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<1>
Accession Number
366069873
Title
A systematic review and meta-analysis of the cardioprotective effects of
remote ischaemic preconditioning in open cardiacsurgery.
Source
Journal of the Royal Society of Medicine. 105(10) (pp 436-445), 2012. Date
of Publication: October 2012.
Author
Pilcher J.M.; Young P.; Weatherall M.; Rahman I.; Bonser R.S.; Beasley
W.R.
Institution
(Pilcher, Young, Beasley) Medical Research Institute of New Zealand,
Wellington 6242, New Zealand
(Young, Weatherall, Beasley) Capital and Coast District Health Board,
Wellington 6242, New Zealand
(Weatherall) University of Otago Wellington, Wellington 6242, New Zealand
(Rahman, Bonser) University Hospital, Birmingham NHS Trust, Birmingham B15
2PR, United Kingdom
(Bonser) University of Birmingham, Edgbaston, Birmingham B15 2TT, United
Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: To investigate the cardioprotective efficacy of remote
ischaemic preconditioning (RIPC) in cardiac surgery. <br/>Design(s): We
have performed a systematic search of MEDLINE, EMBASE and Cochrane Central
Register of Controlled Trials to identify randomized controlled trials
involving RIPC. <br/>Setting(s): Randomized controlled trials of RIPC in
open cardiac surgery patients. <br/>Main Outcome Measure(s): Meta-analysis
was performed with the primary outcome the standardized mean difference
between intervention and control groups in 12 hour postoperative troponin
concentration. Heterogeneity was examined by fixed effects
meta-regression. <br/>Result(s): Ten studies with a total of 693
participants were included in the meta-analysis. RIPC reduced troponin
levels 12 hours after surgery compared with control. The fixed and random
effects differences were 0.35 (95% CI 0.19 to 0.51) and 0.53 (95% CI
0.18-0.88) respectively. However, important heterogeneity was present.
Fixed effects metaregression partially accounted for heterogeneity based
on whether studies had full blinding, comprising blinding of patients,
surgeons, anaesthetists and investigators. Studies with incomplete or no
blinding demonstrated a larger estimate of effect, 0.74 (95% CI 0.47 to
1.00) compared to those with full blinding, 0.13 (95% CI - 0.07 to 0.33).
<br/>Conclusion(s): Although our analysis suggests RIPC may result in
cardiac protection during cardiac surgery, the effect was most marked in
studies without full blinding, with a smaller and statistically
nonsignificant effect in fully blinded studies. We propose that further
double blind randomized controlled trials investigating the
cardioprotective effects of RIPC in cardiac surgery are required to
resolve the current clinical uncertainty.

<2>
Accession Number
361711213
Title
Clinical evaluation of the air removal characteristics of an oxygenator
with integrated arterial filter in a minimized extracorporeal circuit.
Source
International Journal of Artificial Organs. 34(4) (pp 374-382), 2011. Date
of Publication: April 2011.
Author
Stehouwer M.C.; Boers C.; de Vroege R.; Kelder J.C.; Yilmaz A.; Bruins P.
Institution
(Stehouwer, Boers) Department of Extracorporeal Circulation, St Antonius
Hospital, Nieuwegein, Netherlands
(de Vroege) Department of Extracorporeal Circulation, HAGA Hospital, The
Hague, Netherlands
(Kelder) Department of Cardiology, St Antonius Hospital, Nieuwegein,
Netherlands
(Yilmaz) Department of Cardiothoracic Surgery, St Antonius Hospital,
Nieuwegein, Netherlands
(Bruins) Department of Anesthesiology, Intensive Care and Pain Management,
St Antonius Hospital, Nieuwegein, Netherlands
Publisher
Wichtig Publishing Srl
Abstract
The use of minimized extracorporeal circuits (MECC) in cardiac surgery is
an important measure to increase the biocompatibility of cardiopulmonary
bypass during coronary artery bypass grafting (CABG). These circuits
eliminate volume storage reservoirs and bubble traps to minimize the
circuit. However, the reduction in volume may increase the risk of gaseous
microemboli (GME). The MECC system as used by our group consists of a
venous bubble trap, centrifugal pump, and an oxygenator. To further reduce
the risk of introducing GME, an oxygenator with an integrated arterial
filter was developed based on the concept of minimal volume and foreign
surface. We studied the air removal characteristics of this oxygenator
with and without integrated arterial filter. The quantity and volume of
GME were measured with precision at both the inlet and outlet of the
devices. Our results showed that integration of an arterial filter into
this oxygenator increased GME reducing capacity from 69.2% to 92%.
Moreover, we were able to obtain data on the impact of an arterial filter
on the exact size-distribution of GME entering the arterial line. The
present study demonstrates that an MECC system and oxygenator with
integrated arterial filter significantly reduces the volume and size of
GME. The use of an integrated arterial filter in an MECC system may
protect the patient from the deleterious effects of CPB and may further
improve patient safety. &#xa9; 2011 Wichtig Editore.

<3>
Accession Number
358099927
Title
Clinical and biomaterial evaluation of a new condensed dual-function
extracorporeal circuit in reoperation for coronary artery bypass surgery.
Source
International Journal of Artificial Organs. 32(11) (pp 802-810), 2009.
Date of Publication: 2009.
Author
Gunaydin S.; McCusker K.; Vijay V.
Institution
(Gunaydin) Department of Cardiovascular Surgery, University of Kirikkale,
Kirikkale, Turkey
(McCusker) Portsmouth Regional Hospital, Portsmouth, NH, United States
(Vijay) State University of New York, Brooklyn, NY, United States
(Gunaydin) Department of CV Surgery, University of K. Kale, Angora Evleri
G-8 Bl. No: 1, Beysukent-Ankara 06800, Turkey
Publisher
Wichtig Publishing Srl
Abstract
Purpose: This prospective, randomized study compared the clinical
performance of three types of circuits: a newly introduced, fully-coated,
interchangeable open-closed circuit with a dual configuration (hard shell
with a bypass shunt), reduced length, and reduced prime of less than 800
cc (CondECC); a completely coated circuit (ECC); and a similar uncoated,
open circuit with standard length and prime (CONT). <br/>Method(s): 75
patients undergoing reoperation for coronary revascularization were
randomly allocated into three groups (n=25): Group 1: CondECC with
shortened tubing, components and an open-closed configuration of low
priming volume with a centrifugal pump and a shunt which bypassed the
reservoir for closed configuration; Group 2: ECC with a roller pump and
hard-shell reservoir; Group 3: CONT. Blood samples for CBC, inflammatory
mediators [interleukin-2 (IL-2), complement-3a (C3a)] and flow cytometry
(CD11b/CD18) were collected after induction (T1) and heparin
administration (T2), 15 min after cardiopulmonary bypass (CPB) (T3),
before cessation of CPB (T4), 15 min after reversal (T5), and the first
postoperative day (T6). <br/>Result(s): Leukocyte counts demonstrated
significant increases at T4, T5 in CONT but remained stable in ECC and
CondECC (p<0.05). Platelets were preserved better at T4, T5 in both ECC
and CondECC study groups (p<0.05). IL-2 and C3a levels were significantly
lower at T3, T4, T5 in CondECC and T4, T5 in ECC (p<0.05). Blood protein
adsorption analysis demonstrated increased amount of microalbumin on CONT
fibers (p<0.05). <br/>Conclusion(s): The CondECC is a flexible,
dual-function, open/closed configuration system that was easy to use, safe
and achieved better biocompatibility when compared to coated and uncoated
conventional circuits. &#xa9; Wichtig Editore, 2009.

<4>
Accession Number
637460912
Title
Benefits and harms of direct oral anticoagulation and low molecular weight
heparin for thromboprophylaxis in patients undergoing non-cardiac surgery:
Systematic review and network meta-analysis of randomised trials.
Source
The BMJ. 376 (no pagination), 2022. Article Number: e066785. Date of
Publication: 09 Mar 2022.
Author
Marcucci M.; Etxeandia-Ikobaltzeta I.; Yang S.; Germini F.; Gupta S.;
Agarwal A.; Ventresca M.; Tang S.; Morgano G.P.; Wang M.; Ahmed M.M.;
Neumann I.; Izcovich A.; Criniti J.; Popoff F.; Devereaux P.J.; Dahm P.;
Anderson D.; Lavikainen L.I.; Tikkinen K.A.O.; Guyatt G.H.; Schunemann
H.J.; Violette P.D.
Institution
(Marcucci, Etxeandia-Ikobaltzeta, Germini, Ventresca, Morgano, Devereaux,
Guyatt, Schunemann, Violette) Department of Health Research Methods
Evidence and Impact, McMaster University, Hamilton, ON, Canada
(Marcucci, Germini, Agarwal, Ahmed, Devereaux, Guyatt) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Marcucci, Devereaux) Population Health Research Institute, Hamilton, ON,
Canada
(Yang) Department of Anaesthesia, Jewish General Hospital, Montreal, QC,
Canada
(Gupta) Department of Medicine, Kingston Health Sciences Centre, Queen's
University, Kingston, ON, Canada
(Agarwal) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Tang) Department of Epidemiology, Nanjing Medical University, Nanjing,
China
(Wang) Department of Science, McMaster University, Hamilton, ON, Canada
(Wang) Department of Mathematics, University of Waterloo, Waterloo, ON,
Canada
(Neumann) Department of Internal Medicine, Pontificia Universidad Catolica
de Chile, Santiago de Chile, Chile
(Izcovich, Criniti, Popoff) Department of Internal Medicine, Hospital
Aleman, Buenos Aires, Argentina
(Dahm) Minneapolis Veterans Affair Health Care System, Urology Section,
Minneapolis, MN, United States
(Dahm) University of Minnesota, Department of Urology, Minneapolis, MN,
United States
(Anderson) Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
(Lavikainen) Faculty of Medicine, University of Helsinki, Helsinki,
Finland
(Tikkinen) Department of Urology, University of Helsinki, Helsinki
University Hospital, Helsinki, Finland
(Tikkinen) Department of Surgery, South Karelian Central Hospital,
Lappeenranta, Finland
(Schunemann) Michael DeGroote Cochrane Canada Centre, Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Violette) Department of Surgery, McMaster University, Hamilton, ON,
Canada
Publisher
BMJ Publishing Group
Abstract
Objective To systematically compare the effect of direct oral
anticoagulants and low molecular weight heparin for thromboprophylaxis on
the benefits and harms to patients undergoing non-cardiac surgery. Design
Systematic review and network meta-analysis of randomised controlled
trials. Data sources Medline, Embase, and the Cochrane Central Register of
Controlled Trials (CENTRAL), up to August 2021. Review methods Randomised
controlled trials in adults undergoing non-cardiac surgery were selected,
comparing low molecular weight heparin (prophylactic (low) or higher dose)
with direct oral anticoagulants or with no active treatment. Main outcomes
were symptomatic venous thromboembolism, symptomatic pulmonary embolism,
and major bleeding. Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines were used for network meta-analyses.
Abstracts and full texts were screened independently in duplicate. Data
were abstracted on study participants, interventions, and outcomes, and
risk of bias was assessed independently in duplicate. Frequentist network
meta-analysis with multivariate random effects models provided odds ratios
with 95% confidence intervals, and GRADE (grading of recommendations,
assessment, development, and evaluation) assessments indicated the
certainty of the evidence. Results 68 randomised controlled trials were
included (51 orthopaedic, 10 general, four gynaecological, two thoracic,
and one urological surgery), involving 45 445 patients. Low dose (odds
ratio 0.33, 95% confidence interval 0.16 to 0.67) and high dose (0.19,
0.07 to 0.54) low molecular weight heparin, and direct oral anticoagulants
(0.17, 0.07 to 0.41) reduced symptomatic venous thromboembolism compared
with no active treatment, with absolute risk differences of 1-100 per 1000
patients, depending on baseline risks (certainty of evidence, moderate to
high). None of the active agents reduced symptomatic pulmonary embolism
(certainty of evidence, low to moderate). Direct oral anticoagulants and
low molecular weight heparin were associated with a 2-3-fold increase in
the odds of major bleeding compared with no active treatment (certainty of
evidence, moderate to high), with absolute risk differences as high as 50
per 1000 in patients at high risk. Compared with low dose low molecular
weight heparin, high dose low molecular weight heparin did not reduce
symptomatic venous thromboembolism (0.57, 0.26 to 1.27) but increased
major bleeding (1.87, 1.06 to 3.31); direct oral anticoagulants reduced
symptomatic venous thromboembolism (0.53, 0.32 to 0.89) and did not
increase major bleeding (1.23, 0.89 to 1.69). Conclusions Direct oral
anticoagulants and low molecular weight heparin reduced venous
thromboembolism compared with no active treatment but probably increased
major bleeding to a similar extent. Direct oral anticoagulants probably
prevent symptomatic venous thromboembolism to a greater extent than
prophylactic low molecular weight heparin. Systematic review registration
PROSPERO CRD42018106181.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2019.

<5>
Accession Number
637198934
Title
Cardiac Infiltration as the First Manifestation of Acute Lymphoblastic
Leukemia: A Systematic Review.
Source
Frontiers in Oncology. 12 (no pagination), 2022. Article Number: 805981.
Date of Publication: 27 Jan 2022.
Author
Luo Z.; Cheng J.; Wang Y.
Institution
(Luo, Wang) Department of Internal Medicine, Zhongnan Hospital of Wuhan
University, Wuhan, China
(Cheng, Wang) Medical Research Institute of Wuhan University, Wuhan, China
Publisher
Frontiers Media S.A.
Abstract
Cardiac symptoms or signs as the first manifestations in acute
lymphoblastic leukemia patients are sporadically reported which lead to
misdiagnosis or delayed diagnosis due to lack of clinical experience and
improper diagnosis procedures. Here, we documented the clinical features,
procedures of diagnosis, treatments, and outcomes from the so-far reported
30 lymphoblastic leukemia cases that initially presented as cardiac
problems and provided management recommendations based on the experiences
and lessons learned from these patients to help physicians avoid
misdiagnosis and improper treatment.<br/>Copyright &#xa9; 2022 Luo, Cheng
and Wang.

<6>
Accession Number
2016019136
Title
Coronary Revascularization Versus Optimal Medical Therapy in Renal
Transplant Candidates With Coronary Artery Disease: A Systematic Review
and Meta-Analysis.
Source
Journal of the American Heart Association. 11(4) (no pagination), 2022.
Article Number: e023548. Date of Publication: 15 Feb 2022.
Author
Siddiqui M.U.; Junarta J.; Marhefka G.D.
Institution
(Siddiqui, Junarta) Department of Medicine, Thomas Jefferson University
Hospitals, Philadelphia, PA, United States
(Marhefka) Jefferson Heart Institute, Thomas Jefferson University
Hospitals, Philadelphia, PA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Coronary artery disease (CAD) is highly prevalent in patients
with chronic kidney disease and is a common cause of mortality in
end-stage renal disease. Thus, patients with end-stage renal disease are
routinely screened for CAD before renal transplantation. The usefulness of
revascularization before transplantation remains unclear. We hypothesize
that there is no difference in all-cause and cardiovascular mortality in
waitlisted renal transplant candidates with CAD who underwent
revascularization versus those treated with optimal medical therapy before
transplantation. METHODS AND RESULTS: This meta-analysis was reported
according to the Preferred Reporting Items for Systematic Review and
Meta-Analyses guidelines. MEDLINE, Scopus, and Cochrane Central Register
of Controlled Trials were systematically searched to identify relevant
studies. Risk of bias was assessed using the modified Newcastle-Ottawa
Scale and Cochrane risk of bias tool. The primary outcome of interest was
all-cause mortality. Eight studies comprising 945 patients were included
(36% women, mean age 56 years). There was no difference in all-cause
mortality (risk ratio [RR], 1.16 [95% CI, 0.63- 2.12), cardiovascular
mortality (RR, 0.75 [95% CI, 0.29-1.89]), or major adverse cardiovascular
events (RR, 0.78 [95% CI, 0.30- 2.07]) when comparing renal transplant
candidates with CAD who underwent revascularization versus those who were
on optimal medical therapy before renal transplant. <br/>CONCLUSION(S):
This meta-analysis demonstrates that revascularization is not superior to
optimal medical therapy in reducing all-cause mortality, cardiovascular
mortality, or major adverse cardiovascular events in waitlisted kidney
transplant candidates with CAD who eventually underwent kidney
transplantation.<br/>Copyright &#xa9; 2022 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley. T.

<7>
[Use Link to view the full text]
Accession Number
2016780020
Title
Efficacy of distraction for reducing pain and distress associated with
venipuncture in the pediatric posttransplant population.
Source
Pediatric Emergency Care. 38(2) (pp E811-E815), 2022. Date of Publication:
01 Feb 2022.
Author
Grabinski Z.G.; Boscamp N.S.; Zuckerman W.A.; Zviti R.; O'Brien A.;
Martinez M.; Tsze D.S.
Institution
(Grabinski, Tsze) Division of Pediatric Emergency Medicine, Department of
Emergency Medicine, Columbia University Irving Medical Center, New York,
NY, United States
(Boscamp) Department of Pediatrics, Columbia University Irving Medical
Center, New York, NY, United States
(Zuckerman) Division of Cardiology, Department of Pediatrics, Columbia
University Irving Medical Center, New York, NY, United States
(Zviti, O'Brien) Division of Nephrology, Department of Pediatrics,
Columbia University Irving Medical Center, New York, NY, United States
(Martinez) Division of Hepatology and Gastroenterology, Department of
Pediatrics, Columbia University Irving Medical Center, New York, NY,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Distraction can reduce pain and distress associated with
painful procedures but has never been studied in children with solid organ
transplants. We aimed to determine whether there is a difference in pain
and distress associated with venipuncture in pediatric posttransplant
patients who receive distraction compared with those who do not.
<br/>Method(s): Randomized controlled trial of children aged 4 to 17 years
with solid organ transplants undergoing venipuncture in the outpatient
setting. Patients were randomized to receive distraction or no
distraction. The primary outcome was the Faces Pain Scale-Revised.
Secondary outcomes were the Observational Scale of Behavioral
Distress-Revised; Faces, Leg, Activity, Cry, Consolability; and Children's
Hospital of Eastern Ontario Pain Scale. Exploratory outcomes included the
number of venipuncture attempts, time to successful venipuncture, and
satisfaction of phlebotomists and parents. <br/>Result(s): Median age of
the 40 children enrolled was 11.5 years. Type of transplants included the
heart (67.5%), kidney (22.5%), liver (7.5%), and more than 1 organ (2.5%).
There was no difference between the Faces Pain Scale-Revised scores in
distraction and no distraction groups (1.4; 95% confidence interval,
0.9-1.9; and 1.3, 95% confidence interval, 0.5-2.1, respectively). There
was also no difference in the Observational Scale of Behavioral
Distress-Revised; Faces, Leg, Activity, Cry, Consolability; and Children's
Hospital of Eastern Ontario Pain Scale scores, number of venipuncture
attempts, or time to successful venipuncture. Phlebotomists were more
satisfied with the venipuncture when distraction was implemented.
<br/>Conclusion(s): In children with solid organ transplants, there was no
difference in pain and distress associated with venipuncture between those
who did and did not receive distraction. There was also no difference in
other procedure-related outcomes except for greater phlebotomist
satisfaction when distraction was implemented.<br/>Copyright &#xa9; 2021
Wolters Kluwer Health, Inc. All rights reserved.

<8>
Accession Number
2016694612
Title
Tongxinluo capsule as supplementation and cardiovascular endpoint events
in patients with coronary heart disease: A systematic review and
meta-analysis of randomized, double-blind, placebo-controlled trials.
Source
Journal of Ethnopharmacology. 289 (no pagination), 2022. Article Number:
115033. Date of Publication: 10 May 2022.
Author
Lv J.; Liu S.; Guo S.; Gao J.; Song Q.; Cui X.
Institution
(Lv, Song) Department of General Internal Medicine, Guang'anmen Hospital,
China Academy of Chinese Medical Sciences, Beijing 100053, China
(Liu) College of Traditional Chinese Medicine, China Academy of Chinese
Medical Science, Beijing 100000, China
(Guo) College of Traditional Chinese Medicine, Shandong University of
Traditional Chinese Medicine, Jinan, Shandong Province 250355, China
(Gao, Cui) Department of Cardiology, Guang'anmen Hospital, China Academy
of Chinese Medical Sciences, Beijing 100053, China
Publisher
Elsevier Ireland Ltd
Abstract
Ethnopharmacological relevance: Tongxinluo Capsule(TXLC) is a well-known
traditional Chinese medicine prescription with effects of tonifying Qi and
activating blood based on the Chinese herbal medicine theory that has been
recommended as routine adjuvant treatment in patients with coronary heart
disease (CHD) in China. Aim of the study: This meta-analysis aimed to
evaluate the efficacy and safety of TXLC as supplementation in the
prevention of adverse cardiovascular events in patients with CHD.
<br/>Material(s) and Method(s): We performed a literature search in
Pubmed, Cochrane Library, China National Knowledge Infrastructure (CNKI),
Chinese Scientific Journals Database (VIP), Wan Fang Database, and Chinese
Biomedical Database (CBM) from their inceptions to March 2020. Only
randomized controlled trials (RCTs) that assessed supplementation with
TXLC or placebo and with adverse cardiovascular outcomes, were included in
this meta-analysis. Primary end points were myocardial infarction (MI),
target vessel revascularization (TVR) or in-stent restenosis (ISR), and
cardiovascular death. Secondary end points included cerebrovascular
accidents, heart failure (HF), and unscheduled readmission for
cardiovascular diseases (CVDs). Adverse drug events were also evaluated.
Trial sequential analysis (TSA) was conducted to reduce random errors
introduced by possible insufficient sample size. <br/>Result(s): Eleven
RCTs involving 1505 patients were analyzed. The mean(SD) age of included
patients were 59.03(9.7) years. Treatment duration varied from 2 months to
12 months. Compared with placebo, TXLC supplementation showed significant
effects on reducing the risk of MI (RR = 0.44, [95% CI, 0.24-0.80]), TVR
or ISR (RR = 0.43, [95% CI, 0.31-0.58]), cerebrovascular accidents(RR =
0.17, [95% CI, 0.06-0.46]), HF (RR = 0.41, [95% CI, 0.21-0.79]), and
unscheduled readmission for CVDs (RR = 0.72, [95% CI], P = 0.04), but did
not have associations with incidence of cardiovascular death (RR = 0.53,
[95% CI, 0.15-1.91]). Subgroups of trials with 2-month (MI: RR = 0.44,
[95% CI, 0.13-1.53]; cardiovascular death: RR = 0.30, [95% CI, 0.01-7.67];
cerebrovascular accidents: RR = 0.04, [95% CI, 0.01-0.26]; unscheduled
readmission for CVDs: RR = 0.43, [95% CI, 0.20-0.94]) and 12-month (MI: RR
= 0.42, [95% CI, 0.20-0.89]; TVR or ISR: RR = 0.42, [95% CI, 0.31-0.58];
HF: RR = 0.34, [95% CI, 0.14-0.78]; unscheduled readmission for CVDs: RR =
0.85, [95% CI, 0.59-1.22]) intervention period were analyzed. The adverse
drug reactions were mild with no significant difference between TXLC and
placebo. <br/>Conclusion(s): This meta-analysis indicated that TXLC
supplementation had beneficial effects on the prevention of cardiovascular
adverse events, especially in TVR or ISR after coronary revascularization
and may possibly lower the incidence of first or recurrent MI and HF
within 12 months in patients with CHD, while insufficient sample size
implied that these results lacked certain stability. And the effects of
TXLC on cardiovascular mortality, cerebrovascular events, and unscheduled
readmission for CVDs could not be confirmed due to insufficient cases.
Clinical trials with large-sample sizes and extended follow-up time are of
interest in the future researches.<br/>Copyright &#xa9; 2022 Elsevier B.V.

<9>
Accession Number
2015388550
Title
A Loading Dose of Dexmedetomidine With Constant Infusion Inhibits
Intraoperative Neuromonitoring During Thoracic Spinal Decompression
Surgery: A Randomized Prospective Study.
Source
Frontiers in Pharmacology. 13 (no pagination), 2022. Article Number:
840320. Date of Publication: 07 Mar 2022.
Author
Liu T.; Qin Y.; Qi H.; Luo Z.; Yan L.; Yu P.; Dong B.; Zhao S.; Wu X.;
Chang Z.; Liu Z.; Liu X.; Yuan T.; Li H.; Xiao L.; Wang G.
Institution
(Liu, Qin, Luo, Dong, Wu, Xiao) Department of Anesthesiology, Xi'an
Honghui Hospital, Xi'an Jiaotong University Health Science Center, Xi'an,
China
(Qi, Liu, Yuan) Department of Functional Inspection Section, Xi'an Honghui
Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, China
(Yan, Zhao, Chang, Li) Department of Spine Surgery, Xi'an Honghui
Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, China
(Yu) Department of Gastrointestinal Surgery, Xijing Hospital of Digestive
Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an,
China
(Liu, Wang) The Key Laboratory of Biomedical Information Engineering,
Ministry of Education, School of Life Science and Technology, Institute of
Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
Publisher
Frontiers Media S.A.
Abstract
Background: The effect of a bolus dose of dexmedetomidine on
intraoperative neuromonitoring (IONM) parameters during spinal surgeries
has been variably reported and remains a debated topic. <br/>Method(s): A
randomized, double-blinded, placebo-controlled study was performed to
assess the effect of dexmedetomidine (1 mug/kg in 10 min) followed by a
constant infusion rate on IONM during thoracic spinal decompression
surgery (TSDS). A total of 165 patients were enrolled and randomized into
three groups. One group received propofol- and remifentanil-based total
intravenous anesthesia (TIVA) (T group), one group received TIVA combined
with dexmedetomidine at a constant infusion rate (0.5 mug kg^-1
h^-1) (D<inf>1</inf> group), and one group received TIVA
combined with dexmedetomidine delivered in a loading dose (1 mug
kg^-1 in 10 min) followed by a constant infusion rate (0.5 mug
kg^-1 h^-1) (D<inf>2</inf> group). The IONM data
recorded before test drug administration was defined as the baseline
value. We aimed at comparing the parameters of IONM. <br/>Result(s): In
the D<inf>2</inf> group, within-group analysis showed suppressive effects
on IONM parameters compared with baseline value after a bolus dose of
dexmedetomidine. Furthermore, the D<inf>2</inf> group also showed
inhibitory effects on IONM recordings compared with both the D<inf>1</inf>
group and the T group, including a statistically significant decrease in
SSEP amplitude and MEP amplitude, and an increase in SSEP latency. No
significance was found in IONM parameters between the T group and the
D<inf>1</inf> group. <br/>Conclusion(s): Dexmedetomidine delivered in a
loading dose can significantly inhibit IONM parameters in TSDS. Special
attention should be paid to the timing of a bolus dose of dexmedetomidine
under IONM. However, dexmedetomidine delivered at a constant speed does
not exert inhibitory effects on IONM data.<br/>Copyright &#xa9; 2022 Liu,
Qin, Qi, Luo, Yan, Yu, Dong, Zhao, Wu, Chang, Liu, Liu, Yuan, Li, Xiao and
Wang.

<10>
Accession Number
2015371370
Title
Autologous pericardium for adult and elderly patients undergoing aortic
valve replacement: A systematic review.
Source
Cirugia Cardiovascular. 29(1) (pp 25-30), 2022. Date of Publication: 01
Jan 2022.
Author
Dilawar I.; Putra M.A.; Makdinata W.; Billy M.; Paat R.K.
Institution
(Dilawar, Putra, Makdinata, Billy, Paat) Division of Adult Cardiac
Surgery, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas
Indonesia, Indonesia
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Ozaki et al. first performed aortic valve replacement using autologous
pericardium in 2007. Compared to mechanical and bioprosthetic valves which
have apparent disadvantages, this technique has been an alternative with a
promising safety and efficacy result. A comprehensive search was carried
out in 4 databases (Pubmed, Cochrane Library, Proquest, Scopus) from
February to March 2021 using search terms "autologous pericardium",
"aortic valve replacement", and "aortic valve reconstruction". Outcomes
measured in this study were mortality, freedom of operation,
thromboembolic and endocarditis event, and echocardiography finding. Risk
bias of all studies was measured using MINORS criteria. A total of 12
studies involving 1427 subjects were included. The mean age was 64.95
years and 52.1% subjects were male. Mortality due to cardiac and
noncardiac cause was 1.75%. Reoperation was needed in 1.12% subjects.
Thromboembolic and endocarditis events occurred in 0.21% and 0.91%
respectively. All studies reported lower average peak pressure gradient
after surgery. Aortic valve replacement using autologous pericardium has a
tolerable safety and efficacy.<br/>Copyright &#xa9; 2021 Sociedad Espanola
de Cirugia Cardiovascular y Endovascular

<11>
Accession Number
2015090564
Title
Variable definitions and treatment approaches for atrial functional mitral
regurgitation: A scoping review of the literature.
Source
Journal of Cardiac Surgery. 37(5) (pp 1182-1191), 2022. Date of
Publication: May 2022.
Author
Amabile A.; Fereydooni S.; Mori M.; Hameed I.; Jung J.; Krane M.; Geirsson
A.
Institution
(Amabile, Fereydooni, Mori, Hameed, Jung, Krane, Geirsson) Division of
Cardiac Surgery, Department of Surgery, Yale School of Medicine, New
Haven, CT, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Atrial functional mitral regurgitation (AFMR) is a subtype of
functional mitral regurgitation due to longstanding atrial fibrillation
(AF) or heart failure with preserved ejection fraction. The variation in
AFMR' definition and the common mode of treatment described in the
literature remain unknown. <br/>Method(s): We performed a scoping review
of studies that surgically treated AFMR to characterize the existing
variability in the definition of AFMR, the type of operations performed
for AFMR valvulopathy, and the treatment for the chronic AF. We searched
Medline, EMBASE, Cochrane Library, Scopus, and Web of Science since their
inceptions for studies of patients affected by AFMR and surgically treated
for their valvulopathy. <br/>Result(s): Twelve studies (n = 494 patients)
met eligibility criteria. All studies excluded patients with signs of left
ventricular (LV) dysfunction, but the way additional parameters were used
to define AFMR at a more granular level varied across studies: nine
studies (75%) used the presence of AF to define their AFMR cohorts, with
five (41.2%) requiring a history of AF of >1 year; additionally, the
threshold values for the LV ejection fraction differed (45%-55%). Isolated
mitral annuloplasty was performed in 96.2% of patients. Broad variability
was detected in the proportion of patients undergoing the Cox-Maze
procedure (range, 17.8%-79.5%), pulmonary vein isolation (0.0%-66.7%), and
left atrial appendage ligation (0.0%-100.0%). <br/>Conclusion(s): AFMR
remains variably defined in surgical studies, making comparisons across
studies difficult. Mitral annuloplasty was most commonly performed. The
proportion of AFMR patients undergoing concomitant procedures for AF
varied substantially.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<12>
Accession Number
2013725904
Title
Long-term ticagrelor in patients with prior coronary stenting in the
pegasus-timi 54 trial.
Source
Journal of the American Heart Association. 10(17) (no pagination), 2021.
Article Number: e020446. Date of Publication: 2021.
Author
Bergmark B.A.; Bhatt D.L.; Steg P.G.; Budaj A.; Storey R.F.; Gurmu Y.;
Kuder J.F.; Im K.; Magnani G.; Ophuis T.O.; Hamm C.; Spinar J.; Kiss R.G.;
Van de Werf F.J.; Montalescot G.; Johanson P.; Braunwald E.; Sabatine
M.S.; Bonaca M.P.
Institution
(Bergmark, Bhatt, Gurmu, Kuder, Im, Braunwald, Sabatine, Bonaca) TIMI
Study Group, Cardiovascular Medicine, Department of Medicine, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Steg) French Alliance for Cardiovascular Trials, AP-HP, Hopital Bichat,
Universite de Paris, Institut National de la Sante et de la Recherche
Medicale U-1148, Paris, France
(Steg) National Heart and Lung Institute, Royal Brompton Hospital,
Imperial College London, London, United Kingdom
(Budaj) Centre of Postgraduate Medical Education, Grochowski Hospital,
Warsaw, Poland
(Storey) University of Sheffield, Sheffield, United Kingdom
(Magnani) University Hospital of Parma, Parma, Italy
(Ophuis) Canisius-Wilhelmina Hospital, Nijmegen, Netherlands
(Hamm) Kerckhoff Heart Center, Bad Nauheim, University of Giessen,
Giessen, Germany
(Spinar) University hospital St. Ann, Pekarska and Medical faculty, Brno,
Czechia
(Kiss) Department of Cardiology, Military Hospital, Budapest, Hungary
(Van de Werf) University of Leuven, Leuven, Belgium
(Montalescot) Sorbonne Universite, Paris 6, ACTION Study Group,
INSERM-UMRS 1166, Institut de Cardiologie, Pitie-Salpetriere Hospital
(AP-HP), Paris, France
(Johanson) AstraZeneca, Molndal, Sweden
(Bonaca) Colorado Prevention Center (CPC) Clinical Research, the
Department of Medicine, Division of Cardiovascular Medicine, University of
Colorado Anschutz Medical Campus, Aurora, CO, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Coronary stent type and risk of stent thrombosis remain
important factors affecting recommended duration of dual antiplatelet
therapy. We investigated the efficacy and safety of long-term ticagrelor
in patients with prior coronary stenting enrolled in the PEGASUS-TIMI 54
(Prevention of Cardiovascular Events in Patients with Prior Heart Attack
Using Ticagrelor Compared to Placebo on a Background of
Aspirin-Thrombolysis in Myocardial Infarction 54) trial. METHODS AND
RESULTS: Patients in PEGASUS-TIMI 54 had a myocardial infarction 1 to 3
year prior and were randomized 1:1:1 to ticagrelor 60 or 90 mg BID or
placebo. The primary end point was a composite of cardiovascular death,
myocardial infarc-tion, or stroke (major adverse cardiovascular events).
Stent thrombosis was prospectively adjudicated (Academic Research
Consortium definition). Baseline characteristics were compared by most
recent stent type (bare metal versus drug-eluting stent and first-versus
later-generation drug-eluting stent). Treatment arms were compared using
Cox proportional hazards models. Of 21 162 patients randomized, 80% (n=16
891) had prior coronary stenting. Following randomization, myocardial
infarction was the most frequent ischemic event in patients with prior
stenting in the placebo arm, occurring in 5.2% of patients (Type 1: 4.1%),
followed by cardiovascular death (2.3%), stroke (1.7%), and stent
thrombosis (0.9%). Ticagrelor<inf>pooled</inf> reduced major adverse
cardiovascular events (7.0% versus 8.0%; hazard ratio [HR], 0.85; 95% CI,
0.75- 96) regardless of stent type (bare metal stent versus drug-eluting
stent: p<inf>interaction</inf> =0.767; first versus later generation:
p<inf>interaction</inf> =0.940). The rate of any stent thrombosis was
numerically lower with ticagrelor<inf>pooled</inf> (0.7% versus 0.9%; HR,
0.73; 95% CI, 0.50-1.05) and Thrombolysis in Myocardial Infarction major
bleeding was increased (HR, 2.65; 95% CI, 1.90- 3.68). <br/>CONCLUSION(S):
Long-term ticagrelor reduces major adverse cardiovascular events in
patients with prior myocardial infarction and coronary stenting regardless
of stent type, with the benefit driven predominantly by reduction in de
novo events. Nonfatal major bleeding is increased with
ticagrelor.<br/>Copyright &#xa9; 2021 The Authors. Published on behalf of
the American Heart Association, Inc., by Wiley.

<13>
Accession Number
2013399336
Title
Interventional bronchoscopy for chronic obstructive pulmonary disease:
more than a pipe dream.
Source
Medical Journal of Australia. 215(6) (pp 280-285), 2021. Date of
Publication: 20 Sep 2021.
Author
Carew A.M.; Williamson J.P.; Farah C.S.; Saghaie T.; Phillips M.; Ing A.
Institution
(Carew, Williamson, Farah, Saghaie, Phillips) Macquarie Health, Sydney,
NSW, Australia
(Carew) University of Queensland, Brisbane, QLD, Australia
(Williamson) South Western Sydney Clinical School, University of New South
Wales, Sydney, NSW, Australia
(Farah, Saghaie, Ing) Concord Hospital, Sydney, NSW, Australia
(Ing) Macquarie University, Sydney, NSW, Australia
Publisher
John Wiley and Sons Inc
Abstract
Endoscopic lung volume reduction (ELVR) is recognised in both national and
international expert guidelines as one of the few additive treatments to
benefit patients with advanced chronic obstructive pulmonary disease
(COPD) who are otherwise receiving optimal medical and supportive care.
Despite these recommendations and a growing evidence base, these
procedures are not widely offered across Australia and New Zealand, and
general practitioner and physician awareness of this therapy can be
improved. ELVR aims to mitigate the impact of hyperinflation and gas
trapping on dyspnoea and exercise intolerance in COPD. Effective ELVR is
of proven benefit in improving symptoms, quality of life, lung function
and survival. Several endoscopic techniques to achieve ELVR have been
developed, with endobronchial valve placement to collapse a single lobe
being the most widely studied and commonly practised. This review
describes the physiological rationale underpinning lung volume reduction,
highlights the challenges of patient selection, and provides an overview
of the evidence for current and investigational endoscopic interventions
for COPD.<br/>Copyright &#xa9; 2021 AMPCo Pty Ltd

<14>
Accession Number
636585701
Title
Nurse-guided incentive spirometry use and postoperative pulmonary
complications among cardiac surgery patients: A randomized controlled
trial.
Source
International journal of nursing practice. 28(2) (pp e13023), 2022. Date
of Publication: 01 Apr 2022.
Author
Alwekhyan S.A.; Alshraideh J.A.; Yousef K.M.; Hayajneh F.
Institution
(Alwekhyan) Princess Muna College of Nursing, Mutah University, Jordan
(Alshraideh, Yousef, Hayajneh) School of Nursing, University of Jordan,
Amman, Jordan
(Yousef) School of Humanities, Social Sciences and Health University of
Wollongong, Dubai, United Arab Emirates
Publisher
NLM (Medline)
Abstract
AIMS: To assess the effect of nurse-guided use of incentive spirometer on
postoperative oxygenation and pulmonary complications after coronary
artery bypass graft surgery. BACKGROUND: Deep breathing exercises have
been shown to improve postoperative lung expansion and reduce pulmonary
complications. An incentive spirometer is a deep breathing exercises
device that imitates continuous sigh-like maximal inspiration. DESIGN:
Randomized control trial, two groups nonblinded parallel design.
<br/>METHOD(S): A total of n=89 eligible patients were randomized to
either control or intervention group. Patients in the intervention group
received bihourly nurse-guided incentive spirometry for 48-h
postextubation. The endpoints were: the number and duration of hypoxic
events during the first 24-hr postsurgery, pneumonia and pulmonary
function parameters. Data were collected May to September 2019.
<br/>RESULT(S): Patients in the intervention group had a significantly
lower mean number of hypoxic events with shorter duration and shorter
length of stay in the hospital and the ICU. Patients in the intervention
group also had greater postoperative forced expiratory volume in 1second.
<br/>CONCLUSION(S): Nurse-guided use of the incentive spirometer reduces
the risk of pulmonary complications and hospital length of stay after
cardiac surgery.<br/>Copyright &#xa9; 2021 John Wiley & Sons Australia,
Ltd.

