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<1>
Accession Number
2016424001
Title
The prospective randomized trial of the optimal evaluation of cardiac
symptoms and revascularization: Rationale and design of the PRECISE trial.
Source
American Heart Journal. 245 (pp 136-148), 2022. Date of Publication: March
2022.
Author
Nanna M.G.; Vemulapalli S.; Fordyce C.B.; Mark D.B.; Patel M.R.;
Al-Khalidi H.R.; Kelsey M.; Martinez B.; Yow E.; Mullen S.; Stone G.W.;
Ben-Yehuda O.; Udelson J.E.; Rogers C.; Douglas P.S.
Institution
(Nanna) Section of Cardiovascular Medicine, Yale School of Medicine, New
Haven, CT, United States
(Vemulapalli, Mark, Patel, Al-Khalidi, Kelsey, Martinez, Yow, Douglas)
Duke Clinical Research Institute, Duke University School of Medicine,
Durham, NC, United States
(Fordyce) Division of Cardiology, Vancouver General Hospital, University
of British Columbia, Vancouver, BC, Canada
(Mullen, Rogers) HeartFlow, Inc., Redwood City, CA, United States
(Stone) Icahn School of Medicine at Mount Sinai, Mount Sinai Heart and the
Cardiovascular Research Foundation, New York, NY, United States
(Ben-Yehuda) Cardiovascular Research Foundation, New York, NY and the
University of California, San Diego, CA, United States
(Udelson) Division of Cardiology and the CardioVascular Center, Tufts
Medical Center, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Clinicians vary widely in their preferred diagnostic approach
to patients with non-acute chest pain. Such variation exposes patients to
potentially avoidable risks, as well as inefficient care with increased
costs and unresolved patient concerns. Method(s): The Prospective
Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and
Revascularization (PRECISE) trial (NCT03702244) compares an
investigational "precision" diagnostic strategy to a usual care diagnostic
strategy in participants with stable chest pain and suspected coronary
artery disease (CAD). Result(s): PRECISE randomized 2103 participants
with stable chest pain and a clinical recommendation for testing for
suspected CAD at 68 outpatient international sites. The investigational
precision evaluation strategy started with a pre-test risk assessment
using the PROMISE Minimal Risk Tool. Those at lowest risk were assigned to
deferred testing (no immediate testing), and the remainder received
coronary computed tomographic angiography (cCTA) with selective fractional
flow reserve (FFR<inf>CT</inf>) for any stenosis meeting a threshold of
>=30% and <90%. For participants randomized to usual care, the clinical
care team selected the initial noninvasive or invasive test (diagnostic
angiography) according to customary practice. The use of cCTA as the
initial diagnostic strategy was proscribed by protocol for the usual care
strategy. The primary endpoint is time to a composite of major adverse
cardiac events (MACE: all-cause death or non-fatal myocardial infarction)
or invasive cardiac catheterization without obstructive CAD at 1 year.
Secondary endpoints include health care costs and quality of life.
 Conclusion(s): PRECISE will determine whether a precision approach
comprising a strategically deployed combination of risk-based deferred
testing and cCTA with selective FFR<inf>CT</inf> improves the clinical
outcomes and efficiency of the diagnostic evaluation of stable chest pain
over usual care. Copyright © 2021

<2>
Accession Number
2015496261
Title
Progression of atherosclerosis with carnitine supplementation: a
randomized controlled trial in the metabolic syndrome.
Source
Nutrition and Metabolism. 19(1) (no pagination), 2022. Article Number: 26.
Date of Publication: December 2022.
Author
Johri A.M.; Hetu M.-F.; Heyland D.K.; Herr J.E.; Korol J.; Froese S.;
Norman P.A.; Day A.G.; Matangi M.F.; Michos E.D.; LaHaye S.A.; Saunders
F.W.; Spence J.D.
Institution
(Johri, Hetu, Herr) Department of Medicine, Cardiovascular Imaging Network
at Queen's University, Kingston, ON, Canada
(Heyland, Korol, Froese) Department of Critical Care Medicine, Clinical
Evaluation Research Unit, Kingston, ON, Canada
(Norman, Day) Kingston Health Sciences Centre, Kingston, ON, Canada
(Matangi) The Kingston Heart Clinic, Kingston, ON, Canada
(Michos) Division of Cardiology, Johns Hopkins University School of
Medicine, Baltimore, United States
(Johri, LaHaye) Department of Medicine, Queen's University, 76 Stuart
Street, KGH FAPC 3, Kingston, ON K7L 2V7, Canada
(Saunders) Southeastern Ontario Vascular Laboratory, Kingston Health
Sciences Centre, Kingston, ON, Canada
(Spence) Stroke Prevention and Atherosclerosis Research Centre, University
of Western Ontario, London, ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background: L-carnitine (L-C), a ubiquitous nutritional supplement, has
been investigated as a potential therapy for cardiovascular disease, but
its effects on human atherosclerosis are unknown. Clinical studies suggest
improvement of some cardiovascular risk factors, whereas others show
increased plasma levels of pro-atherogenic trimethylamine N-oxide. The
primary aim was to determine whether L-C therapy led to progression or
regression of carotid total plaque volume (TPV) in participants with
metabolic syndrome (MetS). Method(s): This was a phase 2,
prospective, double blinded, randomized, placebo-controlled, two-center
trial. MetS was defined as >= 3/5 cardiac risk factors: elevated waist
circumference; elevated triglycerides; reduced HDL-cholesterol; elevated
blood pressure; elevated glucose or HbA1c; or on treatment. Participants
with a baseline TPV >= 50 mm3 were randomized to placebo or 2 g
L-C daily for 6 months. Result(s): The primary outcome was the
percent change in TPV over 6 months. In 157 participants (L-C N = 76,
placebo N = 81), no difference in TPV change between arms was found. The
L-C group had a greater increase in carotid atherosclerotic stenosis of
9.3% (p = 0.02) than the placebo group. There was a greater increase in
total cholesterol and LDL-C levels in the L-C arm. Conclusion(s):
Though total carotid plaque volume did not change in MetS participants
taking L-C over 6-months, there was a concerning progression of carotid
plaque stenosis. The potential harm of L-C in MetS and its association
with pro-atherogenic metabolites raises concerns for its further use as a
potential therapy and its widespread availability as a nutritional
supplement. Trial registration: ClinicalTrials.gov, NCT02117661,
Registered April 21, 2014,
https://clinicaltrials.gov/ct2/show/NCT02117661. Copyright ©
2022, The Author(s).

<3>
Accession Number
2016465881
Title
Association between Colchicine Treatment and Clinical Outcomes in Patients
with Coronary Artery Disease: Systematic Review and Meta-analysis.
Source
European Cardiology Review. 16 (no pagination), 2021. Article Number: e39.
Date of Publication: 2021.
Author
Condello F.; Sturla M.; Reimers B.; Liccardo G.; Stefanini G.G.;
Condorelli G.; Ferrante G.
Institution
(Condello, Sturla, Reimers, Liccardo, Stefanini, Condorelli, Ferrante)
Humanitas University, Department of Biomedical Sciences, Pieve Emanuele,
Milan, Italy
(Condello, Sturla, Reimers, Liccardo, Stefanini, Condorelli, Ferrante)
Department of Cardiovascular Medicine, Humanitas Research Hospital, IRCCS,
Rozzano, Milan, Italy
Publisher
Radcliffe Medical Media
Abstract
Background: The authors examined the association between colchicine
treatment and clinical outcomes in patients with coronary artery disease.
 Method(s): They performed a meta-analysis of randomised controlled
trials (RCTs) involving patients with coronary artery disease receiving
addon colchicine to standard treatment compared with standard treatment.
They used a mixed-effects Poisson regression model with random
intervention effects to estimate the pooled incidence rate ratios (IRR)
with 95% CI. Result(s): Ten RCTs were identified, including 12,819
participants followed up for a median of 6 months. Colchicine was
associated with a lower risk of major adverse cardiovascular events (IRR
0.69; 95% CI [0.60-0.79]; number needed to treat for an additional
beneficial outcome [NNTB] = 28); MI (IRR 0.77; 95% CI [0.64-0.93]; NNTB =
95) and ischaemic stroke (IRR 0.48; 95% CI [0.30-0.76]; NNTB = 155) and
with a higher risk of gastrointestinal adverse events (IRR 1.69; 95% CI
[1.12-2.54]; number needed to treat for an additional harmful outcome
[NNTH] = 10). Colchicine did not affect all-cause death (IRR 1.09; 95% CI
[0.85-1.40]), or cardiovascular death (IRR 0.75; 95% CI [0.51-1.12]),
while it was associated with a higher risk of non-cardiovascular death
(IRR 1.45; 95% CI [1.04-2.02]; NNTH = 396). Conclusion(s): The
meta-analysis showed that the relative and absolute beneficial treatment
effects of colchicine on cardiovascular outcomes outweigh the potential
harm for non-cardiovascular mortality. Registration: PROSPERO 2021
CRD42021248874. Copyright © 2021 Radcliffe Group Ltd. All rights
reserved.

<4>
Accession Number
2017681278
Title
Temporal Trends in Self-Expandable Transcatheter Aortic Valve Replacement
in South America: A Systematic Review and Meta-Analysis.
Source
Value in Health Regional Issues. 30 (pp 148-160), 2022. Date of
Publication: July 2022.
Author
Boissonnet C.P.; Wisner J.N.; Giorgi M.A.; Carosella L.; Brescacin
Castillejo C.; Pissinis J.; Guetta J.N.
Institution
(Boissonnet, Giorgi, Guetta) Health Economics and Technology Assessment
Unit, Instituto Universitario CEMIC, Buenos Aires, Argentina
(Boissonnet, Giorgi, Guetta) Centro de Educacion Medica e Investigaciones
Clinicas "Norberto Quirno" CEMIC, Buenos Aires, Argentina
(Boissonnet, Giorgi, Carosella, Guetta) Cardiology Section, Department of
Internal Medicine, Centro de Educacion Medica e Investigaciones Clinicas
"Norberto Quirno" CEMIC, Buenos Aires, Argentina
(Wisner) Invasive Cardiology Section, Centro de Educacion Medica e
Investigaciones Clinicas "Norberto Quirno" CEMIC, Buenos Aires, Argentina
(Giorgi) Department of Pharmacology, Instituto Universitario CEMIC, Buenos
Aires, Argentina
(Brescacin Castillejo, Pissinis) Department of Internal Medicine, Centro
de Educacion Medica e Investigaciones Clinicas "Norberto Quirno" CEMIC,
Buenos Aires, Argentina
Publisher
Elsevier Inc.
Abstract
Objectives: This study aimed to estimate temporal trends in clinical
presentation and short-term outcomes of transcatheter aortic valve
replacement (TAVR) with self-expandable prostheses in South America
through a systematic review and meta-analysis of observational data.
 Method(s): We comprehensively searched for articles published in
peer-reviewed medical journals and for abstracts presented in medical
conferences of the region from September 1, 2008, to June 29, 2020. We
included single-center studies on self-expandable TAVR populations with >=
10 patients from South America. Result(s): A total of 28 cohorts from
6 countries pooling 1780 patients were included in a random-effects
meta-analysis. Pooled estimates of age changed during time (period
2011-2015, 81.6 years; 95% confidence interval [CI] 80.7-82.4; period
2016-2018, 80.6 years; 95% CI 79.8-81.3; period 2019: 78.5 years; 95% CI
77.0-80.0; P = .0003); no other temporal trends in patient characteristics
were ascertained. Temporal trends in short-term mortality pooled estimates
were in-hospital mortality (11.8% [95% CI 8.2-16.7] for the period
2011-2015, 6.6% [95% CI 4.5-9.6] for the period 2016-2018, and 4.4% [95%
CI 1.9-9.8] for the period 2019 [P = .007]) and 30-day mortality (12.8%
[95% CI 7.7-20.4], 9.7% [95% CI 7.0-13.3], and 5.7% [95% CI 2.8-11.3],
respectively [P =.044]). These associations between reporting year of the
study and lower mortality remained after adjusting by age and surgical
risk (multivariate meta-regression). Conclusion(s): In studies
reported between 2011 and 2019 in South America, we demonstrated a clear
time trend toward reduction of short-term mortality after self-expandable
TAVR, independently of age and surgical risk of populations. These
findings are relevant to the local reassessment of cost-effectiveness of
TAVR. Copyright © 2022 International Society for Health Economics
and Outcomes Research

<5>
Accession Number
2014644893
Title
Changes in eicosapentaenoic acid and docosahexaenoic acid and risk of
cardiovascular events and atrial fibrillation: A secondary analysis of the
OMEMI trial.
Source
Journal of Internal Medicine. 291(5) (pp 637-647), 2022. Date of
Publication: May 2022.
Author
Myhre P.L.; Kalstad A.A.; Tveit S.H.; Laake K.; Schmidt E.B.; Smith P.;
Nilsen D.W.T.; Tveit A.; Solheim S.; Arnesen H.; Seljeflot I.
Institution
(Myhre, Tveit, Smith) Department of Cardiology, Division of Medicine,
Akershus University Hospital, Lorenskog, Norway
(Myhre, Kalstad, Tveit, Smith, Tveit, Arnesen, Seljeflot) Institute of
Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
(Kalstad, Laake, Solheim, Arnesen, Seljeflot) Center for Clinical Heart
Research, Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(Schmidt) Department of Cardiology, Aalborg University Hospital and
Aalborg University, Aalborg, Denmark
(Nilsen) Department of Cardiology, Stavanger University Hospital,
Stavanger, Norway
(Nilsen) Department of Clinical Science, Faculty of Medicine, University
of Bergen, Bergen, Norway
(Tveit) Department of Medical Research, Vestre Viken Hospital Trust,
Baerum Hospital, Gjettum, Norway
Publisher
John Wiley and Sons Inc
Abstract
Background: The cardiovascular benefit from n-3 polyunsaturated fatty
acids (PUFAs) after acute myocardial infarction (AMI) is controversial,
and the importance of serum eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA) concentrations for clinical events is unclear.
 Objective(s): To assess changes in EPA and DHA serum concentrations
during n-3 PUFA supplementation and their association with incident
cardiovascular events. Method(s): In the OMEMI trial, elderly
patients with a recent AMI were randomized to 1.8 g/day of EPA/DHA or
control (corn oil) for 2 years. The primary outcome was a composite of
AMI, coronary revascularization, stroke, heart failure hospitalization, or
all-cause death (major adverse cardiovascular event [MACE]) and the
secondary outcome was new-onset atrial fibrillation (AF). Result(s):
EPA and DHA measurements were available in 881 (92% of survivors)
participants at randomization and study completion. EPA and DHA increased
in the active treatment arm (n = 438) by a median of 87% and 16%,
respectively. Greater on-treatment increases in EPA and DHA were
associated with decreasing triglycerides, increasing high-density
lipoprotein cholesterol, and lower baseline EPA and DHA concentrations.
Greater on-treatment increases in EPA were associated with lower risk of
MACE (adjusted hazard ratio 0.86 [95% confidence interval, CI, 0.75-0.99],
p = 0.034), and higher risk of AF (adjusted hazard ratio (HR) 1.36 [95% CI
1.07-1.72], p = 0.011). Although there were similar tendencies for DHA
changes and outcomes, these associations were not statistically
significant (HR 0.84 [0.66-1.06] for MACE and 1.39 [0.90-2.13] for AF).
 Conclusion(s): Greater on-treatment increases in EPA were associated
with lower risk of MACE and higher risk of new-onset AF. These data
suggest that the cardiovascular effects of increasing n-3 PUFA levels
through supplements are complex, involving both potential benefits and
harm. Copyright © 2021 The Authors. Journal of Internal Medicine
published by John Wiley & Sons Ltd on behalf of Association for
Publication of The Journal of Internal Medicine.

<6>
Accession Number
637771573
Title
Intravenous iron supplementation treats anemia and reduces blood
transfusion requirements in patients undergoing coronary artery bypass
grafting-A prospective randomized trial.
Source
Annals of cardiac anaesthesia. 25(2) (pp 141-147), 2022. Date of
Publication: 01 Apr 2022.
Author
Shokri H.; Ali I.
Institution
(Shokri) Department of Anesthesiology, Ain Shams University, Cairo, Egypt
(Ali) Department of Cardiothoracic Surgery, Ain Shams University, Cairo,
Egypt
Publisher
NLM (Medline)
Abstract
Study Objective: Preoperative anemia results in two- to sixfold increased
incidence of perioperative blood transfusion requirements and reduced
postoperative hemoglobin (Hb) level. This prospective study was designed
to investigate the effect of preoperative intravenous infusion of iron on
Hb levels, blood transfusion requirements, and incidence of postoperative
adverse events in patients undergoing coronary artery bypass grafting.
 Design(s): Prospective randomized trial. Setting(s): Academic
university hospital. Patient(s): Eighty patients (52-67 years old)
underwent coronary artery bypass grafting and received either iron therapy
or saline infusion preoperatively. Intervention(s): Patients were
randomly allocated to iron or placebo groups. In the iron group, patients
received a single intravenous dose of ferric carboxymaltose (1000 mg in
100 mL saline) infused slowly over 15 min 7 days before surgery. In
placebo group, patients received a single intravenous dose of saline (100
mL saline) infused slowly over 15 min 7 days before surgery. Measurements:
Patients were followed up with regards to incidence of anemia, Hb level on
admission, preoperatively, postoperatively, 1 week and 4 weeks after
discharge, aortic cross-clamp time, the number of packed red blood cells
(pRBCs) units, the percentage of reticulocytes pre-postoperatively and 1
week later, hospital stay and intensive care unit (ICU) stay length, and
the incidence of postoperative complications. Main Result(s): Iron
therapy was associated with lower incidence of anemia 4 weeks after
discharge (P < 0.001). Hb level was significantly higher in the iron group
compared to the placebo group preoperatively and postoperatively, and 4
weeks after discharge (P < 0.001). Iron therapy resulted in shorter
hospital and ICU stay (P < 0.001) and shorter aortic cross-clamp time,
reduced pRBCs requirements postoperatively. Percentage of reticulocytes
was significantly higher in placebo group than in iron group
postoperatively and 1 week after discharge and the incidence of
postoperative complications was similar to the placebo group.
 Conclusion(s): Preoperative IV iron infusion is a safe and feasible
way to manage preoperative anemia. Preoperative administration of IV iron
is associated with a higher postoperative Hb level, shorter hospital and
ICU stay, and reduced perioperative red blood cell transfusion
requirements with insignificant difference in incidence of postoperative
complications.

<7>
Accession Number
637771356
Title
The neurocognitive outcomes of hemodilution in adult patients undergoing
coronary artery bypass grafting using cardiopulmonary bypass.
Source
Annals of cardiac anaesthesia. 25(2) (pp 133-140), 2022. Date of
Publication: 01 Apr 2022.
Author
Soliman R.; Saad D.; Abukhudair W.; Abdeldayem S.
Institution
(Soliman) Department of Anesthesia, Cairo University, Egypt; Department of
Cardiac Anesthesia, King Fahd Armored Forces Hospital, Jeddah, Saudi
Arabia
(Saad) Department of Anesthesia, Cairo University, Egypt
(Abukhudair) Department of Cardiac Surgery, King Fahd Armored Forces
Hospital, Jeddah, Saudi Arabia
(Abdeldayem) Department of Neurology, Tanta University, Egypt
Publisher
NLM (Medline)
Abstract
Objective: The study aimed to evaluate the effect of mild and moderate
hemodilution during CPB on the neurocognitive dysfunction in patients
undergoing coronary artery bypass grafting. Design(s): A randomized
clinical study. Setting(s): Cardiac center. Patient(s): 186
patients scheduled for cardiac surgery with cardiopulmonary bypass.
 Intervention(s): The patients were classified into 2 groups (each =
93), Mild hemodilution group: The hematocrit value was maintained >25% by
transfusion of packed-red blood cells plus hemofiltration during CPB.
Moderate hemodilution group: the hematocrit value was maintained within
the range of 21-25%. Measurements: The monitors included the hemofiltrated
volume, number of transfused packed red blood cells, and the incidence of
postoperative cognitive dysfunction. Main Result(s): The
hemofiltrated volume during CPB was too much higher with mild hemodilution
compared to the moderate hemodilution (p = 0.001). The number of the
transfused packed red blood cells during CPB was higher with mild
hemodilution compared to the moderate hemodilution (p = 0.001), but after
CPB, the number of the transfused packed red blood cells was lower with
the mild hemodilution group than the moderate hemodilution (p = 0.001).
The incidence of total postoperative neurological complications was
significantly lower with the mild hemodilution group than moderate
hemodilution (p = 0.033). The incidence of neurocognitive dysfunction was
significantly lower with mild hemodilution group than moderate
hemodilution (p = 0.042). Conclusion(s): The mild hemodilution was
associated with a significant decrease in the incidence of neurocognitive
dysfunction compared to moderate hemodilution in patients undergoing
coronary artery bypass grafting. Also, the transfused packed red blood
cells increased during CPB and decreased after CPB with the mild
hemodilution than moderate hemodilution.

<8>
Accession Number
2017664246
Title
Results of concomitant cryoablation for atrial fibrillation during mitral
valve surgery.
Source
Interactive Cardiovascular and Thoracic Surgery. 34(4) (pp 540-547), 2022.
Date of Publication: 01 Apr 2022.
Author
Bogachev-Prokophiev A.; Sharifulin R.; Karadzha A.; Zheleznev S.;
Afanasyev A.; Ovcharov M.; Pivkin A.; Zalesov A.; Budagaev S.; Ivantsov
S.; Chernyavsky A.
Institution
(Bogachev-Prokophiev, Sharifulin, Karadzha, Zheleznev, Afanasyev,
Ovcharov, Pivkin, Zalesov, Budagaev, Ivantsov) Department of Heart Valve
Surgery, E. Meshalkin National Medical Research Centre, 15, Rechkunovskaya
Street, Novosibirsk 630055, Russian Federation
(Ivantsov) Department of Congenital Heart Disease, E. Meshalkin National
Medical Research Centre, Novosibirsk, Russian Federation
(Chernyavsky) Department of Aortic and Coronary Artery Surgery, E.
Meshalkin National Medical Research Centre, Novosibirsk, Russian
Federation
Publisher
Oxford University Press
Abstract
OBJECTIVES: Concomitant atrial fibrillation ablation during mitral valve
(MV) surgery using radio frequency energy sources has been reported
previously with excellent outcomes. However, data regarding the
effectiveness of concomitant cryoablation remain limited. This study aimed
to assess the efficacy of concomitant cryoablation in patients scheduled
for MV surgery. METHOD(S): Between 2012 and 2020, 242 adult patients
who underwent MV surgery and concomitant cryoablation were included. Data
on rhythm, medication status and clinical events were assessed at 3, 6 and
12 months, then annually thereafter. RESULT(S): Early mortality was
0.4%. The mean follow-up period duration was 43.9 months. The survival
rates at 1, 3 and 5 years were 97.3%, 94.3% and 87.7%, respectively. The
rates of freedom from atrial arrhythmia paroxysms at 1, 3 and 5 years were
79.0%, 64.0% and 60.5%, respectively. Atrial arrhythmia recurrence was
associated with isolated left atrial lesion set (P = 0.038), large right
atrial size (P = 0.002), lower surgeon experience (P = 0.003) and atrial
fibrillation paroxysms in the early postoperative period (P = 0.002).
 CONCLUSION(S): Concomitant cryoablation during MV surgery is a safe
and reproducible technique. The procedure provides acceptable freedom from
atrial arrhythmias recurrences during long-term follow-up. The biatrial
lesion set has advantages over the left atrium pattern in terms of atrial
arrhythmias freedom. Surgeon experience significantly influences atrial
fibrillation ablation success. Randomized trials are needed to compare
radiofrequency and cryoablation. Copyright © 2021 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<9>
Accession Number
637788262
Title
Hybrid coronary revascularization versus coronary artery bypass grafting
for multivessel coronary artery disease: A systematic review and
meta-analysis.
Source
International journal of cardiology. (no pagination), 2022. Date of
Publication: 13 Apr 2022.
Author
Dixon L.K.; Akberali U.; Di Tommaso E.; George S.; Johnson T.; Bruno V.D.
Institution
(Dixon) Bristol Medical School, Public Health Science, University of
Bristol, Bristol, United Kingdom
(Akberali, Di Tommaso, George) Bristol Medical School, Translational
Health Science, University of Bristol, Bristol, United Kingdom
(Johnson) Bristol Heart Institute, University Hospitals of Bristol and
Weston NHS Foundation Trust, Bristol, United Kingdom
(Bruno) Bristol Medical School, Translational Health Science, University
of Bristol, Bristol, UK; Bristol Heart Institute, University Hospitals of
Bristol and Weston NHS Foundation Trust, Bristol, UK
Publisher
NLM (Medline)
Abstract
BACKGROUND: Hybrid coronary revascularization (HCR) combines the benefits
of a left internal mammary artery to left anterior descending artery
anastomosis, via a mini thoracotomy, with percutaneous coronary
intervention (PCI) for other diseased coronaries. AIMS: The aim of this
meta-analysis is to compare the short- and long-term outcomes of HCR with
those of coronary artery bypass grafting (CABG) for multi-vessel coronary
artery disease (MCAD). METHOD(S): We performed a meta-analysis with a
primary outcome of short-term mortality and secondary outcomes of mid-term
survival, length of hospital stay, stroke, renal failure and mid-term MACE
rate. RESULT(S): 3399 patients (HCR=1164, CABG=2235) were included,
with no significant difference in short-term mortality between groups
(OR=1.50, 95% CI=[0.90,2.49], p=0.11), although a higher mortality rate
was seen in the HCR group (0.73% vs 0.64%). The average length of stay in
intensive care unit was significantly shorter following HCR than CABG
(mean difference=-15.52h, CI=[-22.47,-8.59], p<0.001) and overall hospital
stay was also shorter in this group, although not statistically
significant (mean difference=-3.15days, 95% CI=[-6.55, 0.25], p=0.07). HCR
was associated with a reduced odds of blood transfusion (OR=0.34, 95%
CI=[0.22,0.54], p<0.001). There was not a significant difference in
mid-term survival (OR=0.86, 95% CI=[0.62,1.21], p=0.39) or MACE rate
(OR=0.82, 95% CI=[0.55,1.23], p=0.34). No differences were found between
HCR and CABG for post-operative stroke (OR=1.36, 95% CI=[0.87, 2.13],
p=0.16) or renal failure (OR=0.71, 95% CI=[0.43,1.16], p=0.14).
 CONCLUSION(S): HCR has a higher incidence of short-term mortality
compared to CABG in patients with MCAD, although this difference is not
statistically significant. Similar rates of mid-term survival and other
short term post-operative complications were found between the two groups.
HCR has a shorter ICU stays and reduced requirement for blood
transfusion. Copyright © 2022. Published by Elsevier B.V.

<10>
Accession Number
637787235
Title
Comparison of coronary revascularization strategies in older adults
presenting with acute coronary syndromes.
Source
Journal of the American Geriatrics Society. (no pagination), 2022. Date
of Publication: 16 Apr 2022.
Author
Shah A.I.; Alabaster A.; Dontsi M.; Rana J.S.; Solomon M.D.; Krishnaswami
A.
Institution
(Shah, Rana, Solomon) Division of Cardiology, Kaiser Permanente Oakland
Medical Center, Oakland, CA, United States
(Alabaster, Dontsi, Rana, Solomon) Division of Research, Kaiser
Permanente, Oakland, CA, United States
(Krishnaswami) Division of Cardiology, Kaiser Permanente San Jose Medical
Center, San Jose, California, USA
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal coronary revascularization strategy to maximize
the patient-centered outcome of days alive and out of hospital (DAOH), in
multimorbid older (>=65-years) adults after an acute coronary syndrome
(ACS) is incompletely understood. METHOD(S): Using Kaiser Permanente
Northern California Health Plan databases, we identified 3871 patients
>=65-years presenting with ACS between 1/1/2010-3/1/2018 who underwent
coronary revascularization with either coronary artery bypass grafting
(CABG, N = 1575) or multivessel percutaneous coronary intervention (PCI, N
= 2296). Selection bias was accounted for through propensity score
modeling techniques and inverse probability of treatment weighting. Cox
proportional hazards models were fit to evaluate the association of
revascularization type with outcomes. PRIMARY OUTCOMES: Absolute DAOH and
the relative risk of achieving >=90%DAOH during three time intervals.
SECONDARY OUTCOMES: All-cause mortality, recurrent MI, stroke,
rehospitalization, repeat revascularization, and dialysis initiation.
 RESULT(S): CABG (compared to PCI) was associated with greater
absolute number of DAOH, significant after the first year (mean difference
at 1-year: +5.8days, 95% confidence interval [CI], -1.6 to 13days;
3-years: +56days, 95%CI, +25 to +88days; 5-years: + 131days, 95%CI, +57 to
+205days). The relative risk of achieving >=90% DAOH significantly favored
CABG after the first year (1-year:1.02, 95%CI, 0.98-1.05; 3-years:1.06,
95%CI 1.002-1.11, 5-years:1.12, 95%CI, 1.03-1.22), and was related to
lower incidences of all-cause mortality, repeat revascularization,
rehospitalization, incident dialysis, and nonfatal MI with CABG.
 CONCLUSION(S): In older adults with multivessel or left main coronary
artery disease who presented with ACS, CABG, after the first year, was
associated with a greater absolute number of DAOH-a geriatric and
patient-centered outcome, compared to PCI. CABG patients also had a higher
probability of achieving >=90%DAOH-with lower all-cause mortality,
recurrent MI, repeat revascularization, new dialysis, and
rehospitalization rates. Future randomized trials should study the impact
of optimal revascularization strategies on the quality of life of older
adults with multimorbidity. Copyright © 2022 The American
Geriatrics Society.

