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<1>
Accession Number
2012313271
Title
Iatrogenic atrial septal defect persistence after percutaneous mitral
valve repair: a meta-analysis.
Source
Acta Cardiologica. 77(2) (pp 166-175), 2022. Date of Publication: 2022.
Author
Maier O.; Hellhammer K.; Horn P.; Afzal S.; Jung C.; Westenfeld R.; Zeus
T.; Kelm M.; Veulemans V.
Institution
(Maier, Horn, Afzal, Jung, Westenfeld, Zeus, Kelm, Veulemans) Department
of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty,
Heinrich Heine University, Dusseldorf, Germany
(Hellhammer) Department of Cardiology and Angiology, Elisabeth-Krankenhaus
Essen, Essen, Germany
(Kelm) CARID (Cardiovascular Research Institute Dusseldorf), Dusseldorf,
Germany
Publisher
Taylor and Francis Ltd.
Abstract
Background: Percutaneous mitral valve repair (PMVR) requires a puncture of
the atrial septum, resulting in iatrogenic atrial septal defect (iASD),
which usually causes a transient left-to-right shunt. However, the
influencing risk factors for iASD persistence and functional consequences
are not fully understood. This meta-analysis aimed to summarise available
data on the persistence of iASD following PMVR. Method(s): The
authors conducted a literature search in PubMed/MEDLINE and EMBASE
databases to identify studies investigating iASD persistence in PMVR
patients. Result(s): Six observational studies (n = 361) met
inclusion criteria for the final analysis. Prevalence of persistent iASD
was documented with 28% after 12 months follow-up. iASD size increased
over time with a diameter of 5.3 +/- 0.76 mm after one month and 6.5 +/-
0.21 mm after 12 months. Possible predictors of iASD persistence after
PMVR appeared to be pre-existing AF (RR 1.24; p =.03), residual mitral
regurgitation > IIdegree (RR 2.06; p =.03) and prolonged fluoroscopic time
(RR 8.27; p =.01). Patients with iASD persistence had a higher risk for
development of right heart overload regarding the increased area of the
right atrium (MD 5.24; p =.004) and enlarged diameter of the right
ventricle (MD 3.33; p <.0001). Rehospitalization was more frequently
reported in iASD patients (RR 9.52; p =.004). Conclusion(s): This
meta-analysis proved iASD persistence in 28% of PMVR after 12 months
follow-up with a higher risk for right heart volume overload and more
frequent rehospitalization compared to patients without iASD persistence.
Since percutaneous catheter-based treatments with transseptal approaches
are rising, further evidence about the hemodynamic impact of persistent
iASD is warranted. Copyright © 2021 Belgian Society of
Cardiology.

<2>
Accession Number
2015929267
Title
Acute Kidney Injury and 3-Year Mortality in Elderly Patients After
Non-cardiac Surgery.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 779754.
Date of Publication: 12 Apr 2022.
Author
Wu Q.-F.; Xing M.-W.; Hu W.-J.; Su X.; Zhang D.-F.; Mu D.-L.; Wang D.-X.
Institution
(Wu, Xing, Su, Mu, Wang) Department of Anesthesiology and Critical Care
Medicine, Peking University First Hospital, Beijing, China
(Hu) Department of Anesthesiology, The 305th Hospital of the Chinese
People's Liberation Army, Beijing, China
(Zhang) Department of Anesthesiology, Fujian Medical University Union
Hospital, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Objective: The present study aimed to investigate whether acute kidney
injury (AKI) was associated with 3-year mortality in elderly patients
after non-cardiac surgery. Method(s): The present study was a 3-year
follow-up study of two randomized controlled trials. A total of 1,319
elderly patients who received non-cardiac surgery under general anesthesia
were screened. AKI was diagnosed by the elevation of serum creatinine
within a 7-day postoperative period according to Kidney Disease: Improving
Global Outcomes (KDIGO) guidelines. A long-term telephonic follow-up was
undertaken by investigators who were not involved in the previous two
trials and had no access to the study group assignment. The date of death
was taken from the official medical death certificate. The primary outcome
was to investigate the association between AKI and postoperative 3-year
mortality using the multivariable Cox regression risk model.
 Result(s): Of the 1,297 elderly patients (mean age 71.8 +/- 7.2 years
old) who were included in the study, the incidence of AKI was 15.5%
(201/1297). Of the patients with AKI, 85% (170/201) were at stage 1, 10%
(20/201) at stage 2, and 5% (11/201) at stage 3. The 3-year all-cause
mortality was 28.9% (58/201) in patients with AKI and 24.0% (263/1,096) in
patients without AKI (hazard ratio 1.247, 95% confidence interval
0.939-1.657, P = 0.128). The multivariable Cox regression showed that AKI
was not associated with 3-year mortality after adjustment of confounding
factors (adjusted hazard ratio 1.045, 95% confidence interval 0.780-1.401,
P = 0.766). Conclusion(s): AKI was a common postoperative
complication, but it was not associated with 3-year mortality in elderly
patients who underwent non-cardiac surgery. The low incidence of severe
AKI might underestimate its underlying association with long-term
mortality. Copyright © 2022 Wu, Xing, Hu, Su, Zhang, Mu and Wang.

<3>
Accession Number
2016445073
Title
Impact of Icosapent Ethyl on Cardiovascular Risk Reduction in Patients
With Heart Failure in REDUCE-IT.
Source
Journal of the American Heart Association. 11(7) (no pagination), 2022.
Article Number: e024999. Date of Publication: 05 Apr 2022.
Author
Selvaraj S.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson
T.A.; Juliano R.A.; Jiao L.; Tardif J.-C.; Ballantyne C.M.
Institution
(Selvaraj) Division of Cardiology, Department of Medicine, Hospital of the
University of Pennsylvania, Philadelphia, PA, United States
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center, Harvard
Medical School, Boston, MA, United States
(Steg) Universite Paris-Cite, AP-HP (Assistance Publique-Hopitaux de
Paris), Hopital Bichat, FACT (French Alliance for Cardiovascular Trials),
INSERM U-1148, Paris, France
(Miller) Department of Medicine, University of Maryland School of
Medicine, Baltimore, MD, United States
(Brinton) Utah Lipid Center, Salt Lake City, UT, United States
(Jacobson) Office of Health Promotion and Disease Prevention, Department
of Medicine, Emory University School of Medicine, Atlanta, GA, United
States
(Juliano, Jiao) Amarin Pharma, Inc (Amarin), Bridgewater, NJ, United
States
(Tardif) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Patients with heart failure (HF) are at high risk for
atherosclerotic cardiovascular disease. Studies of atherothrombotic
treatments in this population have been disappointing to date. Icosapent
ethyl reduced the risk of atherosclerotic cardiovascular disease among a
broad array of statin-treated patients at elevated risk for
atherosclerotic cardiovascular disease. Whether the treatment benefits of
icosapent ethyl are consistent among those with HF is unknown. METHODS AND
RESULTS: REDUCE-IT (Reduction of Cardiovascular Events With Icosapent
Ethyl-Intervention Trial) randomized 8179 participants, including 1446
(17.7%) patients with a history of HF (icosapent ethyl, N=703; and
placebo, N=743). The primary end point was a composite of cardiovascular
death, nonfatal myocardial infarction, nonfatal stroke, coronary
revascularization, or unstable angina. We used Cox regression to estimate
the risk of outcomes of participants with and without HF. We estimated the
placebo-controlled change in triglycerides and hs-CRP (high-sensitivity
C-reactive protein) from baseline to 2 years. Among 1446 patients with HF,
median age was 63.0 years, median body mass index was 31.0
kg/m2, and more were men (69.3%). Icosapent ethyl reduced
triglycerides (median reduction, 33.5 mg/dL, or 15.4%; P<0.0001) and
hs-CRP (35.1%; P<0.0001) compared with placebo, similar to patients
without HF (P-interaction>0.90). The treatment effect on the primary end
point in patients with HF history (hazard ratio [HR], 0.87; 95% CI,
0.70-1.08) was consistent with the effects observed in patients without HF
history (HR, 0.73; 95% CI, 0.65-0.81) (P-interaction=0.13).
 CONCLUSION(S): In REDUCE-IT, icosapent ethyl provided similar
improvements in triglyceride levels and hs-CRP as well as similar
cardiovascular risk reduction in patients with and without HF.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01492361. Copyright © 2022 The Authors. Published on behalf of
the American Heart Association, Inc., by Wiley.

<4>
Accession Number
2017574864
Title
Effect of a Lifestyle-Focused Web-Based Application on Risk Factor
Management in Patients Who Have Had a Myocardial Infarction: Randomized
Controlled Trial.
Source
Journal of Medical Internet Research. 24(3) (no pagination), 2022. Article
Number: e25224. Date of Publication: March 2022.
Author
Michelsen H.O.; Sjolin I.; Back M.; Garcia M.G.; Olsson A.; Sandberg C.;
Schiopu A.; Leosdottir M.
Institution
(Michelsen, Schiopu, Leosdottir) Department of Clinical Sciences Malmo,
Lund University, Malmo, Sweden
(Michelsen) Department of Internal Medicine, Helsingborg Hospital,
Helsingborg, Sweden
(Sjolin, Leosdottir) Department of Cardiology, Skane University Hospital,
Malmo, Sweden
(Back) Department of Health, Medicine and Caring Sciences, Unit of
Physiotherapy, Linkoping University, Linkoping, Sweden
(Back) Department of Occupational Therapy and Physiotherapy, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Garcia, Sandberg) Department of Epidemiology and Global Health, Umea
University, Umea, Sweden
(Garcia) Faculty of Medicine, University of Queensland, Herston, QLD,
Australia
(Olsson) Department of Cardiology, Skane University Hospital, Lund, Sweden
(Olsson) Department of Clinical Sciences, Lund University, Lund, Sweden
(Sandberg) Department of Community Medicine and Rehabilitation,
Physiotherapy, Umea University, Umea, Sweden
(Schiopu) Department of Internal Medicine, Skane University Hospital,
Lund, Sweden
(Michelsen) Department of Clinical Sciences Malmo Lund University, Jan
Waldenstroms Gata 35, Malmo 205 02, Sweden
Publisher
JMIR Publications Inc.
Abstract
Background: Cardiac rehabilitation is central in reducing mortality and
morbidity after myocardial infarction. However, the fulfillment of
guideline-recommended cardiac rehabilitation targets is unsatisfactory.
eHealth offers new possibilities to improve clinical care.
 Objective(s): This study aims to assess the effect of a web-based
application designed to support adherence to lifestyle advice and
self-control of risk factors (intervention) in addition to center-based
cardiac rehabilitation, compared with cardiac rehabilitation only (usual
care). Method(s): All 150 patients participated in cardiac
rehabilitation. Patients randomized to the intervention group (n=101)
received access to the application for 25 weeks where information about
lifestyle (eg, diet and physical activity), risk factors (eg, weight and
blood pressure [BP]), and symptoms could be registered. The software
provided feedback and lifestyle advice. The primary outcome was a change
in submaximal exercise capacity (Watts [W]) between follow-up visits.
Secondary outcomes included changes in modifiable risk factors between
baseline and follow-up visits and uptake and adherence to the application.
Regression analysis was used, adjusting for relevant baseline variables.
 Result(s): There was a nonsignificant trend toward a larger change in
exercise capacity in the intervention group (n=66) compared with the usual
care group (n=40; +14.4, SD 19.0 W, vs +10.3, SD 16.1 W; P=.22). Patients
in the intervention group achieved significantly larger BP reduction
compared with usual care patients at 2 weeks (systolic -27.7 vs -16.4 mm
Hg; P=.006) and at 6 to 10 weeks (systolic -25.3 vs -16.4 mm Hg; P=.02,
and diastolic -13.4 vs -9.1 mm Hg; P=.05). A healthy diet index score
improved significantly more between baseline and the 2-week follow-up in
the intervention group (+2.3 vs +1.4 points; P=.05), mostly owing to an
increase in the consumption of fish and fruit. At 6 to 10 weeks, 64%
(14/22) versus 46% (5/11) of smokers in the intervention versus usual care
groups had quit smoking, and at 12 to 14 months, the respective
percentages were 55% (12/22) versus 36% (4/11). However, the number of
smokers in the study was low (33/149, 21.9%), and the differences were
nonsignificant. Attendance in cardiac rehabilitation was high, with 96%
(96/100) of patients in the intervention group and 98% (48/49) of patients
receiving usual care only attending 12- to 14-month follow-up. Uptake
(logging data in the application at least once) was 86.1% (87/101).
Adherence (logging data at least twice weekly) was 91% (79/87) in week 1
and 56% (49/87) in week 25. Conclusion(s): Complementing cardiac
rehabilitation with a web-based application improved BP and dietary habits
during the first months after myocardial infarction. A nonsignificant
tendency toward better exercise capacity and higher smoking cessation
rates was observed. Although the study group was small, these positive
trends support further development of eHealth in cardiac
rehabilitation. Copyright © 2022 Journal of Medical Internet
Research. All rights reserved.

<5>
Accession Number
2016192616
Title
EFFECT of INTRAOPERATIVE DEXMEDETOMIDINE on RENAL FUNCTION in PATIENTS
UNDERGOING CARDIOPULMONARY BYPASS GRAFT SURGERY under CARDIOPULMONARY
BYPASS.
Source
Bulletin of Pharmaceutical Sciences. Assiut. 44(2) (pp 467-476), 2021.
Date of Publication: December 2021.
Author
Jannati M.; Shahbazi S.; Lotfi H.R.
Institution
(Jannati) Cardiovascular Surgery Ward, Namazee Hospital, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Shahbazi) Department of Anaesthesiology, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Lotfi) Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
Publisher
Assiut University
Abstract
Acute kidney injury (AKI) post-cardiac surgeries happens as a prompt
deterioration in renal function subsequent to cardiac surgery including
cardiopulmonary bypass graft surgery (CABG). This study is aimed to
evaluate the effect of intraoperative dexmedetomidine on renal function in
patients undergoing CABG by using cardiopulmonary bypass (CPB). Methods.
This Double-blinded randomized clinical trial study was performed on 58
patients who were candidates for CABG in Namazi Hospital of Shiraz. In the
dexmedetomidine group, dexmedetomidine infusion at a dose of 0.5 mug/kg/h
without a loading dose, and in the control group placebo was initiated.
After the end of surgery and ICU admission and on days 2 and 3
postoperatively, serum BUN, Cr, and eGFR levels, also urine output,
Inotrope usage, and packed red blood cells (PRBC) consumption were
recorded. SPSS software 24 was used for data analysis. Results. No
significant differences were observed in any of the steps in serum
creatinine levels between the two groups (P > 0.05). A significant
difference in serum BUN levels was observed between the two groups except
for the third day (P <0.05). Heterogeneity was seen in preoperative BUN in
the two groups. There was no significant difference between the mean of
eGFR in the dexmedetomidine and control groups over time (P >0.05). There
was a significant difference between the mean urine output in the two
groups only on the second day (P = 0.04). There was no significant
difference in PRBC intake and inotrope usage between the two groups (P >
0.05). Conclusion. The findings of this study indicate that
dexmedetomidine does not affect the renal function of patients undergoing
coronary artery bypass graft surgery. According to the findings,
dexmedetomidine can increase the urine output of patients during surgery.
However, it has no positive effect on the postoperative
period. Copyright © 2021 Assiut University. All rights reserved.

<6>
Accession Number
2016585108
Title
Outcomes of total arterial revascularization vs conventional
revascularization in patients unergoing coronary artery bypass graft
surgery: A narrative review of major stuies t.
Source
Pakistan Journal of Medical Sciences. 38(5) (no pagination), 2022. Date of
Publication: May-June 2022.
Author
Dominici C.; Chello M.; Saeed S.
Institution
(Dominici, Chello) Department of Cardiac Surgery, Universita Campus
Bio-Medico di Roma, Rome, Italy
(Saeed) Department of Heart Disease, Haukeland University Hospital,
Bergen, Norway
Publisher
Professional Medical Publications
Abstract
Coronary artery bypass grafting (CABG) is a widely used surgical procedure
which improves clinical outcomes in appropriately selected patients.
Conventionally, the greater saphenous vein is often used in CABG. However,
due to their higher long-term patency rates, arterial conduits are
routinely used, with the left internal thoracic artery (LITA) on left
anterior descending (LAD) being the gold standard in CABG. Our aim in the
present work was to investigate the outcomes of a total arterial grafting
(TAG) on the whole heart, with no use of venous grafts, compared to mixed
conduits in real-world data. A literature search was conducted in the
bibliographic databases PubMed and Web of Science. Only studies comparing
TAG with conventional CABG (at least one venous graft plus one or more
arterial grafts), with at least one hundred patients in each group were
included in this review. After study selection, a total of 15 relevant
studies were evaluated and discussed in the present review. Results
indicated that TAG is a highly efficient technique, and multiple arterial
grafts can be used to reliably revascularize all coronary artery
territories. TAG was more beneficial in terms of both short and long-term
outcomes and its use should be encouraged. Large randomized clinical
trials are needed to confirm the superiority of total arterial grafting
with regard to long-term outcomes. Copyright © 2022, Professional
Medical Publications. All rights reserved.

<7>
Accession Number
2016102219
Title
Direct oral anticoagulation in atrial fibrillation and heart valve
surgery-a meta-analysis and systematic review.
Source
Therapeutic Advances in Cardiovascular Disease. 16 (no pagination), 2022.
Date of Publication: 2022.
Author
Gerfer S.; Djordjevic I.; Eghbalzadeh K.; Mader N.; Wahlers T.; Kuhn E.
Institution
(Gerfer) Department of Cardiothoracic Surgery, Heart Center, University
Hospital of Cologne, Kerpener Strase 62, Cologne 50937, Germany
(Djordjevic, Eghbalzadeh, Mader, Wahlers, Kuhn) Department of
Cardiothoracic Surgery, Heart Center, University Hospital of Cologne,
Cologne, Germany
Publisher
SAGE Publications Ltd
Abstract
Aims: Oral anticoagulation with direct oral anticoagulants (DOAC) could
provide an alternative to vitamin K antagonists (VKA) for patients with
atrial fibrillation (AF) undergoing bioprosthetic heart valve replacement
or valve repair. Methods and Results: The aim of this meta-analysis
was to review the safety and efficacy of DOAC in patients with surgical
implanted bioprosthetic heart valves or valve repairs and AF including
data from six clinical trials with a total of 1,857 patients. The efficacy
and safety data of DOAC and VKA were pooled to perform random-effects
meta-analyses using the Mantel-Haenszel method with pooled risk ratios
(RR) and 95% confidence interval (CI). A trial sequential analysis (TSA)
was performed to assess statistical robustness. Death caused by
cardiovascular cause or thromboembolic events were comparable (RR 0.67,
95% CI: 0.42-1.08; p = 0.10) as DOAC significantly reduced the risk for
major bleeding (RR 0.55, 95% CI: 0.35-0.88; p = 0.01) and thromboembolic
stroke or systemic embolism rates (RR 0.54, 95% CI: 0.32-0.90; p = 0.02).
Rates for intracranial bleeding and hemorrhagic stroke (RR 0.27, 95% CI:
0.07-0.99; p = 0.05) show a trend toward fewer events in the DOAC group.
Outcomes for major or minor bleeding events and all-cause mortality were
comparable for DOAC and VKA. Conclusion(s): Cumulative data analysis
reveals that DOAC may provide an effective and safe alternative to VKA in
patients with AF after surgically implanted bioprosthetic heart valves or
repair with AF. Within a relatively heterogeneous study population, this
meta-analysis shows a risk reduction of major bleedings and thromboembolic
stroke or systemic embolisms for DOAC. Copyright © The Author(s),
2022.

<8>
Accession Number
2017788137
Title
Pulmonary Function Tests for the Prediction of Postoperative Pulmonary
Complications.
Source
Deutsches Arzteblatt International. 119(7) (pp 99-106), 2022. Date of
Publication: 18 Feb 2022.
Author
Dankert A.; Dohrmann T.; Loser B.; Zapf A.; Zollner C.; Petzoldt M.
Institution
(Dankert, Dohrmann, Zollner, Petzoldt) Department of Anesthesiology,
Center of Anesthesiology and Intensive Care Medicine, University Medical
Center Hamburg, Eppendorf, Germany
(Loser) Department of Anesthesiology, Center of Anesthesiology and
Intensive Care Medicine, University Medicine Rostock, Germany
(Zapf) Department of Medical Biometry and Epidemiology, University Medical
Center Hamburg, Eppendorf, Germany
Publisher
Deutscher Arzte-Verlag GmbH
Abstract
Background: Pulmonary function tests (PFTs) such as spirometry and blood
gas analysis have been claimed to improve preoperative risk assessment.
This systematic review summarizes the available scientific literature
regarding the ability of PFTs to predict postoperative pulmonary
complications (PPC) in non-thoracic surgery. Method(s): We
systematically searched MEDLINE, CINAHL, and the Cochrane Library for
pertinent original research articles (PROSPERO CRD42020215502), framed by
the PIT-criteria (PIT, participants, index test, target conditions),
respecting the PRISMA-DTA recommendations (DTA, diagnostic test accuracy).
 Result(s): 46 original research studies were identified that used
PFT-findings as index tests and PPC as target condition. QUADAS-2 quality
assessment revealed a high risk of bias regarding patient selection,
blinding, and outcome definitions. Qualitative synthesis of prospective
studies revealed inconclusive study findings: 65% argue for and 35%
against preoperative spirometry, and 43% argue for blood gas analysis. A
(post-hoc) subgroup analysis in prospective studies with low-risk of
selection bias identified a possible benefit in upper abdominal surgery
(three studies with 959 participants argued for and one study with 60
participants against spirometry). Conclusion(s): As the existing
literature is inconclusive it is currently unknown if PFTs improve risk
assessment before non-thoracic surgery. Spirometry should be considered in
individuals with key indicators for chronic obstructive pulmonary disease
(COPD) scheduling for upper abdominal surgery. Copyright © 2022
Deutscher Arzte-Verlag GmbH. All rights reserved.

<9>
Accession Number
2013401953
Title
Effects of remote ischemic postconditioning on HIF-1alpha and other
markers in on-pump cardiac surgery.
Source
General Thoracic and Cardiovascular Surgery. 70(3) (pp 239-247), 2022.
Date of Publication: March 2022.
Author
Garcia-de-la-Asuncion J.; Moreno T.; Duca A.; Garcia-del-Olmo N.;
Perez-Griera J.; Belda J.; Soro M.; Garcia-del-Olmo E.
Institution
(Garcia-de-la-Asuncion, Moreno, Duca, Belda, Soro) Department of
Anaesthesiology and Critical Care, Hospital Clinico Universitario,
Instituto de Investigacion Sanitaria-INCLIVA, Valencia, Spain
(Garcia-del-Olmo) Department of General Surgery, Hospital Lluis Alcanyis,
Xativa, Spain
(Perez-Griera) Laboratory of Biochemistry, Hospital Clinico Universitario,
Instituto de Investigacion Sanitaria-INCLIVA, Valencia, Spain
(Garcia-del-Olmo) Department of Thoracic Surgery, Consorcio Hospital
General Universitario, Valencia, Spain
Publisher
Springer Japan
Abstract
Background: There is a lack of data about the effects of remote ischemic
postconditioning (RIPostC) on hypoxia-inducible factor-1alpha (HIF-1alpha)
plasma levels after on-pump cardiac surgery (OPCS). This study aimed to
measure the effects of RIPostC on postoperative HIF-1alpha plasma levels,
cardiac markers and arterial oxygenation in patients undergoing OPCS.
 Method(s): This single-centre randomized, double blind, controlled
trial, enrolled 70 patients (35 control and 35 RIPostC). RIPostC was
performed by 3 cycles (5 min of ischemia followed by 5 min of reperfusion)
administered in upper arm immediately after the pump period. The primary
outcome was to measure HIF-1alpha plasma levels: before surgery (T0), and
2 h (T1), 8 h (T2), 24 h (T3), 36 h (T4) and 48 h (T5) after RIPostC. As
secondary endpoint, Troponin T, CK-MB, CPK plasma levels and
PaO<inf>2</inf>/FiO<inf>2</inf> ratio were measured. Result(s):
HIF-1alpha plasma levels were increased at T1-T3 compared to T0 in both
groups (P < 0.001). In the RIPostC group HIF-1alpha increased compared to
the control group: differences between means (95% CI) were 0.034
(0.006-0.06) P = 0.019 at T1; 0.041 (0.013-0.069) P = 0.005 at T2; and
0.021 (0.001-0.042) P = 0.045 at T3. PaO<inf>2</inf>/FiO<inf>2</inf> was
higher in the RIPostC group than in the control group: at T3, T4 and T5.
Moreover, Troponin T, CK-MB and CPK values decreased in the RIPostC group
compared to the control group. Conclusion(s): HIF-1alpha plasma
levels increased in control patients during for at least 36 h after OPCS.
RIPostC resulted in even higher HIF-1alpha levels during at least the
first 24 h and improved arterial oxygenation and cardiac
markers. Copyright © 2021, The Japanese Association for Thoracic
Surgery.

<10>
Accession Number
2011864941
Title
Distal Versus Proximal Radial Artery Access for Cardiac Catheterization
and Intervention: Design and Rationale of the DIPRA Trial.
Source
Cardiovascular Revascularization Medicine. 35 (pp 104-109), 2022. Date of
Publication: February 2022.
Author
Al-Azizi K.M.; Idris A.; Christensen J.; Hamandi M.; Hale S.;
Martits-Chalangari K.; Van Zyl J.S.; Ravindranathan P.; Banwait J.K.;
Mcckracken J.; Smith A.; Apakama G.; Swim J.; Dolton P.; Chionh K.; Dimaio
M.; Thomas S.; Szerlip M.; Sayfo S.; Dib C.; Mack M.; Potluri S.
Institution
(Al-Azizi) Interventional Cardiology and Structural Heart Disease, Texas
A&M University College of Medicine, The Heart Hospital - Plano, Baylor
Scott & White Health, 1100 Allied Dr, Plano, TX 75093, United States
(Idris, Christensen) The Heart Hospital Plano - Baylor Scott & White,
United States
(Hamandi, Hale, Martits-Chalangari, Van Zyl, Ravindranathan, Banwait,
Mcckracken, Smith, Apakama, Swim, Dolton, Chionh, Dimaio, Mack) Baylor
Research Institute, The Heart Hospital Plano - Baylor Scott & White,
United States
(Thomas, Szerlip, Sayfo, Potluri) Interventional Cardiology and Structural
Heart Disease, The Heart Hospital - Plano, Baylor Scott & White Health,
United States
(Dib) Interventional Cardiology, The Heart Hospital - Plano, Baylor Scott
& White Health, United States
Publisher
Elsevier Inc.
Abstract
Background: Radial artery (RA) catheterization is the access of choice
over femoral artery access for most interventional vascular procedures
given its safety and faster patient recovery. There has been growing
interest in distal radial artery (dRA) access as an alternative to the
conventional proximal radial artery (pRA) access. Preserving the RA is
important which serves as a potential conduit for future coronary artery
bypass surgery, dialysis conduit or preserve the artery for future
cardiovascular procedures. The dRA runs in close proximity to the radial
nerve, which raises the concern of potential detrimental effects on hand
function. Study design: The Distal versus Proximal Radial Artery Access
for cardiac catheterization and intervention (DIPRA) trial is a
prospective, randomized, parallel-controlled, open-label, single center
study evaluating the outcomes of hand function and effectiveness of dRA
compared to pRA access in patients undergoing cardiac catheterization. The
eligible subjects will be randomized to dRA and pRA access in a (1:1)
fashion. The primary end point is an evaluation of hand function at one
and twelve months follow-up. Secondary end points include rates of access
site hematoma, access site bleeding, other vascular access complications,
arterial access success rate, and RA occlusion at one and twelve months
follow up. Conclusion(s): Effects of dRA on hand function remains
unknown and it's use questionable in the presence of a widely accepted
pRA. DIPRA trial is designed to determine the safety and effectiveness of
dRA for diagnostic and interventional cardiovascular procedures compared
to the standard of care pRA. Copyright © 2021 Elsevier Inc.

<11>
Accession Number
2015257705
Title
Off-pump versus on-pump coronary artery bypass grafting for octogenarians:
A meta-analysis involving 146 372 patients.
Source
Clinical Cardiology. 45(4) (pp 331-341), 2022. Date of Publication: April
2022.
Author
Sun L.; Zhou M.; Ji Y.; Wang X.
Institution
(Sun, Ji, Wang, Wang) Department of Cardiovascular Surgery, The First
Affiliated Hospital of Nanjing Medical University, Nanjing, China
(Zhou) Department of Endocrine, The First Affiliated Hospital of Nanjing
Medical University, Nanjing, China
Publisher
John Wiley and Sons Inc
Abstract
There is an ongoing debate concerning the optimal surgical option of
myocardial revascularization for octogenarians. The current meta-analysis
aimed to compare clinical outcomes following off-pump coronary artery
bypass grafting (OPCABG) or conventional coronary artery bypass grafting
(CCABG) in octogenarians. PubMed, Cochrane, Web of Science, and EMBASE
databases were searched to identify eligible studies from inception to
March 2021. The analysis was performed using STATA 15.1. A literature
search yielded 18 retrospective studies involving 146 372 patients (OPCABG
= 44 522 vs. CCABG = 101 850). Pooled analysis showed a strong trend
toward reducing mortality risk in the OPCABG group (odds ratio: 0.75, 95%
confidence interval: 0.56-1.00, p =.05). However, it did not reach
statistical significance. The sensitive analysis demonstrated that OPCABG
was less likely to cause death than CCABG. There were comparable data in
myocardial infarction, renal failure, deep sternal wound infection, and
hospital stays between the two groups, although the incidence of stroke,
atrial fibrillation, prolonged ventilation, and reoperation for bleeding
was significantly lower in the OPCAGB group. OPCABG may be an effective
surgical strategy for myocardial revascularization, especially in reducing
the incidence of postoperative stroke, atrial fibrillation, prolonged
ventilation, and reoperation for bleeding. Copyright © 2022 The
Authors. Clinical Cardiology published by Wiley Periodicals LLC.