<15>
Accession Number
636295104
Title
Continuous Pecto-Intercostal Fascial Block Provides Effective Analgesia in
Patients Undergoing Open Cardiac Surgery: A Randomized Controlled Trial.
Source
Pain medicine (Malden, Mass.). 23(3) (pp 440-447), 2022. Date of
Publication: 02 Mar 2022.
Author
Zhang Y.; Min J.; Chen S.
Institution
(Zhang, Min, Chen) Department of Anesthesiology, First Affiliated Hospital
of Nanchang University, Nanchang, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal analgesia regimen after open cardiac surgery has
been unclear. The aim of this study was to investigate the beneficial
effects of continuous pecto-intercostal fascial blocks (PIFB) initiated
before surgery on outcomes after open cardiac surgery. <br/>METHOD(S): A
group of 116 patients were randomly allocated to receive either bilateral
continuous PIFB (PIF group) or the same block with saline (SAL group). The
primary endpoint was postoperative pain at 4, 8, 16, 24, 48, and 72hours
after extubation at rest and during exercise. The secondary outcome
measures included analgesia requirements (sufentanil and flurbiprofen
consumption), time to extubation, length of stay in the intensive care
unit, incidence of postoperative nausea and vomiting, time until return of
bowel function, time to mobilization, time to urinary catheter removal,
and the length of hospital stay. <br/>RESULT(S): The length of stay in the
intensive care unit (29+/-7hours vs 13+/-4hours, P<0.01) and length of
hospital stay (8.9+/-0.9 days vs 6.5+/-1.1 days, P<0.01) were
significantly longer in the SAL group than in the PIF group. Resting pain
scores (2hours after extubation: 1.1 vs 3.3, P<0.01; 4hours after
extubation: 1.0 vs 3.5, P<0.01; 8hours after extubation: 1.2 vs 3.7,
P<0.01; 16hours after extubation: 1.3 vs 3.7, P<0.01; 24hours after
extubation: 1.4 vs 2.8, P<0.01; 48hours after extubation: 0.9 vs 2.2,
P<0.01; 72hours after extubation: 0.8 vs 2.1, P<0.01) and dynamic pain
scores (2hours after extubation: 1.4 vs 3.7, P<0.01; 4hours after
extubation: 1.3 vs 3.8, P<0.01; 8hours after extubation: 1.4 vs 3.5,
P<0.01; 16hours after extubation: 1.2 vs 3.4, P<0.01; 24hours after
extubation: 1.1 vs 3.1, P<0.01; 48hours after extubation: 1.0 vs 2.9,
P<0.01; 72hours after extubation: 0.9 vs 2.8, P<0.01) were significantly
lower in the PIF group than in the SAL group at all time points. The PIF
group required significantly less intraoperative sufentanil consumption
(123+/-32mug vs 63+/-16mug, P<0.01), postoperative sufentanil consumption
(102+/-22mug vs 52+/-17mug, P<0.01), and postoperative flurbiprofen
consumption (350+/-100mg vs 100+/-100mg, P<0.01) than the SAL groups. Time
to extubation (8.9+/-2.4 hours vs 3.2+/-1.3 hours, P<0.01), time to first
flatus (43+/-6hours vs 30+/-7hours, P<0.01), time until mobilization
(35+/-5hours vs 24+/-7hours, P<0.01), and time until urinary catheter
removal (47+/-9hours vs 31+/-4hours, P<0.01) were significantly earlier in
the PIF group than in the SAL group. The incidence of postoperative nausea
and vomiting was significantly lower in the PIF group (9.1% vs 27.3%,
P<0.01). <br/>CONCLUSION(S): Bilateral continuous PIFB reduced the length
of hospital stay and provided effective postoperative pain relief for 3
days.<br/>Copyright &#xa9; The Author(s) 2021. Published by Oxford
University Press on behalf of the American Academy of Pain Medicine. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<16>
Accession Number
2016159052
Title
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization:
Executive Summary: A Report of the American College of Cardiology/American
Heart Association Joint Committee on Clinical Practice Guidelines.
Source
Journal of the American College of Cardiology. 79(2) (pp 197-215), 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
Elsevier Inc.
Abstract
Aim: The executive summary of the American College of Cardiology/American
Heart Association/Society for Cardiovascular Angiography and Interventions
coronary artery revascularization guideline provides the top 10 items
readers should know about the guideline. In the full guideline, the
recommendations replace the 2011 coronary artery bypass graft surgery
guideline and the 2011 and 2015 percutaneous coronary intervention
guidelines. This summary offers a patient-centric approach to guide
clinicians in the treatment of patients with significant coronary artery
disease undergoing coronary revascularization, as well as the supporting
documentation to encourage their use. <br/>Method(s): A comprehensive
literature search was conducted from May 2019 to September 2019,
encompassing studies, reviews, and other evidence conducted on human
subjects that were published in English from PubMed, EMBASE, the Cochrane
Collaboration, CINHL Complete, and other relevant databases. Additional
relevant studies, published through May 2021, were also considered.
Structure: Recommendations from the earlier percutaneous coronary
intervention and coronary artery bypass graft surgery guidelines have been
updated with new evidence to guide clinicians in caring for patients
undergoing coronary revascularization. This summary includes
recommendations, tables, and figures from the full guideline that relate
to the top 10 take-home messages. The reader is referred to the full
guideline for graphical flow charts, supportive text, and tables with
additional details about the rationale for and implementation of each
recommendation, and the evidence tables detailing the data considered in
the development of this guideline.<br/>Copyright &#xa9; 2022 The American
College of Cardiology Foundation and the American Heart Association, Inc.

<17>
Accession Number
2016159049
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
Journal of the American College of Cardiology. 79(2) (pp e21-e129), 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
Elsevier Inc.
Abstract
Aim: The guideline for coronary artery revascularization replaces the 2011
coronary artery bypass graft surgery and the 2011 and 2015 percutaneous
coronary intervention guidelines, providing a patient-centric approach to
guide clinicians in the treatment of patients with significant coronary
artery disease undergoing coronary revascularization as well as the
supporting documentation to encourage their use. <br/>Method(s): A
comprehensive literature search was conducted from May 2019 to September
2019, encompassing studies, reviews, and other evidence conducted on human
subjects that were published in English from PubMed, EMBASE, the Cochrane
Collaboration, CINHL Complete, and other relevant databases. Additional
relevant studies, published through May 2021, were also considered.
Structure: Coronary artery disease remains a leading cause of morbidity
and mortality globally. Coronary revascularization is an important
therapeutic option when managing patients with coronary artery disease.
The 2021 coronary artery revascularization guideline provides
recommendations based on contemporary evidence for the treatment of these
patients. The recommendations present an evidence-based approach to
managing patients with coronary artery disease who are being considered
for coronary revascularization, with the intent to improve quality of care
and align with patients' interests.<br/>Copyright &#xa9; 2022 The American
College of Cardiology Foundation and the American Heart Association, Inc.

<18>
Accession Number
2015496045
Title
Comparison of left double lumen tube and y-shaped and double-ended
bronchial blocker for one lung ventilation in thoracic surgery-a
randomised controlled clinical trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 92. Date
of Publication: December 2022.
Author
Risse J.; Szeder K.; Schubert A.-K.; Wiesmann T.; Dinges H.-C.; Feldmann
C.; Wulf H.; Meggiolaro K.M.
Institution
(Risse) Center of Emergency Medicine, University Hospital Essen, Essen,
Germany
(Risse, Szeder, Schubert, Wiesmann, Dinges, Feldmann, Wulf, Meggiolaro)
Department of Anesthesiology and Intensive Care Medicine,
Philipps-University, Marburg, Germany
(Wiesmann) Department of Anesthesiology and Operative Intensive Care
Medicine, Diakoneo Diak Hospital Schwabisch Hall gGmbH, Schwabisch Hall,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Double lumen tube (DLT) intubation is the most commonly used
technique for one lung ventilation. Bronchial blockers (BB) are an
alternative, especially for difficult airways. The EZ-bronchial blocker
(EZB) is an innovative y-shaped and double-ended device of the BB family.
<br/>Method(s): A randomised, controlled trial was conducted in 80
patients undergoing elective thoracic surgery using DLT or EZB for one
lung ventilation (German Clinical Trial Register DRKS00014816). The
objective of the study was to compare the clinical performance of EZB with
DLT. Primary endpoint was total time to obtain successful one lung
ventilation. Secondary endpoints were time subsections, quality of lung
collapse, difficulty of intubation, any complications during the
procedure, incidence of objective trauma of the oropharynx and
supraglottic space and intubation-related subjective symptoms.
<br/>Result(s): 74 patients were included, DLT group (n = 38), EZB group
(n = 36). Median total time to obtain one lung ventilation [IQR] in the
DLT group was 234 s [207 to 294] versus 298 s [243 to 369] in the EZB
group (P = 0.007). Median total time was relevantly influenced by
different preparation times. Quality of lung collapse was equal in both
groups, DLT group 89.5% were excellent vs. 83.3% in the EZB group (P =
0.444). Inadequate lung collapse in five patients of the EZB group
resulted in unsuccessful repositioning attempts and secondary DLT
placement. Endoscopic examinations revealed significantly more carina
trauma (P = 0.047) and subglottic haemorrhage (P = 0.047) in the DLT
group. Postoperative subjective symptoms (sore throat, hoarseness) were
more common in the DLT group, as were speech problems. <br/>Conclusion(s):
Using EZB prima facie results in prolonged time to obtain one lung
ventilation with equal quality of lung collapse for the thoracic surgeon.
If preparation times are omitted in the analysis, the time difference is
statistically and clinically not relevant. Our data showed only little
evidence for reducing objective airway trauma as well as subjective
complaints. In summary both procedures were comparable in terms of times
and clinical applicability. Therefore decisions for DLT or EZB should
depend more on individual experience, in-house equipment and the
individual patient, than on any times that are neither clinically
significant nor relevant. Trial registration: German Clinical Trial
Register DRKS00014816, prospectively registered on
07.06.2018<br/>Copyright &#xa9; 2022, The Author(s).

<19>
Accession Number
2015481632
Title
Mitral valve repair versus replacement in severe ischemic mitral
regurgitation systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
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. <br/>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. <br/>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)]. <br/>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.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<20>
Accession Number
2015476123
Title
Mitral valve repair or replacement. How long is this feud to last?.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
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.<br/>Copyright &#xa9; 2022 The Authors. Journal
of Cardiac Surgery Published by Wiley Periodicals LLC.

<21>
Accession Number
2017540939
Title
The effect of Hugo point acupressure massage on respiratory volume and
pain intensity due to deep breathing in patients with chest tube after
chest surgeries.
Source
Contemporary Clinical Trials Communications. 27 (no pagination), 2022.
Article Number: 100914. Date of Publication: June 2022.
Author
Fasihi S.M.; Karampourian A.; Khatiban M.; Hashemi M.; Mohammadi Y.
Institution
(Fasihi) Department of Nursing and Midwifery, Hamadan University of
Medical Sciences, Hamadan, Iran, Islamic Republic of
(Karampourian) Urology and Nephrology Research Center, Chronic Diseases
(Home Care) Research Center, School of Nursing and Midwifery, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Khatiban) Department of Medical Surgical Nursing, School of Nursing and
Midwifery, Mother and Child Care Research Center, Hamadan University of
Medical Sciences, Hamadan, Iran, Islamic Republic of
(Hashemi) Department of Persian Medicine, School of Medicine, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Mohammadi) Department of Public Health, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
Introduction: Hugo point is the most important pain control point in the
body, so the study was performed to determine the effect of Hugo point
massage on respiratory volume and the pain intensity after chest tube
placement. <br/>Material(s) and Method(s): The study was performed as a
randomized crossover clinical trial on 61 patients with a chest tube.
Patients were placed in every 2 h through the ternary permutation block
once under a false point pressure, once under a Hugo point pressure, and
once without intervention. Data were collected using a questionnaire of
demographic, clinical information, the Numerical Pain Rating Scale, and
spirometry. Analysis of variance with repeated measures was used to
analyze the data. <br/>Finding(s): There was no significant difference in
the pain intensity before and during the intervention between the three
groups. However, after the intervention, the mean pain intensity in the
control group was higher than the Hugo and placebo groups (P < 0.001), and
the mean pain intensity in the placebo group was higher than in the Hugo
group (P < 0.001). There was no significant difference between the three
groups in terms of the rate of ascent and retention time of spirometry
ball the three times before, during, and after the intervention.
<br/>Conclusion(s): Hugo point massage reduces the pain intensity;
however, has no significant effect on their respiratory volume. Hugo point
massage is recommended to reduce the severity of pain in patients with
chest tube.<br/>Copyright &#xa9; 2022

<22>
Accession Number
2017565871
Title
A Randomized Clinical Trial of Perfusion Modalities in Pediatric
Congenital Heart Surgery Patients.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Undar A.; Patel K.; Holcomb R.M.; Clark J.B.; Ceneviva G.D.; Young C.A.;
Spear D.; Kunselman A.R.; Thomas N.J.; Myers J.L.
Institution
(Undar, Patel, Holcomb, Clark, Ceneviva, Young, Spear, Kunselman, Thomas,
Myers) Departments of Pediatrics, Penn State Hershey Pediatric
Cardiovascular Research Center, Pennsylvania, Hershey
(Undar, Patel, Holcomb, Clark, Myers) Department of Surgery, Penn State
Hershey Pediatric Cardiovascular Research Center, Pennsylvania, Hershey
(Undar) Department of Biomedical Engineering, Penn State Hershey Pediatric
Cardiovascular Research Center, Pennsylvania, Hershey
(Ceneviva, Young, Spear) Division of Pediatric Critical Care Medicine,
Penn State Health Children's Hospital, Penn State College of Medicine,
Pennsylvania, Hershey
(Kunselman, Thomas) Department of Public Health Sciences, Penn State
Health Children's Hospital, Penn State College of Medicine, Pennsylvania,
Hershey
Publisher
Elsevier Inc.
Abstract
Background: The objective of this randomized clinical trial was to
investigate the effects of perfusion modalities on cerebral hemodynamics,
vital organ injury, quantified by the Pediatric Logistic Organ
Dysfunction-2 (PELOD-2) Score, and clinical outcomes in risk-stratified
congenital cardiac surgery patients. <br/>Method(s): This randomized
clinical trial included 159 consecutive congenital cardiac surgery
patients in whom pulsatile (n = 83) or nonpulsatile (n = 76) perfusion was
used. Cerebral hemodynamics were assessed using transcranial Doppler
ultrasound. Multiple organ injury was quantified using the PELOD-2 score
at 24, 48, and 72 hours. Clinical outcomes, including intubation time,
intensive care unit length of stay (LOS), hospital LOS, and mortality,
were also evaluated. <br/>Result(s): The Pulsatility Index at the middle
cerebral artery and in the arterial line during aortic cross-clamping was
consistently better maintained in the pulsatile group. Demographics and
cardiopulmonary bypass characteristics were similar between the 2 groups.
While risk stratification with The Society of Thoracic Surgeons-European
Association for Cardio-Thoracic Surgery (STAT) Mortality Categories was
similar between the groups, Mortality Categories 1 to 3 demonstrated more
patients than Mortality Categories 4 and 5. There were no differences in
clinical outcomes between the groups. The PELOD-2 scores showed a
progressive improvement from 24 hours to 72 hours, but the results were
not statistically different between the groups. <br/>Conclusion(s): The
Pulsatillity Index for the pulsatile group demonstrated a more physiologic
pattern compared with the nonpulsatile group. While pulsatile perfusion
did not increase plasma-free hemoglobin levels or microemboli delivery, it
also did not demonstrate any improvements in clinical outcomes or PELOD-2
scores, suggesting that while pulsatile perfusion is a safe method, it not
a "magic bullet" for congenital cardiac operations.<br/>Copyright &#xa9;
2022 The Society of Thoracic Surgeons

<23>
Accession Number
637659901
Title
Effect of Different Nursing Interventions on Discharged Patients with
Cardiac Valve Replacement Evaluated by Deep Learning Algorithm-Based MRI
Information.
Source
Contrast media & molecular imaging. 2022 (pp 6331206), 2022. Date of
Publication: 2022.
Author
Zhang J.; Zhou Q.
Institution
(Zhang) Department of Cardiology Second Ward, Jingzhou First People's
Hospital, Hubei Province 434000, No. 8 Hangkang Road, Jingzhou, China
(Zhou) Department of Cardiology Third Ward, Jingzhou First People's
Hospital, Hubei Province 434000, No. 8 Hangkang Road, Jingzhou, China
Publisher
NLM (Medline)
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 6months, 1year, 2years, and 3years 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 6months, 1year, 2years,
and 3years 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.<br/>Copyright &#xa9; 2022 Jing Zhang
and Qiong Zhou.

<24>
[Use Link to view the full text]
Accession Number
2017479047
Title
Cytokine Hemoadsorption during Cardiac Surgery Versus Standard Surgical
Care for Infective Endocarditis REMOVE: Results from a Multicenter
Randomized Controlled Trial.
Source
Circulation. 145(13) (pp 959-968), 2022. Date of Publication: 29 Mar 2022.
Author
Diab M.; Lehmann T.; Bothe W.; Akhyari P.; Platzer S.; Wendt D.; Deppe
A.-C.; Strauch J.; Hagel S.; Gunther A.; Faerber G.; Sponholz C.; Franz
M.; Scherag A.; Velichkov I.; Silaschi M.; Fassl J.; Hofmann B.; Lehmann
S.; Schramm R.; Fritz G.; Szabo G.; Wahlers T.; Matschke K.; Lichtenberg
A.; Pletz M.W.; Gummert J.F.; Beyersdorf F.; Hagl C.; Borger M.A.; Bauer
M.; Brunkhorst F.M.; Doenst T.
Institution
(Diab, Faerber, Velichkov, Doenst) Department of Cardiothoracic Surgery,
Jena University Hospital-Friedrich Schiller University of Jena, Am
Klinikum 1, Jena 07747, Germany
(Diab, Lehmann, Platzer, Scherag, Bauer, Brunkhorst) Center for Sepsis
Control and Care, Jena University Hospital-Friedrich Schiller University
of Jena, Germany
(Lehmann, Platzer, Scherag, Brunkhorst) Center for Clinical Studies, Jena
University Hospital-Friedrich Schiller University of Jena, Germany
(Hagel, Pletz) Institute for Infectious Diseases and Infection Control,
Jena University Hospital-Friedrich Schiller University of Jena, Germany
(Gunther) Department of Neurology, Jena University Hospital-Friedrich
Schiller University of Jena, Germany
(Sponholz, Bauer) Department of Anesthesiology and Critical Care Medicine,
Jena University Hospital-Friedrich Schiller University of Jena, Germany
(Franz) Department of Internal Medicine I, Jena University
Hospital-Friedrich Schiller University of Jena, Germany
(Scherag) Institute of Medical Statistics, Computer and Data Sciences,
Jena University Hospital-Friedrich Schiller University of Jena, Germany
(Bothe, Beyersdorf) Department of Cardiovascular Surgery, University Heart
Center Freiburg-Bad Krozingen, Freiburg, Germany
(Akhyari, Lichtenberg) Department of Cardiothoracic Surgery,
Heinrich-Heine-University, Duesseldorf, Germany
(Wendt) Department of Thoracic and Cardiovascular Surgery, University
Hospital, Essen, Germany
(Deppe, Wahlers) Department of Cardiothoracic Surgery, Heart Center of the
University of Cologne, Germany
(Strauch) Department of Cardiac and Thoracic Surgery, Bergmannsheil
University Hospitals, Bochum, Germany
(Silaschi) Clinic and Polyclinic for Cardiac Surgery, University Hospital,
Bonn, Germany
(Fassl) Institute for Cardiac Anesthesiology, Dresden Heart Center,
University Hospital at the Technical University, Dresden, Germany
(Hofmann, Szabo) Department of Cardiac Surgery, Mid-German Heart Center,
University Hospital Halle Saale, Halle, Germany
(Lehmann, Borger) Department of Cardiac Surgery, Heart Center, Leipzig,
Germany
(Schramm, Gummert) Department of Thoracic and Cardiovascular Surgery,
Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
(Fritz) Department of Anesthesiology, Intensive Care and Pain Therapy,
Heart Center Brandenburg, Immanuel Clinic, Bernau, Germany
(Matschke) Department of Cardiac Surgery, Heart Center, Dresden, Germany
(Hagl) Department of Cardiac Surgery, Ludwig Maximilian University,
Munich, Germany
(Hagl) DZHK German Centre for Cardiovascular Research, Partner Site Munich
Heart Alliance, Munich, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardiac surgery often represents the only treatment option in
patients with infective endocarditis IE. However, IE surgery may lead to a
sudden release of inflammatory mediators, which is associated with
postoperative organ dysfunction. We investigated the effect of
hemoadsorption during IE surgery on postoperative organ dysfunction.
<br/>Method(s): This multicenter, randomized, nonblinded, controlled trial
assigned patients undergoing cardiac surgery for IE to hemoadsorption
integration of CytoSorb to cardiopulmonary bypass or control. The primary
outcome change in sequential organ failure assessment score [DELTASOFA]
was defined as the difference between the mean total postoperative SOFA
score, calculated maximally to the 9th postoperative day, and the basal
SOFA score. The analysis was by modified intention to treat. A predefined
intergroup comparison was performed using a linear mixed model for
DELTASOFA including surgeon and baseline SOFA score as fixed effect
covariates and with the surgical center as random effect. The SOFA score
assesses dysfunction in 6 organ systems, each scored from 0 to 4. Higher
scores indicate worsening dysfunction. Secondary outcomes were 30-day
mortality, duration of mechanical ventilation, and vasopressor and renal
replacement therapy. Cytokines were measured in the first 50 patients.
<br/>Result(s): Between January 17, 2018, and January 31, 2020, a total of
288 patients were randomly assigned to hemoadsorption n=142 or control
n=146. Four patients in the hemoadsorption and 2 in the control group were
excluded because they did not undergo surgery. The primary outcome,
DELTASOFA, did not differ between the hemoadsorption and the control group
1.79+/-3.75 and 1.93+/-3.53, respectively; 95% CI, -1.30 to 0.83;
P=0.6766. Mortality at 30 days 21% hemoadsorption versus 22% control;
P=0.782, duration of mechanical ventilation, and vasopressor and renal
replacement therapy did not differ between groups. Levels of
interleukin-1beta and interleukin-18 at the end of integration of
hemoadsorption to cardiopulmonary bypass were significantly lower in the
hemoadsorption than in the control group. <br/>Conclusion(s): This
randomized trial failed to demonstrate a reduction in postoperative organ
dysfunction through intraoperative hemoadsorption in patients undergoing
cardiac surgery for IE. Although hemoadsorption reduced plasma cytokines
at the end of cardiopulmonary bypass, there was no difference in any of
the clinically relevant outcome measures. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT03266302.
<br/>Copyright &#xa9; 2022 American Heart Association, Inc.

<25>
Accession Number
2016103020
Title
Effects of Physical Prehabilitation on the Dynamics of the Markers of
Endothelial Function in Patients Undergoing Elective Coronary Bypass
Surgery.
Source
Journal of Personalized Medicine. 12(3) (no pagination), 2022. Article
Number: 471. Date of Publication: March 2022.
Author
Argunova Y.; Belik E.; Gruzdeva O.; Ivanov S.; Pomeshkina S.; Barbarash O.
Institution
(Argunova, Belik, Gruzdeva, Ivanov, Pomeshkina, Barbarash) Federal State
Budgetary Scientific Institution "Research Institute for Complex Issues of
Cardiovascular Diseases", 6, Sosnovy Boulevard, Kemerovo 650002, Russian
Federation
Publisher
MDPI
Abstract
Our aim in this study was to evaluate the effect of physical training
performed before CABG on the perioperative dynamics of the serum levels of
asymmetric dimethylarginine (ADMA) and endothelin-1 (ET-1) of patients
with stable coronary heart disease (CHD). Patients in the preoperative
period were randomized into two groups: the training group (n = 43)
underwent high-intensity treadmill training; the patients in the control
group (n = 35) received no training before the procedure. The serum
concentrations of ADMA and ET-1 were determined in the perioperative
period, and the course of the early postoperative period was analyzed. In
the training group, we found a significantly lower incidence of
postoperative complications during hospital stays (p = 0.013). At the end
of the training program, the ADMA levels were 1.8 times higher in the
controls than in the training group (p = 0.001). We found that type 2
diabetes increased the probability of complications by 12 times (OR: 12.3;
95% CI: 1.24-121.5; p = 0.03), as well as elevating the concentration of
ET-1 on the eve of surgery (OR: 10.7; 95% CI: 1.4-81.3; p = 0.02).
Physical prehabilitation reduced the likelihood of complications nine
times (OR: 0.11; 95% CI: 0.02-0.83; p = 0.03). The AUC was 0.851 +/- 0.07
(95% CI: 0.71-0.98). The obtained results indicate the benefit of physical
training during the prehabilitation stage since it can help to preserve
endothelial function.<br/>Copyright &#xa9; 2022 by the authors. Licensee
MDPI, Basel, Switzerland.

<26>
Accession Number
2017539560
Title
Novel Insights Into the 1969 Whole-Eye Transplant: Medical Ethics and
Evolving Safety Mechanisms.
Source
American Journal of Ophthalmology. 238 (pp 120-127), 2022. Date of
Publication: June 2022.
Author
Blodi C.F.
Institution
(Blodi) Truhlsen Eye Institute, Department of Ophthalmology, University of
Nebraska Medical Center, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Purpose: The controversial whole-eye transplant (WET) of 1969 performed by
Texas Medical Center (TMC) eye surgeon Conard Moore, MD, is examined to
determine whether he performed a WET or a different operation. New
materials are reviewed to evaluate the conflicting historical WET reports:
Moore claimed that he performed the world's first WET, then retracted his
claim amid criticism. Medical and ethical factors are explored. The
parameters for experimental surgery of that era are compared to current
policies. <br/>Design(s): Retrospective study. <br/>Method(s): This is a
retrospective analysis of a single patient's ophthalmic operations
performed in April 1969 and the controversial claim of the world's first
WET. Oral and written interviews with witnesses were conducted. Primary
and secondary literature sources were reviewed. Ocular illustrations
provided by the surgeon in 1969 were reviewed and compared to verbal
reports. <br/>Result(s): A newly uncovered book chapter by Moore's
departmental chairman Louis Girard, MD, supports the initial claim of a
WET, as do recent interviews with medical journalist Miriam Kass, JD.
Ophthalmic pathologist Milton Boniuk, MD, states that he did not receive
the whole eye for examination. Moore made his claim of a WET amid the
intense attention to TMC's aggressive heart transplantation operations.
Moore retracted his claim after professional criticism.
<br/>Conclusion(s): New evidence supports Moore's initial claim that he
performed a WET, although other scenarios remain plausible. This case
highlights the boundary between accepted and experimental operations, and
underscores the need for modern bioethics oversight to provide safeguards
for novel surgical procedures.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<27>
[Use Link to view the full text]
Accession Number
2017343133
Title
A meta-analysis of impact of low-flow/low-gradient aortic stenosis on
survival after transcatheter aortic valve implantation.
Source
Journal of Cardiovascular Medicine. 20(10) (pp 691-698), 2019. Date of
Publication: 01 Oct 2019.
Author
Takagi H.; Hari Y.; Kawai N.; Kuno T.; Ando T.
Institution
(Takagi, Hari, Kawai) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari) Department of Cardiovascular Surgery, Kitasato University
School of Medicine, Sagamihara, Japan
(Kuno) Department of Medicine, Mount Sinai Beth Israel Medical Center, New
York, NY, United States
(Ando) Department of Cardiology, Detroit Medical Center, Detroit, MI,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Aims To determine whether low-flow/low-gradient (LF/LG) aortic stenosis
affects survival after transcatheter aortic valve implantation (TAVI), we
performed a meta-analysis of currently available studies. Methods MEDLINE
and EMBASE were searched through January 2019 using PubMed and OVID.
Observational studies comparing all-cause mortality after TAVI for
patients with classical LF/LG (C/LF/LG) aortic stenosis versus
normal-flow/high-gradient (NF/HG) aortic stenosis, paradoxical LF/LG
(P/LF/LG) aortic stenosis versus NF/HG aortic stenosis, and (3) C/LF/LG
aortic stenosis versus P/LF/LG aortic stenosis were included.
Study-specific estimates, risk and hazard ratios of mortality, were
combined in the random-effects model. Results Our search identified nine
eligible studies including a total of 5512 TAVI patients. Pooled analysis
demonstrated significantly higher early mortality in C/LF/LG aortic
stenosis than NF/HG aortic stenosis (risk ratio, 1.72; P U 0.02) and no
statistically significant difference in early mortality between P/LF/LG
aortic stenosis and NF/HG aortic stenosis (P U 0.67) and between C/LF/LG
aortic stenosis and P/LF/LG aortic stenosis (P U 0.51). Midterm mortality
in C/LF/LG (risk ratio/hazard ratio, 1.73; P U 0.0003) and P/LF/LG aortic
stenosis (risk ratio/hazard ratio, 1.48; P < 0.0001) was significantly
higher than that in NF/HG aortic stenosis. There was no statistically
significant difference in midterm mortality between C/LF/LG aortic
stenosis and P/LF/LG aortic stenosis (P U 0.63). Conclusion After TAVI,
C/LF/LG aortic stenosis is associated with increased early mortality
compared with NF/HG, and C/LF/LG and P/LF/LG aortic stenosis is associated
with increased midterm mortality compared with NF/HG aortic stenosis
despite no difference in early mortality between P/LF/LG aortic stenosis
and NF/HG aortic stenosis. There is no difference in early and midterm
mortality between C/LF/LG aortic stenosis and P/LF/LG aortic
stenosis.<br/>Copyright &#xa9; 2019 Italian Federation of Cardiology -
I.F.C.

<28>
Accession Number
2017527510
Title
Effects of Landiolol on Macrocirculatory Parameters and Left and Right
Ventricular Performances Following Cardiac Surgery: A Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Ferraris A.; Jacquet-Lagreze M.; Cazenave L.; Fornier W.; Jalalzai W.;
Rousseau-Saine N.; Pozzi M.; Fellahi J.-L.
Institution
(Ferraris, Jacquet-Lagreze, Cazenave, Fornier, Jalalzai, Rousseau-Saine,
Fellahi) Service d'Anesthesie-Reanimation, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
(Jacquet-Lagreze, Pozzi, Fellahi) Laboratoire CarMeN, Lyon, France
(Pozzi) Service de Chirurgie Cardiaque, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
Publisher
W.B. Saunders
Abstract
Objectives: Postoperative atrial fibrillation (POAF) is a major
complication after cardiac surgery, and an early postoperative
introduction of beta-blockers is recommended to reduce its incidence.
Landiolol, a new intravenous short-acting beta-1 blocker, could present a
useful and safe macrohemodynamic profile after cardiac surgery. Detailed
metabolic and hemodynamic effects of landiolol on cardiac performance,
however, remain poorly documented. The authors aimed to investigate the
dose-dependent hemodynamic and metabolic effects of landiolol in that
specific setting. <br/>Design(s): A prospective, randomized, double-blind
study versus placebo. <br/>Setting(s): A tertiary university hospital.
<br/>Participant(s): Adult patients scheduled for elective cardiac surgery
with cardiopulmonary bypass. <br/>Intervention(s): Incremental doses of
intravenous landiolol (0.5, 1, 2, 5, and 10 mug/kg/min) were given within
the 2 hours after arrival in the intensive care unit. Macrocirculatory
parameters and cardiac performances were derived from transpulmonary
thermodilution and transthoracic echocardiography. Metabolic data were
obtained from arterial blood tests. <br/>Measurements and Main Results:
From January to November 2019, 58 patients were analyzed and divided into
a landiolol group (n = 30) and a control group (n = 28). Heart rate
significantly decreased in the landiolol group (p < 0.01), whereas mean
arterial pressure and stroke volume remained unchanged. No significant
modification was found in both left and right systolic and diastolic
performances. Metabolic variables were similar in both groups. New-onset
POAF occurred in 9 (32%) versus 5 (17%) patients in the control and
landiolol groups, respectively (p = 0.28). <br/>Conclusion(s): Infusion of
landiolol in the range of 0.5-to-10 mug/kg/min during the early
postoperative period presents a good macrohemodynamic safety profile in
cardiac surgical patients and could be useful to prevent
POAF.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<29>
Accession Number
2017525300
Title
A Cardiovascular Risk Assessment Model According to Behavioral,
Psychosocial and Traditional Factors in Patients With ST-Segment Elevation
Myocardial Infarction (CRAS-MI): Review of Literature and Methodology of a
Multi-Center Cohort Study.
Source
Current Problems in Cardiology. (no pagination), 2022. Article Number:
101158. Date of Publication: 2022.
Author
Roohafza H.; Noohi F.; Hosseini S.G.; Alemzadeh-Ansari M.; Bagherieh S.;
Marateb H.; Mansourian M.; Mousavi A.F.; Seyedhosseini M.; Farshidi H.;
Ahmadi N.; Yazdani A.; Sadeghi M.
Institution
(Roohafza) Assistance Professor, Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Noohi) Professor, Cardiovascular Intervention Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Hosseini) Research Assistant, Cardiac Rehabilitation Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Alemzadeh-Ansari) Associate Professor, Cardiovascular Intervention
Research Center, Rajaie Cardiovascular Medical and Research Center,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bagherieh) Biomedical Engineering Department, Engineering Faculty,
University of Isfahan, Isfahan, Iran, Islamic Republic of
(Marateb) Department of Automatic Control, Biomedical Engineering Research
Center, Universitat Politecnica de Catalunya, BarcelonaTech (UPC),
Barcelona, Spain
(Marateb, Mansourian) Pediatric Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Mansourian) Cardiovascular Diseases Research Center, Department of
Cardiology, Heshmat Hospital, School of Medicine, Guilan University of
Medical Sciences, Rasht, Iran, Islamic Republic of
(Mousavi) Yazd Cardiovascular Research Center, Shahid Sadoughi University
of Medical Sciences, Yazd, Iran, Islamic Republic of
(Seyedhosseini) Cardiovascular Research Center, Hormozgan University of
Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Farshidi) Professor, Cardiovascular Research Center, Hormozgan University
of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Ahmadi) Research Assistant, Yazd Cardiovascular Research Center, Shahid
Sadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Yazdani) Research Assistant, Rajaie Cardiovascular Medical and Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Sadeghi) Professor, Cardiac Rehabilitation Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
This study aims to provide a comprehensive risk-assessment model including
lifestyle, psychological parameters, and traditional risk factors to
determine the risk of major adverse cardiovascular events (MACE) in
patients with the first acute ST-segment elevation myocardial infarction
episode. Patients were recruited from new hospital admissions of acute
ST-segment elevation myocardial infarction and will be followed up to 3
years. Clinical and paraclinical characteristics, lifestyle,
psychological, and MACE information are collected and will be used in the
risk-assessment model. Totally, 1707 patients were recruited (male: 81.4%,
mean age: 56.60 +/- 10.34). Primary percutaneous coronary intervention was
the most prevalent type of coronary revascularization (81.9%). In case of
baseline psychological characteristics, mean depression score was 5.40 +/-
4.88, and mean distress score was 7.64 +/- 5.08. A comprehensive approach,
focusing on medical, lifestyle, and psychological factors, will lead to
better identification of cardiovascular disease patients at risk of
developing MACE through comprehensive risk-assessment
models.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<30>
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. (no pagination), 2022. Date of
Publication: 2022.
Author
Jarrah M.I.; Hweidi I.M.; Al-Dolat S.A.; Alhawatmeh H.N.; Al-Obeisat S.M.;
Hweidi L.I.; Hweidi A.I.; Alkouri O.A.
Institution
(Jarrah, Hweidi, Hweidi) Faculty of Medicine, Jordan University of Science
& Technology, Irbid, Jordan
(Hweidi, Al-Dolat, Alhawatmeh, Al-Obeisat) Faculty of Nursing, Jordan
University of Science & Technology, Irbid, Jordan
(Alkouri) Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
Publisher
Chinese Nursing Association
Abstract
Objectives: This study aimed to evaluate the effectiveness of slow deep
breathing relaxation exercise (SDBRE) in reducing patients' pain levels
during chest tube removal (CTR) post coronary artery bypass grafting
(CABG) surgery. <br/>Method(s): In 2019, fifty post-CABG patients were
conveniently selected from a cardiac intensive care unit in Jordan's major
referral heart institute. The patients were randomly assigned to either an
intervention group or a control group. A total of 25 patients were
assigned into the experimental group who received slow deep breathing
relaxation Exercise (SDBRE) alongside the conventional care before CTR.
The remaining 25 patients constituted the control group (50%) that had CTR
following conventional care. The Visual Analogue Scale (VAS) was used to
measure the participants' pain levels during three phases: before CTR
(Time 1), 5-min post CTR (Time 2), and 15-min post CTR (Time 2) to compare
the intervention effect between the two groups. <br/>Result(s): The data
analysis findings for the control and intervention group of patients
showed that there was a statistically significant decline in their pain
level across time for both groups (H = 32.71, P < 0.01; H = 47.23, P <
0.01) respectively. The intervention group had significantly lower pain
levels than the control group at Time 2 (3.50 [1.20, 5.30] vs. 7.90 [7.00,
9.00], P < 0.01) and Time 3 (0.00 [0.00, 1.30] vs. 3.60 [2.40, 4.10] P <
0.01). <br/>Conclusion(s): Using SDBRE during CTR is an effective
technique for reducing pain which can minimize the need for analgesics and
their associated adverse effects.<br/>Copyright &#xa9; 2022 The authors

<31>
Accession Number
637670576
Title
Derivation and validation of the bridge to transplantation with left
ventricular assist device score for 1year mortality after heart
transplantation. The BTT-LVAD score.
Source
The International journal of artificial organs. (pp 3913988221082690),
2022. Date of Publication: 01 Apr 2022.
Author
Okoh A.K.; Fugar S.; Dodoo S.; Selevany M.; Al-Obaidi N.; Ozturk E.; Singh
S.; Tayal R.; Lee L.Y.; Russo M.J.; Camacho M.
Institution
(Okoh) Division of Cardiology, Emory Clinical Cardiovascular Research
Institute, Emory University School of Medicine, Atlanta, United States
(Fugar) Division of Cardiology, Rush University Medical Center, Chicago,
United States
(Dodoo) Department of Medicine, Piedmont Newnan Hospital, Newnan, United
States
(Selevany, Al-Obaidi, Singh, Tayal, Camacho) Cardiovascular Research Unit,
RWJBarnabas Health, Newark Beth Israel Medical Center, Newark, United
States
(Ozturk) Division of Biostatistics, Hacettepe University School of
Medicine, Ankara, Turkey
(Lee, Russo, Camacho) Division of Cardiothoracic Surgery, Rutgers Robert
Wood Johnson Medical School, NB, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: To derive and validate a risk score that accurately predicts
1-year mortality after heart transplantation (HT) in patients bridged to
transplant (BTT) with a left ventricular assist device (LVAD).
<br/>METHOD(S): The UNOS database was queried to identify patients BTT
with an LVAD between 2008 and 2018. Patients with 1-year follow up were
randomly divided into derivation (70%) and validation (30%) cohorts. The
primary endpoint was 1-year mortality. A simple additive risk score was
developed based on the odds of 1-year mortality after HT. Risk groups were
created, and survival was estimated and compared. <br/>RESULT(S): A total
of 7759 patients were randomly assigned to derivation (n=5431) and
validation (n=2328) cohorts. One-year post-transplant mortality was 9.8%
(n=760). A 33-point scoring was created from six recipient variables and
two donor variables. Risk groups were classified as low (0-5),
intermediate (6-10), and high (>10). In the validation cohort, the
predicted 1-year mortality was significantly higher in the high-risk group
than the intermediate and low-risk groups, 14.7% versus 9% versus 6.1%
respectively (log-rank test: p<0.0001). <br/>CONCLUSION(S): The BTT-LVAD
Score can serve as a clinical decision tool to guide therapeutic decisions
in advanced heart failure patients.