<11>
Accession Number
2017717896
Title
Bilateral internal thoracic artery versus single internal thoracic artery
plus radial artery: A double meta-analytic approach.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Urso S.; Sadaba R.; Gonzalez Martin J.M.; Nogales E.; Tena M.A.; Portela
F.
Institution
(Urso, Tena, Portela) Cardiac Surgery Department, Hospital Universitario
Dr. Negrin, Las Palmas de Gran Canaria, Spain
(Sadaba) Cardiac Surgery Department, Hospital Universitario de Navarra,
Pamplona, Spain
(Gonzalez Martin) Research Unit, Hospital Universitario Dr. Negrin, Las
Palmas de Gran Canaria, Spain
(Nogales) Cardiology Department, Hospital Universitario Insular, Las
Palmas de Gran Canaria, Spain
Publisher
Elsevier Inc.
Abstract
Objectives: We explored the current evidence on the best second conduit in
coronary surgery carrying out a double meta-analysis of propensity score
matched or adjusted studies comparing bilateral internal thoracic artery
(BITA) versus single internal thoracic artery plus radial artery.
 Method(s): PubMed, Embase, and Google Scholar were searched for
propensity score matched or adjusted studies comparing BITA versus single
internal thoracic artery plus radial artery. The end point was long-term
mortality. Two statistical approaches were used: the generic inverse
variance method and the pooled meta-analysis of Kaplan-Meier-derived
individual patient data. Result(s): Twelve matched populations
comparing 6450 patients with BITA versus 9428 patients with single
internal thoracic artery plus radial artery were included in our
meta-analysis. The generic inverse variance method showed a statistically
significant survival benefit of the BITA group (hazard ratio, 0.84; 95%
CI, 0.74-0.95; P = .04). The Kaplan-Meier estimates of survival at 1, 5,
10, and 15 years of the BITA group were 97.0%, 91.3%, 80.0%, and 68.0%,
respectively. The Kaplan-Meier estimates of survival at 1, 5, 10, and 15
years of the single internal thoracic artery plus radial artery group were
97.3%, 91.5%, 79.9%, and 63.9%, respectively. The Kaplan-Meier-derived
individual patient data meta-analysis applied to very long follow-up time
data, showed that BITA provided a survival benefit after 10 years from
surgery (hazard ratio, 0.77; 95% CI, 0.63-0.94; P = .01). No differences
in terms of survival between the 2 groups were detected when the analysis
was focused on the first 10 years of follow-up (hazard ratio, 0.99; 95%
CI, 0.91-1.09; P = .93). Conclusion(s): The present meta-analysis
suggests that double internal thoracic artery may provide, compared with
single internal thoracic artery plus radial artery, a statistically
significant survival advantage after 10 years of follow-up, but not
before. Video Abstract: [Figure presented] Copyright © 2022 The
American Association for Thoracic Surgery

<12>
Accession Number
364593001
Title
Vorapaxar in the secondary prevention of atherothrombotic events.
Source
New England Journal of Medicine. 366(15) (pp 1404-1413), 2012. Date of
Publication: 12 Apr 2012.
Author
Morrow D.A.; Braunwald E.; Bonaca M.P.; Ameriso S.F.; Dalby A.J.; Fish
M.P.; Fox K.A.A.; Lipka L.J.; Liu X.; Nicolau J.C.; Ophuis A.J.O.;
Paolasso E.; Scirica B.M.; Spinar J.; Theroux P.; Wiviott S.D.; Strony J.;
Murphy S.A.; McCabe C.H.; Morin S.; Lamp J.; Gershman E.; Deenadayalu N.;
Skene A.; Hill K.; Bennett L.; Plat F.; Berman G.; Kilian A.; He W.;
Aylward P.; Bassand J.P.; Betriu A.; Bounameaux H.; Corbalan R.; Creager
M.; De Ferrari G.; Dellborg M.; Diehm C.H.; Dietz R.; Goto S.; Grande P.;
Hankey G.; Isaza D.; Jensen P.; Kiss R.; Lewis B.; Merlini P.; Moliterno
D.; Morais J.; Nieminen M.; Nilsen D.; Olin J.; Ophuis T.O.; Pichler M.;
Shinohara Y.; Teal P.; Tendera M.; Thomassen L.; Van de Werf F.; White H.;
Wilcox R.; Alberts M.; Diener H.; Mohr J.; Welch M.; Awtry E.; Berger C.;
Desai A.; Gelfand E.; Ho C.; Leeman D.; Link M.; Norden A.; Pande A.; Rost
N.; Ruberg R.; Silverman S.; Singhal A.; Vita J.; Frye R.L.; Bailey K.R.;
Easton J.; Hochman J.; Steg P.G.; Verheught F.; Lee K.; Mauro D.O.;
Centurion A.; Carlevaro O.; Cardozo E.; Cartasegna L.; Soccini N.; Farras
H.A.; Molina Aguirre E.; Duronto E.; Arrechavala L.; Rey R.; Stilman A.;
Fernandez H.; Marinsalta G.; Tartaglione J.; Chekherdemian M.; Povedano
G.; Casares E.; Kantor P.; Reges P.; Cuneo C.; Martinez G.; MacKinnon I.;
Bagnato B.; Fernandez A.; Funosas C.; Lozada A.; Barilati P.; Ferrari J.;
Ferrari N.; Llanos J.; Casaccia G.; Giannaula R.; Garcia Mendez C.; Cirio
J.; Garcia Davila C.; Estol C.; Chiezzo D.; Ramirez J.; Garrido S.;
Hominal M.; Bianchini M.V.; Ramos M.; Verdini E.; Herrera G.; Monne H.;
Ioli P.; Samudio M.A.; Rotta Escalante R.; Tarulla A.; Reich E.; Perez G.;
Milesi R.; Berli M.; Marino J.; Funes I.; Prado A.; Bezi M.; Fernandez R.;
Rojas M.; Cimbaro Canella J.P.; Galarza Salazan M.; Chew D.; Horsfall L.;
Claxton A.; French J.; O'Brien K.; Nelson G.; Loxton A.; McCann A.; Downey
C.; Aroney C.; Cleave P.; Worthley S.; Roach A.; Amerena J.; Long A.;
Thompson P.; Ferguson L.; Fitzpatrick M.; Mackenzie M.; Youssef G.;
Goldsmith H.; Jayasinghe R.; Quinlan S.; Arstall M.; Rose J.; Counsell J.;
Martin M.; Crimmins D.; Slattery A.; Anderson C.; Paraskevaidis T.; Davis
S.; Silver G.; Gerraty R.P.; Gapper J.; Donnan G.; Petrolo S.; Whelan A.;
Tulloch G.; Singh B.; Campo M.A.; Dick R.; Savage C.; Hill A.; Conway B.;
Waites J.; Keays P.; Kopp K.; Hainzer D.; Podczeck-Schweighofer A.;
Priesnitz T.; Drexel H.; Hagspiel V.; Foeger B.; Hilbe C.; Trinka E.;
Sinadinoska D.; Pilger E.; Brodmann M.; Stollberger C.; Jungbauer L.V.;
Koppensteiner R.; Hoke M.; Grisold W.; Berger O.; Gaul G.B.; Fazekas N.;
Wandaller C.; Stockenhuber F.; Rek A.; Willeit J.; Zangerle A.; Kiechl S.;
Sturm W.; Theurl M.; Gruber F.; Schacherl S.; Auer J.; Primus C.; Eber B.;
Ammer M.; Hofer J.F.; Mayr H.; Moser S.; Hoellmueller I.; Motte S.; Jorion
M.; Schroe H.; Zwinnen W.; Vermassen F.; Geenens M.; De Wolf L.; Brike C.;
De Deyn P.; Ongena P.; De Klippel N.; Meeuwissen K.; Desfontaines P.;
Tincani G.; Vandermeeren Y.; de Fays K.; Pandolfo M.; Alaerts N.; Peeters
A.; Findik A.; Tack P.; deGrande E.; Thijs V.; Marcelis E.; Van Landegem
W.; Vanhagendoren S.; Vanhooren G.; Schotte V.; Celen H.; Bes N.; De
Letter J.; Holvoet G.; Claerbout B.; Verhamme P.; Debaveye B.; Bourgeois
P.; Debrabandere K.; Stalpaert S.; Dhondt E.; De Maeseneire S.; De
Bleecker J.; de Koning K.; Vincent M.; Tahon S.; Monte C.; Maes J.;
Vossaert R.; Vandenhoven C.; Roosen J.; Vissers C.; Sinnaeve P.; de Velder
L.; Thoeng J.; Cauwenberghs J.; Deceuninck F.; Ardito W.R.; Queirantes C.;
de Araujo Filho J.D.; Queirantes C.S.; Ribeiro J.P.; Guizzardi S.P.;
Chaves M.L.; Titton N.F.; Pereira A.H.; Webber I.; da Silva D.G.; Uehara
R.M.; Brasileiro J.; Maia L.N.; Souza A.; Bodanese L.C.; Homem R.;
Friedrich M.A.; Macagnan A.P.; Dutra O.P.; Brum A.B.; Rossi P.R.; Herek
L.; Feitosa G.S.; Bernardes Ade S.; Braga J.; Rodrigues D.; Guimaraes A.;
Teixeira A.B.; Marin Neto J.A.; Tonani M.; Piegas L.S.; Amato V.; Leaes
P.; Osorio R.L.; Ganem F.; Vieira A.P.; Leao P.; Kanashiro V.; Franken
R.A.; Martins E.P.; Gagliardi R.J.; Silva L.; Caffaro R.A.; Novaes G.S.;
Carvalho A.; Laet V.L.; Miranda F.; Crippa B.A.; Saraiva J.F.; Ormundo
C.T.; Speciali J.G.; Guandolini G.; de Albuquerque D.C.; Silva V.;
Abrantes J.A.; Pinheiro L.; Teixeira M.S.; Guanaes D.F.; Resende E.S.;
Andrade S.F.; Alves A.R.; Oliveira O.M.; Tauil C.B.; Araujo E.; de Souza
J.; de Freitas G.R.; Horokosky A.P.; Barbosa E.C.; Muniz P.; de Moraes
J.B.; Cabral M.; Faria Neto J.R.; Belemer A.; Paiva M.S.; Brito A.;
Hernandes M.E.; Amorim R.; Pittella F.J.; Brito H.H.; Kouz S.; Roy M.;
Gosselin G.; David M.; Huynh T.; Boudreault C.; Heath J.; Scott L.;
Bhargava R.; Stafford C.; Klinke W.P.; Martin L.; Chan Y.K.; Zaniol D.;
Rebane T.; Abramovich M.; Vizel S.; Fox B.; Kornder J.; Breakwell L.;
Constance C.; Gauthier M.; Cleveland D.; Valley S.; Dion D.; Morissette
A.; Vertes G.; Ross B.; Pandey A.S.; Byrne M.; Abramson B.; Sodhi N.;
Ervin F.; Thiessen S.; Halperin F.; Stedham V.; Pesant Y.; Sardin V.; Saw
J.; Tarry L.; Pouliot J.; Marquette S.; Belisle P.; Gagne D.; Ducas J.;
Munoz A.; Sussex B.; Newman S.; Madan M.; Hsu E.; Bata I.; Cossett J.;
Glanz A.; Vilag C.; Paddock V.; Collings E.; Sabbah E.; Chausse I.; Fortin
C.; Lepage C.; Chehayeb R.; Viau C.; Ma P.; Seib M.; Lamy A.; Rizzo A.;
Rajakumar A.R.; Eikel L.; Nigro F.; Stoger S.; Welsh R.; Lindholm L.;
Parker J.D.; Webber S.; Winkler L.; Hannah G.; Gupta M.; Kubiak A.;
Mukherjee A.; Bozek B.; Nguyen M.; Dufort L.; Haichin R.; Toyota V.;
Bujold S.; Syan G.; Chinnasane S.; Houde G.; Rousseau S.; Poirier P.;
Lariviere M.; Dupuis R.; Ouimet F.; Audet J.; Darveau C.; Labonte R.; Rice
T.; Nawaz S.; Cantor W.; Robbins K.; Boucher P.; Roberge J.; Zadra R.;
McPherson C.; Prieto J.C.; Noriega V.; Cereno C.; Mestas M.; Yovaniniz P.;
Ferrada W.; Pincetti C.; Torres G.; Perez L.; Villan C.; Escobar E.;
Martin R.; Padilla I.; Ramirez M.; Hormazabal R.; Pedemonte O.; Suazo E.;
Hasbun S.; Mejias M.; Cardenas F.; Donoso L.; Godoy I.; Henriquez P.;
Marine L.; Vergara T.; Juri C.; Vergara E.; Munoz M.; Solano E.; Toro J.;
Cardenas S.; Mendoza F.; Martinez S.; Saaibi J.F.; Castillo K.M.; Ruiz
N.P.; Castillo T.; Orozco A.; Munoz C.; Martinez J.; Lopez D.; Ochoa J.;
Andrade J.; Jaramillo C.; Garces G.P.; Botero R.; Caceres A.; Jaramillo
M.; Mejia C.; Schlesinger A.; Munevar V.; Rodriguez J.; Granados L.M.;
Jaramillo N.; Aristizabal C.; Cano N.; Salazar J.C.; Urina M.; Manco T.;
Valenzuela C.; Hernandez H.J.; Delgado P.S.; Vagner B.; Castano L.A.;
Ucros P.; Tellez M.; Delgado J.A.; Piedrahita C.A.; Crump J.; Fernandez
V.; Quintero C.A.; Moreno M.; Hernandez Triana E.; Cuentas I.; Accini
J.L.; Accini M.; Manzur F.; Rivera E.; Reynales H.; Huertas D.; Hovorka
J.; Filipovsky J.; Hirmerova J.; Peska S.; Jura R.; Kanovsky P.; Herzig
R.; Jansky P.; Fiala R.; Kalita Z.; Gatkova A.; Bauer J.; Fiksa J.;
Sedlacek J.; Monhart Z.; Bren J.; Linhart A.; Skalicka L.; Vitovec J.;
Hlinomaz O.; Parenica J.; Soucek M.; Rihacek I.; Branny M.; Sknouril L.;
Klimsa Z.; Holub M.; Linkova H.; Rektor I.; Mikulik R.; Mayer O.; Novakova
B.; Bar M.; Brodova P.; Polasek R.; Sabl P.; Kos P.; Lorenc Z.; Macel I.;
Graversen K.H.; Galatius S.; Soderberg L.H.; Sillesen H.; Madelung S.;
Overgard K.; Stan V.; Rasmussen L.H.; Mortensen B.; Iversen H.K.; Back C.;
Olesen C.; Christensen H.; Pedersen A.; Nielsen T.; Hasain M.; Tanggaard
L.; Husted S.; Christensen L.L.; Haas L.; Mickley H.; Hosbond S.;
Rosenlund I.; Jepsen J.; Kaspersen B.B.; Bronnum-Schou J.; Hempel H.;
Nyvad O.; Feldthaus B.; Jensen B.S.; Jensen M.K.; Andersen G.; Thomsen
R.B.; Rokkedal J.; Joergensen A.; Bulow M.; Jeppesen J.; Lederballe O.;
Scheibel I.; Sjol A.; Larsen J.; Graner M.; Svahn T.; Melin J.; Kaakkomaki
A.; Airaksinen J.; Vasankari T.; Tatlisumak T.; Metso M.; Remes A.; Nappa
M.; Jakala P.; Sivenius J.; Kalinen M.; Roine R.O.; Ketola R.; Pales D.;
Coisne D.; Berger N.; Galinier M.; Rosolin N.; Elbaz M.; Lacassagne L.;
Montalescot G.; Vignolles N.; Gully C.; Lepage I.; Roynard J.; Hamon M.;
Brucato S.; Macquin-Mavier I.; Beitar T.; Berthezene P.; Medkour T.;
Amarenco P.; Gueblaoui N.; Timsit S.; Riou D.; Mahagne M.; Suissa L.;
Quere I.; Clouzot S.; Emmerich J.; Martinez I.; Moulin T.; Cole M.;
Hosseini H.; Monod V.; Cottin Y.; Bichat F.; Galley D.; Beltra C.; Samson
Y.; Pires R.; Bura-Riviere A.; Pelvet B.; Giroud M.; Lecheneaut C.;
Ohlmann P.; Ait-m-bark Z.; Farah B.; Petit F.; Caussin C.; Braun C.;
Mehrhof F.; Inkrot S.; Darius H.; Heinze H.; Radke P.; Kulikowsky C.;
Ferrari M.; Utschig S.; Strasser R.; Haacke K.; Felix S.B.; Bruder M.;
Nienaber C.; Pfaff H.; Sohn H.; Baylacher M.; Mudra H.; Setzer P.;
Konstantinides S.; Hallmann A.; Kreuzer J.; Tsoy I.; Schneider P.; Appel
K.F.; Habermeier A.; Zeiher A.M.; Kretschmer T.; Mitrovic V.; Lehinant S.;
Bohlscheid V.; Palme B.; Heuer H.; Espinola-Klein C.; Savvidis S.;
Kleinertz K.; Hanel J.; Schmidt E.; Schmidt A.; Ringleb P.A.; Ludwig I.;
Dietzold M.; Schaffranka A.; Ranft J.; Cegla C.; Berrouschot J.; Stoll A.;
Tanislav C.; Brandtner M.A.; Rosenkranz M.; Otto D.; Gortler M.; Barleben
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H.; Nabavi D.G.; Seraphin D.; Schellong S.; Frommhold R.; Dichgans M.;
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Ferretti C.; Piti A.; Terrosu P.; Perrone P.F.; Marconi R.; Grasso L.;
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O.; Testa R.; Novo S.; Itamoto K.; Niinuma Y.; Okada Y.; Oshiba S.; Takano
K.; Maruyama J.; Kouno M.; Nakagawara J.; Chiba M.; Takeda R.; Suzuki A.;
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M.; Ando M.; Kotera M.; Kurosaki E.; Araki N.; Oono Y.; Takagi S.;
Nakamura M.; Hashimoto K.; Hirayama K.; Itagaki T.; Funama M.; Ohta K.;
Matsumoto M.; Sakaida H.; Nishimura N.; Ino T.; Yokoyama M.; Asoshima K.;
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Nakamura T.; Uchiyama S.; Komatsu M.; Nakagawa S.; Katayama S.; Kawano S.;
Hamanaka I.; Honda Y.; Kamitani T.; Ishigaki C.; Taguchi S.; Yonezawa E.;
Ishige N.; Tanabe K.; Yagi H.; Kuroda S.; Kanda M.; Kanbe T.; Sakota S.;
Hamada M.; Yoshioka A.; Nagata H.; Ishigami M.; Takahashi S.; Nakagawa H.;
Honda T.; Manabe Y.; Nomura T.; Chee K.H.; Loke L.; Ong T.K.; Sekon M.;
Kandasamy B.; Radzali N.; Ophuis A.O.; Hamer B.; van Doorn M.; Tan T.; van
der Spoel A.; van Stralen R.; van der Zeijst M.; Dunselman P.;
Lauwerijssen I.; van Dijkman P.; de Lange H.; Wardeh A.; Dille-Amo C.;
Westendorp P.; Stuij S.; van Hessen M.; Engelen W.; Bartels G.; Hendriks
M.; Prins F.; Van Gent M.; Kuijper A.; Schiks M.; Romer T.; Kerssen E.;
Schut A.; Nierop P.; Danse I.; Leenders C.; Swets E.; Freericks M.;
Brilman C.F.; van Daele M.; Bouwens M.; Swart H.; Meijlis P.; van der
Zwaan C.; Havenaar H.; Holwerda N.; van de Loo R.; Hamraoui K.; Dabrowska
K.; Werner H.; Wittekoek M.; Ronner E.; Dijkshoorn A.; Herrman J.; Bosman
F.; Basart D.; Scholtze A.; Post J.; Hendrix H.; Troquay R.; Daniels R.;
van den Berg J.; van Vemde G.; ten Berg J.; Helwig J.; Schreuder T.;
Simons T.; Groenemeijer B.; Mulder R.; Heymeriks J.; Ketting P.; Keizer
K.; Bongenaar H.; Welten R.; Dahlmans A.; Jukema J.; van der Willik E.;
Smits P.; Jones B.; Cunningham L.P.; Scott D.S.; Eadie P.; Hart H.; Turner
A.; Devlin G.; Peek D.; Tisch J.; Arnold W.; Hamer A.; Tomlinson J.;
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T.; Skarpenes I.; Kontny F.; Olsen B.B.; Graven T.; Haug H.H.; Morsund
A.H.; Sivertsen S.; Hysing J.; Flagstad E.; Sirnes P.A.; Nilsen V.V.;
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M.S.; Sandvik J.E.; Thunhaug H.; Kozakiewicz K.; Pluta W.; Kania M.;
Kubica J.; Kozinski M.; Gil R.J.; Pawlak A.; Gasior Z.; Szymanski L.;
Loboz-Grudzien K.; Jaroch J.; Nowalany-Kozielska E.; Glanowska G.; Ziaja
K.; Bolkowski T.; Napora P.; Molski S.; Molski M.; Staszkiewicz W.;
Slowinski P.; Krzeminska-Pakula M.; Bednarkiewicz Z.; Gruszka A.; Fiszer
U.; Palasik W.; Kornacewicz-Jach Z.; Wojtarowicz A.; Ponikowski P.; Szajn
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Revilla A.; Mota P.; Fernandez-Vazquez F.; Larrode O.; Bruguera Cortada
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M.; Pedreira Perez M.; Moure M.; San Jose J.; Gutierrez J.; Gallego J.;
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Garcia V.; Barquero R.; Roquer J.; Llop M.; Ruiz Salmeron R.; Campuzano
Ruiz R.; Kulisevsky J.; Campolongo A.; Pons J.; Segura Martin T.; Ayo
Martin O.; Mostacero E.; Perez C.; Aladro Benito Y.; Escolar E.;
Fernandez-Bolanos R.; Ossorno P.; Casado Naranjo I.; Portilla Cuenca J.;
Gil Nunez A.; Garcia Pastor A.; Marti Vilalta J.; Marin R.; Millan M.;
Reverte S.; Garcia-Moll X.; Terns M.; Dachs M.; Svensson H.; Cederin B.;
Elgasen A.; Jonasson T.; Brock A.; Lindblad B.; Karlsson J.; Sundqvist Y.;
Tyden P.; Stensgaard E.; Erlinge D.; Wagner H.; Hakansson A.; Svensson P.;
Andersson I.; Jernberg T.; Berglund M.; Mooe T.; Carlsson B.; Bandh S.;
Andersson C.; Wahlgren C.M.; Johansson M.; Lund L.; Lidin M.; Hellberg A.;
Fallden-Gunnnarsson A.; Konrad P.; Jarl L.; Tygesen H.; Bergsten J.;
Christensen K.; Johansson K.; Samad B.; Lof P.; Lannemyr O.; Magyarovari
I.; Persson B.; Moodh J.; Welin L.; Pettersson U.; Ercegovac V.; Wedeen
G.; Engstrom A.; Bjurling E.; Wahlgren N.; Gottsater A.; Eriksson M.; Blom
K.B.; Andersson R.; Amann-Vesti B.; Gitzelmann-Saxer G.; Banyai M.; Probst
E.; Baumgartner-Peuker I.; Zinger T.; Beer H.; Hischier D.; Krapf R.;
Kofmel A.; Spycher R.; Cerny A.; Fossati E.; Eberli F.; Frey C.; Frank U.;
Genne D.; Kundig F.; Grochenig E.; Sidler L.; Jager K.; Widmer S.;
Moccetti T.; Rossi M.; Mueller C.; Haaf P.; Pieper M.; Weber K.; Rickli
H.; Schefer M.; Mazzolai L.; Jaltier A.; Michel M.; D'Ambrogio S.; Gallino
A.; Moccetti M.; Levy T.; Lakeman N.; Squire I.; Parker E.; Brady A.;
McAdam M.; de Belder M.; Atkinson B.; Penny W.; Davies L.; Bellenger N.;
Renouf A.; Mcintyre H.; Bacon S.; Dutka D.; Pugh J.; Davies J.; Covell W.;
Gorog D.; Gregory T.; Khattar R.; Maciver K.; Ahsan A.; Burton J.; Sulke
N.; Large J.; Pye M.; Hairsine B.; Cohen A.; Wilmott R.; Riddell J.;
Hunter B.; Spratt J.; Taylor F.; Been M.; De Burca B.; Roberts D.;
Helliwell L.; Soo L.; Arbenser E.; O Rourke B.; Young J.; Pell A.;
Anderson J.; Oldroyd K.; Fraser D.; Senior R.; Young G.; Keeling P.;
Hughes D.; Scott D.; Dewhirst N.; Brittenden J.; Herd V.; Rowlands D.;
Hamill S.; Rees A.; Jones L.; MacLeod M.; McGhee C.; Krishnamoorthy S.;
Cochrane H.; Prakash K.; Swart E.; Jenkinson D.; Orpen A.; Henriksen P.;
Rif B.; Sprigings D.; O' Callaghan J.; Manoharan G.; McAllister P.; Kaski
J.; Brown S.; Storey R.; Steele H.; Calvert J.; Brodie K.; Tindall H.;
Serghides H.; Manoj A.; Ledger A.; Bamford J.; Bellfield R.; Bath P.; Cox
P.; Connor M.; McCormick K.; Connolly D.; Lambley-Burke R.; Rowley J.;
Aldred J.; Qureshi N.; Nolt J.; Bank A.; LaRock J.; Aggarwal K.;
Lau-Sieckman A.; Ashraf R.; Frew S.; Atassi K.; Christy L.; Aycock G.R.;
Tatum D.; Lafferty J.; Acevedo L.; Bertolet B.; McDuffie D.; Broadwater
S.R.; Edwards M.; Carr K.; Peek M.; Chandler A.B.; Hansen J.;
Chandrashekhar Y.; Tetrick L.; Cohen M.; Strout B.; Comerota A.; Shuman
S.; Vicari R.M.; Jordan J.; Corbelli J.C.; Galla A.; Weiss R.J.; Crawford
M.; Wohns D.; Singh V.; Marlow L.; Bresee S.B.; Alexander J.; Stella J.;
Garvey M.L.; Suresh D.P.; Cook V.; Tilkian A.; Parker S.; Unks D.M.;
Blakely J.; Rogers W.; Saag L.; Blonder R.D.; Graf E.; Roth E.M.; Baumann
M.; Saenz C.; Stastny C.; Saucedo J.; Clark J.; Seigel P.; Riofrio K.D.;
deLemos J.; Kelly C.; Peart B.; Peart K.; Pollock S.; Johnson S.; Harris
J.S.; Abell T.; Puri S.; Antonio-Drabek C.; Qureshi M.A.; Marentette C.;
Ramachandran A.; Kelso K.; Rezkalla S.; Johnson M.; Ring M.; Barnett S.;
Minisi A.; Jeter D.; Strootman D.; Tadros G.; Antolick A.; Nadar V.;
Darrow K.A.; Drenning D.; Lamb B.; Nash S.; Wallace H.; D'Urso M.; Southam
D.; Niederman A.; Vujanic S.; Eaton G.M.; Looney A.; Denning S.M.; Cuenot
N.; French W.; Barillas O.; Gelormini J.; Hejna E.; Gilmore R.; Bruney C.;
Lopez M.; Schenks R.; Goodman M.A.; Cappelli J.; Mahmud E.; Judd C.;
Gordon P.; Desimone L.; Gupta D.; Trussell C.; McGuinn W.P.; Walton A.;
Hakas J.F.; Horne W.; McLaurin B.T.; Davis C.; Hamroff G.S.; Hollenweger
L.; Harris J.O.; Scott M.; Khan N.; Sutton B.; Henderson D.; Crandall L.;
Langer M.; Mack M.; Hermany P.; Dengler S.; Jan M.; Warrener C.; Jones S.;
Stover T.; Kase C.; Lau H.; Kereiakes D.J.; Francis K.; Kim E.; Rasmussen
H.; Kleiman N.; Hernandez E.; Korban E.; Manns D.; Clark W.; Foley J.;
Prashad R.; McDonough C.; House K.W.; Hobbs-Williams J.; Mayer T.A.;
Genova E.; Lui H.K.; Holman L.; Ravi R.C.; Diederick M.; Hughes R.;
Applegate M.; Cucher F.H.; Gerrish S.; Kirkhuff B.; Pacheco T.;
Kuchenrither C.; Josephson R.; Warnick K.; Doty W.D.; Parsons T.;
Vlastaris A.; Bittel B.; Ziada K.; Oremus R.; Moles E.K.; Mugmon M.A.;
Latteri J.; Nygaard T.; White J.; Thomas J.C.; Tetrault A.L.; Campbell
W.B.; Dekoff N.; Chilakamarri V.; Park T.; Hodson R.; Payne C.; DelCore
M.; Butkus E.; Lewis D.; Jacobson D.; Helmy T.; Werner C.; Gurbel P.;
Gesheff T.; McCullum K.; Delio-Cox B.; Chaturvedi S.; Mada F.; Shaikh
S.R.; Shepler A.; Moursi M.; Brock S.; Ledbetter L.; Royse H.; Quartner
J.; Downing J.; Haddad T.M.; Overbeck D.; Langer M.M.; Fritsch J.;
Drossner M.N.; Simmons T.; Katzan I.; Turczyk J.; Oliver T.; Lapsansky J.;
Goldstein M.A.; Lutz H.; Yousuf K.A.; Nash M.N.; Previto L.; Levin K.;
Warnock L.; Alberts M.J.; Muskovich K.; Sotolongo C.; Domingo D.; Ford A.;
Serna J.; Chandna H.; Holly D.; Labroo A.; Lopez C.; Carlini W.G.; Jaasko
K.; Picone M.F.; Musick P.; Vora K.N.; Hillard T.; Varma S.K.; Collins S.;
Kuvin J.T.; Mooney P.; Porterfield J.; Katopodis J.; Knap P.; Madison J.;
Morgan J.; Cochran D.; Swafford S.; Lloyd B.F.; Lehmann J.; Wiseman A.;
Whited C.; Muhlestein J.B.; Johnson E.; Hack T.; Sullivan S.L.; Mehta
R.H.; Watkins K.; Lee-Kwen P.; McGowan P.; Pratt R.; Neeper L.; Gencheff
N.E.; Nease J.; Felten W.; Braem J.; Perlmutter N.; Rees J.; Das D.; Byrd
J.; Abrahams L.; Leone C.; Chen C.; Gilbert C.; Banish D.H.; Nicely V.L.;
Chokshi S.; Holbrook V.; Misra V.; Brott B.; Harshberger J.; Horwitz P.;
Wilson R.K.; Bacharach J.M.; Farley R.; Verro P.; Lim S.; Peterson J.G.;
Pape G.; Bach R.; Palazzolo M.; Cooper M.D.; Lord S.; Lim M.; Weber E.;
Koch S.; Lichtenberger M.; Prior J.; Carlson T.A.; Cashion W.R.; Cherry
R.; Minor S.T.; Shipwash T.; MacDonald L.; Derbyshire S.; Kraft P.;
Tessmar C.; Fraizer M.; French D.; Leimbach W.; Durham J.; Fintel D.;
Chippendale T.J.; Soto E.; Jacoby D.; Donovan S.E.; Haskel E.J.; Powell
J.; Shirwany A.; Wilson J.; Cole J.F.; Fisher M.; Bayron C.J.; Kochounian
C.; Williams L.; Kasner S.E.; DeSanto M.L.; Altafullah I.; Lemm J.; Rabiee
H.; Shirley T.; Iteld B.J.; Dureau D.; Concha M.; Martinez E.; Teklinski
A.; Shaw C.; Bradley A.J.; Terry P.S.; Rashid J.; Pierson M.; Silliman S.;
Stegmaier M.; Lee T.; Burton C.; Dietrich D.W.; Schaefer V.; Madison J.D.;
MacDonald H.; Kmetzo J.; Pierce K.; Ostfeld R.; Rosal-Greif V.; Chaudhuri
P.; Kelley M.; Adams K.; Lohman J.; Schrank J.; Ebreo N.; Brooks R.B.;
Sadekoski C.; Kozlowski J.; Kozlowski R.; Tietjen G.; Korsnack A.;
Albirini A.; Moore A.; Holt W.; Goldberg R.K.; Barrett M.; Gips S.J.;
Davis M.; Fertels S.; Jeffers H.; Gelernt M.; Vogt T.; Baron S.; Gros C.;
Koren M.J.; Givens L.; Gupta A.; Seaton D.; Staniloae C.S.; Liu M.H.;
Howell G.J.; Howell S.T.; Thadani U.; Alexander D.; Reyes P.; Black L.;
Sharma M.K.; Gibson T.; Libman R.; DeMers C.; Ebrahimi R.; Mirshkarlo
H.B.; Ellis J.; Mooney J.; Gomez C.R.; Lewis A.; Bilazarian S.; Langone
L.; Lowenkopf T.; Rodriguez M.; Abadier R.; Gray L.; Desai V.; Myers C.;
Altschuller A.; Oliveira K.S.; Patel P.; Fini G.; Bhagwat R.; Winterrowd
D.; Chu A.A.; Edwards N.; Wilson W.W.; Needham J.; Lieberman S.; Perez
J.A.; Addington J.; Adams H.P.; Sieren J.; Katz R.; Marshall L.; Stein
M.J.; Dagher E.; O'Dea D.J.; Landi T.; McKay R.; Cloutier J.; Hinchman
D.A.; Ross J.; Sanderson J.N.; House K.; Schidemantle E.; H'Doubler P.;
Barnes C.; Rohrbeck S.; Howard A.; Odhav A.; Schmitz N.; Schneck M.J.;
Chadwick L.R.; Sewing P.; Portelli J.; Mansouri V.; Duncan R.; Osborne J.;
Gonzalez M.; Gillespie E.L.; Rhoades S.; Zweifler R.M.; Spady M.A.;
Whitney R.; Gocke B.; Angirekula M.; Bridges D.; Reen B.M.; Marshall E.;
Saba F.; Dunaway B.; Berlowitz M.; Nuce R.; Whitaker J.; Brooks J.;
Kumkumian G.; Murphy M.; Brown C.S.; Smith M.A.; Mostel E.; Harris R.;
Camp A.; Sheets L.; Steinhoff J.; Renaud K.; Mayer N.J.; Escallier K.;
Tang A.; Green C.; Taheri H.; Morgan K.; Galloway J.; Dauer M.; Arthur A.;
Hogan C.; Kozak M.; Jefferson D.; Carter E.; Moore R.; Isserman S.M.;
Moore C.; Kersh R.I.; DaCosta A.; Frey A.; Short L.; Stein B.; McGee R.;
Schneider D.; Chadwick L.; Puleo P.; Tarsi D.; Singh N.; Logwood D.
Institution
(Morrow, Braunwald, Bonaca, Fish, Scirica, Wiviott, Murphy) TIMI Study
Group, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis
St., Boston, MA 02115, United States
(Ameriso) Institute for Neurological Research, FLENI, Buenos Aires,
Argentina
(Dalby) Milpark Hospital, Johannesburg, South Africa
(Fox) Division of Cardiovascular Research, University of Edinburgh,
Edinburgh, United Kingdom
(Lipka, Liu, Strony) Merck Research Laboratories, Rahway, NJ, United
States
(Nicolau) Heart Institute (InCor), University of Sao Paulo Medical School,
Sao Paulo, Brazil
(Ophuis) Canisius-Wilhelmina Hospital, Nijmegen, Netherlands
(Paolasso) Instituto de Investigaciones Clinicas Rosario, Rosario,
Argentina
(Spinar) University Hospital Brno, Masaryk University, Brno, Czechia
(Theroux) Montreal Heart Institute, University of Montreal, Montreal,
Canada
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: Thrombin potently activates platelets through the
protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent
that selectively inhibits the cellular actions of thrombin through
antagonism of PAR-1. METHOD(S): We randomly assigned 26,449 patients
who had a history of myocardial infarction, ischemic stroke, or peripheral
arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo
and followed them for a median of 30 months. The primary efficacy end
point was the composite of death from cardiovascular causes, myocardial
infarction, or stroke. After 2 years, the data and safety monitoring board
recommended discontinuation of the study treatment in patients with a
history of stroke owing to the risk of intracranial hemorrhage.
 RESULT(S):At 3 years, the primary end point had occurred in 1028
patients (9.3%) in the vorapaxar group and in 1176 patients (10.5%) in the
placebo group (hazard ratio for the vorapaxar group, 0.87; 95% confidence
interval [CI], 0.80 to 0.94; P<0.001). Cardiovascular death, myocardial
infarction, stroke, or recurrent ischemia leading to revascularization
occurred in 1259 patients (11.2%) in the vorapaxar group and 1417 patients
(12.4%) in the placebo group (hazard ratio, 0.88; 95% CI, 0.82 to 0.95; P
= 0.001). Moderate or severe bleeding occurred in 4.2% of patients who
received vorapaxar and 2.5% of those who received placebo (hazard ratio,
1.66; 95% CI, 1.43 to 1.93; P<0.001). There was an increase in the rate of
intracranial hemorrhage in the vorapaxar group (1.0%, vs. 0.5% in the
placebo group; P<0.001). CONCLUSION(S):Inhibition of PAR-1 with
vorapaxar reduced the risk of cardiovascular death or ischemic events in
patients with stable atherosclerosis who were receiving standard therapy.
However, it increased the risk of moderate or severe bleeding, including
intracranial hemorrhage. (Funded by Merck; TRA 2P-TIMI 50
ClinicalTrials.gov number, NCT00526474.) Copyright © 2012
Massachusetts Medical Society.

