risk of bleeding after cardiac surgery (64%), active major bleeding
(23%) or presence of severe traumatic injury (9%). Duration of support
ranged from 0.3 to 1128 h. Heparin was antagonized by protamine in all the
post-cardiotomy cases. Successfully extracorporeal membrane oxygenation
weaning was achieved in 74% of the treated cases, with a hospital
discharge of 58% of patients. Rates of extracorporeal membrane oxygenation
malfunctioning due to clot formation and blood transfusion requirement
varied remarkably in the published series. Extracorporeal membrane
oxygenation without systemic anticoagulation appears feasible in selected
circumstances. Further investigations are warranted to elucidate actual
aspects regarding extracorporeal membrane oxygenation system performance,
related adverse events and benefits associated with this
management.<br/>Copyright &#xa9; The Author(s) 2020.

<48>
Accession Number
628857899
Title
The low accuracy of the non-ST-elevation myocardial infarction
electrocardiograph criteria of the fourth universal definition of
myocardial infarction.
Source
Hong Kong Journal of Emergency Medicine. 27(4) (pp 229-235), 2020. Date of
Publication: 01 Jul 2020.
Author
Morris N.; Reynard C.; Body R.
Institution
(Morris, Reynard, Body) Division of Cardiovascular Sciences, The
University of Manchester, Manchester, United Kingdom
(Morris) Emergency Department, Manchester Royal Infirmary, Manchester,
United Kingdom
(Morris, Reynard, Body) Manchester University Foundation Hospital NHS
Trust, Manchester Academic Health Science Centre, Manchester, United
Kingdom
(Body) Manchester Metropolitan University, Manchester, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background: The electrocardiograph has been integral to the diagnosis of
acute coronary syndromes since the mid-20th Century and is an important
initial investigation that chest pain patients undergo on presentation to
the Emergency Department. The Fourth Universal Definition of Myocardial
Infarction recommends using dichotomous cut-offs to identify ischaemic
electrocardiographs. <br/>Objective(s): We aimed to summarise the existing
knowledge to inform emergency clinicians about the diagnostic accuracy of
the new guidelines. <br/>Method(s): We performed a systematic review and a
narrative analysis due to the heterogeneity of the studies.
<br/>Result(s): We were able to obtain diagnostic characteristics for 10
papers. The ST-depression criteria were highly specific but poorly
sensitive in five papers, with a specificity of 97.2%-99.3% and a
sensitivity of 16.6%-20.0%. The remaining papers reported a higher
sensitivity of 25.7%-58.6% but a lower specificity of 86.0%-91.2%. T wave
inversion demonstrated poor specificity; the papers that looked at 0.1 mV
T wave inversion demonstrated a sensitivity of 26.9%-46.8% and a
specificity of 68.6%-86.4%. <br/>Conclusion(s): The heterogeneous evidence
database demonstrates that the Fourth universal definition's diagnostic
performance varies wildly. Apart from two outlying papers, ST-depression
has suboptimal sensitivity but high specificity. T wave inversion appears
to be more sensitive yet less specific.<br/>Copyright &#xa9; The Author(s)
2019.

<49>
Accession Number
628273723
Title
Can venous cannula design influence venous return and negative pressure
with a minimally invasive extracorporeal circulation?.
Source
International Journal of Artificial Organs. 42(12) (pp 704-710), 2019.
Date of Publication: 01 Dec 2019.
Author
Bennett M.J.; Hodgkiss S.; Lloyd C.T.; Webb G.
Institution
(Bennett) Cardiothoracic Anaesthesia, University Hospitals Plymouth NHS
Trust, Plymouth, United Kingdom
(Hodgkiss, Webb) Clinical Perfusion, University Hospitals Plymouth NHS
Trust, Plymouth, United Kingdom
(Lloyd) Cardiothoracic Surgery, University Hospitals Plymouth NHS Trust,
Plymouth, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Introduction: Recent advances to make cardiopulmonary bypass more
physiological include the use of kinetic-assisted venous drainage but
without a venous reservoir. Despite manipulation of intravascular volume
and patient positioning, arterial flow is frequently reduced. Negative
venous line pressures can be generated, which may elicit gaseous
microemboli. We investigated the influence of venous cannula design on
venous return and negative venous line pressures. <br/>Method(s): In a
single-centre, single-surgeon, prospective, randomized, double-blind
trial, 48 patients undergoing isolated coronary artery, aortic valve or
combined coronary artery and aortic valve surgery, with a minimally
invasive circuit, were randomized to a conventional two-stage (2S) or
three-stage venous cannula (3S), or to a three-stage venous cannula with
additional 'fenestrated' ridges (F3S). Blood flow, venous line pressures
and gaseous microemboli number and size were measured. <br/>Result(s): The
pump flow achieved was the same between groups, but in each case fell
below the target range of 2.2-2.4 L min^-1 m^-2. The
three-stage cannula recorded significantly lower negative pressure than
the other cannulae. The total count and volume of gaseous emboli detected
with the F3S cannulae was very high in some cases, with wide
heterogeneity. <br/>Discussion(s): The low negative pressures recorded
with three-stage cannula, despite having a larger drainage orifice area,
suggest that negative pressure may be more influenced by lumen diameter
and vena cava collapse rather than drainage hole size. The additional
fenestrations resulted in flow characteristics and negative pressures
similar to the larger two-stage cannula but are associated with generation
of gaseous microemboli.<br/>Copyright &#xa9; The Author(s) 2019.

<50>
Accession Number
626963739
Title
Efficacy of management for obstruction caused by precipitated medication
or lipids in central venous access devices: A systematic review and
meta-analysis.
Source
Journal of Vascular Access. 20(6) (pp 583-591), 2019. Date of Publication:
01 Nov 2019.
Author
Zheng L.-Y.; Xue H.; Yuan H.; Liu S.-X.; Zhang X.-Y.
Institution
(Zheng, Yuan, Liu, Zhang) Department of Fundamental Nursing, School of
Nursing, Jilin University, Changchun, China
(Xue) Department of Histology Embryology, College of Basic Medical
Sciences, Jilin University, Changchun, China
Publisher
SAGE Publications Ltd
Abstract
At present, central venous access devices (CVADs) are widely used in
clinical practice. The reasons for CVAD obstruction caused by precipitated
medication or lipids are increasingly complex. However, there is no clear
treatment program for CVAD obstruction caused by precipitated medication
or lipids. The target of this study was to analyze data regarding
obstruction caused by precipitated medication or lipids in CVADs and to
calculate the efficacy of different treatment methods. A systematic review
with meta-analysis was conducted in alignment with the Preferred Reporting
Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The
PubMed, Web of Science, EMBASE, Cochrane Library, CINAHL, and China
National Knowledge Internet databases were searched for original research
published before 2018. There were 1356 publications initially screened,
with one additional study identified through snowballing. Seven studies
met the inclusion criteria. The reasons for obstruction, except for clot
formation, primarily included the following: mechanical complications;
lipid deposition; mineral deposition; or drug precipitation. Meta-analysis
showed that sodium hydroxide resulted in the highest recanalization rate
in lipid deposition, followed by ethanol, and the difference was
significant. The efficacy analysis revealed that hydrochloric acid and
l-cysteine have similar effects on mineral deposition and drug
precipitation. According to this review, the most effective methodology
was shown to be the intravenous perfusion of sodium hydroxide in several
treatments when the obstruction is caused by lipid deposition. In
contrast, mineral deposition and drug deposition are best treated with
l-cysteine to recover the patency of central venous access
devices.<br/>Copyright &#xa9; The Author(s) 2019.

<51>
Accession Number
619449789
Title
Ultrasound-guided radial artery catheterisation increases the success rate
among anaesthesiology residents: A randomised study.
Source
Journal of Vascular Access. 18(6) (pp 546-551), 2017. Date of Publication:
November-December 2017.
Author
Gopalasingam N.; Hansen M.A.; Thorn S.; Sloth E.; Juhl-Olsen P.
Institution
(Gopalasingam, Hansen, Thorn, Sloth, Juhl-Olsen) Department of
Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus N,
Denmark
Publisher
Wichtig Publishing Srl
Abstract
Introduction: The palpation technique is generally used for radial artery
catheterisation, but is associated with a high rate of failure and
complications. Dynamic needle tip positioning (DNTP) is a new
ultrasound-guided technique. We aimed to compare the traditional palpation
technique with DNTP performed by four anaesthesiology residents.
<br/>Method(s): The study was a randomised, controlled, patient-blinded,
crossover study. Fourty patients underwent bilateral radial artery
catheterisation using both techniques. The primary endpoint was the first
attempt success rate. The secondary endpoints were: 1) number of skin
perforations, 2) number of needle retractions, 3) needle manipulation
time, 4) total time, 5) attempts lasting >180 seconds, 6) number of
catheters used, 7) frequency of aborted attempts or crossovers, and 8)
pain scores (VAS). <br/>Result(s): The first attempt success rate was
significantly higher in the DNTP group compared with the palpation group
(36/40 vs. 28/40, p = 0.022). The palpation technique group required a
higher number of skin perforations (44 vs. 60, p = 0.016), needle
retractions (p = 0.001) and catheters (42 vs. 52, p = 0.011) compared with
the DNTP group. Neither the total time required for arterial
catheterisation, the needle manipulation time nor the VAS scores were
significantly different between the groups (all p>0.407). Aborted attempts
were only seen in the palpation group (7/40, p = 0.016).
<br/>Conclusion(s): Ultrasound-guided arterial catheterisation using the
DNTP technique is superior to the standard palpation technique. This study
favours the ultrasound-guided DNTP technique as the first choice rather
than merely being viewed as a rescue procedure.<br/>Copyright &#xa9; 2017
Wichtig Publishing.

<52>
Accession Number
2017254581
Title
New Zealand COPD Guidelines: Quick Reference Guide.
Source
New Zealand Medical Journal. 134(1530) (pp 76-110), 2021. Date of
Publication: 19 Feb 2021.
Author
Hancox R.J.; Jones S.; Baggott C.; Chen D.; Corna N.; Davies C.; Fingleton
J.; Hardy J.; Hussain S.; Poot B.; Reid J.; Travers J.; Turner J.; Young
R.
Institution
(Hancox) Waikato District Health Board, Hamilton, New Zealand
(Hancox, Reid) University of Otago, Dunedin, New Zealand
(Jones, Corna) Middlemore Hospital, Counties Manukau, Auckland, New
Zealand
(Baggott, Fingleton, Hardy) Medical Research Institute of New Zealand, New
Zealand
(Chen) Canterbury Clinical Network, Christchurch, New Zealand
(Davies) Tu Kotahi Maori Asthma Trust, New Zealand
(Fingleton) Capital and Coast District Health Board, Wellington, New
Zealand
(Hussain, Young) Auckland District Health Board, New Zealand
(Poot, Travers) Hutt Valley District Health Board, Lower Hutt, New Zealand
(Poot) School of Nursing, Midwifery and Health Practice, Victoria
University of Wellington, Wellington, New Zealand
(Reid) Best Practice Advisory Centre (BPAC), Dunedin, New Zealand
(Turner) Asthma and Respiratory Foundation of New Zealand, New Zealand
Publisher
New Zealand Medical Association
Abstract
The purpose of the Asthma and Respiratory Foundation of New Zealand's COPD
Guidelines: Quick Reference Guide is to provide simple, practical,
evidence-based recommendations for the diagnosis, assessment, and
management of chronic obstructive pulmonary disease (COPD) in clinical
practice. The intended users are health professionals responsible for
delivering acute and chronic COPD care in community and hospital settings,
and those responsible for the training of such health
professionals.<br/>Copyright &#xa9; NZMA

<53>
Accession Number
2016003885
Title
Evaluation of Right Ventricular Outflow Tract Stenting as Palliative
Treatment in Severely Cyanotic Tetralogy of Fallot: A Systematic Review
and Meta-analysis of Observational Studies.
Source
Journal of Tehran University Heart Center. 16(4) (pp 135-146), 2021. Date
of Publication: 2021.
Author
Laurentius A.; Wiyono L.; Subali A.D.; Siagian S.N.
Institution
(Laurentius, Wiyono) Faculty of Medicine, Universitas Indonesia, Jakarta,
Indonesia
(Subali) Faculty of Medicine, Universitas Brawijaya, East Java, Indonesia
(Siagian) National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Publisher
Tehran Heart Center
Abstract
Background: Tetralogy of Fallot (ToF) is a cardiac malformation that
accounts for up to 1/10 of all congenital diseases. Although surgical
repair serves as a treatment of choice, it cannot be performed unless
weight and anatomical key factors are favorable. The stenting of the right
ventricular outflow tract (RVOT) has become an alternative palliative
procedure for ToF as an option to alleviate infundibular obstruction with
minimal invasion. <br/>Method(s): A literature search was conducted
through 7 databases, followed by the screening and independent assessment
of 6 final studies, using the Newcastle-Ottawa Quality Assessment Scale
(NOS). Analysis was then conducted using inverse variance analysis, and
cumulative data were presented with forest and funnel plots.
<br/>Result(s): Studied patients were referred for RVOT stenting due to
the marked obstruction of the pulmonary blood flow, a low birth weight, or
a small pulmonary artery size. The analysis revealed a significant
increase in O2 saturation (mean difference [MD=18%; 13-23.78). The same
trend was observed concerning an increase in the Nakata index (MD=54.59;
10.05-99.14), the right pulmonary artery diameter (MD=2.28; 1.20-3.36),
and the left pulmonary artery diameter (MD=1.77; 0.22-3.32). Several
complications were found, including tricuspid regurgitation and frequent
premature beats. <br/>Conclusion(s): RVOT stenting is considered a
feasible palliative treatment for ToF, with its high effectiveness in
improving patients' condition, especially their pulmonary flow. While
complications are scarce, several conditions should be noted, particularly
for fatal complications. Finally, this study has limitations as
catheterization details in studies and diverse infants' conditions may
have caused potential bias.<br/>Copyright &#xa9; 2021 Tehran University of
Medical Sciences. Published by Tehran University of Medical Sciences.

<54>
Accession Number
2017524243
Title
The effect of slow deep breathing relaxation exercise on pain levels
during and post chest tube removal after coronary artery bypass graft
surgery.
Source
International Journal of Nursing Sciences. 9(2) (pp 155-161), 2022. Date
of Publication: April 2022.
Author
Jarrah M.I.; Hweidi I.M.; Al-Dolat S.A.; Alhawatmeh H.N.; Al-Obeisat S.M.;
Hweidi L.I.; Hweidi A.I.; Alkouri O.A.
Institution
(Jarrah, Hweidi, Hweidi) Faculty of Medicine, Jordan University of Science
& Technology, Irbid, Jordan
(Hweidi, Al-Dolat, Alhawatmeh, Al-Obeisat) Faculty of Nursing, Jordan
University of Science & Technology, Irbid, Jordan
(Alkouri) Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
Publisher
Chinese Nursing Association
Abstract
Objectives: This study aimed to evaluate the effectiveness of slow deep
breathing relaxation exercise (SDBRE) in reducing patients' pain levels
during chest tube removal (CTR) post coronary artery bypass grafting
(CABG) surgery. <br/>Method(s): In 2019, fifty post-CABG patients were
conveniently selected from a cardiac intensive care unit in Jordan's major
referral heart institute. The patients were randomly assigned to either an
intervention group or a control group. A total of 25 patients were
assigned into the experimental group who received slow deep breathing
relaxation Exercise (SDBRE) alongside the conventional care before CTR.
The remaining 25 patients constituted the control group (50%) that had CTR
following conventional care. The Visual Analogue Scale (VAS) was used to
measure the participants' pain levels during three phases: before CTR
(Time 1), 5-min post CTR (Time 2), and 15-min post CTR (Time 2) to compare
the intervention effect between the two groups. <br/>Result(s): The data
analysis findings for the control and intervention group of patients
showed that there was a statistically significant decline in their pain
level across time for both groups (H = 32.71, P < 0.01; H = 47.23, P <
0.01) respectively. The intervention group had significantly lower pain
levels than the control group at Time 2 (3.50 [1.20, 5.30] vs. 7.90 [7.00,
9.00], P < 0.01) and Time 3 (0.00 [0.00, 1.30] vs. 3.60 [2.40, 4.10] P <
0.01). <br/>Conclusion(s): Using SDBRE during CTR is an effective
technique for reducing pain which can minimize the need for analgesics and
their associated adverse effects.<br/>Copyright &#xa9; 2022 The authors

<55>
Accession Number
2017049591
Title
Pericardial Involvement in Sarcoidosis.
Source
American Journal of Cardiology. 170 (pp 100-104), 2022. Date of
Publication: 01 May 2022.
Author
Mahalwar G.; Kumar A.; Agrawal A.; Bhat A.; Furqan M.; Yesilyaprak A.;
Verma B.R.; Chan N.; Schleicher M.; Neto M.L.R.; Xu B.; Jellis C.L.; Klein
A.L.
Institution
(Mahalwar, Kumar, Agrawal, Bhat, Furqan, Yesilyaprak, Verma, Chan, Xu,
Jellis, Klein) Center for the Diagnosis and Treatment of Pericardial
Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular
Medicine, Heart, Vascular, and Thoracic Institute
(Neto) Department of Pulmonary Medicine, Respiratory Institute
(Yesilyaprak) Department of Internal Medicine, Wayne State University,
Detroit, Michigan, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Ohio,
Cleveland
Publisher
Elsevier Inc.
Abstract
Pericardial disease secondary to sarcoidosis is a rare clinical entity
with no observational studies in previous research. Therefore, we
evaluated reported cases of pericarditis because of sarcoidosis to further
understand its diagnosis and management. We performed a systematic review
of previous research until December 16, 2020 in MEDLINE, Embase, Scopus,
Cochrane Central Register of Controlled Trials, and Web of Science. Case
reports and case series demonstrating pericardial involvement in
sarcoidosis were included. Fourteen reports with a total of 27 patients
were identified. Dyspnea (82%) was the most common presentation, with the
lungs being the primary site of sarcoidosis in most patients (77%). The
most frequently encountered pericardial manifestations were pericardial
effusion (89%), constrictive pericarditis and cardiac tamponade (48%).
Management of these patients included use of corticosteroids (82%),
colchicine (11%), and nonsteroidal anti-inflammatory agents (7%). Similar
to the general population, the most common intervention in these patients
was pericardiocentesis (59%), pericardial window (30%), and
pericardiectomy (19%). Overall, the majority of this population (70%)
achieved clinical improvement during median follow-up time of 8 months. In
conclusion, the prevalence and incidence of sarcoid-induced pericarditial
disease remain unclear. Clinical manifestations of pericardial involvement
are variable, though many patients present with asymptomatic pericardial
effusions. No consensus exists on the treatment of this special
population, but corticosteroids and combination therapies are considered
first-line therapies because of their efficacy in suppressing pericardial
inflammation and underlying sarcoidosis. Patients with refractory cases of
pericarditis may also benefit therapeutically from the addition of
nonsteroidal anti-inflammatory agents, colchicine, and/or
biologics.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<56>
Accession Number
2016967979
Title
Meta-Analysis Comparing Risk Factors, Incidence, and Outcomes of Patients
With Versus Without Prosthesis-Patient Mismatch Following Transcatheter
Aortic Valve Implantation.
Source
American Journal of Cardiology. 170 (pp 91-99), 2022. Date of Publication:
01 May 2022.
Author
Lim O.Z.H.; Mai A.S.; Ng C.H.; Tang A.; Chin Y.H.; Kong G.; Ho Y.J.; Ong
J.; Tay E.; Kuntjoro I.; Chew N.W.; Lim Y.
Institution
(Lim, Mai, Ng, Tang, Chin, Kong, Ho, Kuntjoro, Lim) Yong Loo Lin School of
Medicine, National University of Singapore, Singapore
(Ong, Tay, Kuntjoro, Chew, Lim) Department of Cardiology, National
University Heart Centre, Singapore
Publisher
Elsevier Inc.
Abstract
Current guidelines on the management of patients with aortic valvular
disease have widened the use of transcatheter aortic valve implantation
(TAVI) with an emphasis on avoidance of prosthesis-patient mismatch (PPM).
This study sought to examine the incidence, risk factors, and all-cause
mortality of PPM after TAVI. Medline and Embase databases were searched
from inception to August 10, 2021. Patients were compared along 2 arms:
(1) any degree of PPM and those without PPM, (2) severe PPM, and nonsevere
PPM. A total of 22 articles involving 115,442 patients after TAVI were
included. Pooled incidence for any degree of PPM was 30.1% and 10.7% in
severe PPM. Incidence was significantly higher (p <0.001) for any degree
of PPM in Europe (33.1%) and North America (34.4%) compared with Asia
(10.4%). Incidence of severe PPM was higher (p = 0.015) in older
generation (13.6%) compared with current-generation valves (6.3%). Severe
PPM increased the risk of all-cause mortality relative to nonsevere PPM
(hazard ratio: 1.86, 95% confidence interval: 1.05 to 3.29, p = 0.034).
Patients of younger age, increased body surface area, lower left
ventricular ejection fraction, and classified New York Heart Association
Class III/IV were at greater risk of both any degree and severe PPM.
Smaller prosthesis size increased the risk of any degree of PPM, whereas
postdilation and larger prostheses were protective factors. In conclusion,
all-cause mortality was significantly affected in severe PPM compared with
nonsevere cases, whereas this excess mortality was not observed between
those with any degree of PPM and those without. Closer attention to
patient and bioprosthetic valve factors is required to minimize the
occurrence of severe PPM.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<57>
Accession Number
2012315448
Title
Comparison of ultrasound-guided femoral artery cannulation versus
palpation technique in neonates undergoing cardiac surgery.
Source
Journal of Vascular Access. (no pagination), 2021. Date of Publication:
2021.
Author
Salik F.; Bicak M.
Institution
(Salik, Bicak) Department of Anesthesiology and Reanimation, Diyarbakir
Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objectives: Palpation technique for femoral artery cannulation can be very
difficult, especially in neonates. In this study, we evaluated whether
ultrasound-guided cannulation of the femoral artery is superior to
palpation technique in neonates undergoing cardiac surgery.
<br/>Method(s): Forty neonates undergoing cardiac surgery were
prospectively randomized into two groups (Ultrasound group and Palpation
group). Access time, number of attempts, number of successful cannulations
on first attempt, success rate, number of cannulas used, inadvertent
access, and complications were compared between the two groups. Cost
analyses of the cannulation were performed in two groups. <br/>Result(s):
In the ultrasound group, access time for femoral artery cannulation was
shorter (6.4 +/- 3.0 and 10.2 +/- 4.4, p = 0.003) and the number of
attempts (1.4 +/- 0.6 and 2.3 +/- 0.8, p < 0.001) was lower compared to
the palpation group. The number of successful cannulations on
first-attempt (15 (75%) and 5 (25%), p = 0.002) and the success rate (95%
(19) and 60% (12), p = 0.008) were higher in the ultrasound group. The
number of cannulas used in the ultrasound group was less than the
palpation group (p = 0.001). The cost of intervention was higher in the
palpation group compared to the ultrasound group (p = 0.048).
<br/>Conclusion(s): The ultrasound-guided cannulation of the femoral
artery in neonates is superior to the palpation technique based on the
increased of the number of successful first-attempt cannulation and
success rate, and the reducing of the access time, number of attempts,
number of cannulas used, and cost of cannulation.<br/>Copyright &#xa9; The
Author(s) 2021.

<58>
Accession Number
2017612143
Title
Intramuscular stimulation as a new modality to control postthoracotomy
pain: A randomized clinical trial.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Moon D.H.; Park J.; Park Y.G.; Kim B.J.; Woo W.; Na H.; Oh S.; Lee H.S.;
Lee S.
Institution
(Moon, Kim, Woo, Na, Oh, Lee) Department of Thoracic and Cardiovascular
Surgery, Gangnam Severance Hospital, Yonsei University College of
Medicine, Seoul, South Korea
(Park, Park) Department of Rehabilitation Medicine, Gangnam Severance
Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei
University College of Medicine, Seoul, South Korea
(Lee) Biostatistics Collaboration Unit, Department of Research Affairs,
Yonsei University College of Medicine, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Objective: Postoperative pain after thoracic surgery primarily hinders
patients' mobility, decreasing the quality of life. To date, various
modalities have been suggested to improve postoperative pain. However,
pain alleviation still remains a challenge, resulting in continued
reliance on opioids. To tackle this problem, this study introduces a
needle electrical twitch obtaining intramuscular stimulation (NETOIMS) as
a new effective treatment modality for postoperative pain after
thoracoscopic surgery. <br/>Method(s): This randomized clinical trial
analyzed patients receiving video-assisted thoracoscopic surgery pulmonary
resection between March 2018 and June 2020 at a single institution. A
total of 77 patients (NETOIMS, 36; intravenous patient-controlled
analgesia, 41) were included. NETOIMS was conducted on the retracted
intercostal muscle immediately following the main procedure, just before
skin closure. Postoperative pain (numeric rating scale) and oral opioid
morphine milligram equivalent were assessed daily until postoperative day
5. <br/>Result(s): The NETOIMS group had a significantly lower numeric
rating scale score on postoperative day (POD) 0 (P < .01), POD2 (P <
.001), POD4 (P < .001), and POD5 (P = .01). The predicted time to complete
pain resolution was 6.15 days in the NETOIMS group and 20.7 days in the
intravenous patient-controlled analgesia group. The oral opioid morphine
milligram equivalent was significantly lower in the NETOIMS group on POD0
(P < .001) and POD1 (P < .001). <br/>Conclusion(s): NETOIMS appears to be
an effective modality in alleviating postoperative pain after
thoracoscopic surgery, thereby reducing the reliance on opioid
use.<br/>Copyright &#xa9; 2022 The American Association for Thoracic
Surgery

<59>
Accession Number
2016174747
Title
Comparative Myocardial Protection Effects of Buckberg and del Nidin Mitral
Valve Surgery: A Prospective Randomized Trial.
Source
International Cardiovascular Research Journal. 15(4) (pp 143-148), 2021.
Article Number: e117124. Date of Publication: Dec 2021.
Author
Mousavizadeh M.; Ghanbari A.; Zirak N.; Ghadrdoost B.; Yaghubi M.;
Hosseini S.
Institution
(Mousavizadeh, Ghanbari, Ghadrdoost, Hosseini) Heart Valve Disease
Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Zirak) Lung Disease Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
(Yaghubi) Department of Extra Corporeal Circulation, Razavi Hospital, Imam
Reza International University, Mashhad, Iran, Islamic Republic of
Publisher
Iranian Cardiovascular Research Journal
Abstract
Background: Myocardial protection during cardiopulmonary bypass requires
essential techniques to preserve myocardial function and protect the
myocardium from cellular damage. <br/>Objective(s): This study aimed to
investigate the efficacy of del Nido cardioplegia in mitral valve surgery
compared to Buckberg solution. <br/>Method(s): All patients who underwent
mitral valve surgery from April 2018 to December 2018 were recruited in
the present trial. The patients were assigned randomly into del Nido and
Buckberg groups. Trans-thoracic and trans-esophageal echocardiography were
performed before and after the procedure to evaluate left ventricular
ejection fraction, as the primary outcome. <br/>Result(s): A total of 152
patients (77 in the del Nido group and 75 in the Buckberg group) were
included in the final analysis. The mean age of the participants was 51.3
+/- 13.4 years, and 55.3% of the patients were female. The two groups were
comparable in terms of all baseline characteristics. The results also
showed no significant difference between the two groups regarding
pre-operative ejection fractions (P = 0.063). However, ventilation time
and the mean length of ICU stay were higher in the Buckberg group (0.018
and 0.001, respectively). Moreover, the results indicated a more prominent
reduction in left ventricular ejection fraction measured via
trans-thoracic and trans-esophageal echocardiography in the Buckberg group
compared to the del Nido group (13.7% versus 4.7%, P < 0.001 for
trans-thoracic echocardiography). <br/>Conclusion(s): Del Nido
cardioplegia solution exerted beneficial effects on myocardial protection
evaluated by echocardiography compared to Buckberg in adult patients with
preserved ejection fraction undergoing mitral valve surgery.<br/>Copyright
&#xa9; 2021, Iranian Cardiovascular Research Journal. All rights reserved.

<60>
[Use Link to view the full text]
Accession Number
2017431911
Title
Revascularization strategies in patients with diabetes and stable ischemic
heart disease: A systematic review and meta-analysis of randomized trials.
Source
Journal of Cardiovascular Medicine. 23(4) (pp 242-246), 2022. Date of
Publication: 01 Apr 2022.
Author
Noguchi M.; Ueyama H.; Fujisaki T.; Takagi H.; Kuno T.
Institution
(Noguchi) Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical
Center, Urayasu, Japan
(Ueyama, Kuno) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Beth Israel, United States
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, New York, NY, United States
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, 111 East 210th St, Bronx, NY 10467-2401, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
AimsThe optimal treatment strategy comparing invasive revascularization
versus optimal medical therapy (OMT) in patients with diabetes mellitus
(DM) and stable ischemic heart disease (SIHD) still remains unclear. We
aimed to investigate clinical outcomes of invasive revascularization
(percutaneous coronary intervention, coronary artery bypass grafting or
both) versus OMT in patients with DM and SIHD from updated published
randomised-controlled trials (RCTs).MethodsWe conducted a comprehensive
literature search through PubMed and EMBASE to investigate the effect of
revascularization versus OMT for patients with DM and SIHD. The studies
were limited to RCTs or their subgroup data for a meta-analysis. The
outcomes of interest were major adverse cardiovascular events (MACE) in
patients with DM and SIHD.ResultsOur search identified subgroup data with
DM of four RCTs including a total of 5742 patients with SIHD. Our results
showed that invasive revascularization was not associated with a decreased
risk of MACE when compared to OMT [hazard ratio (95% confidence interval):
0.95 (0.85-1.05), P-=-0.31; I²-=-0%].ConclusionInvasive
revascularization was not associated with a decreased risk of MACE when
compared with OMT.<br/>Copyright &#xa9; 2022 Lippincott Williams and
Wilkins. All rights reserved.

