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<1>
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).

<2>
Accession Number
2017680354
Title
The Frequency, Risk Factors, and Management of Complications From Pleural
Procedures.
Source
Chest. 161(5) (pp 1407-1425), 2022. Date of Publication: May 2022.
Author
Sundaralingam A.; Bedawi E.O.; Harriss E.K.; Munavvar M.; Rahman N.M.
Institution
(Sundaralingam, Bedawi, Rahman) Oxford Pleural Unit, Oxford Centre for
Respiratory Medicine, Churchill Hospital, University of Oxford, Oxford,
United Kingdom
(Harriss) Bodleian Health Care Libraries, University of Oxford, Oxford,
United Kingdom
(Munavvar) Chest Medicine, Lancashire Teaching Hospitals NHS Foundation
Trust, Preston, United Kingdom
(Rahman) NIHR Oxford Biomedical Research Centre, University of Oxford,
Oxford, United Kingdom
Publisher
Elsevier Inc.
Abstract
Pleural disease is a common presentation and spans a heterogeneous
population across broad disease entities; a common feature is the
requirement for interventional procedures. Despite the frequency of such
procedures, there is little consensus on rates of complications and risk
factors associated with such complications. This narrative review was
based on a structured search of the literature. Searches were limited to
2010 onward, in recognition of the transformation in procedural
complications following the mainstream use of thoracic ultrasound.
Procedures of interest were limited to thoracocentesis, intercostal
drains, indwelling pleural catheters (IPCs), and local anesthetic
thoracoscopy. A total of 4,308 studies were screened, and 48 studies were
identified for inclusion. Iatrogenic pneumothorax remains the most common
complication following thoracocentesis (3.3%; 95% CI, 3.2-3.4), although
pneumothorax requiring intervention was rare (0.3%; 95% CI, 0.2-0.4) when
the procedure was ultrasound guided. Drain blockage and displacement were
the most common complications following intercostal drain insertion (6.3%
and 6.8%, respectively). IPC-related infections can be a significant
problem (5.8%; 95% CI, 5.1-6.7). However, most cases can be managed
without removal of the IPC. Local anesthetic thoracoscopy has an overall
mortality of 0.1% (95% CI, 0.03-0.3). Data on safety and complication
rates in procedural interventions are limited by methodologic problems,
and novel methods to study this topic should be considered. Although
complications remain rare events, once encountered, they have the
potential to rapidly escalate. It is of paramount importance for operators
to prepare and have in place plans for such events to ensure high quality
and, above all, safe care. Copyright © 2021 American College of
Chest Physicians

<3>
Accession Number
637409878
Title
Transcatheter Aortic Valve Replacement in Nonagenarians: A Systematic
Review and Meta-Analysis.
Source
The Journal of invasive cardiology. 34(3) (pp E226-E236), 2022. Date of
Publication: 01 Mar 2022.
Author
Demir O.M.; Curio J.; Pagnesi M.; Rahman H.; Mitomo S.; Colombo A.; Chau
M.; Prendergast B.; Latib A.
Institution
(Demir) Department of Cardiology, St Thomas' Hospital, London SE1 7EH,
United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Nonagenarians represent only a small proportion of patients
included in large transcatheter aortic valve replacement (TAVR) trials,
but will become a relevant future population in need of treatment due to
demographic change. Thus, this study sought to evaluate outcomes of TAVR
for the treatment of severe aortic stenosis (AS) in nonagenarian patients.
 METHOD(S): We screened Medline/Pubmed for studies that stated
specific outcomes for nonagenarians undergoing TAVR. A weighted
meta-analysis was conducted, calculating pooled estimate rates using a
binary random-effects model for dichotomous variables, and comparing
non-dichotomous outcomes with a continuous random-effects model.
 RESULT(S): Data from 23 studies including 16,094 nonagenarians were
merged; 53.4% were women. Despite reasonable rates of comorbidities,
Society of Thoracic Surgeons mortality risk score was 10.2 +/- 5.4. Pooled
estimate rate of procedural success was 94.1% (95% confidence interval
[CI], 91.7-96.6), with major vascular complications occurring in 6.3% (95%
CI, 2.7-9.8) and at least moderate postprocedural paravalvular leak in
7.5% (95% CI, 4.4-10.6). The rate of periprocedural stroke or transient
ischemic attack was 2.6% (95% CI, 2.0-3.2). At 30 days, the pooled
estimate of mortality was 6.1% (95% CI, 4.7-7.4) and a permanent pacemaker
was implanted in 12.6% (95% CI, 7.6-17.6). After 1 year, the mortality
rate was 20.5% (95% CI, 15.9-25.1). CONCLUSION(S): TAVR in
nonagenarians is an effective and safe procedure, with encouraging
outcomes given the general life expectancy of these patients. Currently,
only selected nonagenarians are undergoing TAVR, but their number will
grow as life expectancy continues to increase in the developed world.
Specific research to identify ideal candidates and techniques in this
cohort is needed.

<4>
Accession Number
637409695
Title
Clinically Significant Incidental Findings on CT Imaging During TAVI
Work-up: A Systematic Review and Meta-Analysis.
Source
The Journal of invasive cardiology. 34(3) (pp E218-E225), 2022. Date of
Publication: 01 Mar 2022.
Author
Ko K.; Zwetsloot P.-P.; Voskuil M.; Stella P.; Leiner T.; Kraaijeveld A.
Institution
(Kraaijeveld) Department of Cardiology, University Medical Centre Utrecht,
Heidelberglaan 100, CX Utrecht 3584, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: The transcatheter aortic valve implantation (TAVI) population
is mostly elderly and frail. Clinically significant incidental findings
(SIFs) are commonly encountered in the work-up of TAVI patients. This is a
systematic review of current literature on the occurrence of SIFs on
computed tomography (CT) imaging preceding TAVI and their association with
mortality, delayed planning, and procedure cancellation. METHOD(S): A
systematic search on Medline, Embase, and Cochrane resulted in 19
retrospective studies (published from 2010-2020) reporting SIFs in the
work-up for TAVI. A total of 6358 individuals from 19 studies were
analyzed, with mean age of 80 years and sex equally divided. A
random-effects meta-analysis was performed, with weighting based on study
size. RESULT(S): Pooled prevalence of patients with SIF was 22.2%
(95% confidence interval [CI], 17.8-26.6) and most findings (48.3%) were
found in the lungs. Pooled prevalence of new malignancies was 3.4% (95%
CI, 2.5-4.4). Higher mortality in patients with SIF was only found in
studies with a follow-up period >4 years (hazard ratio, 1.5-1.7). TAVI was
more frequently cancelled in patients with SIF vs those with no SIF
(ranges, 10.1%-47.1% vs 5.2%-37.0%, respectively). SIF did not delay time
to TAVI (ranges, 6-91 days in SIF patients vs 4-81 days in non-SIF
patients). CONCLUSION(S): SIFs are common in patients screened for
TAVI. SIF is associated with a higher risk of TAVI cancellation and with
increased mortality risk over the long term, which should be taken into
consideration in decision making. These findings may help inform patients
and aid patient selection.

<5>
Accession Number
637015901
Title
Transcatheter Aortic Valve Implantation With or Without Predilation: A
Meta-Analysis.
Source
The Journal of invasive cardiology. 34(2) (pp E104-E113), 2022. Date of
Publication: 01 Feb 2022.
Author
Conrotto F.; D'Ascenzo F.; Franchin L.; Bruno F.; Mamas M.A.; Toutouzas
K.; Cuisset T.; Leclercq F.; Dumonteil N.; Latib A.; Nombela-Franco L.;
Schaefer A.; Anderson R.D.; Marruncheddu L.; Gallone G.; De Filippo O.; La
Torre M.; Rinaldi M.; Omede P.; Salizzoni S.; De Ferrari G.M.
Institution
(D'Ascenzo) Division of Cardiology, Department of Medical Science,
University of Turin, Corso Bramante 88/90, Turin, Italy
Publisher
NLM (Medline)
Abstract
AIMS: To evaluate the impact of systematic predilation with balloon aortic
valvuloplasty (BAV) on transcatheter aortic valve implantation (TAVI).
METHODS AND RESULTS: We performed a systematic meta-analysis investigating
patients undergoing TAVI with systematic BAV vs no BAV in RCT or in
adjusted studies. Device success was the primary endpoint, while all-cause
mortality, 30-day moderate/severe aortic regurgitation (AR), stroke,
permanent pacemaker implantation (PPI) and acute kidney injury (AKI) were
the secondary endpoints. Subanalysis according to design of the study (RCT
and adjusted analysis) and to the type of valve (balloon-expandable [BE]
vs self-expanding [SE]) were conducted. We obtained data from 15 studies,
comprising 16,408 patients: 10,364 undergoing BAV prior to TAVI and 6,044
in which direct TAVI has been performed. At 30-day follow-up, BAV did not
improve the rate of device success in the overall population (OR, 1.09;
95% CI, 0.90-1.31), both in SE (OR, 0.93; 95% CI, 0.60-1.45) and in BE
(OR, 1.16; 95% CI, 0.88-1.52) valves. Between BAV and direct TAVI, no
differences in secondary outcomes were observed neither in overall
population nor according to valve type between BAV and direct TAVI
strategies. All endpoints results were consistent between RCTs and
adjusted studies except for postdilation rate that did not differ in
observational studies (OR, 0.70; 95% CI, 0.47-1.04), while it was lower in
BAV when only RCTs were included in the analysis (OR, 0.48; 95% CI,
0.24-0.97). CONCLUSION(S): Direct TAVI is feasible and safe compared
to predilation approach with similar device success rates and clinical
outcomes. Direct TAVI could represent a first-choice approach in
contemporary TAVI procedures.

<6>
Accession Number
636973179
Title
Effect of neuromuscular electrical stimulation on functional exercise
capacity in patients undergoing cardiac surgery: A randomized clinical
trial.
Source
Clinical rehabilitation. 36(6) (pp 789-800), 2022. Date of Publication: 01
Jun 2022.
Author
Cerqueira T.C.F.; de Cerqueira Neto M.L.; Cacau L.A.P.; de Araujo Filho
A.A.; Oliveira G.U.; da Silva Junior W.M.; Carvalho V.O.; de Mendonca
J.T.; de Santana Filho V.J.
Institution
(Cerqueira) Department of Physical Therapy, Federal University of Sergipe,
Lagarto, SE, Brazil
(de Cerqueira Neto, da Silva Junior, Carvalho, de Santana Filho)
Department of Physical Therapy, Federal University of Sergipe, Sao
Cristovao, SE, Brazil
(Cacau) AracajuSEBrazil
(de Araujo Filho) Department of Physical Therapy, Tiradentes University,
Aracaju SE, Brazil
(Oliveira) University Hospital of the Federal University of Sergipe,
Aracaju, SE, Brazil
(de Mendonca) Department of Medicine, Federal University of Sergipe, Sao
Cristovao, SE, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the effects of neuromuscular electrical stimulation
on functional capacity of patients in the immediate postoperative period
of cardiac surgery. DESIGN: A prospective, randomized controlled trial.
SETTING: A cardiac surgery specialist hospital in Aracaju, Sergipe,
Brazil. Subjects: Patients in the postoperative period of cardiac surgery.
INTERVENTION: The control group received the conventional physiotherapy
and the intervention group received neuromuscular electrical stimulation
of the rectus femoris and gastrocnemius muscles bilaterally, applied for
60 min, twice a day for up to 10 sessions per patient, in the immediate
postoperative period until postoperative day 5. MAIN MEASURES: The primary
outcome was the distance walked, which was evaluated using the 6-min walk
test on postoperative day 5. Secondary outcomes were gait speed, lactate
levels, muscle strength, electromyographic activity of the rectus femoris
and Functional Independence Measure, some of them evaluated on
preoperative and postoperative period. RESULT(S): Of 132 eligible
patients, 88 patients were included and randomly allocated in two groups,
and 45 patients were included in the analysis. No significant difference
was found on the distance walked (p=0.650) between patients allocated in
intervention group (239.06+/-88.55) and control group (254.43+/-116.67) as
well as gait speed (p=0.363), lactate levels (p=0.302), knee extensor
strength (p=0.117), handgrip strength (p=0.882), global muscle strength
(p=0.104), electromyographic activity (p=0.179) and Functional
Independence Measure (p=0.059). CONCLUSION(S): Although the effects
are still uncertain, the use of neuromuscular electrical stimulation
carried out in five days didn't present any benefit on functional capacity
of patients in the immediate postoperative period of cardiac surgery.

<7>
Accession Number
636916479
Title
Five-year outcomes in trials comparing transcatheter aortic valve
implantation versus surgical aortic valve replacement: a pooled
meta-analysis of reconstructed time-to-event data.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 61(5) (pp 977-987),
2022. Date of Publication: 02 May 2022.
Author
Barili F.; Freemantle N.; Musumeci F.; Martin B.; Anselmi A.; Rinaldi M.;
Kaul S.; Rodriguez-Roda J.; Di Mauro M.; Folliguet T.; Verhoye J.-P.;
Sousa-Uva M.; Parolari A.
Institution
(Barili) Department of Cardiac Surgery, S. Croce Hospital, Cuneo, Italy
(Barili) Department of Epidemiology, Harvard T.H. Chan School of Public
Health, MA, Boston, United States
(Freemantle) Institute of Clinical Trials and Methodology, University
College London, London, United Kingdom
(Musumeci) Department of Heart and Vessels, Cardiac Surgery Unit and Heart
Transplantation Center, S. Camillo-Forlanini Hospital, Rome, Italy
(Martin) Department of Research and Third Mission Area, University of
Turin, Turin, Italy
(Anselmi, Verhoye) Division of Thoracic and Cardiovascular Surgery,
Pontchaillou University Hospital, Rennes, France
(Rinaldi) Department of Cardiac Surgery, AOU "Citta della Salute e della
Scienza di Torino", University of Turin, Turin, Italy
(Kaul) Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, USA
(Rodriguez-Roda) Department of Cardiac Surgery, Ramon y Cajal University
Hospital, Madrid, Spain
(Di Mauro) Cardiothoracic and Vascular Department, Maastricht University
Medical Center, Maastricht, Netherlands
(Folliguet) Department of Cardiac Surgery, Hopital Henri Mondor, Paris,
France
(Sousa-Uva) Department of Cardiothoracic Surgery, Hospital de Santa Crux,
Carnaxide, Portugal
(Parolari) Universitary Cardiac Surgery Unit, IRCCS Policlinico S. Donato,
Italy
(Parolari) Department of Biomedical Sciences for Health, University of
Milan, Milan, Italy
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The incidence of outcomes in trials comparing transcatheter
aortic valve implantation (TAVI) and surgical aortic valve replacement
(SAVR) is expected to be different in the short and long term. We planned
a meta-analysis of reconstructed time-to-event data from trials comparing
TAVI and SAVR to evaluate their time-varying effects on outcomes.
 METHOD(S): We performed a systematic review of the literature from
January 2007 through September 2021 on Medline, Embase, the Cochrane
Central Register of Controlled Trials and specialistic websites, including
randomized trials with allocation to TAVI or SAVR that reported at least
1-year follow-up and that graphed Kaplan-Meier curves of end points. The
comparisons were done with grouped frailty Cox models in a landmark
framework and fully parametric models. RESULT(S): Seven trials were
included (7770 participants). TAVI showed a lower incidence of the
composite of death or stroke in the first 6months [risk-stratified hazard
ratio (HR) 0.66, 95% confidence interval (CI) 0.56-0.77, P-value <0.001],
with an HR reversal after 24months favouring SAVR (risk-stratified HR
1.25; 95% CI 1.08-1.46; P-value 0.003). These outcomes were confirmed for
all-cause death (risk-stratified HR after 24months 1.18; 95% CI 1.03-1.35;
P-value 0.01). TAVI was also associated with an increased incidence of
rehospitalization after 6months (risk-stratified HR 1.42; 95% CI
1.06-1.91; P-value 0.018) that got worse after 24months (risk-stratified
HR 1.67; 95% CI 1.24-2.24; P-value <0.001). CONCLUSION(S): Although
it could appear that there is no difference between TAVI and SAVR in the
5-year cumulative results, TAVI shows a strong protective effect in the
short term that runs out after 1year. TAVI becomes a risk factor for
all-cause mortality and the composite end point after 24months and for
rehospitalization after 6months. Copyright © The Author(s) 2021.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<8>
Accession Number
636837731
Title
Effects of ischaemic postconditioning in aortic valve replacement: a
multicenter randomized controlled trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 61(5) (pp 1144-1152),
2022. Date of Publication: 02 May 2022.
Author
Kaljusto M.-L.; Bautin A.; Jakobsen O.; Wilimski R.; Brunborg C.; Wennemo
M.; Karpova L.; Nergaard Aas K.; Arendarczyk A.; Landsverk S.A.; Galagudza
M.; Naesheim T.; Czub P.; Gordeev M.; Vaage J.
Institution
(Kaljusto) Department of Cardiothoracic Surgery, Oslo University Hospital,
Oslo, Norway
(Bautin) Research Division of Anesthesiology and Intensive Care, Almazov
National Medical Research Centre, Saint Petersburg, Russian Federation
(Jakobsen, Nergaard Aas, Naesheim) Department of Thoracic and
Cardiovascular Surgery, University Hospital of North Norway, Tromso,
Norway
(Wilimski, Arendarczyk, Czub) Department of Cardiac Surgery, Medical
University of Warsaw, Warsaw, Poland
(Brunborg) Oslo Centre for Biostatistics and Epidemiology, Research
Support Services, Oslo University Hospital, Oslo, Norway
(Wennemo, Landsverk) Department of Anesthesiology, Oslo University
Hospital, Oslo, Norway
(Karpova) Department of Anesthesiology, Almazov National Medical Research
Centre, Saint Petersburg, Russian Federation
(Galagudza) Institute of Experimental Medicine, Almazov National Medical
Research Centre, Saint Petersburg, Russian Federation
(Gordeev) Research Division of Cardiothoracic Surgery, Almazov National
Medical Research Centre, Saint Petersburg, Russian Federation
(Vaage) Institute of Clinical Medicine, University of Oslo, Oslo, Norway
(Vaage) Section of Physiology, Department of Molecular Medicine, Institute
of Basic Medical Sciences, University of Oslo, Oslo, Norway
(Vaage) Division of Emergencies and Critical Care, Department of Research
& Development, Oslo University Hospital, Oslo, Norway
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The effect of ischaemic postconditioning (IPost) on
postcardioplegic cardiac function is not known. We hypothesized that IPost
was cardioprotective in adult patients undergoing elective aortic valve
replacement. METHOD(S): In a multicentre, prospective, randomized
trial, patients (n=209) were randomized to either a standard operation
(controls) or postconditioning. Immediately before the cross-clamp was
released, patients in the postconditioning group underwent 3 cycles of
flow/non-flow (2 min each) of normothermic blood via the antegrade
cardioplegia line. The primary end point was cardiac index. Secondary end
points included additional haemodynamic measurements, biomarkers of
cardiomyocyte injury, renal function parameters, intra- and postoperative
arrhythmias and use of inotropic agents. RESULT(S): There was no
significant difference between the groups regarding cardiac index [mean
between-group difference, 95% confidence interval (CI), 0.11 (-0.1 to
0.3), P=0.27]. Postconditioning had no effect on other haemodynamic
parametres. There was no between-group difference regarding troponin T or
creatine kinase MB. Postconditioning reduced the relative risk for
arrhythmias by 45% (P=0.03) when postoperative atrial fibrillation and
intraoperative ventricular fibrillation were combined. There were no
differences in patients with/without diabetes, patients above/below
70years of age or between the centres. However, after postconditioning,
the cardiac index [95% CI, 0.46 (0.2-0.7), P=0.001], cardiac output
(P<0.001), mean arterial pressure (P<0.001) and left ventricular stroke
work index (P<0.001) were higher in males compared to females.
 CONCLUSION(S): IPost had no overall cardioprotective effects in
patients undergoing aortic valve replacement but improved postoperative
cardiac performance in men compared to women. Copyright © The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<9>
Accession Number
636834622
Title
Application of local gentamicin in the treatment of deep sternal wound
infection: a randomized controlled trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 61(5) (pp 1135-1141),
2022. Date of Publication: 02 May 2022.
Author
Vos R.J.; van Putte B.P.; de Mol B.A.J.M.; Hoogewerf M.; Mandigers T.J.;
Kloppenburg G.T.L.
Institution
(Vos, van Putte, Hoogewerf, Mandigers, Kloppenburg) Department of
Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
(van Putte, de Mol) Department of Cardiothoracic Surgery, Amsterdam
University Medical Center, Amsterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: In patients with deep sternal wound infection (DSWI), primary
closure of the sternal bone over high negative pressure Redon drains has
shown to be a safe and feasible treatment method. Addition of local
gentamicin could accelerate healing and improve clinical outcomes.
 METHOD(S): We conducted a randomized controlled trial to evaluate the
effectiveness of local gentamicin in the treatment of DSWI. In the
treatment group, collagenous carriers containing gentamicin were left
between the sternal halves during sternal refixation. In the control
group, no local antibiotics were used. Primary outcome was hospital stay.
Secondary outcomes were mortality, reoperation, wound sterilization time,
time till removal of all drains and duration of intravenous antibiotic
treatment. RESULT(S): Forty-one patients were included in the trial
of which 20 were allocated to the treatment group. Baseline
characteristics were similar in both groups. Drains could be removed after
a median of 8.5days in the treatment group and 14.5days in the control
group (P-value: 0.343). Intravenous antibiotics were administered for a
median of 23.5days in the treatment group and 38.5days in the control
group (P-value: 0.343). The median hospital stay was 27days in the
treatment group and 28days in the control group (P-value: 0.873).
Mortality rate was 10% in the treatment group and 9.5% in the control
group (P-value: 0,959). No side effects were observed. CONCLUSION(S):
This randomized controlled trial showed that addition of local gentamicin
in the treatment of DSWI did not result in shorter length of stay.
CLINICAL TRIAL REGISTRATION NUMBER: 2014-001170-33. Copyright ©
The Author(s) 2021. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<10>
Accession Number
636722208
Title
Incidence and prognosis of COVID-19 amongst heart transplant recipients: a
systematic review and meta-analysis.
Source
European journal of preventive cardiology. 29(6) (pp e224-e226), 2022.
Date of Publication: 06 May 2022.
Author
Ahmed F.; Abid M.; Maniya T.; Usman M.S.; Fudim M.
Institution
(Ahmed, Abid) Department of Medicine, Dow University of Health Sciences,
Mission Rd, Karachi 74200, Pakistan
(Maniya) Department of Medicine, Ziauddin University, Shahrah-e-Ghalib Rd,
Block 6 Clifton, Karachi 74200, Pakistan
(Usman) Department of Medicine, University of Mississippi Medical Center,
MS 39216, 2500 North State Street, Jackson, United States
(Fudim) Division of Cardiology, Duke University Medical Center, 2301 Ervin
Rd, Durham, United States
(Fudim) Duke Clinical Research Institute, Durham, United States
Publisher
NLM (Medline)

<11>
Accession Number
636379010
Title
Effect of coronary artery bypass grafting on quality of life: a
meta-analysis of randomized trials.
Source
European heart journal. Quality of care & clinical outcomes. 8(3) (pp
259-268), 2022. Date of Publication: 05 May 2022.
Author
Creber R.M.; Dimagli A.; Spadaccio C.; Myers A.; Moscarelli M.; Demetres
M.; Little M.; Fremes S.; Gaudino M.
Institution
(Creber, Myers) Division of Health Informatics, Department of Healthcare
Policy and Research, Weill Cornell Medicine, NY, NY, United States
(Dimagli) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Spadaccio) Institute of Cardiovascular and Medical Sciences, University
of Glasgow, United Kingdom
(Spadaccio) Lancashire Cardiac Center, Blackpool Victoria Teaching
Hospital, Blackpool, United Kingdom
(Moscarelli) Department of Cardiac Surgery, Imperial College London,
London, United Kingdom
(Demetres) Weill Cornell Medicine, Samuel J. Wood Library and C.V. Starr
Biomedical Information Center, NY
(Little) Health Economics Research Centre, Nuffield Department of
Population Health, University of Oxford, United Kingdom
(Fremes) Sunnybrook Health Sciences Center, University of Toronto,
Toronto, Canada
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
NY, NY, United States
Publisher
NLM (Medline)
Abstract
AIMS: We conducted a systematic review and meta-analysis to evaluate
temporal trends in quality of life (QoL) after coronary artery bypass
grafting (CABG) surgery in randomized clinical trials, and a quantitative
comparison from before surgery to up to 5 years after surgery. METHODS AND
RESULTS: We searched MEDLINE, CINAHL, EMBASE, Cochrane Library, and
PsycINFO from 2010 to 2020 to identify studies that included the
measurement of QoL in patients undergoing CABG. The primary outcome was
the Seattle Angina Questionnaire (SAQ), and secondary outcomes were the
36-item Short Form Health Survey (SF-36) and EuroQol Questionnaire
(EQ-5D). We pooled the means and the weighted mean differences over the
follow-up period. In the meta-analysis, 2586 studies were screened and 18
full-text studies were included. There was a significant trend towards
higher QoL scores from before surgery to 1 year post-operatively for the
SAQ angina frequency (AF), SAQ QoL, SF-36 physical component (PC), and
EQ-5D, whereas the SF-36 mental component (MC) did not improve
significantly. The weighted mean differences from before surgery to 1 year
after was 24 [95% confidence interval (CI): 21.6-26.4] for the SAQ AF, 31
(95% CI: 27.5-34.6) for the SAQ QoL, 9.8 (95% CI: 7.1-12.8) for the SF-36
PC, 7.1 (95% CI: 4.2-10.0) for the SF-36 MC, and 0.1 (95% CI: 0.06-0.14)
for the EQ-5D. There was no evidence of publication bias or small-study
effect. CONCLUSION(S): CABG had both short- and long-term
improvements in disease-specific QoL and generic QoL, with the largest
improvement in angina frequency. Copyright © The Author(s) 2021.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<12>
Accession Number
2017212854
Title
Preoperative Iron Supplementation in Pediatric Cardiac Surgical Patients:
A Preliminary Single-Center Experience.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(6) (pp 1565-1570),
2022. Date of Publication: June 2022.
Author
Otsuka Y.; Naraine N.; Switzer T.; Faraoni D.
Institution
(Otsuka, Switzer) Division of Cardiac Anesthesia, Department of
Anesthesiology and Pain Medicine, The Hospital for Sick Children,
University of Toronto, Toronto, ON, Canada
(Naraine) Transfusion Medicine, Department of Pediatric Laboratory
Medicine, The Hospital for Sick Children, University of Toronto, Toronto,
ON, Canada
(Faraoni) Arthur S. Keats Division of Pediatric Cardiovascular Anesthesia,
Department of Anesthesiology, Perioperative and Pain Medicine, Texas
Children's Hospital, Baylor College of Medicine, TX, Houston
Publisher
W.B. Saunders
Abstract
Objective: To assess preoperative hemoglobin and perioperative red blood
cell transfusion in children undergoing cardiac surgery after the
implementation of a preoperative patient blood management (PBM) clinic
with oral iron supplementation. Design(s): A retrospective analysis.
 Setting(s): A single tertiary hospital. Participant(s): Patients
who underwent cardiac surgery with cardiopulmonary bypass at the Hospital
for Sick Children (Toronto, Canada) during a 12-month period before and
following the implementation of a preoperative PBM clinic. Patients
younger than 3 months of age, or who were admitted to the cardiac
intensive care unit preoperatively, were excluded because they were not
systematically assessed by the PBM clinic. Intervention(s): None.
 Measurements and Main Results: A total of 296 patients were included
in the authors' analysis. After adjustment for confounding factors (age at
surgery, preoperative oxygen saturation, type of congenital heart disease,
surgery type), they found that preoperative hemoglobin levels were
significantly higher in children treated with iron supplementation (n =
201) compared to historic controls (n = 95) (13.9 [12.8-15.1] g/dL v 12.9
[11.7-15.0] g/dL, adjusted p = 0.001). The exposure rate to red blood cell
transfusion (50% v 61%, adjusted p = 0.930) was not significantly
different between groups. However, the volumes of allogeneic red blood
cells (1.4 (0.0-14.0) mL/kg v 12.5 (0.0-23.0) mL/kg, adjusted p = 0.004)
and autologous blood (11.0 (6.8-17.0) v 17.0 (11.0-31.0), adjusted p <
0.001) transfused were significantly reduced in children treated with iron
supplementation. Conclusion(s): Preoperative iron supplementation led
to an increase in preoperative hemoglobin levels. The exact prevalence of
iron deficiency and the effect of iron supplementation on perioperative
allogeneic blood transfusion and long-term outcomes should be studied in a
prospective randomized study. Copyright © 2021 Elsevier Inc.

<13>
Accession Number
2016795362
Title
Autonomic Neuromodulation for Atrial Fibrillation Following Cardiac
Surgery: JACC Review Topic of the Week.
Source
Journal of the American College of Cardiology. 79(7) (pp 682-694), 2022.
Date of Publication: 22 Feb 2022.
Author
Zafeiropoulos S.; Doundoulakis I.; Farmakis I.T.; Miyara S.; Giannis D.;
Giannakoulas G.; Tsiachris D.; Mitra R.; Skipitaris N.T.; Mountantonakis
S.E.; Stavrakis S.; Zanos S.
Institution
(Zafeiropoulos, Miyara) Elmezzi Graduate School of Molecular Medicine,
Northwell Health, Manhasset, NY, United States
(Zafeiropoulos, Miyara, Giannis, Zanos) Feinstein Institutes for Medical
Research at Northwell Health, Manhasset, NY, United States
(Doundoulakis) Department of Cardiology, 424 General Military Training
Hospital, Thessaloniki, Greece
(Doundoulakis, Tsiachris) Athens Heart Center, Athens Medical Center,
Athens, Greece
(Farmakis, Giannakoulas) Department of Cardiology, AHEPA University
Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
(Mitra) Division of Electrophysiology, Department of Cardiology, North
Shore University Hospital, Northwell Health, Manhasset, NY, United States
(Skipitaris, Mountantonakis) Department of Cardiology, Lenox Hill
Hospital, Northwell Health, New York City, New York, United States
(Stavrakis) Heart Rhythm Institute, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
Publisher
Elsevier Inc.
Abstract
Autonomic neuromodulation therapies (ANMTs) (ie, ganglionated plexus
ablation, epicardial injections for temporary neurotoxicity, low-level
vagus nerve stimulation [LL-VNS], stellate ganglion block, baroreceptor
stimulation, spinal cord stimulation, and renal nerve denervation)
constitute an emerging therapeutic approach for arrhythmias. Very little
is known about ANMTs' preventive potential for postoperative atrial
fibrillation (POAF) after cardiac surgery. The purpose of this review is
to summarize and critically appraise the currently available evidence.
Herein, the authors conducted a systematic review of 922 articles that
yielded 7 randomized controlled trials. In the meta-analysis, ANMTs
reduced POAF incidence (OR: 0.37; 95% CI: 0.25 to 0.55) and burden (mean
difference [MD]: -3.51 hours; 95% CI: -6.64 to -0.38 hours), length of
stay (MD: -0.82 days; 95% CI: -1.59 to -0.04 days), and interleukin-6 (MD:
-79.92 pg/mL; 95% CI: -151.12 to -8.33 pg/mL), mainly attributed to LL-VNS
and epicardial injections. Moving forward, these findings establish a base
for future larger and comparative trials with ANMTs, to optimize and
expand their use. Copyright © 2022 American College of Cardiology
Foundation

<14>
Accession Number
2016382954
Title
Evaluating the Impact of Cardiopulmonary Bypass Priming Fluids on Bleeding
After Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(6) (pp 1584-1594),
2022. Date of Publication: June 2022.
Author
Siemens K.; Donnelly P.; Hunt B.J.; Carter M.J.; Murdoch I.A.; Tibby S.M.
Institution
(Siemens, Donnelly, Carter, Murdoch, Tibby) PICU Evelina London Children's
Hospital, St Thomas' Hospital, London, United Kingdom
(Hunt, Tibby) Haematology, St Thomas' Hospital, London, United Kingdom
Publisher
W.B. Saunders
Abstract
Objectives: Cardiopulmonary bypass (CPB) predisposes young children to
coagulopathy. The authors evaluated possible effects of CPB priming fluids
on perioperative bleeding in pediatric cardiac surgery. Design(s):
Meta-analysis and systematic review of previously published studies.
 Setting(s): Each study was conducted in a surgical center or
intensive care unit. Participant(s): Studies investigating patients
<18 years without underlying hematologic disorders were included.
 Intervention(s): The authors evaluated randomized controlled trials
(RCTs) published between 1980 and 2020 on MEDLINE, EMBASE, PubMed, and
CENTRAL databases. The primary outcome was postoperative bleeding;
secondary endpoints included blood product transfusion, mortality, and
safety. Measurements and Main Results: Twenty eligible RCTs were
analyzed, with a total of 1,550 patients and a median of 66 patients per
study (range 20-200). The most frequently assessed intervention was adding
fresh frozen plasma (FFP) to the prime (8/20), followed by albumin (5/20),
artificial colloids (5/20), and blood-based priming solutions (3/20). Ten
studies with 771 patients evaluated blood loss at 24 hours in mL/kg and
were included in a meta-analysis. Most of them investigated the addition
of FFP to the priming fluid (7/10). No significant difference was found
between intervention and control groups, with a mean difference of -0.13
(-2.61 to 2.34), p = 0.92, I2 = 69%. Further study endpoints
were described but their reporting was too heterogeneous to be
quantitatively analyzed. Conclusion(s): This systematic review of
current evidence did not show an effect of different CPB priming solutions
on 24-hour blood loss. The analysis was limited by heterogeneity within
the dataset regarding population, type of intervention, dosing, and the
chosen comparator, compromising any conclusions. Copyright © 2021
Elsevier Inc.

<15>
Accession Number
2015146759
Title
Risk of Pneumothorax Requiring Pleural Drainage after Drainless VATS
Pulmonary Wedge Resection: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 17(1) (pp 14-24), 2022. Date of Publication: January 2022.
Author
Laven I.E.W.G.; Daemen J.H.T.; Janssen N.; Franssen A.J.P.M.; Gronenschild
M.H.M.; Hulsewe K.W.E.; Vissers Y.L.J.; de Loos E.R.
Institution
(Laven, Daemen, Janssen, Franssen, Hulsewe, Vissers, de Loos) Department
of Surgery, Division of General Thoracic Surgery, Zuyderland Medical
Center, Heerlen, Netherlands
(Gronenschild) Department of Respiratory Medicine, Zuyderland Medical
Center, Heerlen, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Objective: Omitting pleural drainage after video-assisted thoracic surgery
(VATS) for pulmonary wedge resections has been shown to be a safe approach
to enhance recovery. However, major concerns remain regarding the risk of
postoperative pneumothoraces requiring surgical interventions. Therefore,
our objective was to provide conclusive evidence whether chest tube
omission after VATS wedge resection is safe and does not increase the risk
of pneumothoraces requiring pleural drainage. Method(s): Five
scientific databases were searched. Studies comparing patients with (CT
group) and without chest tube drainage (NCT group) after VATS wedge
resection were evaluated. Outcomes included radiographically diagnosed
pneumothoraces and pneumothoraces requiring pleural drainage,
postoperative complications, hospitalization, and pain scores.
 Result(s): Overall, 9 studies (3 randomized controlled trials) were
included (N = 928). Meta-analysis showed significantly more
radiographically diagnosed pneumothoraces in the NCT group (risk ratio
[RR] = 2.58, 95% confidence interval [CI]: 1.56 to 4.29, P < 0.001; I
2 = 0%). However, no significant differences were found in
postoperative pneumothoraces requiring pleural drainage (RR = 1.72, 95%
CI: 0.63 to 4.74, P = 0.29; I2 = 0%) or complications (RR =
0.77, 95% CI: 0.39 to 1.52, P = 0.46; I 2 = 0%). Furthermore,
the NCT group showed significantly shorter hospitalization (mean
difference = -1.26, 95% CI: -1.56 to -0.95, P < 0.001) with high
heterogeneity (I 2 = 58%, P = 0.02), and lower pain scores on
postoperative day 1 (standard mean difference [SMD] = -0.98, 95% CI: -1.71
to -0.25, P = 0.009; I 2 = 92%) and postoperative day 2 (SMD =
-1.28, 95% CI: -2.55 to -0.01, P = 0.05; I 2 = 96%) compared
with the CT group. Conclusion(s): VATS wedge resection without
routine chest tube placement is suggested as a safe and less invasive
approach in selected patients that does not increase the risk of a
pneumothorax requiring pleural drainage. Copyright © The
Author(s) 2022.

<16>
Accession Number
2014782537
Title
Conventional Versus Minimally Invasive Aortic Valve Replacement Surgery: A
Systematic Review, Meta-Analysis, and Meta-Regression.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 17(1) (pp 3-13), 2022. Date of Publication: January 2022.
Author
Almeida A.S.; Ceron R.O.; Anschau F.; de Oliveira J.B.; Leao Neto T.C.;
Rode J.; Rey R.A.W.; Lira K.B.; Delvaux R.S.; de Souza R.O.R.R.
Institution
(Almeida, de Oliveira, Leao Neto, de Souza) Postgraduate Studies Program
in Minimally Invasive Cardiovascular Surgery, Goiania, Brazil
(Almeida, Ceron, Anschau, Rode, Rey, Lira, Delvaux) Cardiothoracic Surgery
Division, Hospital Nossa Senhora da Conceicao, Grupo Hospitalar Conceicao,
Porto Alegre, Brazil
(Almeida, Anschau) Health Technology Assessment Center (NATS), Grupo
Hospitalar Conceicao, Porto Alegre, Brazil
(Anschau) Postgraduate Program in Technology Assessment for SUS
(PPGATSUS/GHC), Grupo Hospitalar Conceicao, Porto Alegre, Brazil
(de Oliveira, Leao Neto, de Souza) Cardiothoracic Surgery Division,
Hospital Ruy Azeredo, Goiania, Brazil
Publisher
SAGE Publications Ltd
Abstract
Objective: To assess the potential benefits of minimally invasive aortic
valve replacement (MIAVR) compared with conventional AVR (CAVR) by
examining short-term outcomes. Method(s): A systematic search
identified randomized trials comparing MIAVR with CAVR. To assess study
limitations and quality of evidence, we used the Cochrane Risk of Bias
tool and GRADE and performed random-effects meta-analysis. We used
meta-regression and sensitivity analysis to explore reasons for diversity.
 Result(s): Thirteen studies (1,303 patients) were included. For the
comparison of MIAVR and CAVR, the risk of bias was judged low or unclear
and the quality of evidence ranged from very low to moderate. No
significant difference was observed in mortality, stroke, acute kidney
failure, infectious outcomes, cardiac events, intubation time, intensive
care unit stay, reoperation for bleeding, and blood transfusions. Blood
loss (mean difference [MD] = -130.58 mL, 95% confidence interval [CI] =
-216.34 to -44.82, I2 = 89%) and hospital stay (MD = -0.93
days, 95% CI = -1.62 to -0.23, I2 = 81%) were lower with MIAVR.
There were shorter aortic cross-clamp (MD = 5.99 min, 95% CI = 0.99 to
10.98, I2 = 93%) and cardiopulmonary bypass (CPB) times (MD =
7.75 min, 95% CI = 0.27 to 15.24, I2 = 94%) in the CAVR group.
In meta-regression analysis, we found that age was the variable with the
greatest influence on heterogeneity. Conclusion(s): MIAVR seems to be
an excellent alternative to CAVR, reducing hospital stay and incidence of
hemorrhagic events. Despite significantly greater aortic cross-clamp and
CPB times with MIAVR, this did not translate into adverse effects, with no
changes in the results found with CAVR. Copyright © The Author(s)
2022.

<17>
Accession Number
2013338112
Title
Right Anterolateral Thoracotomy Versus Sternotomy for Resection of Benign
Atrial Masses: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16(5) (pp 426-433), 2021. Date of Publication: September 2021.
Author
Olsthoorn J.R.; Daemen J.H.T.; de Loos E.R.; ter Woorst J.F.; van Straten
A.H.M.; Maessen J.G.; Sardari Nia P.; Heuts S.
Institution
(Olsthoorn, ter Woorst, van Straten) Department of Cardiothoracic Surgery,
Catharina Ziekenhuis Eindhoven, Netherlands
(Daemen, de Loos) Department of Surgery, Division of General Thoracic
Surgery, Zuyderland Medical Center, Heerlen, Netherlands
(Maessen, Sardari Nia, Heuts) Department of Cardiothoracic Surgery,
Maastricht University Medical Center, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Objective: Primary benign cardiac tumors are rare disease entity that
predominantly originate from the atria. Benign masses can induce heart
failure, arrhythmia, or thromboembolic events. Therefore, surgical
excision is often indicated. Current guidelines on the preferred
approaches for resection (i.e., median sternotomy [MST] or right
anterolateral thoracotomy [RAT]) are lacking. The aim of the current
meta-analysis was to evaluate all studies comparing RAT to MST for
excision of benign atrial masses in terms of safety, efficacy, and
complications. Method(s): The PubMed and EMBASE databases were
searched through 9 June 2020. Data regarding mortality, complications,
recurrence, ICU stay, and length of hospital stay were extracted and
submitted to meta-analysis using random effects modelling. Heterogeneity
was assessed by the I2 test. Result(s): Four retrospective
observational studies were included, including 196 patients (RAT n = 97,
MST n = 99). Mortality was 0% in both groups. Recurrence was <1% in the
RAT group and 0% in the MST group. Complication rate tended to be lower in
favor of the RAT group. Furthermore, RAT was associated with lower length
of ICU stay (-17.7 hr, P = 0.01) and hospital stay (-4.0 days, P < 0.001).
No significant differences in cardiopulmonary bypass (P = 0.09) and
cross-clamp times (P = 0.15) were observed. Conclusion(s): The RAT
approach is as safe and effective as MST for the excision of benign atrial
masses. Moreover, RAT is associated with a reduced complication rate and a
reduced duration of hospitalization and could be considered as the
preferred approach in anatomically suitable patients. Copyright ©
The Author(s) 2021.

<18>
Accession Number
2012942652
Title
TAVI Beyond 3 Years: Durability and Predictors for Survival.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16(5) (pp 417-425), 2021. Date of Publication: September 2021.
Author
Rahman F.; Resar J.R.
Institution
(Rahman, Resar) Division of Cardiology, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
Publisher
SAGE Publications Ltd
Abstract
The use of transcatheter aortic valve implantation (TAVI) has greatly
increased over the past 2 decades and now has overtaken surgical aortic
valve replacement. We have limited data regarding the long-term durability
of TAVI and the predictors of survival. Calcification, inflammation,
fibrous tissue deposition, and mechanical stress are important in the
structural deterioration of surgical bioprosthetic valves and likely
contribute to TAVI durability. However, TAVI has several differences to
surgical valve replacement such as valve preparation, valve to native
anatomy interaction, and valve sizing which all likely contribute to
durability and long-term survival. Most procedures have been performed on
older patients and therefore long-term follow-up studies have noted
mortality of approximately 50% at 5 years and 75% by 7 years. Current data
are limited by the high mortality of patients who have received TAVI often
as a result of age, frailty, and other competing comorbidities. TAVI as
compared with surgical valve replacement is associated with several
differences including higher conduction abnormalities (i.e., need for
pacemakers) and paravalvular leak, both of which may affect long-term
morbidity and mortality. In this review, we discuss the current status of
our knowledge and identify areas that require further
investigation. Copyright © The Author(s) 2021.

<19>
Accession Number
2011117206
Title
Systematic Review of Minimally Invasive Surgery for Mitral Valve Infective
Endocarditis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16(3) (pp 244-248), 2021. Date of Publication: May 2021.
Author
Shih E.; Squiers J.J.; DiMaio J.M.
Institution
(Shih, Squiers, DiMaio) Baylor Scott White Research Institute, The Heart
Hospital Baylor Plano, Plano, TX, United States
(Shih, Squiers) Department of Surgery, Baylor University Medical Center,
Dallas, TX, United States
(DiMaio) Department of Cardiothoracic Surgery, The Heart Hospital, Plano,
TX, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: The scope of application of minimally invasive mitral valve
surgery is expanding. However, the safety and efficacy of minimally
invasive mitral valve surgery in the setting of infective endocarditis is
not well known. We sought to identify the best evidence available to
support a minimally invasive surgical approach for mitral valve infective
endocarditis. Method(s): A systematic review of minimally invasive
mitral valve surgery for infective endocarditis was conducted according to
the Preferred Reporting Items for Systematic reviews and Meta-Analyses
(PRISMA) guidelines. Result(s): A total of 6 manuscripts describing
271 patients were identified. Mean age was 60.4 +/- 14.9 years old, and
60.1% patients were male. Mean EuroSCORE II was 24.6 +/- 23.2. Mitral
valve repair was achieved in 32.4% of cases. The average in-hospital
mortality was 9.4%, and average length of hospital stay was 21.6 days.
Survival was 89.1% at 30 days, and 1-year survival was 79.3%. Rate of
conversion to sternotomy was 1.8%. Postoperative complications included:
6.9% postoperative bleeding, 9.3% new postoperative dialysis, 2.3%
postoperative stroke, and 3.4% recurrence of endocarditis. Reoperation
over the long-term was required in 9.3% of cases. Conclusion(s):
Minimally invasive mitral valve surgery for infective endocarditis has
acceptable perioperative morbidity as well as short- and intermediate-term
mortality at experienced centers. Minimally invasive mitral valve surgery
may be an acceptable alternative approach to infective endocarditis and
warrants further study. Copyright © The Author(s) 2021.