<13>
Accession Number
2013643401
Title
Atrial fibrillation management during septal myectomy for hypertrophic
cardiomyopathy: A systematic review.
Source
Asian Cardiovascular and Thoracic Annals. 30(1) (pp 98-107), 2022. Date of
Publication: January 2022.
Author
Seco M.; Lau J.C.L.; Medi C.; Bannon P.G.
Institution
(Seco, Lau, Medi, Bannon) Sydney Medical School, University of Sydney,
Australia
(Seco, Lau, Bannon) The Baird Institute of Applied Heart & Lung Surgical
Research, Australia
(Seco, Bannon) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Australia
(Medi) Department of Cardiology, Royal Prince Alfred Hospital, Australia
Publisher
SAGE Publications Inc.
Abstract
Introduction: Atrial fibrillation is common in patients with hypertrophic
cardiomyopathy, and significantly impacts mortality and morbidity. In
patients with atrial fibrillation undergoing septal myectomy, concomitant
surgery for atrial fibrillation may improve outcomes. Method(s): A
systematic review was performed according to Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines. All studies reporting the
outcomes of combined septal myectomy and atrial fibrillation surgery were
included. Result(s): A total of 10 observational studies were
identified, including 644 patients. Most patients had paroxysmal atrial
fibrillation. The proportion with prior unsuccessful ablation ranged from
0 to 19%, and preoperative left atrial diameter ranged from 44 +/- 17 to
52 +/- 8 mm. Cox-Maze IV (n = 311) was the most common technique used,
followed by pulmonary vein isolation (n = 222) and Cox-Maze III (n = 98).
Patients with persistent or longstanding atrial fibrillation more
frequently received Cox-Maze III/IV. Ranges of early postoperative
outcomes included: mortality 0 to 7%, recurrence of atrial
tachyarrhythmias 4.4 to 48%, cerebrovascular events 0 to 1.5%, and
pacemaker insertion 3 to 21%. Long-term data was limited. Freedom from
atrial tachyarrhythmias at 1 year ranged from 74% to 96%, and at 5 years
from 52% to 100%. Preoperative predictors of late atrial tachyarrhythmia
recurrence included left atrial diameter >45 mm, persistent or
longstanding preoperative atrial fibrillation and longer atrial
fibrillation duration. Conclusion(s): In patients with atrial
fibrillation undergoing septal myectomy, the addition of ablation surgery
adds low overall risk to the procedure, and likely reduces the risk of
recurrent atrial fibrillation in the long term. Future randomised studies
comparing septal myectomy with or without concomitant AF ablation are
needed. Copyright © The Author(s) 2021.

<14>
Accession Number
2017050034
Title
Prevalence and outcomes of concomitant cardiac amyloidosis and aortic
stenosis: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. 64 (pp 67-76), 2022. Date of Publication:
01 Mar 2022.
Author
Ho J.S.-Y.; Kor Q.; Kong W.K.; Lim Y.C.; Chan M.Y.-Y.; Syn N.L.; Ngiam
J.N.; Chew N.W.; Yeo T.-C.; Chai P.; Poh K.-K.; Wong R.C.; Lin W.; Sia
C.-H.
Institution
(Ho) Academic Foundation Programme, North Middlesex University Hospital
NHS Trust, United Kingdom
(Kor, Kong, Chan, Syn, Yeo, Chai, Poh, Wong, Lin, Sia) Department of
Medicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Kong, Lim, Chan, Chew, Yeo, Chai, Poh, Wong, Lin, Sia) Department of
Cardiology, National University Heart Centre Singapore, Singapore
(Ngiam) Internal Medicine Residency, University Medicine Cluster, National
University Health System, Singapore
Publisher
Hellenic Cardiological Society
Abstract
Objective: Cardiac amyloidosis (CA) is an increasingly recognised
condition in patients with aortic stenosis (AS). However, there is a large
variation in the reported prevalence figures, due to differences in
populations and diagnostic methods. We aimed to investigate the
prevalence, risk factors and outcomes of concomitant CA and AS.
 Method(s): We performed a systematic review and meta-analysis of the
literature searched on MEDLINE, Embase, Scopus and CENTRAL. We analysed
the prevalence of CA in patients with AS grouped according to the
diagnostic techniques, and the risk factors and outcomes of concomitant CA
and AS were analysed in AS patients referred for surgical or transcatheter
aortic valve replacement (AVR). Result(s): A total of 21 studies were
included, involving 4,243 patients. The pooled prevalence of CA in
patients with AS was 14.4%, with substantial heterogeneity. The pooled
prevalence of AS in patients CA was 8.7%, with substantial heterogeneity.
Patients with both AS and CA had higher all-cause mortality than those
with AS or CA alone. In AS patients requiring AVR, CA was associated with
increasing age, male sex, higher NT-proBNP levels, increased
interventricular septal end diastole (IVSd) thickness and lower left
ventricular ejection fraction. Concomitant AS and CA was associated with
increased all-cause mortality and pacemaker implantation post-procedure.
Study limitations included heterogeneity of the results and the fair to
good quality of the studies published. Conclusion(s): Overall, a
substantial proportion of patients with AS may have CA, and they have
poorer prognosis. A high degree of clinical suspicion is needed to
identify the "red flags" and perform appropriate diagnostic
imaging. Copyright © 2021 Hellenic Society of Cardiology

<15>
Accession Number
2016567451
Title
Angiography-derived physiology guidance vs usual care in an All-comers PCI
population treated with the healing-targeted supreme stent and Ticagrelor
monotherapy: PIONEER IV trial design.
Source
American Heart Journal. 246 (pp 32-43), 2022. Date of Publication: April
2022.
Author
Hara H.; Serruys P.W.; O'Leary N.; Gao C.; Murray A.; Breslin E.; Garg S.;
Bureau C.; Reiber J.H.; Barbato E.; Aminian A.; Janssens L.; Rosseel L.;
Benit E.; Campo G.; Guiducci V.; Casella G.; Santarelli A.; Franze A.;
Diaz V.A.J.; Iniguez A.; Brugaletta S.; Sabate M.; Amat-Santos I.J.;
Amoroso G.; Wykrzykowska J.; von Birgelen C.; Somi S.; Liu T.; Hofma S.H.;
Curzen N.; Trillo R.; Ocaranza R.; Mathur A.; Smits P.C.; Escaned J.;
Baumbach A.; Wijns W.; Sharif F.; Onuma Y.
Institution
(Hara) Department of Cardiology, Academic Medical Center, University of
Amsterdam, Amsterdam, Netherlands
(Hara, Serruys, Gao, Sharif, Onuma) Department of Cardiology, National
University of Ireland, Galway (NUIG), Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(O'Leary, Murray, Breslin) CORRIB Research Centre, College of Medicine,
Nursing and Health Sciences, National University of Ireland, Galway,
Ireland
(Gao) Deparment of Cardiology. Radboudumc, Nijmegen, Netherlands
(Gao) Department of Cardiology, Xijing Hospital, Xi'an, China
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Bureau) AlchiMedics S.A.S, Paris, France
(Reiber) Department of Radiology, Leiden University Medical Center,
Leiden, Netherlands
(Barbato) Cardiovascular Research Center Aalst, OLV-Clinic, Aalst, Belgium
and Department of Advanced Biomedical Sciences, University Federico II,
Naples, Italy
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Janssens) Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium
(Rosseel) Department of Cardiology, Algemeen stedelijk ziekenhuis, Aalst,
Belgium
(Benit) Hartcentrum Jessa Ziekenhuis, Campus Virga Jesse, Hasselt, Belgium
(Campo) Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara,
Cona, Italy
(Guiducci) Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
(Casella) U.O.C. Cardiologia, Ospedale Maggiore, Bologna, Italy
(Santarelli) Cardiology Unit, Infermi Hospital, Rimini, Italy
(Franze) Interventional Cardiology Unit, San Luigi Gonzaga University
Hospital (Orbassano) and Rivoli Infermi Hospital (Rivoli), Turin, Italy
(Diaz, Iniguez) Department of Cardiology, Hospital Universitario de Vigo,
Vigo, Spain
(Iniguez) Department of Cardiology, Hospital Universitario Alvaro
Cunqueiro, Vigo, Spain
(Brugaletta, Sabate) Cardiology Department, Clinic Cardiovascular
Institute, Hospital Clinic, Institut d'Investigacions Biomediques August
Pi i Sunyer, IDIBAPS, Barcelona, Spain
(Amat-Santos) CIBERCV, Cardiology Department, Hospital Clinico de
Valladolid, Spain
(Amoroso) OLVG, Amsterdam, Netherlands
(Wykrzykowska) Department of Cardiology, University Medical Center
Groningen, Groningen, Netherlands
(von Birgelen) Department of Cardiology, Medisch Spectrum Twente,
Thoraxcentrum Twente, Enschede, Netherlands
(von Birgelen) Department of Health Technology and Services Research,
Faculty BMS, Technical Medical Centre, University of Twente, Netherlands
(Somi, Liu) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Hofma) Department of Cardiology, Medical Centre Leeuwarden, Leeuwarden,
Netherlands
(Curzen) Faculty of Medicine, University of Southampton, University
Hospital Southampton NHS Trust, Southampton, United Kingdom
(Trillo) Department of Cardiology, University Clinic Hospital, CIBERCV,
Santiago de Compostela, Spain
(Ocaranza) Interventional Cardiology Section, Lucus Augusti University
Hospital, Lugo, Spain
(Mathur) Barts Interventional Group, Barts Heart Centre, Barts Health NHS
Trust, London, United Kingdom
(Mathur, Baumbach) Centre for Cardiovascular Medicine and Devices, William
Harvey Research Institute, Queen Mary University of London, United Kingdom
(Smits) Maasstad Ziekenhuis, Rotterdam, Netherlands
(Escaned) Hospital Clinico San Carlos IDISCC, Complutense University of
Madrid, Madrid, Spain
(Baumbach) Barts Heart Centre, London, United Kingdom
(Baumbach) Yale University School of Medicine, New Haven, United States
(Wijns) The Lambe Institute for Translational Medicine and Curam, NUIG,
Galway, Ireland
(Sharif) SFI infrastructure funding, NUIG, Galway, Ireland
Publisher
Elsevier Inc.
Abstract
Background: Current ESC guidelines recommend the use of intra-coronary
pressure guidewires for functional assessment of intermediate-grade
coronary stenoses. Angiography-derived quantitative flow ratio (QFR) is a
novel method of assessing these stenoses, and guiding percutaneous
coronary intervention (PCI). Methods/Design: The PIONEER IV trial is a
prospective, all-comers, multi-center trial, which will randomize 2,540
patients in a 1:1 ratio to PCI guided by angiography-derived physiology or
usual care, with unrestricted use in both arms of the Healing-Targeted
Supreme sirolimus-eluting stent (HT Supreme). The stent's fast,
biologically healthy, and robust endothelial coverage allows for short
dual-antiplatelet therapy (DAPT); hence the antiplatelet regimen of choice
is 1-month DAPT, followed by ticagrelor monotherapy. In the
angiography-derived physiology guided arm, lesions will be functionally
assessed using on-line QFR, with stenting indicated in lesions with a QFR
<=0.80. Post-stenting, QFR will be repeated in the stented vessel(s), with
post-dilatation or additional stenting recommended if the QFR<0.91 distal
to the stent, or if the delta QFR (across the stent) is >0.05. Usual care
PCI is performed according to standard clinical practice. The primary
endpoint is a non-inferiority comparison of the patient-oriented composite
endpoint (POCE) of all-cause death, any stroke, any myocardial infarction,
or any clinically, and physiologically driven revascularization with a
non-inferiority risk-difference margin of 3.2%, at 1-year post-procedure.
Clinical follow-up will be up to 3 years. The PIONEER IV trial aims to
demonstrate non-inferiority of QFR-guided PCI to usual care PCI with
respect to POCE at 1-year in patients treated with HT Supreme stents and
ticagrelor monotherapy. Clinical Trial Registration: ClinicalTrials.gov
Unique Identifier: NCT04923191 Classifications: Interventional
Cardiology Copyright © 2022

<16>
Accession Number
2016017320
Title
Treatment With Icosapent Ethyl to Reduce Ischemic Events in Patients With
Prior Percutaneous Coronary Intervention: Insights From REDUCE-IT PCI.
Source
Journal of the American Heart Association. 11(6) (no pagination), 2022.
Article Number: e022937. Date of Publication: 15 Mar 2022.
Author
Peterson B.E.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson
T.A.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz C.;
Gibson C.M.; Pinto D.; Giugliano R.P.; Budoff M.J.; Tardif J.-C.; Verma
S.; Ballantyne C.M.
Institution
(Peterson, Bhatt, Giugliano) Brigham and Women's Hospital Heart and
Vascular Center, Harvard Medical School, Boston, MA, United States
(Steg) Universite de Paris, AP-HP (Assistance Publique-Hopitaux de Paris),
Hopital Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM
U-1148, Paris, France
(Miller) Department of Medicine, University of Maryland School of
Medicine, Baltimore, MD, United States
(Brinton) Utah Lipid Center, Salt Lake City, UT, United States
(Jacobson, Ketchum, Juliano, Jiao, Doyle, Granowitz) Department of
Medicine, Office of Health Promotion and Disease Prevention, Emory
University School of Medicine, Atlanta, GA, United States
(Jacobson, Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc.
(Amarin), Bridgewater, NJ, United States
(Gibson, Pinto) Baim Clinical Research Institute, Boston, MA, United
States
(Budoff) David Geffen School of Medicine, Lundquist Institute, Torrance,
CA, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, QC, Canada
(Verma) Division of Cardiac Surgery, St Michael's Hospital, University of
Toronto, ON, Canada
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Patients who undergo percutaneous coronary intervention (PCI)
are at increased risk for recurrent cardiovascular events despite
aggressive medical therapy. METHODS AND RESULTS: This post hoc analysis
focused on the subset of patients with prior PCI enrolled in REDUCE-IT
(Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention
Trial), a multicenter, randomized, double-blind, placebo-controlled trial
of icosapent ethyl versus placebo. Icosapent ethyl was added to statins in
patients with low-density lipoprotein cholesterol <100 mg/dL and fasting
triglycerides 135-499 mg/dL. The primary end point was a composite of
cardiovascular death, nonfatal myocardial infarction, nonfatal stroke,
coronary revascularization, or unstable angina requiring hospitalization.
There were 8179 patients randomized in REDUCE-IT followed for a median of
4.9 years, and 3408 (41.7%) of them had a prior PCI with a median
follow-up of 4.8 years. These patients were randomized a median of 2.9
years (11 days to 30.7 years) after PCI. Among patients treated with
icosapent ethyl versus placebo, there was a 34% reduction in the primary
composite end point (hazard ratio [HR], 0.66; 95% CI, 0.58-0.76; P<0.001;
number needed to treat4.8 years=12) and a 34% reduction in the
key secondary composite end point of cardiovascular death, nonfatal
myocardial infarction, or nonfatal stroke (HR, 0.66; 95% CI, 0.56-0.79;
P<0.001; NNT4.8 years=19) versus placebo. Similarly, large
reductions occurred in total coronary revascularizations and
revascularization subtypes. There was also a 39% reduction in total events
(rate ratio, 0.61; 95% CI, 0.52-0.72; P<0.001). CONCLUSION(S): Among
patients treated with statins with elevated triglycerides and a history of
prior PCI, icosapent ethyl substantially reduced the risk of recurrent
events during an average of ~5 years of follow-up with a number needed to
treat of only 12. REGISTRATION: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT01492361. Copyright © 2022 The Authors.

<17>
Accession Number
2015209915
Title
Rationale and design of the SMall Annuli Randomized To Evolut or SAPIEN
Trial (SMART Trial).
Source
American Heart Journal. 243 (pp 92-102), 2022. Date of Publication:
January 2022.
Author
Herrmann H.C.; Abdel-Wahab M.; Attizzani G.F.; Batchelor W.; Bleiziffer
S.; Verdoliva S.; Chang Y.; Gada H.; Gillam L.; Guerrero M.; Mahoney P.D.;
Petronio A.S.; Rogers T.; Rovin J.; Szerlip M.; Whisenant B.; Mehran R.;
Tchetche D.
Institution
(Herrmann) Perelman School of Medicine at the University of Pennsylvania,
Philadelphia, PA
(Abdel-Wahab) Heart Center Leipzig at the University of Leipzig, Leipzig,
Germany
(Attizzani) University Hospitals of Cleveland, Cleveland, OH
(Batchelor) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(Bleiziffer) Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
(Verdoliva, Chang) Medtronic, Mounds View, MN, United States
(Gada) UPMC Harrisburg, Harrisburg, PA
(Gillam) Morristown Medical Center/Atlantic Health System, Morristown, NJ,
United States
(Guerrero) Mayo Clinic, Rochester, MN
(Mahoney) Sentara Healthcare, Norfolk, VA
(Petronio) Universita di Pisa, Ospedale di Cisanello Pisa, Italy
(Rogers) MedStar Washington Hospital Center, DC, Washington
(Rogers) National Institutes of Health, Bethesda, MD
(Rovin) BayCare Health System/Morton Plant Hospital, Clearwater, FL
(Szerlip) Baylor Scott and White Heart Hospital, Plano, TX
(Whisenant) Intermountain Medical Center, Murray, UT
(Mehran) Mount Sinai School of Medicine, New York, NY
(Tchetche) Clinique Pasteur, Toulouse, France
Publisher
Elsevier Inc.
Abstract
Background: The SMall Annuli Randomized To Evolut or SAPIEN (SMART) Trial
was designed to compare the performance of the two most widely available
commercial transcatheter aortic valve replacement (TAVR) devices in
patients with symptomatic severe native aortic stenosis with a small
aortic valve annulus undergoing transfemoral TAVR. Patients with small
aortic valve annuli are typically female and are often underrepresented in
clinical trials. Method(s): The SMART Trial is an international,
prospective, multi-center, randomized controlled, post-market trial. The
trial will be conducted in approximately 700 subjects at approximately 90
sites globally. Inclusion criteria include severe aortic stenosis, aortic
valve annulus area of <=430 mm2 based on multi-detector
computed tomography, and appropriate anatomy for both the Medtronic Evolut
PRO/PRO+ self-expanding and Edwards SAPIEN 3/3 Ultra balloon-expandable
devices. The primary clinical outcome composite endpoint is defined as
mortality, disabling stroke or heart failure rehospitalization at 12
months. The co-primary valve function composite endpoint is defined as
bioprosthetic valve dysfunction at 12 months which includes hemodynamic
structural valve dysfunction, defined as a mean gradient >=20 mmHg,
non-structural valve dysfunction, defined as severe prothesis-patient
mismatch or >=moderate aortic regurgitation, thrombosis, endocarditis, and
aortic valve re-intervention. Powered secondary endpoints will be assessed
hierarchically. Conclusion(s): The SMART trial will be the largest
head-to-head comparative trial of transfemoral TAVR using the two most
widely available contemporary TAVR devices in the setting of small aortic
annuli and the largest trial to enroll primarily women. Clinical trial
registration: URL: www.clinicaltrials.gov, Unique identifier:
NCT04722250. Copyright © 2021 Elsevier Inc.

<18>
Accession Number
2017574336
Title
Image-guided procedures in the hybrid operating room: A systematic scoping
review.
Source
PLoS ONE. 17(4 April) (no pagination), 2022. Article Number: e0266341.
Date of Publication: April 2022.
Author
Spenkelink I.M.; Heidkamp J.; Futterer J.J.; Rovers M.M.
Institution
(Spenkelink, Heidkamp, Futterer) Department of Medical Imaging, Radboud
University Medical Center, Nijmegen, Netherlands
(Rovers) Department of Operating Rooms, Radboud Institute for Health
Sciences, Radboud University Medical Center, Nijmegen, Netherlands
(Rovers) Department of Health Evidence, Radboud Institute of Health
Sciences, Radboud University Medical Center, Nijmegen, Netherlands
Publisher
Public Library of Science
Abstract
Background The shift from open to minimally invasive procedures with
growing complexity has increased the demand for advanced intraoperative
medical technologies. The hybrid operating room (OR) combines the
functionality of a standard OR with fixed advanced imaging systems to
facilitate minimally invasive image-guided procedures. Objective This
systematic scoping review provides an overview of the use of the hybrid OR
over the years, and reports on the encountered advantages and challenges.
Methods We conducted a systematic search in PubMed, Embase, Web of
Science, and Cochrane library databases for studies that described
procedures being performed with the aid of 3D imaging in the hybrid OR.
Results The search identified 123 studies that described 44 distinct
procedures, divided over nine clinical disciplines. The number of studies
increased from two in 2010 to 15 in the first five months of 2020.
Ninety-nine (80%) of the studies described how 3D imaging was performed in
the hybrid OR; 95 (96%) used cone-beam CT; four (4%) used multi-detector
CT. Advantages and challenges of the hybrid OR were described in 94 (76%)
and 34 (35%) studies, respectively. The most frequently reported advantage
of using a hybrid OR is the achievement of more accurate treatment
results, whereas elongation of the procedure time is the most important
challenge, followed by an increase in radiation dose. Conclusion In
conclusion, the growing number of clinical disciplines that uses the
hybrid OR shows its wide functionality. To optimize its use, future
comparative studies should be conducted to investigate which procedures
really benefit from being performed in the hybrid OR. Copyright:
© 2022 Spenkelink et al. This is an open access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<19>
Accession Number
2014313573
Title
Comparative study of clinical outcomes of methylprednisolone and
dexamethasone in prime solution during cardiopulmonary pump after coronary
artery bypass grafting.
Source
Journal of Cellular and Molecular Anesthesia. 6(2) (pp 174-180), 2021.
Date of Publication: April 2021.
Author
Tahmasbi T.; Shahzamani M.; Satehi S.B.; Khodadadi F.
Institution
(Tahmasbi, Khodadadi) Department of Extracorporeal Technology, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Shahzamani) Department of Surgery, School of Medicine, Chamran Hospital,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Satehi) Department of Intensive Care, School of Nursing and Midwifery,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Shahid Beheshti University of Medical Sciences, Anesthesiology Research
Center
Abstract
Background: The study was performed to compare clinical outcomes of
methylprednisolone and dexamethasone in prime solution during
cardiopulmonary pump after coronary artery bypass grafting (CABG).
 Material(s) and Method(s): In this double-blind clinical trial,
sixty-two patients who underwent CABG were divided into the control group
(31 patients with dexamethasone in their prime solution) and the study
group (31 patients using methylprednisolone in their prime solution).
Duration of mechanical ventilation, length of intensive care unit (ICU)
stays, bleeding rate (chest tube volume), arrhythmia, and need for
inotropic intake were compared. Result(s): The mean duration of
mechanical ventilation and ICU stay in the dexamethasone group were
significantly higher than the methylprednisolone group and the mean
bleeding rate in the dexamethasone group was significantly lower than the
methylprednisolone group (p<0.05). Conclusion(s): The mean duration
of mechanical ventilation and ICU stay in the dexamethasone group was
higher than the methylprednisolone group, but the use of dexamethasone has
the advantage of being associated with less bleeding. Copyright ©
2021 Journal of Cellular and Molecular Anesthesia. All rights reserved.

<20>
Accession Number
2014286064
Title
Calcium administration In patients undergoing CardiAc suRgery under
cardiopulmonary bypasS (ICARUS trial): Rationale and design of a
randomized controlled trial.
Source
Contemporary Clinical Trials Communications. 23 (no pagination), 2021.
Article Number: 100835. Date of Publication: September 2021.
Author
Lomivorotov V.; Ponomarev D.; Boboshko V.; Shmyrev V.; Ismoilov S.;
Efremov S.; Kamenshchikov N.; Akselrod B.; Pasyuga V.; Urusov D.; Ovezov
A.; Evdokimov M.; Turchaninov A.; Bogachev-Prokofiev A.; Bukamal N.; Afifi
S.; Belletti A.; Bellomo R.; Landoni G.
Institution
(Lomivorotov, Ponomarev, Boboshko, Shmyrev, Ismoilov, Bogachev-Prokofiev)
E. Meshalkin National Medical Research Centre, Novosibirsk, Russian
Federation
(Lomivorotov) Novosibirsk State University, Novosibirsk, Russian
Federation
(Efremov) Saint Petersburg State University Hospital, Saint Petersburg,
Russian Federation
(Kamenshchikov) Sardiology Research Institute, Tomsk National Research
Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation
(Akselrod) Petrovsky National Research Centre of Surgery, Moscow, Russian
Federation
(Pasyuga) Federal Center for Cardiovascular Surgery, Astrakhan, Russian
Federation
(Urusov) District Clinical Hospital, Khanty-Mansiysk, Russian Federation
(Ovezov) Moscow Regional Research and Clinical Institute (MONIKI), Moscow,
Russian Federation
(Evdokimov) Federal Center for Cardiovascular Surgery, Penza, Russian
Federation
(Turchaninov) Federal Center for Cardiovascular Surgery, Chelyabinsk,
Russian Federation
(Bukamal) Sh. Mohammed Bin Khalifa Bin Sulman Al-Khalifa Cardiac Center,
Awali, Bahrain
(Afifi) King Abdullah Medical City, Makkah, Saudi Arabia
(Belletti, Landoni) IRCCS San Raffaele Scientific Institute, Milan, Italy
(Bellomo) The University of Melbourne, Melbourne, Australia
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
Publisher
Elsevier Inc.
Abstract
Introduction: Weaning from cardiopulmonary bypass (CPB) is a critical step
of any cardiac surgical procedure and often requires pharmacologic
intervention. Calcium ions are pivotal elements for the
excitation-contraction coupling process of cardiac myocytes. Thus, calcium
administration might be helpful during weaning from CPB. Method(s):
We describe a multicenter, placebo-controlled, double blind randomized
clinical trial to assess the effect of calcium chloride on the need for
inotropic support among adult patients during weaning from CPB. The
experimental group (409 patients) will receive 15 mg/kg of calcium
chloride. The control group (409 patients) will receive an equivalent
volume of 0.9% sodium chloride. Both drugs will be administered
intravenously as a bolus at the beginning of weaning from CPB.
 Result(s): The primary outcome will be the need for inotropic support
between termination of CPB and completion of surgery. Secondary outcomes
will be: duration of inotropic support, vasoactive-inotropic score 30 min
after transfer to intensive care unit and on postoperative day 1, plasma
alpha-amylase on postoperative day 1, plasma Ca2+ concentration
immediately before and 10-15 min after calcium chloride administration,
non-fatal myocardial infarction, blood loss on postoperative day 1, need
for transfusion of red blood cells, signs of myocardial ischemia on
electrocardiogram after arrival to intensive care unit, all-cause
mortality at 30 days or during hospital stay if this is longer than 30
days. Discussion(s): This trial is designed to assess whether
intravenous calcium chloride administration could reduce the need for
inotropic support after cardiopulmonary bypass weaning among adults
undergoing cardiac surgery. Copyright © 2021 The Authors

<21>
Accession Number
2015481632
Title
Mitral valve repair versus replacement in severe ischemic mitral
regurgitation systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(6) (pp 1591-1598), 2022. Date of
Publication: June 2022.
Author
Gamal M.A.; El-Fiky M.M.; Gamea M.M.; Ali I.
Institution
(Gamal, El-Fiky, Gamea, Ali) Department of Cardiothoracic Surgery, Faculty
of Medicine, Ain Shams University, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim: Ischemic mitral regurgitation (IMR) is a serious
consequence of coronary artery disease. The choice of the optimal surgical
strategy remains debatable. The aim of the present meta-analysis is to
compare the outcomes of mitral valve repair (RPR) versus replacement (RPL)
regarding perioperative mortality, overall mortality, reoperation,
recurrence of MR, and reverse remodeling after surgery. Method(s):
Electronic searches were performed using the searchable databases of
Google Scholar, Pubmed, and Embase, and the search terms mitral valve,
IMR, RPR, RPL, and coronary artery bypass grafting. The main outcomes of
interest are perioperative mortality, overall mortality, reoperation,
recurrence of MR, and reverse remodeling after surgery. Perioperative
mortality was defined as death during the surgery or within 30 days after
the operation. Result(s): There was a trend towards better
perioperative survival in the RPR arm. However, the difference fell short
of statistical significance [odds ratio (OR) (95% confidence interval
[CI]): 0.66 (0.41-1.07), p = 0.09]. Patients submitted to RPR experienced
a significantly higher MR recurrence rate when compared with their
counterparts submitted to RPL [OR (95% CI): 16.8 (5.07-55.7, p =
0.00001)]. Conclusion(s): There is a trend towards lower
perioperative mortality in RPR in comparison to RPL. On the other hand,
RPL was associated with significantly lower recurrence
rates. Copyright © 2022 Wiley Periodicals LLC.

<22>
Accession Number
2015476123
Title
Mitral valve repair or replacement. How long is this feud to last?.
Source
Journal of Cardiac Surgery. 37(6) (pp 1599-1601), 2022. Date of
Publication: June 2022.
Author
Di Mauro M.; Cargoni M.; Liberi R.; Lorusso R.; Calafiore A.M.
Institution
(Di Mauro, Lorusso) Cardio-Thoracic Surgery Department, Heart & Vascular
Centre, Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University Medical Centre (MUMC), Maastricht, Netherlands
(Cargoni) Department of Cardiac Anaesthesia and Intensive Care, "Mazzini"
Hospital, Teramo, Italy
(Liberi) Department of Heart Disease, "SS Annunziata" Hospital, Chieti,
Italy
(Calafiore) Division of Cardiac Surgery A, "Henry Dunant" Hospital,
Athens, Greece
Publisher
John Wiley and Sons Inc
Abstract
Choosing to perform mitral valve (MV) repair or replacement remains a hot
and highly debated topic. The current guidelines seem to be conflicting in
this specific field and the evidence at our disposal are scarce, only one
small randomized trial and few larger retrospective studies. The
meta-analysis by Gamal and coworkers tries to summarize the current
evidence, concluding that MV replacement for the treatment of ischemic
mitral regurgitation (MR) is at least as safe as repair and certainly
offers a more stable result over time than the latter. Obviously, the
implantation of a prosthesis, especially a mechanical one, brings with it
a series of problems, such as anticoagulation and, above all, a possible
lack of ventricular remodeling, especially if a chordal sparing
replacement is not performed. It must be said, on the other hand, that
isolated annuloplasty cannot act as a counterpart to replacement, because
ischemic MR cannot be considered only an annular disease. Therefore,
wanting to mimic the nature that, after an infarction, enacts a series of
changes involving also the mitral leaflets and chordae, the surgeons are
called to act also on these two entities and not only to downsize the
annulus. In a nutshell, a procedure should not be opposed in a
fundamentalist way to another one, but we must accept the concept of
armamentarium where both procedures are present and tail on the single
patient, and also on the surgeon's expertize, the technique guaranteeing
the best possible result. Copyright © 2022 The Authors. Journal
of Cardiac Surgery Published by Wiley Periodicals LLC.

<23>
Accession Number
2015421676
Title
Current trends in minimally invasive valve-sparing aortic root
replacement-Best available evidence.
Source
Journal of Cardiac Surgery. 37(6) (pp 1684-1690), 2022. Date of
Publication: June 2022.
Author
Sef D.; Bahrami T.; Raja S.G.; Klokocovnik T.
Institution
(Sef, Bahrami, Raja) Department of Cardiac Surgery, Harefield Hospital,
Royal Brompton and Harefield Hospitals, Part of Guy's and St. Thomas' NHS
Foundation Trust, London, United Kingdom
(Klokocovnik) Department of Cardiovascular Surgery, University Hospital
Center Ljubljana, Ljubljana, Slovenia
Publisher
John Wiley and Sons Inc
Abstract
Background: Valve-sparing aortic root replacement such as the
reimplantation (David) procedure is becoming increasingly popular. Despite
the fact that the procedure is technically more complex, long-term studies
demonstrated that excellent clinical outcomes in selected patients with
durable repair are achievable. Benefits of minimal access cardiac surgery
have stimulated enthusiasm in the use of this access for valve-sparing
aortic root replacement. Method(s): We have reviewed available
literature on the topic of valve-sparing aortic root replacement (David
procedure) via minimally invasive access through upper hemisternotomy in
an attempt to assess current trends and to recognize potential advantages
of this technique. Patient selection and preoperative work-up play
important role in performing minimally invasive David procedure safely.
Surgical technique corresponds to the standard David procedure, with a few
exceptions related to the minimal access, and is performed via upper
ministernotomy. Results and Conclusion(s): Evidence from
nonrandomized observational and comparative studies demonstrated excellent
clinical outcomes of minimally invasive David procedure in selected
patients with comparable perioperative mortality and outcomes to the
conventional technique. To date, David procedure with a minimal access
technique has been performed in carefully selected patients. We believe it
could be particularly beneficial to provide younger patients (Marfan
syndrome and bicuspid aortic valve) with minimally invasive David
procedure as it can allow faster recovery with improved cosmesis with
excellent outcomes. A decision to perform minimally invasive David
procedure should be individualized to each patient and based on the
experience of the team. Further large prospective randomized studies with
long-term follow-up are still needed to confirm durability of minimal
access technique. Copyright © 2022 Wiley Periodicals LLC.

<24>
Accession Number
2012313271
Title
Iatrogenic atrial septal defect persistence after percutaneous mitral
valve repair: a meta-analysis.
Source
Acta Cardiologica. 77(2) (pp 166-175), 2022. Date of Publication: 2022.
Author
Maier O.; Hellhammer K.; Horn P.; Afzal S.; Jung C.; Westenfeld R.; Zeus
T.; Kelm M.; Veulemans V.
Institution
(Maier, Horn, Afzal, Jung, Westenfeld, Zeus, Kelm, Veulemans) Department
of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty,
Heinrich Heine University, Dusseldorf, Germany
(Hellhammer) Department of Cardiology and Angiology, Elisabeth-Krankenhaus
Essen, Essen, Germany
(Kelm) CARID (Cardiovascular Research Institute Dusseldorf), Dusseldorf,
Germany
Publisher
Taylor and Francis Ltd.
Abstract
Background: Percutaneous mitral valve repair (PMVR) requires a puncture of
the atrial septum, resulting in iatrogenic atrial septal defect (iASD),
which usually causes a transient left-to-right shunt. However, the
influencing risk factors for iASD persistence and functional consequences
are not fully understood. This meta-analysis aimed to summarise available
data on the persistence of iASD following PMVR. Method(s): The
authors conducted a literature search in PubMed/MEDLINE and EMBASE
databases to identify studies investigating iASD persistence in PMVR
patients. Result(s): Six observational studies (n = 361) met
inclusion criteria for the final analysis. Prevalence of persistent iASD
was documented with 28% after 12 months follow-up. iASD size increased
over time with a diameter of 5.3 +/- 0.76 mm after one month and 6.5 +/-
0.21 mm after 12 months. Possible predictors of iASD persistence after
PMVR appeared to be pre-existing AF (RR 1.24; p =.03), residual mitral
regurgitation > IIdegree (RR 2.06; p =.03) and prolonged fluoroscopic time
(RR 8.27; p =.01). Patients with iASD persistence had a higher risk for
development of right heart overload regarding the increased area of the
right atrium (MD 5.24; p =.004) and enlarged diameter of the right
ventricle (MD 3.33; p <.0001). Rehospitalization was more frequently
reported in iASD patients (RR 9.52; p =.004). Conclusion(s): This
meta-analysis proved iASD persistence in 28% of PMVR after 12 months
follow-up with a higher risk for right heart volume overload and more
frequent rehospitalization compared to patients without iASD persistence.
Since percutaneous catheter-based treatments with transseptal approaches
are rising, further evidence about the hemodynamic impact of persistent
iASD is warranted. Copyright © 2021 Belgian Society of
Cardiology.