<12>
Accession Number
2014908310
Title
Long-term impact of permanent cardiac pacing after surgical aortic valve
replacement: systematic review and meta-analysis.
Source
Expert Review of Cardiovascular Therapy. 20(1) (pp 81-86), 2022. Date of
Publication: 2022.
Author
Servito M.; Khoury W.; Payne D.; Baranchuk A.; El-Diasty M.
Institution
(Servito, Khoury) Faculty of Medicine, Queen's University, Kingston, ON,
Canada
(Payne, El-Diasty) Division of Cardiac Surgery, Kingston Health Sciences
Centre, Kingston, ON, Canada
(Baranchuk) Division of Cardiology, Kingston Health Sciences Centre,
Kingston, ON, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Permanent pacemaker (PPM) implantation after surgical aortic
valve (SAVR) is associated with short- and long-term complications.
However, the impact of PPM implantation on long-term mortality has not
been fully established. The aim of this meta-analysis was to determine
whether PPM post-SAVR increases the risk of mortality. Method(s): We
searched Cochrane, MEDLINE, and EMBASE from inception to December 2020 for
studies comparing mortality between patients who received PPM post-SAVR
and those who did not. Random effects meta-analysis was performed to
determine the effect of PPM on early and late mortality. The effect sizes
were reported as hazard ratio (HR) with 95% confidence intervals.
 Result(s): Three studies met criteria, which yielded a total of 9,105
patients. The most common indication was post-operative complete
atrioventricular block. While there was no difference in early mortality
between the PPM and no PPM groups (RR 1.19; 95%CI 0.20-7.08; I2
= 23%), PPM implantation was shown to significantly increase late
mortality (RR 1.49; 95%CI 1.25-1.77; I2 = 0%).
 Conclusion(s): The need for permanent pacemaker after surgically
isolated aortic valve replacement is associated with increased risk of
long-term mortality. This warrants further exploration on the effect of
PPM on long-term mortality in patients receiving sutureless prostheses or
transcatheter aortic valve implants. Abbreviations PPM Permanent
PacemakerSAVR Surgical Aortic Valve Replacement. Copyright © 2022
Informa UK Limited, trading as Taylor & Francis Group.

<13>
Accession Number
2014741899
Title
Safety and efficacy of drug-coated balloon for peripheral artery
revascularization-A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(4) (pp 1319-1326),
2022. Date of Publication: March 1, 2022.
Author
Ullah W.; Zghouzi M.; Sattar Z.; Ahmad B.; Zahid S.; Suleiman A.-R.M.;
Sattar Y.; Khan M.Z.; Paul T.; Bagur R.; Qureshi M.I.; Fischman D.L.;
Banerjee S.; Prasad A.; Alraies M.C.
Institution
(Ullah, Fischman) Department of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
(Zghouzi, Ahmad, Suleiman, Qureshi, Alraies) Department of Cardiology,
Detroit Medical Center, Heart Hospital, Detroit, MI, United States
(Sattar) Department of Internal Medicine, SUNY Downstate Medical Center,
Brooklyn, NY, United States
(Zahid) Department of Internal Medicine, Rochester General Hospital,
Rochester, NY, United States
(Sattar, Khan) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
(Paul) Department of Cardiology, The University of Tennessee, Nashville,
TN, United States
(Bagur) Department of Cardiology, London Health Science Centre Western
University, London, ON, Canada
(Banerjee) Department of Cardiology, University of Texas Southwestern
Medical Center, Dallas, TX, United States
(Prasad) Department of Cardiology, UT Health San Antonio, San Antonio, TX,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The relative merits of the drug-coated balloon (DCB) versus
uncoated balloon (UCB) angioplasty in endovascular intervention for
patients with symptomatic lower extremity peripheral arterial disease
(PAD) remains controversial. Method(s): Online databases were queried
with various combinations of keywords to identify relevant articles. Net
adverse events (NAEs) and its components were compared using a random
effect model to calculate unadjusted odds ratios (ORs). Result(s): A
total of 26 studies comprising 26,845 patients (UCB: 17,770 and DCB: 9075)
were included. On pooled analysis, DCB was associated with significantly
lower odds of NAE (OR: 0.47, 95% confidence interval [CI]: 0.36-0.61),
vessel restenosis (OR: 0.46, 95% CI: 0.37-0.57), major amputation (OR:
0.68, 95% CI: 0.47-99), need for repeat target lesion (OR: 0.38, 95% CI:
0.31-0.47) and target vessel revascularization (OR: 0.62, 95% CI:
0.47-0.81) compared with UCB. Similarly, the primary patency rate was
significantly higher in patients undergoing DCB angioplasty (OR: 1.44, 95%
CI: 1.19-1.75), while the odds for all-cause mortality (OR: 0.96, 95% CI:
0.85-1.09) were not significantly different between the two groups. A
subgroup analysis based on follow-up duration (6 months vs. 1 vs. 2 years)
followed the findings of the pooled analysis with few exceptions.
 Conclusion(s): The use of DCB in lower extremity PAD intervention is
associated with higher primary patency, lower restenosis, lower amputation
rate, and decreased need for repeat revascularization with similar
all-cause mortality as compared to UCB. Copyright © 2022 Wiley
Periodicals LLC.

<14>
Accession Number
2014686337
Title
Dexmedetomidine versus propofol in reducing atrial fibrillation after
cardiac surgery.
Source
Egyptian Journal of Anaesthesia. 38(1) (pp 72-77), 2022. Date of
Publication: 2022.
Author
Abdallah O.; Salem M.I.; Gomaa M.
Institution
(Abdallah) Department of Anesthesia, General Organization for Teaching
Hospitals and Institutes, Damanhur, Egypt
(Salem) Department of Cardiothoracic Surgery, Port Said University, Port
Said, Egypt
(Gomaa) Department of Anesthesia and Surgical Intensive Care, Alexandria
University, Alexandria, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Atrial fibrillation is a common complication associated with
cardiac surgery after cardiopulmonary bypass with a deleterious effect on
morbidity and mortality. The current study aimed to compare between
dexmedetomidine and propofol in reducing atrial fibrillation after cardiac
surgery. Design(s): A randomized prospective cohort study.
 Setting(s): Conducted in Alexandria main university hospital.
 Participant(s): 98 patients of either sex ASA II physical status aged
40-60 years. Intervention(s): All patients were subjected to either
propofol or dexmedetomidine infusion after cardiac surgery according to
the assigned group. Measurements and Main Results: The patients were
divided into two groups where first group received dexmedetomidine
infusion as postoperative sedation and the second group received propofol
infusion. Both groups were assessed for incidence of atrial fibrillation,
hypotension and length of intensive care stay. Incidence with atrial
fibrillation was 0.9% in dexmedetomidine group vs. 13% in propofol group
(P = 0.001) and intensive care stay was prolonged in propofol group 4.6
+/- 1.2 day vs. 2.7 +/- 1 for dexmedetomidine group (P = 0.002). There was
no statistically significant difference between both groups regarding
blood pressure or heart rate. Conclusion(s): The use of
dexmedetomidine for sedation after cardiac surgery was associated with a
lower incidence of atrial fibrillation and hence decreased the duration of
intensive care stay. Copyright © 2022 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<15>
Accession Number
2015842987
Title
Aspirin to target arterial events in chronic kidney disease (ATTACK):
study protocol for a multicentre, prospective, randomised, open-label,
blinded endpoint, parallel group trial of low-dose aspirin vs. standard
care for the primary prevention of cardiovascular disease in people with
chronic kidney disease.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 331. Date of
Publication: December 2022.
Author
Gallagher H.; Dumbleton J.; Maishman T.; Whitehead A.; Moore M.V.; Fuat
A.; Fitzmaurice D.; Henderson R.A.; Lord J.; Griffith K.E.; Stevens P.;
Taal M.W.; Stevenson D.; Fraser S.D.; Lown M.; Hawkey C.J.; Roderick P.J.
Institution
(Gallagher) SW Thames Renal Unit, Epsom and St Helier University Hospitals
NHS Trust, Epsom, United Kingdom
(Dumbleton, Stevenson, Hawkey) Faculty of Medicine and Health Sciences,
University of Nottingham, Nottingham, United Kingdom
(Maishman, Whitehead) Southampton Clinical Trials Unit, University of
Southampton, Southampton, United Kingdom
(Moore, Fraser, Lown, Roderick) Department of Primary Care and Population
Sciences, Faculty of Medicine, University of Southampton, Southampton,
United Kingdom
(Fuat) School of Medicine, Pharmacy and Health, Durham University, Durham,
United Kingdom
(Fuat) Carmel Medical Practice, Nunnery Lane, Darlington, United Kingdom
(Fitzmaurice) University of Warwick, Coventry CV4 7AL, United Kingdom
(Henderson) Trent Cardiac Centre, Nottingham University Hospitals NHS
Trust, Nottingham, United Kingdom
(Lord) Health Technology Assessment Centre, Faculty of Medicine,
University of Southampton, Southampton, United Kingdom
(Griffith) YorkUnited Kingdom
(Stevens) Kent Kidney Care Centre, East Kent Hospitals University
Foundation Trust, Canterbury, United Kingdom
(Taal) School of Medicine, University of Nottingham, Nottingham, United
Kingdom
(Taal) University Hospitals of Derby and Burton NHS Foundation Trust,
Derby, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Chronic kidney disease (CKD) is a very common long-term
condition and powerful risk factor for cardiovascular disease (CVD).
Low-dose aspirin is of proven benefit in the secondary prevention of
myocardial infarction (MI) and stroke in people with pre-existing CVD.
However, in people without CVD, the rates of MI and stroke are much lower,
and the benefits of aspirin in the primary prevention of CVD are largely
balanced by an increased risk of bleeding. People with CKD are at greatly
increased risk of CVD and so the absolute benefits of aspirin are likely
to be greater than in lower-risk groups, even if the relative benefits are
the same. Post hoc evidence suggests the relative benefits may be greater
in the CKD population but the risk of bleeding may also be higher. A
definitive study of aspirin for primary prevention in this high-risk
group, recommended by the National Institute for Health and Care
Excellence (NICE) in 2014, has never been conducted. The question has
global significance given the rising burden of CKD worldwide and the low
cost of aspirin. Method(s): ATTACK is a pragmatic multicentre,
prospective, randomised, open-label, blinded endpoint adjudication
superiority trial of aspirin 75 mg daily vs. standard care for the primary
prevention of CVD in 25,210 people aged 18 years and over with CKD
recruited from UK Primary Care. Participants aged 18 years and over with
CKD (GFR category G1-G4) will be identified in Primary Care and followed
up using routinely collected data and annual questionnaires for an average
of 5 years. The primary outcome is the time to first major vascular event
(composite of non-fatal MI, non-fatal stroke and cardiovascular death
[excluding confirmed intracranial haemorrhage and other fatal
cardiovascular haemorrhage]). Deaths from other causes (including fatal
bleeding) will be treated as competing events. The study will continue
until 1827 major vascular events have occurred. The principal safety
outcome is major intracranial and extracranial bleeding; this is
hypothesised to be increased in those randomised to take aspirin. The key
consideration is then whether and to what extent the benefits of aspirin
from the expected reduction in CVD events exceed the risks of major
bleeding. Discussion(s): This will be the first definitive trial of
aspirin for primary CVD prevention in CKD patients. The research will be
of great interest to clinicians, guideline groups and policy-makers, in
the UK and globally, particularly given the high and rising prevalence of
CKD that is driven by population ageing and epidemics of obesity and
diabetes. The low cost of aspirin means that a positive result would be of
relevance to low- and middle-income countries and the impact in the
developed world less diluted by any inequalities in health care access.
Trial registration: ISRCTN: ISRCTN40920200. EudraCT: 2018-000644-26.
ClinicalTrials.gov: NCT03796156. Copyright © 2022, The Author(s).

<16>
Accession Number
2007236979
Title
Sutureless versus transcatheter aortic valves in elderly patients with
aortic stenosis at intermediate risk: A multi-institutional study.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(3) (pp 925-935.e5),
2022. Date of Publication: March 2022.
Author
Muneretto C.; Solinas M.; Folliguet T.; Di Bartolomeo R.; Repossini A.;
Laborde F.; Rambaldini M.; Santarpino G.; Di Bacco L.; Fischlein T.
Institution
(Muneretto, Repossini, Di Bacco) University of Brescia, Brescia, Italy
(Solinas) Monasterio Foundation Heart Hospital, Massa, Italy
(Folliguet) Centre Hospitalo-universitaire Brabois ILCV, Vandoeuvre les
Nancy, France
(Di Bartolomeo) University of Bologna, Bologna, Italy
(Laborde) Institut Mutualiste Montsouris, Paris, France
(Rambaldini) Carlo Poma Hospital of Mantova, Mantova, Italy
(Santarpino, Fischlein) Universitatsklinik der Paracelsus Medizinischen
Privatuniversitat, Nuremberg, Germany
Publisher
Elsevier Inc.
Abstract
Objective: This multi-institutional study compares the long-term outcome
of elderly patients with severe aortic stenosis and an intermediate risk
profile undergoing sutureless versus transcatheter aortic valve
implantation. Method(s): From 2008 to 2015, 967 elderly patients (>75
years) with intermediate risk (Society of Thoracic Surgeons score 4%-8%)
and isolated aortic stenosis were included in the study (sutureless valve
= 481; transcatheter aortic valve implantation = 486). After propensity
score matching, 2 matched groups of 291 patients were obtained.
Transcatheter valves implanted in patients were the CoreValve (Medtronic,
Minneapolis, Minn), Edwards SAPIEN-XT (Edwards Lifesciences, Irvine,
Calif), and Acurate-TA (Symetis, Lausanne, Switzerland). Primary end
points included all-cause death at 30 days and 5 years. Secondary end
points included early and 5-year incidence of composite adverse events
(major adverse cardiovascular events: all-cause death, stroke, pacemaker
implant, myocardial infarction, paravalvular leak >=II, and reoperation).
 Result(s): After matching, there were no substantial differences
between groups. The 30-day mortality was significantly lower in the
sutureless valve group (sutureless valve = 1.7% vs transcatheter aortic
valve implantation = 5.5%; P = .024) and the rate of permanent pacemaker
implantation (sutureless valve = 5.5% vs transcatheter aortic valve
implantation = 10.7%, P = .032). Stroke/transient ischemic attack
cumulative incidence at 5 years was 1.4% in the sutureless valve group and
5.3% in the transcatheter aortic valve implantation group (P = .010). The
incidence of perivalvular leak grade II or greater was 1.3% in the
sutureless valve group and 9.8% in the transcatheter aortic valve
implantation group (P < .001). At 60 months follow-up, the all-cause death
rate was lower in the sutureless valve group than in the transcatheter
aortic valve implantation group (sutureless valve = 16.1% +/- 4.1% vs
transcatheter aortic valve implantation = 28.9% +/- 5.3%, P = .006), and
the major adverse cardiovascular event rate was lower in the sutureless
valve group (sutureless valve = 23.5% +/- 4.1% vs transcatheter aortic
valve implantation = 39.0% +/- 5.6%, P = .002). Multivariable Cox
regression identified transcatheter aortic valve implantation as an
independent predictor for 5-year mortality and major adverse
cardiovascular events (hazard ratio, 1.86; confidence interval, 1.09-3.18;
P = .022) (hazard ratio, 1.73; confidence interval, 1.13-2.73; P = .010).
 Conclusion(s): Sutureless valves improved the outcomes of aortic
stenosis in elderly patients with an intermediate risk profile when
compared with transcatheter aortic valve implantation. The use of
transcatheter aortic valve implantation in this subset population should
be evaluated in further controlled randomized trials with sutureless valve
use in a comparative cohort. Copyright © 2020 The American
Association for Thoracic Surgery

<17>
Accession Number
2017664609
Title
Amphilimus- vs. zotarolimus-eluting stents in patients with diabetes
mellitus and coronary artery disease: The SUGAR trial.
Source
European Heart Journal. 43(13) (pp 1320-1330), 2022. Date of Publication:
01 Apr 2022.
Author
Romaguera R.; Salinas P.; Gomez-Lara J.; Brugaletta S.; Gomez-Menchero A.;
Romero M.A.; Garcia-Blas S.; Ocaranza R.; Bordes P.; Kockar M.J.;
Salvatella N.; Jimenez-Diaz V.A.; Alameda M.; Trillo R.; Lee D.H.; Martin
P.; Lopez-Benito M.; Freites A.; Pascual-Tejerina V.; Hernandez-Hernandez
F.; Blanco B.G.D.; Mohandes M.; Bosa F.; Pinar E.; Roura G.; Comin-Colet
J.; Fernandez-Ortiz A.; MacAya C.; Rossello X.; Sabate M.; Pocock S.J.;
Gomez-Hospital J.A.; Salazar C.H.; Ortega-Paz L.; De La Torre Hernandez
J.M.; De Prado A.P.; Sanchis J.; Ojeda S.; Ferreiro J.L.; Gracida M.;
Fuentes L.; Teruel L.; Muntane-Carol G.; Castillo-Poyo R.; Jimenez-Quevedo
P.; Cequier A.
Institution
(Romaguera, Gomez-Lara, Roura, Comin-Colet, Gomez-Hospital) Hospital de
Bellvitge - IDIBELL, University of Barcelona, Barcelona, Spain
(Salinas, Fernandez-Ortiz, MacAya) Hospital Clinico San Carlos, Instituto
de Investigacion Sanitaria Del Hospital Clinico San Carlos (IdISSC),
Madrid, Spain
(Brugaletta, Sabate) Hospital Clinic, Institut d'Investigacions
Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona,
Barcelona, Spain
(Gomez-Menchero) Hospital Juan Ramon Jimenez, Huelva, Spain
(Romero) Hospital Reina Sofia, Cordoba, Spain
(Garcia-Blas) Hospital Clinico Universitario de Valencia-INCLIVA,
Valencia, Spain
(Garcia-Blas) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares (CIBERCV)
(Ocaranza) Hospital Lucus Augusti, Lugo, Spain
(Bordes) Hospital General Universitario, Alicante, Spain
(Kockar) Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Salvatella) Hospital Del Mar, Barcelona, Spain
(Jimenez-Diaz) Hospital Alvaro Cunqueiro, University Hospital of Vigo,
Vigo, Spain
(Alameda, Rossello) Hospital Universitario Son Espases - IDISBA, Mallorca,
Spain
(Trillo) Hospital de Santiago, Santiago de Compostela, Spain
(Lee) Hospital Marques de Valdecilla, Santander, Spain
(Martin) Hospital Doctor Negrin, Gran Canaria, Spain
(Lopez-Benito) Hospital Universitario de Leon, Leon, Spain
(Freites) Hospital San Juan, Alicante, Spain
(Pascual-Tejerina) Hospital Virgen de la Salud, Toledo, Spain
(Hernandez-Hernandez) Clinica Universidad de Navarra, Madrid, Spain
(Blanco) Hospital Vall d'Hebron, Barcelona, Spain
(Mohandes) Hospital Joan XXIII de Tarragona, Tarragona, Spain
(Bosa) Hospital Universitario de Canarias, Tenerife, Spain
(Pinar) Hospital Virgen de la Arrixaca, Murcia, Spain
(Rossello, Pocock) Centro Nacional de Investigaciones Cardiovaculares
(CNIC), Madrid, Spain
(Rossello) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: Patients with diabetes mellitus are at high risk of adverse events
after percutaneous revascularization, with no differences in outcomes
between most contemporary drug-eluting stents. The Cre8 EVO stent releases
a formulation of sirolimus with an amphiphilic carrier from laser-dug
wells, and has shown clinical benefits in diabetes. We aimed to compare
Cre8 EVO stents to Resolute Onyx stents (a contemporary polymer-based
zotarolimus-eluting stent) in patients with diabetes. Methods and
Results: We did an investigator-initiated, randomized, controlled,
assessor-blinded trial at 23 sites in Spain. Eligible patients had
diabetes and required percutaneous coronary intervention. A total of 1175
patients were randomly assigned (1:1) to receive Cre8 EVO or Resolute Onyx
stents. The primary endpoint was target-lesion failure, defined as a
composite of cardiac death, target-vessel myocardial infarction, and
clinically indicated target-lesion revascularization at 1-year follow-up.
The trial had a non-inferiority design with a 4% margin for the primary
endpoint. A superiority analysis was planned if non-inferiority was
confirmed. There were 106 primary events, 42 (7.2%) in the Cre8 EVO group
and 64 (10.9%) in the Resolute Onyx group [hazard ratio (HR): 0.65, 95%
confidence interval (CI): 0.44-0.96; Pnon-inferiority < 0.001;
Psuperiority = 0.030]. Among the secondary endpoints, Cre8 EVO stents had
significantly lower rate than Resolute Onyx stents of target-vessel
failure (7.5% vs. 11.1%, HR: 0.67, 95% CI: 0.46-0.99; P = 0.042). Probable
or definite stent thrombosis and all-cause death were not significantly
different between groups. Conclusion(s): In patients with diabetes,
Cre8 EVO stents were non-inferior to Resolute Onyx stents with regard to
target-lesion failure composite outcome. An exploratory analysis for
superiority at 1 year suggests that the Cre8 EVO stents might be superior
to Resolute Onyx stents with regard to the same outcome. Clinical trial
registration: ClinicalTrials.gov: NCT03321032. Copyright © 2021
The Author(s) 2021. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<18>
Accession Number
2017664244
Title
Impact of early quantitative morbidity on 1-year outcomes in coronary
artery bypass graft surgery.
Source
Interactive Cardiovascular and Thoracic Surgery. 34(4) (pp 523-531), 2022.
Date of Publication: 01 Apr 2022.
Author
Hebert M.; Lamy A.; Noiseux N.; Stevens L.-M.
Institution
(Hebert) Faculty of Medicine, Universite de Montreal, Montreal, QC, Canada
(Lamy) Division of Cardiac Surgery, Department of Surgery, Hamilton
General Hospital, Hamilton, ON, Canada
(Noiseux, Stevens) Division of Cardiac Surgery, Department of Surgery,
Centre Hospitalier Universitaire, Universite de Montreal, 1000 Saint-Denis
Street, Montreal, QC H2X 0C1, Canada
Publisher
Oxford University Press
Abstract
OBJECTIVES: We applied the Clavien-Dindo Complications Classification
(CDCC) and the Comprehensive Complication Index (CCI) to the CORONARY
trial to assess whether quantitative early morbidity affects outcomes at 1
year. METHOD(S): All postoperative hospitalization and 30-day
follow-up complications were assigned a CDCC grade. CCI were calculated
for all patients (n = 4752). Kaplan-Meier analysis examined 1-year
mortality and 1-year co-primary outcome (i.e. death, non-fatal stroke,
non-fatal myocardial infarction, new-onset renal failure requiring
dialysis or repeat coronary revascularization) by CDCC grade.
Multivariable logistic regression evaluated the predictive value of CCI
for both outcomes. RESULT(S): For off-pump and on-pump coronary
artery bypass graft surgery, median CDCC were 1 [interquartile range: 0,
2] and 2 [1, 2] (P < 0.001), while median CCI were 8.7 [0, 22.6] and 20.9
[8.7, 29.6], respectively (P < 0.001). In on-pump, there were more grade I
and grade II complications, particularly grade I and II transfusions (P <
0.001) and grade I acute kidney injury (P = 0.039), and more grade IVa
respiratory failures (P = 0.047). Patients with >=IIIa complications had
greater cumulative 1-year mortality (P < 0.001). The median CCI was 8.7
[0, 22.6] in patients who survived and 22.6 [8.7, 44.3] in patients who
died at 1 year (P < 0.001). The CCI remained an independent risk factor
for 1-year mortality and 1-year co-primary outcome after multivariable
adjustment (P < 0.001). CONCLUSION(S): On-pump coronary artery bypass
graft surgery had a greater number of complications in the early
postoperative period, likely driven by transfusions, respiratory outcomes
and acute kidney injury. This affects 1-year outcomes. Similar analyses
have not yet been used to compare both techniques and could prove useful
to quantify procedural morbidity. Copyright © 2021 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<19>
Accession Number
2017647789
Title
Factor XIII and surgical bleeding.
Source
Minerva Anestesiologica. 88(3) (pp 156-165), 2022. Date of Publication:
March 2022.
Author
Guilabert P.; Asmis L.; Cortina V.; Barret J.P.; Colomina M.J.
Institution
(Guilabert) Department of Anesthesia and Critical Care, Vall d'Hebron
University Hospital, Autonomous University of Barcelona, Barcelona, Spain
(Asmis) University of Zurich, Center for Perioperative Thrombosis and
Hemostasis, Zurich, Switzerland
(Cortina) Hemostasis Laboratory, Vall d'Hebron University Hospital,
Barcelona, Spain
(Barret) Department of Plastic Surgery and Burn Center, Vall d'Hebron
University Hospital, Autonomous University of Barcelona, Barcelona, Spain
(Colomina) Department of Anesthesia and Critical Care, Bellvitge
University Hospital, University of Barcelona, Barcelona, Spain
Publisher
Edizioni Minerva Medica
Abstract
Factor XIII (FXIII) is the final factor in the coagulation cascade. It
converts soluble fibrin monomers into a stable fibrin clot, prevents
premature degradation of fibrin, participates in wound healing, and helps
prevent the loss of the endothelial barrier function. FXIII deficiency is
believed to be rare, and this may explain why clinicians do not routinely
take it into consideration. Congenital FXIII deficiency is a rare disease
with a reported prevalence of 1 per million. However, the prevalence of
acquired FXIII deficiency is much higher. Acquired forms have been
described in patients with decreased hepatic or bone marrow synthesis,
overconsumption and increased degradation by autoantibodies. This review
offers guidance on how to suspect and diagnose FXIII deficiency in both
the preoperative consultation and different surgical settings. We also
analyze current scientific evidence in order to clarify when and why this
clinical situation should be suspected, and how it may be
treated. Copyright © 2022 EDIZIONI MINERVA MEDICA.

<20>
Accession Number
2015508266
Title
Aortic Valve Repair Decreases Risks of VRE in AI at 10 Years: A Propensity
Score-Matched Analysis.
Source
Annals of Thoracic Surgery. 113(5) (pp 1469-1475), 2022. Date of
Publication: May 2022.
Author
Jabagi H.; Chan V.; Ruel M.; Mesana T.G.; Boodhwani M.
Institution
(Jabagi, Chan, Ruel, Mesana, Boodhwani) Division of Cardiac Surgery,
University of Ottawa Heart Institute, Ottawa, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Aortic valve repair (AVr) has emerged as a feasible and
effective alternative to AV replacement (AVR) in patients with aortic
insufficiency (AI); however, little data exist comparing outcomes. Thus,
the objective of this study was to compare early and long-term
valve-related complications between AVr and AVR in the treatment of AI.
 Method(s): This was a single-center, retrospective study of all
patients (n = 417) undergoing AVr (n = 264) or AVR (n = 153) for primary
AI. Propensity matching using a 1:1 greedy matching algorithm identified
140 patients using 6 covariates (age, sex, left ventricular function,
size, presence of aortopathy, and urgency of operation) for comparison.
The primary outcome was a composite of all valve-related events (VREs),
including endocarditis, myocardial infarction stroke, transient ischemic
attack, thromboembolisms, bleeding, and AV reoperation. VREs were defined
as per published guidelines. Survival and freedom from VREs were reported
using the Kaplan-Meier method. Result(s): Propensity matching
identified 70 well-matched pairs with no major differences in baseline
demographics, comorbidities, or AI severity (P = .57). Perioperative
outcomes showed no significant differences in VREs (AVR 8 vs AVr 7; P =
.78) or mortality (AVR 3 vs AVr 1; P = .62). Event-free survival from the
primary outcome at 10 years was significantly better after AVr than after
AVR (82% vs 68%; P = .024), with no significant differences in 10-year
overall survival between groups (82% vs 72%; P = .29). No significant
differences in AI severity (P = .07) or reoperation rate (P = .44) were
detected between groups. Conclusion(s): This study demonstrated a
lower long-term risk of VREs with repair compared with replacement, with
low mortality and comparable durability. Further prospective randomized
control trials are necessary to formally compare outcomes and determine
superiority. Copyright © 2022 The Society of Thoracic Surgeons

<21>
Accession Number
2016192965
Title
PRE-SURGICAL USE of MELATONIN and ITS SIGNIFICANCE on ENHANCING PROGNOSIS
PROCESS in PATIENTS UNDERGOING CARDIOPULMONARY BYPASS GRAFT.
Source
Bulletin of Pharmaceutical Sciences. Assiut. 44(2) (pp 455-466), 2021.
Date of Publication: December 2021.
Author
Jouybar R.; Jannati M.; Khademi S.
Institution
(Jouybar, Khademi) Anesthesiology and Critical Care Research Center,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Jannati) Cardiovascular Ward, Namazi Hospital, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Assiut University
Abstract
One treatment choice for patients with coronary artery disease is coronary
artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB).
After CABG, a series of inflammatory processes occur which affect other
organs of the body and even cause severe organ damage and subsequently a
worse prognosis. The purpose of this study was to evaluate the effect of
pre-surgically administered Melatonin (MTN) on interleukins 22 and 13 in
patients undergoing CABG. In this clinical trial study, 22 patients were
evaluated, 10 patients (45.5%) in the MTN group, and 12 patients in the
placebo group. The MTN group received 10 mg/day of MTN and the placebo
group received placebo 2 weeks before surgery. Serum interleukin 13
(IL-13) and interleukin 22 (IL-22) levels were measured two weeks before
surgery (T1), on the day of surgery before induction (T2), 6 hrs. after
removal of the pump by the cardiac surgeon (T3), and 2 days after surgery
(T4). The mean level of IL-22 at all time points in T2, T3, and T4 was
significantly lower in the MTN group (P <0.05). There was also a
significant increase in IL-22 in both groups at T4 compared to T1. The
levels of IL-13 were also decreased, however, in the MTN group, the
difference was only significant at T2 compared to T1 for IL-13. The
current study found that taking melatonin for two weeks before having CABG
can help to minimize inflammation and inflammatory biomarkers including
IL-22 and IL-13 after the procedure. Copyright © 2021 Assiut
University. All rights reserved.

<22>
Accession Number
2016081482
Title
Advances in Clinical Cardiology 2021: A Summary of Key Clinical Trials.
Source
Advances in Therapy. (no pagination), 2022. Date of Publication: 2022.
Author
Savage P.; Cox B.; Linden K.; Coburn J.; Shahmohammadi M.; Menown I.
Institution
(Savage, Cox, Linden, Coburn, Shahmohammadi, Menown) Craigavon Cardiac
Centre, Southern Health and Social Care Trust, Northern Ireland,
Craigavon, United Kingdom
Publisher
Adis
Abstract
Introduction: Over the course of 2021, numerous key clinical trials with
valuable contributions to clinical cardiology were published or presented
at major international conferences. This review seeks to summarise these
trials and reflect on their clinical context. Method(s): The authors
reviewed clinical trials presented at major cardiology conferences during
2021 including the American College of Cardiology (ACC), European
Association for Percutaneous Cardiovascular Interventions (EuroPCR),
European Society of Cardiology (ESC), Transcatheter Cardiovascular
Therapeutics (TCT), American Heart Association (AHA), European Heart
Rhythm Association (EHRA), Society for Cardiovascular Angiography and
Interventions (SCAI), TVT-The Heart Summit (TVT) and Cardiovascular
Research Technologies (CRT). Trials with a broad relevance to the
cardiology community and those with potential to change current practice
were included. Result(s): A total of 150 key cardiology clinical
trials were identified for inclusion. Interventional cardiology data
included trials evaluating the use of new generation novel stent
technology and new intravascular physiology strategies such as
quantitative flow ratio (QFR) to guide revascularisation in stable and
unstable coronary artery disease. New trials in acute coronary syndromes
focused on shock, out of hospital cardiac arrest (OOHCA), the impact of
COVID-19 on ST-elevation myocardial infarction (STEMI) networks and
optimal duration/type of antiplatelet treatment. Structural intervention
trials included latest data on transcatheter aortic valve replacement
(TAVR) and mitral, tricuspid and pulmonary valve interventions. Heart
failure data included trials with sodium-glucose cotransporter 2 (SGLT2)
inhibitors, sacubitril/valsartan and novel drugs such as mavacamten for
hypertrophic cardiomyopathy (HCM). Prevention trials included new data on
proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. In
electrophysiology, new data regarding atrial fibrillation (AF) screening
and new evidence for rhythm vs. rate control strategies were evaluated.
 Conclusion(s): This article presents a summary of key clinical
cardiology trials published and presented during the past year and should
be of interest to both practising clinicians and
researchers. Copyright © 2022, The Author(s).