<20>
Accession Number
2011023358
Title
Minimally Invasive Versus Sternotomy for Mitral Surgery in the Elderly: A
Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16(4) (pp 310-316), 2021. Date of Publication: July 2021.
Author
Hage A.; Hage F.; Al-Amodi H.; Gupta S.; Papatheodorou S.I.; Hawkins R.;
Ailawadi G.; Mittleman M.A.; Chu M.W.A.
Institution
(Hage, Hage, Al-Amodi, Chu) Western University, London, ON, Canada
(Hage, Hage, Gupta, Papatheodorou, Mittleman) Department of Epidemiology,
Harvard T.H. Chan School of Public Health, Boston, MA, United States
(Hawkins, Ailawadi) University of Virginia, Charlottesville, VA, United
States
Publisher
SAGE Publications Ltd
Abstract
Objective: The safety of minimally invasive mitral valve surgery (MIMVS)
in elderly patients is still debated. Our objective was to perform a
systematic review and meta-analysis of studies comparing MIMVS with
conventional sternotomy (CS) in elderly patients (>=65 years old).
 Method(s): We searched PubMed, EMBASE, Web of Science,
clinicaltrials.gov, and Cochrane Central Register of Controlled Trials for
trials and observational studies comparing MIMVS with CS in patients >=65
years old presenting for mitral valve surgery. We performed a
random-effects meta-analysis of all outcomes. Result(s): The MIMVS
group had lower odds of acute renal failure (odds ratio [OR] 0.27; 95% CI
0.10 to 0.78), prolonged intubation (>48 h; OR 0.47; 95% CI 0.31 to 0.70),
less blood product transfusion (weighted mean difference [WMD] -0.82
units; 95% CI -1.29 to -0.34 units), shorter ICU length of stay (LOS; WMD
-2.57 days; 95% CI -3.24 to -1.90 days) and hospital LOS (WMD -4.06 days;
95% CI -5.19 to -2.94 days). There were no significant differences in the
odds of mortality, stroke, respiratory infection, reoperation for
bleeding, and postoperative atrial fibrillation. MIMVS was associated with
longer cross-clamp (WMD 11.8 min; 95% CI 3.5 to 20.1 min) and
cardiopulmonary bypass times (WMD 23.0 min; 95% CI 10.4 to 35.6 min).
 Conclusion(s): MIMVS in elderly patients is associated with lower
postoperative complications, blood transfusion, shorter ICU, and hospital
LOS, and longer cross-clamp and bypass times. Copyright © The
Author(s) 2021.

<21>
Accession Number
2010284327
Title
The International Society for Minimally Invasive Cardiothoracic Surgery
Expert Consensus Statement on Transcatheter and Surgical Aortic Valve
Replacement in Low- and Intermediate-Risk Patients: A Meta-Analysis of
Randomized and Propensity-Matched Studies.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 16(1) (pp 3-16), 2021. Date of Publication: January 2021.
Author
Thourani V.H.; Edelman J.J.; Holmes S.D.; Nguyen T.C.; Carroll J.; Mack
M.J.; Kapadia S.; Tang G.H.L.; Kodali S.; Kaneko T.; Meduri C.U.; Forcillo
J.; Ferdinand F.D.; Fontana G.; Suwalski P.; Kiaii B.; Balkhy H.; Kempfert
J.; Cheung A.; Borger M.A.; Reardon M.; Leon M.B.; Popma J.J.; Ad N.
Institution
(Thourani) Department of Cardiovascular Surgery, Marcus Heart and Vascular
Center, Piedmont Heart and Vascular Institute, Atlanta, GA, United States
(Edelman) Department of Cardiac Surgery, Fiona Stanley Hospital,
University of Western Australia, Perth, Australia
(Holmes, Ad) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, MD, United States
(Nguyen) Division of Adult Cardiothoracic Surgery, University of
California, San Francisco, CA, United States
(Carroll) Division of Cardiology, University of Colorado, Denver, CO,
United States
(Mack) Department of Cardiology, Baylor Health Care System, Heart Hospital
Baylor Plano, Dallas, TX, United States
(Kapadia) Department of Cardiology, Cleveland Clinic Foundation,
Cleveland, OH, United States
(Tang) Department of Cardiovascular Surgery, Mount Sinai Health System,
New York, NY, United States
(Kodali, Leon) Division of Cardiology, Columbia University Medical Center,
New York, NY, United States
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Boston, MA, United States
(Meduri) Division of Cardiology, Marcus Heart and Vascular Center,
Piedmont Heart Institute, Atlanta, GA, United States
(Forcillo) Department of Cardiac Surgery, Centre Hospitalier de
l'Universite de Montreal (CHUM), Montreal, Canada
(Ferdinand) Department of Cardiothoracic Surgery, University of Pittsburgh
School of Medicine $and$ UPMC Hamot Heart and Vascular Institute,
University of Pittsburgh Medical Center, PA, United States
(Fontana) Cardiovascular Institute, Los Robles Hospital and Medical
Center, Thousand Oaks, CA, United States
(Suwalski) Department of Cardiac Surgery, Central Clinical Hospital of the
Ministry of Interior and Administration, Centre of Postgraduate Medical
Education, Warsaw, Poland
(Kiaii) Cardiothoracic Surgery, UC Davis Medical Center, Sacramento, CA,
United States
(Balkhy) Section of Cardiac Surgery, University of Chicago Medicine, IL,
United States
(Kempfert) Department of Cardiac Surgery, German Heart Institute, Berlin,
Germany
(Cheung) Department of Cardiac Surgery, The University of British
Columbia, St. Paul's Hospital, Vancouver, Canada
(Borger) Department of Cardiac Surgery, Leipzig Heart Centre, Germany
(Reardon) Department of Cardiac Surgery, Methodist DeBakey Heart &
Vascular Center, Houston, TX, United States
(Popma) Department of Interventional Cardiology, Beth Israel Deaconess
Medical Center, Boston, MA, United States
(Ad) Cardiovascular Surgery, Adventist White Oak Medical Center, Silver
Spring, MD, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: There is an increasing amount of evidence supporting use of
transcatheter aortic valve replacement (TAVR) for treatment of aortic
stenosis in patients at low or intermediate risk for surgical aortic valve
replacement (SAVR). TAVR is now approved for use in all patient cohorts.
Despite this, there remains debate about the relative efficacy of TAVR
compared with SAVR in lower-risk cohorts and various subgroups of
patients. We performed a systematic review and meta-analysis of randomized
controlled trials (RCTs) and propensity-matched trials to guide a
consensus among expert cardiologists and surgeons. Method(s): Studies
comparing TAVR and SAVR in low- and intermediate-risk patients were
identified by a thorough search of the major databases. Mortality, stroke,
and other perioperative outcomes were assessed at 30 days and 1 year.
 Result(s): Early mortality was lower in TAVR compared to SAVR in
RCTs, but not propensity-matched studies in low-risk cohorts (0.66% vs
1.5%; odds ratio [OR] = 0.44, 95% confidence interval [CI] 0.20 to 0.98,
I2 = 0%). No difference in mortality between TAVR and SAVR was
identified in intermediate-risk patients at early or later time points.
Incidence of perioperative stroke in 3 low-risk RCTs was significantly
lower in TAVR (0.4%) than SAVR (1.4%; OR = 0.33, 95% CI 0.13 to 0.81,
I2 = 0%). There was no difference in stroke for
intermediate-risk patients between TAVR and SAVR. The expert panel of
cardiologists and cardiac surgeons provided recommendations for TAVR and
SAVR in various clinical scenarios. Conclusion(s): In RCTs comparing
TAVR and SAVR in low-risk patients, early mortality and stroke were lower
in TAVR, but did not differ at 1 year. There was no difference in
mortality and stroke in intermediate-risk patients. The Multidisciplinary
Heart Team must consider individual patient characteristics and
preferences when recommending TAVR or SAVR. The decision must consider the
long-term management of each patient's aortic valve disease. Copyright
© The Author(s) 2021.

<22>
Accession Number
2004029015
Title
Contemporary Status of Percutaneous Transcatheter Edge-to-Edge Repair: Is
It a Complement or Replacement to Mitral Surgery?.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 15(1) (pp 26-35), 2020. Date of Publication: 01 Feb 2020.
Author
Shim H.; Percy E.; Hirji S.; Kaneko T.
Institution
(Shim, Percy, Hirji, Kaneko) Division of Cardiac Surgery, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Percy) Division of Cardiovascular Surgery, University of British
Columbia, Vancouver, Canada
Publisher
SAGE Publications Ltd
Abstract
Transcatheter mitral valve repair devices borrow from the concept of
surgical edge-to-edge approximation and are becoming increasingly used in
patients with both primary and functional mitral regurgitation. The
application of these new devices is expanding globally; however, debates
between which patients are amenable to surgery vs. percutaneous approaches
are ongoing. As new trials and regulatory approvals have evolved, the
indications for transcatheter approaches have expanded, in a way that is
complementaty to existing indications for surgical repair. In general, the
treatment of mitral regurgitation should be stratified based on underlying
pathophysiology and anatomy by a multidisciplinary team including cardiac
surgeons and interventional cardiologists. This review aims to provide
practical approaches to patient selection and treatment strategies for
mitral regurgitation based on historical data and recently published
trials, with a focus on the distinction between surgical and transcatheter
mitral therapies. Copyright © The Author(s) 2019.

<23>
Accession Number
632644453
Title
Transcatheter versus surgical aortic valve replacement in renal transplant
patients: A meta-analysis.
Source
Cardiology Research. 11(5) (pp 280-285), 2020. Date of Publication: 2020.
Author
Mir T.; Darmoch F.; Ullah W.; Sattar Y.; Hakim Z.; Pacha H.M.; Fouad L.;
Gardi D.; Glazier J.J.; Zehr K.; Alraies M.C.
Institution
(Mir) Wayne State University/Detroit Medical Center, Detroit, MI, United
States
(Darmoch) Internal Medicine, Beth Israel Deaconess Medical Center/Harvard
School of Medicine, Boston, MA, United States
(Ullah) Internal Medicine, Abington Jefferson Health, 1200 Old York Road,
Abington, PA 19044, United States
(Sattar) Internal Medicine, Icahn School of Medicine, Mount Sinai Elmhurst
Hospital, New York, NY, United States
(Hakim, Gardi, Glazier, Zehr, Alraies) Cardiovascular Medicine, Detroit
Medical Center, Wayne State University, Detroit, MI, United States
(Pacha) University of Texas Health Science Center, McGovern Medical
School, Memorial Hermann Heart and Vascular Institute, Houston, TX, United
States
(Fouad) Detroit Medical Center, Heart Hospital, Detroit, MI, United States
Publisher
Elmer Press
Abstract
Background: The outcome of transcutaneous aortic valve replacement (TAVR)
in patients with kidney transplant is unknown, as majority of these
patients were excluded from the major TAVR clinical trials. We sought to
compare patients with severe aortic stenosis who underwent TAVR versus
surgical aortic valve replacement (SAVR) with a history of kidney
transplant. Method(s): PubMed, Google Scholar and Cochrane databases
were searched to identify relevant articles. The incidence of all-cause
mortality and acute kidney injury (AKI) was calculated using relative risk
on a random effect model. Result(s): A total of 1,538 patients (TAVR
328, SAVR 1,210) were included in the study. TAVR was associated with
lower mortality as compared with SAVR at 30 days from the index procedure
(odds ratio (OR) 0.48, 95% confidence interval (CI): 0.25-0.93; P = 0.03).
Oneyear mortality was studied in three studies and showed comparable
mortality in patients undergoing TAVR and SAVR (OR: 0.76, 95% CI:
0.10-5.51; P = 0.78). Compared to SAVR, TAVR carries an identical risk of
AKI (OR: 0.44, 95% CI: 0.10-1.90; P = 0.27). A sensitivity analysis
performed by exclusion of Voudris et al study showed a non-significant
difference in the mortality incidence of two groups at 30 days (OR: 0.72,
95% CI: 0.27-1.91; P = 0.51). Conclusion(s): In patients with a
history of kidney transplant, TAVR was associated with a comparable risk
of mortality and AKI compared to SAVR. Copyright © 2020 Elmer
Press.

<24>
Accession Number
631934264
Title
Comparing transcatheter aortic valve replacement (AVR) with surgical AVR
in lower risk patients: A comprehensive meta-analysis and systematic
review.
Source
Cardiology Research. 11(3) (pp 168-178), 2020. Article Number: 1046. Date
of Publication: 01 Jun 2020.
Author
Khan M.S.; Mir T.; Ullah W.; Ali Z.; Idris O.; Khan G.; Ur Rashid M.;
Salman; Mehmood M.; Ali S.S.
Institution
(Khan, Salman) Department of Internal Medicine, Mercy St Vincent Medical
Center, Toledo, OH 43608, United States
(Mir) Department of Internal Medicine, Detroit Medical Center, Wayne State
University, Detroit, MI 48201, United States
(Ullah, Ali) Department of Internal Medicine, Abington Jefferson Health,
Abington, PA 19001, United States
(Idris, Mehmood, Ali) Department of Cardiology, Mercy Saint Vincent
Medical Center, Toledo, OH 43608, United States
(Khan) University of Missouri, Kansas City, MO 64110, United States
(Ur Rashid) Department of Internal Medicine, Advent Health, Orlando, FL
32803, United States
(Khan) Department of Internal Medicine, Mercy Saint Vincent Medical
Center, Toledo, OH 43608, United States
Publisher
Elmer Press
Abstract
Background: Transcutaneous aortic valve replacement (TAVR) is a novel
percutaneous procedure for severe aortic stenosis and has been recently
approved by Food and Drug Administration in lower risk patients. We
performed the first ever meta-analysis and literature review of clinical
trials comparing both 30-day and 1-year outcomes in lower risk patients
undergoing TAVR vs. surgical aortic valve replacement (SAVR, having
Society of Thoracic Surgeons score < 4% or equivalent). Method(s):
Using predefined selection criteria as above, 68 articles were identified.
Seven eligible articles were selected after extensive review. Primary
effect outcomes were 30-day and 1-year all-cause mortality using risk
ratio (RR) with significant P value of < 0.05. Result(s): A total of
4,859 subjects were included. Risk of 30-day all-cause mortality was 40.1%
less in TAVR group, RR 0.59 (95% confidence interval (CI): 0.38-0.92, P =
0.02) with no significant heterogeneity. Six studies except Schymik et al
also reported 1-year risk. This was, however, not statistically
significant with a 21% decrease in the TAVR group, RR 0.79 (95% CI:
0.57-1.09, P = 0.15). Six studies reported 30-day risk of secondary
outcomes. The risk of 30-day stroke was 36% less in TAVR group, although
this was not statistically significant, RR 0.64 (95% CI: 0.38-1.9, P =
0.10). The risk of acute kidney injury (AKI) stage 2 and above was 56%
less in post-TAVR patients, RR 0.43 (95% CI: 0.35-0.54, P < 0.001) with no
heterogeneity. For vascular complications, RR was high in TAVR group 4.62
(95% CI: 1.42-15.18, P = 0.01). Significant heterogeneity was demonstrated
though (I2 = 81). The risks for permanent pacemaker (PPM) were also higher
in the TAVR group, RR 3.30 (95% CI: 2.04-5.33, P < 0.001) and significant
heterogeneity was observed. After removing Thyregod et al and Partner 3
trial from the analysis, heterogeneity was removed, but the RR was still
high 3.21 (95% CI: 2.54-4.068, P < 0.001). Post-operative incidence of
endocarditis among TAVR patients was low but not statistically
significant. The 30-day risk for infective endocarditis was RR 0.67 (95%
CI: 0.13-3.48, P = 0.63). The 1-year risk was similarly low but not
significant, RR 0.73 (95% CI: 0.28-1.92, P = 0.53). Conclusion(s):
Among low risk patients, TAVR was found to be superior in short-term
all-cause mortality and 1-year stroke, a result that was statistically
significant for TAVR and close to significance for stroke. TAVR patients
were also less likely to have post-operative bleeding and AKI stage 2 and
beyond. Post-operative incidence of endocarditis among TAVR patients was
low but not statistically significant. However, the rates of PPM and
vascular complications are higher in TAVR patients. The results of TAVR in
low risk population are thus extremely encouraging. However, the issue of
long-term valve durability in this group needs further studies. Also,
caution needs to be exercised while extending the indications to extremely
young patients due to lack of enough studies. Copyright © The
authors.

<25>
Accession Number
2010440751
Title
Erdheim-Chester Disease With Extensive Pericardial Involvement: A Case
Report and Systematic Review.
Source
Cardiology Research. 11(2) (pp 118-128), 2020. Date of Publication: 2020.
Author
Sanchez-Nadales A.; Anampa-Guzman A.; Navarro-Motta J.
Institution
(Sanchez-Nadales, Navarro-Motta) Department of Medicine, Advocate Illinois
Masonic Medical Center, Chicago, IL, United States
(Anampa-Guzman) Sociedad Cientifica de San Fernando, Faculty of Medicine,
Universidad Na- cional Mayor de San Marcos, Lima, Peru
(Sanchez-Nadales) Alejandro Sanchez-Nadales, Department of Medicine,
Advocate Illinois Masonic Medical Center, Chicago, IL, United States
Publisher
Elmer Press
Abstract
Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis
characterized by systemic xanthogranulomatous infiltration. We described
the case of a female adult presenting with pericardial effusion.
Pericardial infiltration is the most frequent cardiac manifestation of ECD
and is the one discussed in this article. We found that the majority of
patients with pericardial infiltration needed a cardiovascular procedure.

<26>
[Use Link to view the full text]
Accession Number
2010440234
Title
Efficacy of Allopurinol in Cardiovascular Diseases: A Systematic Review
and Meta-Analysis.
Source
Cardiology Research. 11(14) (pp 226-232), 2020. Date of Publication:
August 2020.
Author
Khanal S.; Basyal B.; Munir S.; Minalyan A.; Khan R.; Alraies C.; Fischman
D.L.; Ullah W.
Institution
(Ullah, Khanal, Basyal, Munir, Minalyan) Abington Jefferson Health, United
States
(Khan) Medstar Union Memorial Hospital, Baltimore, United States
(Alraies) Detroit Medical Center, DMC Heart Hospital, United States
(Fischman) Thomas Jefferson University, Philadelphia, United States
(Ullah) Abington Jefferson Health, United States
Publisher
Elmer Press
Abstract
Background: Given current evidence, the use of allopurinol for the
prevention of major cardiovascular events (acute cardiovascular syndrome
(ACS) or cardiovascular mortality) in patients undergoing coronary artery
bypass graft (CABG), after index ACS or heart failure remains unknown.
 Method(s): Multiple databases were queried to identify studies
comparing the efficacy of allopurinol in patients undergoing CABG, after
ACS or heart failure. The unadjusted odds ratio (OR) was calculated using
a random effect model. Result(s): A total of nine studies comprising
850 patients (allopurinol 480, control 370) were identified. The pooled OR
of periprocedural ACS (OR: 0.25, 95% confidence interval (CI): 0.06 -
0.96, P = 0.05) and cardiovascular mortality (OR: 0.22, 95% CI: 0.07 -
0.71, P = 0.01) was significantly lower in patients receiving allopurinol
during CABG compared to patients in the control group. The overall number
needed to treat (NNT) to prevent one ACS event was 11 (95% CI: 7 28),
while the NNT to prevent one death was 24 (95% CI: 13 - 247). By contrast,
the odds of cardiovascular mortality in the allopurinol group were not
significantly different from the control group in patients on long-term
allopurinol after ACS or heart failure (OR: 0.33, 95% CI: 0.01 - 8.21, P =
0.50) and (OR: 1.12, 95% CI: 0.39 - 3.20, P = 0.83), respectively.
Similarly, the use of allopurinol did not reduce the odds of recurrent ACS
events at 2 years (OR: 0.32, 95% CI: 0.03 - 3.18, P = 0.33).
 Conclusion(s): Periprocedural use of allopurinol might be associated
with a significant reduction in the odds of ACS and cardiovascular
mortality in patients undergoing CABG. Allopurinol, however, offers no
long-term benefits in terms of secondary prevention of ACS or mortality.
Larger scale studies are needed to validate our findings. Copyright
© The authors

<27>
Accession Number
2004909887
Title
Evaluation of Serratus Anterior Plane Block for Pain Relief in Patients
Undergoing MIDCAB Surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 15(2) (pp 148-154), 2020. Date of Publication: 01 Mar 2020.
Author
Gautam S.; Pande S.; Agarwal A.; Agarwal S.K.; Rastogi A.; Shamshery C.;
Singh A.
Institution
(Gautam, Agarwal, Rastogi, Shamshery, Singh) Department of Anesthesiology,
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
(Pande, Agarwal) Department of Cardiovascular and Thoracic Surgery, Sanjay
Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
Publisher
SAGE Publications Ltd
Abstract
Objective: The minimally invasive direct coronary artery bypass (MIDCAB)
surgery is associated with severe chest pain in the first 2 to 3
postoperative days; this may delay the patient recovery. In this
randomized controlled trial we evaluated the role of serratus anterior
plane (SAP) block for postoperative pain relief in patients undergoing
MIDCAB surgery. Method(s): Patients undergoing MIDCAB surgery were
randomized into 2 groups of 25 each; SAP group received 20 mL of 0.2%
ropivacaine with 1 mug/mL fentanyl as bolus followed by infusion at 8
mL/h; control group received saline for both bolus and infusion. Primary
outcome measure was postoperative pain when supine, and during deep
inspiration, coughing, and patient movement; secondary outcome measures
were requirement of postoperative intravenous fentanyl and opioid-related
side effects. All patients were followed at 6-hourly intervals for 48
hours in the postoperative period. Results were analyzed by the Student's
t -test, chi2 test, Mann-Whitney U-test and Kruskall-Wallis
test. A P-value <0.05 was considered significant. Result(s): The 2
groups were similar with respect to patient characteristics. Static and
dynamic pain visual analog scale scores were significantly reduced in the
SAP group as compared to the control group at most of the time points of
assessment (P < 0.05). Patient-controlled fentanyl requirements were
reduced in the SAP group as compared to control group on the second
postoperative day (P < 0.05). Conclusion(s): SAP block reduced the
postoperative pain scores and opioid requirements in patients undergoing
MIDCAB surgery. Copyright © The Author(s) 2020.

<28>
Accession Number
2003955615
Title
Left Atrial Appendage Management: No Better Time Than the Present.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 14(6) (pp 498-502), 2019. Date of Publication: 01 Dec 2019.
Author
Romano M.A.; Bergquist C.S.
Institution
(Romano, Bergquist) Department of Cardiac Surgery, University of Michigan,
Ann Arbor, MI, United States
Publisher
SAGE Publications Ltd

<29>
Accession Number
630337640
Title
Pre-operative sildenafil for patients with pulmonary hypertension
undergoing mitral valve surgery: A systematic review and meta-analysis.
Source
Cardiology Research. 10(6) (pp 369-377), 2019. Date of Publication: 2019.
Author
Villanueva D.L.E.; Agustin R.D.; Llanes E.J.
Institution
(Villanueva, Agustin, Llanes) Division of Cardiovascular Medicine,
University of the Philippines, Philippine General Hospital, Taft Avenue,
Manila 1000, Philippines
Publisher
Elmer Press
Abstract
Background: Pulmonary hypertension is a usual complication of
long-standing mitral valve disease. Perioperative pulmonary hypertension
is a risk factor for right ventricular failure and is an important cause
of morbidity and mortality in patients with pulmonary hypertension
undergoing mitral valve surgery. Phosphodiesterase-5 inhibitors
particularly sildenafil citrate have proven clinical benefit for pulmonary
arterial hypertension but have shown discordant results in group 2
pulmonary hypertension patients. We sought to determine the effect of
pre-operative sildenafil on the intra-operative hemodynamic parameters of
these patients. Method(s): Studies were included if they satisfied
the following criteria: 1) Randomized controlled trials; 2) Adult patients
with pulmonary hypertension scheduled for elective mitral valve surgery;
and 3) Reported data on changes in pre-, intra-, and post-operative
hemodynamic parameters. Using PUBMED, Clinical Key, Science Direct, and
Cochrane databases, a search for eligible studies was conducted from
September 1 to December 31, 2018. The quality of each study was evaluated
using the Cochrane Risk of Bias Tool. The primary outcome of interest is
on the effect of pre-operative sildenafil on the improvement of
intra-operative hemodynamic parameters such as systolic pulmonary artery
pressure (sPAP), mean pulmonary arterial pressure, mean arterial pressure,
pulmonary and systemic vascular resistances. We also investigated its
effect on the post-operative mortality, length of cardiopulmonary bypass
time, ventilation time, and inotrope support requirement. Review Manager
5.3 was utilized to perform analysis of random effects for continuous
outcomes. Result(s): We identified three studies involving 153
patients with pulmonary hypertension undergoing mitral valve surgery,
showing that among those who received pre-operative sildenafil there is a
significant decrease in intra-operative systolic pulmonary arterial
pressure (mean difference -11.19 (95% confidence interval (CI), -20.23 to
-2.15), P < 0.05) and post-operative sPAP (mean difference -13.67 (95% CI,
- 19.56 to - 7.78), P < 0.05) without significantly affecting the mean
arterial pressure (mean difference 1.94 (95% CI, -5.49 to 9.37), P <
0.05). The systemic and pulmonary vascular resistances were not affected
as well. Conclusion(s): Administration of pre-operative sildenafil to
patients with pulmonary hypertension undergoing mitral valve surgery
decreases intra-operative and post-operative systolic pulmonary arterial
pressure without significantly affecting other systemic hemodynamic
parameters. Copyright © The authors.

<30>
Accession Number
630276908
Title
Efficacy and safety of subcutaneous fellow's stitch using "fisherman's
knot" technique to achieve large caliber (> 10 french) venous hemostasis.
Source
Cardiology Research. 10(5) (pp 303-308), 2019. Date of Publication: 01 Oct
2019.
Author
Kumar P.; Aggarwaal P.; Sinha S.K.; Pandey U.; Razi M.; Sharma A.K.;
Thakur R.; Varma C.M.; Krishna V.
Institution
(Kumar) Department of Cardiology, Rajendra Institute of Medical Science,
Ranchi, Jharkhand, India
(Aggarwaal, Sinha, Pandey, Razi, Sharma, Thakur, Varma, Krishna)
Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical
College, Kanpur, Uttar Pradesh 208002, India
Publisher
Elmer Press
Abstract
Background: Among patients undergoing intervention involving venous
access, various techniques have been implemented to achieve hemostasis in
order to reduce local access site complications, to decrease length of
stay and to facilitate early ambulation. We aimed to assess the efficacy
and safety of fellow's stitch using "fisherman's knot" (figure of Z (FoZ)
technique when compared with conventional manual compression for immediate
closure of large venous sheath (> 10 French (Fr). Method(s): Between
November 2012 and March 2019, 949 patients underwent various interventions
which involved venous access requiring hemostasis. All the patients were
anticoagulated with heparin during the procedure. In a sequential
allocation, fellow's stitch using "fisherman's knot" (group I: n = 384)
and conventional manual compression (group II: n = 365) were used in
achieving hemostasis at right/left femoral venous access site following
sheath removal (> 12 Fr). A 0-Vicryl suture was used to make one deep
stitch just distal to entry of sheath and one superficial stitch just
proximal to entry site, thereby creating an FoZ. A fisherman's knot was
then tied, and knot was pushed down while sheath was removed. In cases
where immediate hemostasis was not achieved, it was compressed for 2 min
to achieve it. Result(s): The mean age of 949 patients was 13.1 +/-
8.2 years where male (n = 574; 65%) outnumbered female (n = 375; 35%). In
group I, hemostasis was achieved immediately after tying the knot in 343
(89.3%) patients, while within <= 2 min of light pressure in 41 (10.7%)
patients. Five (1.3%) patients had failure of stitch as suture snapped
during knotting, and hemostasis was achieved by manual compression as per
protocol in group I. The median time to hemostasis (1.1 vs. 14.3 min, P <
0.001), ambulation (3.3 vs. 18.9 h, P < 0.01) and hospital stay (24.6 vs.
36.8 h, P < 0.001) was significantly shorter in group I compared to group
II. The minor vascular access site complications in form of hematoma (n =
6 (1.6%) vs. n = 1 (0.2%); P < 0.001), and thrombosis at femoral vein (n =
4 (1.1%) vs. n = 0 (0%); P < 0.001) were significantly higher in group II
when compared to group I. The differences regarding re-bleeding and
formation of arterio-venous fistula between both the groups were
statistically insignificant. Conclusion(s): The fellow's stitch using
"fisherman's knot" or "FoZ" suture is a simple, efficacious and safe
technique to achieve an immediate hemostasis after removal of larger
venous sheath (> 10 Fr). Copyright © The authors.

<31>
Accession Number
628862252
Title
A Systematic Review and Meta-Analysis of del Nido Versus Conventional
Cardioplegia in Adult Cardiac Surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 14(5) (pp 385-393), 2019. Date of Publication: 01 Oct 2019.
Author
An K.R.; Rahman I.A.; Tam D.Y.; Ad N.; Verma S.; Fremes S.E.; Latter D.A.;
Yanagawa B.
Institution
(An, Rahman, Tam, Verma, Latter, Yanagawa) Division of Cardiac Surgery, Li
Ka Shing Knowledge Institute, St Michael's Hospital, University of
Toronto, ON, Canada
(Ad) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, United States
(Fremes) Division of Cardiac Surgery, Department of Surgery, Schulich
Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto,
ON, Canada
Publisher
SAGE Publications Ltd
Abstract
Objective: Del Nido cardioplegia (DC) has been used extensively in
pediatric cardiac surgery but the efficacy and safety in adults remains
uncertain. Our objective was to perform a systematic review and
meta-analysis comparing DC and blood cardioplegia (BC) in our primary
endpoint of 30-day or in-hospital mortality as well as other efficacy and
safety endpoints. Method(s): Both MEDLINE and EMBASE were searched
from 1996 to 2017 for studies comparing DC and BC. Data were extracted by
2 independent investigators and aggregated in a random effects model.
 Result(s): One randomized controlled trial (n = 89), 7 adjusted (n =
1,104), and 5 unadjusted observational studies (n = 717) were included.
There was no difference in in-hospital mortality between DC and BC
(relative risk:0.67, 95% confidence interval [CI]: 0.22, 2.07; P = 0.49).
DC reduced cardioplegia volume requirements (mean difference [MD]:-1.1 L,
95% CI, -1.6, -0.6; P < 0.0001), aortic cross-clamp time (MD: -8 minutes,
95% CI, -12, -3; P = 0.0004), and cardiopulmonary bypass (CPB) times (MD:
-8 minutes, 95% CI, -14, -3; P = 0.03). DC reduced troponin release
(standardized MD: -0.3, 95% CI, -0.5, -0.1; P = 0.001). In-hospital
outcomes of stroke, atrial fibrillation, acute kidney injury/dialysis, low
cardiac output state, blood transfusion, reoperation rate, postoperative
left ventricular EF, intensive care unit length of stay (LOS), and
in-hospital LOS were comparable between groups. Conclusion(s): DC is
a safe alternative to BC in routine adult cardiac surgery. Its use is
associated with reduction in CPB and aortic cross-clamp times and may
potentially offer improved myocardial protection. Copyright © The
Author(s) 2019.

<32>
Accession Number
627538529
Title
Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer: Systemic
Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 14(2) (pp 90-116), 2019. Date of Publication: 01 Apr 2019.
Author
Ng C.S.H.; Macdonald J.K.; Gilbert S.; Khan A.Z.; Kim Y.T.; Louie B.E.;
Blair Marshall M.; Santos R.S.; Scarci M.; Shargal Y.; Fernando H.C.
Institution
(Ng) Chinese University of Hong Kong, Shatin, China
(Macdonald) Western University, London, ON, Canada
(Gilbert) University of Ottawa, ON, Canada
(Khan) Medanta, Medicity, Gurgaon, India
(Kim) Seoul National University Hospital, Chongro-Ku, South Korea
(Louie) Swedish Cancer Institute, Medical Center, Seattle, WA, United
States
(Blair Marshall) Georgetown University Hospital, Washington, DC, United
States
(Santos) Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Scarci) San Gerardo Hospital, Monza, MB, Italy
(Shargal) St Joseph's Healthcare, MacMaster University, Hamilton, ON,
Canada
(Fernando) Inova Fairfax Medical Campus, Virginia Commonwealth University,
Falls Church, Richmond, VA, United States
Publisher
SAGE Publications Ltd
Abstract
Objective Video-assisted thoracic surgery (VATS) lobectomy was introduced
over 25 years ago. More recently, the technique has been modified from a
multiport video-assisted thoracic surgery (mVATS) to uniportal (uVATS) and
robotic (rVATS), with proponents for each approach. Additionally most
lobectomies are still performed using an open approach. We sought to
provide evidence-based recommendations to help define the optimal surgical
approach to lobectomy for early stage non-small cell lung cancer. Methods
Systematic review and meta-analysis of articles searched without limits
from January 2000 to January 2018 comparing open, mVATS, uVATS, and rVATS
using sources Medline, Embase, and Cochrane Library were considered for
inclusion. Articles were individually scrutinized by ISMICS consensus
conference members, and evidence-based statements were created and
consensus processes were used to determine the ensuing recommendations.
The ACC/AHA Clinical Practice Guideline Recommendation Classification
system was used to assess the overall quality of evidence and the strength
of recommendations. Results and recommendations One hundred and forty-five
studies met the predefined inclusion criteria and were included in the
meta-analysis. Comparisons were analyzed between VATS and open, and
between different VATS approaches looking at oncological outcomes
(survival, recurrence, lymph node evaluation), safety (adverse events),
function (pain, quality of life, pulmonary function), and
cost-effectiveness. Fifteen statements addressing these areas achieved
consensus. The highest level of evidence suggested that mVATS is
preferable to open lobectomy with lower adverse events (36% versus 42%;
88,460 patients) and less pain (IIa recommendation). Our meta-analysis
suggested that overall survival was better (IIb) with mVATS compared with
open (71.5% versus 66.7% 5-years; 16,200 patients). Different VATS
approaches were similar for most outcomes, although uVATS may be
associated with less pain and analgesic requirements (IIb). Conclusions
This meta-analysis supports the role of VATS lobectomy for non-small cell
lung cancer. Apart from potentially less pain and analgesic requirement
with uVATS, different minimally invasive surgical approaches appear to
have similar outcomes. Copyright © International Society for
Minimally Invasive Cardiothoracic Surgery. All rights reserved.

<33>
Accession Number
627538525
Title
Expert Consensus Statement on Optimal Approach to Lobectomy for Non-Small
Cell Lung Cancer.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 14(2) (pp 87-89), 2019. Date of Publication: 01 Apr 2019.
Author
Ng C.S.H.; Macdonald J.K.; Gilbert S.; Khan A.Z.; Kim Y.T.; Louie B.E.;
Blair Marshall M.; Santos R.S.; Scarci M.; Shargal Y.; Fernando H.C.
Institution
(Ng) Chinese University of Hong Kong, Hong Kong, Hong Kong
(Macdonald) Western University, London, ON, Canada
(Gilbert) University of Ottawa, C-Ontario, Canada
(Khan) Medanta, Medicity, Gurgaon, India
(Kim) Seoul National University Hospital, South Korea
(Louie) Swedish Cancer Institute, Medical Center, Seattle, WA, United
States
(Blair Marshall) Georgetown University Hospital, Washington, DC, United
States
(Santos) Hospital Israelite Albert Einstein, Sao Paulo, Brazil
(Scarci) San Gerardo Hospital, Monza, Italy
(Shargal) St Joseph's Healthcare, MacMaster University, Canada
(Fernando) Inova Fairfax Medical Campus, Virginia Commonwealth University,
Falls Church, VA, United States
Publisher
SAGE Publications Ltd
Abstract
A systematic review and meta-analysis to help define the optimal approach
for lobectomy for non-small cell lung cancer was undertaken. Articles
comparing thoracotomy (open), multi-port Video-assisted thoracic surgery
(mVATS), robotic VATS (rVATS), and uniportal VATS (uVATS) were scrutinized
and evidence-based statements using the American College of
Cardiology/American Heart Association clinical practice guideline
recommendations made.1 A total of 145 studies met the inclusion criteria
and the following 15 evidence-based statements achieved consensus.2 The
statements are as follows. Copyright © International Society for
Minimally Invasive Cardiothoracic Surgery. All rights reserved.

<34>
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Accession Number
622901361
Title
Homograft Versus Conventional Prosthesis for Surgical Management of Aortic
Valve Infective Endocarditis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13(3) (pp 163-170), 2018. Date of Publication: 01 May 2018.
Author
Yanagawa B.; Mazine A.; Tam D.Y.; Juni P.; Bhatt D.L.; Spindel S.; Puskas
J.D.; Verma S.; Friedrich J.O.
Institution
(Yanagawa, Mazine, Tam, Verma) Division of Cardiac Surgery, St Michael's
Hospital, University of Toronto, Division of Cardiac Surgery, 30 Bond
Street, 8th Floor, Bond Wing, Toronto, ON M5B 1W8, Canada
(Juni) Applied Health Research Centre, St Michael's Hospital, University
of Toronto, Toronto, ON, Canada
(Juni, Friedrich) Li Ka Shing Knowledge Institute, St Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(Bhatt) Brigham and Women's Hospital Heart and Vascular Center, Harvard
Medical School, Boston, MA, United States
(Spindel, Puskas) Department of Cardiothoracic Surgery, Mount Sinai
Hospital, New York, NY, United States
(Friedrich) Department of Critical Care and Medicine, St Michael's
Hospital, University of Toronto, Toronto, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objective Surgical management of aortic valve infective endocarditis (IE)
with cryopreserved homograft has been associated with lower risk of
recurrent IE, but there is equipoise with regard to the optimal
prosthesis. This systematic review and meta-analysis were performed to
compare outcomes between homograft and conventional prosthesis for aortic
valve IE. Methods We searched MEDLINE database to September 2017 for
studies comparing homograft versus conventional prosthesis. The main
outcomes were all-cause mortality, recurrent IE, and reoperation. Results
There were 18 included comparative observational studies with 2232
patients (median follow up = 5 [interquartile range: 2-7] years, 30%
prosthetic valve endocarditis); four studies were adjusted for baseline
differences. There were no differences in perioperative mortality or
stroke despite a greater proportion of staphylococcal endocarditis,
abscess, and root replacements but less multivalve involvement in the
homograft group. Long-term outcomes of all-cause mortality [incidence rate
ratio (IRR) = 1.03, 95% confidence interval (CI) = 0.81-1.31, P = 0.83,
for unmatched, and IRR = 0.82, 95% CI = 0.36-1.84, P = 0.63, for matched
studies], recurrent endocarditis (IRR = 1.01, 95% CI = 0.53-1.93, P =
0.96, for unmatched, and IRR = 1.04, 95% CI = 0.49-2.19, P = 0.92, for
matched studies), and reoperation (IRR = 1.60, 95% CI = 0.80-3.21, P =
0.18, for unmatched, and IRR = 3.17, 95% CI = 0.52-19.44, P = 0.21, for
matched studies) were not different comparing homograft versus
conventional prosthesis. There was a significantly increased need for
reoperation with homograft versus mechanical prosthetic valves, but this
comparison was based on limited data. Conclusions Homografts and
conventional prostheses offer similar survival and freedom from recurrent
endocarditis and reoperation for aortic valve IE. Homografts may be
associated with greater risk of reoperation compared with mechanical
valves. Copyright © 2018 by the International Society for
Minimally Invasive Cardiothoracic Surgery.

<35>
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Accession Number
622901359
Title
Three-Year Survival Comparison between Transcatheter and Surgical Aortic
Valve Replacement for Intermediate- and Low-Risk Patients.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13(3) (pp 153-162), 2018. Date of Publication: 01 May 2018.
Author
Siordia J.A.; Loera J.M.; Scanlon M.; Evans J.; Knight P.A.
Institution
(Siordia, Loera, Scanlon, Evans, Knight) Department of Cardiac Surgery,
University of Rochester Medical Center, 7796 Victor Mendon Rd, Victor,
Rochester, NY 14564, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve implantation is a suitable therapeutic
intervention for patients deemed inoperable or high risk for surgical
aortic valve replacement. Current investigations question whether it is a
suitable alternative to surgery for intermediate- and low-risk patients.
The following meta-analysis presents a comparison between transcatheter
versus surgical aortic valve replacement in patients that are intermediate
and low risk for surgery. Articles were collected via an electronic search
using Google Scholar and PubMed. Articles of interest included studies
comparing the survival of intermediate- and low-risk patients undergoing
transcatheter aortic valve implantation to those undergoing surgical
aortic valve replacement. Primary end points included 1-, 2-, and 3-year
survival. Secondary end points included postintervention thromboembolic
events, stroke, transient ischemic attacks, major vascular complications,
permanent pacemaker implantation, life-threatening bleeding, acute kidney
injury, atrial fibrillation, and moderate-to-severe aortic regurgitation.
Six studies met the criteria for the meta-analysis. One- and two-year
survival comparisons showed no difference between the two interventions.
Surgical aortic valve replacement, however, presented with favorable
3-year survival compared with the transcatheter approach. Transcatheter
aortic valve implantation had more major vascular complications, permanent
pacemaker implantation, and moderate-to-severe aortic regurgitation rates
compared with surgery. Surgical aortic valve replacement presented more
life-threatening bleeding, acute kidney injury, and atrial fibrillation
compared with a transcatheter approach. There was no statistical
difference between the two approaches in terms of thromboembolic events,
strokes, or transient ischemic attack rates. Surgical aortic valve
replacement presents favorable 3-year survival rates compared with
transcatheter aortic valve implantation. Copyright © 2018 by the
International Society for Minimally Invasive Cardiothoracic Surgery.

<36>
Accession Number
622518976
Title
Extended duration dual antiplatelet therapy after percutaneous coronary
intervention in patients with peripheral arterial disease: A
meta-analysis.
Source
Cardiology Research. 9(3) (pp 137-143), 2018. Date of Publication: 01 Jun
2018.
Author
Ling H.; Andrews E.; Ombengi D.; Li F.
Institution
(Ling) Department of Pharmacy Practice, School of Pharmacy, Georgia
Campus- Philadelphia College of Osteopathic Medicine, Suwanee, GA, United
States
(Andrews) Department of Pharmacy Practice, School of Pharmacy, Hampton
University, Hampton, VA, United States
(Ombengi) Department of Clinical Sciences, Medical College of Wisconsin
Pharmacy School, Milwaukee, WI, United States
(Li) Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, China
Publisher
Elmer Press
Abstract
Background: Patients with peripheral arterial disease (PAD) undergoing
percutaneous coronary intervention (PCI) are at elevated risk of ischemic
and bleeding events. However, the optimal duration of dual antiplatelet
therapy (DAPT) after PCI in patients with PAD remains unclear.
 Method(s): A systematic literature search was performed through June
2017 using PubMed, EMBASE and Cochrane databases with the following key
terms: "dual antiplatelet therapy", "P2Y12 inhibitor", "myocardial
infarction", "percutaneous coronary intervention", "stent", "peripheral
arterial disease", and "ankle-brachial index". The analysis was restricted
to randomized trials published in English in patients with PAD receiving
extended DAPT ( > 12-month) after PCI. Overall analysis was performed
using Review Manager 5.3 with the Mantel-Haenszel method. Result(s):
Two randomized controlled trials involving 895 patients were included in
this review. Compared to the placebo group, there was no statistical
significance in the occurrence of major adverse cardiovascular and
cerebrovascular events (MACCE) in patients receiving extended DAPT (odds
ratio (OR) 0.76, 95% confidence interval (CI) 0.37 - 1.57; P = 0.46). The
results were associated with substantial heterogeneity (I2 =
71%, P = 0.07). Extended DAPT was not significantly associated with
increased moderate/severe bleeding events (OR 1.63, 95% CI 0.84 - 3.18; P
= 0.15; I2 = 0%, P = 0.59). The extended DAPT was associated
with 82% relative risk reduction in the events of definite/probably stent
thrombosis. Conclusion(s): Among patients with PAD, extended DAPT
after PCI resulted in a non-significant difference in ischemic and
bleeding events compared to placebo, respectively. The routine use of
extended DAPT in this cohort should be carefully evaluated. Copyright
© The authors.

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Accession Number
2004197949
Title
Comparison of Automated Titanium Fasteners to Hand-Tied Knots in Open
Aortic Valve Replacement.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13(1) (pp 29-34), 2018. Date of Publication: 01 Jan 2018.
Author
Lee C.Y.; Johnson C.A.; Siordia J.A.; Lehoux J.M.; Knight P.A.
Institution
(Lee, Johnson, Siordia, Lehoux, Knight) Division of Cardiac Surgery,
University of Rochester Medical Center, Rochester, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Aortic cross-clamp and cardiopulmonary bypass times are
independent predictors of postoperative morbidity and mortality. Reducing
ischemic times with automated titanium fasteners may improve surgical
outcomes. This study compared operative times and costs of titanium
fasteners versus hand-tied knots for prosthesis securement in open aortic
valve replacement. Method(s): A randomized control trial was
conducted during a 16-month period at a single university medical center.
Patients undergoing elective aortic valve replacement were randomized to
the titanium fastener (n = 37) or hand-tied groups (n = 36). Knotting,
aortic cross-clamp, cardiopulmonary bypass, and total operating room times
were recorded. Hospital charges were also calculated for these procedures.
 Result(s): Baseline characteristics, concomitant procedures,
prosthetic valve size, and sutures were similar between groups. The
titanium fastener group had significantly reduced knotting (7.4 vs. 13.0
minutes, P < 0.001), aortic cross-clamp (69 vs. 90 minutes, P < 0.05),
cardiopulmonary bypass (86 vs. 114 minutes, P < 0.05), and total operating
room times (234 vs. 266 minutes, P < 0.05). Intraoperative complications
occurred more frequently in the hand-tied group compared with the titanium
fastener group. Postoperative complications were similar between groups.
Operating room costs were significantly higher in the titanium fastener
group (US $10,428 vs. US $9671, P = 0.01). Hospitalization costs did not
differ significantly between the titanium fastener and hand-tied group (US
$23,987 vs. US $21,068, P = 0.12). Conclusion(s): Titanium fastener
use was associated with shorter knotting, aortic cross-clamp,
cardiopulmonary bypass, and operating room times and fewer intraoperative
complications in open aortic valve replacement, without significantly
increasing hospitalization cost. Copyright © 2018 International
Society for Minimally Invasive Cardiothoracic Surgery.

