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<1>
Accession Number
2010407218
Title
Long-term outcomes of transcatheter valve-in-valve replacement for failed
aortic bioprosthesis: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(4) (pp 1370-1372),
2022. Date of Publication: March 1, 2022.
Author
Abushouk A.I.; Saad A.M.; Isogai T.; Shekhar S.; Krishnaswamy A.; Yun J.;
Kapadia S.R.
Institution
(Abushouk, Saad, Isogai, Shekhar, Krishnaswamy, Yun, Kapadia) Department
of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic
Foundation, Cleveland, OH, United States
Publisher
John Wiley and Sons Inc

<2>
Accession Number
2006898594
Title
microRNAs Alterations of Myocardium and Brain Ischemia-Reperfusion Injury:
Insight to Improve Infarction.
Source
Immunological Investigations. 51(1) (pp 51-72), 2022. Date of Publication:
2022.
Author
Sabet Sarvestani F.; Azarpira N.
Institution
(Sabet Sarvestani, Azarpira) Transplant Research Center, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Taylor and Francis Ltd.
Abstract
Heart and cerebral infarctions, as two important ischemic diseases, lead
to the death of tissues due to inadequate blood supply and high mortality
worldwide. These statuses are started via blockage of vessels and
depletion of oxygen and nutrients which affected these areas. After
reperfusion and restoration of oxygen supply, more severe injury was
mediated by multifaceted cascades of inflammation and oxidative stress.
microRNAs (miRNAs) as the regulator of biological and pathological
pathways can adjust these conditions by interaction with their targets.
Also, miRNAs can be modulated by preconditioning and external agents that
may improve the functional outcome after IRI. miRNAs might be considered
as therapeutic approaches to improve the symptoms of patients after
myocardial infarction and cerebral ischemic stroke. Copyright ©
2020 Taylor & Francis Group, LLC.

<3>
Accession Number
2017181023
Title
A randomized controlled trial of renin-angiotensin-aldosterone system
inhibitor management in patients admitted in hospital with COVID-19.
Source
American Heart Journal. 247 (pp 76-89), 2022. Date of Publication: May
2022.
Author
Sharma A.; Elharram M.; Afilalo J.; Flannery A.; Afilalo M.; Tselios C.;
Ni J.; Ezekowitz J.A.; Cheng M.P.; Ambrosy A.P.; Zannad F.; Brophy J.M.;
Giannetti N.; Bessissow A.; Kronfli N.; Marelli A.; Aziz H.; Alqahtani M.;
Aflaki M.; Craig M.; Lopes R.D.; Ferreira J.P.
Institution
(Sharma, Elharram, Ni, Brophy, Giannetti, Marelli, Aziz) Division of
Cardiology, McGill University Health Centre, Montreal, QC, Canada
(Sharma, Elharram, Flannery, Ni) DREAM-CV Lab, McGill University Health
Centre Research Institute, McGill University, Montreal, QC, Canada
(Afilalo) Division of Cardiology, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Afilalo, Tselios) Department of Emergency Medicine, Jewish General
Hospital, McGill Hospital, Montreal, QC, Canada
(Ezekowitz) Canadian VIGOUR Centre, University of Alberta, Edmonton, AB,
Canada
(Cheng) Division of Infectious Disease, McGill University Health Centre,
McGill University, Montreal, QC, Canada
(Ambrosy) Department of Cardiology, Kaiser Permanente San Francisco
Medical Center, CA, San Francisco
(Ambrosy, Kronfli) Division of Research, Kaiser Permanente Northern
California, CA, Oakland
(Zannad, Ferreira) Centre D'Investigation Clinique- Plurithematique Inserm
CIC-P 1433, Inserm U1116, CHRU Nancy Hopitaux de Brabois, F-CRIN INI-CRCT
(Cardiovascular and Renal Clinical Trialists), Universite de Lorraine,
Nancy, France
(Bessissow, Alqahtani, Aflaki) Division of Internal Medicine, McGill
University Health Centre, McGill University, Montreal, QC, Canada
(Craig) Sainte-Justine University Hospital Research Centre and Department
of Mathematics and Statistics, Universite de Montreal, Montreal, QC,
Canada
(Lopes) Duke Clinical Research Institute, Duke University, NC, Durham
(Ferreira) Cardiovascular Research and Development Center, Department of
Surgery and Physiology, Faculty of Medicine of the University of Porto,
Porto, Portugal
Publisher
Elsevier Inc.
Abstract
Background: Renin-angiotensin aldosterone system inhibitors (RAASi) are
commonly used among patients hospitalized with a severe acute respiratory
syndrome coronavirus 2 infection coronavirus disease 2019 (COVID-19). We
evaluated whether continuation versus discontinuation of RAASi were
associated with short term clinical or biochemical outcomes.
 Method(s): The RAAS-COVID-19 trial was a randomized, open label study
in adult patients previously treated with RAASi who are hospitalized with
COVID-19 (NCT04508985). Participants were randomized 1:1 to discontinue or
continue RAASi. The primary outcome was a global rank score calculated
from baseline to day 7 (or discharge) incorporating clinical events and
biomarker changes. Global rank scores were compared between groups using
the Wilcoxon test statistic and the negative binomial test (using incident
rate ratio [IRR]) and the intention-to-treat principle. Result(s):
Overall, 46 participants were enrolled; 21 participants were randomized to
discontinue RAASi and 25 to continue. Patients' mean age was 71.5 years
and 43.5% were female. Discontinuation of RAASi, versus continuation,
resulted in a non-statistically different mean global rank score
(discontinuation 6 [standard deviation [SD] 6.3] vs continuation 3.8 (SD
2.5); P = .60). The negative binomial analysis identified that
discontinuation increased the risk of adverse outcomes (IRR 1.67 [95% CI
1.06-2.62]; P = .027); RAASi discontinuation increased brain natriuretic
peptide levels (% change from baseline: +16.7% vs -27.5%; P = .024) and
the incidence of acute heart failure (33% vs 4.2%, P = .016).
 Conclusion(s): RAASi continuation in participants hospitalized with
COVID-19 appears safe; discontinuation increased brain natriuretic peptide
levels and may increase risk of acute heart failure; where possible, RAASi
should be continued. Copyright © 2022 Elsevier Inc.

<4>
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).

<5>
Accession Number
2015783952
Title
Surgical outcomes of diaphragmatic resection during cytoreductive surgery
for advanced gynecological ovarian neoplasia: A randomized single center
clinical trial - DRAGON.
Source
Gynecologic Oncology. 164(2) (pp 271-277), 2022. Date of Publication:
February 2022.
Author
Cianci S.; Fedele C.; Vizzielli G.; Pasciuto T.; Gueli Alletti S.;
Cosentino F.; Chiantera V.; Fagotti A.; Scambia G.
Institution
(Cianci) Department of Human Pathology of Adult and Childhood "G.
Barresi", University Hospital "G. Martino", Messina, Italy
(Cianci, Fedele, Vizzielli, Gueli Alletti, Fagotti, Scambia) Gynecologic
Oncology Unit, Women Wealth Area, Department of Woman and Child Health and
Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS,
Rome, Italy
(Pasciuto) Research Core Facilty Data Collection G-STeP, Fondazione
Policlinico Universitario Agostino Gemelli IRCCS, Italy
(Cosentino) Division of Gynecologic Oncology, Gemelli Molise Hospital,
Campobasso, Italy
(Chiantera) Department of Gynecologic Oncology, ARNAS Civico Di Cristina
Benfratelli, Palermo, Italy
(Chiantera) Gynecologic Oncology, University of Palermo, Palermo, Italy
(Fagotti, Scambia) Catholic University of Sacred Heart, Rome, Italy
Publisher
Academic Press Inc.
Abstract
Introduction: Ovarian cancer (OC) represent nearly 4% of gynecologic
malignancies and it is often diagnosed at advanced stage. Diaphragmatic
surgery, a fundamental step of advanced stage ovarian cancer (ASOC)
debulking surgery, is associated with a high post-operative complication
incidence, which is supposedly reduced with thoracostomy tube placement.
We assessed the role of intra-operative thoracostomy tube placement, as a
prevention measure for post-operative complications, after diaphragmatic
resection. Method(s): This was a single center prospective randomized
trial. Ovarian cancer patients, who underwent mono-lateral diaphragmatic
resection, were randomized 1:1 into two arms. Arm A included patients
receiving intra-operative thoracostomy tube placement (TP); Arm B patients
did not receive thoracostomy tube placement (NTP). After surgery, all
patients underwent seriate chest x-ray and ultrasound to record thoracic
complications. Statistical analysis included uni- and multivariable
logistic regression model (proportional odds model). Result(s): Three
hundred seventy-one patients were screened and 88 patients were enrolled:
44 in arm A and B, respectively. No statistically significant differences
for intra-operative (p = 0.291) and any grade of post-operative
complication (p = 0.072) were detected, while 6.8% of patients in arm A
and 22.7% in arm B experienced severe respiratory symptoms (p = 0.035);
18.2% of patients in arm A had a moderate/large pleural effusion versus
65.9% in arm B (p < 0.0001). At multivariable analysis, results confirmed
that the NTP-group had a higher risk to receive post-operative
thoracostomy tube placement due to pleural effusion than the TP-group
(odds ratio [95% Confidence Interval] = 14.5 [3.7-57.4]).
 Conclusion(s): Thoracostomy intra-operative tube placement after
diaphragmatic resection is effective to prevent post-operative thoracic
complications. The extension of resection does not influence outcomes and
the risk of post-operative thoracentesis or TP remain
elevated. Copyright © 2021 Elsevier Inc.

<6>
Accession Number
2017684276
Title
Concomitant surgical ablation for treatment of atrial fibrillation in
patients undergoing cardiac surgery.
Source
Reviews in Cardiovascular Medicine. 23(3) (no pagination), 2022. Article
Number: rcm2303101. Date of Publication: March 2022.
Author
Dominici C.; Chello M.
Institution
(Dominici, Chello) Cardiovascular Surgery, Universita Campus Bio-Medico di
Roma, Rome 00128, Italy
Publisher
IMR Press Limited
Abstract
Surgical ablation is a well-established therapy for patients with atrial
fibrillation (AF) undergoing cardiac surgery. However, it is not clear if
this translates to an improvement in patient important outcomes such as
mortality, stroke, and quality of life (QoL). Electronic searches were
performed of Ovid Medline and PubMed from their inception to October 2021.
Eligible literature included comparative studies with patient undergoing
surgical ablative treatment for AF concomitant to any cardiac surgery
procedure and patients without specific AF treatment. For this paper, the
studies listed are presented descriptively without statistical processing
or collection of a metaanalysis. Freedom from AF at 1 year was
consistently shown to be improved by surgical ablation. No differences in
30-day mortality or in safety outcomes were observed between the group who
received ablation and the control group. A significant increase in
pacemaker implantation in the ablation group was generally detected among
studies, especially if the lesions were biatrial. Amongst the studies that
reported on health-related quality of life (HRQoL) a statistically
significant improvement was seen in the ablation group over the control,
especially in the physical domains. Surgical ablation is the most
effective procedure to treat AF during cardiac surgery, and it is a unique
opportunity to return to sinus rhythm with no added mortality risk and a
potential improvement in quality of life. There is however an increased
risk of pacemaker implantation and complications such as renal failure
which must be weighed with tailored treatment and patient selection. It is
also not clear how long-term outcomes are affected due to underpowered
randomized controlled trials. This review summarized short term outcomes
of concomitant AF treatment during cardiac surgery and highlight the
importance of reporting long-term outcomes to confirm the
benefits. Copyright © 2022 The Author(s).

<7>
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)

<8>
Accession Number
2014525317
Title
Effectiveness of a real-time x-ray dosimetry monitor in reducing radiation
exposure in coronary procedures: The ESPRESSO-raysafe randomized trial.
Source
Journal of Clinical Medicine. 10(22) (no pagination), 2021. Article
Number: 5350. Date of Publication: November-2 2021.
Author
Olschewski M.; Ullrich H.; Brandt M.; Steven S.; Ahoopai M.; Blessing R.;
Petrescu A.; Wenzel P.; Munzel T.; Gori T.
Institution
(Olschewski, Ullrich, Brandt, Steven, Ahoopai, Blessing, Petrescu, Wenzel,
Munzel, Gori) Department of Cardiology, Cardiology 1, University Medical
Center Mainz and Deutsches Zentrum fur Herz und Kreislauf Forschung,
Standort Rhein-Main, Mainz 55131, Germany
Publisher
MDPI
Abstract
Background-Several methods to reduce radiation exposure in the setting of
coronary procedures are available on the market, and we previously showed
that additional radiation shields reduce operator exposure during radial
interventions. We set out to examine the efficacy of real-time personal
dosimetry monitoring in a real-world setting of radial artery
catheterization. Methods and Results-In an all-comer prospective, parallel
study, consecutive coronary diagnostic and intervention procedures were
performed with the use of standard radiation shield alone (control group)
or with the addition of a real-time dosimetry monitoring system (Raysafe,
Billdal, Sweden, monitoring group). The primary outcome was the difference
in exposure of the primary operator among groups. Additional endpoints
included patient, nurse, second operator exposure and fluoroscopy time. A
total of 700 procedures were included in the analysis (n = 369 in the
monitoring group). There were no differences among groups in patients'
body mass index (p = 0.232), type of procedure (intervention vs.
diagnostic, p = 0.172), and patient sex (p = 0.784). Fluoroscopy time was
shorter in the monitoring group (5.6 (5.1-6.2) min vs. 7.0 (6.1-7.7) min,
p = 0.023). Radiation exposure was significantly lower in the monitoring
group for the patient (135 (115-151) microSv vs. 208 (176-245) microSv, p
< 0.0001) but not for the first operator (9 (7-11) microSv vs. 10 (8-11),
p = 0.70) and the assistant (2 (1-2) microSv vs. 2 (1-2) microSv, p =
0.121). Conclusions-In clinical daily practice, the use of a real-time
dosimetry monitoring device reduces patient radiation exposure and
fluoroscopy time without an effect on operator radiation
exposure. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<9>
Accession Number
2015364439
Title
Early and late outcomes of surgical aortic valve replacement with
sutureless and rapid-deployment valves versus transcatheter aortic valve
implantation: Meta-analysis with reconstructed time-to-event data of
matched studies.
Source
Catheterization and Cardiovascular Interventions. 99(6) (pp 1886-1896),
2022. Date of Publication: May 1, 2022.
Author
Sa M.P.; Jabagi H.; Dokollari A.; Awad A.K.; Van den Eynde J.; Malin J.H.;
Sicouri S.; Torregrossa G.; Ruhparwar A.; Weymann A.; Ramlawi B.
Institution
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Malin, Sicouri, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Jabagi) Department of Cardiothoracic Surgery, Valley Heart and Vascular
Institute, Ridgewood, NJ, United States
(Dokollari) Division of Cardiac Surgery, St Michael's Hospital, University
of Toronto, Toronto, ON, Canada
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Malin) Philadelphia College of Osteopathic Medicine, Bala Cynwyd, PA,
United States
(Ruhparwar, Weymann) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
Publisher
John Wiley and Sons Inc
Abstract
Sutureless/rapid-deployment (SURD) valves are options different from the
stented prostheses included in the pivotal trials comparing surgical
aortic valve replacement (AVR) and transcatheter aortic valve implantation
(TAVI). We performed a meta-analysis with reconstructed time-to-event data
of matched studies published by November 2021 to compare SURD-AVR and
TAVI. Primary endpoints were 30-day mortality and overall survival in the
follow-up. Secondary endpoints included: 30-day stroke, acute kidney
injury (AKI), major bleeding, permanent pacemaker implantation (PPI),
paravalvular leak (PVL), prosthesis-patient mismatch (PPM), postoperative
aortic valve area (AVA), and mean gradients. Ten studies met our
eligibility criteria, including a total of 5134 patients (2567 underwent
SURD-AVR and 2567 underwent TAVI). Pooled risk of 30-day mortality did not
favor any group (odds ratio [OR]: 0.69; 95% confidence interval [CI]:
0.31-1.53; p = 0.360). Patients undergoing SURD-AVR had lower risk of PVL
(OR: 0.09; 95% CI: 0.05-0.17; p < 0.001). No statistically significant
differences were observed for 30-day stroke, AKI, major bleeding, PPI,
PPM, and postoperative AVA. In the follow-up, we observed a higher risk of
mortality (hazard ratio: 1.74; 95% CI: 1.26-2.40; p < 0.001) with TAVI.
Patients who underwent SURD-AVR experienced better survival, however, the
interpretation of these results warrant caution due to the fact that
SURD-AVR patients tended to be younger than TAVI patients. Structural
heart surgeons and interventional cardiologists should consider initial
risk and life expectancy when referring patients for one approach over the
other. Copyright © 2022 Wiley Periodicals LLC.

<10>
Accession Number
637988984
Title
Does Dexmedetomidine Reduce the Risk of Atrial Fibrillation and Stroke
After Adult Cardiac Surgery? A Systematic Review and Meta-analysis of
Randomized Controlled Trials.
Source
Anatolian journal of cardiology. 26(5) (pp 354-365), 2022. Date of
Publication: 01 May 2022.
Author
Jing C.; Lin L.; Zhou T.; Li Y.L.; Fu L.; Gao M.Q.
Institution
(Jing, Lin, Zhou, Gao) Department of Intensive Care Unit, Beijing Shijitan
Hospital, Capital Medical University, Beijing, China
(Li, Fu) Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen,
Guangdong, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation is a common consequence of
cardiac sur-gery with increased stroke complications and mortality.
Although dexmedetomidine is thought to prevent postoperative atrial
fibrillation and stroke because of its sympa-tholytic and
anti-inflammatory properties, data from different studies show the effect
of dexmedetomidine on postoperative atrial fibrillation and stroke
uncertain in adult patients with cardiac surgery. METHOD(S): A
database including EMBASE, PubMed, and Cochrane CENTRAL was searched for
randomized controlled trials comparing dexmedetomidine with placebo or
other anesthetic drugs in adult cardiac surgery. The primary outcome was
the incidence of postoperative atrial fibrillation. The secondary outcomes
were the incidence of postop-erative stroke, mechanical ventilation
duration, intensive care unit length of stay, hospi-tal length of stay,
and mortality. RESULT(S): Eighteen trials with a total of 2933
patients were enrolled in the meta-analyses. Compared with controls,
dexmedetomidine significantly reduced the incidence of post-operative
atrial fibrillation [odds ratio, 0.82; 95% CI, 0.69-0.98; P = .03]. There
was no sig-nificant difference between groups in stroke (odds ratio, 1.36;
95% CI, 0.59-3.16; P = .47), mechanical ventilation duration [weighted
mean difference, -0.17; 95% CI, -0.35 to 0.14;P=.39], intensive care unit
length of stay (weighted mean difference, -0.03; 95% CI,-0.93 to 0.87; P =
.95), hospital length of stay (weighted mean difference, -0.04; 95%
CI,-0.40 to 0.32; P = .83) and mortality (odds ratio, 0.72; 95% CI,
0.32-1.60; P = .42). CONCLUSION(S): Perioperative dexmedetomidine
reduced the incidence of postoperative atrial fibrillation in adult
patients undergoing cardiac surgery. But there was no signifi-cant
difference in the incidence of stroke, mechanical ventilation duration,
intensive care unit length of stay, hospital length of stay, and
mortality.