<23>
Accession Number
2017889459
Title
Diagnostic Value of Coronary Computed Tomography Angiography Image under
Automatic Segmentation Algorithm for Restenosis after Coronary Stenting.
Source
Contrast Media and Molecular Imaging. 2022 (no pagination), 2022. Article
Number: 7013703. Date of Publication: 2022.
Author
He X.; Zhao J.; Xu Y.; Lei H.; Zhang X.; Xiao T.
Institution
(He, Xu) Department Of Cardiovascular Medicine 7, Xianyang Hospital Of
Yan'an University, Shaanxi, Xianyang 712000, China
(Zhao) Department Of Cardiovascular Medicine 2, Xianyang Hospital Of
Yan'an University, Shaanxi, Xianyang 712000, China
(Lei) Interventional Operating Room, Shangluo Central Hospital, Shaanxi,
Shangluo 726000, China
(Zhang) Department Of Cardiology, Xi'an Changan Hospital, Shaanxi, Xi'an
710000, China
(Xiao) Department Of Cardiovascular Medicine, Shangluo Central Hospital,
Shaanxi, Shangluo 726000, China
Publisher
Hindawi Limited
Abstract
The diagnostic efficacy of coronary computed tomography angiography (CTA)
images of coronary arteries in restenosis after coronary stenting based on
the combination of the convolutional neural network (CNN) algorithm and
the automatic segmentation algorithm for region growth of vascular
similarity features was explored to provide a more effective diagnostic
method for patients. 130 patients with coronary artery disease were
randomly selected as the research objects, and they were averagely
classified into the control group (conventional coronary CTA image
diagnosis) and the observation group (coronary CTA image diagnosis based
on an improved automatic segmentation algorithm). Based on the diagnostic
criteria of coronary angiography (CAG), the efficacy of two kinds of
coronary CTA images on the postoperative subsequent visit of coronary
heart disease (CHD) stenting was evaluated. The results showed that the
accuracy of the CNN algorithm was 87.89%, and the average voxel error of
the improved algorithm was signally lower than that of the traditional
algorithm (1.8921 HU/voxel vs. 7.10091 HU/voxel) (p < 0.05). The average
score of the coronary CTA image in the observation group was higher than
that in the control group (2.89 +/- 0.11 points vs. 2.01 +/- 0.73 points)
(p < 0.05). The diagnostic sensitivity (91.43%), specificity (86.76%),
positive predictive value (88.89%), negative predictive value (89.66%),
and accuracy (89.23%) of the observation group were higher than those of
the control group (p < 0.05). In conclusion, the region growth algorithm
under the CNN algorithm and vascular similarity features had an accurate
segmentation effect, which was helpful for the diagnosis of CTA image in
restenosis after coronary stenting. Copyright © 2022 Xinrong He
et al.

<24>
Accession Number
2017875337
Title
Bilateral erector spinae plane blocks in children undergoing cardiac
surgery: A randomized, controlled study.
Source
Journal of Clinical Anesthesia. 80 (no pagination), 2022. Article Number:
110797. Date of Publication: September 2022.
Author
Karacaer F.; Biricik E.; Ilginel M.; Tunay D.; Topcuoglu S.; Unlugenc H.
Institution
(Karacaer, Biricik, Ilginel, Tunay, Unlugenc) Department of Anesthesiology
and Reanimation, Cukurova University, Adana, Turkey
(Topcuoglu) Department of Cardiovascular Surgery, Cukurova University,
Adana, Turkey
Publisher
Elsevier Inc.
Abstract
Study objective: We aimed to test the hypothesis that erector spinae plane
block (ESPB) provides efficient analgesia and reduces postoperative
morphine consumption in children undergoing cardiac surgery with median
sternotomy. Design(s): A prospective, blinded, randomized, controlled
study. Setting(s): A tertiary university hospital, operating room and
intensive care unit. Patient(s): Forty children aged 2-10 years, who
underwent cardiac surgery with median sternotomy. The patients were
randomly divided into the block group (Group B) and the control group
(Group C). Intervention(s): Group B (n = 20) were treated with
ultrasound-guided bilateral ESPB at the level of the T4-T5 transverse
process, whereas no block was administered in Group C (n = 20). In all
children, intravenous morphine at 0.05 mg/kg was used whenever the
modified objective pain score (MOPS) >=4 for postoperative analgesia.
Measurements: The MOPS and Ramsay sedation score (RSS) were assessed at 0,
1, 2, 4, 6, 8, 10, 12, 16, 20 and 24 h postoperatively. Total morphine
consumption at 24 h, extubation time and length of intensive care unit
(ICU) stay was also evaluated and recorded. Main Result(s): Bilateral
ESPB significantly decreased the consumption of morphine in the first 24
h, postoperatively. During the postoperative 24-h follow-up, 11 children
in Group C requested morphine and the cumulative dose of morphine was 0.83
+/- 0.91 mg, while 4 children in Group B requested morphine and the
cumulative dose of morphine was 0.26 +/- 0.59 mg (p = 0.043). There was no
significant difference between Groups B and C in terms of MOPS and RSS
values, extubation time or length of ICU stay. Conclusion(s):
Ultrasound-guided bilateral ESPB with bupivacaine provides efficient
postoperative analgesia and reduces postoperative morphine consumption at
24 h in children undergoing cardiac surgery. Copyright © 2022
Elsevier Inc.

<25>
Accession Number
2016161468
Title
Crossed pulmonary arteries: An underestimated cardiovascular variant with
a strong association with genetic syndromes-A report of 74 cases with
systematic review of the literature.
Source
American Journal of Medical Genetics, Part A. (no pagination), 2022. Date
of Publication: 2022.
Author
Mastromoro G.; Calcagni G.; Vignaroli W.; Anaclerio S.; Pugnaloni F.;
Rinelli G.; Secinaro A.; Bordonaro V.; Putotto C.; Unolt M.; Digilio M.C.;
Marino B.; Versacci P.
Institution
(Mastromoro, Vignaroli, Anaclerio, Pugnaloni, Putotto, Marino, Versacci)
Department of Pediatrics, Obstetrics and Gynecology, "Sapienza" University
of Rome, Rome, Italy
(Calcagni, Rinelli, Unolt) Department of Pediatric Cardiology and Cardiac
Surgery, Bambino Gesu Pediatric Hospital and Research Institute, Rome,
Italy
(Secinaro, Bordonaro) Department of Imaging, Advanced Cardiovascular
Imaging Unit, Bambino Gesu Pediatric Hospital and Research Institute,
Rome, Italy
(Digilio) Rare Diseases and Medical Genetics, Department of Pediatrics,
Bambino Gesu Pediatric Hospital and Research Institute, Rome, Italy
Publisher
John Wiley and Sons Inc
Abstract
Crossed pulmonary arteries (CPAs) represent an uncommon anatomic variant,
usually associated with some specific syndromes and conotruncal defects.
This finding has been described in 22q11.2 Deletion Syndrome (22q11.2DS).
We evaluated the correlation between CPAs and genetic diseases, in order
to better define the characteristics of this variant, considered a rare
anatomic pattern. An in-depth analysis of CPAs genotype-phenotype
correlations was performed via a literature review. We detected 74 CPAs
patients through echocardiography. Of these 74 patients, 35.1% of patients
showed additional intracardiac malformations, while 29.7% showed
extracardiac vascular anomalies, of which 16.2% were associated with
intracardiac defects and 13.5% were not. In all, 62.2% of patients were
diagnosed with genetic diseases and 52.2% of them were 22q11.2DS patients.
In conclusions, CPAs represent a cardiovascular variant, which is
detectable in nonsyndromic individuals, but especially in various genetic
syndromes and in particular in 22q11.2DS patients. Data on the real
prevalence of this morphology is lacking in literature. Knowledge of this
anatomic variant is useful to interpret the unusual course of the
pulmonary branches and is helpful information before cardiovascular
surgical correction. Moreover, due to the strong association of CPAs with
some genetic syndromes, the identification of this anatomic pattern can
indicate the utility of a genetic assessment of these
patients. Copyright © 2022 Wiley Periodicals LLC.

<26>
Accession Number
2016133072
Title
Predicting outcomes of mesenteric ischemia postcardiac surgery: A
systematic review.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Kayali F.; Sarodaya V.; Shah H.I.; Hayat M.Y.; Leung M.S.T.; Harky A.
Institution
(Kayali) UCLan Medical School, University of Central Lancashire, Preston,
United Kingdom
(Sarodaya) Department of Critical Care Medicine, Barts Health NHS Trust,
London, United Kingdom
(Shah) UCL Medical School, University College London, London, United
Kingdom
(Hayat) Faculty of Medicine, St George's Hospital Medical School, London,
United Kingdom
(Leung) Department of Surgery, Imperial Healthcare Trust, London, United
Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Objective: This systematic review aims to identify predictors of outcomes
of mesenteric ischemia in patients following cardiac surgery.
 Method(s): A comprehensive literature search was done on EMBASE,
PubMed, Ovid MEDLINE, and SCOPUS using keywords relating to bowel ischemia
and cardiac surgery. Database search results were screened by at least two
authors and 32 articles were selected for inclusion in this review.
 Result(s): Data on 1907 patients were analyzed. The mean age was 70.0
+/- 2.99 years and the prevalence of bowel ischemia was 1.74%. Advanced
age was a significant risk factor. 63.16% of patients reported were men,
and 58.4% of patients died in hospital. There was heterogeneity in the
reported significance of the following preoperative risk factors:
hypertension, smoking status, type 2 diabetes mellitus, end-stage renal
disease, preoperative left ventricular ejection fraction <35%.
Cardiopulmonary bypass (CPB) time, preoperative/operative intra-aortic
balloon pump (IABP) support, and inotrope usage were significantly
associated with the development of mesenteric ischemia; however, other
intraoperative factors including the type of cardiac surgery and duration
of aortic cross-clamping had varying levels of reported significance.
There were discrepancies in the reported significance of leukocytosis and
metabolic acidosis (pH <7.3) as postoperative markers. Postoperative
vasopressor use, prolonged ventilation time, and elevation in lactate,
transaminases, creatinine, and intestinal fatty acid-binding protein
(IFABP) levels were found to be strongly associated with bowel ischemia.
 Conclusion(s): This systematic review found the strongest
associations of mesenteric ischemia postcardiac surgery to be advanced
age, CPB time, rise in lactate, transaminases, creatinine, and IFABP. IABP
support, vasopressor, and inotrope use as well as prolonged ventilation
were strongly linked too. Copyright © 2022 Wiley Periodicals LLC.

<27>
Accession Number
2016132836
Title
Systematic review of electrophysiology procedures in patients with
obstruction of the inferior vena cava.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2022. Date
of Publication: 2022.
Author
Al-Sinan A.; Chan K.H.; Young G.D.; Martin A.; Sepahpour A.; Sy R.W.
Institution
(Al-Sinan, Chan, Sy) Department of Cardiology, Royal Prince Alfred
Hospital, Sydney, Australia
(Al-Sinan) Department of Cardiology, Waikato Hospital, Hamilton, New
Zealand
(Chan, Sy) Faculty of Medicine and Health, The University of Sydney,
Sydney, Australia
(Young) Department of Cardiology, Royal Adelaide Hospital, Adelaide,
Australia
(Martin) Green Lane Cardiovascular Service, Auckland City Hospital,
Auckland, New Zealand
(Sepahpour) Department of Cardiology, St. George Hospital, Sydney,
Australia
Publisher
John Wiley and Sons Inc
Abstract
Aims: The objective of the study was to conduct a systematic review to
describe and compare the different approaches for performing cardiac
electrophysiology (EP) procedures in patients with interrupted inferior
vena cava (IVC) or equivalent entities causing IVC obstruction.
 Method(s): We conducted a structured search to identify manuscripts
reporting EP procedures with interrupted IVC or IVC obstruction of any
aetiology published up until August 2020. No restrictions were applied in
the search strategy. We also included seven local cases that met inclusion
criteria. Result(s): The analysis included 142 patients (mean age
48.9 years; 48% female) undergoing 143 procedures. Obstruction of the IVC
was not known before the index procedure in 54% of patients. Congenital
interruption of IVC was the most frequent cause (80%); and, associated
congenital heart disease (CHD) was observed in 43% of patients in this
setting. The superior approach for ablation was the most frequently used
strategy (52%), followed by inferior approach via the azygos or hemiazygos
vein (24%), transhepatic approach (14%), and retroaortic approach (10%).
Electroanatomical mapping (58%), use of long sheaths (41%), intracardiac
echocardiography (19%), transesophageal echocardiography (15%) and remote
controlled magnetic navigation (13%) were used as adjuncts to aid
performance. Ablation was successful in 135 of 140 procedures in which
outcomes were reported. Major complications were only reported in patients
undergoing AF ablation, including two patients with pericardial effusion,
one of whom required surgical repair, and another patient who died after
inadvertent entry into an undiagnosed atrioesophageal fistula from a
previous procedure. Conclusion(s): The superior approach is most
frequent approach for performing EP procedures in the setting of
obstructed IVC. Transhepatic approach is a feasible alternative, and may
provide a "familiar approach" for transseptal access when it is required.
Adjunctive use of long sheaths, intravascular echocardiography,
electro-anatomical mapping and remote magnetic navigation may be helpful,
especially if there is associated complex CHD. With careful planning, EP
procedures can usually be successfully performed with a low risk of
complications. Copyright © 2022 The Authors. Journal of
Cardiovascular Electrophysiology published by Wiley Periodicals LLC.

<28>
Accession Number
2016005077
Title
Novel oral anticoagulants versus vitamin K antagonists in patients with
atrial fibrillation after transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Memon M.M.; Siddiqui A.A.; Amin E.; Shaikh F.N.; Khan M.S.; Doukky R.;
Krasuski R.A.
Institution
(Memon, Siddiqui, Amin, Shaikh) Department of Medicine, Dow University of
Health Sciences, Karachi, Pakistan
(Khan, Krasuski) Division of Cardiology, Duke University Medical Center,
Durham, NC, United States
(Doukky) Division of Cardiology, Cook County Health and Hospitals System,
Chicago, IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The efficacy and safety of novel oral anticoagulants (NOACs)
compared to the current guideline-recommended vitamin K antagonists (VKAs)
in atrial fibrillation (AF) patients undergoing transcatheter aortic valve
replacement (TAVR) has not been well established. We pooled evidence from
all available studies to assess the risks and benefits of this drug class.
 Method(s): We queried electronic databases (MEDLINE, Scopus, and
Cochrane central) up until January 28th, 2022 for studies comparing NOACs
to VKAs in AF patients undergoing TAVR. Results from studies were
presented as risk ratios (RR) and pooled using a random-effects model.
Subgroup analysis by study design and meta-regression analysis were
performed to explore heterogeneity. Result(s): A total of 12 studies
(3 RCTs and 9 observational) containing 12,203 patients (mean age 81.2
years; 50.5% men) were identified and included in the analysis. Pooled
analysis revealed no significant difference between NOACs and VKAs in
terms of stroke or systemic embolism (RR: 0.78; p = 0.18), major bleeding
(RR: 0.84; p = 0.32), intracranial hemorrhage (RR 0.61; p = 0.06),
all-cause mortality (RR: 0.69; p = 0.07), and myocardial infarction (RR:
1.60; p = 0.24) at a mean length of follow-up of 15.1 months. RCTs and
observational studies did not significantly differ across outcomes on
subgroup analysis. Meta-regression analysis found heterogeneity in
all-cause mortality to be significantly explained by percentage of males
(coefficient: 0.049, p = 0.007), mean age (coefficient: 0.221, p < 0.001),
and CHA2DS2-VASc score (coefficient: -1.657, p < 0.001).
 Conclusion(s): This meta-analysis suggests that outcomes with NOACs
do not significantly differ compared to VKAs following TAVR in patients
with AF. Copyright © 2022 Wiley Periodicals LLC.

<29>
Accession Number
2015583769
Title
Non-heparin-induced thrombocytopenia in patients after open-heart surgery.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Keles E.; Bilen C.; Aygun H.; Gencpinar T.; Catalyurek H.
Institution
(Keles, Aygun) Bakircay University Cigli Training and Research Hospital,
Izmir, Turkey
(Bilen) Health Sciences University Dr Behcet Uz Training and Research
Hospital, Izmir, Turkey
(Gencpinar, Catalyurek) Dokuz Eylul University Hospital, Izmir, Turkey
Publisher
SAGE Publications Ltd
Abstract
Background: Thrombocytopenia (platelet count below 150 x
103/muL) is a common finding after open-heart surgery and can
lead to various complications, including patient death. This study aimed
to determine the extent of non-heparin-induced thrombocytopenia in
open-heart surgery and to highlight the associated factors.
 Material(s) and Method(s): In this cohort study, 842 patients who
underwent valve and/or coronary bypass surgery over a 5-year period were
retrospectively analyzed. After open-heart surgery, patients whose
platelet count was less than 150 x 103/muL on a complete blood
count 12 and 24 h after surgery were classified as thrombocytopenic. Three
hundred twenty patients without thrombocytopenia and 21 patients with a
high probability of heparin-induced thrombocytopenia were excluded from
the study. Logistic regression analysis was used to assess the association
of independent variables in moderate-severe thrombocytopenia: Age groups,
sex, underlying disease, symptoms, type of surgery, pump time, pulsatile
or non-pulsatile duration, degree of hypothermia, hemodilution, oxygenator
type, use of an intra-aortic balloon, and erythrocyte transfusion counts
were included in the analysis. Result(s): A total of 501 patients
were diagnosed as having non-heparin-induced thrombocytopenia, and 64.3%
were male. Three hundred seventy-seven (75.2%) patients had mild
thrombocytopenia and 124 (24.7%) had moderate-severe thrombocytopenia. The
postoperative platelet count was significantly lower than the preoperative
platelet count (213 x 103 vs.117 x 103/muL; p <
0.001). Moderate-severe thrombocytopenia was associated with age >=80
years odds (OR = 9.026, 95% CI: [1.757-46.363]; p = 0.008), isolated valve
surgery (OR = 3.090, 95% CI: [1.867-5.114]; p < 0.001), and valve surgery
with coronary bypass (OR = 4.938, 95% CI: [1.638-14.889]; p = 0.005)
compared to isolated coronary bypass, type of oxygenator (Nipro vital
compared with Affinity OR = 11.097, 95% CI: [1.923-64.023]; p = 0.007),
erythrocyte transfusion count (OR = 1.219, 95%CI: [1.046-1.420]; p =
0.011). Conclusion(s): Age 80 years or older, surgical procedures
including heart-valve surgery, and the number of red blood cell
transfusions are associated with the risk of moderate-to-severe
thrombocytopenia. This study provides a guide in terms of risk factors
that may lead to moderate-to-severe thrombocytopenia after open-heart
surgery. However, future multicentre prospective randomized studies may
provide more detailed information on this subject. Copyright ©
The Author(s) 2022.

<30>
Accession Number
2015556365
Title
Infective endocarditis by Actinomyces species: a systematic review.
Source
Journal of Chemotherapy. (no pagination), 2022. Date of Publication:
2022.
Author
Ioannou P.; Baliou S.; Papakitsou I.; Kofteridis D.P.
Institution
(Ioannou, Baliou, Papakitsou, Kofteridis) Department of Internal Medicine
& Infectious Diseases, University Hospital of Heraklion, Heraklion, Greece
Publisher
Taylor and Francis Ltd.
Abstract
Actinomycosis, is a slowly progressive infection that may mimic malignancy
due to the invasiveness of tissues and the ability to form sinus tracts.
Infective Endocarditis (IE) is a rare disease with significant morbidity
and mortality. Interestingly, even though there are scarce data of IE by
Actinomyces spp. in the literature, a review adequately summarizing all
available evidence on the topic in a systematic way is lacking. The aim of
this study was to systematically review all cases of IE by Actinomyces
spp. in the literature and describe the epidemiology, microbiology,
clinical characteristics, treatment and outcomes of this infection. A
systematic review of PubMed, Scopus and Cochrane library (through 19
August 2021) for studies providing epidemiological, clinical,
microbiological as well as treatment data and outcomes of IE by
Actinomyces spp. was performed. A total of 31 studies providing data for
31 patients were included. A prosthetic valve was present in 12.9%, while
the most common microorganism was A. meyeri. Aortic valve was the most
commonly infected intracardiac site, followed by the mitral valve.
Diagnosis was most commonly performed with transesophageal
echocardiography, while the diagnosis was made at autopsy in 16.1%.
Penicillin, cephalosporins and aminopenicillins were the most commonly
used antimicrobials. Clinical cure was noted in 80.6%, while mortality was
19.4%. Development of heart failure was associated with mortality by IE.
This systematic review thoroughly describes IE by Actinomyces and provides
information on epidemiology, clinical presentation, treatment and
outcomes. Copyright © 2022 Edizioni Scientifi che per
l'Informazione su Farmaci e Terapia.

<31>
Accession Number
2015516845
Title
Derivation and validation of the bridge to transplantation with left
ventricular assist device score for 1 year mortality after heart
transplantation. The BTT-LVAD score.
Source
International Journal of Artificial Organs. (no pagination), 2022. Date
of Publication: 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, GA, United States
(Fugar) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Dodoo) Department of Medicine, Piedmont Newnan Hospital, Newnan, GA,
United States
(Selevany, Al-Obaidi, Singh, Tayal, Camacho) Cardiovascular Research Unit,
RWJBarnabas Health, Newark Beth Israel Medical Center, Newark, NJ, 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, New Brunswick, NJ, United States
Publisher
SAGE Publications Ltd
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).
 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. 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). Conclusion(s): The BTT-LVAD
Score can serve as a clinical decision tool to guide therapeutic decisions
in advanced heart failure patients. Copyright © The Author(s)
2022.

<32>
[Use Link to view the full text]
Accession Number
2016121803
Title
Perioperative Pulmonary Atelectasis: Part II. Clinical Implications.
Source
Anesthesiology. 136(1) (pp 206-236), 2022. Date of Publication: 01 Jan
2022.
Author
Lagier D.; Zeng C.; Fernandez-Bustamante A.; Vidal Melo M.F.
Institution
(Lagier, Zeng, Vidal Melo) Department of Anesthesia, Critical Care and
Pain Medicine, Massachusetts General Hospital, 55 Fruit St., Boston, MA
02114, United States
(Fernandez-Bustamante) Department of Anesthesiology, University of
Colorado, Aurora, CO, United States
Publisher
Lippincott Williams and Wilkins
Abstract
The development of pulmonary atelectasis is common in the surgical
patient. Pulmonary atelectasis can cause various degrees of gas exchange
and respiratory mechanics impairment during and after surgery. In its most
serious presentations, lung collapse could contribute to postoperative
respiratory insufficiency, pneumonia, and worse overall clinical outcomes.
A specific risk assessment is critical to allow clinicians to optimally
choose the anesthetic technique, prepare appropriate monitoring, adapt the
perioperative plan, and ensure the patient's safety. Bedside diagnosis and
management have benefited from recent imaging advancements such as lung
ultrasound and electrical impedance tomography, and monitoring such as
esophageal manometry. Therapeutic management includes a broad range of
interventions aimed at promoting lung recruitment. During general
anesthesia, these strategies have consistently demonstrated their
effectiveness in improving intraoperative oxygenation and respiratory
compliance. Yet these same intraoperative strategies may fail to affect
additional postoperative pulmonary outcomes. Specific attention to the
postoperative period may be key for such outcome impact of lung expansion.
Interventions such as noninvasive positive pressure ventilatory support
may be beneficial in specific patients at high risk for pulmonary
atelectasis (e.g., obese) or those with clinical presentations consistent
with lung collapse (e.g., postoperative hypoxemia after abdominal and
cardiothoracic surgeries). Preoperative interventions may open new
opportunities to minimize perioperative lung collapse and prevent
pulmonary complications. Knowledge of pathophysiologic mechanisms of
atelectasis and their consequences in the healthy and diseased lung should
provide the basis for current practice and help to stratify and match the
intensity of selected interventions to clinical conditions. Copyright
© 2022 Lippincott Williams and Wilkins. All rights reserved.

<33>
Accession Number
2014759317
Title
Biomarkers of acute kidney injury after pediatric cardiac surgery: a
meta-analysis of diagnostic test accuracy.
Source
European Journal of Pediatrics. 181(5) (pp 1909-1921), 2022. Date of
Publication: May 2022.
Author
Van den Eynde J.; Schuermans A.; Verbakel J.Y.; Gewillig M.; Kutty S.;
Allegaert K.; Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, United States
(Van den Eynde, Schuermans, Gewillig) Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Verbakel) Department of Public Health and Primary Care, KU Leuven,
Leuven, Belgium
(Verbakel) Nuffield Department of Primary Care Health Sciences, University
of Oxford, Oxford, United Kingdom
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Allegaert) Department of Development and Regeneration, KU Leuven, Leuven,
Belgium
(Allegaert) Department of Pharmacy and Pharmaceutical Sciences, KU Leuven,
Leuven, Belgium
(Allegaert) Department of Hospital Pharmacy, Erasmus Medical Center,
Rotterdam, Netherlands
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Acute kidney injury (AKI) occurs frequently after cardiac surgery in
children. Although current diagnostic criteria rely on serum creatinine
and urine output, changes occur only after considerable loss of kidney
function. This meta-analysis aimed to synthesize the knowledge on novel
biomarkers and compare their ability to predict AKI. PubMed/MEDLINE,
Embase, Scopus, and reference lists were searched for relevant studies
published by March 2021. Diagnostic accuracy parameters were extracted and
analyzed using hierarchical summary receiver operating characteristic
(HSROC) method. Pooled estimates of the area under the curve (AUC) were
calculated using conventional random-effects meta-analysis. Fifty-six
articles investigating 49 biomarkers in 8617 participants fulfilled our
eligibility criteria. Data from 37 studies were available for
meta-analysis. Of the 10 biomarkers suitable for HSROC analysis, urinary
neutrophil gelatinase-associated lipocalin (uNGAL) to creatinine (Cr)
ratio yielded the highest diagnostic odds ratio (91.0, 95% CI 90.1-91.9),
with a sensitivity of 91.3% (95% CI 91.2-91.3%) and a specificity of 89.7%
(95% CI 89.6-89.7%). These results were confirmed in pooled AUC analysis,
as uNGAL-to-Cr ratio and uNGAL were the only elaborately studied
biomarkers (> 5 observations) with pooled AUCs >= 0.800. Liver fatty
acid-binding protein (L-FABP), serum cystatin C (sCysC), serum NGAL
(sNGAL), and interleukin-18 (IL-18) all had AUCs >= 0.700.
 Conclusion(s): A variety of biomarkers have been proposed as
predictors of cardiac surgery-associated AKI in children, of which uNGAL
was the most prominent with excellent diagnostic qualities. However, more
consolidatory evidence will be required before these novel biomarkers may
eventually help realize precision medicine in AKI management.What is
Known:* Acute kidney injury (AKI) occurs in about 30-60% of children
undergoing cardiac surgery and is associated with increased in-hospital
mortality and adverse short-term outcomes. However, in current clinical
practice, AKI definitions and detection often rely on changes in serum
creatinine and urine output, which are late and insensitive markers of
kidney injury.* Although various novel biomarkers have been studied for
the diagnosis of AKI in children after cardiac surgery, it remains unclear
how these compare to one another in terms of diagnostic accuracy.What is
New:* Pooled analyses suggest that for the diagnosis of AKI in children
who underwent cardiac surgery, NGAL is the most accurate among the most
frequently studied biomarkers.* A number of other promising biomarkers
have been reported, although they will require further research into their
diagnostic accuracy and clinical applicability. Copyright © 2022,
The Author(s), under exclusive licence to Springer-Verlag GmbH Germany,
part of Springer Nature.

<34>
Accession Number
2017930598
Title
Religious-based interventions for depression: A systematic review and
meta-analysis of experimental studies.
Source
Journal of Affective Disorders. 309 (pp 289-296), 2022. Date of
Publication: 15 Jul 2022.
Author
Marques A.; Ihle A.; Souza A.; Peralta M.; de Matos M.G.
Institution
(Marques, Peralta) CIPER, Faculdade de Motricidade Humana, Universidade de
Lisboa, Lisboa, Portugal
(Marques, Peralta, de Matos) ISAMB, Universidade de Lisboa, Lisboa,
Portugal
(Ihle) Center for the Interdisciplinary Study of Gerontology and
Vulnerability, University of Geneva, Geneva, Switzerland
(Ihle) Swiss National Centre of Competence in Research LIVES - Overcoming
Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
(Ihle) Department of Psychology, University of Geneva, Geneva, Switzerland
(Souza) Seminario Teologico Baptista, Queluz, Portugal
(de Matos) Faculdade de Motricidade Humana, Universidade de Lisboa,
Lisboa, Portugal
Publisher
Elsevier B.V.
Abstract
Background: Depression is the most prevalent mental disorder. In the
treatment of depressive symptoms, patients' religious practices and
beliefs are often not considered. We carried out a systematic review and
meta-analysis of RCTs to analyse the effect of religious interventions on
depression. Method(s): A literature screening was performed on August
2021, using the Cochrane Collaboration, PubMed, Scopus, and Web of Science
databases. Primary source articles published from 2015 to August 2021 in
peer-reviewed journals were eligible for inclusion if data were presented
on religious interventions' effects on depression. Result(s): The
literature search yielded 208 potentially relevant publications. Eight
articles were identified and included in the review. One of the articles
was excluded from the meta-analysis because it did not report the mean
data for the baseline and follow-up assessment results. From the 7 out of
8 included studies, the results consistently indicated that
religious-based interventions effectively reduced depressive symptoms
among vulnerable persons with chronic medical illness, pregnant women,
haemodialysis patients, elderly nursing home residents, people with major
depressive disorders or dysthymia, and coronary artery bypass graft
surgery patients. Limitation(s): The definition of the
religious-based intervention varied substantially among the trials. These
differences can make interpretation and comparing implications on the
treatment of depression difficult. Conclusion(s): Compared to
standard/other usual therapies for treating depression, religious-based
interventions provide superior effects. This review and meta-analysis
strongly suggest that patients' religious beliefs should be considered
when diagnosing and treating depression. Copyright © 2022
Elsevier B.V.