<38>
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Accession Number
2004197918
Title
Stented versus Stentless Aortic Valve Replacement in Patients with Small
Aortic Root: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13(6) (pp 404-416), 2018. Date of Publication: 01 Nov 2018.
Author
Harky A.; Wong C.H.M.; Hof A.; Froghi S.; Ahmad M.U.; Howard C.; Rimmer
L.; Bashir M.
Institution
(Harky) Department of Vascular Surgery, Countess of Chester Hospital,
Chester, United Kingdom
(Wong) Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
(Hof) Department of Cardiovascular Surgery, Heinrich-Heine-University,
Medical Faculty, Dusseldrof, Germany
(Froghi) Department of Surgery, Imperial College NHS Trust, Hammersmith,
London, United Kingdom
(Ahmad, Howard, Rimmer) School of Medicine, University of Liverpool,
Liverpool, United Kingdom
(Bashir) Manchester Royal Infirmary, Manchester, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: The aim of the study was to compare hemodynamic and
perioperative outcomes of stented against stentless aortic valve
replacement in patients with small aortic root (21 mm or less).
 Method(s): A comprehensive search was undertaken among the four major
databases (PubMed, Embase, Scopus, and Ovid) to identify all randomized
and nonrandomized controlled trials comparing stentless to stented
bioprosthetic valves in small aortic root patients. Odds ratios, weighted
mean differences, or standardized mean differences and their 95%
confidence intervals were analyzed. Result(s): A total of seven
studies with a total of 965 patients fulfilled the inclusion criteria.
There was no significant difference in preoperative baselines including
mean age between both groups (P = 0.08), peak aortic valve gradient (P =
0.06), and effective orifice area (P = 0.28), whereas higher mean aortic
valve gradient in the stented group (P = 0.007). No difference in
cardiopulmonary bypass time (P = 0.74), aortic cross-clamp times (P =
0.88), intensive care unit stay (P = 0.13), and stroke rate (P = 0.56)
were noted. However, stented group of patients showed higher rate of
patient prosthesis mismatch (P = 0.0001) and longer total hospital stay (P
= 0.002). Postoperatively, stentless group showed lower peak and mean
aortic valve gradient (P = 0.003 and P = 0.008, respectively) with a
better effective orifice area (P < 0.00001) at 6 months of follow-up.
Mortality rates while in-hospital and at 1 year were similar in both
groups (P = 0.94 and P = 0.86, respectively). Conclusion(s):
Stentless aortic valves offer superior short-term hemodynamic outcomes in
patients with small aortic root when compared with stented aortic valves.
Although both groups have similar perioperative complications rates,
stentless valves bring about a shorter hospital stay. A further large
multicenter randomized controlled trial should address the longer-term
benefit of stentless aortic valve over stented valve. Copyright ©
2018 International Society for Minimally Invasive Cardiothoracic Surgery.

<39>
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Accession Number
2004197902
Title
Multicenter Assessment of Grafts in Coronaries: Midterm Evaluation of the
C-Port Device (the MAGIC Study).
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13(4) (pp 273-281), 2018. Date of Publication: 01 Jul 2018.
Author
Balkhy H.H.; Patel N.C.; Ramshandani M.; Kitahara H.; Subramanian V.A.;
Augelli N.V.; Tobler G.; Cai T.H.
Institution
(Balkhy, Kitahara) Division of Cardiothoracic Surgery, The University of
Chicago Medicine, Chicago, IL, United States
(Patel, Subramanian) Department of Cardiac Surgery, Lenox Hill Hospital,
New York, NY, United States
(Ramshandani) Department of Cardiothoracic Surgery, Houston Methodist
Hospital, Houston, TX, United States
(Augelli) Department of Cardiac Surgery, ThedaCare Regional Medical
Center, Appleton, WI, United States
(Tobler) Department of Cardiothoracic Surgery, John L. McClellan Veterans
Administration Medical Center, Little Rock, AR, United States
(Cai) Department of Cardiothoracic Surgery, CRSTI Heart Hospital, Plano,
TX, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: The commercially available C-Port distal anastomotic device
(Food and Drug Administration cleared in 2007) is an automated miniature
vascular stapler that performs the coronary anastomosis. This prospective
multicenter registry sought to evaluate midterm patency using this device
compared with hand-sewn grafts. Method(s): Patients receiving at
least one C-Port anastomosis during coronary artery bypass grafting
surgery were enrolled at eight sites. Of the 117 patients enrolled, 78
patients (67%) with 104 C-Port vein grafts completed the study to patency
assessment via computed tomography angiography. Clinical follow-up and
index graft patency (Gated 64-slice computed tomography scan) were
performed at least 12 months postoperatively. The primary efficacy
endpoint was patency compared with the peer-reviewed results from the
PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT IV)
trial. Result(s): The patient population was consistent with the
PREVENT IV placebo cohort. The mortality at 12 months was 0.85% (1/117).
The major cardiac morbidity rate was 3.4% (4/117). The C-Port vein graft
occlusion rate was 16.3% (17/104) compared with 26.6% (597/2242) in the
PREVENT IV trial (P = 0.011). Within this study, C-Port graft occlusion
rates were not significantly different from the hand-sewn grafts (P =
0.821). Conclusion(s): The C-Port device is safe and effective in
creating the distal anastomosis with equivalent patency rates to hand-sewn
grafts at 12 months. When compared with hand-sewn anastomoses from a
recent large prospective trial, the C-Port device demonstrated a
statistically significant reduction in midterm graft occlusion. Further
studies are required to evaluate its effect in less invasive coronary
surgery. Copyright © 2018 International Society for Minimally
Invasive Cardiothoracic Surgery.

<40>
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Accession Number
2004197896
Title
Magna Ease versus Trifecta Early Hemodynamics: A Systematic Review and
Meta-analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13(4) (pp 267-272), 2018. Date of Publication: 01 Jul 2018.
Author
Yanagawa B.; Tam D.Y.; Hong K.; Mazine A.; Bagai A.; Shahbaz N.K.;
Ouzounian M.; Verma S.
Institution
(Yanagawa, Tam, Hong, Mazine, Shahbaz, Verma) Divisions of Cardiac
Surgery, University of Toronto, Toronto, ON, Canada
(Bagai) Divisions of Cardiology, St Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Ouzounian) Division of Cardiac Surgery, Toronto General Hospital,
Toronto, ON, Canada
Publisher
SAGE Publications Ltd
Abstract
Objective: This meta-analysis compares the early echocardiographic
outcomes of aortic valve replacement using the two most commonly implanted
stented bioprostheses. Method(s): We searched MEDLINE and EMBASE
databases until 2017 for studies comparing Magna or Magna Ease (Edwards
Lifesciences, Irvine, CA USA) versus Trifecta (St Jude Medical, St. Paul,
MN USA) aortic bioprosthetic valves. A random-effects meta-analysis was
performed for the primary outcome of mean gradient on echocardiography and
secondary outcomes of effective orifice area, indexed effective orifice
area, and in-hospital mortality. Result(s): There were two randomized
controlled trial, three matched, and six unmatched retrospective
observational studies with 2119 patients [median reported follow-up = 6
months (interquartile range = 6 to 12)]. The Magna/Magna Ease valve was
associated with higher early mean gradient (mean difference = 4.09, 95%
confidence interval = 3.48 to 4.69, P < 0.0001) and smaller effective
orifice area (mean difference = 0.30, 95% confidence interval = -0.38 to
-0.22, P < 0.0001). There were no differences in 30-day mortality between
Magna/Magna Ease and Trifecta (relative risk = 1.01, 95% confidence
interval = 0.41 to 2.50, P = 1.0). Conclusion(s): Trifecta may offer
a small hemodynamic advantage compared with the Magna/Magna Ease valve
with no differences in early mortality. Long-term follow-up is required to
determine whether these differences persist and translate into differences
in clinical outcomes. Copyright © 2018 International Society for
Minimally Invasive Cardiothoracic Surgery.

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Accession Number
620308238
Title
Randomized Study Comparing the Effect of Carbon Dioxide Insufflation on
Veins Using 2 Types of Endoscopic and Open Vein Harvesting.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 12(5) (pp 320-328), 2017. Date of Publication: 01 Sep 2017.
Author
Krishnamoorthy B.; Critchley W.R.; Nair J.; Malagon I.; Carey J.; Barnard
J.B.; Waterworth P.D.; Venkateswaran R.V.; Fildes J.E.; Caress A.L.; Yonan
N.
Institution
(Krishnamoorthy, Malagon, Carey, Barnard, Waterworth, Venkateswaran,
Yonan) Department of Cardiothoracic Surgery, University Hospital of South
Manchester NHS Foundation Trust, Manchester M23 9LT, United Kingdom
(Krishnamoorthy) Faculty of Health and Social Care, Edge Hill University,
Ormskirk, Lancashire, United Kingdom
(Critchley, Nair, Fildes) Manchester Collaborative Centre for Inflammation
Research, Faculty of Medical and Human Sciences, University of Manchester,
Manchester, United Kingdom
(Caress) School of Nursing and Midwifery, University of Manchester,
Manchester, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: The aim of the study was to assess whether the use of carbon
dioxide insufflation has any impact on integrity of long saphenous vein
comparing 2 types of endoscopic vein harvesting and traditional open vein
harvesting. Method(s): A total of 301 patients were prospectively
randomized into 3 groups. Group 1 control arm of open vein harvesting (n =
101), group 2 closed tunnel (carbon dioxide) endoscopic vein harvesting (n
= 100) and Group 3 open tunnel (carbon dioxide) endoscopic vein harvesting
(open tunnel endoscopic vein harvesting) (n = 100). Each group was
assessed to determine the systemic level of partial arterial carbon
dioxide, end-tidal carbon dioxide, and pH. Three blood samples were
obtained at baseline, 10 minutes after start of endoscopic vein
harvesting, and 10 minutes after the vein was retrieved. Vein samples were
taken immediately after vein harvesting without further surgical handling
to measure the histological level of endothelial damage. A modified
validated endothelial scoring system was used to compare the extent of
endothelial stretching and detachment. Result(s): The level of
end-tidal carbon dioxide was maintained in the open tunnel endoscopic vein
harvesting and open vein harvesting groups but increased significantly in
the closed tunnel endoscopic vein harvesting group (P = 0.451, P = 0.385,
and P < 0.001). Interestingly, partial arterial carbon dioxide also did
not differ over time in the open tunnel endoscopic vein harvesting group
(P = 0.241), whereas partial arterial carbon dioxide reduced significantly
over time in the open vein harvesting group (P = 0.001). A profound
increase in partial arterial carbon dioxide was observed in the closed
tunnel endoscopic vein harvesting group (P < 0.001). Consistent with these
patterns, only the closed tunnel endoscopic vein harvesting group
demonstrated a sudden drop in pH over time (P < 0.001), whereas pH
remained stable for both open tunnel endoscopic vein harvesting and open
vein harvesting groups (P = 0.105 and P = 0.869, respectively).
Endothelial integrity was better preserved in the open vein harvesting
group compared with open tunnel endoscopic vein harvesting or closed
tunnel endoscopic vein harvesting groups (P = 0.012) and was not affected
by changes in carbon dioxide or low pH. Significantly greater stretching
of the endothelium was observed in the open tunnel endoscopic open tunnel
endoscopic vein harvesting group compared with the other groups (P =
0.003). Conclusion(s): This study demonstrated that the different
vein harvesting techniques impact on endothelial integrity; however, this
does not seem to be related to the increase in systemic absorption of
carbon dioxide or to the pressurized endoscopic tunnel. The open tunnel
endoscopic harvesting technique vein had more endothelial stretching
compared with the closed tunnel endoscopic technique; this may be due to
manual dissection of the vein. Further research is required to evaluate
the long-term clinical outcome of these vein grafts. © Copyright
2017 by the International Society for Minimally Invasive Cardiothoracic
Surgery.

<42>
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Accession Number
620308203
Title
Endoscopic Conduit Harvest in Coronary Artery Bypass Grafting Surgery: An
ISMICS Systematic Review and Consensus Conference Statements.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 12(5) (pp 301-319), 2017. Date of Publication: 01 Sep 2017.
Author
Ferdinand F.D.; MacDonald J.K.; Balkhy H.H.; Bisleri G.; Hwang H.Y.;
Northrup P.; Trimlett R.H.J.; Wei L.; Kiaii B.B.
Institution
(Ferdinand, Northrup) Division of Cardiothoracic Surgery, Albany Medical
College, 563 New Scotland Ave, MC 8656, Albany, NY 12208, United States
(MacDonald) Department of Medicine, University of Western Ontario, London,
ON, Canada
(Balkhy) Section of Cardiac and Thoracic Surgery, University of Chicago
Medicine and Biological Sciences, Chicago, IL, United States
(Bisleri) Division of Cardiac Surgery, Kingston General Hospital,
Kingston, ON, Canada
(Hwang) Division of Cardiac Surgery, Seoul National University Hospital,
Seoul, South Korea
(Trimlett) Department of Surgery, Royal Brompton and Harefield NHS
Foundation Trust, London, United Kingdom
(Wei) Division of Cardiovascular Surgery, Zhongshan Hospital of Fudan
University, Shanghai, China
(Kiaii) Division of Cardiac Surgery, University Campus, Western
University, London, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: The purpose of this consensus conference was to develop and
update evidence-informed consensus statements and recommendations on
harvesting saphenous vein and radial artery via an open as compared with
endoscopic technique by systematically reviewing and performing a
meta-analysis of randomized and nonrandomized clinical trials.
 Method(s): All randomized controlled trials and nonrandomized
controlled trials included in the first the International Society for
Minimally Invasive Cardiothoracic Surgery Consensus Conference and
Statements,1,2 in 2005 up to November 30, 2015, were included
in a systematic review and meta-analysis. Based on the resultant, 76
studies (23 randomized controlled trials and 53 nonrandomized controlled
trials) on 281,459 patients analyzed, consensus statements, and
recommendations were generated comparing the risks and benefits of
endoscopic versus open conduit harvesting for patients undergoing coronary
artery bypass grafting. Result(s): Compared with open vein harvest,
it is reasonable to perform endoscopic vein harvest of saphenous vein to
reduce wound-related complications, postoperative length of stay, and
outpatient wound management resources and to increase patient satisfaction
(class I, level A). Based on the quality of the conduit and major adverse
cardiac events as well as 6-month angiographic patency, endoscopic vein
harvest was noninferior to open harvest. It is reasonable to perform
endoscopic radial artery harvest to reduce wound-related complication and
to increase patient satisfaction (class I, level B-R and B-NR,
respectively) with reduction in major adverse cardiac events and
noninferior patency rate at 1 and 3 to 5 years (class III, level B-R).
 Conclusion(s): Based on the consensus statements, the consensus panel
recommends (class I, level B) that endoscopic saphenous vein and radial
artery harvesting should be the standard of care for patients who require
these conduits for coronary revascularization. © Copyright 2017
by the International Society for Minimally Invasive Cardiothoracic
Surgery.

<43>
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Accession Number
619000848
Title
Video-Assisted Thoracoscopic Versus Robotic-Assisted Thoracoscopic
Thymectomy.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 12(4) (pp 259-264), 2017. Date of Publication: 01 Jul 2017.
Author
Fok M.; Bashir M.; Harky A.; Sladden D.; Dimartino M.; Elsyed H.; Howard
C.; Knipe M.; Shackcloth M.J.
Institution
(Fok, Elsyed, Howard, Knipe) Thoracic Aortic Aneurysm Service, Liverpool
Heart and Chest Hospital, Liverpool, United Kingdom
(Bashir, Harky, Sladden, Dimartino) Cardiothoracic Surgery, Barts Heart
Centre, St. Bartholomew's Hospital, London EC1A 7BE, United Kingdom
(Shackcloth) General Thoracic and Oesophageal Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Objective Minimally invasive thoracic surgical procedures, performed with
or without the assistance of a robot, have gained popularity over the last
decade. They have increasingly become the choice of intervention for a
number of thoracic surgical operations. Minimally invasive surgery
decreases postoperative pain, hospital stay and leads to a faster recovery
in comparison with conventional open methods. Minimally invasive
techniques to perform a thymectomy include video-assisted thoracoscopic
surgery (VATS) or robotic-assisted thoracoscopic surgery (RATS). In this
study, we aim to systematically review and interrogate the literature on
minimally invasive thymectomy and draw a meta-analysis on the outcomes
between the two approaches. Methods An extensive electronic health
database search was performed on all articles published from inception to
May 2015 for studies describing outcomes in VATS and RATS thymectomy.
Results A total of 350 patients were included in this study, for which 182
and 168 patients underwent RATS and VATS thymectomy, respectively. There
were no recorded in-hospital deaths for either procedure. There was no
statistical difference in conversion to open, length of hospital stay, or
postoperative pneumonia. Operational times for RATS thymectomy were
longer. Conclusions The VATS and RATS thymectomy offer good and safe
operative and perioperative outcomes. There is little difference between
the two groups. However, there is poor evidence basis for the long-term
outcomes in minimally invasive procedures for thymectomy. It is imperative
that future studies evaluate oncological outcomes both short and long term
as well as those related to safety. Copyright © 2017 by the
International Society for Minimally Invasive Cardiothoracic Surgery.

<44>
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Accession Number
619000838
Title
A Prospective Randomized Study of Endoscopic Versus Conventional
Harvesting of the Radial Artery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 12(4) (pp 231-238), 2017. Date of Publication: 01 Jul 2017.
Author
Kiaii B.B.; Swinamer S.A.; Fox S.A.; Stitt L.; Quantz M.A.; Novick R.J.
Institution
(Kiaii, Swinamer, Fox, Stitt, Quantz) Departments of Surgery, Western
University, 339 Windermere Rd, London, ON N0M 1C0, Canada
(Novick) Department of Surgery, University of Calgary, Calgary, AL, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objective The aims of the study were to determine whether endoscopic
harvesting of the radial artery (RA) reduces morbidity due to pain,
infection, and disability with improvement in satisfaction and cosmesis
compared to the conventional technique and (2) to compare the 6-month
angiographic patency of the RA harvested conventionally and
endoscopically. Methods In a prospective randomized study, 119 patients
undergoing coronary artery bypass grafting using the RA were randomized to
have RA harvested either conventionally (n = 59) or endoscopically (n =
60). Results Radial artery harvest time (open wound time) was
significantly reduced in the endoscopic group (36.5 +/- 9.4 vs 57.7 +/-
9.4 minutes, P < 0.001). Only one patient developed wound infection (1.6%)
in the endoscopic group compared with six patients (10.2%), P = 0.061, in
the conventional group. Although this was not statistically significant,
clinically this was relevant in terms of reduction in postoperative
morbidity. Postoperative pain in the arm incision was significantly lower
in the endoscopic group at postoperative day 2 (P < 0.001) and at
discharge (P < 0.001) and similar to the conventional open group at 6
weeks' follow-up (P = 0.103). Overall patient satisfaction and cosmesis
were significantly better in the endoscopic group at postoperative day 2
(P < 0.001), at discharge (P < 0.001), and at 6 weeks' follow-up (P <
0.001). There was no difference in the arm disability postoperatively (P =
0.505) between the two groups. Six-month angiographic assessment of 23
patients (12 endoscopic and 11 open) revealed no difference in the patency
rate (10/12 in endoscopic and 9/11 in open group). Conclusions Endoscopic
RA harvesting reduced the incidence of postoperative wound infection and
wound pain and improved patient satisfaction and cosmesis compared with
conventional harvesting technique. There was no difference in the 6-month
angiographic patency of the RA harvested conventionally and
endoscopically. Copyright © 2017 by the International Society for
Minimally Invasive Cardiothoracic Surgery.

<45>
Accession Number
618987811
Title
Occurrence and impact of time delay to primary percutaneous coronary
intervention in patients with ST-segment elevation myocardial infarction.
Source
Cardiology Research. 8(5) (pp 190-198), 2017. Date of Publication: 2017.
Author
Shahin M.; Obeid S.; Hamed L.; Templin C.; Gamperli O.; Nietlispach F.;
Maiera W.; Yousif N.; Mach F.; Roffi M.; Windecker S.; Raber L.; Matter
C.M.; Luscher T.F.
Institution
(Shahin, Obeid, Templin, Gamperli, Nietlispach, Maiera, Yousif, Matter,
Luscher) Department of Cardiology, University Heart Center, Zurich,
Switzerland
(Hamed) Department of Internal Medicine, University Hospital Sohag, Egypt
(Mach, Roffi) Cardiovascular Center, Department of Cardiology, University
Hospital Geneva, Switzerland
(Windecker, Raber) Cardiovascular Center, Department of Cardiology,
University Hospital Bern, Switzerland
Publisher
Elmer Press
Abstract
Background: The aim of the study was to evaluate the occurrence, duration
and impact of time delays to primary percutaneous coronary intervention
(pPCI) in ST-segment elevation myocardial infarction (STEMI).
 Method(s): A total of 357 consecutive STEMI patients enrolled in the
prospective Special Program University Medicine ACS (SPUMACS) cohort were
included. In order to identify the causes behind a possible treatment
delay, we constructed four different time points which included: 1)
symptom onset to hospital arrival, 2) hospital arrival to arrival in the
catheterization laboratory, 3) hospital arrival to first balloon
inflation, and 4) time from arrival in the catheterization laboratory to
first balloon inflation in addition to total ischemic time. Patients were
stratified according to a delay > 3 h, > 30 min, > 90 min and > 1 h,
respectively and major adverse events at 0, 30 and 365 days were analyzed.
 Result(s): Resuscitated STEMI patients (23 patients) and STEMI
patients presenting at weekends (101 patients) and to lesser extent at
night hours (100 patients) experienced more time delays than stable
patients and those presenting at office hours. Median door-to-balloon time
averaged 93 min in resuscitated, but 65 min in stable patients. Median
door-to-balloon time at weekends and public holidays was 89 min, but 68
min at office hours. Median time from hospital arrival to cathlab arrival
at weekends and public holidays was 30 min, but 15 min during office
hours. Corresponding times for resuscitated patients was 45 and 15 min in
stable patients. Of note, resuscitated patients were late presenters as
regards time from symptoms onset to hospital arrival with a median time of
180 min compared to 155 min in stable patients. Median total ischemic time
was 225 min for all patients, 223 min at day hours, 239 at night hours,
244 min at weekends, 233 min at office days, 220 min in stable patients
and 273 min in resuscitated patients. Patients with STEMI who arrived > 3
h after symptom onset had a higher rate of myocardial infarction (MI) at 1
year (1.6% vs. 9% in < 3 h; P = 0.008). Furthermore, STEMI patients who
had a delay of > 1 h from cathlab arrival to first balloon inflation had a
higher rate of in hospital reinfarction at 0 day (0.6% vs. 0% in < 1 h; P
= 0.007), MI at 30 days (0.8% vs. 0% in < 1 h; P = 0.001) and MI at 1 year
(1.4% vs. 1.1% in < 1 h; P = 0.012). Similarly, in these patients, cardiac
deaths at 0 day (0.8% vs. 0.6% in < 1 h; P = 0.035) and at 30 days (0.8%
vs. 0.6% in < 1 h; P = 0.035) were higher as were major adverse
cardiovascular events (MACCE) at 0 day (1.4% vs. 0.8% in < 1 h; P =
0.004). Conclusion(s): Resuscitated STEMI patients and those
presenting at weekends and to lesser extent at night hours experienced
more time delays and longer ischemic time than stable patients and those
presenting at office hours. In STEMI patients, any delay in treatment
increased their risk of MACCE. Efforts should focus on improving patient's
awareness along with minimizing in-hospital transfer to the
catheterization laboratory especially at weekends and in resuscitated
patients. Copyright © The authors.

<46>
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Accession Number
611321827
Title
A meta-analysis of early versus delayed surgery for valvular infective
endocarditis complicated by embolic ischemic stroke.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 11(3) (pp 187-192), 2016. Date of Publication: 23 Aug 2016.
Author
Mihos C.G.; Pineda A.M.; Santana O.
Institution
(Mihos) Cardiac Ultrasound Laboratory, Massachusetts General Hospital,
Harvard Medical School, Boston, MA 02114, United States
(Pineda, Santana) Columbia University, Division of Cardiology, Mount Sinai
Heart Institute, Miami Beach, FL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: An embolic ischemic stroke occurs in 10% to 40% of patients
with valvular infective endocarditis (IE) and confers significant
morbidity. The optimal timing of valve surgery in this population is not
well defined. Method(s):With the use of PubMed, EMBASE, Ovid, and
Cochrane databases, a systematic review identified 14 studies through
October 2015 that compared early versus delayed surgery for valvular IE
complicated by an ischemic stroke. Early surgery was defined as 3 days or
less in one, 7 days or less in eight, and 14 days or less in five studies.
Risk ratios (RRs) were calculated by the Mantel-Haenszel method under a
fixed- or random-effects model, for the outcomes of perioperative stroke,
operative mortality, and 1-year survival. Result(s): A total of 833
patients (early surgery, 330; delayed surgery, 503) were included. The
majority of operations were for aortic and/or mitral valve IE, with
prosthetic valve IE present in 0%to 60%. Infection with Staphylococcus
aureus ranged from 19% to 66%, and heart failure prevalence at the time of
operation was 24% to 66%. Early surgery was associated with an increased
risk of operative mortality (RR, 1.72; 95% confidence interval [CI],
1.27-2.34; P = 0.0005), which was significant regardless of surgery within
the first 7 days (RR, 2.19; 95% CI, 1.45-3.31; P = 0.0002) or 14 days (RR,
1.72; 95% CI, 1.12-2.64; P = 0.01) after stroke. Surgical timing did not
affect the risk of perioperative ischemic or hemorrhagic stroke or 1-year
survival. Conclusion(s): In patients with valvular IE complicated by
ischemic stroke, early surgery is associated with an increased risk of
operative mortality, with no observed benefit in 1-year
survival. Copyright © 2016 by the International Society for
Minimally Invasive Cardiothoracic Surgery.

<47>
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Accession Number
607576306
Title
A meta-analysis examining differences in short-term outcomes between
sutureless and conventional aortic valve prostheses.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 10(6) (pp 375-382), 2015. Date of Publication: 2015.
Author
Hurley E.T.; O'Sullivan K.E.; Segurado R.; Hurley J.P.
Institution
(Hurley, O'Sullivan, Hurley) Heart Team, Mater Private Hospital, Eccles
St., Dublin 7, Ireland
(Segurado) CSTAR Centre for Statistical Training and Research, University
College, Dublin, Ireland
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Sutureless aortic valve prostheses are anchored by radial force
in a mechanism similar to that of transcatheter aortic valve implantation.
Transcatheter aortic valve implantation is associated with an increased
permanent pacemaker (PPM) requirement in a significant proportion of
patients. We undertook a meta-analysis to examine the incidence of PPM
insertion associated with sutureless compared with conventional surgical
aortic valve replacement. Method(s): A systematic review was
conducted in accordance with the Prisma guidelines.1 All
searches were performed on August 10, 2014. Studies between 2007 and 2014
were included in the search. Result(s): A total of 832 patients were
included in the sutureless group and 3,740 in the conventional group.
Aortic cross-clamp (39.8 vs 62.4 minutes; P < 0.001) and cardiopulmonary
bypass (64.9 vs 86.7 minutes; P = 0.002) times were shorter in the
sutureless group. Permanent pacemaker implantation rate was higher in the
sutureless cohort (9.1% vs 2.4%; P = 0.025). Conclusion(s):
Sutureless aortic valve prostheses are associated with significantly
shorter cardiopulmonary bypass and aortic cross-clamp times and a higher
incidence of PPM insertion than conventional. Further investigation of the
prognostic significance is required. Copyright © 2015 by the
International Society for Minimally Invasive Cardiothoracic Surgery.

<48>
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Accession Number
607321519
Title
Validation of a novel virtual reality training curriculum for robotic
cardiac surgery a randomized trial.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 10(6) (pp 383-388), 2015. Date of Publication: 2015.
Author
Valdis M.; Chu M.W.A.; Schlachta C.M.; Kiaii B.
Institution
(Valdis, Chu, Kiaii) Division of Cardiac Surgery, Department of Surgery,
Western University, London Health Sciences Centre, 339 Windermere Rd.,
London, ON N6A 5A5, Canada
(Schlachta) Division of General Surgery, Department of Surgery, Western
University, London Health Sciences Centre, London, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Robotic cardiac surgery training has relied entirely on
classical methods of surgical teaching. We sought to evaluate the impact
of a virtual reality (VR) simulation curriculum to improve skill
acquisition in robotic cardiac surgery. Method(s): We randomly
assigned 20 surgical trainees to undergo a 9-exercise VR curriculum on a
robotic surgical simulator or a control group that received no additional
training. The trainees were then evaluated in a blinded fashion by
assessing their de-identified video recordings of the following: (1)
standardized robotic internal thoracic artery harvest and (2) mitral valve
annuloplasty performed in porcine models, using a validated time-based
scoring system and an objective intraoperative scoring tool.
Postintervention assessments were compared to baseline. Result(s):
Trainees randomized to the VR group were faster than the control group for
both the internal thoracic artery harvest (957.3 T 98.9 vs. 749.1 T 171.9;
P = 0.004) and mitral annuloplasty (580.4 T 14.4 vs. 463.8 T 86.4; P G
0.001) and scored significantly higher with the intraoperative scoring
tool (22.8 T 2.7 vs. 11.0 T 4.5; P G 0.001). Additionally, the VR group
achieved a proficiency level similar to our experts for both time-based
scores (P = 0.624 and P = 0.967), and the intraoperative assessment (P =
0.110), whereas the control group was not able to meet this level of
proficiency for any of the primary outcomes. The average duration of
training to successfully complete all required tasks was 9.3 hours.
 Conclusion(s): We have demonstrated that a VR simulation curriculum
can significantly improve the efficiency and quality of learning in
robotic cardiac surgery. Further evaluation of this curriculum is required
for its widespread implementation in surgical training
(ClinicalTrials.gov, NCT#02357056). Copyright © 2015 by the
International Society for Minimally Invasive Cardiothoracic Surgery.

<49>
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Accession Number
606469318
Title
Pretransfusion comparison of dialyser-based hemoconcentrator with cell
saver system for perioperative cell salvage.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 10(5) (pp 334-341), 2015. Date of Publication: 2015.
Author
Garg P.; Malhotra A.; Desai M.; Sharma P.; Bishnoi A.K.; Tripathi P.;
Rodricks D.; Pandya H.
Institution
(Garg, Malhotra, Desai, Sharma, Bishnoi) Department of Cardiovascular and
Thoracic Surgery, U. N. Mehta Institute of Cardiology and Research Center,
Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016, India
(Tripathi) Department of Pathology, U. N. Mehta Institute of Cardiology
and Research Center (Affiliated to B. J. Medical College), Civil Hospital
Campus, Asarwa, Ahmedabad, India
(Rodricks) Department of Perfusion, U. N. Mehta Institute of Cardiology
and Research Center (Affiliated to B. J. Medical College), Civil Hospital
Campus, Asarwa, Ahmedabad, India
(Pandya) Department of Medical Research, U. N. Mehta Institute of
Cardiology and Research Center (Affiliated to B. J. Medical College),
Civil Hospital Campus, Asarwa, Ahmedabad, India
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Cell Saver system is the method of choice for red blood cell
salvage from the surgical field; however, cost is a limiting factor. We at
our institute have devised a cost-effective version of dialyser-based
autotransfusion system. We performed pretransfusion comparison of our
autotransfusion system with conventional cell saver system.
 Method(s): Aprospective randomized observational studywas performed
in 104 consecutive patients with coronary artery disease undergoing by
off-pump coronary artery bypass grafting. Patients were divided into two
groups. In the dialyser group (53 patients), blood from surgical field was
salvaged by our dialyser-based system. In the cell saver group (51
patients), blood was salvaged by cell saver. In both groups, 20-mL sample
from the salvaged blood was analyzed for hemoglobin, platelets, protein,
albumin, free hemoglobin, osmotic fragility, and peripheral blood smear
examination. Result(s): Total hemoglobin salvaged was comparable in
both groups (85% vs 76%). On peripheral smear, red blood cells were
swollen, but morphologywas preserved.Moreover, normal osmotic fragility
suggested absence of any lethal damage to red blood cells in either group.
Dialyserbased system was more efficient in salvaging platelets (42.9% vs
6%), proteins (79.2% vs 0%), and albumin (65% vs 0%). Total free
hemoglobin was three times more in dialyser group but was well below
recommended limits. Conclusion(s): Dialyser-based system is
economical, is equally efficacious in salvaging red blood cells, is more
effective in salvaging platelets and proteins, and does not contain
significant amount of free hemoglobin. Therefore, this salvaged blood can
be safely transfused. Copyright © 2015 by the International
Society for Minimally Invasive Cardiothoracic Surgery.

<50>
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Accession Number
606105878
Title
Fasudil is an effective graft vasodilator for gastroepiploic artery in
coronary artery bypass grafting.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 10(4) (pp 268-272), 2015. Date of Publication: 01 Sep 2015.
Author
Watanabe G.; Yamaguchi S.; Tomita S.; Nishida Y.
Institution
(Watanabe, Yamaguchi, Tomita, Nishida) Department of General and
Cardiothoracic Surgery, Kanazawa University Graduate School of Medical
Science, Kanazawa, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: The gastroepiploic artery (GEA) has been used as an alternative
arterial in situ graft for coronary artery bypass grafting (CABG).
However, because of the large individual differences and the spastic
nature of the GEA, caution has to be exercised during harvesting. We
evaluated the usefulness of fasudil, a Rho kinase inhibitor, as a
vasodilator for rightGEA(RGEA) graft after harvesting, compared with the
conventional agents papaverine and verapamil-nitroglycerin.
 Method(s): Between June 2009 and January 2013, 30 patients with
ischemic heart disease who underwent isolated CABG using RGEA graft were
randomly assigned to fasudil (n = 10), papaverine (n = 10), or
verapamil-nitroglycerin (n = 10) group. Fasudil (2.67 mmol/L), papaverine
(1.0 mmol/L) mixed with heparinized blood, or verapamilnitroglycerin (30
Kmol/L each) was injected intraluminally into the RGEA graft after
harvesting. Right GEA graft free flow (GFF), hemodynamic changes, and
histopathology of RGEA were evaluated. Result(s): Intraluminal
injection of fasudil increased GFF significantly (PG 0.001) andmarkedly
from41.5 T 31.5mL/min at baseline to 149.3 T 46.7mL/min after injection.
Papaverine increasedGFF (P G 0.001) from 40.0 T 35.8 to 64.9 T 33.7
mL/min, and verapamil-nitroglycerin also increasedGFF (P G 0.001) from38.8
T 32.1 to 79.0 T 35.2 mL/min. The GFF was significantly higher (P = 0.001)
in the fasudil group than in the other two groups. Histopathologically,
fasudil treatment markedly increased the diameter of RGEA graft, while
maintaining integrity of the multiple elastic lamellae. Blood pressure did
not change significantly after drug injection in all groups.
 Conclusion(s): Fasudil is more potent than papaverine or
verapamilnitroglycerin in increasing GFF of RGEA graft for CABG.

<51>
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Accession Number
606105807
Title
ISMICS consensus conference and statements of randomized controlled trials
of off-pump versus conventional coronary artery bypass surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 10(4) (pp 219-229), 2015. Date of Publication: 01 Sep 2015.
Author
Puskas J.D.; Martin J.; Cheng D.C.H.; Benussi S.; Bonatti J.O.; Diegeler
A.; Ferdinand F.D.; Kieser T.M.; Lamy A.; Mack M.J.; Patel N.C.; Ruel M.;
Sabik J.F.; Yanagawa B.; Zamvar V.
Institution
(Puskas, Yanagawa) Department of Cardiovascular Surgery, Icahn School of
Medicine, Mount Sinai Beth Israel, New York, NY, United States
(Martin, Cheng) Centre for Medical Evidence, Decision Integrity, Clinical
Impact (MEDICI), Department of Anesthesia and Perioperative Medicine,
Department of Epidemiology and Biostatistics, Western University, London,
ON, Canada
(Benussi) Division of Cardiovascular Surgery, University Hospital Zurich,
Zurich, Switzerland
(Bonatti) Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu
Dhabi, United Arab Emirates
(Diegeler) Herz-Und Gefasse Klinik Bad Neustadt, University of Leipzig,
Bad Neustadt, Germany
(Ferdinand) Division of Cardiovascular and Thoracic Surgery, Lankenau
Medical Center, Wynnewood, PA, United States
(Kieser) Libin Cardiovascular Institute of Alberta, University of Calgary,
Calgary, AB, Canada
(Lamy) Division of Cardiac Surgery and Department of Clinical Epidemiology
and Biostatistics, McMaster University, Hamilton, ON, Canada
(Mack) Baylor Health System, Heart Hospital Baylor Plano, Dallas, TX,
United States
(Patel) Department of Cardiothoracic Surgery, Lenox Hill, New York, NY,
United States
(Ruel) University of Ottawa Heart Institute, Ottawa, Ontario, Canada
(Sabik) Heart Vascular Institute, Cleveland Clinic, Cleveland, OH, United
States
(Zamvar) Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: At this consensus conference, we developed evidenceinformed
consensus statements and recommendations on the practice of off-pump
coronary artery bypass graft (OPCAB) by systematically reviewing and
performing meta-analysis of the randomized controlled trials (RCTs)
comparing OPCAB and conventional coronary artery bypass (CCAB).
 Method(s): All RCTs of OPCAB versus CCAB through April 2013 were
screened, and 102 relevant RCTs (19, 101 patients) were included in a
systematic review and meta-analysis (15 RCTs of 9551 high-risk patients;
and 87 RCTs of 9550 low-risk patients) in accordance with the Cochrane
Collaboration and PRISMA (Preferred Reporting Items for Systematic Reviews
and Meta-Analyses) methodology. Consensus statements for the risks and
benefits of OPCAB surgery in mortality, morbidity, and resource use were
developed based on best available evidence. Result(s): Compared to
CCAB, it is reasonable to perform OPCAB to reduce risks of stroke [class
IIa, level of evidence (LOE) A], renal dysfunction/failure (class IIa, LOE
A), blood transfusion (class I, LOE A), respiratory failure (class I, LOE
A), atrial fibrillation (class I, LOE A), wound infection (class I, LOE
A), ventilation time, and ICU and hospital length of stay (class I, LOE
A). However, OPCAB may be associated with a reduced number of grafts
performed (class I, LOE A) and with diminished graft patency (class IIa,
LOE A, with increased coronary reintervention at 1 year and beyond (class
IIa, LOE A), aswell as increased mortality at a median follow-up of 5
years (class IIb, LOE A). Conclusion(s): OPCAB compared with CCAB may
improve outcomes in the short-term (stroke, renal dysfunction, blood
transfusion, respiratory failure, atrial fibrillation, wound infection,
ventilation time, and length of stay). However, over the longer-term,
OPCAB may be associated with reduced graft patency, and increased risk of
cardiac re-intervention and death.

<52>
Accession Number
602122072
Title
Systemic inflammatory response during cardiac surgery: A pilot study.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 10(2) (pp 125-132), 2015. Date of Publication: 04 Mar 2015.
Author
Fitzgerald D.C.; Holmes S.D.; St. Onge J.R.; Ioanou C.; Martin L.M.; Ad N.
Institution
(Fitzgerald, Holmes, St. Onge, Ioanou, Martin, Ad) Division of
Cardiothoracic Surgery, Department of Cardiovascular Perfusion, Inova
Fairfax Hospital, 3300 Gallows Rd, Falls Church, VA 22042, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: There is a growing body of evidence indicating that
perioperative fluid management during cardiac surgery influences patient
care and outcome. The choice of fluid therapy and the degree of systemic
inflammatory response triggered during surgery control the effects of
tissue edema formation and end-organ function. As such, "goal-directed"
fluid resuscitation protocols that measure colloid osmotic pressure (COP)
may promote improvements in patient morbidity and mortality.
 Method(s): Thirty patients scheduled for primary coronary artery
bypass grafting were prospectively randomized for perioperative fluid
treatment under COP guidance [albumin (ALB), n = 17] or conventional fluid
protocols without COP support (control, n = 13). Wholeblood samples were
drawn at four different time intervals including (A) anesthesia induction,
(B) 10 minutes after the initiation of cardiopulmonary bypass, (C) at the
completion of sternal skin approximation, and (D) 3 hours after admission
to the cardiac intensive care unit. Interleukin 6 (IL-6) and IL-8 were
measured by immunometric, enzyme-linked immunosorbent assays as well as
C-reactive protein. Colloid osmotic pressure values were measured using a
colloid osmometer. Result(s): As compared with conventional fluid
protocols, the patients treated in the intervention (ALB) group received
significantly less total perioperative fluid [7893.6 (1874.5) vs 10,754.8
(2403.9), P = 0.001], and this relationship remained after controlling for
age, sex, and The Society of Thoracic Surgeons risk score (beta = -0.5, t
= -3.1, P =0.005). Colloid osmotic pressure values were significantly
higher in the ALB group at time point D after surgery (P = 0.03). There
were no significant differences in IL-6, IL-8, and C-reactive protein
values between the groups at any of the time blood draw intervals.
Perioperative outcomes were evaluated by treatment group. For both groups,
the incidence of perioperative morbidity was low and did not differ by
treatment group. Conclusion(s): The use of COP-guided fluid
resuscitation was associated with a significant reduction in perioperative
fluid demand. However, patients prescribed toCOP-guided fluid therapy did
not experience a reduction in whole-body inflammation or improved surgical
outcome as compared with conventional fluid management
techniques. Copyright © 2015 by the International Society for
Minimally Invasive Cardiothoracic Surgery.

<53>
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Accession Number
53270759
Title
A meta-analysis of endoscopic versus conventional open radial artery
harvesting for coronary artery bypass graft surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 9(4) (pp 269-275), 2014. Date of Publication: July-August 2014.
Author
Cao C.; Tian D.H.; Ang S.C.; Peeceeyen S.; Allan J.; Fu B.; Yan T.D.
Institution
(Cao, Tian, Ang, Allan, Fu, Yan) Collaborative Research (CORE) Group,
Macquarie University, St. George Hospital, 2 Technology Place, Sydney, NSW
2109, Australia
(Cao) Baird Institute for Applied Heart and Lung Surgical Research, St.
George Hospital, Sydney, Australia
(Cao, Ang, Peeceeyen) Department of Cardiothoracic Surgery, St. George
Hospital, Sydney, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVE: The radial artery has been demonstrated to provide superior
long-term patency outcomes compared with saphenous veins for selected
patients who undergo coronary artery bypass graft surgery. Recently,
endoscopic radial artery harvesting has been popularized to improve
cosmetic and perioperative outcomes. However, concerns have been raised
regarding the effects on long-term survival and graft patency of this
relatively novel technique. The present meta-analysis aimed to assess the
safety and the efficacy of endoscopic radial artery harvesting versus the
conventional open approach. METHOD(S): A systematic review of the
current literature was performed on five electronic databases. All
comparative studies on endoscopic versus open radial artery harvesting
were included for analysis. Primary endpoints included mortality and
recurrent myocardial infarction. Secondary endpoints included graft
patency, wound infection, hematoma formation, and paresthesia.
 RESULT(S): Twelve studies involving 3314 patients were included for
meta-analysis according to predefined selection criteria. There were no
statistically significant differences in overall mortality, recurrent
myocardial infarction, or graft patency between the two surgical
techniques. However, patients who underwent endoscopic harvesting were
found to have significantly lower incidences of wound infection, hematoma
formation, and paresthesia. CONCLUSION(S): Current literature on
endoscopic harvesting of the radial artery for coronary artery bypass
graft surgery is limited by relatively short follow-up periods as well as
differences in patient selection and surgical techniques. In addition,
there are currently no randomized controlled trials to provide robust
clinical data. However, the available evidence suggests that the
endoscopic approach is associated with superior perioperative outcomes
without clear evidence demonstrating compromised patency or survival
outcomes. Copyright © 2014 by the International Society for Minimally
Invasive Cardiothoracic Surgery.

<54>
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Accession Number
368757436
Title
Novel sternum lifting technique for robotic internal thoracic artery graft
harvesting.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 8(1) (pp 76-79), 2013. Date of Publication: January-February
2013.
Author
Watanabe G.; Matsumoto I.; Kiuchi R.
Institution
(Watanabe, Matsumoto, Kiuchi) Department of General and Cardiothoracic
Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa,
13-1, Takara-machi, Kanazawa 920-8640, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Internal thoracic artery (ITA) harvesting using the robotic system usually
requires artificially induced capnothorax to provide visualization and
working space, but this procedure has the disadvantage of deteriorating
the hemodynamics. We developed an electrical sternum lifting system (ESLS)
for robotic ITA harvesting, which is robust and can be finely adjusted,
capable of lifting the sternum for a maximum of 5 to 10 cm. Using a
mechanical sternum lifting device significantly (P < 0.01) shortened the
time of ITA harvesting from a mean +/- SD of 55.5 +/- 24.1 minutes to 33.0
+/- 15.7 minutes. No patient using the ESLS required induced capnothorax.
Our novel ESLS provides a good operative field of view and allows ITA
harvesting without inducing capnothorax. Copyright © 2013 by the
International Society for Minimally Invasive Cardiothoracic Surgery.