<25>
[Use Link to view the full text]
Accession Number
637758272
Title
Home-Based Versus Outpatient-Based Cardiac Rehabilitation Post-Coronary
Artery Bypass Graft Surgery: A Randomized Controlled Trial.
Source
The Journal of cardiovascular nursing. 37(3) (pp 274-280), 2022. Date of
Publication: 01 May 2022.
Author
Takroni M.A.; Thow M.; Ellis B.; Seenan C.
Publisher
NLM (Medline)
Abstract
BACKGROUND: The prevalence of coronary heart disease continues to increase
in the Kingdom of Saudi Arabia (KSA). Despite advances in cardiac surgery,
there are no established outpatient cardiac rehabilitation programs in the
KSA. OBJECTIVE(S): The aim of this study was to investigate the
effectiveness of home-based cardiac rehabilitation compared with
outpatient-based cardiac rehabilitation and usual care for patients who
are post-coronary artery bypass graft surgery. METHOD(S): This 3-arm,
single-blind, randomized controlled trial was carried out at the King
Faisal Specialist Hospital, Riyadh, KSA. A total of 82 patients
post-coronary artery bypass graft surgery were randomized and 73 patients
completed the study. Recruited patients were distributed to home-based
cardiac rehabilitation (n = 24), outpatient-based cardiac rehabilitation
(n = 25), or usual care (control group) (n = 24). Participants in the
intervention groups completed an individualized exercise program for 2
hours, 3 times a week for 8 weeks. The control group followed usual care
(no intervention). The incremental shuttle walk test (ISWT), metabolic
equivalence task, Short Form-36, and Hospital Anxiety and Depression Scale
(HADS) were measured at baseline, postintervention, and after a 4-week
follow-up period. RESULT(S): Postintervention, there was an increase
in mean ISWT score from baseline in both the home-based cardiac
rehabilitation and outpatient-based cardiac rehabilitation groups (66
[0.58] m and 71 [9.19] m, respectively). No difference was observed in the
control group. At the 4-week follow-up, both intervention groups showed
statistically significant improvements in all outcome measures (ISWT,
metabolic equivalence tasks, HADS-A, HADS-D, and Short Form-36) compared
with baseline (all P < .001). The home-based cardiac rehabilitation group
showed statistically continuous improvement compared with the
outpatient-based cardiac rehabilitation group. The control group did not
show any significant changes across time in outcome measures.
 CONCLUSION(S): Home-based cardiac rehabilitation is as effective as
outpatient-based cardiac rehabilitation. Home-based cardiac rehabilitation
appears to be more effective at maintaining improvements follow the end of
the intervention. Copyright © 2020 Wolters Kluwer Health, Inc.
All rights reserved.

<26>
Accession Number
2016376129
Title
Assessment of the Effect of Family-Centered Care on Anxiety and Care
Burden in Parents of Children Undergoing Heart Transplantation.
Source
Iranian Heart Journal. 23(2) (pp 87-95), 2022. Date of Publication: April
2022.
Author
Jafarnejad S.; Ebrahimi H.K.; Saremi H.; Esmaeilian S.; Mahdavi M.;
Mostafavi A.
Institution
(Jafarnejad, Ebrahimi, Esmaeilian) Emergency Medicine Management Research
Center, Iran University of Medical Sciences, Ali Asghar Children Hospital,
Tehran, Iran, Islamic Republic of
(Saremi, Mahdavi) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Mostafavi) Department of Cardiology, Shariati Hospital, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: The frequency of organ transplantation is increasing, leading
to increased stress in patients and families. Family performance
assessment can express psychological and health consequences for children
and their families and provide an opportunity for targeted interventions.
 Method(s): After necessary permits were obtained, the cases were
randomly divided into experimental and control groups. Fifty parents of
children who underwent heart transplantation participated in the research.
Then, after the identification of the subjects in the experimental and
control groups, the experimental group was subjected to the
family-centered model. Following the completion of the training and 1
month later, anxiety and care-burden questionnaires were distributed to
the experimental and control groups. Finally, the data obtained from the
questionnaires were collected and analyzed. Result(s): Fifty
individuals participated in this study. The results of the independent t
test showed no significant difference concerning anxiety among parents
before and after the intervention between the 2 study groups (P=0.217).
Care burden was less in the intervention group than in the controls
(P=0.039). Conclusion(s): After training, anxiety and care burden in
the intervention group improved compared with the control group.
Information support of patients' families will help them better adapt to
stressful situations. Educating patients and their families can increase
their information and reduce their anxiety. Copyright © 2022,
Iranian Heart Association. All rights reserved.

<27>
[Use Link to view the full text]
Accession Number
2017581184
Title
American College of Gastroenterology-Canadian Association of
Gastroenterology Clinical Practice Guideline: Management of Anticoagulants
and Antiplatelets during Acute Gastrointestinal Bleeding and the
Periendoscopic Period.
Source
American Journal of Gastroenterology. 117(4) (pp 542-558), 2022. Date of
Publication: 01 Apr 2022.
Author
Abraham N.S.; Barkun A.N.; Sauer B.G.; Douketis J.; Laine L.; Noseworthy
P.A.; Telford J.J.; Leontiadis G.I.
Institution
(Abraham) Division of Gastroenterology and Hepatology, Department of
Medicine, Mayo Clinic, Scottsdale, AR, United States
(Barkun) Division of Gastroenterology, Department of Medicine, McGill
University, Montreal, QC, Canada
(Sauer) Division of Gastroenterology and Hepatology, University of
Virginia, Charlottesville, VA, United States
(Douketis) Department of Medicine, St. Joseph's Healthcare Hamilton,
McMaster University, Hamilton, ON, Canada
(Laine) Yale School of Medicine, New Haven, CT, United States
(Laine) Virginia Connecticut Healthcare System, West Haven, CT, United
States
(Noseworthy) Department of Cardiovascular Diseases, Electrophysiology,
Mayo Clinic, Rochester, MN, United States
(Telford) Division of Gastroenterology, Department of Medicine, St. Paul's
Hospital, University of British Columbia, Vancouver, BC, Canada
(Leontiadis) Division of Gastroenterology and Farncombe, Family Digestive
Health Research Institute, Department of Medicine, McMaster University,
Hamilton, ON, Canada
Publisher
Wolters Kluwer Health
Abstract
We conducted systematic reviews of predefined clinical questions and used
the Grading of Recommendations, Assessment, Development and Evaluations
approach to develop recommendations for the periendoscopic management of
anticoagulant and antiplatelet drugs during acute gastrointestinal (GI)
bleeding and the elective endoscopic setting. The following
recommendations target patients presenting with acute GI bleeding: For
patients on warfarin, we suggest against giving fresh frozen plasma or
vitamin K; if needed, we suggest prothrombin complex concentrate (PCC)
compared with fresh frozen plasma administration; for patients on direct
oral anticoagulants (DOACs), we suggest against PCC administration; if on
dabigatran, we suggest against the administration of idarucizumab, and if
on rivaroxaban or apixaban, we suggest against andexanet alfa
administration; for patients on antiplatelet agents, we suggest against
platelet transfusions; and for patients on cardiac acetylsalicylic acid
(ASA) for secondary prevention, we suggest against holding it, but if the
ASA has been interrupted, we suggest resumption on the day hemostasis is
endoscopically confirmed. The following recommendations target patients in
the elective (planned) endoscopy setting: For patients on warfarin, we
suggest continuation as opposed to temporary interruption (1-7 days), but
if it is held for procedures with high risk of GI bleeding, we suggest
against bridging anticoagulation unless the patient has a mechanical heart
valve; for patients on DOACs, we suggest temporarily interrupting rather
than continuing these; for patients on dual antiplatelet therapy for
secondary prevention, we suggest temporary interruption of the P2Y12
receptor inhibitor while continuing ASA; and if on cardiac ASA monotherapy
for secondary prevention, we suggest against its interruption. Evidence
was insufficient in the following settings to permit recommendations. With
acute GI bleeding in patients on warfarin, we could not recommend for or
against PCC administration when compared with placebo. In the elective
periprocedural endoscopy setting, we could not recommend for or against
temporary interruption of the P2Y12 receptor inhibitor for patients on a
single P2Y12inhibiting agent. We were also unable to make a recommendation
regarding same-day resumption of the drug vs 1-7 days after the procedure
among patients prescribed anticoagulants (warfarin or DOACs) or P2Y12
receptor inhibitor drugs because of insufficient evidence. Copyright
© 2022 Wolters Kluwer Health. All rights reserved.

<28>
Accession Number
2017647745
Title
Cardiac Cement Embolism after Thoracic Kyphoplasty: Successful
Conservative Treatment with 4-Year Follow-Up.
Source
International Journal of Spine Surgery. 16(1) (pp 27-32), 2022. Date of
Publication: 01 Feb 2022.
Author
Mills S.; Pizones J.; Rueda L.R.M.; Talavera G.; Sanchez-Marquez J.M.;
Fernandez-Baillo N.
Institution
(Mills, Pizones, Rueda, Talavera, Sanchez-Marquez, Fernandez-Baillo) Spine
Unit, Department of Orthopaedic Surgery, La Paz Hospital Universitario,
Madrid, Spain
(Mills) Spine Unit, Department of Orthopaedic Surgery, Hospital
Universitario La Paz, Madrid, Spain
Publisher
ISASS
Abstract
Background: The present case report describes a complication after a
percutaneous spine surgery technique that is highly uncommon in clinical
practice: a bone cement cardiac embolism. This rare complication
emphasizes the importance of this case, which is also interesting
considering the midterm follow-up. Documented cardiac embolisms published
in the literature (which are scarce) describe the acute phase of these
cases but lack follow-up. There are no systematic reviews on this topic,
only case-by-case presentations, and surgeons are not aware of its real
implications. Case: We report a case of an 84-year-old man who developed
sudden thoracic and spinal pain associated with 82% saturation and dyspnea
a few hours after 4-level thoracic spine vertebroplasty and kyphoplasty.
Imaging revealed multiple bone cement embolisms in his lung and heart.
Because the patient was hemodynamically stable, cardiologists recommended
conservative treatment with low molecular weight heparin, without embolus
removal. At 4-year follow-up, the patient remained asymptomatic.
 Conclusion(s): Cardiac cement embolization following percutaneous
techniques represents a life-threatening situation that should be ruled
out if the patient presents symptoms during the early postoperative
period. Treatment may vary from conservative to emergency open-heart
surgery. Copyright © International Society for the Advancement of
Spine Surgery.

<29>
Accession Number
2016363642
Title
A Comparative Effectiveness Systematic Review and Meta-analysis of Drugs
for the Prophylaxis of Junctional Ectopic Tachycardia.
Source
Current Cardiology Reviews. 18(1) (pp 101-111), 2022. Article Number:
e030621193817. Date of Publication: January 2022.
Author
Mendel B.; Christianto C.; Setiawan M.; Prakoso R.; Siagian S.N.
Institution
(Mendel, Christianto, Setiawan) Faculty of Medicine, Universitas
Indonesia, Jakarta, Indonesia
(Prakoso, Siagian) Pediatric Cardiology and Congenital Heart Defect
Division, Department of Cardiology and Vascular Medicine, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Publisher
Bentham Science Publishers
Abstract
Background: Junctional Ectopic Tachycardia (JET) is an arrhythmia
originating from the AV junction, which may occur following congenital
heart surgery, especially when the intervention is near the
atrioventricular junction. Objective(s): The aim of this systematic
review and meta-analysis is to compare the effectiveness of amiodarone,
dexmedetomidine, and magnesium in preventing JET following congenital
heart surgery. Method(s): This meta-analysis was conducted according
to the Preferred Reporting Items for Systematic Review and Meta-Analysis
(PRISMA) statement, where 11 electronic databases were searched from the
date of inception to August 2020. The incidence of JET was calculated with
the relative risk of 95% Confidence Interval (CI). Quality assessment of
the included studies was assessed using the Consolidated Standards of
Reporting Trials (CONSORT) 2010 statement. Result(s): Eleven studies
met the predetermined inclusion criteria and were included in this
meta-analysis. Amiodarone, dexmedetomidine, and magnesium significantly
reduced the incidence of postoperative JET [Amiodarone: risk ratio 0.34;
I2= 0%; Z=3.66 (P=0.0002); 95% CI 0.19-0.60. Dexmedetomidine: risk ratio
0.34; I2= 0%; Z=4.77 (P<0.00001); 95% CI 0.21-0.52. Magnesium: risk ratio
0.50; I2= 24%; Z=5.08 (P<0.00001); 95% CI 0.39-0.66]. Conclusion(s):
All three drugs have shown promising results in reducing the incidence of
JET. Our systematic review found that dexmedetomidine is better in
reducing the length of ICU stays as well as mortality. In addition,
dexmedetomidine also has the least pronounced side effects among the
three. However, it should be noted that this conclusion was derived from
studies with small sample sizes. Therefore, dexmedetomidine may be
considered as the drug of choice for preventing JET. Copyright ©
2022 Bentham Science Publishers.

<30>
Accession Number
2016360775
Title
Spine Surgery Assisted by Augmented Reality: Where Have We Been?.
Source
Yonsei Medical Journal. 63(4) (pp 305-316), 2022. Date of Publication: Apr
2022.
Author
Liu Y.; Lee M.-G.; Kim J.-S.
Institution
(Liu, Lee, Kim) Department of Neurosurgery, Seoul St. Mary's Hospital,
College of Medicine, The Catholic University of Korea, Seoul, South Korea
Publisher
Yonsei University College of Medicine
Abstract
This present systematic review examines spine surgery literature
supporting augmented reality (AR) technology and summarizes its current
status in spinal surgery technology. Database search strategies were
retrieved from PubMed, Web of Science, Cochrane Library, Embase, from the
earliest records to April 1, 2021. Our review briefly examines the history
of AR, and enumerates different device application workflows in a variety
of spinal surgeries. We also sort out the pros and cons of current
mainstream AR devices and the latest updates. A total of 45 articles are
included in our review. The most prevalent surgical applications included
are the augmented reality surgical navigation system and head-mounted
display. The most popular application of AR is pedicle screw
instrumentation in spine surgery, and the primary responsible surgical
levels are thoracic and lumbar. AR guidance systems show high potential
value in practical clinical applications for the spine. The overall number
of cases in AR-related studies is still rare compared to traditional
surgical-assisted techniques. These lack long-term clinical efficacy and
robust surgical-related statistical data. Changing healthcare laws as well
as the increasing prevalence of spinal surgery are generating critical
data that determines the value of AR technology. Copyright ©
Yonsei University College of Medicine 2022.

<31>
Accession Number
2015613203
Title
The effect of calcium gluconate administration during cardiopulmonary
bypass on hemodynamic variables in infants undergoing open-heart surgery.
Source
Egyptian Heart Journal. 74(1) (no pagination), 2022. Article Number: 29.
Date of Publication: December 2022.
Author
Faritous S.Z.; Zaree S.R.; Morshedizad Z.; Jalali A.H.; Mahani S.M.;
Gholampour M.
Institution
(Faritous, Zaree, Morshedizad, Jalali, Mahani, Gholampour) Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Vali_e_Asr St., Tehran, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The incidence of complications after heart surgery is a
critical factor in disability, deaths, lengthening hospital stays, and
increasing treatment costs. The metabolic balance of certain hormones and
electrolytes is necessary for proper cardiac function. In children,
various biochemical conditions may cause calcium depletion during heart
surgery. The purpose of this study was to determine the effect of calcium
gluconate administration during cardiopulmonary bypass on hemodynamic
variables and clinical outcomes in infants undergoing open-heart surgery.
This study was conducted at Rajaie Cardiovascular Medical and Research
Center in 2021 using a controlled randomized clinical trial. A total of 60
patients with open-heart surgery weighing up to 10 kg were included in the
study. The first group received an intravenous injection of calcium
gluconate 20 min after opening the aortic clamp, and the second group was
monitored as a control group. Data collection tools included checklists
containing demographics, surgical information, and intensive care unit
measures. Result(s): The Chi-square test or Fisher's exact test
showed that the frequency distribution of gender, blood group, Rhesus
factor (RH), and clinical diagnosis in the two groups of intervention and
control was not statistically significant (p < 0.05). The mean and
standard deviation of Ejection Fraction (EF) changes (before and after)
were 13.27 +/- 9.16 in the intervention group and 8.31 +/- 9.80 in the
control group (p = 0.065). The results of two-way repeated measures ANOVA
showed that mean systolic blood pressure (p = 0.030), mean diastolic blood
pressure (p = 0.021), mean heart rate (p = 0.025), mean arterial pressure
(p = 0.020), mean pH (p < 0.001), and mean hemoglobin (p = 0.018) in the
intervention, and control groups were statistically significant.
 Conclusion(s): In the present study, unlike systolic pressure, mean
diastolic blood pressure decreased, and mean arterial pressure increased
significantly. As a result, the slope of changes during the study period
was different in the intervention and control groups. Copyright ©
2022, The Author(s).

<32>
Accession Number
2015601179
Title
Perioperative coronary artery spasm after off-pump coronary artery bypass
grafting in the non-manipulated coronary artery.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
166. Date of Publication: December 2022.
Author
Bai Y.; Jiang N.; Chen Q.; Guo Z.
Institution
(Bai, Jiang, Chen, Guo) Department of Cardiac Surgery, Chest Hospital,
Tianjin University, No. 261 Taierzhuang South Road, Jinnan District,
Tianjin 300222, China
(Bai, Bai, Jiang, Chen, Guo) Department of Cardiac Surgery, Tianjin Chest
Hospital, Tianjin Medical University, Tianjin 300222, China
(Bai) Graduate School, Tianjin Medical University, Tianjin 300070, China
Publisher
BioMed Central Ltd
Abstract
Background: Perioperative coronary artery spasm (CAS) following coronary
artery bypass grafting (CABG) is a severe or lethal condition that is
rarely reported. In addition, rare cases with CAS following CABG in the
non-manipulated coronary artery are angiographically documented in the
perioperative period. We aimed to report our experiences on the diagnosis
and treatment of a case with CAS following off-pump CABG in the
non-manipulated coronary artery. Method(s): A 57-year old male with
coronary heart disease and unstable angina willing to undergo CABG was
admitted to our department. CABG was recommended as he showed 90% stenosis
in distal left anterior descending artery, 90% stenosis in intermediate
branch, 90% stenosis in left circumflex coronary artery, as well as 50%
stenosis in proximal right coronary artery (RCA). Result(s): After
CABG, the patient showed Adams-Stokes syndrome and ST-segment elevation.
Then CPR was conducted and coronary angiography indicated perioperative
CAS in the non-manipulated posterior descending artery. For the treatment,
the patient received nitroglycerin injection into the coronary artery by
catheter and pumping of diltiazem. Finally, the patient was discharged on
day 7 after surgery. A comprehensive literature search was conducted to
summarize the studies focused on the diagnosis and treatment of such
condition, which indicated that all of the CAS cases occurred in the
manipulated vessels, except one study showing CAS in the untouched native
coronary artery which was similar with our case. Conclusion(s):
Perioperative CAS in the non-manipulated coronary artery following CABG is
a severe or lethal condition that is rarely reported, which deserves close
attention by the clinicians in clinical practice. Copyright ©
2022, The Author(s).

<33>
Accession Number
2015521647
Title
A randomized controlled comparison of three modes of ventilation during
cardiopulmonary bypass on oxygenation in pediatric patients with pulmonary
hypertension undergoing congenital heart surgeries.
Source
Egyptian Journal of Anaesthesia. 38(1) (pp 193-200), 2022. Date of
Publication: 2022.
Author
Gado A.A.; Hefnawy S.M.; Abdelrahim A.M.; Alberry M.A.W.A.A.; Madkour
M.A.E.F.
Institution
(Gado, Hefnawy, Abdelrahim, Alberry, Madkour) Anesthesia and Intensive
Care Department, Faculty of Medicine, Cairo University, Giza, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Several studies have attempted to improve post bypass
oxygenation, decrease extravascular total lung water volume, utilizing
continuous positive airway pressure (CPAP) and high-frequency ventilation
(HFV) during cardiopulmonary bypass (CPB). Aim(s): To assess the
influence of various ventilation modes during CPB on direct pulmonary
artery systolic pressure and post bypass oxygenation in pediatric patients
with moderate to severe pulmonary hypertension undergoing corrective
cardiac surgeries. Method(s): Included in the study were 24 patients
aged 4 months to 6 years, suffering from moderate to severe pulmonary
hypertension, undergoing elective corrective cardiac surgeries for atrial
septal defect (ASD) or ventricular septal defect (VSD) or atrioventricular
canal defects (AVC) (ASA II and III). Group A patients (n = 8) received
high-frequency positive pressure ventilation during cardiopulmonary
bypass, Group B patients (n = 8) received continuous positive, while group
C patients (n = 8) disconnected from the ventilation (passive deflation)
(control group). Result(s): There was no statistically significant
difference regarding the pulmonary artery systolic pressure (PASP) and
pulmonary artery systolic pressure to systemic systolic blood pressure
(PASP/SSBP Ratio) at t1, t2, and t3 between the three groups.
 Conclusion(s): After cadiopulmonary bypass, no significant changes in
pulmonary artery pressure was observed in pediatric patients, regardless
of the ventilation mode utilized during cardiopulmonary bypass.
Conversely, the pulmonary outcomes; delivered Oxygen (DA-aO2), arterial
oxygen tension (paO2) and paO2/FiO2 (p/f ratio) and lung ultrasound (LUS)
were significantly improved when comparing continuous positive airway
pressure (CPAP) with high frequency positive pressure ventilation (HFPPV)
and passive deflation during cardiopulmonary bypass. Copyright ©
2022 The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<34>
Accession Number
2015481451
Title
Effects of rhomboid intercostal plane block for postoperative analgesia
after thoracoscopic surgery compared with local anesthetic infiltration: A
randomized clinical trial.
Source
Egyptian Journal of Anaesthesia. 38(1) (pp 179-184), 2022. Date of
Publication: 2022.
Author
Toulan H.F.; Abdelrazik R.A.
Institution
(Toulan, Abdelrazik) Department of Anesthesiology, Intensive Care, and
Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: The efficacy of pain control is a crucial element of improved
recovery following thoracic surgery. Inadequate analgesia may extend the
interval of hospitalization, besides raising medical costs. Fascial plane
blocks are quickly becoming a feasible as well as a safe alternative to
epidural analgesia for abdominal and thoracic pain. Rhomboid intercostal
block (RIB) is a novel, simple block utilized in a region that is
described as a triangle of auscultation on the scapula's medial edge. This
study attempted to determine the impact of RIB on postoperative pain
following thoracoscopic surgery compared to local anesthetic (LA)
infiltration. Method(s): The current research is a randomized,
controlled trial on 60 subjects undergoing video-assisted thoracic
surgery. Participants were randomly divided into two groups. All subjects
received standard general anesthesia protocol, which included the
insertion of a double-lumen endotracheal tube as well as mechanical
ventilation. At the end of the operation in the RIB group, an injection of
20 ml bupivacaine (0.25%) was administered below the rhomboid major muscle
guided by ultrasound. In the LA group, patients received local wound
infiltration. Visual analog scores for pain during coughing and at rest,
total postoperative analgesic consumption, adverse effects, and hospital
stay were recorded. Result(s): The study group demonstrated
diminished visual analog scores during coughing as well as at rest with
less overall consumption of analgesia compared to the local infiltration
group. Conclusion(s): Our study showed that ultrasound guided RIB
provides better pain relief and less postoperative opioid consumption
after thoracoscopic surgeries compared to local anesthetic
infiltration. Copyright © 2022 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<35>
Accession Number
2015635006
Title
Complete transcatheter versus complete surgical treatment in patients with
aortic valve stenosis and concomitant coronary artery disease: Study-level
meta-analysis with reconstructed time-to-event data.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Sa M.P.; Sun T.; Fatehi Hassanabad A.; Awad A.K.; Van den Eynde J.; Malin
J.H.; Sicouri S.; Torregrossa G.; Ruhparwar A.; Weymann A.; Ramlawi B.
Institution
(Sa, Sun, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery,
Lankenau Heart Institute, Lankenau Medical Center, Main Line Health,
Wynnewood, PA, United States
(Sa, Sicouri, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Fatehi Hassanabad) Section of Cardiac Surgery, Department of Cardiac
Sciences, Libin Cardiovascular Institute, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(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
(Ruhparwar, Weymann) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To compare outcomes of complete transcatheter (TAVI plus PCI)
versus complete surgical (SAVR plus CABG) approach to treat patients with
aortic stenosis (AS) and concomitant coronary artery disease (CAD).
 Method(s): Study-level meta-analysis with reconstructed time-to-event
data including studies published by November 2021. The primary endpoints
were 30-day mortality, overall survival, and major adverse cardiovascular
and cerebrovascular events (MACCE). The secondary endpoints were 30-day
stroke, myocardial infarction, and permanent pacemaker implantation (PPI);
in-hospital major vascular events and acute kidney injury (AKI).
 Result(s): Eight studies met our eligibility criteria, including a
total of 33,286 patients (3448 for TAVI plus PCI and 29,838 for SAVR plus
CABG). The pooled risk of 30-day mortality was lower for TAVI plus PCI (OR
0.63; 95% CI 0.51-0.80; p <.001). Patients undergoing TAVI plus PCI had
lower risk of in-hospital AKI (OR 0.49; 95% CI 0.28-0.85; p =.01),
however, higher risk of major vascular events (OR 7.33; 95% CI 1.80-29.85;
p =.005) and higher risk of PPI (OR 2.96; 95% CI 1.80-4.85; p <.001). No
statistically significant difference was observed for myocardial
infarction and stroke between the groups. In the follow-up analyses, we
observed a higher risk of mortality (HR 1.64, 95% CI 1.36-1.96, p <.001)
and MACCE with TAVI plus PCI (HR 1.35 (95% CI 1.08-1.69, p =.009).
 CONCLUSION(S): Patients who undergo TAVI plus PCI (in comparison with
SAVR plus CABG) initially experience lower rates of in-hospital death and
AKI; however, they experience significantly lower survival rates and more
MACCE at 5-year follow up. Structural heart surgeons and interventional
cardiologists should consider these aspects when referring patients for
one approach or the other. Copyright © 2022 Wiley Periodicals
LLC.

<36>
Accession Number
637778323
Title
Effects of a spray-based oropharyngeal moisturising programme for patients
following endotracheal extubation after cardiac surgery: A randomised,
controlled three-arm trial.
Source
International journal of nursing studies. 130 (pp 104214), 2022. Date of
Publication: 01 Mar 2022.
Author
Lin R.; Chen H.; Chen L.; Lin X.; He J.; Li H.
Institution
(Lin, Chen, Li) Research Centre for Nursing Theory and Practice, Fujian
Provincial Hospital, 134 East Street, Gulou District, Fuzhou City, Fujian
Province, China; School of Nursing, Fujian Medical University, No.1 of
Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province,
China; Hospital Service Center, Fujian Provincial Hospital, 134 East
Street, Gulou District, Fuzhou City, Fujian Province, China; Department of
Nursing, Fujian Provincial Hospital, Shengli Clinical Medical College of
Fujian Medical University, 134 East Street, Gulou District, Fuzhou City,
Fujian Province, China
(Chen) Hospital Service Center, Fujian Provincial Hospital, Fujian
Province, 134 East Street ,Gulou District, China
(Lin, He) Intensive Care Unit, Fujian Provincial Hospital, Fujian
Province, 134 East Street ,Gulou District, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: When a patient emerges from cardiac surgery, they may
experience intense thirst and discomfort or even impaired swallowing after
endotracheal extubation. This may lead to feelings of suffocation,
desperation, fear, and anxiety. Although thirst relief and dysphagia
prevention share similar mechanisms, there is limited evidence for a
combined intervention to alleviate thirst and prevent dysphagia.
Furthermore, no studies to date have targeted postoperative cardiac
patients. OBJECTIVE(S): To evaluate the safety, feasibility, and
effects of a spray-based oropharyngeal moisturising programme for cardiac
surgery patients following endotracheal extubation. DESIGN: A randomised,
controlled three-arm trial was conducted from October 2017 to December
2019. SETTING: Tertiary medical centre cardiac care unit. PARTICIPANTS:
Participants (N = 145) were patients who underwent cardiac surgery and
received mechanical ventilation. METHOD(S): Participants were
randomly assigned to one of three groups: a four-part programme offering
spray-based therapy with either a constant low-temperature cold spray
(programme A; n = 47) or low-to-normal temperature spray (programme B; n =
49), or those that received usual care (control group; n = 49). Control
group patients who complained of thirst were given wet cotton swabs to
moisten their mouths. The primary outcomes included discomfort and various
levels of thirst intensity; secondary outcomes included dysphagia and
adverse events. Outcomes were evaluated at Time 0 (baseline), Time 1 (3
h), Time 2 (6 h) and Time 3 (96 h) post intervention. Repeated-measures
analyses was performed using generalised estimating equations.
 RESULT(S): The baseline evaluation indicated no significant
differences between the groups. Participants (average age: 55 years; 53.8%
men) underwent cardiac surgery for; valvular heart disease (64.8%),
coronary atherosclerotic heart disease (25.5%), or aortic dissection
(9.7%). Baseline scores indicated moderately severe thirst (6.24+/-1.57)
and discomfort (9.88+/-2.23). Post intervention, the thirst intensity in
the intervention groups was significantly lower than that of the control
group (p<0.001). The generalised estimating equation analysis showed no
significant difference in reduced thirst intensity between programmes A
and B (adjusted beta=0.08, 95% CI: -0.59-0.76, p = 0.810) when controlling
for intervention condition and time. Comparable results were found for
reduced thirst discomfort (adjusted beta=0.36, 95% CI: -0.66-1.38, p =
0.493). The three groups showed no significant differences for dysphagia
frequency. No observable adverse events were reported during the
intervention period. CONCLUSION(S): A spray-based oropharyngeal
moisturising programme is a practical and effective intervention to
alleviate patient thirst after cardiac surgery and tracheal intubation
that could be integrated into comfort care for post-surgical patients'
critical care management. TWEETABLE ABSTRACT: A spray-based oropharyngeal
moisturising programme for cardiac surgery recipients following
endotracheal extubation may alleviate thirst. Copyright © 2022.
Published by Elsevier Ltd.

<37>
Accession Number
637771666
Title
Aortic valve intervention for aortic stenosis and cardiac amyloidosis: a
systematic review and meta-analysis.
Source
Future cardiology. (no pagination), 2022. Date of Publication: 14 Apr
2022.
Author
de Campos D.; Saleiro C.; Botelho A.; Costa M.; Goncalves L.; Teixeira R.
Institution
(de Campos, Saleiro, Botelho, Costa, Goncalves, Teixeira) Centro
Hospitalar e Universitario de Coimbra - Hospital Geral, Quinta dos Vales
,Sao Martinho do Bispo 108, Coimbra 3041-801, Portugal
(Goncalves, Teixeira) Faculdade de Medicina da Universidade de Coimbra, R.
Larga 2, Coimbra 3000-370, Portugal
(Goncalves) Coimbra Institute for Clinical & Biomedical Research (iCBR),
Celas, Azinhaga Santa Comba, Coimbra 3000-548, Portugal
Publisher
NLM (Medline)
Abstract
Aortic stenosis with cardiac amyloidosis (CA-AS) is common in the elderly.
We provide an overview and a meta-analysis of outcomes after aortic valve
(AV) intervention. The primary end point was all-cause mortality. Weighted
pooled analysis showed a non-significant higher risk of death in CA-AS
patients following surgical or transcatheter AV replacement. After
transcatheter AV replacement, the risk of death in CA-AS patients was
comparable to that associated with aortic stenosis alone (risk ratio:
1.23; 95% CI: 0.77-1.96; p = 0.39; I2 = 0%). An AV intervention is
possibly not futile in CA-AS and should not be denied to patients with
this condition.

<38>
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. 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. 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. 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. Copyright © 2021, Springer Science+Business Media, LLC,
part of Springer Nature.

<39>
Accession Number
2016199058
Title
Iron Deficiency in Heart Failure with Reduced Ejection Fraction:
Pathophysiology, Diagnosis and Treatment.
Source
Arquivos Brasileiros de Cardiologia. 118(3) (pp 646-654), 2022. Date of
Publication: 2022.
Author
Pereira G.A.R.; Beck-Da-silva L.
Institution
(Pereira) Hospital Sao Lucas da Pontificia Universidade Catolica do Rio
Grande do Sul, RS, Porto Alegre, Brazil
(Pereira, Beck-Da-silva) Programa de Pos-Graduacao em Cardiologia,
Universidade Federal do Rio Grande do Sul, RS, Porto Alegre, Brazil
(Beck-Da-silva) Hospital de Clinicas de Porto Alegre, RS, Porto Alegre,
Brazil
Publisher
Arquivos Brasileiros de Cardiologia
Abstract
Iron deficiency (ID) is an important comorbidity in heart failure with
reduced ejection (HFrEF) and is highly prevalent in both anemic and
non-anemic patients. In HFrEF, iron deficiency should be investigated by
measurements of transferrin saturation and ferritin. There are two types
of ID: absolute deficiency, with depletion of iron stores; and functional
ID, where iron supply is not sufficient despite normal stores. ID is
associated with worse functional class and higher risk of death in
patients with HFrEF, and scientific evidence has indicated improvement of
symptoms and quality of life of these patients with treatment with
parenteral iron in the form of ferric carboxymaltose. Iron plays vital
roles such as oxygen transportation (hemoglobin) and storage (myoblogin),
and is crucial for adequate functioning of mitochondria, which are
composed of iron-based proteins and the place of energy generation by
oxidative metabolism at the electron transport chain. An insufficient
generation and abnormal uptake of iron by skeletal and cardiac muscle
cells contribute to the pathophysiology of HF. The present review aims to
increase the knowledge of the pathophysiology of ID in HFrEF, and to
address available tools for its diagnosis and current scientific evidence
on iron replacement therapy. Copyright © 2022, Arquivos
Brasileiros de Cardiologia. All rights reserved.