<11>
Accession Number
633481933
Title
Transcatheter Mitral Valve Repair in Patients With and Without Cardiac
Resynchronization Therapy: The COAPT Trial.
Source
Circulation: Heart Failure. 13(11) (pp E007293), 2020. Date of
Publication: 01 Nov 2020.
Author
Kosmidou I.; Lindenfeld J.; Abraham W.T.; Kar S.; Lim D.S.; Mishell J.M.;
Whisenant B.K.; Kipperman R.M.; Boudoulas K.D.; Redfors B.; Shahim B.;
Zhang Z.; Mack M.J.; Stone G.W.
Institution
(Kosmidou, Redfors, Shahim, Zhang, Stone) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Kosmidou, Redfors) NewYork-Presbyterian Hospital, Columbia University
Irving Medical Center, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, Nashville, TN,
United States
(Abraham, Boudoulas) Division of Cardiovascular Medicine, The Ohio State
University, Columbus, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville,
United States
(Mishell) Kaiser Permanente - San Francisco Hospital, CA, United States
(Whisenant) Intermountain Heart Center, Salt Lake City, UT, United States
(Kipperman) Gagnon Cardiovascular Institute, Morristown Medical Center,
NJ, United States
(Kosmidou, Kosmidou, Lindenfeld, Abraham, Kar, Kar, Lim, Mishell,
Whisenant, Kipperman, Boudoulas, Redfors, Redfors, Shahim, Zhang, Mack,
Stone, Stone) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In the COAPT trial (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation), treatment of heart failure (HF) patients with
moderate-severe or severe secondary mitral regurgitation with
transcatheter mitral valve repair (TMVr) using the MitraClip plus
guideline-directed medical therapy (GDMT) reduced 2-year rates of HF
hospitalization and all-cause mortality compared with GDMT alone. Whether
the benefits of the MitraClip extend to patients with previously implanted
cardiac resynchronization therapy (CRT) is unknown. We sought to examine
the effect of prior CRT in patients enrolled in COAPT. Method(s):
Patients (N=614) with moderate-severe or severe secondary mitral
regurgitation who remained symptomatic despite maximally tolerated doses
of GDMT were randomized 1:1 to the MitraClip (TMVr arm) versus GDMT only
(control arm). Outcomes were assessed according to prior CRT use.
 Result(s): Among 614 patients, 224 (36.5%) had prior CRT (115 and 109
randomized to TMVr and control, respectively) and 390 (63.5%) had no CRT
(187 and 203 randomized to TMVr and control, respectively). Patients with
CRT had similar 2-year rates of the composite of death or HF
hospitalization compared with those without CRT (57.6% versus 55%,
P=0.32). Death or HF hospitalization at 2 years was lower with TMVr versus
control treatment in patients with prior CRT (48.6% versus 67.2%, hazard
ratio, 0.60 [95% CI, 0.42-0.86]) and without CRT (42.5% versus 66.9%,
hazard ratio, 0.52 [95% CI, 0.39-0.69]; adjusted Pinteraction=0.23). The
effects of TMVr with the MitraClip on reducing the 2-year rates of
all-cause death (adjusted Pinteraction=0.14) and HF hospitalization
(adjusted Pinteraction=0.82) were also consistent in patients with and
without CRT as were improvements in quality-of-life and exercise capacity.
 Conclusion(s): In the COAPT trial, TMVr with the MitraClip improved
the 2-year prognosis of patients with HF and moderate-severe or severe
secondary mitral regurgitation who remained symptomatic despite maximally
tolerated GDMT, regardless of prior CRT implantation. Registration: URL:
https://www.clinicaltrials.gov. Unique identifier:
NCT01626079. Copyright © 2020 Lippincott Williams and Wilkins.
All rights reserved.

<12>
Accession Number
2017904327
Title
Validity Evidence for Procedure-Specific Competency Assessment Tools in
Cardiovascular and Thoracic Surgery: A Scoping Review: Procedure-specific
competence assessment in CVT surgery.
Source
Journal of Surgical Education. (no pagination), 2022. Date of
Publication: 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
Elsevier Inc.
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

<13>
Accession Number
2015944758
Title
Celiac Artery Coverage After Thoracic Endovascular Aortic Procedure: A
Meta-Analysis of Early and Late Results.
Source
Journal of Endovascular Therapy. (no pagination), 2022. Date of
Publication: 2022.
Author
Mezzetto L.; Mastrorilli D.; Bravo G.; Scorsone L.; Gennai S.; Leone N.;
D'Oria M.; Veraldi E.; Veraldi G.F.
Institution
(Mezzetto, Mastrorilli, Scorsone, Veraldi, Veraldi) Integrated University
Hospital of Verona, Verona, Italy
(Bravo) Department of Medicine, University of Udine, Udine, Italy
(Gennai, Leone) Ospedale Civile di Baggiovara, Azienda
Ospedaliero-Universitaria di Modena, University of Modena and Reggio
Emilia, Modena, Italy
(D'Oria) Vascular and Endovascular Surgery, Trieste University Hospital,
Trieste, Italy
Publisher
SAGE Publications Inc.
Abstract
Background/aim: Clinical outcomes of celiac artery (CA) coverage during
aortic procedures are often contradicting and the fate of this additional
maneuver is still unclear. This study summarizes the results of available
literature and aims to clarify the impact of CA coverage during thoracic
endovascular aneurysm repair (TEVAR) in patients with inadequate distal
sealing zone. Method(s): Prospective and retrospective, observational
original articles focused on CA coverage during elective/urgent TEVAR for
descending thoracic aortic pathology (DTAP) were included. PubMed/MEDLINE,
Embase, and Cochrane Central Register of Controlled Trials database were
examined to identify articles published from January 2007 to December
2020, according to PRISMA guidelines. Early and late visceral (any sign or
symptom reported) and neurological (both transient and permanent)
complications were considered as primary outcomes. Onset of any endoleak,
type IB endoleak, need of reintervention, and TEVAR-related mortality were
considered as secondary outcomes. Result(s): A total of 5618 articles
were extracted for analysis and 13 studies were finally included in the
synthesis. A total of 178 CAs were covered during 2653 TEVAR (7%). Spinal
cord ischemia was 8% (95% CI, 5-14%, I2 0%) Any endoleak and
type IB endoleak was observed in 12% (95% CI, 6-21%, I2 17%)
and 5% (95% CI, 2-11%, I2 0%), respectively. Thoracic
endovascular aneurysm repair-related reoperation was necessary in 8% (95%
CI, 4-14%, I2 0%), the majority of which (14/18, 78%) performed
for distal sealing failure; mortality rate was 9% (95% CI, 5-14%,
I2 0%). Out of 178 patients, 168 (94%) were available for
follow-up, ranged 12 to 42 months. Visceral complications, any endoleak,
and type IB endoleak were identified in 15% (95% CI, 10-23%, I2
45%), 20% (95% CI, 13-29%, I2 8%), and 8% (95% CI, 4-15%,
I2 0%), respectively. Thoracic endovascular aneurysm
repair-related reintervention was required in 8% (95% CI, 4-14%,
I2 0%). Mortality rate was 17% (95% CI, 12-25%, I2
4%). Conclusion(s): Celiac artery coverage in DTAP should be regarded
as a "bailout" procedure especially in urgent/emergent settings but
requires caution in elective cases. Even if transient visceral ischemia is
frequent, life-threatening complications are rare. Early and late
mortality rates are similar to standard TEVAR although the risk of type IB
endoleak and reintervention may be an issue. Copyright © The
Author(s) 2022.

<14>
Accession Number
2015455465
Title
Heart Team risk assessment with angiography-derived fractional flow
reserve determining the optimal revascularization strategy in patients
with multivessel disease: Trial design and rationale for the DECISION QFR
randomized trial.
Source
Clinical Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Miyata K.; Asano T.; Saito A.; Abe K.; Tanigaki T.; Hoshino M.; Kobayashi
T.; Takaoka Y.; Kanie T.; Yamasaki M.; Yoshino K.; Wakabayashi N.; Ouchi
K.; Kodama H.; Shiina Y.; Tamaki R.; Nishihata Y.; Masuda K.; Suzuki T.;
Nonaka H.; Emori H.; Katagiri Y.; Miyazaki Y.; Sotomi Y.; Yasunaga M.;
Kogame N.; Kuramitsu S.; Reiber J.H.C.; Okamura T.; Higuchi Y.; Kakuta T.;
Misumi H.; Komiyama N.; Matsuo H.; Tanabe K.
Institution
(Miyata, Asano, Saito, Takaoka, Kanie, Kodama, Shiina, Nishihata, Masuda,
Suzuki, Komiyama) Department of Cardiovascular Medicine, St. Luke's
International Hospital, St. Luke's International University, Tokyo, Japan
(Abe, Yamasaki, Yoshino, Tamaki, Misumi) Department of Cardiovascular
Surgery, St. Luke's International Hospital, St. Luke's International
University, Tokyo, Japan
(Tanigaki, Matsuo) Department of Cardiovascular Medicine, Gifu Heart
Center, Gifu, Japan
(Hoshino, Kakuta) Division of Cardiovascular Medicine, Tsuchiura Kyodo
General Hospital, Ibaraki, Japan
(Kobayashi, Yasunaga, Higuchi) Department of Cardiology, Osaka Police
Hospital, Osaka, Japan
(Wakabayashi, Ouchi) Department of Radiology, St. Luke's International
Hospital, St. Luke's International University, Tokyo, Japan
(Nonaka, Tanabe) Division of Cardiology, Mitsui Memorial Hospital, Tokyo,
Japan
(Emori) Department of Cardiovascular Medicine, Wakayama Medical
University, Wakayama, Japan
(Katagiri) Department of Cardiovascular Medicine, Sapporo Higashi
Tokushukai Hospital, Sapporo, Japan
(Miyazaki, Okamura) Division of Cardiology, Department of Medicine and
Clinical Science, Yamaguchi University Graduate School of Medicine,
Yamaguchi, Japan
(Sotomi) Department of Cardiovascular Medicine, Osaka University Graduate
School of Medicine, Osaka, Japan
(Kogame) Division of Cardiovascular Medicine, Toho University Ohashi
Medical Center, Tokyo, Meguro, Japan
(Kuramitsu) Department of Cardiology, Kokura Memorial Hospital,
Kitakyushu, Japan
(Reiber) Department of Radiology, Leiden University Medical Center,
Leiden, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
In patients with multivessel disease (MVD), functional information on
lesions improves the prognostic capability of the SYNTAX score.
Quantitative flow ratio (QFR) is an angiography-derived fractional flow
reserve (FFR) that does not require a pressure wire or pharmacological
hyperemia. We aimed to investigate the feasibility of QFR-based patient
information in Heart Teams' discussions to determine the optimal
revascularization strategy for patients with MVD. We hypothesized that
there is an acceptable agreement between treatment recommendations based
on the QFR approach and recommendation based on the FFR approach. The
DECISION QFR study is a prospective, multicenter, randomized controlled
trial that will include patients with MVD who require revascularization.
Two Heart Teams comprising cardiologists and cardiac surgeons will be
randomized to select a revascularization strategy (percutaneous coronary
intervention or coronary artery bypass graft) according to patient
information either based on QFR or on FFR. All 260 patients will be
assessed by both teams with reference to the anatomical and functional
SYNTAX score/SYNTAX score II 2020 derived from the allocated physiological
index (QFR or FFR). The primary endpoint of the trial is the level of
agreement between the treatment recommendations of both teams, assessed
using Cohen's kappa. As of March 2022, the patient enrollment has been
completed and 230 patients have been discussed in both Heart Teams. The
current trial will indicate the usefulness of QFR, which enables a
wireless multivessel physiological interrogation, in the discussions of
Heart Teams to determine the optimal revascularization strategy for
MVD. Copyright © 2022 The Authors. Clinical Cardiology published
by Wiley Periodicals, LLC.

<15>
Accession Number
2014939234
Title
Protective ballooning technique for prevention of side branch occlusion in
coronary nonleft main true bifurcation lesions: A single-center study.
Source
Catheterization and Cardiovascular Interventions. 99(S1) (pp 1418-1423),
2022. Date of Publication: May 15, 2022.
Author
Wang M.; Liu H.; Xu B.; Bian X.; Liu L.; Hu F.; Chen J.; Gao L.; Zou T.;
Yang Y.; Qiao S.
Institution
(Wang, Liu, Xu, Hu, Chen, Gao, Zou, Yang, Qiao) Coronary Heart Disease
Center, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences & Peking Union Medical College,
Beijing, China
(Bian) Department of Cardiology, Jiangdu People's Hospital, Yangzhou,
China
(Liu) Department of Cardiology, The Second People's Hospital of An Yang,
Anyang, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We aimed to evaluate the efficacy of a protective ballooning
technique in preventing side branch (SB) occlusion and to assess the
long-term clinical outcomes for coronary nonleft main true bifurcation
lesions. Background(s): SB occlusion is a major complication
associated with percutaneous coronary intervention (PCI) for coronary
bifurcation lesions. Method(s): Patients were consecutively enrolled
and randomly assigned to protective ballooning technique or jailed wire
technique group. Periprocedural and long-term clinical outcomes were
compared. Result(s): Patients in the protective ballooning technique
(n = 173) and jailed wire technique (n = 167) groups were followed up for
12 months. SB occlusion occurred in one patient (0.6%) and nine patients
(5.4%) in each group, respectively. The proportion of thrombolysis in
myocardial infarction (TIMI) flow grade 3 of the SB was higher in the
protective ballooning technique group (98.8% vs. 95.2%, p < 0.05). SB
rewiring was necessary in one patient in the protective ballooning
technique group (0.6%) with provisional stenting, significantly lower than
that in the jailed wire technique group (seven patients, 4.2%; p = 0.03).
Periprocedural myocardial infarction occurred in three (1.73%) and six
(3.59%) patients in the protective ballooning technique and jailed wire
technique groups without significant difference, respectively. Major
adverse cardiovascular events at 12 months were similar in both groups.
 Conclusion(s): Protective ballooning technique is effective for the
prevention of SB occlusion in nonleft main true bifurcation lesions and
had favorable long-term outcomes at the 12-month follow-up. Copyright
© 2022 Wiley Periodicals LLC.

<16>
Accession Number
2007179352
Title
Nitric oxide delivery during cardiopulmonary bypass reduces acute kidney
injury: A randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(4) (pp 1393-1403.e9),
2022. Date of Publication: April 2022.
Author
Kamenshchikov N.O.; Anfinogenova Y.J.; Kozlov B.N.; Svirko Y.S.; Pekarskiy
S.E.; Evtushenko V.V.; Lugovsky V.A.; Shipulin V.M.; Lomivorotov V.V.;
Podoksenov Y.K.
Institution
(Kamenshchikov, Anfinogenova, Kozlov, Svirko, Pekarskiy, Evtushenko,
Lugovsky, Shipulin, Podoksenov) Cardiology Research Institute, Tomsk
National Research Medical Center, Russian Academy of Sciences, Tomsk,
Russian Federation
(Kozlov, Svirko, Shipulin, Podoksenov) Department of Cardiovascular
Surgery, Siberian State Medical University, Tomsk, Russian Federation
(Lomivorotov) Department of Anesthesiology and Critical Care, Meshalkin
National Medical Research Center, Novosibirsk, Russian Federation
Publisher
Elsevier Inc.
Abstract
Objective: Acute kidney injury (AKI) is a serious complication of cardiac
surgery with cardiopulmonary bypass (CPB). The aim of this study was to
evaluate the effects of nitric oxide (NO) supplementation to the CPB
circuit on the development of cardiac surgery-associated AKI.
 Method(s): This prospective randomized controlled study included 96
patients with moderate risk of renal complications who underwent elective
cardiac surgery with CPB. The study protocol was registered at
ClinicalTrials.gov (identifier NCT03527381). Patients were randomly
allocated to either NO supplementation to the CPB bypass circuit (NO
treatment group; n = 48) or usual care (control group; n = 48). In the NO
treatment group, 40-ppm NO was administered during the entire CPB period.
The primary outcome was the incidence of AKI. Result(s): NO treatment
was associated with a significant decrease in AKI incidence (10 cases
[20.8%] vs 20 cases [41.6%] in the control group; relative risk, 0.5; 95%
confidence interval, 0.26-0.95; P = .023) and a higher median urine output
during CPB (2.6 mL/kg/h [interquartile range (IQR), 2.1-5.08 mL/kg/h] vs
1.7 mL/kg/h [IQR, 0.80-2.50 mL/kg/h]; P = .0002). The median urinary
neutrophil gelatinase-associated lipocalin level at 4 hours after surgery
was significantly lower in the NO treatment group (1.12 ng/mL [IQR,
0.75-5.8 ng/mL] vs 4.62 ng/mL [IQR, 2.02-34.55 ng/mL]; P = .005). In the
NO treatment group, concentrations of NO metabolites were significantly
increased at 5 minutes postclamping, at 5 minutes after declamping, and at
the end of the operation. Concentrations of proinflammatory and
anti-inflammatory mediators and free plasma hemoglobin did not differ
significantly between the 2 groups. Conclusion(s): NO administration
in patients at moderate risk of renal complications undergoing elective
cardiac surgery with CPB was associated with a lower incidence of
AKI. Copyright © 2020 The American Association for Thoracic
Surgery

<17>
Accession Number
2014470324
Title
Ten-Year All-Cause Mortality Following Staged Percutaneous
Revascularization in Patients With Complex Coronary Artery Disease.
Source
Cardiovascular Revascularization Medicine. 38 (pp 124-126), 2022. Date of
Publication: May 2022.
Author
Kawashima H.; Ono M.; Hara H.; de Winter R.J.; Holmes D.R.; Thuijs
D.J.F.M.; Milojevic M.; Garg S.; Serruys P.W.; Onuma Y.
Institution
(Kawashima, Ono, Hara, Serruys, Onuma) Department of Cardiology, National
University of Ireland, Galway (NUIG) and CORRIB Corelab and Center for
Research and Imaging, Galway, Ireland
(Kawashima, Ono, Hara, de Winter) Department of Cardiology, Academic
Medical Center, University of Amsterdam, Amsterdam, Netherlands
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Thuijs, Milojevic) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Rotterdam, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Serruys, Onuma) CURAM, the SFI Research Centre for Medical Devices,
Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Medical and/or economic reasons sometimes necessitate the
staging of percutaneous coronary intervention (SPCI) procedures in
patients with complex coronary artery disease; however, the impact of this
on very long-term outcomes is unknown. The aim of the present study is to
assess 10-year all-cause mortality in patients with the three-vessel
disease (3VD) and/or left main disease (LM) undergoing SPCI.
 Method(s): This is a sub-analysis of patients undergoing SPCI in the
SYNTAXES study, which investigated 10-year all-cause mortality in patients
with 3VD and/or LM in the randomized SYNTAX trial, beyond its original
5-year follow-up. An SPCI was allowed within 72 h or, if renal
insufficiency or contrast-induced nephropathy occurred, within 14 days of
the index procedure. Mortality was compared between patients having SPCI
versus those not having SPCI or undergoing CABG. PCI patients were further
stratified according to 3VD or LM. Result(s): In the SYNTAX PCI
population (overall: n = 903, 3VD: n = 546, LM: n = 357), 125 (13.8%)
patients underwent SPCI. Patients with SPCI had a higher 10-year mortality
compared to those who didn't (40.0% vs 26.6%; hazard ratio [HR] 1.69; 95%
confidence interval [CI] 1.23-2.32; p < 0.01) and those having CABG(40.0%
vs 24.5%; HR 1.85; 95%CI 1.35-2.53; p < 0.01). Patients having SPCI with
3VD (n = 103) or LM (n = 22) had higher mortality than respective patients
not having SPCI (3VD: 37.4% vs 27.1%; HR 1.52; 95%CI 1.05-2.21; p = 0.03
and LM: 51.8% vs 25.9%; HR 2.39; 95%CI 1.27-4.47; p = 0.01).
 Conclusion(s): At 10-year follow-up, SPCI was associated with higher
mortality than single-session PCI, so that CABG may be preferable if a
staged procedure is anticipated. Copyright © 2021 Elsevier Inc.