<61>
Accession Number
2015355642
Title
Effects of early rehabilitation on functional outcomes in patients after
coronary artery bypass graft surgery: a randomized controlled trial.
Source
Journal of International Medical Research. 50(3) (no pagination), 2022.
Date of Publication: March 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, Hubei, Wuhan, China
(Xie) Shanghai Jiangwan Hospital, Shanghai, China
Publisher
SAGE Publications Ltd
Abstract
Objective: This study evaluated the effectiveness, feasibility, and safety
of early rehabilitation for patients after coronary artery bypass graft
(CABG) surgery. <br/>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.
<br/>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. <br/>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.<br/>Copyright &#xa9; The Author(s) 2022.

<62>
Accession Number
2015583993
Title
High-dose preoperative glucocorticoid for prevention of emergence and
postoperative delirium in liver resection: A double-blinded randomized
clinical trial substudy.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 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, Denmark
(Awada, Steinthorsdottir, Kehlet) Surgical Pathophysiology Unit,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Schultz, Hillingso, Larsen) Department of Gastrointestinal Surgery and
Transplantation, Centre for Cancer and Organ Diseases, Rigshospitalet
Copenhagen University Hospital, Copenhagen, Denmark
(Aasvang) Department of Clinical Medicine, Faculty of Health and Medical
Sciences, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
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- versus
low-dose glucocorticoid on the occurrence of ED and POD. <br/>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-dose (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-min Diagnostic Interview for
CAM-defined delirium (3D-CAM) was used for assessment, 15 and 90 min after
arrival in the post-anesthesia care unit (PACU), and subsequently once
daily in the ward. <br/>Result(s): Fifty-three patients were included in
this secondary substudy (26 HD-group and 27 LD-group). ED occurred in n =
5 HD versus n = 6 LD patients 15 min after PACU arrival. At 90 min after
PACU arrival, 4 patients had ED, all from LD-group, and resulted in
significantly longer PACU admission, 273 versus 178 min in ED versus
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. <br/>Conclusion(s): The
primary finding of the current substudy was a lower occurrence of ED/POD
in the PACU 90 min 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.<br/>Copyright &#xa9; 2022 The Authors. Acta Anaesthesiologica
Scandinavica published by John Wiley & Sons Ltd on behalf of Acta
Anaesthesiologica Scandinavica Foundation.

<63>
Accession Number
637710069
Title
Cold application for pain and anxiety reduction following chest tube
removal: A systematic review and meta-analysis.
Source
Journal of clinical nursing. (no pagination), 2022. Date of Publication:
06 Apr 2022.
Author
Chen C.-T.; Tung H.-H.; Chen Y.-C.; Wang J.-L.; Tsai S.-H.; Huang Y.-T.;
Hsu T.-F.
Institution
(Chen, Tung, Hsu) College of Nursing, National Yang Ming Chiao Tung
University, Taipei, Taiwan (Republic of China)
(Chen, Chen) Department of Nursing, College of Medicine, National Cheng
Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
(Chen) Department of Nursing, College of Medicine, National Cheng Kung
University, Tainan, Taiwan (Republic of China)
(Wang, Tsai) Department of Internal Medicine, College of Medicine,
National Cheng Kung University Hospital, National Cheng Kung University,
Tainan, Taiwan (Republic of China)
(Huang) Department of Surgery, College of Medicine, National Cheng Kung
University Hospital, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
(Hsu) Department of Emergency Medicine, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
(Hsu) Center for Evidence-Based Medicine, Taipei Veterans General
Hospital, Taipei, Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
AIM AND OBJECTIVES: To conduct a systematic review and meta-analysis to
evaluate the effects of cold application on pain and anxiety reduction
after chest tube removal (CTR). BACKGROUND: The act of removing the chest
tube often causes pain among cardiothoracic surgery patients. Most
guidelines regarding CTR do not mention pain management. The effects of
cold application on reducing pain and anxiety after CTR are inconsistent.
DESIGN: Systematic review and meta-analysis. <br/>METHOD(S): We searched
six databases, including Embase, Ovid Medline, Cochrane Library, Scopus,
the Index to Taiwan Periodical Literature System and Airiti Library, to
identify relevant articles up to the end of February 2021. We limited the
language to English and Chinese and the design to randomised controlled
trials (RCTs). All studies were reviewed by two independent investigators.
The Cochrane Collaboration's tool was used to assess the risk of bias,
Review Manager 5.4 was used to conduct the meta-analysis. The Grading of
Recommendations, Assessment, Development and Evaluation (GRADE)
methodology was used for assessing certainty of evidence (CoE).
<br/>RESULT(S): Ten RCTs with 683 participants were included in the
meta-analysis. The use of cold application could effectively reduce pain
and anxiety after CTR. The subgroup showed that a skin temperature drops
to 13degreeC of cold application was significantly more effective for the
immediate reduction in pain intensity after CTR compared with control
group. The GRADE methodology demonstrated that CoE was very low level.
<br/>CONCLUSION(S): Cold application is a safe and easy-to-administer
nonpharmacological method with immediate and persistent effects on pain
and anxiety relief after CTR. Skin temperature drops to 13degreeC or lasts
20 min of cold application were more effective for immediate reduction of
pain intensity following CTR. RELEVANCE TO CLINICAL PRACTICE: In addition
to pharmacological strategy, cold application could be used as evidence
for reducing pain intensity and anxiety level after CTR.<br/>Copyright
&#xa9; 2022 John Wiley & Sons Ltd.

<64>
Accession Number
637700550
Title
Infective endocarditis by Actinomyces species: a systematic review.
Source
Journal of chemotherapy (Florence, Italy). (pp 1-8), 2022. Date of
Publication: 06 Apr 2022.
Author
Ioannou P.; Baliou S.; Papakitsou I.; Kofteridis D.P.
Institution
(Ioannou, Baliou, Papakitsou, Kofteridis) Department of Internal Medicine
& Infectious Diseases, University Hospital of Heraklion, Heraklion, Greece
Publisher
NLM (Medline)
Abstract
Actinomycosis, is a slowly progressive infection that may mimic malignancy
due to the invasiveness of tissues and the ability to form sinus tracts.
Infective Endocarditis (IE) is a rare disease with significant morbidity
and mortality. Interestingly, even though there are scarce data of IE by
Actinomyces spp. in the literature, a review adequately summarizing all
available evidence on the topic in a systematic way is lacking. The aim of
this study was to systematically review all cases of IE by Actinomyces
spp. in the literature and describe the epidemiology, microbiology,
clinical characteristics, treatment and outcomes of this infection. A
systematic review of PubMed, Scopus and Cochrane library (through 19
August 2021) for studies providing epidemiological, clinical,
microbiological as well as treatment data and outcomes of IE by
Actinomyces spp. was performed. A total of 31 studies providing data for
31 patients were included. A prosthetic valve was present in 12.9%, while
the most common microorganism was A. meyeri. Aortic valve was the most
commonly infected intracardiac site, followed by the mitral valve.
Diagnosis was most commonly performed with transesophageal
echocardiography, while the diagnosis was made at autopsy in 16.1%.
Penicillin, cephalosporins and aminopenicillins were the most commonly
used antimicrobials. Clinical cure was noted in 80.6%, while mortality was
19.4%. Development of heart failure was associated with mortality by IE.
This systematic review thoroughly describes IE by Actinomyces and provides
information on epidemiology, clinical presentation, treatment and
outcomes.

<65>
Accession Number
637699542
Title
Efficacy of ultrasound-guided parasternal block in adult cardiac surgery:
a meta-analysis of randomized controlled trials.
Source
Minerva anestesiologica. (no pagination), 2022. Date of Publication: 05
Apr 2022.
Author
Li J.; Lin L.; Peng J.; He S.; Wen Y.; Zhang M.
Institution
(Li, Peng, He) Department of Anesthesiology, People's Hospital of Yilong
County, China
(Lin) Department of Anesthesiology, The General Hospital of Western
Theater Command Hospital, Chengdu, China
(Wen) Department of Anesthesiology, Traditional Chinese Medicine Hospital
of Nanchong, China
(Zhang) Department of Neurology, People's Hospital of Yilong County, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Pain after cardiac surgery is a common and severe
postoperative complication. As a new regional nerve block method,
ultrasound-guided parasternal block (PSB) has been increasingly used to
supplement the analgesic effects of opioids in order to eliminate
opioid-related adverse drug events, but its efficacy still remains
controversial. In the present meta-analysis, we aim to screen all eligible
randomized controlled trials (RCTs) and give a comprehensive summary of
the clinical value of PSB after adult cardiac surgery. EVIDENCE
ACQUISITION: We searched all RCTs about PSB after cardiac surgery in the
database of Pubmed, Embase, Cochrane, CNKI and Wanfang with no limitation
of language from inception to September 2021. Two reviewers were
independently involved in the process of data extraction. Meta-analysis
was performed by using Review Manager software. The quality of included
RCTs were assessed by using Cochrane's risk of bias assessment tool, and
funnel plots were drawn to assess publication bias. EVIDENCE SYNTHESIS: A
total of 12 RCTs with 366 patients in PSB group and 364 patients in
control group were included in the present meta-analysis. Pooled analysis
revealed that intraoperative and postoperative consumption of sufentanil
were significantly decreased with the addition of PSB (P<0.05). Numerical
rating scale (NRS) scores in PSB group were found to be significantly
lower than that of control group at extubation, postoperative 4h and 8h
(P<0.05) instead of postoperative 24h or longer. PSB could reduce the
incidence of postoperative nausea and vomiting (PONV) (P<0.05). In
addition, we demonstrated that PSB was significantly related to decreased
mechanical ventilation time, total length of ICU stay and hospital days
(P<0.05). <br/>CONCLUSION(S): Through decreasing the consumption of
opioids, ultrasound-guided PSB could relieve pain and limit opioid-related
complications. Clinical outcomes, such as mechanical ventilation time,
total length of ICU stay and hospital days, will also be improved. Our
findings prove that ultrasound-guided PSB is an effective regional
analgesic method after adult cardiac surgery.

<66>
Accession Number
637699379
Title
Duloxetine role in reducing opioid consumption after thoracotomy: a
prospective, randomized, double -blinded, placebo - controlled pilot
trial.
Source
Minerva anestesiologica. (no pagination), 2022. Date of Publication: 05
Apr 2022.
Author
Abdelghfar E.M.; Othman A.H.; Elrawas M.M.; Kilany A.M.; Shaker E.H.
Institution
(Abdelghfar, Elrawas) Department of Anesthesia and Pain management,
National Cancer Institute, Cairo University, Cairo, Egypt
(Othman) Department of Anesthesia, ICU and Pain Relief, South Egypt Cancer
Institute, Assiut University, Egypt
(Kilany) Department of Research on Children with Special Needs, National
Research Center, Cairo, Egypt
(Shaker) Department of Anesthesia and Pain management, National Cancer
Institute, Cairo University, Cairo, Egypt
Publisher
NLM (Medline)
Abstract
BACKGROUND: Exploration of the thoracic cavity through a thoracotomy
incision for thoracic malignancies is accompanied by severe, excruciating
acute postoperative pain. The objective of this study is to evaluate the
efficacy of perioperative duloxetine when given as part of a multimodal
analgesia in reducing the dose of opioids needed to treat acute
postoperative pain after thoracotomy. <br/>METHOD(S): 60 patients
scheduled for thoracotomy were randomly assigned to one of two treatment
groups. The duloxetine group (D) received duloxetine 60 mg orally two
hours before the surgical procedure and 24 hours after surgery, and the
placebo group (P) received oral equivalent placebo capsules during the
same time schedule. The primary outcome was the postoperative consumption
of narcotics. Secondary outcome measures were assessment of postoperative
pain scores (VAS) during rest, walking and coughing ,hemodynamic variables
and development of any side effects. <br/>RESULT(S): Total dose of
morphine needed to treat postoperative pain in first 48 hours,
intraoperative isoflurane concentrations, intra and postoperative epidural
infusion rates all were significantly lower in group D (P < 0.001).
Postoperative pain at rest (VAS-R) was significantly less frequent in
group D compared to group P at all-time intervals so as during walking
(VAS-W) (P < 0.001). While during cough (VAS-C), it was comparable at all
time point except at 12 hrs which was significantly low in group D (P <
0.001) . The intra, postoperative mean blood pressure and development of
side effects were comparable between the two groups. <br/>CONCLUSION(S):
Oral duloxetine used peri-operatively during thoracic surgery may play an
important role as multimodal analgesia for acute postoperative pain
without any added side effects.

<67>
Accession Number
2016103020
Title
Effects of Physical Prehabilitation on the Dynamics of the Markers of
Endothelial Function in Patients Undergoing Elective Coronary Bypass
Surgery.
Source
Journal of Personalized Medicine. 12(3) (no pagination), 2022. Article
Number: 471. Date of Publication: March 2022.
Author
Argunova Y.; Belik E.; Gruzdeva O.; Ivanov S.; Pomeshkina S.; Barbarash O.
Institution
(Argunova, Belik, Gruzdeva, Ivanov, Pomeshkina, Barbarash) Federal State
Budgetary Scientific Institution "Research Institute for Complex Issues of
Cardiovascular Diseases", 6, Sosnovy Boulevard, Kemerovo 650002, Russian
Federation
Publisher
MDPI
Abstract
Our aim in this study was to evaluate the effect of physical training
performed before CABG on the perioperative dynamics of the serum levels of
asymmetric dimethylarginine (ADMA) and endothelin-1 (ET-1) of patients
with stable coronary heart disease (CHD). Patients in the preoperative
period were randomized into two groups: the training group (n = 43)
underwent high-intensity treadmill training; the patients in the control
group (n = 35) received no training before the procedure. The serum
concentrations of ADMA and ET-1 were determined in the perioperative
period, and the course of the early postoperative period was analyzed. In
the training group, we found a significantly lower incidence of
postoperative complications during hospital stays (p = 0.013). At the end
of the training program, the ADMA levels were 1.8 times higher in the
controls than in the training group (p = 0.001). We found that type 2
diabetes increased the probability of complications by 12 times (OR: 12.3;
95% CI: 1.24-121.5; p = 0.03), as well as elevating the concentration of
ET-1 on the eve of surgery (OR: 10.7; 95% CI: 1.4-81.3; p = 0.02).
Physical prehabilitation reduced the likelihood of complications nine
times (OR: 0.11; 95% CI: 0.02-0.83; p = 0.03). The AUC was 0.851 +/- 0.07
(95% CI: 0.71-0.98). The obtained results indicate the benefit of physical
training during the prehabilitation stage since it can help to preserve
endothelial function.<br/>Copyright &#xa9; 2022 by the authors. Licensee
MDPI, Basel, Switzerland.

<68>
[Use Link to view the full text]
Accession Number
2016751091
Title
What if the Destination Is Transplant? Outcomes of Destination Therapy
Patients Who Were Transplanted.
Source
ASAIO Journal. 68(2) (pp 178-183), 2022. Date of Publication: 01 Feb 2022.
Author
Atluri P.; Silvestry S.C.; Teuteberg J.J.; Milano C.A.; Selzman C.H.;
Cowger J.A.
Institution
(Atluri) Hospital of the University of Pennsylvania, Philadelphia, PA,
United States
(Silvestry) AdventHealth Transplant Institute, Orlando, FL, United States
(Teuteberg) Stanford University Medical Center, Stanford, CA, United
States
(Milano) Duke University Medical Center, Durham, NC, United States
(Selzman) University of Utah Hospital, Salt Lake City, UT, United States
(Cowger) Henry Ford Hospitals, Detroit, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
We sought to characterize patients who underwent heart transplant (HTx)
following destination therapy (DT) implant in the combined
ENDURANCE/ENDURANCE Supplemental Trials (DT/DT2). A post hoc analysis of
the DT/DT2 trials was performed. Baseline characteristics and adverse
events between the HTx and no-HTx cohorts were analyzed. Reasons for
transplant were examined. Time to HTx was compared with contemporaneous
HVAD BTT trial patients. Of the 604 DT/DT2 HVAD patients, 80 (13%)
underwent HTx. The HTx cohort was younger (53.6 +/- 11.1 vs. 65.2 +/-
10.8, P < 0.0001) with fewer Caucasians (60.0% vs. 76.5%, P = 0.002), less
ischemic cardiomyopathy (42.5% vs. 58.8%, P = 0.01), and atrial
fibrillation (38.8% vs. 54.4%, P = 0.01). The HTx cohort had longer
6-minute walk distances (183.6 vs. 38.0 m, P = 0.02). Most HTx in DT/DT2
were categorized as elective (n = 63, 79%) and, of these, 70% were due to
modification of behavioral issues and weight loss. Adverse events were the
main indication for urgent HTx (n = 17, 21%). Median times to HTx were
longer in DT/DT2 (550.0 days) versus BTT/lateral (285.2 days). In this
post hoc analysis of the DT/DT2 trials, over 1 in 10 underwent heart
transplantation within 3 years of HVAD support. In DT therapy patients,
consideration for transplant following DT VAD implant may be
feasible.<br/>Copyright ASAIO 2021.

<69>
[Use Link to view the full text]
Accession Number
2017479047
Title
Cytokine Hemoadsorption during Cardiac Surgery Versus Standard Surgical
Care for Infective Endocarditis REMOVE: Results from a Multicenter
Randomized Controlled Trial.
Source
Circulation. 145(13) (pp 959-968), 2022. Date of Publication: 29 Mar 2022.
Author
Diab M.; Lehmann T.; Bothe W.; Akhyari P.; Platzer S.; Wendt D.; Deppe
A.-C.; Strauch J.; Hagel S.; Gunther A.; Faerber G.; Sponholz C.; Franz
M.; Scherag A.; Velichkov I.; Silaschi M.; Fassl J.; Hofmann B.; Lehmann
S.; Schramm R.; Fritz G.; Szabo G.; Wahlers T.; Matschke K.; Lichtenberg
A.; Pletz M.W.; Gummert J.F.; Beyersdorf F.; Hagl C.; Borger M.A.; Bauer
M.; Brunkhorst F.M.; Doenst T.
Institution
(Diab, Faerber, Velichkov, Doenst) Department of Cardiothoracic Surgery,
Jena University Hospital-Friedrich Schiller University of Jena, Am
Klinikum 1, Jena 07747, Germany
(Diab, Lehmann, Platzer, Scherag, Bauer, Brunkhorst) Center for Sepsis
Control and Care, Jena University Hospital-Friedrich Schiller University
of Jena, Germany
(Lehmann, Platzer, Scherag, Brunkhorst) Center for Clinical Studies, Jena
University Hospital-Friedrich Schiller University of Jena, Germany
(Hagel, Pletz) Institute for Infectious Diseases and Infection Control,
Jena University Hospital-Friedrich Schiller University of Jena, Germany
(Gunther) Department of Neurology, Jena University Hospital-Friedrich
Schiller University of Jena, Germany
(Sponholz, Bauer) Department of Anesthesiology and Critical Care Medicine,
Jena University Hospital-Friedrich Schiller University of Jena, Germany
(Franz) Department of Internal Medicine I, Jena University
Hospital-Friedrich Schiller University of Jena, Germany
(Scherag) Institute of Medical Statistics, Computer and Data Sciences,
Jena University Hospital-Friedrich Schiller University of Jena, Germany
(Bothe, Beyersdorf) Department of Cardiovascular Surgery, University Heart
Center Freiburg-Bad Krozingen, Freiburg, Germany
(Akhyari, Lichtenberg) Department of Cardiothoracic Surgery,
Heinrich-Heine-University, Duesseldorf, Germany
(Wendt) Department of Thoracic and Cardiovascular Surgery, University
Hospital, Essen, Germany
(Deppe, Wahlers) Department of Cardiothoracic Surgery, Heart Center of the
University of Cologne, Germany
(Strauch) Department of Cardiac and Thoracic Surgery, Bergmannsheil
University Hospitals, Bochum, Germany
(Silaschi) Clinic and Polyclinic for Cardiac Surgery, University Hospital,
Bonn, Germany
(Fassl) Institute for Cardiac Anesthesiology, Dresden Heart Center,
University Hospital at the Technical University, Dresden, Germany
(Hofmann, Szabo) Department of Cardiac Surgery, Mid-German Heart Center,
University Hospital Halle Saale, Halle, Germany
(Lehmann, Borger) Department of Cardiac Surgery, Heart Center, Leipzig,
Germany
(Schramm, Gummert) Department of Thoracic and Cardiovascular Surgery,
Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
(Fritz) Department of Anesthesiology, Intensive Care and Pain Therapy,
Heart Center Brandenburg, Immanuel Clinic, Bernau, Germany
(Matschke) Department of Cardiac Surgery, Heart Center, Dresden, Germany
(Hagl) Department of Cardiac Surgery, Ludwig Maximilian University,
Munich, Germany
(Hagl) DZHK German Centre for Cardiovascular Research, Partner Site Munich
Heart Alliance, Munich, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiac surgery often represents the only treatment option in
patients with infective endocarditis IE. However, IE surgery may lead to a
sudden release of inflammatory mediators, which is associated with
postoperative organ dysfunction. We investigated the effect of
hemoadsorption during IE surgery on postoperative organ dysfunction.
<br/>Method(s): This multicenter, randomized, nonblinded, controlled trial
assigned patients undergoing cardiac surgery for IE to hemoadsorption
integration of CytoSorb to cardiopulmonary bypass or control. The primary
outcome change in sequential organ failure assessment score [DELTASOFA]
was defined as the difference between the mean total postoperative SOFA
score, calculated maximally to the 9th postoperative day, and the basal
SOFA score. The analysis was by modified intention to treat. A predefined
intergroup comparison was performed using a linear mixed model for
DELTASOFA including surgeon and baseline SOFA score as fixed effect
covariates and with the surgical center as random effect. The SOFA score
assesses dysfunction in 6 organ systems, each scored from 0 to 4. Higher
scores indicate worsening dysfunction. Secondary outcomes were 30-day
mortality, duration of mechanical ventilation, and vasopressor and renal
replacement therapy. Cytokines were measured in the first 50 patients.
<br/>Result(s): Between January 17, 2018, and January 31, 2020, a total of
288 patients were randomly assigned to hemoadsorption n=142 or control
n=146. Four patients in the hemoadsorption and 2 in the control group were
excluded because they did not undergo surgery. The primary outcome,
DELTASOFA, did not differ between the hemoadsorption and the control group
1.79+/-3.75 and 1.93+/-3.53, respectively; 95% CI, -1.30 to 0.83;
P=0.6766. Mortality at 30 days 21% hemoadsorption versus 22% control;
P=0.782, duration of mechanical ventilation, and vasopressor and renal
replacement therapy did not differ between groups. Levels of
interleukin-1beta and interleukin-18 at the end of integration of
hemoadsorption to cardiopulmonary bypass were significantly lower in the
hemoadsorption than in the control group. <br/>Conclusion(s): This
randomized trial failed to demonstrate a reduction in postoperative organ
dysfunction through intraoperative hemoadsorption in patients undergoing
cardiac surgery for IE. Although hemoadsorption reduced plasma cytokines
at the end of cardiopulmonary bypass, there was no difference in any of
the clinically relevant outcome measures. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT03266302.<br/>Copyright &#xa9; 2022 American Heart Association, Inc.

<70>
Accession Number
2013262856
Title
Implantable cardioverter defibrillators in left ventricular assist device
patients: A systematic review and meta-analysis.
Source
Journal of Heart and Lung Transplantation. 40(10) (pp 1098-1106), 2021.
Date of Publication: October 2021.
Author
Rorris F.-P.; Antonopoulos C.N.; Kyriakopoulos C.P.; Drakos S.G.; Charitos
C.
Institution
(Rorris, Antonopoulos, Charitos) Department of Thoracic and Cardiovascular
Surgery, Evangelismos General Hospital, Athens, Greece
(Kyriakopoulos, Drakos) Division of Cardiovascular Medicine, Department of
Internal Medicine, University of Utah Health & School of Medicine, Salt
Lake City, UT, United States
Publisher
Elsevier Inc.
Abstract
Implantable cardioverter-defibrillators (ICDs) remain the standard of care
in advanced heart failure with reduced ejection fraction patients for the
prevention of sudden cardiac death. However, current guidelines remain
conflicting with respect to the use of ICDs in patients supported with a
continuous flow left ventricular assist device (CF-LVAD). The current
review adhered to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. Studies comparing the use of ICD in patients
with CF-LVADs were included. The 2 primary outcomes studied were all-cause
mortality, and a successful bridge to heart transplantation. We calculated
pooled odds ratios (ORs) with 95% confidence intervals (CIs). We also
compared baseline characteristics between US and European studies, for
CF-LVAD patients with an ICD. Among all studies, the use of an ICD was not
associated with all-cause mortality in patients with CF-LVADs (OR: 0.85,
95% CIs: 0.64-1.12, p = 0.24). The presence of an ICD was associated with
a trend towards increased likelihood of successful bridge to heart
transplantation (OR: 1.12, 95% CI: 1.0-1.3, p = 0.06). A subgroup analysis
of studies published by European centers revealed a significant decrease
in pooled mortality (OR: 0.58, 95% CI: 0.4-0.83, p = 0.003) with the use
of ICD, contrary to an increase in pooled mortality among studies
published by US centers (OR: 1.2, 95% CI 1.02-1.33, p = 0.025). Moreover,
we identified significant differences in baseline characteristics such as
bridge to transplantation rate, Interagency Registry for Mechanically
Assisted Circulatory Support profiles, and use of an intra-aortic balloon
pump or extracorporeal membrane oxygenation preoperatively, between the US
and European populations. While this meta-analysis did not show an overall
survival benefit with the use of an ICD in CF-LVAD patients, it revealed
significant differences in the derived benefit, in distinct patient
populations. This might reflect differences in baseline patient
characteristics and warrants further investigation.<br/>Copyright &#xa9;
2021 International Society for Heart and Lung Transplantation

<71>
[Use Link to view the full text]
Accession Number
2014641234
Title
Smart Glasses for Radial Arterial Catheterization in Pediatric Patients: A
Randomized Clinical Trial.
Source
Anesthesiology. 135(4) (pp 612-620), 2021. Date of Publication: 01 Oct
2021.
Author
Jang Y.-E.; Cho S.-A.; Ji S.-H.; Kim E.-H.; Lee J.-H.; Kim H.-S.; Kim
J.-T.
Institution
(Jang, Ji, Kim, Lee, Kim, Kim) Seoul National University Hospital, Seoul
National University College of Medicine, 101 Daehakno, Jongnogu, Seoul,
South Korea
(Cho) Department of Anesthesiology and Pain Medicine, Konyang University
Hospital, Daejeon, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Hand-eye coordination and ergonomics are important for the
success of delicate ultrasound-guided medical procedures. These can be
improved using smart glasses (head-mounted display) by decreasing the head
movement on the ultrasound screen. The hypothesis was that the smart
glasses could improve the success rate of ultrasound-guided pediatric
radial arterial catheterization. <br/>Method(s): This prospective,
single-blinded, randomized controlled, single-center study enrolled
pediatric patients (n = 116, age less than 2 yr) requiring radial artery
cannulation during general anesthesia. The participants were randomized
into the ultrasound screen group (control) or the smart glasses group.
After inducing general anesthesia, ultrasound-guided radial artery
catheterization was performed. The primary outcome was the first-Attempt
success rate. The secondary outcomes included the first-Attempt procedure
time, the overall complication rate, and operators' ergonomic satisfaction
(5-point scale). <br/>Result(s): In total, 116 children were included in
the analysis. The smart glasses group had a higher first-Attempt success
rate than the control group (87.9% [51/58] vs. 72.4% [42/58]; P = 0.036;
odds ratio, 2.78; 95% CI, 1.04 to 7.4; absolute risk reduction,-15.5%; 95%
CI,-29.8 to-12.8%). The smart glasses group had a shorter first-Attempt
procedure time (median, 33 s; interquartile range, 23 to 47 s; range, 10
to 141 s) than the control group (median, 43 s; interquartile range, 31 to
67 s; range, 17 to 248 s; P = 0.007). The overall complication rate was
lower in the smart glasses group than in the control group (5.2% [3/58]
vs. 29.3% [17/58]; P = 0.001; odds ratio, 0.132; 95% CI, 0.036 to 0.48;
absolute risk reduction, 24.1%; 95% CI, 11.1 to 37.2%). The proportion of
positive ergonomic satisfaction (4 = good or 5 = best) was higher in the
smart glasses group than in the control group (65.5% [38/58] vs. 20.7%
[12/58]; P <0.001; odds ratio, 7.3; 95% CI, 3.16 to 16.8; absolute risk
reduction,-44.8%; 95% CI,-60.9% to-28.8%). <br/>Conclusion(s): Smart
glasses-Assisted ultrasound-guided radial artery catheterization improved
the first-Attempt success rate and ergonomic satisfaction while reducing
the first-Attempt procedure time and overall complication rates in small
pediatric patients.<br/>Copyright &#xa9; 2021 Lippincott Williams and
Wilkins. All rights reserved.