<40>
Accession Number
2015038819
Title
Left atrial appendage occlusion vs novel oral anticoagulation for stroke
prevention in atrial fibrillation: rationale and design of the multicenter
randomized occlusion-AF trial.
Source
American Heart Journal. 243 (pp 28-38), 2022. Date of Publication: January
2022.
Author
Korsholm K.; Damgaard D.; Valentin J.B.; Packer E.J.S.; Odenstedt J.;
Sinisalo J.; Putaala J.; Naess H.; Al-Jazi M.A.; Karlsson J.-E.;
Pontoppidan J.; Modrau B.; Hjort J.; Matzen K.L.; Johnsen S.P.;
Nielsen-Kudsk J.E.
Institution
(Korsholm, Matzen, Nielsen-Kudsk) Department of Cardiology, Aarhus
University Hospital, Aarhus N, Denmark
(Korsholm) Department of Cardiology, Regional Hospital, West Jutland,
Denmark
(Damgaard) Department of Neurology, Aarhus University Hospital, Aarhus,
Denmark
(Valentin, Johnsen) Danish Center for Clinical Health Services Research,
Department of Clinical Medicine, Aalborg University and Aalborg University
Hospital, Aalborg, Denmark
(Packer) Department of Heart Disease, Haukeland University Hospital,
Bergen, Norway
(Odenstedt) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Sinisalo) Heart and Lung Center, Helsinki University Central Hospital,
and Helsinki University Helsinki, Finland
(Putaala) Department of Neurology, Helsinki University Hospital and
University of Helsinki, Finland
(Naess) Department of Neurology, Haukeland University Hospital, Bergen,
Norway
(Al-Jazi) Department of Neurology, Regional Hospital, West Jutland,
Denmark
(Karlsson) Department of Neurology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Pontoppidan) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Modrau) Department of Neurology, Aalborg University Hospital, Aalborg,
Denmark
(Hjort) Clinical Trial Unit, Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
Publisher
Elsevier Inc.
Abstract
Background: The prevalence of atrial fibrillation (AF) is increasing
globally, which is a major clinical and public health concern due to the
5-fold increased risk of stroke. Oral anticoagulation with novel oral
anticoagulants (NOACs) is the current primary option for stroke prevention
in patients with AF, although it increases the risk of major bleeding.
Patients with prior ischemic cerebrovascular events are at particularly
high risk of both recurrent ischemic events and major bleeding. Left
atrial appendage occlusion (LAAO) provides an alternative option for
stroke prevention in high-risk patients, however, with currently limited
evidence. Thus, randomized trials comparing LAAO to NOACs are needed.
 Objective(s): The Occlusion-AF trial is designed to assess whether
LAAO is non-inferior to NOAC therapy for reduction of the combined
endpoint of stroke, systemic embolism, major bleeding (Bleeding Academic
Research Consortium >= 3) and all-cause mortality in patients with AF and
a recent ischemic stroke or transient ischemic attack (TIA). Methods and
analysis: Investigator-initiated multicenter, multinational, randomized
open-label non-inferiority trial with blinded outcome evaluation (PROBE
design). Patients with documented AF, and an ischemic stroke or TIA within
6 months will be eligible for enrollment. Major exclusion criteria are
modified Rankin Scale > 3 at enrollment, glomerular filtration rate < 15
ml/min, and life-expectancy less than 2 years. A total of 750 patients
will be randomized 1:1 to receive either a NOAC or LAAO using the
Amplatzer Amulet (Abbott, MN, USA) or Watchman FLX (Boston Scientific, MN,
USA) with subsequent life-long aspirin 75 mg daily. Follow-up will be
based on in-office and telephone follow-up in combination with long-term
follow-up (10 years) through national hospital discharge registries in the
individual Nordic countries. The primary outcome will be a composite
endpoint of stroke, systemic embolism, major bleeding (BARC >= 3) and
all-cause mortality at 2-year follow-up. Conclusion(s): The
Occlusion-AF trial is designed to compare LAAO to NOAC therapy for
secondary stroke prevention in AF patients with a high risk of recurrent
thromboembolic events, i.e. with previous ischemic stroke or TIA, and
otherwise eligible for anticoagulation. The results are expected to
contribute significantly to the understanding of the effects of LAAO
compared to the standard contemporary pharmacological treatment in these
patients. Copyright © 2021 Elsevier Inc.

<41>
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.
 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. 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. 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.
 Conclusion(s): The obtained results did not approve the effect of Se
in AKI prevention in coronary artery bypass grafting
patients. Copyright © 2021 Author(s).

<42>
Accession Number
2016907901
Title
What is the role of septal myectomy in aortic stenosis?.
Source
Revista Portuguesa de Cardiologia. 41(4) (pp 341-346), 2022. Date of
Publication: April 2022.
Author
Magro P.L.; Sousa Uva M.
Institution
(Magro, Sousa Uva) Department of Cardio-thoracic Surgery, Hospital de
Santa Cruz, Carnaxide, Portugal
Publisher
Sociedade Portuguesa de Cardiologia
Abstract
Asymmetric basal septal hypertrophy is present in 10% of patients with
hemodynamic significant aortic valve stenosis. From the surgeon's
standpoint, it represents a dilemma as it may be implicated in suboptimal
short and long-term results after aortic valve replacement (AVR), but also
heighten unwarranted complications at the time of surgical correction. To
provide insight about the usefulness and safety of concomitant septal
myectomy in this setting, we performed a literature review searching
Medline from its inception to November 2020 using the Pubmed interface.
Only five low evidence retrospective analyses, comprising a total of <200
patients undergoing AVR with concomitant septal myectomy, were found in
the literature. In summary, routine myectomy, in the presence of suspected
or directly visualized asymmetric septal hypertrophy on echocardiogram
during AVR, seems to be a safe procedure, with all authors reporting a low
rate or absence of complications. Overall, myectomy in this setting is
associated with superior echocardiographic results concerning surrogates
of LV remodelling (LVM; LVM index; LVM/height) and diastolic function
(E/E'), suggesting some benefit for hemodynamic outcomes. However, to what
extent hemodynamic improvement is exclusively attributable to myectomy is
uncertain, as is, the clinical significance of such an improvement, with
similar short and mid-term survival rates being reported. Copyright
© 2022 Sociedade Portuguesa de Cardiologia

<43>
Accession Number
2016756225
Title
Meta-Analysis of Mitral Valve Repair Versus Replacement for Rheumatic
Mitral Valve Disease.
Source
Heart Lung and Circulation. 31(5) (pp 705-710), 2022. Date of Publication:
May 2022.
Author
Liao Y.-W.B.; Wang T.K.M.; Wang M.T.M.; Ramanathan T.; Wheeler M.
Institution
(Liao, Wang, Wang, Ramanathan, Wheeler) Green Lane Cardiovascular Service,
Auckland City Hospital, Auckland, New Zealand
(Wang, Wang) Department of Medicine, University of Auckland, Auckland, New
Zealand
Publisher
Elsevier Ltd
Abstract
Background: Rheumatic heart disease remains one of the leading causes of
heart valve disease worldwide despite being a preventable condition.
Mitral valve repair is superior to replacement in severe degenerative
mitral valve disease, however its role in rheumatic valve disease remains
controversial. This meta-analysis compared mitral valve repair and
replacement in rheumatic heart disease. Method(s): Medline, EMBASE,
Cochrane and Scopus were searched from January 1980 to June 2016 for
original studies reporting outcomes of both mitral valve repair and
replacement in rheumatic heart disease in adults, children or both. Two
(2) authors independently assessed studies for inclusion, followed by data
extraction and analysis. Result(s): The search yielded 930 articles,
with 98 full-texts reviewed after initial screening and 13 studies
subsequently included for analysis, totalling 2,410 mitral valve repairs
and 3,598 replacements. Pooled rates and odds ratio (95% confidence
interval) for operative mortality of repair versus replacement was 3.2%
versus 4.3%, 0.68 (0.50-0.92; p=0.01). Pooled odds ratios (95% confidence
interval) were for long-term mortality 0.41 (0.30-0.56; p<0.001);
reoperation 3.02 (1.72-5.31; p<0.001); and bleeding 0.26 (0.11-0.63;
p=0.003). There was a trend towards lower thrombo-embolism 0.42
(0.17-1.03; p=0.06), and no significant difference in endocarditis
(p=0.76), during follow-up. Conclusion(s): Mitral valve repair is
associated with reduction in operative and long-term mortality and
bleeding, so is recommended in rheumatic mitral valve disease where
feasible, but it does entail a higher rate of reoperation during
follow-up. Copyright © 2021

<44>
Accession Number
2016514159
Title
Prognostic Value of Pulmonary Hypertension, Right Ventricular Function and
Tricuspid Regurgitation on Mortality After Transcatheter Mitral Valve
Repair: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. 31(5) (pp 696-704), 2022. Date of Publication:
May 2022.
Author
Meijerink F.; de Witte S.M.; Limpens J.; de Winter R.J.; Bouma B.J.; Baan
J.
Institution
(Meijerink, de Witte, de Winter, Bouma, Baan) Department of Cardiology,
Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Limpens) Medical Library, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
Publisher
Elsevier Ltd
Abstract
Background: Pulmonary hypertension (PH), right ventricular (RV)
dysfunction, and tricuspid regurgitation (TR) are commonly present in
patients with mitral regurgitation (MR) and known to impair prognosis.
This systematic review and meta-analysis aimed to determine the prognostic
value of PH, RV function, and TR on mortality after transcatheter mitral
valve repair (TMVR). Method(s): A systematic search was performed to
identify studies investigating PH, RV function, or TR in patients who
underwent TMVR. Studies were included for pooled analysis if hazard ratios
(HR) for all-cause mortality were given. Result(s): A total of 8,672
patients from 21 selected studies were included (PH, 11 studies; RV
function, nine studies; TR, 10 studies). Mean follow-up was 2.7+/-1.6
years. The HRs and 95% CIs for all-cause mortality of PH (dichotomised: HR
1.70, 95% CI 1.00-2.87; per 10 mmHg increase in systolic PAP: HR 1.17, 95%
CI 1.07-1.29), RV function (dichotomised: HR 1.86, 95% CI 1.45-2.38; per 5
mm decrease in TAPSE: HR 1.18, 95% CI 0.97-1.43) and TR (HR 1.51, 95% CI
1.28-1.79) indicated a significant association. Conclusion(s):
Prognosis after TMVR is worse in patients with significant MR when
concomitant PH, RV dysfunction, or TR are present. Careful assessment of
these parameters should therefore precede clinical decision-making for
TMVR. The current results encourage investigation into whether (1)
intervention at an earlier stage of MR reduces incidence of PH, RV
dysfunction, and TR; and (2) transcatheter treatment of concomitant TR can
improve clinical outcome and prognosis for these patients. Copyright
© 2021 The Author(s)

<45>
Accession Number
637750985
Title
Myocardial Protecting Role of Glutamine in Patients with Low Ejection
Fraction Undergoing Elective On-Pump Coronary Artery Bypass Graft Surgery.
Source
Vascular health and risk management. 18 (pp 219-231), 2022. Date of
Publication: 2022.
Author
Parmana I.M.A.; Boom C.E.; Rachmadi L.; Hanafy D.A.; Widyastuti Y.;
Mansyur M.; Siswanto B.B.
Institution
(Parmana, Boom) Department of Anesthesiology and Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Rachmadi) Department of Anatomical Pathology, Faculty of Medicine,
Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
(Hanafy) Department of Cardiothoracic and Vascular Surgery, Faculty of
Medicine, Universitas Indonesia/National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
(Widyastuti) Department of Anesthesiology and Intensive Care, Universitas
Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
(Mansyur) Department of Community Medicine, Faculty of Medicine,
Universitas Indonesia, Jakarta, Indonesia
(Siswanto) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Indonesia/National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
Publisher
NLM (Medline)
Abstract
Purpose: Myocardial injury due to on-pump coronary artery bypass grafting
(CABG) in patients with low ejection fraction (EF) is associated with poor
outcomes. This study determines whether intravenous glutamine could
protect the myocardium during on-pump CABG in patients with low EF.
 Material(s) and Method(s): This was a double-blind, randomized
controlled trial to assess glutamine as a myocardial protector during
on-pump CABG in patients with left ventricle EF of 31-50%, conducted from
January to October 2021. Patients in the glutamine group (n = 30) received
0.5 g/kg of 20% glutamine solution diluted with 0.9% NaCl up to 500 mL in
total volume over a period of 24 hours. Patients in the control group (n =
30) received 0.9% NaCl over the same period. The primary outcomes were
plasma troponin I and plasma glutamine levels. Secondary outcomes included
alpha-ketoglutarate (alpha-KG) levels and histopathology scoring of the
right atrial appendage tissue, plasma lactate levels, hemodynamic
measurement, and morbidity. Result(s): Twenty-nine patients from each
group (58 in total) were included in the analysis. Plasma troponin I
levels at 6 and 24 hours after cardiopulmonary bypass (CPB) were
significantly lower in the glutamine than the control group (mean 3.43 +/-
1.51 ng/mL vs mean 4.41 +/- 1.89 ng/mL; p = 0.034; median 3.08 ng/mL
[min-max: 1.30-6.59] vs median 3.77 ng/mL [min-max: 0.00-36.53]; p =
0.038, respectively). Plasma glutamine levels at 24 hours after CPB were
significantly higher in the glutamine than the control group (mean 935.42
+/- 319.10 mumol/L vs mean 634.79 +/- 243.89 mumol/L, p = 0.001). Plasma
lactate levels at 6 and 24 hours after CPB were significantly lower in the
glutamine than the control group (median 5.30 mmol/L [min-max: 1.20-9.50]
vs median 5.70 mmol/L [min-max: 2.80-11.30], p = 0.042; mean 2.08 +/- 0.67
mmol/L vs mean 2.46 +/- 0.69 mmol/L, p = 0.044, respectively). Myocardial
injury score was significantly lower in the glutamine than the control
group (mean 1.30 +/- 0.24 vs mean 1.48 +/- 0.26, p = 0.011).
 Conclusion(s): Perioperative administration of 0.5 g/kg intravenous
glutamine solution over the period of 24 hours has myocardial protection
effect in patients with low EF who undergo elective on-pump
CABG. Copyright © 2022 Parmana et al.

<46>
Accession Number
637749679
Title
Human albumin and 6% hydroxyethyl starches (130/0.4) in cardiac surgery: a
meta-analysis revisited.
Source
BMC surgery. 22(1) (pp 140), 2022. Date of Publication: 12 Apr 2022.
Author
Wiedermann C.J.
Institution
(Wiedermann) Institute of General Practice and Public Health, Claudiana
College of Health Professions, Lorenz Bohler Street 13, Bolzano 39100,
Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: A meta-analysis of randomized controlled trials was recently
published in BMC Surgery that compared the use of human albumin with 6%
hydroxyethyl starches 130/0.4 for cardiopulmonary bypass prime and
perioperative fluid management in pediatric and adult cardiac surgery
patients. The two plasma expanding solutions are described as equivalent
for efficacy and safety outcomes, and, on that basis, the preferential use
of hydroxyethyl starches 130/0.4 was recommended for economic reasons
because of the higher unit costs of human albumin solutions.
 RESULT(S): In addition to the fact that trials were mostly small,
single-center studies and the number of total participants was low, making
the meta-analysis underpowered for several outcomes, selective reporting
of data for ICU length of stay was identified. Re-calculation of
statistics at higher precision showed that ICU length of stay of patients
in the human albumin group was significantly shorter than that of patients
in the 6% hydroxyethyl starches 130/0.4 group (standard mean difference -
0.181, 95% confidence interval - 0.361 to - 0.001, P=0.049), which may
offset any proposed economic advantage of using 6% hydroxyethyl starches
130/0.4. At the same time, the renal safety of 6% hydroxyethyl starches
130/0.4 in surgical patients is under regulatory review.
 CONCLUSION(S): Underpowered trials and selective reporting may impair
the validity of the meta-analysis. A more cautious conclusion about the
interchangeability between human albumin and 6% hydroxyethyl starches
130/0.4 in cardiac surgery should have been reached. Copyright ©
2022. The Author(s).

<47>
Accession Number
2015537081
Title
Machine Perfusion for Human Heart Preservation: A Systematic Review.
Source
Transplant International. 35 (no pagination), 2022. Article Number: 10258.
Date of Publication: 21 Mar 2022.
Author
Qin G.; Jernryd V.; Sjoberg T.; Steen S.; Nilsson J.
Institution
(Qin, Jernryd, Sjoberg, Steen, Nilsson) Department of Clinical Sciences
Lund, Cardiothoracic Surgery, Lund University and Skane University
Hospital, Lund, Sweden
(Nilsson) Department of Translational Medicine, Thoracic Surgery and
Bioinformatics, Lund University, Lund, Sweden
Publisher
European Society for Organ Transplantation
Abstract
Currently, static cold storage (SCS) of hearts from donations after
brainstem death remains the standard clinically. However, machine
perfusion (MP) is considered an approach for donor organ management to
extend the donor pool and/or increase the utilization rate. This review
summarizes and critically assesses the available clinical data on MP in
heart transplantation. We searched Medline (PubMed), Cochrane, Embase, and
clinicaltrials.gov, along with reference lists of the included
publications and identified 40 publications, including 18 articles, 17
conference abstracts, and five ongoing clinical trials. Two types of MP
were used: hypothermic MP (HMP) and normothermic MP (NMP). Three studies
evaluated HMP, and 32 evaluated NMP. Independent of the system, MP
resulted in clinical outcomes comparable to traditional SCS. However, NMP
seemed especially beneficial for high-risk cases and donation after
circulatory death (DCD) hearts. Based on currently available data, MP is
non-inferior to standard SCS. Additionally, single-centre studies suggest
that NMP could preserve the hearts from donors outside standard
acceptability criteria and DCD hearts with comparable results to SCS.
Finally, HMP is theoretically safer and simpler to use than NMP. If a
machine malfunction or user error occurs, NMP, which perfuses a beating
heart, would have a narrower margin of safety. However, further
well-designed studies need to be conducted to draw clear
conclusions. Copyright © 2022 Qin, Jernryd, Sjoberg, Steen and
Nilsson.

<48>
Accession Number
2017653540
Title
Effect of Different Nursing Interventions on Discharged Patients with
Cardiac Valve Replacement Evaluated by Deep Learning Algorithm-Based MRI
Information.
Source
Contrast Media and Molecular Imaging. 2022 (no pagination), 2022. Article
Number: 6331206. Date of Publication: 2022.
Author
Zhang J.; Zhou Q.
Institution
(Zhang) Department of Cardiology Second Ward, Jingzhou First People's
Hospital, No. 8 Hangkang Road, Hubei Province, Jingzhou 434000, China
(Zhou) Department of Cardiology Third Ward, Jingzhou First People's
Hospital, No. 8 Hangkang Road, Hubei Province, Jingzhou 434000, China
Publisher
Hindawi Limited
Abstract
This study was aimed to explore the application of cardiac magnetic
resonance imaging (MRI) image segmentation model based on U-Net in the
diagnosis of a valvular heart disease. The effect of continuous nursing on
the survival of discharged patients with cardiac valve replacement was
analyzed in this study. In this study, the filling completion operation,
cross entropy loss function, and guidance unit were introduced and
optimized based on the U-Net network. The heart MRI image segmentation
model ML-Net was established. We compared the Dice, Hausdorff distance
(HD), and percentage of area difference (PAD) values between ML-Net and
other algorithms. The MRI image features of 82 patients with valvular
heart disease who underwent cardiac valve replacement were analyzed.
According to different nursing methods, they were randomly divided into
the control group (routine nursing) and the intervention group (continuous
nursing), with 41 cases in each group. The Glasgow Outcome Scale (GOS)
score and the Self-rating Anxiety Scale (SAS) were compared between the
two groups to assess the degree of anxiety of patients and the survival
status at 6 months, 1 year, 2 years, and 3 years after discharge. The
results showed that the Dice coefficient, HD, and PAD of the ML-Net
algorithm were (0.896 +/- 0.071), (5.66 +/- 0.45) mm, and (15.34 +/- 1.22)
%, respectively. The Dice, HD, and PAD values of the ML-Net algorithm were
all statistically different from those of the convolutional neural
networks (CNN), fully convolutional networks (FCN), SegNet, and U-Net
algorithms P<0.05. Atrial, ventricular, and aortic abnormalities can be
seen in MRI images of patients with valvular heart disease. The cardiac
blood flow signal will also be abnormal. The GOS score of the intervention
group was significantly higher than that of the control group P<0.01. The
SAS score was lower than that of the control group P<0.05. The survival
rates of patients with valvular heart disease at 6 months, 1 year, 2
years, and 3 years after discharge were significantly higher than those in
the control group P<0.05. The abovementioned results showed that an
effective segmentation model for cardiac MRI images was established in
this study. Continuous nursing played an important role in the
postoperative recovery of discharged patients after cardiac valve
replacement. This study provided a reference value for the diagnosis and
prognosis of valvular heart disease. Copyright © 2022 Jing Zhang
and Qiong Zhou.

<49>
Accession Number
2015519623
Title
Twelve-Month Cognitive and Functional Outcomes Following Cardiac Surgery:
The DEXACET Trial of Intravenous Acetaminophen Versus Placebo.
Source
Frontiers in Pharmacology. 13 (no pagination), 2022. Article Number:
803903. Date of Publication: 22 Mar 2022.
Author
Khera T.; Helfand J.; Kelly L.; Mueller A.; Shankar P.; Marcantonio E.R.;
Subramaniam B.
Institution
(Khera, Helfand, Kelly, Mueller, Shankar, Subramaniam) Center for
Anesthesia Research Excellence, Department of Anesthesia, Critical Care
and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA,
United States
(Mueller) Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Marcantonio) Department of Medicine, Divisions of General Medicine and
Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School,
Boston, MA, United States
Publisher
Frontiers Media S.A.
Abstract
Background: Delirium, an acute decline in attention and global cognitive
dysfunction, occurs frequently following cardiac surgery and has been
demonstrated to be significantly associated with cognitive dysfunction and
reduced functional ability. In the DEXACET trial, we demonstrated a
significant reduction in postoperative in-hospital delirium with
intravenous (IV) acetaminophen when compared with placebo. In this
analysis we examined whether this protective association also extended to
12 month cognitive and functional outcomes. Method(s): This study was
a prospective, randomized, placebo-controlled, triple-blinded, factorial
design trial conducted at Beth Israel Deaconess Medical Center, approved
by the IRB. In this trial, 120 older cardiac surgical patients were
randomly assigned to receive either intravenous (IV) acetaminophen or
placebo in addition to propofol or dexmedetomidine. Those receiving IV
acetaminophen displayed a significant reduction in in-hospital delirium.
We collected cognitive, mood and functional outcome data using the
Montreal Cognitive Assessment, telephone version (T-MoCA), Geriatric
Depression Scale (GDS) and the Basic and Instrumental Activities of Daily
Living (ADLs, IADLs) at 1 month and 12 months after surgery.
 Result(s): Of the 120 enrolled patients in the primary trial, 93
(77.5%) and 83 (69.2%) patients responded to assessments at 1 month and 12
months, respectively. No statistically significant differences in median
T-MoCA scores were observed between acetaminophen and placebo groups at 1
month (18.0 vs.18.0, p = 0.52) or 12 months (19.0 vs.18.0, p = 0.62)
following surgery. There were similarly no differences in GDS, ADLs or
IADLs between treatment groups. Losses to follow-up limited the sample
sizes and 10 of the 23 (45%) original study participants who had
postoperative delirium were lost to follow up. Conclusion(s):
Administration of intravenous acetaminophen was not associated with a
difference in long term cognitive or functional status following cardiac
surgery. Additional research on long-term outcomes following postoperative
delirium with a larger sample size and improved cohort retention
strategies will be needed to address this important area. Copyright
© 2022 Khera, Helfand, Kelly, Mueller, Shankar, Marcantonio and
Subramaniam.

<50>
Accession Number
637772146
Title
The Hybrid Convergent Procedure for Persistent and Long-Standing
Persistent Atrial Fibrillation From an Electrophysiologist's Perspective.
Source
Journal of cardiovascular electrophysiology. (no pagination), 2022. Date
of Publication: 14 Apr 2022.
Author
DeLurgio D.B.
Institution
(DeLurgio) Emory University, St. Joseph's Hospital
Publisher
NLM (Medline)
Abstract
In atrial fibrillation (AF), the pulmonary veins (PV) are central to
arrhythmogenicity and are targeted by PV isolation (PVI). As AF
progresses, triggers become more prevalent in non-PV areas including the
left atrial posterior wall (LAPW). Reported benefits of LAPW isolation in
Cox-maze IV led to exploration of ablation strategies using endocardial
catheters. However, no single approach to endocardial LAPW isolation
exists. Relative success in comparison to PVI alone has been mixed. The
hybrid convergent procedure was developed to combine minimally invasive
surgical and electrophysiology techniques to accomplish effective PVI and
LAPW isolation. Epicardial LAPW isolation is performed by a cardiothoracic
surgeon followed by endocardial ablation by an electrophysiologist who
ensures PVI completion and targets any remaining gaps. Safety and
effectiveness of hybrid convergent was evaluated in the prospective,
multi-center, randomized controlled trial, Convergence of Epicardial and
Endocardial Ablation for the Treatment of Symptomatic Persistent AF
(CONVERGE). CONVERGE compared the effectiveness of the hybrid convergent
procedure to endocardial catheter ablation for treatment of
drug-refractory persistent and longstanding persistent AF and demonstrated
primary effectiveness of higher freedom from atrial arrhythmias absent
new/increased dose previously failed/intolerant anti-arrhythmic drugs
through 12 months compared to endocardial catheter ablation. Greater
freedom from AF and proportion of patients experiencing >=90% burden
reduction with hybrid convergent ablation were seen through 18 months
follow-up. Improved electrophysiology lab efficiency was demonstrated by
the reduction in endocardial ablation time with addition of epicardial
ablation. This multi-disciplinary heart team procedure may improve
outcomes in difficult-to-treat patients with advanced AF. This article is
protected by copyright. All rights reserved.

<51>
Accession Number
637760264
Title
Effects of postoperative cognitive training on neurocognitive decline
after heart surgery: A randomized clinical trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 12 Apr 2022.
Author
Butz M.; Gerriets T.; Sammer G.; El-Shazly J.; Tschernatsch M.; Huttner
H.B.; Braun T.; Boening A.; Mengden T.; Choi Y.-H.; Schoenburg M.;
Juenemann M.
Institution
(Butz, Gerriets, Sammer, Tschernatsch, Braun, Schoenburg, Juenemann) Heart
and Brain Research Group, Kerckhoff Heart and Thorax Center, Benekestrase
2-8, 61231, Bad Nauheim, Germany and Department of Neurology, University
Hospital Giessen and Marburg, Klinikstrase 33, 35385, Giessen, Germany
(Butz, Gerriets, Tschernatsch, Huttner, Braun, Juenemann) Department of
Neurology, University Hospital Giessen and Marburg, Klinikstrase 33,
Giessen 35385, Germany
(Sammer) Cognitive Neuroscience at the Center of Psychiatry, University
Giessen, Klinikstrase 36, Giessen 35385, Germany
(Sammer) Department of Psychology, Justus-Liebig University, Giessen
35392, Germany
(El-Shazly) Department of Psychocardiology, Kerckhoff Heart and Thorax
Center, Bad Nauheim 61231, Germany
(Boening) Department of Cardiovascular Surgery, University Hospital
Giessen and Marburg, Rudolf-Buchheim-Strase 7, Giessen 35385, Germany
(Mengden) Department of Rehabilitation, Kerckhoff Heart and Thorax Center,
Bad Nauheim 61231, Germany
(Choi, Schoenburg) Department of Cardiac Surgery, Kerckhoff Heart and
Thorax Center, Benekestrase 2-8, Bad Nauheim 61231, Germany
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Following cardiac surgery, postoperative cognitive decline
(POCD) is a common complication that can impair quality of life and
increase mortality. The aim of this study was to investigate whether early
postoperative cognitive training can decrease POCD after cardiac surgery.
 METHOD(S): The study was a multi-centered, 2-arm, randomized (1:1
ratio), controlled trial involving older patients undergoing elective
heart valve surgery with extracorporeal circulation. Recruitment took
place at the Departments of Cardiac Surgery of the Kerckhoff-Clinic in Bad
Nauheim (Germany) and the University-Hospital in Giessen (Germany). The
patients were randomized to either a paper-and-pencil-based cognitive
training group or a standard rehabilitation care control group. The
cognitive training started 1week after surgery and lasted about 3weeks
until discharge from rehabilitation. To detect POCD, neuropsychological
functions were assessed prior to surgery, upon discharge from
rehabilitation (primary outcome), and 3months after discharge (secondary
outcome). Data were primarily analyzed in a per-protocol fashion.
 RESULT(S): The frequency of POCD at discharge from rehabilitation
(training group, n=37; control group, n=44) was 50% in the control group
and 19% in the training group (chi2[1]=8.45, p=0.004; OR=4.29, 95% CI
[1.56-11.80]). Three months after the cognitive training (training group,
n=33; control group, n=34), POCD frequency was 29% in the control group
and 6% in the training group (chi2[1]=6.21, p=0.013; OR=6.46, 95% CI
[1.29-32.28]). CONCLUSION(S): Since our cognitive training showed
beneficial effects, it could be a promising method to prevent
POCD. Copyright © The Author(s) 2022. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<52>
Accession Number
2017710600
Title
Leaflet Resection vs Preservation for Degenerative Mitral Regurgitation:
Functional Outcomes and Mitral Stenosis at 12 Months in a Randomized
Trial.
Source
Canadian Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Hibino M.; Pandey A.; Chan V.; Mazer C.D.; Dhingra N.K.; Bonneau C.; Verma
R.; Quan A.; Teoh H.; Cheema A.; Yanagawa B.; Leong-Poi H.; Connelly K.A.;
Bisleri G.; Verma S.
Institution
(Hibino, Dhingra, Quan, Teoh, Yanagawa, Bisleri, Verma) Division of
Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael's Hospital,
Toronto, ON, Canada
(Hibino, Yanagawa, Bisleri, Verma) Department of Surgery, University of
Toronto, ON, Canada
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Chan) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Chan) School of Epidemiology, Public Health and Preventive Medicine,
University of Ottawa, Ottawa, Ontario, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute of St
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, ON, Canada
(Mazer, Connelly) Department of Physiology, University of Toronto,
Toronto, ON, Canada
(Bonneau) Division of Cardiac Surgery, McGill University, Montreal, QC,
Canada
(Verma) Royal College of Surgeons in Ireland, Dublin, Ireland
(Teoh) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute of St Michael's Hospital, Toronto, ON, Canada
(Cheema) Division of Cardiology, Southlake Regional Health Centre,
Newmarket, ON, Canada
(Leong-Poi, Connelly) Division of Cardiology, Li Ka Shing Knowledge
Institute of St Michael's Hospital, Toronto, ON, Canada
(Leong-Poi, Connelly) Department of Medicine, University of Toronto, ON,
Canada
(Verma) Department of Pharmacology and Toxicology, University of Toronto,
ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Mitral valve repair is the gold standard treatment for
degenerative mitral regurgitation (MR). The Canadian Mitral Research
Alliance (CAMRA) CardioLink-2 trial showed no significant association
between repair strategy, that is, leaflet resection vs preservation, and
risk of functional mitral stenosis. In this subanalysis, we compared
outcomes and functional tests at 12 months. Method(s): CAMRA
CardioLink-2 was a multicentre randomized controlled trial that allocated
patients with degenerative MR and posterior leaflet prolapse to leaflet
resection (n = 54) or preservation (n = 50). Stress echocardiography and
functional status assessments, including the 6-minute walk test, were
compared 12 months after repair. Result(s): Baseline demographics,
stress echocardiographic findings, and mitral annuloplasty prosthesis size
(33.0 +/- 3.0 vs 33.6 +/- 3.4 mm; P = 0.4) were similar between the two
groups. There were no readmissions for heart failure or deaths during the
follow-up period. At 12 months, a larger percentage of patients were in
NYHA functional class >= 2 in the resection group compared with the
preservation group (P = 0.01). Exercise capacity, rate-pressure product,
6-minute walk distance, and mean mitral valve gradients were not
significantly different between the groups at 12 months. A more prominent
increase in mean mitral gradient with smaller annuloplasty sizes was
observed in the resection group at both rest (P = 0.03) and peak exercise
(P = 0.005) in the linear regression model. Conclusion(s): At 12
months, there were no significant differences in mitral valve gradient,
exercise capacity, and 6-minute walk test between repair strategies.
Leaflet preservation may offer a larger mitral valve orifice with improved
gradients in patients requiring smaller annuloplasty sizes. Copyright
© 2022 Canadian Cardiovascular Society

<53>
Accession Number
2017692196
Title
Robotic cardiac surgery training during residency: Preparing residents for
the inevitable future.
Source
Laparoscopic, Endoscopic, and Robotic Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Vinck E.E.; Smood B.; Barros L.; Palmen M.
Institution
(Vinck) Department of Cardiovascular Surgery, Cardio VID Clinic,
Pontifical Bolivarian University, Medellin, Colombia
(Smood) Department of Surgery, Division of Cardiothoracic Surgery,
University of Pennsylvania, PA, United States
(Barros) Department of Cardiovascular Surgery, Santa Casa of Sao Paulo,
Sao Paulo, Brazil
(Palmen) Department of Cardiothoracic Surgery, Leiden University Medical
Center, Leiden, Netherlands
Publisher
KeAi Communications Co.
Abstract
Unlike other surgical residency training programs including thoracic
surgery, robotic cardiac surgery skill training is minimal or absent in
residency curricula. A review was conducted to identify residents'
exposure to robotic cardiac surgery training based on databases including
PubMed, MEDLINE and Google Scholar. Published papers and cardiothoracic
surgical societies with robotic cardiac surgery training courses were
reviewed. Robotic cardiac surgery training for residents is almost
non-existent. Strategies to establish proper robotic cardiac surgical
training for residents include, implementing simulation training,
implementing hour requirements and establishing wet/dry lab model training
in a progressive fashion. As robot-assisted cardiac surgery becomes
increasingly commonplace, it will be imperative to provide cardiothoracic
surgery training for residents with dedicated opportunities to develop
their skills in robotic cardiac surgery. Copyright © 2022
Zhejiang University

<54>
Accession Number
2015323677
Title
Efficacy and safety of rhomboid intercostal block for analgesia in breast
surgery and thoracoscopic surgery: a meta-analysis.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 71. Date
of Publication: December 2022.
Author
Chen R.; Su S.; Shu H.
Institution
(Chen, Shu) Department of Anesthesiology, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Second
Road, Yuexiu District, Guangdong, Guangzhou 510080, China
(Chen, Su, Shu) The Second School of Clinical Medicine, Southern Medical
University, 106 Zhongshan Second Road, Yuexiu District, Guangdong,
Guangzhou 510080, China
Publisher
BioMed Central Ltd
Abstract
Background: Rhomboid intercostal block (RIB) is a new regional anesthesia
technique that provides postoperative analgesia for breast surgery and
thoracoscopic surgery. The published papers are not yet fully integrated
and do not adequately address the impact and safety of the RIB on
postoperative pain. Method(s): The PubMed, Web of Science and Embase
were searched from 2016 to 2021 for all available randomized controlled
trials (RCTs) that evaluated the analgesic efficacy and safety of RIB
after thoracic surgery and breast surgery. Random and fixed-effects
meta-analytical models were used where indicated, and between-study
heterogeneity was assessed. The primary outcome was Postoperative
Numerical Rating Scale (NRS) scores of patients at rest recorded 0-1, 6-8,
24 h after surgery. The secondary outcomes included rate of postoperative
nausea and vomiting (PONV), postoperative fentanyl consumption and
presence of complications of the block. Result(s): From 81 records
identified, four studies met our inclusion criteria, including 216
patients (RIB:108 patients; no block: 108 patients). In the primary
outcome, RIB group showed significantly lower postoperative NRS at rest at
first 0-1 h and 6-8 h (weighted mean difference [WMD] = -1.55; 95%
confidence internal [CI] = -2.92 to -0.19; p < 0.05), (WMD = -0. 69; 95%
CI = -1.29 to -0. 09; p < 0. 05). And there was no significant difference
between groups in NRS at rest at 24 h (WMD = -0.78; 95% CI = -1.64 to
-0.08; p = 0.77). Also, RIB group showed significantly lower postoperative
NRS of breast surgery and thoracoscopic surgery at 0-1 h (WMD = -3.00; 95%
CI = -3.13 to -2.87; p < 0.01), (WMD = -1.08; 95% CI = -1.98 to -0.18; p <
0.05). In the secondary outcome, the analysis also showed RIB group had
significant lower of POVN rates (summary relative risk (RR) = 0.212;95%CI
= 0.10 to 0.45; p < 0. 01) and the postoperative consumption of fentanyl
(WMD = -57.52;95%CI = -106.03 to -9.02; p < 0. 05). Conclusion(s):
This review shows that RIB was more effective in controlling acute pain
after breast surgery and thoracoscopic surgery than general analgesia. And
it is a trend that RIB may be a kind of effective and safe nerve bock
technology and it requires further studies. Copyright © 2022, The
Author(s).