<18>
Accession Number
2017213917
Title
The association of transradial access and transfemoral access with
procedural outcomes in acute ischemic stroke patients receiving
endovascular thrombectomy: A meta-analysis.
Source
Clinical Neurology and Neurosurgery. 215 (no pagination), 2022. Article
Number: 107209. Date of Publication: April 2022.
Author
Shaban S.; Rastogi A.; Phuyal S.; Huasen B.; Haridas A.; Zelenak K.;
Iacobucci M.; Martinez-Galdamez M.; Jabbour P.; Bhaskar S.M.M.
Institution
(Shaban, Rastogi, Bhaskar) Global Health Neurology and Translational
Neuroscience Laboratory, Sydney and Neurovascular Imaging Laboratory,
Clinical Sciences Stream, Ingham Institute for Applied Medical Research,
Sydney, NSW, Australia
(Shaban, Rastogi) University of New South Wales (UNSW), South-Western
Sydney Clinical School, NSW, Australia
(Bhaskar) NSW Brain Clot Bank, NSW Health Pathology, Sydney, Australia
(Bhaskar) Department of Neurology and Neurophysiology, Comprehensive
Stroke Center, Liverpool Hospital and South-Western Sydney Local Health
District, Sydney, Australia
(Phuyal) Division of Neurointerventional Surgery, Neuroimaging, and
Interventional Radiology, Upendra Devkota Memorial National Institute of
Neurological and Allied Sciences (UDM-NINAS), Kathmandu, Nepal
(Huasen) Department of Interventional Radiology, Lancashire University
Teaching Hospitals, Lancashire Care NHS Foundation Trust, Preston, United
Kingdom
(Haridas) St Joseph's Hospital, Baycare Medical Group, Pediatric
Neurosurgery, Cerebrovascular and Skull Base Neurosurgery, Tampa, FL,
United States
(Zelenak) Department of Interventional Radiology, Jessenius Faculty of
Medicine in Martin, Comenius University, Bratislava, Slovakia
(Iacobucci) Department of Human Neurosciences, Interventional
Neuroradiology Unit, University Hospital "Umberto I", Rome, Italy
(Martinez-Galdamez) Division of Interventional Neuroradiology, Junta de
Castilla y Leon University Clinic Hospital and Service of Diagnostic
Imaging, Hospital La Luz, Quiron Salud, Madrid, Spain
(Jabbour) Division of Neurovascular Surgery and Endovascular Neurosurgery,
Thomas Jefferson University and Jefferson Hospital for Neuroscience,
Philadelphia, PA, United States
Publisher
Elsevier B.V.
Abstract
Objective: There is an ongoing debate regarding the benefits of using
transradial access (TRA) over transfemoral access (TFA) in endovascular
therapies including endovascular thrombectomy (EVT) for acute ischemic
stroke (AIS) patients. This study sought to investigate the association of
TRA and TFA with procedural success, access-site complications, first-pass
reperfusion (FPR), puncture-to-recanalisation (PTR) time and hemorrhagic
transformation (HT) by performing a meta-analysis. Material(s) and
Method(s): PubMed, EMBASE and Scopus were searched. Studies with patients
aged >= 18 years and head-to-head TRA vs TFA comparisons were included.
Random-effects modeling was performed to obtain summary effects and forest
plots were plotted to study the association of TFA with access site
complications, FPR, HT, PTR time and procedural success. Result(s):
Six studies encompassing 945 patients (347 TRA and 598 TFA) were included
in the meta-analysis. Meta-analysis revealed that in AIS patients
receiving EVT, TRA was significantly associated with a decreased risk of
access-site complications (RR 0.17, 95% CI 0.05 0.54; p = 0.003, z =
-2.957) and HT (RR 0.07, 95% CI 0.02 0.27; p < 0.0001, z = -3.8841).
However, TRA was not significantly associated with procedural success (RR
0.96, 95% CI 0.90 1.01; p = 0.141, z = -1.473), FPR (RR 0.91, 95% CI 0.79
1.05; p = 0.194, z = -1.299) and PTR time (SMD -0.14, 95% CI -0.42 -0.14;
p = 0.323, z = -0.989). Conclusion(s): Our meta-analysis demonstrated
that TRA is a safe alternative to TFA, in AIS patients receiving EVT, with
significantly decreased access-site complications and HT with TRA, albeit
with comparable procedural success, FPR and PTR time to TFA. Data
availability statement: The original contributions presented in the study
are included in the article/Supplementary information, further inquiries
can be directed to the corresponding author. Copyright © 2022
Elsevier B.V.

<19>
Accession Number
2017788137
Title
Pulmonary Function Tests for the Prediction of Postoperative Pulmonary
Complications.
Source
Deutsches Arzteblatt International. 119(7) (pp 99-106), 2022. Date of
Publication: 18 Feb 2022.
Author
Dankert A.; Dohrmann T.; Loser B.; Zapf A.; Zollner C.; Petzoldt M.
Institution
(Dankert, Dohrmann, Zollner, Petzoldt) Department of Anesthesiology,
Center of Anesthesiology and Intensive Care Medicine, University Medical
Center Hamburg, Eppendorf, Germany
(Loser) Department of Anesthesiology, Center of Anesthesiology and
Intensive Care Medicine, University Medicine Rostock, Germany
(Zapf) Department of Medical Biometry and Epidemiology, University Medical
Center Hamburg, Eppendorf, Germany
Publisher
Deutscher Arzte-Verlag GmbH
Abstract
Background: Pulmonary function tests (PFTs) such as spirometry and blood
gas analysis have been claimed to improve preoperative risk assessment.
This systematic review summarizes the available scientific literature
regarding the ability of PFTs to predict postoperative pulmonary
complications (PPC) in non-thoracic surgery. Method(s): We
systematically searched MEDLINE, CINAHL, and the Cochrane Library for
pertinent original research articles (PROSPERO CRD42020215502), framed by
the PIT-criteria (PIT, participants, index test, target conditions),
respecting the PRISMA-DTA recommendations (DTA, diagnostic test accuracy).
 Result(s): 46 original research studies were identified that used
PFT-findings as index tests and PPC as target condition. QUADAS-2 quality
assessment revealed a high risk of bias regarding patient selection,
blinding, and outcome definitions. Qualitative synthesis of prospective
studies revealed inconclusive study findings: 65% argue for and 35%
against preoperative spirometry, and 43% argue for blood gas analysis. A
(post-hoc) subgroup analysis in prospective studies with low-risk of
selection bias identified a possible benefit in upper abdominal surgery
(three studies with 959 participants argued for and one study with 60
participants against spirometry). Conclusion(s): As the existing
literature is inconclusive it is currently unknown if PFTs improve risk
assessment before non-thoracic surgery. Spirometry should be considered in
individuals with key indicators for chronic obstructive pulmonary disease
(COPD) scheduling for upper abdominal surgery. Copyright © 2022
Deutscher Arzte-Verlag GmbH. All rights reserved.

<20>
Accession Number
2013963298
Title
Effect of remimazolam besylate compared with propofol on the incidence of
delirium after cardiac surgery: study protocol for a randomized trial.
Source
Trials. 22(1) (no pagination), 2021. Article Number: 717. Date of
Publication: December 2021.
Author
Yang M.; Liu X.; Yang D.; Bai Y.; Qin B.; Tian S.; Dong R.; Song X.
Institution
(Yang, Liu, Yang, Bai, Qin, Tian, Dong) Liaocheng Cardiac Hospital,
Shandong 252200, China
(Yang, Liu, Yang, Bai, Qin, Tian, Dong, Song) Dong E Hospital Affiliated
to Shandong First Medical University, Shandong 252200, China
(Song) ICU, Shandong First Medical University, Shandong 250117, China
(Song) ICU, Shandong Provincial Hospital Affiliated to Shandong First
Medical University, Shandong 250021, China
Publisher
BioMed Central Ltd
Abstract
Background: Delirium is an acute cognitive disorder that presents with
fluctuation in cognition, apathy, and non-organized thinking, resulting in
increased morbidity, mortality, intensive care unit (ICU) stay, and total
healthcare costs. In patients undergoing cardiac surgery, delirium also
increases the risk of postoperative complications, such as respiratory
insufficiency, sternum instability, and need for re-operation of the
sternum. This study aims to understand the incidence of delirium in
patients after cardiac surgery in patients sedated with remimazolam
besylate versus propofol. Method(s): In this prospective,
double-blind, randomized controlled clinical trial, we aim to recruit 200
patients undergoing cardiac surgery between January 1, 2021, and December
31, 2021, who will be randomized to receive either remimazolam besylate or
propofol infusions postoperatively, until they are extubated. The primary
outcome is the incidence of delirium within 5 days after surgery.
Secondary outcomes include the time of delirium onset, duration of
delirium, ICU length of stay, hospital length of stay, and mechanical
ventilation time. Discussion(s): The key objective of this study is
to assess whether remimazolam besylate reduces the incidence of delirium
in patients after cardiac surgery compared to propofol sedation. In this
preliminary randomized controlled clinical trial, we will test the
hypothesis that the use of remimazolam besylate lowers the incidence of
delirium when compared to propofol in patients undergoing cardiac surgery.
Trial registration: chictr.org.cn ChiCTR2000038976. Registered on October
11, 2020 Copyright © 2021, The Author(s).

<21>
Accession Number
2016733714
Title
Autologous red blood cell transfusion does not result in a more profound
increase in pulmonary capillary wedge pressure compared to saline in
critically ill patients: A randomized crossover trial.
Source
Vox Sanguinis. (no pagination), 2022. Date of Publication: 2022.
Author
Bosboom J.J.; Klanderman R.B.; Terwindt L.E.; Bulle E.B.; Wijnberge M.;
Eberl S.; Driessen A.H.; Winkelman T.A.; Geerts B.F.; Veelo D.P.; Hollmann
M.W.; Vlaar A.P.J.
Institution
(Bosboom, Klanderman, Terwindt, Wijnberge, Eberl, Veelo, Hollmann)
Department of Anesthesiology, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Bosboom, Klanderman, Bulle, Wijnberge, Vlaar) Department of Intensive
Care, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Klanderman, Wijnberge, Hollmann, Vlaar) Laboratory of Experimental
Intensive Care and Anesthesiology, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Driessen, Winkelman) Department of Cardiothoracic Surgery, Amsterdam UMC,
University of Amsterdam, Amsterdam, Netherlands
(Geerts) Healthplus.ai-R&D B.V., Amsterdam, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background and Objectives: Transfusion-associated circulatory overload
(TACO) is a major cause of severe transfusion-related morbidity.
Transfusion of red blood cells (RBCs) has been shown to induce hydrostatic
pressure overload. It is unclear which product-specific factors
contribute. We set out to determine the effect of autologous RBC
transfusion versus saline on pulmonary capillary wedge pressure (PCWP)
change. Material(s) and Method(s): In a randomized crossover trial,
patients who had undergone coronary bypass surgery were allocated to
treatment post-operatively in the intensive care unit with either an
initial 300 ml autologous RBC transfusion (salvaged during surgery) or 300
ml saline infusion first, followed by the other. Primary outcome was the
difference in PCWP change. Secondary outcome measures were the difference
in extra-vascular lung water index (EVLWI) and pulmonary vascular
permeability index (PVPI). Result(s): Change in PCWP was not higher
after autologous RBC transfusion compared to saline (DELTAPCWP 0.3 +/- 0.4
vs. 0.1 +/- 0.4 mmHg). DELTAEVLWI and DELTAPVPI were significantly
decreased after autologous RBC transfusion compared to saline (DELTAEVLWI
-1.6 +/- 0.6 vs. 0.2 +/- 0.4, p = 0.02; DELTAPVPI -0.3 +/- 0.1 vs. 0.0 +/-
0.1, p = 0.01). Haemodynamic variables and colloid osmotic pressure were
not different for autologous RBC transfusion versus saline.
 Conclusion(s): Transfusion of autologous RBCs did not result in a
more profound increase in PCWP compared to saline. RBC transfusion
resulted in a decrease of EVLWI and PVPI compared to saline. Our data
suggest that transfusing autologous RBCs may lead to less pulmonary oedema
compared to saline. Future studies with allogeneic RBCs are needed to
investigate other factors that may mediate the increase of PCWP, resulting
in TACO. Copyright © 2022 The Authors. Vox Sanguinis published by
John Wiley & Sons Ltd on behalf of International Society of Blood
Transfusion.

<22>
Accession Number
2016497375
Title
Natriuretic Peptides and Troponins to Predict Cardiovascular Events in
Patients Undergoing Major Non-Cardiac Surgery.
Source
International Journal of Environmental Research and Public Health. 19(9)
(no pagination), 2022. Article Number: 5182. Date of Publication: May-1
2022.
Author
Perrone M.A.; Aimo A.; Bernardini S.; Clerico A.
Institution
(Perrone) Department of Cardiology, University of Rome Tor Vergata, Rome
00133, Italy
(Perrone, Bernardini) Department of Experimental Medicine and CardioLab,
University of Rome Tor Vergata, Rome 00133, Italy
(Aimo, Clerico) Fondazione CNR Regione Toscana G. Monasterio, Pisa 56124,
Italy
(Aimo, Clerico) Scuola Superiore Sant'Anna, Pisa 56124, Italy
Publisher
MDPI
Abstract
Patients undergoing major surgery have a substantial risk of
cardiovascular events during the perioperative period. Despite the
introduction of several risk scores based on medical history, classical
risk factors and non-invasive cardiac tests, the possibility of predicting
cardiovascular events in patients undergoing non-cardiac surgery remains
limited. The cardiac-specific biomarkers, natriuretic peptides (NPs) and
cardiac troponins (cTn) have been proposed as additional tools for risk
prediction in the perioperative period. This review paper aims to discuss
the value of preoperative levels and perioperative changes in
cardiac-specific biomarkers to predict adverse outcomes in patients
undergoing major non-cardiac surgery. Based on several prospective
observational studies and six meta-analyses, some guidelines recommended
the measurement of NPs to refine perioperative cardiac risk estimation in
patients undergoing non-cardiac surgery. More recently, several studies
reported a higher mortality in surgical patients presenting an elevation
in high-sensitivity cardiac troponin T and I, especially in elderly
patients or those with comorbidities. This evidence should be considered
in future international guidelines on the evaluation of perioperative risk
in patients undergoing major non-cardiac surgery. Copyright ©
2022 by the authors. Licensee MDPI, Basel, Switzerland.

<23>
Accession Number
635311309
Title
Health-Related Quality of Life and Angina in Fractional Flow
Reserve-Versus Angiography-Guided Coronary Artery Bypass Grafting: FARGO
Trial (Fractional Flow Reserve Versus Angiography Randomization for Graft
Optimization).
Source
Circulation: Cardiovascular Quality and Outcomes. 14(6) (pp E007302),
2021. Date of Publication: 01 Jun 2021.
Author
Thuesen A.L.; Riber L.P.; Veien K.T.; Christiansen E.Ho.; Jensen S.E.;
Modrau I.; Andreasen J.J.; Borregaard B.; Junker A.; Mortensen P.E.;
Jensen L.O.
Institution
(Thuesen, Veien, Borregaard, Junker, Jensen) Department Of Cardiology,
Odense University Hospital, Denmark
(Riber, Mortensen) Department Of Cardiothoracic Surgery, Odense University
Hospital, Denmark
(Christiansen) Department Of Cardiology, Aarhus University Hospital,
Skejby, Denmark
(Modrau) Department Of Cardiothoracic Surgery, Aarhus University Hospital,
Skejby, Denmark
(Jensen) Department Of Cardiology, Aalborg University Hospital, Denmark
(Andreasen) Department Of Cardiothoracic Surgery, Aalborg University
Hospital, Denmark
(Andreasen, Borregaard) Department Of Clinical Research, Aalborg
University, Denmark
(Jensen) Department Of Clinical Research, University Of Southern Denmark,
Odense, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In coronary artery bypass grafting (CABG), the use of
fractional flow reserve (FFR) is insufficiently investigated. Stenosis
assessment usually relies on visual estimates of lesion severity. This
study evaluated health-related quality of life (HRQoL) and angina after
FFR-versus angiography-guided CABG. Method(s): One hundred patients
referred for CABG were randomized to FFR-or angiography-guided CABG. In
the FFR group, lesions with FFR>0.80 were deferred, while the surgeon was
blinded to the FFR values in the angiography group. Before and 6 months
after CABG, HRQoL was assessed by the health state classifier EQ-5D of the
EuroQoL 5-level instrument and angina status based on the Canadian
Cardiovascular Society classification system were registered.
 Result(s): Six-month angiography included FFR evaluations of deferred
lesions. In total, completed EQ-5D of the EuroQoL 5-level instrument
questionnaires were available in 86 patients (43 in the FFR versus 43 in
the angiography-guided group). HRQoL was significantly improved and angina
significantly decreased from baseline to 6 months after CABG with no
difference between the randomization groups. Graft failure rates and
clinical outcomes were similar in both groups. Patients with graft failure
or FFR<0.80 of the previous deferred lesions had significantly lower
visual analogue scale scores (78.7+/-14.2 versus 86.8+/-14.7, P=0.004) and
more angina compared with patients without graft failure or FFR>=0.80 at
6-month follow-up. Conclusion(s): FFR-versus angiography-guided CABG
demonstrated similar improvements in HRQoL and angina 6 months after CABG.
Graft failure or low FFR in deferred lesions were associated with low
HRQoL and angina. Registration: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT02477371. Copyright © 2021 Lippincott
Williams and Wilkins. All rights reserved.