<32>
Accession Number
637663711
Title
Study Level Meta-Analysis of TAVI with the ACURATE neo Self-expanding
Transcatheter Heart Valve.
Source
Cardiology in review. (no pagination), 2022. Date of Publication: 30 Mar
2022.
Author
Koliastasis L.; Doundoulakis I.; Kokkinidis D.G.; Milkas A.; Kostopoulos
G.; Drakopoulou M.; Latsios G.; Synetos A.; Benetos G.; Lampropoulos K.;
Economou F.; Tsioufis K.; Toutouzas K.
Institution
(Koliastasis, Doundoulakis, Drakopoulou, Latsios, Synetos, Benetos,
Tsioufis, Toutouzas) First Department of Cardiology, National and
Kapodistrian University, "Hippokration" Hospital, Athens, Greece
(Koliastasis, Milkas) Athens Naval and Veterans Hospital, Athens, Greece
(Doundoulakis, Economou) Department of Cardiology, 424 General Military
Training Hospital, Thessaloniki, Greece
(Kokkinidis) Section of Cardiovascular Medicine, Yale University School of
Medicine, Yale New Haven Hospital, CT, New Haven, United States
(Kostopoulos) Department of Endocrinology, 424 General Military Training
Hospital, Thessaloniki, Greece
(Lampropoulos) Department of Cardiology, Evangelismos General Hospital,
Athens, Greece
Publisher
NLM (Medline)
Abstract
The ACURATE neo transcatheter aortic valve is a self-expanding device.
Several studies have investigated safety and efficacy, but meta-analysis
and pooled data are lacking. We aimed to provide a comprehensive
systematic review and meta-analysis on the clinical outcomes of
transcatheter aortic valve implantation with the ACURATE neo valve. A
systematic literature search for eligible records was conducted. The
primary endpoint was device success as designated by Valve Academic
Research Consortium-2 criteria. The secondary endpoints (time frame: 30
days) were all-cause mortality, stroke, myocardial infarction, need for
new permanent pacemaker, major vascular complications, major bleeding,
acute kidney injury stage II or III and paravalvular regurgitation grade
moderate or severe (II or III). Our search yielded a total of 355 records,
20 of those (n = 5,858 ACURATE neo receivers) were included in our
meta-analysis. Device success was achieved in 94.5% (95%CI: 91.4-96.5) of
the patients. The 30-day all-cause mortality incidence proportion was 1.8%
(95%CI: 1.3-2.4). New pacemaker implantation was required in 7.7% (95%CI:
6.4-9.2) of the patients, stroke occurred in 1.9% (95%CI: 1.6-2.3),
myocardial infarction in 0.5% (95%CI: 0.3-0.7), major bleeding in 5.0%
(95%CI: 3.9-6.5), major vascular complication in 5.6% (95%CI: 4.0-7.8),
acute kidney injury stage >=2 in 2.5% (95%CI: 1.8-3.4) and paravalvular
leak grade >=moderate was observed in 4.3% (95%CI: 3.0-6.2). Balloon
predilatation and postdilatation incidence was 93.9% (95%CI: 87.0-97.3)
and 43.2% (95%CI: 37.9-48.6) respectively. ACURATE neo appears to be safe
and effective in our analysis with high device success incidence, low
mortality and low new pacemaker implantations.<br/>Copyright &#xa9; 2022
Wolters Kluwer Health, Inc. All rights reserved.

<33>
Accession Number
637663689
Title
The use of steroids in treating chylothorax following cardiac surgery in
children: a unique perspective.
Source
Cardiology in the young. (pp 1-6), 2022. Date of Publication: 01 Apr
2022.
Author
Saad D.; Makarem A.; Fakhri G.; Al Amin F.; Bitar F.; El Rassi I.; Arabi
M.
Institution
(Saad, Fakhri) Department of Pediatrics and Adolescent Medicine, American
University of Beirut Medical Center, Beirut, Lebanon
(Makarem) Faculty of Medicine, American University of Beirut Medical
Center, Beirut, Lebanon
(Al Amin, Bitar, Arabi) Division of Pediatric Cardiology, Department of
Pediatrics and Adolescent Medicine, American University of Beirut Medical
Center, Beirut, Lebanon
(El Rassi) Department of Cardiothoracic Surgery, American University of
Beirut Medical Center, Beirut, Lebanon
Publisher
NLM (Medline)
Abstract
BACKGROUND: Chylothorax is the accumulation of chyle fluid in the pleural
space. The incidence of chylothorax is quite common post-cardiac surgeries
in pediatrics especially in Fontan procedures. Although several treatment
lines are known for the management of chylothorax, steroids were scarcely
reported as a treatment option. We present a unique case of a 4-year-old
child who underwent Fontan procedure and suffered a long-term consequence
of chylothorax. The chylothorax only fully resolved after introducing
corticosteroids as part of her management. <br/>METHOD(S): A literature
review about management of chylothorax post-cardiac surgery in children
using Ovid Medline (19462021), PubMed, and google scholar was performed.
<br/>CONCLUSION(S): Conservative management without additional surgical
intervention is adequate in most patients. Additionally, somatostatin can
be used with variable success rate. However, a few cases mentioned using
steroids in such cases. More research and reporting on the use of steroids
in the treatment of chylothorax post-cardiac surgeries in children is
needed to prove its effectivity. In this article, we describe a case of
chylothorax post-Fontan procedure that supports the use of steroids.

<34>
Accession Number
637663292
Title
An Intervention Trial for Strengthening Medical Adherence after Heart
Transplantation.
Source
Progress in transplantation (Aliso Viejo, Calif.). (pp
15269248221089013), 2022. Date of Publication: 31 Mar 2022.
Author
Tigges-Limmer K.; Stock Gissendanner S S.; Schmid-Ott G.; Wlost S.;
Gummert J.F.; Zittermann A.
Institution
(Tigges-Limmer, Wlost, Gummert, Zittermann) Clinic for Thoracic and
Cardiovascular Surgery, Ruhr University Bochum, Bad Oeynhausen, Germany
(Stock Gissendanner S) Social Sciences Faculty, 9375Georg August
University, Gottingen, Germany
(Schmid-Ott) LohneGermany
Publisher
NLM (Medline)
Abstract
INTRODUCTION: In heart transplant recipients, nonadherence is associated
with higher risk of morbidity and mortality. RESEARCH QUESTION: Can a
psychoeducational intervention enhance adherence to medical
recommendations? DESIGN: We randomized 200 patients awaiting heart
transplantation on the high urgency wait list to a manualized
psychoeducational intervention or standard care. Follow-up continued to
three years after transplantation. Primary endpoint was adherence to
immunosuppressive medication, assessed at 3, 6, 12, 24, and 36 months
posttransplant. Secondary endpoints were barriers to adherence during
follow-up and clinical outcomes, including cardiac rejection within the
first postoperative year and postoperative 3-year mortality.
<br/>RESULT(S): Fifty patients died before or within the first 3 months of
transplantation. The primary endpoint was analyzed in 66 patients in the
intervention group and 66 in the control group. Both study groups showed
almost maximal adherence to immunosuppressive medication throughout
follow-up, with no significant time x treatment interaction (P>0.99).
Likewise, there was no significant time x treatment interaction (P=0.41)
on barriers to adherence. The percentage of patients with International
Society for Heart and Lung Transplantation standard grade 1 and 2
rejection was in the intervention and control groups 82.5% and 78.7%,
respectively, and 8.8% and 13.1%, respectively, without significant
differences between study groups (P=0.75). Considering all randomized and
transplanted patients in the intervention group (N=85) and control group
(N=87), postoperative 3-year mortality was 29.4% and 27.6%, respectively
(P=0.82). <br/>CONCLUSION(S): Adherence to immunosuppressive medication
was high, even without a complex, manualized psychoeducational
intervention. The intervention had no significant positive impact on
cardiac rejection and mortality.

<35>
Accession Number
637661625
Title
Transcatheter-based aortic valve replacement vs. isolated surgical aortic
valve replacement in 2020.
Source
Clinical research in cardiology : official journal of the German Cardiac
Society. (no pagination), 2022. Date of Publication: 01 Apr 2022.
Author
Gaede L.; Blumenstein J.; Eckel C.; Grothusen C.; Tiyerili V.; Sotemann
D.; Nef H.; Elsasser A.; Achenbach S.; Mollmann H.
Institution
(Gaede, Achenbach) Medizinische Klinik 2, Universitatsklinikum Erlangen
,Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
(Blumenstein, Eckel, Grothusen, Tiyerili, Sotemann, Elsasser) Klinik Fur
Innere Medizin I, St.-Johannes-Hospital Dortmund, Dortmund, Germany
(Blumenstein, Eckel) Klinikum Oldenburg, Carl-Von-Ossietzky-Universitat
Oldenburg, Oldenburg, Germany
(Nef) Klinik Fur Kardiologie Und Angiologie, Justus-Liebig-Universitat
Giesen, Giesen, Germany
(Mollmann) Klinik Fur Innere Medizin I, St.-Johannes-Hospital Dortmund,
Dortmund, Germany
(Mollmann) Department of Cardiology, St-Johannes-Hospital Dortmund,
Johannesstrase 9-13, Dortmund 44137, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Based on the results of several recent randomized trials,
European and American guidelines on valvular heart disease management have
substantially expanded the indications for transcatheter aortic valve
implantation (TAVI). We present an all-comer data on peri-operative risk
profile and in-hospital outcomes from Germany for patients treated by TAVI
or isolated surgical aortic valve replacement (iSAVR) in 2020, providing
an opportunity to compare study data with data from daily clinical
practice. <br/>METHOD(S): Data concerning all isolated aortic valve
procedures performed in Germany in 2020 were retrieved from the mandatory
nationwide quality control program. Expected mortality was calculated with
the annually revised German Aortic valve score (AKL-score) based on the
data of either catheter-based (AKL-CATH) or isolated surgical (AKL-CHIR)
aortic valve replacement in Germany from the previous year (2019).
<br/>RESULT(S): In 2020 21,903 TAVI procedures (20,810 transvascular (TV;
vs. 2019: 22.973; -9.4%), 1093 transapical (TA; vs. 2019: 1413; -22.6%))
and 6144 (vs. 2019 7905; -22.5%) iSAVR were performed in Germany. Patients
who received TAVI showed a significantly higher perioperative risk profile
than patients undergoing iSAVR based on older age and more severe
co-morbidities. While in-hospital mortality after TAVI (2.3%) was
numerically lower than in 2019 (2.5%), this difference was not significant
(p=0.11). In-hospital mortality after iSAVR was identical in 2020 and 2019
(2.8%) and thus higher than after TAVI (p=0.003), resulting in an observed
expected mortality ratio of 1.02 after TAVI and 1.05 after iSAVR. After
exclusion of the emergency procedures, in-hospital mortality did not
differ significantly between the groups (TAVI 2.2% vs. iSAVR 1.9%,
p=0.26). <br/>CONCLUSION(S): Total numbers of both iSAVR and TAVI in
Germany were lower in 2020 than in 2019, most likely due to the COVID-19
pandemic. However, the relative number of patients treated by TAVI as
compared to iSAVR continues to increase. Despite older age and more severe
comorbidities compared to patients undergoing iSAVR the in-hospital
mortality after TAVI continued to decrease in 2020 and remains
significantly lower than after iSAVR.<br/>Copyright &#xa9; 2022. The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

<36>
Accession Number
637660608
Title
The effect of peripheral regional analgesia in thoracic surgery: a
systematic review and a meta-analysis of randomized-controlled trials.
Source
Tumori. (pp 3008916221081891), 2022. Date of Publication: 31 Mar 2022.
Author
Balzani E.; Rosboch G.L.; Ceraolo E.; Lyberis P.; Filippini C.; Piccioni
F.; Guerrera F.; Ruffini E.; Pedoto A.; Brazzi L.
Institution
(Balzani, Guerrera, Ruffini, Brazzi) Department of Surgical Science,
University of Turin, Torino, Italy
(Rosboch, Ceraolo, Brazzi) Department of Anesthesia, Intensive Care and
Emergency, 'Citta della Salute e della Scienza di Torino' Hospital,
Torino, Italy
(Lyberis, Guerrera, Ruffini) Department of Cardiovascular and Thoracic
Surgery, 'Citta della Salute e della Scienza di Torino' Hospital, Torino,
Italy
(Filippini) Clinical Statistics, Department of Surgical Sciences,
University of Torino, Corso Bramante 88, Turin, Italy
(Piccioni) General and Specialistic Surgical Department, Anesthesia and
Intensive Care Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
(Pedoto) Clinical Attending Department of Anesthesia and CCM, Memorial
Sloan Kettering Cancer Center, NY, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Several peripheral regional anaesthesia (RA) techniques are
commonly used in thoracic surgery even in the absence of precise
indications regarding their effectiveness on postoperative pain
management. <br/>OBJECTIVE(S): This systematic review and meta-analysis
aims to describe and evaluate the relative effectiveness of different
peripheral regional blocks and systemic analgesia in the context of
video-assisted thoracoscopic surgery (VATS) or thoracotomy. DESIGN:
Systematic review of randomized controlled clinical trials (RCTs) with
meta-analyses. DATA SOURCES: We searched PubMed and Embase for all RCTs
comparing the 24 hour morphine equivalents (MMEs) consumption following
peripheral regional blocks and systemic analgesia (SA). ELIGIBILITY
CRITERIA: We selected only RCTs including adult participants undergoing
thoracic surgery, including esophagectomy and reporting on postoperative
pain outcomes including 24 hour MMEs consumption. <br/>RESULT(S): Among
the 28 randomized studies including adult participants undergoing thoracic
surgery and reporting on 24 hour opioid consumption, 11 reporting a
comparison of individual blocks with systemic analgesia were
meta-analyzed. RA was effective for almost all peripheral blocks.
Regarding intercostal block, its antalgic effect was not well evaluated
SMD -1.57 (CI -3.88, 0.73). RA in VATS was more effective in reducing MMEs
than thoracotomy SMD -1.10 (CI -1.78, -0.41). <br/>CONCLUSION(S): RA is a
useful choice in thoracic surgery. However, it is still not possible to
determine the most appropriate block in the individual surgical settings
to be performed due to RCTs paucity.

<37>
Accession Number
637660252
Title
Heart Team risk assessment with angiography-derived fractional flow
reserve determining the optimal revascularization strategy in patients
with multivessel disease: Trial design and rationale for the DECISION QFR
randomized trial.
Source
Clinical cardiology. (no pagination), 2022. Date of Publication: 31 Mar
2022.
Author
Miyata K.; Asano T.; Saito A.; Abe K.; Tanigaki T.; Hoshino M.; Kobayashi
T.; Takaoka Y.; Kanie T.; Yamasaki M.; Yoshino K.; Wakabayashi N.; Ouchi
K.; Kodama H.; Shiina Y.; Tamaki R.; Nishihata Y.; Masuda K.; Suzuki T.;
Nonaka H.; Emori H.; Katagiri Y.; Miyazaki Y.; Sotomi Y.; Yasunaga M.;
Kogame N.; Kuramitsu S.; Reiber J.H.C.; Okamura T.; Higuchi Y.; Kakuta T.;
Misumi H.; Komiyama N.; Matsuo H.; Tanabe K.
Institution
(Miyata, Asano, Saito, Takaoka, Kanie, Kodama, Shiina, Nishihata, Masuda,
Suzuki, Komiyama) Department of Cardiovascular Medicine, St. Luke's
International Hospital, St. Luke's International University, Tokyo, Japan
(Abe, Yamasaki, Yoshino, Tamaki, Misumi) Department of Cardiovascular
Surgery, St. Luke's International Hospital, St. Luke's International
University, Tokyo, Japan
(Tanigaki, Matsuo) Department of Cardiovascular Medicine, Gifu Heart
Center, Gifu, Japan
(Hoshino, Kakuta) Division of Cardiovascular Medicine, Tsuchiura Kyodo
General Hospital, Ibaraki, Japan
(Kobayashi, Yasunaga, Higuchi) Department of Cardiology, Osaka Police
Hospital, Osaka, Japan
(Wakabayashi, Ouchi) Department of Radiology, St. Luke's International
Hospital, St. Luke's International University, Tokyo, Japan
(Nonaka, Tanabe) Division of Cardiology, Mitsui Memorial Hospital, Tokyo,
Japan
(Emori) Department of Cardiovascular Medicine, Wakayama Medical
University, Wakayama, Japan
(Katagiri) Department of Cardiovascular Medicine, Sapporo Higashi
Tokushukai Hospital, Sapporo, Japan
(Miyazaki, Okamura) Division of Cardiology, Department of Medicine and
Clinical Science, Yamaguchi University Graduate School of Medicine,
Yamaguchi, Japan
(Sotomi) Department of Cardiovascular Medicine, Osaka University Graduate
School of Medicine, Osaka, Japan
(Kogame) Division of Cardiovascular Medicine, Toho University Ohashi
Medical Center, Meguro, Tokyo, Japan
(Kuramitsu) Department of Cardiology, Kokura Memorial Hospital,
Kitakyushu, Japan
(Reiber) Department of Radiology, Leiden University Medical Center,
Leiden, Netherlands
Publisher
NLM (Medline)
Abstract
In patients with multivessel disease (MVD), functional information on
lesions improves the prognostic capability of the SYNTAX score.
Quantitative flow ratio (QFR) is an angiography-derived fractional flow
reserve (FFR) that does not require a pressure wire or pharmacological
hyperemia. We aimed to investigate the feasibility of QFR-based patient
information in Heart Teams' discussions to determine the optimal
revascularization strategy for patients with MVD. We hypothesized that
there is an acceptable agreement between treatment recommendations based
on the QFR approach and recommendation based on the FFR approach. The
DECISION QFR study is a prospective, multicenter, randomized controlled
trial that will include patients with MVD who require revascularization.
Two Heart Teams comprising cardiologists and cardiac surgeons will be
randomized to select a revascularization strategy (percutaneous coronary
intervention or coronary artery bypass graft) according to patient
information either based on QFR or on FFR. All 260 patients will be
assessed by both teams with reference to the anatomical and functional
SYNTAX score/SYNTAX score II 2020 derived from the allocated physiological
index (QFR or FFR). The primary endpoint of the trial is the level of
agreement between the treatment recommendations of both teams, assessed
using Cohen's kappa. As of March 2022, the patient enrollment has been
completed and 230 patients have been discussed in both Heart Teams. The
current trial will indicate the usefulness of QFR, which enables a
wireless multivessel physiological interrogation, in the discussions of
Heart Teams to determine the optimal revascularization strategy for
MVD.<br/>Copyright &#xa9; 2022 The Authors. Clinical Cardiology published
by Wiley Periodicals, LLC.

<38>
Accession Number
354483285
Title
Body perfusion during adult cardiopulmonary bypass is improved by
pulsatile flow with intra-aortic balloon pump.
Source
International Journal of Artificial Organs. 32(1) (pp 50-61), 2009. Date
of Publication: 2009.
Author
Onorati F.; Santarpino G.; Rubino A.S.; Caroleo S.; Dardano A.; Scalas C.;
Gulletta E.; Santangelo E.; Renzulli A.
Institution
(Onorati, Santarpino, Rubino, Scalas, Renzulli) Department of Clinical and
Experimental Medicine, Cardiac Surgery Unit, Magna Graecia University
Medical School, Catanzaro, Italy
(Caroleo, Santangelo) Department of Clinical and Experimental Medicine,
Anesthesiology Unit, Magna Graecia University Medical School, Catanzaro,
Italy
(Dardano, Gulletta) Department of Clinical and Experimental Medicine,
Biochemistry Unit, Magna Graecia University Medical School, Catanzaro,
Italy
(Onorati) Viale Europa, localita Germaneto, 88100 Catanzaro, Italy
Publisher
Wichtig Editore s.r.l.
Abstract
Purpose: To evaluate if the use of an intra-aortic balloon pump (IABP)
during cardioplegic arrest improves body perfusion. <br/>Method(s): 158
coronary artery bypass graft (CABG) patients were randomized to linear
cardiopulmonary bypass (CPB) (n=71, Group A) or automatic 80 bpm
intra-aortic ballon pump (IABP) induced pulsatile CPB (n=87, Group B). We
evaluated hemodynamic response by Swan-Ganz catheter, inflammation by
cytokines, coagulation and fibrinolysis, transaminase, bilirubin, amylase,
lactate and renal function (estimated glomerular filtration rate (eGFR),
creatinine, and incidence of renal insufficiency and failure).
<br/>Result(s): IABP induced Surplus Hemodynamic Energy was 15.8+/-4.9
mmHg, with higher mean arterial pressure during cross-clamping (p=0.001),
and lower indexed systemic vascular resistances during cross-clamping
(p=0.001) and CPB discontinuation (p=0.034). IL-2 and IL-6 were lower,
while IL-10 proved higher in Group B (p<0.05). Group B showed lower chest
drainage (p<0.05), transfusions (p<0.05), INR (p<0.05), and AT-III
(p=0.001), together with higher platelets, aPTT (p<0.05), fibrinogen
(p<0.05) and D-dimer (p<0.05). Transaminases, bilirubin, amylase, lactate
were lower in Group B (p<0.05); eGFR was better in Group B from
ITU-arrival to 48 hours, both in preoperative kidney disease Stages 1-2
(p<0.03) and Stage 3 (p<0.05), resulting in lower creatinine from
ITU-arrival to 48 hours (p<0.03). Incidence of renal insufficiency
(p=0.004) and need for renal replacement therapy (p=0.044) was lower in
Group B Stage 3. Group B PaO2/FiO2 and lung compliance improved from
aortic declamping to the first day (p<0.003) with shorter intubation time
(p=0.01). <br/>Conclusion(s): Pulsatile flow by IABP improves whole-body
perfusion during CPB. &#xa9; Wichtig Editore, 2009.

<39>
Accession Number
2007324785
Title
Clinical outcomes of transcatheter aortic valve implantation in failed
bioprosthetic surgical valves vs. native aortic stenosis: insights from a
meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 37(1) (pp 182-190), 2022.
Date of Publication: January 2022.
Author
Yashima F.; Yokoyama Y.; Takagi H.; Briasoulis A.; Kuno T.
Institution
(Yashima) Department of Cardiology, Saiseikai Utsunomiya Hospital,
Utsunomiya, Japan
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Briasoulis) Division of Cardiovascular Medicine, Section of Heart Failure
and Transplantation, University of Iowa, IA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, First Avenue, 16th street, New York, NY 10003,
United States
Publisher
Springer Japan
Abstract
There is no meta-analysis comparing clinical outcomes between
valve-in-valve transcatheter aortic valve implantation for failed surgical
bioprosthetic valves (ViV-TAVI) and native valve TAVI for aortic stenosis
(NV-TAVI). We aimed to investigate clinical outcomes between ViV-TAVI and
NV-TAVI using a meta-analysis. EMBASE and MEDLINE were searched through
April 2020 to investigate the comparative outcomes between ViV-TAVI and
NV-TAVI. The main outcomes were short-term (30-day/in-hospital) mortality,
pacemaker implantation (PMI), life threatening and/or major bleeding,
stroke, and coronary obstruction, and long-term (1-year) mortality and
stroke. Our search identified 5 observational studies enrolling a total of
8428 patients (1442 patients with ViV-TAVI and 6986 with NV-TAVI).
ViV-TAVI was associated with significantly lower rates of short-term
mortality, PMI, and life threatening and/or major bleeding, compared with
NV-TAVI (relative risk [RR] [95% CI] 0.54 [0.34-0.84], P = 0.007; 0.25
[0.19-0.35], P < 0.0001; 0.64 [0.46-0.89], P = 0.008, respectively). There
were no significant differences in rates of short-term stroke and coronary
obstruction between ViV-TAVI and NV-TAVI (RR [95% CI] 0.59 [0.35-1.01], P
= 0.06; 1.86 [0.78-4.41], P = 0.16, respectively). ViV-TAVI was also
associated with a significantly lower rate of 1-year mortality compared
with NV-TAVI (RR [95% CI] 0.64 [0.51-0.81], P = 0.0002), whereas there was
no significant difference in long-term stroke (RR [95% CI] 0.71
[0.45-1.12], P = 0.51). ViV-TAVI was associated with significantly lower
rates of short-term mortality, PMI, and life threatening and/or major
bleeding, and long-term mortality, without increased risks of stroke and
coronary obstruction, compared with NV-TAVI.<br/>Copyright &#xa9; 2020,
Japanese Association of Cardiovascular Intervention and Therapeutics.

<40>
Accession Number
637482411
Title
Rationale and design for comparison of non-compliant balloon with
drug-coating balloon angioplasty for side branch after provisional
stenting for patients with true coronary bifurcation lesions: A
prospective, multicentre and randomised DCB-BIF trial.
Source
BMJ Open. 12(3) (no pagination), 2022. Article Number: e052788. Date of
Publication: 11 Mar 2022.
Author
Gao X.-F.; Ge Z.; Kan J.; Kong X.-Q.; Wang Y.; Qiu C.-G.; Tresukosol D.;
He Y.-Q.; Wu Q.; Li J.-F.; Yuan H.-T.; Shen C.; Chen X.; Munawar M.; Hanif
B.; Santoso T.; Shin E.-S.; Sheiban I.; Ye F.; Zhang J.-J.; Chen S.-L.
Institution
(Gao, Ge, Kan, Kong, Ye, Zhang, Chen) Department of Cardiology, Nanjing
First Hospital, Nanjing Medical University, Jiangsu, Nanjing, China
(Wang, Chen) Department of Cardiology, Xiamen Cardiovascular Hospital,
Xiamen University, Fujian, Xiamen, China
(Qiu) Cardiology, Zhengzhou University First Affiliated Hospital, Henan,
Zhengzhou, China
(Tresukosol) Department of Cardiology, Medicine Siriraj Hospital, Bangkok,
Thailand
(He) Department of Cardiology, China-Japan Union Hospital of Jilin
University, Jilin, Changchun, China
(Wu) Department of Cardiology, Xuzhou Central Hospital, Jiangsu, Xuzhou,
China
(Li) Department of Cardiology, Qilu Hospital, Shandong, Jinan, China
(Yuan) Department of Cardiology, Shandong Provincial Hospital, Shandong,
Jinan, China
(Shen) Department of Cardiology, Shanghai Sixth People's Hospital,
Shanghai, Shanghai, China
(Munawar) Department of Cardiology, Binawaluya Heart Hospital, Jakarta,
Indonesia
(Hanif) Department of Cardiology, Tabba Heart Institute, Karachi, Pakistan
(Santoso) Department of Cardiology, Medistra Hospital, Jakarta, Indonesia
(Shin) Department of Cardiology, Ulsan Medical Center, Ulsan, South Korea
(Sheiban) Interventional Cardiology, Casa di Cura Dottor Pederzoli SpA,
Peschiera del Garda, Italy
Publisher
BMJ Publishing Group
Abstract
Introduction Provisional stenting using drug-eluting stent is effective
for simple coronary bifurcation lesions. Kissing balloon inflation using
conventional non-compliant balloon is the primary treatment of side branch
(SB) after main vessel (MV) stenting. Drug-coating balloon (DCB) is
reported to be associated with less frequent clinical events in in-stent
restenosis and small vessel disease. The importance of DCB in bifurcation
treatment is understudied. Accordingly, this trial is designed to
investigate the superiority of DCB to non-compliant balloon angioplasty
for SB after provisional stenting in patients with true coronary
bifurcation lesions. Methods and analysis The DCB-BIF trial is a
prospective, multicentre, randomised, superiority trial including 784
patients with true coronary bifurcation lesions. Patients will be
randomised in a 1:1 fashion to receive either DCB or non-compliant balloon
angioplasty if SB diameter stenosis >70% after MV stenting. The primary
endpoint is the composite of major adverse cardiac event at the 1-year
follow-up, including cardiac death, myocardial infarction (MI) or
clinically driven target lesion revascularisation. The major secondary
endpoints include all-cause death, periprocedural MI, spontaneous MI,
clinically driven target vessel revascularisation, in-stent restenosis,
stroke and individual component of the primary endpoint. The safety
endpoint is the risk of stent thrombosis. Ethics and dissemination The
study protocol and informed consent have been reviewed and approved by the
Institutional Review Board of all participating centres. The written
informed consent for participation in the trial will be obtained from all
participants. The results of this study will be published in a
peer-reviewed journal and disseminated at conferences. Trial registration
number NCT04242134.<br/>Copyright &#xa9; 2022 BioMed Central Ltd.. All
rights reserved.

<41>
Accession Number
637460948
Title
Intrapleural fibrinolysis and DNase versus video-assisted thoracic surgery
(VATS) for the treatment of pleural empyema (FIVERVATS): Protocol for a
randomised, controlled trial - Surgery as first-line treatment.
Source
BMJ Open. 12(3) (no pagination), 2022. Article Number: e054236. Date of
Publication: 09 Mar 2022.
Author
Christensen T.D.; Bendixen M.; Skaarup So.H.; Jensen J.-U.; Petersen R.H.;
Christensen M.; Licht P.; Neckelmann K.; Bibby B.M.; Moller L.B.; Bodtger
U.; Borg M.H.; Saghir Z.; Langfeldt S.; Harders S.M.W.; Bedawi E.O.; Naidu
B.; Rahman N.; Laursen C.B.
Institution
(Christensen) Department of Cardiothoracic and Vascular Surgery,
Department of Clinical Medicine, Aarhus University Hospital, Aarhus,
Denmark
(Bendixen) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Skaarup) Department of Respiratory Diseases and Allergy, Aarhus
University Hospital, Aarhus, Denmark
(Jensen, Saghir) Department of Internal Medicine, Respiratory Medicine
Section, Herlev and Gentofte Hospital, Copenhagen, Denmark
(Jensen, Petersen, Saghir) Institute for Clinical Medicine, Faculty of
Health Sciences, University of Copenhagen, Copenhagen, Denmark
(Petersen, Christensen) Department of Cardiothoracic Surgery, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Licht, Neckelmann) Department of Cardiothoracic Surgery, Odense
University Hospital, Odense, Denmark
(Bibby) Department of Public Health, Section for Biostatistics, Aarhus
University, Aarhus, Denmark
(Moller) Department of Cardiothoracic Surgery, Aalborg University
Hospital, Aalborg, Denmark
(Bodtger) Department of Internal Medicine, Department of Respiratory
Medicine, Zealand University Hospital, Naestved-Slagelse Hospital,
Naestved, Denmark
(Bodtger) Institute of Regional Health Research, University of Southern
Denmark, Odense, Denmark
(Borg) Department of Respiratory Medicine and Clinical Institute, Aalborg
University Hospital, Aalborg, Denmark
(Langfeldt) Department of Radiology, Aarhus University Hospital, Aarhus,
Denmark
(Harders) Department of Radiology, Odense University Hospital, Odense,
Denmark
(Bedawi, Rahman) NIHR Oxford Biomedical Research Centre, University of
Oxford, Oxford, United Kingdom
(Naidu) Department of Thoracic Surgery, Queen Elizabeth Hospital,
Birmingham, United Kingdom
(Naidu) Institute of Inflammation and Ageing, University of Birmingham,
Birmingham, United Kingdom
(Laursen) Department of Respiratory Medicine, Odense University Hospital,
Odense, Denmark
(Laursen) Odense Respiratory Research Unit (ODIN), Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
Publisher
BMJ Publishing Group
Abstract
Introduction Pleural empyema is a frequent disease with a high morbidity
and mortality. Current standard treatment includes antibiotics and
thoracic ultrasound (TUS)-guided pigtail drainage. Simultaneously with
drainage, an intrapleural fibrinolyticum can be given. A potential better
alternative is surgery in terms of video-assisted thoracoscopic surgery
(VATS) as first-line treatment. The aim of this study is to determine the
difference in outcome in patients diagnosed with complex parapneumonic
effusion (stage II) and pleural empyema (stage III) who are treated with
either VATS surgery or TUS-guided drainage and intrapleural therapy
(fibrinolytic (Alteplase) with DNase (Pulmozyme)) as first-line treatment.
Methods and analysis A national, multicentre randomised, controlled study.
Totally, 184 patients with a newly diagnosed community acquired
complicated parapneumonic effusion or pleural empyema are randomised to
either (1) VATS procedure with drainage or (2) TUS-guided pigtail catheter
placement and intrapleural therapy with Actilyse and DNase. The total
follow-up period is 12 months. The primary endpoint is length of hospital
stay and secondary endpoints include for example, mortality, need for
additional interventions, consumption of analgesia and quality of life.
Ethics and dissemination All patients provide informed consent before
randomisation. The research project is carried out in accordance with the
Helsinki II Declaration, European regulations and Good Clinical Practice
Guidelines. The Scientific Ethics Committees for Denmark and the Danish
Data Protection Agency have provided permission. Information about the
subjects is protected under the Personal Data Processing Act and the
Health Act. The trial is registered at www.clinicaltrials.gov, and
monitored by the regional Good clinical practice monitoring unit. The
results of this study will be published in peer-reviewed journals and
presented at various national and international conferences. Trial
registration number NCT04095676.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<42>
Accession Number
2016981570
Title
Prediction models for treatment-induced cardiac toxicity in patients with
non-small-cell lung cancer: A systematic review and meta-analysis.
Source
Clinical and Translational Radiation Oncology. 33 (pp 134-144), 2022. Date
of Publication: March 2022.
Author
Tohidinezhad F.; Pennetta F.; van Loon J.; Dekker A.; de Ruysscher D.;
Traverso A.
Institution
(Tohidinezhad, Pennetta, van Loon, Dekker, de Ruysscher, Traverso)
Department of Radiation Oncology (Maastro Clinic), School for Oncology and
Developmental Biology (GROW), Maastricht University Medical Center,
Maastricht, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: To maximize the likelihood of positive outcome in
non-small-cell lung cancer (NSCLC) survivors, potential benefits of
treatment modalities have to be weighed against the possibilities of
damage to normal tissues, such as the heart. High-quality data-driven
evidence regarding appropriate risk stratification strategies is still
scarce. The aim of this review is to summarize and appraise available
prediction models for treatment-induced cardiac events in patients with
NSCLC. <br/>Method(s): A systematic search of MEDLINE was performed using
a Boolean combination of appropriate truncation and indexing terms related
to "NSCLC", "prediction models", "cardiac toxicity", and "treatment
modalities". The following exclusion criteria were applied: sample-size of
less than 100, no significant predictors in multivariate analysis, lack of
model specifications, and case-mix studies. The generic inverse variance
method was used to pool the summary effect estimate for each predictor.
The quality of the papers was assessed using the Prediction model Risk Of
Bias Assessment Tool. <br/>Result(s): Of the 3,056 papers retrieved, 28
prediction models were identified, including seven for
(chemo-)radiotherapy, one for immunotherapy, and 20 for surgical
resection. Forty-one distinct predictors were entered in the prediction
models. The pooled effect estimate of the mean heart dose (HR = 1.06,
95%CI:1.04-1.08) and history of cardiovascular diseases (HR = 3.1,
95%CI:1.8-5.36) were shown to significantly increase the risk of
developing late cardiac toxicity after (chemo-)radiotherapy. Summary
estimates of age (OR = 1.17, 95%CI:1.06-1.29), male gender (OR = 1.61,
95%CI:1.4-1.85), and advanced stage (OR = 1.34, 95%CI:1.06-1.69) were
significantly associated with higher risk of acute cardiac events after
surgery. Risk of bias varied across studies, but analysis was the most
concerning domain where none of the studies were judged to be low risk.
<br/>Conclusion(s): This review highlights the need for a robust
prediction model which can inform patients and clinicians about expected
treatment-induced heart damage. Identified clues suggest incorporation of
detailed cardiac metrics (substructures' volumes and doses).<br/>Copyright
&#xa9; 2022

<43>
Accession Number
2015986073
Title
The Analgesic Efficacy of Ultrasound-Guided Bilateral Transversus Thoracic
Muscle Plane Block After Open-Heart Surgeries: A Randomized Controlled
Study.
Source
Journal of Pain Research. 15 (pp 675-682), 2022. Date of Publication:
2022.
Author
Hamed M.A.; Boules M.L.; Sobhy M.M.; Abdelhady M.A.
Institution
(Hamed, Boules, Sobhy, Abdelhady) Department of Anesthesiology, Faculty of
Medicine, Fayoum University, Fayoum, Egypt
Publisher
Dove Medical Press Ltd
Abstract
Background: We aimed to evaluate the analgesic efficacy of
ultrasound-guided bilateral transversus thoracic muscle plane block after
open-heart surgeries. <br/>Method(s): Seventy patients aged above 18 years
and scheduled for valve replacement or adult congenital via median
sternotomy were enrolled in this study. Patients were divided into two
groups, randomized by computer-generated random numbers: the block group,
which had the ultrasound-guided bilateral transversus thoracic muscle
plane block, and the control group, which had a sham block. The primary
outcome was total fentanyl consumption in the first 24-hours. The
secondary outcomes were pain score, time to the first analgesic request,
time to extubation, ICU stays, and hospital stay. <br/>Result(s): The
total fentanyl consumption in the first 24 hours was significantly lower
in the block group, with a mean difference of -158.286 (95% CI = (-179.271
to -137.300; p =<0.0001)). The time to the first analgesic request was
statistically significantly shorter in the non-block group (median 3
hours) than the block group (median 14 hours). During the postoperative
period (0.5-24 hours), at-rest pain scores were 1.86 units lower in the
block group (the estimate was -1.80, 95% CI = -2.14 to -1.45, t = -10.323
with p < 0.0001). Likewise, pain scores with cough were 3.29 units lower
in the block group (the estimate was -3.29, 95% CI = -3.80 to -2.77, t =
-12.703, p < 0.0001). <br/>Conclusion(s): Bilateral transversus thoracic
muscle plane block is a promising and effective technique in reducing
opioid consumption and controlling post-sternotomy pain after open-heart
surgery via median sternotomy.<br/>Copyright &#xa9; 2022 Hamed et al.