<35>
Accession Number
637884793
Title
Prospective national audit of major gastrointestinal complications of
transesophageal echocardiography studies in children.
Source
Annals of Cardiac Anaesthesia. 25(2) (pp 178-181), 2022. Date of
Publication: April-June 2022.
Author
Murphy T.; McCheyne A.
Institution
(Murphy) Department of Anesthetics, Bristol Royal Hospital for Children,
Upper Maudlin Street, Bristol BS2 8EJ, United Kingdom
(McCheyne) Department of Anesthetics, Freeman Hospital, High Heaton,
Newcastle-Upon-Tyne NE7 7DN, United Kingdom
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Perioperative trans-esophageal echocardiography ('TEE') is
widely used for the assessment of anatomy/repair of congenital cardiac
defects. It is recognised that there are risks associated with its use.
 Aim(s): We wished, by means of a contemporaneous prospective national
audit over a six-month period, to establish what proportion of TEE studies
in children are complicated by major upper gastrointestinal or upper
aerodigestive tract trauma. Method(s): After obtaining appropriate
local institutional ethics committee approval, a national prospective
audit of the rate and severity of gastrointestinal complications of
trans-esophageal echocardiography studies in anaesthetised adult
cardiology and cardiac surgical patients was conducted by the Association
of Cardiothoracic Anaesthesia and Critical Care in the United Kingdom and
Ireland during the twelve months of 2017. During the second six months of
the audit, the Congenital Cardiac Anaesthesia Network (an organisation
including anaesthetists with a paediatric cardiac anaesthetic practice in
all the United Kingdom cardiac surgical centres) prospectively audited the
incidence of such complications of TEE studies in children.
 Result(s): A total of 1,059 studies were included in this six-month
paediatric audit. There were no reports of the specified major
complication. Statistical Analysis: The zero incidence of the major
complication is consistent with a worst possible incidence of five per
thousand TEE examinations. Conclusion(s): Such potentially reassuring
information could be included in discussions with patients or families
about the risk of trans-esophageal studies in children. Copyright
© 2022 Wolters Kluwer Medknow Publications. All rights reserved.

<36>
Accession Number
637884705
Title
Intravenous iron supplementation treats anemia and reduces blood
transfusion requirements in patients undergoing coronary artery bypass
grafting - A prospective randomized trial.
Source
Annals of Cardiac Anaesthesia. 25(2) (pp 141-147), 2022. Date of
Publication: April-June 2022.
Author
Shokri H.; Ali I.
Institution
(Shokri) Department of Anesthesiology, Ain Shams University, Cairo, Egypt
(Ali) Department of Cardiothoracic Surgery, Ain Shams University, Cairo,
Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Study Objective: Preoperative anemia results in two- to sixfold increased
incidence of perioperative blood transfusion requirements and reduced
postoperative hemoglobin (Hb) level. This prospective study was designed
to investigate the effect of preoperative intravenous infusion of iron on
Hb levels, blood transfusion requirements, and incidence of postoperative
adverse events in patients undergoing coronary artery bypass grafting.
 Design(s): Prospective randomized trial. Setting(s): Academic
university hospital. Patient(s): Eighty patients (52-67 years old)
underwent coronary artery bypass grafting and received either iron therapy
or saline infusion preoperatively. Intervention(s): Patients were
randomly allocated to iron or placebo groups. In the iron group, patients
received a single intravenous dose of ferric carboxymaltose (1000 mg in
100 mL saline) infused slowly over 15 min 7 days before surgery. In
placebo group, patients received a single intravenous dose of saline (100
mL saline) infused slowly over 15 min 7 days before surgery. Measurements:
Patients were followed up with regards to incidence of anemia, Hb level on
admission, preoperatively, postoperatively, 1 week and 4 weeks after
discharge, aortic cross-clamp time, the number of packed red blood cells
(pRBCs) units, the percentage of reticulocytes pre-postoperatively and 1
week later, hospital stay and intensive care unit (ICU) stay length, and
the incidence of postoperative complications. Main Result(s): Iron
therapy was associated with lower incidence of anemia 4 weeks after
discharge (P < 0.001). Hb level was significantly higher in the iron group
compared to the placebo group preoperatively and postoperatively, and 4
weeks after discharge (P < 0.001). Iron therapy resulted in shorter
hospital and ICU stay (P < 0.001) and shorter aortic cross-clamp time,
reduced pRBCs requirements postoperatively. Percentage of reticulocytes
was significantly higher in placebo group than in iron group
postoperatively and 1 week after discharge and the incidence of
postoperative complications was similar to the placebo group.
 Conclusion(s): Preoperative IV iron infusion is a safe and feasible
way to manage preoperative anemia. Preoperative administration of IV iron
is associated with a higher postoperative Hb level, shorter hospital and
ICU stay, and reduced perioperative red blood cell transfusion
requirements with insignificant difference in incidence of postoperative
complications. Copyright © 2022 Wolters Kluwer Medknow
Publications. All rights reserved.

<37>
Accession Number
637884681
Title
The neurocognitive outcomes of hemodilution in adult patients undergoing
coronary artery bypass grafting using cardiopulmonary bypass.
Source
Annals of Cardiac Anaesthesia. 25(2) (pp 133-140), 2022. Date of
Publication: April-June 2022.
Author
Soliman R.; Saad D.; Abukhudair W.; Abdeldayem S.
Institution
(Soliman, Saad) Department of Anesthesia, Cairo University, Egypt
(Soliman) Department of Cardiac Anesthesia, King Fahd Armored Forces
Hospital, Jeddah, Saudi Arabia
(Abukhudair) Department of Cardiac Surgery, King Fahd Armored Forces
Hospital, Jeddah, Saudi Arabia
(Abdeldayem) Department of Neurology, Tanta University, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Objective: The study aimed to evaluate the effect of mild and moderate
hemodilution during CPB on the neurocognitive dysfunction in patients
undergoing coronary artery bypass grafting. Design(s): A randomized
clinical study. Setting(s): Cardiac center. Patient(s): 186
patients scheduled for cardiac surgery with cardiopulmonary bypass.
 Intervention(s): The patients were classified into 2 groups (each =
93), Mild hemodilution group: The hematocrit value was maintained >25% by
transfusion of packed-red blood cells plus hemofiltration during CPB.
Moderate hemodilution group: the hematocrit value was maintained within
the range of 21-25%. Measurements: The monitors included the hemofiltrated
volume, number of transfused packed red blood cells, and the incidence of
postoperative cognitive dysfunction. Main Result(s): The
hemofiltrated volume during CPB was too much higher with mild hemodilution
compared to the moderate hemodilution (p = 0.001). The number of the
transfused packed red blood cells during CPB was higher with mild
hemodilution compared to the moderate hemodilution (p = 0.001), but after
CPB, the number of the transfused packed red blood cells was lower with
the mild hemodilution group than the moderate hemodilution (p = 0.001).
The incidence of total postoperative neurological complications was
significantly lower with the mild hemodilution group than moderate
hemodilution (p = 0.033). The incidence of neurocognitive dysfunction was
significantly lower with mild hemodilution group than moderate
hemodilution (p = 0.042). Conclusion(s): The mild hemodilution was
associated with a significant decrease in the incidence of neurocognitive
dysfunction compared to moderate hemodilution in patients undergoing
coronary artery bypass grafting. Also, the transfused packed red blood
cells increased during CPB and decreased after CPB with the mild
hemodilution than moderate hemodilution. Copyright © 2022 Wolters
Kluwer Medknow Publications. All rights reserved.

<38>
Accession Number
2017791462
Title
Intraoperative transesophageal echocardiography following mitral valve
repair: a systematic review.
Source
Brazilian Journal of Anesthesiology (English Edition). (no pagination),
2022. Date of Publication: 2022.
Author
Zamper R.; Prempeh A.; Iglesias I.; Fayad A.
Institution
(Zamper, Prempeh, Iglesias, Fayad) Western University, Schulich School of
Medicine and Dentistry, Department of Anesthesia and Perioperative
Medicine, London, Canada
Publisher
Elsevier Editora Ltda
Abstract
Objective: We aimed to examine the recent evidence and search for novel
assessments on intraoperative TEE following mitral valve repair that can
impact short and long-term outcomes. Method(s): The Ovid MEDLINE,
PubMed, and EMBASE databases were searched from January 1, 2008, until
January 27, 2021, for studies on patients with severe Mitral Valve
Regurgitation (MR) undergoing Mitral Valve (MV) repair surgery with
intraoperative Transesophageal Echocardiography (TEE) performed after the
repair. Additional searches were conducted using Google search engine, Web
of Science, and Cochrane Library. Result(s): After reviewing 302
records, 8 retrospective and 22 prospective studies were included (n =
30). Due to clinical and methodological diversity, these studies are
noncomparable and data were not amenable to quantitative synthesis.
 Conclusion(s): Although technological advances allowed the objective
assessment of geometric and dynamic alterations of the MV, the impact of
the use of these technologies on short- or long-term outcomes was not
studied. There is uncertainty and conflicting evidence on the ideal method
and metrics to evaluate MV patency post-repair. Few isolated studies
validated methods to assess coaptation surface and LV function
post-repair. Copyright © 2022 Sociedade Brasileira de
Anestesiologia

<39>
Accession Number
2015929588
Title
The effects of vitamin D supplementation on postoperative atrial
fibrillation after coronary artery bypass grafting in patients with
vitamin D deficiency.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Talasaz A.H.; Salehiomran A.; Heidary Z.; Gholami K.; Aryannejad H.;
Jalali A.; Daei M.
Institution
(Talasaz, Salehiomran, Aryannejad, Jalali) Tehran Heart Center, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Heidary) Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Gholami) Department of Clinical Pharmacy, School of Pharmacy, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Daei) Department of Clinical Pharmacy, Faculty of Pharmacy, Alborz
University of Medical Sciences, Alborz, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative atrial fibrillation (POAF) as a common
complication of coronary artery bypass grafting (CABG) surgery is
associated with increased mortality and morbidity rates. Vitamin D
deficiency increases the prevalence of POAF; however, the effects of
vitamin D supplementation on the incidence of POAF have not yet been
completely elucidated. Method(s): In this prospective, open-label,
randomized clinical trial the level of 25-hydroxy vitamin D (25(OH) D) was
measured in patients undergoing CABG surgery. Patients with vitamin D
insufficiency (defined as 25(OH) D level < 30 ng/ml) were included and
randomly assigned to control group to receive either the general standard
of care (Group A) or to study group to receive the general standard of
care plus oral vitamin D<inf>3</inf>, 600,000 IU 5 days before surgery
(Group B). The primary outcome of our study was the occurrence of POAF
during the first 5 days after CABG surgery. Result(s): Totally, 93
patients in group B and 103 patients in group A completed the study. The
occurrence of POAF was significantly lower in group B as compared to group
A (9.68% vs. 20.39%, p =.038). The length of intensive care unit (ICU)
stay and hospital stay were reduced in group B patients (2.21 vs. 3.86
days, p <.001 and 7.40 vs. 9.58 days, p =.022, respectively).
 Conclusion(s): Our study demonstrated that vitamin D supplementation
reduces the incidence of POAF, duration of ICU, and hospital stay
following CABG surgery. Copyright © 2022 Wiley Periodicals LLC.

<40>
Accession Number
2015632070
Title
Comparison of coronary revascularization strategies in older adults
presenting with acute coronary syndromes.
Source
Journal of the American Geriatrics Society. (no pagination), 2022. Date
of Publication: 2022.
Author
Shah A.I.; Alabaster A.; Dontsi M.; Rana J.S.; Solomon M.D.; Krishnaswami
A.
Institution
(Shah, Rana, Solomon) Division of Cardiology, Kaiser Permanente Oakland
Medical Center, Oakland, CA, United States
(Alabaster, Dontsi, Rana, Solomon) Division of Research, Kaiser
Permanente, Oakland, CA, United States
(Krishnaswami) Division of Cardiology, Kaiser Permanente San Jose Medical
Center, San Jose, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The optimal coronary revascularization strategy to maximize
the patient-centered outcome of days alive and out of hospital (DAOH), in
multimorbid older (>=65-years) adults after an acute coronary syndrome
(ACS) is incompletely understood. Method(s): Using Kaiser Permanente
Northern California Health Plan databases, we identified 3871 patients
>=65-years presenting with ACS between 1/1/2010-3/1/2018 who underwent
coronary revascularization with either coronary artery bypass grafting
(CABG, N = 1575) or multivessel percutaneous coronary intervention (PCI, N
= 2296). Selection bias was accounted for through propensity score
modeling techniques and inverse probability of treatment weighting. Cox
proportional hazards models were fit to evaluate the association of
revascularization type with outcomes. Primary Outcomes: Absolute DAOH and
the relative risk of achieving >=90%DAOH during three time intervals.
 Secondary Outcomes: All-cause mortality, recurrent MI, stroke,
rehospitalization, repeat revascularization, and dialysis initiation.
 Result(s): CABG (compared to PCI) was associated with greater
absolute number of DAOH, significant after the first year (mean difference
at 1-year: +5.8 days, 95% confidence interval [CI], -1.6 to 13 days;
3-years: +56 days, 95%CI, +25 to +88 days; 5-years: + 131 days, 95%CI, +57
to +205 days). The relative risk of achieving >=90% DAOH significantly
favored CABG after the first year (1-year:1.02, 95%CI, 0.98-1.05;
3-years:1.06, 95%CI 1.002-1.11, 5-years:1.12, 95%CI, 1.03-1.22), and was
related to lower incidences of all-cause mortality, repeat
revascularization, rehospitalization, incident dialysis, and nonfatal MI
with CABG. Conclusion(s): In older adults with multivessel or left
main coronary artery disease who presented with ACS, CABG, after the first
year, was associated with a greater absolute number of DAOH-a geriatric
and patient-centered outcome, compared to PCI. CABG patients also had a
higher probability of achieving >=90%DAOH-with lower all-cause mortality,
recurrent MI, repeat revascularization, new dialysis, and
rehospitalization rates. Future randomized trials should study the impact
of optimal revascularization strategies on the quality of life of older
adults with multimorbidity. Copyright © 2022 The American
Geriatrics Society.

<41>
Accession Number
2015500472
Title
The effect of peripheral regional analgesia in thoracic surgery: a
systematic review and a meta-analysis of randomized-controlled trials.
Source
Tumori. (no pagination), 2022. Date of Publication: 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
SAGE Publications Ltd
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. 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(s): 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.
 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).
 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. Copyright © Fondazione IRCCS Istituto Nazionale dei
Tumori 2022.

<42>
Accession Number
635560167
Title
Early clinical and haemodynamic matched comparison of balloon-expandable
valves.
Source
Heart. 108(9) (pp 725-732), 2022. Date of Publication: 01 May 2022.
Author
Delgado-Arana J.R.; Gordillo-Monge M.X.; Halim J.; De Marco F.; Trani C.;
Martin P.; Infusino F.; Ancona M.; Den Heijer P.; Bedogni F.; Nombela
Franco L.; Moreno R.; Sargella G.; Montorfano M.; Aristizabal-Duque C.;
Romero-Delgado T.; Santos S.; Barrero A.; Gomez Salvador I.; Ijsselmuiden
S.; Redondo Dieguez A.; San Roman Calvar J.A.; Amat-Santos I.J.
Institution
(Delgado-Arana, Aristizabal-Duque) Cardiology Depatment, Valladolid
University Hospital, Castilla y Leon, Valladolid, Spain
(Gordillo-Monge, Romero-Delgado) Cardiology Department, San Carlos
University Hospital, Madrid, Spain
(Halim, Den Heijer, Ijsselmuiden) Cardiology Department, Amphia Hospital,
North Brabant, Breda, Netherlands
(De Marco) Cardiology Department, Ospedale Niguarda Ca'Granda, Milan,
Italy
(Trani) Department of Cardiovascular Medecine, Policlinico Universitario
Agostino Gemelli, Rome, Italy
(Martin) Cardiology Department, Hospital Universitario de Gran Canaria Dr.
Negrin, Las Palmas de Gran Canaria, Las Palmas, Spain
(Infusino, Sargella) Cardiology Department, Umberto i Policlinico di Roma,
Lazio, Roma, Italy
(Ancona) Cardiology Department, Istituto Scientifico Universitario San
Raffaele, Lombardia, Milano, Italy
(Bedogni) Istituto Clinico S. Ambrogio, Department of Cardiology Irccs San
Donato, Milan, Italy
(Nombela Franco) Interventional Cardiology, Hospital Clinico Universitario
San Carlos, Madrid, Spain
(Nombela Franco) Cardiology, Institut Universitaire de Cardiologie et de
Pneumologie de Quebec, Quebec City, QC, Canada
(Moreno) Interventional Cardiology, University Hospital la Paz, Madrid,
Spain
(Montorfano) Interventional Cardiology, San Raffaele Scientific Institute,
Milan, Italy
(Santos) Cardiology, Hospital Clinico Universitario de Valladolid,
Valladolid, Valladolid, Spain
(Barrero) Interventional Cardiology, Valladolid University Hospital,
Castilla y Leon, Valladolid, Spain
(Gomez Salvador) Biostatistics Department, Institute of Heart Sciences,
ICICOR- University Hospital, Valladolid, Spain, Valladolid, Spain
(Redondo Dieguez) Cardiovascular, Royal Brompton Hospital, London, United
Kingdom
(Redondo Dieguez) Servicio de Cardiologia y Unidad Coronaria, Complejo
Hospitalario Universitario de Santiago de Compostela, A Coruna, Santiago
de Compostela, Spain
(San Roman Calvar) Cardiology, Hospital Clinico Universitario de
Valladolid, Valladolid, Spain
(Amat-Santos) Cardiology, Universitary Clinical Hospital, Valladolid,
Spain
Publisher
BMJ Publishing Group
Abstract
Objectives The balloon-expandable Sapien-3 valve demonstrated superior
results in terms of residual aortic regurgitation when compared with
self-expandable devices. We aimed to compare for the first-time early
outcomes of Sapien-3 transcatheter heart valve (THV) with the
balloon-expandable Myval device. Methods Consecutive real-world patients
from nine European institutions with symptomatic severe aortic stenosis
treated either with Sapien-3 or Myval THV devices after June 2018 were
compared. Early clinical outcomes were prospectively gathered and blinded
analysis of 30-day echocardiography was conducted. Matching for the
following variables was performed: age, body surface area, Society of
Thoracic Surgeons risk score, left ventricular function, mean gradient,
transfemoral approach, aortic valvular calcium, aortic annulus mean
diameter, area and eccentricity index. Results A total of 416 patients
treated either with the Sapien-3 (n=286, 68.7%) or with Myval THV (n=130,
31.3%) were included and 103 pairs compared after matching. Baseline
characteristics were similar. Procedural success rate (Sapien-3: 94.2%;
Myval: 93.2%, p=0.219), 30-day mortality (Sapien-3: 2.9%; Myval: 0.97%,
p=0.625), clinical efficacy (12.6 vs 4.9%, p=0.057) and early safety (12.6
vs 4.9%, p=0.096) were comparable. There was a lower need for new
permanent pacemaker (15.5 vs 5.8% p=0.020) with Myval. No significant
differences were found in terms of >=moderate aortic regurgitation (1% for
Sapien-3, 0% for Myval, p=0.314), but mean gradients were higher following
Sapien-3 than after Myval (p<0.001). Conclusions The new Myval
balloon-expandable THV was favourable in terms of safety, with low rate of
permanent pacemaker and with favourable residual gradients and
paravalvular leak rate according to blinded echocardiographic
analysis. Copyright ©

<43>
Accession Number
2015115347
Title
Non-vitamin K oral anticoagulants versus vitamin K antagonists in post
transcatheter aortic valve replacement patients with clinical indication
for oral anticoagulation: A meta-analysis.
Source
Clinical Cardiology. 45(4) (pp 401-406), 2022. Date of Publication: April
2022.
Author
Chen Y.-F.; Liu F.; Li X.-W.; Zhang H.-J.; Liu Y.-G.; Lin L.
Institution
(Chen, Li, Zhang, Liu, Lin) Department of Pharmacy, Xiamen Cardiovascular
Hospital of Xiamen University, School of Medicine, Xiamen University,
Xiamen, China
(Liu) Department of Cardiovascular Surgery, Xiamen Cardiovascular Hospital
of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Current guidelines recommend oral anticoagulation (OAC)
following transcatheter aortic valve replacement (TAVR) in patients with
clinical indication, but the optimal antithrombotic regimen remains
uncertain. We aimed to compare the efficacy and safety of non-vitamin K
oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in
patients undergoing TAVR with concomitant indication of OAC. Hypothesis:
Comparing with VKAs therapy, NOACs are similar in reducing the all-cause
mortality and major bleeding in post-TAVR patients requiring OAC
medication. Method(s): We searched the databases of PubMed, Embase,
and Cochrane library databases to identify studies that investigated NOACs
versus VKAs after TAVR in patients with another indication of OAC, which
were published before 28th September 28, 2021. The effectiveness of
outcomes was all-cause mortality and stroke or systemic embolism, while
the main safety outcome was major and/or life-threatening bleeding. The
hazard ratio (HR) with 95% confidence interval (CI) was used as a measure
of treatment effect. Result(s): Our search identified eight studies.
We included 4947 post-TAVR patients with another indication of OAC
allocated to the NOAC (n = 2146) or VKA groups (n = 2801). There were no
significant differences in the all-cause mortality (HR: 0.91, 95% CI:
0.77-1.08, p =.29, I2 = 47%), stroke or systemic embolism (HR:
0.96, 95% CI: 0.68-1.37, p =.84, I2 = 0%), and major and/or
life-threatening bleeding (HR: 1.09, 95% CI: 0.89-1.32, p =.40,
I2 = 30%) in both groups. Conclusion(s): Among post-TAVR
patients who required OAC therapy, NOACs therapy compared to VKAs is
similar in reducing the all-cause mortality, stroke or systemic embolism,
and major and/or life-threatening bleeding events. Copyright ©
2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.

<44>
Accession Number
2015093859
Title
Timing of mechanical circulatory support during primary angioplasty in
acute myocardial infarction and cardiogenic shock: Systematic review and
meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(4) (pp 998-1005),
2022. Date of Publication: March 1, 2022.
Author
Archilletti F.; Giuliani L.; Dangas G.D.; Ricci F.; Benedetto U.; Radico
F.; Gallina S.; Rossi S.; Maddestra N.; Zimarino M.
Institution
(Archilletti, Radico, Zimarino) Department of Innovative Technologies in
Medicine & Odontology, Institute of Cardiology, "G. d'Annunzio"
University, Chieti, Italy
(Giuliani, Rossi, Maddestra, Zimarino) Interventional Cardiology
Department, Cath Lab, Ospedale SS. Annunziata, ASL 2 Abruzzo, Chieti,
Italy
(Dangas) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Ricci, Gallina) Department of Neuroscience, Imaging and Clinical
Sciences, "G. d'Annunzio" University, Chieti, Italy
(Ricci) Department of Clinical Sciences, Lund University, Malmo, Sweden
(Ricci) Department of Cardiology, Casa di Cura Villa Serena, Pescara,
Citta Sant'Angelo, Italy
(Benedetto) Department of Cardiac Surgery, "G D'Annunzio" University,
Chieti, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We aim to define whether the timing of microaxial left
ventricular assist device (IMLVAD) implantation might impact on mortality
in acute myocardial infarction (AMI) cardiogenic shock (CS) patients who
underwent primary percutaneous coronary intervention (PPCI).
 Background(s): Despite the widespread use of PPCI, mortality in
patients with AMI and CS remains high. Mechanical circulatory support is a
promising bridge to recovery strategy, but evidence on its benefit is
still inconclusive and the optimal timing of its utilization remains
poorly explored. Method(s): We compared clinical outcomes of upstream
IMLVAD use before PPCI versus bailout use after PPCI in patients with AMI
CS. A systematic review and meta-analysis of studies comparing the two
strategies were performed. Effect size was reported as odds ratio (OR)
using bailout as reference group and a random effect model was used.
Study-level risk estimates were pooled through the generic inverse
variance method (random effect model). Result(s): A total of 11
observational studies were identified, including a pooled population of
6759 AMI-CS patients. Compared with a bailout approach, upstream IMLVAD
was associated with significant reduction of 30-day (OR = 0.65; 95%
confidence interval [CI] = 0.51-0.82; I2 = 43%, adjusted OR =
0.54; 95% CI = 0.37-0.59; I2 = 3%, test for subgroup difference
p = 0.30), 6-month (OR = 0.51; 95% CI = 0.27-0.96; I2 = 66%),
and 1-year (OR = 0.56; 95% CI = 0.39-0.79; I2 = 0%) all-cause
mortality. Incidence of access-related bleeding, acute limb ischemia and
transfusion outcomes were similar between the two strategies.
 Conclusion(s): In patients with AMI-CS undergoing PPCI, upstream
IMLVAD was associated with reduced early and midterm all-cause mortality
when compared with a bailout strategy. Copyright © 2022 Wiley
Periodicals LLC.

<45>
Accession Number
2014111560
Title
Association between fluid overload and mortality in newborns: a systematic
review and meta-analysis.
Source
Pediatric Nephrology. 37(5) (pp 983-992), 2022. Date of Publication: May
2022.
Author
Matsushita F.Y.; Krebs V.L.J.; de Carvalho W.B.
Institution
(Matsushita, Krebs, de Carvalho) Department of Pediatrics, Neonatology
Division, Faculty of Medicine of the University of Sao Paulo, Instituto da
Crianca, Av. Dr. Eneas de Carvalho Aguiar, 647, SP, Sao Paulo 05403-000,
Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Fluid overload (FO) is associated with higher rates of mortality and
morbidity in pediatric and adult populations. The aim of this systematic
review and meta-analysis was to investigate the association between FO and
mortality in critically ill neonates. Systematic search of Ovid MEDLINE,
EMBASE, Cochrane Library, trial registries, and gray literature from
inception to January 2021. We included all studies that examined neonates
admitted to neonatal intensive care units and described FO and outcomes of
interest. We identified 17 observational studies with a total of 4772
critically ill neonates who met the inclusion criteria. FO was associated
with higher mortality (OR, 4.95 [95% CI, 2.26-10.87]), and survivors had a
lower percentage of FO compared with nonsurvivors (WMD, - 4.33 [95% CI, -
8.34 to - 0.32]). Neonates who did not develop acute kidney injury (AKI)
had lower FO compared with AKI patients (WMD, - 2.29 [95% CI, - 4.47 to -
0.10]). Neonates who did not require mechanical ventilation on postnatal
day 7 had lower fluid balance (WMD, - 1.54 [95% CI, - 2.21 to - 0.88]). FO
is associated with higher mortality, AKI, and need for mechanical
ventilation in critically ill neonates in the intensive care unit. Strict
control of fluid balance to prevent FO is essential. Graphical abstract: A
higher resolution version of the Graphical abstract is available as
Supplementary information [Figure not available: see
fulltext.] Copyright © 2021, The Author(s), under exclusive
licence to International Pediatric Nephrology Association.

<46>
Accession Number
2017049591
Title
Pericardial Involvement in Sarcoidosis.
Source
American Journal of Cardiology. 170 (pp 100-104), 2022. Date of
Publication: 01 May 2022.
Author
Mahalwar G.; Kumar A.; Agrawal A.; Bhat A.; Furqan M.; Yesilyaprak A.;
Verma B.R.; Chan N.; Schleicher M.; Neto M.L.R.; Xu B.; Jellis C.L.; Klein
A.L.
Institution
(Mahalwar, Kumar, Agrawal, Bhat, Furqan, Yesilyaprak, Verma, Chan, Xu,
Jellis, Klein) Center for the Diagnosis and Treatment of Pericardial
Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular
Medicine, Heart, Vascular, and Thoracic Institute
(Neto) Department of Pulmonary Medicine, Respiratory Institute
(Yesilyaprak) Department of Internal Medicine, Wayne State University,
Detroit, Michigan, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Ohio,
Cleveland
Publisher
Elsevier Inc.
Abstract
Pericardial disease secondary to sarcoidosis is a rare clinical entity
with no observational studies in previous research. Therefore, we
evaluated reported cases of pericarditis because of sarcoidosis to further
understand its diagnosis and management. We performed a systematic review
of previous research until December 16, 2020 in MEDLINE, Embase, Scopus,
Cochrane Central Register of Controlled Trials, and Web of Science. Case
reports and case series demonstrating pericardial involvement in
sarcoidosis were included. Fourteen reports with a total of 27 patients
were identified. Dyspnea (82%) was the most common presentation, with the
lungs being the primary site of sarcoidosis in most patients (77%). The
most frequently encountered pericardial manifestations were pericardial
effusion (89%), constrictive pericarditis and cardiac tamponade (48%).
Management of these patients included use of corticosteroids (82%),
colchicine (11%), and nonsteroidal anti-inflammatory agents (7%). Similar
to the general population, the most common intervention in these patients
was pericardiocentesis (59%), pericardial window (30%), and
pericardiectomy (19%). Overall, the majority of this population (70%)
achieved clinical improvement during median follow-up time of 8 months. In
conclusion, the prevalence and incidence of sarcoid-induced pericarditial
disease remain unclear. Clinical manifestations of pericardial involvement
are variable, though many patients present with asymptomatic pericardial
effusions. No consensus exists on the treatment of this special
population, but corticosteroids and combination therapies are considered
first-line therapies because of their efficacy in suppressing pericardial
inflammation and underlying sarcoidosis. Patients with refractory cases of
pericarditis may also benefit therapeutically from the addition of
nonsteroidal anti-inflammatory agents, colchicine, and/or
biologics. Copyright © 2022 Elsevier Inc.