<24>
Accession Number
2016752768
Title
Dilated cardiomyopathy as the initial presentation of Becker muscular
dystrophy: a systematic review of published cases.
Source
Orphanet Journal of Rare Diseases. 17(1) (no pagination), 2022. Article
Number: 194. Date of Publication: December 2022.
Author
Del Rio-Pertuz G.; Morataya C.; Parmar K.; Dubay S.; Argueta-Sosa E.
Institution
(Del Rio-Pertuz, Morataya, Parmar) Department of Internal Medicine, Texas
Tech University Health Sciences Center, 3601 4th St, Lubbock, TX 79430,
United States
(Dubay) Department of Clinical and Diagnostic Sciences, University of
Alabama at Birmingham, Birmingham, AL 35294, United States
(Argueta-Sosa) Division of Cardiology, Texas Tech University Health
Sciences Center, Lubbock, TX 79430, United States
Publisher
BioMed Central Ltd
Abstract
There are scarce publications regarding the presentation and outcome of
Becker muscular dystrophy in adulthood when idiopathic dilated
cardiomyopathy is the initial disease manifestation. We performed a
systematic review using Medline, Embase, Cochrane, and Scopus to identify
cases of adults with idiopathic dilated cardiomyopathy who were
subsequently diagnosed with Becker muscular dystrophy from inception
through August 2020. Six cases were found. We identified young males
(Median age: 26 years) with Becker muscular dystrophy who first presented
with dilated cardiomyopathy. Most patients initially presented with
congestive heart failure symptoms (5/6, 83%), and had a median left
ventricular ejection fraction of 23%. One case did have calf
pseudohypertrophy. Musculoskeletal symptoms later appeared one to six
years after the initial dilated cardiomyopathy presentation. Heart
transplantation was the most common management strategy (4/6, 67%). A left
ventricular assist device was used in one case as a bridge to heart
transplant. Dilated cardiomyopathy can be the initial presentation of
Becker muscular dystrophy in the third to fourth decades of life in adult
patients, and musculoskeletal symptoms can be subclinical. Copyright
© 2022, The Author(s).

<25>
Accession Number
2016521072
Title
The Outcome of Post-cardiotomy Extracorporeal Membrane Oxygenation in
Neonates and Pediatric Patients: A Systematic Review and Meta-Analysis.
Source
Frontiers in Pediatrics. 10 (no pagination), 2022. Article Number: 869283.
Date of Publication: 25 Apr 2022.
Author
Cho H.J.; Choi I.; Kwak Y.; Kim D.W.; Habimana R.; Jeong I.-S.
Institution
(Cho, Choi) Division of Pediatric Cardiology and Cardiac Critical Care,
Department of Pediatrics, Chonnam National University Children's Hospital
and Medical School, Gwangju, South Korea
(Cho, Kim, Habimana, Jeong) Cardiovascular and Respiratory Research Team,
Chonnam National University Hospital, Gwangju, South Korea
(Kwak, Kim, Jeong) Department of Thoracic and Cardiovascular Surgery,
Chonnam National University Hospital and Medical School, Gwangju, South
Korea
(Habimana) Department of Biomedical Sciences, College of Medicine, Chonnam
National University Graduate School, Gwangju, South Korea
Publisher
Frontiers Media S.A.
Abstract
Objective: Post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO)
is a known rescue therapy for neonates and pediatric patients who failed
to wean from cardiopulmonary bypass (CPB) or who deteriorate in intensive
care unit (ICU) due to various reasons such as low cardiac output syndrome
(LCOS), cardiac arrest and respiratory failure. We conducted a systematic
review and meta-analysis to assess the survival in neonates and pediatric
patients who require PC-ECMO and sought the difference in survivals by
each indication for PC-ECMO. Design(s): Systematic review and
meta-analysis. Setting(s): Multi-institutional analysis.
 Participant(s): Neonates and pediatric patients who requires PC-
ECMO. Intervention(s): ECMO after open-heart surgery. Result(s):
Twenty-six studies were included in the analysis with a total of 186,648
patients and the proportion of the population who underwent PC-ECMO was
2.5% (2,683 patients). The overall pooled proportion of survival in this
population was 43.3% [95% Confidence interval (CI): 41.3-45.3%;
I2: 1%]. The survival by indications of PC-ECMO were 44.6% (95%
CI: 42.6-46.6; I2: 0%) for CPB weaning failure, 47.3% (95% CI:
39.9-54.7%; I2: 5%) for LCOS, 37.6% (95% CI: 31.0-44.3%;
I2: 32%) for cardiac arrest and 47.7% (95% CI: 32.5-63.1%;
I2: 0%) for respiratory failure. Survival from PC-ECMO for
single ventricle or biventricular physiology, was reported by 12 studies.
The risk ratio (RR) was 0.74 for survival in patients with single
ventricle physiology (95% CI: 0.63-0.86; I2: 40%, P < 0.001).
Eight studies reported on the survival after PC-ECMO for genetic
conditions. The RR was 0.93 for survival in patients with genetic
condition (95% CI: 0.52-1.65; I2: 65%, P = 0.812).
 Conclusion(s): PC-ECMO is an effective modality to support neonates
and pediatric patients in case of failed CPB weaning and deterioration in
ICU. Even though ECMO seems to improve survival, mortality and morbidity
remain high, especially in neonates and pediatric patients with single
ventricle physiology. Most genetic conditions alone should not be
considered a contraindication to ECMO support, further studies are needed
to determine which genetic abnormalities are associated with favorable
outcome. Copyright © 2022 Cho, Choi, Kwak, Kim, Habimana and
Jeong.

<26>
Accession Number
2016786135
Title
Comorbid Hypertension Reduces the Risk of Ventricular Arrhythmia in
Chronic Heart Failure Patients with Implantable
Cardioverter-Defibrillators.
Source
Journal of Clinical Medicine. 11(10) (no pagination), 2022. Article
Number: 2816. Date of Publication: May-2 2022.
Author
Huang H.; Deng Y.; Cheng S.; Zhang N.; Cai M.; Niu H.; Chen X.; Gu M.; Liu
X.; Yu Y.; Hua W.
Institution
(Huang, Deng, Cheng, Zhang, Cai, Niu, Chen, Gu, Liu, Yu, Hua) State Key
Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing 100037, China
(Zhang) Department of Cardiology, Cardiovascular Center, Beijing
Friendship Hospital, Capital Medical University, Beijing 100050, China
Publisher
MDPI
Abstract
Aims: Low blood pressure (BP) has been shown to be associated with
increased mortality in patients with chronic heart failure. This study was
designed to evaluate the relationships between diagnosed hypertension and
the risk of ventricular arrhythmia (VA) and all-cause death in chronic
heart failure (CHF) patients with implantable cardioverter-defibrillators
(ICD), including those with preserved left ventricular ejection fraction
(HFpEF) and indication for ICD secondary prevention. We hypothesized that
a stable hypertension status, along with an increasing BP level, is
associated with a reduction in the risk of VA in this population, thereby
limiting ICD efficacy. Method(s): We retrospectively enrolled 964 CHF
patients, with hypertension diagnosis and hospitalized BP measurements
obtained before ICD implantation. The primary outcome measure was defined
as the composite of SCD, appropriate ICD therapy, and sustained VT. The
secondary endpoint was time to death or heart transplantation (HTx). We
performed multivariable Cox proportional hazard regression and entropy
balancing to calculate weights to control for baseline imbalances with or
without hypertension. The Fine-Gray subdistribution hazard model was used
to confirm the results. The effect of random BP measurements on the
primary outcome was illustrated in the Cox model with inverse probability
weighting. Result(s): The 964 patients had a mean (SD) age of 58.9
(13.1) years; 762 (79.0%) were men. During the interrogation follow-up
[median 2.81 years (interquartile range: 1.32-5.27 years)], 380 patients
(39.4%) reached the primary outcome. A total of 244 (45.2%) VA events in
non-hypertension patients and 136 (32.1%) in hypertension patients were
observed. A total of 202 (21.0%) patients died, and 31 (3.2%) patients
underwent heart transplantation (incidence 5.89 per 100 person-years; 95%
CI: 5.16-6.70 per 100 person-years) during a median survival follow-up of
4.5 (IQR 2.8-6.8) years. A lower cumulative incidence of VA events was
observed in hypertension patients in the initial unadjusted Kaplan-Meier
time-to-event analysis [hazard ratio (HR): 0.65, 95% confidence interval
(CI): 0.53-0.80]. The protective effect was robust after entropy balancing
(HR: 0.71, 95% CI: 0.56-0.89) and counting death as a competing risk (HR:
0.71, 95% CI: 0.51-1.00). Hypertension diagnosis did not associate with
all-cause mortality in this population. Random systolic blood pressure was
negatively associated with VA outcomes (p = 0.065). Conclusion(s): In
hospitalized chronic heart failure patients with implantable
cardioverter-defibrillators, the hypertension status and higher systolic
blood pressure measurements are independently associated with a lower risk
of combined endpoints of ventricular arrhythmia and sudden cardiac death
but not with all-cause mortality. Randomized controlled trials are needed
to confirm the protective effect of hypertension on ventricular arrhythmia
in chronic heart failure patients. Copyright © 2022 by the
authors. Licensee MDPI, Basel, Switzerland.

<27>
Accession Number
2016782484
Title
The Effect of Low-Dose Dexmedetomidine on Pain and Inflammation in
Patients Undergoing Laparoscopic Hysterectomy.
Source
Journal of Clinical Medicine. 11(10) (no pagination), 2022. Article
Number: 2802. Date of Publication: May-2 2022.
Author
Lee J.; Hwang H.W.; Jeong J.-Y.; Kim Y.M.; Park C.; Kim J.Y.
Institution
(Lee, Hwang, Park) Department of Anesthesiology and Pain Medicine, CHA
Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam
13496, South Korea
(Lee) Department of Medical Sciences, Graduate School of Ajou University,
164 World Cup-ro, Yeongtong-gu, Suwon 16499, South Korea
(Jeong) CHA Future Medical Research Institute, CHA Bundang Medical Center,
CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, South Korea
(Kim) Department of Obstetrics and Gynecology, CHA Bundang Medical Center,
CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Ajou University
School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon 16499, South
Korea
Publisher
MDPI
Abstract
Dexmedetomidine has sedative, sympatholytic, analgesic, and
anti-inflammatory effects. We investigated the effects of intraoperative
dexmedetomidine infusion without a loading dose in the prevention of pain
and inflammation after laparoscopic hysterectomy. In this study, 100
patients undergoing laparoscopic hysterectomy under desflurane anesthesia
were randomized to receive either 0.9% saline or dexmedetomidine (0.4
microg/kg/h) after induction to trocar removal. The primary endpoints were
postoperative pain and inflammatory response presented by the level of
tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-10, and
C-reactive protein (CRP). The secondary endpoints were hemodynamics during
the anesthesia and surgery and postoperative nausea and vomiting.
Postoperative pain was decreased in the dexmedetomidine group for every
time point, and post-anesthesia care unit (PACU) rescue fentanyl doses
were decreased in the dexmedetomidine group. The inflammatory response
representing TNF-alpha, IL-6, IL-10, and CRP were similar across the two
groups. Postoperative nausea and vomiting from PACU discharge to 24 h
post-surgery were reduced in the dexmedetomidine group. During anesthesia
and surgery, the patient's heart rate was maintained lower in the
dexmedetomidine-receiving group. Dexmedetomidine of 0.4 microg/kg/h given
as an intraoperative infusion significantly reduced postoperative pain but
did not reduce the inflammatory responses in patients undergoing
laparoscopic hysterectomy. Copyright © 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<28>
Accession Number
637993443
Title
Understanding Baseline Physical Activity in Cardiac Rehabilitation
Enrollees Using Mobile Health Technologies.
Source
Circulation. Cardiovascular quality and outcomes. (no pagination), 2022.
Date of Publication: 13 May 2022.
Author
Golbus J.R.; Gupta K.; Stevens R.; Jeganathan V.S.; Luff E.; Boyden T.;
Mukherjee B.; Klasnja P.; Kheterpal S.; Kohnstamm S.; Nallamothu B.K.
Institution
(Golbus) Division of Cardiovascular Diseases, Department of Internal
Medicine, University of Michigan, MI; Michigan Integrated Center for
Health Analytics and Medical Prediction (MiCHAMP), University of Michigan,
MI
(Gupta) Department of Internal Medicine, University of Missouri Kansas
City, Kansas City, MO
(Stevens, Jeganathan, Luff, Kohnstamm) Division of Cardiovascular
Diseases, Department of Internal Medicine, University of Michigan, MI
(Boyden) Division of Cardiovascular Diseases, Department of Internal
Medicine, Spectrum Health, MI
(Mukherjee) School of Public Health, University of Michigan, MI, Ann
Arbor, United States
(Klasnja) School of Information, University of Michigan, MI, Ann Arbor,
United States
(Kheterpal) Department of Anesthesiology, University of Michigan, MI
(Nallamothu) Division of Cardiovascular Diseases, Department of Internal
Medicine, University of Michigan, MI; Michigan Integrated Center for
Health Analytics and Medical Prediction (MiCHAMP), University of Michigan,
MI; The Center for Clinical Management and Research, Ann Arbor VA Medical
Center, MI
Publisher
NLM (Medline)
Abstract
Background: Baseline physical activity in patients when they initiate
cardiac rehabilitation is poorly understood. We used mobile health
(mHealth) technology to understand baseline physical activity of patients
initiating cardiac rehabilitation within a clinical trial to potentially
inform personalized care. Method(s): The Virtual
AppLication-Supported ENvironment To INcrease Exercise During Cardiac
Rehabilitation Study (VALENTINE) Study is a prospective,
randomized-controlled, remotely administered trial designed to evaluate an
mHealth intervention to supplement cardiac rehabilitation for low and
moderate risk patients. All participants receive a smartwatch and usual
care. Baseline physical activity was assessed remotely after enrollment
and included 1) 6-minute walk distance, 2) daily step count, and 3) daily
exercise minutes, both over 7 days and for compliant days, defined by >=8
hours of watch wear time. Multivariable linear regression identified
patient-level features associated with these 3 measures of baseline
physical activity. Result(s): From October 2020 to March 2022, 220
participants enrolled in the study. Participants are mostly White [184
(83.6%)]; 67 (30.5%) are female and 84 (38.2%) are >= 65 years old. Most
participants enrolled in cardiac rehabilitation after percutaneous
coronary intervention [105 (47.7%)] or coronary artery bypass surgery [39
(17.7 %)]. Clinical diagnoses include coronary artery disease (78.6%),
heart failure (17.3%), and valve repair or replacement (26.4%). Baseline
mean 6-minute walk distance was 489.6 (standard deviation [SD], 143.4)
meters, daily step count was 6845 (SD, 3353), and exercise minutes was
37.5 (SD, 33.5). In a multivariable model, 6-minute walk distance was
significantly associated with age and sex, but not cardiac rehabilitation
indication. Sex but not age or cardiac rehabilitation indication was
significantly associated with daily step count and exercise minutes.
 Conclusion(s): Baseline physical activity varies substantially in low
and moderate risk patients enrolled in cardiac rehabilitation. Future
studies are warranted to explore whether personalizing cardiac
rehabilitation programs using mHealth technologies could optimize
recovery. Registration: URL: https://clinicaltrials.gov Unique Identifier:
NCT04587882.