<44>
Accession Number
2006893205
Title
Off-pump versus on-pump redo coronary artery bypass grafting: a systematic
review and meta-analysis.
Source
Perfusion (United Kingdom). 36(7) (pp 724-736), 2021. Date of Publication:
October 2021.
Author
Zhang P.; Wang L.; Zhai K.; Huang J.; Wang W.; Ma Q.; Liu D.; Gao B.; Li
Y.
Institution
(Zhang, Wang, Zhai, Huang, Wang, Ma, Liu, Gao, Li) Department of Cardiac
Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou,
China
(Zhang, Zhai, Huang, Li) Laboratory of Extracorporeal Life Support,
Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China
Publisher
SAGE Publications Ltd
Abstract
Background: Redo coronary artery bypass grafting (redo CABG) is associated
with increased mortality and morbidity. The aim of this study was to
systematically evaluate the evidence comparing the outcomes of off-pump
with on-pump redo CABG. <br/>Method(s): Studies were systematically
searched and identified using PubMed, EMBASE, the Cochrane Library, and
the International Clinical Trials Registry Platform (ICTRP) by two
researchers independently. The primary outcome was 30-day mortality, and
the secondary outcomes were in-hospital mortality, post-operative
complications, completeness of revascularization, blood transfusion rate,
duration of mechanical ventilation, intensive care unit and hospital
stays. <br/>Result(s): The 21 studies including 4,889 patients were
enrolled in our meta-analysis. Compared with on-pump, the off-pump
technique was associated with significantly reduced 30-day mortality (odds
ratio [OR] = 0.43, 95% confidence interval [CI] = 0.26-0.72, p = 0.001).
Moreover, a notably decreased in-hospital mortality (OR = 0.55, 95% CI =
0.39-0.76, p = 0.0004) and incidence of post-operative new-onset atrial
fibrillation, myocardial infarction, acute kidney injury, low cardiac
output state, blood transfusion rate (OR = 0.46, 95% CI = 0.35-0.60, p <
0.00001; OR = 0.54, 95% CI = 0.38-0.78, p = 0.0007; OR = 0.51, 95% CI =
0.37-0.70, p < 0.0001; OR = 0.31, 95% CI = 0.20-0.47, p < 0.00001; OR =
0.29, 95% CI = 0.14-0.61, p = 0.001) and significantly shortened duration
of mechanical ventilation, intensive care unit and hospital stays (mean
difference [MD] = -8.21 h, 95% CI = -11.74 to -4.68, p < 0.00001; MD =
-0.77 d, 95% CI = -0.81 to -0.73, p < 0.00001; MD = -2.24 d, 95% CI =
-3.17 to -1.32, p < 0.00001) could be observed when comparing the outcomes
of off-pump with on-pump redo CABG. There was nonsignificant difference
between off-pump and on-pump redo CABG in completeness of
revascularization. <br/>Conclusion(s): In patients undergoing redo CABG
surgery, the off-pump technique was associated with decreased mortality,
less post-operative complications when compared to on-pump.<br/>Copyright
&#xa9; The Author(s) 2020.

<45>
Accession Number
2006140373
Title
The impact of minimal invasive extracorporeal circulation on postoperative
kidney function.
Source
Perfusion (United Kingdom). 36(7) (pp 745-750), 2021. Date of Publication:
October 2021.
Author
Media A.S.; Juhl-Olsen P.; Magnusson N.E.; Modrau I.S.
Institution
(Media, Modrau) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Juhl-Olsen) Department of Anaesthesiology and Intensive Care, Aarhus
University Hospital, Aarhus, Denmark
(Juhl-Olsen, Magnusson, Modrau) Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
(Magnusson) Medical Research Laboratory, Aarhus University, Aarhus,
Denmark
Publisher
SAGE Publications Ltd
Abstract
Introduction: Acute kidney injury following cardiac surgery is a frequent
complication associated with increased mortality and morbidity. Minimal
invasive extracorporeal circulation is suggested to preserve postoperative
renal function. The aim of this study was to assess the impact of minimal
invasive versus conventional extracorporeal circulation on early
postoperative kidney function. <br/>Method(s): Randomized controlled trail
including 60 patients undergoing elective stand-alone coronary artery
bypass graft surgery and allocated in a 1:1 ratio to either minimal
invasive (n = 30) or conventional extracorporeal circulation (n = 30).
Postoperative kidney injury was assessed by elevation of plasma neutrophil
gelatinase-associated lipocalin (NGAL), a sensitive tubular injury
biomarker. In addition, we assessed changes in estimated glomerular
filtration rate (eGFR), and the incidence of acute kidney injury according
to the Acute Kidney Injury Network (AKIN) classification. <br/>Result(s):
We observed no differences between groups regarding increase of plasma
NGAL (p = 0.31) or decline of eGFR (p = 0.82). In both groups, 6/30
patients developed acute kidney injury according to the AKIN
classification, all regaining preoperative renal function within 30 days.
<br/>Conclusion(s): Our findings challenge the superiority of minimal
invasive compared to conventional extracorporeal circulation in terms of
preservation of renal function following low-risk coronary
surgery.<br/>Copyright &#xa9; The Author(s) 2020.

<46>
[Use Link to view the full text]
Accession Number
637651309
Title
Extremely premature infants with patent ductus arteriosus closure:
Comparative analysis of surgical ligation versus cardiac
catheterization-based closure.
Source
Medicine. 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, TX, Houston
(Breinholt) Phoenix Children's Hospital, AZ, Phoenix, United States
Publisher
NLM (Medline)
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.<br/>Copyright &#xa9; 2022
the Author(s). Published by Wolters Kluwer Health, Inc.

<47>
Accession Number
637644622
Title
Derivacion de la arteria coronaria en supervivencia de pacientes con
insuficiencia valvular mitral isquemica moderada: un meta-analisis,
Coronary artery bypass on survival in patients with moderate ischemic
mitral regurgitation: meta-analysis.
Source
Cirugia y cirujanos. 90(2) (pp 180-186), 2022. Date of Publication: 2022.
Author
Lv J.; Liu K.; Lu R.; He R.; Chen S.
Institution
(Lv) Department of General Medicine
(Liu, Lu, He, Chen) Department of Cardiovascular Surgery. ZheJiang
Hospital, Hangzhou, China
Publisher
NLM (Medline)

<48>
Accession Number
2015504119
Title
When coronary imaging and physiology are discordant, how best to manage
coronary lesions? An appraisal of the clinical evidence.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Fernandez-Peregrina E.; Ahmad H.; Mintz G.S.; Garcia-Garcia H.M.
Institution
(Fernandez-Peregrina, Ahmad, Mintz, Garcia-Garcia) Division of Section of
Interventional Cardiology, MedStar Washington Hospital Center, Washington,
DC, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Discordant physiology and anatomy may occur when nonsevere
angiographic stenosis has positive physiology as well as the opposite
situation. <br/>Aim(s): To underline the reasons behind the discrepancy in
physiology and anatomy and to summarize the information that coronary
imaging may add to physiology. <br/>Method(s): A review of the published
literature on physiology and intravascular imaging assessment of
intermediate lesions was carried out. <br/>Result(s): The limitations of
angiography, the possibility of an underlying diffuse disease, the
presence of a "grey zone" in both techniques, the amount of myocardial
mass that subtends the stenosis, and plaque vulnerability may play a role
in such discrepancy. Intracoronary imaging has a poor diagnostic accuracy
compared to physiology. However, it may add information about plaque
vulnerability that might be useful in deciding whether to treat or not a
certain lesion. <br/>Conclusion(s): Coronary revascularization is
recommended for patients with ischemia based on physiology. Intracoronary
imaging adds information on plaque vulnerability and can help on the
decision whether to revascularize or not a lesion.<br/>Copyright &#xa9;
2022 Wiley Periodicals LLC.

<49>
Accession Number
2016680202
Title
Outcomes in Patients With Asymptomatic Aortic Stenosis (from the Evolut
Low Risk Trial).
Source
American Journal of Cardiology. 168 (pp 110-116), 2022. Date of
Publication: 01 Apr 2022.
Author
Merhi W.M.; Heiser J.; Deeb G.M.; Yakubov S.J.; Lim D.S.; Bladergroen M.;
Tadros P.; Zorn G.; Byrne T.; Kirshner M.; Huang J.; Reardon M.J.
Institution
(Merhi, Heiser) Departments of Cardiothoracic Surgery and Interventional
Cardiology, Spectrum Health Hospitals, Grand Rapids, MI, United States
(Deeb) Departments of Cardiac Surgery and Interventional Cardiology,
University of Michigan Hospitals, Ann Arbor, MI, United States
(Yakubov) Department of Cardiology, Ohio Health Riverside Methodist
Hospital, Columbus, OH, United States
(Lim) Department of Cardiology, University of Virginia Health,
Charlottesville, VA, United States
(Bladergroen) Department of Thoracic Surgery, Bon Secours Saint Mary's
Hospital, Virginia, Richmond
(Tadros, Zorn) Departments of Thoracic Surgery and Interventional
Cardiology, The University of Kansas Hospital, Kansas, Kansas City
(Byrne, Kirshner) Department of Cardiology, Abrazo Arizona Heart Hospital,
Arizona, Phoenix
(Huang) Statistical Services, Medtronic, Minneapolis, MN, United States
(Reardon) Department of Cardiothoracic Surgery and Interventional
Cardiology, Methodist DeBakey Heart and Vascular Center, Houston
Methodist, Texas, Houston
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) has comparable outcomes
with surgical aortic valve replacement (SAVR) in symptomatic patients with
severe aortic stenosis, including those at low risk for surgery. Less is
known about TAVI outcomes in asymptomatic patients. This analysis compares
clinical, hemodynamic, and quality of life (QOL) outcomes after TAVI or
SAVR for low-risk asymptomatic patients. The randomized Evolut Low Risk
trial enrolled asymptomatic patients treated with TAVI (n = 76) and SAVR
(n = 62). New York Heart Association functional class I identified
patients without symptoms. Clinical outcomes, echocardiographic findings,
and QOL in both groups were compared 30 days and 12 months after AVR.
Asymptomatic patients had a mean Society of Thoracic Surgeons score of 1.7
+/- 0.6, 73% were men, and mean age was 74.2 +/- 5.8 years. The composite
end point of all-cause mortality or disabling stroke was similar at 12
months in patients with TAVI (1.3%) and SAVR (6.5%; p = 0.11), although
patients with SAVR tended to have higher rates of all-cause mortality
(4.8%) compared with patients with TAVI (0.0%, p = 0.05). Patients with
TAVI had lower mean aortic valve gradients (8.1 +/- 3.2 mm Hg) and larger
mean effective orifice area (2.3 +/- 0.6 mm Hg) than patients with SAVR
(10.8 +/- 3.8; p <0.001 and 1.9 +/- 0.6; p = 0.001, respectively), and
showed significant improvement in Kansas City Cardiomyopathy Questionnaire
scores from baseline to 30 days (12.1 +/- 23.6; p <0.001), whereas
patients with SAVR did not (2.2 +/- 20.3; p = 0.398). Patients with TAVI
and SAVR had a significant improvement in QOL by 12 months compared with
baseline. In conclusion, low risk asymptomatic patients with severe aortic
stenosis who underwent TAVI had comparable clinical outcomes to SAVR, with
superior valve performance and faster QOL improvement.<br/>Copyright
&#xa9; 2022 Elsevier Inc.

<50>
Accession Number
2014656457
Title
Cardiac transplantation after heparin-induced thrombocytopenia: A
systematic review.
Source
Clinical Transplantation. 36(2) (no pagination), 2022. Article Number:
e14567. Date of Publication: February 2022.
Author
Jimenez D.C.; Warner E.D.; Ahmad D.; Rosen J.L.; Al-Rawas N.; Morris R.J.;
Alvarez R.; Rame J.E.; Entwistle J.W.; Massey H.T.; Tchantchaleishvili V.
Institution
(Jimenez, Warner, Ahmad, Rosen, Morris, Entwistle, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Al-Rawas) Department of Anesthesiology, Thomas Jefferson University,
Philadelphia, PA, United States
(Alvarez, Rame) Division of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Purpose: Heparin-induced thrombocytopenia (HIT) presents a unique
challenge in patients requiring orthotopic heart transplantation (OHT). We
sought to pool the existing evidence in a systematic review.
<br/>Method(s): Electronic search was performed to identify all relevant
studies on OHT in patients with HIT. Patient-level data for 33 patients
from 21 studies were extracted for statistical analysis. <br/>Result(s):
Median patient age was 51 [IQR 41, 55] years, with 75.8% (25/33) males.
All patients had a clinical diagnosis of HIT, and anti-PF4/Heparin
antibodies were positive in 87.9% (29/33). Median lowest reported platelet
count was 46 x 10⁹/L [27.2, 73.5]. Intraoperatively, 61%
(20/33) of patients were given unfractionated heparin (UFH), while 39%
(13/33) were given alternative anticoagulants. The alternative agent
subgroup required more antifibrinolytics [54% (7/13) vs 10% (2/20), P
=.02] and clotting factors [69.2% (9/13) vs 15.0% (3/20), P <.01].
Perioperative thrombosis occurred more [53.8% (7/13) vs 0% (0/20, P <.01)
in alternate agent subgroup. More patients in the alternate agent subgroup
required post-operative transfusions [54% (7/13) vs 0% (0/20), P <.01].
Thirty-day mortality of 15.2% (5/33) was comparable between the subgroups.
<br/>Conclusion(s): Heparin use during OHT may be associated with less
adverse effects compared to use of other anticoagulants with no difference
in 30-day mortality.<br/>Copyright &#xa9; 2021 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd.

<51>
Accession Number
2014672606
Title
Aspirin: Friend or enemy?.
Source
IJC Heart and Vasculature. 36 (no pagination), 2021. Article Number:
100874. Date of Publication: October 2021.
Author
Marlicz W.; Charisopoulou D.; Koulaouzidis A.; Koulaouzidis G.
Institution
(Marlicz) Department of Gastroenterology, Pomeranian Medical University,
Szczecin 71-252, Poland
(Charisopoulou) Amalia Children's Hospital, Radboud University Medical
Centre, Nijmegen, Netherlands
(Charisopoulou) Academic Centre for Congenital Heart Disease, Netherlands
(Koulaouzidis) Department of Social Medicine and Public Health, Pomeranian
Medical University, Szczecin, Poland
(Koulaouzidis) Department of Biochemical Sciences, Pomeranian Medical
University, Szczecin, Poland
Publisher
Elsevier Ireland Ltd

<52>
Accession Number
2014595645
Title
Improved recovery protocols in cardiac surgery: A systematic review and
meta-analysis of observational and quasi-experimental studies.
Source
MEDICC Review. 23(3) (pp 46-53), 2021. Date of Publication: July 2021.
Author
Aguero-Martinez M.O.; Tapia-Figueroa V.M.; Hidalgo-Costa T.
Institution
(Aguero-Martinez) Hermanos Ameijeiras Clinical-Surgical Hospital (HHA),
Havana, Cuba
(Tapia-Figueroa, Hidalgo-Costa) HHA, Havana, Cuba
Publisher
MEDICC Medical Education Cooperation with Cuba
Abstract
INTRODUCTION Improved recovery protocols were implemented in surgical
specialties over the last decade, which decreased anesthetic and surgical
stress and the incidence of perioperative complications. However, these
recovery protocols were introduced more slowly for cardiac surgeries. The
most frequent complications in cardiac surgery are related to patient
clinical status and the characteristics of the surgical procedures
involved, which are becoming more varied and complex every day. The first
version of the enhanced recovery program for cardiac surgery was published
in 2019, but its recommendations were based on only a few studies, and
scant research has evaluated its implementation. Randomized and controlled
clinical trials for these protocols are scarce, so research that
summarizes the results of studies with other methodological designs are
useful in demonstrating their benefits in cardiovascular surgery services
in Cuba and in other limited-resource settings. OBJECTIVE Estimate the
effectiveness of improved recovery protocols in the perioperative
evolution of patients undergoing cardiac surgery. METHODS We performed a
systematic review and meta-analysis according to the guidelines of manual
5.1.0 for reviews of the Cochrane library. We included observational and
quasi-experimental studies published from January 2015 through May 2020
that compared enhanced recovery protocols with conventional treatments in
patients older than 18 years, and used a quality score to evaluate them.
We used the following sources: the Cochrane Library, PubMed, LILACS,
SciELO, EBSCO, Google Scholar, Web of Science, Clinical Key, ResearchGate
and HINARI. The following keywords were used for the database searches in
English: ERAS, protocols and cardiac surgery, enhanced recovery after
cardiac surgery, ERACS, clinical pathway recovery and cardiac surgery,
perioperative care and cardiac surgery. We used the following search terms
for databases in Spanish: protocolos de recuperacion precoz and cirugia
cardiaca, protocolos de recuperacion mejorada and cirugia cardiaca,
cuidados perioperatorios and cirugia cardiaca, programas de recuperacion
precoz and cirugia cardiovascular. Methodological quality of included
investigations was evaluated using the surgical research methodology
scale. Meta-analyses were performed for perioperative complications,
intensive care unit and hospital stays, and hospital readmission within 30
days of surgery. We calculated effect sizes of the interventions and the
corresponding 95% confidence intervals. We used mean differences and
confidence intervals for continuous variables, and for qualitative
variables we calculated relative risk (RR). Random effects analysis was
used. Heterogeneity of the studies was assessed using the Q statistic and
the I² statistic. RESULTS We selected 15 studies (a total of
5059 patients: study group, n = 1706; control group, n = 3353). The
average quality score for the 15 articles included was 18.9 (out of a
maximum of 36 according to the scale) and 66.6% had a score >=18. With
improved recovery protocols in cardiac surgery, the incidence of
perioperative complications decreased (RR = 0.73; 95% CI 0.52-0.98) as did
hospital readmission within 30 days after surgery (RR = 0.51; 95% CI 95%
CI: 0.31-0.86). Differences in extubation time, hospital stay and length
of stay in intensive care units were less marked, but always favored the
group in which the enhanced protocols were implemented. CONCLUSIONS
Improved recovery protocols in cardiac surgery increase quality of care
evidenced by reductions in perioperative complications and decreased
incidence of hospital readmission in the month following
surgery.<br/>Copyright &#xa9; 2021 MEDICC Medical Education Cooperation
with Cuba. All rights reserved.

<53>
[Use Link to view the full text]
Accession Number
2017329658
Title
Impact of Race on Clinical Outcomes after Implantation with a Fully
Magnetically Levitated Left Ventricular Assist Device: An Analysis from
the MOMENTUM 3 Trial.
Source
Circulation: Heart Failure. 14(10) (pp E008360), 2021. Date of
Publication: 01 Oct 2021.
Author
Sheikh F.H.; Ravichandran A.K.; Goldstein D.J.; Agarwal R.; Ransom J.;
Bansal A.; Kim G.; Cleveland J.C.; Uriel N.; Sheridan B.C.; Chomsky D.;
Patel S.R.; Dirckx N.; Franke A.; Mehra M.R.
Institution
(Sheikh) Medstar Heart and Vascular Institute, Washington, DC, United
States
(Ravichandran) Ascension St Vincent, Indianapolis, IN, United States
(Goldstein, Patel) Montefiore Medical Center, Bronx, NY, United States
(Agarwal) Duke University Medical Center, Durham, NC, United States
(Ransom) Baptist Health, Heart and Transplant Institute, Little Rock, AR,
United States
(Bansal) Ochsner Medical Center, New Orleans, LA, United States
(Kim) University of Chicago, Medical Center, IL, United States
(Cleveland) University of Colorado Hospital, Aurora, United States
(Uriel) New York Presbyterian and Columbia University, United States
(Sheridan) California Pacific Medical Centerc, San Francisco, United
States
(Chomsky) St Thomas Hospital, Nashville, TN, United States
(Dirckx) Global Biometrics, Abbott, Plymouth, MN, United States
(Franke) Global Clinical Affairs - Heart Failure, Abbott, Sylmar, CA,
United States
(Mehra) Center for Advanced Heart Disease, Brigham and Women's Hospital,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Heart failure disproportionately affects Black patients.
Whether differences among race influence outcomes in advanced heart
failure with use of a fully magnetically levitated continuous-flow left
ventricular assist device remains uncertain. <br/>Method(s): We included
515 IDE (Investigational Device Exemption) clinical trial patients and 500
Continued Access Protocol patients implanted with the HeartMate 3 left
ventricular assist device in the MOMENTUM 3 study (Multicenter Study of
MagLev Technology in Patients Undergoing Mechanical Circulatory Support
Therapy With HeartMate 3). Outcomes were compared between Black and White
left ventricular assist device recipients for the primary end point of
survival free of disabling stroke or reoperation to replace or remove a
malfunctioning device at 2 years, overall survival, adverse events,
6-minute walk distance, and quality of life scores. <br/>Result(s): Of
1015 HeartMate 3 patients, 675 were self-identified as White and 285 as
Black individuals. The Black patient cohort was younger, more obese and
with a history of hypertension, and more nonischemic cause of heart
failure, relative to the White patient group. Black and White patients did
not experience a difference in the primary end point (81.1% versus 77.9%;
hazard ratio, 1.08 [95% CI, 0.76-1.54], P=0.6568). Black patients were at
higher risk of adverse events (calculated as events per 100
patient-years), including bleeding (75.4 versus 63.5; P<0.0001), stroke
(9.5 versus 7.2; P=0.0183), and hypertension (10.1 versus 3.2; P<0.0001).
The 6-minute walk distance was not different at baseline and 6 months
between the groups, however, the absolute change from baseline was greater
for White patients (median: +183.0 [interquartile range, 42.0-335.3]
versus +163.8 [interquartile range, 42.3-315.0] meters, P=0.01). The
absolute quality of life measurement (EuroQoL group, 5-dimension, 5-level
instrument visual analog scale) at baseline and 6 months was better in the
Black patient group, but relative improvement from baseline to 6 months
was greater in White patients (median: +20.0 [interquartile range,
5.0-40.0] versus +25.0 [interquartile range, 10.0-45.0]; P=0.0298).
<br/>Conclusion(s): Although the survival free of disabling stroke or
reoperation to replace/remove a malfunctioning device at 2 years with the
HM 3 left ventricular assist device did not differ by race, Black
HeartMate 3 patients experienced a higher morbidity burden and smaller
gains in functional capacity and quality of life when compared with White
patients. These findings require efforts designed to better understand and
overcome these gaps through systematic identification and tackling of
putative factors. Registration: URL: https://www.clinicaltrials.gov;
Unique identifiers: NCT02224755 and NCT02892955.<br/>Copyright &#xa9; 2021
Lippincott Williams and Wilkins. All rights reserved.

<54>
Accession Number
2014156932
Title
Prognostic Importance of Health Status Versus Functional Status in Heart
Failure and Secondary Mitral Regurgitation.
Source
JACC: Heart Failure. 9(9) (pp 684-692), 2021. Date of Publication:
September 2021.
Author
Arnold S.V.; Stone G.W.; Jain S.S.; Mack M.J.; Saxon J.T.; Zhang Z.;
Lindenfeld J.; Abraham W.T.; Cohen D.J.
Institution
(Arnold, Saxon) Department of Cardiovascular Research, Saint Luke's Mid
America Heart Institute, Kansas City, MO, United States
(Arnold, Saxon) Department of Medicine, University of Missouri-Kansas
City, Kansas City, MO, United States
(Stone, Zhang, Cohen) Clinical Trials Center, Cardiovascular Research
Foundation, New York, NY, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Jain) Department of Medicine, New York-Presbyterian Hospital/Columbia
University Irving Medical Center, New York, NY, United States
(Mack) Department of Cardiac Surgery, Baylor Scott & White Health, Plano,
Texas, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Cohen) Department of Cardiology, St. Francis Hospital, Roslyn, NY, United
States
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to understand the extent to which health
status and exercise capacity are independently associated with long-term
outcomes in patients with heart failure (HF) and secondary mitral
regurgitation (MR). <br/>Background(s): Secondary MR in patients with HF
leads to impaired health status (Kansas City Cardiomyopathy Questionnaire
Overall Summary Score [KCCQ-OS]) and exercise capacity (6-minute walk
distance [6MWD]), both of which improve after transcatheter mitral valve
repair (TMVr). <br/>Method(s): The study used data from the COAPT trial (N
= 604) to examine the association of baseline KCCQ-OS and 6MWD with 2-year
mortality and HF hospitalization, adjusting for treatment arm and patient
factors. We also examined the association of change in KCCQ-OS and 6MWD
from baseline to 1 month with risk of outcomes from 1 month to 2 years.
Interactions of KCCQ-OS and 6MWD with treatment assignment were explored.
<br/>Result(s): Mean baseline KCCQ-OS was 53 +/- 23 points, and 6MWD was
240 +/- 125 meters. In models including both measures, greater baseline
6MWD (but not KCCQ-OS) was associated with reduced 2-year mortality (HR
per 125 meters: 0.75, 95% CI: 0.61-0.92). When stratified by treatment
group, both baseline KCCQ-OS and 6MWD were independently associated with
HF hospitalization in patients treated with medical therapy, whereas only
KCCQ-OS was associated with HF hospitalization in patients treated with
TMVr. In separate analyses, 1-month improvements in KCCQ-OS and 6MWD were
each associated with lower subsequent risk of mortality and HF
hospitalization, independent of treatment group. <br/>Conclusion(s): Among
patients with HF and severe secondary MR, assessment of both health status
and exercise capacity provide complementary prognostic information for
patients with HF and severe secondary MR-both before and after TMVr.
(Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Functional Mitral Regurgitation [The COAPT
Trial]; NCT01626079)<br/>Copyright &#xa9; 2021 American College of
Cardiology Foundation

<55>
Accession Number
2014571380
Title
Self-reported poor quality of sleep in solid organ transplant: A
systematic review.
Source
Transplantation Reviews. 35(4) (no pagination), 2021. Article Number:
100650. Date of Publication: December 2021.
Author
Cordoza M.; Koons B.; Perlis M.L.; Anderson B.J.; Diamond J.M.; Riegel B.
Institution
(Cordoza, Riegel) School of Nursing, University of Pennsylvania, Claire M.
Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104, United States
(Koons) M. Lousie Fitzpatrick College of Nursing, Villanova University,
800 E. Lancaster Ave, Villanova, PA 19085 and Clinical Nurse, Heart and
Vascular ICU, Hospital of the University of Pennsylvania, 3400 Spruce
Street, Philadelphia, PA 19104, United States
(Perlis) Behavioral Sleep Medicine Program, Perelman School of Medicine,
University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104,
United States
(Anderson) Hospital of the University of Pennsylvania, 3400 Spruce Street,
5036 Gates Building, Philadelphia, PA 19104, United States
(Diamond) Lung Transplantation, Hospital of the University of
Pennsylvania, 3400 Spruce Street, 9039 West Gates, Philadelphia, PA 19104,
United States
Publisher
W.B. Saunders
Abstract
Background: High quality sleep of sufficient duration is vital to overall
health and wellbeing. Self-reported poor quality of sleep, sleep reported
as irregular in timing, marked by frequent awakenings, or shortened in
duration, is common across the solid-organ transplant trajectory.
<br/>Aim(s): This Systematic Review aimed to summarize available
literature on rates of self-reported poor quality of sleep among solid
organ transplant candidates and recipients. <br/>Method(s): A systematic
search of published literature was conducted in PubMed/MEDLINE, Embase,
Web of Science, CINHAL, and PsychInfo databases with no date restrictions.
Original articles in the English language describing self-reported quality
of sleep using standardized questionnaires in adults either waitlisted
for, or who received a solid organ transplant (heart, lung, kidney, liver,
pancreas, or multi-solid organ) were included. <br/>Result(s): Of a
potential 2054 articles identified, 44 were included (63.6% renal
transplant, 20.5% liver transplant, 11.4% lung transplant, and 4.5%
included multiple organ transplant populations), with the majority (68.2%)
focusing only on post-transplant populations. No included articles focused
solely on heart or pancreas transplant populations. On average, the
transplant population with the greatest improvement in quality of sleep
(reported as poor sleep quality, insomnia, sleep disturbance, or sleep
dissatisfaction) from transplant candidacy to post-transplantation were
renal transplant (from 53.5% pre, to 38.9% post) followed by liver
transplant patients (from 52.8% pre, to 46.3% post), while lung transplant
patients remained similar pre- to post-transplantation (55.6% pre, to 52%
post). Poor quality of sleep was frequently associated with anxiety and
depression, poorer quality of life, restless legs syndrome, and higher
comorbidity. <br/>Conclusion(s): Reports of poor quality of sleep are
highly prevalent across all solid-organ transplant populations, both pre-
and post-transplantation. Future studies should assess quality of sleep
longitudinally throughout all phases of the transplantation trajectory,
with more research focusing on how to optimize sleep in solid organ
transplant populations.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<56>
Accession Number
634837253
Title
The effects of showering in 48-72 h after coronary artery bypass graft
surgery through median sternotomy on wound infection, pain, comfort, and
satisfaction: randomized controlled trial.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. 21(1) (pp
56-66), 2022. Date of Publication: 11 Jan 2022.
Author
Gok F.; Demir Korkmaz F.; Emrecan B.
Institution
(Gok) Faculty of Health Sciences, Department of Surgical Diseases Nursing,
Pamukkale University, Denizli 20020, Turkey
(Demir Korkmaz) Faculty of Nursing, Department of Surgical Diseases
Nursing, Ege University, 35100 Izmir, Turkey
(Emrecan) Faculty of Medicine, Department of Cardiac Surgery, Pamukkale
University, Denizli 20020, Turkey
Publisher
NLM (Medline)
Abstract
AIMS: Time of showering after surgery is still a controversial issue for
surgical patients and health professionals. We evaluated the effects of
showering in 48-72h after median sternotomy on sternal wound infections,
pain due to sternotomy, patient comfort, and satisfaction levels. METHODS
AND RESULTS: The study was a randomized controlled clinical trial.
Fifty-one patients were randomly allocated (1:1) to the shower (n=26) or
non-shower group (n=25). The patients in the shower group (intervention
group) showered in the first 48-72h after surgery and the patients in the
non-shower group (control group) were not allowed to shower until their
chest tube sutures were removed. They were instructed to shower on the
next day after removal of the chest tube sutures. The rate of sternal
wound infections was significantly lower in the shower group (n=2, 7.7%)
than in the non-shower group patients (n=8, 32.0%; P=0.038). A logistic
regression analysis showed that early post-operative showering was
protective and significantly reduced the risk of sternal wound infections
independently of other variables [odds ratio (OR): 0.177; 95% confidence
interval (CI): 0.033-0.940; P=0.042]. The pain severity score was
significantly lower in the shower group patients. Also, comfort and
satisfaction scores were significantly higher in this group (P<0.05).
<br/>CONCLUSION(S): Early showering after sternotomy was found to be
protective against sternal wound infections and had a positive effect on
pain, comfort, and satisfaction. TRIAL REGISTRATION: Clinical Trials.gov
registration number NCT04250961
(https://clinicaltrials.gov/ct2/show/NCT04250961).<br/>Copyright Published
on behalf of the European Society of Cardiology. All rights reserved.
&#xa9; The Author(s) 2021. For permissions, please email:
journals.permissions@oup.com.

<57>
Accession Number
634754014
Title
The effects of Nurse Led Transitional Care Model on elderly patients
undergoing open heart surgery: a randomized controlled trial.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. 21(1) (pp
46-55), 2022. Date of Publication: 11 Jan 2022.
Author
Coskun S.; Duygulu S.
Institution
(Coskun) Bolu Abant Izzet Baysal University, Faculty of Health Sciences,
Nursing Department, Turkey
(Duygulu) Hacettepe University, Faculty of Nursing, 06100 S?hhiye/ Ankara
/ Turkey
Publisher
NLM (Medline)
Abstract
AIMS: Rate and number of successful cases in open heart surgery has been
increasing due to the advances in medical technology and surgery. To
improve patient convalescence results and reduce rate of post-discharge
readmission to hospital and unplanned post-discharge rehospitalization,
home-care and follow-up process of patients should be managed
successfully. To evaluate the effectiveness of Nurse Led Transitional Care
Model on the functional autonomy, quality of life, readmission, and
rehospitalization rates of elderly patients undergoing open heart surgery.
A randomized controlled trial was conducted from November 2017 to December
2018 and performed according to the CONSORT Guidelines. METHODS AND
RESULTS: Sixty-six elderly patients were randomly allocated to the
intervention (n: 33) and control (n: 33) groups. Patients in intervention
group were given care based on the Transitional Care Model until the
post-discharge 9th week starting from date of hospitalization. Patients in
control group were given standard care services. Functional autonomy,
quality of life levels, and repeated admission/re-hospitalization rates to
the clinic were evaluated. The Functional Autonomy Measurement System and
SF-36 Quality of Life Scale scores of the intervention group were higher
than that of the control group at the 9th week (P < 0.05). In addition,
rate of readmission and rehospitalization during the follow-up period
(6months) of patients in the intervention group was found to be lower than
the patients in the control group (P<0.05). <br/>CONCLUSION(S): Care
services offered under the Transitional Care Model improved functional
autonomy and quality of life and decreased post-discharge hospital
readmission and rehospitalization rates of patients. TRIAL REGISTRATION:
The study was registered on ClinicalTrials.gov (ID:
NCT04384289).<br/>Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. &#xa9; The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<58>
Accession Number
636761823
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: 31 Mar 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, Novosibirsk,
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
NLM (Medline)
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. <br/>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. <br/>RESULT(S): Early mortality was
0.4%. The mean follow-up period duration was 43.9months. The survival
rates at 1, 3 and 5years were 97.3%, 94.3% and 87.7%, respectively. The
rates of freedom from atrial arrhythmia paroxysms at 1, 3 and 5years 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).
<br/>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.<br/>Copyright &#xa9; The Author(s) 2021.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<59>
Accession Number
2016659566
Title
Clinical Utility of a Biomarker to Detect Contrast-Induced Acute Kidney
Injury during Percutaneous Cardiovascular Procedures.
Source
CardioRenal Medicine. 12(1) (pp 11-19), 2022. Date of Publication: 14 Mar
2022.
Author
Peabody J.; Paculdo D.; Valdenor C.; McCullough P.A.; Noiri E.; Sugaya T.;
Dahlen J.R.
Institution
(Peabody, Paculdo, Valdenor) QURE Healthcare, San Francisco, CA, United
States
(Peabody) University of California, School of Medicine, San Francisco, CA,
United States
(Peabody) University of California, Fielding School of Public Health, Los
Angeles, CA, United States
(McCullough) Texas Christian University, The University of North Texas
Health Sciences Center School of Medicine, Dallas, TX, United States
(Noiri) Department of Nephrology and Endocrinology, The University of
Tokyo Hospital, Tokyo, Japan
(Noiri) National Center Biobank Network, National Center for Global Health
and Medicine, Tokyo, Japan
(Sugaya) Timewell Medical, Tokyo, Japan
(Sugaya) St. Marianna University School of Medicine, Kawasaki, Japan
(Dahlen) Hikari Dx, Inc., San Diego, CA, United States
Publisher
S. Karger AG
Abstract
Introduction: Contrast-induced acute kidney injury (CI-AKI) is a major
clinical complication of percutaneous cardiovascular procedures requiring
iodinated contrast. Despite its relative frequency, practicing physicians
are unlikely to identify or treat this condition. <br/>Method(s): In a
2-round clinical trial of simulated patients, we examined the clinical
utility of a urine-based assay that measures liver-type fatty acid-binding
protein (L-FABP), a novel marker of CI-AKI. We sought to determine if
interventional cardiologists' ability to diagnose and treat potential
CI-AKI improved using the biomarker assay for 3 different patient types:
pre-procedure, peri-procedure, and post-procedure patients.
<br/>Result(s): 154 participating cardiologists were randomly divided into
either control or intervention. At baseline, we found no difference in the
demographics or how they identified and treated potential complications of
AKI, with both groups providing less than half the necessary care to their
patients (46.4% for control vs. 47.6% for intervention, p = 0.250). The
introduction of L-FABP into patient care resulted in a statistically
significant improvement of 4.6% (p = 0.001). Compared to controls,
physicians receiving L-FABP results were 2.9 times more likely to
correctly identify their patients' risk for AKI (95% CI 2.1-4.0) and were
more than twice as likely to treat for AKI by providing volume expansion
and withholding nephrotoxic medications. We found the greatest clinical
utility in the pre-procedure and peri-procedure settings but limited value
in the post-procedure setting. <br/>Conclusion(s): This study suggests
L-FABP as a clinical marker for assessing the risk of potential CI-AKI,
has clinical utility, and can lead to more accurate diagnosis and
treatment.<br/>Copyright &#xa9; 2022 S. Karger AG, Basel.