<55>
Accession Number
2013355908
Title
Effects of continuous erector spinae plane block on postoperative pain in
video-assisted thoracoscopic surgery: a randomized controlled study.
Source
General Thoracic and Cardiovascular Surgery. 70(1) (pp 64-71), 2022. Date
of Publication: January 2022.
Author
Piskin O.; Gokce M.; Altinsoy B.; Baytar C.; Aydin B.G.; Okyay R.D.;
Kucukosman G.; Bollucuoglu K.; Ayoglu H.
Institution
(Piskin, Baytar, Aydin, Okyay, Kucukosman, Bollucuoglu, Ayoglu) Department
of Anesthesiology and Reanimation, School of Medicine, Zonguldak Bulent
Ecevit University, Zonguldak, Turkey
(Gokce) Department of Thoracic Surgery, School of Medicine, Zonguldak
Bulent Ecevit University, Zonguldak, Turkey
(Altinsoy) Department of Pulmonary Medicine, School of Medicine, Zonguldak
Bulent Ecevit University, Zonguldak, Turkey
Publisher
Springer Japan
Abstract
Background: The aim of this prospective, randomized, controlled study was
to evaluate the analgesic effect of ultrasonography (USG) guided
continuous erector spinae plane block (ESPB) for postoperative analgesia
in video-assisted thoracoscopic surgery (VATS). Method(s): Eighty
American Society of Anesthesiologists (ASA) physical status I-III patients
aged 18-75 and who were to undergo VATS were included in this study.
Randomization was performed in 2 groups, continuous ESPB (ESPB Group) and
no intervention (Control Group). 20 mL of 0.25% bupivacaine was
administered for the block. Immediately after surgery, the patient
received continuous infusion of 0.125% bupivacaine at 4 mL h-1
via the catheter inserted for the block. Patients in both groups received
tramadol via an intravenous patient-controlled analgesia device. Tramadol
and meperidine consumption, visual analog scale pain scores and
opioid-related side effects were recorded at 0, 1, 4, 8, 12, 24, 36, and
48 h postoperatively. Result(s): The use of continuous ESPB in VATS
significantly decreased the amount of tramadol used in the first 48 h
postoperatively (P < 0.001). There was a statistically significant
difference in the number of meperidine rescue analgesia administered
between the ESPB and Control Groups (P < 0.001). While the incidences of
nausea and itching were higher in Control Group, there were no differences
in terms of the other side effects between the groups. Conclusion(s):
This study shows that USG-guided continuous ESPB provides adequate
analgesia following VATS as part of multimodal analgesia. Continuous ESPB
significantly reduced opioid consumption and opioid-related side effects
compared to those in the Control Group. Copyright © 2021, The
Japanese Association for Thoracic Surgery.

<56>
Accession Number
2016425199
Title
Stroke in Male-to-Female Transgenders: A Systematic Review and
Meta-Analysis.
Source
Canadian Journal of Neurological Sciences. 49(1) (pp 76-83), 2022. Date of
Publication: 26 Jan 2022.
Author
Ignacio K.H.D.; Diestro J.D.B.; Espiritu A.I.; Pineda-Franks M.C.
Institution
(Ignacio, Espiritu, Pineda-Franks) Department of Neurosciences, College of
Medicine and Philippine General Hospital, University of the Philippines
Manila, Manila, Philippines
(Diestro) Department of Medical Imaging, Division of Diagnostic and
Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto,
Toronto, ON, Canada
(Diestro) Departement de Radiologie, Radio-oncologie et Medecine
Nucleaire, Centre Hospitalier de l'Universite de Montreal, Universite de
Montreal, Montreal, QC, Canada
(Espiritu) Department of Clinical Epidemiology, College of Medicine,
University of the Philippines Manila, Manila, Philippines
Publisher
Cambridge University Press
Abstract
Background: The effect of hormonal therapy has been extensively studied in
women. However, similar data on male-to-female (MTF) transgenders, another
important population that receives hormonal therapy is lacking. Existing
studies in MTF transgenders are skewed toward mental health and
health-harming behaviors while few have focused on chronic health
conditions. Our study aims to review the existing data on stroke in MTF
transgenders and perform a quantitative analysis on the frequency of this
condition in this special population. Method(s): PubMed, Cochrane,
Scopus, Embase, ClinicalTrials.gov, and Web of Science were systematically
searched for studies that reported data on the occurrence of
cerebrovascular diseases in MTF transgenders. We reported the hormonal
regimens, clinical characteristics, and outcomes of stroke in MTF
transgenders. A meta-analysis of proportions was performed by the
random-effects model to compute for the frequency of cerebrovascular
events in MTF transgenders. Result(s): Fourteen studies were included
in the qualitative analysis while five studies were included in the
quantitative analysis. A total of 109 MTF transgenders (Mean 14; range
1-53) suffered a cerebrovascular event. Random-effect modeling analysis
showed an overall estimated frequency of 2% for cerebrovascular events in
transgenders with a moderate degree of heterogeneity (I2 = 62%).
 Conclusion(s): Hormonal therapy in MTF transgenders may confer
cardiovascular risks in this population. However, more population-based
studies that include clinical characteristics and outcomes of chronic
health diseases in MTF transgenders are warranted. Such studies may be
crucial in directing future guidelines on the health care and management
of MTF transgenders. Copyright ©

<57>
Accession Number
2015194972
Title
Effect of intensive versus limited monitoring on clinical trial conduct
and outcomes: A randomized trial.
Source
American Heart Journal. 243 (pp 77-86), 2022. Date of Publication: January
2022.
Author
Butala N.M.; Song Y.; Shen C.; Cohen D.J.; Yeh R.W.
Institution
(Butala, Song, Shen, Yeh) Richard A. and Susan F. Smith Center for
Outcomes Research in Cardiology, Division of Cardiovascular Medicine, Beth
Israel Deaconess Medical Center, Boston, MA
(Butala) Department of Medicine, Cardiology Division, Massachusetts
General Hospital, Boston, MA
(Butala, Yeh) Harvard Medical School, Boston, MA
(Shen) Biogen Inc., Cambridge, MA
(Cohen) Cardiovascular Research Foundation, New York, NY
(Cohen) St. Francis Hospital, Roslyn, NY
Publisher
Elsevier Inc.
Abstract
Background: Regulatory agencies have endorsed more limited approaches to
clinical trial site monitoring. However, the impact of different
monitoring strategies on trial conduct and outcomes is unclear.
 Method(s): We conducted a patient-level block-randomized controlled
trial evaluating the effect of intensive versus limited monitoring on
cardiovascular clinical trial conduct and outcomes nested within the
CoreValve Continued Access and Expanded Use Studies. Intensive monitoring
included complete source data verification of all critical datapoints
whereas limited monitoring included automated data checks only. This
study's endpoints included clinical trial outcome ascertainment as well as
monitoring action items, protocol deviations, and adverse event
ascertainment. Result(s): A total of 2,708 patients underwent
transcatheter aortic valve replacement (TAVR) and were randomized to
either intensive monitoring (n = 1,354) or limited monitoring (n = 1,354).
Monitoring action items were more common with intensive monitoring (52% vs
15%; P <.001), but there was no difference in the percentage of patients
with any protocol deviation (91.6% vs 90.4%; P =.314). The reported
incidence of trial outcomes between intensive and limited monitoring was
similar for mortality (30 days: 4.8% vs 5.5%, P =.442; 1 year: 20.3% vs
21.3%, P =.473) and stroke (30 days: 2.8% vs 2.4%, P =.458), as well as
most secondary trial outcomes with the exception of bleeding (intensive:
36.3% vs limited: 32.0% at 30 days, P =.019). There was a higher reported
incidence of cardiac adverse events reported in the intensive monitoring
group at 1 year (76.7% vs 72.4%; P =.019). Conclusion(s): Tailored
limited monitoring strategies can be implemented without influencing the
integrity of TAVR trial outcomes. Copyright © 2021 Elsevier Inc.

<58>
Accession Number
2010182627
Title
A systematic review and meta-analysis of delayed coronary artery access
for coronary angiography with or without percutaneous coronary
intervention (PCI) in patients who underwent transcatheter aortic valve
replacement (TAVR).
Source
Cardiovascular Intervention and Therapeutics. 37(1) (pp 167-181), 2022.
Date of Publication: January 2022.
Author
Diaz M.A.; Patton M.; Valdes P.; Vieira J.L.; Rmeileh A.; Macedo F.Y.
Institution
(Diaz, Patton, Valdes, Rmeileh, Macedo) Division of Cardiology, Department
of Internal Medicine, Palmetto General Hospital, 2001 W 68th St, Hialeah,
FL 33016, United States
(Vieira) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
Springer Japan
Abstract
Coronary artery disease (CAD) and severe aortic valve stenosis frequently
coexist. Given the progressive nature of CAD, silent or non-significant
CAD may become symptomatic or functionally relevant years after TAVR.
However, there is a paucity of data documenting the feasibility of either
coronary angiography and/or PCI after TAVR. We systematically searched
Medline, Pubmed, Embase, Cochrane database, Google Scholar, Science
Direct, Web of Science, and conference abstracts from conception to March
2020 using OvidSP in TAVR patients undergoing coronary angiography with or
without PCI at least 6 months after TAVR. Patients and procedural
characteristics were summarized. The primary outcome of interest was
successful coronary angiography for either the left main coronary artery
(LMCA) or right coronary artery (RCA) with or without PCI. Pooled
estimates were calculated using a random-effects meta-analysis. The study
protocol was registered in PROSPERO. Eleven reports for a total of 696
coronary angiograms and 287 PCI were included in the analysis. Patients
were slightly predominantly male, older and had a mean left ventricular
ejection fraction of more than 50% with an intermediate STS. The summary
estimate rates of successful LMCA and RCA angiography with a Medtronic
self-expandable valve (SEV) were 84% (95% CI 73-90%, I2 = 79, p
= 0.015) and 69% (95% CI 37-89%, I2 = 86, p = 0.23),
respectively, while with the Edwards Lifesciences balloon expandable valve
(BEV), the summary estimate rates for successful LMCA and RCA angiography
were 94% (95% CI 72-99%, I2 = 66, p = 0.003) and 95% (95% CI
48-99%, I2 = 83, p = 0.05), respectively. The summary estimate
rate of successful PCI post TAVR with either a Medtronic SEV or Edwards
Lifesciences BEV was 93% (95% CI 86-96%, I2 = 33, p = 0.0001).
The overall achievement of a successful coronary angiography with or
without PCI in post-TAVR patients is high, with a lower success rate for
RCA angiography in patients with the Medtronic SEV Mortality and bleeding
did not differ in our analysis. Copyright © 2021, Japanese
Association of Cardiovascular Intervention and Therapeutics.

<59>
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. Copyright © 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<60>
Accession Number
2016135291
Title
Low-dose ticagrelor with or without acetylsalicylic acid in patients with
acute coronary syndrome: Rationale and design of the ELECTRA-SIRIO 2
trial.
Source
Cardiology Journal. 29(1) (pp 148-153), 2022. Article Number: 84307. Date
of Publication: 23 Feb 2022.
Author
Kubica J.; Adamski P.; Gorog D.A.; Kubica A.; Jilma B.; Budaj A.;
Siller-Matula J.M.; Gurbel P.A.; Alexopoulos D.; Badariene J.; Dabrowski
P.; Dudek D.; Giannitsis E.; Horszczaruk G.; Jaguszewski M.J.; James S.;
Jeong Y.-H.; Kryjak M.; Niezgoda P.; Ostrowska M.; Patti G.; Romanek J.;
Di Somma S.; Specchia G.; Tantry U.; Gasior M.; Tycinska A.; Wojakowski
W.; Buszko K.; Gil R.; Gruchala M.; Kasprzak J.; Kleinrok A.; Legutko J.;
Lesiak M.; Navarese E.P.
Institution
(Kubica, Adamski, Kubica, Niezgoda, Ostrowska, Buszko, Navarese) Collegium
Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Gorog) Postgraduate Medical School, University of Hertfordshire,
Stevenage, United Kingdom
(Gorog) Faculty of Medicine, National Heart and Lung Institute, Imperial
College, London, United Kingdom
(Jilma) Department of Clinical Pharmacology, Medical University of Vienna,
Austria
(Budaj) Center of Postgraduate Medical Education, Grochowski Hospital,
Warsaw, Poland
(Siller-Matula) Department of Experimental and Clinical Pharmacology,
Medical University of Warsaw, Poland
(Siller-Matula) Department of Cardiology, Medical University of Vienna,
Austria
(Gurbel, Tantry) Sinai Center for Thrombosis Research and Drug
Development, Sinai Hospital, LifeBridge Health System, Baltimore, MD,
United States
(Alexopoulos) National and Kapodistrian University of Athens Medical
School, Attikon University Hospital, Athens, Greece
(Badariene) Clinic of Cardiac and Vascular Diseases, Institute of Clinical
Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
(Badariene) Center of Cardiology and Angiology, Vilnius University
Hospital Santaros Klinikos, Vilnius, Lithuania
(Dabrowski, Kleinrok) Department of Cardiology, The Pope John Paul II
Hospital, Zamosc, Poland
(Dudek) Institute of Cardiology, Jagiellonian University Medical College,
Krakow, Poland
(Dudek) Maria Cecilia Hospital, GVM Care and Research, Cotignola (RA),
Ravenna, Italy
(Giannitsis) Medizinische Klinik III, Department of Cardiology, Angiology
and Pulmology, University Hospital of Heidelberg, Germany
(Horszczaruk) Department of Cardiology, Voivodeship Hospital, Lomza,
Poland
(Jaguszewski, Gruchala) 1stDepartment of Cardiology, Medical University of
Gdansk, Poland
(James) Department of Medical Sciences and Uppsala Clinical Research
Center, Uppsala University Hospital, Uppsala, Sweden
(Jeong) Department of Internal Medicine, Gyeongsang National University,
School of Medicine and Cardiovascular Center, Gyeongsang National
University Changwon Hospital, Changwon, South Korea
(Kryjak) Department of Cardiology, The Doctor Sokolowski Hospital,
Walbrzych, Poland
(Patti) University of Eastern Piedmont, Maggiore della Carita Hospital,
Novara, Italy
(Romanek) Cardiology Department with the Acute Coronary Syndromes
Subdivision, Clinical Provincial Hospital No. 2, Faculty of Medicine,
University of Rzeszow, Poland
(Di Somma) Department of Medical-Surgery Sciences and Translational
Medicine, University La Sapienza, Rome, Italy
(Specchia) PaviaItaly
(Gasior) 3rdDepartment of Cardiology, Silesian Center for Heart Diseases,
Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze,
Poland
(Tycinska) Department of Cardiology, Medical University of Bialystok,
Poland
(Wojakowski) Division of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Gil) Department of Invasive Cardiology, Center of Postgraduate Medical
Education, Central Hospital of the Internal Affairs and Administration
Ministry, Warsaw, Poland
(Kasprzak) 1stDepartment and Chair of Cardiology, Medical University of
Lodz, Bieganski Hospital, Lodz, Poland
(Kleinrok) University of Information Technology and Management in Rzeszow,
Poland
(Legutko) Department of Interventional Cardiology, Institute of
Cardiology, Jagiellonian University Medical College and John Paul II
Hospital in Krakow, Poland
(Lesiak) Chair and 1stDepartment of Cardiology, Poznan University of
Medical Sciences, Poznan, Poland
Publisher
Via Medica

<61>
Accession Number
2015939512
Title
The Placebo Effect on Symptoms, Quality of Life, and Functional Outcomes
in Patients With Angina Pectoris: A Meta-analysis of Randomized
Placebo-Controlled Trials.
Source
Canadian Journal of Cardiology. 38(1) (pp 113-122), 2022. Date of
Publication: January 2022.
Author
Gallone G.; Baldetti L.; Angelini F.; Saglietto A.; Bellettini M.;
Beneduce A.; Ranotti V.; Chiarito M.; Leone P.P.; Pagnesi M.; De Filippo
O.; Landra F.; Bruno F.; Marengo G.; Collino M.; Ferrante G.; Stefanini
G.G.; Colombo A.; Al-Lamee R.; Francis D.P.; Jolicoeur M.E.; Henry T.D.;
Giannini F.; D'Ascenzo F.; De Ferrari G.M.
Institution
(Gallone, Angelini, Saglietto, Bellettini, De Filippo, Landra, Bruno,
Marengo, D'Ascenzo, De Ferrari) Division of Cardiology, Department of
Internal Medicine, Citta della Salute e della Scienza, Torino, Italy
(Baldetti, Beneduce, Pagnesi) Cardiac Intensive Care Unit, IRCCS San
Raffaele Scientific Institute, Milan, Italy
(Ranotti, Collino) Department of Drug Science and Technology, University
of Turin, Turin, Italy
(Chiarito, Leone, Ferrante, Stefanini) Department of Biomedical Sciences,
Humanitas University, Pieve Emanuele-Milan, Italy
(Colombo, Giannini) Interventional Cardiology Unit, GVM Care and Research,
Maria Cecilia Hospital, Cotignola, Italy
(Al-Lamee, Francis) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
(Jolicoeur) Department of Medicine, Montreal Heart Institute, Universite
de Montreal, Montreal, Quebec, Canada
(Henry) The Christ Hospital Heart and Vascular Center/The Lindner Center
for Research and Education, Cincinnati, Ohio, United States
Publisher
Elsevier Inc.
Abstract
Background: The placebo effect is a well described phenomenon in blinded
studies evaluating antianginal therapeutics, although its effect on
clinical research metrics remains unknown. We conducted a systematic
review and meta-analysis to quantify the effect of placebo on end points
of symptoms, life quality, and functional outcomes in randomized
placebo-controlled trials (RCTs) of symptomatic stable coronary artery
disease. Method(s): We systematically reviewed MEDLINE, EMBASE, and
the Cochrane database for double-blind RCTs of antiangina therapeutics.
Patients randomized to the placebo arm were the study population. Main
outcomes were the changes in exercise performance (exercise treadmill test
[ETT] parameters), quality of life (Seattle Angina Questionnaire domains),
symptoms (Canadian Cardiovascular Society angina class) and drug usage
(nitroglycerin tablets per week) between baseline and after placebo
treatment. The primary outcome was ETT total duration time. Data were
pooled with a random effect model. Result(s): Seventy-eight RCTs (83%
drug-controlled, 17% procedure-controlled) were included encompassing 4925
patients randomized to placebo. ETT total duration time was significantly
improved after placebo treatment compared with baseline (mean, 29.2; 95%
confidence interval, 20.6-37.8] seconds) with evidence of high
heterogeneity (I2 = 98%) At subgroup analysis, crossover design
was associated with a smaller placebo effect on ETT performance than
parallel study design (P for interaction = 0.001). A significant placebo
effect was observed for all secondary outcomes with overall high
heterogeneity. Conclusion(s): A substantial placebo effect was
present in angina RCTs across a variety of functional and life quality
metrics. High variability in placebo effect size was present, mostly
unexplained by differences in study and patient
characteristics. Copyright © 2021 Canadian Cardiovascular Society

<62>
Accession Number
2015811384
Title
Individualised or liberal red blood cell transfusion after cardiac
surgery: a randomised controlled trial.
Source
British Journal of Anaesthesia. 128(1) (pp 37-44), 2022. Date of
Publication: January 2022.
Author
Fischer M.-O.; Guinot P.-G.; Debroczi S.; Huette P.; Beyls C.; Babatasi
G.; Bafi K.; Guilbart M.; Caus T.; Lorne E.; Dupont H.; Hanouz J.-L.;
Diouf M.; Abou-Arab O.
Institution
(Fischer, Debroczi, Bafi, Hanouz) Normandy University, UNICAEN, CHU de
Caen Normandie, Service d'Anesthesie Reanimation, Caen, France
(Guinot) Department of Anesthesiology and Critical Care Medicine, Dijon
University Hospital, Dijon, France
(Huette, Beyls, Guilbart, Dupont, Abou-Arab) Department of Anesthesiology
and Critical Care Medicine, Amiens Picardy University Hospital, Amiens,
France
(Babatasi) Normandy University, UNICAEN, CHU de Caen Normandie, Department
of Cardiac Surgery, Caen, France
(Caus) Department of Cardiac Surgery, Amiens University Hospital, Amiens
Picardy University Hospital, Amiens, France
(Lorne) Department of Anesthesiology and Critical Care Medicine, Clinique
du Millenaire, Montpellier, France
(Diouf) Department of Biostatistics, Amiens Picardy University Hospital,
Amiens, France
Publisher
Elsevier Ltd
Abstract
Background: Current practice guidelines for red blood cell (RBC)
transfusion in ICUs are based on haemoglobin threshold, without
consideration of oxygen delivery or consumption. We aimed to evaluate an
individual physiological threshold-guided by central venous oxygen
saturation ScvO<inf>2</inf>. Method(s): In a randomised study in two
French academic hospitals, 164 patients who were admitted to ICU after
cardiac surgery with postoperative haemoglobin <9 g dl-1 were
randomised to receive a transfusion with one unit of RBCs (haemoglobin
group) or transfusion only if the ScvO<inf>2</inf> was <70%
(individualised group). The primary outcome was the number of subjects
receiving at least one unit of RBCs. The secondary composite outcome was
acute kidney injury, stroke, myocardial infarction, acute heart failure,
mesenteric ischaemia, or in-hospital mortality. One- and 6-month mortality
were evaluated during follow-up. Result(s): The primary outcome was
observed for 80 of 80 subjects (100%) in the haemoglobin group and in 61
of 77 patients (79%) in the individualised group (absolute risk -21%
[-32.0; -14.0]; P<0.001). There was no significant difference in the
secondary outcome between the two groups. Follow-up showed a
non-significant difference in mortality at 1 and 6 months.
 Conclusion(s): An individualised strategy based on an central venous
oxygen saturation threshold of 70% allows for a more restrictive red blood
cell transfusion strategy with no incidence on postoperative morbidity or
6-month mortality. Clinical trial registration: NCT02963883. Copyright
© 2021 British Journal of Anaesthesia

<63>
Accession Number
2015811369
Title
Targeted temperature management in cardiac surgery: a systematic review
and meta-analysis on postoperative cognitive outcomes.
Source
British Journal of Anaesthesia. 128(1) (pp 11-25), 2022. Date of
Publication: January 2022.
Author
Linassi F.; Maran E.; De Laurenzis A.; Tellaroli P.; Kreuzer M.; Schneider
G.; Navalesi P.; Carron M.
Institution
(Linassi, Maran, De Laurenzis, Navalesi, Carron) Department of Medicine,
Anaesthesiology and Intensive Care, University of Padova, Padova, Italy
(Linassi, Kreuzer, Schneider) Department of Anaesthesiology and Intensive
Care, Klinikum rechts der Isar, Technical University of Munich, School of
Medicine, Munich, Germany
(Tellaroli) Department of Developmental Psychology and Socialisation,
University of Padova, Padova, Italy
Publisher
Elsevier Ltd
Abstract
Background: Postoperative cognitive decline occurs commonly after cardiac
surgery. The available literature is inconclusive on the role of
intraoperative causal or protective factors. Method(s): We
systematically reviewed studies evaluating delayed neurocognitive recovery
(DNR), postoperative neurocognitive disorder (NCD), stroke, and the
mortality rates among patients undergoing hypothermic or normothermic
cardiopulmonary bypass (CPB). We further performed a subgroup analysis for
age, surgery type (coronary artery bypass grafting [CABG], valve surgery,
or combined), and the mean arterial blood pressure (MAP) during CPB, and
conducted a proportion meta-analysis after calculation of single
proportions and confidence intervals (CIs). Result(s): We included a
total of 58 studies with 9609 patients in our analysis. Among these, 1906
of 4010 patients (47.5%) had DNR, and 2071 of 7160 (28.9%) had
postoperative NCD. Ninety of 4625 patients (2.0%) had a stroke, and 174 of
7589 (2.3%) died. There was no statistically significant relationship
between the considered variables and DNR, NCD, stroke, and mortality. In
the subgroup analysis comparing hypothermic with normothermic CPB, we
found higher NCD rates after combined surgery; for normothermic CPB cases
only, the rates of DNR and NCD were lower after combined surgery compared
with CABG surgery. A MAP >70 mm Hg compared with MAP=50-70 mm Hg during
CPB was associated with a lower rate of DNR. Conclusion(s):
Temperature, MAP during cardiopulmonary bypass age, and surgery type were
not associated with neurocognitive disorders, stroke, and mortality in
cardiac surgery. Normothermic cardiopulmonary bypass, particularly when
performed with MAP >70 mm Hg, may reduce the risk of postoperative
neurocognitive decline after cardiac surgery. PROSPERO registration
number: CRD42019140844. Copyright © 2021 British Journal of
Anaesthesia

<64>
Accession Number
2016064757
Title
Postoperative Transfusion Guidelines in Aneurysmal Cerebral Subarachnoid
Hemorrhage: A Systematic Review and Critical Summary of Available
Evidence.
Source
World Neurosurgery. 158 (pp 234-243.e5), 2022. Date of Publication:
February 2022.
Author
Mofor P.; Oduguwa E.; Tao J.; Barrie U.; Kenfack Y.J.; Montgomery E.;
Edukugho D.; Rail B.; Hicks W.H.; Pernik M.N.; Adeyemo E.; Caruso J.; El
Ahmadieh T.Y.; Bagley C.A.; De Oliveira Sillero R.; Aoun S.G.
Institution
(Mofor, Oduguwa, Tao, Barrie, Kenfack, Montgomery, Rail, Hicks, Pernik,
Adeyemo, Caruso, Bagley, De Oliveira Sillero, Aoun) Department of
Neurological Surgery, University of Texas Southwestern Medical Center,
Dallas, Texas, United States
(Edukugho) Department of Neurological Surgery, Boonshoft School of
Medicine, Wright State University, Dayton, Ohio, United States
(El Ahmadieh) Department of Neurological Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Objective: Surgical management of aneurysmal subarachnoid hemorrhage (SAH)
often involves red blood cell (RBC) transfusion, which increases the risk
of postoperative complications. RBC transfusion guidelines report on
chronically critically ill patients and may not apply to patients with
SAH. Our study aims to synthesize the evidence to recommend RBC
transfusion thresholds among adult patients with SAH undergoing surgery.
 Method(s): A systematic review was conducted using PubMed, Google
Scholar, and Web of Science electronic databases according to the PRISMA
(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
guidelines to critically assess primary articles discussing RBC
transfusion thresholds and describe complications secondary to RBC
transfusion in adult patients with SAH in the perioperative period.
 Result(s): Sixteen articles meeting our search strategy were
reviewed. Patients with SAH who received blood transfusion were older,
female, had World Federation of Neurosurgical Societies grade IV-V and
modified Fisher grade 3-4 scores, and presented with more comorbidities
such as hypertension, diabetes, and cardiovascular and pulmonary diseases.
In addition, transfusion was associated with multiple postoperative
complications, including higher rates of vasospasms, surgical site
infections, cardiovascular and respiratory complications, increased
postoperative length of stay, and 30-day mortality. Analysis of transfused
patients showed that a higher hemoglobin (>10 g/dL) goal after SAH was
safe and that patients may benefit from a higher whole hospital stay
hemoglobin nadir, as shown by a reduction in risk of cerebral vasospasm
and improvement in clinical outcomes (level B class II).
 Conclusion(s): Among patients with SAH, the benefits of reducing
cerebral ischemia and anemia are shown to outweigh the risks of
transfusion-related complications. Copyright © 2021 Elsevier Inc.

<65>
Accession Number
2016185540
Title
Design and Rationale of a Phase 2 Study of NeurOtoxin (Botulinum Toxin
Type A) for the PreVention of Post-Operative Atrial Fibrillation - The
NOVA Study.
Source
American Heart Journal. 245 (pp 51-59), 2022. Date of Publication: March
2022.
Author
Piccini J.P.; Ahlsson A.; Dorian P.; Gillinov M.A.; Kowey P.R.; Mack M.J.;
Milano C.A.; Perrault L.P.; Steinberg J.S.; Waldron N.H.; Adams L.M.;
Bharucha D.B.; Brin M.F.; Ferguson W.G.; Benussi S.
Institution
(Piccini, Waldron) Duke Clinical Research Institute / Duke University
Medical Center, Durham, NC, United States
(Ahlsson) Karolinska University Hospital, Sweden
(Dorian) St. Michael's Hospital, Canada
(Gillinov) Cleveland Clinic
(Kowey) Lankenau Heart Institute
(Mack) Baylor University Medical Center
(Milano) Duke University Medical Center
(Perrault) Montreal Heart Institute, Canada
(Steinberg) University of Rochester School of Medicine & Dentistry
(Adams) AbbVie Inc.
(Bharucha) AbbVie Inc.
(Brin) XXX
(Ferguson) AbbVie Inc.
(Benussi) University of Brescia, Italy
Publisher
Elsevier Inc.
Abstract
Background: : Post-operative AF (POAF) is the most common complication
following cardiac surgery, occurring in 30% to 60% of patients undergoing
bypass and/or valve surgery. POAF is associated with longer intensive care
unit/hospital stays, increased healthcare utilization, and increased
morbidity and mortality. Injection of botulinum toxin type A into the
epicardial fat pads resulted in reduction of AF in animal models, and in
two clinical studies of cardiac surgery patients, without new safety
observations. Method(s): : The objective of NOVA is to assess the use
of AGN-151607 (botulinum toxin type A) for prevention of POAF in cardiac
surgery patients. This randomized, multi-site, placebo-controlled trial
will study one-time injections of AGN-151607 125 U (25 U / fat pad) and
250 U (50 U / fat pad) or placebo during cardiac surgery in ~330
participants. Primary endpoint: % of patients with continuous AF >= 30 s.
Secondary endpoints include several measures of AF frequency, duration,
and burden. Additional endpoints include clinically important tachycardia
during AF, time to AF termination, and healthcare utilization. Primary and
secondary efficacy endpoints will be assessed using continuous ECG
monitoring for 30 days following surgery. All patients will be followed
for up to 1 year for safety. Conclusion(s): : The NOVA Study will
test the hypothesis that injections of AGN-151607 will reduce the
incidence of POAF and associated resource utilization. If demonstrated to
be safe and effective, the availability of a one-time therapy for the
prevention of POAF would represent an important treatment option for
patients undergoing cardiac surgery. Copyright © 2021 Elsevier
Inc.