<72>
Accession Number
2014638183
Title
Radiation Toxicity in Patients With Collagen Vascular Disease: A
Meta-Analysis of Case-Control Studies.
Source
International Journal of Radiation Oncology Biology Physics. 111(5) (pp
1214-1226), 2021. Date of Publication: 01 Dec 2021.
Author
Shaikh P.M.; Singh S.A.; Alite F.; Vargo J.A.; Emami B.; Wu M.-J.;
Jacobson G.; Bakalov V.; Small W.; Dahshan B.; Weir J.; Renz P.B.;
Harkenrider M.M.
Institution
(Shaikh, Singh, Jacobson, Dahshan, Weir) West Virginia University,
Department of Radiation Oncology, Morgantown, WV, United States
(Alite) Geisinger Medical Center, Department of Radiation Oncology,
Danville, PA, United States
(Vargo) University of Pittsburgh Medical Center, Department of Radiation
Oncology, Pittsburgh, PA, United States
(Emami, Wu, Small, Harkenrider) Loyola University Chicago, Stritch School
of Medicine, Department of Radiation Oncology, Maywood, IL, United States
(Bakalov, Renz) Allegheny General Hospital, Department of Radiation
Oncology, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Several retrospective series have reported that patients with
collagen vascular disease (CVD) are at increased risk of radiation (RT)
toxicity. However, the evidence is mixed, and many series lack control
groups. We performed a meta-analysis including only case-cohort or
randomized studies that examined the risk of RT toxicity for patients with
CVD compared with controls. Methods and Materials: Meta-analysis of
Observational Studies in Epidemiology guidelines were used to perform a
comprehensive search identifying case-control or randomized studies
reporting RT toxicity outcomes for patients with CVD versus controls. Data
were synthesized from studies reporting grade 2 to 3 or more (G2/3 +)
acute and late RT toxicities. Results were analyzed with fixed effects
meta-analysis on the random-effects model for between-study heterogeneity;
otherwise, the fixed-effects model was used. Hazard ratio or odds ratio
(OR) were the effect-size estimators, as appropriate. <br/>Result(s): Ten
studies were included, with 4028 patients (CVD: 406, control: 3622).
Patients with CVD had higher rates of acute G2/3 + toxicity (26.2% vs
16.5%, OR [odds ratio] 2.01; P <.001) and late G2/3 + toxicity (18.4% vs
10.1%, OR 2.37; P <.001). Higher rates of late G2/3 + toxicity were
observed for CVD patients with systemic lupus erythematous (21% vs 9.7%;
OR 2.55, P =.03), systemic scleroderma (31.8% vs 9.7%, OR 3.85; P =.03),
rheumatoid arthritis (11.7% vs 8.4%, OR = 2.56; P =.008), and those
irradiated to the pelvis/abdomen (32.2% vs 11.9%, OR 3.29; P =.001),
breast (14.7% vs 4.4%, OR 3.51; P =.003), thorax (12.5% vs 8.7%, OR 3.46;
P <.001), and skin (14.6% vs 5.2%, OR 2.59; P =.02). Late grade 5
toxicities were significantly higher for patients with CVD, although
absolute rates were low (3.9% vs 0.6%, OR = 7.81; P =.01).
<br/>Conclusion(s): Moderate and severe toxicities are more likely in
patients with CVD, with variable risk depending on toxicity grade, CVD
subtype, treatment site, and dose. Severe toxicities are uncommon. These
factors should be considered when informing patients of treatment-related
risks and monitoring for morbid treatment sequelae.<br/>Copyright &#xa9;
2021 Elsevier Inc.

<73>
Accession Number
2013342731
Title
Variability and Reproducibility of the SYNTAX Score for Triple-Vessel
Disease.
Source
Cardiovascular Revascularization Medicine. 37 (pp 86-89), 2022. Date of
Publication: April 2022.
Author
Basman C.; Levine E.; Tejpal A.; Thampi S.; Rashid U.; Barry R.; Stoffels
G.; Kliger C.A.; Coplan N.; Patel N.; Scheinerman S.J.; Singh V.P.
Institution
(Basman, Levine, Tejpal, Thampi, Rashid, Barry, Stoffels, Kliger, Coplan,
Patel, Scheinerman, Singh) Department of Cardiothoracic Surgery and
Cardiovascular Medicine, Lenox Hill Heart and Lung, Northwell Health
System, 130 East 77th Street, Black Hall 4th floor, New York, NY 10075,
United States
(Basman, Rashid, Singh) Department of Cardiovascular Medicine, Northern
Westchester Hospital, Northwell Health System, 400 E. Main St, Mt Kisco,
NY 10549, United States
Publisher
Elsevier Inc.
Abstract
Background: The SYNTAX score (SX) is an angiographic grading system to
determine the burden and complexity of coronary artery disease (CAD) and
to guide operators as to the appropriateness of percutaneous coronary
intervention (PCI) vs coronary artery bypass grafting (CABG). However,
variability of the SX may exist since the assessment relies on individual
clinicians to visually interpret lesion severity and characteristics. We
therefore aimed to assess SX variability and reproducibility among
interpreting physicians. <br/>Method(s): Fifty patient angiograms were
randomly selected from a registry of patients with multi-vessel CAD
(treated with PCI or CABG) completed at our institution during the years
2011-2018. Each angiogram was evaluated by 6 clinicians on 2 separate
occasions (minimum 8 weeks between occasions) for a total of 600 SX. Our
goal was to evaluate both inter- and intra- observer reliability of SX
scores. Variation in both raw score as well as risk classification (low,
intermediate or high SX) was observed. Inter- and intra-observer
reliability were assessed using the intra-class correlation coefficient
(ICC), Cohen's weighted Kappa, and Fleiss' Kappa. <br/>Result(s): SYNTAX
scores on both assessments and across all 6 cardiologists had a mean score
of 25.3. On the first assessment, the ICC for the inter-observer
reliability of SX scores was 0.61 (95% CI: 0.50, 0.73). Across the 6
observers, only 16% of angiograms were classified in the same risk
classification by all observers. 34% of angiograms had less than a
majority agreement (3 or less observers) on risk classification. The
weighted Kappa for intra-observer reliability of risk classification
scores ranged from 0.30 to 0.81. Across the 6 observers, the proportion of
angiograms classified as the same risk classification between each
observer's 1st and 2nd assessment ranged from 46% to 84%.
<br/>Conclusion(s): This study shows a wide inter- and intra- user
variability in calculating SX. Our data indicates a significant limitation
in using the SX to guide revascularization strategies. Further studies are
needed to determine more reliable ways to quantitate burden of
CAD.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<74>
Accession Number
2011614145
Title
Testing the feasibility of operationalizing a prospective, randomized
trial with remote cardiac safety EKG monitoring during a pandemic.
Source
Journal of Interventional Cardiac Electrophysiology. 63(2) (pp 345-356),
2022. Date of Publication: March 2022.
Author
Liu H.H.; Ezekowitz M.D.; Columbo M.; Khan O.; Martin J.; Spahr J.; Yaron
D.; Cushinotto L.; Kapelusznik L.
Institution
(Liu, Ezekowitz, Columbo, Martin, Kapelusznik) Department of Medicine,
Bryn Mawr Hospital, Bryn Mawr, PA, United States
(Ezekowitz) The Sidney Kimmel Medical College, Philadelphia, PA, United
States
(Khan) Lankenau Internal Medicine Residency Program, Lankenau Hospital,
Main Line Health System, Wynnewood, PA, United States
(Spahr) LewesDEUnited States
(Yaron) Bryn Mawr Family Practice Residency, Bryn Mawr Hospital, Bryn
Mawr, PA, United States
(Cushinotto) Department of Pharmacy, Bryn Mawr Hospital, Bryn Mawr, PA,
United States
Publisher
Springer
Abstract
Background: The coronavirus SARS-CoV-2 is highly contagious.
Hydroxychloroquine (HCQ) has in vitro activity against SARS-CoV-2. The FDA
authorized emergency use of HCQ against COVID-19. HCQ may have
dose-related cardiotoxicity. This clinical trial received ethical approval
on May 15, 2020, operationalized in June to evaluate a low prophylaxis
dose of HCQ (200mg BID) in household contacts of COVID-19-positive
patients without physical contact between investigators and participants.
It represents the first report of the FDA approved 6-lead EKGs with a
smartphone KardiaMobile 6L application. <br/>Method(s): To reach a sample
size of 170, household members were contacted by telephone, emailed
consent forms with electronic signature capability, and randomized 2:1 to
HCQ or observation for 10 days with follow-up of 14 days. Home saliva PCR
tests recorded COVID status on days 1 and 14. Symptoms and 6-lead EKGs
were obtained daily. <br/>Result(s): Fifty-one participants were
randomized with 42 evaluable at day 14. Remote monitoring of 407 EKGs
revealed no QTc prolongation or other ECG changes in either group. At time
of consent, no participants were symptomatic or COVID+. On days 1 and 14,
COVID tests were positive in 4 and 2 in the HCQ group and 4 and 0 in the
observation group. No tests converted to positive. There were no deaths or
hospitalizations. <br/>Conclusion(s): A clinical trial without personal
contact, rapidly initiated and operationalized to exclude cardiac toxicity
using daily remote 6-lead EKG monitoring, is feasible. Of 407 EKGs from 42
participants, there was no evidence of cardiac toxicity. Clinical trial
registration: Clinicaltrials.gov: NCT04652648 registration date: December
3, 2020.<br/>Copyright &#xa9; 2021, Springer Science+Business Media, LLC,
part of Springer Nature.

<75>
Accession Number
2015260958
Title
Comparison of Warfarin Initiation at 3 mg Versus 5 mg for Anticoagulation
of Patients with Mechanical Mitral Valve Replacement Surgery: A
Prospective Randomized Trial.
Source
Clinical Drug Investigation. 42(4) (pp 309-318), 2022. Date of
Publication: April 2022.
Author
Sabry S.; El Wakeel L.M.; Saleh A.; Ahmed M.A.
Institution
(Sabry) The Cardiovascular Hospital, Ain Shams University, Cairo, Egypt
(El Wakeel, Ahmed) Department of Clinical Pharmacy, Faculty of Pharmacy,
Ain Shams University, 8/4 Badr Street from Al Gazaer Street, New Maadi,
Cairo, Egypt
(Saleh) Department of Cardiology, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
Publisher
Adis
Abstract
Background: The increased warfarin sensitivity observed after mechanical
mitral valve replacement (MVR) operations dictates clinical discretion in
warfarin dose initiation. Evidence is still lacking with regard to
anticoagulation management of MVR patients. <br/>Objective(s): This study
aimed to compare initiating warfarin at the recommended dosing regimen
versus empirically lowered doses intended to account for the variation in
warfarin sensitivity. <br/>Method(s): A prospective, single-blind,
randomized, comparative study was conducted in postoperative MVR patients.
Patients were randomly assigned to either the 5 mg group (n = 25) or the 3
mg group (n = 25) and were initiated on a 5 or 3 mg warfarin dose,
respectively. Time to target international normalized ratio (INR), time in
therapeutic range, occurrence of bleeding/thromboembolic events, and cost
of bridging with enoxaparin were assessed for both groups. <br/>Result(s):
Target INR was achieved earlier in the 5 mg group than in the 3 mg group
(p = 0.033), with a mean +/- SD of 5.3 +/- 2.0 and 6.6 +/- 2.0,
respectively (95% confidence interval of the mean difference 1.022-1.890).
Bleeding events did not differ significantly between the two groups. The
cost of enoxaparin consumption per patient was significantly higher in the
3 mg group versus the 5 mg group (p = 0.002). <br/>Conclusion(s): The
initiation of warfarin at a 5 mg dose in MVR patients was more efficacious
than the 3 mg dose in terms of time to reach the target INR. Moreover, the
cost of enoxaparin bridging was significantly reduced with a 5 mg warfarin
initiation dose. Bleeding events were comparable. ClinicalTrials.gov ID:
NCT04235569, 22 January 2020.<br/>Copyright &#xa9; 2022, The Author(s).

<76>
Accession Number
2013892224
Title
Efficacy and safety of low intensity vitamin K antagonists in Western and
East-Asian patients with left-sided mechanical heart valves.
Source
Journal of Thrombosis and Thrombolysis. 53(3) (pp 697-707), 2022. Date of
Publication: April 2022.
Author
Pandey A.K.; Xu K.; Zhang L.; Gupta S.; Eikelboom J.; Lopes R.D.; Crowther
M.; Belley-Cote E.P.; Whitlock R.P.
Institution
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, Canada
(Xu) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong
University, Shanghai, China
(Zhang) Banner University Medical Center, Tucson, United States
(Gupta, Whitlock) Division of Cardiac Surgery, Department of Surgery,
McMaster University, Hamilton, Canada
(Eikelboom, Crowther) Department of Medicine, McMaster University,
Hamilton, Canada
(Eikelboom, Belley-Cote, Whitlock) Population Health Research Institute,
237 Barton Street East, Hamilton, ON, Canada
(Lopes) Duke Clinical Research Institute, Durham, United States
(Lopes) Duke University School of Medicine, Durham, United States
(Crowther) Division of Hematology, Department of Medicine, McMaster
University, Hamilton, Canada
(Belley-Cote, Whitlock) Department of Health Research Methods, Evidence
and Impact, McMaster University, Hamilton, Canada
(Belley-Cote) Division of Cardiology, Department of Medicine, McMaster
University, Hamilton, Canada
Publisher
Springer
Abstract
The optimal INR target in patients with mechanical heart valves is
unclear. Higher INR targets are often used in Western compared with East
Asian countries. The objective of this systematic review and meta-analysis
was to summarize the evidence for the efficacy and safety of lower versus
higher INR targets in Western and East Asian left-sided mechanical heart
valve patients. We searched Western databases including Cochrane CENTRAL,
Medline, and Embase as well as Chinese databases including SinoMed, CNKI,
and Wanfang Data in addition to grey literature for Randomized Controlled
Trials (RCTs) and observational studies. We pooled risk ratios (RRs) using
random-effects model. Low and high INR targets were defined by the
individual studies. We identified nine RCTs, including six Western (n =
5496) and three East Asian (n = 209) trials, and 17 observational studies,
including two Western (n = 3199) and 15 East Asian (n = 5485) studies. In
the RCTs, lower compared with higher targets were associated with similar
rates of thromboembolism (2.4 vs. 2.3%; RR: 1.14, 95% CI 0.82, 1.60,
I² = 0%) and lower rates of both total bleeding (21.9 vs.
40.9%, RR: 0.46, 95% CI 0.28, 0.78, I² = 88%) and major
bleeding. RCT data showed no statistical heterogeneity by region. These
effects were consistent in the observational data. We downgraded the
quality of evidence due to serious risk of bias and imprecision. In
patients with left-sided contemporary mechanical heart valves, low quality
evidence suggests lower INR targets are associated with similar rates of
thromboembolism and moderate quality evidence suggests lower rates of
bleeding.<br/>Copyright &#xa9; 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<77>
Accession Number
637669337
Title
The effect of diabetes on surgical versus percutaneous left main
revascularization outcomes: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 17(1) (pp 61), 2022. Date of
Publication: 01 Apr 2022.
Author
d'Entremont M.-A.; Yagi R.; Salia S.J.S.; Zhang S.; Shaban L.;
Bene-Alhasan Y.; Papatheodorou S.; Couture EL.; Huynh T.; Nguyen M.;
Hamaya R.
Institution
(d'Entremont) Division of Cardiology, Department of Medicine, Sherbrooke
University Hospital Center (CHUS), 3001, 12e Avenue Nord, Sherbrooke, QC,
J1H 5N4, Canada. marc-andre.dentremont@usherbrooke.ca
(d'Entremont) Harvard T.H. Chan School of Public Health, MA, Boston,
United States
(Yagi, Salia, Zhang, Shaban, Bene-Alhasan, Papatheodorou, Hamaya) Harvard
T.H. Chan School of Public Health, MA, Boston, United States
(Yagi) Saiseikai Central Hospital, Tokyo, Japan
(Couture, Nguyen) Division of Cardiology, Department of Medicine,
Sherbrooke University Hospital Center (CHUS), 3001, 12e Avenue Nord,
Sherbrooke, QC, J1H 5N4, Canada
(Huynh) McGill Health University Center, QC, Montreal, Canada
(Hamaya) Brigham and Women's Hospital, MA, Boston, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal method of coronary revascularization for diabetes
mellitus (DM) patients with left main coronary artery disease (LMCAD) is
controversial in the drug-eluting stent (DES) era. <br/>METHOD(S): We
performed a systematic review and meta-analysis comparing DES-based
percutaneous coronary intervention (PCI) to coronary artery bypass
grafting (CABG) for LMCAD in DM patients and tested for effect measure
modification (EMM) by diabetes for adverse events. We included all
randomized controlled trials (RCTs) and observational studies comparing
CABG to DES-based PCI including DM patients with LMCAD published up to
March 1, 2021. We completed separate random-effects meta-analyses for four
RCTs (4356 patients, mean follow-up of 4.9 years) and six observational
studies (9360 patients, mean follow-up of 5.2 years). <br/>RESULT(S): In
RCTs among DM patients, DES-based PCI, compared to CABG, was associated
with a 30% increased relative risk (RR) (RR 1.30, 95% CI 1.09-1.56,
I2=0%), while among non-DM patients, there was a 25% increased relative
risk (RR 1.25, 95% CI 1.07-1.44, I2=0%) for the composite endpoint of
all-cause mortality, myocardial infarction, stroke, and unplanned
revascularization (MACCE). There was no evidence of EMM (p-value for
interaction=0.70). The mean weighted SYNTAX score was 25.7. In
observational studies, there was no difference between DES-based PCI and
CABG for all-cause mortality in patients with DM (RR 1.13, 95% CI
0.91-1.40, I2=0%). <br/>CONCLUSION(S): CABG was superior to PCI for LMCAD
in RCTs in DM patients for MACCE. Heart teams may consider DM as one of
the many components in the clinical decision-making process, but may not
want to consider DM as a primary deciding factor between DES-based PCI and
CABG for LMCAD with low to intermediate anatomical complexity in the other
coronary arteries. STUDY REGISTRATION: CRD42021246931
(PROSPERO).<br/>Copyright &#xa9; 2022. The Author(s).

<78>
Accession Number
636585701
Title
Nurse-guided incentive spirometry use and postoperative pulmonary
complications among cardiac surgery patients: A randomized controlled
trial.
Source
International journal of nursing practice. 28(2) (pp e13023), 2022. Date
of Publication: 01 Apr 2022.
Author
Alwekhyan S.A.; Alshraideh J.A.; Yousef K.M.; Hayajneh F.
Institution
(Alwekhyan) Princess Muna College of Nursing, Mutah University, Jordan
(Alshraideh, Yousef, Hayajneh) School of Nursing, University of Jordan,
Amman, Jordan
(Yousef) School of Humanities, Social Sciences and Health University of
Wollongong, Dubai, United Arab Emirates
Publisher
NLM (Medline)
Abstract
AIMS: To assess the effect of nurse-guided use of incentive spirometer on
postoperative oxygenation and pulmonary complications after coronary
artery bypass graft surgery. BACKGROUND: Deep breathing exercises have
been shown to improve postoperative lung expansion and reduce pulmonary
complications. An incentive spirometer is a deep breathing exercises
device that imitates continuous sigh-like maximal inspiration. DESIGN:
Randomized control trial, two groups nonblinded parallel design.
<br/>METHOD(S): A total of n=89 eligible patients were randomized to
either control or intervention group. Patients in the intervention group
received bihourly nurse-guided incentive spirometry for 48-h
postextubation. The endpoints were: the number and duration of hypoxic
events during the first 24-hr postsurgery, pneumonia and pulmonary
function parameters. Data were collected May to September 2019.
<br/>RESULT(S): Patients in the intervention group had a significantly
lower mean number of hypoxic events with shorter duration and shorter
length of stay in the hospital and the ICU. Patients in the intervention
group also had greater postoperative forced expiratory volume in 1second.
<br/>CONCLUSION(S): Nurse-guided use of the incentive spirometer reduces
the risk of pulmonary complications and hospital length of stay after
cardiac surgery.<br/>Copyright &#xa9; 2021 John Wiley & Sons Australia,
Ltd.

<79>
Accession Number
627653230
Title
Transcutaneous electrical acupoint stimulation improves immunological
function during the perioperative period in patients with non-small cell
lung cancer undergoing video-assisted thoracic surgical lobectomy.
Source
Technology in Cancer Research and Treatment. 17 (no pagination), 2018.
Date of Publication: January 2018.
Author
Tu Q.; Yang Z.; Gan J.; Zhang J.; Que B.; Song Q.; Wang Y.
Institution
(Tu, Gan) Department of Anesthesiology, Tangshan People's Hospital, North
China University of Science and Technology, Tangshan, China
(Tu) The Graduate School of NorthChina University of Science and
Technology, Tangshan, China
(Yang) Department of Gastrointestinal Surgery, Sichuan Academy of Medical
Sciences, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
(Zhang) Department of Anesthesiology, The Third People's Hospital of
Chengdu, Southwest Jiao Tong University, Chendu, China
(Que) Department of Anesthesiology, Hangzhou Hospital of Traditional
Chinese Medicine, Hangzhou, China
(Song) Department of Cardiology, Tangshan People's Hospital, North China
University of Science and Technology, Tangshan, China
(Wang) Department of Neurology, Tangshan People's Hospital, North China
University of Science and Technology, Tangshan, China
Publisher
SAGE Publications Inc.
Abstract
The immunological function of patients with malignant tumors may be
suppressed during the perioperative period. However, details on the
effects of transcutaneous electrical acupoint stimulation (TEAS) on
immunological function are relatively lacking. We designed this study to
examine the effects of TEAS on the immunological function of patients with
non-small cell lung cancer (NSCLC) during the perioperative period.
Participants (n = 144) were enrolled and randomly assigned into group TEAS
or group sham TEAS. TEAS on bilateral Feishu (BL13), Hegu (L14), and
Zusanli (ST36) was performed continuously throughout the procedure. The
primary outcome was the quantities of natural killer (NK) cells at 30
minutes before induction (T<inf>0</inf>), 5 minutes after intubation
(T<inf>1</inf>), at the beginning of the operation (T<inf>2</inf>), at the
beginning of the lobectomy (T<inf>3</inf>), at the beginning of the
lymphadenectomy (T<inf>4</inf>), and immediately after extubation
(T<inf>5</inf>). The secondary outcomes were the serum levels of tumor
necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) at
T<inf>0</inf> to T<inf>5</inf>, the mean arterial pressure (MAP) and heart
rate (HR), the intraoperative consumption of propofol and remifentanil,
the incidence of hypoxemia, postoperative nausea and vomiting (PONV), and
the length of hospital stay. The quantities of NK cells were decreased in
group sham TEAS after intubation compared to that in group TEAS, while the
quantities of NK cells in group TEAS were similar at T<inf>0</inf> to
T<inf>5</inf>. Meanwhile, the quantities of NK cells in group sham TEAS at
T<inf>1</inf> (P =.012), T<inf>2</inf> (P <.001), T<inf>3</inf> (P =.027),
T<inf>4</inf> (P =.045), and T<inf>5</inf> (P =.021) were lower than those
in group TEAS. In group TEAS, the serum levels of TNF-alpha were lower at
T<inf>1</inf> to T<inf>5</inf>, while the levels of IL-6 were lower at
T<inf>2</inf> to T<inf>5</inf>. Furthermore, the intraoperative MAP and HR
were more stable, the total propofol and remifentanil consumptions were
lower, and the length of hospital stay was shorter than those in group
sham TEAS. The application of TEAS can effectively reverse the decrease in
NK cells, decrease the serum levels of TNF-alpha and IL-6, maintain
hemodynamic stability during the perioperative period, decrease the
consumption of propofol and remifentanil, and shorten the length of the
hospital stay.<br/>Copyright &#xa9; The Author(s) 2018.

<80>
Accession Number
2017591782
Title
Immunosuppressant Drug Level Monitoring in Pediatric Heart Transplant
Recipients: A Report from the TEAMMATE Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S87-S88), 2022. Date of Publication:
April 2022.
Author
Bock M.J.; Lal A.K.; Auerbach S.R.; Castleberry C.; Hollander S.A.; Daly
K.P.; Almond C.; Rossano J.W.; Lee J.; Sleeper L.A.; Pahl E.; TEAMMATE
Trial Investigators F.T.
Institution
(Bock) Rady Children's Hospital, UC San Diego, San Diego, CA, United
States
(Lal) University of Utah, Primary Children's Hospital, Salt Lake City, UT,
United States
(Auerbach) Children's Hospital Colorado, Denver, CO, United States
(Castleberry) Dell Children's Medical Center, Austin, TX, United States
(Hollander, Almond, Lee) Stanford University School of Medicine, Palo
Alto, CA, United States
(Daly, Sleeper, TEAMMATE Trial Investigators) Boston Children's Hospital,
Boston, MA, United States
(Rossano) Children's Hospital of Philadelphia, Philadelphia, PA, United
States
(Pahl) Northwestern University Feinberg School of Medicine, Chicago, IL,
United States
Publisher
Elsevier Inc.
Abstract
Purpose: The TEAMMATE Trial is studying everolimus (EVL) with low-dose
tacrolimus (LDTAC) vs. standard tacrolimus (TAC) with mycophenolate (MMF)
in a randomized trial in children enrolled at 6 months post-heart
transplant. Since therapeutic levels are correlated with lower rejection
rates, we sought to describe the immunosuppressant drug level monitoring
experience in the trial to date. <br/>Method(s): All children in the
TEAMMATE Trial remaining on assigned therapy as of August 2021 were
included. Drug levels were obtained at 0, 3, 6, 9, 12, 18, 24, & 30 months
post-randomization. Formulation, time to therapeutic level, and number of
dose adjustments were tracked at each study visit. Stability was assessed
by the coefficient of variation (CoV) (SD/mean). Adherence was assessed by
the % of levels within range; and the SD of levels divided by therapeutic
window (lower values indicating better adherence). Independence of all
levels was assumed in analysis. <br/>Result(s): A total of 211 children
were randomized to either EVL/LDTAC (n=107) or usual care TAC/MMF (n=104).
After randomization, a therapeutic level was achieved in 94% (EVL) & 91%
(MMF). Liquid formulation was used in 37% of EVL subjects. Median time to
a therapeutic level for EVL was 10 (tablet) & 11 (liquid) days. The CoV
was lower for TAC (36%), EVL (47%), & LDTAC (52%), compared to MMF (103%).
Drug levels were in target range 80% (EVL), 20% (MMF), 55% (LDTAC), & 54%
(TAC) of the time (Figure). The SD of levels divided by therapeutic window
was lowest for EVL (44%), compared to TAC (94%), LDTAC (112%), & MMF
(158%). In response to these levels, dose changes were made in 13% (EVL) &
18% (LDTAC) in the EVL/LDTAC group (16% combined) and in 27% (TAC) and 11%
(MMF) in the control group (22% combined). <br/>Conclusion(s): EVL
achieves stable target levels more frequently than MMF, LDTAC or TAC,
likely due to decreased trough level variability and its wider therapeutic
window. Fewer dose adjustments have been required for the EVL/LDTAC
regimen compared to TAC/MMF.<br/>Copyright &#xa9; 2022

<81>
Accession Number
2017591779
Title
PCSK9 Inhibitors Safely and Effectively Lower LDL After Heart
Transplantation: A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S408), 2022. Date of Publication:
April 2022.
Author
Jennings D.L.; Sultan L.; Mingov J.; Choe J.; Finnegan K.; Latif F.;
Restaino S.; Clerkin K.; Yuzefpolskaya M.; Sayer G.; Uriel N.; Baker W.
Institution
(Jennings) Pharmacy, New York-Presbyterian Hospital, New York, NY, United
States
(Sultan, Mingov) Long Island University, Brooklyn, NY, United States
(Choe, Finnegan) New York Presbyterian Hospital, New York, NY, United
States
(Latif, Restaino, Clerkin, Yuzefpolskaya, Sayer, Uriel) Columbia
University, New York, NY, United States
(Baker) University of Connecticut, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Coronary allograft vasculopathy (CAV) continues to afflict a
majority of heart transplant (HT) recipients, and elevated LDL is a key
risk factor. Many patients cannot tolerate statin medications after HT,
however data for alternative agents remains scarce. To address this key
evidence gap, we evaluated the safety and efficacy of the PCSK9i after HT
through systematic review and meta-analysis. <br/>Method(s): We searched
Medline, Cochrane Central, and Scopus from the earliest date through July
15^th, 2021. Citations were included if they were a report of
PCSK9i use in adults after HT and reported an outcome of interest.
Outcomes included change in LDL cholesterol from baseline, incidence of
adverse events, and evidence of CAV. Changes from baseline and outcome
incidences were pooled using contemporary random-effects model
methodologies. <br/>Result(s): 'A total of six studies including 97
patients were evaluated, most of which either had statin intolerance or
refractory hyperlipidemia. Over a mean follow up of 13 months (range
3-21), PCSK9i use lowered LDL by 82.61 mg/dL (95% CI -119.15 to -46.07;
I²=82%) (Figure 1) from baseline. Serious adverse drug
reactions were rarely reported, and none were attributable to the PCSK9i
therapy. Three studies reported stable calcineurin inhibitor levels during
PCSK9i initiation. One study reported outcomes in 33 patients with serial
coronary angiography and intravascular ultrasound, and PCSK9i were
associated with stable coronary plaque thickness and lumen area. No
studies reported on immunologic safety (i.e. development of DSA), hence
this endpoint cannot be assessed. <br/>Conclusion(s): Preliminary data
suggest that long-term PCSK9i therapy is safe, significantly lowers LDL,
and may attenuate CAV after HT. Additional study on larger cohorts is
warranted to confirm these findings.<br/>Copyright &#xa9; 2022