<29>
Accession Number
637989949
Title
Sex differences in mortality after first time, isolated coronary artery
bypass graft surgery: a systematic review and meta-analysis of randomized
controlled trials.
Source
European journal of cardiovascular nursing. (no pagination), 2022. Date
of Publication: 12 May 2022.
Author
Matthews S.; Buttery A.; O'Neil A.; Sanders J.; Marasco S.; Fredericks S.;
Martorella G.; Keenan N.; Ghanes A.; Wynne R.
Institution
(Matthews, Buttery) National Heart Foundation of Australia, Melbourne,
VIC, Australia
(Matthews, O'Neil) Melbourne School of Population & Global Health,
University of Melbourne, Parkville, VIC, Australia
(Matthews, Wynne) Royal Melbourne Hospital, Parkville, VIC, Australia
(O'Neil) Food and Mood Centre, School of Medicine, Barwon Health, Deakin
University, iMPACT (the Institute for Mental and Physical Health and
Clinical Translation), Geelong, VIC, Australia
(Sanders) Barts Health NHS Trust, St Bartholomew's Hospital, London,
United Kingdom
(Sanders) William Harvey Research Institute, Charterhouse Square Barts,
London, United Kingdom
(Sanders) London School of Medicine and Dentistry Queen Mary University of
London, London EC1 M 6BQ, United Kingdom
(Marasco) Department of Surgery, The Alfred Hospital, Melbourne, VIC,
Australia
(Marasco) Department of Surgery, Monash University, Melbourne, VIC,
Australia
(Fredericks) Daphne Cockwell School of Nursing, Ryerson University, 350
Victoria St, Toronto m5B 2K3, Canada
(Martorella) Tallahassee Memorial Healthcare Center for Research and
Evidence-Based Practice, Florida State University, FL 32304, 98 Varsity
Way, Tallahassee, United States
(Keenan) St James Hospital, Dublin, Ireland
(Ghanes) Barwon Health, Geelong, VIC, Australia
(Wynne) School of Nursing and Midwifery, Deakin University, Gheringhap
Street, Geelong, VIC 3220, Australia
Publisher
NLM (Medline)
Abstract
AIM: Reports of sex-specific differences in mortality after coronary
artery bypass graft surgery (CABGS) are contradictory. The review aim was
to determine whether CABGS is differentially efficacious than alternative
procedures by sex, on short- and longer-term mortality. METHODS AND
RESULTS: EMBASE, CINAHL, Medline, and the Cochrane Library were searched.
Inclusion criteria: English language, randomized controlled trials from
2010, comparing isolated CABGS to alternative revascularization. Analyses
were included Mantel-Haenszel fixed-effects modelling, risk of bias
(Cochrane RoB2), and quality assessment (CONSORT). PROSPERO Registration
ID: CRD42020181673. The search yielded 4459 citations, and full-text
review of 29 articles revealed nine studies for inclusion with variable
time to follow-up. Risk of mortality for women was similar in pooled
analyses [risk ratio (RR) 0.94, 95% confidence interval (CI) 0.84-1.05,
P=0.26] but higher in sensitivity analyses excluding 'high risk' patients
(RR 1.22, 95% CI 1.01-1.48, P=0.04). At 30 days and 10 years, in contrast
to men, women had an 18% (RR 0.82, 95% CI 0.66-1.02, P=0.08) and 19% (RR
0.81, 95% CI 0.69-0.95, P=0.01) mortality risk reduction. At 1-2 years
women had a 7% (RR 1.07, 95% CI 0.69-1.64, P=0.77), and at 2-5 years a 25%
increase in risk of mortality compared with men (RR 1.25, 95% CI
1.03-1.53, P=0.03). Women were increasingly under-represented over time
comprising 41% (30 days) to 16.7% (10 years) of the pooled population.
 CONCLUSION(S): Meta-analysis revealed inconsistent sex-specific
differences in mortality after CABGS. Trials with sex-specific
stratification are required to ensure appropriate sex-differentiated
treatments for revascularization. Copyright © The Author(s) 2022.
Published by Oxford University Press on behalf of European Society of
Cardiology. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<30>
Accession Number
2017861659
Title
The impact of perioperative stroke and delirium on outcomes after surgical
aortic valve replacement.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 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.; 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.; Taddei-Peters W.C.; Jeffries N.O.;
Buxton D.; Geller N.L.; Gordon D.; Burke C.; Lee A.; Smith T.; Moy C.S.;
Gombos I.K.; Weisel R.; Gardner T.J.; Rose E.A.; Parides M.K.; Ascheim
D.D.; Bagiella E.; Moquete E.; Shah K.; Chang H.; Chase M.; Goldfarb S.;
Kirkwood K.; Dobrev E.; Levitan R.; O'Sullivan K.; Santos M.; Ye X.; Mack
M.; Winkle R.; Boswell H.; Fenlon A.; Johnson M.; Jones J.; Kolb M.; Lam
S.; Miranda L.; Ward J.; Whitman R.; Zingler B.; Ryan W.; Smith R.L.;
Grayburn P.; Nosnik P.; Blackstone E.H.; Moazami N.; Starling R.C.;
Barzilai B.; Grimm R.A.; Soltesz E.G.; Katzan I.; Strippy B.; Smith S.;
Garcia M.; Alice bowman M.; Geither C.; Wang R.; Argenziano M.; Borger M.;
Takayama H.; Leon M.B.; Goldsmith L.; Schwartz A.; Sookraj N.;
McCright-Gill T.; Sreekanth S.; McCullough J.N.; Iribarne A.; DeSimone
J.P.; DiScipio A.W.; Stokes H.; Ivany A.S.; Petty G.; Smith P.K.;
Alexander J.H.; Milano C.A.; Glower D.D.; Huber J.; Morganlander J.;
Mathew J.P.; Welsh S.; Casalinova S.; Johnson V.; Lane K.; Smith D.;
Tipton G.; Berry M.F.; Williams J.B.; Englum B.; Hartwig M.; Guyton R.;
Lattouf O.; Chen E.; Vega J.D.; Baer J.; Nguyen D.; Halkos M.; Baio K.;
Prince T.; Cook N.; Neill A.A.; Senechal M.; Dagenais F.; Laforce R.;
O'Connor K.; Dussault G.; Caouette M.; Tremblay H.; Gagne N.; Dumont J.;
Landry P.; Trichon B.H.; Binns O.A.; Ely S.W.; Johnson A.M.; Hansen T.H.;
Short J.G.; Taylor R.D.; Mangusan R.; Nanney T.; Aubart H.; Cross K.;
McPeters L.; Riggsbee C.; Rixey L.; Michler R.E.; DeRose J.J.; Goldstein
D.J.; Bello R.A.; Taub C.; Spevack D.; Kirchoff K.; Meli R.; Garcia J.;
Goldenberg J.; Kealy L.; Bouchard D.; Tanguay J.F.; O'Meara E.; Lacharite
J.; Robichaud S.; Horvath K.A.; Corcoran P.C.; Siegenthaler M.P.; Murphy
M.; Iraola M.; Greenberg A.; Kumkumian G.; Milner M.; Nadareishvili Z.;
Hasan A.; McDavid A.; Fadorsen D.; Yau T.; Farkouh M.; Woo A.; Cusimano
R.J.; David T.; Feindel C.; Fumakia N.; Christie S.; Bissonauth A.; Hripko
A.; Noor Z.; Mackowick K.; Deasey S.; Al-Suqi M.; Collins J.; Acker M.A.;
Messe S.; Kirkpatrick J.; Mayer M.L.; McDonald C.; Fok H.; Maffei B.;
Cresse S.; Gepty C.; Bowdish M.; Starnes V.A.; Shavalle D.; Heck C.;
Hackmann A.; Baker C.; Fleischman F.; Cunningham M.; Lozano E.; Hernandez
M.; Kron I.L.; Johnston K.; Ghanta R.K.; Dent J.M.; Kern J.; Yarboro L.;
Ragosta M.; Annex B.; Bergin J.; Burks S.; Cosner M.; Green C.; Loya S.;
Kim H.R.; Bull D.A.; Desvigne-Nickens P.; Dixon D.O.; Gottesman R.;
Haigney M.; Holubkov R.; Iadecola C.; Jacobs A.; Meslin E.M.; Murkin J.M.;
Spertus J.A.; Sellke F.; McDonald C.L.; Canty J.; Dickert N.; Ikonomidis
J.S.; Kim K.; Williams D.O.; Yancy C.W.; Chaturvedi S.; Chimowitz M.; Fang
J.C.; Richenbacher W.; Rao V.; Miller R.; Cook J.; D'Alessandro D.; Han
F.; Pinney S.; Walsh M.N.; Greer D.; Ishida K.; Stapf C.; Hung J.; Zeng
X.; Hung D.; Satitthummanid S.; Billelo M.; Davatzikos C.; Karpf L.;
Desiderio L.; Toulgoat-Dubois Y.; Brassard R.; Virmanu R.; Romero M.E.;
Braumann R.
Institution
(Messe) Department of Stroke and Neurocritical Care, Perelman School of
Medicine University of Pennsylvania, Pa, Philadelphia
(Overbey, Moskowitz, Gelijns, Gupta, Pan) International Center for Health
Outcomes and Innovation Research (InCHOIR), The Department of Population
Health Science and Policy, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Thourani) Marcus Valve Center, Department of Cardiovascular Surgery,
Piedmont Heart Institute, Ga, Atlanta
(Groh) Asheville Heart, Mission Health and Hospitals, Asheville, NC,
United States
(Mack) Cardiovascular Surgery, Baylor Scott & White Health, Tex, Plano
(Ailawadi) Departments of Cardiac Surgery and Surgery, University of
Michigan Health System, Ann Arbor, Mich, United States
(Furie) Department of Neurology, Alpert Medical School of Brown
University, RI, Providence
(Southerland) Division of Vascular Neurology, University of Virginia
Health System, Charlottesville, VA, United States
(James) Department of Anesthesiology, Duke University Medical Center, NC,
Durham
(James) Department of Neurology, Duke University Medical Center, NC,
Durham
(Moy) Division of Clinical Research, National Institute of Neurological
Disorders and Stroke, National Institutes of Health, Bethesda, Md, 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, Calif, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
Mass, United States
(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, The 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, and
Blood Institute, National Institutes of Health, Bethesda, Md, United
States
(Gammie) Department of Cardiac Surgery, Johns Hopkins Heart and Vascular
Institute, Baltimore, Md, United States
(Erus) Department of Radiology, Perelman School of Medicine University of
Pennsylvania, Pa, Philadelphia
(Browndyke) Department of Psychiatry & Behavioral Sciences, Duke
University Medical Center, NC, Durham
Publisher
Elsevier Inc.
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

<31>
Accession Number
2016578122
Title
Pulsatile versus non-pulsatile perfusion in coronary artery bypass
operation: The comparison of laboratory and clinical outcomes.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Shahandashti F.J.; Asadian S.; Habibi N.; Gorjipour F.; Jalali A.;
Toloueitabar Y.
Institution
(Shahandashti, Asadian, Habibi, Gorjipour, Jalali, Toloueitabar) Iranian
Scientific Society Of Extracorporeal Technology, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
SAGE Publications Ltd
Abstract
Introduction: The superiority of pulsatile or non-pulsatile perfusion in
cardiopulmonary bypass (CPB) regarding morbidity and mortality is still
debated. Therefore, we aimed to investigate the effect of different pulse
rates in pulsatile perfusion in patients undergoing coronary artery bypass
graft (CABG) and compared it with non-pulsatile perfusion.
 Material(s) and Method(s): In this randomized clinical trial, 90
patients who were all candidates for CABG under CPB were enrolled.
Patients in groups A and B received pulsatile perfusion with 30 and 70
pulses per minute, and group C received non-pulsatile perfusion. The
biochemical and clinical parameters in the ICU were evaluated in the study
groups. Result(s): There was no statistically significant difference
between patients' clinical outcomes and kidney and liver function markers
(all Ps> 0.05). Mean serum lactate level increased but did not show a
statistically significant difference between the study groups (p = 0.8).
The mean urine volume at 12 and 24 h after surgery was higher in group A,
but there was no statistically significant difference between the three
groups during the study period (p = 0.3). No significant difference was
found in the length of the ICU stay between the study groups (p = 0.2).
 Conclusion(s): Our studied parameters demonstrated no significant
difference between pulsatile and non-pulsatile and between 30 and 70 pulse
rate pulsatile perfusion methods. Our findings support that pulsatile
perfusion with different pulse rates has no advantages over non-pulsatile
perfusion in selected CABG cases. Copyright © The Author(s) 2022.

<32>
Accession Number
637994718
Title
Timing of cardiac surgery during pregnancy: a patient-level meta-analysis.
Source
European heart journal. (no pagination), 2022. Date of Publication: 13
May 2022.
Author
van Steenbergen G.J.; Tsang Q.H.Y.; van der Heijden O.W.H.; Vart P.;
Rodwell L.; Roos-Hesselink J.W.; van Kimmenade R.R.J.; Li W.W.L.; Verhagen
A.F.T.M.
Institution
(van Steenbergen, Tsang, Li, Verhagen) Department of Cardiothoracic
Surgery, Radboud University Medical Centre, P.O. Box 9101, HB Nijmegen
6500, Netherlands
(van der Heijden) Department of Obstetrics and Gynaecology, Radboud
University Medical Centre, P.O. Box 9101, HB Nijmegen 6500, Netherlands
(Vart, van Kimmenade) Department of Cardiology, Radboud University Medical
Centre, P.O. Box 9101, HB Nijmegen 6500, Netherlands
(Rodwell) Radboud Institute for Health Sciences, Health Evidence, Section
Biostatistics, Nijmegen, Netherlands
(Roos-Hesselink) Department of Cardiology, Erasmus University Medical
Centre, Box 2040, 3000 CA Rotterdam, The Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: To investigate the association between the timing of cardiac surgery
during pregnancy and both maternal and foetal outcomes. METHODS AND
RESULTS: Studies published up to 6 February 2021 on maternal and/or foetal
mortality after cardiac surgery during pregnancy that included individual
patient data were identified. Maternal and foetal mortality was analysed
per trimester for the total population and stratified for patients who
underwent caesarean section (CS) prior to cardiac surgery (Caesarean
section (CaeSe) group) vs. patients who did not (Cardiac surgery (CarSu)
group). Multivariable logistic regression analysis was performed to
evaluate predictors of both maternal and foetal mortality. In total, 179
studies were identified including 386 patients of which 120 underwent CS
prior to cardiac surgery. Maternal mortality was 7.3% and did not differ
significantly among trimesters of pregnancy (P=0.292) nor between subgroup
CaeSe and CarSu (P=0.671). Overall foetal mortality was 26.5% and was
lowest when cardiac surgery was performed during the third trimester
(10.3%, P<0.01). CS prior to surgery was significantly associated with a
reduced risk of foetal mortality in a multivariable model [odds ratio
0.19, 95% confidence interval [0.06-0.56)]. Trimester was not identified
as an independent predictor for foetal nor maternal mortality.
 CONCLUSION(S): Maternal mortality after cardiac surgery during
pregnancy is not associated with the trimester of pregnancy. Cardiac
surgery is associated with high foetal mortality but is significantly
lower in women where CS is performed prior to cardiac surgery. When the
foetus is viable, CS prior to cardiac surgery might be safe. When CS is
not feasible, trimester stage does not seem to influence foetal
mortality. Copyright © The Author(s) 2022. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please email:
journals.permissions@oup.com.

<33>
Accession Number
2010705806
Title
Mechanical circulatory support in patients with cardiogenic shock not
secondary to cardiotomy: a network meta-analysis.
Source
Heart Failure Reviews. 27(3) (pp 927-934), 2022. Date of Publication: May
2022.
Author
Benenati S.; Toma M.; Canale C.; Vergallo R.; Bona R.D.; Ricci D.; Canepa
M.; Crimi G.; Santini F.; Ameri P.; Porto I.
Institution
(Benenati, Toma, Canale, Bona, Canepa, Crimi, Ameri, Porto) Cardiovascular
Disease Unit, IRCCS Policlinic Hospital San Martino, Genova, Italy
(Benenati, Toma, Canale, Canepa, Ameri, Porto) Department of Internal
Medicine, University of Genoa, Genova, Italy
(Vergallo) Department of Cardiovascular Sciences, Fondazione Policlinico
Universitario Agostino Gemelli IRCCS, Roma, Italy
(Ricci, Santini) Cardiac Surgery Unit, IRCCS Policlinic Hospital San
Martino, Genova, Italy
(Ricci, Santini) Department of Integrated Surgical and Diagnostic
Sciences, University of Genova, Genova, Italy
Publisher
Springer
Abstract
To compare the efficacy and safety of different mechanical circulatory
support (MCS) devices in CS. A total of 24 studies (7 randomized
controlled trials-RCTs-and 17 non-RCTs) involving 11,117 patients were
entered in a Bayesian network meta-analysis. The primary endpoint was
30-day mortality. Secondary endpoints were stroke and bleeding (requiring
transfusion and/or intracranial and/or fatal). Compared with no MCS,
extra-corporeal membrane oxygenation (ECMO) reduced 30-day mortality when
used both alone (OR 0.37, 95% CrI 0.15-0.90) and together with the
micro-axial pump Impella (OR 0.13, 95% CrI 0.02-0.80) or intra-aortic
balloon pump (IABP) (OR 0.19, 95% CrI 0.05-0.63), although the relevant
articles were affected by significant publication bias. Consistent results
were obtained in a sensitivity analysis including only studies of CS due
to myocardial infarction. After halving the weight of studies with a
non-RCT design, only the benefit of ECMO + IABP on 30-day mortality was
maintained (OR 0.22, 95% CI 0.057-0.76). The risk of bleeding was
increased by TandemHeart (OR 13, 95% CrI 3.50-59), Impella (OR 5, 95% CrI
1.60-18), and IABP (OR 2.2, 95% CrI 1.10-4.4). No significant differences
were found across MCS strategies regarding stroke. Although limited by
important quality issues, the studies performed so far indicate that ECMO,
especially if combined with Impella or IABP, reduces short-term mortality
in CS. MCS increases the hazard of bleeding. Copyright © 2021,
The Author(s).

<34>
Accession Number
2015843350
Title
Effects of adding low-dose ketamine to etomidate on serum cortisol levels
in critically ill cardiac patients: a randomized clinical trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 114. Date
of Publication: December 2022.
Author
Elhamamsy M.M.; Aldemerdash A.M.; Zahran F.B.; Ezz G.F.M.; AlSaud S.A.;
Boules M.L.; Abdelhady M.A.; Hamed M.A.
Institution
(Elhamamsy, Aldemerdash, Zahran, AlSaud) King Saud University, Riyadh,
Saudi Arabia
(Ezz, Boules, Abdelhady) Department of Anesthesiology, Faculty of
Medicine, Zagazig University, Zagazig, Egypt
(Hamed) Department of Anesthesiology, Faculty of Medicine, Fayoum
University, Fayoum 63511, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Etomidate was associated with an inhibition of adrenal steroid
synthesis. This study aimed to evaluate the effects of adding low-dose
ketamine to etomidate to minimize the decrease in serum cortisol level in
critically ill cardiac patients. Method(s): Sixty adult cardiac
patients, >= 18 years, who underwent upper endoscopy and Colonoscopy to
manage acute anemia in the cardiac intensive care units were enrolled.
Patients were randomly divided into two groups: (group (E): n = 30)
received etomidate 0.2 mg/kg IV followed by etomidate 0.05 mg/kg IV, and
(group (KE): n = 30) received ketamine 0.5 mg/kg IV, then etomidate 0.1
mg/kg IV, followed by etomidate 0.05 mg/kg IV. The primary outcome was
Serum cortisol level at 6 h after the procedure. Result(s): The mean
postoperative cortisol level was significantly lower in group E (295.60
+/- 49.218 nmol/L) versus group KE (461.00 +/- 67.946 nmol/L), with 95% CI
= 351.94 to 404.66; p = 0.000. In addition, the estimated serum cortisol
reduction level was also significant between groups; In group E, the
estimated cortisol level decreased nearly 53% from 632.40 +/- 35.066
nmol/L to 295.60 +/- 49.218 nmol/L 6 hours postoperative. While in group
KE, the estimated cortisol level decreased only 27% from 639.13 +/- 43.035
nmol/L to 461.00 +/- 67.946 nmol/L. Conclusion(s): Single-dose
ketamine (0.5 mg/kg) was helpful to decrease the total dose of etomidate
and hence decreased the percentage of serum cortisol level in such
critically ill patients with preservation of patient satisfaction. Trial
Registration: This study is registered on ClinicalTrials.gov (NCT04857450;
principal investigator: Mostafa Mohammed Elsaid Elhamamsy; registration
date: 23/04/ 2021). Copyright © 2022, The Author(s).