<60>
Accession Number
2015186748
Title
Representation of racial minorities in cardiac surgery randomized clinical
trials.
Source
Journal of Cardiac Surgery. 37(5) (pp 1311-1316), 2022. Date of
Publication: May 2022.
Author
Cancelli G.; Audisio K.; Perezgrovas-Olaria R.; Soletti G.J.; Chadow D.;
Rahouma M.; Robinson N.B.; Gaudino M.
Institution
(Cancelli, Audisio, Perezgrovas-Olaria, Soletti, Chadow, Rahouma,
Robinson, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Racial minorities account for 39.9% of the population in the
United States, but are often underrepresented in clinical research.
Results from studies predominantly enrolling White patients may not apply
to racial minorities. The aim of this analysis is to assess the
representation of racial minorities in cardiac surgery randomized clinical
trials (RCTs). <br/>Method(s): A systematic search of the literature was
performed. All RCTs published from 2000 to 2020 including at least 100
patients and comparing two or more adult cardiac surgery procedures were
included. Meta-analytic estimates were calculated. <br/>Result(s): Among
51 cardiac surgery RCTs published between 2000 and 2020, only 9 (17.6%)
reported the race of patients and were included in the final analysis. All
of them were multicentric, with a mean of 33 centers included. Six RCTs
enrolled patients undergoing coronary artery bypass grafting (66.7%),
while the remaining three were on valve surgery (33.3%). Overall, 9193
patients were included; of them, 8034 (87.4%) were White and 1026 (11.2%)
nonWhite (386 [4.2%] Black, 191 [2.1%] Hispanic, 274 [3.0%] from other
races, and 175 [1.9%] nonWhite patients of unspecified race). The
proportion of nonWhite patients did not change over time.
<br/>Conclusion(s): Only 9 (17.6%) of the 51 cardiac surgery RCTs
published between 2000 and 2020 reported the race of the patients enrolled
and only 11.2% of them were nonWhite patients. Given the association
between race and clinical outcomes, future RCTs should either guarantee a
balanced inclusion of racial minorities or be designed to specifically
enroll them.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<61>
Accession Number
2015124749
Title
Auto-Pericardial Mitral Valve Implantation: A Pilot Study.
Source
Heart Lung and Circulation. 31(4) (pp 575-581), 2022. Date of Publication:
April 2022.
Author
Manohar P.; Naik L R.; Mohan Rao P.S.
Institution
(Manohar, Naik L, Mohan Rao) Department of Cardiothoracic and Vascular
Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Karnataka, Bangalore, India
Publisher
Elsevier Ltd
Abstract
Introduction: Developing nations continue to grapple with rheumatic heart
disease, particularly in the young. There is a need for an alternative to
prosthetic mitral valve replacement in irreparable mitral valves, which
avoids the need for anticoagulation and risks of thromboembolism.
<br/>Method(s): Twelve (12) patients with irreparable severe mitral valve
disease underwent auto-pericardial mitral valve implantation from August
2020 to February 2021. The mitral valve leaflets were excised. Autologous
pericardium treated with 0.5% glutaraldehyde for 8 minutes was fashioned
into anterior and posterior mitral leaflets as per the dimensions on an
indigenously designed template based on the studies by Ranganathan and
Lam. The pericardial leaflets were sutured onto an appropriately sized
mitral annuloplasty ring. The ring with the leaflets was implanted onto
the mitral annulus. The leaflets were supported with neo-chordae prepared
with Gore-Tex (W L Gore and Associates, Inc. Newark, DE, USA) and
polyester sutures to mimic a repaired mitral valve in its structure and
dynamics. <br/>Result(s): The mean cross-clamp time was 138+/-21.7
minutes. None of the patients required re-exploration. On the third
postoperative day, a mean mitral valve orifice area of 3+/-0.47 cm and
mean mitral valve gradient of 2+/-1.04 were observed. None of the patients
had any more than 1+ mitral regurgitation. None of them have required a
re-intervention for mitral insufficiency to date. <br/>Discussion(s):
Auto-pericardial mitral valve re-implantation is a safe and effective
procedure for severe, irreparable, mitral valve pathologies. However, the
mid-term and long-term results need to be compared with conventional
mitral valve replacement with a prosthetic valve in a randomised
controlled trial.<br/>Copyright &#xa9; 2021 Australian and New Zealand
Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society
of Australia and New Zealand (CSANZ)

<62>
Accession Number
2015070855
Title
Minimally invasive mitral valve surgery versus conventional sternotomy
mitral valve surgery: A systematic review and meta-analysis of 119
studies.
Source
Journal of Cardiac Surgery. 37(5) (pp 1319-1327), 2022. Date of
Publication: May 2022.
Author
Eqbal A.J.; Gupta S.; Basha A.; Qiu Y.; Wu N.; Rega F.; Chu F.V.;
Belley-Cote E.P.; Whitlock R.P.
Institution
(Eqbal, Gupta, Chu, Whitlock) Division of Cardiac Surgery, McMaster
University, Hamilton, ON, Canada
(Basha) Libin Cardiovascular Institute, University of Calgary, Calgary,
AB, Canada
(Qiu) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Wu) Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
(Rega) Department of Cardiac Surgery, Universitair Ziekenhuis Leuven,
Leuven, Belgium
(Belley-Cote) Division of Cardiology, McMaster University, Hamilton, ON,
Canada
(Belley-Cote, Whitlock) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim of the Study: Whether minimally invasive mitral valve
surgery (MMVS) leads to better outcomes remains unclear. We conducted a
systematic review and meta-analysis comparing various MMVS approaches with
conventional sternotomy. <br/>Method(s): We searched Cochrane CENTRAL,
MEDLINE, EMBASE, ClinicalTrials. gov, and the ISRCTN Register for studies
comparing minimally invasive approach (thoracotomy, port access, partial
sternotomy, or robotic) with median sternotomy for mitral valve surgery.
We performed title and abstract, full-text screening, and data extraction
independently and in duplicate. We pooled data using random effect models.
Quality assessment was performed using validated tools. Certainty of
evidence was established using the GRADE framework. <br/>Result(s): One
hundred and nineteen studies (n = 38,106) met eligibility criteria: eight
randomized controlled trials (RCTs) and 111 observational studies. MMVS
was associated with fewer days in hospital (RCT: MD: -2.2 days, 95% CI,
[-3.7 to -0.8]; observational: MD: -2.4 days, 95% CI, [-2.7 to -2.1]).
Observational studies suggested that MMVS reduced transfusion requirements
with fewer units transfused per patient (MD: -1.2; 95% CI, [-1.6 to -0.9])
and fewer patients transfused (RR, 0.7; 95% CI, [0.6-0.7]). Observational
data also suggested lower mortality with MMVS (RR, 0.6; 95% CI, [0.5-0.7],
p <.001, I² = 0%), but this was not corroborated by RCT data.
The risk of postoperative mitral regurgitation (>=2+ or requiring
re-intervention) did not differ between the two groups.
<br/>Conclusion(s): MMVS may be associated with shorter length of hospital
stay with no significant difference in short-term morbidity and mortality.
There is a paucity of high-quality data on the long-term outcomes of MMVS
when compared with conventional sternotomy.<br/>Copyright &#xa9; 2022
Wiley Periodicals LLC.

<63>
Accession Number
2014759838
Title
The impact of intraoperative blood pressure variability on the risk of
postoperative adverse outcomes in non-cardiac surgery: a systematic
review.
Source
Journal of Anesthesia. 36(2) (pp 316-322), 2022. Date of Publication:
April 2022.
Author
Putowski Z.; Czok M.; Krzych L.J.
Institution
(Putowski, Czok) Students' Scientific Society, Department of
Anaesthesiology and Intensive Care, Faculty of Medical Sciences in
Katowice, Medical University of Silesia, Medykow 14 Street, Katowice
40752, Poland
(Krzych) Department of Anaesthesiology and Intensive Care, Faculty of
Medical Sciences in Katowice, Medical University of Silesia, Katowice,
Poland
Publisher
Springer Japan
Abstract
Hemodynamic stability during surgery seems to account for positive
postoperative outcomes in patients. However, little is known about the
impact of intraoperative blood pressure variability (IBPV) on the
postoperative complications. The aim was to investigate whether IBPV is
associated with the development of postoperative complications and what is
the nature of this association. We conducted a systematic search in
PubMed, Medical Subject Headings, Embase, Web of Science, SCOPUS,
clinicaltrials.gov, and Cochrane Library on the 8th of April, 2021. We
included studies that only focused on adults who underwent primarily
elective, non-cardiac surgery in which intraoperative blood pressure
variation was measured and analyzed in regard to postoperative,
non-surgical complications. We identified 11 papers. The studies varied in
terms of applied definitions of blood pressure variation, of which
standard deviation and average real variability were the most commonly
applied definitions. Among the studies, the most consistent analyzed
outcome was a 30-day mortality. The studies presented highly heterogeneous
results, even after taking into account only the studies of best quality.
Both higher and lower IBPV were reported to be associated for
postoperative complications. Based on a limited number of studies, IBPV
does not seem to be a reliable indicator in predicting postoperative
complications. Existing premises suggest that either higher or lower IBPV
could contribute to postoperative complications. Taking into account the
heterogeneity and quality of the studies, the conclusions may not be
definitive.<br/>Copyright &#xa9; 2022, The Author(s).

<64>
Accession Number
637166112
Title
The Association Between Preoperative Frailty and Postoperative Delirium: A
Systematic Review and Meta-analysis.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 37(1) (pp 53-62), 2022. Date of
Publication: 01 Feb 2022.
Author
Liu C.-Y.; Gong N.; Liu W.
Institution
(Liu) Second Department of Anesthesiology, Affiliated Zhongshan Hospital
of Dalian University, Dalian, Liaoning, China
(Gong) Second Affiliated Hospital and Yuying Children's Hospital of
Wenzhou Medical University, Wenzhou, Zhejiang, China
(Liu) School of Nursing, Liaoning University of Traditional Chinese
Medicine, Shenyang, Liaoning, China
Publisher
NLM (Medline)
Abstract
PURPOSE: Identifying factors that place patients at high risk for
developing postoperative delirium is an important first step to reduce
incidence. Frailty is associated with poor postoperative outcomes. This
meta-analysis aims to determine the association between preoperative
frailty and postoperative delirium. DESIGN: This is a systematic review
and meta-analysis. <br/>METHOD(S): We used PubMed, Scopus, Embase, CINAHL,
Cochrane, and Web of Science as databases for the search up to April 23,
2020. We included cohort studies that assessed postoperative delirium as
the outcome and described the prevalence of delirium among participants
during the postoperative period. Odds ratio and 95% confidence interval
were calculated to examine the association. FINDINGS: Twenty cohort
studies met our inclusion criteria, which included a total of 4,568
patients. We found that preoperative frailty was significantly associated
with an increased risk of postoperative delirium (crude odds ratio: 3.28;
95% confidence interval: 2.51 to 4.28; I2 = 46.7%) (adjusted odds ratio:
2.45; 95% confidence interval: 1.58 to 3.81; I2 = 88.6%).
<br/>CONCLUSION(S): This meta-analysis showed that preoperative frailty is
an independent risk factor for postoperative delirium. In patients
undergoing cardiovascular surgery, there is a lower association between
frailty and postoperative delirium. In patients with other types of
surgery, preoperative frailty is closely related to postoperative
delirium.<br/>Copyright &#xa9; 2020 American Society of PeriAnesthesia
Nurses. Published by Elsevier Inc. All rights reserved.

<65>
Accession Number
2015418216
Title
Effects of Preserving the Pulmonary Vagus Nerve Branches on Cough After
Pneumonectomy During Video-Assisted Thoracic Surgery.
Source
Frontiers in Oncology. 12 (no pagination), 2022. Article Number: 837413.
Date of Publication: 09 Mar 2022.
Author
Gu S.; Wang W.; Wang X.; Wu K.; Zhang X.; Xie S.; Zhou Y.
Institution
(Gu, Wang, Wang, Wu, Zhang, Xie, Zhou) Department of Thoracic Surgery,
Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai,
China
Publisher
Frontiers Media S.A.
Abstract
Background: Cough is one of the most common complications of early-stage
non-small cell lung cancer (NSCLC) after video-assisted thoracoscopic
surgery (VATS). The vagus nerve plays an important role in pulmonary
inflammation and the cough reflex. In this study, we attempted to reduce
the incidence of postoperative chronic cough and other complications by
preserving the pulmonary vagus nerve branches. <br/>Patients and Methods:
This study was a randomized controlled double-blinded trial of subjects
and observers. A total of 158 NSCLC patients were enrolled. We randomly
assigned 79 patients to Group A (pulmonary branch of vagus nerve
preservation group) and 79 cases to Group B (conventional surgical
treatment group). In the final analysis, 72 patients from Group A and 69
patients from Group B were included. The main outcome measure of the study
was the occurrence of CAP or other postoperative complications within five
weeks. This trial was registered with ClinicalTrials.gov (number
NCT03921828). <br/>Result(s): There was no significant difference in
preoperative general clinical data between the two groups. No death during
the perioperative period occurred in either of the two groups. There was
no significant difference between the two groups in operation time,
intraoperative bleeding, number of lymph nodes sent for examination,
number of cases transferred to ICU after operation, postoperative
catheterization time, or postoperative hospital stay (P>0.05). There was
no significant difference in other pulmonary and cardiovascular
complications between the two groups, including pulmonary infection (2.78%
vs. 8.70%, P = 0.129), atelectasis (1.39% vs. 0%, P = 0.326), pleural
effusion (2.78% vs. 1.45%, P = 0.585), persistent pulmonary leakage (2.78%
vs. 2.90%, P = 0.965), arrhythmia (2.78% vs. 1.45%, P = 0.585), and heart
failure (0% vs. 1.45%, P = 0.305). The incidence of CAP in Group A was
significantly lower than that in Group B (13.89% vs. 30.43%, P = 0.018).
The LCQ-MC scores in Group A were significantly higher than those in Group
B at two and five weeks after operation (P<0.05). Univariate and
multivariate analysis showed that the risk factors for postoperative CAP
were surgical side (right lung), surgical lung lobe (upper lobe),
preservation of pulmonary branch of the vagus nerve during operation, and
duration of anesthesia. <br/>Conclusion(s): Preserving the pulmonary vagus
nerve branches during VATS in patients with stage IA1-2 NSCLC can reduce
the incidence of postoperative CAP.<br/>Copyright &#xa9; 2022 Gu, Wang,
Wang, Wu, Zhang, Xie and Zhou.

<66>
Accession Number
2015418115
Title
Red Flags, Prognostic Impact, and Management of Patients With Cardiac
Amyloidosis and Aortic Valve Stenosis: A Systematic Review and
Meta-Analysis.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 858281.
Date of Publication: 09 Mar 2022.
Author
Myasoedova V.A.; Conte M.; Valerio V.; Moschetta D.; Massaiu I.; Petraglia
L.; Leosco D.; Poggio P.; Parisi V.
Institution
(Myasoedova, Valerio, Moschetta, Massaiu, Poggio) Centro Cardiologico
Monzino Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS),
Milan, Italy
(Conte, Petraglia, Leosco, Parisi) Dipartimento di Scienze Mediche
Traslazionali, Universita degli Studi di Napoli Federico II, Naples, Italy
(Conte) Casa di Cura San Michele, Maddaloni, Italy
(Moschetta) Dipartimento di Scienze farmacologiche e biomolecolari,
Universita degli Studi di Milano, Milano, Italy
(Massaiu) Developmental Biology of the Immune System, Life and Medical
Sciences Institute, University of Bonn, Bonn, Germany
Publisher
Frontiers Media S.A.
Abstract
Background: Cardiac amyloidosis (CA) has been recently recognized as a
condition frequently associated with aortic stenosis (AS). The aim of this
study was to evaluate: the main characteristics of patients with AS with
and without CA, the impact of CA on patients with AS mortality, and the
effect of different treatment strategies on outcomes of patients with AS
with concomitant CA. <br/>Material(s) and Method(s): A detailed search
related to CA in patients with AS and outcomes was conducted according to
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines. Seventeen studies enrolling 1,988 subjects (1,658 AS
alone and 330 AS with CA) were included in the qualitative and
quantitative analysis of main patients with AS characteristics with and
without CA, difference in mortality, and treatment strategy.
<br/>Result(s): The prevalence of CA resulted in a mean of 15.4% and it
was even higher in patients with AS over 80 years old (18.2%). Patients
with the dual diagnosis were more often males, had lower body mass index
(BMI), were more prone to have low flow, low gradient with reduced left
ventricular ejection fraction AS phenotype, had higher E/A and E/e', and
greater interventricular septum hypertrophy. Lower Sokolow-Lyon index,
higher QRS duration, higher prevalence of right bundle branch block,
higher levels of N-terminal pro-brain natriuretic peptide, and
high-sensitivity troponin T were significantly associated with CA in
patients with AS. Higher overall mortality in the 178 patients with AS +
CA in comparison to 1,220 patients with AS alone was observed [odds ratio
(OR) 2.25, p = 0.004]. Meta-regression analysis showed that younger age
and diabetes were associated with overall mortality in patients with CS
with CA (Z-value -3.0, p = 0.003 and Z-value 2.5, p = 0.013,
respectively). Finally, patients who underwent surgical aortic valve
replacement (SAVR) or transcatheter aortic valve implantation (TAVI) had a
similar overall mortality risk, but lower than medication-treated only
patients. <br/>Conclusion(s): Results from our meta-analysis suggest that
several specific clinical, electrocardiographic, and echocardiographic
features can be considered "red flags" of CA in patients with AS. CA
negatively affects the outcome of patients with AS. Patients with
concomitant CA and AS benefit from SAVR or TAVI.<br/>Copyright &#xa9; 2022
Myasoedova, Conte, Valerio, Moschetta, Massaiu, Petraglia, Leosco, Poggio
and Parisi.

<67>
Accession Number
2015418012
Title
Risk Factors for Post-operative Planned Reintubation in Patients After
General Anesthesia: A Systematic Review and Meta-Analysis.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 839070.
Date of Publication: 09 Mar 2022.
Author
Xie Z.; Liu J.; Yang Z.; Tang L.; Wang S.; Du Y.; Yang L.
Institution
(Xie, Yang, Tang, Wang) Department of Nursing, First Affiliated Hospital
of Nanchang University, Nanchang, China
(Xie, Liu, Du, Yang) School of Nursing, Nanchang University, Nanchang,
China
Publisher
Frontiers Media S.A.
Abstract
Background: The occurrence of postoperative reintubation (POR) in patients
after general anesthesia (GA) is often synonymous with a poor prognosis in
patients. This is the first review analyzing scientific literature to
identify risk factors of POR after general anesthesia. The purpose of this
study was to collect currently published studies to determine the most
common and consistent risk factors associated with POR after GA.
<br/>Method(s): We have retrieved all relevant research published before
April 2021 from PubMed, Embase, Web of Science, and the Cochrane Library
electronic databases. These studies were selected according to the
inclusion and exclusion criteria. The Z test determined the combined odds
ratio (OR) of risk factors. We used OR and its corresponding 95%
confidence interval (CI) to identify significant differences in risk
factors. The quality of the study was evaluated with the NOS scale, and
meta-analysis was carried out with Cochrane Collaboration's Revman 5.0
software. <br/>Result(s): A total of 10 studies were included, with a
total of 7,789 recipients of POR. We identified 7 risk factors related to
POR after GA: ASA >= 3 (OR = 3.58), COPD (OR = 2.09), thoracic surgery (OR
= 17.09), airway surgery (OR = 9.93), head-and-neck surgery (OR = 3.49),
sepsis (OR = 3.50), DVT (OR = 4.94). <br/>Conclusion(s): Our meta-analysis
showed that ASA >= 3, COPD, thoracic surgery, airway surgery,
head-and-neck surgery, sepsis and DVT were associated with POR after GA.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?, Identifier:
CRD42021252466.<br/>Copyright &#xa9; 2022 Xie, Liu, Yang, Tang, Wang, Du
and Yang.

<68>
Accession Number
2017430036
Title
Prediction of recurrent event in patients with coronary heart disease: The
EUROASPIRE Risk Model.
Source
European Journal of Preventive Cardiology. 29(2) (pp 328-339), 2022. Date
of Publication: 01 Jan 2022.
Author
De Bacquer D.; Ueda P.; Reiner Z.; De Sutter J.; De Smedt D.; Lovic D.;
Gotcheva N.; Fras Z.; Pogosova N.; Mirrakhimov E.; Lehto S.; Jernberg T.;
Kotseva K.; Ryden L.; Wood D.; De Backer G.
Institution
(De Bacquer, De Smedt, De Backer) Department of Public Health and Primary
Care, Ghent University, C. Heymanslaan 10, Gent 9000, Belgium
(Ueda, Ryden) Department of Medicine, Solna, Karolinska Institutet,
Stockholm, Sweden
(Ueda, Reiner) Department of Internal Medicine, University Hospital Center
Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
(De Sutter) Department of Internal Medicine and Paediatrics, Ghent
University, Ghent, Belgium
(De Sutter) Department of Cardiology, AZ Maria Middelares Ghent, Ghent,
Belgium
(Lovic) Cardiology Department, School of Medicine, Clinic for Internal
Disease Intermedica, Hypertensive Centre, Singidunum University, Nis,
Serbia
(Gotcheva) Department of Cardiology, National Heart Hospital, Sofia,
Bulgaria
(Fras) Department of Vascular Medicine, Division of Medicine, University
Medical Centre Ljubljana, Ljubljana, Slovenia
(Fras) Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
(Pogosova) National Medical Research Centre of Cardiology, Ministry of
Healthcare of the Russian Federation, Moscow, Russian Federation
(Mirrakhimov) Kyrgyz State Medical Academy, Bishkek, Kyrgyztan
(Mirrakhimov) National Centre of Cardiology and Internal Medicine named
after academician Mirrakhimov MM, Bishkek, Kyrgyztan
(Lehto) Varkaus Hospital, Varkaus, Finland
(Jernberg) Department of Clinical Sciences, Danderyd Hospital, Karolinska
Institutet, Stockholm, Sweden
(Kotseva, Wood) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
(Kotseva, Wood) National University of Ireland, Galway, Ireland
Publisher
Oxford University Press
Abstract
Aims: Most patients with established atherosclerotic cardiovascular
disease (CVD) are at very high risk for developing recurrent events. Since
this risk varies a lot between patients there is a need to identify those
in whom an even more intensive secondary prevention strategy should be
envisaged. Using data from the EUROASPIRE IV and V cohorts of coronary
heart disease (CHD) patients from 27 European countries, we aimed at
developing and internally and externally validating a risk model
predicting recurrent CVD events in patients aged < 75 years. <br/>Methods
and Results: Prospective data were available for 12 484 patients after a
median follow-up time of 1.7 years. The primary endpoint, a composite of
fatal CVD or new hospitalizations for non-fatal myocardial infarction
(MI), stroke, heart failure, coronary artery bypass graft, or percutaneous
coronary intervention (PCI), occurred in 1424 patients. The model was
developed based on data from 8000 randomly selected patients in whom the
association between potential risk factors and the incidence of the
primary endpoint was investigated. This model was then validated in the
remaining 4484 patients. The final multivariate model revealed a higher
risk for the primary endpoint with increasing age, a previous
hospitalization for stroke, heart failure or PCI, a previous diagnosis of
peripheral artery disease, self-reported diabetes and its glycaemic
control, higher non-high-density lipoprotein cholesterol, reduced renal
function, symptoms of depression and anxiety and living in a higher risk
country. The model demonstrated excellent internal validity and proved
very adequate in the validation cohort. Regarding external validity, the
model demonstrated good discriminative ability in 20 148 MI patients
participating in the SWEDEHEART register. Finally, we developed a risk
calculator to estimate risks at 1 and 2 years for patients with stable
CHD. <br/>Conclusion(s): In patients with CHD, fatal and non-fatal rates
of recurrent CVD events are high. However, there are still opportunities
to optimize their management in order to prevent further disease or death.
The EUROASPIRE Risk Calculator may be of help to reach this goal.
<br/>Copyright &#xa9; 2020 Published on behalf of the European Society of
Cardiology. All rights reserved.

<69>
Accession Number
2017430034
Title
Ten-year all-cause mortality according to smoking status in patients with
severe coronary artery disease undergoing surgical or percutaneous
revascularization.
Source
European Journal of Preventive Cardiology. 29(2) (pp 312-320), 2022. Date
of Publication: 01 Jan 2022.
Author
Takahashi K.; Thuijs D.J.F.M.; Gao C.; Ono M.; Holmes D.R.; Mack M.J.;
Morice M.-C.; Mohr F.-W.; Curzen N.; Davierwala P.M.; Milojevic M.;
Dawkins K.D.; Wykrzykowska J.J.; De Winter R.J.; Mcevoy J.W.; Onuma Y.;
Head S.J.; Kappetein A.P.; Serruys P.W.
Institution
(Takahashi, Ono, Wykrzykowska, De Winter) Department of Cardiology,
Amsterdam Universities Medical Centers, Location Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Thuijs, Milojevic, Head, Kappetein) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Gao) Department of Cardiology, Radboud Medical Center, Nijmegen,
Netherlands
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Mack) Department of Cardiothoracic Surgery, Baylor Scott and White
Health, Dallas, TX, United States
(Morice) Departement of Cardiologie, Hopital prive Jacques Cartier, Gerale
de Sante Massy, Paris, France
(Mohr, Davierwala) University Department of Cardiac Surgery, Heart Centre
Leipzig, Leipzig, Germany
(Curzen) Department of Cardiology, Coronary Research Group, University
Hospital Southampton NHS FT, Southampton, United Kingdom
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Dawkins) Shockwave Medical Inc, 5403 Betsy Ross Dr Santa Clara, Santa
Clara, CA 95054, United States
(Wykrzykowska) Department of Cardiology, University Medical Centre
Groningen, University of Groningen, Groningen, Netherlands
(Mcevoy, Onuma, Serruys) Department of Cardiology, National University of
Ireland, Galway (NUIG), Galway, Ireland
Publisher
Oxford University Press
Abstract
Aims: To evaluate the impact of various smoking status on 10-year
all-cause mortality and to examine a relative treatment benefit of
coronary artery bypass grafting (CABG) vs. percutaneous coronary
intervention (PCI) according to smoking habits. <br/>Methods and Results:
The SYNTAX Extended Survival study evaluated vital status up to 10 years
in 1800 patients with de novo three-vessel disease and/or left main
coronary artery disease randomized to CABG or PCI in the SYNTAX trial. In
the present analysis, patients were divided into three groups (current,
former, or never smokers), and the primary endpoint of 10-year all-cause
mortality was assessed according to smoking status. Smoking status was
available in 1793 (99.6%) patients at the time of randomization, of whom
363 were current smokers, 798 were former smokers, and 632 were never
smokers. The crude rates of 10-year all-cause mortality were 29.7% in
current smokers, 25.3% in former smokers, and 25.9% in never smokers
(Log-rank P = 0.343). After adjustment for imbalances in baseline
characteristics, current smokers had a significantly higher risk of
10-year all-cause mortality than never smokers [adjusted hazard ratio
(aHR): 2.29; 95% confidence interval (CI): 1.60-3.27; P < 0.001], whereas
former smokers did not. PCI was associated with a higher risk of all-cause
mortality than CABG among current smokers (HR: 1.60; 95% CI: 1.09-2.35; P
= 0.017), but it failed to show a significant interaction between
revascularization strategies and smoking status (Pinteraction = 0.910).
<br/>Conclusion(s): Current smokers had a higher adjusted risk of 10-year
all-cause mortality, whereas former smokers did not. The treatment effect
of CABG vs. PCI did not differ significantly according to smoking status.
Clinical trial registration: SYNTAX: ClinicalTrials.gov reference:
NCT00114972; SYNTAX Extended Survival. ClinicalTrials.gov reference:
NCT03417050. <br/>Copyright &#xa9; 2020 Published on behalf of the
European Society of Cardiology. All rights reserved.

<70>
Accession Number
2017334225
Title
Effect of Ascorbic Acid on Postoperative Acute Kidney Injury in Coronary
Artery Bypass Graft Patients: A Pilot Study.
Source
Heart Surgery Forum. 20(5) (pp E124-E128), 2017. Date of Publication:
2017.
Author
Antonic M.
Institution
(Antonic) Dept. for Cardiac Surgery, University Medical Centre Maribor,
Ljubljanska ulica 5, Maribor SI-2000 , Slovenia
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Even minor postoperative reductions in renal function
influence the outcome of cardiac surgery. The mechanisms of postoperative
renal injury in cardiac surgery are multifactorial and include
ischemia-reperfusion injury. The study investigates the effect of the
antioxidant ascorbic acid on the postoperative acute kidney injury after
elective CABG surgery. <br/>Method(s): A prospective randomized
single-center trial was conducted in on-pump coronary artery bypass
patients. The patients in the ascorbic acid group received 2 grams of
ascorbic acid 24 hours and 2 hours preoperatively and 1 gram twice daily
five days after the surgery. Postoperatively, the subjects were monitored
for renal dysfunction and other complications. <br/>Result(s): 100
patients were included, with 50 patients in each study group. The groups
were well matched for baseline demographics, preoperative medications,
comorbidities, and had similar intraoperative characteristics. The
incidence of postoperative acute kidney injury in the ascorbic acid group
was 16% and 14% in the control group (P = .779). The groups also did not
differ in peak postoperative serum creatinine (83 [33] mumol/L versus 83
[39] mumol/L; P = .434), the lowest postoperative creatinine clearance
(96.40 +/- 35.78 mL/min versus 90.89 +/- 36.18 mL/min; P = .766), and time
from surgery to the onset of peak postoperative serum creatinine (1.64 +/-
1.34 days versus 1.92 +/- 1.54 days; P= .393). There was no dialysis
required in any patient. <br/>Conclusion(s): The results of this study did
not demonstrate a significant protective effect of ascorbic acid on the
incidence of postoperative acute renal injury in elective on- pump CABG
patients.<br/>Copyright &#xa9; 2017 Forum Multimedia Publishing LLC. All
rights reserved.

<71>
Accession Number
2017334218
Title
Randomized Trial of Sternal Closure for Low Risk Patients: Rigid Fixation
versus Wire Closure.
Source
Heart Surgery Forum. 20(4) (pp E164-E169), 2017. Date of Publication:
2017.
Author
Peigh G.; Kumar J.; Unai S.; Diehl J.T.; Hirose H.
Institution
(Peigh, Kumar, Unai, Diehl, Hirose) Division of Cardiothoracic Surgery,
Thomas Jefferson University Hospital, Philadelphia, PA, United States
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: A previous retrospective analysis of our cardiac surgery
patients showed shortened ventilation time and hospital stay among
patients receiving rigid sternal fixation compared to sternal wire
fixation. We performed a prospective randomized study to further
investigate these outcomes and determine if rigid closure can provide
reduced pain after cardiac surgery. <br/>Method(s): Patients undergoing
cardiac surgery between July 2011 and May 2014 were prospectively
randomized into wire closure (Group C) or rigid fixation using sternal
plates (Group R) groups. Age above 80, emergency surgery, redo sternotomy,
and immunosuppression were among major exclusion criteria precluding
randomization. Intubation time was recorded for all patients. Pain scores
were determined daily from postoperative day 1 until day 5 at 6 a.m. using
a numeric rating scale. Narcotic pain medication requirements from day 1
to 5 were collected and converted into intravenous morphine equivalents.
<br/>Result(s): Of 80 patients, 39 patients were in Group R (average age
65 +/- 8; 31 male and 8 female) and 41 patients were in Group C (average
age 66 +/- 9; 34 male and 7 female). Group R patients had a higher body
mass index than patients in Group C (Group R: 31 +/- 5; Group C: 29 +/- 5;
P = .04). No significant differences in the end points of intubation time
and postoperative pain were observed. <br/>Conclusion(s): This randomized
study of cardiac surgery patients showed no significant benefits of rigid
fixation over conventional sternal wire closure with regard to intubation
time, postoperative pain, or length of hospital stay.<br/>Copyright &#xa9;
2017 Forum Multimedia Publishing LLC. All rights reserved.

<72>
Accession Number
2015502851
Title
Intraarterial papaverine for relief of catheter-induced peripheral
arterial vasospasm during pediatric cardiac surgery: A randomized
double-blind controlled trial.
Source
Paediatric Anaesthesia. (no pagination), 2022. Date of Publication: 2022.
Author
Gautam N.K.; Griffin E.; Hubbard R.; Pawelek O.; Edmonds K.; Rydalch E.;
Zhang X.; Sharma S.; Hoffmann C.
Institution
(Gautam, Griffin, Hubbard, Pawelek, Edmonds, Rydalch, Zhang, Hoffmann)
Department of Anesthesiology, McGovern Medical School, UT Health Houston,
Houston, TX, United States
(Sharma) Mayo Clinic, Scottsdale, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Maintaining the patency of peripheral arterial lines in
pediatric patients during surgery can be challenging due to multiple
factors, and catheter-related arterial vasospasm is a potentially
modifiable cause. Papaverine, a potent vasodilator, improves arterial line
patency when used as a continuous infusion in the pediatric intensive care
setting, but this method is not convenient during surgery. <br/>Aim(s):
Extrapolating from the benefit seen in the intensive care unit, the
authors hypothesize that a small-volume intraarterial bolus of papaverine
immediately after arterial line placement will reduce vasospasm-related
arterial line malfunction. <br/>Method(s): This was a prospective,
randomized, double-blind study. Patients less than 17 years of age
undergoing cardiac surgery were enrolled. Patients were randomized into
the heparin or papaverine groups. Immediately after arterial line
insertion, an intraarterial bolus of heparin (2 units/ml, 1 ml) or
papaverine (0.12 mg/ml, 1 ml) was administered (T1, Figure 1). An optimal
waveform was defined as the ease of aspirating a standardized blood sample
within 30 s, absence of cavitation when sampling, absence of color change
at the catheter site during injection, and presence of a dicrotic notch.
The primary outcome evaluated was the presence of an optimal arterial
waveform at 5 min after the first randomized dose (T1 + 5 min). The
secondary outcomes were the presence of optimal arterial waveform an hour
after the first dose and the ability of papaverine to rescue suboptimal
waveforms. <br/>Result(s): A total of 100 patients were enrolled in the
study. Twelve patients were excluded from the analysis. Complete datasets
after randomization were available in 88 patients (heparin group, n = 46;
papaverine group, n = 42). At baseline, groups were similar for age,
weight, arterial vessel size, and arterial line patency. At T1 + 5 min, an
improvement in the waveform characteristics was observed in the papaverine
group (heparin,39% [8/46] vs. papaverine, 64% [27/42]; p =.02; odds ratio,
2.8; 95% CI, 1.2 to 6.6, Figure 3, Table 2). At the end of 1 h, both
groups showed continued improvement in arterial line patency. After the
second dose, a higher number of patients in the heparin group had
suboptimal waveforms and were treated with papaverine (heparin,37% [17/46]
vs. papaverine,17% [7/42], p =.05). Patients in the heparin group treated
with papaverine showed significant improvement in patency (13/17 vs. 3/7,
p =.01). No serious adverse events were reported. <br/>Conclusion(s): In
pediatric patients, papaverine injection immediately after peripheral
arterial catheter placement was associated with relief of vasospasm and
improved initial arterial line patency. Further, papaverine can be used as
a rescue to improve and maintain arterial line patency.<br/>Copyright
&#xa9; 2022 John Wiley & Sons Ltd.

<73>
Accession Number
2015452925
Title
Retained surgical drain fragments: A systematic review and case report.
Source
Surgical Practice. (no pagination), 2022. Date of Publication: 2022.
Author
Indja B.; Chen K.; Cheng E.; Kennedy H.; Alzahrani N.; Morris D.L.
Institution
(Indja) School of Health Sciences, Faculty of Medicine and Health, The
University of Sydney, Camperdown, NSW, Australia
(Indja, Chen, Cheng, Kennedy, Alzahrani, Morris) Hepatobilliary and
Surgical Oncology Unit, Department of Surgery, St George Hospital,
Kogarah, NSW, Australia
(Chen, Cheng, Morris) St George and Sutherland Clinical School, University
of New South Wales, Sydney, NSW, Australia
(Alzahrani) College of Medicine, Al Imam Mohammad Ibn Saud Islamic
University (IMSIU), Riyadh, Saudi Arabia
Publisher
John Wiley and Sons Inc
Abstract
Aim: Retained surgical drains are an avoidable and serious cause of
postoperative morbidity. This study aims to first report on our unit's
experience in identifying and managing retained surgical drains and then
consolidate current knowledge regarding retained surgical drains, causes
and associated complications. <br/>Patients and Methods: A systematic
review of the literature was performed through searches in electronic
databases to identify studies that described incidents involving retained
surgical drains. Data were extracted regarding patient and operative
characteristics, drain complications and management. <br/>Result(s): A
total of 36 case reports and/or series were identified in the literature,
with 39 individual cases of retained surgical drains in patients
undergoing abdominal, thoracic or orthopaedic procedures. The most common
cause for retained drain was fracture of drain tubing. Patients presented
with complications ranging from chronic pain, abscess or fistula
formation, to migration of the drain fragment into a hollow viscus. In all
cases an invasive intervention was required to remove the retained drain.
<br/>Conclusion(s): Surgeons should be aware of retained surgical drains
as an iatrogenic cause of postoperative morbidity. Contemporary surgical
practice should include methods to prevent, identify and manage retained
drains and associated complications.<br/>Copyright &#xa9; 2022 College of
Surgeons of Hong Kong.

<74>
Accession Number
2014072382
Title
Perioperative Neutrophil-Lymphocyte Ratio Predicts Mortality After Cardiac
Surgery: Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(5) (pp 1296-1303),
2022. Date of Publication: May 2022.
Author
Perry L.A.; Liu Z.; Loth J.; Penny-Dimri J.C.; Plummer M.; Segal R.; Smith
J.
Institution
(Perry, Liu, Loth, Segal) Department of Anaesthesia, Royal Melbourne
Hospital, Parkville, Australia
(Penny-Dimri, Smith) Department of Surgery, Monash University, Clayton,
Australia
(Penny-Dimri, Smith) School of Clinical Sciences, Monash Health, Clayton,
Australia
(Plummer) Intensive Care Unit, Royal Melbourne Hospital, Parkville,
Australia
(Plummer) Department of Critical Care, University of Melbourne, Parkville,
Australia
(Segal) Department of Medicine, University of Melbourne, Parkville,
Australia
Publisher
W.B. Saunders
Abstract
Objectives: Neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker
that has been evaluated across a variety of surgical disciplines and is
widely predictive of poor postoperative outcome, but its value in cardiac
surgery is unclear. The authors did this systematic review and
meta-analysis to determine the impact of elevated perioperative NLR on
survival after cardiac surgery. <br/>Design(s): Systematic review and
meta-analysis of study-level data. <br/>Setting(s): Multiple hospitals
involved in an international pool of studies. <br/>Participant(s): Adults
undergoing cardiac surgery. <br/>Intervention(s): None. <br/>Measurements
and Main Results: The authors searched multiple databases from inception
until November 2020. They generated summary hazard ratios (HR) and odds
ratios (OR) for the association of elevated preoperative NLR with
long-term and short-term mortality following cardiac surgery. They
separately reported on elevated postoperative NLR. Between-study
heterogeneity was explored using metaregression. The authors included 12
studies involving 13,262 patients undergoing cardiac surgery. Elevated
preoperative NLR was associated with worse long-term (>30 days) (hazard
ratio [HR] 1.56; 95% CI [confidence interval], 1.18-2.06; 8 studies) and
short-term (<30 days) mortality (OR 3.18; 95% CI, 1.90-5.30; 7 studies).
One study reported the association of elevated postoperative NLR with
long-term mortality (HR 8.58; 95% CI, 2.55-28.85). There was considerable
between-study heterogeneity for the analysis of long-term mortality
(I² statistic 94.39%), which mostly was explained by
study-level variables, such as the number of variables adjusted for by
included studies and how many of these significantly increased the risk of
long-term mortality, high risk of bias, and number of study centers, as
well as participant level factors, such as average participant age and
hypertension prevalence. <br/>Conclusion(s): Perioperative NLR is an
independent predictor of short-term and long-term postoperative mortality
following cardiac surgery. Further research is required to determine which
patient-level factors modify the prognostic value of NLR and to evaluate
its role in routine clinical practice.<br/>Copyright &#xa9; 2021 Elsevier
Inc.