<82>
Accession Number
2017591712
Title
Artificial Intelligence for the Prognostication and Management of Heart
Transplant: A Scoping Review.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S219), 2022. Date of Publication:
April 2022.
Author
Giacobbo S.; Murray K.R.; Moayedi Y.; Duero Posada J.; McIntosh C.; Ross
H.J.; Foroutan F.
Institution
(Giacobbo, Murray, Moayedi, Duero Posada, Ross) Cardiology, University
Health Network, Toronto, ON, Canada
(McIntosh, Foroutan) Ted Rogers Computational Program, University Health
Network, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: Current clinical guidelines related to the identification and
management of heart transplant (HT) outcomes are based on small studies or
expert consensus. With a growing interest in artificial intelligence (AI)
to optimize prognostication and management of patients post-HT, our
scoping review aims to summarize the current state of AI in the setting of
HT, and its potential impact on clinical practice. <br/>Method(s): We
systematically searched MEDLINE, Embase, and Inspec for observational and
interventional studies that applied AI methodologies to a HT population.
Blinded abstract screening and full text review were completed in
duplicate. Disagreements were resolved by consensus or independent
third-party adjudication. <br/>Result(s): A total of 1351 publications
were initially identified. Among these, 78 met our inclusion criteria,
primarily addressing themes of prognosis (n=53), diagnosis (n=23), and
management (n=2) of HT patients (Fig 1A). AI models were applied to
various clinical applications, including the classification and prediction
of pre- and post-HT outcomes (e.g., graft function, hospitalization,
re-HT, and survival), detection of acute cellular rejection and cardiac
allograft vasculopathy, and modelling of blood levels of immunosuppressive
agents. In 18 studies, AI models were directly compared against
conventional logistic regression, and in half of these studies AI
outperformed conventional models. Of note, 31% (n=24) of the included
studies were full manuscripts, whereas 69% (n=54) were peer-reviewed
conference abstracts (Fig 1B). <br/>Conclusion(s): AI presents a unique
opportunity to enhance organ allocation, donor-recipient matching, and
post-HT survival and management. Unfortunately, with the current state of
evidence, there is a lack of primary studies that transition from abstract
presentation to manuscript publication, perhaps suggesting more robust
validation is required prior to the ubiquitous integration of AI into
clinical practice.<br/>Copyright &#xa9; 2022

<83>
Accession Number
2017591708
Title
Post-Heart Transplant Employment: Rates, Predictors, and Interventions.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S198-S199), 2022. Date of Publication:
April 2022.
Author
Casciato M.
Institution
(Casciato) University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: Heart transplantation (HT) extends survival and improves quality
of life, permitting patients to regain a more active role in society. The
ISHLT reports that approximately 70% of adult HT recipients can engage in
their daily activities without limitation, however, overall rates of
employment remain less than 40% between three and five-years post-HT. The
purpose of this study is to describe rates, predictors, and interventions
of employment in HT recipients based on the available literature.
<br/>Method(s): We conducted a systematic literature search of four
electronic databases in May 2021 using a combination of key terms
including "organ transplantation", "return to work", "employment", and
"social integration." Eligible studies on post-HT social reintegration,
specifically employment, were selected by three independent reviewers.
<br/>Result(s): A total of 4,360 title and abstracts were generated. The
literature search and reference lists of relevant articles identified
twenty-two papers on post-HT employment rates, nineteen papers on
predictors of employment post-HT, and two papers on interventions for
social reintegration in HT recipients. Employment was defined as paid
part-time or full-time work. Post-HT employment rates were highly variable
and ranged from 21% to 73% at 1 year post-transplant. The most frequently
reported predictors of post-HT employment were younger age at time of HT,
pre-HT employment, higher education, and positive self-perception of
workability. Successful Interventions in increasing employment rates and
social reintegration included both physical and psychosocial
rehabilitation programs reported in a case study and cross-sectional
study. <br/>Conclusion(s): Our review of the available literature has
demonstrated variability in post-HT employment rates and some patient
characteristics associated with post-HT employment. However, only a small
number of interventions have specifically targeted the HT population. We
proposed an approach to developing an intervention that is patient
informed and requires multidisciplinary methods to identify patients at
high risk of unemployment post-transplant, is sustainable outside of the
transplant centre, and is patient partnered to ensure feasibility and
practicality.<br/>Copyright &#xa9; 2022

<84>
Accession Number
2017591589
Title
Donor Simvastatin Treatment is More Effective in Donors with Low Plasma
Levels of Arginine.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S147), 2022. Date of Publication:
April 2022.
Author
Dhaygude K.U.; Nykanen A.I.; Krebs R.; Lemstrom K.
Institution
(Dhaygude, Nykanen, Krebs, Lemstrom) Transplantation Laboratory,
University of Helsinki, Helsinki, Finland
Publisher
Elsevier Inc.
Abstract
Purpose: Brain death may lead to a severe impairment of endothelial
function and affect graft function. Recent study shows that simvastatin
treatment to the organ donor decreases plasma biomarker levels of
myocardial injury and heart failure and reduces the number of acute
rejection episodes with hemodynamic compromise early after heart
transplantation. However, the mechanisms of donor simvastatin treatment
remain unknown. Therefore, we analyzed the plasma metabolomics of
brain-dead heart transplant donors with or without simvastatin treatment
to examine the molecular background of the beneficial effects.
<br/>Method(s): In a prospective, double-blinded randomized controlled
trial, 84 multiorgan donors were randomly assigned to receive either 80 mg
of simvastatin (n=42) via nasogastric tube or to receive no simvastatin
(n=42). Plasma samples from 84 human brain-dead multi-organ donors were
collected immediately before organ procurement. We profiled over 100
targeted metabolites using mass spectrometry. <br/>Result(s): We found
that arginine and tryptophan were weakly negatively correlated with
simvastatin treatment. Univariate Cox regression analysis showed that low
levels of arginine were significantly associated with acute rejection and
graft-related mortality (Figure 1 A,B). Additionally, we saw that donor
simvastatin treatment significantly reduced the number of acute rejections
by 41% (p=0.012) in low arginine group within the first year (Figure 1C).
There was no difference in donor demographics between the groups. However,
there was a statistically significantly higher need for mechanical
circulatory support for hearts from donors with low arginine levels.
<br/>Conclusion(s): This study shows that donor simvastatin treatment
could be more efficient in brain-dead heart transplant donors with low
arginine. Further analysis will be conducted by exploring the interplay
between arginine and simvastatin in detail. The complete results will be
presented at the ISHLT2022 congress.<br/>Copyright &#xa9; 2022

<85>
Accession Number
2017591508
Title
Outcomes of Patients with SCAD Complicated by Cardiogenic Shock Bridged
with Temporary Mechanical Circulatory Support to Heart Transplant and
Durable LVAD.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S355-S356), 2022. Date of Publication:
April 2022.
Author
Nosair W.; Kadaru T.; Mammen P.; Araj F.
Institution
(Nosair, Kadaru) Department of Internal Medicine, University of Texas
Southwestern Medical Center, Dallas, TX, United States
(Mammen, Araj) Department of Internal Medicine, Division of Cardiology,
University of Texas Southwestern Medical Center, Dallas, TX, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Cardiogenic shock (CS) is a rare but potentially fatal
presentation of spontaneous coronary artery dissection (SCAD). SCAD is
often associated with abnormalities in other vascular beds. The safety and
outcomes of patients with SCAD-CS on temporary MCS (TCMS) devices as a
bridge to heart transplant (HT) and durable left ventricular assist device
(LVAD) is unknown. We sought to characterize the outcomes of this unique
population. <br/>Method(s): A comprehensive search of MEDLINE/PubMed
identified 33 relevant publications meeting inclusion criteria. Data on
patient characteristics, safety, and clinical outcomes was extracted.
<br/>Result(s): A cohort of 37 patients from a total of 33 case reports
and series were identified. Most were female with an average age of 36 +/-
6 years. SCAD-CS was the presenting manifestation in 16% of patients,
while others progressed to CS later in their course. Revascularization was
performed by CABG and PCI in 42% and 31% of patients, respectively. TMCS
use included IABP (57%), VA-ECMO (31%), Impella (16%), surgically placed
temporary VAD (8%), and biventricular support device (3%). Escalation to
VA-ECMO or surgically placed temporary VAD was required in 7 patients (6
on IABP; 1 on Impella). Non-fatal TMCS complications included hemolysis
(n=1, Impella) and bleeding with femoral artery dissection (n=1, VA-ECMO).
Fatal complications included death from hemorrhagic shock due to
accidental decannulation (n=1, VA-ECMO). Overall survival to discharge was
86%. Fourteen percent of patients received HT and 8.1% received durable
LVAD. Complications related to HT include RV failure/death from a marginal
donor allograft (n=1), acute graft rejection (n=1), and CMV viremia (n=1).
Complications of durable VAD included pump thrombosis requiring pump
exchange and HT (n=1). Other causes of death unrelated to TMCS included
cardiac arrest (n=1), rupture of the right common iliac artery (n=1), and
LV wall rupture (n=1). There was great variability in post-discharge
outcome reporting. <br/>Conclusion(s): Little is known about the
appropriate management of SCAD-CS. To our knowledge, no prior studies have
reported on outcomes of patients with SCAD-CS bridged with TMCS to HT and
durable LVAD. Our data suggests acceptable outcomes in this subset of
patients. Larger scale prospective studies are warranted to validate this
data.<br/>Copyright &#xa9; 2022

<86>
Accession Number
2017591440
Title
Post-Transplant Metabolomics Profiles in Patients Undergoing Lung
Transplantation.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S51), 2022. Date of Publication: April
2022.
Author
Varghese A.; Ryan A.; Wells C.; Li G.; Baer D.; Parker E.A.; Buko A.; Kaza
V.; Banga A.; Bollineni S.; Mahan L.D.; Mohanka M.; Lawrence A.; Joerns
J.; Torres F.; Wait M.; Iacono A.; Verceles A.C.; Terada L.; Terrin M.;
Timofte I.
Institution
(Varghese) Pulmonary, University of Maryland, BaltimoreBaltimore, MD,
United States
(Ryan, Li) Gerontology and Geriatric Medicine, University of Maryland
School of Medicine, and the Baltimore Geriatric Research, Education and
Clinical Center, Baltimore, MD, United States
(Wells, Parker) Physical Therapy and Rehabilitation Science, University of
Maryland, Baltimore, Baltimore, MD, United States
(Baer) Heart and Lung Transplant, University of Maryland, Baltimore,
Baltimore, MD, United States
(Buko) Human Metabolome, Human Metabolome Technologies America Inc.,
Boston, MA, United States
(Kaza, Banga, Bollineni, Mahan, Mohanka, Lawrence, Joerns, Torres, Terada,
Timofte) Pulmonary and Critical Care, UT Southwestern, Dallas, TX, United
States
(Wait) Cardiovascular and Thoracic Surgery, UT Southwestern, Dallas, TX,
United States
(Iacono) Pulmonary, Northwell Health, Manhasset, NY, United States
(Verceles) Pulmonary and Critical Care, University of Maryland, Baltimore,
Baltimore, MD, United States
(Terrin) Department of Epidemiology and Public Health, University of
Maryland, Baltimore, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Optimal nutrition is recognized as an essential component to
successful outcomes for post procedure recovery after a major
cardio-thoracic procedure. We developed a unique multi-modal
rehabilitation program that combines physical therapy protocol with
neuromuscular electric stimulation (NMES) and protein supplementation to
achieve improved functional outcomes for advanced lung disease patients
requiring transplantation Methods: The patients were randomized to either
the treatment arm (n=5) or usual care (n=6) 72 hours after the transplant.
Both groups of patients underwent an initial global assessment of
functional capabilities and blood metabolomic profile evaluation 72 hours
post-transplantation. Patients in the treatment arm received additional
physical therapy plus NMES (10 days) and nutrition supplementation with
essential amino acids (3 times/day) during hospital recovery. Follow up
metabolomic profile analysis was performed on 14 days and 3-month
post-transplant plasma samples. <br/>Result(s): Compared to the standard
of care group, the treatment group decreased average time of intubation
(1.6 vs 2.16 days), decreased average ICU length of stay (5.80 vs 8.67
days) and decreased average hospital length of stay (16.8 vs 19.5 days).
The treatment group had increased hypotaurine levels indicating a
cytoprotective anti-oxidant effect against free radicals and tissue
damage. Preliminary results comparing hypotaurine levels at 72 hours,14
days and 3 month in the treatment group (T-72 hr T-14 days, T-3 months)
compared to control group (C-72 hr C-14 days, C-3 months) are presented in
figure 1. <br/>Conclusion(s): Defining the role of metabolomics in
post-transplant monitoring is still in its early stages. We intend to use
the data obtained from this pilot study to develop a larger, randomized
interventional trial evaluating the effects of an intense multimodal
rehabilitation program on improving post-operative outcomes and defining
blood biomarkers of muscle atrophy during ICU stay after lung
transplantation.<br/>Copyright &#xa9; 2022

<87>
Accession Number
2017591408
Title
Gene Expression Transcriptome Profile Validation: A Critical Appraisal of
Methods and Signature Analyses.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S302), 2022. Date of Publication:
April 2022.
Author
Giarraputo A.; Barison I.; Fedrigo M.; Vedovelli L.; Castellani C.; Rossi
E.; Tona F.; Bottio T.; Gerosa G.; Abate D.; Mandruzzato S.; Basso C.;
Gregori D.; Angelini A.
Institution
(Giarraputo, Barison, Fedrigo, Castellani, Basso, Angelini) Cardiovascular
Pathology, Department of Cardiac, Thoracic and Vascular Science and Public
Health, University of Padova, Padova, Italy
(Vedovelli, Gregori) Unit of Biostatistics, Epidemiology and Public
Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public
Health, University of Padova, Padova, Italy
(Rossi, Mandruzzato) Oncology and Immunology Section, Department of
Surgery, Oncology and Gastroenterology, University of Padova, Padova,
Padova, Italy
(Tona, Bottio, Gerosa) Division of Cardiac Surgery, Dept. of Cardiac,
Thoracic and Vascular Surgery and Public Health, University of Padova,
Padova, Italy
(Abate) Department of Molecular Medicine, University of Padova, Padova,
Italy
Publisher
Elsevier Inc.
Abstract
Purpose: The aim of our study is to assess the reliability of
transcriptome profile platform outcomes between different tissue
preservation conditions, RNA extraction methods and heart-failure-related
genes, minimizing intra- and inter-experimental variability.
<br/>Method(s): Our cohort of study is composed by 6 FFPE endomyocardial
biopsies (EMBs) and 6 fresh frozen (FF) heart tissues samples belonging to
the same adult end-stage heart failure patient, limiting inter-patient
variability bias. Two major RNA extraction procedure were tested for FF
and FFPE tissues. Then, we performed a high-throughput microarray
expression profiling without a bias of transcript selection. We analyzed
mRNAs expression through R programming and transcriptome analysis
software, exploring >20000 transcripts. We refined the transcriptome
analysis selecting, from a literature systematic review appraisal 30
heart-failure related genes, coupling the overlapping genes in the
differential expression and network analysis. <br/>Result(s): We compared
the analysis of up- and down-regulated genes between the groups,
addressing both the different RNA extraction procedure and tissue
preservation, while sharing the same transcriptome platform. The
differential expressed genes (DEG) analyzed had fold change set at 2 and
-2, and a cut-off threshold of FDR adjusted p-value < 0,05. Heatmap showed
a great samples' clusterization according to preservation and extraction
methods. Only 284 genes passed filter criteria in FFPE inter-groups
comparison of extraction methods, while 52 differed in FFPE vs. FF,
showing a great overlap of transcriptome signature, corroborated by the
heart-failure related set of genes. The network analysis highlighted that
most of the DEG are strongly associated (p-value adjusted <0.004) to the
dysregulation of reticulum and collagen related cell component, in
accordance with heart failure stage. <br/>Conclusion(s): To the best of
our knowledge, this is the first study in heart transplantation fields
comparing genetic extraction and preservation methods for microarray
expression profile evaluation correlated with pathophysiological
mechanism. A proof of concept that RNAs from FFPE-EMBs, and not only FF,
are feasible for microarray expression profile evaluation, and derived
transcriptome profiles have a strong potential for research and diagnostic
clinical application.<br/>Copyright &#xa9; 2022

<88>
Accession Number
2017591267
Title
Quality of Life Post-Sternotomy: Reassessing the Utility of
Standard-of-Care Sternal Precautions.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S477), 2022. Date of Publication:
April 2022.
Author
Li Z.; Rasheed N.; Jang A.; Patel A.; Jang Y.; Yu D.; Adatsi C.; Nowak A.;
Hoang R.; Hu K.; Siddiqi U.; Rodgers D.; Jeevanandam V.
Institution
(Li, Rasheed, Jang, Patel, Jang, Yu, Adatsi, Nowak, Hoang, Hu, Siddiqi,
Rodgers, Jeevanandam) University of Chicago, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Standard sternal precautions are prescribed for six to eight
weeks following median sternotomy and include measures such as avoiding
>10 lb weight lifting, overhead movements, and driving. However,
postoperative complications have declined in large part due to advances in
sternal closure techniques from traditional wire cerclage to sternal
plating. A single published report from overseas suggested that current
precautions may be unnecessarily restrictive and result in increased
recovery time and reduced quality of life post sternotomy. To date, there
is no published US study that investigated the psychosocial outcomes
following median sternotomy. We hypothesize that reduction in sternal
precautions will lead to a higher quality of life without compromising
sternal integrity. <br/>Method(s): In this single-center, prospective 1:1
randomized study, we plan to enroll 64 patients who will undergo
sternotomy for open heart surgeries (excluding heart transplant and LVAD
implantation) at University of Chicago Medical Center into either standard
of care or self-managed precautions groups. The former group requires
strict adherence to current institutional sternal precautions, while the
latter group will be guided by comfort and/or pain based on self-perceived
and self-assessed physical limitations. English-speaking patients between
the ages of 18-70 receiving a first-time median sternotomy are eligible
for enrollment. For eight weeks post discharge, a quality of life EQ5D
questionnaire will be administered weekly via telephone by a medical
professional who will separately verify adherence to the assigned
protocols as well as document occurrence of major adverse clinical events.
Endpoints: The primary objective of this study is to determine whether
patients in the self-managed group can achieve increased quality of life
as compared to the standard sternal precautions group following median
sternotomy without increase in adverse clinical events. The findings could
potentially provide strong evidence for updated and uniform sternal
precautions protocols that eliminate outdated restrictions and enhance
overall quality of life post sternotomy.<br/>Copyright &#xa9; 2022

<89>
Accession Number
2017591237
Title
Expanding Heart Transplants from Donors After Circulatory Death (DCD) -
Results of the First Randomized Controlled Trial Using the Organ Care
System (OCSTM) Heart - (OCS DCD Heart Trial).
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S72), 2022. Date of Publication: April
2022.
Author
Schroder J.N.; Shah A.; Pretorius V.; Smith J.; Daneshmand M.; Geirsson
A.; Pham S.; Um J.; Silvestry S.; Shaffer A.; Mudy K.; Kai M.; Joyce D.;
Philpott J.; Takeda K.; Goldstein D.; Shudo Y.; Couper G.; Mallidi H.;
Esmailian F.; Pham D.; Salerno C.; Lozonschi L.; Quader M.; Patel C.;
DeVore A.; Bryner B.; Madsen J.; Absi T.; Milano C.; D'Alessandro D.
Institution
(Schroder) Duke University School of Medicine, Duke, Durham, NC, United
States
(Shah, Absi) Vanderbilt University Medical Center, Nashville, TN, United
States
(Pretorius) University of California at San Diego, San Diego, CA, United
States
(Smith) University of Wisconsin Hospitals, Madison, WI, United States
(Daneshmand) Emory University, Atlanta, GA, United States
(Geirsson) Yale New Haven Hospital, New Haven, CT, United States
(Pham) Mayo Clinic - Florida, Jacksonville, FL, United States
(Um) Nebraska Medical Center, Omaha, NE, United States
(Silvestry) AdventHealth, Orlando, FL, United States
(Shaffer) University of Minnesota, Minneapolis, MN, United States
(Mudy) Minneapolis Heart Institute Foundation, Minneapolis, MN, United
States
(Kai) Westchester Medical Center, Westchester, NY, United States
(Joyce) Medical College of Wisconsin, Milwaukee, WI, United States
(Philpott) Sentara Medical Group, Norfolk, VA, United States
(Takeda) Columbia University, New York, NY, United States
(Goldstein) Montefiore Medical Center, New York, NY, United States
(Shudo) Stanford University, Palo Alto, CA, United States
(Couper) Tufts Medical Center, Boston, MA, United States
(Mallidi) Brigham and Women's Hospital, Boston, MA, United States
(Esmailian) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Pham) Northwestern University, Chicago, IL, United States
(Salerno) University of Chicago, Chicago, IL, United States
(Lozonschi) Tampa General Hospital, Tampa, FL, United States
(Quader) Virginia Commonwealth University, Richmond, VA, United States
(Patel, DeVore, Bryner, Milano) Duke University School of Medicine,
Durham, NC, United States
(Madsen, D'Alessandro) Massachusetts General Hospital, Boston, MA, United
States
Publisher
Elsevier Inc.
Abstract
Purpose: To evaluate the effectiveness of the OCS Heart technology to
resuscitate, preserve and assess DCD hearts for transplantation.
<br/>Method(s): OCS DCD Heart Trial included the following donor inclusion
criteria: Maastricht Category III DCD donor, donor age 18-49 years old,
warm ischemic time (WIT) <=30 mins. Donor exclusions: Previous history of
cardiac surgery, coronary artery disease, cardiogenic shock, or myocardial
infarction, terminal EF of <=50%, or significant valve disease. Recipient
inclusion criteria: primary adult heart transplant candidates. Recipient
exclusion: multi-organ transplant candidates, history of prior solid organ
or bone marrow transplants, history of chronic renal failure, or
unrandomized recipients. Candidates were randomized 3:1 into two groups:
DCD Heart Possible (DCD) or DBD cold stored hearts (Control). The trial
protocol final analysis was prespecified to compare the post-transplant
outcome from recipients of DCD hearts preserved on OCS (DCD) to all those
who received DBD hearts preserved with cold storage (DBD Control).
Endpoints: Patient survival at 6- and 12-months post-transplantation.
Other endpoints included; OCS DCD hearts utilization rate defined as the
number of DCD hearts transplanted after OCS perfusion divided by the total
number of eligible DCD donor hearts that were instrumented on OCS,
incidence of severe left or right ventricular ISHLT PGD. Safety endpoint
was defined as the incidence of Heart Graft-related Serious Adverse Events
(HGRSAEs) in the first 30 days post-transplant defined as moderate or
severe left or right ventricular ISHLT PGD, or primary graft failure
requiring re-transplantation. <br/>Result(s): A total of 180 patients were
randomized and transplanted in the trial (DCD-OCS n=90 and Control-DBD
n=90) at 13 heart transplant centers in the U.S. between 2019 and 2020.
There was a total of 101 DCD donor hearts instrumented on OCS Heart
technology, of those 90 were transplanted for an overall DCD hearts
utilization rate of 89% (90/101). Donors and Recipients' demographics and
risk factors were similar between the two arms except for age (donors- DCD
29.3 +/- 7.5 vs Control 33.2 +/- 11.4) (recipients- DCD-OCS 51.3 +/- 12.6
vs Control-DBD 55.0 +/- 11.4 p=0.041). Patient survival at 6 months was
DCD 94.4% vs Control 88.6% p<0.0001, and graft survival at 6 months was
DCD 98.9% vs Control 96.7% from K-M analysis. Patient survival at 1 year
was DCD 93.3% vs Control 87.3%, and graft survival at 1 year was DCD 97.7%
vs Control 96.7% from K-M analysis. Safety endpoint was similar between
both trial arms DCD 0.2 HGRSAE per patient vs Control 0.1 HGRSAE per
patient. Incidence of moderate or severe ISHLT PGD was 20% in DCD arm vs.
9.1% in Control arm. Incidence of primary graft failure was 0% in the DCD
arm vs 2.2% in Control. <br/>Conclusion(s): The OCS DCD Heart trial was
the first ever randomized trial comparing DCD heart transplant to DBD
standard criteria heart transplant clinical outcomes. The trial
demonstrated that the use of OCS Heart resulted in high rate of DCD heart
utilization for transplantation with excellent patient and graft survival
outcomes compared to DBD donor hearts. These results support the increased
use of DCD hearts for transplantation to expand the pool of donor hearts
for transplantation.Kaplan-Meier Analysis of Patient & Graft
Survival.<br/>Copyright &#xa9; 2022

<90>
Accession Number
2017591146
Title
Effect of Hydroxocobalamin Compared to Methylene Blue for Management of
Vasoplegia.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S129-S130), 2022. Date of Publication:
April 2022.
Author
Trinh L.; Pearston A.; Fernandes S.E.; Kiley P.; Floroff C.K.; Ingemi A.I.
Institution
(Trinh, Kiley) Virginia Commonwealth University, Richmond, VA, United
States
(Pearston, Floroff, Ingemi) Sentara Norfolk General Hospital, Norfolk, VA,
United States
(Fernandes) Inpatient Pharmacy, Sentara Norfolk General Hospital, Norfolk,
VA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Vasoplegic syndrome is a common complication following cardiac
surgery, characterized by profound systemic hypotension from poor systemic
vascular resistance (SVR) requiring high doses of vasopressors.
Hydroxocobalamin and methylene blue are two medications used to decrease
vasoplegia and vasopressors requirements, thereby decreasing morbidity and
mortality. The purpose of this study is to evaluate whether
hydroxocobalamin or methylene blue is more effective in relieving
vasoplegia as defined by reducing vasopressor requirements.
<br/>Method(s): This was a retrospective chart review performed at an
academic medical center between March 2020 through August 2021. Patients
ages 18-89 who received a dose of hydroxocobalamin or methylene blue while
in a cardiac intensive care unit for vasoplegia were included for
analysis. The primary outcome was the time to reduction of 50% of original
vasopressor requirements, defined in norepinephrine equivalents. Secondary
outcomes include change in mean arterial pressure (MAP), cardiac index,
SVR, ICU length of stay (LOS), mortality, and the need for renal
replacement therapy. The primary outcome will be expressed as means with
standard deviations as well as a time to event analysis with a
Kaplan-Meier Curve and log rank test. <br/>Result(s): Patients were
treated with a one-time 5mg dose of hydroxocobalamin (n=8) or dose(s) of
methylene blue (n=15). The time to reduction of 50% of vasopressor
requirements was 5.75 hours with hydroxocobalamin and 13.08 hours with
methylene blue (p=0.0248). Change in MAP at 4 hours post dose was 7.75
mmHg with hydroxocobalamin and -0.93 mmHg in methylene blue (p=0.150).
There was no difference in change in cardiac index (p=0.11), ICU LOS
(p=0.11), or mortality (p=1). Change in SVR increased by 428.4
dynes/sec/cm5 with hydroxocobalamin and 95.6 dynes/sec/cm5 with methylene
blue (p=0.0238). Need for renal replacement therapy was 62.5% with
hydroxocobalamin and 13% with methylene blue (p=0.0257).
<br/>Conclusion(s): Use of hydroxocobalamin for vasoplegia is associated
with a significantly faster time to a 50% reduction of vasopressor
requirements and an increase in SVR post administration compared to
methylene blue. Hydroxocobalamin was also significantly associated with an
increase in need for renal replacement therapy. The clinical significance
of these effects must be determined in larger, randomized controlled
trials.<br/>Copyright &#xa9; 2022

<91>
Accession Number
2017591069
Title
Influence of Probiotic Supplementation in Inflammatory Profile of Patients
with Heart Failure - Study PROBHF: A Clinical Trial, Randomized,
Double-Blind, Placebo-Controlled.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S203), 2022. Date of Publication:
April 2022.
Author
Gomes T.T.; Mangini S.; Marcondes-Braga F.G.; Avila M.S.; Campos I.W.;
Santos F.B.; Seguro L.F.; Bacal F.
Institution
(Gomes, Mangini, Marcondes-Braga, Avila, Campos, Santos, Seguro, Bacal)
Heart Institute, Sao Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Purpose: In previous studies in different clinical scenarios, probiotics
can help to modulate inflammatory cytokines and impact in clinical
outcomes. Heart failure presents an intense inflammatory profile that is
related to worse outcomes. We have scarce information about the impact of
probiotic supplementation in heart failure. <br/>Method(s): In this
randomized, double-blind, placebo-controlled clinical trial, we randomly
assigned 57 outpatients with functional class III or IV, or that were
included in heart transplant waiting list, to receive probiotic
Lactobacillus acidophilus LA14 (at a dose of 1x10⁹ CFU once a
day) or placebo. The primary outcome was the impact in plasmatic levels of
TNF-alpha. Secondary outcomes included the influence of probiotic in other
inflammatory cytokines (interleukins (IL) 1,6), lipopolysaccharide (LPS)
and clinical outcomes as hospitalizations, transplantation and death.
<br/>Result(s): After six months follow-up, there were no evidence of
effect of probiotic in plasmatic levels of TNF- alpha (4,55 x 5,18pg/mL,
p=0,294) and other cytokines (IL1 3,9 x 3,12 pg/mL, p=0,688; IL6 1,21 x
1,19 pg/mL, p= 0,915) and LPS (1,39 x 1,81 pg/mL, p=0,708). Probiotic also
did not exert impact on hospitalization (relative risk, 1,1; 95% CI, 0,28
to 2,7, p=0,81), transplantation (relative risk, 1,1; 95% CI; 0,13 to
6,55, p= 0,94) and mortality (relative risk, 1,1; 95% CI, 0,18 to 4,51, p=
0,91). <br/>Conclusion(s): Probiotic supplementation in outpatients with
advanced heart failure did not impact in plasmatic levels of inflammatory
cytokines, LPS and clinical outcomes.<br/>Copyright &#xa9; 2022