<35>
Accession Number
2015140023
Title
Efficacy of bilateral PECS II block in postoperative analgesia for
ultrafast track pediatric cardiac anesthesia.
Source
Egyptian Journal of Anaesthesia. 38(1) (pp 150-157), 2022. Date of
Publication: 2022.
Author
Kamal F.; Abd El-Rahman A.; Hassan R.M.; Helmy A.F.
Institution
(Kamal, Abd El-Rahman, Hassan, Helmy) Pain Management Department. Faculty
of Medicine, Ain Shams University, Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Effective analgesia after cardiac surgery contributes to fast
recovery, and discharge from the critical care unit. Aim(s): This
study was conducted to evaluate PECS II block for controlling
post-sternotomy pain in pediatric population in ultrafast track cardiac
surgery. Method(s): In this double-blind, randomized control trial,
40 children, 1-5 years old, underwent cardiac surgery via median
sternotomy, Group (A) control: Analgesics were administered intravenously.
Group (B): received 0.25% bupivacaine at 0.5 ml/kg divided equally to both
sides for PECS block. Result(s): PECS group had lower median Modified
Objective Pain Score (MOPS) immediately, two, four, and 6 h
postoperatively. PECS group had lower median fentanyl utilization by 35%
than the control group with median utilization of 2.72 (95% CI
2.490-2.960) mic/kg/in the first 24 hours in contrast to 4.17 (95% CI
3.834-4.516) mic/kg/in the first 24 hours in the control group (P <
0.001). First rescue analgesia was later in PECS group compared to the
control group with median time (7 hours) and (2 hours), respectively.
Furthermore, Pediatric Anesthesia Emergence Agitation (PAED) score was
lower in the intervention group with median 9.5 and 12 in the control
group (P < 0.001). PECS group had shorter ICU stay than the control group
(P < 0.05), with mean ICU stay 52 hours (95% CI 43.522-62.378) compared to
80.40 hours (95% CI 64.310-96.490). Conclusion(s): PECS block is an
efficient technique that can be implemented as an integral part of
fast-track cardiac surgery. Copyright © 2022 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<36>
Accession Number
637535953
Title
Prasugrel Dose De-escalation Therapy after Complex Percutaneous Coronary
Intervention in Patients with Acute Coronary Syndrome: A Post Hoc Analysis
from the HOST-REDUCE-POLYTECH-ACS Trial.
Source
JAMA Cardiology. 7(4) (pp 418-426), 2022. Date of Publication: April 2022.
Author
Hwang D.; Lim Y.-H.; Park K.W.; Chun K.J.; Han J.-K.; Yang H.-M.; Kang
H.-J.; Koo B.-K.; Kang J.; Cho Y.-K.; Hong S.J.; Kim S.; Jo S.-H.; Kim
Y.H.; Kim W.; Lee S.Y.; Kim Y.D.; Oh S.K.; Lee J.-H.; Kim H.-S.
Institution
(Hwang, Park, Han, Yang, Kang, Koo, Kang, Kim) Department of Internal
Medicine, Cardiovascular Center, Seoul National University Hospital, 101
Daehak-ro, Jongro-gu, Seoul 03080, South Korea
(Lim) Hanyang University Seoul Hospital, Seoul, South Korea
(Chun) Cardiovascular Center, Pusan National University, Yangsan Hospital,
20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 50612, South Korea
(Cho) Keimyung University Dongsan Medical Center, Daegu, South Korea
(Hong) Korea University Anam Hospital, Seoul, South Korea
(Kim) Seoul Boramae Hospital, Seoul, South Korea
(Jo) Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea
(Kim) Kangwon National University, Chuncheon, South Korea
(Kim) Kyung Hee University Medical Center, Seoul, South Korea
(Lee) Ilsan Paik Hospital, Goyang, South Korea
(Kim) Dong-A University Hospital, Pusan, South Korea
(Oh) Wonkwang University Hospital, Iksan, South Korea
(Lee) Yeungnam University Hospital, Daegu, South Korea
Publisher
American Medical Association
Abstract
Importance: De-escalation of dual-antiplatelet therapy through dose
reduction of prasugrel improved net adverse clinical events after acute
coronary syndrome (ACS), mainly through the reduction of bleeding without
an increase in ischemic outcomes. However, whether such benefits are
similarly observed in those receiving complex procedures is unknown.
 Objective(s): To investigate whether the benefits of prasugrel dose
de-escalation therapy are maintained in the complex percutaneous coronary
intervention (PCI) subgroup. Design, Setting, and Participant(s):
This was a post hoc analysis of the HOST-REDUCE-POLYTECH-ACS trial, a
randomized, open-label, adjudicator-blinded, multicenter trial performed
at 35 hospitals in South Korea. Study participants included patients with
ACS who were receiving PCI. Data were collected from September 30, 2014,
to December 18, 2015, and analyzed from September 17, 2020, to June 15,
2021. Interventions and Exposures: Patients were randomized to a prasugrel
dose de-escalation (5 mg daily) at 1 month post-PCI group or a
conventional (10 mg daily) group. Complex PCI was defined as having at
least 1 of the following features: 3 or more stents implanted, 3 or more
lesions treated, bifurcation PCI, total stent length 60 mm or larger, left
main PCI, or heavy calcification. Main Outcomes and Measures: The
main analysis end points were MACE (major adverse cardiac event, a
composite of cardiovascular death, nonfatal myocardial infarction, stent
thrombosis, and repeat revascularization) at 1 year for ischemic outcomes,
and BARC (Bleeding Academic Research Consortium) class 2 or higher
bleeding events at 1 year for bleeding outcomes. Result(s): Of 2271
patients (mean [SD] age, 58.9 [9.0] years; 2024 [89%] male patients) for
whom full procedural data were available, 705 patients received complex
PCI, and 1566 patients received noncomplex PCI. Complex PCI was associated
with higher rates of ischemic outcomes but not with bleeding outcomes.
Prasugrel dose de-escalation did not increase the risk of MACE (hazard
ratio [HR], 0.88; 95% CI, 0.47-1.66; P =.70 in complex PCI; HR, 0.81; 95%
CI, 0.45-1.46; P =.48 in noncomplex PCI; P for interaction =.84) but
decreased BARC class 2 or higher bleeding events (HR, 0.25; 95% CI,
0.10-0.61; P =.002 in complex PCI; HR, 0.62; 95% CI, 0.38-1.00; P =.05 in
noncomplex PCI; P for interaction =.08), albeit with wide 95% CIs.
 Conclusions and Relevance: In this post hoc analysis of patients with
ACS, prasugrel dose de-escalation compared with conventional therapy was
not associated with an increased risk of ischemic outcomes but may reduce
the risk of minor bleeding events at 1 year, irrespective of PCI
complexity. Trial Registration: ClinicalTrials.gov Identifier:
NCT02193971. Copyright © 2022 American Medical Association. All
rights reserved.

<37>
Accession Number
637392711
Title
Association of Annual N-Terminal Pro-Brain Natriuretic Peptide
Measurements with Clinical Events in Patients with Asymptomatic Nonsevere
Aortic Stenosis: A Post Hoc Substudy of the SEAS Trial.
Source
JAMA Cardiology. 7(4) (pp 435-444), 2022. Date of Publication: April 2022.
Author
Hadziselimovic E.; Greve A.M.; Sajadieh A.; Olsen M.H.; Kesaniemi Y.A.;
Nienaber C.A.; Ray S.G.; Rossebo A.B.; Willenheimer R.; Wachtell K.;
Nielsen O.W.
Institution
(Hadziselimovic, Sajadieh, Nielsen) Department of Cardiology, Bispebjerg
University Hospital, Bakke 23, Kobenhavn, Copenhagen 2400, Denmark
(Greve) Department of Clinical Biochemistry 3011, Rigshospitalet,
Copenhagen, Denmark
(Sajadieh, Nielsen) Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Olsen) Department of Cardiology, Holbaek Hospital, Holbaek, Denmark
(Olsen) Department of Regional Health Research, University of Southern
Denmark, Odense, Denmark
(Kesaniemi) Research Unit of Internal Medicine, Medical Research Center
Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
(Nienaber) Royal Brompton and Harefield NHS Foundation Trust, Imperial
College, London, United Kingdom
(Ray) Manchester Academic Health Sciences Centre, Manchester, United
Kingdom
(Rossebo) Department of Cardiology, Oslo University Hospital, Ulleval,
Oslo, Norway
(Willenheimer) Lund University, Heart Health Group, Malmo, Sweden
(Wachtell) Department of Cardiology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
Publisher
American Medical Association
Abstract
Importance: Recent studies have questioned the presumed low-risk status of
patients with asymptomatic nonsevere aortic stenosis (AS). Whether annual
N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements are
useful for risk assessment is unknown. Objective(s): To assess the
association of annual NT-proBNP measurements with clinical outcomes in
patients with nonsevere AS. Design, Setting, and Participant(s):
Analysis of annual NT-proBNP concentrations in the multicenter,
double-blind Simvastatin and Ezetimibe in Aortic Stenosis (SEAS)
randomized clinical trial was performed. SEAS was conducted from January
6, 2003, to April 1, 2008. Blood samples were analyzed in 2016, and data
analysis was performed from February 10 to October 10, 2021. SEAS included
1873 patients with asymptomatic AS not requiring statin therapy with
transaortic maximal flow velocity from 2.5 to 4.0 m/s and preserved
ejection fraction. This substudy included 1644 patients (87.8%) with
available blood samples at baseline and year 1. Exposures: Increased age-
A nd sex-adjusted NT-proBNP concentrations at year 1 and a 1.5-fold or
greater relative NT-proBNP concentration change from baseline to year 1.
Moderate AS was defined as baseline maximal flow velocity greater than or
equal to 3.0 m/s. Main Outcomes and Measures: Aortic valve events
(AVEs), which are a composite of aortic valve replacement, cardiovascular
death, or incident heart failure due to AS progression, were noted.
Landmark analyses from year 1 examined the association of NT-proBNP
concentrations with outcomes. Result(s): Among 1644 patients, 996
were men (60.6%); mean (SD) age was 67.5 (9.7) years. Adjusted NT-proBNP
concentrations were within the reference range (normal) in 1228 of 1594
patients (77.0%) with NT-proBNP values available at baseline and in 1164
of 1644 patients (70.8%) at year 1. During the next 2 years of follow-up,
the AVE rates per 100 patient-years for normal vs increased adjusted
NT-proBNP levels at year 1 were 1.39 (95% CI, 0.86-2.23) vs 7.05 (95% CI,
4.60-10.81) for patients with mild AS (P <.01), and 10.38 (95% CI,
8.56-12.59) vs 26.20 (95% CI, 22.03-31.15) for those with moderate AS (P
<.01). Corresponding all-cause mortality rates were 1.05 (95% CI,
0.61-1.81) vs 4.17 (95% CI, 2.42-7.19) for patients with mild AS (P <.01),
and 1.60 (95% CI, 0.99-2.57) vs 4.78 (95% CI, 3.32-6.87) for those with
moderate AS (P <.01). In multivariable Cox proportional hazards regression
models, the combination of a 1-year increased adjusted NT-proBNP level and
1.5-fold or greater NT-proBNP level change from baseline was associated
with the highest AVE rates in both patients with mild AS (hazard ratio,
8.12; 95% CI, 3.53-18.66; P <.001) and those with moderate AS (hazard
ratio, 4.05; 95% CI, 2.84-5.77; P <.001). Conclusions and Relevance:
The findings of this study suggest that normal NT-proBNP concentrations at
1-year follow-up are associated with low AVE and all-cause mortality rates
in patients with asymptomatic nonsevere AS. Conversely, an increased
1-year NT-proBNP level combined with a 50% or greater increase from
baseline may be associated with high AVE rates. Trial Registration:
ClinicalTrials.gov Identifier: NCT00092677. Copyright © 2022
American Medical Association. All rights reserved.

<38>
Accession Number
2016505558
Title
Narrative review of Ebstein's anomaly beyond childhood: Imaging, surgery,
and future perspectives.
Source
Cardiovascular Diagnosis and Therapy. 11(6) (pp 1310-1323), 2021. Date of
Publication: December 2021.
Author
Neumann S.; Ruffer A.; Sachweh J.; Biermann D.; Herrmann J.;
Jerosch-Herold M.; Hazekamp M.; Sinning C.; Zengin E.; Blankenberg S.;
Girdauskas E.; Reichenspurner H.; Kehl T.; Muller G.; Kozlik-Feldmann R.;
Rickers C.
Institution
(Neumann, Kehl, Muller, Kozlik-Feldmann) Department of Pediatric
Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany
(Ruffer, Sachweh, Biermann) Surgery for Congenital Heart Disease,
University Heart & Vascular Center Hamburg, Hamburg, Germany
(Herrmann) Department of Pediatric Radiology, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Jerosch-Herold) Brigham and Women's Hospital, Harvard Medical School,
Boston, United States
(Hazekamp) Department of Cardiothoracic Surgery, Leiden University Medical
Center, Leiden, Netherlands
(Sinning, Zengin, Blankenberg) Department of Cardiology, University Heart
& Vascular Center Hamburg, Hamburg, Germany
(Girdauskas, Reichenspurner) Department of Cardiovascular Surgery,
University Heart & Vascular Center Hamburg, Hamburg, Germany
(Rickers) Adult Congenital Heart Disease Section, University Heart &
Vascular Center Hamburg, Hamburg, Germany
Publisher
AME Publishing Company
Abstract
Ebstein's anomaly is a rare congenital heart disease with malformation of
the tricuspid valve and myopathy of the right ventricle. The septal and
inferior leaflets adhere to the endocardium due to failure of
delamination. This leads to apical displacement of their hinge points with
a shift of the functional tricuspid valve annulus towards the right
ventricular outflow tract with a possibly restrictive orifice. Frequently,
a coaptation gap yields tricuspid valve regurgitation and over time the
"atrialized" portion of the right ventricle may dilate. The highly
variable anatomy determines the clinical presentation ranging from
asymptomatic to very severe with need for early operation.
Echocardiography and magnetic resonance imaging are the most important
diagnostic modalities to assess the tricuspid valve as well as ventricular
morphology and function. While medical management of asymptomatic patients
can be effective for many years, surgical intervention is indicated before
development of significant right ventricular dilatation or dysfunction.
Onset of symptoms and arrhythmias are further indications for surgery.
Modified cone reconstruction of the tricuspid valve is the
state-of-the-art approach yielding the best results for most patients.
Alternative procedures for select cases include tricuspid valve
replacement and bidirectional cavopulmonary shunt depending on patient age
and other individual characteristics. Long-term survival after surgery is
favorable but rehospitalization and reoperation remain significant issues.
Further studies are warranted to identify the optimal surgical strategy
and timing before adverse right ventricular remodeling occurs. It is this
article's objective to provide a comprehensive review of current
literature and an overview on the management of Ebstein's Anomaly. It
focuses on imaging, cardiac surgery, and outcome. Additionally, a brief
insight into arrhythmias and their management is given. The "future
perspectives" summarize open questions and fields of future
research. Copyright © Cardiovascular Diagnosis and Therapy. All
rights reserved.

<39>
Accession Number
2015219584
Title
Effect of Benson and progressive muscle relaxation techniques on sleep
quality after coronary artery bypass graft: A randomized controlled trial.
Source
Complementary Therapies in Medicine. 63 (no pagination), 2021. Article
Number: 102784. Date of Publication: December 2021.
Author
Bagheri H.; Moradi-Mohammadi F.; Khosravi A.; Ameri M.; Khajeh M.; Chan
S.W.-C.; Abbasinia M.; Mardani A.
Institution
(Bagheri, Ameri, Khajeh) School of Nursing and Midwifery, Shahroud
University of Medical Sciences, Shahroud, Iran, Islamic Republic of
(Moradi-Mohammadi) ICU department, Shahid Beheshti Hospital, Shahid
Beheshti Boulevard, Azadegan Square, Qom, Iran, Islamic Republic of
(Khosravi) School of Public Health, Shahroud University of Medical
Sciences, Shahroud, Iran, Islamic Republic of
(Chan) Tung Wah College, Hong Kong
(Abbasinia) Nursing faculty, Qom University of Medical Sciences, Qom,
Iran, Islamic Republic of
(Mardani) Nursing Care Research Center, Department of Medical Surgical
Nursing, School of Nursing and Midwifery, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Churchill Livingstone
Abstract
Objective: This study aimed to investigate the effect of Benson relaxation
(BR) and progressive muscle relaxation (PMR) techniques on the sleep
quality of patients undergoing coronary artery bypass graft (CABG)
surgery. Method(s): This study was a three-arm, parallel, randomized
controlled trial. 120 patients who underwent CABG surgery at two academic
hospitals in an urban area of Iran were randomly allocated into three
groups (40 per group): the BR, PMR, and control groups. Patients in the BR
and the PMR groups performed relevant exercises twice a day for four
weeks. Sleep quality was measured before and immediately after the
intervention using Pittsburgh Sleep Quality Index. Result(s):
Within-group comparison in the BR (t = 3.51, p = 0.001) and the PMR (t =
4.58, p < 0.001) group showed that the overall sleep quality showed a
significant improvement after the intervention when compared to baseline.
The between-group comparison showed that both the BR and PMR groups showed
significant improvements in subjective sleep quality (F = 3.75, p = 0.02),
habitual sleep efficiency (F = 4.81, p = 0.01), and overall sleep quality
(F = 5.53, p = 005) when compared to the control group after the
intervention. However, no statistically significant differences were
identified among the three study groups in terms of sleep latency, sleep
duration, sleep disturbances, sleeping medication, and daytime dysfunction
after the intervention (p > 0.05). Conclusion(s): The study showed
that a four-week program of both PMR and BR can be effective in the
overall improvement of sleep quality in patients following CABG. Further
research is required to replicate the findings of the present
study. Copyright © 2021 The Authors

<40>
Accession Number
637472518
Title
Amiodarone with or without N-Acetylcysteine for the Prevention of Atrial
Fibrillation after Thoracic Surgery: A Double-blind, Randomized Trial.
Source
Anesthesiology. 136(6) (pp 916-926), 2022. Date of Publication: 01 Jun
2022.
Author
Amar D.; Zhang H.; Chung M.K.; Tan K.S.; Desiderio D.; Park B.J.; Pedoto
A.; Roistacher N.; Isbell J.M.; Molena D.; Milne G.L.; Meyers B.F.;
Fischer G.W.; Rusch V.W.; Jones D.R.
Institution
(Amar) Department of Anesthesiology and Critical Care Medicine, Memorial
Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical
College, New York, New York
(Zhang, Desiderio, Pedoto, Fischer) Department of Anesthesiology and
Critical Care Medicine, Memorial Sloan Kettering Cancer Center, NY
(Chung) Department of Cardiovascular Medicine, Heart, Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Tan) Department of Epidemiology and Biostatistics, Memorial Sloan
Kettering Cancer Center, NY
(Park, Isbell, Molena, Rusch, Jones) Thoracic Service, Department of
Surgery, Memorial Sloan Kettering Cancer Center, NY
(Roistacher) Department of Medicine, Memorial Sloan Kettering Cancer
Center, NY
(Milne) Department of Medicine, Division of Clinical Pharmacology,
Vanderbilt University Medical Center, Nashville, TN, United States
(Meyers) Department of Surgery, Washington University Medical Center, St.
Louis, MO, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation may identify patients at
risk of subsequent atrial fibrillation, with its greater risk of stroke.
This study hypothesized that N-acetylcysteine mitigates inflammation and
oxidative stress to reduce the incidence of postoperative atrial
fibrillation. METHOD(S): In this double-blind, placebo-controlled
trial, patients at high risk of postoperative atrial fibrillation
scheduled to undergo major thoracic surgery were randomized to
N-acetylcysteine plus amiodarone or placebo plus amiodarone. On arrival to
the postanesthesia care unit, N-acetylcysteine or placebo intravenous
bolus (50 mg/kg) and then continuous infusion (100 mg/kg over the course
of 48 h) was administered plus intravenous amiodarone (bolus of 150 mg and
then continuous infusion of 2 g over the course of 48 h). The primary
outcome was sustained atrial fibrillation longer than 30 s by telemetry
(first 72 h) or symptoms requiring intervention and confirmed by
electrocardiography within 7 days of surgery. Systemic markers of
inflammation (interleukin-6, interleukin-8, tumor necrosis factor alpha,
C-reactive protein) and oxidative stress (F2-isoprostane prostaglandin
F2alpha; isofuran) were assessed immediately after surgery and on
postoperative day 2. Patients were telephoned monthly to assess the
occurrence of atrial fibrillation in the first year. RESULT(S): Among
154 patients included, postoperative atrial fibrillation occurred in 15 of
78 who received N-acetylcysteine (19%) and 13 of 76 who received placebo
(17%; odds ratio, 1.24; 95.1% CI, 0.53 to 2.88; P = 0.615). The trial was
stopped at the interim analysis because of futility. Of the 28 patients
with postoperative atrial fibrillation, 3 (11%) were discharged in atrial
fibrillation. Regardless of treatment at 1 yr, 7 of 28 patients with
postoperative atrial fibrillation (25%) had recurrent episodes of atrial
fibrillation. Inflammatory and oxidative stress markers were similar
between groups. CONCLUSION(S): Dual therapy comprising
N-acetylcysteine plus amiodarone did not reduce the incidence of
postoperative atrial fibrillation or markers of inflammation and oxidative
stress early after major thoracic surgery, compared with amiodarone alone.
Recurrent atrial fibrillation episodes are common among patients with
postoperative atrial fibrillation within 1 yr of major thoracic
surgery. Copyright © 2022, the American Society of
Anesthesiologists. All Rights Reserved.