<55>
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Accession Number
366101495
Title
Drug, devices, technologies, and techniques for blood management in
minimally invasive and conventional cardiothoracic surgery: A Consensus
Statement from the International Society for Minimally Invasive
Cardiothoracic Surgery (ISMICS) 2011.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 7(4) (pp 229-241), 2012. Date of Publication: July-August 2012.
Author
Menkis A.H.; Martin J.; Cheng D.C.H.; Fitzgerald D.C.; Freedman J.J.; Gao
C.; Koster A.; MacKenzie G.S.; Murphy G.J.; Spiess B.; Ad N.
Institution
(Menkis) WRHA Cardiac Sciences Program, Department of Surgery, University
of Manitoba, Winnipeg, MB, Canada
(Martin, Cheng) Evidence-Based Perioperative Clinical Outcomes Research
(EPiCOR), Department of Anesthesia and Perioperative Medicine, Western
University, 339 Windermere Rd, London, ON N6A 5A5, Canada
(Fitzgerald) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(Freedman) Division of Hematology, Department of Medicine, St. Michael
Hospital, Toronto, ON, Canada
(Gao) Department of Cardiovascular Surgery, Minimally Invasive and Robotic
Cardiac Surgery Center, PLA General Hospital, Beijing, China
(Koster) Heart and Diabetes Center NRW, Bad Oeynhausen, Germany,
Ruhr-University, Bochum, Germany
(MacKenzie) Cardiac Anesthesia, WRHA/SBGH Cardiac Sciences Program,
Winnipeg, MB, Canada
(Murphy) Glenfield Hospital, University of Leicester, Leicester, United
Kingdom
(Spiess) Department of Anesthesiology, Virginia Commonwealth University,
Medical College of Virginia, Richmond VA, United States
(Ad) Cardiac Surgery, Inova Heart and Vascular Institute, Falls Church,
VA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVE: The objectives of this consensus conference were to evaluate
the evidence for the efficacy and safety of perioperative drugs,
technologies, and techniques in reducing allogeneic blood transfusion for
adults undergoing cardiac surgery and to develop evidence-based
recommendations for comprehensive perioperative blood management in
cardiac surgery, with emphasis on minimally invasive cardiac surgery.
 METHOD(S): The consensus panel short-listed the potential topics for
review from a comprehensive list of potential drugs, devices,
technologies, and techniques. The process of short-listing was based on
the need to prioritize and focus on the areas of highest importance to
surgeons, anesthesiologists, perfusionists, hematologists, and allied
health care involved in the management of patients who undergo cardiac
surgery whether through the conventional or minimally invasive approach.
MEDLINE, Cochrane Library, and Embase databases were searched from their
date of inception to May 2011, and supplemental hand searches were also
performed. Detailed methodology and search strategies are outlined in each
of the subsequently published systematic reviews. In general, all relevant
synonyms for drugs (antifibrinolytic, aprotinin, [Latin Small Letter Open
E]-aminocaproic acid, tranexamic acid [TA], desmopressin, anticoagulants,
heparin, antiplatelets, anti-Xa agents, adenosine diphosphate inhibitors,
acetylsalicylic acid [ASA], factor VIIa [FVIIa]), technologies (cell
salvage, miniaturized cardiopulmonary bypass (CPB) circuits, biocompatible
circuits, ultrafiltration), and techniques (transfusion thresholds,
minimally invasive cardiac or aortic surgery) were searched and combined
with terms for blood, red blood cells, fresh-frozen plasma, platelets,
transfusion, and allogeneic exposure. The American Heart
Association/American College of Cardiology system was used to label the
level of evidence and class of each recommendation. RESULTS AND
RECOMMENDATIONS: Database search identified more than 6900 articles, with
4423 full-text randomized controlled trials assessed for eligibility, and
the final 125 systematic reviews and meta-analyses were used in the
consensus conference. The results of the consensus conference, including
the evidence-based statements and the recommendations, are outlined in the
text, with references given for the relevant evidence that formed the
basis for the statements and recommendations. © 2012 by the
International Society for Minimally Invasive Cardiothoracic Surgery.

<56>
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Accession Number
365522665
Title
The efficacy of electromagnetic navigation to assist with computed
tomography-guided percutaneous thermal ablation of lung tumors.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 7(3) (pp 187-190), 2012. Date of Publication: May-June 2012.
Author
Narsule C.K.; Sales Dos Santos R.; Gupta A.; Ebright M.I.; Rivas R.; Daly
B.D.T.; Fernando H.C.
Institution
(Narsule, Ebright, Rivas, Daly, Fernando) Department of Cardiothoracic
Surgery, Boston University School of Medicine, 88 East Newton Street,
Robinson B-402, Boston, MA 02118, United States
(Sales Dos Santos) Department of Thoracic Surgery, Albert Einstein Israeli
Hospital, Sao Paulo, Brazil
(Gupta) Department of Radiology, Boston University School of Medicine,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVE: Electromagnetic (EM) navigation is increasingly used to assist
with bronchoscopic interventions such as biopsy or fiducial placement.
Electromagnetic navigation can also be a useful adjunct to computed
tomography (CT)-guided thermal ablation and biopsy of lung tumors. This
study compares procedures carried out using an EM navigation system (Veran
Medical Technologies Inc, St Louis, MO) with procedures using CT
fluoroscopy only. METHOD(S): Over a 23-month period, 17 patients
scheduled for thermal ablation were prospectively enrolled in this study.
The mean age was 72 years (range, 60-84 years). Seven patients were women.
Patients were randomized to EM navigation (n = 7) or CT fluoroscopy alone
(n = 10). In some cases, additional ablation or biopsies were performed
with or without EM navigation depending on the randomization arm. All
procedures were performed under general anesthesia either by a thoracic
surgeon or a radiologist. RESULT(S): A total of 23 procedures were
performed in 17 patients: 20 were ablation procedures and 3 were biopsies.
Fourteen were performed for non-small cell lung cancer, and 9 for
pulmonary metastases from other organs. Despite randomization, patients
receiving EM navigation had a trend for smaller tumors (mean diameter,
1.45 vs 2.90 cm; P = 0.06). For thermal ablation procedures, the time to
complete intervention was significantly less when EM navigation was used
(mean, 7.6 vs 19 minutes; P = 0.022). Although not statistically
significant, there were fewer skin punctures (mean, 1 vs 1.25; P = 0.082),
fewer adjustments (mean, 5.6 vs 11.8; P = 0.203), less CT fluoroscopy time
(mean, 21.3 vs 34.3 seconds; P = 0.345), and fewer CT scans (mean, 7 vs
15; P = 0.204) whenever EM navigation was used. CONCLUSION(S):
Electromagnetic navigation reduces the time to successfully place an
ablation probe in a target tumor. Further study is required to determine
whether EM navigation may also reduce the number of adjustments, skin
punctures, and CT scans as well as decrease CT fluoroscopy time. Copyright
© 2012 by the International Society for Minimally Invasive
Cardiothoracic Surgery.

<57>
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Accession Number
364825644
Title
The early inflammatory response in a mini-cardiopulmonary bypass system: A
prospective randomized study.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 7(1) (pp 23-32), 2012. Date of Publication: January-February
2012.
Author
Kiaii B.; Fox S.; Swinamer S.A.; Rayman R.; Higgins J.; Cleland A.;
Fernandes P.; MacDonald J.; Dobkowski W.B.; Stitt L.W.; Novick R.J.; Singh
B.; Bureau Y.; Summers K.
Institution
(Kiaii, Fox, Swinamer, Rayman, Higgins, Novick) Department of Surgery,
University of Western Ontario, University Hospital, 339 Windermere Road,
London, ON N6A 5A5, Canada
(Kiaii, Bureau, Summers) Lawson Health Research Institute, University of
Western Ontario, University Hospital, London, ON, Canada
(Cleland, Fernandes, MacDonald) Department of Clinical Perfusion Services
Medicine, University of Western Ontario, University Hospital, London, ON,
Canada
(Dobkowski) Department of Anesthesia and Perioperative, University of
Western Ontario, University Hospital, London, ON, Canada
(Stitt) Department of Epidemiology and Biostatistics, University of
Western Ontario, University Hospital, London, ON, Canada
(Singh, Summers) Department of Microbiology and Immunology, University of
Western Ontario, University Hospital, London, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVE: The aim of this study was to compare the early systemic
inflammatory response of the Resting Heart System (RHS; Medtronic,
Minneapolis, MN USA), a miniaturized cardiopulmonary bypass (CPB) system,
with two groups using a standard extracorporeal circulation system during
on-pump coronary artery bypass grafting (CABG) surgery. METHOD(S): A
total of 60 consecutive patients requiring CABG were prospectively
randomized to undergo on-pump CABG using conventional CPB without
cardiotomy suction (group A), conventional CPB with cardiotomy suction
(group B), or the RHS (group C). Blood samples were collected at five time
points: immediately before CPB, 30 minutes into CPB, immediately at the
end of CPB, 30 minutes post-CPB, and 1 hour post-CPB. Inflammation was
analyzed by changes in (a) levels of plasma proteins, including
inflammatory cytokines (interleukin-6 [IL-6], IL-10, and tumor necrosis
factor-alpha), chemokines (IL-8, monokine induced by interferon-gamma,
monocyte chemotactic protein-1, regulated on activation normal T cell
expressed and secreted, and interferon-inducible protein-10), and acute
phase proteins (C-reactive protein and complement protein 3); (b)
biochemical variables (cardiac troponin I, hematocrit, and immunoglobulin
G); and (c) cell numbers (leukocytes, neutrophils, and thrombocytes).
 RESULT(S): The RHS showed more delayed secretion of the cytokines
tumor necrosis factor-alpha and IL-10, chemokines monokine induced by
interferon-gamma (P < 0.001); IL-8, and interferon-inducible protein-10;
and complement protein 3 than conventional CPB systems did. Median
thrombocyte numbers were higher in the RHS group. Levels of cardiac
troponin I, monocyte chemotactic protein-1, and IL-6 were lower in both
the RHS and conventional CPB without suction than with suction. Levels of
C-reactive protein and regulated on activation normal T cell expressed and
secreted, plus leukocyte and neutrophil numbers, were similar in all
groups. CONCLUSION(S): The Medtronic RHS may induce less systemic
inflammation than conventional CPB systems, particularly when cardiotomy
suction was used, but it did not result in improved clinical benefit.
Copyright © 2012 by the International Society for Minimally Invasive
Cardiothoracic Surgery.

<58>
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Accession Number
364379011
Title
Pilot study of sternal plating for primary closure of the sternum in
cardiac surgical patients.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 6(6) (pp 382-388), 2011. Date of Publication: November-December
2011.
Author
Bennett-Guerrero E.; Phillips-Bute B.; Waweru P.M.; Gaca J.G.; Spann J.C.;
Milano C.A.
Institution
(Bennett-Guerrero) Perioperative Clinical Research, Duke Clinical Research
Institute, Duke University, Durham, NC 27710, United States
(Phillips-Bute, Waweru) Department of Anesthesiology, Duke University
Medical Center, Durham, NC, United States
(Gaca, Milano) Division of Cardiothoracic Surgery, Duke University Medical
Center, Durham, NC, United States
(Spann) Oklahoma Heart Institute, Hillcrest Medical Center, Tulsa, OK,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Postoperative sternal wound complications are a significant
problem in high-risk patients. In addition to closure with conventional
wires, several systems involving rigid fixation with metal plates are
currently available. The Rapid Sternal Closure System (Talon) is approved
for stabilization and fixation of the anterior chest wall. Anecdotal
evidence suggests that use of the Talon may result in improved
postoperative recovery. Method(s): Fifty-one cardiac surgical
patients at higher risk for sternal wound complications were enrolled at
two sites. Subjects were randomized to insertion of Talons (n = 28) or
wires only (control, n = 23) for sternal closure. The primary endpoint was
a comparison between study groups of the percent of baseline incentive
spirometry volume through postoperative day 7. Secondary endpoints
included other measures of quality of recovery, sternal wound infection,
and nonunion. Result(s): The percentage of preoperative incentive
spirometry volume achieved was higher in the Talon arm (67% +/- 32%)
versus control (58% +/- 24%); however, this was not statistically
significant (P = 0.41). Use of the Talon was associated with decreased use
of opiates (21.3 +/- 11.8 vs 25.4 +/- 21.6 mg, P = 0.44), increased
ability to ambulate 1000 ft on postoperative day 5 (25% vs 13%, P = 0.28),
and decreased duration of mechanical ventilation (median 0.5 vs 1.0 days,
P = 0.24) and hospital length of stay (4.5 +/- 3.2 vs 5.3 +/- 4.0 days, P
= 0.40). One superficial sternal wound infection was observed in each
study arm. There were no cases of nonunion. Conclusion(s): In this
pilot study, the primary endpoint was not statistically different between
the treatment groups. Use of the Talon was associated with trends toward
benefit in endpoints consistent with enhanced postoperative recovery,
highlighting a need for additional data from larger randomized trials.
Copyright © 2012 by the International Society for Minimally Invasive
Cardiothoracic Surgery.

<59>
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Accession Number
361697904
Title
Minimally invasive versus conventional open mitral valve surgery: A
meta-analysis and systematic review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 6(2) (pp 84-103), 2011. Date of Publication: March-April 2011.
Author
Cheng D.C.H.; Martin J.; Lal A.; Diegeler A.; Folliguet T.A.; Nifong L.W.;
Perier P.; Raanani E.; Smith J.M.; Seeburger J.; Falk V.
Institution
(Cheng, Martin, Lal) Department of Anesthesia and Perioperative Medicine,
Evidence-Based Perioperative Clinical Outcomes Research Group (EPiCOR),
University of Western Ontario, London, ON, Canada
(Martin) High Impact Technology Evaluation Centre, London Health Sciences
Centre, London, ON, Canada
(Diegeler, Perier) Division of Cardiothoracic Surgery, Herz-und Gefasse
Klinik Bad Neustadt, Bad Neustadt, Germany
(Folliguet) Departement de Pathologie Cardiaque, L'Institut Mutualiste
Montsouris, Paris, France
(Nifong) Department of Cardiothoracic Surgery, East Carolina University
School of Medicine, Greenville, NC, United States
(Raanani) Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
(Smith) Cardiac, Vascular and Thoracic Surgeons, Inc., Cincinnati, OH,
United States
(Seeburger) Klinik fur Herzchirurgie, Herzzentrum der Universitat Leipzig,
Leipzig, Germany
(Falk) Klinik fur Herz- und Gefasschirurgie, Universitatsspital Zurich,
Zurich, Switzerland
(Cheng) LHSC-University Hospital, 339 Windermere Road, C3-172, London, ON
N6A 5A5, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This meta-analysis sought to determine whether minimally
invasive mitral valve surgery (mini-MVS) improves clinical outcomes and
resource utilization compared with conventional open mitral valve surgery
(conv-MVS) in patients undergoing mitral valve repair or replacement.
 Method(s): A comprehensive search of MEDLINE, Cochrane Library,
EMBASE, CTSnet, and databases of abstracts was undertaken to identify all
randomized and nonrandomized studies up to March 2010 of mini-MVS through
thoracotomy versus conv-MVS through median sternotomy for mitral valve
repair or replacement. Outcomes of interest included death, stroke,
myocardial infarction, aortic dissection, need for reintervention, and any
other reported clinically relevant outcomes or indicator of resource
utilization. Relative risk and weighted mean differences and their 95%
confidence intervals were analyzed as appropriate using the random effects
model. Heterogeneity was measured using the I statistic. Result(s):
Thirty-five studies met the inclusion criteria (two randomized controlled
trials and 33 nonrandomized studies). The mortality rate after mini-MVS
versus conv-MVS was similar at 30 days (1.2% vs 1.5%), 1 year (0.9% vs
1.3%), 3 years (0.5% vs 0.5%), and 9 years (0% vs 3.7%). A number of
clinical outcomes were significantly improved with mini-MVS versus
conv-MVS including atrial fibrillation (18% vs 22%), chest tube drainage
(578 vs 871 mL), transfusions, sternal infection (0.04% vs 0.27%), time to
return to normal activity, and patient scar satisfaction. However, the
30-day risk of stroke (2.1% vs 1.2%), aortic dissection/injury (0.2% vs
0%), groin infection (2% vs 0%), and phrenic nerve palsy (3% vs 0%) were
significantly increased for mini-MVS versus conv-MVS. Other clinical
outcomes were similar between groups. Cross-clamp time, cardiopulmonary
bypass time, and procedure time were significantly increased with
mini-MVS; however, ventilation time and length of stay in intensive care
unit and hospital were reduced. Conclusion(s): Current evidence
suggests that mini-MVS maybe associated with decreased bleeding, blood
product transfusion, atrial fibrillation, sternal wound infection, scar
dissatisfaction, ventilation time, intensive care unit stay, hospital
length of stay, and reduced time to return to normal activity, without
detected adverse impact on long-term need for valvular reintervention and
survival beyond 1 year. However, these potential benefits for mini-MVS may
come with an increased risk of stroke, aortic dissection or aortic injury,
phrenic nerve palsy, groin infections/ complications, and increased
cross-clamp, cardiopulmonary bypass, and procedure time. Available
evidence is largely limited to retrospective comparisons of small cohorts
comparing mini-MVS versus conv-MVS that provide only short-term outcomes.
Given these limitations, randomized controlled trials with adequate power
and duration of follow-up to measure clinically relevant outcomes are
recommended to determine the balance of benefits and risks. Copyright
© 2011 by the International Society for Minimally Invasive
Cardiothoracic Surgery.

<60>
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Accession Number
361697902
Title
Minimally invasive versus open mitral valve surgery: A consensus statement
of the international society of minimally invasive coronary surgery
(ISMICS) 2010.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 6(2) (pp 66-76), 2011. Date of Publication: March-April 2011.
Author
Falk V.; Cheng D.C.H.; Martin J.; Diegeler A.; Folliguet T.A.; Nifong
L.W.; Perier P.; Raanani E.; Smith J.M.; Seeburger J.
Institution
(Falk) Klinik fur Herz- und Gefasschirurgie, Universitatsspital Zurich,
Ramistrasse 100, CH-8091 Zurich, Switzerland
(Cheng, Martin) Department of Anesthesia and Perioperative Medicine,
Evidence-Based Perioperative Clinical Outcomes Research Group (EPiCOR),
University of Western Ontario, London, ON, Canada
(Martin) High Impact Technology Evaluation Centre, London Health Sciences
Centre, London, ON, Canada
(Diegeler, Perier) Klinik fur Kardiochirurgie, Herz- und Gefas-Klinik
GmbH, Bad Neustadt, Germany
(Folliguet) Departement de Pathologie Cardiaque, L'Institut Mutualiste
Montsouris, Paris, France
(Nifong) Department of Cardiothoracic Surgery, East Carolina University
School of Medicine, Greenville, NC, United States
(Raanani) Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
(Smith) Cardiac, Vascular and Thoracic Surgeons, Inc., Cincinnati, OH,
United States
(Seeburger) Klinik fur Herzchirurgie, Herzzentrum der Universitat Leipzig,
Leipzig, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: The purpose of this consensus conference was to deliberate the
evidence regarding whether minimally invasive mitral valve surgery via
thoracotomy improves clinical and resource outcomes compared with
conventional open mitral valve surgery via median sternotomy in adults who
require surgical intervention for mitral valve disease. Method(s):
Before the consensus conference, the consensus panel reviewed the best
available evidence up to March 2010, whereby systematic reviews,
randomized trials, and nonrandomized trials were considered in descending
order of validity and importance. The accompanying meta-analysis article
in this issue of the Journal provides the systematic review of the
evidence. Based on this systematic review, evidence-based statements were
created for prespecified clinical questions, and consensus processes were
used to derive recommendations. The American Heart Association/American
College of Cardiology system was used to label the level of evidence and
class of each recommendation. Results and Conclusion(s): Considering
the underlying level of evidence, and notwithstanding the limitations of
the evidence base (retrospective studies with important differences in
baseline patient characteristics, which may produce bias in results of the
evidence syntheses), the consensus panel provided the following
evidence-based statements and overall recommendation:In patients with
mitral valve disease, minimally invasive surgery may be an alternative to
conventional mitral valve surgery (Class IIb), given that there was
comparable short-term and long-term mortality (level B), comparable
in-hospital morbidity (renal, pulmonary, cardiac complications, pain
perception, and readmissions) (level B), reduced sternal complications,
transfusions, postoperative atrial fibrillation, duration of ventilation,
and intensive care unit and hospital length of stay (level B). However,
this should be considered against the increased risk of stroke (2.1% vs
1.2%) (level B), aortic dissection (0.2% vs 0%) (level B), phrenic nerve
palsy (3% vs 0%) (level B), groin infections/complications (2% vs 0%)
(level B), and, prolonged cross-clamp time, cardiopulmonary bypass time,
and procedure time (level B). The available evidence consists almost
entirely of observational studies and must not be considered definitive
until future adequately controlled randomized trials further address the
risk of stroke, aortic complications, phrenic nerve complications, pain,
long-term survival, need for reintervention, quality of life, and
cost-effectiveness. Copyright © 2011 by the International Society for
Minimally Invasive Cardiothoracic Surgery.

<61>
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Accession Number
359464067
Title
Prospective, randomized study comparing two different minimized versus
conventional cardiopulmonary bypass systems.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 5(4) (pp 270-277), 2010. Date of Publication: July-August 2010.
Author
Schoenebeck J.; Haddad M.; Wegscheider K.; Joubert-Huebner E.;
Reichenspurner H.; Detter C.
Institution
(Schoenebeck, Joubert-Huebner, Reichenspurner, Detter) Department of
Cardiovascular Surgery, University Heart Center Hamburg, Martinistrasse
52, 20246 Hamburg, Germany
(Haddad) Departments of Clinical Chemistry, University of Hamburg,
Hamburg, Germany
(Wegscheider) Medical Biometry and Epidemiology, University of Hamburg,
Hamburg, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Conventional cardiopulmonary bypass (CCPB) is a major trigger
of inflammatory response. We aimed to assess the impact of two different
minimized cardiopulmonary bypass systems (mini-CPB) with and without
Bioline-coating compared with CCPB regarding organ function, inflammatory
response, and early clinical outcome. Method(s): In a prospective,
randomized study, 120 patients underwent elective coronary artery bypass
grafting and were randomized into three groups: mini-CPB using a
Bioline-coated (group A, n = 40) or an uncoated (group B, n = 40) circuit,
or CCPB (group C, n = 40). Cytokines (interleukin-6, interleukin-8, and
tumor necrosis factor-alpha), myocardial markers (creatine kinase [CK],
CK-MB, and troponin-T), hematocrit, and platelet counts were measured up
to 48 hours postoperatively. Early clinical outcome was assessed at 3
months postoperatively. Result(s): Demographics, number of distal
anastomoses, ventilation time, blood loss, intensive care unit, and
hospital stay were comparable (P = not significant). Extracorporeal
circulation and cross-clamp time were significantly longer in group A and
B versus C (P < 0.005). No significant differences could be found in the
release of interleukin-6, interleukin-8, and tumor necrosis factor-alpha
among groups. Myocardial markers were significantly reduced in group A and
B versus group C (P < 0.001). Hematocrit and platelet counts did not
differ among the groups. No differences could be found in early clinical
outcome up to 3 months. Conclusion(s): This study showed significant
better myocardial preservation with lower CK-MB and troponin-T levels in
both mini-CPB groups. No significant differences could be found in terms
of inflammation, hematologic effects, and early clinical outcome. ©
2010 by the International Society for Minimally Invasive Cardiothoracic
Surgery.

<62>
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Accession Number
359464066
Title
Endoscopic radial artery harvest produces equivalent and excellent midterm
patency compared with open harvest.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 5(4) (pp 265-269), 2010. Date of Publication: July-August 2010.
Author
Dimitrova K.R.; Hoffman D.M.; Geller C.M.; Decastro H.; Dienstag B.;
Tranbaugh R.F.
Institution
(Dimitrova, Hoffman, Geller, Decastro, Dienstag, Tranbaugh) Division of
Cardiac Surgery, Beth Israel Medical Center, 317 East 17th Street, New
York, NY 10003, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: A recent multicenter study reported reduced patency of
aortocoronary bypass grafts when the saphenous vein was harvested by
endoscopic technique compared with patency of vein grafted after harvest
by the traditional "open" approach. Our aim was to compare the patency
rates of radial artery graft (RAG) harvested endoscopically with those
harvested using an open technique. Method(s): Two cohorts were
identified: from January 1995 to January 2000, 724 consecutive patients
had one or both radial arteries harvested through an open technique, and
from February 2000 to January 2008, 727 consecutive patients had
endoscopic radial artery (RA) harvest. All patients who underwent
symptom-indicated angiography in our institution at any time after
coronary artery bypass grafting (CABG) surgery were identified.
 Result(s): Two hundred two patients had angiograms for symptoms: 90
of these patients (119 RAG) had open RA harvest and were studied 78.3 +/-
40 months (range, 1-156 months) after CABG. The other 112 patients (148
RAG) had endoscopic RA harvest and underwent angiography 36 +/- 24 months
(range, 1-96 months) after CABG. The two groups had identical demographics
and risk profiles. Overall patency of the "open" RAG was 78.9% versus
83.7% for the endoscopic group (P = 0.3). Patency increased to 90% in both
groups when the RAG was anastomosed to a native coronary vessel with
stenosis >80%. Conclusion(s): Endoscopic and open RA harvesting
techniques have equivalent and excellent midterm and long-term patency
rates in CABG patients studied by angiography for recurrent symptoms of
myocardial ischemia. The degree of stenosis of the target vessel strongly
influences the patency rate independent of the harvesting technique.
© 2010 by the International Society for Minimally Invasive
Cardiothoracic Surgery.

<63>
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Accession Number
358643761
Title
Surgical ablation for atrial fibrillation in cardiac surgery: A
meta-analysis and systematic review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 5(2) (pp 84-96), 2010. Date of Publication: March-April 2010.
Author
Cheng D.C.H.; Ad N.; Martin J.; Berglin E.E.; Chang B.-C.; Doukas G.;
Gammie J.S.; Nitta T.; Wolf R.K.; Puskas J.D.
Institution
(Cheng, Martin) Department of Anesthesia and Perioperative Medicine,
Evidence-Based Perioperative Clinical Outcomes Research Group (EPiCOR),
University of Western Ontario, London, ON, Canada
(Ad) Department of Cardiac Surgery, Inova Heart and Vascular Institute,
Falls Church, VA, United States
(Martin) High Impact Technology Evaluation Centre, London Health Sciences
Centre, London, ON, Canada
(Berglin) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Goteborg, Sweden
(Chang) Department of Cardiac Surgery, Yonsei University College of
Medicine, Seoul, South Korea
(Doukas) Department of Cardiothoracic Surgery, Glenfield Hospital,
Leicester, United Kingdom
(Gammie) Division of Cardiac Surgery, University of Maryland, School of
Medicine, Baltimore, MD, United States
(Nitta) Department of Cardiac Surgery, Nippon Medical School Main
Hospital, Tokyo, Japan
(Wolf) Deaconess Hospital, Cincinnati, OH, United States
(Puskas) Division of Cardiothoracic Surgery, Emory University, Atlanta,
GA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES:: This meta-analysis sought to determine whether surgical
ablation improves clinical outcomes and resource utilization compared with
no ablation in adult patients with persistent and permanent atrial
fibrillation (AF) undergoing cardiac surgery. METHOD(S):: A
comprehensive search was undertaken to identify all randomized (RCT) and
nonrandomized (non-RCT) controlled trials of surgical ablation versus no
ablation in patients with AF undergoing cardiac surgery up to April 2009.
The primary outcome was sinus rhythm. Secondary outcomes included survival
and any other reported clinically relevant outcome or indicator of
resource utilization. Odds ratios (OR) and weighted mean differences (WMD)
and their 95% confidence intervals (95% CI) were analyzed as appropriate
using the random effects model. Heterogeneity was measured using the I
statistic. Meta-regression was performed to explore the relationship
between the benefit from surgical AF and duration of follow-up.
 RESULT(S):: Thirty-three studies met the inclusion criteria (10 RCTs
and 23 non-RCTs) for a total of 4647 patients. The number of patients in
sinus rhythm was significantly improved at discharge in the surgical AF
ablation group versus (68.6%) the surgery alone group (23.0%) in RCTs (OR
10.1, 95% CI 4.5-22.5) and non-RCTs (OR 7.15, 95% CI 3.42-14.95). This
effect on sinus rhythm (74.6% vs. 18.4%) remained at follow-up of 1 to 5
years (OR 6.7, 95% CI 2.8-15.7 for RCT, and OR 15.5, 95% CI 6.6-36.7 for
non-RCT). The risk of all-cause mortality at 30 days was not different
between the groups in RCT (OR 1.20, 95% CI 0.52-3.16) or non-RCT studies
(OR 0.99, 95% CI 0.52-1.87). In studies reporting all-cause mortality at 1
year or more (up to 5 years), mortality did not differ in RCT studies (OR
1.21, 95% CI 0.59-2.51) but was significantly reduced in non-RCT studies
(OR 0.54, 95% CI 0.31-0.96). Stroke incidence was not reduced
significantly; however, in meta-regression, the risk of stroke decreased
significantly with longer follow-up. Other clinical outcomes were similar
between groups. Operation time was significantly increased with surgical
AF ablation; however, overall impact on length of stay was variable.
 CONCLUSION(S):: In patients with persistent or permanent AF who
present for cardiac surgery, the addition of surgical AF ablation led to a
significantly higher rate of sinus rhythm in RCT and non-RCT studies
compared with cardiac surgery alone, and this effect remains robust over
the longer term (1-5 years). Although non-RCT studies suggest the
possibility of reduced risk of stroke and death, this remains to be proven
in prospective RCTs with adequate power and follow-up. Copyright ©
2010 by the International Society for Minimally Invasive Cardiothoracic
Surgery.

<64>
[Use Link to view the full text]
Accession Number
355375638
Title
The effect of combined clopidogrel and aspirin therapy after off-pump
coronary surgery: A pilot study.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 4(5) (pp 265-268), 2009. Date of Publication: September-October
2009.
Author
Mujanovic E.; Nurkic M.; Caluk J.; Terzic I.; Kabil E.; Bergsland J.
Institution
(Mujanovic, Nurkic, Caluk, Terzic, Kabil, Bergsland) Cardiovascular
Clinic, University Clinical Medical Center, Tuzla, Bosnia and Herzegovina
(Mujanovic, Caluk, Terzic, Kabil, Bergsland) BH Heart Center Tuzla, Tuzla,
Bosnia and Herzegovina
(Mujanovic, Nurkic, Caluk, Terzic, Kabil) Tuzla University, Tuzla, Bosnia
and Herzegovina
(Bergsland) Interventional Centre, Rikshospitalet, Oslo, 0027, Norway
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVE: The purpose of this randomized study was to evaluate the effect
on graft patency by adding clopidogrel to aspirin in off-pump coronary
artery bypass (OPCAB) grafting and the possible side effects of such
therapy. METHOD(S): Twenty patients who underwent standard OPCAB
through median sternotomy were randomized immediately after surgery in two
groups. Patients in group A (n = 10) received 100 mg of aspirin starting
preoperatively, continuing indefinitely. Patients in group B received 100
mg of aspirin and, in addition, 75 mg of clopidogrel starting immediately
after the operation and for 3 months. Postoperative bleeding and other
perioperative parameters were compared. Angiography was repeated 3 months
after surgery to determine the patency and quality of grafts.
 RESULT(S): Preoperative risk factors were similar in the two groups.
There was no significant difference in average number of distal
anastomosis (P = 0.572), operation time (P = 0.686), postoperative
bleeding (P = 0.256), ventilation time (P = 0.635), and intensive care
unit stay (P = 0.065). Length of stay was shorter in group B (P = 0.024).
There was no postoperative complication in either groups. Eight of 27
grafts in group A and 2 of 29 grafts in group B (P = 0.037) were occluded
at the time of control angiography. CONCLUSION(S): Early
administration of a combined regimen of clopidogrel and aspirin after
OPCAB grafting is not associated with increased postoperative bleeding or
other major complications. Despite the small number of patients in this
study and small number of examined grafts, the results suggest that the
addition of clopidogrel may increase graft patency after OPCAB grafting.
Copyright © 2009 by the International Society for Minimally Invasive
Cardiothoracic Surgery.

<65>
[Use Link to view the full text]
Accession Number
355297677
Title
Stentless versus stented bioprosthetic aortic valves: A systematic review
and meta-analysis of controlled trials.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 4(2) (pp 61-73), 2009. Date of Publication: March-April 2009.
Author
Cheng D.; Pepper J.; Martin J.; Stanbridge R.; Ferdinand F.D.; Jamieson
W.R.E.; Stelzer P.; Berg G.; Sani G.
Institution
(Cheng) Department of Anesthesia and Perioperative Medicine, London Health
Sciences Centre, The University of Western Ontario, London, ON, Canada
(Pepper) Department of Cardiothoracic Surgery, Imperial College, Royal
Brompton Hospital, London, United Kingdom
(Martin) High Impact Technology Evaluation Centre, London Health Sciences
Centre, London, ON, Canada
(Stanbridge) Department of Cardiothoracic Surgery, St. Mary's Hospital,
London, United Kingdom
(Ferdinand) Division of Thoracic and Cardiovascular Surgery, The Lankenau
Hospital, Wynnewood, PA, United States
(Jamieson) Division of Cardiovascular Surgery, St. Paul's Hospital,
University of British Columbia, Vancouver, BC, Canada
(Stelzer) Department of Cardiothoracic Surgery, Mount Sinai Medical
Center, Mount Sinai School of Medicine, NY, United States
(Berg) Golden Jubilee National Hospital, Clydebank, United Kingdom
(Sani) Department of Surgery, Siena University School of Medicine, Siena,
Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This meta-analysis sought to determine whether stentless
bioprosthetic valves improve clinical and resource outcomes compared with
stented valves in patients undergoing aortic valve replacement.
 Method(s): A comprehensive search was undertaken to identify all
randomized and nonrandomized controlled trials comparing stent-less to
stented bioprosthetic valves in patients undergoing aortic valve
replacement available up to March 2008. The primary outcomes were clinical
and resource outcomes in randomized controlled trial (RCT). Secondary
outcomes clinical and resource outcomes in nonrandomized controlled trial
(non-RCT). Odds ratios (OR), weighted mean differences (WMD), or
standardized mean differences and their 95% confidence intervals (CI) were
analyzed as appropriate. Accepted for publication February 15, 2009.
 Result(s): Seventeen RCTs published in 23 articles involving 1317
patients, and 14 non-RCTs published in 18 articles involving 2485 patients
were included in the meta-analysis. For the primary analysis of randomized
trials, mortality for stentless versus stented valve groups did not differ
at 30 days (OR 1.36, 95% CI 0.68-2.72), 1 year (OR 1.01, 95% CI
0.55-1.85), or 2 to 10 years follow-up (OR 0.82, 95% CI 0.50-1.33).
Aggregate event rates for all-cause mortality at 30 days were 3.7% versus
2.9%, at 1 year were 5.5% versus 5.9% and at 2 to 10 years were 17% versus
19% for stentless versus stented valve groups, respectively. Stroke or
neurologic complications did not differ between stentless (3.6%) and
stented (4.0%) valve groups. Risk of prosthesis-patient mismatch was
numerically lower in the stentless group (11.0% vs. 31.3%, OR 0.30, 95% CI
0.05-1.66), but this parameter was reported in few trials and did not
reach statistical significance. Effective orifice area index was
significantly greater for stentless aortic valve compared with stented
valves at 30 days (WMD 0.12 cm2/m2), at 2 to 6 months (WMD 0.15 cm2/m2),
and at 1 year (WMD 0.26 cm2/m2). Mean gradient at 1 month was
significantly lower in the stentless valve group (WMD -6 mm Hg), at 2 to 6
month follow-up (WMD -4 mm Hg,), at 1 year follow-up (WMD -3 mm Hg) and up
to 3 year follow-up (WMD - 3 mm Hg) compared with the stented valve group.
Although the left ventricular mass index was generally lower in the
stentless group versus the stented valve group, the aggregate estimates of
mean difference did not reach significance during any time period of
follow-up (1 month, 2-6 months, 1 year, and 8 years). Conclusion(s):
Evidence from randomized trials shows that subcoro-nary stentless aortic
valves improve hemodynamic parameters of effective orifice area index,
mean gradient, and peak gradient over the short and long term. These
improvements have not led to proven impact on patient morbidity,
mortality, and resource-related outcomes; however, few trials reported on
clinical outcomes beyond 1 year and definitive conclusions are not
possible until sufficient evidence addresses longer-term effects.
Copyright © 2009 by the International Society for Minimally Invasive
Cardiothoracic Surgery.

<66>
Accession Number
2013353695
Title
Myocardial protective and anti-inflammatory effects of dexmedetomidine in
patients undergoing cardiovascular surgery with cardiopulmonary bypass: a
systematic review and meta-analysis.
Source
Journal of Anesthesia. 36(1) (pp 5-16), 2022. Date of Publication:
February 2022.
Author
Chen M.; Li X.; Mu G.
Institution
(Chen, Li) Department of Anesthesiology, Shehong People's Hospital, NO.
19, Guanghan road, Sichuan, Shehong 629200, China
(Mu) Department of Anesthesiology, Zigong Fourth People's Hospital,
Sichuan, Zigong, China
Publisher
Springer Japan
Abstract
Cardiopulmonary bypass (CPB) technology provides potential for cardiac
surgery, but it is followed by myocardial injury and inflammation related
to ischemia-reperfusion. This meta-analysis aimed to systematically
evaluate the cardioprotective effect of dexmedetomidine on cardiac surgery
under CPB and its effect on accompanied inflammation. PubMed, Cochrane
Library, EMBASE and Web of Science databases were comprehensively searched
for all randomized controlled trials (RCTs) published before April 1st,
2021 that explored the application of dexmedetomidine in cardiac surgery.
Compared with the control group (group C), the concentrations of CK-MB in
the perioperative period and cTn-I at 12 h and 24 h after operation in
dexmedetomidine group (group D) were significantly decreased (P < 0.05).
In addition, in group D, the levels of interleukin-6 at 24 h after
operation, tumor necrosis factor-a at the 12 h and 24 h after operation
were significantly decreased (P < 0.05). At the same time, the length of
Intensive Care Unit stay in group D was significantly shorter than group C
(P < 0.05). However, there was no significant difference in interleukin-10
level, C reactive protein level, the time on ventilator and length of
hospital stay between the two groups (P > 0.05). The application of
dexmedetomidine in cardiac surgery with CPB can reduce CK-MB and cTn-I
concentration and interleukin-6, tumor necrosis factor-alpha levels to a
certain extent and shorten the length of Intensive Care Unit stay, but it
has no significant effect on IL-10 level, C reactive protein level, the
time on ventilator and length of hospital stay. Copyright © 2021,
Japanese Society of Anesthesiologists.

<67>
Accession Number
2013280393
Title
The Cost Implications of Dabigatran in Patients with Myocardial Injury
After Non-Cardiac Surgery.
Source
American Journal of Cardiovascular Drugs. 22(1) (pp 83-91), 2022. Date of
Publication: January 2022.
Author
Lamy A.; Tong W.; Mian R.; Vincent J.; Szczeklik W.; Biccard B.M.; Duceppe
E.; Franzosi M.G.; Srinathan S.K.; Meyhoff C.S.; Parlow J.; Xavier D.;
Devereaux P.J.
Institution
(Lamy) Population Health Research Institute, McMaster University, DBCVSRI
C1-112, 237 Barton St East, Hamilton, ON L8L 2X2, Canada
(Lamy) CADENCE Research Group, Hamilton Health Sciences, Hamilton, ON,
Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Lamy) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Tong, Mian, Vincent) Population Health Research Institute, Hamilton, ON,
Canada
(Szczeklik) Department of Intensive Care and Perioperative Medicine,
Jagiellonian University Medical College, Krakow, Poland
(Biccard) Department of Anaesthesia and Perioperative Medicine, Groote
Schuur Hospital and University of Cape Town, Cape Town, South Africa
(Duceppe) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Duceppe) Department of Medicine, University of Montreal, Montreal, QC,
Canada
(Franzosi) Department of Cardiovascular Research, IRCCS Istituto di
Ricerche Farmacologiche Mario Negri, Milan, Italy
(Srinathan) Department of Surgery, University of Manitoba, Winnipeg, MB,
Canada
(Meyhoff) Department of Anaesthesia and Intensive Care, Bispebjerg and
Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
(Parlow) Department of Anesthesiology and Perioperative Medicine, Queen's
University, Kingston, ON, Canada
(Xavier) Department of Pharmacology, St John's Medical College and
Research Institute, Bangalore, India
(Devereaux) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Devereaux) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Devereaux) Population Health Research Institute, Hamilton, ON, Canada
Publisher
Adis
Abstract
Background: The Management of Myocardial Injury after Non-Cardiac Surgery
(MANAGE) trial demonstrated that dabigatran 110 mg twice daily was more
effective than placebo in preventing the primary composite outcome of
vascular mortality, non-fatal myocardial infarction, non-hemorrhagic
stroke, peripheral arterial thrombosis, amputation and symptomatic venous
thromboembolism in patients with myocardial injury after non-cardiac
surgery (MINS). The cost implications of dabigatran for this population
are unknown but are important given the significant clinical implications.
 Method(s): Hospitalized events, procedures, and study and non-study
medications were documented. We applied Canadian unit costs to healthcare
resources consumed for all patients in the trial, and calculated the
average cost per patient in Canadian dollars for the duration of the study
(median follow-up of 16 months). A sensitivity analysis was performed
using only Canadian patients, and subgroup analyses were also conducted.
 Result(s): The total study cost for the dabigatran group was $9985
per patient, compared with $10,082 for placebo, a difference of - $97 (95%
confidence interval [CI] - $2128 to $3672). Savings arising from fewer
clinical events and procedures in the dabigatran 110 mg twice-daily group
were enough to offset the cost of the study drug. In Canadian patients,
the difference was $250 (95% CI -$2848 to $4840). Both differences were
considered cost neutral. Dabigatran 110 mg twice daily was cost saving or
cost neutral in many subgroups that were considered. Conclusion(s):
Dabigatran 110 mg twice daily was cost neutral for patients in the MANAGE
trial. Our cost findings support the use of dabigatran 110 mg twice daily
in patients with MINS. Trial Registration: ClinicalTrials.gov identifier
number NCT01661101. Copyright © 2021, The Author(s), under
exclusive licence to Springer Nature Switzerland AG.

<68>
Accession Number
2014763658
Title
Hematinic and Iron Optimization in Peri-operative Anemia and Iron
Deficiency.
Source
Current Anesthesiology Reports. 12(1) (pp 65-77), 2022. Date of
Publication: March 2022.
Author
Miles L.F.; Richards T.
Institution
(Miles) Department of Critical Care, Faculty of Medicine, Dentistry and
Health Sciences, The University of Melbourne, Melbourne, Australia
(Miles) Department of Anaesthesia, Austin Health, Melbourne, Australia
(Miles, Richards) Division of Surgery, Faculty of Health and Medical
Science, The University of Western Australia, Perth, Australia
Publisher
Springer
Abstract
Purpose of Review: Preoperative anemia is independently associated with
worse postoperative outcomes following cardiac and noncardiac surgery.
This article explores the current understanding of perioperative anemia
and iron deficiency with reference to definition, diagnosis, and
treatment. Recent Findings: Iron deficiency is the most common cause of
anemia. It can arise from reduced iron intake, poor absorption, or excess
iron loss. Inflammation throughout the preoperative period can drive iron
sequestration, leading to a functional deficiency of iron and the
development of what was referred to until recently as the "anemia of
chronic disease." Current best practice guidance supports the routine
administration of preoperative intravenous iron to treat anemia despite
limited evidence. This "one size fits all" approach has been called into
question following results from a recent large, randomized trial (the
PREVENTT trial) that assessed the use of a single dose of intravenous iron
compared to placebo 10-42 days before major abdominal surgery. Although
there were no improvements in patient-centered outcomes apparent during
the initial hospital stay, secondary endpoints of this trial suggested
there may be some late benefit after discharge from the hospital (8 weeks
postoperatively). This trial raises questions on (1) the mechanisms of
iron deficiency in the perioperative patient; (2) the need to reassess our
opinions on generic anemia management; and (3) the need to address patient
outcomes after discharge from hospital. Summary: Despite the known
associations between preoperative anemia (particularly iron deficiency
anemia) and poor postoperative outcome, recent evidence suggests that
administering intravenous iron relatively close to surgery does not yield
a tangible short-term benefit. This is made more complex by the interplay
between iron and innate immunity. Iron deficiency irrespective of
hemoglobin concentration may also impact postoperative outcomes.
Therefore, further research into associations between iron deficiency and
postoperative outcomes, and between postoperative anemia, delayed outcomes
(hospital readmission), and the efficacy of postoperative intravenous iron
is required. Copyright © 2022, The Author(s).

<69>
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.

<70>
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.