<92>
Accession Number
2017590993
Title
Early Single Center Experience of Heart Transplantation from Donation
After Circulatory Death Donors in the United States.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S74), 2022. Date of Publication: April
2022.
Author
Fetten K.; White R.; Huynh D.; Gernhofer Y.K.; Jackson B.; Lee C.; Adler
E.; Kearns M.J.; Pretorius V.
Institution
(Fetten, White, Huynh, Gernhofer, Jackson, Lee, Adler, Kearns, Pretorius)
UC San Diego, San Diego, CA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Heart transplantation (HT) from donation after circulatory death
(DCD) donors has been proposed as a means of addressing the scarcity of
available donor grafts. International experience has suggested that DCD HT
is safe, with outcomes comparable to donation after brain death (DBD) HT.
Herein we describe our center's early experience using 2 DCD heart
procurement strategies: 1) A direct procurement and perfusion (DPP)
protocol, and 2) A thoracoabdominal normothermic regional perfusion
(TA-NRP) protocol. <br/>Method(s): In September 2020, we launched a DCD HT
program as part of a randomized trial using DPP and the OCS Transmedics
platform. We subsequently launched a TA-NRP program. The TA-NRP protocol
uses mobile cardiopulmonary bypass (CPB) to assess hearts in situ
following declaration of death. Functional warm ischemic time (FWIT) was
defined as the time from onset of mean pressure <50mm Hg or oxygen
saturation <70%, to cold flush (DPP) or initiation of CPB (TA-NRP). FWIT
was <=30 minutes for DPP, while there was no pre-defined limit for TA-NRP.
Data was prospectively collected. Donor and recipient characteristics were
analyzed. We report 30-day survival as the primary endpoint. Secondary
endpoints include incidence of primary graft dysfunction requiring
mechanical support, immediate cardiac performance, ventilator days, need
for renal replacement therapy, and intensive care and hospital length of
stay. <br/>Result(s): From September 2020 to October 2021, our center
attended 50 candidate DCD donors, and performed 33 DCD HTs (66.0%),
comprised of 13 DPP and 20 TA-NRP protocol donors. Among candidate DPP
donors, 13 of 23 (56.5%) hearts were transplanted, whereas among candidate
TA-NRP donors, 20 of 27 (74.1%) were transplanted. Year-to-date, DCD as a
proportion of all HTs at our center has been 43.1%. Comparing similar time
periods before and after implementing our DCD heart transplant program
revealed a 20.3% increase in transplant activity. Donor and recipient
characteristics are described in tabular format. 30-day survival is 100%
among all DCD heart recipients. The incidence of primary graft dysfunction
and other secondary endpoints are comparable with standard DBD HT.
<br/>Conclusion(s): DCD HT using both the DPP and TA-NRP procurement
protocols is feasible and safe. Outcomes in our early single center
experience are comparable with standard DBD HT.<br/>Copyright &#xa9; 2022

<93>
Accession Number
2017590930
Title
Induction Therapy in Heart Transplantation: A Systematic Review and
Network Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S151), 2022. Date of Publication:
April 2022.
Author
Kugathasan L.; Wang S.M.; Rodenas-Alesina E.; Orchanian-Cheff A.; Kozuszko
S.; Demas-Clarke P.; Bertolotti A.M.; Greig D.; Gustafsson F.; Stehlik J.;
Badiwala M.; McDonald M.; Foroutan F.; Alba A.C.
Institution
(Kugathasan, Wang, Rodenas-Alesina, Orchanian-Cheff, Kozuszko,
Demas-Clarke, Badiwala, McDonald, Foroutan, Alba) Toronto General
Hospital, Toronto, ON, Canada
(Bertolotti) Favaloro Foundation University Hospital, Buenos Aires,
Argentina
(Greig) Pontificia Universidad Catolica de Chile Universitary Hospital,
Santiago, Chile
(Gustafsson) University of Copenhagen, Copenhagen, Denmark
(Stehlik) University of Utah School of Medicine, Salt Lake City, UT,
United States
Publisher
Elsevier Inc.
Abstract
Purpose: The utility of immunosuppressive induction therapy (IT) following
heart transplantation remains contested. In order to evaluate the
effectiveness and safety of IT, we conducted a systematic review and
network meta-analysis (NMA), evaluating outcomes at 1 year post-heart
transplantation. <br/>Method(s): We searched bibliographic databases for
studies published from January 2000 to July 2021, reporting on the impact
of any IT agent in adult patients undergoing heart transplantation. We
performed a frequentist NMA evaluating the impact of currently available
agents on 1-year all-cause mortality and treated rejection. The analysis
generated direct and/or indirect estimates on the effect of IT on outcomes
as relative risks (RR). The GRADE framework informed the quality of
evidence. <br/>Result(s): Of the 3,913 publications identified, 23
full-text studies proved eligible, of which 10 reported mortality or
rejection outcomes at 1-year, informing the comparison among basiliximab,
thymoglobulin (ATG), and no IT. These studies included 7 randomized
controlled trials (RCTs) and 3 observational studies with adjusted
analyses. Compared to no IT, ATG (RR 0.87, 95% CI 0.80-0.94) was
associated with a significantly decreased risk of rejection, while
basiliximab was not (RR 1.02, 95% CI 0.89-1.16). Mortality at 1 year was
similar with vs without IT - ATG: RR 4.82, 95% CI 0.63-36.71 and
basiliximab: RR 4.26, 95% CI 0.57-32.02. The use of ATG was associated
with a significantly lower risk of rejection compared to basiliximab (RR
0.85, 95% CI 0.77-0.94), but with similar mortality (RR 1.14, 95% CI
0.40-3.23). As compared to the full network, our sensitivity analysis of
RCTs alone showed no significant differences in pooled estimates of
rejection or mortality for any of the network comparisons.
<br/>Conclusion(s): With low certainty in the synthetized evidence, this
NMA suggests that the use of IT does not confer mortality benefit at 1
year after heart transplantation. The risk of rejection may, however, be
reduced by ATG compared to no IT or basiliximab, although this was not
statistically significant when only evaluating data from RCTs, likely due
to the small number of events and insufficient power. The utility of IT in
specific patient populations, in the long-term, and on other outcomes such
as infections, graft dysfunction, kidney dysfunction, and malignancies,
remains to be explored.<br/>Copyright &#xa9; 2022

<94>
Accession Number
2017590736
Title
Ventricular Arrhythmias and Implantable Cardioverter-Defibrillator Use in
Patients with Left-Ventricular Assist Device: Validation of the VT-LVAD
Prediction Score.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S357), 2022. Date of Publication:
April 2022.
Author
Massie E.; Boulet J.; De Marco C.; Noly P.; Mondesert B.; Ducharme A.
Institution
(Massie, Boulet, De Marco, Mondesert, Ducharme) Cardiology, Montreal Heart
Institute, Montreal, QC, Canada
(Noly) Cardiac Surgery, Montreal Heart Institute, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: In the absence of proven survival benefit, de novo implantation
of an implantable cardioverter defibrillator (ICD) in patients treated
with a durable left ventricular assist device (LVAD) remains
controversial. This study aims to assess the incidence of ventricular
arrhythmias (VA) and ICD complications in patients stratified by VT-LVAD
Score. <br/>Method(s): Patients implanted with a durable LVAD at our
institution between 2010 and 2020 were reviewed (n=63). They were
retrospectively classified into two groups according to the VT-LVAD
prediction score: 27 patients were deemed at low/intermediate risk (&lt5)
and 36 patients at high/very high arrhythmic risk (&gt5). Preoperative
characteristics, outcomes, ICD-related complications and arrhythmic events
were compared between the two groups. <br/>Result(s): Mean follow-up was
43+/-35 months, and mean duration of support was 11+/-16 months. Patients
in the low/intermediate risk group were generally healthier. They were
younger (53 vs. 60 years old) and had less atrial fibrillation (18% vs.
64%) and VA (22% vs. 81%). In the low/intermediate risk group, 12 (44%)
patients had an ICD prior to LVAD implantation, 8 (30%) patients had an
ICD post LVAD implantation and 7 (26%) patients either died or underwent
cardiac transplantation before consideration of an ICD. In the high/very
high risk group, 28 (78%) patients had an ICD prior to LVAD implantation,
5 (14%) patients had an ICD post LVAD implantation and 3 (8%) patients
either died before consideration of an ICD. Among patients with an ICD in
the low/intermediate-risk group (n=20), 2 (10%) patients had an
inappropriate shock secondary to supraventricular tachycardia (SVT). Two
patients required appropriate antitachycardia pacing (ATP) without shock.
In patients with an ICD in the high/very high risk group (n=33), 9 (27%)
required appropriate ATP and 1 (3%) had an inappropriate shock secondary
to SVT. There was no other ICD complication. <br/>Conclusion(s): Our
analysis showed that patients with LVAD do not seem to derive a mortality
benefit from a primary prevention strategy for ICD implantation.
Nevertheless, the rate of ICD-associated complications was low. The
VT-LVAD score may be useful to discriminate amongst LVAD patients at high
risk of arrhythmic events. However, a large, randomized trial is needed to
validate this strategy.<br/>Copyright &#xa9; 2022

<95>
Accession Number
2017590693
Title
Use of Induction Therapy Post Heart Transplantation: A Heart Transplant
Rapid Recommendations.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S303), 2022. Date of Publication:
April 2022.
Author
Foroutan F.; Guyatt G.H.; Stehlik J.; Gustafsson F.; Greig D.; McDonald
M.; Badiwala M.; Bertolotti A.M.; Kugathasan L.; Cook A.; Zlatanoski D.;
Ram S.; Demas-Clarke P.; Kozuszko S.; Alba A.
Institution
(Foroutan) Ted Rogers Centre for Heart Research, Toronto General Hospital,
Toronto, ON, Canada
(Guyatt) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Stehlik) University of Utah School of Medicine, Utah, UT, United States
(Gustafsson) Rigshospitalet, Copenhagen, Denmark
(Greig) Pontificia Universidad Catolica de Chile, Santiago, Chile
(McDonald, Badiwala, Kugathasan, Kozuszko, Alba) Ted Rogers Centre for
Heart Research, Toronto, ON, Canada
(Bertolotti) Jefe de Cirugia Cardiovascular y Toracica Hospital
Universitario Fundacion Favaloro, Buenos Aires, Argentina
(Cook, Zlatanoski, Ram) None, Toronto, ON, Canada
(Demas-Clarke) Toronto General Hospital, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: Induction therapy provides, when the risk of allograft rejection
is the highest, early intense immunosuppression. Whether to use induction
therapy, and the choice of optimal regimen remains controversial. Our goal
is to develop a clinical practice guideline for the use of induction
therapy (IT) in the heart transplant (HT) setting. <br/>Method(s): We
recruited a worldwide multidisciplinary panel free of financial and
intellectual conflicts of interest made up of three patient partners, five
cardiologists, two surgeons, one nurse practitioner, one pharmacist, two
guideline methodologists, and one systematic reviewer. This panel will use
the GRADE framework and follow the standards for trustworthy guideline
development, in compliance with Institute of Medicine and the Guideline
International Network. Through consideration of balance between benefits
and harms, quality of the evidence, and patient's values and preferences,
the panel will make strong or weak recommendations for or against the use
of the currently available IT agents. The panel has held its first meeting
at which it finalized the guideline question as: Which aspects of IT
should be used in adult HT recipients in the early post-operative period?
The panel determined that to answer this question, knowledge of the impact
of IT on the following outcomes is critical: all-cause mortality,
re-transplant, rate of treated rejection (cellular and antibody-mediated),
graft dysfunction (heart failure symptoms), infections and need for
dialysis. The panel assessed the following as further important outcomes:
length of hospital stay, post-surgical bleeding, risk of cancer, and
quality of life. The panel's assessment of outcome importance was similar
whether the time-frame was early (within the first-year) or late
post-transplant. The panel will meet two further times during a timeframe
of 6 months: once to review the evidence synthesized by the systematic
review and a second time to develop recommendations including their
direction and strength for or against the use of specific aspects of IT.
Endpoints: Our recommendations will be based on the perspective of
patients. We have already begun a systematic review and network
meta-analysis on all agents used for IT. The results of this review will
inform our panel in making their final recommendations by February
28^th, 2022.<br/>Copyright &#xa9; 2022

<96>
Accession Number
2017590691
Title
Isoproterenol to Terbutaline Transition for Chronotropic Support in Heart
Transplantation to Avoid Pacemaker Implantation.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S225-S226), 2022. Date of Publication:
April 2022.
Author
Baird M.; Gagnon Z.; Burton G.; Brewster A.; Bacon S.; Yaranov D.
Institution
(Baird, Burton, Brewster, Bacon, Yaranov) Baptist Memorial Healthcare,
Memphis, TN, United States
(Gagnon) Christus Trinity Mother Frances Hospital, Tyler, TX, United
States
Publisher
Elsevier Inc.
Abstract
Introduction: Sinus node dysfunction following cardiac transplantation
often requires additional medication therapy and invasive procedures. The
successful use of terbutaline for treatment has previously been reported.
We sought to describe our experience with the transition from
isoproterenol to terbutaline to avoid permanent pacemaker (PPM)
implantation and prolonged use of intravenous (IV) chronotropic therapies
after heart transplant in a case series. Case Report: Out of 97
consecutive heart transplants at a single center between 2014 and 2020, 18
patients (19%) received oral terbutaline after heart transplant. Seven
patients were excluded from further analysis. One did not tolerate
terbutaline due to transaminase elevation three days after initiation
resulting in discontinuation of the drug and placement of a PPM. Six
patients received terbutaline for bradycardia occurring after IV
chronotropic agents were already weaned off. Eleven patients (Table 1)
directly transitioned to terbutaline from isoproterenol and were included
in this analysis. Three patients required a PPM despite terbutaline use.
Eight patients were successfully weaned off IV isoproterenol after a
median of 15.5 hours of overlap with terbutaline and were also discharged
on terbutaline. An initial dose of terbutaline 5 mg three times daily was
used with the exception of one patient maintained on 2.5 mg three times
daily and one patient started on 10 mg three times daily. At one month
post-discharge, the three patients who received a PPM were still paced,
and the average heart rate of the eight patients on terbutaline was 94
beats per minute. In conclusion, oral terbutaline is a well-tolerated
alternative to treat sinus node dysfunction after heart transplant in
order to avoid invasive interventions and additional days on IV therapies.
If successful, effect can generally be seen in less than 24 hours. This
finding should be further evaluated in a randomized controlled
trial.<br/>Copyright &#xa9; 2022

<97>
Accession Number
2017590688
Title
Anti-Thymocyte Globulin Protects Against Ischemia Reperfusion Injury in
the Immediate Post Heart Transplant Period.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S339), 2022. Date of Publication:
April 2022.
Author
Kobashigawa J.A.; Kittleson M.; Kim S.; Singer-Englar T.; Patel N.;
Kransdorf E.; Hage A.; Czer L.; Trento A.; Patel J.
Institution
(Kobashigawa, Kittleson, Kim, Singer-Englar, Patel, Kransdorf, Hage, Czer,
Trento, Patel) Smidt Heart Institute at Cedars-Sinai, Los Angeles, CA,
United States
Publisher
Elsevier Inc.
Abstract
Purpose: Ischemia reperfusion injury after heart transplant is not
uncommon. This may lead to rejection and endothelial cell dysfunction with
subsequent development of cardiac allograft vasculopathy (CAV). It has
been reported that the use of anti-thymocyte globulin (ATG) as induction
therapy post-transplant may lessen the ischemia reperfusion injury that
occurs to donor hearts. This has not been confirmed. <br/>Method(s):
Between 2010 and 2020, we assessed 1082 heart transplant patients and
divided them into those who received induction with ATG versus those who
did not. In our program, ATG is given to patients who are sensitized or
have baseline serum creatinine >2.0 mg/dL to delay initiation of
tacrolimus. Weekly endomyocardial biopsy samples were reviewed for the
first month after heart transplantation for ischemia reperfusion injury.
First year outcomes included survival and freedom from CAV (stenosis
>=30%). <br/>Result(s): Patients who underwent induction therapy with ATG
had significantly greater freedom from any ischemia reperfusion injury
noted on weekly endomyocardial biopsies in the first month
post-transplant. There was no difference between the two groups in
first-year survival and freedom from CAV. <br/>Conclusion(s): ATG as
induction therapy appears to provide protection against ischemia
reperfusion injury in donor hearts. Longer follow-up is needed to show
potential outcomes benefit. This finding should be confirmed in a
randomized clinical trial.<br/>Copyright &#xa9; 2022

<98>
Accession Number
2017590518
Title
Rationale and Design of a Randomized Controlled Trial of Donor-Derived
Cell-Free DNA to Detect Rejection in Cardiac Transplantation (DETECT).
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S114-S115), 2022. Date of Publication:
April 2022.
Author
Shah P.; Mehra M.R.; Colvin M.M.; DeVore A.D.; Eisen H.J.; Friedman L.;
Hsich E.; Kim P.J.; Marshall K.; Olymbios M.; Patel J.; Schlendorf K.H.;
Rabine S.; Stehlik J.
Institution
(Shah) Inova Heart and Vascular Institute, Falls Church, VA, United States
(Mehra) Brigham and Women's Hospital and Harvard Medical School, Boston,
MA, United States
(Colvin) University of Michigan, Ann Arbor, MI, United States
(DeVore) Duke University, Durham, NC, United States
(Eisen) Penn State University, Hershey, PA, United States
(Friedman) Natera, San Carlos, CA, United States
(Hsich) Cleveland Clinic, Cleveland, OH, United States
(Kim) University of California San Diego, San Diego, CA, United States
(Marshall, Olymbios, Rabine) Natera, Santa Clara, CA, United States
(Patel) Smidt Heart Institute, Cedars-Sinai, Los Angeles, CA, United
States
(Schlendorf) Vanderbilt University, Nashville, TN, United States
(Stehlik) University of Utah School of Medicine, Salt Lake City, UT,
United States
Publisher
Elsevier Inc.
Abstract
Purpose: Endomyocardial biopsy (EMB) for rejection surveillance in cardiac
transplantation is invasive, costly, associated with complications,
variable in interpretation and thus an imperfect gold standard.
Donor-derived cell-free DNA (dd-cfDNA) is an emerging biomarker for
detection and surveillance of cardiac allograft rejection. Elevated
circulating levels of dd-cfDNA are associated with acute cellular and
antibody-mediated rejection in observational studies, but a clinical
strategy trial to establish its usefulness in decreasing or eliminating
EMB has not been conducted. We describe the rationale and design of the
randomized clinical trial, Donor-Derived Cell-free DNA to DETect REjection
in Cardiac Transplantation (DETECT) to test the hypothesis that dd-cfDNA
monitoring is non-inferior to standard of care (SOC) surveillance EMB
during year 1 post-transplant. <br/>Method(s): DETECT is a prospective,
multicenter, open-label, randomized controlled trial in 600 adult heart
transplant recipients at 40 transplant centers, randomized 1:1 30 days
post-transplant to surveillance with dd-cfDNA (Prospera, Natera, San
Carlos, CA) (Intervention) versus EMB surveillance (SOC) and followed for
1 year. Rejection surveillance in both arms will be performed per the
institution's SOC EMB surveillance schedule. <br/>Result(s): The primary
endpoint is the composite of treated rejection +/- graft dysfunction, any
graft dysfunction, listing for or undergoing re-transplantation or death.
Secondary endpoints include number of heart biopsies performed,
development of de novo donor specific antibodies and cost of care. The
study has 80% power to demonstrate non-inferiority if the primary endpoint
rate in the experimental arm is no greater than 0.27 (non-inferiority
margin of 0.15, assuming a control rate of 0.22). Sample size
re-estimation will occur once 80% of subjects are enrolled or 50% reach 1
year follow-up, whichever occurs first in order to maintain 80% power. If
the non-inferiority hypothesis is met, analysis for superiority of
surveillance with dd-cfDNA will be performed. <br/>Conclusion(s): The
DETECT trial will establish the efficacy and safety of dd-cfDNA as a
primary clinical monitoring strategy for cardiac allograft rejection in an
effort to decrease or eliminate invasive surveillance biopsies in adult
heart transplant recipients.<br/>Copyright &#xa9; 2022

<99>
Accession Number
2017590314
Title
Cognitive Function in Iron Deficient Heart Transplant Recipients Receiving
Intravenous Iron Supplement: A Prespecified Secondary Endpoint in the
Randomized Ironic Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S206), 2022. Date of Publication:
April 2022.
Author
Brautaset Englund K.V.; Oestby C.M.; Rolid K.; Gude E.; Andreassen A.K.;
Gullestad L.; Broch K.
Institution
(Brautaset Englund, Oestby, Rolid, Gude, Andreassen, Gullestad, Broch)
Oslo University Hospital, Oslo, Rikshospitalet, Norway
Publisher
Elsevier Inc.
Abstract
Purpose: Results from previous trials have suggested a decline in
cognitive function following heart transplant (HTx). The IronIC trial was
a randomized controlled trial, designed to test if ferric derisomaltose
could improve exercise capacity in HTx recipients > 1 year after HTx.
Cognitive function was a prespecified secondary endpoint. <br/>Method(s):
HTx recipients with iron deficiency (ID) were randomized to ferric
derisomaltose or placebo. ID was defined as ferritin <100mug/l, or
ferritin 100-300mug/l in combination with transferrin saturation of <20%,
the definition used in heart failure. Core cognitive functions were
assessed at baseline and follow-up at 6 months using the Cambridge
Neuropsychological Test Automated Battery (CANTAB). Reaction time was
measured from a signal was shown to the participant released a button, and
from the button was released to the participant pressed a yellow circle
(Figure 1). Spatial working memory was assessed as the ability to recall
where a token already was found among a given number of boxes, and the
strategy used when opening the boxes. Episodic memory was assessed using
paired associated learning. Different figures were presented around the
screen, and the participants had to recall the placing when the figures
were presented in the middle of the screen. <br/>Result(s): Cognitive
functions did not differ significantly between the treatment arms(Table
1). <br/>Conclusion(s): Intravenous iron supplement did not improve
cognitive functions in HTx recipients with ID defined as in heart
failure.<br/>Copyright &#xa9; 2022

<100>
Accession Number
2017590106
Title
Instrumental Variable Estimation of the Effect of Increased Donor Heart
Ischemic Time on Post-Transplant Survival.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2022. Boston
United States. 41(4 Supplement) (pp S153), 2022. Date of Publication:
April 2022.
Author
Ran G.; Lazenby K.; Narang N.; Parker W.F.
Institution
(Ran, Lazenby) University of Chicago Pritzker School of Medicine, Chicago,
IL, United States
(Narang) Department of Medicine, University of Illinois-Chicago, Chicago,
IL, United States
(Parker) Department of Medicine, University of Chicago, Chicago, IL,
United States
Publisher
Elsevier Inc.
Abstract
Purpose: As donor hearts are shared more widely under the new U.S. heart
allocation policy, more hearts with long cold ischemic time are used for
transplant. Ischemic time > 4 hours has previously been associated with
lower post-transplant survival. However, the association may have been
biased. Transplant programs are more likely to accept organs with longer
ischemic time for more urgent candidates with higher risks of mortality
post-transplant. Using the policy revision as a natural experiment, we
assessed the isolated impact of ischemic time on post-transplant survival.
<br/>Method(s): Using the Scientific Registry of Transplant Recipients, we
examined heart transplants occurring prior to (11/01/2016 - 10/31/2017)
and after the policy change (11/01/2018 - 10/31/2019). Graft with extended
(>4 hours) cold ischemic time was our exposure of interest. An
instrumental variable (IV) model was constructed to address bias from
unobserved confounders in the relationship between the receipt of ischemic
organ and mortality post-transplant, while controlling for observed
candidate and donor characteristics. <br/>Result(s): An additional 10% of
heart recipients post-policy change (n=3418) received an organ with > 4
hours ischemic time compared to the pre-policy period (n=3278) (15% pre
vs. 25% post, F-value = 116). Without addressing unobserved confounders,
1-year post-transplant survival was significantly worse among recipients
of extendedly ischemic heart (adjusted HR: 1.43, in green, P < 0.001). By
using policy period as an instrument to address unobserved confounders, we
found no difference in survival between recipients of graft with < 4 hours
ischemic time and those who received an extendedly ischemic organ solely
due to the policy change (adjusted HR: 0.689, in blue, P = 0.73).
<br/>Conclusion(s): For heart transplant recipients who were "randomized"
a graft with > 4 hours of ischemic time by changes in heart allocation
policy, we found no effect on survival within the first-year of
transplantation.<br/>Copyright &#xa9; 2022

<101>
Accession Number
2017581519
Title
TCTAP A-022 Long-Term Outcome of Transcatheter Aortic Valve Replacement
Versus Surgical Aortic Valve Replacement for Aortic Stenosis: A
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: 27th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Virtual, Online. 79(15 Supplement) (pp S14), 2022. Date
of Publication: 19 Apr 2022.
Author
Putra H.B.P.; Juslim R.R.; Jovie B.; Pintaningrum Y.; Rahadisiwi S.
Institution
(Putra, Juslim, Jovie, Rahadisiwi) Dr. Ramelan Navy Hospital Surabaya,
Indonesia
(Pintaningrum) University of Mataram, Indonesia
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an emerging
alternative to surgical aortic valve replacement (SAVR) to treat aortic
stenosis. However, the long-term outcomes of TAVR remain controversial.
This meta-analysis aims to evaluate outcomes of TAVR compared to SAVR in
the long-term periods. <br/>Method(s): A systematic literature search of
several electronic databases was performed. Inclusion criteria were a
randomized clinical trial comparing TAVR and SAVR for more than five
years, regardless of the surgical risk and the type of valve. The primary
endpoint was cardiac death. Secondary endpoints included stroke,
myocardial infarction (MI), and endocarditis. Risk ratio (RR) with 95%
confidence intervals (CIs) were used to report all outcomes. A p-value
less than 0.05 was considered statistically significant. <br/>Result(s): 4
RCT were selected. All of them had five years follow up, in the exception
NOTION Trial had eight years follow up. 3.761 patients were pooled in our
analysis. 1.895 patients performed TAVR, and 1.866 patients performed
SAVR. Comparing to SAVR, TAVR had no significant difference in long-term
outcome, all cause death (RR: 1.10 [95% CI, 1.00-1.22], p=0.05), stroke
(RR: 1.06 [95% CI,0.89-1.27], p=0.49), MI (RR: 1.23 [95% CI, 0.94-1.62],
p=0.13), and endocarditis (RR: 1.23 [95% CI, 0.82-1.84], p=0.33). [Formula
presented] <br/>Conclusion(s): There are no significant differences
between TAVR versus SAVR in cardiac death, stroke, MI, and endocarditis
after five years of follow up. However, further studies and development of
advanced valves remain needed to improve the outcomes<br/>Copyright &#xa9;
2022

<102>
Accession Number
2017580878
Title
TCTAP A-030 Ten Years Survival Benefit and Appropriateness of Surgical or
Percutaneous Revascularization Based on Individual Predicted All-Cause
Mortality in Patients With Complex Coronary Artery Disease.
Source
Journal of the American College of Cardiology. Conference: 27th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Virtual, Online. 79(15 Supplement) (pp S21-S22), 2022.
Date of Publication: 19 Apr 2022.
Author
Serruys P.W.; Gao C.; Garg S.; Onuma Y.; Holmes D.R.; Morice M.-C.; Mohr
F.W.; Mack M.J.
Institution
(Serruys, Onuma) National University of Ireland, Galway, Ireland
(Gao) Xijing Hospital, China
(Garg) Royal Blackburn Hospital, United Kingdom
(Holmes) Mayo Clinic, United States
(Morice) Jacques Cartier Private Hospital, France
(Mohr) Herzzentrum Universitaet Leipzig, Germany
(Mack) Baylor University Medical Center, United States
Publisher
Elsevier Inc.
Abstract
Background: To compare the observed and individual predicted mortalities
according to the SYNTAX score II 2020 (SSII-2020) in the all-comers SYNTAX
population, and retrospectively assess the appropriateness of
revascularization with percutaneous coronary intervention (PCI) and
coronary artery bypass grafting (CABG) in patients with three vessel
disease (3VD) and/or left main disease (LMCAD). <br/>Method(s): Internal
and external validation of the SSII-2020 to predict 10-year all-cause
death was performed in the respective randomized and registry SYNTAX
populations. Differences in individual predicted mortalities following
CABG or PCI were ranked and displayed with the observed mortalities. The
proportions of screened patients deriving a survival benefit from CABG or
PCI were determined retrospectively. <br/>Result(s): A total of 2602
participants (as-treated population) were included in the randomized and
registry cohorts. In the randomized cohort, all-cause mortality at 10
years, as an average treatment effect, was 23.8% (199/865) with CABG and
28.6% (249/901) with PCI, with a differential survival benefit of 4.6%
(95% CI: 0.58% to 8.7%, log-rank p value=0.023). In the CABG and PCI
registries, mortalities were 27.8% (167/644) and 55.4% (99/192),
respectively. Calibration and discrimination of the SSII-2020 was helpful
in CABG and PCI patients in the randomized and registry cohorts. In the
PCI registry, the SSII-2020 underestimated mortality since specific
comorbidities that entail high mortality are not included in the formula
(C-index: 0.72, intercept: 0.38, slope: 0.66), whilst in the CABG
registry, it predicted mortality with a helpful calibration and
discrimination (C-index: 0.70, intercept: 0.00, slope: 0.76). The
proportions of patients with a predicted survival benefit following CABG
and PCI were respectively 78.3% (1383/1766) and 21.7% (383/1766) in the
randomized cohort, and 82.4% (2143/2602) and 17.7% (459/2602) in the whole
SYNTAX trial population. <br/>Conclusion(s): In the randomized and
registry cohort of this all-comers population with 3VD and/or LMCAD, there
was reasonable agreement between the individual predicted and observed
mortalities after CABG or PCI, such that the predicted 10-year survival
benefit might be helpful in determining the appropriateness of each
modality of revascularization. [Formula presented]<br/>Copyright &#xa9;
2022