<41>
Accession Number
637978194
Title
The Effects of Dexmedetomidine on Perioperative Neurocognitive Outcomes
After Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized
Controlled Trials.
Source
Annals of surgery. 275(5) (pp 864-871), 2022. Date of Publication: 01 May
2022.
Author
Singh A.; Brenna C.T.A.; Broad J.; Kaustov L.; Choi S.
Institution
(Singh, Broad, Kaustov, Choi) Department of Anesthesia, Sunnybrook Health
Sciences Centre, University of Toronto, ON, Toronto, Canada
(Singh, Brenna, Kaustov, Choi) Perioperative Brain Health Centre,
Sunnybrook Research Institute, ON, Toronto, Canada
(Brenna, Choi) Department of Anesthesiology & Pain Medicine, University of
Toronto, ON, Toronto, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The purpose of this systematic review and meta-analysis is to
examine the effect of DEX on delayed dNCR (cognitive dysfunction >= 1 week
postoperative) after cardiac surgery. BACKGROUND: DEX has salutary effects
on cognitive outcomes following cardiac surgery, however, studies are
limited by inconsistent assessment tools, timing, and definitions of
dysfunction. It is imperative to identify accurate point estimates of
effect of DEX on clinically relevant changes in cognitive function.
 METHOD(S): Randomized trials of adults undergoing cardiac surgery
comparing perioperative DEX to placebo or alternate sedation and assessing
cognitive function >= 1 week postoperative were included. Data was
abstracted by three reviewers independently and in parallel according to
PRISMA guidelines. The primary outcome is dNCR. To classify as dNCR,
cognitive function must decrease by at least the minimal clinically
important difference or accepted alternate measure (eg, Reliable Change
Index >=1.96). Bias was assessed with the Cochrane Collaboration tool.
Data was pooled using a random effects model. RESULT(S): Nine trials
(942 participants) were included in qualitative analysis, of which seven
were included in the meta-analysis of dNCR. DEX reduced the incidence of
dNCR (OR 0.39, 95% CI 0.25-0.61, P < 0.0001) compared to placebo/no DEX.
There was no difference in the incidence of delirium (OR 0.69, 95% CI
0.35-1.34, P = 0.27) or incidence of hemodynamic instability (OR 1.14, 95%
CI 0.59-2.18, P = 0.70) associated with perioperative DEX.
 CONCLUSION(S): DEX reduced the incidence of dNCR 1 week after cardiac
surgery. Although this meta-analysis demonstrates short term cognitive
outcomes are improved after cardiac surgery with perioperative DEX, future
trials examining long term cognitive outcomes, using robust cognitive
assessments, and new perioperative neurocognitive disorders nomenclature
with objective diagnostic criteria are necessary. Copyright ©
2021 Wolters Kluwer Health, Inc. All rights reserved.

<42>
Accession Number
2018076864
Title
Negative pressure wound therapy in patients with diabetes undergoing left
internal thoracic artery harvest: A randomized control trial.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Jenkins S.; Komber M.; Mattam K.; Briffa N.
Institution
(Jenkins, Briffa) Department of Infection, Immunity, and Cardiovascular
Disease, The University of Sheffield, Sheffield, United Kingdom
(Komber, Mattam, Briffa) Department of Cardiothoracic Surgery, Sheffield
Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Patients with diabetes undergoing CABG are at risk of wound
infection. Incisional negative pressure wound therapy has been shown to be
effective in decreasing incidence of infection in high-risk wounds. Near
infrared spectroscopy (NIRS) can be used to assess wound oxygenation and
low values can predict infection. Objective(s): To evaluate utility
of NIRS to assess wound oxygenation, to assess effect of sternotomy, left
internal thoracic artery harvest, and wound dressing type on wound edge
oxygenation. Method(s): In this blinded randomized control trial,
patients with diabetes undergoing isolated coronary artery bypass grafting
with a left internal thoracic artery were randomized to receive either
incisional negative pressure wound therapy dressing or a standard
dressing. NIRS measurements were made on the left upper arm (control), and
left and right parasternal regions on day -1 (preoperative), day 5, and
week 6 after surgery. Results were analyzed using repeated measures
parametric methods. Result(s): Eighty patients with diabetes were
recruited, 40 to the incisional negative pressure wound therapy group and
40 to the standard dressing group. Adjusted NIRS readings dropped
significantly in all patients by day 5 and partially recovered by week 6.
In both groups, there was no difference between readings on the left and
right. At all time points and on both sides, there was no difference in
readings between patients in the 2 groups. Conclusion(s): NIRS can be
used to assess oxygenation adjacent to a sternotomy wound. Adjusted tissue
oxygen levels change with time after sternotomy and left internal thoracic
artery harvest in patients with diabetes. Wound dressing type does not
influence day 5 wound edge oxygenation. Copyright © 2022

<43>
Accession Number
2018058225
Title
Selected 2021 Highlights in Congenital Cardiac Anesthesia.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Motta P.; Kreeger R.; Resheidat A.M.; Faraoni D.; Nasr V.G.; Mossad E.B.;
Mittnacht A.J.C.
Institution
(Motta, Resheidat, Faraoni, Mossad, Mittnacht) Division of Pediatric
Cardiovascular Anesthesia, Baylor College of Medicine, Texas Children's
Hospital, Houston, TX, United States
(Kreeger) Department of Anesthesia, Cincinnati Children's Hospital,
University of Cincinnati, Cincinnati, OH, United States
(Nasr) Department of Anesthesiology, Critical Care and Pain Medicine,
Boston Children's Hospital, Boston, MA, United States
(Mittnacht) Department of Anesthesiology, Westchester Medical Center, New
York Medical College, Valhalla, NY, United States
Publisher
W.B. Saunders
Abstract
This article is a review of the highlights of pertinent literature of
interest to the congenital cardiac anesthesiologist and was published in
2021. After a search of the United States National Library of Medicine
PubMed database, several topics emerged where significant contributions
were made in 2021. The authors of this manuscript considered the following
topics noteworthy to be included in this review: risk stratification in
adult congenital heart disease surgery, physician burnout in pediatric
cardiac anesthesia, transfusion practice in pediatric congenital heart
surgery, and racial disparity and outcomes in pediatric patients with
congenital heart disease. Copyright © 2022 Elsevier Inc.

<44>
Accession Number
2018058027
Title
Late Outcomes After Aortic Root Enlargement During Aortic Valve
Replacement: Meta-Analysis With Reconstructed Time-To-Event Data.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Sa M.P.; Van den Eynde J.; Amabile A.; Malin J.H.; Jacquemyn X.; Tasoudis
P.; Sicouri S.; Schena S.; Torregrossa G.; Ramlawi B.
Institution
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood,
Panama
(Sa, Tasoudis, Sicouri, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood,
Panama
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Amabile) Division of Cardiac Surgery, Department of Surgery, Yale School
of Medicine, New Haven, CT, United States
(Malin) Philadelphia College of Osteopathic Medicine, Bala Cynwyd, PA,
United States
(Schena) Division of Cardiac Surgery, The Johns Hopkins Hospital,
Baltimore, Moldova
Publisher
W.B. Saunders
Abstract
Objectives: The present authors aimed to assess the late outcomes of
patients undergoing aortic root enlargement (ARE) at the time of surgical
aortic valve replacement (SAVR). Design(s): Study-level meta-analysis
with reconstructed time-to-event data. Setting(s): Follow-up of
patients after surgical procedure. Participant(s): Adult patients
with aortic valve disease requiring surgery. Intervention(s): SAVR
with ARE versus SAVR without ARE. Measurements and Main Results: This
study followed the Preferred Reporting Items for Systematic Reviews and
Meta-analyses reporting guideline. The following databases were searched
for studies meeting the authors' inclusion criteria and published by
November 30, 2021: PubMed/MEDLINE, Embase, SciELO, LILACS, CCTR/CENTRAL,
and Google Scholar. Nine nonrandomized studies met the authors'
eligibility criteria. All studies were nonrandomized. A total of 213,134
patients (SAVR with ARE: 7,556 patients; SAVR without ARE: 205,578
patients) were included from studies published from 1997 to 2021. The
total rate of AAE was 3.7%, varying in the studies from 2.9% to 28.1%. The
studies consisted of patients whose mean age varied from 63 to 79 years.
Patients in the SAVR with ARE group had a significantly better overall
survival (hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.90-0.99,
p = 0.016) in the unmatched populations, but the matched analysis revealed
no difference between SAVR with/without ARE in terms of overall survival
(HR, 1.06; 95% CI, 0.90-1.25; p = 0.474). Conclusion(s): In the
context of patients undergoing SAVR with or without ARE, patients who
undergo ARE do not experience worse late outcomes. Further randomized
controlled trials are needed to confirm or refute the authors' current
findings. Copyright © 2022 Elsevier Inc.

<45>
Accession Number
2017603659
Title
The use of steroids in treating chylothorax following cardiac surgery in
children: a unique perspective.
Source
Cardiology in the Young. 32(4) (pp 525-530), 2022. Date of Publication: 01
Apr 2022.
Author
Saad D.; Makarem A.; Fakhri G.; Al Amin F.; Bitar F.; El Rassi I.; Arabi
M.
Institution
(Saad, Fakhri) Department Of Pediatrics And Adolescent Medicine, American
University Of Beirut Medical Center, Beirut, Lebanon
(Makarem) Faculty Of Medicine, American University Of Beirut Medical
Center, Beirut, Lebanon
(Al Amin, Bitar, Arabi) Division Of Pediatric Cardiology, Department Of
Pediatrics And Adolescent Medicine, American University Of Beirut Medical
Center, Beirut, Lebanon
(El Rassi) Department Of Cardiothoracic Surgery, American University Of
Beirut Medical Center, Beirut, Lebanon
Publisher
Cambridge University Press
Abstract
Background: Chylothorax is the accumulation of chyle fluid in the pleural
space. The incidence of chylothorax is quite common post-cardiac surgeries
in pediatrics especially in Fontan procedures. Although several treatment
lines are known for the management of chylothorax, steroids were scarcely
reported as a treatment option. We present a unique case of a 4-year-old
child who underwent Fontan procedure and suffered a long-term consequence
of chylothorax. The chylothorax only fully resolved after introducing
corticosteroids as part of her management. Method(s): A literature
review about management of chylothorax post-cardiac surgery in children
using Ovid Medline (19462021), PubMed, and google scholar was performed.
 Conclusion(s): Conservative management without additional surgical
intervention is adequate in most patients. Additionally, somatostatin can
be used with variable success rate. However, a few cases mentioned using
steroids in such cases. More research and reporting on the use of steroids
in the treatment of chylothorax post-cardiac surgeries in children is
needed to prove its effectivity. In this article, we describe a case of
chylothorax post-Fontan procedure that supports the use of steroids.
 Copyright ©

<46>
Accession Number
637983238
Title
Radial Artery Versus Saphenous Vein as Third Conduit in Coronary Artery
Bypass Graft Surgery for Multivessel Coronary Artery Disease: a Ten-Year
Literature Review.
Source
Acta bio-medica : Atenei Parmensis. 93(2) (pp e2022049), 2022. Date of
Publication: 11 May 2022.
Author
Maestri F.; Formica F.; Gallingani A.; Gripshi F.; Nicolini F.
Institution
(Maestri) a:1:{s:5:"en_US";s:140:"Department of Cardiac-Thoracic and
Vascular Surgery, Unit of Cardiac Surgery, University Hospital Azienda
Ospedaliera-Universitaria di Parma";}
(Formica) Department of Cardio-Thoracic and Vascular Surgery, Cardiac
Surgery Unit, University Hospital "Azienda Ospedaliera-Universitaria" of
Parma, University of Parma, Parma, Italy
(Gallingani) Department of Cardio-Thoracic and Vascular Surgery, Cardiac
Surgery Unit, University Hospital "Azienda Ospedaliera-Universitaria" of
Parma, Parma, Italy
(Gripshi, Nicolini) Department of Cardio-Thoracic and Vascular Surgery,
Cardiac Surgery Unit, University Hospital "Azienda
Ospedaliera-Universitaria" of Parma, University of Parma, Parma, Italy
Publisher
NLM (Medline)
Abstract
Coronary artery bypass grafting is the gold standard strategy for
obtaining complete coronary revascularization in patients with multivessel
coronary artery disease. The recent AHA and EACTS guidelines on myocardial
revascularization recommend total arterial revascularization, especially
in younger patients, whenever possible. However, the use of saphenous vein
grafts in association with single or bilateral internal thoracic artery
(SITA, BITA) instead of arterial grafts (radial arteries, right
gastroepiploic artery and inferior epigastric artery) is widespread. We
analyzed literature from the last ten years (January 2010 to December
2020) looking for evidence in favour of the use of a radial artery
compared to a saphenous vein in association with BITA. We identified nine
studies (4 Systematic Reviews and Meta-analyses and 6 large cohort
observational studies with propensity score-matching) that compared
arterial with saphenous grafts as third conduit. The main finding of the
review is the higher rate of freedom from any cardiac adverse event in the
population which reached Total Arterial myocardial Revascularization
(TAR). A probable reason for the limited application of TAR as a strategy
is the shortage of Randomized Controlled Trials (RCTs).

<47>
Accession Number
2018008262
Title
Effect of preoperative renin-angiotensin system blockade on vasoplegia
after cardiac surgery: A systematic review with meta-analysis.
Source
World Journal of Cardiology. 14(4) (pp 250-259), 2022. Date of
Publication: 01 Apr 2022.
Author
Noubiap J.J.; Nouthe B.; Sia Y.T.; Spaziano M.
Institution
(Noubiap) The University of Adelaide, Adelaide, SA 5000, Australia
(Nouthe) Department of Medicine, University of British Columbia, Vancouver
V6T 1W5, Canada
(Sia) Department of Medicine, Regional Trois-Rivieres Hospital
(CIUSSS-MCQ), Trois-Rivieres 5000, Canada
(Spaziano) Department of Cardiology, McGill University Health Centre,
Montreal, QC H4A 3J1, Canada
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Vasoplegia is a common complication of cardiac surgery but its
causal relationship with preoperative use of renin angiotensin system
(RAS) blockers [angiotensin converting enzyme inhibitors (ACEIs) and
angiotensin receptor blockers (ARB)] is still debated. AIM To update and
summarize data on the effect of preoperative use of RAS blockers on
incident vasoplegia. METHODS All published studies from MEDLINE, EMBASE,
and Web of Science providing relevant data through January 13, 2021 were
identified. A random-effects meta-analysis method was used to pool
estimates, and post-cardiac surgery shock was differentiated from
vasoplegia. RESULTS Ten studies reporting on a pooled population of 15672
patients (none looking at ARBs exclusively) were included in the
meta-analysis. All were case-control studies. Use of ACEIs was associated
with an increased risk of vasoplegia [pooled adjusted odds ratio (Aor) of
2.06, 95%CI: 1.45-2.93] and increased inotropic/vasopressor support
requirement (pooled aOR 1.19, 95%CI: 1.10-1.29). Post-cardiac surgery
shock was increased in the presence of left ventricular dysfunction
(pooled aOR 2.32, 95%CI: 1.60-3.36; I2 49%) but not increased
by the use of beta blockers (pooled aOR 0.78, 95%CI: 0.36-1.69;
I2 77%). Two randomized control trials (RCTs), not eligible for
the meta-analysis, did not show an association between continuation of RAS
blockers and vasoplegia. CONCLUSION Preoperative continuation of ACEIs is
associated with an increased need for inotropic support postoperatively
and with an increased risk of vasoplegia in observational studies but not
in RCTs. The absence of a consensus definition of vasoplegia should lead
to the use of perioperative cardiovascular monitoring when designing RCTs
to better understand this discrepancy. Copyright © The Author(s)
2022. Published by Baishideng Publishing Group Inc. All rights reserved.

<48>
Accession Number
2016754854
Title
Comparative Evaluation of the Incidence of Postoperative Pulmonary
Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy:
A Systematic Review and Meta-Analysis of Randomized Controlled Trials and
Propensity Score-Matched Studies.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 724178. Date of Publication: 2021.
Author
Mohamed M.A.; Ding S.; Ali Shah S.Z.; Li R.; Dirie N.I.; Cheng C.; Wei X.
Institution
(Mohamed, Ding, Cheng, Wei) Division of Cardiothoracic and Vascular
Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China
(Ali Shah, Li) Department of Rehabilitation Medicine, Tongji Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
(Dirie) Division of Urology, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
Publisher
Frontiers Media S.A.
Abstract
Background: Postoperative pulmonary complications remain a leading cause
of increased morbidity, mortality, longer hospital stays, and increased
costs after cardiac surgery; therefore, our study aims to analyze whether
minimally invasive valve surgery (MIVS) for both aortic and mitral valves
can improve pulmonary function and reduce the incidence of postoperative
pulmonary complications when compared with the full median sternotomy (FS)
approach. Method(s): A comprehensive systematic literature research
was performed for studies comparing MIVS and FS up to February 2021.
Randomized controlled trials (RCTs) and propensity score-matching (PSM)
studies comparing early respiratory function and pulmonary complications
after MIVS and FS were extracted and analyzed. Secondary outcomes included
intra-and postoperative outcomes. Result(s): A total of 10,194
patients from 30 studies (6 RCTs and 24 PSM studies) were analyzed. Early
mortality differed significantly between the groups (MIVS 1.2 vs. FS 1.9%;
p = 0.005). Compared with FS, MIVS significantly lowered the incidence of
postoperative pulmonary complications (odds ratio 0.79, 95% confidence
interval [0.67, 0.93]; p = 0.004) and improved early postoperative
respiratory function status (mean difference -24.83 [-29.90, -19.76]; p <
0.00001). Blood transfusion amount was significantly lower after MIVS (p <
0.02), whereas cardiopulmonary bypass time and aortic cross-clamp time
were significantly longer after MIVS (p < 0.00001). Conclusion(s):
Our study showed that minimally invasive valve surgery decreases the
incidence of postoperative pulmonary complications and improves
postoperative respiratory function status. Copyright © 2021
Mohamed, Ding, Ali Shah, Li, Dirie, Cheng and Wei.