<47>
Accession Number
2016534800
Title
Effects of Shen-Yuan-Dan on Periprocedural Myocardial Injury and the
Number of Peripheral Blood Endothelial Progenitor Cells in Patients with
Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary
Intervention.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 9055585. Date of Publication: 2022.
Author
Zhang Z.; Xing W.; Liu H.; Zhou Q.; Liu X.; Shang J.
Institution
(Zhang, Xing, Liu, Zhou, Shang) Beijing Hospital of Traditional Chinese
Medicine, Capital Medical University, Beijing 100010, China
(Liu) Capital Medical University, Beijing 100069, China
Publisher
Hindawi Limited
Abstract
Objectives. We aimed to investigate the effects of Shen-Yuan-Dan (SYD), a
Chinese medicine preparation, on periprocedural myocardial injury (PMI)
and the number of peripheral blood endothelial progenitor cells (EPCs) in
patients with unstable angina pectoris (UA) who underwent elective
percutaneous coronary intervention (PCI). Methods. Patients were randomly
divided into the experimental (group A) and control (group B) groups
through the random number table method. In group A, patients concurrently
received the conventional western treatment and SYD orally (4
capsules/time, 3 times/d, from 3 d before surgery to 7 d after surgery).
In group B, patients received conventional Western medicine treatment.
Both groups underwent coronary angiography, and patients undergoing PCI
were eventually included in the study. The following patient data were
collected: incidence of PMI, serum CK-MB content before PCI, 4 h, 24 h,
and 7 d after PCI, number of CD45dim/-CD34+CD309+ peripheral venous EPCs,
and number of CD184 coexpressed EPCs. The incidence of adverse reactions
and 30-day major adverse cardiovascular events (MACEs) were also recorded.
Results. Sixty-two patients were finally included in this study, with 32
and 30 in groups A and B, respectively. In group A, the number of
peripheral blood EPCs and the number of CD184 coexpressed EPCs at 1 h
before surgery were higher than those at 3 d before surgery (37.24 +/-
25.20 vs. 22.78 +/- 9.60/ml; P<0.001 and 23.38 +/- 15.30 vs. 13.54 +/-
8.08/ml; P<0.001, resp.). The number of peripheral blood EPCs and number
of CD184 coexpressed EPCs at 4 h after surgery were lower than those at 1
h before surgery (25.30 +/- 11.90 vs. 37.24 +/- 25.20/ml; P=0.019 and
15.38 +/- 8.78 vs. 23.38 +/- 15.30/ml; P=0.013, resp.), but there was no
difference at 24 h and at 7 d after surgery in comparison with that at 1 h
before surgery (P>0.05). In group B, compared with that at 1 h before
surgery, there existed a decline in the number of EPCs in peripheral blood
and the number of CD184 coexpressed EPCs at 4 h after surgery, but without
a statistical difference (P>0.05). Comparing both groups, it was found
that the incidence of PMI in group A was lower (6.25% vs. 26.67%; P=0.04),
and the serum CK-MB content at 4 and 24 h after surgery was also lower
than that in group B (17.33 +/- 5.83 vs. 20.38 +/- 4.32 U/l; P=0.048 and
15.79 +/- 5.32 vs. 19.10 +/- 4.93 U/l; P=0.030, resp.). The number of EPCs
in peripheral blood and the number of CD184 coexpressed EPCs in group A
were higher than those in group B at 1 h before surgery (37.24 +/- 25.20
vs. 22.36 +/- 12.26/ml; P=0.034 and 23.38 +/- 15.30 vs. 13.12 +/-
14.62/ml; P=0.013, resp.). In addition, there were no obvious adverse
reactions and no 30-day MACEs in both groups during the trial. Conclusion.
SYD can reduce PMI and promote the mobilization of EPCs in the
perioperative period of elective PCI in patients with UA. Copyright
© 2022 Zhenmin Zhang et al.

<48>
Accession Number
2017664611
Title
Single or multiple arterial bypass graft surgery vs. percutaneous coronary
intervention in patients with three-vessel or left main coronary artery
disease.
Source
European Heart Journal. 43(13) (pp 1334-1344), 2022. Date of Publication:
01 Apr 2022.
Author
Davierwala P.M.; Gao C.; Thuijs D.J.F.M.; Wang R.; Hara H.; Ono M.; Noack
T.; Garg S.; O'Leary N.; Milojevic M.; Kappetein A.P.; Morice M.-C.; Mack
M.J.; Van Geuns R.-J.; Holmes D.R.; Gaudino M.; Taggart D.P.; Onuma Y.;
Mohr F.W.; Serruys P.W.
Institution
(Davierwala) Division of Cardiovascular Surgery, Peter Munk Cardiac
Centre, Toronto General Hospital, University Health Network, 200 Elizabeth
St, Toronto, ON M5G 2C4, Canada
(Gao, Wang) Department of Cardiology, Xijing Hospital, Changle West Road,
Xi'an 710032, China
(Gao, Wang, Van Geuns) Department of Cardiology, Radboud University, Geert
Grooteplein Zuid 10, Nijmegen 6525 GA, Netherlands
(Gao, Wang, Hara, Ono, O'Leary, Onuma, Serruys) Department of Cardiology,
National University of Ireland, Galway (NUIG), University Road, Galway H91
TK33, Ireland
(Thuijs, Milojevic) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Doctor Molewaterplein 40, Rotterdam 3015 GD,
Netherlands
(Hara, Ono, Kappetein) Department of Cardiology, Academic Medical Center,
University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
(Noack, Mohr) University Department of Cardiac Surgery, Heart Centre
Leipzig, Strumpellstrase 39, Leipzig 04289, Germany
(Garg) Department of Cardiology, Royal Blackburn Hospital, Haslingden Rd,
Blackburn BB2 3HH, United Kingdom
(Morice) Department of Cardiology, Cardiovascular Institute Paris-Sud
(ICPS), Hopital Prive Jacques Cartier, Ramsay, Generale de Sante Massy, 6
Av. du Noyer Lambert, Massy 91300, France
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, 3500 Gaston Ave, Dallas, TX 75246, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, 1216 2nd St SW, Rochester, MN 55902, United States
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
1300 York Ave, New York, NY 10065, United States
(Taggart) Department of Cardiovascular Surgery, University of Oxford,
Headley Way, Headington, Oxford OX3 9DU, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: The aim of this study was to compare long-term all-cause mortality
between patients receiving percutaneous coronary intervention (PCI) and
coronary artery bypass grafting (CABG) using multiple (MAG) or single
arterial grafting (SAG). Methods and Results: The current study is a
post hoc analysis of the SYNTAX Extended Survival Study, which compared
PCI with CABG in patients with three-vessel (3VD) and/or left main
coronary artery disease (LMCAD) and evaluated survival with >=10 years of
follow-up. The primary endpoint was all-cause mortality at maximum
follow-up (median 11.9 years) assessed in the as-treated population. Of
the 1743 patients, 901 (51.7%) underwent PCI, 532 (30.5%) received SAG,
and 310 (17.8%) had MAG. At maximum follow-up, all-cause death occurred in
305 (33.9%), 175 (32.9%), and 70 (22.6%) patients in the PCI, SAG, and MAG
groups, respectively (P < 0.001). Multiple arterial grafting [adjusted
hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.49-0.89], but not
SAG (adjusted HR 0.83, 95% CI 0.67-1.03), was associated with
significantly lower all-cause mortality compared with PCI. In patients
with 3VD, both MAG (adjusted HR 0.55, 95% CI 0.37-0.81) and SAG (adjusted
HR 0.68, 95% CI 0.50-0.91) were associated with significantly lower
mortality than PCI, whereas in LMCAD patients, no significant differences
between PCI and MAG (adjusted HR 0.90, 95% CI 0.56-1.46) or SAG (adjusted
HR 1.11, 95% CI 0.81-1.53) were observed. In patients with
revascularization of all three major myocardial territories, a positive
correlation was observed between the number of myocardial territories
receiving arterial grafts and survival (Ptrend = 0.003).
 Conclusion(s): Our findings suggest that MAG might be the more
desirable configuration for CABG to achieve lower long-term all-cause
mortality than PCI in patients with 3VD and/or LMCAD. Trial registration:
Registered on clinicaltrial.gov. SYNTAXES: NCT03417050
(https://clinicaltrials.gov/ct2/show/NCT03417050); SYNTAX: NCT00114972
(https://www.clinicaltrials.gov/ct2/show/NCT00114972). Copyright
© 2021 The Author(s) 2021. Published by Oxford University Press on
behalf of the European Society of Cardiology.

<49>
Accession Number
2015355642
Title
Effects of early rehabilitation on functional outcomes in patients after
coronary artery bypass graft surgery: a randomized controlled trial.
Source
Journal of International Medical Research. 50(3) (no pagination), 2022.
Date of Publication: March 2022.
Author
Han P.; Yu H.; Xie F.; Li M.; Chen X.; Yu X.; Li J.; Shao B.; Liu J.; Liu
Y.; Liu Z.; Liu X.; Guo Q.
Institution
(Han, Li, Yu, Guo) Shanghai University of Medicine and Health Sciences
Affiliated Zhoupu Hospital, Shanghai, China
(Han, Chen, Li, Liu, Shao, Liu, Liu, Liu, Liu, Guo) TEDA International
Cardiovascular Hospital, Tianjin, China
(Yu) Zhongnan Hospital of Wuhan University, Hubei, Wuhan, China
(Xie) Shanghai Jiangwan Hospital, Shanghai, China
Publisher
SAGE Publications Ltd
Abstract
Objective: This study evaluated the effectiveness, feasibility, and safety
of early rehabilitation for patients after coronary artery bypass graft
(CABG) surgery. Method(s): In a three-arm randomized controlled
trial, patients who underwent CABG from January 2018 to June 2018 were
randomly assigned to one of three groups: (i) usual care (UC group); (ii)
UC + single general ward rehabilitation (SGR group); and (iii) UC +
general ward rehabilitation and intensive care unit (ICU) rehabilitation
(IGR group). The primary outcome was the Barthel Index scores.
 Result(s): The Barthel Index score for UC (75.3 +/- 12.1) was
significantly lower than that of both SGR (86.2 +/- 14.1) and IGR (89.1
+/- 15.5). There was no significant difference in the Barthel Index scores
between the SGR and IGR groups. Statistically significant differences were
found in the length of ICU stay and post-operative hospital stay but not
in post-operative pulmonary complications (PPC) or atrial fibrillation
between the three groups. Conclusion(s): Early rehabilitation
implemented during ICU stay and on the general ward resulted in
significant improvements in functional independence and could be a safe
part of routine care post-CABG. Copyright © The Author(s) 2022.

<50>
Accession Number
2015199597
Title
Drug-Coated Balloon Versus Drug-Eluting Stent in Patients With
Femoropopliteal Artery Disease: A Systematic Review and Meta-Analysis.
Source
Vascular and Endovascular Surgery. 56(4) (pp 385-392), 2022. Date of
Publication: May 2022.
Author
Nugraha H.G.; Hilman S.; Santiana L.; Dewi D.K.; Raffaelo W.M.; Wibowo A.;
Pranata R.; Aristiady E.B.
Institution
(Nugraha, Hilman, Santiana, Dewi, Aristiady) Department of Radiology,
Faculty of Medicine, Hasan Sadikin General Hospital, Universitas
Padjadjaran, Bandung, Indonesia
(Raffaelo, Pranata) Faculty of Medicine, Universitas Pelita Harapan,
Tangerang, Indonesia
(Wibowo) Faculty of Medicine, Universitas Jenderal Achmad Yani, Cimahi,
Bandung, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Objective: In this systematic review and meta-analysis, we aimed to
compare drug-coated balloon (DCB) to drug-eluting stent (DES) in patients
with femoropopliteal lesions in terms of restenosis, target lesion
revascularization (TLR), and mortality. Method(s): A comprehensive
literature search was performed through PubMed, Scopus, and Embase
databases. The intervention group was patients receiving percutaneous
balloon angioplasty using the DCB. The control group was patients
receiving percutaneous intervention using the DES. The primary outcome was
restenosis, and the secondary outcomes were TLR and mortality.
 Result(s): There were 4 studies comprising 812 patients (906 lesions)
included in this systematic review and meta-analysis. The rate of
restenosis was.19 [.13,.26] in DCB and.24 [.20,.28] in DES. There was a
trend toward lower rate of restenosis (OR.73 [.52, 1.03], P =.074;
I2: 46.3%) for DCB use compared to DES use. The rate of TLR
was.11 [.08,.14] in DCB and.17 [.14,.21] in DES. TLR was lower (OR.61
[.41,.92], P =.017; I2: 1.2%) in the DCB group compared to the
DES group. There were no significant differences in mortality (OR 1.38
[.78, 2.44], P =.268; I2: 0%) among the two groups.
Meta-regression analysis showed that the rate of restenosis in DCB in this
pooled analysis was affected by sex (reference: male, coefficient -.004, P
=.009), smoking (coefficient:.003, P =.010), and total occlusion
(coefficient:.008, P =.004). Conclusion(s): DCB use in patients with
femoropopliteal lesion was associated with similar rate of restenosis,
lower TLR, and similar mortality rate compared to DES use. Copyright
© The Author(s) 2022.

<51>
Accession Number
2016967979
Title
Meta-Analysis Comparing Risk Factors, Incidence, and Outcomes of Patients
With Versus Without Prosthesis-Patient Mismatch Following Transcatheter
Aortic Valve Implantation.
Source
American Journal of Cardiology. 170 (pp 91-99), 2022. Date of Publication:
01 May 2022.
Author
Lim O.Z.H.; Mai A.S.; Ng C.H.; Tang A.; Chin Y.H.; Kong G.; Ho Y.J.; Ong
J.; Tay E.; Kuntjoro I.; Chew N.W.; Lim Y.
Institution
(Lim, Mai, Ng, Tang, Chin, Kong, Ho, Kuntjoro, Lim) Yong Loo Lin School of
Medicine, National University of Singapore, Singapore
(Ong, Tay, Kuntjoro, Chew, Lim) Department of Cardiology, National
University Heart Centre, Singapore
Publisher
Elsevier Inc.
Abstract
Current guidelines on the management of patients with aortic valvular
disease have widened the use of transcatheter aortic valve implantation
(TAVI) with an emphasis on avoidance of prosthesis-patient mismatch (PPM).
This study sought to examine the incidence, risk factors, and all-cause
mortality of PPM after TAVI. Medline and Embase databases were searched
from inception to August 10, 2021. Patients were compared along 2 arms:
(1) any degree of PPM and those without PPM, (2) severe PPM, and nonsevere
PPM. A total of 22 articles involving 115,442 patients after TAVI were
included. Pooled incidence for any degree of PPM was 30.1% and 10.7% in
severe PPM. Incidence was significantly higher (p <0.001) for any degree
of PPM in Europe (33.1%) and North America (34.4%) compared with Asia
(10.4%). Incidence of severe PPM was higher (p = 0.015) in older
generation (13.6%) compared with current-generation valves (6.3%). Severe
PPM increased the risk of all-cause mortality relative to nonsevere PPM
(hazard ratio: 1.86, 95% confidence interval: 1.05 to 3.29, p = 0.034).
Patients of younger age, increased body surface area, lower left
ventricular ejection fraction, and classified New York Heart Association
Class III/IV were at greater risk of both any degree and severe PPM.
Smaller prosthesis size increased the risk of any degree of PPM, whereas
postdilation and larger prostheses were protective factors. In conclusion,
all-cause mortality was significantly affected in severe PPM compared with
nonsevere cases, whereas this excess mortality was not observed between
those with any degree of PPM and those without. Closer attention to
patient and bioprosthetic valve factors is required to minimize the
occurrence of severe PPM. Copyright © 2022 Elsevier Inc.

<52>
Accession Number
2016964852
Title
Gender Distribution in Randomized Controlled Trials among Patients with
Heart Failure with Reduced Ejection Fraction: A Systematic Review.
Source
Global Heart. 17(1) (no pagination), 2022. Article Number: 8. Date of
Publication: 2022.
Author
Gulab A.; Essa H.; Lo K.B.; Sankaranarayanan R.; Rangaswami J.
Institution
(Gulab, Lo, Rangaswami) Department of Medicine, Einstein Medical Center,
PA, United States
(Essa, Sankaranarayanan) Liverpool University Hospitals NHS Foundation
Trust, Liverpool, United Kingdom
(Essa, Sankaranarayanan) Faculty of Life Sciences, University of
Liverpool, United Kingdom
(Essa, Sankaranarayanan) Liverpool Centre for Cardiovascular Sciences,
United Kingdom
(Rangaswami) Sidney Kimmel College of Thomas Jefferson University, PA,
United States
Publisher
Ubiquity Press
Abstract
BACKGROUND Heart failure (HF) is a major cause of morbidity and mortality
at a global level, affecting 64 million people worldwide with about 40-50%
of the hospitalized heart failure patients being female [1]. Despite high
disease burden of HF in women, HF trials have consistently
underrepresented women in enrollment [2]. The objective of this study was
to determine the trends in the representation of women in randomized
controlled trials (RCTs) for therapies for heart failure with reduced
ejection fraction (HFrEF). METHODS This systematic review looked at the
patterns and rates of inclusion of women in RCTs among patients with
HFrEF. We utilized PubMed to extract RCTs conducted between January 1,
2010, and December 1, 2020. The medical subject headings (MeSH) terms used
for extraction were heart failure OR heart failure, congestive OR heart
failure with reduced ejection fraction. Terms like left sided heart
failure OR systolic heart failure were not included to keep the search
strategy easily replicable and clear. Studies were reviewed individually
and screened by title and abstract. Sub-studies or post-hoc analyses were
excluded. Trials looking at heart failure with preserved ejection fraction
were excluded. Data are presented using descriptive statistics frequencies
and percentages. Mean and standard deviation were used while median
interquartile range was used for skewed variables. The percentage of
females included in studies with studies per year was log transformed and
fitted into a time regression model by year. The Mann Whitney U test was
used to compare the median percentages of females according to study size
(more than 100 samples included and less than 100 samples). A p-value of
0.05 was considered statistically significant. FINDINGS A total of 3052
studies were reviewed, and 706 studies met criteria for inclusion.
Thirty-seven percent of studies involved pharmacologic interventions,
while 10% of studies looked at device therapy (implantable cardioverter
and defibrillator/cardiac resynchronization therapy). The rest of the
studies included a combination of exercise, community programs, surgical,
procedural and laboratory testing. The pooled study sample age ranged from
42 to 85 years. Only 26% (17-36) of the participants were women. There
were no significant differences in representation of women (%) across the
nature of interventions (pharmacotherapy, device, other interventions).
The median percentage of females included in trials of HFrEF over the past
10 years was less than 50% per year, but with a gradual increasing trend
towards the later part of the decade p < 0.001 for linear trend, as shown
in Figure 1. Copyright © 2022 The Author(s).

<53>
Accession Number
2017779522
Title
Statistical Evaluation of Transformation Methods Accuracy on Derived
Pathological Vectorcardiographic Leads.
Source
IEEE Journal of Translational Engineering in Health and Medicine. 10 (pp
1-8), 2022. Date of Publication: 2022.
Author
Vondrak J.; Penhakert M.
Institution
(Vondrak, Penhakert) Faculty of Electrical Engineering and Computer
Science, VSB-Technical University of Ostrava, Ostrava 708 33, Czechia
Publisher
Institute of Electrical and Electronics Engineers Inc.
Abstract
Objective: Vectorcardiography (VCG) as an alternative form of ECG provides
important spatial information about the electrical activity of the heart.
It achieves higher sensitivity in the detection of some pathologies such
as myocardial infarction, ischemia and hypertrophy. However,
vectorcardiography is not commonly measured in clinical practice, and for
this reason mathematical transformations have been developed to obtain
derived VCG leads, which in application in current systems and subsequent
analysis can contribute to early diagnosis and obtaining other useful
information about the electrical activity of the heart. Methods and
procedures: The most frequently used transformation methods are compared,
namely the Kors regression method, the Inverse Dower transformation, QLSV
and the Quasi-orthogonal transformation. These transformation methods were
used on 30 randomly selected records with a diagnosis of myocardial
infarction from the Physikalisch-Technische Bundesanstalt (PTB) database
and their accuracy was evaluated based on the calculation of the mean
square error (MSE). MSE was subjected to statistical evaluation at a
significance level of 0.05. Result(s): Based on statistical testing
using the nonparametric multiselective Kruskall-Wallis test and subsequent
post-hoc analysis using the Dunn method, the Kors regression as a whole
method achieved the most accurate transformation. Conclusion(s): The
results of statistical analysis provide an evaluation of the accuracy of
several transformation methods for deriving orthogonal leads, for possible
application in measuring and evaluation systems, which may contribute to
the correct choice of method for subsequent analysis of electrical
activity of the heart at orthogonal leads to predict various diseases.
 Copyright © 2013 IEEE.

<54>
Accession Number
2016008520
Title
Multicenter randomized study evaluating the outcome of ganglionated plexi
ablation in maze procedure.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2022. Date
of Publication: 2022.
Author
Sakamoto S.-I.; Ishii Y.; Otsuka T.; Mitsuno M.; Shimokawa T.; Isomura T.;
Yaku H.; Komiya T.; Matsumiya G.; Nitta T.
Institution
(Sakamoto, Ishii, Nitta) Department of Cardiovascular Surgery, Nippon
Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
(Otsuka) Department of Hygiene and Public Health, Nippon Medical School,
Tokyo, Japan
(Mitsuno) Department of Cardiovascular Surgery, Hyogo College of Medicine,
Hyogo, Japan
(Shimokawa) Department of Cardiovascular Surgery, Teikyo University,
Tokyo, Japan
(Isomura) Department of Cardiovascular Surgery, IMS Tokyo Katsushika
General Hospital, Tokyo, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Kyoto, Japan
(Komiya) Department of Cardiovascular Surgery, Kurashiki Central Hospital,
Okayama, Japan
(Matsumiya) Department of Cardiovascular Surgery, Chiba University
Graduate School of Medicine, Chiba, Japan
Publisher
Springer Japan
Abstract
Objective: The benefit of adding ganglionated plexi ablation to the maze
procedure remains controversial. This study aims to compare the outcomes
of the maze procedure with and without ganglionated plexi ablation.
 Method(s): This multicenter randomized study included 74 patients
with atrial fibrillation associated with structural heart disease.
Patients were randomly allocated to the ganglionated plexi ablation group
(maze with ganglionated plexi ablation) or the maze group (maze without
ganglionated plexi ablation). The lesion sets in the maze procedure were
unified in all patients. High-frequency stimulation was applied to clearly
identify and perform ganglionated plexi ablation. Patients were followed
up for at least 6 months. The primary endpoint was a recurrence of atrial
fibrillation. Result(s): The intention-to-treat analysis included 69
patients (34 in the ganglionated plexi ablation group and 35 in the maze
group). No surgical mortality was observed in either group. After a mean
follow-up period of 16.3 +/- 7.9 months, 86.8% of patients in the
ganglionated plexi ablation group and 91.4% of those in the maze group did
not experience atrial fibrillation recurrence. Kaplan-Meier atrial
fibrillation-free curves showed no significant difference between the two
groups (P =.685). Cox proportional hazards regression analysis indicated
that left atrial dimension was the only risk factor for atrial
fibrillation recurrence (hazard ratio: 1.106, 95% confidence interval
1.017-1.024, P =.019). Conclusion(s): The addition of ganglionated
plexi ablation to the maze procedure does not improve early outcome when
treating atrial fibrillation associated with structural heart
disease. Copyright © 2022, The Author(s), under exclusive licence
to The Japanese Association for Thoracic Surgery.

<55>
Accession Number
637304553
Title
Ten-Year Outcomes of Off-Pump vs On-Pump Coronary Artery Bypass Grafting
in the Department of Veterans Affairs: A Randomized Clinical Trial.
Source
JAMA Surgery. 157(4) (pp 303-310), 2022. Date of Publication: April 2022.
Author
Quin J.A.; Wagner T.H.; Hattler B.; Carr B.M.; Collins J.; Almassi G.H.;
Grover F.L.; Shroyer A.L.
Institution
(Quin) Department of Surgery, Veterans Affairs Boston Healthcare System,
West Roxbury, MA, United States
(Wagner) Research Office, Veterans Affairs Health Economics and Research
Center, Palo Alto, CA, United States
(Wagner) Department of Surgery, Stanford University, Palo Alto, CA, United
States
(Hattler) Department of Medicine, Rocky Mountain Regional Veterans Affairs
Medical Center, Aurora, CO, United States
(Hattler) Division of Cardiology, Department of Medicine, University of
Colorado, School of Medicine, Aurora, United States
(Carr) Department of Emergency Medicine, Mayo Clinic, Rochester, MN,
United States
(Collins) Research Office, Veterans Affairs Cooperative Studies Program,
Perry Point, MD, United States
(Almassi) Department of Surgery, Clement J. Zablocki Veterans Affairs
Medical Center, Milwaukee, WI, United States
(Almassi) Division of Cardiothoracic Surgery, Department of Surgery,
Medical College of Wisconsin, Milwaukee, United States
(Grover) Division of Cardiothoracic Surgery, Department of Surgery,
University of Colorado, School of Medicine, Aurora, United States
(Grover) Department of Surgery, Rocky Mountain Regional Veterans Affairs
Medical Center, Aurora, CO, United States
(Shroyer) Research and Development Office (151), Northport Veterans
Affairs Medical Center, 79 Middleville Rd, Northport, NY 11768, United
States
(Shroyer) Department of Surgery, Stony Brook University, Renaissance
School of Medicine, Stony Brook, NY, United States
Publisher
American Medical Association
Abstract
Importance: The long-term benefits of off-pump ("beating heart") vs
on-pump coronary artery bypass grafting (CABG) remain controversial.
 Objective(s): To evaluate the 10-year outcomes and costs of off-pump
vs on-pump CABG in the Department of Veterans Affairs (VA) Randomized
On/Off Bypass (ROOBY) trial. Design, Setting, and Participant(s):
From February 27, 2002, to May 7, 2007, 2203 veterans in the ROOBY trial
were randomly assigned to off-pump or on-pump CABG procedures at 18
participating VA medical centers. Per protocol, the veterans were observed
for 10 years; the 10-year, post-CABG clinical outcomes and costs were
assessed via centralized abstraction of electronic medical records
combined with merges to VA and non-VA databases. With the use of an
intention-to-treat approach, analyses were performed from May 7, 2017, to
December 9, 2021. Intervention(s): On-pump and off-pump CABG
procedures. Main Outcomes and Measures: The 10-year coprimary end
points included all-cause death and a composite end point identifying
patients who had died or had undergone subsequent revascularization (ie,
percutaneous coronary intervention [PCI] or repeated CABG); these 2 end
points were measured dichotomously and as time-to-event variables (ie,
time to death and time to composite end points). Secondary 10-year end
points included PCIs, repeated CABG procedures, changes in cardiac
symptoms, and 2018-adjusted VA estimated costs. Changes from baseline to
10 years in post-CABG, clinically relevant cardiac symptoms were evaluated
for New York Heart Association functional class, Canadian Cardiovascular
Society angina class, and atrial fibrillation. Outcome differences were
adjudicated by an end points committee. Given that pre-CABG risks were
balanced, the protocol-driven primary and secondary hypotheses directly
compared 10-year treatment-related effects. Result(s): A total of
1104 patients (1097 men [99.4%]; mean [SD] age, 63.0 [8.5] years) were
enrolled in the off-pump group, and 1099 patients (1092 men [99.5%]; mean
[SD] age, 62.5 [8.5] years) were enrolled in the on-pump group. The
10-year death rates were 34.2% (n = 378) for the off-pump group and 31.1%
(n = 342) for the on-pump group (relative risk, 1.05; 95% CI, 0.99-1.11; P
=.12). The median time to composite end point for the off-pump group (4.6
years; IQR, 1.4-7.5 years) was approximately 4.3 months shorter than that
for the on-pump group (5.0 years; IQR, 1.8-7.9 years; P =.03). No
significant 10-year treatment-related differences were documented for any
other primary or secondary end points. After the removal of conversions,
sensitivity analyses reconfirmed these findings. Conclusions and
Relevance: No off-pump CABG advantages were found for 10-year death or
revascularization end points; the time to composite end point was lower in
the off-pump group than in the on-pump group. For veterans, in the absence
of on-pump contraindications, a case cannot be made for supplanting the
traditional on-pump CABG technique with an off-pump approach. Trial
Registration: ClinicalTrials.gov Identifier: NCT01924442. Copyright
© 2022 American Medical Association. All rights reserved.