<103>
Accession Number
2017580815
Title
TCTAP A-028 Predicted and Observed Mortality at 10-Year in Patients With
Bifurcation Lesion in the SYNTAX Trial.
Source
Journal of the American College of Cardiology. Conference: 27th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Virtual, Online. 79(15 Supplement) (pp S20-S21), 2022.
Date of Publication: 19 Apr 2022.
Author
Ninomiya K.; Serruys P.W.; Masuda S.; Burzotta F.; Morice M.-C.; Mack
M.J.; Holmes D.R.; Onuma Y.
Institution
(Ninomiya, Serruys, Masuda, Onuma) National University of Ireland, Galway,
Ireland
(Burzotta) The Gemelli University Hospital, Italy
(Morice) Jacques Cartier Private Hospital, France
(Mack) Medical City Hospital, United States
(Holmes) Mayo Clinic, United States
Publisher
Elsevier Inc.
Abstract
Background: Percutaneous coronary intervention (PCI) of bifurcation
lesions is associated with higher rates of adverse events. Whether
coronary artery bypass grafting (CABG) or PCI is a safer revascularization
modality for bifurcation lesions remains to be elucidated. The SYNTAX
score II 2020 (SSII-2020) can be used to individualize the prediction of
all-cause mortality at 10-year after CABG or PCI. The present study is a
subgroup analysis of the SYNTAXES, (The SYNTAX Extended Survival, NCT
03417050) an investigator-driven extended 10-year follow-up of the SYNTAX
trial; the impact of bifurcation lesions on individual predicted and
observed all-cause 10-year mortality was investigated in patients with 3VD
and/or LMCAD undergoing PCI or CABG. <br/>Method(s): Patients were
categorized in four groups: (a) presence of >=1 bifurcation lesion and
treatment with PCI, (b) no bifurcation lesion and treatment with PCI, (c)
presence of >=1 bifurcation lesion and treatment with CABG, and (d) no
bifurcation lesion and treatment with CABG. The primary endpoint was
all-cause mortality at 10-year. <br/>Result(s): In patient receiving PCI,
compared to those without a bifurcation lesion, those with bifurcation
lesion(s) had a significantly higher risk of all-cause death (19.8% vs
30.1%; HR: 1.55, 95% CI: 1.12-2.14; p=0.007), whereas following CABG,
mortality was similar in patients with or without bifurcation lesion(s)
(23.3% vs 23.0%; adjusted HR: 0.81, 95% CI: 0.59-1.12; p=0.207). There was
a significant interaction between bifurcation lesion(s) and the treatment
effect of PCI versus CABG on mortality (p for interaction =0.006). Of
note, a landmark analysis in patients with bifurcation lesions treated
with PCI, shows a continuous and significant divergence of cumulative
mortality beyond 5-year (Figure 1). At 5-year, all-cause death was similar
between patients treated with a 2-stent compared to a 1-stent technique
(15.0% vs 13.4%, adjusted HR:1.13; 95% CI: 0.68-1.88; p=0.642), whereas at
10-year, use of a 2-stent technique was an independent predictor of all
cause death after adjustment (33.3% vs 25.9%; adjusted HR: 1.51; 95% CI:
1.06-2.14; p=0.021). According to the SSII-2020, 22.7% of the randomized
population with a bifurcation lesion had an ARD in mortality between PCI
and CABG of zero. When the Credo Kyoto cut-off criteria of an ARD<4.5% was
used, 48.1% of the population (with or without bifurcation) could
legitimately undergo PCI (Figure 2). [Formula presented] [Formula
presented] <br/>Conclusion(s): Bifurcation lesion(s) require specific
consideration by the Heart team when deciding between PCI and CABG as a
consequence of their higher associated all-cause mortality following PCI.
Notwithstanding this, the average treatment effect can be mitigated by
calculating an individualized 10-year vital prognosis using the
SSII-2020.<br/>Copyright &#xa9; 2022

<104>
Accession Number
2017580738
Title
TCTAP A-083 Quantitative Angiographic Assessment of Aortic Regurgitation
Post 11 Different Types of TAVR Devices (A MulticentER Pooled Analysis of
2665 Valves).
Source
Journal of the American College of Cardiology. Conference: 27th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Virtual, Online. 79(15 Supplement) (pp S51-S52), 2022.
Date of Publication: 19 Apr 2022.
Author
Abdelshafy M.; Soliman O.; Kim W.-K.; Elkoumy A.; Elzomor H.; Onuma Y.;
Serruys P.W.
Institution
(Abdelshafy, Soliman, Elkoumy, Elzomor, Onuma, Serruys) National
University of Ireland, Galway, Ireland
(Kim) Kerckhoff Heart Center, Germany
Publisher
Elsevier Inc.
Abstract
Background: Regurgitation following TAVR impacts all-cause mortality. Thus
far, no quantitative comparison of regurgitation by the same core lab has
been performed among the various commercially available transcatheter
heart valves (THV) We aimed to compare quantitative angiographic aortic
regurgitation (AR) of 11 different types of THVs. <br/>Method(s): This is
a multicentER retrospective core lab pooled analysis of aortograms from
2665 consecutive patients treated with 11 different THV devices. Analysis
was done by quantitative videodensitometric aortography (LVOT-AR), which
is an objective, accurate, and reproducible tool for assessment of AR
following TAVR. This method relies on time density changes in contrast
medium after injection in the ascending aorta and its regurgitation (and
subsequent density increase) in the LVOT. The ratio between the areas
under the two-time density curves of these regions quantifies the AR in
absolute percentage. The valves evaluated include ACURATE neo2 (Boston
Scientific, Massachusetts, USA) (n=120), Lotus (n = 546), Myval (Meril
Life Sciences Pvt. Ltd., India) (n =108), VitaFlow (MicroPort, Shanghai,
China)(n=105), Evolut PRO (Medtronic, Dublin, Ireland) (n=95), SAPIEN 3
(Edwards Lifesciences, Irvine, CA, USA) (n=397), Evolut R (n=295), SAPIEN
XT (n=239), ACURATE neo (n=120), Venus-A (Venus Medtech Inc., Hangzhou,
China) (n=113) and CoreValve (n=532). Stratification of continuous
variable regurgitation into categorical variables was performed according
to the following pre-determined threshold criteria: 1) none/trace
regurgitation (LVOT-AR<6%); 2) mild (6%<= LVOT-AR<=17%); and 3) moderate
or severe (LVOT-AR >17%). The attached video shows step by step example of
videodensitometric analysis. [Formula presented] Results: The attached
Figure (1) shows the Cumulative Percentage of the Different Degrees of
Post-TAVR Aortic Regurgitation Assessed with Quantitative Aortography.
Figure 2 shows the comparison of the mean LVOT-AR after TAVR among the 11
THVs. The main findings of the present study are that: 1- The addition of
anti-PVR sealing features to the new generations ACURATE neo2 THV proved
to be effective in reducing the incidence of significant PVR In comparison
with the first generation ACURATE neo. 2- Myval, VitaFlow, and Venus-A
THVs are showing promising results. 3- Although the incidence of
moderate/severe AR has regressed over time with new generations of THVs,
the incidence of mild AR is still prominent with all THVs still exhibiting
mild AR with an incidence ranging between 30% and 50% apart from the Lotus
valve that had an 19% incidence of mild AR. [Formula presented] [Formula
presented] <br/>Conclusion(s): The ACURATE neo2 THV had the lowest
severe/moderate percentage of AR showing significant improvements in
comparison to ACURATE neo. Myval, VitaFlow, and Venus-A are promising
options in the THV armamentarium. These results should be confirmed in
prospective randomized, head-to-head comparisons between
THVs.<br/>Copyright &#xa9; 2022

<105>
Accession Number
2017580712
Title
TCTAP A-027 Impact of Left Ventricular Ejection Fraction (EF) on 10-Year
Mortality After PCI or CABG in the SYNTAXES Trial: CABG Safer Than PCI in
Reduced Ejection Fraction (rEF).
Source
Journal of the American College of Cardiology. Conference: 27th
Cardiovascular Summit Transcatheter Cardiovascular Therapeutics Asia
Pacific (TCTAP). Virtual, Online. 79(15 Supplement) (pp S20), 2022. Date
of Publication: 19 Apr 2022.
Author
Masuda S.; Ninomiya K.; Kageyama S.; Mack M.J.; Kappetein A.P.; Morice
M.-C.; Onuma Y.; Serruys P.W.
Institution
(Masuda, Ninomiya, Kageyama, Onuma, Serruys) National University of
Ireland, Galway, Ireland
(Mack) Baylor University Medical Center, United States
(Kappetein) Erasmus University Rotterdam, Netherlands
(Morice) Jacques Cartier Private Hospital, France
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery bypass grafting (CABG) has been recommended in
European Society of Cardiology (ESC) guidelines as a standard treatment
for patients with multivessel coronary artery disease (CAD) and severely
impaired left ventricular ejection fraction (LVEF); however, the impact on
vital prognosis at very long-term of percutaneous coronary intervention
(PCI) and CABG in patients with reduced ejection fraction remains to be
elucidated. <br/>Method(s): The present report is a predefined subgroup
analysis of the SYNTAXES study (NCT03417050). A total of 1,800 randomized
patients with stable de novo three vessel disease and/or left main CAD
were categorized into three groups according to the current guidelines of
the ESC (1) reduced ejection fraction (rEF; LVEF<=40%), (2) mildly reduced
ejection fraction (mrEF; LVEF 41-49%), (3) preserved ejection fraction
(pEF; LVEF>=50%). The primary endpoint was 10-year all-cause mortality.
<br/>Result(s): The entire randomized population was stratified as rEF (n
= 168), mrEF (n = 179), and pEF (n = 1453). The rates of 10-year all-cause
death were 44.0% vs. 31.8% vs. 22.6% (P < 0.001), according to LVEF
subgroups (rEF, mrEF and pEF). Among the patients with rEF, there was a
tendency toward higher 10-year mortality in PCI group, but the difference
was not significant (52.9% after PCI vs 39.6% after CABG, P = 0.054).
There were no significant differences in the sub-group of with mrEF (36.0%
after PCI vs. 28.6% after CABG, P = 0.273), and pEF, (23.9% after PCI vs.
22.2% after CABG, P = 0.275) respectively. Regarding the 10-year all-cause
mortality, there was a significant interaction between LVEF subgroups at
5-year follow-up (P value for interaction 0.049); however, the difference
disappeared at 10-year follow-up (P value for interaction 0.183). [Formula
presented] <br/>Conclusion(s): Considering a significantly reduced
mortality at 5 years and a numerical trend towards lower 10-year mortality
in CABG than PCI among patients with reduced EF, CABG might be a safer
revascularization strategy than PCI for patients with EF of less than
40%.<br/>Copyright &#xa9; 2022

<106>
Accession Number
2017510165
Title
The transcatheter aortic valve implantation: an assessment of the
generalizability of the economic evidences following a systematic review.
Source
International Journal of Technology Assessment in Health Care. 38(1) (no
pagination), 2022. Article Number: e27. Date of Publication: 24 Mar 2022.
Author
Ruggeri M.; Donatella M.; Federica C.; Salvatore D.; Costanza S.; Marta
C.; Paolo R.; Marco M.
Institution
(Ruggeri, Donatella, Federica, Salvatore, Costanza, Marta, Paolo, Marco)
National Center For Hta, Istituto Superiore Di Sanita, Rome, Italy
Publisher
Cambridge University Press
Abstract
Objectives Scientific literature debates on the economic affordability of
transcatheter aortic valve implantation (TAVI) in order to give a useful
support to decision makers aiming at establishing a reimbursement scheme
for TAVI. For this reason, it is important to assess the quality and the
generalizability of the existing economic evidences. Methods The first
step was to run a literature search according to a predefined population,
intervention, comparator, and outcome on the cost and effectiveness of the
TAVI procedure in comparison to medical therapy and traditional surgery.
Second, a manual search was carried out on the Web sites of the main HTA
agencies. Third, the checklist developed by Augustovski et al. was applied
in order to assess the quality and the generalizability of the articles
resulting from the selection process. Results Overall, 106 articles were
obtained. Of these, sixty-five articles were excluded since the title was
not consistent with the objective. Further selection took place after
abstract and full-text reading. In the end, thirty-one documents were
included for the review. According to the checklist, none of the articles
was considered generalizable and only one was considered transferable
which compares the TAVI procedure with Medical Management in inoperable
patients. Conclusions Despite the overall quality of the selected studies
was considered good, there is still a lack of evidence on whether
evidences generated in different contexts can be considered generalizable.
Further research on resource consumption and preferences is needed in
order to provide decision makers with more robust evidences.
<br/>Copyright &#xa9;

<107>
[Use Link to view the full text]
Accession Number
2017430782
Title
Effect of Platelet Inhibition by Cangrelor Among Obese Patients Undergoing
Coronary Stenting: Insights From CHAMPION.
Source
Circulation: Cardiovascular Interventions. 15(3) (pp E011069), 2022. Date
of Publication: 01 Mar 2022.
Author
Peterson B.E.; Harrington R.A.; Stone G.W.; Steg P.G.; Gibson C.M.; Hamm
C.W.; Price M.J.; Lopes R.D.; Leonardi S.; Prats J.; Deliargyris E.N.;
Mahaffey K.W.; White H.D.; Bhatt D.L.
Institution
(Peterson, Bhatt) Brigham and Women's Hospital, Heart and Vascular Center,
Harvard Medical School, 75 Francis St, Boston, MA 02115, United States
(Harrington, Mahaffey) Stanford University Medical Center, Palo Alto, CA,
United States
(Stone) New York Presbyterian Hospital, NYC, United States
(Steg) Universite Paris Diderot, INSERM U-1148 and Hopital Bichat
Assistance Publique, Paris, France
(Gibson) Baim Institute for Clinical Research, Boston, MA, United States
(Hamm) Kerckhoff Klinik, Department of Cardiology, Bad Nauheim, Germany
(Price) Scripps Medical Center, La Jolla, CA, United States
(Lopes) Duke Clinical Research Institute, Durham, NC, United States
(Leonardi) Fondazione I.R.C.C.S. Policlinico San Matteo Pavia, Pavia,
Italy
(Prats) ELYSIS-Med Carlisle, MA, United States
(Deliargyris) Science and Strategy Consulting Group, Basking Ridge, NJ,
United States
(White) Auckland City Hospital, NZ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In randomized trials, cangrelor reduced periprocedural
ischemic events related to percutaneous coronary intervention without
increasing GUSTO severe bleeding. However, some antiplatelet agents have
shown a differential treatment effect by body mass index (BMI).
<br/>Method(s): Patients from the 3 CHAMPION trials (Cangrelor Versus
Standard Therapy to Achieve Optimal Management of Platelet Inhibition) who
were randomized to cangrelor versus clopidogrel during percutaneous
coronary intervention were stratified by BMI. The primary efficacy end
point was a composite of death, myocardial infarction, ischemia-driven
revascularization, or stent thrombosis within 48 hours. The principal
safety outcome was GUSTO moderate or severe bleeding at 48 hours, although
more sensitive bleeding measures such as Thrombolysis in Myocardial
Infarction major bleeding were also assessed. We examined obese patients
(defined as BMI>=30) versus nonobese patients. <br/>Result(s): There were
24 893 patients, with 8979 (36.1%) having BMI of >=30. There was no
significant difference in the primary efficacy end point among obese
versus nonobese patients (4.3% versus 4.2%; rate ratio, 1.01 [95% CI,
0.89-1.15]; P=0.82). There was a consistent benefit in the primary
efficacy end point in patients who received cangrelor versus placebo who
were obese (3.9% versus 4.7%, rate ratio, 0.83 [95% CI, 0.68-1.02];
P=0.07) and not obese (3.8% versus 4.7%; rate ratio, 0.81 [95% CI,
0.69-0.94]; P=0.0053); interaction P=0.77. There was no difference in
GUSTO moderate or severe bleeding among patients who received cangrelor
versus placebo who were obese (0.6% versus 0.6%; rate ratio, 0.99 [95% CI,
0.58-1.67]; P=0.96). <br/>Conclusion(s): Cangrelor at the time of
percutaneous coronary intervention is effective and safe in obese and
nonobese patients. There was no difference in short-term efficacy between
obese and nonobese patients. Periprocedural cangrelor is an effective and
safe antiplatelet agent, irrespective of BMI. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT01156571,
NCT00385138, NCT00305162.<br/>Copyright &#xa9; 2022 Lippincott Williams
and Wilkins. All rights reserved.

<108>
[Use Link to view the full text]
Accession Number
2017430781
Title
Effect of Evolocumab in Patients with Prior Percutaneous Coronary
Intervention.
Source
Circulation: Cardiovascular Interventions. 15(3) (pp 227-236), 2022. Date
of Publication: 01 Mar 2022.
Author
Furtado R.H.M.; Fagundes A.A.; Oyama K.; Zelniker T.A.; Tang M.; Kuder
J.F.; Murphy S.A.; Hamer A.; Wang H.; Keech A.C.; Giugliano R.P.; Sabatine
M.S.; Bergmark B.A.
Institution
(Furtado) Academic Research Organization, Hospital Israelita Albert
Einstein, Sao Paulo, Brazil
(Furtado) Instituto Do Coracao (InCor), Hospital das Clinicas da Faculdade
de Medicina, Universidade de Sao Paulo, Brazil
(Fagundes, Oyama, Zelniker, Tang, Kuder, Murphy, Giugliano, Sabatine,
Bergmark) Thrombolysis in Myocardial Infarction (TIMI) Study Group,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Oyama) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Oyama) Division of Cardiology, Vienna General Hospital and Medical
University of Vienna, Austria
(Hamer) Cardiol Therapeutics, Oakville, ON, Canada
(Wang) Amgen, Thousand Oaks, CA, United States
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Sydney Medical School, University of Sydney, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Patients with prior percutaneous coronary intervention (PCI)
are at high residual risk for multiple types of coronary events within and
beyond the stented lesion. This risk might be mitigated by more intensive
LDL-C (low-density lipoprotein cholesterol)-lowering beyond just with
statin therapy. <br/>Method(s): FOURIER (Further Cardiovascular Outcomes
Research With PCSK9 Inhibition in Subjects With Elevated Risk) randomized
27 564 patients with stable atherosclerotic disease on statin to the PCSK9
(proprotein convertase subtilisin-kexin type 9) inhibitor evolocumab or
placebo with a median follow-up of 2.2 years. The end points of interest
were major adverse cardiovascular events (MACE; a composite of
cardiovascular death, myocardial infarction, stroke, unstable angina or
coronary revascularization), and major coronary events (a composite of
coronary heart death, myocardial infarction, or coronary
revascularization). We compared the risk of MACE and the magnitude of
relative and absolute risk reductions with evolocumab in patients with and
without prior PCI. <br/>Result(s): Seventeen thousand seventy-three
patients had prior PCI. In the placebo arm, those with prior PCI had
higher rates of MACE (13.2% versus 8.3%; hazard ratio
[HR]<inf>adj</inf>1.61 [95% CI, 1.42-1.84]; P<0.0001) and major coronary
events (11.5% versus 6.0%; HR<inf>adj</inf>, 1.72 [95% CI, 1.49-1.99];
P<0.0001). Relative risk reductions with evolocumab were similar in
patients with and without prior PCI (MACE: HR, 0.84 [0.77-0.91] versus HR,
0.88 [0.77-1.01]; P<inf>interaction</inf>0.51; major coronary events: HR,
0.82 [0.75-0.90] versus HR, 0.88 [0.75-1.04];
P<inf>interaction</inf>0.42). Absolute risk reductions for MACE were 2.0%
versus 0.9% (P<inf>interaction</inf>0.14) and for major coronary events
2.0% versus 0.7% (P<inf>interaction</inf>0.045). In those with prior PCI,
the effect of evolocumab on coronary revascularization (HR, 0.76
[0.69-0.85]) was directionally consistent across types of
revascularization procedures: coronary artery bypass grafting (HR, 0.71
[0.54-0.94]); any PCI (HR, 0.77 [0.69-0.86]); PCI for de novo lesions (HR,
0.76 [0.66-0.88]); and PCI for stent failure or graft lesions (HR, 0.76
[0.63-0.91]). <br/>Conclusion(s): Evolocumab reduces the risk of MACE in
patients with prior PCI including the risk of coronary revascularization,
with directionally consistent effects across several types of
revascularization procedures, including coronary artery bypass grafting
and PCI for stent or graft failure. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT01764633.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<109>
Accession Number
2017367206
Title
Atrial nitroso-redox balance and refractoriness following on-pump cardiac
surgery: A randomized trial of atorvastatin.
Source
Cardiovascular Research. 118(1) (pp 184-195), 2022. Date of Publication:
01 Jan 2022.
Author
Jayaram R.; Jones M.; Reilly S.; Crabtree M.J.; Pal N.; Goodfellow N.;
Nahar K.; Simon J.; Carnicer R.; Desilva R.; Ratnatunga C.; Petrou M.;
Sayeed R.; Roalfe A.; Channon K.M.; Bashir Y.; Betts T.; Hill M.; Casadei
B.
Institution
(Jayaram, Reilly, Crabtree, Pal, Goodfellow, Nahar, Simon, Carnicer,
Channon, Casadei) Division of Cardiovascular Medicine, Radcliffe
Department of Medicine, University of Oxford, L6, West Wing, Oxford OX3
9DU, United Kingdom
(Jones, Bashir, Betts) Cardiology, Oxford Heart Centre, Oxford University
Hospitals Nhs Foundation Trust, Oxford, United Kingdom
(Desilva, Ratnatunga, Petrou, Sayeed) Cardiothoracic Surgery, Oxford Heart
Centre, Oxford University Hospitals Nhs Foundation Trust, Oxford, United
Kingdom
(Roalfe) Nuffield Department of Primary Care Health Sciences, University
of Oxford, Oxford, United Kingdom
(Hill) Clinical Trial Service Unit, Nuffield Department of Population
Health, University of Oxford, Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: Systemic inflammation and increased activity of atrial
NOX2-containing NADPH oxidases have been associated with the new onset of
atrial fibrillation (AF) after cardiac surgery. In addition to lowering
LDL-cholesterol, statins exert rapid anti-inflammatory and antioxidant
effects, the clinical significance of which remains controversial.
<br/>Methods and Results: We first assessed the impact of cardiac surgery
and cardiopulmonary bypass (CPB) on atrial nitroso-redox balance by
measuring NO synthase (NOS) and GTP cyclohydrolase-1 (GCH-1) activity,
biopterin content, and superoxide production in paired samples of the
right atrial appendage obtained before (PRE) and after CPB and reperfusion
(POST) in 116 patients. The effect of perioperative treatment with
atorvastatin (80 mg once daily) on these parameters, blood biomarkers, and
the post-operative atrial effective refractory period (AERP) was then
evaluated in a randomized, double-blind, placebo-controlled study in 80
patients undergoing cardiac surgery on CPB. CPB and reperfusion led to a
significant increase in atrial superoxide production (74% CI 71-76%, n =
46 paired samples, P < 0.0001) and a reduction in atrial
tetrahydrobiopterin (BH4) (34% CI 33-35%, n = 36 paired samples, P <
0.01), and in GCH-1 (56% CI 55-58%, n = 26 paired samples, P < 0.001) and
NOS activity (58% CI 52-67%, n = 20 paired samples, P < 0.001).
Perioperative atorvastatin treatment prevented the effect of CPB and
reperfusion on all parameters but had no significant effect on the
postoperative right AERP, troponin release, or NT-proBNP after cardiac
surgery. <br/>Conclusion(s): Perioperative statin therapy prevents
post-reperfusion atrial nitroso-redox imbalance in patients undergoing
on-pump cardiac surgery but has no significant impact on postoperative
atrial refractoriness, perioperative myocardial injury, or markers of
postoperative LV function. Clinical Trial Registration:
https://clinicaltrials.gov/ct2/show/NCT01780740.<br/>Copyright &#xa9; 2020
The Author(s) 2020. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<110>
Accession Number
2015575433
Title
Predictors of permanent pacemaker insertion after mitral valve
replacement: A systematic review.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2022. Date
of Publication: 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, Wah, 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
John Wiley and Sons Inc
Abstract
As the established surgical mitral valve replacement (MVR) expands toward
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. 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. A total of 12 studies, recruiting 37,124
patients were included in the final analysis. Overall, 2820 (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 antiarrhythmic drugs, atrial
fibrillation ablation, and double valve replacement were predictors of PPM
implantation post-MVR. Age, male gender, comorbid conditions like diabetes
and renal impairment, prior CABG, double valve replacement, and
antiarrhythmic drugs served as positive predictors of PPM implantation in
patients undergoing MVR.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<111>
Accession Number
2015519442
Title
Analgesic effect of inhaled lavender essential oil for frenotomy in
healthy neonates: a randomized clinical trial.
Source
World Journal of Pediatrics. (no pagination), 2022. Date of Publication:
2022.
Author
Maya-Enero S.; Fabregas-Mitjans M.; Llufriu-Marques R.M.; Candel-Pau J.;
Garcia-Garcia J.; Lopez-Vilchez M.A.
Institution
(Maya-Enero, Fabregas-Mitjans, Llufriu-Marques, Candel-Pau, Garcia-Garcia,
Lopez-Vilchez) Department of Neonatology, Service of Pediatrics, Hospital
del Mar, Parc de Salut Mar, Universitat Pompeu Fabra, Passeig Maritim
25-29, Barcelona 08003, Spain
Publisher
Institute of Pediatrics of Zhejiang University
Abstract
Background: Neonatal pain may affect long-term neurodevelopment and must
be treated. Frenotomy is a painful procedure wherein a common strategy to
relieve pain (sucking) cannot be used because the technique is performed
on the tongue. Lavender essential oil (LEO) has sedative and antispasmodic
properties and has been successfully used to treat pain during heel
puncture and vaccination. Our aim was to demonstrate if the use of inhaled
LEO is effective in reducing pain during frenotomy in healthy, full-term
neonates. <br/>Method(s): We conducted a randomized clinical trial in
neonates who underwent a frenotomy between August 2020 and April 2021. We
assessed pain using pre and post-procedure heart rate and oxygen
saturation, crying time and Neonatal Infant Pain Scale (NIPS) score.
Patients with type 3 tongue tie were randomized into the "experimental
group" and "control group". In both groups, we performed swaddling,
administered oral sucrose, and let the newborn suck for two minutes. In
the experimental group, we also placed a gauze pad with one drop of LEO
under the neonate's nose for two minutes prior to and during the
frenotomy. <br/>Result(s): We enrolled 142 patients (71 per group). The
experimental group showed significantly lower NIPS scores (1.88 vs 2.92)
and cried almost half the amount of time (14.8 vs. 24.6 seconds, P =
0.006). Comparing with the control group, we observed no side effects in
either of the groups. <br/>Conclusion(s): We observed a significant
decrease in crying time and lower NIPS scores in the neonates who received
inhaled LEO and underwent a frenotomy for type 3 tongue-ties. Thus, we
recommend using inhaled LEO during neonatal frenotomies.<br/>Copyright
&#xa9; 2022, Children's Hospital, Zhejiang University School of Medicine.

<112>
Accession Number
600108036
Title
The effect of pulsatile cardiopulmonary bypass on lung function in elderly
patients.
Source
International Journal of Artificial Organs. 37(9) (pp 679-687), 2014. Date
of Publication: 01 Sep 2014.
Author
Engels G.E.; Dodonov M.; Rakhorst G.; van Oeveren W.; Milano A.D.; Gu
Y.J.; Faggian G.
Institution
(Engels, van Oeveren) HaemoScan BV, Groningen, Netherlands
(Dodonov, Milano, Faggian) Department of Cardiothoracic Surgery,
University of Verona Medical School, Verona, Italy
(Rakhorst, van Oeveren, Gu) Department of Cardiothoracic Surgery,
University of Groningen, University Medical Center Groningen, Groningen,
Netherlands
Publisher
Wichtig Publishing Srl
Abstract
Purpose: Cardiopulmonary bypass is still a major cause of lung injury and
delay in pulmonary recovery after cardiac surgery. Although it has been
shown that pulsatile flow induced by intra-aortic balloon pumping is
beneficial for preserving lung function, it is not clear if the same
beneficial effect can be accomplished with pulsatile flow generated in the
extracorporeal circuit. Therefore, we investigated the effect of pulsatile
flow, produced by a centrifugal pump, on lung function in elderly
patients.
Methods: Serial measurements of lung biomarkers Clara cell 16 kD protein,
surfactant protein D, and elastase were performed on blood samples from 37
elderly patients (>=75 years) who underwent elective aortic valve
replacement surgery with CPB, either with pulsatile perfusion or
continuous perfusion. Pulmonary function was assessed by postoperative
ventilation time, the arterial blood oxygenation
(PaO<inf>2</inf>/FiO<inf>2</inf>), the alveolar-arterial oxygen gradient
(Aa-O<inf>2</inf> gradient) and the pulmonary vascular resistance indexed
by body surface area (PVRi).
Results: There was no difference in lung function between both groups, as
assessed by the postoperative ventilation time, the
PaO<inf>2</inf>/FiO<inf>2</inf> ratio, and the Aa-O<inf>2</inf> gradient.
The PVRi, however, was significantly lower in the pulsatile perfusion
group 15 mins after the administration of protamine (p<0.05). The plasma
concentrations of the lung biomarkers increased during surgery and peaked
at 1 h ICU, there were however no differences between groups.
Conclusions: Pulsatile flow does not seem beneficial to postoperative lung
function in elderly patients. Moreover, pulsatile flow does not affect
lung function on a subclinical level as assessed by lung
biomarkers.<br/>Copyright &#xa9; 2014 Wichtig Publishing.