<75>
Accession Number
2017144379
Title
A comparison of the analgesic efficacy of serratus anterior plane block
vs. paravertebral nerve block for video-assisted thoracic surgery: a
randomized controlled trial.
Source
Wideochirurgia I Inne Techniki Maloinwazyjne. 17(1) (pp 134-142), 2022.
Date of Publication: 2022.
Author
Zhang Y.; Fu Z.; Fang T.; Wang K.; Liu Z.; Li H.; Jiang W.; Cao X.
Institution
(Zhang, Fu, Fang, Wang, Liu, Li, Jiang, Cao) Department of Anesthesiology,
The First Hospital of China Medical University, Liaoning, Shenyang, China
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Patients who undergo video-assisted thoracic surgery (VATS)
frequently experience moderate to severe postoperative pain. Serratus
anterior plane block (SAPB) is a relatively novel technique that can block
the lateral cutaneous branches of the intercostal nerves as well as the
long thoracic nerve. <br/>Aim(s): To evaluate the analgesic efficiency of
deep serratus plane block (DSPB) and superficial serratus anterior plane
block (SSPB) as well as paravertebral nerve block (PVB) in patients
undergoing VATS. <br/>Material(s) and Method(s): A total of 74 patients
aged 16-80 undergoing VATS were randomized to receive either DSPB or SSPB
as well as PVB. Ultrasound (US) guided DSPB or SSPB as well as PVB was
performed preoperatively on the patients according to their groups. All
patients were provided with patient-controlled intravenous analgesia
(PCIA) for postoperative analgesia. The primary outcomes were the levels
of postoperative pain at rest and on coughing evaluated by the visual
analog scale (VAS), and intraoperative and postoperative opioid
consumption. The secondary outcomes included PCIA pressing times, side
effects and satisfaction with analgesia, duration of nerve block,
intraoperative hemodynamic changes and vasoactive drug dosage.
<br/>Result(s): No significant differences of VAS score were found. During
the operation, PVB reduced consumption of opioids (27.23 +/-5.10 mg)
compared to DSPB (31.20 +/-3.80 mg) and SSPB (32.61 +/-5.28 mg). The
effective pressing times of PCIA in the SSPB group (0.18 +/-0.65) were
significantly lower compared to the PVB group (1.09 +/-1.50) at 12 h
postoperatively. Accordingly, SSPB also reduced the dosage of PCIA (26.55
+/-4.72 ml) compared to PVB (31.45 +/-7.60 ml). Time of the PVB procedure
was longer (11.14 +/-1.66 min) than DSPB (5.68 +/-1.10 min) and SSPB (4.77
+/-1.04 min). <br/>Conclusion(s): DSPB and SSPB are easy to perform and
can serve as a promising alternative technique to PVB that may offer
comparable analgesic effectiveness for patients undergoing
VATS.<br/>Copyright &#xa9; 2022 Termedia Publishing House Ltd.. All rights
reserved.

<76>
Accession Number
2017070131
Title
Efficacy and safety of coronary computed tomography angiography in
patients with a high clinical likelihood of obstructive coronary artery
disease.
Source
Kardiologia Polska. 80(1) (pp 49-55), 2022. Date of Publication: 2022.
Author
Rudzinski P.N.; Kruk M.; Demkow M.; Oleksiak A.; Schoepf J.U.; Mach M.;
Dzielinska Z.; Pregowski J.; Witkowski A.; Ruzyllo W.; Kepka C.
Institution
(Rudzinski, Kruk, Demkow, Oleksiak, Dzielinska, Pregowski, Witkowski,
Ruzyllo, Kepka) National Institute of Cardiology, Warszawa, Poland
(Schoepf) Division of Cardiovascular Imaging, Department of Radiology and
Radiological Science, Medical University of South Carolina, Charleston,
SC, United States
(Schoepf) Division of Cardiology, Department of Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Mach) Division of Cardiac Surgery, Department of Surgery, Vienna General
Hospital, Vienna, Austria
Publisher
Via Medica
Abstract
Background: The CAT-CAD trial showed that coronary computed tomography
angiography (CTA) in patients with a high prevalence of coronary artery
disease (CAD) and indications for invasive coronary angiography (ICA)
reduces the number of patients undergoing ICA by two-thirds and nearly
eradicates non-actionable ICAs. However, the long-term benefits of this
non-invasive strategy remain unknown. <br/>Aim(s): To evaluate the
long-term efficacy and safety of a non-invasive strategy employing
coronary CTA vs. ICA as the first-line imaging test in stable patients
with a high clinical likelihood of obstructive CAD. <br/>Method(s): The
long-term outcomes were evaluated for 36 months following randomization
and included the efficacy outcome (analyzed as the composite of major
adverse cardiovascular events (MACE): all-cause death, acute coronary
syndrome, unplanned coronary revascularization, urgent hospitalization for
a cardiovascular reason, a stroke) and the safety outcome (analyzed as a
cumulative incidence of serious adverse events). <br/>Result(s): One
hundred and twenty participants at a mean age of 60.6 (7.9) years (female,
35.0%) were randomized with an allocation ratio of 1:1 to coronary CTA and
direct ICA as the first-line anatomical test for suspected obstructive
CAD. There were no significant differences between both diagnostic
strategies neither in terms of the long-term efficacy (MACE occurrence:
15.5% in coronary CTA group vs. 16.7% in ICA group; log-rank P = 0.89) nor
the long-term safety (cumulative number of serious adverse events: 36 vs.
38; P = 0.79, respectively). <br/>Conclusion(s): Long-term follow-up of
the randomized CAT-CAD trial confirms t hat t he s trategy employing
coronary CTA is an effective and safe, non-invasive, outpatient-based
alternative to ICA for patients with a high clinical likelihood of
obstructive CAD.<br/>Copyright by the Author(s), 2022

<77>
Accession Number
2015986068
Title
The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid
Consumption for Various Surgeries: A Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Pain Research. 15 (pp 683-699), 2022. Date of Publication:
2022.
Author
Cui Y.; Wang Y.; Yang J.; Ran L.; Zhang Q.; Huang Q.; Gong T.; Cao R.;
Yang X.
Institution
(Cui, Yang, Ran, Zhang, Huang, Gong, Cao) Department of Anesthesiology,
The Affiliated Hospital, School of Medicine, UESTC Chengdu Women's &
Children's Central Hospital, Chengdu, China
(Wang) Department of Anesthesiology, No.363 Hospital, Chengdu, China
(Yang) Department of Hospital Management, The Affiliated Hospital, School
of Medicine, UESTC Chengdu Women's & Children's Central Hospital, Chengdu,
China
Publisher
Dove Medical Press Ltd
Abstract
Study Objective: Pain management plays a pivotal role in enhanced recovery
after surgery (ERAS). Erector spinae plane block (ESPB) is widely used in
many regions to treat perioperative pain, but its benefits are still
somewhat controversial. We, therefore, intent to systematically review the
available literature on ESPB, to elucidate its effects on opioid-sparing
analgesia, and summarize its potential complications. <br/>Design(s):
Systematic review of randomized controlled trials (RCTs) with
meta-analysis. <br/>Setting(s): Postoperative opioid consumption for
various surgeries. <br/>Patient(s): Patients undergoing various surgeries.
<br/>Intervention(s): We searched relevant studies in PubMed, EMBASE,
Medline, and the Cochrane Library up to May 16, 2021. All prospective and
RCTs that compared ESPB and sham block or no block were enrolled.
Measurements: The primary outcomes were postoperative opioid consumption
during the first 24 hours. The secondary outcomes were the requirement of
rescue analgesia, time to first rescue analgesic and ESPB-related adverse
events. <br/>Result(s): We included 52 trials that reported postoperative
opioid consumption during the first 24 hours. The results presented that
compared to control group (ie, no intervention or a sham block), ESPB
reduced the accumulated opioid consumption during the first 24 h after
surgery [mean difference (MD) of - 12.83 (95% CI: - 17.29 to - 8.38; p <
0.001) mg; I² = 100%]. Besides, ESPB could prolong time to
first rescue analgesia after surgery [SMD = 5.31; 95% CI 4.01-6.61; p <
0.001; I² = 97%]. The number of patients who received rescue
analgesia after surgery in the ESPB group was less than that in the
control group (OR 0.13; 95% CI 0.09, 0.21; p < 0.001; I² =
54%), and the incidence of PONV was lower in the ESPB group (OR 0.51; 95%
CI 0.43, 0.62; p < 0.001; I² = 19%). <br/>Conclusion(s): ESPB
is an effective technique on pain management with few
complications.<br/>Copyright &#xa9; 2022 Cui et al.

<78>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2022, The
Author(s).

<79>
Accession Number
2017248442
Title
A scoping review of artificial intelligence applications in thoracic
surgery.
Source
European Journal of Cardio-thoracic Surgery. 61(2) (pp 239-248), 2022.
Date of Publication: 01 Feb 2022.
Author
Seastedt K.P.; Moukheiber D.; Mahindre S.A.; Thammineni C.; Rosen D.T.;
Watkins A.A.; Hashimoto D.A.; Hoang C.D.; Kpodonu J.; Celi L.A.
Institution
(Seastedt, Watkins) Department of Surgery, Beth Israel Deaconess Medical
Center, Harvard Medical School, Chest Disease Center, 185 Pilgrim Road,
Suite 201, Boston, MA 02215, United States
(Moukheiber) Laboratory for Computational Physiology, Massachusetts
Institute of Technology, Cambridge, MA, United States
(Mahindre) Institute for Computational and Data Sciences, University at
Buffalo, State University of New York, Buffalo, NY, United States
(Thammineni) HILS Laboratory, University at Buffalo, State University of
New York, Buffalo, NY, United States
(Rosen) Department of Medicine, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
(Hashimoto) Surgical AI & Innovation Laboratory, Department of Surgery,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Hoang) Thoracic Surgery Branch, National Cancer Institute, National
Institutes of Health, Bethesda, MD, United States
(Kpodonu) Division of Cardiac Surgery, Department of Surgery, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, MA, United
States
(Celi) Division of Pulmonary, Critical Care and Sleep Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Machine learning (ML) has great potential, but there are few
examples of its implementation improving outcomes. The thoracic surgeon
must be aware of pertinent ML literature and how to evaluate this field
for the safe translation to patient care. This scoping review provides an
introduction to ML applications specific to the thoracic surgeon. We
review current applications, limitations and future directions.
<br/>METHOD(S): A search of the PubMed database was conducted with
inclusion requirements being the use of an ML algorithm to analyse patient
information relevant to a thoracic surgeon and contain sufficient details
on the data used, ML methods and results. Twenty-two papers met the
criteria and were reviewed using a methodological quality rubric.
<br/>RESULT(S): ML demonstrated enhanced preoperative test accuracy,
earlier pathological diagnosis, therapies to maximize survival and
predictions of adverse events and survival after surgery. However, only 4
performed external validation. One demonstrated improved patient outcomes,
nearly all failed to perform model calibration and one addressed fairness
and bias with most not generalizable to different populations. There was a
considerable variation to allow for reproducibility. <br/>CONCLUSION(S):
There is promise but also challenges for ML in thoracic surgery. The
transparency of data and algorithm design and the systemic bias on which
models are dependent remain issues to be addressed. Although there has yet
to be widespread use in thoracic surgery, it is essential thoracic
surgeons be at the forefront of the eventual safe introduction of ML to
the clinic and operating room.<br/>Copyright &#xa9; 2021 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<80>
Accession Number
2013682146
Title
Efficacy of Erector Spinae Plane Block for Analgesia in Thoracic Surgery:
A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(5) (pp 1387-1395),
2022. Date of Publication: May 2022.
Author
Koo C.-H.; Lee H.-T.; Na H.-S.; Ryu J.-H.; Shin H.-J.
Institution
(Koo, Lee, Na, Ryu, Shin) Department of Anesthesiology & Pain Medicine,
Seoul National University Bundang Hospital, Seongnam, South Korea
(Ryu) Department of Anesthesiology & Pain Medicine, Seoul National
University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: The objective of this study was to determine whether erector
spinae plane block (ESPB) can provide an effective analgesia for managing
pain after thoracic surgery and compare the efficacy of ESPB with that of
other regional analgesic techniques. <br/>Design(s): Systematic review and
meta-analysis of randomized controlled trials. <br/>Setting(s): PubMed,
EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science were searched.
<br/>Participant(s): Patients undergoing thoracic surgeries.
<br/>Intervention(s): Erector spinae plane block with local anesthetics
for postoperative analgesia. Measurement and Main Results: Seventeen
studies, including 1,092 patients, were included in the final analysis.
Erector spinae plane block reduced 24-hour postoperative opioid
consumption (mean difference [MD] -17.49, 95% CI -26.87 to -8.12), pain
score at rest (MD -0.82, 95% CI -1.31 to -0.33), and pain score at
movement (MD -0.77, 95% CI -1.20 to -0.3) compared to no block. Compared
with other regional blocks, various results have been observed. Although
statistical results showed that ESPB is inferior to thoracic paravertebral
block and intercostal nerve block and superior to serratus anterior plan
block in postoperative analgesia, clinical differences remain unclear. The
incidence of hematoma was lower in the ESPB group than in the other groups
(odds ratio 0.19, 95% CI 0.05-0.73). <br/>Conclusion(s): Erector spinae
plane block may provide effective analgesia after thoracic surgery.
Compared with other techniques, it is a safer method, without clinically
important differences, for postoperative pain control. Therefore, ESPB may
be considered as a valuable option for postoperative pain management after
thoracic surgery.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<81>
Accession Number
2007586930
Title
Effects of remote ischemic preconditioning on platelet activation and
reactivity in patients undergoing cardiac surgery using cardiopulmonary
bypass: a randomized controlled trial.
Source
Platelets. 33(1) (pp 123-131), 2022. Date of Publication: 2022.
Author
Cho Y.J.; Nam K.; Yoo S.J.; Lee S.; Bae J.; Park J.-Y.; Kim H.-R.; Kim
T.K.; Jeon Y.
Institution
(Cho, Nam, Yoo, Lee, Bae, Kim, Jeon) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Park) FACS Core Facility, Seoul National University College of Medicine,
Seoul, South Korea
(Kim) Department of Biomedical Sciences, BK21 FOUR Biomedical Science
Project, Seoul National University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae
Medical Center, Seoul National University College of Medicine, Seoul,
South Korea
Publisher
Taylor and Francis Ltd.
Abstract
During cardiopulmonary bypass (CPB), platelet activation and dysfunction
are associated with adverse outcomes. Remote ischemic preconditioning
(RIPC) has been shown to attenuate platelet activation. We evaluated the
effects of RIPC on platelet activation during CPB in patients undergoing
cardiac surgery. Among 58 randomized patients, 26 in the RIPC group and 28
in the sham-RIPC group were analyzed. RIPC consisted of 4 cycles of 5-min
ischemia induced by inflation of pneumatic cuff pressure to 200 mmHg,
followed by 5-min reperfusion comprising deflation of the cuff on the
upper arm. Platelet activation was assessed using flow cytometry analysis
of platelet activation markers. The primary endpoint was the AUC of CD62P
expression during the first 3 h after initiation of CPB. Secondary
outcomes were the AUC of PAC-1 expression and monocyte-platelet aggregates
(MPA) during 3 h of CPB. The AUCs of CD62P expression during 3 h after
initiation of CPB were 219.4 +/- 43.9 and 211.0 +/- 41.2 MFI in the RIPC
and sham-RIPC groups, respectively (mean difference, 8.42; 95% CI, -14.8
and 31.7 MFI; p =.471). The AUCs of PAC-1 expression and MPA did not
differ between groups. RIPC did not alter platelet activation and
reactivity during CPB in patients undergoing cardiac
surgery.<br/>Copyright &#xa9; 2020 Taylor & Francis Group, LLC.

<82>
Accession Number
2015094045
Title
Serum biomarkers of brain injury after uncomplicated cardiac surgery:
Secondary analysis from a randomized trial.
Source
Acta Anaesthesiologica Scandinavica. 66(4) (pp 447-453), 2022. Date of
Publication: April 2022.
Author
Barbu M.; Jonsson K.; Zetterberg H.; Blennow K.; Kolsrud O.; Ricksten
S.-E.; Dellgren G.; Bjork K.; Jeppsson A.
Institution
(Barbu, Dellgren, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Barbu) Department of Cardiology, Blekinge Hospital, Karlskrona, Sweden
(Jonsson, Kolsrud, Dellgren, Bjork, Jeppsson) Department of Cardiothoracic
Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
(Zetterberg, Blennow) Clinical Neurochemistry Laboratory, Sahlgrenska
University Hospital, Molndal, Sweden
(Zetterberg, Blennow) Department of Psychiatry and Neurochemistry,
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University
of Gothenburg, Molndal, Sweden
(Zetterberg) Department of Neurodegenerative Disease, UCL Institute of
Neurology, London, United Kingdom
(Zetterberg) UK Dementia Research Institute at UCL, London, United Kingdom
(Ricksten) Department of Cardiothoracic Anesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Ricksten) Department of Anesthesiology and Intensive Care, Institute of
Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Postoperative cognitive dysfunction is common after cardiac
surgery. Postoperative measurements of brain injury biomarkers may
identify brain damage and predict cognitive dysfunction. We describe the
release patterns of five brain injury markers in serum and plasma after
uncomplicated cardiac surgery. <br/>Method(s): Sixty-one elective cardiac
surgery patients were randomized to undergo surgery with either a
dextran-based prime or a crystalloid prime. Blood samples were taken
immediately before surgery, and 2 and 24 h after surgery. Concentrations
of the brain injury biomarkers S100B, glial fibrillary acidic protein
(GFAP), tau, neurofilament light (NfL) and neuron-specific enolase (NSE))
and the blood-brain barrier injury marker beta-trace protein were
analyzed. Concentrations of brain injury biomarkers were correlated to
patients' age, operation time, and degree of hemolysis. <br/>Result(s): No
significant difference in brain injury biomarkers was observed between the
prime groups. All brain injury biomarkers increased significantly after
surgery (tau +456% (25th-75th percentile 327%-702%), NfL +57% (28%-87%),
S100B +1145% (783%-2158%), GFAP +17% (-3%-43%), NSE +168% (106%-228%),
while beta-trace protein was reduced (-11% (-17-3%). Tau, S100B, and NSE
peaked at 2h, NfL and GFAP at 24 h. Postoperative concentrations of brain
injury markers correlated to age, operation time, and/or hemolysis.
<br/>Conclusion(s): Uncomplicated cardiac surgery with cardiopulmonary
bypass is associated with an increase in serum/plasma levels of all the
studied injury markers, without signs of blood-brain barrier injury. The
biomarkers differ markedly in their levels of release and time course.
Further investigations are required to study associations between
perioperative release of biomarkers, postoperative cognitive function and
clinical outcome.<br/>Copyright &#xa9; 2022 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<83>
Accession Number
2014738581
Title
Five-year follow-up of intracoronary autologous cell therapy in acute
myocardial infarction: the REGENERATE-AMI trial.
Source
ESC Heart Failure. 9(2) (pp 1152-1159), 2022. Date of Publication: April
2022.
Author
Mathur A.; Sim D.S.; Choudry F.; Veerapen J.; Colicchia M.; Turlejski T.;
Hussain M.; Hamshere S.; Locca D.; Rakhit R.; Crake T.; Kastrup J.;
Agrawal S.; Jones D.A.; Martin J.
Institution
(Mathur, Sim, Choudry, Veerapen, Hussain, Locca, Jones) Centre for
Cardiovascular Medicine and Devices, William Harvey Research Institute,
Queen Mary University of London, London, United Kingdom
(Mathur, Choudry, Veerapen, Colicchia, Turlejski, Hussain, Hamshere,
Crake, Jones) Department of Cardiology, Barts Heart Centre, Barts Health
NHS Trust, London, United Kingdom
(Sim) Department of Cardiovascular Medicine, Chonnam National University
Hospital, Chonnam National University School of Medicine, Gwangju, South
Korea
(Locca) Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
(Rakhit) Department of Cardiology, The Royal Free Hospital, Royal Free
London Foundation Trust, London, United Kingdom
(Kastrup) Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
(Agrawal) Haemato-Oncology, Barts Health NHS Trust & Immunobiology,
Blizard Institute, Queen Mary University of London, London, United Kingdom
(Martin) University College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Aims: The long-term outcomes of the intracoronary delivery of autologous
bone marrow-derived cells (BMCs) after acute myocardial infarction are not
well established. Following the promising 1 year results of the
REGENERATE-AMI trial (despite it not achieving its primary endpoint), this
paper presents the analysis of the 5 year clinical outcomes of these acute
myocardial infarction patients who were treated with an early
intracoronary autologous BMC infusion or placebo. <br/>Methods and
Results: A 5 year follow-up of major adverse cardiac events (defined as
the composite of all-cause death, recurrent myocardial infarction, and all
coronary revascularization) and of rehospitalization for heart failure was
completed in 85 patients (BMC n = 46 and placebo n = 39). The incidence of
major adverse cardiac events was similar between the BMC-treated patients
and the placebo group (26.1% vs. 18.0%, P = 0.41). There were no cases of
cardiac death in either group, but an increase in non-cardiac death was
seen in the BMC group (6.5% vs. 0%, P = 0.11). The rates of recurrent
myocardial infarction and repeat revascularization were similar between
the two groups. There were no cases of rehospitalization for heart failure
in either group. <br/>Conclusion(s): This 5 year follow-up analysis of the
REGENERATE-AMI trial did not show an improvement in clinical outcomes for
patients treated with cell therapy. This contrasts with the 1 year results
which showed improvements in the surrogate outcome measures of ejection
fraction and myocardial salvage index.<br/>Copyright &#xa9; 2022 The
Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of
European Society of Cardiology.

<84>
Accession Number
2014694375
Title
The novel proteomic signature for cardiac allograft vasculopathy.
Source
ESC Heart Failure. 9(2) (pp 1216-1227), 2022. Date of Publication: April
2022.
Author
Wei D.; Trenson S.; Van Keer J.M.; Melgarejo J.; Cutsforth E.; Thijs L.;
He T.; Latosinska A.; Ciarka A.; Vanassche T.; Van Aelst L.; Janssens S.;
Van Cleemput J.; Mischak H.; Staessen J.A.; Verhamme P.; Zhang Z.-Y.
Institution
(Wei, Melgarejo, Thijs, Zhang) Studies Coordinating Centre, Research Unit
Hypertension and Cardiovascular Epidemiology, KU Leuven Department of
Cardiovascular Sciences, University of Leuven, Campus Sint Rafael,
Kapucijnenvoer 7, Box 7001, Leuven BE-3000, Belgium
(Trenson) Department of Cardiology, Sint-Jan Hospital Bruges, Bruges,
Belgium
(Van Keer, Ciarka, Van Aelst, Janssens, Van Cleemput) Division of
Cardiology, University Hospitals Leuven, Leuven, Belgium
(Cutsforth, Staessen) Biomedical Sciences Group, Faculty of Medicine,
University of Leuven, Leuven, Belgium
(He, Latosinska, Mischak) Mosaiques Diagnostics GmbH, Hannover, Germany
(Ciarka) Faculty of Medicine, University of Information Technology and
Management in Rzeszow, Rzeszow, Poland
(Vanassche, Verhamme) Centre for Molecular and Vascular Biology, KU Leuven
Department of Cardiovascular Sciences, University of Leuven, Leuven,
Belgium
(Mischak) BHF Institute of Cardiovascular and Medical Sciences, University
of Glasgow, Glasgow, United Kingdom
(Staessen) Non-Profit Research Institute Alliance for the Promotion of
Preventive Medicine, Mechelen, Belgium
Publisher
John Wiley and Sons Inc
Abstract
Aims: Cardiac allograft vasculopathy (CAV) is the major long-term
complication after heart transplantation, leading to mortality and
re-transplantation. As available non-invasive biomarkers are scarce for
CAV screening, we aimed to identify a proteomic signature for CAV.
<br/>Methods and Results: We measured urinary proteome by capillary
electrophoresis coupled with mass spectrometry in 217 heart
transplantation recipients (mean age: 55.0 +/- 14.4 years; women: 23.5%),
including 76 (35.0%) patients with CAV diagnosed by coronary angiography.
We randomly and evenly grouped participants into the derivation cohort (n
= 108, mean age: 56.4 +/- 13.8 years; women: 22.2%; CAV: n = 38) and the
validation cohort (n = 109, mean age: 56.4 +/- 13.8 years; women: 24.8%,
CAV: n = 38), stratified by CAV. Using the decision tree-based machine
learning methods (extreme gradient boost), we constructed a proteomic
signature for CAV discrimination in the derivation cohort and verified its
performance in the validation cohort. The proteomic signature that
consisted of 27 peptides yielded areas under the curve of 0.83 [95%
confidence interval (CI): 0.75-0.91, P < 0.001] and 0.71 (95% CI:
0.60-0.81, P = 0.001) for CAV discrimination in the derivation and
validation cohort, respectively. With the optimized threshold of 0.484,
the sensitivity, specificity, and accuracy for CAV differentiation in the
validation cohort were 68.4%, 73.2%, and 71.6%, respectively. With
adjustment of potential clinical confounders, the signature was
significantly associated with CAV [adjusted odds ratio: 1.31 (95% CI:
1.07-1.64) for per 0.1% increment in the predicted probability, P =
0.012]. Diagnostic accuracy significantly improved by adding the signature
to the logistic model that already included multiple clinical risk
factors, suggested by the integrated discrimination improvement of 9.1%
(95% CI: 2.5-15.3, P = 0.005) and net reclassification improvement of
83.3% (95% CI: 46.7-119.5, P < 0.001). Of the 27 peptides, the majority
were the fragments of collagen I (44.4%), collagen III (18.5%), collagen
II (3.7%), collagen XI (3.7%), mucin-1 (3.7%), xylosyltransferase 1
(3.7%), and protocadherin-12 (3.7%). Pathway analysis performed in
Reactome Pathway Database revealed that the multiple pathways involved by
the signature were related to the pathogenesis of CAV, such as collagen
turnover, platelet aggregation and coagulation, cell adhesion, and
motility. <br/>Conclusion(s): This pilot study identified and validated a
urinary proteomic signature that provided a potential approach for the
surveillance of CAV. These proteins might provide insights into CAV
pathological processes and call for further investigation into
personalized treatment targets.<br/>Copyright &#xa9; 2022 The Authors. ESC
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<85>
Accession Number
2015119868
Title
CABG in patients with liver cirrhosis: to pump or not to pump?.
Source
Expert Review of Cardiovascular Therapy. 20(2) (pp 95-99), 2022. Date of
Publication: 2022.
Author
Jiang S.M.; Liblik K.; Baranchuk A.; Payne D.; El-Diasty M.
Institution
(Jiang, Payne, El-Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
(Liblik, Baranchuk) Department of Cardiology, Queen's University,
Kingston, ON, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Coronary artery bypass grafting in patients with established
liver cirrhosis is generally associated with poor outcomes. Avoiding
cardiopulmonary bypass (CPB) in these patients has not demonstrated any
advantage over the use of CPB. We review the current available literature
that compared the outcome of both on-pump (ONCABG) and off-pump (OPCAB)
techniques in cirrhotic patients in terms of morbidity and mortality.
Areas covered: A comprehensive search was conducted in the PubMed/MEDLINE
and EMBASE databases in January 2021. Articles that reported outcomes of
OPCAB and/or ONCABG in cirrhotic patients with no concomitant surgical
procedures were included. 829 unique abstracts were retrieved with title
and abstract screening completed independently by two reviewers. Two case
studies and six retrospective cohort studies were included. The largest
study comprised more than 98% of the total population, showing some
survival benefit for OPCAB over ONCABG. However, it was population-based
and did not report the severity of liver. The remaining studies reported
no clear difference in outcome between the two techniques. Expert opinion:
Surgical myocardial revascularisation carries high perioperative risk in
patients with liver cirrhosis irrespective of the surgical technique.
There is a lack of evidence to suggest that avoiding CPB in these patients
may be beneficial.<br/>Copyright &#xa9; 2022 Informa UK Limited, trading
as Taylor & Francis Group.

<86>
Accession Number
2014782427
Title
Narrative review of the systemic inflammatory reaction to cardiac surgery
and cardiopulmonary bypass.
Source
Artificial Organs. 46(4) (pp 568-577), 2022. Date of Publication: April
2022.
Author
Squiccimarro E.; Stasi A.; Lorusso R.; Paparella D.
Institution
(Squiccimarro, Paparella) Division of Cardiac Surgery, Department of
Medical and Surgical Sciences, University of Foggia, Foggia, Italy
(Squiccimarro, Lorusso) Cardio-Thoracic Surgery Department, Heart &
Vascular Centre, Maastricht University Medical Centre, Maastricht,
Netherlands
(Stasi) Department of Emergency and Organ Transplantation, University of
Bari, Bari, Italy
(Lorusso) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
(Paparella) Division of Cardiac Surgery, Santa Maria Hospital, GVM Care &
Research, Bari, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Data from large cardiac surgery registries have been depicting
a downward trend of mortality and morbidities in the last 20 years.
However, despite decades of medical evolution, cardiac surgery and
cardiopulmonary bypass still provoke a systemic inflammatory response,
which occasionally leads to worsened outcome. This article seeks to
outline the mechanism of the phenomenon. <br/>Method(s): A thorough review
of the literature has been performed. Criteria for considering studies for
this non-systematic review were as follows: observational and
interventional studies investigating the systemic inflammatory response to
cardiac surgery, experimental studies describing relevant molecular
mechanisms, and essential review studies pertinent to the topic.
<br/>Result(s): The intrinsic variability of the inflammatory response to
cardiac surgery, together with its heterogenous perception among
clinicians, as well as the arduousness to early discriminate
high-responder patients from those who will not develop a clinically
relevant reaction, concurred to hitherto unconclusive randomized
controlled trials. Furthermore, peremptory knowledge about the
pathophysiology of maladaptive inflammation following heart surgery is
still lacking. <br/>Conclusion(s): Systemic inflammation following cardiac
surgery is a frequent entity that occasionally becomes clinically
relevant. Specific genomic differences, age, and other preoperative
factors influence the magnitude of the response, which elements display
extreme redundancy and pleiotropism that the target of a single pathway
cannot represent a silver bullet.<br/>Copyright &#xa9; 2022 The Authors.
Artificial Organs published by International Center for Artificial Organ
and Transplantation (ICAOT) and Wiley Periodicals LLC.

<87>
Accession Number
634396081
Title
Effect of nurse-initiated forced-air warming blanket on the reduction of
hypothermia complications following coronary artery bypass grafting: a
randomized clinical trial.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. 20(5) (pp
445-453), 2021. Date of Publication: 29 Jun 2021.
Author
Bezerra A.S.M.; Santos V.B.; Lopes C.T.; de Barros A.L.B.L.
Institution
(Bezerra, Santos, Lopes, de Barros) Escola Paulista de Enfermagem,
Universidade Federal de Sao Paulo (EPE-UNIFESP), Departamento de
Enfermagem Clinica e Cirurgica and Programa de Pos Graduacao em
Enfermagem, 754 Napoleao de Barros St, Vila Clementino 04024-002, Brazil
(Bezerra) Instituto Dante Pazzanese de Cardiologia (IDPC), Divisao de
Enfermagem. 500 Dr Dante Pazzanese Av 04012-909, Brazil
Publisher
NLM (Medline)
Abstract
AIMS: To evaluate the effect of postoperative forced-air warming (FAW) on
the incidence of excessive bleeding (ExB), arrhythmia, acute myocardial
infarction (AMI), and blood product transfusion in hypothermic patients
following on-pump CABG and compare temperatures associated with the use of
FAW and warming with a sheet and wool blanket. METHODS AND RESULTS: A
randomized clinical trial conducted with 200 patients undergoing isolated
on-pump CABG from January to November 2018. Patients were randomly
assigned into an Intervention Group (IG, FAW, n=100) and Control Group
(CG, sheet and blanket, n=100). The tympanic temperature of all patients
was measured over a 24-h period. ExB was the primary outcome, while
arrhythmia, AMI, and blood product transfusion were secondary outcomes.
The effect of the interventions on the outcomes was investigated through
using bivariate logistic regression, with a level of significance of 5%.
The IG was 79% less likely to experience bleeding than the CG [odds ratio
(OR)=0.21, confidence interval (CI) 95% 0.12-0.39, P<0.001]; the
occurrence of AMI in the IG was 94% lower than that experienced by the CG
(OR=0.06, CI 95% 0.01-0.48, P<0.001); and the IG was also 77% less likely
to experience arrhythmia than the CG (OR=0.23, CI 95% 0.12-0.47, P<0.001);
no difference was found between groups in terms of blood product
transfusion (P<0.279). <br/>CONCLUSION(S): These findings show that FAW
can be used following CABG until patients reach normothermia to avoid
undesirable clinical outcomes. TRIAL REGISTRATION: REBeC
RBR-5t582g.<br/>Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. &#xa9; The Author(s) 2020. For
permissions, please email: journals.permissions@oup.com.

<88>
Accession Number
2016084886
Title
The Effect of Normal Saline Injection Volumes on the Optic Nerve Sheath
Diameter during Thoracic Epidural Analgesia.
Source
Pain Physician. 24(7) (pp E1007-E1013), 2021. Date of Publication: 2021.
Author
Hong J.; Kim J.S.; Lee Y.H.
Institution
(Hong, Kim, Lee) Department of Anesthesiology and Pain Medicine, Keimyung
University DongSan Hospital, Keimyung University School of Medicine,
Daegu, South Korea
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Saline or local anesthetic injection into the epidural space
increases intracranial pressure (ICP), at least transiently. Measurement
of the optic nerve sheath diameter (ONSD) using ocular ultrasonography is
one of the noninvasive methods for ICP assessment. <br/>Objective(s): The
purpose of this study is to investigate the effects of the different
volume on the ONSD and cerebral oxygen saturation (rSO<inf>2</inf>) during
thoracic epidural saline injection under awake conditions. <br/>Study
Design: Prospective randomized, controlled trial. <br/>Setting(s): An
interventional pain management practice in South Korea. <br/>Method(s):
This study included 71 patients receiving thoracic epidural
catheterization for pain management, following upper abdominal or thoracic
surgery. Following successful epidural space confirmation, patients were
randomly allocated to receive 5 mL (5 mL group), 10 mL (10 mL group), and
20 mL (20 mL group) of epidural normal saline. Transorbital sonography was
performed to measure the ONSD. This was measured at 3 mm posterior to the
optic nerve head. An rSO<inf>2</inf> was measured using cerebral oximeter
sensors. <br/>Result(s): All 3 groups showed significant increases of ONSD
from 10 minutes to 40 minutes as compared to baseline (before procedure).
Among the 3 groups, the 20 mL group demonstrated the most significantly
increased ONSD, as compared to the 5 mL and 10 mL groups. At the 20 minute
and 40 minute time points, the ONSD showed a volume-dependent increase (P
= 0.0005, P = 0.014). All 3 groups showed the rSO<inf>2</inf> to be
distributed between 60~70% without any statistical difference.
<br/>Limitation(s): We could not determine the returning point of the
normalized ONSD value. <br/>Conclusion(s): Twenty milliliters of normal
saline epidural injection resulted in a significant increase of ONSD, as
compared to the 5 mL and 10 mL groups. Our results also indicate that an
increase of ONSD occurs in accordance with the injected volume of normal
saline.<br/>Copyright &#xa9; 2021, American Society of Interventional Pain
Physicians. All rights reserved.

<89>
[Use Link to view the full text]
Accession Number
2017344911
Title
RBC Transfusion Strategies in the ICU: A Concise Review.
Source
Critical Care Medicine. 47(11) (pp 1637-1644), 2019. Date of Publication:
01 Nov 2019.
Author
Cable C.A.; Razavi S.A.; Roback J.D.; Murphy D.J.
Institution
(Cable, Murphy) Division of Pulmonary, Allergy, Critical Care and Sleep
Medicine, Department of Medicine, Emory University School of Medicine,
Atlanta, GA, United States
(Razavi) Department of Surgery, Emory University School of Medicine,
Atlanta, GA, United States
(Roback) Department of Pathology and Laboratory Medicine, Emory University
School of Medicine, Atlanta, GA, United States
(Cable) Division of Pulmonary Diseases and Critical Care Medicine,
Department of Internal Medicine, Virginia Commonwealth University,
Richmond, VA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: To critically assess available high-level clinical studies
regarding RBC transfusion strategies, with a focus on hemoglobin
transfusion thresholds in the ICU. <br/>Data Sources: Source data were
obtained from a PubMed literature review. Study Selection: English
language studies addressing RBC transfusions in the ICU with a focus on
the most recent relevant studies. <br/>Data Extraction: Relevant studies
were reviewed and the following aspects of each study were identified,
abstracted, and analyzed: study design, methods, results, and implications
for critical care practice. <br/>Data Synthesis: Approximately 30-50% of
ICU patients receive a transfusion during their hospitalization with
anemia being the indication for 75% of transfusions. A significant body of
clinical research evidence supports using a restrictive transfusion
strategy (e.g., hemoglobin threshold < 7g/dL) compared with a more liberal
approach (e.g., hemoglobin threshold < 10g/dL). A restrictive strategy
(hemoglobin < 7g/dL) is recommended in patients with sepsis and
gastrointestinal bleeds. A slightly higher restrictive threshold is
recommended in cardiac surgery (hemoglobin < 7.5g/dL) and stable
cardiovascular disease (hemoglobin < 8g/dL). Although restrictive
strategies are generally supported in hematologic malignancies, acute
neurologic injury, and burns, more definitive studies are needed,
including acute coronary syndrome. Massive transfusion protocols are the
mainstay of treatment for hemorrhagic shock; however, the exact RBC to
fresh frozen plasma ratio is still unclear. There are also emerging
complimentary practices including nontransfusion strategies to avoid and
treat anemia and the reemergence of whole blood transfusion.
<br/>Conclusion(s): The current literature supports the use of restrictive
transfusion strategies in the majority of critically ill populations.
Continued studies of optimal transfusion strategies in various patient
populations, coupled with the integration of novel complementary ICU
practices, will continue to enhance our ability to treat critically ill
patients.<br/>Copyright &#xa9; 2019 by the Society of Critical Care
Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

<90>
[Use Link to view the full text]
Accession Number
2017347602
Title
Short- and long-term impact of remifentanil on thermal detection and pain
thresholds after cardiac surgery A randomised controlled trial.
Source
European Journal of Anaesthesiology. 36(1) (pp 32-39), 2019. Date of
Publication: 01 Jan 2019.
Author
de Hoogd S.; Valkenburg A.J.; van Dongen E.P.A.; Daeter E.J.; van Rosmalen
J.; Dahan A.; Tibboel D.; Knibbe C.A.J.
Institution
(de Hoogd, Knibbe) Department of Clinical Pharmacy, St. Antonius Hospital,
Nieuwegein, Netherlands
(Valkenburg, Tibboel, Knibbe) Intensive Care, Department of Paediatric
Surgery, Erasmus MC - Sophia Children's Hospital, Rotterdam, Netherlands
(van Dongen) Department of Anaesthesiology and Intensive Care, Denmark
(Daeter) Department of Cardiothoracic Surgery, St. Antonius Hospital,
Nieuwegein, Netherlands
(van Rosmalen) Department of Biostatistics, Erasmus MC, Rotterdam,
Netherlands
(Dahan) Department of Anaesthesiology, Leiden University Medical Centre,
Netherlands
(Knibbe) Division of Pharmacology, Leiden Academic Centre for Drug
Research, Leiden University, Leiden, Netherlands
(Knibbe) Department of Clinical Pharmacy, St. Antonius Hospital,
Koekoekslaan 1, Nieuwegein 3435 CM, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND The clinical relevance of the suggested hyperalgesic effects of
remifentanil is still unclear, especially in the long term. OBJECTIVE The
current study evaluated the impact of remifentanil on thermal thresholds 3
days and 12 months after surgery, measured with Quantitative Sensory
Testing. DESIGN A single-blind, randomised controlled trial. SETTING A
tertiary care teaching hospital in The Netherlands, from 2014 to 2016.
PATIENTS A total of 126 patients aged between 18 and 85 years, undergoing
cardiothoracic surgery via sternotomy (coronary artery bypass grafts
and/or valve replacement) were included. Exclusion criteria were BMI above
35 kg m^-2, history of cardiac surgery, chronic pain conditions,
neurological conditions, allergy to opioids or paracetamol, language
barrier and pregnancy. INTERVENTIONS Patients were allocated randomly to
receive intra-operatively either a continuous remifentanil infusion or
intermittent intra-operative fentanyl as needed in addition to
standardised anaesthesia with propofol and intermittent intravenous
fentanyl at predetermined time points. MAIN OUTCOME MEASURES Warm and cold
detection and pain thresholds 3 days and 12 months after surgery. In
addition the use of remifentanil, presence of postoperative chronic pain,
age, opioid consumption and pre-operative quality of life were tested as a
predictor for altered pain sensitivity 12 months after surgery. RESULTS
Both warm and cold detection, and pain thresholds, were not significantly
different between the remifentanil and fentanyl groups 3 days and 12
months after surgery (P > 0.05). No significant predictors for altered
pain sensitivity were identified. CONCLUSION Earlier reports of increased
pain sensitivity 1 year after the use of remifentanil could not be
confirmed in this randomised study using Quantitative Sensory Testing.
This indicates that remifentanil plays a minor role in the development of
chronic thoracic pain. Still, the relatively high incidence of chronic
thoracic pain and its accompanying impact on quality of life remain
challenging problems.
Assistance with the study: the authors thank Richard Sandifort, BSc,
Department of Clinical Pharmacy, St Antonius Hospital, Nieuwegein, The
Netherlands for support in data entry and Ko Hagoort, MA, Department of
Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, the
Netherlands for text editing. Financial support and sponsorship: support
was provided solely from institutional and/or departmental sources.
Conflicts of interest: none. Presentation: none.<br/>Copyright s 2018 The
Author(s).