<71>
Accession Number
637692386
Title
Diagnostic validity and clinical utility of genetic testing for
hypertrophic cardiomyopathy: A systematic review and meta-Analysis.
Source
Open Heart. 9(1) (no pagination), 2022. Article Number: e001815. Date of
Publication: 06 Apr 2022.
Author
Christian S.; Cirino A.; Hansen B.; Harris S.; Murad A.M.; Natoli J.L.;
Malinowski J.; Kelly M.A.
Institution
(Christian) Department of Medical Genetics, University of Alberta,
Edmonton, AB, Canada
(Cirino) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
(Cirino) MGH Institute of Health Professions, Boston, MA, United States
(Hansen) Center for Personalized Genetic Healthcare, Cleveland Clinic,
Cleveland, OH, United States
(Harris) Cardiology Division, Cardiovascular Genetics Program,
Massachusetts General Hospital, Boston, MA, United States
(Murad) Division of Genetic Medicine, Department of Internal Medicine,
University of Michigan Hospitals and Health Centers, Ann Arbor, MI, United
States
(Natoli) Kaiser Permanente, Southern California Permanente Medical Group,
Pasadena, CA, United States
(Malinowski) Write Inscite, South Salem, NY, United States
(Kelly) Genomic Medicine Institute, Danville, PA, United States
Publisher
BMJ Publishing Group
Abstract
Objective This study summarises the diagnostic validity and clinical
utility of genetic testing for patients with hypertrophic cardiomyopathy
(HCM) and their at-risk relatives. Methods A systematic search was
performed in PubMed (MEDLINE), Embase, CINAHL and Cochrane Central Library
databases from inception through 2 March 2020. Subgroup and sensitivity
analyses were prespecified for individual sarcomere genes,
presence/absence of pathogenic variants, paediatric and adult cohorts,
family history, inclusion of probands, and variant classification method.
Study quality was assessed using the Newcastle-Ottawa tool. Results A
total of 132 articles met inclusion criteria. The detection rate based on
pathogenic and likely pathogenic variants was significantly higher in
paediatric cohorts compared with adults (56% vs 42%; p=0.01) and in adults
with a family history compared with sporadic cases (59% vs 33%; p=0.005).
When studies applied current, improved, variant interpretation standards,
the adult detection rate significantly decreased from 42% to 33%
(p=0.0001) because less variants met criteria to be considered pathogenic.
The mean difference in age-of-onset in adults was significantly earlier
for genotype-positive versus genotype-negative cohorts (8.3 years;
p<0.0001), MYH7 versus MYBPC3 cohorts (8.2 years; p<0.0001) and
individuals with multiple versus single variants (7.0 years; p<0.0002).
Overall, disease penetrance in adult cohorts was 62%, but differed
significantly depending on if probands were included or excluded (73% vs
55%; p=0.003). Conclusions This systematic review and meta-Analysis is the
first, to our knowledge, to collectively quantify historical
understandings of detection rate, genotype-phenotype associations and
disease penetrance for HCM, while providing the answers to important
routine clinical questions and highlighting key areas for future
study. Copyright ©

<72>
[Use Link to view the full text]
Accession Number
2016121796
Title
Hemodynamic Responses to Crystalloid and Colloid Fluid Boluses during
Noncardiac Surgery.
Source
Anesthesiology. 136(1) (pp 127-137), 2022. Date of Publication: 01 Jan
2022.
Author
Reiterer C.; Kabon B.; Halvorson S.; Sessler D.I.; Mascha E.J.; Kurz A.;
Maheshwari K.; Kot M.; Kopyeva T.; Naylor A.; Podolyak A.; Yang D.;
Fleischmann E.; Zotti O.M.; Obradovic M.; Luf F.; Muehlbacher J.; Sljivic
S.; Bayoumi A.; Marschalek C.; Eredics K.; Taschner A.
Institution
(Reiterer, Kabon) Department of Anesthesia, General Intensive Care
Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
(Halvorson, Mascha) Departments of Quantitative Health Sciences and
Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
(Sessler, Kurz) Departments of Outcomes Research and General
Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH,
United States
(Kurz) Department of Anesthesia, Emergency and General Intensive Care
Medicine, Medical University of Graz, Graz, Austria
(Reiterer, Kabon) Outcomes Research Consortium, Cleveland, OH, United
States
(Halvorson, Maheshwari, Kot, Kopyeva, Naylor, Podolyak, Yang) Cleveland
Clinic, Cleveland, OH, United States
(Fleischmann, Zotti, Obradovic, Luf, Muehlbacher, Sljivic, Bayoumi,
Marschalek, Eredics, Taschner) Medical University of Vienna, Vienna,
Austria
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Colloids are thought to sustain blood pressure and cardiac
index better than crystalloids. However, the relative effects of
intraoperative hydroxyethyl starch and crystalloid administration on the
cardiac index and blood pressure remain unclear. This study therefore
tested in this subanalysis of a previously published large randomized
trial the hypothesis that intraoperative goal-directed colloid
administration increases the cardiac index more than goal-directed
crystalloid administration. Further, the effects of crystalloid and
colloid boluses on blood pressure were evaluated. Method(s): This
planned subanalysis of a previous trial analyzed data from 973 patients,
of whom 480 were randomized to colloids and 493 were randomized to
crystalloids. Fluid administration was guided by esophageal Doppler. The
primary outcome was the time-weighted average cardiac index during surgery
between the colloid and crystalloid group. The secondary outcomes were the
cardiac index just after bolus administration, time elapsed between
boluses, and the average real variability during surgery. The study
recorded cardiac index, corrected flow time, and blood pressure at 10-min
intervals, as well as before and after each bolus. Result(s):
Time-weighted average of cardiac index over the duration of anesthesia was
only slightly greater in patients given colloid than crystalloid, with the
difference being just 0.20 l . min-1. m-2(95% CI,
0.11 to 0.29; P < 0.001). However, the hazard for needing additional
boluses was lower after colloid administration (hazard ratio [95% CI],
0.60 [0.55 to 0.66]; P < 0.001) in a frailty time-to-event model
accounting for within-subject correlation. The median [quartiles] number
of boluses per patient was 4 [2, 6] for colloids and 6 [3, 8] for
crystalloids, with a median difference (95% CI) of -1.5 (-2 to -1; P <
0.001). The average real mean arterial pressure variability did not differ
significantly between the groups (difference in means [95% CI] of -0.03
(-0.07 to 0.02) mmHg, P = 0.229). Conclusion(s): There were not
clinically meaningful differences in the cardiac index or mean pressure
variability in patients given goal-directed colloid and crystalloids. As
might be expected from longer intravascular dwell time, the interval
between boluses was longer with colloids. However, on a case basis, the
number of boluses differed only slightly. Colloids do not appear to
provide substantial hemodynamic benefit. Copyright © 2022
Lippincott Williams and Wilkins. All rights reserved.

<73>
Accession Number
2015987644
Title
Prehabilitation in adult patients undergoing surgery: an umbrella review
of systematic reviews.
Source
British Journal of Anaesthesia. 128(2) (pp 244-257), 2022. Date of
Publication: February 2022.
Author
McIsaac D.I.; Gill M.; Boland L.; Hutton B.; Branje K.; Shaw J.;
Grudzinski A.L.; Barone N.; Gillis C.; Akhtar S.; Atkins M.; Aucoin S.;
Auer R.; Basualdo-Hammond C.; Beaule P.; Brindle M.; Bittner H.; Bryson
G.; Carli F.; Eskander A.; Fata P.; Fergusson D.; Fiore J.; Forster A.;
Gillam M.; Gramlich L.; Holroyd-Leduc J.; Jackson T.; Jacobsohn E.;
Khadaroo R.; Lalu M.; Love C.; Martel G.; McCartney C.; McKeen D.;
Meliambro A.; Moloo H.; Moore R.; Muscedere J.; Nantel J.; Poitras S.;
Scheede-Bergdahl C.; Taljaard M.; Wallace T.; Wijeysundera D.
Institution
(McIsaac, Hutton, Branje, Shaw, Grudzinski) Department of Anesthesiology
and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
(McIsaac, Branje, Shaw) Clinical Epidemiology Program, Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(McIsaac, Hutton) School of Epidemiology and Public Health, University of
Ottawa, Ottawa, ON, Canada
(Gill) Patient and Community Engagement Research Program, University of
Calgary, Calgary, AB, Canada
(Boland) Centre for Practice-Changing Research, Ottawa Hospital Research
Institute, Ottawa, ON, Canada
(Barone) Department of Medicine, McGill University, Montreal, QC, Canada
(Gillis) Department of Anesthesia, McGill University, Montreal, QC, Canada
(Akhtar) Yale University, School of Medicine, New Haven, United States
(Atkins, Basualdo-Hammond, Gillam, Holroyd-Leduc, Moore) Alberta Health
Services, Edmonton, Canada
(Aucoin, Bryson, McCartney) The Ottawa Hospital, Department of
Anesthesiology and Pain Medicine, Ottawa, Canada
(Auer, Moloo) The Ottawa Hospital, Department of Surgery, Ottawa, Canada
(Beaule) University of Ottawa, Department of Surgery, Ottawa, Canada
(Bittner, Love) The Ottawa Hospital, Ottawa, Canada
(Brindle) The University of Calgary, Calgary, Canada
(Carli) McGill University, Department of Anesthesiology, Montreal, Canada
(Eskander) Sunnybrook Hospital, Toronto, Canada
(Fata, Fiore) McGill University, Division of General Surgery, Montreal,
Canada
(Fergusson, Forster, Lalu, Martel, Taljaard) Ottawa Hospital Research
Institute, Clinical Epidemiology Program, Ottawa, Canada
(Gramlich) University of Alberta, Edmonton, Canada
(Jackson) University Health Network, Toronto, Canada
(Jacobsohn) University of Manitoba, Faculty of Medicine, Winnipeg, Canada
(Khadaroo) University of Alberta, Department of Surgery, Edmonton, Canada
(McKeen) Memorial University of Newfoundland, St. John's, Canada
(Meliambro) Carleton University, Ottawa, Canada
(Muscedere) Kingston General Hospital, Department of Critical Care,
Kingston, Canada
(Nantel, Poitras) University of Ottawa, Faculty of Health Sciences,
Ottawa, Canada
(Scheede-Bergdahl) Montreal General Hospital, Department of
Anesthesiology, Montreal, Canada
(Wallace) University of British Columbia, Department of Surgery, Kamloops,
Canada
(Wijeysundera) St. Michael's Hospital, Department of Anesthesia, Toronto,
Canada
Publisher
Elsevier Ltd
Abstract
Background: The certainty that prehabilitation improves postoperative
outcomes is not clear. The objective of this umbrella review (i.e.
systematic review of systematic reviews) was to synthesise and evaluate
evidence for prehabilitation in improving health, experience, or cost
outcomes. Method(s): We performed an umbrella review of
prehabilitation systematic reviews. MEDLINE, Embase, Cochrane, Cumulative
Index to Nursing and Allied Health Literature, PsycINFO, Joanna Briggs
Institute's database, and Web of Science were searched (inception to
October 20, 2020). We included all systematic reviews of elective, adult
patients undergoing surgery and exposed to a prehabilitation intervention,
where health, experience, or cost outcomes were reported. Evidence
certainty was assessed using Grading of Recommendations Assessment,
Development and Evaluation. Primary syntheses of any prehabilitation were
stratified by surgery type. Result(s): From 1412 titles, 55
systematic reviews were included. For patients with cancer undergoing
surgery who participate in any prehabilitation, moderate certainty
evidence supports improvements in functional recovery. Low to very low
certainty evidence supports reductions in complications (mixed,
cardiovascular, and cancer surgery), non-home discharge (orthopaedic
surgery), and length of stay (mixed, cardiovascular, and cancer surgery).
There was low to very low certainty evidence that exercise prehabilitation
reduces the risk of complications, non-home discharge, and length of stay.
There was low to very low certainty evidence that nutritional
prehabilitation reduces risk of complications, mortality, and length of
stay. Conclusion(s): Low certainty evidence suggests that
prehabilitation may improve postoperative outcomes. Future low risk of
bias, randomised trials, synthesised using recommended standards, are
required to inform practice. Optimal patient selection, intervention
design, and intervention duration must also be determined. Copyright
© 2021 British Journal of Anaesthesia

<74>
[Use Link to view the full text]
Accession Number
2015123624
Title
Intrathecal Morphine for Analgesia in Minimally Invasive Cardiac Surgery:
A Randomized, Placebo-controlled, Double-blinded Clinical Trial.
Source
Anesthesiology. 135(5) (pp 864-876), 2021. Date of Publication: 01 Nov
2021.
Author
Dhawan R.; Daubenspeck D.; Wroblewski K.E.; Harrison J.-H.; McCrorey M.;
Balkhy H.H.; Chaney M.A.
Institution
(Dhawan, Daubenspeck, Chaney) The Department of Anesthesia and Critical
Care, University of Chicago Medicine, Chicago, IL, United States
(McCrorey, Balkhy) Department of Cardiothoracic Surgery, University of
Chicago Medicine, Chicago, IL, United States
(Wroblewski) The Department of Public Health Sciences, University of
Chicago, Chicago, IL, United States
(Harrison) The Department of Anesthesiology, University of Wisconsin
School of Medicine and Public Health, Madison, WI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Intrathecal morphine decreases postoperative pain in standard
cardiac surgery. Its safety and effectiveness have not been adequately
evaluated in minimally invasive cardiac surgery. The authors hypothesized
that intrathecal morphine would decrease postoperative morphine
consumption after minimally invasive cardiac surgery. Method(s): In
this randomized, placebo-controlled, double-blinded clinical trial,
patients undergoing robotic totally endoscopic coronary artery bypass
received either intrathecal morphine (5 mcg/kg) or intrathecal saline
before surgery. The primary outcome was postoperative morphine equivalent
consumption in the first 24 h after surgery; secondary outcomes included
pain scores, side effects, and patient satisfaction. Pain was assessed via
visual analog scale at 1, 2, 6, 12, 24, and 48 h after intensive care unit
arrival. Opioid-related side effects (nausea/vomiting, pruritus, urinary
retention, respiratory depression) were assessed daily. Patient
satisfaction was evaluated with the Revised American Pain Society Outcome
Questionnaire. Result(s): Seventy-nine patients were randomized to
receive intrathecal morphine (n = 37) or intrathecal placebo (n = 42),
with 70 analyzed (morphine 33, placebo 37). Intrathecal morphine patients
required significantly less median (25th to 75th percentile) morphine
equivalents compared to placebo during first postoperative 24 h (28 [16 to
46] mg vs. 59 [41 to 79] mg; difference, -28 [95% CI, -40 to -18]; P <
0.001) and second postoperative 24 h (0 [0 to 2] mg vs. 5 [0 to 6] mg;
difference, -3.3 [95% CI, -5 to 0]; P < 0.001), exhibited significantly
lower visual analog scale pain scores at rest and cough at all
postoperative timepoints (overall treatment effect, -4.1 [95% CI, -4.9 to
-3.3] and -4.7 [95% CI, -5.5 to -3.9], respectively; P < 0.001), and
percent time in severe pain (10 [0 to 40] vs. 40 [20 to 70]; P = 0.003)
during the postoperative period. Mild nausea was more common in the
intrathecal morphine group (36% vs. 8%; P = 0.004). Conclusion(s):
When given before induction of anesthesia for totally endoscopic coronary
artery bypass, intrathecal morphine decreases use of postoperative opioids
and produces significant postoperative analgesia for 48 h. Copyright
© 2021, the American Society of Anesthesiologists. All Rights
Reserved.

<75>
Accession Number
2013135387
Title
Effect of levosimendan on renal function in background of left ventricular
dysfunction: a meta-analysis of randomized trials.
Source
Expert Opinion on Drug Safety. 20(11) (pp 1411-1420), 2021. Date of
Publication: 2021.
Author
Long Y.-X.; Cui D.-Y.; Kuang X.; Hu Y.; Hu S.; Wang C.-P.; Liu Z.-Z.
Institution
(Long, Cui, Kuang, Hu, Hu, Wang, Liu) Department of Cardiology, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: Levosimendan, an inotrope, is widely used in the management of
heart failure (HF) and cardiac surgery, but it remains uncertain whether
levosimendan can improve renal function in patients with left ventricular
dysfunction (LVD). Method(s): PubMed, Embase, and Cochrane CENTRAL
from the inception to June 2020 were systematically screened for
randomized controlled trials (RCTs) to investigate whether levosimendan
offers kidney-related advantages in cardiovascular patients with LVD. We
pooled the effects using a random-effect model. Result(s):
Twenty-eight studies enrolling 5069 patients were included. Levosimendan
reduced the sCr (SMD -0.28, 95% CI (-0.48, -0.09), P = 0.005,
I2 = 52.5%, high quality) and the risk of ARF (relative risk
0.75, 95%CI (0.60, 0.95), P = 0.017, I2 = 11.3%,
moderate-quality) in patients with LVD compared with control group. The
reduction of sCr was more pronounced in patients with a relatively higher
baseline sCr level. For secondary outcomes, levosimendan therapy was
associated with the improvement of GFR (SMD 0.32, 95%CI (-0.05, 0.68), P =
0.092, I2 = 55.1%, low-quality) and urine output (SMD 0.42,
95%CI (0.06, 0.79), P = 0.024, I2 = 50.0%, very low-quality),
but there was no significant reduction in BUN (SMD -0.14, 95%CI (-0.97,
0.70), P = 0.774, I2 = 77.9%, very low-quality).
 Conclusion(s): Levosimendan might improve renal function of patients
with LVD. Copyright © 2021 Informa UK Limited, trading as Taylor
& Francis Group.

<76>
Accession Number
2017780743
Title
Bone Marrow Cells Improve Coronary Flow Reserve in Ischemic
Nonrevascularized Myocardium: A MiHeart/IHD Quantitative Perfusion CMR
Substudy.
Source
JACC: Cardiovascular Imaging. 15(5) (pp 812-824), 2022. Date of
Publication: May 2022.
Author
Assuncao-Jr A.N.; Rochitte C.E.; Kwong R.Y.; Wolff Gowdak L.H.; Krieger
J.E.; Jerosch-Herold M.
Institution
(Assuncao-Jr, Rochitte, Wolff Gowdak, Krieger) Heart Institute (InCor),
University of Sao Paulo Medical School, Brazil, Sao Paulo, Brazil
(Kwong, Jerosch-Herold) Division of Cardiovascular Medicine and Radiology,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
Publisher
Elsevier Inc.
Abstract
Objectives: This study investigated whether intramyocardial bone
marrow-derived hematopoietic progenitor cells (BMCs) increase coronary
flow reserve (CFR) in ischemic myocardial regions where direct
revascularization was unsuitable. Background(s): Patients with
diffuse coronary artery disease frequently undergo incomplete myocardial
revascularization, which increases their risk for future adverse
cardiovascular outcomes. The residual regional ischemia related to both
untreated epicardial lesions and small vessel disease usually contributes
to the disease burden. Method(s): The MiHeart/IHD study randomized
patients with diffuse coronary artery disease undergoing incomplete
coronary artery bypass grafting to receive BMCs or placebo in ischemic
myocardial regions. After the procedure, 78 patients underwent
cardiovascular magnetic resonance (CMR) at 1, 6, and 12 months and were
included in this cardiac magnetic resonance substudy with perfusion
quantification. Segments were classified as target (injected), adjacent
(surrounding the injection site), and remote from injection site.
 Result(s): Of 1,248 segments, 269 were target (22%), 397 (32%)
adjacent, and 582 (46%) remote. The target had significantly lower CFR at
baseline (1.40 +/- 0.79 vs 1.64 +/- 0.89 in adjacent and 1.79 +/- 0.79 in
remote; both P < 0.05). BMCs significantly increased CFR in target and
adjacent segments at 6 and 12 months compared with placebo. In target
regions, there was a progressive treatment effect (27.1% at 6 months, P =
0.037, 42.2% at 12 months, P = 0.001). In the adjacent segments, CFR
increased by 21.8% (P = 0.023) at 6 months, which persisted until 12
months (22.6%; P = 0.022). Remote segments in both the BMC and placebo
groups experienced similar improvements in CFR (not significant at 12
months compared with baseline). Conclusion(s): BMCs, injected in
severely ischemic regions unsuitable for direct revascularization, led to
the largest CFR improvements, which progressed up to 12 months, compared
with smaller but persistent CFR changes in adjacent and no improvement in
remote segments. Copyright © 2022 The Authors

<77>
Accession Number
2011519288
Title
The ongoing impact of COVID-19 on adult cardiac surgery and suggestions
for safe continuation throughout the pandemic: a review of expert
opinions.
Source
Perfusion (United Kingdom). 37(4) (pp 340-349), 2022. Date of Publication:
May 2022.
Author
Kirkley K.; Benedetto U.; Caputo M.; Angelini G.D.; Vohra H.A.
Institution
(Kirkley, Benedetto, Caputo, Angelini, Vohra) Department of Cardiac
Surgery/Cardiovascular Sciences, Bristol Heart Institute, University of
Bristol, Bristol, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objectives: To establish the impact of the COVID-19 pandemic on adult
cardiac surgery by reviewing current data and use this to establish
methods for safely continuing to carry out surgery. Method(s):
Conduction of a literature search via PubMed using the search terms:
'(adult cardiac OR cardiothoracic OR surgery OR minimally invasive OR
sternotomy OR hemi-sternotomy OR aortic valve OR mitral valve OR elective
OR emergency) AND (COVID-19 or coronavirus OR SARS-CoV-2 OR 2019-nCoV OR
2019 novel coronavirus OR pandemic)'. Thirty-two articles were selected.
 Result(s): Cardiac surgery patients have an increased risk of
complications from COVID-19 and require vital finite resources such as
intensive care beds, also required by COVID-19 patients. Thus reducing
their admission and potential hospital-acquired infection with COVID-19 is
paramount. During the peak, only emergencies such as acute aortic
dissections were treated, triaging patients according to surgical priority
and cancelling all elective procedures. Screening and 2-week quarantine
prior to admission were essential changes, alongside additional levels of
PPE. Focus was on reducing length of stay and switching to day-cases to
reduce post-operative transmission risk, whilst several hospitals adopted
'hot' and 'cold' operating theatres for covid-confirmed and covid-negative
patients. Conclusion(s): This paper suggests a 'CARDIO' approach for
reintroducing elective procedures: 'Care, Assess, Re-Evaluate, Develop,
Implement, Overcome'; prioritising the mental and physical health of the
workforce, learning from and sharing experiences and objectively
prioritising patients to improve case load. Copyright © The
Author(s) 2021.

<78>
Accession Number
637612740
Title
A systematic review and meta-analysis of percutaneous coronary
intervention compared to coronary artery bypass grafting in
non-ST-elevation acute coronary syndrome.
Source
Scientific reports. 12(1) (pp 5138), 2022. Date of Publication: 24 Mar
2022.
Author
Kirov H.; Caldonazo T.; Rahouma M.; Robinson N.B.; Demetres M.; Serruys
P.W.; Biondi-Zoccai G.; Gaudino M.; Doenst T.
Institution
(Kirov, Caldonazo, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena 07747, Germany
(Rahouma, Robinson, Gaudino) Department of Cardiothoracic Surgery at New
York Presbyterian, Weill Cornell Medical Center, NY, United States
(Demetres) Weill Cornell Medicine, Samuel J. Wood Library and C.V. Starr
Biomedical Information Center, NY, NY, United States
(Serruys) Department of Cardiology, National University of Ireland, Galway
(NUIG), Galway, Ireland
(Serruys) CORRIB Corelab and Center for Research and Imaging, Galway,
Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) NaplesItaly
Publisher
NLM (Medline)
Abstract
Non-ST-elevation acute coronary syndrome (NSTE-ACS) affects millions of
patients. Although an invasive strategy can improve survival, the optimal
treatment [i.e., percutaneous coronary intervention (PCI) or coronary
artery bypass grafting (CABG)] is not clear. We performed a meta-analysis
of studies reporting outcomes between PCI and CABG in patients with
NSTE-ACS. MEDLINE, EMBASE and Cochrane Library were assessed. The primary
outcome was long-term mortality. Inverse variance method and random model
were performed. We identified 13 observational studies (48,891 patients).
No significant difference was found in the primary endpoint [CABG vs. PCI,
incidence rate ratio (IRR) 0.93, 95% confidence interval (CI) 0.70; 1.23].
CABG was associated with lower long-term major adverse cardiovascular
events (MACE) (IRR 0.64, 95% CI 0.54; 0.76) and lower long-term
re-revascularization (IRR 0.37, 95% CI 0.30; 0.47). There was no
significant difference in long-term myocardial infarction (CABG vs. PCI,
IRR 0.96, 95% CI 0.50; 1.84) and peri-operative mortality (CABG vs. PCI,
odds ratio 1.36, 95% CI 0.94; 1.95). For the treatment of NSTE-ACS, CABG
and PCI are associated with similar rates of long-term mortality and
myocardial infarction. CABG is associated with lower rates of long-term
MACE and re-revascularization. Randomized comparisons in this setting are
necessary. Copyright © 2022. The Author(s).

<79>
Accession Number
2007108576
Title
The Cost of Innovation and Evidence in Cardiac Surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 15(5) (pp 395-396), 2020. Date of Publication: 01 Sep 2020.
Author
Chikwe J.; Gaudino M.
Institution
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Gaudino) Division of Cardiac Surgery, Weill Cornell, New York, NY, United
States
Publisher
SAGE Publications Ltd
Abstract
This review summarizes a systematic analysis of 216 randomized trials of
cardiovascular interventions performed during 2008-2019, according to the
source of trial funding. The systematic analysis showed that on average
the results of each trial would change significance if only 5 patients
experienced different outcomes. Industry-sponsored trials were more likely
to use composite endpoints, noninferiority designs, and twice as likely as
nonindustry trials to report results favoring the device arm. Over 80% of
industry trials used reporting strategies or "spin" suggesting the device
arm was advantageous versus fewer than half of non-industry trials. The
review discusses the implications of these findings. Copyright ©
The Author(s) 2020.

<80>
Accession Number
628249428
Title
Management of Less-Than-Severe Aortic Stenosis During Coronary Bypass: A
Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 14(4) (pp 291-298), 2019. Date of Publication: 01 Aug 2019.
Author
Yanagawa B.; An K.R.; Ouzounian M.; Gaudino M.; Puskas J.D.; Asaoka N.;
Verma S.; Friedrich J.O.
Institution
(Yanagawa, An, Asaoka, Verma) Divisions of Cardiac Surgery, St Michael's
Hospital, University of Toronto, ON, Canada
(Ouzounian) Division of Cardiac Surgery, Toronto General Hospital,
University of Toronto, ON, Canada
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Heart at Mount
Sinai Saint Luke's, New York, NY, United States
(Friedrich) Divisions of Critical Care, St Michael's Hospital, University
of Toronto, ON, Canada
Publisher
SAGE Publications Ltd
Abstract
Objective: The management of concomitant mild-to-moderate aortic stenosis
(AS) at the time of coronary artery bypass graft (CABG) is controversial.
Here we perform a systematic review and meta-analysis of CABG and aortic
valve replacement (AVR) versus CABG alone in patients with mild-moderate
AS. Method(s): We searched MEDLINE and EMBASE databases until July
2018 for studies comparing CABG & AVR versus CABG in patients with
mild-moderate AS undergoing coronary bypass. Data were extracted by 2
independent investigators. The main outcomes were operative mortality,
long-term survival, and reintervention for AS. Result(s): There were
6 unmatched retrospective observational studies with 1,172 patients
(median follow-up 4.7 [interquartile range: 4.3 to 5.3] years). Patients
undergoing CABG & AVR had less severe coronary artery disease. There were
no differences in operative mortality (relative risk [RR]: 1.07; 95% CI,
0.59 to 1.94; P = 0.8). CABG & AVR was associated with greater incidence
of stroke, bleeding, renal failure, and mediastinitis. At median follow-up
of 5 years, there was no difference in long-term mortality (incidence rate
ratio [IRR]:1.44; 95% CI, 0.83 to 2.51; P = 0.19), but CABG & AVR was
associated with 73% lower risk of reoperation for AS (n = 13/485 versus n
= 71/702; IRR: 0.27; 95% CI, 0.14 to 0.51; P < 0.001). Conclusion(s):
In patients undergoing CABG with mild-moderate AS, combining AVR with CABG
was associated with no difference in operative mortality but with
increased risk of stroke, bleeding, renal failure, and mediastinitis.
Long-term mortality was not different, but a risk of reoperation for AS at
5 years was 73% lower. Given the increasingly wide availability and safety
of transcatheter aortic valve replacement (TAVR), one may consider a
conservative approach toward concomitant mild-moderate AS. Copyright
© The Author(s) 2019.

<81>
Accession Number
626912525
Title
Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 14(2) (pp 117-123), 2019. Date of Publication: 01 Apr 2019.
Author
Kitahara H.; Nisivaco S.; Balkhy H.H.
Institution
(Kitahara, Nisivaco, Balkhy) Cardiothoracic Surgery, University of Chicago
Medicine, Chicago, IL, United States
Publisher
SAGE Publications Ltd
Abstract
Objective With advances in robotic instrumentation and technology, both
robotically assisted minimally invasive direct coronary artery bypass
(RMIDCAB) and totally endoscopic coronary artery bypass (TECAB) have been
widely used over the past 20 years. Graft patency is the most important
outcome in coronary bypass surgery and is associated with long-term
prognosis. In this article we reviewed all experts' studies in the field
of robotic assisted coronary artery bypass and investigated graft patency
in patients who underwent RMIDCAB or TECAB. Methods We performed a
literature search in PubMed from 1999 to 2018 using the terms "Robotic"
and "Coronary bypass" and/or "Minimally invasive" and/or "Totally
endoscopic." Of the articles found, studies investigating graft patency
were specifically selected. Results In 33 articles, a total of 4,000
patients underwent robotic assisted coronary artery bypass surgery either
by a RMIDCAB (2,396) or by a TECAB (1,604) approach. The graft patency was
assessed by invasive angiography or computed tomographic angiography in
all studies. The mean graft patency at early (<1 month), midterm (<5
years), and long-term (>5 years) follow-up was 97.7%, 96.1%, and 93.2% in
RMIDCAB and 98.8%, 95.8%, and 93.6% in TECAB, respectively. Conclusions
The graft patency of robotic assisted coronary artery bypass was
equivalent to reported outcomes of the conventional approach. These
results should encourage the adoption of robotic approaches in coronary
bypass surgery. Copyright © International Society for Minimally
Invasive Cardiothoracic Surgery. All rights reserved.

<82>
Accession Number
626733807
Title
Robotic Totally Endoscopic Coronary Artery Bypass Grafting: Systematic
Review of Clinical Outcomes from the Past two Decades.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 14(1) (pp 5-16), 2019. Date of Publication: 01 Feb 2019.
Author
Gobolos L.; Ramahi J.; Obeso A.; Bartel T.; Hogan M.; Traina M.; Edris A.;
Hasan F.; Banna M.E.; Tuzcu E.M.; Bonatti J.
Institution
(Gobolos, Ramahi, Obeso, Bonatti) Department of Cardiac Surgery, Heart and
Vascular Institute, Cleveland Clinic Abu Dhabi, Sowwah Square, Al Maryah
Island, Abu Dhabi, United Arab Emirates
(Bartel, Traina, Edris, Hasan, Banna, Tuzcu) Department of Cardiology,
Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab
Emirates
(Hogan) Departments of Anaesthesia, Intensive Care, Cleveland Clinic, Abu
Dhabi, United Arab Emirates
Publisher
SAGE Publications Ltd
Abstract
Robotic totally endoscopic coronary artery bypass grafting (TECAB) was
introduced in 1998 and has over a period of two decades gradually emerged
from single-vessel revascularization to multivessel bypass grafting.
Dedicated centers have continuously evolved and further developed this
minimally invasive method of coronary bypass surgery. A literature review
was conducted to assess intra- and postoperative outcomes of TECAB. PubMed
returned 19 comprehensive articles on TECAB. Investigation was focused on
perioperative outcome parameters, i.e.: operative time, conversion to
larger incision, revision for bleeding, atrial fibrillation, stroke, acute
renal failure, and mortality. Outcome from the analysis of 2,397 reported
cases showed an average operative time of 291 +/- 57 minutes (range 112 to
1,050), conversion rate to larger incisions at 11.5%, and perioperative
mortality at 0.8%. Pooled data demonstrated 4.2% operative revision rate
due to postoperative hemorrhage, 1.0% stroke incidence, 1.6% acute renal
failure, and 13.3% de novo atrial fibrillation. The mean length of
hospital stay measured 5.8 +/- 1.7 days. Conversion rates and operative
times decreased over time. According to data in the literature, coronary
bypass surgery carried out in completely endoscopic fashion utilizing
robotic assistance can require relatively extensive operative times and
conversion rates are somewhat higher than in other robotic cardiac
surgery. However, major postoperative events lie in an acceptable range.
TECAB remains the surgical revascularization method with the least tissue
trauma and represents an opportunity for coronary artery bypass grafting
via port access. Rates of major complications are at least similar to
conventional surgical access procedures. Copyright ©
International Society for Minimally Invasive Cardiothoracic Surgery. All
rights reserved.

<83>
[Use Link to view the full text]
Accession Number
2004197868
Title
Mitral Valve Annuloplasty Rings: Review of Literature and Comparison of
Functional Outcome and Ventricular Dimensions.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 9(6) (pp 399-415), 2014. Date of Publication: 01 Nov 2014.
Author
Khamooshian A.; Buijsrogge M.P.; De Heer F.; Grundeman P.F.
Institution
(Khamooshian) University Medical Center Groningen, Utrecht, Netherlands
(Buijsrogge, De Heer, Grundeman) University Medical Center Utrecht,
Utrecht, Netherlands
Publisher
SAGE Publications Ltd
Abstract
In the past decades, more than 40 mitral valve annuloplasty rings of
various shapes and consistency were marketed for mitral regurgitation
(MR), although the effect of ring type on clinical outcome remains
unclear. Our objective was to review the literature and apply a
simplification method to make rings of different shapes and rigidity more
comparable. We studied relevant literature from MEDLINE and EMBASE
databases related to clinical studies as well as animal and finite element
models. Annuloplasty rings were clustered into 3 groups as follows: rigid
(R), flexible (F), and semirigid (S). Only clinical articles regarding
degenerative (DEG) or ischemic/dilated cardiomyopathy (ICM) MR were
included and stratified into these groups. A total of 37 rings were
clustered into R, F, and S subgroups. Clinical studies with a mean
follow-up of less than 1 year and a reported mean etiology of valve
incompetence of less than 60% were excluded from the analysis. Forty-one
publications were included. Preimplant and postimplant end points were New
York Heart Association class, left ventricular ejection fraction (LVEF),
left ventricular end-systolic dimension (LVESD), and left ventricular
end-diastolic dimension (LVEDD). Statistical analysis included
paired-samples t test and analysis of variance with post hoc Bonferroni
correction. P < 0.05 indicated statistical difference. Mean +/- SD
follow-up was 38.6 +/- 27 and 29.7 +/- 13.2 months for DEG and ICM,
respectively. In DEG, LVEF remained unchanged, and LVESD decreased in all
subgroups. In our analysis, LVEDD decreased only in F and R, and S did not
change; however, the 4 individual studies showed a significant decline. In
ICM, New York Heart Association class improved in all subgroups, and LVEF
increased. Moreover, LVESD and LVEDD decreased only in F and S; R was
underpowered (1 study). No statistical difference among R, F, and S in
either ICM or DEG could be detected for all end points. Overall, owing to
underpowered data sets derived from limited available publications, major
statistical differences in clinical outcome between ring types could not
be substantiated. Essential end points such as recurrent MR and survival
were incomparable. In conclusion, ring morphology and consistency do not
seem to play a major clinical role in mitral valve repair based on the
present literature. Hence, until demonstrated otherwise, surgeons may
choose their ring upon their judgment, tailored to specific patient
needs. Copyright © 2014 International Society for Minimally
Invasive Cardiothoracic Surgery.

<84>
Accession Number
2016175607
Title
The efficacy and safety of intravenous tranexamic acid in patients with
posterior operation of multilevel thoracic spine stenosis: a prospective
randomized controlled trial.
Source
BMC Musculoskeletal Disorders. 23(1) (no pagination), 2022. Article
Number: 410. Date of Publication: December 2022.
Author
Lei T.; Bingtao W.; Zhaoqing G.; Zhongqiang C.; Xin L.
Institution
(Lei, Bingtao, Zhaoqing, Zhongqiang, Xin) Department of Orthopaedics,
Peking University International Hospital, Life Park Road No 1 Life Science
Park of Zhong Guancun, Changping District, Beijing 102206, China
Publisher
BioMed Central Ltd
Abstract
Background: This study was a randomized controlled trial to evaluate
efficacy and safety of the usage of intravenous tranexamic acid during
posterior operation of multilevel thoracic spine stenosis for controlling
perioperative blood loss. Method(s): Sixty eight patients with
multilevel thoracic spine stenosis were randomized into the tranexamic
acid group receiving 15 mg/kg body weight before the skin incision was
made and 1 mg/kg body weight per hour during operation or the control
group receiving the same dose of placebo (0.9% sodium chloride solution)
intravenously. Pedicle screw fixation, laminectomy and selective
discectomy were performed. Intraoperative and perioperative total blood
loss were compared. The necessity and amount for blood transfusion, blood
coagulation function, durations of postoperative hospital stays were
compared. The complications of tranexamic acid were also investigated such
as cardiovascular and cerebrovascular events, lower limb venous
thrombosis. Result(s): There were no statistically significant
differences in age, gender, body mass index, ASA status, pathology
required surgery, preoperative hemoglobin, operation time, laminectomy
segments and discectomy segments between the tranexamic acid and control
groups. The intraoperative blood loss (455.9 +/- 206.6 ml vs 580.6 +/-
224.3 ml, p < 0.05) and total blood loss (675.3 +/- 170.3 ml vs 936.8 +/-
306.4 ml, p < 0.01) in tranexamic acid group were significant lower than
those in control group. The means of blood unit transfused (2.5 +/- 1.0 vs
4.7 +/- 2.4, p < 0.05) and Hb reduction in 48 h (22.5 +/- 3.4 g/L vs 25.3
+/- 3.9 g/L, p < 0.01) were significantly lower in tranexamic acid group
than that in control group. There were no statistically significant
differences in blood coagulation function pre-operation or 48 h
post-operation between the tranexamic acid and the control groups. The
requirements for patients to receive blood transfusion were fewer and
durations of post-operational hospital stays were shorter in the
tranexamic acid group, however, the difference did not achieve statistical
significance. There was no significant difference in superficial or deep
venous thrombosis of lower limbs or deterioration of neurological function
between tranexamic acid group and control group. Conclusion(s):
Application of intravenous tranexamic acid significantly reduces
intraoperative and perioperative total blood loss without significant side
effects in posterior operation of multilevel thoracic spine stenosis.
Trial registration: At Chinese Clinal Trial Registry.
http://www.chictr.org.cn/, ChiCTR2100054221. Registered on
11/12/2021. Copyright © 2022, The Author(s).

<85>
Accession Number
2017904214
Title
Development of a protocol for conducting a randomized control trial on
effects of artificial intelligence on nutritional status of children post
cardiac surgery.
Source
Journal of the Pakistan Medical Association. 72(5) (pp 908-911), 2022.
Date of Publication: May 2022.
Author
Zahid M.; Sughra U.
Institution
(Zahid, Sughra) Al Shifa Trust Eye Hospital, School of Public Health,
Rawalpindi, Pakistan
Publisher
Pakistan Medical Association
Abstract
Objectives: To assess the effect of diet-related mobile application based
on artificial intelligence on the nutritional status of children
post-cardiac surgery, and to compare their diet-related problems with
their counterparts having the usual diet. Method(s): The two-arm
double-blind randomised controlled trial will be conducted at a tertiary
care hospital in Rawalpindi, Pakistan, over an expected duration of 6
months from March to August 2021. Intervention group A will be given a
diet-related mobile application based on artificial intelligence, while
usual-care group B will be handed a pamphlet with instructions related to
post-operative diet on discharge. Result(s): The findings will
improve perception about the influence of artificial intelligence on
nutritional status of children post-cardiac surgery. If proven to be
effective, this mobile application can be used in other hospitals.
 Conclusion(s): The study protocol will give an indication that
whether diet-related mobile application can contribute to improving the
nutritional status of children post-cardiac surgery. As the pandemic has
forced people to minimise hospital visits, this is the right time to
evaluate the utility of such an application. Copyright © 2022
Pakistan Medical Association. All rights reserved.

<86>
Accession Number
2018009862
Title
Neuroprotective effect of memantine on serum S100-B levels after on-pump
coronary artery bypass graft surgery: A randomized clinical trial.
Source
Caspian Journal of Internal Medicine. 13(2) (pp 412-417), 2022. Date of
Publication: 01 Mar 2022.
Author
Tabary S.Z.; Tabary P.Z.; Motlagh A.S.
Institution
(Tabary) Department of Cardiac Surgery, Cardiovascular Research Center,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Tabary) Faculty of Specialized Veterinary Sciences, Islamic Azad
University, Science and Research Branch, Tehran, Iran, Islamic Republic of
(Motlagh) Mazandaran University of Medical Sciences, Sari, Iran, Islamic
Republic of
Publisher
Babol University of Medical Sciences
Abstract
Background: Brain injury is one of the complications of open heart
surgery. Glutamate plays a key role in this process. In this study, we
evaluated the neuroprotective effect of memantine as NMDAR inhibitor in
patients undergoing on-pump coronary artery bypass graft surgery (CABG).
 Method(s): From July 2019 to May 2020, thirty-four consecutive
patients selected for elective isolated on-pump coronary artery bypass
graft surgery (CABG) enrolled in the trial. Patients were randomly
assigned into two groups; memantine and the control group. For the
memantine group, 10 mg of memantine twice daily was administered at least
72 h before surgery. Venous blood samples were collected before surgery
(T1), at the end of cardiopulmonary bypass (CPB) (T2), 6h and 24h after
CPB (T3 and T4). Serum concentration of S100-B was measured by
enzyme-linked immunosorbent assay (ELISA) technique. Result(s): Serum
S100-B increased during CPB with a peak plasma concentration at the
termination of CPB. Then it gradually decreased during the first 24 hours
in both groups (P=0.001). The mean S100-B levels were significantly lower
in the memantine group compared to the control group at the termination of
CPB (0.863+/-0.203 mug/l vs 1.117+/-0.304 mug/l), at 6 hours post-CPB
(0.731+/-0.168 mug/l vs 0.938+/-0.206 mug/l), and 24 hours post-CPB
(0.595+/-0.189 mug/l vs 0.852+/-0.227 mug/l), respectively (P=0.023). The
mean level of serum S100-B in memantine group was about 0.19 mug/l less
than the control group during the study (CI, 0.07 to 0.30; P=0.001). One
(6.2%) patient in the control group had post-operative left arm
paresthesia Conclusion(s): Administration of memantine before on-pump
CABG can attenuate the postoperative concentrations of serum S100-B, which
may reduce cerebral damage during surgery. Copyright © The
Author(s).

<87>
Accession Number
2017995090
Title
Correlation of Prolonged Cardiopulmonary Bypass time with Postoperative
Complications - A prospective review.
Source
Pakistan Journal of Medical and Health Sciences. 16(4) (pp 23-24), 2022.
Date of Publication: April 2022.
Author
Arif A.; Niazi A.K.; Muneeb M.; Umer K.S.; Ali A.; Shahbaz A.
Institution
(Arif) Cardiac Surgery, Shalamar Medical and Dental College, Lahore,
Pakistan
(Niazi, Muneeb) Cardiovascular Surgery, Shalamar Medical and Dental
College, Lahore, Pakistan
(Umer) Saudi Arabia
(Ali) Pulmonology, SMDC, Punjab Institute of Cardiology, Lahore, Pakistan
(Shahbaz) Cardiac Surgery, Punjab Institute of Cardiology, Lahore,
Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Aim: To compare post-operative in-hospital outcome of on pump CABG in
patients with shorter CPB duration vs. patients with longer CPB duration.
Methodology: In this cross sectional study conducted at Department of
Cardiac Surgery, PIC, Jail Road, Lahore 182 subjects were selected using
non probability Judgmental/Purposive sampling Technique and randomly
divided into two equal groups of 91 each. Group A: patients undergoing
surgery for short duration of CPB < 90 minutes and half treated with Group
B: patients undergoing surgery for long duration of CPB >= 90 minutes.
Data was entered and analyzed using SPSS 25. Result(s): There were
133(73.08%) males and 49(26.92%) females in this study. The mean age of
cases was 50.68+/-9.26 years with minimum and maximum age being 35 and 70
years. Mean Baseline Creatinine recorded for Group A was 0.92+/-0.19 and
for Group B was 0.91+/-0.21. Mean urine output level recorded for Group A
after 6 hours of CABG was 1.05+/-0.25 and for Group B after 6 hours of
CABG was 0.85+/-0.24. There was a significant association in the
occurrence of acute renal Injury in both groups whereas there was no
significant association in the mortality of both groups.
 Conclusion(s): There was a significant difference between
post-operative in-hospital renal outcomes of on pump CABG in patients with
shorter CPB duration vs. patients with longer CPB duration. The results of
both groups are nearly same as far as in-hospital mortality is
concerned. Copyright © 2022 Lahore Medical And Dental College.
All rights reserved.

<88>
Accession Number
2017973764
Title
Heparin Resistance in surgical patients: Could individualized prophylaxis
through recognition of high and low responders to antithrombotic treatment
represent an option to optimal antithrombotic strategy in the future?.
Source
Hellenic Journal of Vascular and Endovascular Surgery. 3(2) (pp 48-53),
2021. Date of Publication: 01 Apr 2021.
Author
Gionis M.N.; Tagarakis G.I.; Manaki V.C.; Chatzigeorgiadis P.;
Koutsoumbelis A.; Ktenidis K.D.
Institution
(Gionis, Manaki, Chatzigeorgiadis, Koutsoumbelis, Ktenidis) Department of
Vascular Surgery, AHEPA University Hospital of Thessaloniki, Aristotle
University of Thessaloniki, Greece
(Tagarakis) Department of Cardiothoracic Surgery, AHEPA Hospital of
Thessaloniki, Aristotle University of Thessaloniki, Greece
Publisher
Rotonda Publications
Abstract
Background: Heparin Resistance (HR) represents a considerable risk factor
for perioperative and postoperative complications in surgical patients.
These complications are expressed with venous and/or arterial thrombotic
events which compromise the patient's outcome after surgery. HR commonly
occurs in patients with coronary disease undergoing cardio-pulmonary
by-pass, cancer patients, as well as in patients suffering from AT-III
deficiency, or type II H.I.T (Heparin induced thrombocytopenia).
Nevertheless, HR occurred also in healthy volunteers and in Oncologic
Surgery, and according to our findings, also in Major Orthopedic Surgery
and in Vascular Surgery. The purpose of the current review was to focus on
the considerable percentage of HR among surgical patients.
 Material(s) and Method(s): The literature search included the
following key words: HR, venous thromboembolism (VTE) and surgical,
cardiovascular, ongological, orthopaedic and vascular patients and
included reports published between 1990 and 2016. Only articles listed in
Pubmed and written in English were included. The aforementioned criteria
provided a total of 1948 papers. After the exclusion of papers regarding
patients with thrombophilia, HIT and antithrombin III deficiency, the
total sum of articles relevant and important to the subject was 43, which
were analyzed in detail in the current article. Result(s): In 2
studies the relation between low molecular weight heparin (LMWH) and HR in
healthy volunteers was investigated. Both confirm that presence of HR in
healthy volunteers is not rare. Four papers from the included studies
refer to the physiologic mechanism through which HR is expressed in cancer
patients. Seven studies refer to the Major orthopedic surgery in relation
to the HR. The presence of HR in oncologic surgery was commented only in
one paper. In coronary patient we found 14 references related to specific
theme. Among them 2 studies examined the efficiency of LMWH's
antithrombotic activity. In 23,2% of papers, HR in patients undergoing
coronary bypass graft surgery treated with UFH, was investigated. Only two
papers investigate HR in patients receiving coronary bypass who were
treated preoperatively with LMWH and perioperatively with UFH. Two papers
were guidelines to prevent VTE, in high-risk surgical patients and one
investigated the antithrombotic properties of LMWH in plasma. Finally,
three studies are related to the properties of the
Thrombogram-Thrombinoscope (TG assay) laboratory method in clot cascade.
 Conclusion(s): Personalized antithrombotic treatment using the method
of Calibrated Thrombin Generation Assay may represent a solution to
optimal treatment in future antithrombotic strategy. Copyright ©
2022 Ethiopian Journal of Reproductive Health. All rights reserved.