<56>
Accession Number
637858793
Title
Negative pressure wound therapy for surgical wounds healing by primary
closure.
Source
The Cochrane database of systematic reviews. 4 (pp CD009261), 2022. Date
of Publication: 26 Apr 2022.
Author
Norman G.; Shi C.; Goh E.L.; Murphy E.M.; Reid A.; Chiverton L.;
Stankiewicz M.; Dumville J.C.
Institution
(Norman, Shi, Dumville) Division of Nursing, Midwifery and Social Work,
School of Health Sciences, Faculty of Biology, Medicine and Health,
University of Manchester, Manchester Academic Health Science Centre,
Manchester, United Kingdom
(Goh) Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and
Musculoskeletal Sciences, Oxford, United Kingdom
(Murphy) St. Mary's Hospital, Manchester Foundation NHS Trust, Ward,
Manchester 64, United Kingdom
(Reid) School of Biological Sciences, Faculty of Biology, Medicine &
Health, Manchester, United Kingdom
(Chiverton) NIHR Clinical Research Facility, Great Ormond Street Hospital,
London, United Kingdom
(Stankiewicz) Chermside Community Health Centre, Community and Oral Health
Directorate, Brisbane, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Indications for the use of negative pressure wound therapy
(NPWT) are broad and include prophylaxis for surgical site infections
(SSIs). Existing evidence for the effectiveness of NPWT on postoperative
wounds healing by primary closure remains uncertain. OBJECTIVE(S): To
assess the effects of NPWT for preventing SSI in wounds healing through
primary closure, and to assess the cost-effectiveness of NPWT in wounds
healing through primary closure. SEARCH METHOD(S): In January 2021,
we searched the Cochrane Wounds Specialised Register; the Cochrane Central
Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including
In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL
Plus. We also searched clinical trials registries and references of
included studies, systematic reviews and health technology reports. There
were no restrictions on language, publication date or study setting.
SELECTION CRITERIA: We included trials if they allocated participants to
treatment randomly and compared NPWT with any other type of wound
dressing, or compared one type of NPWT with another. DATA COLLECTION AND
ANALYSIS: At least two review authors independently assessed trials using
predetermined inclusion criteria. We carried out data extraction,
assessment using the Cochrane risk of bias tool, and quality assessment
according to Grading of Recommendations, Assessment, Development and
Evaluations methodology. Our primary outcomes were SSI, mortality, and
wound dehiscence. MAIN RESULTS: In this fourth update, we added 18 new
randomised controlled trials (RCTs) and one new economic study, resulting
in a total of 62 RCTs (13,340 included participants) and six economic
studies. Studies evaluated NPWT in a wide range of surgeries, including
orthopaedic, obstetric, vascular and general procedures. All studies
compared NPWT with standard dressings. Most studies had unclear or high
risk of bias for at least one key domain. Primary outcomes Eleven studies
(6384 participants) which reported mortality were pooled. There is
low-certainty evidence showing there may be a reduced risk of death after
surgery for people treated with NPWT (0.84%) compared with standard
dressings (1.17%) but there is uncertainty around this as confidence
intervals include risk of benefits and harm; risk ratio (RR) 0.78 (95% CI
0.47 to 1.30; I2 = 0%). Fifty-four studies reported SSI; 44 studies
(11,403 participants) were pooled. There is moderate-certainty evidence
that NPWT probably results in fewer SSIs (8.7% of participants) than
treatment with standard dressings (11.75%) after surgery; RR 0.73 (95% CI
0.63 to 0.85; I2 = 29%). Thirty studies reported wound dehiscence; 23
studies (8724 participants) were pooled. There is moderate-certainty
evidence that there is probably little or no difference in dehiscence
between people treated with NPWT (6.62%) and those treated with standard
dressing (6.97%), although there is imprecision around the estimate that
includes risk of benefit and harms; RR 0.97 (95% CI 0.82 to 1.16; I2 =
4%). Evidence was downgraded for imprecision, risk of bias, or a
combination of these. Secondary outcomes There is low-certainty evidence
for the outcomes of reoperation and seroma; in each case, confidence
intervals included both benefit and harm. There may be a reduced risk of
reoperation favouring the standard dressing arm, but this was imprecise:
RR 1.13 (95% CI 0.91 to 1.41; I2 = 2%; 18 trials; 6272 participants).
There may be a reduced risk of seroma for people treated with NPWT but
this is imprecise: the RR was 0.82 (95% CI 0.65 to 1.05; I2 = 0%; 15
trials; 5436 participants). For skin blisters, there is low-certainty
evidence that people treated with NPWT may be more likely to develop skin
blisters compared with those treated with standard dressing (RR 3.55; 95%
CI 1.43 to 8.77; I2 = 74%; 11 trials; 5015 participants). The effect of
NPWT on haematoma is uncertain (RR 0.79; 95 % CI 0.48 to 1.30; I2 = 0%; 17
trials; 5909 participants; very low-certainty evidence). There is
low-certainty evidence of little to no difference in reported pain between
groups. Pain was measured in different ways and most studies could not be
pooled; this GRADE assessment is based on all fourteen trials reporting
pain; the pooled RR for the proportion of participants who experienced
pain was 1.52 (95% CI 0.20, 11.31; I2 = 34%; two studies; 632
participants). Cost-effectiveness Six economic studies, based wholly or
partially on trials in our review, assessed the cost-effectiveness of NPWT
compared with standard care. They considered NPWT in five indications:
caesarean sections in obese women; surgery for lower limb fracture;
knee/hip arthroplasty; coronary artery bypass grafts; and vascular surgery
with inguinal incisions. They calculated quality-adjusted life-years or an
equivalent, and produced estimates of the treatments' relative
cost-effectiveness. The reporting quality was good but the evidence
certainty varied from moderate to very low. There is moderate-certainty
evidence that NPWT in surgery for lower limb fracture was not
cost-effective at any threshold of willingness-to-pay and that NPWT is
probably cost-effective in obese women undergoing caesarean section. Other
studies found low or very low-certainty evidence indicating that NPWT may
be cost-effective for the indications assessed. AUTHORS'
 CONCLUSION(S): People with primary closure of their surgical wound
and treated prophylactically with NPWT following surgery probably
experience fewer SSIs than people treated with standard dressings but
there is probably no difference in wound dehiscence (moderate-certainty
evidence). There may be a reduced risk of death after surgery for people
treated with NPWT compared with standard dressings but there is
uncertainty around this as confidence intervals include risk of benefit
and harm (low-certainty evidence). People treated with NPWT may experience
more instances of skin blistering compared with standard dressing
treatment (low-certainty evidence). There are no clear differences in
other secondary outcomes where most evidence is low or very low-certainty.
Assessments of cost-effectiveness of NPWT produced differing results in
different indications. There is a large number of ongoing studies, the
results of which may change the findings of this review. Decisions about
use of NPWT should take into account surgical indication and setting and
consider evidence for all outcomes. Copyright © 2022 The Authors.
Cochrane Database of Systematic Reviews published by John Wiley & Sons,
Ltd. on behalf of The Cochrane Collaboration.

<57>
Accession Number
637392711
Title
Association of Annual N-Terminal Pro-Brain Natriuretic Peptide
Measurements with Clinical Events in Patients with Asymptomatic Nonsevere
Aortic Stenosis: A Post Hoc Substudy of the SEAS Trial.
Source
JAMA Cardiology. 7(4) (pp 435-444), 2022. Date of Publication: April 2022.
Author
Hadziselimovic E.; Greve A.M.; Sajadieh A.; Olsen M.H.; Kesaniemi Y.A.;
Nienaber C.A.; Ray S.G.; Rossebo A.B.; Willenheimer R.; Wachtell K.;
Nielsen O.W.
Institution
(Hadziselimovic, Sajadieh, Nielsen) Department of Cardiology, Bispebjerg
University Hospital, Bakke 23, Kobenhavn, Copenhagen 2400, Denmark
(Greve) Department of Clinical Biochemistry 3011, Rigshospitalet,
Copenhagen, Denmark
(Sajadieh, Nielsen) Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Olsen) Department of Cardiology, Holbaek Hospital, Holbaek, Denmark
(Olsen) Department of Regional Health Research, University of Southern
Denmark, Odense, Denmark
(Kesaniemi) Research Unit of Internal Medicine, Medical Research Center
Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
(Nienaber) Royal Brompton and Harefield NHS Foundation Trust, Imperial
College, London, United Kingdom
(Ray) Manchester Academic Health Sciences Centre, Manchester, United
Kingdom
(Rossebo) Department of Cardiology, Oslo University Hospital, Ulleval,
Oslo, Norway
(Willenheimer) Lund University, Heart Health Group, Malmo, Sweden
(Wachtell) Department of Cardiology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
Publisher
American Medical Association
Abstract
Importance: Recent studies have questioned the presumed low-risk status of
patients with asymptomatic nonsevere aortic stenosis (AS). Whether annual
N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements are
useful for risk assessment is unknown. Objective(s): To assess the
association of annual NT-proBNP measurements with clinical outcomes in
patients with nonsevere AS. Design, Setting, and Participant(s):
Analysis of annual NT-proBNP concentrations in the multicenter,
double-blind Simvastatin and Ezetimibe in Aortic Stenosis (SEAS)
randomized clinical trial was performed. SEAS was conducted from January
6, 2003, to April 1, 2008. Blood samples were analyzed in 2016, and data
analysis was performed from February 10 to October 10, 2021. SEAS included
1873 patients with asymptomatic AS not requiring statin therapy with
transaortic maximal flow velocity from 2.5 to 4.0 m/s and preserved
ejection fraction. This substudy included 1644 patients (87.8%) with
available blood samples at baseline and year 1. Exposures: Increased age-
A nd sex-adjusted NT-proBNP concentrations at year 1 and a 1.5-fold or
greater relative NT-proBNP concentration change from baseline to year 1.
Moderate AS was defined as baseline maximal flow velocity greater than or
equal to 3.0 m/s. Main Outcomes and Measures: Aortic valve events
(AVEs), which are a composite of aortic valve replacement, cardiovascular
death, or incident heart failure due to AS progression, were noted.
Landmark analyses from year 1 examined the association of NT-proBNP
concentrations with outcomes. Result(s): Among 1644 patients, 996
were men (60.6%); mean (SD) age was 67.5 (9.7) years. Adjusted NT-proBNP
concentrations were within the reference range (normal) in 1228 of 1594
patients (77.0%) with NT-proBNP values available at baseline and in 1164
of 1644 patients (70.8%) at year 1. During the next 2 years of follow-up,
the AVE rates per 100 patient-years for normal vs increased adjusted
NT-proBNP levels at year 1 were 1.39 (95% CI, 0.86-2.23) vs 7.05 (95% CI,
4.60-10.81) for patients with mild AS (P <.01), and 10.38 (95% CI,
8.56-12.59) vs 26.20 (95% CI, 22.03-31.15) for those with moderate AS (P
<.01). Corresponding all-cause mortality rates were 1.05 (95% CI,
0.61-1.81) vs 4.17 (95% CI, 2.42-7.19) for patients with mild AS (P <.01),
and 1.60 (95% CI, 0.99-2.57) vs 4.78 (95% CI, 3.32-6.87) for those with
moderate AS (P <.01). In multivariable Cox proportional hazards regression
models, the combination of a 1-year increased adjusted NT-proBNP level and
1.5-fold or greater NT-proBNP level change from baseline was associated
with the highest AVE rates in both patients with mild AS (hazard ratio,
8.12; 95% CI, 3.53-18.66; P <.001) and those with moderate AS (hazard
ratio, 4.05; 95% CI, 2.84-5.77; P <.001). Conclusions and Relevance:
The findings of this study suggest that normal NT-proBNP concentrations at
1-year follow-up are associated with low AVE and all-cause mortality rates
in patients with asymptomatic nonsevere AS. Conversely, an increased
1-year NT-proBNP level combined with a 50% or greater increase from
baseline may be associated with high AVE rates. Trial Registration:
ClinicalTrials.gov Identifier: NCT00092677. Copyright © 2022
American Medical Association. All rights reserved.

<58>
Accession Number
637863299
Title
The effect of dexmedetomidine on postoperative and intensive care unit
delirium: A meta-analysis of randomized controlled trials.
Source
FASEB Journal. Conference: Experimental Biology Meeting, EB 2020. San
Diego, CA United States. 34(SUPPL 1) (no pagination), 2020. Date of
Publication: April 2020.
Author
Jiang F.; Ye X.; Cai Y.; Xie X.; Wang L.; Hua L.-L.; Xia Z.
Publisher
John Wiley and Sons Inc
Abstract
Background The present meta-analysis aimed to assess the efficacy of
dexmedetomidine on the occurrence of delirium among critically ill
patients in the postoperative and intensive care unit. Methods Pubmed,
Embase, Cochrane Library (Central), Web of Science and Clinical Trails
databases for randomized controlled trials (RCTs) were searched to compare
the effect of dexmedetomidine administration in comparison with control
group (normal saline or other anesthetic drugs) on the incidence of
delirium in adult patients until April 4, 2019. The sensitivity and
subgroup analyses were adopted. Statistical analysis was performed with
RevMan software version 5.3 and Stata 12.0. The primary endpoint was the
incidence of delirium. The secondary outcome included the occurrence of
hypotension, hypertension, bradycardia and tachycardia. Results 20 RCTs
were finally included in the analysis, with a total of 4,242 adult
patients. The results of meta-analysis showed that dexmedetomidine (odds
ratio [OR]=0.47, 95% confidence interval [CI]: 0.35 to 0.64, p < 0.01)
could significantly reduce the rate of delirium for the entire patients in
the postoperative and intensive care unit when compared with control
group. The subgroup analysis indicated that dexmedetomidine reduced the
incidence of delirium between groups in cardiac surgery (OR=0.55, 95% CI:
0.30 to 0.98) and non-cardiac surgery (OR=0.44, 95% CI: 0.31 to 0.64),
normal saline (OR=0.47, 95% CI: 0.31 to 0.71) and anesthetic drugs
(OR=0.50, 95% CI: 0.30 to 0.81), age >= 60 years old (OR=0.50, 95% CI:
0.36 to 0.68) and age < 60 years old (OR=0.34, 95% CI: 0.13 to 0.91), with
loading dose (OR=0.38, 95% CI: 0.29 to 0.50) and without loading dose
(OR=0.54, 95% CI: 0.44 to 0.67). However, there were no significant
difference in delirium among mechanical ventilated patients (OR=0.30, 95%
CI: 0.07 to 1.22) and in cardiac surgery patients with age >= 60 years old
(OR=0.73, 95% CI: 0.44 to 1.22). Additionally, this analysis found that
dexmedetomidine administration was associated with an increased incidence
of hypertension (OR=0.54, 95% CI: 0.41 to 0.71) and bradycardia (OR=1.59,
95% CI: 1.25 to 2.03), while the incidence of hypotension (OR=0.90, 95%
CI: 0.62 to 1.31) and tachycardia (OR=0.73, 95% CI: 0.37 to 1.45) did not
differ significantly between dexmedetomidine treated and control groups.
Conclusion The present limited evidence suggests that dexmedetomidine can
reduce the incidence of delirium in the postoperative and intensive care
unit except in cardiac surgery patients with age >= 60. However, the
pooled results should be interpreted with more caution due to significant
statistical heterogeneity existed. Therefore, future high-quality, large
RCTs should further verify this findings among this population.

<59>
Accession Number
637862006
Title
Intraoperative Hemidiaphragm Stimulation Offsets Slow-Twitch Muscle Fiber
Atrophy and Contractile Dysfunction.
Source
FASEB Journal. Conference: Experimental Biology Meeting, EB 2020. San
Diego, CA United States. 34(SUPPL 1) (no pagination), 2020. Date of
Publication: April 2020.
Author
Bresciani G.; Mankowski R.; Ferreira L.; Leeuwenburgh C.; Arnaoutakis G.;
Martin T.; Xue W.; Martin D.; Beaver T.; Smith B.K.
Publisher
John Wiley and Sons Inc
Abstract
Prolonged mechanical ventilation induces considerable atrophy of slow- and
fast-twitch fibers in the human diaphragm. In pilot work, we detected
early atrophy and specific force decrement in fast-twitch fibers of
patients following an average 4.6-hour thoracic operations. We now present
interim data from a larger controlled trial of diaphragm stimulation as a
means to reduce slow- and fast-twitch- fiber atrophy and metabolic
derangements that occur with mechanical ventilation. We hypothesized that
intraoperative hemidiaphragm would mitigate both slow- and fast-twitch
fiber contractile dysfunction in the human diaphragm. Twelve adults (6F,
age 62 +/-12 years) consented to participate in this IRB-approved study.
During cardiothoracic surgical procedures, one hemidiaphragm underwent 1
minute of electrical phrenic nerve stimulation every 30 minutes (30
twitches/minute, 1.5 milliseconds pulse duration, amplitude variable to
produce a strong twitch contraction, up to 25 mA), while the contralateral
hemidiaphragm remained inactive. Thirty minutes following the last
stimulation bout, biopsies were obtained from both hemidiaphragms. Muscle
fibers were buffered, permeabilized, and separated for evaluation of
cross-sectional area and force-generating properties. A mixed effects
model with random intercept for each subject was used to evaluate the
fixed effects of stimulation and fiber type on single-fiber force
mechanics, and significance was p<0.05. Subjects underwent an average 7
+/-2 hemidiaphragm stimulations at 17 +/-2 mA, and biopsies were collected
after 4.75 +/-1.03 hours of mechanical ventilation. Cross-sectional area
of unstimulated slow-twitch fibers was significantly smaller than
stimulated slow-twitch fibers (5632 +/-349 vs 4619 +/-247 muM2), with no
effect on fast-twitch fibers (5631 +/-350 vs 5768 +/-351 muM2), [p<0.005].
Likewise, stimulation resulted in significantly higher specific force of
slow-twitch (106 +/-6 vs 97 +/-6 kN/m2), but not fast-twitch diaphragm
single fibers (126 +/-6 vs 130 +/-6 kN/m2), [p<0.001]. Stimulation did not
appreciably alter fiber calcium-sensitivity properties of either fiber
type. Our data suggest that stimulation attenuates diaphragm slow-twitch
fiber atrophy and contractile dysfunction induced by mechanical
ventilation. Fiber type-specific changes with short periods of mechanical
ventilation may be attributed to predominant slow fiber recruitment during
tidal breathing.

<60>
Accession Number
2017890116
Title
Prediction and Evaluation of Machine Learning Algorithm for Prediction of
Blood Transfusion during Cesarean Section and Analysis of Risk Factors of
Hypothermia during Anesthesia Recovery.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 8661324. Date of Publication: 2022.
Author
Ren W.; Li D.; Wang J.; Zhang J.; Fu Z.; Yao Y.
Institution
(Ren, Fu, Yao) Chengdu Institute of Computer Application, Chinese Academy
of Sciences, Chengdu 610041, China
(Ren) University of Chinese Academy of Sciences, Beijing 100049, China
(Li) Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen 518057,
China
(Wang) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, Sichuan 610041, China
(Zhang) Department of Anesthesiology, West China Second University
Hospital, Sichuan University, Chengdu, Sichuan 610041, China
Publisher
Hindawi Limited
Abstract
Objective. To explore the application of machine learning algorithm in the
prediction and evaluation of cesarean section, predicting the amount of
blood transfusion during cesarean section and to analyze the risk factors
of hypothermia during anesthesia recovery. Methods. (1)Through the
hospital electronic medical record of medical system, a total of 600
parturients who underwent cesarean section in our hospital from June 2019
to December 2020 were included. The maternal age, admission time,
diagnosis, and other case data were recorded. The routine method of
cesarean section was intraspinal anesthesia, and general anesthesia was
only used for patients' strong demand, taboo, or failure of intraspinal
anesthesia. According to the standard of intraoperative bleeding, the
patients were divided into two groups: the obvious bleeding group (MH
group, N=154) and nonobvious hemorrhage group (NMH group, N=446). The
preoperative, intraoperative, and postoperative indexes of parturients in
the two groups were analyzed and compared. Then, the risk factors of
intraoperative bleeding were screened by logistic regression analysis with
the occurrence of obvious bleeding as the dependent variable and the
factors in the univariate analysis as independent variables. In order to
further predict intraoperative blood transfusion, the standard cases of
recesarean section and variables with possible clinical significance were
included in the prediction model. Logistic regression, XGB, and ANN3
machine learning algorithms were used to construct the prediction model of
intraoperative blood transfusion. The area under ROC curve (AUROC),
accuracy, recall rate, and F1 value were calculated and compared. (2)
According to whether hypothermia occurred in the anesthesia recovery room,
the patients were divided into two groups: the hypothermia group (N=244)
and nonhypothermia group (N=356). The incidence of hypothermia was
calculated, and the relevant clinical data were collected. On the basis of
consulting the literatures, the factors probably related to hypothermia
were collected and analyzed by univariate statistical analysis, and the
statistically significant factors were analyzed by multifactor logistic
regression analysis to screen the independent risk factors of hypothermia
in anesthetic convalescent patients. Results. (1) First of all, we
compared the basic data of the blood transfusion group and the
nontransfusion group. The gestational age of the transfusion group was
lower than that of the nontransfusion group, and the times of cesarean
section and pregnancy in the transfusion group were higher than those of
the non-transfusion group. Secondly, we compared the incidence of
complications between the blood transfusion group and the nontransfusion
group. The incidence of pregnancy complications was not significantly
different between the two groups (P>0.05). The incidence of premature
rupture of membranes in the nontransfusion group was higher than that in
the transfusion group (P<0.05). There was no significant difference in the
fetal umbilical cord around neck, amniotic fluid index, and fetal heart
rate before operation in the blood transfusion group, but the thickness of
uterine anterior wall and the levels of Hb, PT, FIB, and TT in the blood
transfusion group were lower than those in the nontransfusion group, while
the number of placenta previa and the levels of PLT and APTT in the blood
transfusion group were higher than those in the nontransfusion group. The
XGB prediction model finally got the 8 most important features, in the
order of importance from high to low: preoperative Hb, operation time,
anterior wall thickness of the lower segment of uterus, uterine weakness,
preoperative fetal heart, placenta previa, ASA grade, and uterine
contractile drugs. The higher the score, the greater the impact on the
model. There was a linear correlation between the 8 features (including
the correlation with the target blood transfusion). The indexes with
strong correlation with blood transfusion included the placenta previa,
ASA grade, operation time, uterine atony, and preoperative Hb. Placenta
previa, ASA grade, operation time, and uterine atony were positively
correlated with blood transfusion, while preoperative Hb was negatively
correlated with blood transfusion. In order to further compare the
prediction ability of the three machine learning methods, all the samples
are randomly divided into two parts: the first 75% training set and the
last 25% test set. Then, the three models are trained again on the
training set, and at this time, the model does not come into contact with
the samples in any test set. After the model training, the trained model
was used to predict the test set, and the real blood transfusion status
was compared with the predicted value, and the F1, accuracy, recall rate,
and AUROC4 indicators were checked. In terms of training samples and test
samples, the AUROC of XGB was higher than that of logistic regression, and
the F1, accuracy, and recall rate of XGB of ANN were also slightly higher
than those of logistic regression and ANN. Therefore, the performance of
XGB algorithm is slightly better than that of logistic regression and ANN.
(2) According to the univariate analysis of hypothermia during the
recovery period of anesthesia, there were significant differences in ASA
grade, mode of anesthesia, infusion volume, blood transfusion, and
operation duration between the normal body temperature group and
hypothermia group (P<0.05). Logistic regression analysis showed that ASA
grade, anesthesia mode, infusion volume, blood transfusion, and operation
duration were all risk factors of hypothermia during anesthesia recovery.
Conclusion. In this study, three machine learning algorithms were used to
analyze the large sample of clinical data and predict the results. It was
found that five important predictive variables of blood transfusion during
recesarean section were preoperative Hb, expected operation time, uterine
weakness, placenta previa, and ASA grade. By comparing the three
algorithms, the prediction effect of XGB may be more accurate than that of
logistic regression and ANN. The model can provide accurate individual
prediction for patients and has good prediction performance and has a good
prospect of clinical application. Secondly, through the analysis of the
risk factors of hypothermia during the recovery period of cesarean
section, it is found that ASA grade, mode of anesthesia, amount of
infusion, blood transfusion, and operation time are all risk factors of
hypothermia during the recovery period of cesarean section. In line with
this, the observation of this kind of patients should be strengthened
during cesarean section. Copyright © 2022 Wei Ren et al.

<61>
Accession Number
2017675184
Title
Potential role for pentoxifylline as an anti-inflammatory drug for
patients with acute coronary syndrome.
Source
Experimental and Therapeutic Medicine. 23(6) (no pagination), 2022.
Article Number: 378. Date of Publication: June 2022.
Author
Brie D.M.; Mornos C.; Brie D.A.; Luca C.T.; Petrescu L.; Boruga M.
Institution
(Brie, Mornos, Luca, Petrescu) Department of Interventional Cardiology,
Cardiovascular Disease Institute Timisoara, Timisoara 300310, Romania
(Mornos, Luca, Petrescu) Departments of Cardiology, 'Victor Babes'
University of Medicine and Pharmacy, Timisoara 300041, Romania
(Brie) Departments of Cellular Biology, 'Victor Babes' University of
Medicine and Pharmacy, Timisoara 300041, Romania
(Boruga) Faculty of Pharmacy, Department of Toxicology and Drug Industry,
'Victor Babes' University of Medicine and Pharmacy, Timisoara 300041,
Romania
Publisher
Spandidos Publications
Abstract
The link between inflammation and acute coronary syndrome (ACS) remains to
be sufficiently elucidated. It has been previously suggested that there is
an inflammatory process associated with ACS. Pentoxifylline, a
methylxanthine derivate, is known to delay the progression of
atherosclerosis and reduce the risk of vascular events, especially by
modu- lating the systemic inflammatory response. The present study is a
single-blind, randomized, prospective study of pentoxifyl- line 400 mg
three times a day (TID) added to standard therapy vs. standard therapy
plus placebo in ACS patients with non-ST elevation myocardial infarction
(NSTEMI). Patients with ACS were randomized to receive standard therapy
plus placebo in one arm (group A; aspirin, clopidogrel or ticagrelor,
statin) and in the other arm (group B) pentoxifylline 400 mg TID was added
to standard therapy. The primary outcome was the rate of major adverse
cardiovascular events (MACEs) at 1 year. A total of 500 patients underwent
randomization (with 250 assigned to group A and 250 to group B) and were
followed-up for a median of 20 months. The mean age of the patients was
62.3+/-10.3 years, 80.4% were male, 20.8% had diabetes, 49.4% had
hypertension, and 42% were currently smoking. The statistical analysis was
performed for 209 patients in group A and 210 patients in group B (after
dropouts due to study drug discontinuation). A primary endpoint occurred
in 12.38% (n=26) of patients in group B, as compared with 15.78% (n=33) of
those in group A [relative risk (RR), 0.78; 95% confidence interval (CI),
0.486-0.1.263; P=0.40], including cardiovas- cular death (RR, 0.93; 95%
CI, 0.48-1.80, P=0.84), non-fatal myocardial infarction (RR, 1.1; 95% CI,
0.39-3.39, P=0.78), stroke (RR, 0.99; 95% CI, 0.14-6.99, P=0.99) and
coronary revascularization (RR, 0.12; 95% CI, 0.015-0.985, P=0.048). Thus,
adding pentoxifylline to standard treatment in patients with ACS did not
improve MACE at 1 year but had some benefit on the need for coronary
revascularization. Copyright © 2022 Spandidos Publications. All
rights reserved.

<62>
Accession Number
2017836574
Title
ONE-LUNG VENTILATION PATIENTS: CLINICAL CONTEXT OF ADMINISTRATION OF
DIFFERENT DOSES OF DEXMEDETOMIDINE.
Source
Journal of Medical Biochemistry. 41(2) (pp 230-237), 2022. Date of
Publication: 2022.
Author
Jiang H.; Kang Y.; Ge C.; Zhang Z.; Xie Y.
Institution
(Jiang, Ge, Zhang, Xie) Department of Anesthesiology, Xuhui District
Central Hospital, Shanghai, China
(Kang) Department of Anesthesiology, Tongren Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
Publisher
Society of Medical Biochemists of Serbia
Abstract
Background: Open and endoscopic thoracic surgeries improve surgical
exposure by One-lung ventilation (OLV). The aim of this study was to
investigate the effects of different doses of dexmedetomidine on
inflammatory response, oxidative stress, cerebral tissue oxygen saturation
(S<inf>ct</inf>O<inf>2</inf>) and intrapulmonary shunt in patients
undergoing one-lung ventilation (OLV). Method(s): Seventy-five
patients undergoing open pulmonary lobectomy in our hospital from January
2016 to December 2017 were enrolled and randomly divided into high-dose
dexmedetomidine group (group D1, 1 mg/kg, n=25), low-dose dexmedetomidine
group (group D2, 0.5 mg/kg, n=25) and control group (group C, n=25). Then,
arterial blood and internal jugular venous blood were taken before
anesthesia induction (T0) and at 15 min after two-lung ventilation (T1)
and 5 min (T2) and 30 min (T3) after OLV for later use. Next, the changes
in hemodynamic parameters [mean arterial pressure (MAP), heart rate (HR)
and pulse oxygen saturation (SpO<inf>2</inf>)] of patients were observed
in each group. Enzyme-linked immunosorbent assay (ELISA) was carried out
to detect serum inflammatory factors such as interleukin-6 (IL-6) and
tumor necrosis factor-alpha (TNF-a) and oxidative stress indicators
[superoxide dismutase (SOD) and malondialdehyde (MDA)]. The changes in
S<inf>ct</inf>O<inf>2</inf>, arterial partial pressure of oxygen
(PaO<inf>2</inf>) and intrapulmonary shunt Qs/Qt (a measurement of
pulmonary shunt: right-to-left shunt fraction) were observed.
Additionally, the changes in lung function indicators like lung dynamic
compliance (Cdyn) and airway peak pressure (Ppeak) were determined.
 Result(s): There were no statistically significant differences in the
MAP, HR and SpO<inf>2</inf> among three groups at each observation time
point (P>0.05). At T2 and T3, the levels of serum IL-6, TNF-a and IL-8
were obviously decreased in group D1 and D2 compared with those in group C
(P<0.05), and the decreases in group D1 were overtly larger than those in
group D2, and the decreases at T3 were markedly greater than those at T2
(P<0.05). In comparison with group C, group D1 and D2 had notably reduced
levels of serum reactive oxygen species (ROS) and MDA (P<0.05) and
remarkably increased SOD content (P<0.05) at T2 and T3, and the effects
were markedly better in group D1 than those in group D2. Besides, they
were significantly superior at T3 to those at T2 (P<0.05). The
S<inf>ct</inf>O<inf>2</inf> in group D1 and D2 was evidently lowered at T2
and T3 compared with that at T0, and the decrease in group D1 was
distinctly smaller than that in group D2 (P<0.05). The Qs/Qt was
significantly lower in group D1 and D2 than that in group C at T2 and T3
(P<0.05), while the PaO<inf>2</inf> content was notably raised (P<0.05),
and the decrease and increase were significantly larger in group D1 than
those in group D2, and they were obviously greater at T3 to those at T2
(P<0.05). At T0 and T1, no significant differences were detected in the
Cdyn, Pplat and Ppeak among three groups. At T2 and T3, the Cdyn was
significantly elevated, while the Pplat and Ppeak overtly declined
(P<0.05), and group D1 had greater changes in comparison with group D2,
and the changes were obviously more evident at T3 to those at T2 (P<0.05).
 Conclusion(s): Dexmedetomidine effectively ameliorates inflammatory
response and oxidative stress, lowers oxygenation, Qs/Qt and the decrease
in S<inf>ct</inf>O<inf>2</inf> and improves lung function during OLV, with
good efficacy. Copyright © 2022 Sciendo. All rights reserved.

<63>
Accession Number
2016544819
Title
Postoperative Atrial Fibrillation in Adults with Obstructive Sleep Apnea
Undergoing Coronary Artery Bypass Grafting in the RICCADSA Cohort.
Source
Journal of Clinical Medicine. 11(9) (no pagination), 2022. Article Number:
2459. Date of Publication: May-1 2022.
Author
Peker Y.; Holtstrand-Hjalm H.; Celik Y.; Glantz H.; Thunstrom E.
Institution
(Peker, Celik) Department of Pulmonary Medicine, Koc University Research
Center for Translational Medicine [KUTTAM], Istanbul 34450, Turkey
(Peker) Division of Sleep and Circadian Disorders, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA 02115, United States
(Peker, Holtstrand-Hjalm, Thunstrom) Department of Molecular and Clinical
Medicine, Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg 40530, Sweden
(Peker) Department of Clinical Sciences, Respiratory Medicine and
Allergology, School of Medicine, Lund University, Lund 22185, Sweden
(Peker) Division of Pulmonary, Allergy, and Critical Care Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United
States
(Glantz) Department of Internal Medicine, Skaraborg Hospital, Lidkoping
53151, Sweden
Publisher
MDPI
Abstract
Postoperative atrial fibrillation (POAF) occurs in 20-50% of patients with
coronary artery disease (CAD) after coronary artery bypass grafting
(CABG). Obstructive sleep apnea (OSA) is also common in adults with CAD,
and may contribute to POAF as well to the reoccurrence of AF in patients
at long-term. In the current secondary analysis of the Randomized
Intervention with Continuous Positive Airway Pressure (CPAP) in Coronary
Artery Disease and Obstructive Sleep Apnea (RICCADSA) trial (Trial
Registry: ClinicalTrials.gov; No: NCT 00519597), we included 147 patients
with CABG, who underwent a home sleep apnea testing, in average 73 +/- 30
days after the surgical intervention. POAF was defined as a new-onset AF
occurring within the 30 days following the CABG. POAF was observed among
48 (32.7%) patients, occurring within the first week among 45 of those
cases. The distribution of the apnea-hypopnea-index (AHI) categories < 5.0
events/h (no-OSA); 5.0-14.9 events/h (mild OSA); 15.0-29.9 events/h
(moderate OSA); and >=30 events/h (severe OSA), was 4.2%, 14.6%, 35.4%,
and 45.8%, in the POAF group, and 16.2%, 17.2%, 39.4%, and 27.3%,
respectively, in the no-POAF group. In a multivariate logistic regression
model, there was a significant risk increase for POAF across the AHI
categories, with the highest odds ratio (OR) for severe OSA (OR 6.82, 95%
confidence interval 1.31-35.50; p = 0.023) vs. no-OSA, independent of age,
sex, and body-mass-index. In the entire cohort, 90% were on beta-blockers
according to the clinical routines, they all had sinus rhythm on the
electrocardiogram at baseline before the study start, and 28 out of 40
patients with moderate to severe OSA (70%) were allocated to CPAP. During
a median follow-up period of 67 months, two patients (none with POAF) were
hospitalized due to AF. To conclude, severe OSA was significantly
associated with POAF in patients with CAD undergoing CABG. However, none
of those individuals had an AF-reoccurrence at long term, and whether CPAP
should be considered as an add-on treatment to beta-blockers in secondary
prevention models for OSA patients presenting POAF after CABG requires
further studies in larger cohorts. Copyright © 2022 by the
authors. Licensee MDPI, Basel, Switzerland.