<66>
Accession Number
2016967673
Title
Sex-specific effect of serum urate levels on coronary heart disease and
myocardial infarction prevention: A Mendelian randomization study.
Source
Nutrition, Metabolism and Cardiovascular Diseases. 32(5) (pp 1266-1274),
2022. Date of Publication: May 2022.
Author
Yang F.; Lu Y.; Chen S.; Wang K.; Hu T.; Cui H.
Institution
(Yang) Department of Cardiology, Ningbo Hospital of Zhejiang University
(Ningbo First Hospital), School of Medicine, Zhejiang University,
Zhejiang, Ningbo, China
(Lu) Department of Cardiology, The First Affiliated Hospital, School of
Medicine, Zhejiang University, Zhejiang, Hangzhou, China
(Chen) School of Medicine, Zhejiang University, Zhejiang, Hangzhou, China
(Wang) Eye Center of the Second Affiliated Hospital, School of Medicine,
Zhejiang University, Zhejiang, Hangzhou, China
(Hu) School of Medicine, Ningbo University, Ningbo, China
(Cui) Cardiology Center, Ningbo First Hospital, Ningbo University,
Zhejiang, Ningbo, China
Publisher
Elsevier B.V.
Abstract
Background and aims: Observational studies have examined serum urate
levels in relation to coronary heart disease (CHD) and myocardial
infarction (MI). Whether these associations are causal remains
controversial, due to confounding factors and reverse causality. We aim to
investigate the causality of these associations using Mendelian
randomization method. Methods and Results: Instrumental variables
were obtained from the largest genome-wide association studies of serum
urate (457,690 individuals) to date. Summary statistics were from
CARDIoGRAMplusC4D consortium (60,801 CHD cases; 43,676 MI cases), FinnGen
(21,012 CHD cases; 12,801 MI cases), UK Biobank (10,157 CHD cases; 7018 MI
cases), and Biobank Japan (29,319 CHD cases). Inverse-variance weighted
method was applied as the main results. Other statistical methods and
reverse MR analysis were conducted in the supplementary analyses. Elevated
genetically determined serum urate levels were associated with increased
risks of CHD and MI. The association pattern remained for the datasets in
FinnGen, the combined results of three independent data sources (CHD: odds
ratio (OR), 1.10; 95%CI, 1.06-1.15; p = 4.2 x 10-6; MI: OR,
1.12; 95%CI, 1.07-1.18; p = 2.7 x 10-6), and East Asian
population. Interestingly, sex-specific subgroup analyses revealed that
these associations kept in men only, but not among women in individuals of
European ancestry. No consistent evidence was found for the causal effect
of CHD or MI on serum urate levels. Conclusion(s): We provide
consistent evidence for the causal effect of genetically predicted serum
urate levels on CHD and MI, but not the reverse effect. Urate-lowering
therapy may be of cardiovascular benefit in the prevention of CHD and MI,
especially for men. Copyright © 2022 The Author(s)

<67>
Accession Number
2016536983
Title
Deep Venous Arterialization for Chronic Limb Threatening Ischemia in
Atherosclerosis Patients - A Meta-Analysis.
Source
Annals of Vascular Surgery. 81 (pp 1-21), 2022. Date of Publication: April
2022.
Author
Yan Q.; Prasla S.; Carlisle D.C.; Rajesh A.; Treffalls J.; Davies M.G.
Institution
(Davies) Center for Quality, Effectiveness and Outcomes in Cardiovascular
Diseases, University of Texas Health at San Antonio, TX, San Antonio
(Yan, Davies) Division of Vascular and Endovascular Surgery, University of
Texas Health at San Antonio, TX, San Antonio
(Yan, Prasla, Carlisle, Rajesh, Treffalls, Davies) Department of Surgery,
University of Texas Health at San Antonio, TX, San Antonio
(Yan, Davies) South Texas Center for Vascular Care, South Texas Medical
Center, TX, San Antonio
Publisher
Elsevier Inc.
Abstract
Background: Venous arterialization is an upcoming and novel alternative in
chronic limb threatening ischemia (CLTI) patients in the absence of
standard revascularization options. The aim of this study is to
systematically review and analyze outcomes of venous arterialization.
 Method(s): A systematic literature search was performed in 5
databases using the PRISMA methodology. Inclusion criteria were English
language original research papers on CLTI patients treated with venous
arterialization. Exclusion criteria: absence of CLTI due to
atherosclerosis, duplicate study or reporting of patients, meeting
abstract only. Quality and risk of bias were evaluated. Meta-analysis was
performed using random effects model on articles that have a sample size
of equal or greater than 10. Result(s): Twelve studies included 442
patients that underwent treatment for 445 limbs (374 patients and 377
limbs underwent venous arterialization while remainder underwent
traditional bypass and served as control subjects). Average age was 66 [18
studies, range 37 -91 years], 68% were male [271/366, 15 studies] and 67%
diabetic [271/406, 16 studies]). Most limbs (88%, 352/398, 16 studies) had
tissue loss. Pooled 30-day mortality was 3.7% (95%-confidence interval
[CI] 0.8 -6.6%), 30-day morbidity was 15.5% (95%-CI 3.2 -27.8%), 30-day
major adverse cardiovascular event was 5.2% (95%-CI 1.7 -8.6%) and 30-day
major adverse limb event was 16.7% (95%-CI 1.5 -31.9%). Pooled 1-year
limb-salvage rate was 79.0% (95%-CI 68.7 -90.7) and 1-year survival rate
was 85.7% (95%-CI 76.2 -96.4). Studies quality varied significantly across
studies. Conclusion(s): Venous arterialization has an acceptable a
1-year limb salvage rate of 79%, however, this is based on low levels of
evidence. More randomized controlled trials or high-quality cohort studies
are needed to further define the effectiveness of this procedure for
CLTI. Copyright © 2021

<68>
Accession Number
2005726487
Title
Influence of lipoproteins and antiplatelet agents on vein graft patency 1
year after coronary artery bypass grafting.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(3) (pp 1030-1039.e4),
2022. Date of Publication: March 2022.
Author
Zhu J.; Zhu Y.; Zhang M.; Xue Q.; Hu J.; Liu H.; Wang R.; Wang X.; Zhao Q.
Institution
(Zhu, Zhu, Zhao) Department of Cardiovascular Surgery, Ruijin Hospital
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Zhang) Department of Cancer Control and Prevention, Shanghai Municipal
Center for Disease Control and Prevention, Shanghai, China
(Xue) Department of Cardiovascular Surgery, Changhai Hospital of Shanghai,
Shanghai, China
(Hu) Department of Cardiovascular Surgery, Fuwai Central China
Cardiovascular Hospital, Zhengzhou, China
(Liu) Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai Jiao
Tong University School of Medicine, Shanghai, China
(Wang) Department of Cardiovascular Surgery, Nanjing First Hospital,
Nanjing, China
(Wang) Department of Cardiovascular Surgery, Jiangsu Province Hospital,
Nanjing, China
Publisher
Elsevier Inc.
Abstract
Objective: It remains unclear whether aggressive low-density lipoprotein
cholesterol (LDL-C) management (<1.8 mmol/L) can slow the process of vein
graft stenosis. This study aimed to explore the impact of baseline LDL-C
levels on vein graft patency in patients on ticagrelor with or without
aspirin 1 year after coronary artery bypass grafting (CABG).
 Method(s): This was a post hoc analysis of the DACAB (Different
Antiplatelet Therapy Strategy After Coronary Artery Bypass Graft Surgery)
trial (NCT02201771), a randomized controlled trial (ticagrelor + aspirin
or ticagrelor vs aspirin) of patients undergoing CABG in China. The study
subjects were stratified as LDL-low (baseline LDL-C <1.8 mmol/L, 148
patients with 430 vein grafts) versus LDL-high (baseline LDL-C >=1.8
mmol/L, 352 patients with 1030 vein grafts). The primary outcome was the
1-year vein graft patency (Fitzgibbon grade A) assessed by coronary
computed tomographic angiography or coronary angiography. Result(s):
Baseline/1-year LDL-C were 1.4/1.6 and 2.6/2.4 mmol/L in the LDL-low and
LDL-high subgroups, respectively. Regardless of antiplatelet regimen, no
significant inter-subgroup difference was observed for 1-year graft
patency (LDL-low: 83.8% [359/430 grafts]; LDL-high: 82.3% [848/1030
grafts]; adjusted OR for non-patency [OR<inf>adj</inf>], 0.96; 95%
confidence interval [CI], 0.62-1.50, P = .857). For both subgroups, the
1-year graft patency rates were greater with ticagrelor + aspirin versus
aspirin (LDL-low: OR<inf>adj</inf>, 0.41; 95% CI, 0.17-0.97; LDL-high:
OR<inf>adj</inf>, 0.38; 95% CI, 0.20-0.71; inter P = .679).
 Conclusion(s): In general, baseline LDL-C is not associated with
1-year vein graft patency after CABG. Regardless of the baseline LDL-C
levels, ticagrelor + aspirin was superior to aspirin alone in maintaining
vein graft patency. The primary factor causing early vein graft disease
might not be atherosclerosis but thrombosis. Copyright © 2020 The
American Association for Thoracic Surgery

<69>
Accession Number
2017451047
Title
Efficacy and safety of direct oral anticoagulants with and without
Aspirin: A systematic review and Meta-analysis.
Source
IJC Heart and Vasculature. 40 (no pagination), 2022. Article Number:
101016. Date of Publication: June 2022.
Author
Almas T.; Musheer A.; Ejaz A.; Niaz Shaikh F.; Awais Paracha A.; Raza F.;
Sarwar Khan M.; Masood F.; Siddiqui F.; Raza S.; Fahad Wasim M.; Hasnain
Mankani M.; Fatima K.; Mannan Khan Minhas A.
Institution
(Musheer, Ejaz, Niaz Shaikh, Awais Paracha, Raza, Sarwar Khan, Masood,
Siddiqui, Raza, Fatima) Department of Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Fahad Wasim) Department of Medicine, Baqai Medical University, Karachi,
Pakistan
(Hasnain Mankani) Department of Medicine, Aga Khan University Hospital,
Karachi, Pakistan
(Almas) Department of Medicine, RCSI University of Medicine and Health
Sciences, Dublin, Ireland
(Mannan Khan Minhas) Department of Internal Medicine, Forrest General
Hospital, Hattiesburg, MS, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Various anticoagulant therapies are prescribed to patients
under physicians' discretion and recently Direct Oral Anticoagulants(DOAC)
have been under trials to evaluate their safety and efficacy. In addition
to this, the regimen of DOACs and Aspirin is of keen interest as
researchers continue to find an optimal regimen to treat blood clots in
patients. This study is a systematic review and meta-analysis of
randomized controlled trials and observational studies that asses the
safety and efficacy of DOAC with and without Aspirin. Method(s): We
queried MEDLINE and Cochrane CENTRAL from their inception to April 2021,
for published and randomized controlled trials and observational studies
in any language that compared dual (DOAC + ASA) therapy or mono (DOAC
alone) therapy in patients with AF. The results from the studies were
presented as risk ratios (RRs) with 95% confidence intervals (CIs) and
were pooled using a random-effects model. Endpoints of interest included
major bleeding, myocardial infarction (MI), major adverse cardiovascular
events (MACEs), hospitalizations, all-cause mortality, and stroke.
 Result(s): The risk of major bleeding was significantly lower in the
DOAC alone group compared with DOAC plus aspirin group. Non-significant
results were obtained (P value greater than 0.05) for other outcomes
establishing that DOAC monotherapy was not superior to the combined
regimen in reducing the risk of MACE, Stroke, Hospitalization, Death.
 Conclusion(s): Among patients with NVAF (Non valvular Atrial
Fibrillation) and VTE (Venous thromboembolism) receiving anticoagulation
prophylaxis, in terms of safety profile our comparisons showed a
statistically significant reduction in Major Bleeding in DOAC Alone group
compared with DOAC Plus Aspirin. Copyright © 2022 The Author(s)

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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. 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. Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

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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. 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. 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). 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. Copyright © 2022
Lippincott Williams and Wilkins. All rights reserved.

<72>
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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. 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. Result(s): Between June 2015 and September 2020, 157
patients (mean age, 67 years; 57% men) were randomly allocated to early
surgery (n=78) or conservative treatment (n=79). Follow-up was completed
in May 2021. Overall median follow-up was 32 months: 28 months in the
early surgery group and 35 months in the conservative treatment group.
There was a total of 39 events, 13 in early surgery and 26 in the
conservative treatment group. In the early surgery group, 72 patients
(92.3%) underwent SAVR with operative mortality of 1.4%. In an
intention-to-treat analysis, patients randomized to early surgery had a
significantly lower incidence of primary composite end point than those in
the conservative arm (hazard ratio, 0.46 [95% CI, 0.23-0.90]; P=0.02).
There was no statistical difference in secondary end points, including
all-cause mortality, first heart failure hospitalizations, major bleeding,
or thromboembolic complications, but trends were consistent with the
primary outcome. Conclusion(s): In asymptomatic patients with severe
AS, early surgery reduced a primary composite of all-cause death, acute
myocardial infarction, stroke, or unplanned hospitalization for heart
failure compared with conservative treatment. This randomized trial
provides preliminary support for early SAVR once AS becomes severe,
regardless of symptoms. Registration: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT02436655. Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

<73>
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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. 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. 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. 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. Copyright © 2022 Lippincott Williams and Wilkins.
All rights reserved.

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Accession Number
2017431005
Title
Amulet or Watchman Device for Percutaneous Left Atrial Appendage Closure:
Primary Results of the SWISS-APERO Randomized Clinical Trial.
Source
Circulation. 145(10) (pp 724-738), 2022. Date of Publication: 08 Mar 2022.
Author
Galea R.; De Marco F.; Meneveau N.; Aminian A.; Anselme F.; Grani C.;
Huber A.T.; Teiger E.; Iriart X.; Babongo Bosombo F.; Heg D.; Franzone A.;
Vranckx P.; Fischer U.; Pedrazzini G.; Bedogni F.; Raber L.; Valgimigli M.
Institution
(Galea, Grani, Raber, Valgimigli) Department of Cardiology, Bern
University Hospital, Clinical Trials Unit, University of Bern, Bern,
Switzerland
(Huber) Department of Diagnostic, Interventional and Pediatric Radiology,
Bern University Hospital, Clinical Trials Unit, University of Bern, Bern,
Switzerland
(Fischer) Department of Neurology, Bern University Hospital, Clinical
Trials Unit, University of Bern, Bern, Switzerland
(Babongo Bosombo, Heg) Bern University Hospital, Clinical Trials Unit,
University of Bern, Bern, Switzerland
(De Marco, Bedogni) Department of Cardiology, IRCCS Policlinico San
Donato, San Donato Milanese, Milan, Italy
(Meneveau) Besancon University Hospital, University of Burgundy
Franche-Comte, France
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Belgium
(Anselme) Department of Cardiology, University Hospital of Rouen, France
(Teiger) Department of Cardiology, Henri-Mondor Hospital, Public
Assistance Hospitals of Paris, Creteil, France
(Iriart) Department of Pediatric and Adult Congenital Cardiology, Hopital
Cardiologique du Haut-Leveque, CHU de Bordeaux, Bordeaux-Pessac, France
(Franzone) Department of Advanced Biomedical Sciences, University Federico
II University, Naples, Italy
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Faculty of Medicine and Life Sciences, Hasselt
University, Belgium
(Fischer) Department of Neurology, University Hospital Basel, University
of Basel, Switzerland
(Pedrazzini, Valgimigli) Cardiocentro Ticino Institute, Universita della
Svizzera Italiana (USI), Via Tesserete 48, Lugano 6900, Switzerland
Publisher
Lippincott Williams and Wilkins
Abstract
Background: No study has so far compared Amulet with the new Watchman FLX
in terms of residual left atrial appendage (LAA) patency or clinical
outcomes in patients undergoing percutaneous LAA closure. Method(s):
In the investigator-initiated SWISS APERO trial (Comparison of Amulet
Versus Watchman/FLX Device in Patients Undergoing Left Atrial Appendage
Closure), patients undergoing LAA closure were randomly assigned (1:1)
open label to receive Amulet or Watchman 2.5 or FLX (Watchman) across 8
European centers. The primary end point was the composite of justified
crossover to a nonrandomized device during LAA closure procedure or
residual LAA patency detected by cardiac computed tomography angiography
(CCTA) at 45 days. The secondary end points included procedural
complications, device-related thrombus, peridevice leak at transesophageal
echocardiography, and clinical outcomes at 45 days. Result(s):
Between June 2018 and May 2021, 221 patients were randomly assigned to
Amulet (111 [50.2%]) or Watchman (110 [49.8%]), of whom 25 (22.7%)
patients included before October 2019 received Watchman 2.5, and 85
(77.3%) patients received Watchman FLX. The primary end point was
assessable in 205 (92.8%) patients and occurred in 71 (67.6%) patients
receiving Amulet and 70 (70.0%) patients receiving Watchman, respectively
(risk ratio, 0.97 [95% CI, 0.80-1.16]; P=0.713). A single justified
crossover occurred in a patient with Amulet who fulfilled LAA patency
criteria at 45-day CCTA. Major procedure-related complications occurred
more frequently in the Amulet group (9.0% versus 2.7%; P=0.047) because of
more frequent bleeding (7.2% versus 1.8%). At 45 days, the peridevice leak
rate at transesophageal echocardiography was higher with Watchman than
with Amulet (27.5% versus 13.7%, P=0.020), albeit none was major (ie, >5
mm), whereas device-related thrombus was detected in 1 (0.9%) patient with
Amulet and 3 (3.0%) patients with Watchman at CCTA and in 2 (2.1%) and 5
(5.5%) patients at transesophageal echocardiography, respectively.
Clinical outcomes at 45 days did not differ between the groups.
 Conclusion(s): Amulet was not associated with a lower rate of the
composite of crossover or residual LAA patency compared with Watchman at
45-day CCTA. Amulet, however, was associated with lower peridevice leak
rates at transesophageal echocardiography, higher procedural
complications, and similar clinical outcomes at 45 days compared with
Watchman. The clinical relevance of CCTA-detected LAA patency requires
further investigation. Registration: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT03399851. Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

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Accession Number
2017430970
Title
Robot-assisted Versus Conventional Minimally Invasive Esophagectomy for
Resectable Esophageal Squamous Cell Carcinoma: Early Results of a
Multicenter Randomized Controlled Trial: The RAMIE Trial.
Source
Annals of Surgery. 275(4) (pp 646-653), 2022. Date of Publication: 01 Apr
2022.
Author
Yang Y.; Li B.; Yi J.; Hua R.; Chen H.; Tan L.; Li H.; He Y.; Guo X.; Sun
Y.; Yu B.; Li Z.
Institution
(Yang, Li, Hua, He, Guo, Sun, Li) Department of Thoracic Surgery, Shanghai
Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
(Yi) Department of Cardiothoracic Surgery, Jinling Hospital, Medical
School of Nanjing University, Jiangsu, China
(Chen) Department of Thoracic Surgery, Changhai Hospital Affiliated to the
Second Military Medical University, Shanghai, China
(Tan) Department of Thoracic Surgery, Zhongshan Hospital Affiliated to
Fudan University, Shanghai, China
(Li) Department of Thoracic Surgery, Ruijin Hospital Affiliated to
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Yu) Department of Thoracic Surgery, The First Affiliated Hospital of
Nanchang University, Jiangxi, China
Publisher
Lippincott Williams and Wilkins
Abstract
Objective:To compare perioperative and long-term outcomes of
robot-assisted minimally invasive esophagectomy (RAMIE) and conventional
minimally invasive esophagectomy (MIE) in the treatment for patients with
esophageal squamous cell carcinoma (ESCC).Summary Background Data:RAMIE
has emerged as an alternative to traditional open or thoracoscopic
approaches. Efficacy and safety of RAMIE and MIE in the surgical treatment
for ESCC remains uncertain given the lack of high-level clinical evidence.
 Method(s):The RAMIE trial was designed as a prospective, multicenter,
randomized, controlled clinical trial that compares the efficacy and
safety of RAMIE and MIE in the treatment of resectable ESCC. From August
2017 to December 2019, eligible patients were randomly assigned to receive
either RAMIE or MIE performed by experienced thoracic surgeons from 6
high-volume centers in China. Intent-to-treat analysis was performed.
 Result(s):Significantly shorter operation time was taken in RAMIE
(203.8 vs 244.9 min, P<0.001). Compared with MIE, RAMIE showed improved
efficiency of thoracic lymph node dissection in patients who received
neoadjuvant therapy (15 vs 12, P = 0.016), as well as higher achievement
rate of lymph node dissection along the left recurrent laryngeal nerve
(79.5% vs 67.6%, P = 0.001). No difference was found in blood loss,
conversion rate, and R0 resection. The 90-day mortality was 0.6% in each
group. Overall complications were similar in RAMIE (48.6%) compared with
MIE (41.8%) (RR, 1.16; 95% CI, 0.92-1.46; P = 0.196). Besides, the rate of
major complications (Clavien-Dindo classification >= III) was also
comparable (12.2% vs 10.2%, P = 0.551). RAMIE showed similar incidences of
pulmonary complications (13.8% vs 14.7%; P = 0.812), anastomotic leakage
(12.2% vs 11.3%; P = 0.801), and vocal cord paralysis (32.6% vs 27.1%, P =
0.258) to MIE. Conclusion(s):Early results demonstrate that both
RAMIE and MIE are safe and feasible for the treatment of ESCC. RAMIE can
achieve shorter operative duration and better lymph node dissection in
patients who received neoadjuvant therapy. Long-term results are pending
for further follow-up investigations.Trial Registration:ClinicalTrial.gov
Identifier: NCT03094351. Copyright © 2022 Lippincott Williams and
Wilkins. All rights reserved.

<76>
Accession Number
2017484825
Title
Treatment Approaches to Combined Orthopedic and Vascular Traumas: A
Single-Center Experience.
Source
Iranian Red Crescent Medical Journal. 23(9) (no pagination), 2021. Article
Number: e751. Date of Publication: 14 Sep 2021.
Author
Dereli Y.; Isik M.; Tanyeli O.; Yildirim S.; Altinbas O.; Korucu I.H.;
Taban V.B.; Gormus N.
Institution
(Dereli, Isik, Tanyeli, Yildirim, Taban, Gormus) Department of
Cardiovascular Surgery, Meram Medical Faculty, Necmettin Erbakan
University, Konya, Turkey
(Altinbas) Gaziantep University, Department of Operating Room Services,
Vocational School of Health Services, Gaziantep, Turkey
(Korucu) Department of Orthopedics and Traumatology, Meram Medical
Faculty, Necmettin Erbakan University, Konya, Turkey
Publisher
ZamenPub
Abstract
Background: Orthopedic and vascular trauma can be clinically observed and
have negative consequences if not treated appropriately.
 Objective(s): This study aimed to present the clinical experiences of
the authors regarding vascular traumas in combination with extremity
fractures or dislocations. Method(s): In total, 95 patients (78
males, 17 females, with the mean age of 34.7+/-5.6 years old) who
underwent surgical treatment for combined orthopedic and vascular trauma
between November 2012 and February 2020 were included in the study.
Patients were retrospectively evaluated according to their clinical
properties, treatment strategies, and results. Result(s): Traffic
accidents were the most common reason for trauma with a rate of 36.8%
(n=35). The most common orthopedic injury was seen in the femur, whereas
the most common vascular injury was on the superficial femoral artery. The
most commonly performed treatment methods for vascular and orthopedic
trauma were primary repair and external fixation, respectively. Based on
findings, the mortality and amputation rates were 2.1% (n=2) and 15.7%
(n=15), respectively. Conclusion(s): Combined orthopedic vascular
traumas are less frequent than isolated vascular traumas, but they have
higher mortality and amputation rates. In order to decrease mortality and
amputation rates, communication should be perfectly coordinated between
the emergency department and orthopedic and cardiovascular surgery
clinics; moreover, urgent intervention is crucial. Copyright ©
2021, Author(s).

<77>
Accession Number
2016504702
Title
Use of direct oral anticoagulants in ICU patients. Part II - Clinical
evidence.
Source
Anaesthesiology Intensive Therapy. 53(5) (pp 440-449), 2021. Date of
Publication: 2021.
Author
Wahab A.; Patnaik R.; Gurjar M.
Institution
(Wahab) University of Iowa Hospitals and Clinics, Iowa City, United States
(Patnaik, Gurjar) Sanjay Gandhi Postgraduate Institute of Medical Sciences
(SGPGIMS), Uttar Pradesh, Lucknow, India
Publisher
Termedia Publishing House Ltd.
Abstract
During the last decade, utilization of direct oral anticoagulants (DOACs)
has increased due to their pharmacokinetic profile and the fact that they
are non-inferior to warfarin in the prevention of stroke in patients with
atrial fibrillation, as well as for the treatment of venous
thromboembolism. However, there are few studies about their use in
critically ill patients. This article aims to review available evidence on
the use of DOACs in the indicated conditions and anticoagulant management
of medical or surgical patients receiving DOAC before intensive care unit
(ICU) admission. The rapidly changing pathophysiology and heterogeneous
nature of critically ill patients combined with limited evidence often
leads to a high degree of individualization of DOAC regimens in ICU
patients. This article is the second part of the narrative review series
on the use of DOACs in ICU patients, focusing on current "Clinical
evidence". "Applied pharmacology" has been described in the first
part. Copyright © 2021 Via Medica. All rights reserved.

<78>
Accession Number
2016332345
Title
Permanent pacemaker implantation following transcatheter aortic valve
implantation using self-expandable, balloon-expandable, or mechanically
expandable devices: A network meta-analysis.
Source
Europace. 23(12) (pp 1998-2009), 2021. Date of Publication: 01 Dec 2021.
Author
Ravaux J.M.; Di Mauro M.; Vernooy K.; Kats S.; Mariani S.; Ronco D.; Actis
Dato G.; Simons J.; Hof A.W.V.; Maessen J.G.; Lorusso R.
Institution
(Ravaux, Di Mauro, Kats, Mariani, Ronco, Actis Dato, Simons, Maessen,
Lorusso) Departement of Cardio-Thoracic Surgery, Heart and Vascular
Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25,
Maastricht 6202 AZ, Netherlands
(Vernooy, Hof) Department of Cardiology, Maastricht University Medical
Centre (MUMC), Maastricht, Netherlands
(Vernooy, Hof, Maessen, Lorusso) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University Medical Center, Maastricht,
Netherlands
(Vernooy) Department of Cardiology, Radboud University Medical Center
(Radboudumc), Nijmegen, Netherlands
(Ronco) Department of Medicine and Surgery, Circolo Hospital, University
of Insubria, Varese, Italy
Publisher
Oxford University Press
Abstract
Aims: Permanent pacemaker implantation (PPI) still limits the expansion of
indications for transcatheter aortic valve implantation (TAVI). Comparison
between different systems remains scarce. We aimed to determine the impact
of the device type used on post-TAVI PPI. Methods and Results: A
systematic literature review was performed to identify studies reporting
the use of balloon-expandable valve (BEV), self-expandable valve (SEV),
and mechanically expandable valve (MEV) and post-TAVI PPI. A network
meta-analysis was used to compare TAVI mechanisms (Analysis A) and
transcatheter heart valves (Analysis B) with respect to post-TAVI PPI.
Analysis A included 40 181 patients with a pooled PPI rate of 19.2% in
BEV, 24.7% in SEV, and 34.8% in MEV. Balloon-expandable valve showed lower
risk compared to either SEV or MEV and SEV demonstrated lower risk for PPI
than MEV. Implantation of BEV was associated with 39% and 62% lower PPI
rate with respect to SEV and MEV. Implantation of SEV was associated with
38% lower PPI rate with respect to MEV. Analysis B included 36.143
patients with the lowest pooled PPI rate of 9.6% for Acurate Neo or
others, and the highest pooled PPI rate of 34.3% for Lotus. CoreValve,
Evolut Portico, and Lotus influenced significantly PPI rate, while Sapien
group did not. Conclusion(s): Implantation of BEV and also SEV were
associated with lower post-TAVI PPI rate, while MEV were associated with
higher post-TAVI PPI. Patient tailored-approach including devices
characteristics may help to reduce post-TAVI PPI and to allow TAVI to take
the leap towards extension of use in younger patients. Copyright
© 2021 Published on behalf of the European Society of Cardiology. All
rights reserved.

<79>
Accession Number
2013796114
Title
Meta-analysis of Surgical Left Atrial Appendage Occlusion During Cardiac
Surgery.
Source
American Journal of Cardiology. 155 (pp 150-151), 2021. Date of
Publication: 15 Sep 2021.
Author
Mohamed M.M.G.; Faisaluddin M.; Kheiri B.; Osman M.
Institution
(Mohamed) Internal Medicine Department, SSM Health St. Mary's Hospital,
St. Louis, MO, United States
(Faisaluddin) Internal Medicine Department, Rochester General Hospital,
Rochester, NY, United States
(Kheiri) Knight Cardiovascular Institute, Oregon Health & Science
University, Portland, OR, United States
(Osman) Division of Cardiology, West Virginia University School of
Medicine, Morgantown, WV, United States
Publisher
Elsevier Inc.

<80>
Accession Number
2013930066
Title
Use of Hepatitis B Virus-Positive Organs in Organ Transplantation.
Source
Clinics in Liver Disease. 25(4) (pp 841-857), 2021. Date of Publication:
November 2021.
Author
Khemichian S.; Kahn J.; Terrault N.A.
Institution
(Khemichian, Kahn, Terrault) Division of Gastrointestinal and Liver
Diseases, Keck School of Medicine at University of Southern California,
1520 San Pablo Street, Suite 1000, Los Angeles, CA 90033, United States
Publisher
W.B. Saunders

<81>
Accession Number
2014769926
Title
Adherence to immunosuppression in adult heart transplant recipients: A
systematic review.
Source
Transplantation Reviews. 35(4) (no pagination), 2021. Article Number:
100651. Date of Publication: December 2021.
Author
Hussain T.; Nassetta K.; O'Dwyer L.C.; Wilcox J.E.; Badawy S.M.
Institution
(Hussain) Department of Internal Medicine, Northwestern University McGaw
Medical Center, 251 E. Huron St., Ste. 16-738, Chicago, IL 60611, United
States
(Nassetta) Department of Pediatrics, Lurie Children's Hospital, 225 E.
Chicago Ave., Chicago, IL 60611, United States
(O'Dwyer) Galter Health Sciences Library & Learning Center, Northwestern
University Feinberg School of Medicine, 320 E. Superior Street, Chicago,
IL 60611, United States
(Wilcox) Department of Cardiology, Northwestern Memorial Hospital,
NMH/Arkes Family Pavilion, Ste. 600; 676 N. St. Clair Ave., Chicago, IL
60611, United States
(Badawy) Division of Hematology, Oncology, and Stem Cell Transplant, Lurie
Children's Hospital of Chicago, Chicago, IL 60611, United States
(Badawy) Department of Pediatrics, Northwestern University Feinberg School
of Medicine, 225 E. Chicago Ave., Chicago, IL 60611, United States
Publisher
W.B. Saunders
Abstract
Background: Successful maintenance of a heart transplant (HTx) graft
requires adherence to a triple-drug regimen of immunosuppression. However,
achieving adequate adherence can be difficult secondary to complicated
dosing regimens, side effects, and mental/emotional barriers. A detailed
review of current patterns of adherence to immunosuppression in adult HTx
recipients is lacking. Objective(s): This systematic review aims to
detail the current landscape of adherence to immunosuppression in adult
heart transplant patients, including the measurement of adherence,
correlates to adherence, health outcomes associated with nonadherence, as
well as strategies to improve adherence in HTx patients. Method(s):
We conducted searches in PubMed MEDLINE, Embase, CENTRAL register of
Controlled Trials (Wiley), and Scopus, from inception to March 2020.
Studies were eligible if they outlined an aspect of adherence (as noted
above in the objective) to immunosuppression in adult HTx patients. The
HTx cohort had to contain at least 10 patients and measurement of
adherence had to be done with an objective or otherwise validated measure
of adherence (e.g. drug levels, automated pill bottles or adherence
questionnaires). Two authors independently screened the articles for
inclusion, then subsequently reviewed the full texts of the included
articles. Data was extracted into standardized forms and bias evaluations
were done using the Newcastle-Ottawa or modified Newcastle-Ottawa tools,
depending on the study type. The authors followed all guidelines for the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) statement. Result(s): The titles/abstracts of 880 articles
were reviewed. Ultimately, 23 articles were included in the final review.
The median number of participants was 101, with a range of 19 to 1397.
Studies provided information on baseline levels of adherence (17 studies),
correlates to adherence (14 studies), health outcomes related to
nonadherence (3 studies) and interventions to improve adherence (3
studies). Baseline adherence estimates varied greatly depending on the
adherence measure. Multiple significant correlates to nonadherence exist
and appear to affect patients with certain sociodemographic backgrounds,
those with psychological/psychiatric comorbidities and those with poor
support structures. Nonadherence is associated with transplant coronary
artery disease and acute late rejection; it may also be associated with
long-term mortality. Finally, a simplified dosing regimen with once-a-day
tacrolimus as well as use of a mobile phone-based intervention were
associated with improved adherence. Bias scores were most deficient due to
self-reported outcomes in 18 studies, and lack of controls/adjustments for
confounders, in 7 studies. Conclusion(s): Adherence to
immunosuppression in transplant patients varies, but is associated with
observable and modifiable factors which are worth addressing. Further
high-quality studies regarding strategies to improve adherence are needed
in the literature. Copyright © 2021 Elsevier Inc.