<91>
[Use Link to view the full text]
Accession Number
2017344822
Title
Effect of a Perioperative Intra-Aortic Balloon Pump in High-Risk Cardiac
Surgery Patients: A Randomized Clinical Trial.
Source
Critical Care Medicine. 46(8) (pp E742-E750), 2018. Date of Publication:
01 Aug 2018.
Author
Ferreira G.S.R.; De Almeida J.P.; Landoni G.; Vincent J.L.; Fominskiy E.;
Galas F.R.B.G.; Gaiotto F.A.; Dallan L.O.; Franco R.A.; Lisboa L.A.;
Dallan L.R.P.; Fukushima J.T.; Rizk S.I.; Park C.L.; Strabelli T.M.; Lage
S.H.G.; Camara L.; Zeferino S.; Jardim J.; Arita E.C.T.C.; Ribeiro J.C.;
Ayub-Ferreira S.M.; Auler J.O.C.; Filho R.K.; Jatene F.B.; Hajjar L.A.
Institution
(Ferreira, De Almeida, Galas, Franco, Fukushima, Rizk, Park, Camara,
Zeferino, Jardim, Arita, Ribeiro, Auler) Surgical Intensive Care Unit,
Department of Anesthesiology, Heart Institute (InCor), Hospital das
Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo,
Brazil
(Landoni, Fominskiy) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy
(Landoni) Faculty of Medicine and Surgery, Vita-Salute San Raffaele
University of Milan, Milan, Italy
(Vincent) Department of Intensive Care, Erasme Hospital, Universite Libre
de Bruxelles, Brussels, Belgium
(Gaiotto, Dallan, Lisboa, Dallan, Jatene) Department of Cardiovascular
Surgery, Heart Institute (InCor), Hospital das Clinicas, Faculdade de
Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Strabelli) Department of Infectious Diseases, Heart Institute (InCor),
Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo,
Sao Paulo, Brazil
(Lage, Ayub-Ferreira, Filho, Hajjar) Department of Cardiology, Heart
Institute (InCor), Hospital das Clinicas, Faculdade de Medicina,
Universidade de Sao Paulo, Sao Paulo, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: The aim of this study was to evaluate the efficacy of
perioperative intra-aortic balloon pump use in high-risk cardiac surgery
patients. <br/>Design(s): A single-center randomized controlled trial and
a metaanalysis of randomized controlled trials. <br/>Setting(s): Heart
Institute of Sao Paulo University. <br/>Patient(s): High-risk patients
undergoing elective coronary artery bypass surgery. <br/>Intervention(s):
Patients were randomized to receive preskin incision intra-aortic balloon
pump insertion after anesthesia induction versus no intra-aortic balloon
pump use. <br/>Measurements and Main Results: The primary outcome was a
composite endpoint of 30-day mortality and major morbidity (cardiogenic
shock, stroke, acute renal failure, mediastinitis, prolonged mechanical
ventilation, and a need for reoperation). A total of 181 patients (mean
[sd] age 65.4 [9.4] yr; 32% female) were randomized. The primary outcome
was observed in 43 patients (47.8%) in the intra-aortic balloon pump group
and 42 patients (46.2%) in the control group (p = 0.46). The median
duration of inotrope use (51hr [interquartile range, 32-94 hr] vs 39hr
[interquartile range, 25-66 hr]; p = 0.007) and the ICU length of stay (5
d [interquartile range, 3-8 d] vs 4 d [interquartile range, 3-6 d]; p =
0.035) were longer in the intra-aortic balloon pump group than in the
control group. A meta-analysis of 11 randomized controlled trials
confirmed a lack of survival improvement in high-risk cardiac surgery
patients with perioperative intra-aortic balloon pump use.
<br/>Conclusion(s): In high-risk patients undergoing cardiac surgery, the
perioperative use of an intra-aortic balloon pump did not reduce the
occurrence of a composite outcome of 30-day mortality and major
complications compared with usual care alone. <br/>Copyright &#xa9; 2018
by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.
All Rights Reserved.

<92>
Accession Number
2017527373
Title
Gender Differences and Outcomes of Hypoattenuated Leaflet Thickening
(HALT) Following Transcatheter Aortic Valve Replacement: A Meta-analysis
of Randomized and Cohort Studies.
Source
Current Problems in Cardiology. (no pagination), 2022. Article Number:
101155. Date of Publication: 2022.
Author
Salah H.M.; Almaddah N.; Xu J.; Al-Hawwas M.; Agarwal S.K.; Uretsky B.F.;
Dhar G.; Al'Aref S.J.
Institution
(Salah, Xu, Al-Hawwas, Dhar, Al'Aref) Department of Medicine, Division of
Cardiology. University of Arkansas for Medical Sciences, Little Rock, AR,
United States
(Almaddah) Arkansas Heart Hospital, Little Rock, AR, United States
(Agarwal, Uretsky) Central Arkansas Veterans Health System, Little Rock,
AR, United States
Publisher
Elsevier Inc.
Abstract
Subclinical leaflet thrombosis is characterized by hypoattenuated leaflet
thickening (HALT) after transcatheter aortic valve replacement (TAVR) on
computed tomography. However, given the low incidence of HALT after TAVR,
the clinical significance of HALT is still being investigated. We sought
to generate a more reliable estimate of the risk factors and adverse
outcomes associated with HALT after TAVR by pooling data from randomized
trials and cohort studies. PubMed/Medline database was systematically
searched from inception until November 24, 2021, using the following
terms: ("hypoattenuated leaflet thickening" and "transcatheter aortic
valve replacement") and ("Subclinical leaflet thrombosis" and
"transcatheter aortic valve replacement"). A random effects model
meta-analysis was conducted using Mantel-Haenszel odds ratios (ORs) and
the associated 95% confidence intervals (CIs), mean difference and the
associated 95%. Ten studies with a total of 1462 patients were included,
with follow-up ranging between 4 months and 3 years. HALT occurred in
14.4% of the patients undergoing TAVR. HALT was not associated with
increased risk of stroke/TIA (OR 1.38; 95% CI [0.61-3.11]; I2=0%) or
increased risk of all-cause mortality (OR 0.67; 95% CI [0.25-1.80]; I2=0).
HALT was associated with a greater post-procedural mean aortic valve
gradient (mean difference 2.31 mmHg; 95% CI [0.27, 4.35]; I2=71%).
Interestingly, there was a trend of higher risk of HALT in men (OR 1.37;
95% CI [0.82-2.30]; I2=44%) while there was a trend towards lower risk of
HALT in the presence of CKD (OR 0.76; 95% CI [0.49-1.19]; I2=0%); these
trends did not reach statistical significance. This meta-analysis shows
that the occurrence of HALT following TAVR is associated with a greater
post-procedural mean aortic valve gradient but no excess risk of death or
cerebrovascular events. The clinical significance of this higher
post-procedural mean aortic valve gradient is uncertain and requires
further investigations.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<93>
Accession Number
2017527001
Title
Outcomes of Coronary Artery Bypass Grafting in Patients With Poor
Myocardial Viability: A Systematic Review and Meta-Analysis of the Last
Decade.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Sharma V.J.; Arghami A.; Pasupala D.; Haddad A.; Ke J.X.C.
Institution
(Sharma) Department of Cardiac Surgery, Austin Health, Heidelberg,
Melbourne, VIC, Australia
(Sharma) Department of Surgery (Austin Health), Melbourne Medical School,
Heidelberg, Melbourne, VIC, Australia
(Arghami) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
(Pasupala) Department of Cardiology, MercyOne North Iowa Medical Center,
Mason City, IA, United States
(Ke) Department of Anesthesia, Pain Management & Perioperative Medicine,
Dalhousie University, Halifax, Canada
(Ke) Department of Anesthesia, Providence Health Care, Vancouver, Canada
(Ke) Department of Anesthesiology, Pharmacology and Therapeutics, Faculty
of Medicine, University of British Columbia, Vancouver, Canada
(Sharma, Arghami, Pasupala, Haddad, Ke) Harvard T.H. Chan School of Public
Health, Harvard University, Boston, MA, United States
Publisher
Elsevier Ltd
Abstract
Objectives: Our objective is to assess whether the presence of myocardial
viability is a predictor of mortality among patients undergoing coronary
artery bypasss grafting (CABG) through a systematic review meta-analysis.
<br/>Method(s): Comprehensive review of EMBASE and PubMed in accordance
with PRISMA guidelines, including studies of patients undergoing CABG with
assessment of myocardial viability and recorded long-term mortality, age
and sex. Studies were restricted to the last decade, and data were
stratified by imaging modality (magnetic resonance imaging [MRI] or
nuclear medicine). Random-effects model for assessing pooled effect,
heterogeneity assessment using Chi-square and I² statistics,
publication bias assessed by funnel plots and Egger's test.
<br/>Result(s): Meta-analysis of contemporary data (January 2010 to
October 2020) yielded 3,621 manuscripts of which 92 were relevant, and 6
appropriate for inclusion with 993 patients. Pooled analysis showed that
patients with non-viable myocardium undergoing CABG are at 1.34 times the
risk of mortality compared to those with viable myocardium (95% CI
1.01-1.79 p=0.05). Subgroup analysis of the MRI or nuclear medicine
modalities was not statistically significant and there was no confounding
by age or sex in meta-regression. There was significant heterogeneity in
imaging modality and diagnostic criteria, but heterogeneity between study
findings was low with an I² statistic of 29%. The risk of
publication bias was moderate on the Newcastle-Ottawa Scale), but not
statistically significant (Egger's Test coefficient=1.3 95%CI -0.35-2.61
p=0.10). <br/>Conclusion(s): There is a multitude of methods for assessing
cardiac viability for coronary revascularisation surgery, making
meta-analyses fraught with limitations. Our meta-analysis demonstrates
that the finding of non-viable myocardium can not be used draw conclusions
for risk assessment in coronary surgery.<br/>Copyright &#xa9; 2022

<94>
Accession Number
2017525595
Title
Impact of oral or enteral nutritional support on clinical outcomes of
patients subjected to cardiac surgery: A systematic review.
Source
Clinical Nutrition ESPEN. (no pagination), 2022. Date of Publication:
2022.
Author
Avancini L.; de abreu Silva L.; da Silva V.R.; Duarte C.K.
Institution
(Avancini, da Silva) Unidade Multiprofissional e Reabilitacao - Nutricao
Clinica, Hospital das Clinicas da Universidade Federal de Minas Gerais,
Brazil
(de abreu Silva, Duarte) Departamento de Nutricao da Escola de Enfermagem
da Universidade Federal de Minas Gerais, Brazil
Publisher
Elsevier Ltd
Abstract
Background: Cardiovascular diseases represent the leading cause of death
worldwide, in addition to having a direct negative impact on quality of
life, functional capacity and nutritional status. Studies show high
prevalence of malnutrition in patients undergoing cardiac surgery. It is
known that cardiac surgery can also lead to changes in nutritional status,
through surgical trauma, systemic inflammation and, often, delay in the
initiation of nutritional support. On the other hand, the role of
nutritional support as a driver of clinical outcomes in different surgical
populations is well described in the literature. <br/>Objective(s): To
review the literature in order to assess the effect of perioperative oral
or enteral nutritional support on clinical outcomes of cardiac patients
undergoing cardiac surgery. Methodology: The search was conducted in
February 2021 in the following databases: EMBASE, PubMed/MEDLINE, Scopus
and Web of Science. Randomized clinical trials (RCT) and retrospective
studies were selected, carried out with patients with heart disease,
undergoing cardiac surgery and aged 18 years or over. The Outcomes of
interest were: length of hospital stay, length of stay in the ICU, time on
ventilatory support, mortality rate, clinical complications and use of
vasoactive drugs in the postoperative period. <br/>Result(s): Ten studies
were included in this systematic review, of which 7 were RCTs and 3 were
cohorts. The most prevalent surgery was myocardial revascularization. Six
studies evaluated oral nutritional support, two enteral nutritional
support and two analyzed both. Two studies found a significant reduction
in the length of hospital and ICU staying associated with preoperative
intake of carbohydrate-based beverages. Only one study observed a
significant reduction in the requirement for ventilatory support after
cardiac surgery, after preoperative carbohydrate-based drinks and early
postoperative enteral nutrition. There was no influence of nutritional
support on mechanical ventilation length and mortality.
<br/>Conclusion(s): Most studies showed that nutritional support did not
reduce hospital and ICU staying. Nutritional support benefits were
demonstrated in studies that offered preoperative oral carbohydrate
drinks. No association was observed between nutritional support and
duration of mechanical ventilation or mortality rate. Most studies did not
find any influence of nutritional support on the need and/or dosage of
vasoactive drugs in the postoperative period of cardiac
surgery.<br/>Copyright &#xa9; 2022 European Society for Clinical Nutrition
and Metabolism

<95>
[Use Link to view the full text]
Accession Number
637651058
Title
A holistic investigation of the global outcomes of spontaneous
pneumothorax during 1980-2021, including the COVID-19 pandemic A
bibliometric approach.
Source
Medicine. 101(11) (no pagination), 2022. Date of Publication: 18 Mar 2022.
Author
Baldemir R.; Ulger G.
Publisher
NLM (Medline)
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2022 the Author(s). Published by Wolters
Kluwer Health, Inc.

<96>
Accession Number
2015431120
Title
Effect of high-flow nasal therapy on patient-centred outcomes in patients
at high risk of postoperative pulmonary complications after cardiac
surgery: a study protocol for a multicentre adaptive randomised controlled
trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 232. Date of
Publication: December 2022.
Author
Earwaker M.; Villar S.; Fox-Rushby J.; Duckworth M.; Dawson S.; Steele J.;
Chiu Y.-D.; Litton E.; Kunst G.; Murphy G.; Martinez G.; Zochios V.; Brown
V.; Brown G.; Klein A.
Institution
(Earwaker, Duckworth, Steele, Brown, Brown) Papworth Trials Unit
Collaboration, Royal Papworth Hospital, Cambridge, United Kingdom
(Villar, Dawson) MRC Biostatistics Unit, Cambridge University, Cambridge,
United Kingdom
(Fox-Rushby, Kunst) King's College London, London, United Kingdom
(Chiu, Martinez) Papworth Trials Unit, Royal Papworth Hospital, Cambridge,
United Kingdom
(Litton) Intensive Care Unit, Fiona Stanley Hospital, Perth, WA, Australia
(Murphy) University of Leicester, Leicester, United Kingdom
(Zochios) University Hospitals Birmingham, Birmingham, United Kingdom
(Klein) Department of Anaesthesia, Royal Papworth Hospital, Cambridge,
United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: High-flow nasal therapy is a non-invasive form of respiratory
support that delivers low-level, flow dependent positive airway pressure.
The device can be better tolerated by patients than alternatives such as
continuous positive airway pressure. The primary objective is to determine
if prophylactic high-flow nasal therapy after tracheal extubation can
result in an increase in the number of days alive and at home within the
first 90 days after surgery, when compared with standard oxygen therapy.
The co-primary objective is to estimate the incremental cost-effectiveness
and cost-utility of high-flow nasal therapy vs standard oxygen therapy at
90 days, from the view-point of the public sector, the health service and
patients. <br/>Method(s): This is an adaptive, multicentre, international
parallel-group, randomised controlled trial with embedded
cost-effectiveness analysis comparing the use of high-flow nasal therapy
with control in patients at high risk of respiratory complications
following cardiac surgery. Participants will be randomised before tracheal
extubation and allocated either high-flow nasal therapy or standard oxygen
therapy for a minimum of 16 h immediately post extubation. Participants
will be followed up until 90 days after surgery. The total sample size
needed to detect a 2-day increase in DAH90 with 90% power with an
intention to treat analysis is 850 patients. The adaptive design includes
an interim sample size re-estimation which will provide protection against
deviations from the original sample size assumptions made from the
single-centre pilot study and will allow for a maximum sample size
increase to 1152 patients. <br/>Discussion(s): Evidence to support routine
use of high-flow nasal therapy will inform the development of effective
enhanced recovery care bundles. Reducing complications should reduce
length of stay and re-admission to hospital and provide an important focus
for cost reduction. However; high-quality studies evaluating the clinical
and cost effectiveness of high-flow nasal therapy after cardiothoracic
surgery are lacking. Trial registration: The study has been registered
with ISRCTN (ISRCTN14092678, 13/05/2020) Clinicaltrials.gov Registration
Pending<br/>Copyright &#xa9; 2022, The Author(s).

<97>
Accession Number
2015415997
Title
GLP-1 Receptor Agonists and Coronary Arteries: From Mechanisms to Events.
Source
Frontiers in Pharmacology. 13 (no pagination), 2022. Article Number:
856111. Date of Publication: 08 Mar 2022.
Author
Pahud de Mortanges A.; Sinaci E.; Salvador D.; Bally L.; Muka T.; Wilhelm
M.; Bano A.
Institution
(Pahud de Mortanges, Sinaci) Faculty of Medicine, University of Bern,
Bern, Switzerland
(Salvador, Muka, Bano) Institute of Social and Preventive Medicine,
University of Bern, Bern, Switzerland
(Salvador, Wilhelm, Bano) Department of Cardiology, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
(Bally) Department of Diabetes, Endocrinology, Nutritional Medicine, and
Metabolism, Inselspital, Bern University Hospital, University of Bern,
Bern, Switzerland
Publisher
Frontiers Media S.A.
Abstract
Objective: Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) lower
plasma glucose through effects on insulin and glucagon secretion and by
decelerating gastric emptying. GLP-1 RAs have many beneficial effects
beyond glycemic control, including a protective role on the cardiovascular
system. However, underlying mechanisms linking GLP-1 RAs with coronary
artery disease are complex and not fully elucidated. In this mini-review,
we discuss these mechanisms and subsequent clinical events. <br/>Data
Sources: We searched PubMed and Google Scholar for evidence on GLP-1 RAs
and coronary events. We did not apply restrictions on article type. We
reviewed publications for clinical relevance. Synopsis of Content: In the
first part, we review the current evidence concerning the role of GLP-1
RAs on potential mechanisms underlying the development of coronary events.
Specifically, we discuss the role of GLP-1 RAs on atherosclerosis and
vasospasms of epicardial coronary arteries, as well as
structural/functional changes of coronary microvasculature. In the second
part, we summarize the clinical evidence on the impact of GLP-1 RAs in the
prevention of acute and chronic coronary syndromes and coronary
revascularization. We conclude by discussing existing gaps in the
literature and proposing directions for future research.<br/>Copyright
&#xa9; 2022 Pahud de Mortanges, Sinaci, Salvador, Bally, Muka, Wilhelm and
Bano.

<98>
Accession Number
2015408718
Title
Postoperative outcomes in surgical patients with obstructive sleep apnoea
diagnosed by sleep studies: a meta-analysis and trial sequential analysis.
Source
Anaesthesia. (no pagination), 2022. Date of Publication: 2022.
Author
Pivetta B.; Sun Y.; Nagappa M.; Chan M.; Englesakis M.; Chung F.
Institution
(Pivetta, Sun) Department of Anaesthesia and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Nagappa) Department of Anaesthesia and Peri-Operative Medicine, London
Health Sciences Centre and St. Joseph Health Care, Schulich School of
Medicine and Dentistry, Western University, London, ON, Canada
(Chan) Department of Anaesthesia and Intensive Care, Chinese University of
Hong Kong, Hong Kong
(Englesakis) Library and Information Services, University Health Network,
Toronto, ON, Canada
(Chung) University Health Network, University of Toronto, Toronto, ON,
Canada
Publisher
John Wiley and Sons Inc
Abstract
Identifying surgical patients with obstructive sleep apnoea may assist
with anaesthetic management to minimise postoperative complications. Using
trial sequential analysis, we evaluated the impact of obstructive sleep
apnoea diagnosed by polysomnography or home sleep apnoea testing on
postoperative outcomes in surgical patients. Multiple databases were
systematically searched. Outcomes included: total postoperative
complications, systemic complications (cardiovascular, respiratory,
neurological, renal, infectious) and specific complications (atrial
fibrillation, myocardial infarction, combined hospital and intensive care
unit re-admission, mortality). The pooled odds ratios of postoperative
complications were evaluated by the Mantel-Haenszel method random-effects
model. Meta-analysis and meta-regression were conducted, and the GRADE
approach was used to evaluate the certainty of evidence. Twenty
prospective cohort studies with 3756 patients (2127 obstructive sleep
apnoea and 1629 non-obstructive sleep apnoea) were included (9 in
non-cardiac surgery and 11 in cardiac surgery). Postoperative
complications were almost two-fold higher with obstructive sleep apnoea,
OR (95%CI) 1.92 (1.52-2.42), p < 0.001; certainty of evidence, moderate.
Obstructive sleep apnoea was associated with a 1.5 times increased risk of
postoperative cardiovascular complications, OR (95%CI) 1.56 (1.20-2.02), p
= 0.001; certainty of evidence, moderate; an almost two-fold increase in
respiratory complications, OR (95%CI) 1.91 (1.39-2.62), p < 0.001;
certainty of evidence, moderate; and hospital and ICU re-admission, OR
(95%CI) 2.25 (1.21-4.19), p = 0.01; certainty of evidence, low. Trial
sequential analysis showed adequate information size for postoperative
complications. Baseline confounding factors were adjusted by
meta-regression, and the sub-group analysis did not materially change our
results. This increased risk occurred especially in patients in whom
obstructive sleep apnoea had been newly diagnosed, emphasising the
importance of pre-operative screening.<br/>Copyright &#xa9; 2022
Association of Anaesthetists.

<99>
Accession Number
2015364439
Title
Early and late outcomes of surgical aortic valve replacement with
sutureless and rapid-deployment valves versus transcatheter aortic valve
implantation: Meta-analysis with reconstructed time-to-event data of
matched studies.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Michel Pompeu S.a.; Jabagi H.; Dokollari A.; Awad A.K.; Van den Eynde J.;
Malin J.H.; Sicouri S.; Torregrossa G.; Ruhparwar A.; Weymann A.; Ramlawi
B.
Institution
(Michel Pompeu, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Malin, Sicouri, Torregrossa, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
Wynnewood, PA, United States
(Jabagi) Department of Cardiothoracic Surgery, Valley Heart and Vascular
Institute, Ridgewood, NJ, United States
(Dokollari) Division of Cardiac Surgery, St Michael's Hospital, University
of Toronto, Toronto, ON, Canada
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(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
Sutureless/rapid-deployment (SURD) valves are options different from the
stented prostheses included in the pivotal trials comparing surgical
aortic valve replacement (AVR) and transcatheter aortic valve implantation
(TAVI). We performed a meta-analysis with reconstructed time-to-event data
of matched studies published by November 2021 to compare SURD-AVR and
TAVI. Primary endpoints were 30-day mortality and overall survival in the
follow-up. Secondary endpoints included: 30-day stroke, acute kidney
injury (AKI), major bleeding, permanent pacemaker implantation (PPI),
paravalvular leak (PVL), prosthesis-patient mismatch (PPM), postoperative
aortic valve area (AVA), and mean gradients. Ten studies met our
eligibility criteria, including a total of 5134 patients (2567 underwent
SURD-AVR and 2567 underwent TAVI). Pooled risk of 30-day mortality did not
favor any group (odds ratio [OR]: 0.69; 95% confidence interval [CI]:
0.31-1.53; p = 0.360). Patients undergoing SURD-AVR had lower risk of PVL
(OR: 0.09; 95% CI: 0.05-0.17; p < 0.001). No statistically significant
differences were observed for 30-day stroke, AKI, major bleeding, PPI,
PPM, and postoperative AVA. In the follow-up, we observed a higher risk of
mortality (hazard ratio: 1.74; 95% CI: 1.26-2.40; p < 0.001) with TAVI.
Patients who underwent SURD-AVR experienced better survival, however, the
interpretation of these results warrant caution due to the fact that
SURD-AVR patients tended to be younger than TAVI patients. Structural
heart surgeons and interventional cardiologists should consider initial
risk and life expectancy when referring patients for one approach over the
other.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC

<100>
Accession Number
2015421676
Title
Current trends in minimally invasive valve-sparing aortic root
replacement-Best available evidence.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
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. <br/>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 <br/>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.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<101>
Accession Number
637637473
Title
Concomitant surgical ablation for treatment of atrial fibrillation in
patients undergoing cardiac surgery.
Source
Reviews in cardiovascular medicine. 23(3) (pp 101), 2022. Date of
Publication: 16 Mar 2022.
Author
Dominici C.; Chello M.
Institution
(Dominici, Chello) Cardiovascular Surgery, Universita Campus Bio-Medico di
Roma, Rome 00128, Italy
Publisher
NLM (Medline)
Abstract
Surgical ablation is a well-established therapy for patients with atrial
fibrillation (AF) undergoing cardiac surgery. However, it is not clear if
this translates to an improvement in patient important outcomes such as
mortality, stroke, and quality of life (QoL). Electronic searches were
performed of Ovid Medline and PubMed from their inception to October 2021.
Eligible literature included comparative studies with patient undergoing
surgical ablative treatment for AF concomitant to any cardiac surgery
procedure and patients without specific AF treatment. For this paper, the
studies listed are presented descriptively without statistical processing
or collection of a meta-analysis. Freedom from AF at 1 year was
consistently shown to be improved by surgical ablation. No differences in
30-day mortality or in safety outcomes were observed between the group who
received ablation and the control group. A significant increase in
pacemaker implantation in the ablation group was generally detected among
studies, especially if the lesions were biatrial. Amongst the studies that
reported on health-related quality of life (HRQoL) a statistically
significant improvement was seen in the ablation group over the control,
especially in the physical domains. Surgical ablation is the most
effective procedure to treat AF during cardiac surgery, and it is a unique
opportunity to return to sinus rhythm with no added mortality risk and a
potential improvement in quality of life. There is however an increased
risk of pacemaker implantation and complications such as renal failure
which must be weighed with tailored treatment and patient selection. It is
also not clear how long-term outcomes are affected due to underpowered
randomized controlled trials. This review summarized short term outcomes
of concomitant AF treatment during cardiac surgery and highlight the
importance of reporting long-term outcomes to confirm the
benefits.<br/>Copyright &#xa9; 2022 The Author(s). Published by IMR Press.

<102>
Accession Number
637637344
Title
The role of surgery for secondary mitral regurgitation and heart failure
in the era of transcatheter mitral valve therapies.
Source
Reviews in cardiovascular medicine. 23(3) (pp 87), 2022. Date of
Publication: 04 Mar 2022.
Author
Noly P.-E.; Pagani F.D.; Obadia J.-F.; Bouchard D.; Bolling S.F.; Ailawadi
G.; Tang P.C.
Institution
(Noly, Bouchard) Department of Cardiac Surgery, University of Montreal,
Montreal, Canada
(Noly, Pagani, Bolling, Ailawadi, Tang) Department of Cardiac Surgery,
University of Michigan, Ann Arbor, United States
(Obadia) Department of Cardiac Surgery, "Louis Pradel" Cardiologic
Hospital, Lyon 69001, France
Publisher
NLM (Medline)
Abstract
The approach to the management of mitral valve (MV) disease and heart
failure (HF) has dramatically changed over the last decades. It is well
recognized that severe mitral regurgitation secondary to ischemic or
non-ischemic cardiomyopathy is associated with an excess risk of
mortality. Understanding the impact of the surgical treatment modality on
mortality outcomes has been difficult due to the broad spectrum of
secondary mitral regurgitation (SMR) phenotypes and lack of randomized
surgical clinical trials. Over the last 30 years, surgeons have failed to
provide compelling evidence to convince the medical community of the need
to treat SMR in patients with severe HF. Therefore, the surgical treatment
of SMR has never gained uniform acceptance as a significant option among
patients suffering from SMR. Recent evidence from randomized trials in a
non-surgical eligible patients treated with transcatheter therapies, has
provided a new perspective on SMR treatment. Recently published European
and American guidelines confirm the key role of percutaneous treatment of
SMR and in parallel, these guidelines reinforce the role of mitral valve
surgery in patients who require surgical revascularization. Complex mitral
valve repair combining subvalvular apparatus repair along with
annuloplasty seems to be a promising approach in selected patients in
selected centers. Meanwhile, mitral valve replacement has become the
preferred surgical strategy in most patients with advanced heart failure
and severe LV remodeling or high risk of recurrent mitral regurgitation.
In this comprehensive review, we aimed to discuss the role of mitral
surgery for SMR in patients with heart failure in the contemporary era and
to provide a practical approach for its surgical management.<br/>Copyright
&#xa9; 2022 The Author(s). Published by IMR Press.

<103>
Accession Number
637636498
Title
Remifentanil versus Dexmedetomidine in Cardiac Surgery Patients with
Noninvasive Ventilation Intolerance: Protocol for the REDNIVI Trial.
Source
Reviews in cardiovascular medicine. 23(3) (pp 84), 2022. Date of
Publication: 04 Mar 2022.
Author
Luo M.-H.; Hao G.-W.; Liu K.; Yin K.; Yu S.-J.; Wang H.; Su Y.; Luo J.-C.;
Wei Y.-Q.; Wang Y.-H.; Pan W.-Q.; Tu G.-W.; Luo Z.
Institution
(Luo, Wei, Wang, Pan) Shanghai Medical College, Fudan University, Shanghai
200032, China
(Hao, Liu, Yu, Wang, Su, Luo, Tu, Luo) Department of Critical Care
Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
(Yin) Department of Surgery, Massachusetts General Hospital, Harvard
Medical School, Boston MA 02114, United States
(Luo) Department of Critical Care Medicine, Xiamen Branch, Zhongshan
Hospital, Fudan University, Xiamen, Fujian 361015, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Respiratory failure is one of the most common complications
following cardiac surgery. Although noninvasive ventilation (NIV) has been
an effective treatment, it has a high rate of intolerance. Both
remifentanil and dexmedetomidine are used as sedatives in cardiac surgery
(CS) patients with NIV intolerance. However, no randomized controlled
trials have compared the effects of these drugs in relieving the
intolerance. <br/>METHOD(S): REDNIVI will be a multicenter, prospective,
single-blind, randomized controlled trial carried out in six clinical
sites in China. Subjects with NIV intolerance will be randomized to
receive remifentanil or dexmedetomidine in a ratio of 1:1. Primary
outcomes of intolerance remission rate at different timings (15 minutes,
1, 3, 6, 12, 24, 36, 48, 60, 72 hours after initiation of treatment) and
72 h average remission rate will be determined. In addition, secondary
outcomes such as mortality, duration of intensive care unit (ICU) stay,
duration of mechanical ventilation (MV), the need for endotracheal
intubation, hemodynamic changes, and delirium incidence will also be
determined. <br/>CONCLUSION(S): This trial will provide evidence to
determine the effects of remifentanil and dexmedetomidine in patients with
NIV intolerance after cardiac surgery. CLINICAL TRIAL REGISTRATION: This
study has been registered on ClinicalTrials.gov
(NCT04734418).<br/>Copyright &#xa9; 2022 The Author(s). Published by IMR
Press.

<104>
Accession Number
637636489
Title
Learning from Controversy and Revisiting the Randomized Trials of
Secondary Mitral Regurgitation.
Source
Reviews in cardiovascular medicine. 23(3) (pp 88), 2022. Date of
Publication: 04 Mar 2022.
Author
Fiore A.; Avtaar Singh S.S.; Nappi F.
Institution
(Fiore) Department of Cardiac Surgery, University Hospitals Henri Mondor,
Assistance Publique-Hopitaux de Paris, Creteil 94000, France
(Fiore) Sapienza University of Rome, Rome 00185, Italy
(Avtaar Singh) Department of Cardiothoracic Surgery, Golden Jubilee
National Hospital, United Kingdom
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord,
France
Publisher
NLM (Medline)
Abstract
Until recently, conventional mitral valve surgery has been the treatment
of choice even in secondary mitral regurgitation. Recent evidence,
however, advocates the use of transcatheter edge-to-edge mitral valve
repair (TEER) of the mitral valve. This has been reflected by the change
in guidelines of the American College of Cardiology/American Heart
Association. We reviewed the literature to shed light on the risks and
benefits of all interventions, surgical, transcatheter and
guideline-directed medical therapy. Secondary mitral regurgitation occurs
due to an imbalance between closing forces and tethering forces. Given the
pathology extends beyond the valve alone, treatment should be directed at
restoring the geometrical shape of the left ventricle alongside the valve.
Myocardial revascularization plays a pivotal role in preventing
recurrence. The role of papillary muscle approximation in addition to
restrictive mitral annuloplasty should be considered in a select group of
patients. We also reviewed the current literature on TEERs from the COAPT
and Mitra-FR trials while highlighting the concept of
proportionate/disproportionate MR which may help identify which patients
benefit from mitral valve restoration. Treatment of this condition will
require robust randomized trials alongside the use of state-of-the-art
imaging technologies available with the full complement of the
multidisciplinary team to ensure the best outcomes for each
patient.<br/>Copyright &#xa9; 2022 The Author(s). Published by IMR Press.

<105>
Accession Number
637648145
Title
How do type of preoperative P2Y<inf>12</inf> receptor inhibitor and
withdrawal time affect bleeding? Protocol of a systematic review and
individual patient data meta-analysis.
Source
BMJ open. 12(3) (pp e060404), 2022. Date of Publication: 28 Mar 2022.
Author
Schoerghuber M.; Pregartner G.; Berghold A.; Lindenau I.; Zweiker R.;
Voetsch A.; Mahla E.; Zirlik A.
Institution
(Schoerghuber, Lindenau, Mahla) Division of Anesthesiology for
Cardiovascular Surgery and Intensive Care Medicine, Medical University of
Graz, Graz, Austria
(Pregartner, Berghold) Institute for Medical Informatics, Statistics and
Documentation, Medical University of Graz, Graz, Austria
(Lindenau) Department of Anesthesiology and Intensive Care Medicine,
Hospital Hochsteiermark, Steiermarkische Krankenanstaltengesellschaft mbH,
Leoben, Austria
(Zweiker, Zirlik) Division of Cardiology, Department of Internal Medicine,
Medical University of Graz, Graz, Austria
(Voetsch) Department of Cardiovascular and Endovascular Surgery,
Paracelsus Medical University Salzburg, Salzburg, Austria
Publisher
NLM (Medline)
Abstract
INTRODUCTION: In order to reduce the risk of bleeding in patients on P2Y12
receptor inhibitors presenting for non-emergent coronary artery bypass
grafting (CABG), current guidelines recommend a preoperative
discontinuation period of at least three, five and seven days for
ticagrelor, clopidogrel and prasugrel, respectively, to allow for recovery
of platelet function. However, there is still substantial
interinstitutional variation in preoperative management and relevant
covariates of CABG-related bleeding are largely elusive so far. METHODS
AND ANALYSIS: We will search PubMed (July 2013 to November 2021) and
EMBASE (January 2014 to November 2021) using the following terms, MeSH
terms and their synonyms: clopidogrel, prasugrel, ticagrelor, dual
antiplatelet, P2Y12 receptor inhibitor, CABG, bleeding, haemorrhage. Two
independent reviewers will screen all abstracts and full papers for
eligibility. Disagreements will be solved by consulting with a third
reviewer.The primary outcome is the incidence of Bleeding Academic
Research Consortium type-4 bleeding depending on type of P2Y12 receptor
inhibitor and preoperative withdrawal period. The secondary outcomes are
mortality and ischaemic events according to the Academic Research
Consortium 2 Consensus Document. We will perform an individual patient
data meta-analysis (IPD-MA) with drug-specific preoperative withdrawal
time and adjust for demographic and procedural variables. Subgroup
analyses will be performed for anaemic patients and patients undergoing
non-emergent versus urgent/emergent surgery. ETHICS AND DISSEMINATION:
This IPD-MA consists of secondary analyses of existing non-identifiable
data and meets the criteria for waiver of ethics review by the local
Research Ethics Committee. Data sharing and transfer will be subject to a
confidentiality agreement and a data use agreement. Findings will be
disseminated through peer-reviewed publication and conference
presentation. PROSPERO REGISTRATION NUMBER: CRD42022291946.<br/>Copyright
&#xa9; Author(s) (or their employer(s)) 2022. Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

<106>
Accession Number
637616451
Title
Sublingual microcirculatory alterations during the immediate and early
postoperative period: A systematic review and meta-analysis.
Source
Clinical Hemorheology and Microcirculation. 80(3) (pp 253-265), 2022. Date
of Publication: 2022.
Author
Chalkias A.; Papagiannakis N.; Mavrovounis G.; Kolonia K.; Mermiri M.;
Pantazopoulos I.; Laou E.; Arnaoutoglou E.
Institution
(Chalkias, Kolonia, Mermiri, Laou, Arnaoutoglou) Department of
Anesthesiology, Faculty of Medicine, University of Thessaly, University
Hospital of Larisa, C' Wing, 2nd Floor, Mezourlo, Larisa PC41110, Greece
(Chalkias) Outcomes Research Consortium, Cleveland, OH, United States
(Papagiannakis) First Department of Neurology, National and Kapodistrian
University of Athens, Medical School, Athens, Greece
(Mavrovounis, Pantazopoulos) Department of Emergency Medicine, Faculty of
Medicine, University of Thessaly, Larisa, Greece
Publisher
IOS Press BV
Abstract
BACKGROUND: The incidence of postoperative microcirculatory flow
alterations and their effect on outcome have not been studied extensively.
<br/>OBJECTIVE(S): This systematic review and meta-analysis were designed
to investigate the presence of sublingual microcirculatory flow
alterations during the immediate and early postoperative period and their
correlation with complications and survival. <br/>METHOD(S): A systematic
search of PubMed, Scopus, Embase, PubMed Central, and Google Scholar was
conducted for relevant articles from January 2000 to March 2021.
Eligibility criteria were randomized controlled and non-randomized trials.
Case reports, case series, review papers, animal studies and non-English
literature were excluded. The primary outcome was the assessment of
sublingual microcirculatory alterations during the immediate and early
postoperative period in adult patients undergoing surgery. Risk of bias
was assessed with the Ottawa-Newcastle scale. Standard meta-analysis
methods (random-effects models) were used to assess the difference in
microcirculation variables. <br/>RESULT(S): Thirteen studies were
included. No statistically significant difference was found between
preoperative and postoperative total vessel density (p=0.084; Standardized
Mean Difference (SMD): -0.029; 95%CI: -0.31 to 0.26; I2=22.55%). Perfused
vessel density significantly decreased postoperatively (p=0.035; SMD:
0.344; 95%CI: 0.02 to 0.66; I2=65.66%), while perfused boundary region
significantly increased postoperatively (p=0.031; SMD: -0.415; 95%CI:
-0.79 to -0.03; I2=37.21%). Microvascular flow index significantly
decreased postoperatively (p=0.028; SMD: 0.587; 95%CI: 0.06 to 1.11;
I2=86.09%), while no statistically significant difference was found
between preoperative and postoperative proportion of perfused vessels
(p=0.089; SMD: 0.53; 95%CI: -0.08 to 1.14; I2=70.71%). The results of the
non-cardiac surgery post-hoc analysis were comparable except that no
statistically significant difference in perfused vessel density was found
(p=0.69; SMD: 0.07; 95%CI: -0.26 to 0.39; I2=0%). LIMITATIONS: The
included studies investigate heterogeneous groups of surgical patients.
There were no randomized controlled trials. <br/>CONCLUSION(S):
Significant sublingual microcirculatory flow alterations are present
during the immediate and early postoperative period. Further research is
required to estimate the correlation of sublingual microcirculatory flow
impairment with complications and survival. <br/>Copyright &#xa9; 2022 -
IOS Press. All rights reserved.