<64>
Accession Number
2016536040
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
(Zheng, Lin, Lin, Xu, Cao, Chen) Fujian Children's Hospital, Fuzhou, China
(Zheng, Lin, Lin, Xu, Cao, Chen) Fujian Maternity and Child Health
Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
(Zheng, Lin, Lin, Xu, Cao, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
Publisher
American Association for Respiratory Care
Abstract
BACKGROUND: Extubation early in the postoperative period is beneficial to
the recovery and rehabilitation of patients. This study compared the
postoperative extubation failure rates among infants who received
postextubation respiratory support by either bi-level positive airway
pressure (BPAP) or nasal CPAP following cardiac surgery. METHOD(S):
This was a single-center randomized controlled trial registered at the
Chinese Clinical Trial Registry (number ChiCTR2000041453) and was
conducted between January 2020 and March 2021. Ventilated infants who
underwent cardiac surgery were randomized to either a BPAP or a nasal CPAP
group for ventilatory support following extubation. The primary outcome
measure was the extubation failure rate within 48 h. RESULT(S): The
analyses included 186 subjects. Treatment failure necessitating
re-intubation was noted in 14 of the 93 infants (15%) in the BPAP group
and in 11 of the 93 infants (12%) in the nasal CPAP group (P 5 .52).
Moreover, there were no statistically significant differences between the
2 groups regarding the duration of noninvasive ventilation (P 5 .54),
total enteral feeding time (P 5 .59), or complications (P 5 .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 P<inf>aCO2</inf> level within 24 h was significantly lower in
the BPAP group (P 5 .001) than in the CPAP group. Additionally, the
P<inf>aO2</inf>/F<inf>IO2</inf> in the BPAP group was significantly higher
than in the nasal CPAP group at 6 h, 12 h, and 24 h after treatment (P <
.001). CONCLUSION(S): The introduction of BPAP for postextubation
respiratory support was not inferior to nasal CPAP in infants after
cardiac surgery. Moreover, BPAP was shown to be superior to nasal CPAP in
improving oxygenation and carbon dioxide clearance. Copyright ©
American Association for Respiratory Care. All rights reserved.

<65>
Accession Number
2016531957
Title
Myocardial Protecting Role of Glutamine in Patients with Low Ejection
Fraction Undergoing Elective On-Pump Coronary Artery Bypass Graft Surgery.
Source
Vascular Health and Risk Management. 18 (pp 219-231), 2022. Date of
Publication: 2022.
Author
Parmana I.M.A.; Boom C.E.; Rachmadi L.; Hanafy D.A.; Widyastuti Y.;
Mansyur M.; Siswanto B.B.
Institution
(Parmana, Boom) Department of Anesthesiology and Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Rachmadi) Department of Anatomical Pathology, Faculty of Medicine,
Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
(Hanafy) Department of Cardiothoracic and Vascular Surgery, Faculty of
Medicine, Universitas Indonesia, National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
(Widyastuti) Department of Anesthesiology and Intensive Care, Universitas
Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
(Mansyur) Department of Community Medicine, Faculty of Medicine,
Universitas Indonesia, Jakarta, Indonesia
(Siswanto) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Indonesia, National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Myocardial injury due to on-pump coronary artery bypass grafting
(CABG) in patients with low ejection fraction (EF) is associated with poor
outcomes. This study determines whether intravenous glutamine could
protect the myocardium during on-pump CABG in patients with low EF.
 Material(s) and Method(s): This was a double-blind, randomized
controlled trial to assess glutamine as a myocardial protector during
on-pump CABG in patients with left ventricle EF of 31-50%, conducted from
January to October 2021. Patients in the glutamine group (n = 30) received
0.5 g/kg of 20% glutamine solution diluted with 0.9% NaCl up to 500 mL in
total volume over a period of 24 hours. Patients in the control group (n =
30) received 0.9% NaCl over the same period. The primary outcomes were
plasma troponin I and plasma glutamine levels. Secondary outcomes included
alpha-ketoglutarate (alpha-KG) levels and histopathology scoring of the
right atrial appendage tissue, plasma lactate levels, hemodynamic
measurement, and morbidity. Result(s): Twenty-nine patients from each
group (58 in total) were included in the analysis. Plasma troponin I
levels at 6 and 24 hours after cardiopulmonary bypass (CPB) were
significantly lower in the glutamine than the control group (mean 3.43 +/-
1.51 ng/mL vs mean 4.41 +/- 1.89 ng/mL; p = 0.034; median 3.08 ng/mL
[min-max: 1.30-6.59] vs median 3.77 ng/mL [min-max: 0.00-36.53]; p =
0.038, respectively). Plasma glutamine levels at 24 hours after CPB were
significantly higher in the glutamine than the control group (mean 935.42
+/- 319.10 mumol/L vs mean 634.79 +/- 243.89 mumol/L, p = 0.001). Plasma
lactate levels at 6 and 24 hours after CPB were significantly lower in the
glutamine than the control group (median 5.30 mmol/L [min-max: 1.20-9.50]
vs median 5.70 mmol/L [min-max: 2.80-11.30], p = 0.042; mean 2.08 +/- 0.67
mmol/L vs mean 2.46 +/- 0.69 mmol/L, p = 0.044, respectively). Myocardial
injury score was significantly lower in the glutamine than the control
group (mean 1.30 +/- 0.24 vs mean 1.48 +/- 0.26, p = 0.011).
 Conclusion(s): Perioperative administration of 0.5 g/kg intravenous
glutamine solution over the period of 24 hours has myocardial protection
effect in patients with low EF who undergo elective on-pump
CABG. Copyright © 2022 Parmana et al.

<66>
Accession Number
2016081922
Title
Desflurane improves lung collapse more than propofol during one-lung
ventilation and reduces operation time in lobectomy by video-assisted
thoracic surgery: a randomized controlled trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 125. Date
of Publication: December 2022.
Author
Kawanishi R.; Kakuta N.; Sakai Y.; Hari Y.; Sasaki H.; Sekiguchi R.;
Tanaka K.
Institution
(Kawanishi) Division of Surgical Center, Tokushima University Hospital,
2-50-1 Kuramoto, Tokushima 770-8503, Japan
(Kakuta, Sakai, Tanaka) Department of Anesthesiology, Tokushima University
Graduate School of Biomedical Sciences, Tokushima, Japan
(Hari, Sasaki, Sekiguchi) Department of Anesthesiology, Tokushima
University Hospital, Tokushima, Japan
Publisher
BioMed Central Ltd
Abstract
Background: This study evaluated whether desflurane improved lung collapse
during one-lung ventilation (OLV) more than propofol, and whether it could
reduce the operation time of video-assisted thoracic surgery.
 Method(s): Sixty patients undergoing lobectomy by video-assisted
thoracic surgery (VATS) were randomly assigned to general anesthesia with
desflurane or propofol. Lungs were inspected by thoracoscope at 10, 30,
and 60 min after initiation of OLV. After surgery, the Lung Collapse
Score, a composite of lung color and volume assessments, was assigned by
two clinicians blinded to the anesthetic regimen. The primary outcome was
operation time. The secondary outcome included the complication rate.
 Result(s): Of the 60 participants, 50 completed the study, 26 in
Desflurane group and 24 in Propofol group. The Lung Collapse Scores at 30
and 60 min after OLV initiation were significantly better in Desflurane
group than in Propofol group, and operation time was significantly shorter
in Desflurane group (214 (57) min vs. 262 (72) min [mean (SD)], difference
in means, -48; 95% CI, -85 to -11; P = 0.01). The incidence of multiple
complications was 1/26 (3%) and 6/24 (25%) in Desflurane and Propofol
group, respectively (relative risk, 0.1; 95% CI, 0.02 to 1.18; P = 0.04).
 Conclusion(s): Desflurane improved lung collapse during OLV and
significantly shortened VATS lobectomy operation time compared to propofol
in our studied patients. Desflurane resulted in fewer postoperative
complications. Thus, desflurane may be an appropriate anesthetic during
lobectomy by VATS requiring OLV. Trial registration: The study was
registered with the University Hospital Medical Information Network
(UMIN000009412). The date of disclosure of this study information is
27/11/2012. On this date, we registered the study into UMIN; patients were
included from 2013 to 2014. However, on 11/27/2015, the UMIN system
administrator suggested a detailed description. Thereafter, we added it to
the Randomization Unit. Despite being prospective, it was retrospectively
registered on UMIN for the above reasons. Copyright © 2022, The
Author(s).

<67>
Accession Number
2016544630
Title
Evaluation of the Effect of Modafinil on Respiratory and Cerebral Outcomes
after Coronary Artery Bypass Graft Surgery.
Source
ARYA Atherosclerosis. 17(2) (no pagination), 2021. Date of Publication:
January and February 2021.
Author
Mansouri M.; Massoumi G.; Rezaei-Hoseinabadi M.K.
Institution
(Mansouri, Massoumi, Rezaei-Hoseinabadi) Research Center of Anesthesia and
Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
Publisher
Isfahan University of Medical Sciences(IUMS)
Abstract
BACKGROUND: Pulmonary complications following cardiopulmonary bypass (CPB)
pump during coronary artery bypass grafting (CABG) are relatively common
and the incidence of cognitive dysfunction is reported as ranging in rate
from 30% to 80% in the early postoperative period. The purpose of this
study was to assess the effect of modafinil administration on the
prevention of pulmonary and cerebral complications and shortening the
hospital stay after CABG surgery. METHOD(S): This randomized
double-blind intervention-controlled clinical trial was performed on 74
patients (37 in the intervention group and 37 in the control group)
undertaking CABG surgery. The intervention group was orally treated with
doses of 200 mg of modafinil on the day of surgery, and on the morning of
the day after surgery, the second dose of modafinil 200 mg was given to
patients. The control group underwent a placebo with the same intervals.
 RESULT(S): Administration of modafinil in intervention group
significantly decreased the time to reach consciousness (P = 0.001),
ventilator time in intensive care unit (ICU) (P < 0.001), length of stay
in ICU (P = 0.009), duration of hospitalization (P = 0.008), and arterial
blood carbon dioxide pressure (PaCO2) (P = 0.047). In the intervention
group, no patients with delirium, agitation, respiratory depression,
non-invasive respiratory ventilation, and endotracheal re-intubation were
observed. CONCLUSION(S): Modafinil tablet as a respiratory and brain
stimulant through the central nervous system (CNS) can improve the quality
of breathing and arterial blood gases (ABGs) and also can increase the
level of consciousness and shorten the recovery time. Copyright ©
2021, Isfahan University of Medical Sciences(IUMS). All rights reserved.

<68>
Accession Number
637883273
Title
Vaptans for edematous and hyponatremic disorders in childhood: a
systematic literature review.
Source
British journal of clinical pharmacology. (no pagination), 2022. Date of
Publication: 26 Apr 2022.
Author
Piffer A.; Bianchetti M.G.; Leoni-Foglia C.; Simonetti G.D.; Milani G.P.;
Lava S.A.G.
Institution
(Piffer, Leoni-Foglia, Simonetti) Pediatric Institute of Southern
Switzerland, Ente Ospedaliero Cantonale, Ospedale San Giovanni,
Bellinzona, Switzerland
(Bianchetti) Family Medicine, Faculty of Biomedical Sciences, Universita
della Svizzera Italiana, Lugano, Switzerland
(Bianchetti, Simonetti) Faculty of Biomedical Sciences, Universita della
Svizzera Italiana, Lugano, Switzerland
(Milani) Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore
Policlinico, Milan, Italy
(Milani) Department of Clinical Sciences and Community Health, Universita
degli Studi di Milano, Milan, Italy
(Lava) Pediatric Cardiology Unit, Department of Pediatrics, Centre
Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne,
Switzerland
(Lava) Heart Failure and Transplantation, Department of Pediatric
Cardiology, Great Ormond Street Hospital, London, United Kingdom
Publisher
NLM (Medline)
Abstract
AIMS: To systematically review the use of vaptans (nonpeptide vasopressin
receptor antagonists) in children. METHOD(S): Through a database
search (Web of Science, the National Library of Medicine, Excerpta
Medica), we identified case series and case reports and extracted clinical
and laboratory data. RESULT(S): Twenty-six articles, published since
2008, reported on 226 patients. Among 115 children with hyponatremic
(n=63) and edematous disorders (n=52), a 48h course of tolvaptan with an
initial dose of 0.38+/-0.27 mg/kg was administerd in 106, while
intravenous conivaptan was reported in 9 cases. An increase (p<0.02) in
urine output was shown in both edematous (from 3.2+/-2.0 to 5.3+/-6.7
mL/kg/day) and hyponatraemic (from 3.0+/-1.5 to 4.4+/-2.3 mL/kg/day)
patients. In these latter, sodium increased from 125+/-6 to 133+/-6 mmol/L
(p<0.0001). The increase in sodium level correlated with its basal value,
but not with the administered vaptan dose. Among 111 children undergoing
cardiac surgery, after tolvaptan 0.21+/-0.01 mg/kg/day, mostly combined
with conventional diuretics, an increase in diuresis by 41+/-4% was seen
within 24h (p<0.0001). Similarly, a single add-on dose of tolvaptan 0.45
mg/kg allowed a reduced additional intravenous furosemide administration
(0.26+/-0.23 versus 0.62+/-0.48 mg/kg, p<0.005). Side effects were rarely
reported, and included excessive thirst and xerostomia in seven, skin rash
in one and elevated aminotransferases in one patient(s).
 CONCLUSION(S): Vaptans appear to be safe for edematous and
hyponatremic disorders also in children. Although they increase diuresis
and natremia, no superiority to traditional diuretics and sodium
supplements has been demonstrated. Reported side effects are rare and
non-serious. Copyright This article is protected by copyright. All
rights reserved.

<69>
Accession Number
2017791338
Title
Thoracoscopic Versus Open Lobectomy After Induction Therapy for Nonsmall
Cell Lung Cancer: New Study Results and Meta-Analysis.
Source
Journal of Surgical Research. (no pagination), 2022. Date of Publication:
2022.
Author
Hireche K.; Canaud L.; Lounes Y.; Aouinti S.; Molinari N.; Alric P.
Institution
(Hireche, Canaud, Lounes, Alric) Department of Thoracic and Vascular
Surgery, Arnaud de Villeneuve University Hospital, Montpellier, France
(Hireche, Canaud, Lounes, Alric) PhyMedExp, University of Montpellier,
INSERM, CNRS, Montpellier, France
(Aouinti, Molinari) IDESP, INSERM, University of Montpellier, CHU
Montpellier, Montpellier, France
Publisher
Academic Press Inc.
Abstract
Introduction: The use of video-assisted thoracoscopic surgery (VATS)
lobectomy has become a mainstay of modern thoracic surgery practice and
the technique of choice for resection of early-stage lung cancers.
However, the benefits of VATS following induction therapy are yet to be
clarified. This study aims to assess whether VATS lobectomy achieves
similar perioperative and oncologic outcomes compared to thoracotomy for
nonsmall cell lung cancer after induction therapy. Method(s): We
retrospectively reviewed the outcomes of 72 patients who underwent lung
lobectomy after induction therapy in our institution from January 2017 to
January 2020. Subsequently, we carried out a comprehensive literature
search and pooled our results with available data from previously
published studies to perform a meta-analysis. Result(s): VATS was
associated with reduced intraoperative blood loss (P = 0.05) and less
perioperative complications (P = 0.04) in our local institution. The
meta-analysis comprised nine studies. A total of 943 patients underwent
VATS and 2827 patients underwent open lobectomy. VATS was associated with
significant shorter surgery duration (P < 0.0001), shorter chest-tube
drainage duration (P < 0.0001), and shorter hospital stays (P < 0.0001).
Furthermore, there was significantly less perioperative complications (P =
0.006) and less intraoperative blood loss (P = 0.036) in the VATS group.
However, there were no significant differences in 3-y overall survival and
3-y disease-free survival rates. Conclusion(s): In some selected
patients undergoing induction therapy, VATS lobectomy could achieve
equivalent perioperative outcomes to thoracotomy but evidence is lacking
on oncologic outcomes. Further trials with a focus on oncologic outcomes
and longer follow-up are required. Copyright © 2022 Elsevier Inc.

<70>
Accession Number
2016977438
Title
Neutralization of SARS-CoV-2 Variants in Transplant Recipients After Two
and Three Doses of mRNA-1273 Vaccine.
Source
Annals of Internal Medicine. 175(2) (pp 226-233), 2022. Date of
Publication: 01 Feb 2022.
Author
Kumar D.; Ferreira V.H.; Hall V.G.; Hu Q.; Samson R.; Ku T.; Ierullo M.;
Majchrzak-Kita B.; Tomlinson G.; Gingras A.-C.; Humar A.
Institution
(Kumar, Ferreira, Hall, Ku, Ierullo, Majchrzak-Kita, Tomlinson, Humar)
University Health Network, Toronto, ON, Canada
(Hu, Samson, Gingras) Lunenfeld-Tanenbaum Research Institute, Mount Sinai
Hospital, Sinai Health, Toronto, ON, Canada
(Samson, Gingras) Department of Molecular Genetics, University of Toronto,
Toronto, ON, Canada
Publisher
American College of Physicians
Abstract
Background: COVID-19 is more severe in transplant recipients. Variants of
concern have supplanted wild-type virus. In transplant recipients, data
are limited on 2-dose or 3-dose vaccine immunogenicity against variant
viruses. Objective(s): To assess neutralizing antibody responses
against SARS-CoV-2 variants in transplant recipients after 2 and 3 vaccine
doses. Design(s): Secondary analysis of a randomized, double-blind,
controlled trial of a third dose of mRNA-1273 vaccine versus placebo.
(ClinicalTrials.gov: NCT04885907) Setting: Single-center transplant
program. Patient(s): Organ transplant recipients.
 Intervention(s): Third dose of mRNA-1273 vaccine versus placebo.
Measurements: Sera were analyzed for neutralization against wild-type
virus and the Alpha, Beta, and Delta variants using a surrogate virus
neutralization assay and a spike-pseudotyped lentivirus assay.
 Result(s): A total of 117 transplant recipients were analyzed (60 in
the mRNA-1273 group and 57 in the placebo group). Sera were obtained
before and 4 to 6 weeks after the third dose. After 2 doses, the
proportion of patients with positive neutralization for all 3 variants was
small compared with wild-type virus. After the third dose of mRNA-1273
vaccine, the proportion with a positive neutralization response versus
placebo was improved for all 3 variants as measured by both assays. Based
on the pseudovirus neutralization assay against the Delta variant, 33 of
60 (55%) patients were positive in the mRNA-1273 group versus 10 of 57
(18%) in the placebo group (difference, 37 [95% CI, 19 to 53] percentage
points). The differences were 36 (CI, 17 to 51) percentage points for the
Alpha variant and 31 (CI, 15 to 46) percentage points for the Beta
variant. In the mRNA-1273 group, lower neutralization values were observed
for variants compared with wild-type virus, especially the Beta variant.
 Limitation(s): There is no clear correlate of protection for
neutralizing antibody. This was a secondary analysis. Conclusion(s):
In organ transplant recipients, a third dose of mRNA vaccine increases
neutralizing antibody response against SARS-CoV-2 variants compared with
placebo. Copyright © 2022 American College of Physicians. All
rights reserved.

<71>
Accession Number
2017048672
Title
Associations between adipokines and atrial fibrillation: A systematic
review and meta-analysis.
Source
Nutrition, Metabolism and Cardiovascular Diseases. 32(4) (pp 853-862),
2022. Date of Publication: April 2022.
Author
Agbaedeng T.A.; Zacharia A.L.; Iroga P.E.; Rathnasekara V.M.; Munawar
D.A.; Bursill C.; Noubiap J.J.
Institution
(Agbaedeng, Zacharia, Iroga, Rathnasekara, Bursill, Noubiap) Adelaide
Medical School, The University of Adelaide, Adelaide, Australia
(Munawar) Lyell McEwin Hospital, The University of Adelaide, Adelaide,
Australia
(Munawar) Department of Cardiology and Vascular Medicine, University of
Indonesia, Jakarta, Indonesia
(Bursill) Vascular Research Centre, Lifelong Health Theme, SAHMRI,
Adelaide, Australia
(Noubiap) Centre for Heart Rhythm Disorders, The University of Adelaide,
Adelaide, Australia
Publisher
Elsevier B.V.
Abstract
Aims: Although overweight and obesity are associated with increased risk
of atrial fibrillation (AF), the underlying mechanisms are not well
characterised. Recent data suggest that this link may be partly due to
abnormal adipose tissue-derived cytokines or adipokines. However, this
relationship is not well clarified. To evaluate the association between
adipokines and AF in a systematic review and meta-analysis. Data
synthesis: PubMed, Embase, and Web of Science Core Collection were
searched from inception through 1st March 2021. Studies were
included if they reported any adipokine and AF, with their quality
assessed using the Newcastle-Ottawa scale. Data were independently
abstracted, with unadjusted and multivariable adjusted estimates pooled in
a random-effects meta-analysis. Data are presented for overall prevalent
or incident AF and AF subtypes (paroxysmal, persistent, or non-paroxysmal
AF). A total of 34 studies, with 31,479 patients, were included. The
following adipokines were significantly associated with AF in the pooled
univariate data - apelin (risk ratio for prevalent AF: 0.05 [0.00-0.50], p
= 0.01; recurrent AF: 0.21 [0.11-0.42], p < 0.01) and resistin (incident
AF: 2.05 [1.02-4.1], p = 0.04; prevalent AF: 2.62 [1.78-3.85], p < 0.01).
Pooled analysis of multivariable adjusted effect size estimates showed
adiponectin as the sole independent predictor of AF incidence (1.14
[1.02-1.27], p = 0.02). Moreover, adiponectin was associated with
non-paroxysmal AF (persistent AF: 1.45 [1.08-1.94, p = 0.01;
non-paroxysmal versus paroxysmal AF: 3.14 [1.87-5.27, p < 0.01).
 Conclusion(s): Adipokines, principally adiponectin, apelin, and
resistin, are associated with the risk of atrial fibrillation. However,
the association is not seen after multivariate adjustment, likely
reflecting the lack of statistical power. Future research should
investigate these relationships in larger prospective cohorts and how they
can refine AF monitoring strategies. PROSPERO ID:
CRD42020208879. Copyright © 2022 The Italian Diabetes Society,
the Italian Society for the Study of Atherosclerosis, the Italian Society
of Human Nutrition and the Department of Clinical Medicine and Surgery,
Federico II University

<72>
Accession Number
2017030560
Title
Mechanical vs Bioprosthetic Aortic Valve Replacement in Patients Younger
Than 70 Years of Age: A Hazard Ratio Meta-analysis.
Source
Canadian Journal of Cardiology. 38(3) (pp 355-364), 2022. Date of
Publication: March 2022.
Author
Leviner D.B.; Witberg G.; Levi A.; Landes U.; Schwartz N.; Shiran A.;
Kornowski R.; Sharoni E.
Institution
(Leviner, Sharoni) Department of Cardiothoracic Surgery, Carmel Medical
Center, Haifa, Israel
(Leviner, Shiran, Sharoni) Technion-Israel Institute of Technology,
Faculty of Medicine, Haifa, Israel
(Witberg, Levi, Kornowski) Department of Cardiology, Rabin Medical Center,
Petach Tikva, Israel
(Landes) Departmetnt of Cardiology, Wolfson Medical Centre, Tel Aviv,
Israel
(Schwartz) Department of Biostatistics, Carmel Medical Centre, Haifa,
Israel
(Shiran) Department of Cardiology, Carmel Medical Centre, Haifa, Israel
(Witberg, Levi, Landes, Kornowski) Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel
Publisher
Elsevier Inc.
Abstract
Background: The choice between mechanical valves (MVs) and bioprosthetic
valves (BVs) in patients undergoing aortic valve surgery is complex,
requiring a balance between the inferior durability of BV and the
indicated long-term anticoagulation therapy with MV. This is especially
challenging in the middle age group (< 70 years), which has seen an
increased use of BV over recent years. Method(s): A meta-analysis of
randomised controlled trials (RCTs), observational studies using
propensity score matching (PSM) and inverse probability weighting (IPW)
was conducted to examine the clinical outcomes of patients < 70 years of
age undergoing aortic valve replacement. The primary outcome was overall
long-term mortality. Secondary outcomes included bleeding events,
reoperation, systemic thromboembolism, and cerebrovascular accident.
 Result(s): Fifteen studies (1 RCT, 12 PSM studies, and 2 IPW studies;
aggregated sample size 16,876 patients) were included. Median follow-up
was 7.8 years. Mortality was higher with BVs vs MVs (hazard ratio [HR]
1.22, 95% confidence interval [CI] 1.00-1.49), as was reoperation (HR
3.05, 95% CI 2.22-4.19). Bleeding risk was lower with BVs (HR 0.58, 95% CI
0.48-0.69), and the risk of stroke was similar in both valve types (HR
0.96, 95% CI 0.83-1.11) Conclusion(s): This broadest meta-analysis
comparing BV and MV suggests a survival benefit for MVs in patients < 70
years of age. This should lead to reassessment of current patterns used in
the choice of valves for patients < 70 among the cardiothoracic surgery
community. Copyright © 2021 Canadian Cardiovascular Society

<73>
[Use Link to view the full text]
Accession Number
2017015438
Title
Safety and tolerability of regadenoson compared with dipyridamole in
myocardial perfusion imaging in patients scheduled to undergo medium to
high-risk noncardiac surgery: A randomized controlled study.
Source
Nuclear Medicine Communications. 43(3) (pp 256-264), 2022. Date of
Publication: 01 Mar 2022.
Author
Stavrou P.Z.; Polytarchou K.; Giannopoulou C.; Pantos K.; Mourouzis I.;
Datseris I.; Manolis A.S.
Institution
(Stavrou, Giannopoulou, Datseris) Department of Nuclear Medicine and
PET/CT, Evangelismos General Hospital of Athens
(Stavrou, Polytarchou, Manolis) First Department of Cardiology, National
and Kapodistrian University of Athens, School of Medicine
(Pantos, Mourouzis) Department of Pharmacology, National and Kapodistrian
University of Athens, School of Medicine, Athens, Greece
Publisher
Lippincott Williams and Wilkins
Abstract
Objective Regadenoson is the first Food and Drug Administration-approved
selective A2A adenosine receptor agonist used in myocardial perfusion
imaging. Its main benefits are its simplified and brief protocol, along
with the ability to be administered safely in patients with asthma or
chronic obstructive pulmonary disease of moderate severity. This study
aims to identify any potential benefits of regadenoson, regarding the
frequency of adverse reactions and its tolerability, over dipyridamole.
Methods This is a randomized controlled study of 200 patients scheduled
for medium to high-risk noncardiac surgery, of whom 100 were stressed with
regadenoson (study group) and the rest with dipyridamole (control group).
Results A greater proportion of adverse reactions was recorded in the
regadenoson group as compared to the dipyridamole group (53 vs. 36%; P =
0.023), though the duration of most adverse reactions was shorter in the
regadenoson group. Dyspnea (P < 0.001) and gastrointestinal disturbances
(P = 0.001) were significantly more frequent in the regadenoson group. The
use of aminophylline in patients who developed any adverse events was
similar in the two groups (P > 0.05). When multiple regression analyses
were performed, differences in adverse reactions between the two groups
were no longer significant (odds ratio = 1.96; 95% confidence interval,
0.88-3.25; P = 0.11). Conclusion In our group of patients scheduled for
myocardial perfusion imaging for preoperative assessment, the two agents,
regadenoson and dipyridamole, have no significant differences in the
frequency of mild adverse reactions and in aminophylline use, with
regadenoson also having the advantage of faster symptom resolution.
Nevertheless, dipyridamole can be considered as a well-tolerated and
low-cost alternative. Copyright © 2022 Lippincott Williams and
Wilkins. All rights reserved.

<74>
Accession Number
2015985323
Title
Infusion Versus Bolus Esmolol on Hemodynamic Responses to Intubation in
Patients Undergoing Coronary Artery Bypasses Grafting: a Randomized
Clinical Trial.
Source
Journal of Advances in Medical and Biomedical Research. 30(139) (pp
101-108), 2022. Date of Publication: March-April 2022.
Author
Tashakkor M.; Akbari H.; Mahdian M.; Tobeiha M.
Institution
(Tashakkor) Dept. of Anesthesiology, Faculty of Medicine, Kashan
University of Medical Sciences, Kashan, Iran, Islamic Republic of
(Akbari) Social Determinants of Health Research Center, Kashan University
of Medical Sciences, Kashan, Iran, Islamic Republic of
(Mahdian) Trauma Research Center, Kashan University of Medical Sciences,
Kashan, Iran, Islamic Republic of
(Tobeiha) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
Publisher
Zanjan University of Medical Sciences and Health Services
Abstract
Background & Objective: Perioperative myocardial ischemia remains one of
the most serious complications of cardiac surgery. This study aimed to
evaluate the effect of bolus esmolol versus its infusion on hemodynamic
responses after laryngoscopy and intubation in patients undergoing
coronary artery bypass grafting (CABG). Material(s) and Method(s):
This double-blind randomized clinical trial was conducted on 75 patients
that were allocated into three groups. In the infusion group, 10 minutes
prior to laryngoscopy 0.5 mg/kg esmolol was injected, and then, 200
microg/kg/minute esmolol was infused. In the bolus group, 2 minutes prior
to the laryngoscopy 1.5 mg/kg bolus dose of esmolol was injected
intravenously. In the control group, a bolus dose of normal saline was
administered. Heart rate (HR), Systolic (SBP) and diastolic (DBP) blood
pressures and mean arterial pressure (MAP), were recorded every one minute
from 10 minutes prior to laryngoscopy to 10 minutes after intubation.
Repeated measure ANOVA was applied as statistical analysis.
 Result(s): SBP was at the lowest rate since laryngoscopy was started
until 10 minutes after intubation in the esmolol infusion group (P=
0.029). From the initiation of laryngoscopy to 6 minutes after the
intubation, DBP was at the lowest rate in the infusion group. There was a
significant difference between the groups regarding DBP changes during the
measurement. ANOVA model showed that interaction between time and groups
on SBP, MAP, and HR (P< 0.05). Conclusion(s): According to our
results, the exact doses of esmolol infusion significantly reduced the
level of SBP during intubation, compared with bolus esmolol. Copyright
© The Authors.