<82>
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. 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. 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). Conclusion(s): NETOIMS appears to be
an effective modality in alleviating postoperative pain after
thoracoscopic surgery, thereby reducing the reliance on opioid
use. Copyright © 2022 The American Association for Thoracic
Surgery

<83>
Accession Number
2016506550
Title
Sex-Specific Outcomes Following Percutaneous Coronary Intervention Versus
Coronary Artery Bypass Grafting for Left Main Disease: A Systematic Review
and Meta-Analysis.
Source
Heart Lung and Circulation. 31(5) (pp 658-665), 2022. Date of Publication:
May 2022.
Author
Zhou J.Y.; Tie E.N.; Liew D.; Duffy S.J.; Shaw J.; Walton A.; Chan W.;
Stub D.
Institution
(Zhou, Tie, Liew, Duffy, Shaw, Walton, Chan, Stub) Department of
Cardiology, The Alfred Hospital, Melbourne, VIC, Australia
(Liew, Duffy, Stub) School of Public Health and Preventive Medicine,
Monash University, Melbourne, VIC, Australia
(Chan, Stub) Western Health, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Objective: To assess whether outcomes following percutaneous coronary
intervention (PCI) versus coronary artery bypass grafting (CABG) for left
main coronary artery (LMCA) disease differ between men and women.
 Background(s): Current guidelines recommend either PCI or CABG for
patients with unprotected LMCA disease and low-to-intermediate anatomical
complexity. However, it is unclear whether these guidelines apply to
women, who are underrepresented in clinical trials. Method(s): An
electronic search was performed to identify studies reporting sex-specific
outcomes after PCI versus CABG in patients with LMCA disease. Trial level
hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled by
random-effects modelling. Result(s): Eight (8) studies met inclusion
criteria, comprising 13,066 patients (24.3% women). In both sexes, there
was no difference between PCI and CABG with respect to the primary
composite endpoint of death, myocardial infarction or stroke (HR in women:
1.03, 95% CI 0.76-1.40; HR in men: 1.04, 95% CI 0.92-1.17). However, both
sexes were more likely to require repeat revascularisation after PCI.
There was no interaction between sex and treatment effect for the primary
composite endpoint nor for the individual outcomes of death, stroke and
repeat revascularisation. However, in women the risk of myocardial
infarction was higher after PCI compared with CABG (HR 1.84, 95% CI
1.06-3.18), with a trend toward the opposite in men (HR 0.78, 95% CI
0.54-1.13; p-interaction=0.01). Conclusion(s): Percutaneous coronary
intervention and CABG have a comparable risk of the composite outcome of
death, stroke or myocardial infarction in patients undergoing
revascularisation for LMCA disease, with no significant interaction
between sex and treatment effect. Copyright © 2021 Australian and
New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the
Cardiac Society of Australia and New Zealand (CSANZ)

<84>
Accession Number
2016506473
Title
Colchicine for Secondary Prevention of Coronary Artery Disease: A
Meta-Analysis of Randomised Controlled Trials.
Source
Heart Lung and Circulation. 31(5) (pp 685-695), 2022. Date of Publication:
May 2022.
Author
Xu H.; Mao L.; Liu H.; Lin Z.; Zhang Y.; Yang J.
Institution
(Xu, Liu, Lin, Yang) Department of Cardiology, The Affiliated Huaian No. 1
People's Hospital of Nanjing Medical University, Jiangsu, Huai'an, China
(Mao) Department of Thyroid and Breast Surgery, The Affiliated Huai'an
Hospital of Xuzhou Medical University and The Second People's Hospital of
Huai'an, Jiangsu, Huai'an, China
(Zhang) Department of Medical Laboratory, The Affiliated Huaian No. 1
People's Hospital of Nanjing Medical University, Jiangsu, Huai'an, China
Publisher
Elsevier Ltd
Abstract
Background: Colchicine has become prominent as an anti-inflammatory
therapy for secondary cardiovascular prevention in patients with coronary
artery disease (CAD). This meta-analysis was performed to evaluate the
efficacy and safety of colchicine in patients with CAD. Method(s):
Randomised controlled trials (RCTs) that compare major adverse
cardiovascular events (MACEs) between patients with CAD randomised to
colchicine versus placebo (or no colchicine) were included. Random effect
risk ratios (RRs) were calculated for clinical outcomes. Result(s): A
total of 12,071 patients in seven RCTs were included in the meta-analysis.
Compared with placebo or no colchicine, colchicine was associated with a
significantly lower incidence of MACEs (RR 0.64, 95% CI 0.51-0.80,
p<0.01). The reduction in MACEs in the colchicine group was driven by
statistically significant reductions in the incidence of myocardial
ischaemia (RR 0.74, 95% CI 0.58-0.95, p=0.02), coronary revascularisation
(RR 0.61, 95% CI 0.42-0.89, p=0.01), and stroke (RR 0.48, 95% CI
0.28-0.83, p=0.01). However, there was no statistically significant
difference for cardiovascular death (RR 0.82, 95% CI 0.55-1.22, p=0.33).
All-cause and non-cardiovascular mortality, gastrointestinal events,
infection, and cancer were not significantly different between the
colchicine and control groups. Conclusion(s): Colchicine is a
reasonably efficacious and safe drug that could be successfully utilised
for the secondary prevention of CAD. Copyright © 2021 Australian
and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the
Cardiac Society of Australia and New Zealand (CSANZ)

<85>
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)

<86>
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. Copyright © 2022 Elsevier Inc.
All rights reserved.

<87>
Accession Number
2014391241
Title
Long-Term Follow-Up of Pediatric Patients with Severe Postoperative
Pulmonary Hypertension After Correction of Congenital Heart Defects.
Source
Pediatric Cardiology. 43(4) (pp 827-836), 2022. Date of Publication: April
2022.
Author
Lindberg L.
Institution
(Lindberg) Institution of Clinical Science, Faculty of Medicine, Lund
University, Lund, Sweden
(Lindberg) Lund University and Children's Hospital, PICU, Skane University
Hospital in Lund, Lund 221 85, Sweden
Publisher
Springer
Abstract
The surgical repair of congenital heart defects in children with
preoperative pulmonary hypertension (PH) is to varying degree associated
with the occurrence of postoperative PH. The objective of this study was
to follow up children with severe postoperative PH (pulmonary
arterial/aortic pressure ratio >= 1.0) to evaluate if pulmonary arterial
pressure spontaneously normalized or needed PH-targeting therapy and to
identify potential high-risk diagnoses for bad outcome. Twenty-five
children who developed clinically significant severe PH on at least three
occasions postoperatively were included in the follow-up (20-24 years).
Data from chart reviews, echocardiographic investigations, and
questionnaires were obtained. Three children died within the first year
after surgery. Three children were lost to follow-up. The remaining 17
children normalized their pulmonary arterial pressure without the use of
PH-targeting drugs at any time during the follow-up. Two children had a
remaining mild PH with moderate mitral valve insufficiency. All three
children with bad outcome had combined cardiac lesions causing
post-capillary pulmonary hypertension. Normalization of the pulmonary
arterial pressure occurred in almost all children with severe
postoperative PH, without any need of supplemental PH-targeting therapies.
All children with bad outcome had diagnoses conformable with
post-capillary PH making the use of PH-targeting therapies relatively
contraindicated. These data emphasize the need to perform randomized,
blinded trials on the use of PH-targeting drugs in children with
postoperative PH before accepting it as an indication for routine
treatment. Copyright © 2021, The Author(s).

<88>
Accession Number
2014343865
Title
Indonesian Study: Triiodothyronine for Infants Less than 5 Months
Undergoing Cardiopulmonary Bypass.
Source
Pediatric Cardiology. 43(4) (pp 726-734), 2022. Date of Publication: April
2022.
Author
Marwali E.M.; Lopolisa A.; Sani A.A.; Rayhan M.; Roebiono P.S.; Fakhri D.;
Haas N.A.; Slee A.; Portman M.A.
Institution
(Marwali, Lopolisa, Sani, Rayhan) Pediatric Cardiac Intensive Care Unit,
National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Marwali, Roebiono) Department of Cardiology and Vascular Medicine,
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
(Roebiono) Pediatric Cardiology Unit, National Cardiovascular Center
Harapan Kita, Jakarta, Indonesia
(Fakhri) Pediatric Cardiac Surgery Unit, National Cardiovascular Center
Harapan Kita, Department of Cardiothoracic Vascular Surgery, Faculty of
Medicine, Universitas Indonesia, Jakarta, Indonesia
(Haas) Department of Pediatric Cardiology and Pediatric Intensive Care,
Medical Hospital of the University of Munich, Munich, Germany
(Slee) Axio Research, Seattle Children's Hospital and Research Institute,
Seattle, United States
(Portman) Seattle Children's Hospital, University of Washington, Seattle,
WA, United States
(Marwali) National Cardiovascular Center Harapan Kita, Jl. Let. Jend. S.
Parman, Kav 87, West Jakarta, Slipi 11420, Indonesia
Publisher
Springer
Abstract
This study evaluates the efficacy and safety of oral triiodothyronine on
time to extubation for infants less than 5 months undergoing heart surgery
in Indonesia, and primarily relates to patients in emerging programs with
high malnutrition and mortality. In this randomized, double-blind,
placebo-controlled trial, oral triiodothyronine (T3, Tetronine) 1
mug/kg-body weight/dose or placebo (saccharum lactis) was administered via
nasogastric tube every 6 h for 60 h to treatment group. A total of 120
patients were randomized into T3 (61 patients) and placebo (59 patients)
groups. The majority of the patients had moderate to severe malnutrition
(55.83%) with a high post-operative mortality rate of 23.3%. The T3 group
showed significantly higher serum FT3 levels from 1 until 48 h post
cross-clamp removal (p < 0.0001), lower incidence of low cardiac output
syndrome at both 6 h (28 [45.9%] vs. 39 [66.1%] patients, p = 0.03, OR
2.3, 95% CI: 1.10-4.81) and 12 h after cross-clamp removal (25 [41.7%] vs.
36 [63.2%], p = 0.02, OR 2.40, 95% CI: 1.14-5.05). Although not
statistically significant, the treatment group had shorter median (IQR)
intubation time (2.59 [1.25-5.24] vs. 3.77 [1.28-6.64] days, p = 0.16, HR
1.36, 95% CI: 0.88-2.09)] and lower mortality (10 [16.4%] vs. 18 [30.5%],
p = 0.07]. Patients with Aristotle score < 10.0 (low risk) receiving T3
had faster extubation than placebo patients (p = 0.021, HR of 1.90, 95%
CI: 1.10-3.28) and were significantly less likely to require CPR or
experience infection (p = 0.027, OR 8.56, 95% CI:0.99-73.9 and p = 0.022,
OR 4.09 95% CI: 1.16-14.4, respectively). Oral T3 supplementation reduced
overall incidence of low cardiac output syndrome and significantly reduced
the time to extubation in low-risk patients. Therefore, prophylactic oral
T3 administration may be beneficial in these patients. Trial Registration:
ClinicalTrials.gov NCT02222532. Copyright © 2021, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<89>
[Use Link to view the full text]
Accession Number
2017581309
Title
Extremely premature infants with patent ductus arteriosus closure:
Comparative analysis of surgical ligation versus cardiac
catheterization-based closure.
Source
Medicine (United States). 101(12) (pp E29103), 2022. Date of Publication:
25 Mar 2022.
Author
Pandey R.; Youmans L.; Aneji C.; Bell C.; Breinholt J.; Khan A.
Institution
(Pandey, Youmans, Aneji, Bell, Khan) McGovern School of Medicine,
University of Texas, Health Science Center at Houston, MSB 6.232, Houston,
TX 77584, United States
(Breinholt) Phoenix Children's Hospital, Phoenix, AZ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Abstract Our objective was to compare postprocedure hemodynamic
decompensation in extremely premature infants who had their patent ductus
arteriosus (PDA) closed with surgical ligation (SL) versus cardiac
catheter-based closure (CCC). This is a single-center retrospective review
of extremely premature (< 28 weeks) infants who had their PDA closed by SL
or CCC. Of the total of 69 infants, 53 underwent SL, and 16 had CCC.
Infants in 2 groups were comparable at birth. However, at the time of the
procedure, infants in the SL group were smaller, less mature, and had
higher respiratory support. Vasopressor use, both pre- and postprocedure,
was more common in the SL group. Nineteen percent of the infants in the SL
group, compared to 6% in the CCC group (P =.34), required dose escalation
or use of vasopressors after the PDA closure. There was no significant
difference between the 2 groups in postoperative hemodynamic
decompensation. Large, multicenter, prospective study or randomized
control trial will help to confirm our findings. Copyright © 2022
Lippincott Williams and Wilkins. All rights reserved.

<90>
[Use Link to view the full text]
Accession Number
2017581286
Title
A holistic investigation of the global outcomes of spontaneous
pneumothorax during 1980-2021, including the COVID-19 pandemic A
bibliometric approach.
Source
Medicine (United States). 101(11) (no pagination), 2022. Article Number:
e29113. Date of Publication: 18 Mar 2022.
Author
Baldemir R.; Ulger G.
Institution
(Baldemir, Ulger) Anesthesiology and Reanimation Clinic, Ankara Ataturk
Chest Diseases and Thoracic Surgery Training and Research Hospital,
University of Health Sciences, Ankara, Turkey
Publisher
Lippincott Williams and Wilkins
Abstract
Background: During coronavirus pandemic, despite the increase in the
number of studies on spontaneous pneumothorax (SP), there is not enough
bibliometric study in the literature. In this study, it was aimed to
analyze scientific articles published on SP. Method(s): Studies
published on SP between 1980 and 2021 were obtained from the Web of
Science database and analyzed using statistical and bibliometric methods.
Spearman correlation coefficient was used for correlation studies. The
exponential smoothing estimator was used to forecast publication trend for
coming years. Network visualization maps were used to analyze citations
and identify trending topics. Result(s): A total of 2422 publications
were found. 1403 (57.9%) of these publications were articles. The articles
on SP have increased with a non-linear trend in recent years. The top 5
contributors to the literature were USA (231, 16.4%), Japan (161, 11.4%),
United Kingdom (98, 6.9%), France (81, 5.7%), and Taiwan (78, 5.5%). The
top 3 most active institutions were National Taiwan University Hospital
(22, 1.5%), Catholic University Korea (19, 1.3%), and National Taiwan
University (19, 1.3%). The top 3 journals that published the most articles
were Chest (51), Annals of Thoracic Surgery (46), and Journal of Thoracic
Disease (45). The most studied subjects were primary SP, recurrence,
thoracoscopy, pleurodesis, video-assisted thoracoscopic surgery, COVID-19,
video-assisted thoracic surgery, chest tube(s), and secondary spontaneous
pneumothorax. According to trend topics analysis, the keywords studied in
recent years are COVID-19, chest tubes, pneumonia, subcutaneous emphysema,
risk factors, dyspnea, primary SP, FLCN gene, tension pneumothorax,
uniportal, postoperative recurrence, secondary spontaneous pneumothorax,
chronic obstructive pulmonary disease, and uniportal. Conclusion(s):
In this comprehensive bibliometric study, we summarized 1403 articles
about SP, which has an increasing trend in the number of articles during
the COVID-19 pandemic process. This article can be a useful resource for
clinicians and scientists through presenting a summary of worldwide
studies related to SP, including the ones during COVID-19
pandemic. Copyright © 2022 the Author(s).

<91>
Accession Number
2015573334
Title
The effect of dexmedetomidine on neuroprotection in pediatric cardiac
surgery patients: study protocol for a prospective randomized controlled
trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 271. Date of
Publication: December 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, 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
BioMed Central Ltd
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. 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 1 mug/kg and a maintenance dose of
0.5 mug/kg/h or the same amount of normal saline will be administered.
Upon initiation of cardiopulmonary bypass, an additional dose of
dexmedetomidine (0.01 mug/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(s): 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 Copyright © 2022, The Author(s).

<92>
Accession Number
2015564616
Title
Serum cystatin C is associated with the prognosis in acute myocardial
infarction patients after coronary revascularization: a systematic review
and meta-analysis.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
156. Date of Publication: December 2022.
Author
Chen J.; Yang Y.; Dai C.; Wang Y.; Zeng R.; Liu Q.
Institution
(Liu) The Third Affiliated Hospital, Zhejiang Chinese Medical University,
Zhejiang, Hangzhou 310000, China
(Chen, Yang, Dai, Wang, Zeng, Liu) The First School of Clinical Medicine,
Zhejiang Chinese Medical University, Zhejiang, Hangzhou 310000, China
Publisher
BioMed Central Ltd
Abstract
Objective: Our study aimed to assess the association between serum
cystatin C levels and prognosis in acute myocardial infarction (AMI)
patients after coronary reconstructive surgery. Method(s): We
searched PubMed, Embase, and Cochrane Library up to January 21, 2022
without language restriction. Outcomes were major cardiovascular events
(MACEs) and mortality. The risk ratio (RR) and 95% confidence interval
(CI) were merged by random-effect models. Result(s): We included 8
studies with a total of 7,394 subjects in our meta-analysis. Our
meta-analysis showed that higher-level of serum cystatin C levels were
associated with higher risk of MACEs (RR = 2.52, 95% CI 1.63-3.89, P <
0.001) and mortality (RR = 2.64, 95% CI 1.66-4.19, P < 0.001) in AMI
patients after coronary revascularization. Subgroup analysis showed that
the serum cystatin C levels were associated with significantly higher risk
of MACEs (RR = 2.72, 95% CI 1.32-5.60, P = 0.006) and mortality (RR =
2.98, 95% CI 1.21-7.37, P = 0.020) in AMI patients after percutaneous
coronary intervention (PCI). However, in AMI patients after coronary
artery bypass surgery, there were no significantly higher risk of MACEs
(RR = 2.41, 95% CI 0.98-5.93, P = 0.05) and mortality (RR = 3.15, 95% CI
0.76-13.03, P = 0.10). Further subgroup analysis showed that this
significantly higher risk of MACEs and mortality did not change with the
study sample size, study population area or study follow-up time.
 Conclusion(s): The meta-analysis demonstrated that higher serum
cystatin C levels were associated with significantly higher risk of MACEs
and mortality in AMI patients after PCI. It is a biomarker for risk
stratification for predicting the prognosis in AMI patients after
PCI. Copyright © 2022, The Author(s).

<93>
Accession Number
2017645406
Title
Dielectric property measurements for the rapid differentiation of thoracic
lymph nodes using XGBoost in patients with non-small cell lung cancer: a
self-control clinical trial.
Source
Translational Lung Cancer Research. 11(3) (pp 342-356), 2022. Date of
Publication: March 2022.
Author
Lu D.; Peng J.; Sun Y.; Zhai J.; Wang Z.; Chen Z.; Matsumoto Y.; Wang L.;
Xin S.X.; Cai K.
Institution
(Lu, Peng, Zhai, Wang, Chen, Cai) Department of Thoracic Surgery, Nanfang
Hospital, Southern Medical University, Guangzhou, China
(Wang, Wang) School of Computer and Communication Engineering, University
of Science and Technology Beijing, Beijing, China
(Sun) Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental
Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai,
China
(Sun) School of Biomedical Engineering, Southern Medical University,
Guangzhou, China
(Matsumoto) Respiratory Endoscopy Division, Department of Endoscopy,
National Cancer Center Hospital, Tokyo, Japan
(Xin) Laboratory of Biophysics, School of Medicine, South China University
of Technology, Guangzhou, China
Publisher
AME Publishing Company
Abstract
Background: One of the important criteria for thoracic surgeons in making
surgical strategies is whether the thoracic lymph nodes (LNs) are
metastatic. Frozen section (FS) is widely used as an intraoperative
diagnostic method, which is time-consuming and expensive. The dielectric
property, including permittivity and conductivity, varies with different
tissues. The extreme gradient boosting (XGBoost) is a powerful classifier
and widely used. Thus, this study aims to develop the rapid
differentiation method combining dielectric property and XGBoost, and
assess its efficacy on the thoracic LNs in patients with non-small cell
lung cancer (NSCLC). Method(s): This was a single center self-control
clinical trial with paraffin pathology section (PPS) results as gold
diagnosis. The LNs from the pathologically diagnosed patients with NSCLC
were recruited, which were measured by open-ended coaxial probe for the
dielectric property within 1-4,000 MHz after removal from the patients and
then were sent to perform FS and PPS diagnosis. The XGBoost combining with
dielectric property was developed to differentiate malignant LNs from
benign LNs. The classified efficacy was determined using the receiver
operator characteristic (ROC) curve and area under the curve (AUC).
 Result(s): A total of 204 LNs from 67 NSCLC patients were analyzed.
The mean values of the two parameters differed significantly (P<0.001)
between benign and malignant LNs. The AUC for permittivity and
conductivity were 0.850 [95% confidence interval (CI): 0.786 to 0.915;
P<0.001] and 0.887 (95% CI: 0.828 to 0.946; P<0.001), respectively. The
AUC was 0.893 (95% CI: 0.834 to 0.951; P<0.001) when the two parameters
were combined. After the application of the XGBoost, the AUC was 0.968
(95% CI: 0.918 to 1.000; P<0.001), and the accuracy was 87.80%. Its
sensitivity was 58.33% and the specificity was 100%. When the Synthetic
Minority Oversampling Technique (SMOTE) algorithm was used, the AUC was
0.954 (95% CI: 0.883 to 1.000; P<0.001) and the accuracy was 92.68%. Its
sensitivity was 83.33% and the specificity was 96.55%. Conclusion(s):
This method might be useful for thoracic surgeons during surgery, for its
relatively high efficacy in rapid differentiation of LNs for patients with
NSCLC. Copyright © 2022 AME Publishing Company. All rights
reserved.

<94>
Accession Number
2017637641
Title
Analgesia in Unilateral Breast Surgeries Using Ultra Sound-Guided Serratus
Plane Block With Dexmedetomidine versus fentanyl with bupivacaine.
Source
Journal of Cardiovascular Disease Research. 12(6) (pp 819-826), 2021. Date
of Publication: 2021.
Author
Hawas A.M.; Elhossary Z.E.; El Desouky M.I.; Zakzouk M.M.A.A.
Institution
(Hawas, Elhossary, El Desouky, Zakzouk) Department of anesthesia &
surgical intensive care and pain management, Faculty of Medicine, Zagazig
University, Egypt
Publisher
EManuscript Technologies
Abstract
Background: A large number of patients undergoing major surgical
procedures for the management of breast cancer complain of acute
postoperative pain. Many regional analgesic techniques are trying to
decrease the side effects associated with general anaesthesia and opioid
consumption.The aim of the present study was to find better achievement of
high quality of anesthesia and analgesia with haemodynamic stability for
patients undergoing unilateral breast surgeries. Patients and
Methods: This comparative prospective randomized double blinded controlled
clinical trial were conducted 60 patients who underwent for breast surgery
and carried out at Zagazig University Hospitals and aimedto find better
achievement of analgesia for these patients. Patients were divided into
three equal groups (20 patients in each), Group(C) received general
anesthesia (GA) only, Group (D) received US guided serratus plane block
using 30 ml of bupivacaine 0.25% plus 1mug /kg dexmedetomidine before
induction of GA. Group (F) who received USguided serratus plane block
using30 ml bupivacaine 0.25% plus 25mug fentanyl before induction of GA.
Routine laboratory investigations were applied. Patients were familiar
with the use of VAS score, identifying 0 as no pain and 10 as worst
imaginable pain. Routine monitoring, including ECG, noninvasive blood
pressure, HR, pulse oximetry in the preanesthesia room (base line data)
and every 5 minute for 15 minute then 10 minute till the end of surgery.
 Result(s): All the 60 patients participated in the study completed
the study as shown in the study flow diagram. As regard patients
characteristic, there were no statistically significant difference between
the studied groups as regards age, BMI and duration of surgery and
anesthesia. Post-operative MAP(mmHg) showed all studied groups had
increased mean arterial pressure postoperative with less mean arterial
pressure on group D than Group F than group C group. Post-operative heart
rate (beat/min), the three studied groups had increased heart rate
postoperative with less heart rate on group D than Group F than group C
group. At 18th and 24 hours postoperative, the heart rate returned to
normal with no statistically significant difference among the three
studied groups. The total postoperative pethidine requirement in the first
24 hours was statistically significant lower in group D than group F than
group C. Conclusion(s): Addition of dexmedetomidine to bupivacaine in
US-guided serratus plane block during breast surgery provide better
intraoperative and postoperative analgesia, delays time of first analgesic
request, reduces intraoperative and postoperative analgesic consumptions
compared with addition of fentanyl as an adjuvant to
bupivacaine. Copyright © 2021 EManuscript Technologies. All
rights reserved.

<95>
[Use Link to view the full text]
Accession Number
2017549683
Title
Effects of colloid preload on the incidence of hypotension in spinal
anesthesia for cesarean section: a systematic review and meta-analysis.
Source
Chinese Medical Journal. 134(9) (pp 1043-1051), 2021. Date of Publication:
05 May 2021.
Author
Gong R.-S.; Liu X.-W.; Li W.-X.; Zhao J.
Institution
(Gong) Department of Anesthesia, China-Japan Friendship Hospital, Chinese
Academy of Medical Sciences, Peking Union Medical College, Beijing, China
(Liu, Li, Zhao) Department of Anesthesia, China-Japan Friendship Hospital,
Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Hypotension is a common complication caused by spinal
anesthesia (SA), which may have adverse impacts on the condition of the
parturient and fetus. Liquid infusion was found to be relatively effective
for reducing the incidence of hypotension. However, the question of
whether colloid preload can optimize hemodynamic variables in the cesarean
section remains controversial. This study aims to determine the effects of
colloid preload on the incidence of hypotension induced by SA in elective
cesarean section. Method(s):Related keywords were searched on PubMed,
EMBASE, and Cochrane Library from inception dates to May 2020. Studies
included were evaluated for eligibility and quality. The primary outcome
was the intra-operative incidence of hypotension and severe hypotension.
The secondary outcomes included the lowest intra-operative systolic blood
pressure, the maximal intra-operative heart rate, the intra-operative
needs of ephedrine and phenylephrine, the incidence of maternal nausea
and/or vomiting, and neonatal outcomes (umbilical artery pH and Apgar
scores). Apart from the above, RevMan 5.3 was used for the data analysis.
 Result(s):Altogether nine randomized controlled trials were included
in the meta-analysis. There were no significant differences in the
incidence of intra-operative hypotension, severe hypotension, or neonatal
outcomes between the colloid preload group and control group, except for
the umbilical artery pH. Conclusion(s):This meta-analysis suggests
that colloid preload does not significantly reduce the incidence of
hypotension associated with SA in elective cesarean section.
 Copyright © 2021 The Chinese Medical Association.

<96>
Accession Number
637751567
Title
Cytoreductive surgery with hyperthermic intrathoracic chemotherapy for
malignant pleural mesothelioma: a systematic review.
Source
Thorax. (no pagination), 2022. Date of Publication: 11 Apr 2022.
Author
Dawson A.G.; Kutywayo K.; Mohammed S.B.; Fennell D.A.; Nakas A.
Institution
(Dawson) Department of Thoracic Surgery, University Hospitals of Leicester
NHS Trust, Leicester, United Kingdom
(Dawson, Fennell) Department of Cancer Studies, University of Leicester,
Leicester, United Kingdom
(Kutywayo, Nakas) Department of Thoracic Surgery, University Hospitals of
Leicester NHS Trust, Leicester, United Kingdom
(Mohammed) Department of Statistics, University of Leicester Clinical
Trials Unit, Leicester, United Kingdom
(Fennell) Department of Medical Oncology, University Hospitals of
Leicester NHS Trust, Leicester, United Kingdom
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Cytoreductive surgery has been used a part of multimodality
treatment in patients with malignant pleural mesothelioma (MPM). The
residual microscopic disease that remains will lead to disease progression
in the majority of patients. Delivery of hyperthermic intrathoracic
chemotherapy at the time of surgery has been used to address this
microscopic disease, however it's effect and place in the multimodality
treatment sphere is unknown. The aim of this systematic review was to
assess the effect of surgery and hyperthermic intrathoracic chemotherapy
in patients with MPM on overall survival and disease-free interval.
 METHOD(S): Ovid MEDLINE, Embase, Web of Science and the Cochrane
Database of Systematic Reviews were searched from database inception
through to June 2021. Studies reporting overall survival and/or
disease-free interval in patients with MPM undergoing cytoreductive
surgery with hyperthermic intrathoracic chemotherapy were considered.
Study quality was assessed using the Newcastle-Ottawa Scale. A narrative
review was performed. RESULT(S): Fifteen studies were eligible for
inclusion comprising 598 patients. Surgery with hyperthermic intrathoracic
chemotherapy was associated with a median overall survival and
disease-free interval ranging from 11 to 75 months and 7.2 to 57 months,
respectively. These appeared to be superior to patients not receiving
hyperthermic intrathoracic chemotherapy (overall survival: 5-36 months and
disease-free interval: 12.1-21 months). A higher dose of hyperthermic
intrathoracic chemotherapy was associated with an improvement in overall
survival compared with a lower dose: 18-31 months versus 6-18 months,
respectively. The most common morbidity was atrial fibrillation followed
by renal complications. CONCLUSION(S): Surgery with hyperthermic
intrathoracic chemotherapy offers a safe and effective therapy with an
improvement in disease-free interval and overall survival, particularly
when hyperthermic intrathoracic chemotherapy is administered at a higher
dose. PROSPERO REGISTRATION NUMBER: CRD42019129002. Copyright ©
Author(s) (or their employer(s)) 2022. No commercial re-use. See rights
and permissions. Published by BMJ.

<97>
Accession Number
637751508
Title
Nomogram for Postoperative Headache in Adult Patients Undergoing Elective
Cardiac Surgery.
Source
Journal of the American Heart Association. (pp e023837), 2022. Date of
Publication: 12 Apr 2022.
Author
Wang D.; Le S.; Wu J.; Xie F.; Li X.; Wang H.; Zhang A.; Du X.; Huang X.
Institution
(Wang, Le, Wang, Du, Huang) Department of Cardiovascular Surgery Union
Hospital Tongji Medical CollegeHuazhong University of Science and
Technology Wuhan China, China
(Wang, Xie) Department of Cardiovascular Surgery The First Affiliated
Hospital of Zhengzhou University Zhengzhou China, China
(Le) Department of Thoracic Surgery Zhongnan Hospital of Wuhan
UniversityWuhan University Wuhan China, China
(Wu) Key Laboratory for Molecular Diagnosis of Hubei Province The Central
Hospital of WuhanTongji Medical CollegeHuazhong University of Science and
Technology Wuhan China, China
(Li) Department of Nursing Huaihe Hospital of Henan University Kaifeng
Henan China, China
(Zhang) Department of Cardiology The Central Hospital of WuhanTongji
Medical CollegeHuazhong University of Science and Technology Wuhan China,
China
Publisher
NLM (Medline)
Abstract
Background Postoperative headache (POH) is frequent after cardiac surgery;
however, few studies on risk factors for POH exist. The aims of the
current study were to explore risk factors related to POH after elective
cardiac surgery and to establish a predictive system. Methods and Results
Adult patients undergoing elective open-heart surgery under
cardiopulmonary bypass from 2016 to 2020 in 4 cardiac centers were
retrospectively included. Two thirds of the patients were randomly
allocated to a training set and one third to a validation set. Predictors
for POH were selected by univariate and multivariate analysis. POH
developed in 3154 of the 13 440 included patients (23.5%) and the overall
mortality rate was 2.3%. Eight independent risk factors for POH after
elective cardiac surgery were identified, including female sex, younger
age, smoking history, chronic headache history, hypertension, lower left
ventricular ejection fraction, longer cardiopulmonary bypass time, and
more intraoperative transfusion of red blood cells. A nomogram based on
the multivariate model was constructed, with reasonable calibration and
discrimination, and was well validated. Decision curve analysis revealed
good clinical utility. Finally, 3 risk intervals were divided to better
facilitate clinical application. Conclusions A nomogram model for POH
after elective cardiac surgery was developed and validated using 8
predictors, which may have potential application value in clinical risk
assessment, decision-making, and individualized treatment associated with
POH.

<98>
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. 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. 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). 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. Copyright © 2022 The authors

<99>
Accession Number
2011079946
Title
Bradyarrhythmias and Physiologic Pacing in the ICU.
Source
Journal of Intensive Care Medicine. 37(5) (pp 595-610), 2022. Date of
Publication: May 2022.
Author
Lattell J.; Upadhyay G.A.
Institution
(Lattell, Upadhyay) Center for Arrhythmia Care
Heart and Vascular Institute, University of Chicago Pritzker School of
Medicine, The University of Chicago Medicine, Chicago, IL, United States
Publisher
SAGE Publications Inc.
Abstract
Bradyarrhythmias represent a common pathology in the intensive care unit
(ICU) with etiologies of varying severity. Treatment has often been
focused on correcting underlying causes and may require pacing for urgent
hemodynamic support. In recent years, there has been interest in
physiologic pacing modalities which avoid the dyssynchrony from right
ventricular (RV) only pacing. Cardiac resynchronization therapy (CRT)
through biventricular pacing is a well-established device-based electrical
therapy in patients with wide QRS and heart failure. Recently, it has been
shown that biventricular pacing may also be pursued for hemodynamic rescue
in the ICU setting. Efforts to re-engage the conduction system with His
bundle pacing or further downstream have also emerged as alternative means
to deliver resynchronization, with early applications in the ICU now being
reported. The goal of the review is to examine bradyarrhythmia causes and
management in the ICU as well as investigate new approaches in physiologic
pacing and their potential roles in critically ill patients. Copyright
© The Author(s) 2021.

<100>
Accession Number
637729891
Title
Ticagrelor for patients undergoing coronary artery bypass grafting: A
meta-analysis of randomized controlled trials.
Source
Perfusion. (pp 2676591221076284), 2022. Date of Publication: 10 Apr 2022.
Author
Xiang F.; Lin Y.; Chen B.
Institution
(Xiang, Lin, Chen) Department of Pharmacy, Second Affiliated Hospital,
Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Ticagrelor may be an alternative to aspirin as it provides
robust and consistent platelet inhibition. However, the effect of
ticagrelor treatment in patients undergoing coronary artery bypass
grafting (CABG) has not been well confirmed. We conducted a meta-analysis
to appraise whether ticagrelor therapy affects outcomes in CABG patients.
 METHOD(S): We searched PubMed, Embase, EBSCO, and Cochrane databases
from its inception up to 4 December 2020 for randomized controlled trials
that assessed ticagrelor versus non-ticagrelor in patients undergoing
CABG. The primary outcome was the incidence of saphenous vein graft (SVG)
occlusion at 1 year after CABG. Secondary outcomes were SVG occlusion at 7
days, major adverse cardiovascular events (MACE), and bleeding requiring
reoperation. RESULT(S): Seven trials including 4305 patients (2153
randomized to ticagrelor therapy and 2152 to non-ticagrelor therapy) were
included. One-hundred and thirty of 1140 patients (11.4%) randomized to
the ticagrelor group versus 175 of 1220 patients (14.3%) randomized to the
non-ticagrelor group experienced SVG occlusion at 1 year after CABG.
Compared to the control group, ticagrelor therapy yielded a significantly
lower risk of SVG occlusion [RR 0.79 (0.64-0.97), p = 0.03]. In the
subgroup analysis, ticagrelor plus aspirin compared with aspirin alone did
not decrease the risk of SVG occlusion after 1 year [RR 0.65 (0.40-1.07),
p = 0.09]. There was no difference in the incidence of SVG occlusion at 7
days [RR 0.67 (0.42-1.06), p = 0.09], MACE up to 1 year [RR 0.99
(0.81-1.21), p = 0.90], or bleeding requiring reoperation [RR 1.16
(0.80-1.70), p = 0.44]. CONCLUSION(S): Compared with non-ticagrelor
therapy, ticagrelor decreased the risk of saphenous vein graft occlusion
after 1 year in patients undergoing elective CABG with saphenous vein
grafting.

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