<89>
Accession Number
637941790
Title
The use of FEIBA for refractory bleeding in cardiac surgery - a systematic
review.
Source
Expert review of cardiovascular therapy. (no pagination), 2022. Date of
Publication: 06 May 2022.
Author
Khoury W.; Servito M.; Wang L.; Baranchuk A.; Callum J.; Payne D.;
El-Diasty M.
Institution
(Khoury, Servito) School of Medicine, Queen's University, ON, Kingston,
Canada
(Wang) Department of Anesthesiology, Queen's University, ON, Kingston,
Canada
(Baranchuk) Division of Cardiology, Queen's University, ON, Kingston,
Canada
(Callum) Department of Pathology and Molecular Medicine, Queen's
University, ON, Kingston, Canada
(Payne, El-Diasty) Division of Cardiac Surgery, Queen's University, ON,
Kingston, Canada
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Significant blood loss during cardiac surgery is associated
with a significant increase in morbidity and mortality. Factor Eight
Inhibitor Bypassing Activity (FEIBA), a hemostatic bypassing agent mainly
used in hemophiliac patients, has also been used for intractable surgical
bleeding during cardiac surgical procedures in non-hemophiliac patients.
However, concerns exist that its use may be linked to increased incidence
of perioperative adverse effects including thrombotic complications. AREAS
COVERED: A systematic literature search was performed on MEDLINE, EMBASE,
and the Cochrane Central Register of Controlled Trials databases for all
studies that reported the administration of FEIBA for treatment of
bleeding during adult cardiac surgery in non-hemophiliac patients. After
selecting of title and abstracts, two authors assessed the methodological
quality of the full-text articles prior to final inclusion in the
manuscript. EXPERT OPINION: The safety profile of FEIBA was determined
through an aggregate count of adverse events. Major complications included
renal failure, re-operation for unresolved bleeding, postoperative
mortality, and thromboembolic events. Overall, there is insufficient
robust evidence to make a definitive conclusion about the safety or
efficacy of using of FEIBA as a hemostatic agent in the setting of cardiac
surgery.

<90>
Accession Number
637940802
Title
Baseline depressive symptoms, personal control, and concern moderate the
effects of preoperative psychological interventions: the randomized
controlled PSY-HEART trial.
Source
Journal of behavioral medicine. (no pagination), 2022. Date of
Publication: 06 May 2022.
Author
Horn N.; Laferton J.A.C.; Shedden-Mora M.C.; Moosdorf R.; Rief W.;
Salzmann S.
Institution
(Horn, Rief, Salzmann) Department of Clinical Psychology and
Psychotherapy, Philipps University of Marburg, Marburg, Gutenbergstrase 18
35032, Germany
(Laferton) Division of Medical Psychology, Department of Medicine, Health
and Medical University Potsdam, Potsdam, Germany
(Shedden-Mora) Department of Psychology, Medical School Hamburg, Hamburg,
Germany
(Shedden-Mora) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Moosdorf) Department for Cardiovascular Surgery, Heart Center, Philipps
University of Marburg, Marburg, Germany
Publisher
NLM (Medline)
Abstract
This study examined whether baseline (3-14 days pre-surgery) levels of (i)
depressive or (ii) anxiety symptoms and (iii) illness beliefs moderate the
effects of additional preoperative interventions before coronary artery
bypass graft surgery on (i) depressive or (ii) anxiety symptoms and (iii)
illness beliefs 1 day before surgery, 1 week and 6 months after surgery.
In the PSY-HEART trial, 115 patients were assessed. They were randomized
into one of three groups: 1. receiving standard medical care only (SMC),
additional psychological interventions: 2. aiming to optimize patients'
expectations (EXPECT), or 3. focusing on emotional support. Patients with
a higher baseline level of depressive symptoms receiving a preoperative
psychological intervention indicated lower depressive symptoms 6 months
after surgery compared to SMC. EXPECT increased personal control and
concern levels in patients with low baseline personal control/concern 1
day before surgery. Brief preoperative psychological interventions can
improve psychological outcomes in heart surgery patients. Baseline status
may moderate these effects. The study has been approved by the medical
ethics committee of the Philipps University of Marburg and has been
pre-registered at www.clinicaltrials.gov (NCT01407055) on August 1,
2011. Copyright © 2022. The Author(s).

<91>
Accession Number
637939824
Title
Late Outcomes of Transcatheter Aortic Valve Implantation in Bicuspid
Versus Tricuspid Valves: Meta-Analysis of Reconstructed Time-To-Event
Data.
Source
Trends in cardiovascular medicine. (no pagination), 2022. Date of
Publication: 02 May 2022.
Author
Sa M.P.; Van den Eynde J.; Jacquemyn X.; Tasoudis P.; Erten O.; Dokollari
A.; Torregrossa G.; Sicouri S.; Ramlawi B.
Institution
(Sa) Department of Cardiothoracic Surgery, Lankenau Heart Institute,
Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA;
Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, Pennsylvania, USA; Division of Cardiac
Surgery, St Michael's Hospital, University of Toronto, Toronto, Ontario,
Canada. Electronic address: michel_pompeu@yahoo.com.br
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium; Division of Cardiac Surgery, St Michael's
Hospital, University of Toronto, Toronto, Ontario, Canada
(Tasoudis, Erten, Dokollari, Sicouri) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood,
Pennsylvania, USA; Division of Cardiac Surgery, St Michael's Hospital,
University of Toronto, Toronto, Ontario, Canada
(Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood,
Pennsylvania, USA; Department of Cardiothoracic Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, Pennsylvania, USA; Division of
Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto,
Ontario, Canada
Publisher
NLM (Medline)
Abstract
Based on previous meta-analyses including immediate/1-year results,
individuals with bicuspid aortic valve (BAV) stenosis can undergo TAVI
with similar outcomes as those with tricuspid aortic valve (TAV), but with
higher rates of periprocedural complications. The widespread belief is
that BAV patients would have poor results in comparison with TAV patients
after TAVI over time. Therefore, we performed a systematic review with
meta-analysis with reconstructed time-to-event data of studies published
by January 2022 to compare late outcomes of patients with BAV versus TAV
who underwent TAVI. This approach reconstructs individual patient data
(IPD) based on the published Kaplan-Meier graphs. Ten studies met our
eligibility criteria, including 9,071 patients with BAV and 171,070
patients with TAV. Patients with BAV had a significantly lower risk of
mortality (HR 0.70, 95%CI 0.65-0.77, P<0.001), however, this result was
driven by populations in which the risk score was statistically
significantly lower in the BAV group (HR 0.69, 95%CI 0.63-0.76, P<0.001)
and by populations in which the BAV group was statistically significantly
younger (HR 0.72, 95%CI 0.64-0.81, P<0.001). In patients with selected BAV
anatomy deemed favorable for TAVI, we did not find worse survival over
time in comparison with patients with TAV; however, the follow-up beyond 1
year remains limited in the studies and we need more investigation for
specific bicuspid anatomies with longer follow-up. Most importantly,
randomized controlled trials including exclusively BAV patients treated
with TAVI versus SAVR are warranted. Copyright © 2022. Published
by Elsevier Inc.

<92>
Accession Number
637939294
Title
In patients undergoing esophagectomy does postoperative home enteral
nutrition have any impact on nutritional status?.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2022.
Date of Publication: 05 May 2022.
Author
Li X.; Hu J.; Zhou J.; Fang P.; Yuan Y.
Institution
(Li, Zhou, Fang, Yuan) Department of Thoracic Surgery, West China
Hospital, Sichuan University, Chengdu, China
(Hu) Anesthesia Operation Center of West China Hospital/West China School
of Nursing, Sichuan University, China
Publisher
NLM (Medline)
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was 'In patients undergoing
oesophagectomy does postoperative home enteral nutrition have any impact
on nutritional status'? Altogether, 50 papers were found using the
reported search, of which 5 studies represented the best evidence to
answer the clinical question. This consisted of one systematic review
including a meta-analysis of nine randomized controlled trials (RCTs),
three RCTs and one cohort study. Main outcomes included loss of body
weight and body mass index (BMI), change of serum albumin, hemoglobin,
total protein and prealbumin, rates of nutritional risk patients and score
value of patient-generated subjective global assessment (PG-SGA). The
meta-analysis concluded that there was significant differences in the loss
of body weight and BMI between two groups, with higher values observed in
the HEN group than that in the control group. One RCT showed that patients
receiving HEN had a significantly lower weight loss compared with the
control group. However, in another RCT, there was no significant
difference between two group in the loss of weight and body BMI. The
available evidence shows that patients receiving home enteral nutrition
yielded a significantly better BMI and lower decrease of body weight than
those without after surgical resection of oesophageal cancer. We conclude
that HEN could serve as an effective intervention for patients undergoing
oesophagectomy. Moreover, the optimal time for patients receiving HEN
could be 4-8weeks after discharge. Feeding via jejunostomy and
nasointestinal tube are both feasible and safety approaches for
HEN. Copyright © The Author(s) 2022. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<93>
Accession Number
637939213
Title
Effects of crystalloid and colloid priming strategies for cardiopulmonary
bypass on colloid oncotic pressure and haemostasis: a meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2022.
Date of Publication: 05 May 2022.
Author
Beukers A.M.; de Ruijter J.A.C.; Loer S.A.; Vonk A.; Bulte C.S.E.
Institution
(Beukers, de Ruijter, Loer, Bulte) Amsterdam UMC location Vrije
Universiteit Amsterdam, Department of Anaesthesiology, Boelelaan 1117,
Amsterdam, Netherlands
(Vonk) Amsterdam UMC location University of Amsterdam, Department of
Cardiothoracic Surgery, Meibergdreef 9, Amsterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Colloid oncotic pressure is an important factor in cardiac
surgery, owing to its role in haemodilution. The effect of cardiopulmonary
bypass prime fluids on the colloid oncotic pressure are unknown. In this
study, the effect of crystalloid and colloid prime fluids, with or without
retrograde autologous priming on the colloid oncotic pressure during
elective cardiac surgery were evaluated. METHOD(S): Randomized
controlled trials and prospective clinical trials comparing crystalloid
and colloid priming fluids or with retrograde autologous priming were
selected. Primary outcome was the colloid oncotic pressure; secondary
outcomes were fluid balance, fluid requirements, weight gain, blood loss,
platelet count, and transfusion requirements. RESULT(S): From 1582
records, 29 eligible studies were identified. Colloid oncotic pressures
were comparable between gelofusine and hydroxyethyl starch during bypass
(mean difference [MD]: 0.69; 95% confidence interval [CI]: -2.05, 3.43;
P=0.621), after bypass (MD: -0.11; 95% CI: -2.54, 2.32; P=0.930), and
postoperative (MD: -0.61; 95% CI: -1.60, 0.38; P=0.228). Fluid balance was
lower with hydroxyethyl starch than with crystalloids. Retrograde
autologous priming reduced transfusion requirements compared with
crystalloids. Blood loss was comparable between groups.
 CONCLUSION(S): Colloid oncotic pressures did not differ between
crystalloids and colloids. As a result of increased transcapillary fluid
movement, fluid balance was lower with hydroxyethyl starch than with
crystalloids. Haematocrit and transfusion requirements were comparable
between groups. However, the latter was lower when retrograde autologous
priming was applied to crystalloid priming compared with crystalloids
alone. Finally, no differences in blood loss were observed between the
groups. Copyright © The Author(s) 2022. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<94>
[Use Link to view the full text]
Accession Number
2017899976
Title
Ticagrelor With or Without Aspirin in Chinese Patients Undergoing
Percutaneous Coronary Intervention: A TWILIGHT China Substudy.
Source
Circulation: Cardiovascular Interventions. 15(4) (pp E009495), 2022. Date
of Publication: 01 Apr 2022.
Author
Han Y.; Claessen B.E.; Chen S.-L.; Chunguang Q.; Zhou Y.; Xu Y.; Hailong
L.; Chen J.; Qiang W.; Zhang R.; Luo S.; Zhu J.; Zhao X.; Cheng X.; Wang
J.; Su X.; Tao J.; Sun Y.; Wang G.; Li Y.; Bian L.; Goel R.; Sartori S.;
Zhang Z.; Angiolillo D.J.; Cohen D.J.; Gibson C.M.; Kastrati A.; Krucoff
M.; Mehta S.R.; Ohman E.M.; Steg P.G.; Liu Y.; Dangas G.; Sharma S.; Baber
U.; Mehran R.
Institution
(Han, Wang, Li, Bian) Department of Cardiology, General Hospital of
Northern Theater Command, Liaoning, Shenyang, China
(Claessen, Goel, Sartori, Zhang, Dangas, Sharma, Baber, Mehran) The Zena
and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine
at Mount Sinai, New York, NY, United States
(Chen) Department of Cardiology, Nanjing First Hospital Jiangsu, China
(Chunguang) Department of Cardiology, The First Affiliated Hospital of
Zhengzhou University, China
(Zhou) Department of Cardiology, Beijing Anzhen Hospital Capital Medical
University, China
(Xu) Department of Cardiology, Shanghai Tenth Peoples Hospital, China
(Hailong) Department of Cardiology, Dalian Municipal Central Hospital
Affiliated of Dalian Medical University, China
(Chen) Department of Cardiology, Guangdong Provincial People's Hospital,
Guangzhou, China
(Qiang) Department of Cardiology, Guizhou Provincial People's Hospital,
Guiyang, China
(Zhang) Department of Cardiology, Rui Jin Hospital Shanghai Jiaotong
University School of Medicine, Shanghai, China
(Luo) Department of Cardiology, The First Affiliated Hospital of Chongqing
Medical University, China
(Li) Department of Cardiology, The Second Hospital of Hebei Medical
University (4th Ward), Shijiazhuang, China
(Zhu) Department of Cardiology, The First Affiliated Hospital College of
Medicine of Zheijang University, Hangzhou, China
(Zhao) Department of Cardiology, Shanghai Changhai Hospital, China
(Cheng) Department of Cardiology, Wuhan Union Hospital, China
(Wang) Department of Cardiology, The Second Affiliated Hospital of
Zhejiang University of Medicine, Hangzhou, China
(Su) Department of Cardiology, WuHan Asia Heart Hospital, China
(Tao) Department of Cardiology, Sichuan Provincial People's Hospital,
Chengdu, China
(Sun) Department of Cardiology, The First Hospital of China Medical
University, Shenyang, China
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, United States
(Cohen) Department of Cardiology, University of Missouri-Kansas City,
United States
(Gibson) Department of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Kastrati) Department of Cardiology, Deutsches Herzzentrum Munchen,
Munich, Germany
(Krucoff, Ohman) Department of Cardiology, Hamilton Health Sciences,
Canada
(Mehta) Department of Cardiology, Duke University Medical Center, Durham,
NC, United States
(Steg) Department of Cardiology, Universite de Paris, Assistance
Publique-Hopitaux de Paris, France
(Liu) Department of Cardiology, People's Liberation Army General Hospital,
Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The risk/benefit tradeoff of dual antiplatelet therapy after
percutaneous coronary intervention may vary in East Asian patients as
compared with their non-East Asian counterparts. Method(s): The
double-blind, placebo-controlled, randomized TWILIGHT trial (Ticagrelor
With Aspirin or Alone in High-Risk Patients After Coronary Intervention)
enrolled patients undergoing high-risk percutaneous coronary intervention.
After 3 months of treatment with ticagrelor plus aspirin, event-free and
adherent patients remained on ticagrelor and were randomly assigned to
receive aspirin or placebo for 1 year. The primary end point was Bleeding
Academic Research Consortium type 2, 3, or 5 bleeding; the key secondary
end point was the first occurrence of death from any cause, nonfatal
myocardial infarction, or nonfatal stroke. Result(s): Of 9006
enrolled and 7119 randomized patients in TWILIGHT, 1169 patients (13.0%)
were enrolled at 27 Chinese sites in this prespecified substudy, of whom
1028 (14.4%) patients were randomized after 3 months. The incidence of the
primary end point was 6.2% in the ticagrelor+aspirin group versus 3.5% in
the ticagrelor+placebo group between randomization and 1 year (hazard
ratio, 0.56 [95% CI, 0.31-0.99]; P=0.048). The key secondary end point
occurred in 3.4% of patients in the ticagrelor+aspirin group versus 2.4%
in the ticagrelor+placebo group (hazard ratio, 0.70 [95% CI, 0.33-1.46];
P=0.34). There was no interaction between the region of randomization
(China versus the rest of the world) and randomized treatment assignment
in terms of the primary or key secondary end points. Conclusion(s):
Ticagrelor monotherapy significantly reduced clinically relevant bleeding
without increasing ischemic events as compared with ticagrelor plus
aspirin in Chinese patients undergoing high-risk percutaneous coronary
intervention. Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT02270242. Copyright © 2022 Lippincott Williams and
Wilkins. All rights reserved.

<95>
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.

<96>
Accession Number
2017755531
Title
Minimum Core Data Elements for Evaluation of TAVR: A Scientific Statement
by PASSION CV, HVC, and TVT Registry.
Source
Annals of Thoracic Surgery. 113(5) (pp 1730-1742), 2022. Date of
Publication: May 2022.
Author
Simonato M.; Vemulapalli S.; Ben-Yehuda O.; Wu C.; Wood L.; Popma J.;
Feldman T.; Krohn C.; Hardy K.M.; Guibone K.; Christensen B.; Alu M.C.;
Chen S.; Ng V.G.; Chau K.H.; Shahim B.; Vincent F.; MacMahon J.; James S.;
Mack M.; Leon M.B.; Thourani V.H.; Carroll J.; Krucoff M.
Institution
(Simonato) Yale School of Medicine, Connecticut, New Haven
(Vemulapalli, Krucoff) Duke Clinical Research Institute, North Carolina,
Durham
(Ben-Yehuda) University of California-San Diego, San Diego, California,
United States
(Ben-Yehuda, Alu, Shahim, Vincent) Cardiovascular Research Foundation, New
York, New York
(Wu) U.S. Food and Drug Administration, Silver Spring, MD, United States
(Wood, Feldman) Edwards Lifesciences, Irvine, California, United States
(Popma) Medtronic, Minneapolis, MN, United States
(Krohn) The Society of Thoracic Surgeons, Illinois, Chicago
(Hardy) Common Spirit Health, Illinois, Chicago
(Guibone) Beth Israel Deaconess Medical Center, Boston, Massachusetts,
United States
(Christensen) American College of Cardiology, DC, Washington
(Chen, Ng, Chau, Leon) Columbia University Irving School of Medicine, New
York, New York, United States
(MacMahon) Mitre Medical Corporation, Morgan Hill, CA, United States
(James) Department of Medical Sciences and Uppsala Clinical Research
Center, Uppsala, Sweden
(Mack) Baylor Scott and White Health, Texas, Dallas
(Thourani) Piedmont Heart and Vascular Institute, Georgia, Atlanta,
Georgia
(Carroll) University of Colorado School of Medicine, Colorado, Denver
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) is the standard of care for
severe, symptomatic aortic stenosis. Real-world TAVR data collection
contributes to benefit/risk assessment and safety evidence for the U.S.
Food and Drug Administration, quality evaluation for the Centers for
Medicare and Medicaid Services and hospitals, as well as clinical research
and real-world implementation through appropriate use criteria. The
essential minimum core dataset for these purposes has not previously been
defined but is necessary to promote efficient, reusable real-world data
collection supporting quality, regulatory, and clinical applications. The
authors performed a systematic review of the published research for
high-impact TAVR studies and U.S. multicenter, multidevice registries. Two
expert task forces, one from the Predictable and Sustainable
Implementation of National Cardiovascular Registries/Heart Valve
Collaboratory and another from The Society of Thoracic Surgeons/American
College of Cardiology TVT (Transcatheter Valve Therapy) Registry convened
separately and then met to reconcile a final list of essential data
elements. From 276 unique data elements considered, unanimous consensus
agreement was achieved on 132 "core" data elements, with the most common
reasons for exclusion from the minimum core dataset being burden or
difficulty in accurate assessment (36.9%), duplicative information
(33.3%), and low likelihood of affecting outcomes (10.7%). After a
systematic review and extensive discussions, a multilateral group of
academicians, industry representatives, and regulators established 132
interoperable, reusable essential core data elements essential to
supporting more efficient, consistent, and informative TAVR device
evidence for regulatory submissions, safety surveillance, best practice,
and hospital quality assessments. Copyright © 2022 The Authors

<97>
Accession Number
2017665010
Title
Validation and comparison of 28 risk prediction models for coronary artery
disease.
Source
European Journal of Preventive Cardiology. 29(4) (pp 666-674), 2022. Date
of Publication: 01 Mar 2022.
Author
Lenselink C.; Ties D.; Pleijhuis R.; Van Der Harst P.
Institution
(Lenselink, Ties, Van Der Harst) Department of Cardiology, University
Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen
9700, Netherlands
(Pleijhuis) Department of Internal Medicine, University Medical Center
Groningen, Hanzeplein 1, Groningen 9700, Netherlands
Publisher
Oxford University Press
Abstract
Aims: Risk prediction models (RPMs) for coronary artery disease (CAD),
using variables to calculate CAD risk, are potentially valuable tools in
prevention strategies. However, their use in the clinical practice is
limited by a lack of poor model description, external validation, and
head-to-head comparisons. Methods and Results: CAD RPMs were
identified through Tufts PACE CPM Registry and a systematic PubMed search.
Every RPM was externally validated in the three cohorts (the UK Biobank,
LifeLines, and PREVEND studies) for the primary endpoint myocardial
infarction (MI) and secondary endpoint CAD, consisting of MI, percutaneous
coronary intervention, and coronary artery bypass grafting. Model
discrimination (C-index), calibration (intercept and regression slope),
and accuracy (Brier score) were assessed and compared head-to-head between
RPMs. Linear regression analysis was performed to evaluate predictive
factors to estimate calibration ability of an RPM. Eleven articles
containing 28 CAD RPMs were included. No single best-performing RPM could
be identified across all cohorts and outcomes. Most RPMs yielded fair
discrimination ability: mean C-index of RPMs was 0.706 +/- 0.049, 0.778
+/- 0.097, and 0.729 +/- 0.074 (P < 0.01) for prediction of MI in UK
Biobank, LifeLines, and PREVEND, respectively. Endpoint incidence in the
original development cohorts was identified as a significant predictor for
external validation performance. Conclusion(s): Performance of CAD
RPMs was comparable upon validation in three large cohorts, based on which
no specific RPM can be recommended for predicting CAD risk. Copyright
© 2021 The Author(s) 2021. Published by Oxford University Press on
behalf of the European Society of Cardiology.

<98>
Accession Number
637712442
Title
Utility of a smartphone application in assessing palmar circulation prior
to radial artery harvesting for coronary artery bypass grafting: Rationale
and design of the randomised CAPITAL iRADIAL-CABG trial.
Source
BMJ Open. 12(4) (no pagination), 2022. Article Number: e055580. Date of
Publication: 08 Apr 2022.
Author
Goh C.Y.; Parlow S.; Di Santo P.; Simard T.; Jung R.; Ahmed Z.;
Verreault-Julien L.; Kuhar P.; Chan V.; Al-Atassi T.; Toeg H.; Bernick J.;
Wells G.A.; Ruel M.; Hibbert B.
Institution
(Goh, Parlow, Di Santo, Jung, Ahmed, Verreault-Julien, Hibbert) Capital
Research Group, Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Di Santo, Wells) School of Epidemiology and Public Health, University of
Ottawa, Ottawa, ON, Canada
(Simard) Department of Cardiovascular Diseases, Mayo Clinic School of
Medicine, Rochester, MN, United States
(Jung, Hibbert) Department of Cellular and Molecular Medicine, University
of Ottawa, Ottawa, ON, Canada
(Kuhar) Azumio Inc, Redwood City, San Francisco, United States
(Chan, Al-Atassi, Toeg, Ruel) Division of Cardiac Surgery, University of
Ottawa Heart Institute, Ottawa, ON, Canada
(Bernick, Wells) Cardiovascular Research Methods Centre, University of
Ottawa Heart Institute, Ottawa, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction There is emerging evidence supporting the use of the radial
artery (RA) as a preferred secondary conduit for coronary artery bypass
grafting (CABG) as it is associated with higher rates of graft patency at
5 years when compared with saphenous vein grafts (SVG). The modified
Allen's test (MAT) is traditionally regarded as the standard of care in
the assessment of ulnar artery (UA) patency prior to RA harvesting.
Unfortunately, due to high false-positive rates, a substantial number of
pre-CABG patients are found to have an abnormal MAT despite normal UA
patency, resulting in inappropriate exclusion from RA harvesting. The SVG
is generally used in its place when this occurs, resulting in potentially
lower rates of long-term graft patency. Methods and analysis The CAPITAL
iRADIAL-CABG trial is currently enrolling participants 18 years of age or
older undergoing CABG for whom the treating physician is considering the
use of an RA conduit. Eligible patients will be randomised in a 1:1
fashion to MAT or smartphone-based photoplethysmography application
assessment to assess collateral palmar circulation prior to RA harvesting.
The primary outcome of the trial is the use of the RA as a conduit during
CABG. The primary safety outcome is postoperative palmar ischaemia as
determined by clinical assessment or requirement of vascular intervention.
Secondary outcomes include vascular complications, early graft failure,
need for rescue percutaneous coronary intervention during the index
hospitalisation and a composite cardiovascular outcome of myocardial
infarction, stroke and cardiovascular death prior to discharge from
hospital. A total of 236 participants are planned to be recruited. Ethics
and dissemination The study was approved by the Ottawa Heart Science
Network Research Ethics Board (approval number 20180865-01H). The study
results will be disseminated via conference presentations and
peer-reviewed publications. Trial registration number
NCT03810729. Copyright © Authors 2022

<99>
[Use Link to view the full text]
Accession Number
2015123628
Title
Benefits and Risks of Dexamethasone in Noncardiac Surgery.
Source
Anesthesiology. 135(5) (pp 895-903), 2021. Date of Publication: 01 Nov
2021.
Author
Myles P.S.; Corcoran T.
Institution
(Myles) Department of Anaesthesiology and Perioperative Medicine, Alfred
Hospital and Monash University, Melbourne, Australia
(Corcoran) Department of Anaesthesia and Pain Medicine, Royal Perth
Hospital, Perth, Australia
Publisher
Lippincott Williams and Wilkins

<100>
Accession Number
2016536941
Title
The detection, treatment of parvovirus B19 infection induced anemia in
solid organ transplants: A case series and literature review of 194
patients.
Source
Transfusion Clinique et Biologique. 29(2) (pp 168-174), 2022. Date of
Publication: May 2022.
Author
Zhong Q.; Zeng J.; Lin T.; Song T.
Institution
(Zhong, Lin, Song) Urology Department, Urology research institute, West
China Hospital, Sichuan University, Sichuan, Chengdu, China
(Zhong, Lin, Song) Organ transplantation center, West China Hospital,
Sichuan University, Sichuan, Chengdu, China
(Zeng) Department of Transplantation Surgery, The Affiliated Hospital of
Guizhou Medical University, Guizhou, Guiyang, China
Publisher
Elsevier Masson s.r.l.
Abstract
Background: There are no optimal diagnostic, treatment and post-infection
surveillance strategies for parvovirus B19 infection in solid organ
transplantation (SOT) recipients. Method(s): We conducted a
retrospective review of all PVB19 infected cases confirmed by qPCR among
SOT recipients at our institution over a 3-year period and reviewed the
literature from 1990 to 2021. Result(s): Eight kidney and two heart
transplant patients with refractory anemia had PVB19 infection. The viral
DNA load in peripheral blood ranged from 2.62 x 102 to 8.31 x
106 copies/mL. Two patients with the lowest PVB19 DNA load only
reduced the use of immunosuppressants and anemia was relieved. Eight
received intravenous immunoglobulin (IVIG) (ranging from 0.25 to 0.5
g/kg/day). The median time to anemia improvement (hemoglobulin > 100 g/L)
was 16 days (8-70 days) after treatment. One patient had a PVB19 relapse
and viral DNA load > 1.00 x 108 copies/mL at diagnosis. A total
of 86 studies involving 194 SOTs were screened from the literature, and
the most common symptom was anemia and low reticulocyte count. PVB19 DNA
was detected in all cases. Of that, 91.4% of cases received IVIG, 53.8%
received IVIG and immunosuppression reduction, 6.5% of cases showed
reduced immunosuppression without IVIG, and 2.1% did not receive any
special treatment. The recurrence rate was 17.5%. Conclusion(s):
PVB19 infection is a cause of anemia after SOT, and treatment mainly
relies on IVIG and/or immunosuppression reduction. Copyright ©
2022 Societe francaise de transfusion sanguine (SFTS)

<101>
Accession Number
2017886802
Title
Covid 19 And Pericarditis: Should We Be Worried About Tamponade?.
Source
Journal of Cardiac Failure. Conference: Heart Failure Society of America's
(HFSA) Annual Scientific Meeting 2021. Denver United States. 28(5
Supplement) (pp S97), 2022. Date of Publication: April 2022.
Author
Arshad S.; Gul M.H.; Guglin M.
Institution
(Arshad, Gul) University of Kentucky, Lexington, KY, United States
(Guglin) Indiana University School of Medicine - Department of Medicine
Residency Program, Indianapolis, IN, United States
Publisher
Elsevier B.V.
Abstract
Introduction: Little is known about cardiac manifestations of COVID-19
infection, yet cases of pericarditis, pericardial effusion and with
tamponade due to COVID-19 have been reported. Because of the
life-threatening nature of this complication, we wanted to investigate the
features of pericardial effusion and the rate of occurrence of tamponade
in patients with COVID-19. Method(s): This systematic review was
conducted by searching for studies in Pubmed/Medline and Google Scholar
for the search terms 'COVID-19', 'SARS-COV-2', 'Pericarditis',
'Pericardial Effusion' and 'Cardiac Tamponade', performed on December 7,
2020. Result(s): A total of 47 patients with COVID-19 with
pericarditis were included in the review from 39 published cases. There
were 29 (62%) males and 18 (38%) females and mean age of patients was 53
years. Pulmonary infiltrates were seen in 30 (64%) patients, while 17
(36%) patients did not have pulmonary manifestations. Concomitant
myocarditis was present in 16 (34%) patients. 43 (91%) had pericardial
effusion- 4 (9%) had small, 10 (21%) had moderate, 3 (6%) had a large
pericardial effusion and 26 (55%) patients had cardiac tamponade. 7 (15%)
patients with tamponade died. Pericardiocentesis was done in 27 (57%)
patients and pericardial window was created in 5 (11%) patients. Off these
13 (27%) patients had an exudative effusion while 1 (2%) patient had a
transudative effusion. Conclusion(s): We found that pericarditis in
patients with COVID-19 infection can be present in patients with pulmonary
infiltrates and without them, as well as with myocarditis or as an
isolated feature of cardiac involvement. The effusion is predominantly
exudative. More than half of the patients with pericardial involvement
present with tamponade, and mortality in this subset is high. The pattern
of patients presenting solely with pericarditis and effusion without
pulmonary infiltrates warrants further investigation. Copyright ©
2022

<102>
Accession Number
2017886742
Title
Thin Filament Cardiomyopathy: Natural History, Clinical Features, And
Outcomes.
Source
Journal of Cardiac Failure. Conference: Heart Failure Society of America's
(HFSA) Annual Scientific Meeting 2021. Denver United States. 28(5
Supplement) (pp S121), 2022. Date of Publication: April 2022.
Author
Saul T.; Bui Q.; Keyt L.K.; Brambatti M.; Adler E.D.
Institution
(Saul, Bui, Keyt, Brambatti, Adler) University of California, San Diego,
La Jolla, CA, United States
Publisher
Elsevier B.V.
Abstract
Introduction: Hypertrophic cardiomyopathy due to thin filament mutations
(HCM-Thin) has classically been characterized as more malignant with a
higher burden of lethal arrhythmias and higher risk for sudden cardiac
death compared to HCM from thick filament mutations (HCM-Thick). However,
due to paucity of data and conflicting reports from small retrospective
studies, the treatment of patients with HCM from thin and thick filament
mutations have largely been the same. Objective(s): This systemic
review includes all published case reports and series on HCM-Thin to
understand the natural history and clinical outcomes in those with this
condition. Method(s): A PubMed query regarding HCM-TF cases published
until April 22, 2020 yielded twenty manuscripts that met inclusion
criteria. Patients were included if a pathogenic mutation was identified
or if the patient had clinical manifestations of hypertrophic
cardiomyopathy and a first degree relative with positive genetic testing.
Demographic, clinical characteristics, imaging data and outcomes were
collected. Result(s): A total of 211 HCM-Thin patients were
identified with the most common mutations being TNNT2 (50.0%), TNNI3
(23.7%), and TPM1 (22.2%). The most common symptom reported was dyspnea
(62.4%) with 22.4% classified as NYHA III and IV. Left ventricular outflow
obstruction was present in 9.6% patients with the median left ventricular
maximal thickness of 16.5 mm. Cardiac conduction abnormalities were
frequent (56.9%) with the most common being ST-T abnormalities; Notably
26% were found to have atrial fibrillation and 18.3% had ventricular
arrhythmias. The composite outcome of death, heart transplant, or
ventricular assist device occurred in 18.5% of the cohort. Sudden cardiac
death (55.6%) was the most common cause of mortality, but only 15.9% of
patients received an ICD. Conclusion(s): In this systematic analysis,
HCM-Thin patients had a high risk of all-cause mortality or heart
transplant, arrhythmia and advanced heart failure despite low rates of
obstruction and hypertrophy. HCM-Thin may be a unique endotype that
deserves distinct therapeutic approaches. Copyright © 2022

<103>
Accession Number
2017886720
Title
Transcatheter Repair In Patients With Functional Mitral Regurgitation From
The CLASP Study: Outcomes To 2 Years.
Source
Journal of Cardiac Failure. Conference: Heart Failure Society of America's
(HFSA) Annual Scientific Meeting 2021. Denver United States. 28(5
Supplement) (pp S13), 2022. Date of Publication: April 2022.
Author
Grayburn P.; Kourkoveli P.; Mazimba S.; Hage A.; Goldschmidt M.; Simmons
L.; Moe G.; Mishkin J.; Marcoff L.; Toma M.
Institution
(Grayburn) The Heart Hospital Baylor Plano, Plano, TX, United States
(Kourkoveli) Hygeia Hospital, Athens, Greece
(Mazimba) University of Virginia Health System Hospital, Charlottesville,
VA, United States
(Hage) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Goldschmidt, Marcoff) Morristown Medical Center, Morristown, NJ, United
States
(Simmons) Royal Prince Alfred Hospital, Camperdown, NSW, Australia
(Moe) St. Michael's Hospital, Toronto, ON, Canada
(Mishkin) Sanger Heart & Vascular Institute, Charlotte, NC, United States
(Toma) St. Paul's Hospital, Vancouver, BC, Canada
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter mitral valve repair is a favorable option in
patient care for treating functional mitral regurgitation (FMR). We report
2-year outcomes from the FMR group of the multicenter, prospective, single
arm CLASP study with the PASCAL transcatheter valve repair system.
 Method(s): Patients with symptomatic FMR >=3+ deemed candidates for
transcatheter repair by the local heart team were eligible. Follow-up was
conducted to two years with echocardiographic outcomes evaluated by the
core laboratory at all timepoints; other outcomes included major adverse
events (MAEs) evaluated by an independent clinical events committee to one
year (site-reported thereafter); six-minute walk distance (6MWD) and
quality of life evaluated to one year. Result(s): Eighty-five FMR
patients were treated; mean age 72 years, 55% male, 65% in NYHA Class
III-IVa, mean LVEF 37%, and 100% >=3+ MR. Successful implantation was
achieved in 96% of patients. MAEs included one cardiovascular mortality
(1.2%) and one conversion to mitral valve replacement surgery (1.2%) at 30
days, and two reinterventions between 30 days and two years. Kaplan-Meier
(KM) estimates for survival were 88% at one year and 72% at two years.
Freedom from heart failure (HF) rehospitalization was 81% at one year and
78% at two years. Reduction in annualized HF hospitalization rate was 81%
(p<0.001). MR <=1+ was achieved in 73% of patients at 30 days, 75% at one
year, and 84% at two years; MR <=2+ was achieved in 96% of patients at 30
days, 100% at one year, and 95% at two years (all p<0.001). Mean LVEDV of
199 mL at baseline decreased by 9 mL at 30 days (p=0.039), 29 mL at one
year (p<0.001), and 31 mL at two years (p<0.001). NYHA class I-II was
achieved in 87% of patients at 30 days, 86% at one year, and 88% at two
years (all p<0.001). Average 6MWD improved by 22 m at 30 days (p=0.004)
and 40 m at one year (p=0.003). Kansas City Cardiomyopathy Questionnaire
(KCCQ) score improved by 16 points at 30 days and one year (all p<0.001).
 Conclusion(s): : The PASCAL transcatheter valve repair system
demonstrated sustained favorable outcomes at two years in patients with
FMR. Results showed a high survival rate of 72% and freedom from HF
rehospitalization of 78% with an 81% reduction in annualized HF
hospitalization rate. Sustained MR reduction of MR <=2+ was achieved in
95% and MR <=1+ in 84% of patients, with evidence of left ventricular
reverse remodeling. Improvements in functional status were clinically
significant and durable. The CLASP IIF randomized pivotal trial
(NCT03706833) is ongoing. Copyright © 2022

<104>
Accession Number
2017940646
Title
The role of aromatherapy with lavender in reducing the anxiety of patients
with cardiovascular diseases: A systematic review of clinical trials.
Source
Journal of HerbMed Pharmacology. 11(2) (pp 182-187), 2022. Date of
Publication: 2022.
Author
Amin A.; Gavanrudi M.R.; Karami K.; Raziani Y.; Baharvand P.
Institution
(Amin) Cardiovascular Research Center, Lorestan University of Medical
Sciences, Khorramabad, Iran, Islamic Republic of
(Gavanrudi) Faculty of Pharmacy, Ayatollah Amoli Branch, Islamic Azad
University, Amol, Iran, Islamic Republic of
(Karami, Baharvand) Social Determinants of Health Research Center,
Lorestan University of Medical Sciences, Khorramabad, Iran, Islamic
Republic of
(Raziani) Department of Nursing, Komar University of Science and
Technology, Kurdistan Region, Sulaymaniyah, Iraq
Publisher
Nickan Research Institute
Abstract
Most studies have shown the positive effects of lavender inhalation in
decreasing anxiety in patients with cardiovascular diseases. We aimed to
systematically review the role of aromatherapy with lavender in these
patients. By PRISMA standards, we explored the studies on the role of
aromatherapy with lavender in reducing the anxiety of patients with
cardiovascular diseases in English databases through the words and terms
"aromatherapy", "lavender", "lavandula", "anxiety", "cardiovascular
diseases". Out of 16 647 papers, 12 papers up to January 2022 encountered
the inclusion criteria for involving in this systematic review. The
majority of studies (7 studies, 70%) were used Spielberger Standard
Questionnaire as a measurement scale for their studies. Lavender
aromatherapy was mostly used for myocardial infarction (3 studies, 30%)
and coronary artery bypass graft (CABG) surgery (3 studies, 30%) patients.
We concluded that aromatherapy with lavender essential oil significantly
ameliorated the anxiety signs in some cardiovascular diseases, e.g., CABG
surgery, myocardial infarction, and cardiac ischemia; however, more
studies are required in this field to obtain more specific
evidence. Copyright © 2022 Nickan Research Institute. All rights
reserved.

<105>
Accession Number
2017939744
Title
Effect of hyperglycemia treatment on complications rate after pediatric
cardiac surgery.
Source
Journal of Cardiovascular and Thoracic Research. 14(1) (pp 18-22), 2022.
Date of Publication: March 2022.
Author
Naghipour B.; Bagerpour M.; Shadvar K.; Golzari S.E.J.; Faridaalaee G.
Institution
(Naghipour, Shadvar, Golzari) Department of Anesthesiology and Intensive
Care, Medical Faculty, Tabriz University of Medical Sciences, Tabriz,
Iran, Islamic Republic of
(Bagerpour) Department of Gynecology and obestetric, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
(Faridaalaee) Emergency Medicine Research Team, Faculty of Medicine,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Faridaalaee) Department of Emergency Medicine, Maragheh University of
Medical Sciences, Maragheh, Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: The goal of this study was to elucidate harmful
complications of intraoperative hyperglycemia following children cardiac
surgery and benefits of insulin administration for accurate blood sugar
controlling. Method(s): this study is a Randomized clinical trial. We
conducted this study in the operating room of shahid madani hospital.
Fifty patients who were children under 12 years old undergone cardiac
surgery using cardiopulmonary bypass (CPB). Intraoperative insulin
infusion was administered intravenously targeting blood sugar levels of
110-140 mg/dL. Blood sugar and arterial blood gas (ABG) were measured
every 30 min during operation. Result(s): Inotropes were used less in
the study than the placebo group during surgery. The means of
hospitalization and extubation time were more in the placebo group than
the study group (P= 0.03) and (P= 0.005), respectively. However, the mean
time of hospitalization in the ICU ward did not differ significantly
between the two groups. Conclusion(s): Hyperglycemia has a relation
with long time of intubation and hospitalization in ICU. These findings
suggest the positive effect of accurate blood sugar control on reducing
complication and hospitalization time in children undergoing cardiac
surgery. Copyright © 2022 The Author(s). This is an open access
article distributed under the terms of the Creative Commons Attribution
License (http://creativecommons.org/licenses/by/4.0), which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.

<106>
Accession Number
2017821322
Title
Safety and efficacy of percutaneous coronary intervention versus coronary
artery bypass graft in patients with STEMI and unprotected left main stem
disease: A systematic review & meta-analysis.
Source
IJC Heart and Vasculature. 40 (no pagination), 2022. Article Number:
101041. Date of Publication: June 2022.
Author
Almas T.; Afzal A.; Fatima H.; Yaqoob S.; Ahmad Jarullah F.; Ahmed Abbasi
Z.; Farooqui A.; Jaffar D.; Batool A.; Ahmed S.; Sara Azmat N.; Afzal F.;
Zafar Khan S.; Fatima K.
Institution
(Afzal, Fatima, Ahmed Abbasi, Afzal, Fatima) Department of Medicine, Dow
University of Health Sciences, Karachi, Pakistan
(Jaffar, Batool, Ahmed, Sara Azmat) Department of Medicine, Shaheed
Mohtarma Benazir Bhutto Medical College, Karachi, Pakistan
(Yaqoob, Ahmad Jarullah) Department of Medicine, Jinnah Medical & Dental
College, Karachi, Pakistan
(Farooqui) Department of Medicine, United Medical and Dental College,
Karachi, Pakistan
(Zafar Khan) Department of Medicine, Karachi Medical and Dental College,
Karachi, Pakistan
(Almas) Department of Medicine, RCSI University of Medicine and Health
Sciences, Dublin, Ireland
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Owing to its large area of supply, left main coronary artery
disease (LMCAD) has the highest mortality rate among coronary artery
lesions, resulting in debate about its optimal revascularization
technique. This meta-analysis compares percutaneous coronary intervention
(PCI) versus coronary artery bypass grafting (CABG) for the treatment of
LMCAD. Method(s): MEDLINE, TRIP, and Cochrane Central databases were
queried from their inception until 25 April 2021, to determine MACCE
(major adverse cardiac and cardiovascular events), all-cause mortality,
repeat revascularization, myocardial infarction (MI) and stroke rates
post-revascularization for different follow-ups. 7 RCTs and 50
observational studies having 56,701 patients were included. A
random-effects model was used with effect sizes calculated as odds ratios
(odds ratio, OR). Result(s): In the short term (1 year), PCI had
significantly higher repeat revascularizations (OR = 3.58, 95% CI
2.47-5.20; p < 0.00001), but lower strokes (OR = 0.55, 95% CI 0.38-0.81; p
= 0.002). In the intermediate term (2-5 years), PCI had significantly
higher rates of repeat revascularizations (OR = 3.47, 95% CI 2.72-4.44; p
< 0.00001) and MI (OR = 1.39, 95% CI 1.17-1.64; p = 0.0002), but
significantly lower strokes (OR = 0.54, 95% CI 0.42-0.70; p < 0.0001). PCI
also had significantly higher repeat revascularizations (OR = 2.58, 95% CI
1.89-3.52; p < 0.00001) in the long term (>=5 years), while in the very
long term (>=10 years), PCI had significantly lower all-cause mortalities
(OR = 0.77, 95% CI 0.61-0.96; p = 0.02). Conclusion(s): PCI was safer
than CABG for patients with stroke for most follow-ups, while CABG was
associated with lower repeat revascularizations. However, further research
is required to determine PCI's safety over CABG for reducing post-surgery
MI. Copyright © 2022 The Authors

<107>
Accession Number
637793368
Title
CT Planning prior to Transcatheter Mitral Valve Replacement (TMVR).
Source
RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden
Verfahren. 194(4) (pp 373-383), 2022. Date of Publication: 01 Apr 2022.
Author
Heiser L.; Gohmann R.F.; Noack T.; Renatus K.; Lurz P.; Thiele H.; Seitz
P.; Gutberlet M.
Institution
(Heiser, Gohmann, Renatus, Seitz, Gutberlet) Department Of Diagnostic And
Interventional Radiology, Heart Center Leipzig, Leipzig, Germany
(Noack) Department Of Cardiac Surgery, Heart Center Leipzig, University Of
Leipzig, Leipzig, Germany
(Renatus, Thiele, Gutberlet) Medical Faculty, University Of Leipzig,
Leipzig, Germany
(Lurz, Thiele) Department Of Cardiology, Heart Center Leipzig, University
Of Leipzig, Leipzig, Germany
(Lurz, Thiele, Gutberlet) Lhi, Leipzig Heart Institute, Leipzig, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Transcatheter mitral valve replacement (TMVR) is a treatment
option for patients with therapy refractory high-grade mitral valve
regurgitation and a high perioperative risk. During TMVR, the mitral
annulus cannot be visualized directly. Therefore, comprehensive
pre-interventional planning and a precise visualization of the patient's
specific mitral valve anatomy, outflow tract anatomy and projected
anchoring of the device are necessary. Aim of this review-article is, to
assess the role of pre-procedural computed tomography (CT) for
TMVR-planning Methods: Screening and evaluation of relevant guidelines
(European Society of Cardiology [ESC], American Heart Association
[AHA/ACC]), meta-analyses and original research using the search terms
TVMR or TMVI and CT. In addition to this, the authors included insight
from their own clinical experience. Result(s): CT allows for accurate
measurement of the mitral annulus with high special and adequate temporal
resolution in all cardiac phases. Therefore, CT represents a valuable
method for accurate prosthesis-sizing. In addition to that, CT can provide
information about the valvular- and outflow-tract-anatomy, mitral valve
calcifications, configuration of the papillary muscles and of the left
ventricle. Additionally, the interventional access-route may concomitantly
be visualized. Conclusion(s): CT plays, in addition to
echocardiographic imaging, a central role in pre-interventional assessment
prior to TMVR. Especially the precise depiction of the left ventricular
outflow tract (LVOT) provides relevant additional information, which is
very difficult or not possible to be acquired in their entirety with other
imaging modalities. Key Points:: CT plays a central role in
pre-interventional imaging for TMVR. CT-measurements allow for accurate
prosthesis-sizing. CT provides valuable information about LVOT-anatomy,
mitral calcifications and interventional access-route. Citation Format
Heiser L, Gohmann RF, Noack T etal. CT Planning prior to Transcatheter
Mitral Valve Replacement (TMVR). Fortschr Rontgenstr 2022; 194: 373-383.
 Copyright © 2022. Thieme. All rights reserved.