<75>
Accession Number
636750827
Title
Pulmonary anaplastic large-cell lymphoma: A case-based systematic review
of world literature.
Source
Journal of Cancer Research and Therapeutics. 17(6) (pp 1297-1306), 2021.
Date of Publication: October-December 2021.
Author
Padhi S.; Panigrahi M.; Mohapatra S.; Mishra P.; Patra S.; Sable M.;
Thakur B.; Nayak M.; Panigrahi A.
Institution
(Padhi, Mishra, Patra, Sable, Nayak) Department of Pathology and
Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar,
India
(Panigrahi) Department of Pulmonary Medicine, Critical Care, All India
Institute of Medical Sciences, Bhubaneswar, India
(Mohapatra, Panigrahi) Department of Medical Oncology/Hematology, Critical
Care, All India Institute of Medical Sciences, Bhubaneswar, India
(Thakur) Department of Biostatistics, Kalinga Institute of Medical
Sciences, Bhubaneswar, India
(Nayak) Department of Medical Oncology/Hematology, Critical Care, All
India Institute of Medical Sciences, Bhubaneswar, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
We describe a case of ALK1 negative (-) pulmonary anaplastic large-cell
lymphoma (pALCL) in an adult female with an unfavorable outcome following
combination chemotherapy and present a systematic review of 39 such
sporadic cases reported over the past 28 years (1990-2018). pALCL occurred
in 26 males and 13 females (median age, 43 years [5-81]) and 13/39
(33.33%) were <=18 years. The lesions were endobronchial in 21 (53.85%)
and parenchymal in 18 (46.15%) cases. Twenty-six cases were ALK1-; 13 were
ALK1+ (positive); and 27/34 cases had a T cell phenotype (where tested).
ALK-cases were characterized by higher age (P = 0.012) at presentation,
more B symptoms (P = 0.002), and more parenchymal than endobronchial
lesions (P = 0.039). The median survival (N = 29/39) was 60 months;
pediatric group had a better survival than adult/elderly group (log-rank,
P = 0.026). pALCL is rare and may have a distinct biological
behavior. Copyright © 2021 Wolters Kluwer Medknow Publications.
All rights reserved.

<76>
Accession Number
2015929575
Title
Cardiac surgery in the morbidly obese.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Djouani A.; Smith A.; Choi J.; Lall K.; Ambekar S.
Institution
(Djouani, Smith, Choi, Lall, Ambekar) The Department of Cardiac Surgery,
St Bartholomew's Hospital, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Obesity rates globally continue to rise and in turn the body
mass index (BMI) of patients undergoing cardiac surgery is set to mirror
this. Patients who are Class III obese (BMI >= 40) pose significant
challenges to the surgical teams responsible for their care and are also
at high risk of complications from surgery and even death. To improve
outcomes in this population, interventions carried out in the
preoperative, operative, and postoperative periods have shown promise.
Despite this, there are no defined best practice national guidelines for
perioperative management of obese patients undergoing cardiac surgery.
 Aim(s): This review is aimed at clinicians and researchers in the
field of cardiac surgery and aims to form a basis for the future
development of clinical guidelines for the management of obese cardiac
surgery patients. Method(s): The PubMed database was utilized to
identify relevant literature and strategies employed at various stages of
the surgical journey were analyzed. Conclusion(s): Data presented
identified the benefits of preoperative respiratory muscle training,
off-pump coronary artery bypass grafting where possible, and early
extubation. Further randomized controlled trials are required to identify
optimal operative and perioperative management strategies before the
introduction of such guidance into clinical practice. Copyright ©
2022 Wiley Periodicals LLC.

<77>
Accession Number
2015924781
Title
Conduction system pacing in prosthetic heart valves.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2022. Date of Publication: 2022.
Author
Shah K.; Williamson B.D.; Kutinsky I.; Bhardwaj R.; Contractor T.; Turagam
M.K.; Mandapati R.; Lakkireddy D.; Garg J.
Institution
(Shah, Williamson, Kutinsky) Department of Cardiovascular Medicine,
Beaumont Hospital, Oakland University William Beaumont School of Medicine,
Royal Oak, MI, United States
(Bhardwaj, Contractor, Mandapati, Garg) Division of Cardiology, Cardiac
Arrhythmia Service, Loma Linda University Health, 11234 Anderson St, Loma
Linda, CA 92354, United States
(Turagam) Helmsley Electrophysiology Center, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Kansas City, KS, United States
Publisher
Springer
Abstract
Background: There has been increasing interest in physiologic pacing
techniques that directly activate the specialized conduction system. We
aimed to assess outcomes of conduction system pacing (CSP) in patients
with prosthetic heart valves. Method(s): This systematic review was
performed according to PRISMA guidelines. Freeman-Tukey double arcsine
transformation with the random-effect model was used to summarize the
data. Outcomes studied were 1) implant success (defined as ability to
recruit the His-Purkinje system or the distal Purkinje system); (2) lead
parameters at implant and follow-up; and (3) procedure-related
complications. Result(s): This systematic review of 7 studies
included 267 unique patients in whom CSP was attempted with either HBP or
LBBAP for pacing indications after a prosthetic valve. HBP was attempted
in 38% (n = 108), while LBBAP in 62% (n = 175) patients. The overall
success rate of CSP was 87%, while in patients post-TAVR, the overall
success rate was 83.2%. In the subgroup analysis, LBBAP had a significant
higher overall success rate compared to HBP (94.3% vs. 76.5%, p
<inf>interaction</inf> = 0.02) and post-TAVR patients (94.3 vs. 66.9%, p
<inf>interaction</inf> < 0.01), respectively. The LBBAP thresholds were
significantly lower compared to HBP both at implant (0.67 +/- 0.4 @ 0.44
ms vs. 1.35 +/- 1 @ 0.85 ms, p <inf>interaction</inf> < 0.01) and at a
mean follow-up of 12.4 +/- 8 months (0.73 +/- 0.1 @ 0.44 ms vs. 1.39 +/- 1
@ 0.85 ms, p <inf>interaction</inf> < 0.01), respectively.
 Conclusion(s): CSP is safe and feasible in patients with a prosthetic
valve, with a significantly higher success rate and superior lead
parameters with LBBAP than HBP, especially in patients
post-TAVR. Copyright © 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<78>
Accession Number
2014816652
Title
In-hospital outcomes of transesophageal versus intracardiac
echocardiography guided left atrial appendage closure.
Source
Catheterization and Cardiovascular Interventions. 99(5) (pp 1572-1581),
2022. Date of Publication: April 1, 2022.
Author
Morcos R.; Megaly M.; Saad M.; Barakat A.F.; Rubens M.; Saxena A.;
Elbadawi A.; Kucharik M.; Luna M.; Garcia S.; Veledar E.; Maini B.;
Khalili H.
Institution
(Morcos, Maini, Khalili) Division of Cardiology, Florida Atlantic
University, Boca Raton, FL, United States
(Megaly) Division of Cardiology, Banner University Medical
Center/University of Arizona, Phoenix, AZ, United States
(Saad) Division of Cardiology, Brown University, Providence, RI, United
States
(Barakat) Division of Cardiology, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Rubens, Saxena, Veledar) Baptist Health South Florida, Miami, FL, United
States
(Rubens, Saxena, Veledar) School of Public Health, Florida International
University, Miami, FL, United States
(Elbadawi) Section of Cardiology, Baylor College of Medicine, Houston, TX,
United States
(Kucharik) Charles E. Schmidt College of Medicine, Florida Atlantic
University, Boca Raton, FL, United States
(Luna) School of Medicine, University of Texas Southwestern, Dallas, TX,
United States
(Garcia) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Transesophageal echocardiogram (TEE) is the preferred imaging
modality to guide transcatheter left atrial appendage closure (LAAC).
Intracardiac echocardiography (ICE) has evolved as a less invasive
alternative to TEE. Several observational studies have shown similar
success rates and perioperative complications between TEE and ICE for
LAAC. Objective(s): We sought to examine the temporal trends and
patient characteristics of TEE versus ICE use in LAAC using a national
database. We also evaluated hospital outcomes including periprocedural
complications, mortality, and length of hospital stay. Method(s):
This is a retrospective analysis of data from the National Readmission
Database, collected from 2016 to 2018. The primary outcome was major
adverse events (MAE) defined as in-hospital mortality, cardiac arrest,
pericardial effusion with or without tamponade, pericardiocentesis or
window pericardiocentesis and pericardial window, pericardial effusion and
tamponade, and hemorrhage requiring transfusion. Result(s): Trend
analysis showed that TEE-guided LAAC increased from 96.6% in 2016 to 98.4%
in 2018 (relative increase, 1.9%), while ICE-guided LAAC decreased from
3.4% to 1.6% during the same period (relative decrease, 53%, p for trend =
0.08). In the unmatched cohorts, the MAE was significantly lower in
TEE-guided LAAC compared to ICE-guided LAAC (6.5% vs. 9.3%, p = 0.022). In
the propensity score matching analysis, MAE remained significant (5.6% vs.
9.4%, p < 0.001). The incidence of pericardial effusion with or without
tamponade remained significantly lower in the TEE group (2.3% vs. 5.8%, p
< 0.001). Length of stay (3.4 vs. 1.9 days, p < 0.001) and hospitalization
cost ($34,826 vs. $20,563, p < 0.001) remained significantly lower for
TEE-guided LAAC. Conclusion(s): Compared to ICE, the incidence of MAE
was significantly lower for TEE-guided LAAC, driven mainly by less
pericardial effusion events. Large-scale randomized trials are needed to
confirm the findings of the current and previous studies. Copyright
© 2022 Wiley Periodicals LLC.

<79>
Accession Number
2017787785
Title
Echocardiography-guided Cardiac Implantable Electronic Device Implantation
to Reduce Device Related Tricuspid Regurgitation: A Prospective Controlled
Study.
Source
Israel Medical Association Journal. 24(1) (pp 25-32), 2022. Date of
Publication: January 2022.
Author
Marincheva G.; Levi T.; Brezinov O.P.; Valdman A.; Rahkovich M.; Kogan Y.;
Laish-Farkash A.
Institution
(Marincheva, Levi, Brezinov, Valdman, Rahkovich, Kogan, Laish-Farkash)
Electrophysiology and Pacing Unit, Department of Cardiology, Assuta Ashdod
University Medical Center, Ben Gurion University of the Negev, Beer Sheva,
Israel
Publisher
Israel Medical Association
Abstract
Background: Endocardial leads of permanent pacemakers (PPM) and
implantable defibrillators (ICD) across the tricuspid valve (TV) can lead
to tricuspid regurgitation (TR) or can worsen existing TR with subsequent
severe morbidity and mortality. Objective(s): To evaluate
prospectively the efficacy of intraproce-dural 2-dimentional-transthoracic
echocardiography (2DTTE) in reducing/preventing lead-associated TR.
 Method(s): We conducted a prospective randomized controlled study
comparing echocardiography results in patients undergoing de-novo PPM/ICD
implantation with intraprocedural echo-guided right ventricular (RV) lead
placement (Group 1, n=56) versus non-echo guided implantation (Group 2,
n=55). Lead position was changed if TR grade was more than baseline in
Group 1. Cohort patients underwent 2DTTE at baseline and 3 and/or 6 months
after implantation. Excluded were patients with baseline TR > moderate or
baseline >= moderate RV dysfunction. Result(s): The study comprised
111 patients (74.14 +/- 11 years of age, 58.6% male, 19% ICD, 42% active
leads). In 98 patients there was at least one follow-up echo. Two patients
from Group 1 (3.6%) needed intraprocedural RV electrode repositioning.
Four patients (3.5%, 2 from each group, all dual chamber PPM, 3 atrial
fibrillation, 2 RV pacing > 40%, none with intraprocedural reposition) had
TR deterioration during 6 months follow-up. One patient from Group 2 with
baseline mild-moderate aortic regurgitation (AR) had worsening TR and AR
within 3 months and underwent aortic valve replacement and TV repair.
 Conclusion(s): The rate of mechanically induced lead-associated TR is
low; thus, a routine intraprocedural 2DTTE does not have a significant
role in reducing/preventing it. Copyright © 2022 Israel Medical
Association. All rights reserved.

<80>
Accession Number
2017779088
Title
Predictors of cognitive dysfunction after cardiac surgery: a systematic
review.
Source
European Journal of Cardiovascular Nursing. 21(3) (pp 192-204), 2022. Date
of Publication: 01 Mar 2022.
Author
Bowden T.; Hurt C.S.; Sanders J.; Aitken L.M.
Institution
(Bowden, Hurt, Aitken) School of Health Sciences, City University of
London, Northampton Square, London EC1V 0HB, United Kingdom
(Sanders) St Bartholomew's Hospital, Barts Health Nhs Trust, West
Smithfield, London EC1V 0HB, United Kingdom
(Sanders) William Harvey Research Institute, Barts and the London School
of Medicine and Dentistry, Queen Mary University London, Charterhouse
Square, London EC1M 6BQ, United Kingdom
(Aitken) School of Nursing and Midwifery, Griffith University, 170 Kessels
Road, Nathan, QLD QLD 4111, Australia
Publisher
Oxford University Press
Abstract
Aims: Postoperative cognitive dysfunction (POCD) is often experienced by
cardiac surgery patients; however, it is not known if some groups of
patients experience this more frequently or severely than others. The aim
of this systematic review was to identify preoperative and postoperative
predictors of cognitive dysfunction in adults following cardiac surgery.
 Methods and Results: Eight bibliographic databases were searched
(January 2005 to March 2021) in relation to cardiac surgery and cognition.
Studies including adult patients who had undergone open cardiac surgery
and using a validated measurement of cognitive function were included.
Full-text review for inclusion, quality assessment, and data extraction
were undertaken independently by two authors. A total of 2870 papers were
identified, of which 36 papers met the inclusion criteria and were
included in the review. The majority were prospective observational
studies [n = 28 (75.7%)]. In total, 61 independent predictors (45
preoperative and 16 postoperative) were identified as significant in at
least one study; advancing age and education level appear important. Age
has emerged as the most common predictor of cognitive outcome.
 Conclusion(s): Although a number of predictors of POCD have been
identified, they have inconsistently been reported as significantly
affecting cognitive outcome. Consistent with previous research, our
findings indicate that older patients and those with lower educational
levels should be prioritized when developing and trialling interventions
to improve cognitive function. These findings are less than surprising if
we consider the methodological shortcomings of included studies. It is
evident that further high-quality research exploring predictors of POCD is
required. Registration: This review was registered on Prospero,
CRD42020167037 Copyright © 2021 The Author(s) 2021. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<81>
Accession Number
2015925337
Title
Updated Evaluation of Robotic- and Video-Assisted Thoracoscopic Lobectomy
or Segmentectomy for Lung Cancer: A Systematic Review and Meta-Analysis.
Source
Frontiers in Oncology. 12 (no pagination), 2022. Article Number: 853530.
Date of Publication: 12 Apr 2022.
Author
Zhang J.; Feng Q.; Huang Y.; Ouyang L.; Luo F.
Institution
(Zhang, Luo) Regenerative Medicine Research Center, West China Hospital,
Sichuan University, Chengdu, China
(Feng) Department of Liver Surgery and Liver Transplantation Centre, West
China Hospital, Sichuan University, Chengdu, China
(Huang) Department of Anesthesiology, The Affiliated Hospital of Guizhou
Medical University, Guizhou, China
(Ouyang) Department of Thoracic Surgery, The 3rd Affiliated Hospital of
Chengdu Medical College, Pidu District People's Hospital, Chengdu, China
(Luo) Department of Respiratory and Critical Care Medicine, West China
Hospital, Sichuan University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Objectives: Robot-assisted thoracic surgery (RATS) and video-assisted
thoracic surgery (VATS) are the two principal minimally invasive surgical
approaches for patients with lung cancer. This study aimed at comparing
the long-term and short-term outcomes of RATS and VATS for lung cancer.
 Method(s): A comprehensive search for studies that compared RATS
versus VATS for lung cancer published until November 31, 2021, was
conducted. Data on perioperative outcomes and oncologic outcomes were
subjected to meta-analysis. PubMed, Web of Science, and EMBASE were
searched based on a defined search strategy to identify eligible studies
before November 2021. Result(s): Twenty-six studies comparing 45,733
patients (14,271 and 31,462 patients who underwent RATS and VATS,
respectively) were included. The present meta-analysis showed that there
were no significant differences in operative time, any complications,
tumor size, chest drain duration, R0 resection rate, lymph station, 5-year
overall survival, and recurrence rate. However, compared with the VATS
group, the RATS group had less blood loss, a lower conversion rate to
open, a shorter length of hospital stay, more lymph node dissection, and
better 5-year disease-free survival. Conclusion(s): RATS is a safe
and feasible alternative to VATS for patients with lung
cancer. Copyright © 2022 Zhang, Feng, Huang, Ouyang and Luo.

<82>
Accession Number
637859542
Title
Editorial conflicts of interest related to the Management of Stable
Ischemic Heart Disease.
Source
International journal of cardiology. (no pagination), 2022. Date of
Publication: 22 Apr 2022.
Author
Ferrell M.C.; Elizabeth Garrett B.A.; Alicia Tomlin D.O.; Cole Wayant
D.O.; Vassar M.
Institution
(Ferrell, Elizabeth Garrett) Office of Medical Student Research, Oklahoma
State University Center for Health Sciences, Tulsa, United States
(Alicia Tomlin) Department of Internal Medicine, Oklahoma State University
Medical Center, Tulsa, United States
(Cole Wayant) Department of Internal Medicine, Baylor College of Medicine,
TX, Houston, United States
(Vassar) Office of Medical Student Research, Oklahoma State University
Center for Health Sciences, Tulsa, OK, United States of America;
Department of Psychiatry and Behavioral Sciences, Oklahoma State
University Center for Health Sciences, Tulsa, OK, United States of America
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Our study examines the association between the favorability of
percutaneous coronary intervention (PCI) and/or coronary artery bypass
surgery (CABG) and the presence of conflicts of interest (COIs) among
authors. METHOD(S): We used the "Citing Articles" tool on the New
England Journal of Medicine website to identify editorials on the use of
PCI/CABG for stable ischemic heart disease. Authors were rated as
"supportive," "neutral," or "critical" of these interventions based on the
content of their editorials. COIs for each author were identified using
past publications found on Scopus, PubMed, or a general internet search.
 RESULT(S): A total of 606 articles were identified, and data were
extracted from 56 of them. Among the 149 authors, 64 (43.0%) had a COI. Of
these 64 authors, 19 (29.7%) disclosed their COI, while 45 (70.3%) did
not. Overall, among authors with a COI, there was no association between
disclosed and undisclosed COIs and the authors' view of PCI/CABG [chi2 (2,
N=64)=1.63, p=.44]. If an author was associated with Medtronic, Abbott, or
Boston Scientific, they were more likely to favor PCI/CABG if they had an
undisclosed COI relative to authors who disclosed COIs [chi2 (1,
N=31)=5.04, p=.025]. Authors publishing in a cardiology journal were more
likely to view PCI/CABG favorably relative to those publishing in a
general medicine journal [chi2 (2, N=62)=7.17, p=.028].
 CONCLUSION(S): Editors should adopt policies to counteract the
unbalancing effects that COIs have on medical opinions and
evidence. Copyright © 2022. Published by Elsevier B.V.

<83>
Accession Number
637856759
Title
Letter to the editor regarding left atrial appendage closure during
cardiac surgery for atrial fibrillation: A meta-analysis.
Source
Cardiovascular revascularization medicine : including molecular
interventions. (no pagination), 2022. Date of Publication: 19 Apr 2022.
Author
Prasad R.M.; Saleh Y.; Al-Abcha A.
Institution
(Prasad, Al-Abcha) Department of Internal Medicine, Michigan State
University, MI, East Lansing, United States
(Saleh) Department of Cardiology, Houston Methodist DeBakey Heart &
Vascular Center, TX, Houston, United States
Publisher
NLM (Medline)

<84>
Accession Number
637854838
Title
Cytoreductive surgery with hyperthermic intrathoracic chemotherapy for
malignant pleural mesothelioma: A systematic review.
Source
Thorax. (no pagination), 2022. Article Number: thoraxjnl-2021-218214.
Date of Publication: 2022.
Author
Dawson A.G.; Kutywayo K.; Mohammed S.B.; Fennell D.A.; Nakas A.
Institution
(Dawson, Kutywayo, Nakas) Department of Thoracic Surgery, University
Hospitals of Leicester NHS Trust, Leicester LE39QP, United Kingdom
(Dawson, Fennell) Department of Cancer Studies, University of Leicester,
Leicester, United Kingdom
(Mohammed) Department of Statistics, University of Leicester Clinical
Trials Unit, Leicester, United Kingdom
(Fennell) Department of Medical Oncology, University Hospitals of
Leicester NHS Trust, Leicester, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction: Cytoreductive surgery has been used a part of multimodality
treatment in patients with malignant pleural mesothelioma (MPM). The
residual microscopic disease that remains will lead to disease progression
in the majority of patients. Delivery of hyperthermic intrathoracic
chemotherapy at the time of surgery has been used to address this
microscopic disease, however it's effect and place in the multimodality
treatment sphere is unknown. The aim of this systematic review was to
assess the effect of surgery and hyperthermic intrathoracic chemotherapy
in patients with MPM on overall survival and disease-free interval.
 Method(s): Ovid MEDLINE, Embase, Web of Science and the Cochrane
Database of Systematic Reviews were searched from database inception
through to June 2021. Studies reporting overall survival and/or
disease-free interval in patients with MPM undergoing cytoreductive
surgery with hyperthermic intrathoracic chemotherapy were considered.
Study quality was assessed using the Newcastle-Ottawa Scale. A narrative
review was performed. Result(s): Fifteen studies were eligible for
inclusion comprising 598 patients. Surgery with hyperthermic intrathoracic
chemotherapy was associated with a median overall survival and
disease-free interval ranging from 11 to 75 months and 7.2 to 57 months,
respectively. These appeared to be superior to patients not receiving
hyperthermic intrathoracic chemotherapy (overall survival: 5-36 months and
disease-free interval: 12.1-21 months). A higher dose of hyperthermic
intrathoracic chemotherapy was associated with an improvement in overall
survival compared with a lower dose: 18-31 months versus 6-18 months,
respectively. The most common morbidity was atrial fibrillation followed
by renal complications. Conclusion(s): Surgery with hyperthermic
intrathoracic chemotherapy offers a safe and effective therapy with an
improvement in disease-free interval and overall survival, particularly
when hyperthermic intrathoracic chemotherapy is administered at a higher
dose. PROSPERO registration number: CRD42019129002. Copyright ©
2022 Author(s). Published by BMJ.

<85>
Accession Number
637854209
Title
Vitamin K2 and D in Patients With Aortic Valve Calcification: A Randomized
Double-Blinded Clinical Trial.
Source
Circulation. (no pagination), 2022. Date of Publication: 25 Apr 2022.
Author
Diederichsen A.C.P.; Lindholt J.S.; Moller S.; Ovrehus K.A.; Auscher S.;
Lambrechtsen J.; Hosbond S.E.; Alan D.H.; Urbonaviciene G.; Becker S.W.;
Fredgart M.H.; Hasific S.; Folkestad L.; Gerke O.; Rasmussen L.M.; Moller
J.E.; Mickley H.; Sanchez Dahl J.S.
Institution
(Diederichsen, Ovrehus, Fredgart, Hasific, Mickley, Sanchez Dahl)
Department of Cardiology, Odense University Hospital, Odense, Denmark
(Lindholt) Department of Cardiothoracic and Vascular Surgery, Odense
University Hospital, Odense, Denmark
(Moller) Open Patient data Explorative Network, Odense University
Hospital, Odense, Denmark
(Auscher, Lambrechtsen) Department of Cardiology, Svendborg Hospital,
Svendborg, Denmark
(Hosbond, Alan) Department of Cardiology, Lillebaelt Hospital, Vejle,
Denmark
(Urbonaviciene, Becker) Department of Cardiology, Regional Hospital
Central Jutland, Silkeborg, Denmark
(Folkestad) Department of Endocrinology, Odense University Hospital,
Odense, Denmark
(Gerke) Department of Nuclear Medicine, Odense University Hospital,
Odense, Denmark
(Rasmussen) Department of Clinical Biochemistry and Pharmacology, Odense
University Hospital, Odense, Denmark
(Moller) Department of Cardiology, Copenhagen University Hospital,
Copenhagen, Denmark
Publisher
NLM (Medline)
Abstract
Background: Menaquinone-7 (MK-7), also known as vitamin K2, is a cofactor
for the carboxylation of proteins involved in the inhibition of arterial
calcification and has been suggested to reduce the progression rate of
aortic valve calcification (AVC) in patients with aortic stenosis.
 Method(s): In a randomized, double-blind, multicenter trial, men from
the community with an AVC score >300 arbitrary units (AU) on cardiac
noncontrast computer tomography were randomized to daily treatment with
tablet 720 mug MK-7 plus 25 mug vitamin D or matching placebo for 24
months. The primary outcome was the change in AVC score. Selected
secondary outcomes included change in aortic valve area and peak aortic
jet velocity on echocardiography, heart valve surgery, change in aortic
and coronary artery calcification, and change in dp-ucMGP
(dephosphorylated-undercarboxylated matrix Gla-protein). Safety outcomes
included all-cause death and cardiovascular events. Result(s): From
February 1, 2018, to March 21, 2019, 365 men were randomized. Mean age was
71.0 (+/-4.4) years. The mean (95% CI) increase in AVC score was 275 AU
(95% CI, 225-326 AU) and 292 AU (95% CI, 246-338 AU) in the intervention
and placebo groups, respectively. The mean difference on AVC progression
was 17 AU (95% CI, -86 to 53 AU; P=0.64). The mean change in aortic valve
area was 0.02 cm2 (95% CI, -0.09 to 0.12 cm2; P=0.78) and in peak aortic
jet velocity was 0.04 m/s (95% CI, -0.11 to 0.02 m/s; P=0.21). The
progression in aortic and coronary artery calcification score was not
significantly different between patients treated with MK-7 plus vitamin D
and patients receiving placebo. There was no difference in the rate of
heart valve surgery (1 versus 2 patients; P=0.99), all-cause death (1
versus 4 patients; P=0.37), or cardiovascular events (10 versus 10
patients; P=0.99). Compared with patients in the placebo arm, a
significant reduction in dp-ucMGP was observed with MK-7 plus vitamin D
(-212 pmol/L versus 45 pmol/L; P<0.001). Conclusion(s): In elderly
men with an AVC score >300 AU, 2 years MK-7 plus vitamin D supplementation
did not influence AVC progression.

<86>
Accession Number
637852833
Title
Celiac Artery Coverage After Thoracic Endovascular Aortic Procedure: A
Meta-Analysis of Early and Late Results.
Source
Journal of endovascular therapy : an official journal of the International
Society of Endovascular Specialists. (pp 15266028221090443), 2022. Date
of Publication: 25 Apr 2022.
Author
Mezzetto L.; Mastrorilli D.; Bravo G.; Scorsone L.; Gennai S.; Leone N.;
D'Oria M.; Veraldi E.; Veraldi G.F.
Institution
(Mezzetto, Mastrorilli, Scorsone, Veraldi, Veraldi) Vascular Surgery,
Integrated University Hospital of Verona, Verona, Italy
(Bravo) Department of Medicine, University of Udine, Udine, Italy
(Gennai, Leone) Vascular Surgery, Ospedale Civile di Baggiovara, Azienda
Ospedaliero-Universitaria di Modena, University of Modena and Reggio
Emilia, Modena, Italy
(D'Oria) Vascular and Endovascular Surgery, Trieste University Hospital,
Trieste, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND/AIM: Clinical outcomes of celiac artery (CA) coverage during
aortic procedures are often contradicting and the fate of this additional
maneuver is still unclear. This study summarizes the results of available
literature and aims to clarify the impact of CA coverage during thoracic
endovascular aneurysm repair (TEVAR) in patients with inadequate distal
sealing zone. METHOD(S): Prospective and retrospective, observational
original articles focused on CA coverage during elective/urgent TEVAR for
descending thoracic aortic pathology (DTAP) were included. PubMed/MEDLINE,
Embase, and Cochrane Central Register of Controlled Trials database were
examined to identify articles published from January 2007 to December
2020, according to PRISMA guidelines. Early and late visceral (any sign or
symptom reported) and neurological (both transient and permanent)
complications were considered as primary outcomes. Onset of any endoleak,
type IB endoleak, need of reintervention, and TEVAR-related mortality were
considered as secondary outcomes. RESULT(S): A total of 5618 articles
were extracted for analysis and 13 studies were finally included in the
synthesis. A total of 178 CAs were covered during 2653 TEVAR (7%). Spinal
cord ischemia was 8% (95% CI, 5-14%, I2 0%) Any endoleak and type IB
endoleak was observed in 12% (95% CI, 6-21%, I2 17%) and 5% (95% CI,
2-11%, I2 0%), respectively. Thoracic endovascular aneurysm repair-related
reoperation was necessary in 8% (95% CI, 4-14%, I2 0%), the majority of
which (14/18, 78%) performed for distal sealing failure; mortality rate
was 9% (95% CI, 5-14%, I2 0%). Out of 178 patients, 168 (94%) were
available for follow-up, ranged 12 to 42 months. Visceral complications,
any endoleak, and type IB endoleak were identified in 15% (95% CI, 10-23%,
I2 45%), 20% (95% CI, 13-29%, I2 8%), and 8% (95% CI, 4-15%, I2 0%),
respectively. Thoracic endovascular aneurysm repair-related reintervention
was required in 8% (95% CI, 4-14%, I2 0%). Mortality rate was 17% (95% CI,
12-25%, I2 4%). CONCLUSION(S): Celiac artery coverage in DTAP should
be regarded as a "bailout" procedure especially in urgent/emergent
settings but requires caution in elective cases. Even if transient
visceral ischemia is frequent, life-threatening complications are rare.
Early and late mortality rates are similar to standard TEVAR although the
risk of type IB endoleak and reintervention may be an issue.

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