<107>
Accession Number
637647089
Title
Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients
With Drug-Refractory Hypertrophic Obstructive Cardiomyopathy.
Source
JAMA cardiology. (no pagination), 2022. Date of Publication: 30 Mar 2022.
Author
Zhou M.; Ta S.; Hahn R.T.; Hsi D.H.; Leon M.B.; Hu R.; Zhang J.; Zuo L.;
Li J.; Wang J.; Wang B.; Zhu X.; Han Y.; Li X.; Xu B.; Zhang L.; Hou L.;
Han C.; Liu J.; Liu L.
Institution
(Zhou, Ta, Hu, Zhang, Zuo, Li, Wang, Wang, Zhu, Liu, Han, Li, Zhang, Han,
Liu) Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound,
Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
(Hahn, Leon) Columbia University Medical Center/New York Presbyterian
Hospital, University of Columbia College of Physicians and Surgeons, NY
(Hsi) Heart & Vascular Institute, Stamford Hospital, Stamford, CT
(Hsi) University of Columbia College of Physicians and Surgeons, NY
(Zhang) Department of Ultrasound, Xi'an New Changan Maternity Hospital,
Xi'an, Shaanxi, China
(Xu, Liu) Xijing Hypertrophic Cardiomyopathy Center, Department of Cardiac
Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an,
Shaanxi, China
(Zhang) Department of Cardiology, Xi'an No. 3 Hospital, Northwest
University, Xi'an, Shaanxi, China
(Hou) Xijing Hypertrophic Cardiomyopathy Center, Department of
Anesthesiology, Xijing Hospital, Fourth Military Medical University,
Xi'an, Shaanxi, China
Publisher
NLM (Medline)
Abstract
Importance: Patients with hypertrophic obstructive cardiomyopathy (HOCM)
and drug-refractory symptoms and outflow gradients have limited
nonsurgical treatment options. The feasibility of percutaneous
intramyocardial septal radiofrequency ablation (PIMSRA) has been reported
previously; however, procedural and medium-term outcomes are unknown.
<br/>Objective(s): To describe the safety and medium-term outcomes of
PIMSRA in a large patient cohort with drug-refractory HOCM. <br/>Design,
Setting, and Participant(s): This was a single-arm, open-label study of
PIMSRA in patients with drug-refractory HOCM. Patients presenting to the
Xijing Hospital in Xi'an, China, between October 2016 to June 2020 with
hypertrophic cardiomyopathy. Of 1314 patients presenting with HOCM, 244
fulfilled inclusion criteria of severe resting/provoked outflow gradients
of 50 mm Hg or higher, and symptoms of New York Heart Association
functional class of II or higher refractory to maximum tolerated
medications. After discussion among the heart team, 40 patients underwent
surgical or alcohol septal reduction therapy and 4 required treatment of
significant coronary artery disease. <br/>Intervention(s): PIMSRA
performed in patients. <br/>Main Outcomes and Measures: The primary
outcome was 30-day major adverse clinical events: death, emergency
surgery, severe effusion requiring intervention, procedure-related stroke,
bleeding, and stroke. Secondary outcomes included 30-day technical success
and 90-day improvement in outflow obstruction. <br/>Result(s): The mean
(SD) age of 200 patients was 46.9(14.0) years, and 125 (62.5%) were men.
Resting or provoked left ventricular outflow tract gradients were 50 mm Hg
or higher. The median (IQR) follow-up for all patients was 19 (6-50)
months. Thirty-day major adverse clinical events rate was 10.5% (n=21):
there were 2 in-hospital/30-day deaths (1.0%), 7 patients (3.5%) with
pericardial effusion requiring mini-thoracotomy, 12 patients (6%) with
pericardial effusion requiring pericardiocentesis, and no bleeding or
strokes. Other periprocedural complications included permanent right
bundle branch block in 5 patients (2.5%), resuscitated ventricular
fibrillation in 2 (1.0%), and septal branch aneurysm in 2 (1.0%). There
were no permanent pacemaker implantations. At follow-up, maximum septal
thickness was reduced from a mean (SD) of 24.0(5.1) mm to 17.3(4.4) mm
(P<.001), and left ventricular outflow tract gradient was decreased from a
mean (SD) of 79.0(53.0) mm Hg to 14.0(24.0) mm Hg (P<.001). Overall, 190
patients (96%) with HOCM were in New York Heart Association functional
class I or II at last follow-up. <br/>Conclusions and Relevance: This
study found that PIMSRA in patients with drug-refractory HOCM may be an
effective procedure for relief of left ventricular outflow tract
obstruction and symptoms with acceptable complication rates. These results
are encouraging and support the design of a randomized clinical trial
against well-established septal reduction therapies.

<108>
Accession Number
637640134
Title
Coenzyme Q10 as Adjunctive Therapy for Cardiovascular Disease and
Hypertension: A Systematic Review.
Source
The Journal of nutrition. (no pagination), 2022. Date of Publication: 28
Mar 2022.
Author
Sue-Ling C.B.; Abel W.M.; Sue-Ling K.
Institution
(Sue-Ling) University of South Carolina, Aiken, SC, United States
(Abel) School of Nursing, University of North Carolina at Charlotte,
Charlotte 28223, Saint Vincent and the Grenadines
(Sue-Ling) Department of Cardiology, University Hospital, Augusta 30904,
Georgia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Mitochondrial adenosine triphosphate (ATP) production requires
a small electron carrier, co-enzyme Q10 (CoQ10), which has been used as
adjunctive therapy in patients with cardiovascular disease (CVD) and
hypertension because of its bioenergetics and antioxidant properties.
Randomized controlled trials (RCTs) beyond the last two decades evaluating
CoQ10 added to conventional therapy resulted in mixed results and were
underpowered to address major clinical endpoints. <br/>OBJECTIVE(S): The
objective of this systematic review was to examine the impact of CoQ10
supplementation on older adults with CVD or hypertension in the last two
decades (2000-2020). <br/>METHOD(S): PubMed/MEDLINE, Cochrane Database,
CINAHL, and Google Scholar databases were searched systematically, as well
as manual review of references from selected studies, to identify RCTs or
cross-over studies evaluating the efficacy of CoQ10 supplementation. Data
extracted from selected studies include trial design and duration,
treatment, dose, participant characteristics, study variables, and
important findings. <br/>RESULT(S): A total of 14 studies (1067
participants) met the inclusion criteria. The effect of CoQ10
supplementation was examined among predominantly older adult males with
heart failure (n = 6), hypertension (n = 4), ischemic heart disease (n =
3), and preoperatively in patients scheduled for cardiac surgery (n = 1).
CoQ10 supplementation in patients with heart failure improved functional
capacity, increased CoQ10 serum levels, and led to fewer major adverse
cardiovascular events (MACE). CoQ10 had positive quantifiable effects on
inflammatory markers in patients with ischemic heart disease. Myocardial
hemodynamics improved in patients who received CoQ10 supplementation prior
to cardiac surgery. Effects on hypertension were inconclusive.
<br/>CONCLUSION(S): In predominantly older adult males with CVD or
hypertension, CoQ10 supplementation added to conventional therapy is safe
and offers benefits clinically and at the cellular level. However, results
of the trials need to be viewed with caution, and further studies are
indicated before wide spread usage of CoQ10 is recommended in all older
adults.<br/>Copyright Published by Oxford University Press on behalf of
the American Society for Nutrition 2022.

<109>
Accession Number
637640080
Title
Five-year results of Amaze: a randomized controlled trial of adjunct
surgery for atrial fibrillation.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 26 Mar 2022.
Author
Sharples L.D.; Mills C.; Chiu Y.-D.; Fynn S.; Holcombe H.M.; Nashef S.A.M.
Institution
(Sharples, Mills, Chiu, Fynn, Holcombe, Nashef) Royal Papworth Hospital,
Cambridge, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The Amaze trial showed that adding atrial fibrillation (AF)
surgery to cardiac operations increased return to sinus rhythm (SR)
without impact on quality of life or survival at 2 years. We report
outcomes to 5 years. <br/>METHOD(S): In a multicentre, phase III,
pragmatic, double-blind, randomized controlled superiority trial, cardiac
surgery patients with >3months of AF were randomized 1:1 to adjunct AF
surgery or control. Primary outcomes of 1-year SR restoration and 2-year
quality-adjusted survival were already reported. This study reports on
rhythm, survival, quality-adjusted survival, stroke, medication and safety
to 5 years. <br/>RESULT(S): Between 2009 and 2014, 352 patients were
randomized. By 5 years 79 died, 58 withdrew, 34 were lost to follow-up and
the remaining 182 provided data. AF surgery significantly increased the
odds of remaining in SR at 5 years {odds ratio=2.98 [95% confidence
interval (CI) 1.23, 7.17], P=0.015}. There was a non-significant decrease
in stroke incidence [odds ratio=0.605 (95% CI 0.284, 1.287), P=0.19], but
no improved survival [5-year survival: AF surgery 77.3% (95% CI 71.1%,
83.5%), controls 77.8% (95% CI 71.7%, 84.0%), P=0.85]. Quality-adjusted
survival difference was negligible (-0.03; 95% CI -0.33, 0.27, P=0.85).
The composite of survival free of stroke and AF was better in the AF
surgery group [odds ratio=2.34 (95% CI 1.03, 5.31)]. There were no other
differences. <br/>CONCLUSION(S): Adjunct AF surgery confers a higher rate
of SR to 5 years and a better composite outcome of survival free of stroke
and AF but has no impact on overall or quality-adjusted survival or other
clinical outcomes. CLINICAL TRIAL REGISTRATION NUMBER:
ISRCTN82731440.<br/>Copyright &#xa9; The Author(s) 2022. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<110>
Accession Number
637638166
Title
Confounders and co-interventions identified in non-randomized studies of
interventions.
Source
Journal of clinical epidemiology. (no pagination), 2022. Date of
Publication: 25 Mar 2022.
Author
Pufulete M.; Mahadevan K.; Johnson T.W.; Pithara C.; Redwood S.; Benedetto
U.; Higgins J.P.; Reeves B.C.
Institution
(Pufulete, Reeves) Bristol Trials Centre (Clinical Trials and Evaluation
Unit), Bristol Medical School, University of Bristol, Bristol, UK; NIHR
Biomedical Research Centre at University Hospitals Bristol and Weston NHS
Foundation Trust and the University of Bristol, Bristol, UK
(Mahadevan, Johnson, Benedetto) Bristol Heart Institute, Bristol, United
Kingdom
(Pithara, Redwood) National Institute for Health Research Applied Research
Collaboration West (NIHR ARC West) at University Hospitals Bristol and
Weston NHS Foundation Trust, United Kingdom
(Higgins) The National Institute for Health Research Applied Research
Collaboration West (NIHR ARC West) at University Hospitals Bristol and
Weston NHS Foundation Trust, UK; Population Health Sciences, Bristol
Medical School, University of Bristol, Bristol, UK; NIHR Biomedical
Research Centre at University Hospitals Bristol and Weston NHS Foundation
Trust and the University of Bristol, Bristol, UK
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To identify potential confounders and co-interventions
systematically to optimise control for confounding for three
non-randomized studies of interventions (NRSI) designed to quantify
bleeding in populations exposed to different dual antiplatelet therapies
(DAPT). STUDY DESIGN AND SETTING: Systematic review, interviews and
surveys with clinicians. We searched Ovid Medline, Ovid Embase and the
Cochrane Library to identify randomised controlled trials and cohort
studies of DAPT interventions. Two researchers independently screened
citations, identified eligible studies and extracted data. We conducted
individual semi structured interviews with 6 cardiologists and 6 cardiac
surgeons to elicit factors clinicians consider when they prescribe DAPT.
We administered two online surveys to members of professional cardiology
and cardiac surgery organisations. <br/>RESULT(S): We screened 2544
records, identified 322 eligible studies and extracted data from 47. We
identified 10 co-interventions and 70 potential confounders: review 31
(91%); interviews 19 (56%); surveys 31 (91%). 16/34 (47%) were identified
by all three methods while 3/34 (9%) were picked up by one method only.
<br/>CONCLUSION(S): The review identified the majority of factors, but the
interviews identified hard-to-measure factors such as perceived patient
adherence and local prescribing culture. The methods could, in principle,
be widely applied when designing or reviewing NRSI.<br/>Copyright &#xa9;
2022. Published by Elsevier Inc.

<111>
Accession Number
637635059
Title
Warm humidified CO2 insufflation improves pericardial integrity for
cardiac surgery. A randomized control study.
Source
The Journal of cardiovascular surgery. (no pagination), 2022. Date of
Publication: 28 Mar 2022.
Author
Segal R.; Mezzavia P.M.; Krieser R.B.; Sampurno S.; Taylor M.; Ramsay R.;
Kluger M.; Lee K.; Loh F.L.; Tatoulis J.; O'Keefe M.; Chen Y.; Sindoni T.;
Ng I.
Institution
(Segal, Mezzavia, Krieser, Kluger, Lee, Loh, Tatoulis, O'Keefe, Chen,
Sindoni) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Australia
(Segal, Ramsay, Lee, Tatoulis, O'Keefe, Ng) University of Melbourne,
Melbourne, Australia
(Sampurno, Taylor, Ramsay) Peter MacCallum Cancer Centre, Melbourne,
Australia
(Ng) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Flooding the surgical field with dry cold CO2 during
open-chamber cardiac surgery has been used to mitigate air entrainment
into the systemic circulation. However, exposing epithelial surfaces to
cold, dry gas causes tissue desiccation. This randomised controlled study
was designed to investigate whether the use of humidified warm CO2
insufflation into the cardiac cavity could reduce pericardial tissue
damage and the incidence of micro-emboli when compared to dry cold CO2
insufflation. <br/>METHOD(S): Forty adult patients requiring elective
open-chamber cardiac surgery were randomised to have either dry cold CO2
insufflation via a standard catheter or humidified warm CO2 insufflation
via the HumiGard device. The primary endpoint was biopsied pericardial
tissue damage, assessed using electron microscopy. We assessed the
percentage of microvilli and mesothelial damage, using a damage severity
score (DSS) system. We compared the proportion of patients who had less
damage, defined as DSS < 2. Secondary endpoints included the severity of
micro-emboli, by visual assessment of bubble load on transoesophageal
echocardiogram; lowest near infrared spectroscopy; total de-airing time;
highest cardio-pulmonary bypass sweep speed; hospital length of stay and
complications. <br/>RESULT(S): A higher proportion of patients in the
humidified warm CO2 group displayed conserved microvilli (47% vs 11%,
p=0.03) and preserved mesothelium (42% vs 5%, p=0.02) compared to the
control group. There were no differences in the secondary outcomes.
<br/>CONCLUSION(S): Humidified warm CO2 insufflation significantly reduced
pericardial epithelial damage when compared to dry cold CO2 insufflation
in open-chamber cardiac surgery. Further studies are warranted to look
into its potential clinical benefits.

<112>
Accession Number
637634737
Title
Hybrid revascularization vs coronary bypass for coronary artery disease: a
systematic review and meta-analysis.
Source
The Journal of cardiovascular surgery. (no pagination), 2022. Date of
Publication: 28 Mar 2022.
Author
Hinojosa-Gonzalez D.E.; Bueno-Gutierrez L.C.; Salan-Gomez M.;
Tellez-Garcia E.; Ramirez-Mulhern I.; Sepulveda-Gonzalez D.; Ramonfaur D.;
Roblesgil-Medrano A.; Flores-Villalba E.
Institution
(Hinojosa-Gonzalez, Bueno-Gutierrez, Salan-Gomez, Tellez-Garcia,
Ramirez-Mulhern, Sepulveda-Gonzalez, Roblesgil-Medrano) Tecnologico de
Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo
Leon, Mexico
(Ramonfaur) Division of Postgraduate Education, Harvard Medical School,
MA, Boston, United States
(Flores-Villalba) Tecnologico de Monterrey, Escuela de Medicina y Ciencias
de la Salud, Monterrey, Nuevo Leon, Mexico
(Flores-Villalba) Tecnologico de Monterrey, Escuela de Ingenieria y
Ciencias, Monterrey, Nuevo Leon, Mexico
(Flores-Villalba) Laboratorio Nacional de Manufactura Aditiva y Digital
(MADIT), Apodaca, Nuevo Leon, Mexico
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Coronary artery bypass graft is the mainstay of treatment
for multivessel coronary artery disease and is superior to percutaneous
coronary intervention. Combined approaches such as hybrid coronary
revascularization integrate coronary artery bypass grafting with
percutaneous coronary intervention during the same procedure or weeks
apart. These attempt to improve surgical morbidity and long-term outcomes.
EVIDENCE ACQUISITION: Per PRISMA criteria, a systematic review of keywords
"Hybrid revascularization", "Hybrid Coronary Revascularization",
"Surgical", "Surgery", "Treatment", "CABG", "HCR" and "PCI" was conducted
in PubMed, EMBASE and SCOPUS. Studies comparing this technique's
performance on either single or two-stage approach against traditional
multiple vessel coronary artery bypass grafting were screened and analyzed
for our review. EVIDENCE SYNTHESIS: Twenty-two studies totaling 6,981
participants were ultimately included for analysis. Mean differences in
operative time, bleeding, ventilator time and length of stay were
significantly lower in the hybrid coronary revascularization group. Odds
ratios in transfusions and in-hospital myocardial infarction were also
lower in the hybrid coronary revascularization group. Results for
in-hospital and all-cause mortality, major adverse cardiac events (MACE),
stroke, reintervention, and complete revascularization were not
significantly different. <br/>CONCLUSION(S): Our analysis shows hybrid
coronary revascularization is a feasible alternative to traditional
coronary artery bypass grafting. Short-and long-term outcomes including
mortality, MACE, and postoperative morbidity are similar between both
groups, while hybrid approaches are associated with decreased
perioperative morbidity.

<113>
Accession Number
637632454
Title
Whole Blood Adsorber During CPB and Need for Vasoactive Treatment After
Valve Surgery in Acute Endocarditis: A Randomized Controlled Study.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2022.
Date of Publication: 26 Feb 2022.
Author
Holmen A.; Corderfeldt A.; Lannemyr L.; Dellgren G.; Hansson E.C.
Institution
(Holmen, Corderfeldt) Department of Cardiothoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Lannemyr) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Department
of Anesthesia and Intensive Care, Institution of Clinical Sciences,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Dellgren) The Transplant Institute, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden; Department of Molecular and Clinical
Medicine, Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Hansson) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden; Department
of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska
Academy, University of Gothenburg, Gothenburg, Sweden
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Patients with endocarditis requiring urgent valvular surgery
with cardiopulmonary bypass are at a high risk of developing systemic
inflammatory response syndrome and septic shock, necessitating intensive
use of vasopressors after surgery. The use of a cytokine hemoadsorber
(CytoSorb, CytoSorbents Europe GmbH, Germany) during cardiac surgery has
been suggested to reduce the risk of inflammatory activation. The study
authors hypothesized that adding a cytokine adsorber would reduce cytokine
burden, which would translate into improved hemodynamic stability. DESIGN:
A randomized, controlled, nonblinded clinical trial. SETTING: At a
university hospital, tertiary referral center. PARTICIPANTS: Nineteen
patients with endocarditis undergoing valve surgery. INTERVENTION: A
cytokine hemoadsorber integrated into the cardiopulmonary bypass circuit.
MEASUREMENTS AND MAIN RESULTS: The accumulated norepinephrine dose in the
intervention group was half or less at all postoperative time points
compared to the control group, although it did not reach statistical
significance; at 24 and 48 hours (median 36 [25-75 percentiles; 12-57] mug
v 114 [25-559] mug, p = 0.11 and 36 [12-99] mug v 261 [25-689] mug, p =
0.09). There was no significant difference in chest tube output, but there
was a significantly lower need for the transfusion of red blood cells (285
[0-657] mL v 1,940 [883-2,148] mL, p = 0.03). <br/>CONCLUSION(S): There
was no statistically significant difference between the groups with regard
to vasopressor use after surgery for endocarditis with the use of a
cytokine hemoadsorber during cardiopulmonary bypass. Additional, larger
randomized controlled trials are needed to definitely assess the potential
effect.<br/>Copyright &#xa9; 2022 Elsevier Inc. All rights reserved.

<114>
Accession Number
2017425819
Title
The Role of Pericardial Window Techniques in the Management of Penetrating
Cardiac Injuries in the Hemodynamically Stable Patient: Where Does It Fit
in the Current Trauma Algorithm.
Source
Journal of Surgical Research. 276 (pp 120-135), 2022. Date of Publication:
August 2022.
Author
Selvakumar S.; Newsome K.; Nguyen T.; McKenny M.; Bilski T.; Elkbuli A.
Institution
(Selvakumar, Newsome, Nguyen, McKenny, Elkbuli) Division of Trauma and
Surgical Critical Care, Department of Surgery, Kendall Regional Medical
Center, Miami, Florida, United States
(McKenny) Department of Surgery, University of South Florida, Florida,
Tampa
(Bilski) Division of Trauma and Surgical Critical Care, Department of
Surgery, Orlando Regional Medical Center, Florida, Orlando
Publisher
Academic Press Inc.
Abstract
Introduction: Penetrating cardiac injuries (PCIs) have high in-hospital
mortality rates. Guidelines regarding the use of pericardial window (PW)
for diagnosis and treatment of suspected PCIs are not universally
established. The objective of this review was to provide a critical
appraisal of the current literature to determine the effectiveness and
safety of PW as both a diagnostic and therapeutic technique for suspected
PCIs in patients with hemodynamic stability. <br/>Method(s): A review was
conducted using PubMed/MEDLINE, Google Scholar, and Embase to identify
literature evaluating the accuracy and therapeutic efficacy of PW and its
role in a hemodynamically stable patient with penetrating thoracic or
thoracoabdominal trauma. <br/>Result(s): Eleven studies evaluating
diagnostic PW and two studies evaluating therapeutic PW were included.
These studies ranged from (y) 1977 to 2018. Existing literature indicates
that PW is highly sensitive (92%-100%) and specific (96%-100%) for the
diagnosis of suspected PCIs. PW and drainage, when compared with
sternotomy, may be associated with decreased total hospital stay (4.1
versus 6.5 d; P < 0.001) and intensive care unit stay (0.25 versus 2.04 d;
P < 0.001) along with similar mortality and complication rates after the
management of hemopericardium. <br/>Conclusion(s): In a hemodynamically
stable patient presenting with penetrating cardiac trauma with a high
suspicion for PCI, PWs can (1) facilitate prompt diagnosis in the event of
equivocal ultrasonography findings and (2) serve as an effective
therapeutic modality with the benefit of potentially avoiding more
invasive procedures. Subxiphoid, transdiaphragmatic, and laparoscopic
approaches for PW have been shown to have similar efficacy and
safety.<br/>Copyright &#xa9; 2022

<115>
Accession Number
2010154591
Title
Clinical outcomes in nonagenarians undergoing transcatheter aortic valve
implantation: a systematic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 37(1) (pp 202-208), 2022.
Date of Publication: January 2022.
Author
Noguchi M.; Ueyama H.; Ando T.; Takagi H.; Toshiki K.
Institution
(Noguchi) Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical
Center, Uyarasu, Japan
(Ueyama, Toshiki) Department of Medicine, Icahn School of Medicine at
Mount Sinai, Mount Sinai Beth Israel, New York, NY, United States
(Ando) Department of Cardiology, Kawasaki Saiwai Hospital, Kawasaki, Japan
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
Publisher
Springer Japan
Abstract
To compare the risk of procedural complications and mortality after
transcatheter aortic valve implantation (TAVI) in nonagenarians (age >= 90
years) compared to younger patients (< 90 years). Although TAVI could be
considered as a treatment option in nonagenarians, several previous
studies have shown conflicting outcomes between nonagenarians and younger
patients who underwent TAVI. We conducted a comprehensive literature
search through PubMed and EMBASE to investigate the clinical outcomes of
nonagenarians after TAVI. The outcomes of interest were short- and
long-term mortality and procedural complications. Our study identified 16
observational studies including a total of 179,565 patients (21,674
nonagenarian patients and 157,891 younger patients. Nonagenarians had a
significantly higher rate of short- (hazard ratio [HR], 95% confidence
interval [CI]: 1.48, 1.38-1.59; P < 0.001) and long-term mortality (HR,
95% CI: 1.34, 1.24-1.44; P < 0.001) than younger patients after TAVI.
Furthermore, there were significant differences in major and/or
life-threatening bleeding (risk ratio [RR], 95% CI: 1.21, 1.05-1.39; P =
0.008), stroke (HR, 95% CI: 1.24, 1.11-1.40; P < 0.001), and major
vascular complication (RR, 95% CI: 2.15, 1.35-3.42; P = 0.001) between
nonagenarians and younger patients after TAVI. Minor vascular
complication, myocardial infarction and permanent pacemaker implantation
rate were similar between the two groups. Nonagenarians had significantly
higher rate of short- and long-term mortality, major and/or
life-threatening bleeding, stroke, and major vascular complication after
TAVI. Although TAVI is a treatment option in nonagenarians, careful and
appropriate selection of patients is essential to improve clinical
outcomes.<br/>Copyright &#xa9; 2021, Japanese Association of
Cardiovascular Intervention and Therapeutics.

<116>
Accession Number
2016614830
Title
Anemia and risk of periprocedural cerebral injury detected by
diffusion-weighted magnetic resonance imaging in patients undergoing
transcatheter aortic valve replacement.
Source
World Journal of Emergency Medicine. 13(1) (pp 32-39), 2022. Date of
Publication: 01 Jan 2022.
Author
Ng S.; Zhu Q.-F.; Jiang J.-B.; Liu C.-H.; Fan J.-Q.; Xu Y.-M.; Liu X.-B.;
Wang J.-A.
Institution
(Ng, Zhu, Jiang, Liu, Fan, Xu, Liu, Wang) Department of Cardiology, The
Second Affiliated Hospital of Zhejiang University School of Medicine,
Hangzhou 310009, China
(Ng, Xu, Liu, Wang) Zhejiang University, School of Medicine, Hangzhou
310058, China
Publisher
Second Affiliated Hospital, Zhejiang University School of Medicine
Abstract
BACKGROUND: Anemia is prevalent in patients undergoing transcatheter
aortic valve replacement (TAVR) and has been linked to impaired outcomes
after the procedure. Few studies have evaluated the impact of anemia and
new ischemic lesions post TAVR. <br/>METHOD(S): We prospectively enrolled
158 patients who received TAVR in our center. Anemia was defined according
to the World Health Organization criteria as hemoglobin <12 g/dL in women
and <13 g/dL in men. All patients underwent diffusion-weighted magnetic
resonance imaging (DW-MRI) procedure before and within 4-7 days after
TAVR. <br/>RESULT(S): Anemia was present in 85 (53.8%) patients who
underwent TAVR, and 126 (79.7%) patients had 718 new DW-MRI positive
lesions with a mean of 4.54+/-5.26 lesions per patient. The incidence of
new ischemic lesions was 81.2% in patients with anemia versus 78.1% in
patients without anemia (P=0.629). Moreover, anemic patients had bigger
total volume/lesions in the anterior cerebral artery/middle cerebral
artery (ACA/MCA) and MCA regions compared to the non-anemic patients
(31.89+/-55.78 mm³ vs. 17.08+/-37.39 mm³, P=0.049;
and 54.54+/-74.72 mm³ vs. 33.75+/-46.03 mm³,
P=0.034). Anemia was independently associated with the volume/lesion in
the ACA/MCA (beta=16.796, 95% confidence interval [95% CI] 2.001 to
31.591, P=0.026) and in the MCA zone (beta=0.020, 95% CI 0.001 to 0.040,
P=0.041). <br/>CONCLUSION(S): Patients with pre-procedural anemia may have
bigger total volume/lesions in the ACA/MCA and MCA regions compared to the
non-anemic patients. Whether the consequences of bigger total
volume/lesions impact neurological and cognitive outcomes remains to be
investigated.<br/>Copyright &#xa9; 2022 World Journal of Emergency
Medicine

<117>
Accession Number
2016569472
Title
Critical appraisal of international adult bronchiectasis guidelines using
the AGREE II tool.
Source
European Journal of Internal Medicine. 98 (pp 4-11), 2022. Date of
Publication: April 2022.
Author
Tejada S.; Ramirez-Estrada S.; Tejo A.M.; Forero C.G.; Pomares X.; Gallego
M.; Soriano J.B.; Chalmers J.D.; Rello J.
Institution
(Tejada, Rello) Clinical Research/Epidemiology in Pneumonia & Sepsis
(CRIPS), Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
(Tejada, Pomares, Gallego, Soriano, Rello) Centro de Investigacion
Biomedica En Red de Enfermedades Respiratorias (CIBERES), Instituto de
Salud Carlos III, Madrid, Spain
(Ramirez-Estrada) Intensive Care Department, Clinica Corachan, Barcelona,
Spain
(Tejo) Department of Internal Medicine-Infectious Diseases Division,
Universidade Estadual de Londrina, Londrina, Brazil
(Forero) School of Medicine, Universitat Internacional de Catalunya,
Barcelona, Spain
(Pomares, Gallego) Department of Respiratory Medicine, Hospital De
Sabadell, Institut Universitari Parc Tauli-UAB, Sabadell, Spain
(Soriano) Hospital Universitario La Princesa, Universidad Autonoma de
Madrid, Madrid, Spain
(Chalmers) Scottish Centre for Respiratory Research, University of Dundee,
Dundee, United Kingdom
(Rello) Clinical Research, CHRU Nimes, Nimes, France
Publisher
Elsevier B.V.
Abstract
Background: Guidelines aim to standardize and optimize diagnosis and
management. We evaluated the quality of evidence supporting
recommendations from different international adult guidelines on
bronchiectasis, and classified with the GRADE system. <br/>Method(s):
Quality of eligible clinical practice guidelines was assessed for six
domains using the AGREE II tool, with >= 80% rating as excellent.
<br/>Result(s): Seven guidelines (283 recommendations) were analyzed, and
four of them were considered "recommended for use" (three reported after
2017 as excellent). Overall, 144 (50.9%) recommendations were based on
low-quality evidence, representing 81.5% in diagnosis and 36.2% in
therapy. In contrast, 5/92 (5.4%) and 40/191 (20.9%) recommendations
regarding diagnostic and treatment (respectively) were based on
high-quality evidence. Quality agreement ratings were significantly (p<
0.05) higher for guidelines delivered after 2015, progressing from 27.7%
to 58.3%, qualifying as excellent. Highest scores were documented in the
domains of "scope and purpose" followed by "clarifying of presentation"
and "editorial independence". <br/>Conclusion(s): Updated guidelines
reported after 2017 improved quality, although well-designed randomized
clinical trials remain an unmet need. AGREE II quality assessment
identified four guidelines qualified as recommended for use. Improvements
are required in stakeholder involvement and applicability.<br/>Copyright
&#xa9; 2022 European Federation of Internal Medicine

<118>
Accession Number
637464280
Title
Bi-level Positive Airway Pressure Versus Nasal CPAP for the Prevention of
Extubation Failure in Infants After Cardiac Surgery.
Source
Respiratory care. 67(4) (pp 448-454), 2022. Date of Publication: 01 Apr
2022.
Author
Zheng Y.-R.; Lin W.-H.; Lin S.-H.; Xu N.; Cao H.; Chen Q.
Institution
(Zheng, Lin, Lin, Xu, Cao, Chen) Department of Cardiac Surgery, Fujian
Branch of Shanghai Children's Medical Center, Fuzhou, China; Fujian
Children's Hospital, Fuzhou, China; Fujian Maternity and Child Health
Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China;
and Fujian Key Laboratory of Women and Children's Critical Diseases
Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Extubation early in the postoperative period is beneficial to
the recovery and rehabilitation of patients. This study compared the
postoperative extubation failure rates among infants who received
postextubation respiratory support by either bi-level positive airway
pressure (BPAP) or nasal CPAP following cardiac surgery. <br/>METHOD(S):
This was a single-center randomized controlled trial registered at the
Chinese Clinical Trial Registry (number ChiCTR2000041453) and was
conducted between January 2020 and March 2021. Ventilated infants who
underwent cardiac surgery were randomized to either a BPAP or a nasal CPAP
group for ventilatory support following extubation. The primary outcome
measure was the extubation failure rate within 48 h. <br/>RESULT(S): The
analyses included 186 subjects. Treatment failure necessitating
re-intubation was noted in 14 of the 93 infants (15%) in the BPAP group
and in 11 of the 93 infants (12%) in the nasal CPAP group (P = .52).
Moreover, there were no statistically significant differences between the
2 groups regarding the duration of noninvasive ventilation (P = .54),
total enteral feeding time (P = .59), or complications (P = .85). We found
that both the BPAP group and the nasal CPAP group showed significantly
improved oxygenation and relief of respiratory distress after treatment.
However, the PaCO2 level within 24 h was significantly lower in the BPAP
group (P = .001) than in the CPAP group. Additionally, the PaO2 /FIO2 in
the BPAP group was significantly higher than in the nasal CPAP group at 6
h, 12 h, and 24 h after treatment (P < .001). <br/>CONCLUSION(S): The
introduction of BPAP for postextubation respiratory support was not
inferior to nasal CPAP in infants after cardiac surgery. Moreover, BPAP
was shown to be superior to nasal CPAP in improving oxygenation and carbon
dioxide clearance.<br/>Copyright &#xa9; 2022 by Daedalus Enterprises.

<119>
Accession Number
2016871161
Title
Clinical outcomes of heart transplantation using hepatitis c-viremic
donors: A systematic review with meta-analysis.
Source
Journal of Heart and Lung Transplantation. 41(4) (pp 538-549), 2022. Date
of Publication: April 2022.
Author
Villegas-Galaviz J.; Anderson E.; Guglin M.
Institution
(Villegas-Galaviz) Department of Medicine, Indiana University School of
Medicine, Indianapolis, IN, United States
(Anderson) Cardiothoracic Transplant, Indiana University Health Methodist
Hospital, Indianapolis, IN, United States
(Guglin) Heart Failure/Heart Transplantation/MCS Services, Krannert
Institute of Cardiology, Indiana University School of Medicine,
Indianapolis, IN, United States
Publisher
Elsevier Inc.
Abstract
Background: Heart transplantation (HTx) from hepatitis C virus
(HCV)-viremic donors to nonviremic recipients decreases mortality and
costs. Consequently, many transplant centers have reported their results
using this strategy. Hence, there is a need for an outcome analysis.
<br/>Method(s): We performed a systematic review with meta-analysis. In
August 2020, we searched PubMed and EMBASE for publications containing
data of nonviremic recipients who underwent HTx from HCV-viremic donors
once direct-acting antiviral (DAA) therapy had become available (>=2014).
<br/>Result(s): We identified 398 publications, 13 of which met inclusion
criteria, and analyzed the outcomes of 195 recipients. The
HCV-transmission rate was >97% but, the cure rate was 100% with DAA
therapy. The 6 and 12-month survival were 95.6% and 92.9%, respectively.
Of 10 deaths reported, none were associated with HCV infection. The acute
cellular rejection (ACR) rate was 31.1%. The overall DAA failure rate was
1.1%, defined as the need to alter the initial DAA therapy due to failure
to cure HCV. However, the DAA failure rate was 0% when the DAA therapy was
started within the first 2 weeks post-HTx. No statistically significant
differences in HCV cure rates, survivals, ACR rates, and DAA failure rates
were observed when outcomes were stratified by therapeutic approach type
(i.e., a prophylactic approach in which DAA was given to the recipient
before confirming HCV-transmission vs a reactive approach, in which DAA
was given to the recipient only after an HCV-transmission was confirmed).
<br/>Conclusion(s): Excellent clinical outcomes have been observed in
nonviremic recipients of HTx from HCV-viremic donors since DAA had become
available.<br/>Copyright &#xa9; 2022 International Society for Heart and
Lung Transplantation