<108>
Accession Number
2016477240
Title
The hybrid convergent procedure for persistent and long-standing
persistent atrial fibrillation from an electrophysiologist's perspective.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2022. Date
of Publication: 2022.
Author
DeLurgio D.B.
Institution
(DeLurgio) School of Medicine, Emory University, Atlanta, GA, United
States
Publisher
John Wiley and Sons Inc
Abstract
In atrial fibrillation (AF), the pulmonary veins (PVs) are central to
arrhythmogenicity and are targeted by PV isolation (PVI). As AF
progresses, triggers become more prevalent in non-PV areas including the
left atrial posterior wall (LAPW). Reported benefits of LAPW isolation in
Cox-maze IV led to exploration of ablation strategies using endocardial
catheters. However, no single approach to endocardial LAPW isolation
exists. Relative success in comparison to PVI alone has been mixed. The
hybrid convergent procedure was developed to combine minimally invasive
surgical and electrophysiology techniques to accomplish effective PVI and
LAPW isolation. Epicardial LAPW isolation is performed by a cardiothoracic
surgeon followed by endocardial ablation by an electrophysiologist who
ensures PVI completion and targets any remaining gaps. Safety and
effectiveness of hybrid convergent were evaluated in the prospective,
multicenter, randomized controlled trial, Convergence of Epicardial and
Endocardial Ablation for the Treatment of Symptomatic Persistent AF
(CONVERGE). CONVERGE compared the effectiveness of the hybrid convergent
procedure to endocardial catheter ablation for treatment of
drug-refractory persistent and long-standing persistent AF and
demonstrated primary effectiveness of higher freedom from atrial
arrhythmias absent new/increased dose previously failed/intolerant
antiarrhythmic drugs through 12 months compared to endocardial catheter
ablation. Greater freedom from AF and proportion of patients experiencing
>=90% burden reduction with hybrid convergent ablation were seen through
18 months of follow-up. Improved electrophysiology lab efficiency was
demonstrated by the reduction in endocardial ablation time with addition
of epicardial ablation. This multidisciplinary heart team procedure may
improve outcomes in difficult-to-treat patients with advanced
AF. Copyright © 2022 Wiley Periodicals LLC.

<109>
Accession Number
2016092562
Title
Valve-in-valve transcatheter aortic valve replacement or re-surgical
aortic valve replacement in degenerated bioprostheses: A systematic review
and meta-analysis of short and midterm results.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Bruno F.; Elia E.; D'Ascenzo F.; Marengo G.; Deharo P.; Kaneko T.; Cuisset
T.; Fauchier L.; De Filippo O.; Gallone G.; Andreis A.; Fortuni F.;
Salizzoni S.; La Torre M.; Rinaldi M.; De Ferrari G.M.; Conrotto F.
Institution
(Bruno, Elia, D'Ascenzo, Marengo, De Filippo, Gallone, Andreis, Fortuni,
De Ferrari, Conrotto) Division of Cardiology, Department Cardiovascular
and Thoracic, Citta della Salute e della Scienza Hospital, University of
Turin, Turin, Italy
(Deharo, Cuisset) Departement de Cardiologie, CHU Timone, Marseille,
France
(Deharo, Cuisset) INSRRM, INRA, Aix Marseille University, Marseille,
France
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Boston, MA, United States
(Fauchier) Service de Cardiologie, Centre Hospitalier Trousseau, Tours,
France
(Salizzoni, La Torre, Rinaldi) Division of Cardiosurgery, Department of
Cardiovascular and Thoracic, Citta della Salute e della Scienza Hospital,
University of Turin, Turin, Italy
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Despite limited to short and midterm outcomes,
valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) has
emerged as a valid alternative to re-surgical aortic valve replacement
(re-SAVR) for high- and intermediate-risk patients with degenerated
surgical bioprosthesis. Method(s): All studies comparing multivariate
adjustment between ViV TAVI and re-SAVR were screened. The primary
end-points were all-cause and cardiovascular (CV) mortality at 30 days and
at Midterm follow-up. Short-term complications were the secondary
endpoints. Result(s): We obtained data from 11 studies, encompassing
8570 patients, 4224 undergoing ViV TAVI, and 4346 re-SAVR. Four studies
included intermediate-risk patients and seven high-risk patients. 30-day
all-cause and CV mortality were significantly lower in ViV (odds ratio
[OR] 0.43, 95% confidence intervals [CIs] 0.29-0.64 and OR 0.44, 0.26-0.73
respectively), while after a mean follow-up of 717 (180-1825) days, there
was no difference between the two groups (OR 1.04, 0.87-1.25 and OR 1.05,
0.78-1.43, respectively). The risk of stroke (OR 1.03, 0.59-1.82), MI (OR
0.70, 0.34-1.44), major vascular complications (OR 0.92, 0.50-1.67), and
permanent pacemaker implantation (OR 0.67, 0.36-1.25) at 30 days did not
differ, while major bleedings and new-onset atrial fibrillation were
significantly lower in ViV patients (OR 0.41, 0.25-0.67 and OR 0.23,
0.12-0.42, respectively, all 95% CIs). Conclusion(s): In high- and
intermediate-risk patients with degenerated surgical bioprostheses, ViV
TAVI is associated with reduced short-term mortality, compared with
re-SAVR. Nevertheless, no differences were found in all-cause and CV
mortality at midterm follow-up. PROSPERO CRD42021226488. Copyright
© 2022 Wiley Periodicals LLC.

<110>
Accession Number
637935816
Title
Language abilities in preschool children with critical CHD: a systematic
review.
Source
Cardiology in the young. (pp 1-11), 2022. Date of Publication: 05 May
2022.
Author
Turner T.; El Tobgy N.; Russell K.; Day C.; Cheung K.; Proven S.; Ricci
M.F.
Institution
(Turner, El Tobgy) University of Manitoba Advanced Degrees in Medicine
Program, Winnipeg, MB, Canada
(Russell, Ricci) Department of Pediatrics and Child Health, University of
Manitoba, Winnipeg, MB, Canada
(Russell, Ricci) Children's Hospital Research Institute of Manitoba,
Winnipeg, MB, Canada
(Day, Cheung, Proven, Ricci) Specialized Services for Children and Youth
(SSCY) Centre, Winnipeg, MB, Canada
(Cheung) Department of Clinical Health Psychology, University of Manitoba,
Winnipeg, MB, Canada
Publisher
NLM (Medline)
Abstract
CONTEXT: Children with critical CHD are at risk for neurodevelopmental
impairments, including delays in expressive and receptive language
development. However, no study has synthesised the literature regarding
language abilities in children with this condition. OBJECTIVE(S): We
summarised the literature regarding expressive and receptive language in
preschool children with critical CHD. DATA SOURCES: MEDLINE, Embase,
Scopus, Child Development and Adolescent Studies, ERIC, PsycINFO, and
CINAHL. STUDY SELECTION: We included studies published between January,
1990 and 1 July, 2021, focused on children aged <=5 years with critical
CHD requiring a complex cardiac procedure at age <1 year. Language ability
was documented using standardised, validated tools assessing both
expressive and receptive language outcomes. DATA EXTRACTION: Data (study,
patient and language characteristics, and results) were extracted by two
reviewers. RESULT(S): Seventeen studies were included. Among children
2-5 years old with critical CHD, there were statistically significant
deficits in overall (standardised mean difference: -0.46; 95 % confidence
interval: -0.56, -0.35), expressive (standardised mean difference:
-0.45;95 % confidence interval: -0.54, -0.37), and receptive (standardised
mean difference: -0.32; 95 % confidence interval: -0.40, -0.23) language
compared to normative data. Results reported as medians were similar to
meta-analysis findings. Subgroup analysis showed that children with
univentricular physiology had lower language scores than children with
biventricular physiology. CONCLUSION(S): Preschool children with
critical CHD had statistically significantly lower language outcomes
compared to expected population norms. Healthcare professionals should
test early and often for language deficits, referring to individually
tailored supports.

<111>
Accession Number
637935150
Title
Chronic kidney disease and transcatheter aortic valve implantation.
Source
Cardiovascular intervention and therapeutics. (no pagination), 2022. Date
of Publication: 05 May 2022.
Author
Adachi Y.; Yamamoto M.
Institution
(Adachi) Department of Cardiology, Toyohashi Heart Center, Toyohashi,
Aichi 441-8530, Japan
(Yamamoto) Department of Cardiology, Toyohashi Heart Center, Toyohashi,
Aichi 441-8530, Japan
(Yamamoto) Department of Cardiology, Nagoya Heart Center, Nagoya, Aichi,
Japan
(Yamamoto) Department of Cardiology, Gifu Heart Center, Gifu, Japan
Publisher
NLM (Medline)
Abstract
Transcatheter aortic valve implantation (TAVI) is an established treatment
option for patients with severe aortic stenosis. Patients with aortic
stenosis have a higher prevalence of chronic kidney disease (CKD). CKD is
generally associated with an increased risk of mortality, cardiovascular
events, and readmission for heart failure; this supports the concept of a
cardio-renal syndrome (CRS). CRS encompasses a spectrum of disorders of
the heart and kidneys, wherein dysfunction in one organ may cause
dysfunction in the other. TAVI treatment is expected to break this
malignant cycle of CRS and improve cardio-renal function after the
procedure. However, several reports demonstrate that patients with CKD
have been associated with poor outcomes after the procedure. In addition,
TAVI treatments for patients with advanced CKD and those with end-stage
renal disease on hemodialysis are considered more challenging. Adequate
management to preserve cardio-renal function in patients undergoing TAVI
may reduce the risk of cardio-renal adverse events and improve the
long-term prognosis. The current comprehensive review article aims to
assess the prognostic impact of CKD after TAVI and seek optimal care in
patients with CKD even after successful TAVI. Copyright © 2022.
The Author(s) under exclusive licence to Japanese Association of
Cardiovascular Intervention and Therapeutics.

<112>
Accession Number
637933771
Title
TAVI with ACURATE neo transcatheter heart valve in special populations: A
systematic review.
Source
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese.
(no pagination), 2022. Date of Publication: 01 May 2022.
Author
Koliastasis L.; Doundoulakis I.; Kokkinidis D.G.; Milkas A.; Drakopoulou
M.; Benetos G.; Latsios G.; Synetos A.; Aggeli K.; Tousoulis D.; Tsioufis
K.; Toutouzas K.
Institution
(Koliastasis) First Department of Cardiology, National and Kapodistrian
University, "Hippokration" Hospital, Athens, Greece; Athens Naval and
Veterans Hospital, Athens, Greece
(Doundoulakis) First Department of Cardiology, National and Kapodistrian
University, "Hippokration" Hospital, Athens, Greece; Department of
Cardiology, 424 General Military Training Hospital, Thessaloniki, Greece
(Kokkinidis) Section of Cardiovascular Medicine, Yale University School of
Medicine, Yale New Haven Hospital, CT, New Haven, United States
(Milkas) Athens Naval and Veterans Hospital, Athens, Greece
(Drakopoulou, Benetos, Latsios, Synetos, Aggeli, Tousoulis, Tsioufis,
Toutouzas) First Department of Cardiology, National and Kapodistrian
University, "Hippokration" Hospital, Athens, Greece
Publisher
NLM (Medline)
Abstract
BACKGROUND: The ACURATE neo transcatheter aortic valve is a self-expanding
device suitable for both transfemoral and transapical approach, but
specific groups of patients are under-represented in clinical trials. We
aim to provide a comprehensive systematic review on TAVI with ACURATE neo
in those special populations. METHOD(S): TAVI in bicuspid aortic
valve, TAVI in patients with small aortic annulus, TAVI for pure aortic
regurgitation and valve-in-valve procedures, were systematically reviewed.
The primary endpoint was device success as defined by VARC-2 criteria. The
secondary endpoints were safety and performance outcomes according to
VARC-2 consensus document. RESULT(S): ACURATE neo exhibited similar
outcomes in bicuspid vs tricuspid aortic valve except for pre and
post-dilatation rates in one observational study. Lower mean aortic
gradient and higher pre-dilatation rates with comparable safety outcomes
were described for ACURATE neo when compared to Lotus and Evolut-R for
bicuspid aortic valve stenosis. 2 studies compared ACURATE in small aortic
annuli. ACURATE neo showed lower transvalvular gradients and lower patient
prosthesis mismatch rates compared to Sapien 3 and when compared to Evolut
R/ Evolut PRO/ Portico, results were similar except for pre-dilatation
rates. 3 studies investigated ACURATE neo for pure aortic regurgitation
and one for valve-in-valve procedure and demonstrated safety and efficacy,
with the exception of malposition events in patients designated for higher
valve deployment in the valve-in-valve implantation study.
 CONCLUSION(S): ACURATE neo valve may be a feasible and safe option
for patients with bicuspid anatomy, small aortic annulus, previously
implanted bioprosthetic aortic valve and pure aortic regurgitation.
REGISTRATION NUMBER (DOI): Available at https://osf.io/aus26/ (DOI
10.17605/OSF.IO/AUS26). Copyright © 2022 Hellenic Society of
Cardiology. Published by Elsevier B.V. All rights reserved.

<113>
Accession Number
637924422
Title
Meta-Analysis Comparing 10-Year Mortality Following Percutaneous Coronary
Intervention or Coronary Artery Bypass Grafting in Left Main Stem or
Multivessel Coronary Artery Disease.
Source
The American journal of cardiology. (no pagination), 2022. Date of
Publication: 30 Apr 2022.
Author
Woodhead T.; Matthews C.J.; Blaxill J.M.; Greenwood J.P.; Mozid A.M.;
Rossington J.A.; Veerasamy M.; Wassef N.; Wheatcroft S.B.; Bulluck H.
Institution
(Woodhead, Matthews, Wassef) Yorkshire Heart Centre, Leeds General
Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Blaxill, Greenwood, Mozid, Rossington, Veerasamy, Wheatcroft, Bulluck)
Yorkshire Heart Centre, Leeds General Infirmary, Leeds Teaching Hospitals
NHS Trust, Leeds, United Kingdom; Leeds Institute of Cardiovascular and
Metabolic Medicine, University of Leeds, Leeds, United Kingdom
Publisher
NLM (Medline)

<114>
Accession Number
2017960755
Title
Meta-Analysis of Catheter Ablation Outcomes in Patients With Cardiac
Sarcoidosis Refractory Ventricular Tachycardia.
Source
American Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Adhaduk M.; Paudel B.; Liu K.; Ashwath M.; Giudici M.
Institution
(Adhaduk, Paudel) Division of General Internal Medicine
(Liu, Ashwath, Giudici) Division of Cardiovascular Medicine, Department of
Internal Medicine, University of Iowa, Iowa City, IA, United States
Publisher
Elsevier Inc.
Abstract
Cardiac sarcoidosis (CS) frequently leads to ventricular tachycardia (VT),
which is often refractory to antiarrhythmic and/or immunosuppressive
medications and requires catheter ablation. We conducted a systematic
review and meta-analysis to evaluate the role of catheter ablation in
patients with refractory VT undergoing catheter ablation. We searched
PubMed, Embase, and Scopus databases from their inception to December 31,
2021 with search terms "cardiac sarcoidosis" AND "electrophysiological
studies OR ablation." Fifteen studies were ultimately included for
evaluation. Patient demographics, VT mapping, and acute and long-term
procedural outcomes were extracted. A total of 15 studies were included in
our meta-analysis, with a total of 401 patients, of whom 66% were male,
with ages ranging from 39 to 64 years. A total of 95% of patients were on
antiarrhythmics and 79% of patients were on immunosuppressants. Left
ventricular ejection fraction ranged from 35% to 49% and procedure
duration ranged from 269 to 462 minutes. Ablation was reported using both
irrigated and nonirrigated catheter tips. A total of 25% of patients
(84/339) underwent repeat ablation. Acute procedural success was achieved
in 57% (161/285). Procedure complications occurred in 5.7% (17/297)
procedures. VT recurrence after first ablation was 55% (confidence
interval 48% to 63%, 213/401); VT recurrence after multiple ablations was
37% (81/220). The composite end point of death, heart transplant, and left
ventricular assist device implantation was 21% (confidence interval 14% to
30%, 55/297). In conclusion, catheter ablation is a useful modality in
patients with CS with refractory VT. However, patients with CS presenting
with refractory VT after undergoing VT ablation carry a poor
prognosis. Copyright © 2022 Elsevier Inc.

<115>
Accession Number
2015163153
Title
Cardiac computed tomographic angiography after abnormal ischemia test as a
gatekeeper to invasive coronary angiography.
Source
International Journal of Cardiovascular Imaging. 38(4) (pp 883-893), 2022.
Date of Publication: April 2022.
Author
Reis J.F.; Ramos R.B.; Marques H.; Daniel P.M.; Aguiar S.R.; Morais L.A.;
Cruz M.C.; Moreira R.I.; Monteiro A.V.; Cacela D.; Figueiredo L.; Ferreira
R.C.
Institution
(Reis, Ramos, Daniel, Aguiar, Morais, Cruz, Moreira, Monteiro, Cacela,
Ferreira) Department of Cardiology, Hospital de Santa Marta, Centro
Hospitalar de Lisboa Central, n 50, Lisbon 1169-024, Portugal
(Marques, Figueiredo) Department of Radiology, Hospital de Santa Marta,
Centro Hospitalar de Lisboa Central, Lisbon, Portugal
Publisher
Springer Science and Business Media B.V.
Abstract
This study aimed to determine the impact of systematic coronary computed
tomographic angiography (CCTA) use following an abnormal non-invasive
ischemia test (NIST) on patient selection strategy for invasive coronary
angiography (ICA). In patients with suspected stable coronary artery
disease (CAD), NIST use frequently results in sub-optimal diagnostic and
revascularization yields of ICA. This randomized clinical trial, conducted
at a single academic tertiary center, selected 220 symptomatic patients
with mild-to-moderately abnormal NIST results who were referred for ICA.
Patients received either the originally intended ICA (n = 105) or CCTA (n
= 115). The primary endpoint was the diagnostic yield of ICA in each
group. Revascularization yield and major adverse cardiovascular events at
12 months were also assessed. The patients were 69 +/- 9 years old, 60%
were men, and 31% had typical angina. Mean pre-test probability of
obstructive CAD was 34%. Overall prevalence of obstructive CAD was 37.7%
on the index angiographic procedure. In the CCTA group, ICA was cancelled
by referring physicians in 83 patients (72.2%) after receiving CCTA
results. For those undergoing ICA, diagnostic (84.4% vs. 41.7%, p<0.001)
and revascularization (71.9% vs. 38.8%, p = 0.001) yields were
significantly higher for CCTA-guided ICA than for standard NIST-guided
ICA. Mean cumulative radiation exposure was significantly lower in the
CCTA-guided ICA arm than in the NIST-guided ICA arm (12 +/- 9 vs. 16 +/-
10 mSv, respectively, p = 0.024). There were no significant differences in
the primary safety endpoint rates between the strategies (p = 0.439). In
patients with suspected CAD and mild-to-moderately abnormal ischemia
tests, a diagnostic strategy including CCTA as a gatekeeper is safe and
effective and significantly improves diagnostic and revascularization
yields of ICA. Copyright © 2022, The Author(s), under exclusive
licence to Springer Nature B.V.

<116>
Accession Number
2011279407
Title
An umbrella review of systematic reviews and meta-analyses of
observational investigations of obstructive sleep apnea and health
outcomes.
Source
Sleep and Breathing. 26(1) (pp 167-188), 2022. Date of Publication: March
2022.
Author
Chen W.; Li Y.; Guo L.; Zhang C.; Tang S.
Institution
(Chen, Li, Guo, Zhang, Tang) Department of Gastroenterology, The First
Affiliated Hospital, Jinan University, Guangzhou, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: The previous analysis of systematic reviews and meta-analyses
have illustrated that obstructive sleep apnea (OSA) is correlated with
multiple health outcomes. In the present research, our main aim was to
execute an umbrella review to assess the available evidence for the
associations between OSA and health outcomes. Method(s): Herein, a
meta-analysis of previous observational investigations that have reported
associations between OSA and health outcomes in all human populations and
settings was performed. We used these studies to execute an umbrella
review of available meta-analyses and systematic reviews. Result(s):
Sixty-six articles comprising 136 unique outcomes were enrolled in this
analysis. Of the 136 unique outcomes, 111 unique outcomes had significant
associations (p < 0.05). Only 7 outcomes (coronary revascularization after
PCI, postoperative respiratory failure, steatosis, alaninetrans aminase
(ALT) elevation, metabolic syndrome (MS), psoriasis, and Parkinson's
disease) had a high quality of evidence. Twenty-four outcomes had a
moderate quality of evidence, and the remaining 80 outcomes had a weak
quality of evidence. Sixty-nine outcomes exhibited significant
heterogeneity. Twenty-five outcomes exhibited publication bias.
Sixty-three (95%) studies showed critically low methodological quality.
 Conclusion(s): Among the 66 meta-analyses exploring 136 unique
outcomes, only 7 statistically significant outcomes were rated as high
quality of evidence. OSA may correlate with an increased risk of coronary
revascularization after PCI, postoperative respiratory failure, steatosis,
ALT elevation, MS, psoriasis, and Parkinson's disease. Copyright
© 2021, The Author(s).

<117>
[Use Link to view the full text]
Accession Number
635273957
Title
The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP)
Tool: A Critical Narrative Review.
Source
Journal of Acute Care Physical Therapy. 13(1) (pp 24-44), 2022. Date of
Publication: 01 Jan 2022.
Author
Socwell C.P.; Kanagasaba K.; Pope R.
Institution
(Socwell, Kanagasaba) Faculty of Health Sciences and Medicine, Bond
University, 2 Promethean Way, Robina, QLD 4226, Australia
(Pope) School of Community Health, Charles Sturt University, Albury,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: The aim of this critical narrative review was to identify and
synthesize available research evidence on the utility of Mayo Clinic's
Early Screen for Discharge Planning (ESDP) tool to (1) identify adult
patients early during their hospital stay who require referral to
specialized hospital discharge planning services (SHDCPS) and (2) review
its utility in predicting patient outcomes including hospital length of
stay (LOS), readmission risk, and discharge destination. This review also
begins by highlighting the important role of physical therapists in
discharge planning. Method(s): A critical narrative review was
conducted of relevant studies identified through a systematic search of
PubMed, CINAHL, Embase, and ProQuest databases and subsequent systematic
screening and selection process. Studies were included and critically
appraised if they met eligibility criteria: studies investigating the
development, predictive validity and utility of the ESDP in hospital
patient populations, and studies comparing the ESDP with other discharge
planning tools. Key data were then extracted and tabulated before a
critical narrative synthesis of key findings was completed.
 Result(s): Seven studies met the eligibility criteria, with 5 studies
receiving a rating of "good" quality. The included studies investigated
the ESDP tool in adults within acute inpatient hospital settings,
including heart failure, colorectal surgery, general medical and surgical,
and oncology wards. Conclusion(s): Five of the 7 included studies
were of good quality and, together, studies provided evidence that the
ESDP tool correctly identifies adults requiring referral to SHDCPS.
However, further research of the ESDP tool is recommended to account for
variations observed in special populations and expand knowledge of its
utility to predict outcomes such as hospital LOS, readmission risk, and
discharge destination. Copyright © 2021 Academy of Acute Care
Physical Therapy, APTA.

<118>
Accession Number
2017725617
Title
Temporal trends in clinical outcomes after percutaneous coronary
intervention: a systematic review of 66,327 patients from 25 all-comers
trials.
Source
EuroIntervention. 17(16) (pp 1318-1329), 2022. Date of Publication: March
2022.
Author
Asano T.; Ono M.; Dai Z.; Saito A.; Kanie T.; Takaoka Y.; Mizuno A.;
Yoneoka D.; Komiyama N.
Institution
(Asano, Ono, Saito, Kanie, Takaoka, Mizuno, Komiyama) Department of
Cardiovascular Medicine, St. Luke's International Hospital, St. Luke's
International University, Tokyo, Japan
(Ono) Department of Cardiology, Academic Medical Center, University of
Amsterdam, Amsterdam, Netherlands
(Ono) Department of Cardiology, National University of Ireland Galway
(NUIG), Galway, Ireland
(Dai) Department of Cardiovascular Medicine, Graduate School of Medicine,
University of Tokyo, Tokyo, Japan
(Mizuno) Penn Medicine Nudge Unit, University of Pennsylvania,
Philadelphia, PA, United States
(Mizuno) Perelman School of Medicine, University of Pennsylvania,
Philadelphia, PA, United States
(Mizuno) Leonard Davis Institute of Health Economics, University of
Pennsylvania, Philadelphia, PA, United States
(Yoneoka) Division of Biostatistics and Bioinformatics, Graduate School of
Public Health, St. Luke's International University, Tokyo, Japan
Publisher
Europa Group
Abstract
Background: With the improvements of percutaneous coronary intervention
(PCI) technology and post-PCI patient management, several registry studies
reported temporal trends in post-PCI clinical outcomes. However, their
results are inconclusive, potentially reflecting region-specific trends,
based on site-reported events without external validity. Aim(s): This
study aimed to investigate temporal trends in post-PCI clinical outcomes
in all-comers randomised controlled trials (RCTs) involving coronary
stents. Method(s): We performed a systematic review identifying RCTs
comparing a clinical outcome as a primary endpoint among different
coronary stents with an all-comers design and independent clinical event
adjudication, extracting the study start year, patient baseline
characteristics, and one- and five-year clinical outcomes. Temporal trends
in clinical outcomes (cardiac death, myocardial infarction [MI], target
lesion revascularisation [TLR], stent thrombosis [ST]) were assessed using
random-effects meta-regression analyses, estimating the relationship
between clinical outcomes and study start year. Result(s): Overall,
25 all-comers trials (51 device arms, 66,327 patients) conducted between
2003 and 2018 fulfilled the eligibility criteria. Random-effects
meta-regression analysis revealed significant decreasing trends in one-
and five-year cardiac death, one-year TLR, and five-year ST incidences
(relative risk per 10-year increase: 0.69 [0.51-0.92], 0.66 [0.44-0.98],
0.60 [0.41-0.88], and 0.18 [0.07-0.44], respectively). There was no
significant trend in myocardial infarction incidences. Conclusion(s):
This is the first attempt to clarify and quantify the temporal trends of
post-PCI outcome incidence. The 15-year improvements in PCI therapy and
post-therapeutic patient management are associated with reduced incidences
of cardiac death and PCI-related adverse events. Copyright ©
Europa Digital & Publishing 2022. All rights reserved.

<119>
Accession Number
2014498988
Title
When is a wearable defibrillator indicated?.
Source
Expert Review of Medical Devices. 18(sup1) (pp 51-56), 2021. Date of
Publication: 2021.
Author
Bodin A.; Bisson A.; Fauchier L.
Institution
(Bodin, Bisson, Fauchier) Service de Cardiologie, Centre Hospitalier
Universitaire Trousseau, Faculte de Medecine, Universite Francois
Rabelais, Tours, France
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Wearable cardioverter-defibrillator (WCD) is a novel tool
that may be of interest in situations with atransient risk of sudden
cardiac death. It offers a temporary and easy to remove protection against
malignant ventricular arrhythmias. In this review, the authors describe
evidence in literature and different international guidelines and
consensus. Areas covered: The authors searched PubMed, Cochrane Central
Register of controlled trials, and Google Scholar for relevant studies and
comments. Expert Opinion: If a WCD is indicated, the observance must be as
perfect as possible. Thus, patients need proper education in wearing the
WCD. The temporary use of a WCD is reasonable in patients with a high risk
for SCD, even with a low level of evidence with only one randomized
clinical trial (VEST), as its disadvantages are limited to a transitory
impairment in quality of life and a low risk of inappropriate shock.
Indications are now well accepted: ischemic cardiomyopathy with LVEF below
35% before reassessment, recent onset of NICM or presumed myocarditis with
LVEF <=35% before reassessment, after ICD explant until reimplantation
(e.g. infection), and bridge to transplant. Future guidelines on WCD in
the prevention of SCD may be warranted to harmonize clinical practice
especially in debated indications. Copyright © 2021 Informa UK
Limited, trading as Taylor & Francis Group.

<120>
Accession Number
636675130
Title
Postnatal circulation in patients with aortic stenosis undergoing fetal
aortic valvuloplasty: systematic review and meta-analysis.
Source
Ultrasound in obstetrics & gynecology : the official journal of the
International Society of Ultrasound in Obstetrics and Gynecology. 59(5)
(pp 576-584), 2022. Date of Publication: 01 May 2022.
Author
Vorisek C.N.; Zurakowski D.; Tamayo A.; Axt-Fliedner R.; Siepmann T.;
Friehs I.
Institution
(Vorisek, Tamayo, Siepmann, Friehs) Dresden International University,
Division of Health Care Sciences, Dresden, Germany
(Vorisek) Berlin Institute of Health at Charite - Universitatsmedizin
Berlin, Berlin, Germany
(Zurakowski) Department of Anesthesiology, Perioperative and Pain
Medicine, Boston Children's Hospital, Department of Anesthesia, Harvard
Medical School, MA, Boston, United States
(Tamayo) Max Rady Faculty of Health Sciences, University of Manitoba,
Winnipeg, Canada
(Axt-Fliedner) Justus-Liebig-University Giessen, Giessen, Germany
(Siepmann) University Hospital Carl Gustav Carus Dresden, Dresden, Germany
(Friehs) Harvard Medical School, Boston Children's Hospital, MA, Boston,
United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Fetal aortic valvuloplasty (FAV) has become a treatment option
for critical fetal aortic stenosis (AS) with the goal of preserving
biventricular circulation (BVC); however, to date, it is unclear how many
patients undergoing FAV achieve BVC. The aim of this systematic review and
meta-analysis was to investigate the type of postnatal circulation
achieved following FAV. METHOD(S): The Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.
MEDLINE, EMBASE, Web of Science and the Cochrane Library were searched
systematically for studies investigating postnatal circulation in patients
with AS following FAV. Eligible for inclusion were original papers in the
English language, published from 2000 to 2020, with at least 12months of
follow-up after birth. Review papers, abstracts, expert opinions, books,
editorials and case reports were excluded. The titles and abstracts of all
retrieved literature were screened, duplicates were excluded and the full
texts of potentially eligible articles were obtained and assessed. The
primary endpoint was type of postnatal circulation. Additional assessed
outcomes included fetal death, live birth, neonatal death (NND),
termination of pregnancy (TOP) and technical success of the FAV procedure.
The quality of articles was assessed using the Critical Appraisal Skills
Programme (CASP) tool. To estimate the overall proportion of each
endpoint, meta-analysis of proportions was employed using a random-effects
model. RESULT(S): The electronic search identified 579 studies, of
which seven were considered eligible for inclusion in the systematic
review and meta-analysis. A total of 266 fetuses underwent FAV with median
follow-up per study from 12months to 13.2years. There were no maternal
deaths and only one case of FAV-related maternal complication was
reported. Hydrops was present in 29 (11%) patients. The pooled prevalence
of BVC and univentricular circulation (UVC) among liveborn patients was
45.8% (95%CI, 39.2-52.4%) and 43.6% (95%CI, 33.9-53.8%), respectively. The
pooled prevalence of technically successful FAV procedure was 82.1%
(95%CI, 74.3-87.9%), of fetal death it was 16.0% (95%CI, 11.2-22.4%), of
TOP 5.7% (95%CI, 2.0-15.5%), of live birth 78.8% (95%CI, 66.5-87.4%), of
NND 8.7% (95%CI, 4.7-15.5%), of palliative care 4.0% (95%CI, 1.9-8.4%) and
of infant death 10.3% (95%CI, 3.6-26.1%). The pooled prevalence of BVC and
UVC among liveborn patients who had technically successful FAV was 51.9%
(95%CI, 44.7-59.1%) and 39.8% (95%CI, 29.7-50.9%), respectively.
 CONCLUSION(S): This study showed a BVC rate of 46% among liveborn
patients with AS undergoing FAV, which improved to 52% when subjects
underwent technically successful FAV. Given the lack of randomized
clinical trials, results should be interpreted with caution. Currently,
data do not suggest a true benefit of FAV for achieving BVC. © 2022
The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley
& Sons Ltd on behalf of International Society of Ultrasound in Obstetrics
and Gynecology.

<121>
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.

<122>
Accession Number
637854209
Title
Vitamin K2 and D in Patients With Aortic Valve Calcification: A Randomized
Double-Blinded Clinical Trial.
Source
Circulation. 145(18) (pp 1387-1397), 2022. Date of Publication: 03 May
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.; Dahl J.S.
Institution
(Diederichsen, Ovrehus, Fredgart, Hasific, Mickley, Dahl) Department of
Cardiology (A.C.P.D., Odense University Hospital, Denmark
(Lindholt) Department of Cardiothoracic and Vascular Surgery (J.S.L.),
Odense University Hospital, Denmark
(Moller) Open Patient Data Explorative Network (S.M.), Odense University
Hospital, Denmark
(Auscher, Lambrechtsen) Department of Cardiology, Svendborg Hospital,
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 (L.F.), Odense University
Hospital, Denmark
(Gerke) Department of Nuclear Medicine (O.G.), Odense University Hospital,
Denmark
(Rasmussen) Department of Clinical Biochemistry and Pharmacology (L.M.R.),
Odense University Hospital, Denmark
(Moller) Department of Cardiology, Copenhagen University Hospital, 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 microg MK-7 plus 25 microg 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. REGISTRATION: URL: https://www.
CLINICALTRIALS: gov; Unique identifier: NCT03243890.

<123>
Accession Number
2016871051
Title
Ultrasound-guided versus anatomic landmark-guided vascular access in
cardiac electrophysiology procedures: A systematic review and
meta-analysis: Meta-analysis of ultrasound-guided vascular access in
electrophysiology procedures.
Source
Indian Pacing and Electrophysiology Journal. 22(3) (pp 145-153), 2022.
Date of Publication: 01 May 2022.
Author
Triantafyllou K.; Karkos C.D.; Fragakis N.; Antoniadis A.P.; Meletidou M.;
Vassilikos V.
Institution
(Triantafyllou, Fragakis, Antoniadis, Meletidou, Vassilikos) 3rd
Cardiology Department, Hippokration General Hospital of Thessaloniki,
Aristotle University of Thessaloniki, Greece
(Karkos) Vascular Unit, 5th Surgery Department, Hippokration General
Hospital of Thessaloniki, Aristotle University of Thessaloniki, Greece
Publisher
Indian Pacing and Electrophysiology Group
Abstract
Introduction: Electrophysiology (EP) procedures are nowadays the
gold-standard method for tachyarrhythmia treatment with impressive success
rates, but also with a considerable risk of complications, mainly
vascular. A systematic review and meta-analysis was performed to evaluate
the safety of ultrasound (US)-guided femoral vein access in EP procedures
compared to the traditional anatomic landmark-guided method.
 Method(s): We searched Pubmed (MEDLINE), Embase, Web of Science, and
Cochrane electronic databases for relevant entries, dated from January
1st, 2000 to June 30th, 2021. Only observational studies and randomized
controlled trials were included in this analysis. Data extraction included
study details, patient characteristics, procedure details, and all types
of vascular complications. Complications were classified as major if any
intervention, prolongation of hospitalization, or readmission was
required. Result(s): 9 studies (1 randomized controlled trial and 8
observational), with 7858 participants (3743 in the US-guided group, 4115
in the control group), were included in the meta-analysis. Overall
vascular complication rates were significantly decreased in the US-guided
group compared to the control group (1.2 versus 3.2%, RR = 0.38, 95% CI,
0.27-0.53), in all EP procedures. Sub-group analysis of AF ablation
procedures yielded similar results (RR 0.41, 95% CI, 0.29-0.58, p <
0.00001). The event reduction effect was significant for both major and
minor vascular complications. Conclusion(s): US-guided vascular
access in EP procedures is associated with significantly reduced vascular
complications, compared to the standard anatomic landmark-guided approach,
regardless of procedure complexity. Copyright © 2022 Indian Heart
Rhythm Society

<124>
Accession Number
2017921674
Title
A study of mechanical ventilation in the ICU after cardiac surgery: a
bibliometric analysis.
Source
Journal of Thoracic Disease. 14(4) (pp 1212-1224), 2022. Date of
Publication: April 2022.
Author
Zhang M.; Zhao Y.; Cui R.; An B.
Institution
(Zhang, Cui, An) Department of Outpatients, the 4th Hospital Affiliated to
Hebei Medical University, Shijiazhuang, China
(Zhao) Department of Cardiac Surgery, the 4th Hospital Affiliated to Hebei
Medical University, Shijiazhuang, China
Publisher
AME Publishing Company
Abstract
Background: After cardiac surgery, patients are often admitted to the
intensive care unit (ICU) due to various preoperative factors and continue
to receive mechanical ventilation. This study sought to conduct a
bibliometric analysis to summarize studies on mechanical ventilation among
postoperative ICU patients who had undergone cardiac surgery.
 Method(s): We searched the Science Citation Index Expanded (SCI-E)
database using the following terms: "cardiac surgery (Topic)", "intensive
care (Topic)" and "ventilation (Topic)". The search results were analyzed
using R software. The analysis examined the number of publications of
relevant articles and the annual change trend, the number of times an
article was cited and the annual change trend, the distribution of
countries conducting the research, the cooperation between countries and
the citation frequency, the distribution of institutions conducting
research, the cooperation between institutions, and the citation
frequency, the number of published articles, the cooperation among
researchers, and the citations frequency of researchers, the journals in
which the articles were published, and the use of keywords.
 Result(s): A total of 1,969 relevant research papers were included in
this study. The main countries that conducted the relevant research
included the United States (US), China, Germany, and Canada. The research
institutions were mainly located in the US and Canada, and the main
researchers were from research institutions in these countries. The most
cited authors were Zappitelli, Hichey, and Wypij. According to Bradford's
law, 9 core journals in this field were identified. The results of the
keyword analysis showed that in the past 10 years, research has focused on
the mortality of patients, but only a few related random controlled trials
have been conducted. Conclusion(s): More randomized controlled trials
need to be conducted in this field to provide higher evidence-based
medical evidence. Copyright © 2022 AME Publishing Company. All
rights reserved.

<125>
Accession Number
637847130
Title
Negative pressure wound therapy for surgical wounds healing by primary
closure.
Source
Cochrane Database of Systematic Reviews. 2022(4) (no pagination), 2022.
Article Number: CD009261. Date of Publication: 26 Apr 2022.
Author
Norman G.; Shi C.; Goh E.L.; Murphy E.M.A.; 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) Ward 64, St. Mary's Hospital, Manchester Foundation NHS Trust,
Manchester, 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
John Wiley and Sons Ltd
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 Result(s): 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' conclusions:
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.

<126>
Accession Number
2017921635
Title
The pathological oral cavity as a preventable source of postoperative
pneumonia in thoracic surgery: a prospective observational study.
Source
Journal of Thoracic Disease. 14(4 April) (pp 822-831), 2022. Date of
Publication: April 2022.
Author
Ploenes T.; Pollok A.; Jockel K.-H.; Kampe S.; Darwiche K.; Taube C.; Buer
J.; Aigner C.
Institution
(Ploenes, Pollok, Aigner) Department of Thoracic Surgery and Thoracic
Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital
Essen, University Duisburg-Essen, Essen, Germany
(Jockel) Institute for Medical Informatics Biometry and Epidemiology,
University Hospital of Essen, University Duisburg-Essen, Germany
(Kampe) Department of Anesthesiology, Ruhrlandklinik, West German Lung
Center, University of Duisburg-Essen, Essen, Germany
(Kampe) Department of Anesthesiology and Intensive Care Medicine,
University Hospital Magdeburg, Otto von Guericke University Magdeburg,
Magdeburg, Germany
(Darwiche, Taube) Department of Pneumology, Ruhrlandklinik, University
Hospital of Essen, University of Duisburg-Essen, Essen, Germany
(Buer) Institute of Medical Microbiology, University Hospital Essen,
University of Duisburg-Essen, Essen, Germany
Publisher
AME Publishing Company
Abstract
Background: Pneumonia after thoracic surgery considerably contributes to
perioperative morbidity and mortality. So far, the forced expiratory
volume in one second and diffusing capacity of the lungs for carbon
dioxide are the most common validated prognosticators to estimate
individual risk. Beyond functional parameters, modifiable risk factors for
respiratory complications like pneumonia are poorly investigated in a
prospective way. Thus, we aimed to assess the impact of oral health status
in patients undergoing thoracic surgery and its correlation to
perioperative outcomes. Method(s): A prospective observational study
included adult patients undergoing elective thoracic surgery from October
2, 2018 to April 29, 2020. The day before surgery, patients were examined
by a dentist. Oral health status (caries, periodontal disease, tooth loss,
and regular dental visits) was correlated with perioperative outcomes.
 Result(s): During the study period, 230 consecutive patients were
included. Oral health status was poor in the study population.
Postoperative complications were associated with active caries [odds ratio
(OR) 2.5, P<0.03]. Patients with frequent dental visits and treated teeth
had a lower risk for postoperative complications compared with patients
without regular visits (OR 0.3, P<0.02). Patients with a high burden of
caries had a significantly increased risk for pneumonia (OR 7.9, P<0.002).
The forced expiratory volume in one second was a significant
prognosticator for postoperative complications; however, no association
between the forced expiratory volume in one second and oral health
parameters was observed. Conclusion(s): A pathological oral health
status is a modifiable factor predicting postoperative complications and
pneumonia. A prospective randomized interventional study is warranted to
clarify whether an improvement in oral health status can lead to a
reduction of perioperative risk. Copyright © 2022 AME Publishing
Company. All rights reserved.

<127>
Accession Number
2016631294
Title
The Utility of Pentraxin and Modified Prognostic Scales in Predicting
Outcomes of Patients with End-Stage Heart Failure.
Source
Journal of Clinical Medicine. 11(9) (no pagination), 2022. Article Number:
2567. Date of Publication: May-1 2022.
Author
Szczurek-Wasilewicz W.; Skrzypek M.; Romuk E.; Gasior M.;
Szygula-Jurkiewicz B.
Institution
(Szczurek-Wasilewicz) Silesian Center for Heart Diseases in Zabrze, Zabrze
41-800, Poland
(Skrzypek) Department of Biostatistics, School of Public Health in Bytom,
Medical University of Silesia, Katowice 40-055, Poland
(Romuk) Department of Biochemistry, School of Medical Sciences in Zabrze,
Medical University of Silesia, Katowice 40-055, Poland
(Gasior, Szygula-Jurkiewicz) 3rd Department of Cardiology, School of
Medical Sciences in Zabrze, Medical University of Silesia, Katowice
40-055, Poland
Publisher
MDPI
Abstract
Risk stratification is an important element of management in patients with
heart failure (HF). We aimed to determine factors associated with
predicting outcomes in end-stage HF patients listed for heart
transplantation (HT), with particular emphasis placed on pentraxin-3
(PXT-3). In addition, we investigated whether the combination of PTX-3
with the Heart Failure Survival Score (HFSS), the Seattle Heart Failure
Model (SHFM), or the Meta-Analysis Global Group in Chronic Heart Failure
(MAGGIC) improved the prognostic strength of these scales in the study
population. We conducted a prospective analysis of 343 outpatients with
end-stage HF who accepted the HT waiting list between 2015 and 2018. HFSS,
SHFM, and MAGGIC scores were calculated for all patients. PTX3 was
measured by sandwich enzyme-linked immunosorbent assay with a commercially
available kit. The endpoints were death, left ventricular assist device
implantation, and HT during the one-year follow-up. The median age was 56
(50-60) years, and 86.6% were male. During the follow-up period, 173
patients reached the endpoint. Independent risk factors associated with
outcomes were ischemic etiology of HF [HR 1.731 (1.227-2.441), p =
0.0018], mean arterial pressure (MAP) [1.026 (1.010-1.042), p = 0.0011],
body mass index (BMI) [1.055 (1.014-1.098), p = 0.0083], sodium [1.056
[(1.007-1.109), p = 0.0244] PTX-3 [1.187 (1.126-1.251, p < 0.0001) and
N-terminal pro-brain natriuretic peptide (NT-proBNP) [HR 1.004
(1.000-1.008), p = 0.0259]. The HFSS-PTX-3, SHFM-PTX-3 and MAGGIC-PTX-3
scores had significantly higher predictive power [AUC = 0.951, AUC =
0.973; AUC = 0.956, respectively] than original scores [AUC for HFSS =
0.8481, AUC for SHFM = 0.7976, AUC for MAGGIC = 0.7491]. Higher PTX-3 and
NT-proBNP concentrations, lower sodium concentrations, lower MAP and BMI
levels, and ischemic etiology of HF are associated with worse outcomes in
patients with end-stage HF. The modified SHFM-PTX-3, HFSS-PTX-3, and
MAGGIC-PTX-3 scores provide effective methods of assessing the outcomes in
the analyzed group. Copyright © 2022 by the authors. Licensee
MDPI, Basel, Switzerland.