<113>
Accession Number
372289227
Title
Peritoneal dialysis does not adversely affect kidney function recovery
after congenital heart surgery.
Source
International Journal of Artificial Organs. 37(1) (pp 39-47), 2014. Date
of Publication: January 2014.
Author
Riley A.A.; Jefferies J.L.; Nelson D.P.; Bennett M.R.; Blinder J.J.; Ma
Q.; Devarajan P.; Goldstein S.L.
Institution
(Riley) Pediatric Renal Section, Baylor College of Medicine, Houston, TX,
United States
(Jefferies, Nelson, Bennett, Ma, Devarajan, Goldstein) Center for Acute
Care Nephrology, Cincinnati Children's Medical Center, Cincinnati, OH,
United States
(Blinder) Department of Cardiology, Boston Children's Hospital, Boston,
MA, United States
(Jefferies, Nelson, Goldstein) The Heart Institute, Cincinnati Children's
Hospital Medical Center, Cincinnati, OH, United States
Publisher
Wichtig Publishing Srl
Abstract
Purpose: Acute kidney injury (AKI) after cardiopulmonary bypass surgery to
correct congenital heart disease is common. We prevent fluid overload and
further cardiac compromise in oliguric infants with continuous peritoneal
dialysis (CPD). The effect of CPD on kidney recovery is unknown, thus
indications to discontinue CPD are unclear. We aimed to determine if CPD
affects kidney recovery, measured by urine output and novel urinary AKI
biomarker concentrations. <br/>Method(s): Twenty infants <90 days old with
congenital heart disease who underwent bypass surgery and were
post-operatively treated with CPD were randomized at the time of clinical
readiness for CPD discontinuation to 1) discontinue CPD (control) or 2)
continue 24 h more CPD (experimental). Urine output (ml/kg per h), total
output (ml/kg per h) and urinary neutrophil gelatinase-associated
lipocalin, interleukin-18, liver-type fatty acid binding protein, and
kidney injury molecule-1 were assessed postsurgery until CPD catheter
removal. <br/>Result(s): 24 hours preceding randomization, there were no
differences in mean urine output or total output; 24 hours
post-randomization, the control group had higher mean urine output (4.2
+/- 2.6 ml/kg per h vs. 2.8 +/- 2.0 ml/kg per h, p = 0.02) but lower total
output (6.3 +/- 2.1 ml/kg per h vs. 4.7 +/- 2.7 ml/kg per h, p = 0.01).
Median biomarker concentrations did not differ significantly between
groups at any time point. <br/>Conclusion(s): Our results suggest renal
replacement therapy does not change the time course of kidney function
recovery. &#xa9; 2014 Wichtig Editore.

<114>
Accession Number
369349064
Title
Intra-aortic balloon pump counterpulsation: Are we optimizing the
management of cardiogenic shock?.
Source
Journal of the Royal Society of Medicine. 106(2) (pp 51-56), 2013. Date of
Publication: February 2013.
Author
Shahid F.; Akhtar M.; Khan F.; Chahal C.A.A.
Institution
(Shahid, Khan, Chahal) Department of Cardiology, London Chest Hospital NHS
Trust, London E2 9JX, United Kingdom
(Akhtar) Department of Cardiology, St Thomas's Hospital, London SE1 7EH,
United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Intra-aortic balloon pump counterpulsation (IABPC) has been used in
various forms for decades. The change in physiology brought about by their
use is conceptually appealing in managing cardiogenic shock and mechanical
complications of myocardial infarction. A common myth is that this method
of managing acute cardiological emergencies is to be limited to the realms
of this specialist field. However, as medical physicians an appreciation
and understanding of this novel therapy is essential not onlyas a
lifesaving measure but also as a bridging therapy to more definitive
management in the acute medical setting. IABPC is a safe and
under-utilized technique despite featuring in all major international
guidelines (ESC and ACC) for the management of cardiogenic shock secondary
to acute coronary syndromes. Without awareness of this intervention we may
be suboptimally managing patients in the first instance. To improve
awareness we examine the evidence supporting the use of the IABPC therapy
and the contraindications to their use. Complications and advances in
technology are also addressed.

<115>
Accession Number
2017228735
Title
Development of myocarditis and pericarditis after COVID-19 vaccination in
adult population: A systematic review: Post COVID vaccine Myocarditis and
Pericarditis.
Source
Annals of Medicine and Surgery. 76 (no pagination), 2022. Article Number:
103486. Date of Publication: April 2022.
Author
Fatima M.; Ahmad Cheema H.; Ahmed Khan M.H.; Shahid H.; Saad Ali M.;
Hassan U.; Wahaj Murad M.; Aemaz Ur Rehman M.; Farooq H.
Institution
(Fatima, Ahmad Cheema, Ahmed Khan, Shahid, Saad Ali, Hassan, Aemaz Ur
Rehman, Farooq) Department of Medicine, King Edward Medical University,
Punjab, Lahore, Pakistan
(Wahaj Murad) Shanxi Medical University Yuci District, Shanxi province,
Jin Zhong City, China
Publisher
Elsevier Ltd
Abstract
Objectives: A clear temporal relationship between myocarditis and
pericarditis after COVID-19 vaccination has led to the belief that the
vaccine may act as a trigger for these cardiologic complications. The aim
of this systematic review is to explore the incidence, clinical
presentation, management, and association between them. <br/>Method(s): We
conducted a systematic literature search on Cochrane, MEDLINE, and EMBASE
as per guidelines of PRISMA (Preferred Reporting Items for Systematic
Reviews). A total of 41 case reports and case series describing 97
patients, and 5 original articles describing 15,585,309 participants were
selected as part of this review. <br/>Result(s): Of the 97 reported cases
describing vaccine-associated myocarditis/pericarditis, 67 (69%) patients
received Pfizer-BioNTech and 25 (25.7%) received Moderna. The mean onset
of symptoms after vaccine administration was 3.8 +/- 4.5 days with
three-quarters developing symptoms after the second dose. Chest pain (n =
88, 90%) and fever (n = 33, 34%) were the most common presenting
complaints. Out of 97, 80 (82.5%) patients recovered while 4 (4.1%)
patients expired. The pooled incidence of myocarditis and pericarditis
extrapolated from original studies is 0.001% and 0.0004%, respectively. In
the original studies, nearly all the cases of myocarditis and pericarditis
were mild. Chest pain and fever were the most common presenting symptoms.
<br/>Conclusion(s): Myocarditis and pericarditis after the COVID-19
vaccine have been reported more in young adult males and are most likely
to occur after the second dose of mRNA vaccines. The presentation is mild
and the majority of the patients recover either completely or
partially.<br/>Copyright &#xa9; 2022 The Authors

<116>
Accession Number
2016659566
Title
Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney
Injury during Percutaneous Cardiovascular Procedures.
Source
CardioRenal Medicine. 12(1) (pp 11-19), 2022. Date of Publication: 14 Mar
2022.
Author
Peabody J.; Paculdo D.; Valdenor C.; McCullough P.A.; Noiri E.; Sugaya T.;
Dahlen J.R.
Institution
(Peabody, Paculdo, Valdenor) QURE Healthcare, San Francisco, CA, United
States
(Peabody) University of California, School of Medicine, San Francisco, CA,
United States
(Peabody) University of California, Fielding School of Public Health, Los
Angeles, CA, United States
(McCullough) Texas Christian University, The University of North Texas
Health Sciences Center School of Medicine, Dallas, TX, United States
(Noiri) Department of Nephrology and Endocrinology, The University of
Tokyo Hospital, Tokyo, Japan
(Noiri) National Center Biobank Network, National Center for Global Health
and Medicine, Tokyo, Japan
(Sugaya) Timewell Medical, Tokyo, Japan
(Sugaya) St. Marianna University School of Medicine, Kawasaki, Japan
(Dahlen) Hikari Dx, Inc., San Diego, CA, United States
Publisher
S. Karger AG
Abstract
Introduction: Contrast-induced acute kidney injury (CI-AKI) is a major
clinical complication of percutaneous cardiovascular procedures requiring
iodinated contrast. Despite its relative frequency, practicing physicians
are unlikely to identify or treat this condition. <br/>Method(s): In a
2-round clinical trial of simulated patients, we examined the clinical
utility of a urine-based assay that measures liver-type fatty acid-binding
protein (L-FABP), a novel marker of CI-AKI. We sought to determine if
interventional cardiologists' ability to diagnose and treat potential
CI-AKI improved using the biomarker assay for 3 different patient types:
pre-procedure, peri-procedure, and post-procedure patients.
<br/>Result(s): 154 participating cardiologists were randomly divided into
either control or intervention. At baseline, we found no difference in the
demographics or how they identified and treated potential complications of
AKI, with both groups providing less than half the necessary care to their
patients (46.4% for control vs. 47.6% for intervention, p = 0.250). The
introduction of L-FABP into patient care resulted in a statistically
significant improvement of 4.6% (p = 0.001). Compared to controls,
physicians receiving L-FABP results were 2.9 times more likely to
correctly identify their patients' risk for AKI (95% CI 2.1-4.0) and were
more than twice as likely to treat for AKI by providing volume expansion
and withholding nephrotoxic medications. We found the greatest clinical
utility in the pre-procedure and peri-procedure settings but limited value
in the post-procedure setting. <br/>Conclusion(s): This study suggests
L-FABP as a clinical marker for assessing the risk of potential CI-AKI,
has clinical utility, and can lead to more accurate diagnosis and
treatment.<br/>Copyright &#xa9; 2022 S. Karger AG, Basel.

<117>
Accession Number
2017430034
Title
Ten-year all-cause mortality according to smoking status in patients with
severe coronary artery disease undergoing surgical or percutaneous
revascularization.
Source
European Journal of Preventive Cardiology. 29(2) (pp 312-320), 2022. Date
of Publication: 01 Jan 2022.
Author
Takahashi K.; Thuijs D.J.F.M.; Gao C.; Ono M.; Holmes D.R.; Mack M.J.;
Morice M.-C.; Mohr F.-W.; Curzen N.; Davierwala P.M.; Milojevic M.;
Dawkins K.D.; Wykrzykowska J.J.; De Winter R.J.; Mcevoy J.W.; Onuma Y.;
Head S.J.; Kappetein A.P.; Serruys P.W.
Institution
(Takahashi, Ono, Wykrzykowska, De Winter) Department of Cardiology,
Amsterdam Universities Medical Centers, Location Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Thuijs, Milojevic, Head, Kappetein) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Gao) Department of Cardiology, Radboud Medical Center, Nijmegen,
Netherlands
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Mack) Department of Cardiothoracic Surgery, Baylor Scott and White
Health, Dallas, TX, United States
(Morice) Departement of Cardiologie, Hopital prive Jacques Cartier, Gerale
de Sante Massy, Paris, France
(Mohr, Davierwala) University Department of Cardiac Surgery, Heart Centre
Leipzig, Leipzig, Germany
(Curzen) Department of Cardiology, Coronary Research Group, University
Hospital Southampton NHS FT, Southampton, United Kingdom
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Dawkins) Shockwave Medical Inc, 5403 Betsy Ross Dr Santa Clara, Santa
Clara, CA 95054, United States
(Wykrzykowska) Department of Cardiology, University Medical Centre
Groningen, University of Groningen, Groningen, Netherlands
(Mcevoy, Onuma, Serruys) Department of Cardiology, National University of
Ireland, Galway (NUIG), Galway, Ireland
Publisher
Oxford University Press
Abstract
Aims: To evaluate the impact of various smoking status on 10-year
all-cause mortality and to examine a relative treatment benefit of
coronary artery bypass grafting (CABG) vs. percutaneous coronary
intervention (PCI) according to smoking habits. <br/>Methods and Results:
The SYNTAX Extended Survival study evaluated vital status up to 10 years
in 1800 patients with de novo three-vessel disease and/or left main
coronary artery disease randomized to CABG or PCI in the SYNTAX trial. In
the present analysis, patients were divided into three groups (current,
former, or never smokers), and the primary endpoint of 10-year all-cause
mortality was assessed according to smoking status. Smoking status was
available in 1793 (99.6%) patients at the time of randomization, of whom
363 were current smokers, 798 were former smokers, and 632 were never
smokers. The crude rates of 10-year all-cause mortality were 29.7% in
current smokers, 25.3% in former smokers, and 25.9% in never smokers
(Log-rank P = 0.343). After adjustment for imbalances in baseline
characteristics, current smokers had a significantly higher risk of
10-year all-cause mortality than never smokers [adjusted hazard ratio
(aHR): 2.29; 95% confidence interval (CI): 1.60-3.27; P < 0.001], whereas
former smokers did not. PCI was associated with a higher risk of all-cause
mortality than CABG among current smokers (HR: 1.60; 95% CI: 1.09-2.35; P
= 0.017), but it failed to show a significant interaction between
revascularization strategies and smoking status (Pinteraction = 0.910).
<br/>Conclusion(s): Current smokers had a higher adjusted risk of 10-year
all-cause mortality, whereas former smokers did not. The treatment effect
of CABG vs. PCI did not differ significantly according to smoking status.
Clinical trial registration: SYNTAX: ClinicalTrials.gov reference:
NCT00114972; SYNTAX Extended Survival. ClinicalTrials.gov reference:
NCT03417050.<br/>Copyright &#xa9; 2020 Published on behalf of the European
Society of Cardiology. All rights reserved.

<118>
Accession Number
2015798156
Title
Meningiomas Associated with Subdural Hematomas: A Systematic Review of
Clinical Features and Outcomes.
Source
World Neurosurgery. 158 (pp e465-e475), 2022. Date of Publication:
February 2022.
Author
Omar A.T.; Starreveld Y.P.
Institution
(Omar, Starreveld) Division of Neurosurgery, Department of Clinical
Neurosciences, Cumming School of Medicine, University of Calgary, Calgary,
AB, Canada
Publisher
Elsevier Inc.
Abstract
Background: Meningiomas associated with subdural hematomas (SDHs) are
exceedingly rare. As such, the clinical features, optimal medical and
surgical management, and outcomes of treatment for these lesions remain
unknown. <br/>Method(s): We performed a systematic review of the PubMed
and Scopus databases for case reports and case series of patients with
presumptive clinical or definitive diagnoses of meningiomas presenting
with SDH on computed tomography scan or magnetic resonance imaging. Data
on demographics, clinical manifestations, surgical management, adjuvant
treatment, and outcome on last follow-up were collected. <br/>Result(s):
Inclusion criteria were met by 59 cases, including a case described in the
current study. Mean age of patients was 62 years (range: 5-85 years), with
a slight female predilection (1.3:1). The most common clinical symptom and
sign were headache and focal weakness, respectively. All except 2 patients
underwent surgery, either a single or staged procedure, for evacuation of
hematoma and/or excision of tumor. Treatment for meningioma in patients
who presented with SDH was associated with a mortality rate of 12% (6/51)
at a median follow-up of 3 months. Complete neurologic recovery was
reported in 71% of patients. <br/>Conclusion(s): SDHs are rare
manifestations of intracranial meningiomas. Current management is largely
surgical for immediate relief of mass effect and oncologic control. Most
reported patients survived with complete neurologic
recovery.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<119>
Accession Number
2015070855
Title
Minimally invasive mitral valve surgery versus conventional sternotomy
mitral valve surgery: A systematic review and meta-analysis of 119
studies.
Source
Journal of Cardiac Surgery. 37(5) (pp 1319-1327), 2022. Date of
Publication: May 2022.
Author
Eqbal A.J.; Gupta S.; Basha A.; Qiu Y.; Wu N.; Rega F.; Chu F.V.;
Belley-Cote E.P.; Whitlock R.P.
Institution
(Eqbal, Gupta, Chu, Whitlock) Division of Cardiac Surgery, McMaster
University, Hamilton, ON, Canada
(Basha) Libin Cardiovascular Institute, University of Calgary, Calgary,
AB, Canada
(Qiu) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Wu) Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
(Rega) Department of Cardiac Surgery, Universitair Ziekenhuis Leuven,
Leuven, Belgium
(Belley-Cote) Division of Cardiology, McMaster University, Hamilton, ON,
Canada
(Belley-Cote, Whitlock) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim of the Study: Whether minimally invasive mitral valve
surgery (MMVS) leads to better outcomes remains unclear. We conducted a
systematic review and meta-analysis comparing various MMVS approaches with
conventional sternotomy. <br/>Method(s): We searched Cochrane CENTRAL,
MEDLINE, EMBASE, ClinicalTrials. gov, and the ISRCTN Register for studies
comparing minimally invasive approach (thoracotomy, port access, partial
sternotomy, or robotic) with median sternotomy for mitral valve surgery.
We performed title and abstract, full-text screening, and data extraction
independently and in duplicate. We pooled data using random effect models.
Quality assessment was performed using validated tools. Certainty of
evidence was established using the GRADE framework. <br/>Result(s): One
hundred and nineteen studies (n = 38,106) met eligibility criteria: eight
randomized controlled trials (RCTs) and 111 observational studies. MMVS
was associated with fewer days in hospital (RCT: MD: -2.2 days, 95% CI,
[-3.7 to -0.8]; observational: MD: -2.4 days, 95% CI, [-2.7 to -2.1]).
Observational studies suggested that MMVS reduced transfusion requirements
with fewer units transfused per patient (MD: -1.2; 95% CI, [-1.6 to -0.9])
and fewer patients transfused (RR, 0.7; 95% CI, [0.6-0.7]). Observational
data also suggested lower mortality with MMVS (RR, 0.6; 95% CI, [0.5-0.7],
p <.001, I² = 0%), but this was not corroborated by RCT data.
The risk of postoperative mitral regurgitation (>=2+ or requiring
re-intervention) did not differ between the two groups.
<br/>Conclusion(s): MMVS may be associated with shorter length of hospital
stay with no significant difference in short-term morbidity and mortality.
There is a paucity of high-quality data on the long-term outcomes of MMVS
when compared with conventional sternotomy.<br/>Copyright &#xa9; 2022
Wiley Periodicals LLC.

<120>
Accession Number
2014741248
Title
"When to Nuss? patient age as a risk factor for complications of minimally
invasive repair of pectus excavatum: a systematic review and
meta-analysis".
Source
Pediatric Surgery International. 38(3) (pp 365-375), 2022. Date of
Publication: March 2022.
Author
Coughlin A.C.; Ahsanuddin S.; Inglesby D.; Fox C.; Xu H.; Margulies I.;
Sayegh F.; Soudant C.; Sacks H.S.; Kaufman A.; Taub P.J.
Institution
(Coughlin, Ahsanuddin, Inglesby, Fox, Xu, Margulies, Sayegh, Taub)
Division of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave
Levy Place, New York, NY 10029, United States
(Soudant) Levy Library, Icahn School of Medicine at Mount Sinai, New York,
NY, United States
(Sacks) Department of Environmental Medicine and Public Health, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Kaufman) Department of Thoracic Surgery, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: The optimal age for minimally invasive repair of pectus excavatum
(MIRPE) is unclear; this study investigates the differences in
complication rates among different age groups undergoing repair.
<br/>Method(s): PubMed and Embase databases were searched from inception
to October 2020. To assess age as a risk factor for complications, odds
ratios from relevant studies were analyzed using the Mantel-Haenszel
method with a random-effects model for younger vs older patients. Specific
complication rates were compared between the two cohorts using a
chi-squared test. <br/>Result(s): Of the 4448 studies retrieved, 25
studies stratified complication data by age groups. From these studies,
ten studies compared groups at ages < 18 and >= 18 and four studies
compared ages < 20 and >= 20, and one study compared ages < 19 and >= 19.
These fifteen studies reported on 5978 patients, with 1188 complications,
for a complication rate of 19.87%. Older patients were more likely to have
complications in a pooled analysis of studies comparing older vs younger
patients (OR = 1.66, 95% CI = 1.28-2.14, heterogeneity I² =
49%). Specifically, older patients were significantly more likely to
experience pneumothorax, pleural effusion, wound infection, bar
displacement, and reoperations. <br/>Conclusion(s): Increased age is a
risk factor for complications of MIRPE. This supports repair of pectus
excavatum prior to late adolescence.<br/>Copyright &#xa9; 2022, The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature.

<121>
Accession Number
2013729135
Title
ACTION-1: study protocol for a randomised controlled trial on ACT-guided
heparinization during open abdominal aortic aneurysm repair.
Source
Trials. 22(1) (no pagination), 2021. Article Number: 639. Date of
Publication: December 2021.
Author
Wiersema A.M.; Roosendaal L.C.; Koelemaij M.J.W.; Tijssen J.G.P.; van
Dieren S.; Blankensteijn J.D.; Debus E.S.; Middeldorp S.; Heyligers
J.M.M.; Fokma Y.S.; Reijnen M.M.P.J.; Jongkind V.
Institution
(Wiersema, Roosendaal, Jongkind) Department of Vascular Surgery,
Dijklander ziekenhuis, Maelsonstraat 3, Hoorn, NP 1624, Netherlands
(Wiersema, Roosendaal, Blankensteijn, Jongkind) Department of Vascular
Surgery, Amsterdam UMC, loc. Vrije Universiteit Medical center, De
Boelenlaan 1117, Amsterdam, HV 1081, Netherlands
(Koelemaij, van Dieren) Department of Vascular Surgery, Amsterdam UMC,
loc. AMC, Meibergdreef 9, Amsterdam, AZ 1105, Netherlands
(Tijssen) Emeritus Professor of Clinical Epidemiology & Biostatistics,
Department of Cardiology, Amsterdam UMC - University of Amsterdam,
Amsterdam, AZ 1105, Netherlands
(Debus) Department of Vascular Surgery, University Heart Centre
Hamburg-Eppendorf, Martinistrasse 52, Hamburg 20251, Germany
(Middeldorp) Division of Internal Medicine, Department of Haematology,
Amsterdam UMC, loc. AMC, Meibergdreef 9, Amsterdam, AZ 1105, Netherlands
(Heyligers) Department of Vascular Surgery, Elisabeth-TweeSteden
ziekenhuis, Hilvarenbeekseweg 60, Tilburg, GC 5022, Netherlands
(Fokma) Member of Board of Directors, Dijklander ziekenhuis, Maelsonstraat
3, Hoorn, NP 1624, Netherlands
(Reijnen) Department of Vascular Surgery, Rijnstate ziekenhuis, Wagnerlaan
55, Arnhem, AD 6815, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Heparin is used worldwide for 70 years during all non-cardiac
arterial procedures (NCAP) to reduce thrombo-embolic complications (TEC).
But heparin also increases blood loss causing possible harm for the
patient. Heparin has an unpredictable effect in the individual patient.
The activated clotting time (ACT) can measure the effect of heparin.
Currently, this ACT is not measured during NCAP as the standard of care,
contrary to during cardiac interventions, open and endovascular. A RCT
will evaluate if ACT-guided heparinization results in less TEC than the
current standard: a single bolus of 5000 IU of heparin and no measurements
at all. A goal ACT of 200-220 s should be reached during ACT-guided
heparinization and this should decrease (mortality caused by) TEC, while
not increasing major bleeding complications. This RCT will be executed
during open abdominal aortic aneurysm (AAA) surgery, as this is a
standardized procedure throughout Europe. <br/>Method(s): Seven hundred
fifty patients, who will undergo open AAA repair of an aneurysm
originating below the superior mesenteric artery, will be randomised in 2
treatment arms: 5000 IU of heparin and no ACT measurements and no
additional doses of heparin, or a protocol of 100 IU/kg bolus of heparin
and ACT measurements after 5 min, and then every 30 min. The goal ACT is
200-220 s. If the ACT after 5 min is < 180 s, 60 IU/kg will be
administered; if the ACT is between 180 and 200 s, 30 IU/kg. If the ACT is
> 220 s, no extra heparin is given, and the ACT is measured after 30 min
and then the same protocol is applied. The expected incidence for the
combined endpoint of TEC and mortality is 19% for the 5000 IU group and
11% for the ACT-guided group. <br/>Discussion(s): The ACTION-1 trial is an
international RCT during open AAA surgery, designed to show superiority of
ACT-guided heparinization compared to the current standard of a single
bolus of 5000 IU of heparin. A significant reduction in TEC and mortality,
without more major bleeding complications, must be proven with a relevant
economic benefit. Trial registration {2a}: NTR NL8421 ClinicalTrials.gov
NCT04061798. Registered on 20 August 2019 EudraCT 2018-003393-27 Trial
registration: data set {2b}: ClinicalTrials.gov: NCT04061798NTR:
NL8421Arno@wiersema.nuArno@wiersema.nu<br/>Copyright &#xa9; 2021, The
Author(s).

<122>
Accession Number
2007008517
Title
The effect of levosimendan on postoperative bleeding and blood transfusion
in cardiac surgical patients: a PRISMA-compliant systematic review and
meta-analysis.
Source
Perfusion (United Kingdom). 36(7) (pp 694-703), 2021. Date of Publication:
October 2021.
Author
Yao Y.-T.; He L.-X.; Zhao Y.-Y.
Institution
(Yao, He, Zhao) Department of Anesthesiology, Fuwai Hospital, National
Center for Cardiovascular Diseases, Peking Union Medical College and
Chinese Academy of Medical Sciences, Beijing, China
Publisher
SAGE Publications Ltd
Abstract
Background: Levosimendan (LEVO), is an inotropic agent which has been
shown to be associated with better myocardial performance, and higher
survival rate in cardiac surgical patients. However, preliminary clinical
evidence suggested that LEVO increased the risk of post-operative bleeding
in patients undergoing valve surgery. Currently, there has been no
randomized controlled trials (RCTs) designed specifically on this issue.
Therefore, we performed present systemic review and meta-analysis.
<br/>Method(s): Electronic databases were searched to identify all RCTs
comparing LEVO with Control (placebo, blank, dobutamine, milrinone, etc).
Primary outcomes include post-operative blood loss and re-operation for
bleeding. Secondary outcomes included post-operative transfusion of red
blood cells (RBC), fresh frozen plasma (FFP) and platelet concentrates
(PC). For continuous variables, treatment effects were calculated as
weighted mean difference (WMD) and 95% confidential interval (CI). For
dichotomous data, treatment effects were calculated as odds ratio (OR) and
95% CI. <br/>Result(s): Search yielded 15 studies including 1,528
patients. Meta-analysis suggested that, LEVO administration was not
associated with increased risk of reoperation for bleeding
post-operatively (OR = 1.01; 95%CI: 0.57 to 1.79; p = 0.97) and more blood
loss volume (WMD = 28.25; 95%CI: -19.21 to 75.72; p = 0.24). Meta-analysis
also demonstrated that, LEVO administration did not increase
post-operative transfusion requirement for RBC (rate: OR = 0.97; 95%CI:
0.72 to 1.30; p = 0.83 and volume: WMD = 0.34; 95%CI: -0.55 to 1.22; p =
0.46), FFP (volume: WMD = 0.00; 95%CI: -0.10 to 0.10; p = 1.00) and PC
(rate: OR = 1.01; 95%CI: 0.41 to 2.50; p = 0.98 and volume: WMD = 0.00;
95%CI: -0.05 to 0.04; p = 0.95). <br/>Conclusion(s): This meta-analysis
suggested that, peri-operative administration of LEVO was not associated
with increased risks of post-operative bleeding and blood transfusion
requirement in cardiac surgical patients.<br/>Copyright &#xa9; The
Author(s) 2020.

<123>
Accession Number
2015504119
Title
When coronary imaging and physiology are discordant, how best to manage
coronary lesions? An appraisal of the clinical evidence.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Fernandez-Peregrina E.; Ahmad H.; Mintz G.S.; Garcia-Garcia H.M.
Institution
(Fernandez-Peregrina, Ahmad, Mintz, Garcia-Garcia) Division of Section of
Interventional Cardiology, MedStar Washington Hospital Center, Washington,
DC, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Discordant physiology and anatomy may occur when nonsevere
angiographic stenosis has positive physiology as well as the opposite
situation. <br/>Aim(s): To underline the reasons behind the discrepancy in
physiology and anatomy and to summarize the information that coronary
imaging may add to physiology. <br/>Method(s): A review of the published
literature on physiology and intravascular imaging assessment of
intermediate lesions was carried out. <br/>Result(s): The limitations of
angiography, the possibility of an underlying diffuse disease, the
presence of a "grey zone" in both techniques, the amount of myocardial
mass that subtends the stenosis, and plaque vulnerability may play a role
in such discrepancy. Intracoronary imaging has a poor diagnostic accuracy
compared to physiology. However, it may add information about plaque
vulnerability that might be useful in deciding whether to treat or not a
certain lesion. <br/>Conclusion(s): Coronary revascularization is
recommended for patients with ischemia based on physiology. Intracoronary
imaging adds information on plaque vulnerability and can help on the
decision whether to revascularize or not a lesion.<br/>Copyright &#xa9;
2022 Wiley Periodicals LLC.

<124>
Accession Number
2015027752
Title
Impact of left ventricle outflow tract calcification on the outcomes of
transcatheter aortic valve implantation: A study-level meta-analysis.
Source
Journal of Cardiac Surgery. 37(5) (pp 1379-1390), 2022. Date of
Publication: May 2022.
Author
Sa M.P.; Van den Eynde J.; Malin J.H.; Torregrossa G.; Sicouri S.; Ramlawi
B.
Institution
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Torregrossa, Sicouri, Ramlawi) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Van den Eynde) Helen B. Taussig Heart Center, The Johns Hopkins Hospital
and School of Medicine, Baltimore, MD, United States
(Malin) Philadelphia College of Osteopathic Medicine, Bala Cynwyd, PA,
United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To assess the impact of left ventricle outflow tract
calcification (LVOT) on the outcomes of transcatheter aortic valve
implantation (TAVI). <br/>Method(s): Meta-analysis including studies
published by October 2021. Primary endpoints were operative and 1-year
mortality. The secondary endpoints were stroke, myocardial infarction,
paravalvular leakage (PVL), new permanent pacemaker implantation (PPI),
aortic annulus/root rupture. <br/>Result(s): Nine studies met our
eligibility criteria, including a total of 4459 patients (1330 patients
with significant LVOT calcification and 3129 patients without significant
LVOT calcification). Pooled risk of operative death was higher in the
group with significant LVOT calcification (odds ratio [OR]: 2.28; 95%
confidence interval [CI]: 1.33-3.91; p <.001). Worse 1-year survival was
observed in the group with LVOT calcification (hazard ratio 1.53, 95% CI:
1.26-1.87, p <.001). Patients with significant LVOT calcification had
higher risk of stroke (OR: 1.83; 95% CI: 1.08-3.09; p =.032), myocardial
infarction (OR: 1.74; 95% CI: 1.08-2.80; p =.034), PVL (OR: 1.88; 95% CI:
1.09-3.22; p =.028) and aortic annulus/root rupture (OR: 7.48; 95% CI:
3.58-15.65; p =.002). We did not observe a statistically significant
difference in the pooled results for new PPI between the groups (OR: 1.19;
95% CI: 0.79-1.80; p =.337). <br/>Conclusion(s): The presence of
significant LVOT calcification increases the risk of periprocedural and
1-year mortality, stroke, myocardial infarction, PVL and aortic
annulus/root rupture after TAVI. Self-expandable valves may be a
preferrable option in this scenario. Structural heart surgeons and
interventional cardiologists should consider this factor when referring
patients for TAVI and technical aspects (such as the type of transcatheter
heart valve to be deployed or the use of pre-/post-dilatation) should be
factored in.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<125>
[Use Link to view the full text]
Accession Number
2017431135
Title
Evaluating the impact of personalized rehabilitation nursing intervention
on postoperative recovery of respiratory function among thoracic surgery
patients: A protocol for systematic review and meta-analysis.
Source
Medicine (United States). 101(9) (pp E28776), 2022. Date of Publication:
04 Mar 2022.
Author
Liu A.; Li M.; Gao W.; Wen X.; Zhu H.; Chen Y.
Institution
(Liu, Li, Wen, Chen) Department of Cardiothoracic Surgery, Wuhan Puren
Hospital, Hubei Province, Wuhan, China
(Gao) Department of Neurosurgery, Wuhan Puren Hospital, Hubei Province,
Wuhan, China
(Zhu) Outpatient Department, Wuhan Puren Hospital, Hubei Province, Wuhan,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Owing to clinical developments and economic strain,
perioperative care has undergone considerable changes. Therefore, it is
important to review and critique the efficacy of existing practices in a
context that is placing increasing emphasis on better efficacy and
cost-containment. Considering that the objective involves devising
approaches to minimize postoperative complications and reduce medical
care, efforts should concentrate on postsurgical pulmonary complications
that are common. The present analysis aims to examine how customized
rehabilitation nursing intercession impacts the postsurgical restoration
of respiratory functions in thoracic surgery patients.
<br/>Method(s):Prespecified search strategies will be employed to perform
a methodological search of 6 databases namely EMBASE, Cochrane Library,
PubMed, Web of Science, WanFang Database, and China National Knowledge
Infrastructure. The analysis will comprise original publications that
evaluated how personalized rehabilitation nursing intervention impacts
postsurgical restoration of respiratory function in those who have
undergone thoracic surgery. All considered publications are before
December 25, 2021. Different authors will conduct an independent study
selection process to evaluate the quality of the publications and extract
required data. Based on the standardized mean difference and its 95%
confidence interval, we estimate the summary effects for each
meta-analyses. Based on heterogeneity in considered articles, the related
data will be pooled through either a random- or fixed-effect
meta-analysis. Lastly, the overall quality of evidence using appropriate
methods will be performed. <br/>Result(s):The results of this analysis
will systematically evaluate how customized rehabilitation nursing
interference impact postsurgical healing of respiratory functions in
patients who have undergone thoracic surgery by collecting the existing
evidence.Ethics and dissemination:Not required.Open Science Framework
registration number:10.17605/OSF.IO/NBVYW.<br/>Copyright &#xa9; 2022
Lippincott Williams and Wilkins. All rights reserved.

<126>
Accession Number
2017547137
Title
Efficacy and safety of alirocumab and evolocumab: a systematic review and
meta-analysis of randomized controlled trials.
Source
European Heart Journal. 43(7) (pp E17-E25), 2022. Date of Publication:
2022.
Author
Guedeney P.; Giustino G.; Sorrentino S.; Claessen B.E.; Camaj A.; Kalkman
D.N.; Vogel B.; Sartori S.; De Rosa S.; Baber U.; Indolfi C.; Montalescot
G.; Dangas G.D.; Rosenson R.S.; Pocock S.J.; Mehran R.
Institution
(Guedeney, Giustino, Sorrentino, Claessen, Camaj, Kalkman, Vogel, Sartori,
Baber, Indolfi, Dangas, Rosenson, Mehran) Center for Interventional
Cardiovascular Research, The Zena and Michael A. Weiner Cardiovascular
Institute, The Icahn School of Medicine at Mount Sinai, One Gustave L.
Levy Place, Box 1030, New York, NY 10029, United States
(Guedeney, Montalescot) Department of Cardiology, Sorbonne Universite,
ACTION Study Group, INSERM UMRS 1166, Institut de Cardiologie (AP-HP),
Hopital Pitie Salpetriere, Paris, France
(Sorrentino, De Rosa) Division of Cardiology, Department of Medical and
Surgical Sciences, Magna Graecia University, Catanzaro, Italy
(Kalkman) Department of Cardiology, Academic Medical Center, University of
Amsterdam, Amsterdam, Netherlands
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
Publisher
Oxford University Press
Abstract
Aims The effect of low-density lipoprotein cholesterol-lowering therapy
with alirocumab or evolocumab on individual clinical efficacy and safety
endpoints remains unclear. We aimed to evaluate the efficacy and safety of
alirocumab and evolocumab in patients with dyslipidaemia or
atherosclerotic cardiovascular disease. Methods We performed a review of
randomized controlled trials (RCTs) comparing treatment with alirocumab or
evolocu- and results mab vs. placebo or other lipid-lowering therapies up
to March 2018. Primary efficacy endpoints were all-cause death,
cardiovascular death, myocardial infarction (MI), and stroke. We estimated
risk ratios (RR) and 95% confidence intervals (CI) using random effect
models. We included 39 RCTs comprising 66 478 patients of whom 35 896 were
treated with proprotein convertase subtilisin-kexin type 9 (PCSK9)
inhibitors (14 639 with alirocumab and 21 257 with evolocumab) and 30 582
with controls. Mean weighted follow-up time across trials was 2.3 years
with an exposure time of 150 617 patient-years. Overall, the effects of
PCSK9 inhibition on all-cause death and cardiovascular death were not
statistically significant (P = 0.15 and P = 0.34, respectively).
Proprotein convertase subtilisin-kexin type 9 inhibitors were associated
with lower risk of MI (1.49 vs. 1.93 per 100 patient-year; RR 0.80, 95% CI
0.74-0.86; I² = 0%; P < 0.0001), ischaemic stroke (0.44 vs.
0.58 per 100 patient-year; RR 0.78, 95% CI 0.67-0.89; I² = 0%;
P = 0.0005), and coronary revascularization (2.16 vs. 2.64 per 100
patient-year; RR 0.83, 95% CI 0.78-0.89; I² = 0%; P < 0.0001),
compared with the control group. Use of these PCSK9 inhibitors was not
associated with increased risk of neurocognitive adverse events (P =
0.91), liver enzymes elevations (P = 0.34), rhabdomyolysis (P = 0.58), or
new-onset diabetes mellitus (P = 0.97). Conclusion Proprotein convertase
subtilisin-kexin type 9 inhibition with alirocumab or evolocumab was
associated with lower risk of MI, stroke, and coronary revascularization,
with favourable safety profile.<br/>Copyright &#xa9; The Author(s) 2019.
Published on behalf of the European Society of Cardiology. All rights
reserved.

<127>
[Use Link to view the full text]
Accession Number
2017431166
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 (United States). 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
Lippincott Williams and Wilkins
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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2022 Lippincott Williams
and Wilkins. All rights reserved.

<128>
[Use Link to view the full text]
Accession Number
2017431150
Title
Tranexamic acid reduces postoperative blood loss in Chinese pediatric
patients undergoing cardiac surgery: A PRISMA-compliant systematic review
and meta-analysis.
Source
Medicine (United States). 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, Kunming, China
(Yao) Anesthesia Center, Fuwai Hospital, NCCD, PUMCandCAMS, Beijing, China
Publisher
Lippincott Williams and Wilkins
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. <br/>Participant(s):Chinese pediatric
patients undergoing cardiac surgery. <br/>Intervention(s):Tranexamic acid
or control drugs (saline/blank). <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<129>
Accession Number
2016161030
Title
A Scoping Review of Galectin-3 as a Biomarker of Cardiovascular Diseases
in Pediatric Populations.
Source
International Journal of Environmental Research and Public Health. 19(7)
(no pagination), 2022. Article Number: 4349. Date of Publication: April-1
2022.
Author
Smereczynska-Wierzbicka E.; Pietrzak R.; Werner B.
Institution
(Smereczynska-Wierzbicka, Pietrzak, Werner) Department of Pediatric
Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw
02-091, Poland
Publisher
MDPI
Abstract
Galectin-3 as a cardiac biomarker has proven to be a significant
prognostic tool in adults. However, it has not yet been established in the
pediatric population as a biomarker in daily clinical practice. The aim of
the study was to summarize the current knowledge on galectin-3 as a
biomarker in children with cardiac conditions by reviewing the literature.
Bibliographic databases such as PubMed, Web of Science and Embase were
searched, and consequently twelve articles met the inclusion criteria.
Supplemental handsearching of references delivered one additional source.
These prospective studies concerning galectin-3 as a cardiac biomarker
present analyses performed in cohorts composed of healthy children and
children with cardiovascular diseases. The results, despite being based on
small cohort studies, inform that galectin-3 could serve as a potential
biomarker in cardiovascular risk stratification in children with heart
failure, arrhythmia, Kawasaki disease or in patients undergoing cardiac
surgery. The evidence for the usefulness of galectin-3 in the assessment
of such pathologies as idiopathic dilated cardiomyopathy, coarctation of
the aorta, functionally univentricular heart or tetralogy of Fallot were
not completely confirmed. Galectin-3 seems to be a promising biomarker;
however, there is a need for further research to establish its use in
daily clinical practice.<br/>Copyright &#xa9; 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<130>
[Use Link to view the full text]
Accession Number
2017499976
Title
Regional Analgesia Added to General Anesthesia Compared With General
Anesthesia Plus Systemic Analgesia for Cardiac Surgery in Children: A
Systematic Review and Meta-analysis of Randomized Clinical Trials.
Source
Anesthesia and Analgesia. 128(1) (pp 130-136), 2019. Date of Publication:
January 2019.
Author
Monahan A.; Guay J.; Hajduk J.; Suresh S.
Institution
(Monahan, Hajduk, Suresh) Department of Pediatric Anesthesiology, Ann &
Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
(Guay) Department of Anesthesiology and Critical Care, Faculty of
Medicine, Laval University, Quebec City, QC, Canada
(Guay) Department of Anesthesiology, Faculty of Medicine, University of
Sherbrooke, Quebec, Canada
(Guay) Teaching and Research Unit, Health Sciences, University of Quebec
in AbitibiTemiscamingue, QC, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The aim of this systematic review was to compare the effects
of regional analgesic (RA) techniques with systemic analgesia on
postoperative pain, nausea and vomiting, resources utilization,
reoperation, death, and complications of the analgesic techniques in
children undergoing cardiac surgery. <br/>METHOD(S): A search was done in
May 2018 in PubMed, Embase, and the Cochrane Central Register of
Controlled Trials for randomized controlled trials comparing RA techniques
with systemic analgesia. Risks of bias of included trials were judged with
the Cochrane tool. Data were analyzed with fixed- (I² < 25%) or
random-effects models (I² >= 25%). The quality of evidence was
graded according to the Grading of Recommendations Assessment,
Development, and Evaluation working group scale. <br/>RESULT(S): We
included 14 randomized controlled trials with 605 participants (312 to RA
and 293 to the comparator). RA reduces pain up to 24 hours after surgery.
At 6-8 hours after surgery, the standardized mean difference was -0.81
(95% confidence interval [CI], -1.22 to -0.40; low-quality evidence). We
did not find a difference for nausea and vomiting (risk ratio [RR], 0.89;
95% CI, 0.61-1.31; very low-quality evidence), duration of tracheal
intubation (standardized mean difference, -0.18; 95% CI, -0.40 to 0.05;
low-quality evidence), intensive care unit length of stay (mean
difference, -0.10 hours; 95% CI, -1.31 to 1.12 hours; low-quality
evidence), hospital length of stay (mean difference, -0.02 days; 95% CI,
-1.16 to 1.12 days; low-quality evidence), reoperation (RR, 0.76; 95% CI,
0.17-3.28; low-quality evidence), death (RR, 0.50; 95% CI, 0.05-4.94;
low-quality evidence), and respiratory depression (RR, 2.06; 95% CI,
0.20-21.68; very low-quality evidence). No trial reported signs of local
anesthetic toxicity or lasting neurological or infectious complications
related to the RA techniques. One trial reported 1 transient ipsilateral
episode of diaphragmatic paralysis with intrapleural analgesia that
resolved with cessation of local anesthetic administration.
<br/>CONCLUSION(S): Compared to systemic analgesia, RA techniques reduce
postoperative pain up to 24 hours in children undergoing cardiac surgery.
Currently, there is no evidence that RA for pediatric cardiac surgery has
any impact on major morbidity and mortality. These results should be
interpreted cautiously because they represent a meta-analysis of small and
heterogeneous studies. Further studies are needed.<br/>Copyright &#xa9;
2018 International Anesthesia Research Society

<131>
Accession Number
2017526732
Title
Whole Blood Adsorber During CPB and Need for Vasoactive Treatment After
Valve Surgery in Acute Endocarditis: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Holmen A.; Corderfeldt A.; Lannemyr L.; Dellgren G.; Hansson E.C.
Institution
(Holmen, Corderfeldt, Lannemyr, Hansson) Department of Cardiothoracic
Surgery, Sahlgrenska University Hospital, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Lannemyr) Department of Anesthesia and Intensive Care, Institution of
Clinical Sciences, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Dellgren) The Transplant Institute, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Dellgren, Hansson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
Publisher
W.B. Saunders
Abstract
Objectives: Patients with endocarditis requiring urgent valvular surgery
with cardiopulmonary bypass are at a high risk of developing systemic
inflammatory response syndrome and septic shock, necessitating intensive
use of vasopressors after surgery. The use of a cytokine hemoadsorber
(CytoSorb, CytoSorbents Europe GmbH, Germany) during cardiac surgery has
been suggested to reduce the risk of inflammatory activation. The study
authors hypothesized that adding a cytokine adsorber would reduce cytokine
burden, which would translate into improved hemodynamic stability.
<br/>Design(s): A randomized, controlled, nonblinded clinical trial.
<br/>Setting(s): At a university hospital, tertiary referral center.
<br/>Participant(s): Nineteen patients with endocarditis undergoing valve
surgery. <br/>Intervention(s): A cytokine hemoadsorber integrated into the
cardiopulmonary bypass circuit. <br/>Measurements and Main Results: The
accumulated norepinephrine dose in the intervention group was half or less
at all postoperative time points compared to the control group, although
it did not reach statistical significance; at 24 and 48 hours (median 36
[25-75 percentiles; 12-57] mug v 114 [25-559] mug, p = 0.11 and 36 [12-99]
mug v 261 [25-689] mug, p = 0.09). There was no significant difference in
chest tube output, but there was a significantly lower need for the
transfusion of red blood cells (285 [0-657] mL v 1,940 [883-2,148] mL, p =
0.03). <br/>Conclusion(s): There was no statistically significant
difference between the groups with regard to vasopressor use after surgery
for endocarditis with the use of a cytokine hemoadsorber during
cardiopulmonary bypass. Additional, larger randomized controlled trials
are needed to definitely assess the potential effect.<br/>Copyright &#xa9;
2022 Elsevier Inc.

<132>
Accession Number
637678956
Title
Paediatric brain MRI findings following congenital heart surgery: A
systematic review.
Source
Archives of Disease in Childhood. (no pagination), 2022. Article Number:
323132. Date of Publication: 2022.
Author
Alablani F.J.; Chan H.S.A.; Beishon L.; Patel N.; Almudayni A.; Bu'Lock
F.; Chung E.M.L.
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, Al-Kharj, 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
BMJ Publishing Group
Abstract
Objective: This systematic review aimed to establish the relative
incidence of new postoperative brain MRI findings following paediatric
congenital cardiac surgery. <br/>Design(s): 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. <br/>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. <br/>Conclusion(s): This systematic review
suggests that surgery approximately doubles the number of patients with
new brain lesions.<br/>Copyright &#xa9; 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.

<133>
Accession Number
637675912
Title
Edoxaban versus Dual Antiplatelet Therapy for Leaflet Thrombosis and
Cerebral Thromboembolism after TAVR: The ADAPT-TAVR Randomized Clinical
Trial.
Source
Circulation. (no pagination), 2022. Date of Publication: 04 Apr 2022.
Author
Park D.-W.; Ahn J.-M.; Kang D.-Y.; Kim K.W.; Koo H.J.; Yang D.H.; Jung
S.C.; Kim B.; Wong Y.T.A.; Lam C.C.S.; Yin W.-H.; Wei J.; Lee Y.-T.; Kao
H.-L.; Lin M.-S.; Ko T.-Y.; Kim W.-J.; Kang S.H.; Yun S.-C.; Lee S.-A.; Ko
E.; Park H.; Kim D.-H.; Kang J.-W.; Lee J.-H.; Park S.-J.
Institution
(Park, Ahn, Kang, Lee, Ko, Kim, Park) Division of Cardiology, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
(Kim) Clinical Trial Center, Asan Institute for Life Sciences, Asan
Medical Center, Seoul, South Korea
(Koo, Yang, Jung, Kang) Department of Radiology Research Institute of
Radiology, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Kim) Department of Radiology, Anam Hospital, Korea University College of
Medicine, Seoul, South Korea
(Wong, Lam) Division of Cardiology, Department of Medicine, University of
Hong Kong, Queen Mary Hospital, Hong Kong
(Yin, Wei, Lee) Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
(Republic of China)
(Kao, Lin) Division of Cardiology, Department of Internal Medicine,
National Taiwan University Hospital, Taipei, Taiwan (Republic of China)
(Ko) Division of Cardiology, Department of Internal Medicine, National
Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan (Republic of
China)
(Kim, Kang) Department of Cardiology, CHA Bundang Medical Center,
Seongnam, South Korea
(Yun) Division of Biostatistics, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Park) Division of Cardiology, GangNeung Asan Hospital, University of
Ulsan College of Medicine, GangNeung, South Korea
(Lee) Department of Neurology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
Background: It is unknown whether direct oral anticoagulant edoxaban can
reduce leaflet thrombosis and the accompanying cerebral thromboembolic
risk after transcatheter aortic-valve replacement (TAVR). Also, the causal
relationship of subclinical leaflet thrombosis with cerebral
thromboembolism and neurological or neurocognitive dysfunction remains
unclear. <br/>Method(s): We conducted a multicenter, open-label randomized
trial comparing edoxaban with dual antiplatelet therapy (DAPT; aspirin
plus clopidogrel) in patients who had undergone successful TAVR and did
not have an indication for anticoagulation. The primary end point was an
incidence of leaflet thrombosis on four-dimensional computed tomography
(CT) at 6-month. Key secondary end points were the number and volume of
new cerebral lesions on brain magnetic resonance imaging (MRI) and the
serial changes of neurological and neurocognitive function between 6-month
and immediate post-TAVR. <br/>Result(s): A total of 229 patients were
included in the final intention-to-treat population. There was a trend
toward a lower incidence of leaflet thrombosis in the edoxaban group than
in the DAPT group (9.8% vs. 18.4%; absolute difference, -8.5%; 95%
confidence interval [CI], -17.8% to 0.8%; P=0.076). The percentage of
patients with new cerebral lesions on brain MRI (edoxaban vs. DAPT; 25.0%
vs. 20.2%; difference, 4.8%; 95% CI, -6.4% to 16.0%) and median total new
lesion number and volume were not different between two groups. Also, the
percentages of patients with worsening of neurological and neurocognitive
function were not different among the groups. The incidence of any or
major bleeding events were not different between two groups. We found no
significant association of the presence or extent of leaflet thrombosis
with new cerebral lesions and a change of neurological or neurocognitive
function. <br/>Conclusion(s): In patients without an indication for
long-term anticoagulation after successful TAVR, the incidence of leaflet
thrombosis was numerically lower with edoxaban than with DAPT, but this
was not statistically significant. The effect on new cerebral
thromboembolism and neurological or neurocognitive function were also not
different between two groups. Because the study was underpowered, the
results should be considered hypothesis-generating, highlighting the need
for further research.

<134>
Accession Number
637675852
Title
Cardiac surgery on patients with COVID-19: a systematic review and
meta-analysis.
Source
ANZ journal of surgery. (no pagination), 2022. Date of Publication: 03
Apr 2022.
Author
Gupta A.K.; Leslie A.; Hewitt J.N.; Kovoor J.G.; Ovenden C.D.; Edwards S.;
Chan J.C.Y.; Worthington M.G.
Institution
(Gupta) Department of Surgery, University of Sydney, Sydney, NSW,
Australia
(Gupta, Worthington) Department of Cardiothoracic Surgery, Royal Adelaide
Hospital, Adelaide, Australia
(Gupta, Leslie, Hewitt, Kovoor, Ovenden, Chan) University of Adelaide,
Discipline of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
(Edwards) Adelaide Health Technology Assessment, School of Public Health,
University of Adelaide, Adelaide, SA, Australia
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The COVID-19 pandemic has had a significant impact on global
surgery. In particular, deleterious effects of SARS-CoV-2 infection on the
heart and cardiovascular system have been described. To inform surgical
patients, we performed a systematic review and meta-analysis aiming to
characterize outcomes of COVID-19 positive patients undergoing cardiac
surgery. <br/>METHOD(S): The study protocol was registered with PROSPERO
(CRD42021228533) and conformed with PRISMA 2020 and MOOSE guidelines.
PubMed, Ovid MEDLINE and Web of Science were searched between 1 January
2019 to 24 February 2022 for studies reporting outcomes on COVID-19
positive patients undergoing cardiac surgery. Study screening, data
extraction and risk of bias assessment were conducted in duplicate.
Meta-analysis was conducted using a random-effects model where at least
two studies had sufficient data for that variable. <br/>RESULT(S):
Searches identified 4223 articles of which 18 studies were included with a
total 44 patients undergoing cardiac surgery. Within these studies, 12
(66.7%) reported populations undergoing coronary artery bypass graft
(CABG) surgery, three (16.7%) aortic valve replacements (AVR) and three
(16.7%) aortic dissection repairs. Overall mean postoperative length of
ICU stay was 3.39 (95% confidence interval (CI): 0.38, 6.39) and mean
postoperative length of hospital stay was 17.88 (95% CI: 14.57, 21.19).
<br/>CONCLUSION(S): This systematic review and meta-analysis investigated
studies of limited quality which characterized cardiac surgery in COVID-19
positive patients and demonstrates that these patients have poor outcomes.
Further issues to be explored are effects of COVID-19 on decision-making
in cardiac surgery, and effects of COVID-19 on the cardiovascular system
at a cellular level.<br/>Copyright &#xa9; 2022 The Authors. ANZ Journal of
Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal
Australasian College of Surgeons.

<135>
Accession Number
637675488
Title
Non-heparin-induced thrombocytopenia in patients after open-heart surgery.
Source
Perfusion. (pp 2676591221082496), 2022. Date of Publication: 04 Apr 2022.
Author
Keles E.; Bilen C.; Aygun H.; Gencpinar T.; Catalyurek H.
Institution
(Keles, Aygun) 578037Bakircay University Cigli Training and Research
Hospital, Izmir, Turkey
(Bilen) 147024Health Sciences University Dr Behcet Uz Training and
Research Hospital, Izmir, Turkey
(Gencpinar, Catalyurek) 37508Dokuz Eylul University Hospital, Izmir,
Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thrombocytopenia (platelet count below 150 x 103/muL) is a
common finding after open-heart surgery and can lead to various
complications, including patient death. This study aimed to determine the
extent of non-heparin-induced thrombocytopenia in open-heart surgery and
to highlight the associated factors. MATERIALS AND METHODS: In this cohort
study, 842 patients who underwent valve and/or coronary bypass surgery
over a 5-year period were retrospectively analyzed. After open-heart
surgery, patients whose platelet count was less than 150 x 103/muL on a
complete blood count 12 and 24 h after surgery were classified as
thrombocytopenic. Three hundred twenty patients without thrombocytopenia
and 21 patients with a high probability of heparin-induced
thrombocytopenia were excluded from the study. Logistic regression
analysis was used to assess the association of independent variables in
moderate-severe thrombocytopenia: Age groups, sex, underlying disease,
symptoms, type of surgery, pump time, pulsatile or non-pulsatile duration,
degree of hypothermia, hemodilution, oxygenator type, use of an
intra-aortic balloon, and erythrocyte transfusion counts were included in
the analysis. <br/>RESULT(S): A total of 501 patients were diagnosed as
having non-heparin-induced thrombocytopenia, and 64.3% were male. Three
hundred seventy-seven (75.2%) patients had mild thrombocytopenia and 124
(24.7%) had moderate-severe thrombocytopenia. The postoperative platelet
count was significantly lower than the preoperative platelet count (213 x
103 vs.117 x 103/muL; p < 0.001). Moderate-severe thrombocytopenia was
associated with age >=80 years odds (OR = 9.026, 95% CI: [1.757-46.363]; p
= 0.008), isolated valve surgery (OR = 3.090, 95% CI: [1.867-5.114]; p <
0.001), and valve surgery with coronary bypass (OR = 4.938, 95% CI:
[1.638-14.889]; p = 0.005) compared to isolated coronary bypass, type of
oxygenator (Nipro vital compared with Affinity OR = 11.097, 95% CI:
[1.923-64.023]; p = 0.007), erythrocyte transfusion count (OR = 1.219,
95%CI: [1.046-1.420]; p = 0.011). <br/>CONCLUSION(S): Age 80 years or
older, surgical procedures including heart-valve surgery, and the number
of red blood cell transfusions are associated with the risk of
moderate-to-severe thrombocytopenia. This study provides a guide in terms
of risk factors that may lead to moderate-to-severe thrombocytopenia after
open-heart surgery. However, future multicentre prospective randomized
studies may provide more detailed information on this subject.

<136>
Accession Number
637674315
Title
Quality of Life After Fractional Flow Reserve-Guided PCI Compared with
Coronary Bypass Surgery.
Source
Circulation. (no pagination), 2022. Date of Publication: 02 Apr 2022.
Author
Fearon W.F.; Zimmermann F.M.; Ding V.Y.; Zelis J.M.; Piroth Z.;
Davidavicius G.; Mansour S.; Kharbanda R.; Ostlund-Papadogeorgos N.;
Oldroyd K.G.; Wendler O.; Reardon M.J.; Woo Y.J.; Yeung A.C.; Pijls
N.H.J.; De Bruyne B.; Desai M.; Hlatky M.A.
Institution
(Fearon) Division of Cardiovascular Medicine and Stanford Cardiovascular
Institute, Stanford University, Stanford, CA; VA Palo Alto Health Care
System, Palo Alto CA
(Zimmermann, Zelis, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Ding, Desai) Quantitative Sciences Unit, Stanford University, Stanford,
CA
(Piroth) Gottsegen National Cardiovascular Center, Hungary
(Davidavicius) Clinic of Cardiac and Vascular Diseases, Institute of
Clinical Medicine, Vilnius University, Lithuania and Vilnius University
Hospital Santaros Klinikos, Vilnius, Lithuania
(Mansour) Centre Hospitalier de l'Universite de Montreal, Canada
(Kharbanda) Oxford University Hospital NHS Trust, Oxford, United Kingdom
(Ostlund-Papadogeorgos) Danderyd University Hospital and Karolinska
Institutet, Solna, Sweden
(Oldroyd) Golden Jubilee National Hospital, Glasgow, United Kingdom
(Wendler) King's College Hospital, London, United Kingdom
(Reardon) Houston Methodist Hospital, TX, Houston
(Woo) Department of Cardiothoracic Surgery, Stanford University, Stanford,
CA
(Yeung) Division of Cardiovascular Medicine and Stanford Cardiovascular
Institute, Stanford University, Stanford, CA
(De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium; Lausanne
University Centre Hospital, Lausanne, Switzerland
(Hlatky) Division of Cardiovascular Medicine and Stanford Cardiovascular
Institute, Stanford University, Stanford, CA; Department of Health Policy,
Stanford University, Stanford, CA
Publisher
NLM (Medline)
Abstract
Background: Previous studies have shown quality of life improves after
coronary revascularization, more so after coronary artery bypass grafting
(CABG) than after percutaneous coronary intervention (PCI). This study
aimed to evaluate the impact of fractional flow reserve (FFR) guidance and
current generation, zotarolimus drug-eluting stents (DES) on quality of
life after PCI compared with CABG. <br/>Method(s): The Fractional Flow
Reserve versus Angiography for Multivessel Evaluation (FAME) 3 trial is a
multicenter, international trial including 1500 patients with three-vessel
coronary artery disease (CAD) who were randomly assigned to either CABG or
FFR-guided PCI. Quality of life was measured using the European Quality of
Life-5 Dimensions (EQ-5D) questionnaire at baseline, 1 and 12 months. The
Canadian Cardiovascular Class (CCS) angina grade and working status were
assessed at the same time points and at 6 months. The primary objective
was to compare EQ-5D summary index at 12 months. Secondary endpoints
included angina grade and work status. <br/>Result(s): The EQ-5D summary
index at 12 months did not differ between the PCI and CABG groups
(difference=0.001, 95% confidence interval (CI) -0.016 to 0.017, p=0.946).
The trajectory of EQ-5D over the 12 months differed (p<0.001) between PCI
and CABG: at 1 month, EQ-5D was 0.063 (95% CI 0.047 to 0.079) higher in
the PCI group. A similar trajectory was found for the EQ visual analogue
scale. The proportion of patients with CCS 2 or greater angina at 12
months was 6.2% vs 3.1% (OR=2.5, 95% CI 0.96 to 6.8), respectively in the
PCI group compared with the CABG group. A greater percentage of younger
patients (<65 years-old) were working at 12 months in the PCI group
compared with the CABG group (68% vs 57%, OR=3.9, 95% CI 1.7 to 8.8).
<br/>Conclusion(s): In the FAME 3 trial, quality of life after FFR-guided
PCI with current generation DES compared with CABG was similar at one
year. The rate of significant angina was low in both groups and not
significantly different. The trajectory of improvement in quality of life
was significantly better after PCI, as was working status in those less
than 65 years old.