<128>
Accession Number
2015881362
Title
Characterization of Near-Infrared Imaging and Indocyanine-Green Use
Amongst General Surgeons: A Survey of 263 General Surgeons.
Source
Surgical Innovation. (no pagination), 2022. Date of Publication: 2022.
Author
Verhoeff K.; Mocanu V.; Fang B.; Dang J.; Sun W.; Switzer N.J.; Birch
D.W.; Karmali S.
Institution
(Verhoeff, Mocanu, Fang, Dang, Sun, Switzer) Department of Surgery,
University of Alberta, Edmonton, AB, Canada
(Birch, Karmali) Centre for Advancement of Surgical Education and
Simulation (CASES), Royal Alexandra Hospital, Edmonton, AB, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: Near-infrared fluorescence imaging (NIRFI) is an increasingly
utilized imaging modality, however its use amongst general surgeons and
its barriers to adoption have not yet been characterized. Method(s):
This survey was sent to Canadian Association of General Surgeons and the
Society of American Gastrointestinal and Endoscopic Surgeons members.
Survey development occurred through consensus of NIRFI experienced
surgeons. Result(s): Survey completion rate for those opening the
email was 16.0% (n = 263). Most respondents had used NIRFI (n = 161,
61.2%). Training, higher volumes, and bariatric, thoracic, or foregut
subspecialty were associated with use (P <.001). Common reasons for NIRFI
included anastomotic assessment (n = 117, 72.7%), cholangiography (n =
106, 65.8%), macroscopic angiography (n = 66, 41.0%), and bowel viability
assessment (n = 101, 62.7%). Technical knowledge, training and poor
evidence were cited as common barriers to NIRFI adoption.
 Conclusion(s): NIRFI use is common with high case volume, bariatric,
foregut, and thoracic surgery practices associated with adoption. Barriers
to use appear to be lack of awareness, low confidence in current evidence,
and inadequate training. High quality randomized studies evaluating NIRFI
are needed to improve confidence in current evidence; if deemed
beneficial, training will be imperative for NIRFI adoption. Copyright
© The Author(s) 2022.

<129>
Accession Number
637912559
Title
Mechanical Prosthetic Valve Thrombus in a Term Pregnant Woman Presenting
as Acute Heart Failure: Case Report and Review of Literature.
Source
Indian Journal of Cardiovascular Disease in Women - WINCARS. (no
pagination), 2022. Date of Publication: 2022.
Author
Gethu K.; Jha N.; Rengaraj S.; Pampapati V.; Munuswamy H.; Pillai A.A.
Institution
(Gethu, Jha, Rengaraj, Pampapati) Department of Obstetrics and
Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and
Research, Puducherry 605006, India
(Munuswamy, Pillai) Department of Cardiothoracic and Vascular Surgery,
Jawaharlal Institute of Postgraduate Medical Education and Research,
Puducherry, India
Publisher
Georg Thieme Verlag
Abstract
Cardiovascular disease in pregnancy contributes to a significant
proportion of death worldwide. Though pregnancy-associated myocardial
infarction and aortic dissection are the common causes of adverse cardiac
events in developed countries, rheumatic heart diseases continue to be the
important reason for cardiovascular morbidity and mortality in developing
countries. The risk of adverse cardiac outcome is dependent on the type
and severity of valvular abnormality, functional status, left ventricular
function, and pulmonary arterial pressure. Managing a pregnant woman with
a mechanical heart valve prosthesis is challenging because of the
difficulty in achieving optimal anticoagulation in the presence of
hypercoagulability. Mitral valve thrombus is a life-threatening event and
women can present with acute heart failure or thromboembolic events. We
report successful management of a 26-year-old primigravida with rheumatic
heart disease diagnosed to have huge thrombus on mechanical prosthetic
mitral valve presented with acute heart failure at 36 weeks. She received
multidisciplinary care and underwent concurrent cesarean section followed
by thrombectomy under cardiopulmonary bypass. She had a good recovery
following surgery and the complexity surrounds the management merit the
presentation with a review of management strategies for a women with
mechanical prosthetic heart valve in pregnancy. Copyright © 2022
BMJ Publishing Group. All rights reserved.

<130>
Accession Number
637910283
Title
Validity Evidence for Procedure-Specific Competency Assessment Tools in
Cardiovascular and Thoracic Surgery: A Scoping Review.
Source
Journal of surgical education. (no pagination), 2022. Date of
Publication: 28 Apr 2022.
Author
White A.; Muller Moran H.R.; Ryan J.; Mador B.; Campbell S.; Turner S.R.
Institution
(White, Ryan, Mador, Turner) Department of Surgery, University of Alberta,
Edmonton, AB, Canada
(Muller Moran) Department of Surgery, University of Manitoba, Winnipeg,
MB, Canada
(Campbell) University of Alberta Library, Edmonton, AB, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Surgical education has shifted from a time-based approach to
the achievement and demonstration of procedural competency. High quality,
objective assessment instruments are required to support this new
approach. This study comprehensively reviewed the literature to identify
and evaluate available procedure-specific assessment instruments in
cardiothoracic and vascular surgery. DESIGN: A systematic search of 8
databases identified studies containing procedure-specific operative
assessment instruments in cardiothoracic and vascular surgery. Generic
global rating scales were excluded, unless modified to be
procedure-specific. Two reviewers independently evaluated the validity
evidence, methodological rigour and educational utility of each instrument
using objective scoring criteria. Validity evidence was evaluated with a
scoring tool aligned with the contemporary framework of validity.
Methodological rigour was evaluated using the Medical Education Research
Study Quality Instrument. Educational utility was evaluated according to
the Accreditation Council for Graduate Medical Education (ACGME)
framework. RESULT(S): There were 2130 unique studies describing
procedure-specific assessment in surgery. Of these, 9 studies evaluating 8
procedure-specific assessment instruments met inclusion criteria for
cardiothoracic and vascular surgery. Four instruments were identified in
thoracic surgery, 2 in cardiac surgery, and 2 in vascular surgery. Only 1
instrument was designed to evaluate surgeon performance, with the
remainder designed to evaluate residents. No single instrument scored the
maximum score of 15 for validity evidence. The highest score was 11, with
62.5% (n=5) of instruments scoring greater than 10. All tools attained
high scores in content validity, with minimal evidence generally presented
regarding the consequences of assessment using a particular instrument.
All but 1 instrument scored greater than 11 out of a maximum 16.5 points
for methodological rigour. Very few studies reported on the ACGME domains
of educational utility. CONCLUSION(S): In an era where surgical
education is shifting towards the demonstration of procedural competency,
objective procedure-specific assessment is critical. This review
identified that few procedure-specific assessment instruments in
cardiothoracic and vascular surgery exist, emphasizing the need for such
instruments to ensure the success of competency-based education
models. Copyright © 2022. Published by Elsevier Inc.

<131>
Accession Number
2016426333
Title
The effect of anesthetic agents on intraocular pressure during
laparoscopic gynecological surgery performed in the Trendelenburg
position: A randomized clinical trial.
Source
Ulusal Travma ve Acil Cerrahi Dergisi. 28(4) (pp 498-507), 2022. Date of
Publication: April 2022.
Author
Balkan B.; Tontu F.; Moralar D.G.; Demirayak B.; Emir N.S.; Yektas A.
Institution
(Balkan, Tontu, Moralar, Emir) Department of Anesthesiology and
Reanimation, Health Science University, Bakirkoy Dr. Sadi Konuk Training
and Research Hospital, Istanbul, Turkey
(Demirayak) Department of Ophthalmology, Health Science University,
Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
(Yektas) Department of Anesthesiology and Reanimation, Health Science
University, Diyarbakir Gazi Yasargil Training and Research Hospital,
Diyarbakir, Turkey
Publisher
Turkish Association of Trauma and Emergency Surgery
Abstract
BACKGROUND: Intraocular pressure (IOP) increases due to pneumoperitoneum
and the Trendelenburg position during laparoscopic surgery. Apart from
ketamine and suxamethonium, anesthetic agents generally reduce IOP by
various extents. The present study investigated the effects of
combinations of four anesthetic agents on IOP during laparoscopic
gynecological surgery. METHOD(S): Patients (n=100) were assigned to
one of the four groups: Group 1 (n=25; pentothal induction +
desflurane/remifen-tanil maintenance), Group 2 (n=25; propofol induction +
sevoflurane/remifentanil maintenance), Group 3 (n=25; propofol induction +
desflurane/remifentanil maintenance), and Group 4 (n=25; pentothal
induction + sevoflurane/remifentanil maintenance). The IOPs recorded
before anesthesia induction, after intubation, after carbon dioxide
insufflation, in the Trendelenburg position, and after ex-tubation were
compared among the groups. Hemodynamic parameters were also evaluated.
 RESULT(S): Induction in Group 2 and Group 3 used propofol. When the
IOP in the Trendelenburg position was compared with the IOP before
induction, there was no statistically significant difference in Groups 2
and 3 (p>0.05). In Groups 1 and 4, pentothal was used for induction. The
IOP in Groups 1 and 4 was statistically significantly higher in the
Trendelenburg position than it was before induction (0.027-0.001).
 CONCLUSION(S): To minimize the variation in IOP in the Trendelenburg
position during laparoscopic gynecological surgeries, we recommend the use
of propofol for induction, independent of desflurane or sevoflurane
use. Copyright ©2022 Turkish Association of Trauma and Emergency
Surgery.

<132>
[Use Link to view the full text]
Accession Number
2016329718
Title
Inflammatory Biomarker Levels after Propofol or Sevoflurane Anesthesia: A
Meta-analysis.
Source
Anesthesia and Analgesia. 134(1) (pp 69-81), 2022. Date of Publication: 01
Jan 2022.
Author
Obryan L.J.; Atkins K.J.; Lipszyc A.; Scott D.A.; Silbert B.S.; Evered
L.A.
Institution
(Obryan, Atkins, Lipszyc, Scott, Silbert, Evered) Department of
Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne,
VIC, Australia
(Atkins, Scott, Silbert, Evered) Centre for Integrated Critical Care,
Melbourne Medical School, University of Melbourne, Parkville, VIC,
Australia
(Evered) Department of Anesthesiology, Weill Cornell Medicine, New York,
NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The perioperative inflammatory response may be implicated in
adverse outcomes including neurocognitive dysfunction and cancer
recurrence after oncological surgery. The immunomodulatory role of
anesthetic agents has been demonstrated in vitro; however, its clinical
relevance is unclear. The purpose of this meta-analysis was to compare
propofol and sevoflurane with respect to biomarkers of perioperative
inflammation. The secondary aim was to correlate markers of inflammation
with clinical measures of perioperative cognition. METHOD(S):
Databases were searched for randomized controlled trials examining
perioperative inflammation after general anesthesia using propofol
compared to sevoflurane. Inflammatory biomarkers investigated were
interleukin (IL)-6, IL-10, tissue necrosis factor alpha (TNF-alpha), and
C-reactive protein (CRP). The secondary outcome was incidence of
perioperative neurocognitive disorders. Meta-analysis with metaregression
was performed to determine the difference between propofol and
sevoflurane. RESULT(S): Twenty-three studies were included with 1611
participants. Studies varied by surgery type, duration, and participant
age. There was an increase in the mean inflammatory biomarker levels
following surgery, with meta-analysis revealing no difference in effect
between propofol and sevoflurane. Heterogeneity between studies was high,
with surgery type, duration, and patient age contributing to the variance
across studies. Only 5 studies examined postoperative cognitive outcomes;
thus, a meta-analysis could not be performed. Nonetheless, of these 5
studies, 4 reported a reduced incidence of cognitive decline associated
with propofol use. CONCLUSION(S): Surgery induces an inflammatory
response; however, the inflammatory response did not differ as a function
of anesthetic technique. This absence of an effect suggests that patient
and surgical variables may have a far more significant impact on the
postoperative inflammatory responses than anesthetic technique. The
majority of studies assessing perioperative cognition in older patients
reported a benefit associated with the use of propofol; however, larger
trials using homogenous outcomes are needed to demonstrate such an
effect. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<133>
Accession Number
2014217421
Title
Radial versus femoral secondary access for transcatheter aortic valve
replacement: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(4) (pp 1225-1233),
2022. Date of Publication: March 1, 2022.
Author
Das T.M.; Shin J.; Czarny M.J.; Nanavati J.; Resar J.R.; Hasan R.K.
Institution
(Das, Shin) Department of Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Czarny, Resar, Hasan) Department of Medicine, Division of Cardiology,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
(Nanavati) Welch Medical Library, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We aimed to evaluate the risk of procedural complications
after TAVR using secondary radial access (RA) versus femoral access (FA)
through a systematic review and meta-analysis of the published literature.
 Background(s): Transcatheter aortic valve replacement (TAVR) entails
both large-bore arterial access for device delivery and secondary arterial
access for hemodynamic and imaging assessments. It is unknown whether RA
versus FA for this secondary access reduces the risk of procedural
complications. Method(s): We searched PubMed, Embase, the Cochrane
Library, and Web of Science for observational studies comparing TAVR
procedural complications in RA versus FA. Event rates were compared via
weighted summary odds ratios using the Mantel-Haenszel method.
 Result(s): Six manuscripts encompassing 6132 patients were included.
Meta-analysis showed that RA reduced the risk of major vascular
complications (OR 0.58, 95% CI 0.43-0.77, p < 0.001, I2 0%) and
major/life-threatening bleeding (OR 0.46, 95% CI 0.36-0.59, p < 0.001,
I2 0%) as compared to FA for secondary TAVR access. We also
observed a reduction 30-day mortality (OR 0.55, 95% CI 0.38-0.79, p =
0.001, I2 0%), acute kidney injury (OR 0.45, 95% CI 0.34-0.60,
p < 0.001, I2 0%), and stroke and transient ischemic attack (OR
0.43, 95% CI 0.27-0.67, p < 0.001, I2 0%). Conclusion(s):
RA reduced the risk of major vascular and bleeding complications when
compared to FA for secondary access in TAVR. RA is associated with reduced
risk of other adverse outcomes including mortality, but these associations
may be related to selection bias and confounding given the observational
study designs. Copyright © 2021 Wiley Periodicals LLC.

<134>
Accession Number
637712460
Title
Dexmedetomidine after Cardiac Surgery for Prevention of Delirium (EXACTUM)
trial protocol: A multicentre randomised, double-blind, placebo-controlled
trial.
Source
BMJ Open. 12(4) (no pagination), 2022. Article Number: e058968. Date of
Publication: 08 Apr 2022.
Author
Gargadennec T.; Oilleau J.-F.; Rozec B.; Nesseler N.; Lasocki S.; Futier
E.; Amour J.; Durand M.; Bougle A.; Kerforne T.; Consigny M.; Eddi D.;
Huet O.
Institution
(Gargadennec, Oilleau, Huet) Departement d'Anesthesie et Reanimation
Chirurgicale, Chu Brest, Brest, France
(Gargadennec, Oilleau, Huet) Universite de Bretagne Occidentale, Brest,
France
(Rozec) Intensive Care Unit, Anesthesia and Critical Care Department,
Hopital Laennec, University Hospital Centre Nantes, Nantes, France
(Rozec) Cnrs, Inserm, L'Institut du Thorax, Universite de Nantes, Nantes,
France
(Nesseler) Anaesthesia and Intensive Care Unit, Centre Hospitalier
Universitaire de Rennes, Rennes, France
(Lasocki) Departement Anesthesie Reanimation, Chu Angers, Angers, France
(Lasocki) Universite Angers Faculte des Sciences, Angers, France
(Futier) Departement de Medecine Perioperatoire, Anesthesie Reanimation,
Hopital Estaing, Chu Clermont-Ferrand, Clermont-Ferrand, France
(Futier) Cnrs, Inserm U-1103, Universite Clermont Auvergne,
Clermont-Ferrand, France
(Amour) Institute of Perfusion, Critical Care Medicine and Anesthesiology
in Cardiothoracic Surgery (IPRA), Jacques Cartier Private Hospital, Massy,
France
(Durand) Pole Anesthesie-Reanimation, Chu Grenoble Alpes, Grenoble, France
(Bougle) Sorbonne Universite, Paris, France
(Bougle) Department of Anesthesiology and Critical Care Medicine,
Institute of Cardiology, Grc 29, Pitie-Salpetriere Hospital, Aphp, Paris,
France
(Kerforne) Faculte de Medecine, Inserm U1082, Ischemie Reperfusion en
Transplantation Modelisation et Innovations Therapeutiques, Universite de
Poitiers, Poitiers, France
(Kerforne) Service d'Anesthesie, Reanimation et Medecine Peri-Operatoire,
Chu Poitiers, Poitiers, France
(Consigny, Eddi) Direction de la Recherche Clinique et de l'Innovation
(DRCI), Chu Brest, Brest, France
Publisher
BMJ Publishing Group
Abstract
Introduction Incidence of delirium after cardiac surgery remains high and
delirium has a significant burden on short-term and long-term outcomes.
Multiple causes can trigger delirium occurence, and it has been
hypothesised that sleep disturbances can be one of them. Preserving the
circadian rhythm with overnight infusion of low-dose dexmedetomidine has
been shown to lower the occurrence of delirium in older patients after
non-cardiac surgery. However, these results remain controversial. The aim
of this study was to demonstrate the usefulness of sleep induction by
overnight infusion of dexmedetomidine to prevent delirium after cardiac
surgery. Methods and analysis Dexmedetomidine after Cardiac Surgery for
Prevention of Delirium is an investigator-initiated, randomised,
placebo-controlled, parallel, multicentre, double-blinded trial. Nine
centres in France will participate in the study. Patients aged 65 years or
older and undergoing cardiac surgery will be enrolled in the study. The
intervention starts on day 0 (the day of surgery) until intensive care
unit (ICU) discharge; the treatment is administered from 20:00 to 08:00 on
the next day. Infusion rate is modified by the treating nurse or the
clinician with an objective of Richmond Agitation and Sedation Scale score
from -1 to +1. The primary outcome is delirium occurrence evaluated with
confusion assessment method for the ICU two times per day during 7 days
following surgery. Secondary outcomes include incidence of agitation
related events, self-evaluated quality of sleep, cognitive evaluation 3
months after surgery and quality of life 3 months after surgery. The
sample size is 348. Ethics and dissemination The study was approved for
all participating centers by the French Central Ethics Committee (Comite
de Protection des Personnes Ile de France VI, registration number
2018-000850-22). The results will be submitted for publication in
peer-reviewed journals. Trial registration number
NCT03477344. Copyright ©

<135>
Accession Number
637212779
Title
Comparison the Effect of Etomidate vsThiopentone on Left Ventricular
Strain and Strain Rate at the Time of Anesthesia Induction in Patients
Undergoing Elective Coronary Artery Bypass Surgery: A Randomized Double
Blind Controlled Trial.
Source
Journal of Cardiac Critical Care. 5(3) (pp 201-207), 2021. Article Number:
2190005. Date of Publication: 01 Dec 2021.
Author
Singh U.; Choudhury M.; Choudhury A.; Hote M.P.; Kapoor P.M.
Institution
(Singh) Department of Cardiac Surgical Intensive Care, All India Institute
of Medical Sciences, New Delhi, India
(Choudhury, Choudhury, Kapoor) Department of Cardiac Anaesthesia and
Critical Care, All India Institute of Medical Sciences, New Delhi 110029,
India
(Hote) Department of Cardiothoracic and Vascular Surgery, All India
Institute of Medical Sciences, New Delhi, India
Publisher
Thieme India
Abstract
Myocardial strain imaging with speckle tracking echocardiography (STE) is
getting popularity because it does not depends on insonation angle and has
shown good correlation with intraoperative and postoperative ventricular
function in patients with coronary artery disease. The impact of
thiopentone and etomidate induction on myocardial function was studied and
compared on sixty patients undergoing elective coronary artery bypass
grafting. Three loops for each views (apical 4 chamber, apical 2 chamber,
and apical long axis) were acquired at base line (T0) and 1 minute (T1)
after induction for offline analysis. In Group T, significant increase in
HR from the base line values (67.8 +/- 13.8 vs 79.2 +/- 15.6, p = 0.001)
occurred post induction, where as in Group E it remain near to the base
line (71.7 +/- 8.3 vs 70.1+/- 8.9, p = 0.345). A reduction in mean
arterial pressure (MAP) was noted in both the groups after the injection
of the allocated drug. There was no significant difference in the index of
contractility (ICON) (T0 vs T1: 48.7 +/- 10.6 vs 47.0 +/- 11.7, p = 0.120)
in Group E where as in Group T there was a reduction in the ICON value (T0
vs T1: 45.0 +/- 10.7 vs 41.0 +/- 8.4, p = 0.005). A similar picture was
also noted in systemic vascular resistance index. A significant decrease
in cardiac index (CI) was seen in Group E (T0 vs T1: 2.7 +/- 0.4 vs 2.5
+/- 0.4, p = 0.027), however it remain near to the base line in Group T.
There occurred no changes in stroke index (SI) in Group E (T0 vs T1: 38.7
+/- 6 vs 37.0+/- 5.3, p = 0.134), where as a significant decrease was
noted after injection of thiopental (T0 vs T1: 38.0 +/- 6.2 vs 36.1+/-
4.9, p = 0.049). A significant decline in cardiac performance index (CPI)
was also recorded in Group E (T0 vs T1: 0.57 +/- 0.15 vs 0.52 +/- 0.12, p
= 0.032), and not in Group T. There was decrease in left ventricular
ejection fraction (LVEF) after the injection of both the drugs (Group E,
T0 vs T1: 57 +/- 3.7 vs 54+/- 3.7, p= 0.001; and Group T, T0 vs T1: 57 +/-
3.7 vs 54+/- 3.7, p = 0.001). In Group E, global longitudinal peak
systolic strain (GLPSS) showed no change after the injection of the drug
(T0 vs T1: -13.2 +/- 2.2 vs -13.1+/- 2.3, p = 0.631). However, a
significant decrease in GLPSS (T0 vs T1: -13.5 +/- 1.5 vs - 10 +/- 1.8, p
= 0.001) after injection of thiopental. Longitudinal peak systolic strain
rate (LPSSR) was significantly decreased in all echocardiographic views
after the injection of respective drugs. However, the decrease in LPSSR
was significantly less in Group E in comparison to Group T. To conclude,
STE provides accurate and reliable real time quantitative regional and
global LV assessment. Use of thiopentone for anesthesia induction is
associated with more profound impairment of LV function in comparison to
etomidate as assessed by a decreased longitudinal peak systolic strain
rate and global longitudinal peak systolic strain. Further studies are
warranted to understand the exact clinical impact, which may influence the
choice of intravenous induction agent based upon preoperative patient
characteristics. Copyright © 2021 Thieme India. All rights
reserved.

<136>
Accession Number
2017767068
Title
Prevention of Cardiovascular Events and Mortality With Icosapent Ethyl in
Patients With Prior Myocardial Infarction.
Source
Journal of the American College of Cardiology. 79(17) (pp 1660-1671),
2022. Date of Publication: 03 May 2022.
Author
Gaba P.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson T.A.;
Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz C.; Tardif
J.-C.; Giugliano R.P.; Martens F.M.A.C.; Gibson C.M.; Ballantyne C.M.
Institution
(Gaba, Bhatt, Giugliano) Division of Cardiovascular Medicine, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Steg) Universite de Paris, FACT (French Alliance for Cardiovascular
Trials), Assistance Publique-Hopitaux de Paris, Hopital Bichat, INSERM
Unite 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
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc (Amarin),
Bridgewater, NJ, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Martens) Werkgroep Cardiologische centra Nederland (WCN: Dutch Network
for Cardiovascular Research) and the Department of Cardiology, Deventer
Hospital, Deventer, Netherlands
(Gibson) Department of Cardiovascular Diseases, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, MA, United States
(Ballantyne) Department of Medicine, Baylor College of Medicine, Houston,
TX, United States
(Ballantyne) Center for Cardiovascular Disease Prevention, Methodist
DeBakey Heart and Vascular Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: REDUCE-IT was a double-blind trial that randomized 8,179
statin-treated patients with controlled low-density lipoprotein
cholesterol and moderately elevated triglycerides to icosapent ethyl (IPE)
or placebo. There was a significant reduction in the primary endpoint,
including death from cardiovascular (CV) causes. The specific impact of
IPE among patients with prior myocardial infarction (MI) was unknown.
 Objective(s): Our goal was to examine the benefit of IPE on ischemic
events among patients with prior MI in REDUCE-IT. Method(s): We
performed post hoc analyses of patients with prior MI. The primary
endpoint was CV death, MI, stroke, coronary revascularization, or
hospitalization for unstable angina. The key secondary endpoint was CV
death, MI, or stroke. Result(s): A total of 3,693 patients had a
history of prior MI. The primary endpoint was reduced from 26.1% to 20.2%
with IPE vs placebo; HR: 0.74 (95% CI: 0.65-0.85; P = 0.00001). The key
secondary endpoint was reduced from 18.0% to 13.3%; HR: 0.71 (95% CI:
0.61-0.84; P = 0.00006). There was also a significant 35% relative risk
reduction in total ischemic events (P = 0.0000001), a 34% reduction in MI
(P = 0.00009), a 30% reduction in CV death (P = 0.01), and a 20% lower
rate of all-cause mortality (P = 0.054), although there was a slight
increase in atrial fibrillation. Sudden cardiac death and cardiac arrest
were also significantly reduced by 40% and 56%, respectively.
 Conclusion(s): Patients with a history of prior MI in REDUCE-IT
treated with IPE demonstrated large and significant relative and absolute
risk reductions in ischemic events, including CV death. (A Study of AMR101
to Evaluate Its Ability to Reduce Cardiovascular Events in High Risk
Patients With Hypertriglyceridemia and on Statin. The Primary Objective is
to Evaluate the Effect of 4 g/Day AMR101 for Preventing the Occurrence of
a First Major Cardiovascular Event. [REDUCE-IT];
NCT01492361) Copyright © 2022 The Authors

<137>
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.

<138>
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.

<139>
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. 45(5) (pp 470-477), 2022. Date
of Publication: May 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.

<140>
Accession Number
637902286
Title
Comparison of the effectiveness of home visits and telephone follow-up on
the self-efficacy of patients having un-dergone coronary artery bypass
graft surgery (CABG) and the burden of their family caregivers: A
randomized con-trolled trial.
Source
Investigacion y educacion en enfermeria. 40(1) (no pagination), 2020. Date
of Publication: 01 Mar 2020.
Author
Gohari F.; Hasanvand S.; Gholami M.; Heydari H.; Baharvand P.; Almasian M.
Institution
(Gohari, Hasanvand, Gholami, Baharvand, Almasian) Lorestan University of
Medical Sciences, Iran, Islamic Republic of
(Heydari) Lorestan University of Medical Sciences, Iran, Islamic Republic
of
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This study aimed to compare home visits and telephone
follow-up effectiveness on patients' self-efficacy undergoing Coro-nary
Artery Bypass Graft Surgery -CABG- and caregivers' burden. METHOD(S):
In this randomized clinical trial, 114 patients undergoing CABG were
assigned to the three groups of home visits, telephone follow-up, and
control based on the stratified block randomization. The self-management
program of the home visit group included four face-to-face 60-minute
training sessions once a week, and for the telephone follow-up group, four
30-minute telephone counseling sessions twice each week for a month. The
control group received routine care. Data were collected using the cardiac
rehabilitation self-efficacy questionnaire and the caregiver burden scale
before and after the interven-tion. RESULT(S): Before the study,
there were no statistically significant differences between the three
groups in terms of the means of self-efficacy and caregiver burden scores.
However, there was a statistically significant difference between the home
visit and control groups (p<0.001) and between the telephone follow-up and
control groups (p<0.001) after the intervention, with in-creased
self-efficacy and reduced caregiver burden reported. In contrast, there
was no significant difference between the home visit and telephone
follow-up groups regarding self-efficacy and caregiver burden scores.
 CONCLUSION(S): Both methods of self-management education have similar
effectiveness in increasing self-efficacy and reducing the care-giver
burden after discharge for patients who have undergone CABG. Copyright
by the Universidad de Antioquia.

<141>
Accession Number
2016585302
Title
Nomogram for Postoperative Headache in Adult Patients Undergoing Elective
Cardiac Surgery.
Source
Journal of the American Heart Association. 11(8) (no pagination), 2022.
Article Number: e023837. Date of Publication: 19 Apr 2022.
Author
Wang D.; Le S.; Wu J.; Xie F.; Li X.; Wang H.; Zhang A.; Du X.; Huang X.
Institution
(Wang, Le, Wang, Du, Huang) Department of Cardiovascular Surgery, Union
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, China
(Wang, Xie) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Zhengzhou University, Zhengzhou, China
(Le) Department of Thoracic Surgery, Zhongnan Hospital of Wuhan
University, Wuhan University, Wuhan, China
(Wu) Key Laboratory for Molecular Diagnosis of Hubei Province, The Central
Hospital of Wuhan, Tongji Medical College, Huazhong University of Science
and Technology, Wuhan, China
(Li) Department of Nursing, Huaihe Hospital of Henan University, Henan,
Kaifeng, China
(Zhang) Department of Cardiology, The Central Hospital of Wuhan, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Postoperative headache (POH) is frequent after cardiac
surgery; however, few studies on risk factors for POH exist. The aims of
the current study were to explore risk factors related to POH after
elective cardiac surgery and to establish a predictive system. METHODS AND
RESULTS: Adult patients undergoing elective open-heart surgery under
cardiopulmonary bypass from 2016 to 2020 in 4 cardiac centers were
retrospectively included. Two thirds of the patients were randomly
allocated to a training set and one third to a validation set. Predictors
for POH were selected by univariate and multivariate analysis. POH
developed in 3154 of the 13 440 included patients (23.5%) and the overall
mortality rate was 2.3%. Eight independent risk factors for POH after
elective cardiac surgery were identified, including female sex, younger
age, smoking history, chronic headache history, hypertension, lower left
ventricular ejection fraction, longer cardiopulmonary bypass time, and
more intraoperative transfusion of red blood cells. A nomogram based on
the multivariate model was constructed, with reasonable calibration and
discrimination, and was well validated. Decision curve analysis revealed
good clinical utility. Finally, 3 risk intervals were divided to better
facilitate clinical application. CONCLUSION(S): A nomogram model for
POH after elective cardiac surgery was developed and validated using 8
predictors, which may have potential application value in clinical risk
assessment, decision-making, and individualized treatment associated with
POH. Copyright © 2022 The Authors.

<142>
Accession Number
2014895396
Title
Comparison of plasma concentrations of levobupivacaine with and without
epinephrine for thoracic paravertebral block: A randomised trial.
Source
Anaesthesia Critical Care and Pain Medicine. 40(5) (no pagination), 2021.
Article Number: 100952. Date of Publication: October 2021.
Author
Yamazaki A.; Fujii K.; Aratani Y.; Kuriyama T.; Kawamata T.
Institution
(Yamazaki, Fujii, Aratani, Kuriyama, Kawamata) Department of
Anaesthesiology, Wakayama Medical University School of Medicine, 811-1
Kimiidera, Wakayama, Wakayama City 641-8509, Japan
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Thoracic paravertebral block (TPVB) is effective for analgesia
for unilateral thoracic surgery. However, since the paravertebral space is
highly vascular, injection of local anaesthetics into the paravertebral
space may induce systemic local anaesthetic toxicity. We examined the
effect of addition of epinephrine to paravertebral levobupivacaine on its
plasma concentration. Method(s): In a randomised single blind trial,
twenty-four male patients who were scheduled to undergo elective
unilateral pulmonary lobectomy or segmentectomy under general anaesthesia
combined with TPVB were enrolled in this study. They were randomly divided
into two groups: one group received a single bolus thoracic paravertebral
injection of 1 mg/kg of 0.25% levobupivacaine with 5 mug/mL epinephrine
and the other group received a single bolus thoracic paravertebral
injection of 1 mg/kg of 0.25% levobupivacaine alone. Arterial blood
samples were obtained for plasma levobupivacaine assay after injection.
The peak plasma concentration (Cmax) and the time to peak plasma
concentration (Tmax), for levobupivacaine were calculated. Result(s):
There were no significant differences in patients' characteristics between
the two groups. The mean arterial Cmax values of levobupivacaine were 0.48
+/- 0.11 mug/mL with epinephrine and 0.71 +/- 0.31 mug/mL without
epinephrine (P = 0.041). The mean arterial Tmax values of levobupivacaine
were 46.0 +/- 35.6 min with epinephrine and 12.0 +/- 7.2 min without
epinephrine (P = 0.005). Conclusion(s): The addition of 5-mug/mL
epinephrine to a single bolus thoracic paravertebral injection of 1-mg/kg
levobupivacaine significantly decreased Cmax and delayed Tmax of
levobupivacaine. The addition of epinephrine to levobupivacaine may be a
useful strategy to reduce systemic levobupivacaine toxicity. Clinical
trial registration number: UMIN 000021942 Copyright © 2021 The
Author(s)

<143>
Accession Number
2015599783
Title
Ticagrelor for patients undergoing coronary artery bypass grafting: A
meta-analysis of randomized controlled trials.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Xiang F.; Lin Y.; Chen B.
Institution
(Xiang, Lin, Chen) Department of Pharmacy, The Second Affiliated Hospital,
Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Ticagrelor may be an alternative to aspirin as it provides
robust and consistent platelet inhibition. However, the effect of
ticagrelor treatment in patients undergoing coronary artery bypass
grafting (CABG) has not been well confirmed. We conducted a meta-analysis
to appraise whether ticagrelor therapy affects outcomes in CABG patients.
 Method(s): We searched PubMed, Embase, EBSCO, and Cochrane databases
from its inception up to 4 December 2020 for randomized controlled trials
that assessed ticagrelor versus non-ticagrelor in patients undergoing
CABG. The primary outcome was the incidence of saphenous vein graft (SVG)
occlusion at 1 year after CABG. Secondary outcomes were SVG occlusion at 7
days, major adverse cardiovascular events (MACE), and bleeding requiring
reoperation. Result(s): Seven trials including 4305 patients (2153
randomized to ticagrelor therapy and 2152 to non-ticagrelor therapy) were
included. One-hundred and thirty of 1140 patients (11.4%) randomized to
the ticagrelor group versus 175 of 1220 patients (14.3%) randomized to the
non-ticagrelor group experienced SVG occlusion at 1 year after CABG.
Compared to the control group, ticagrelor therapy yielded a significantly
lower risk of SVG occlusion [RR 0.79 (0.64-0.97), p = 0.03]. In the
subgroup analysis, ticagrelor plus aspirin compared with aspirin alone did
not decrease the risk of SVG occlusion after 1 year [RR 0.65 (0.40-1.07),
p = 0.09]. There was no difference in the incidence of SVG occlusion at 7
days [RR 0.67 (0.42-1.06), p = 0.09], MACE up to 1 year [RR 0.99
(0.81-1.21), p = 0.90], or bleeding requiring reoperation [RR 1.16
(0.80-1.70), p = 0.44]. Conclusion(s): Compared with non-ticagrelor
therapy, ticagrelor decreased the risk of saphenous vein graft occlusion
after 1 year in patients undergoing elective CABG with saphenous vein
grafting. Copyright © The Author(s) 2022.

<144>
Accession Number
637906103
Title
Concomitant Surgical Left Atrial Appendage Occlusion: a Review.
Source
Current cardiology reports. (no pagination), 2022. Date of Publication:
30 Apr 2022.
Author
Whitlock R.P.; Belley-Cote E.P.
Institution
(Whitlock) Division of Cardiac Surgery, Department of Surgery, McMaster
University, ON, Hamilton, Canada
(Whitlock, Belley-Cote) Population Health Research Institute, ON, 237
Barton Street E, Hamilton L8L 2X2, Canada
(Belley-Cote) Divisions of Cardiology and Critical Care, Department of
Medicine, McMaster University, ON, Hamilton, Canada
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: In this review, we discuss some of the observational
studies that examined the impact of left atrial appendage occlusion on
stroke, the Left Atrial Appendage Occlusion Study (LAAOS) III research
program that provided definitive evidence for the benefit of surgical left
atrial appendage occlusion on ischemic stroke, and high priority studies
in the field that should be pursued by the surgical community. RECENT
FINDINGS: Atrial fibrillation is common in patients undergoing cardiac
surgery. Oral anticoagulants are effective at preventing strokes related
to atrial fibrillation; they have been the standard of care for stroke
prevention in patients with atrial fibrillation for decades. Most strokes
in patients with atrial fibrillation originate from the left atrial
appendage. LAAOS III, a large randomized controlled trial, has recently
demonstrated that concomitant left atrial appendage occlusion in patients
undergoing cardiac surgery for another indication reduces the risk of
stroke or systemic embolism on top of oral anticoagulation. Surgical left
atrial appendage occlusion reduces the risk of ischemic stroke and
systemic embolism in patients with atrial fibrillation and a CHA2DS2-VASc
score>=2 undergoing cardiac surgery for another indication. The role of
surgical left atrial appendage occlusion with patients without atrial
fibrillation, as a substitute to anticoagulation and as a standalone
procedure, remains unclear. Copyright © 2022. The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<145>
Accession Number
637902068
Title
Evaluating the effect of multivalvular disease on mortality after
transcatheter aortic valve replacement for aortic stenosis: a
meta-analysis and systematic review.
Source
Future cardiology. (no pagination), 2022. Date of Publication: 29 Apr
2022.
Author
Siddiqi T.J.; Usman M.S.; Ahmed J.; Shahid I.; Ahmed W.; Alkhouli M.
Institution
(Siddiqi, Usman) Department of Medicine, University of Mississippi,
Jackson, United States
(Ahmed) Department of Medicine, Dow University of Health Sciences, Karachi
74200, Pakistan
(Shahid) Department of Medicine, Ziauddin Medical University, Karachi
7500, Pakistan
(Ahmed) Medical College, Aga Khan University, Karachi 74800, Pakistan
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, MN,
Rochester, United States
Publisher
NLM (Medline)
Abstract
Aims: To determine the prognosis of multivalvular disease in patients
undergoing transcatheter aortic valve replacement (TAVR) for severe aortic
stenosis. Method(s): Patients undergoing TAVR for aortic stenosis
with covariate-adjusted risk of mortality associated with concomitant
valve disease (mitral regurgitation [MR], mitral stenosis [MS] or
tricuspid regurgitation [TR]) were included. Result(s):
Moderate-to-severe MR was associated with increased mortality at 30 days
(hazard ratio [HR]: 1.60; 95% CI: 1.11-2.30; p = 0.01) and 1 year (HR:
1.87; 95% CI: 1.22-2.87; p = 0.004). The presence of all-grade MS did not
impact 30-day or 1-year mortality (HR, 30 days: 1.60; 95% CI: 0.71-3.63; p
= 0.26; and HR, 1 year: 1.90; 95% CI: 0.98-3.69; p = 0.06); however, an
increased risk of 1-year mortality (HR: 1.67; 95% CI: 1.03-2.70; p = 0.04)
was observed with severe MS compared with no MS. Moderate-to-severe TR had
a higher risk of all-cause mortality at 1 year (HR: 1.49; 95% CI:
1.24-1.78; p < 0.001) compared with no or mild TR. Conclusion(s):
Moderate-to-severe MR or TR, and severe MS, significantly increase
mid-term mortality after TAVR.

<146>
Accession Number
637900097
Title
The impact of perioperative stroke and delirium on outcomes after surgical
aortic valve replacement.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2022. Date of Publication: 18 Mar 2022.
Author
Messe S.R.; Overbey J.R.; Thourani V.H.; Moskowitz A.J.; Gelijns A.C.;
Groh M.A.; Mack M.J.; Ailawadi G.; Furie K.L.; Southerland A.M.; James
M.L.; Moy C.S.; Gupta L.; Voisine P.; Perrault L.P.; Bowdish M.E.;
Gillinov A.M.; O'Gara P.T.; Ouzounian M.; Whitson B.A.; Mullen J.C.;
Miller M.A.; Gammie J.S.; Pan S.; Erus G.; Browndyke J.N.
Institution
(Messe) Department of Stroke and Neurocritical Care, Perelman School of
Medicine University of Pennsylvania, Pa, Philadelphia, United States
(Overbey, Moskowitz, Gelijns, Gupta, Pan) International Center for Health
Outcomes and Innovation Research (InCHOIR), Department of Population
Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, NY
(Thourani) Marcus Valve Center, Department of Cardiovascular Surgery,
Piedmont Heart Institute, Atlanta, United States
(Groh) Mission Health and Hospitals, Asheville, United States
(Mack) Cardiovascular Surgery, Baylor Scott & White Health, Plano, United
States
(Ailawadi) Departments of Cardiac Surgery and Surgery, University of
Michigan Health System, Mich, Ann Arbor, United States
(Furie) Department of Neurology, Alpert Medical School of Brown
University, Providence, RI
(Southerland) Division of Vascular Neurology, University of Virginia
Health System, Va, Charlottesville, United States
(James) Department of Anesthesiology, Duke University Medical Center,
Durham, NC; Department of Neurology, Duke University Medical Center,
Durham, NC
(Moy) Division of Clinical Research, National Institute of Neurological
Disorders and Stroke, National Institutes of Health, Md, Bethesda, United
States
(Voisine) Department of Surgery, Institut de Cardiologie et Pneumologie de
Quebec, Quebec, Canada
(Perrault) Department of Surgery, Montreal Heart Institute, Quebec, Canada
(Bowdish) Surgery and Preventive Medicine, Keck School of Medicine,
University of Southern California, Los Angeles, Mexico
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Mass,
Boston
(Ouzounian) Division of Cardiac Surgery, Department of Surgery, Peter Munk
Cardiac Centre, UHN-Toronto General Hospital, Toronto, ON, Canada
(Whitson) Division of Cardiac Surgery, Department of Surgery, Ohio State
University, Columbus, OH, United States
(Mullen) Division of Cardiac Surgery, University of Alberta, Edmonton, AB,
Canada
(Miller) Division of Cardiovascular Sciences, National Heart, Lung, Blood
Institute, National Institutes of Health, Md, Bethesda, United States
(Gammie) Department of Cardiac Surgery, Johns Hopkins Heart and Vascular
Institute, Md, Baltimore, United States
(Erus) Department of Radiology, Perelman School of Medicine University of
Pennsylvania, Pa, Philadelphia, United States
(Browndyke) Department of Psychiatry & Behavioral Sciences, Duke
University Medical Center, Durham
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The effects of stroke and delirium on postdischarge cognition
and patient-centered health outcomes after surgical aortic valve
replacement (SAVR) are not well characterized. Here, we assess the impact
of postoperative stroke and delirium on these health outcomes in SAVR
patients at 90 days. METHOD(S): Patients (N = 383) undergoing SAVR
(41% received concomitant coronary artery bypass graft) enrolled in a
randomized trial of embolic protection devices underwent serial neurologic
and delirium evaluations at postoperative days 1, 3, and 7 and magnetic
resonance imaging at day 7. Outcomes included 90-day functional status,
neurocognitive decline from presurgical baseline, and quality of life.
 RESULT(S): By postoperative day 7, 25 (6.6%) patients experienced
clinical stroke and 103 (28.5%) manifested delirium. During index
hospitalization, time to discharge was longer in patients experiencing
stroke (hazard ratio, 0.62; 95% confidence interval [CI], 0.42-0.94; P =
.02) and patients experiencing delirium (hazard ratio, 0.68; 95% CI,
0.54-0.86; P = .001). At day 90, patients experiencing stroke were more
likely to have a modified Rankin score >2 (odds ratio [OR], 5.9; 95% CI,
1.7-20.1; P = .01), depression (OR, 5.3; 95% CI, 1.6-17.3; P = .006), a
lower 12-Item Short Form Survey physical health score (adjusted mean
difference -3.3 +/- 1.9; P = .08), and neurocognitive decline (OR, 7.8;
95% CI, 2.3-26.4; P = .001). Delirium was associated with depression (OR,
2.2; 95% CI, 0.9-5.3; P = .08), lower 12-Item Short Form Survey physical
health (adjusted mean difference -2.3 +/- 1.1; P = .03), and
neurocognitive decline (OR, 2.2; 95% CI, 1.2-4.0; P = .01).
 CONCLUSION(S): Stroke and delirium occur more frequently after SAVR
than is commonly recognized, and these events are associated with
disability, depression, cognitive decline, and poorer quality of life at
90 days postoperatively. These findings support the need for new
interventions to reduce these events and improve patient-centered
outcomes. Copyright © 2022. Published by Elsevier Inc.

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