<49>
Accession Number
637982470
Title
Vitamin C and the risk of atrial fibrillation: Mendelian randomization
study may be misleading.
Source
Clinical nutrition (Edinburgh, Scotland). (no pagination), 2022. Date of
Publication: 29 Apr 2022.
Author
Hemila H.; Chalker E.
Institution
(Hemila) Department of Public Health, University of Helsinki, POB 41,
Helsinki, Finland
(Chalker) Biological Data Science Institute, Australian National
University, Canberra, ACT, Australia
Publisher
NLM (Medline)

<50>
Accession Number
637981672
Title
Society of Cardiovascular Anesthesiologists Clinical Practice Update for
Management of Acute Kidney Injury Associated With Cardiac Surgery.
Source
Anesthesia and analgesia. (no pagination), 2022. Date of Publication: 12
May 2022.
Author
Peng K.; McIlroy D.R.; Bollen B.A.; Billings F.T.; Zarbock A.; Popescu
W.M.; Fox A.A.; Shore-Lesserson L.; Zhou S.; Geube M.A.; Ji F.; Bhatia M.;
Schwann N.M.; Shaw A.D.; Liu H.
Institution
(Peng, Liu) From the Department of Anesthesiology and Pain Medicine,
University of California Davis Health, Sacramento, CA, Mexico
(Peng, Ji) First Affiliated Hospital of Soochow University, Suzhou, China
(McIlroy, Billings) Department of Anesthesiology, Vanderbilt University
Medical Center, Nashville, TN, United States
(Bollen) Department of Anesthesiology, Missoula, MT, United States
(Zarbock) Department of Anesthesiology and Intensive Care Medicine,
University Hospital of Muenster, Muenster, Germany
(Popescu) Department of Anesthesiology, Yale University School of
Medicine, Easton, CT
(Fox) Department of Anesthesiology and Pain Management, University of
Texas Southwestern Medical Center, Dallas, TX, United States
(Shore-Lesserson) Department of Anesthesiology, Northwell Health,
Manhasset, NY, United States
(Zhou) Department of Anesthesiology, University of Texas Medical School,
Sugar Land, TX, United States
(Geube) Department of Cardiothoracic Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Bhatia) Department of Anesthesiology, University of North Carolina,
Chapel Hill, NC
(Schwann) Department of Anesthesiology, Lehigh Valley Health Network,
Allentown, PA, United States
(Shaw) Department of Intensive Care and Resuscitation, Cleveland Clinic,
Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
Cardiac surgery-associated acute kidney injury (CS-AKI) is common and is
associated with increased risk for postoperative morbidity and mortality.
Our recent survey of the Society of Cardiovascular Anesthesiologists (SCA)
membership showed 6 potentially renoprotective strategies for which
clinicians would most value an evidence-based review (ie, intraoperative
target blood pressure, choice of specific vasopressor agent, erythrocyte
transfusion threshold, use of alpha-2 agonists, goal-directed oxygen
delivery on cardiopulmonary bypass [CPB], and the "Kidney Disease
Improving Global Outcomes [KDIGO] bundle of care"). Thus, the SCA's
Continuing Practice Improvement Acute Kidney Injury Working Group aimed to
provide a practice update for each of these strategies in cardiac surgical
patients based on the evidence from randomized controlled trials (RCTs).
PubMed, EMBASE, and Cochrane library databases were comprehensively
searched for eligible studies from inception through February 2021, with
search results updated in August 2021. A total of 15 RCTs investigating
the effects of the above-mentioned strategies on CS-AKI were included for
meta-analysis. For each strategy, the level of evidence was assessed using
the Grading of Recommendations, Assessment, Development and Evaluation
(GRADE) methodology. Across the 6 potentially renoprotective strategies
evaluated, current evidence for their use was rated as "moderate," "low,"
or "very low." Based on eligible RCTs, our analysis suggested using
goal-directed oxygen delivery on CPB and the "KDIGO bundle of care" in
high-risk patients to prevent CS-AKI (moderate level of GRADE evidence).
Our results suggested considering the use of vasopressin in vasoplegic
shock patients to reduce CS-AKI (low level of GRADE evidence). The
decision to use a restrictive versus liberal strategy for perioperative
red cell transfusion should not be based on concerns for renal protection
(a moderate level of GRADE evidence). In addition, targeting a higher mean
arterial pressure during CPB, perioperative use of dopamine, and use of
dexmedetomidine did not reduce CS-AKI (a low or very low level of GRADE
evidence). This review will help clinicians provide evidence-based care,
targeting improved renal outcomes in adult patients undergoing cardiac
surgery. Copyright © 2022 International Anesthesia Research
Society.

<51>
Accession Number
637976438
Title
Cardiac Surgery 2021 Reviewed.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2022. Date of
Publication: 10 May 2022.
Author
Doenst T.; Schneider U.; Can T.; Caldonazo T.; Diab M.; Siemeni T.; Farber
G.; Kirov H.
Institution
(Doenst, Schneider, Can, Caldonazo, Diab, Siemeni, Farber, Kirov)
Department of Cardiothoracic Surgery, Friedrich-Schiller-University of
Jena, Jena, Germany
Publisher
NLM (Medline)
Abstract
PubMed displayed more than 35,000 hits for the search term "cardiac
surgery AND 2021." We used the PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-analyses) approach and selected relevant
publications for a results-oriented summary. As in recent years, we
reviewed the fields of coronary and conventional valve surgery and their
overlap with their interventional alternatives. COVID reduced cardiac
surgical activity around the world. In the coronary field, the FAME 3
trial dominated publications by practically repeating SYNTAX, but with
modern stents and fractional flow reserve (FFR)-guided percutaneous
coronary interventions (PCIs). PCI was again unable to achieve
non-inferiority compared with coronary artery bypass graft surgery (CABG)
in patients with triple-vessel disease. Survival advantages of CABG over
PCI could be linked to a reduction in myocardial infarctions and current
terminology was criticized because the term "myocardial revascularization"
is not precise and does not reflect the infarct-preventing
collateralization effect of CABG. In structural heart disease, new
guidelines were published, providing upgrades of interventional treatments
of both aortic and mitral valve disease. While for aortic stenosis,
transcatheter aortic valve implantation (TAVI) received a primary
recommendation in older and high-risk patients; recommendations for
transcatheter mitral edge-to-edge treatment were upgraded for patients
considered inappropriate for surgery. For heart team discussions it is
important to know that classic aortic valve replacement currently provides
strong signals (from registry and randomized evidence) for a survival
advantage over TAVI after 5 years. This article summarizes publications
perceived as important by us. It can neither be complete nor free of
individual interpretation, but provides up-to-date information for
decision-making and patient information. Copyright Thieme. All rights
reserved.

<52>
Accession Number
637983182
Title
Paravalvular Leak: A Systemic Review.
Source
Current cardiology reviews. (no pagination), 2022. Date of Publication:
11 May 2022.
Author
Randall M.H.; Betageri O.; Hanayneh S.; Anderson R.D.
Institution
(Randall, Anderson) Division of Cardiovascular Medicine, Department of
Medicine, University of Florida, FL, Gainesville, United States
(Betageri, Hanayneh) Department of Medicine, University of Florida, FL,
Gainesville, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Paravalvular Leak (PVL) refers to the retrograde flow of blood
in the space between an implanted cardiac valve and native tissue. These
are an unfortunately but luckily relatively uncommon complication of
prosthetic valve replacement that, especially when moderate or severe,
have important clinical consequences. OBJECTIVE(S): Addressing PVL
requires a multidisciplinary team to properly diagnose this process and
choose the corrective option most likely to result in success.
 METHOD(S): A comprehensive literature search was undertaken to
formulate this narrative review. RESULT(S): This review highlights
the complex nature of PVL and the promising contemporary treatments
available. CONCLUSION(S): Clinicians should be adept at recognizing
PVL and characterizing it using multimodality imaging. Using the many
available tools and a multidisciplinary approach should lead to favorable
outcomes in patients with PVL. Copyright© Bentham Science
Publishers; For any queries, please email at epub@benthamscience.net.

<53>
Accession Number
2018037595
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: 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, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Tasoudis, Erten, Dokollari, Torregrossa, Sicouri, Ramlawi) Department
of Cardiothoracic Surgery Research, Lankenau Institute for Medical
Research, Wynnewood, PA, United States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
Publisher
Elsevier Inc.
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

<54>
Accession Number
2018037573
Title
Low serum albumin: A neglected predictor in patients with cardiovascular
disease.
Source
European Journal of Internal Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Manolis A.A.; Manolis T.A.; Melita H.; Mikhailidis D.P.; Manolis A.S.
Institution
(Manolis) Patras University School of Medicine, Patras, Greece
(Manolis) Aiginiteio University Hospital, Athens University School of
Medicine, Athens, Greece
(Melita) Central Laboratories, Onassis Cardiac Surgery Center, Athens,
Greece
(Mikhailidis) Department of Clinical Biochemistry, Royal Free Hospital
Campus, University College London Medical School, London, United Kingdom
(Manolis) First Department of Cardiology, Athens University School of
Medicine, Athens, Greece
Publisher
Elsevier B.V.
Abstract
Albumin, the most abundant circulating protein in blood, is an essential
protein which binds and transports various drugs and substances, maintains
the oncotic pressure of blood and influences the physiological function of
the circulatory system. Albumin also has anti-inflammatory, antioxidant,
and antithrombotic properties. Evidence supports albumin's role as a
strong predictor of cardiovascular (CV) risk in several patient groups.
Its protective role extends to those with coronary artery disease, heart
failure, hypertension, atrial fibrillation, peripheral artery disease or
ischemic stroke, as well as those undergoing revascularization procedures
or with aortic stenosis undergoing transcatheter aortic valve replacement,
and patients with congenital heart disease and/or endocarditis.
Hypoalbuminemia is a strong prognosticator of increased all-cause and CV
mortality according to several cohort studies and meta-analyses in
hospitalized and non-hospitalized patients with or without comorbidities.
Normalization of albumin levels before discharge lowers mortality risk,
compared with hypoalbuminemia before discharge. Modified forms of albumin,
such as ischemia modified albumin, also has prognostic value in patients
with coronary or peripheral artery disease. When albumin is combined with
other risk factors, such as uric acid or C-reactive protein, the
prognostic value is enhanced. Although albumin supplementation may be a
plausible approach, its efficacy has not been established and in patients
with hypoalbuminemia, priority is focused on diagnosing and managing the
underlying condition. The CV effects of hypoalbuminemia and relevant
issues are considered in this review. Large cohort studies and
meta-analyses are tabulated and the physiologic effects of albumin and the
deleterious effects of low albumin are pictorially
illustrated. Copyright © 2022 European Federation of Internal
Medicine

<55>
Accession Number
637984597
Title
Impact of CPAP on Postoperative Atrial Fibrillation in Obstructive Sleep
Apnea Patients Undergoing CABG Surgery: An Exploratory Randomized,
Multicenter Study.
Source
American journal of respiratory and critical care medicine. (no
pagination), 2022. Date of Publication: 12 May 2022.
Author
Chalegre S.T.; Barros M.M.; Silva B.P.G.; Furlan S.F.; Giampa S.Q.C.;
Marques J.N.; Albuquerque A.L.T.; Monteiro V.S.; Drager L.F.; Pedrosa R.P.
Institution
(Chalegre, Barros, Silva, Albuquerque) Universidade de Pernambuco, Recife,
Brazil
(Furlan) Universidade de Sao Paulo, Hypertension Unit, Sao Paulo, Brazil
(Giampa) Universidade de Sao Paulo, 28133, Hypertension Unit, Sao Paulo,
Sao Paulo, Brazil
(Marques, Monteiro) Instituto de Medicina Integral Professor Fernando
Figueira, Recife, Brazil
(Drager) Universidade de Sao Paulo, Hypertension Unit, Sao Paulo, Brazil
(Pedrosa) Universidade de Pernambuco, 117110, Recife, Brazil;
Publisher
NLM (Medline)

<56>
Accession Number
2007982280
Title
Is bilateral transversus thoracis muscle plane block effective in
minimizing pain in pediatric cardiac surgery?.
Source
Journal of Clinical Anesthesia. 79 (no pagination), 2022. Article Number:
110083. Date of Publication: August 2022.
Author
Bartlett E.; Urman R.D.; Urits I.; Kaye A.D.; Viswanath O.
Institution
(Bartlett) Pain Specialty Group, Newington, NH, United States
(Urits) Brigham and Women's Hospital, Department of Anesthesiology,
Perioperative and Pain Medicine, Harvard Medical School, Boston, MA,
United States
(Kaye) Beth Israel Deaconess Medical Center, Department of Anesthesiology,
Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA,
United States
(Urman, Viswanath) Louisiana State University Health Shreveport,
Department of Anesthesiology, Shreveport, LA, United States
(Viswanath) Valley Anesthesiology and Pain Consultants - Envision
Physician Services, Phoenix, AZ, United States
Publisher
Elsevier Inc.

<57>
Accession Number
2016102262
Title
Predictors of adherence to prescribed exercise programs for older adults
with medical or surgical indications for exercise: a systematic review.
Source
Systematic Reviews. 11(1) (no pagination), 2022. Article Number: 80. Date
of Publication: December 2022.
Author
Shaw J.F.; Pilon S.; Vierula M.; McIsaac D.I.
Institution
(Shaw, McIsaac) Ottawa Hospital Research Institute, Clinical Epidemiology
Program, 1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada
(Shaw, McIsaac) School of Epidemiology & Public Health, University of
Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada
(Pilon, Vierula, McIsaac) Departments of Anesthesiology & Pain Medicine,
University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background and objectives: Prescribed exercise to treat medical conditions
and to prepare for surgery is a promising intervention to prevent adverse
health outcomes for older adults; however, adherence to exercise programs
may be low. Our objective was to identify and grade the quality of
predictors of adherence to prescribed exercise in older adults.
 Method(s): Prospective observational and experimental studies were
identified using a peer-reviewed search strategy applied to MEDLINE,
EMBASE, Cochrane, and CINAHL from inception until October 6, 2020.
Following an independent and duplicate review of titles, abstracts, and
full texts, we included prospective studies with an average population age
>65 years, where exercise was formally prescribed for a medical or
surgical condition. We excluded studies where exercise was prescribed for
a chronic musculoskeletal condition. Risk of bias was assessed using the
Quality in Prognostic studies tool or Cochrane risk of bias tool, as
appropriate. Predictors of adherence were identified and graded for
quality using an adaptation of the Grading of Recommendations Assessment,
Development, and Evaluation (GRADE) framework for predictor studies.
 Result(s): We included 19 observational studies and 4 randomized
controlled trials (n=5785) Indications for exercise included cardiac
(n=6), pulmonary rehabilitation (n=7), or other (n=10; surgical, medical,
and neurologic). Of the 10 studies that reported adherence as the percent
of prescribed sessions completed, average adherence was 80% (range 60-98%;
standard deviation (SD) 11%). Of the 10 studies that reported adherence as
a categorical threshold demarking adherent vs not adherent, average
adherence was 57.5% (range 21-83%; SD 21%). Moderate-quality evidence
suggested that positive predictors of adherence were self-efficacy and
good self-rated mental health; negative predictors were depression (high
quality) and distance from the exercise facility. Moderate-quality
evidence suggested that comorbidity and age were not predictive of
adherence. Conclusion(s): These findings can inform the design of
future exercise programs as well as the identification of individuals who
may require extra support to benefit from prescribed exercise. Systematic
review registration: PROSPERO CRD42018108242 Copyright © 2022,
The Author(s).

<58>
Accession Number
2016922421
Title
Effect of retrograde autologous priming on lactate and hemoglobin levels
of adult patients undergoing coronary artery bypass grafting.
Source
Anaesthesia, Pain and Intensive Care. 26(1) (pp 20-24), 2022. Date of
Publication: 01 Feb 2022.
Author
Naseer M.; Feroze R.; Akram M.A.; Fakhar-E-Fayaz
Institution
(Naseer, Akram, Fakhar-E-Fayaz) Department of Cardiac Anesthesia &
Intensive Care, Army Cardiac Center, Combined Military Hospital, Lahore,
Pakistan
(Feroze) Department of Anesthesiology & Intensive Care, Combined Military
Hospital Lahore Medical & Dental College, Lahore, Pakistan
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background: Reduced hemoglobin, excessive transfusions and raised lactate
levels are important determinants of patient outcome after cardiopulmonary
bypass. Many strategies have been studied for optimum management of these
parameters. In this study, we evaluated the impact of retrograde
autologous priming (RAP) method on hemoglobin and lactate levels in
patients undergoing coronary artery bypass grafting (CABG) on
cardiopulmonary bypass. Methodology: This prospective randomized
controlled trial was conducted at Army Cardiac Centre, CMH, Lahore, from
January 01, 2021 to June 30, 2021. After approval of institutional ethical
committee and taking informed consent from patients, 272 patients
undergoing CABG were enrolled. Patients with ages less than 18 y, LVEF <=
20%, emergency operations, repeat operations, valvular or combined
procedures, recent myocardial infarction, with preoperative lactate levels
of more than 2 mmol/L and Hb of less than 9 gm/dL and other preoperative
systemic diseases or infection were excluded. Patients were divided into
two groups. Group A received conventional priming of bypass circuit with
ringer lactate, and Group B received RAP with patient's own blood. Hb and
lactate levels were measured in arterial blood gases before induction and
upon weaning from bypass. Result(s): The demographic features of both
groups were identical, Group A patients had significantly high levels of
lactate (3.76 +/- 0.81 vs. 2.64 +/- 0.47 mmol/L, P < 0.01). Hb levels of
patients in RAP (RAP) (Group B) were significantly better (9 +/- 0.31 vs.
7.9 +/- 0.39 gm/dL, P < 0.01) than Group A. Conclusion(s): Our study
concludes that when compared with crystalloid priming, retrograde
autologous priming technique is associated with reduced lactate levels and
better hemoglobin levels after cardiopulmonary bypass in patients
undergoing coronary artery bypass grafting. Copyright © 2022
Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights
reserved.

<59>
Accession Number
2017779096
Title
Comprehensive cardiac rehabilitation for patients following infective
endocarditis: results of the randomized CopenHeart<inf>IE</inf>trial.
Source
European Journal of Cardiovascular Nursing. 21(3) (pp 261-270), 2022. Date
of Publication: 01 Mar 2022.
Author
Rasmussen T.B.; Zwisler A.-D.; Risom S.S.; Sibilitz K.Lae.; Christensen
J.; Bundgaard H.; Moons P.; Thygesen L.C.; Lindschou J.; Norekval T.M.;
Berg S.K.
Institution
(Rasmussen, Risom, Sibilitz, Bundgaard, Berg) Heart Centre, Copenhagen
University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen O 2100,
Denmark
(Rasmussen) Department of Cardiology, Herlev and Gentofte University
Hospital, Kildegaardsvej 28 Hellerup 2900, Denmark
(Rasmussen, Risom, Berg) Department of Clinical Medicine, Faculty of
Health and Medical Sciences, University of Copenhagen, Oster Farimagsgade
5, Copenhagen O 1014, Denmark
(Zwisler, Christensen) Danish Centre for Rehabilitation and Palliative
Care, Odense University Hospital, Vestergade 17, Nyborg 5800, Denmark
(Risom) Institute for Nursing and Nutrition, University College
Copenhagen, Tagensvej 86, Copenhagen N 2200, Denmark
(Christensen) Department of Occupational and Physiotherapy, Copenhagen
University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen O 2100,
Denmark
(Moons) Department of Public Health and Primary Care, University of
Leuven, Kapucijnenvoer 35 blok d, box 7001, B-3000, Leuven, Belgium
(Moons) Institute of Health and Care Science, University of Gothenburg,
Arvid Wallgrens backe 1, Goteborg 413 46, Sweden
(Moons) Department of Paediatrics and Child Health, University of Cape
Town, 46 Sawkins Rd, Rosebank, Cape Town 7700, South Africa
(Thygesen) National Institute of Public Health, University of Southern
Denmark, Studiestraede 6, Copenhagen K 1455, Denmark
(Lindschou) Copenhagen Trial Unit, Centre for Clinical Intervention
Research, Copenhagen University Hospital Rigshospitalet, Tagensvej 22,
Copenhagen N 2200, Denmark
(Norekval) Department of Heart Disease, Haukeland University Hospital,
Haukelandsveien 22, Bergen 5021, Norway
(Norekval) Department of Clinical Science, University of Bergen, Jonas
Lies veg 87, Bergen 5021, Norway
Publisher
Oxford University Press
Abstract
Aims: Infective endocarditis is a complex and highly mortal disease
requiring lengthy treatment. Physical and mental deconditioning is common.
Nonetheless, rehabilitation is virtually unexplored in this population.
The aim of this trial was therefore to investigate the effects of cardiac
rehabilitation in patients following endocarditis. Methods and
Results: In a randomized trial, adults with left-sided or cardiac device
endocarditis were randomized 1:1 to 12 weeks of physical exercise training
and five psycho-educational consultations (cardiac rehabilitation) vs.
usual care without rehabilitation (control). Primary outcome was mental
health measured by SF-36 Mental Component Summary (MCS) at 6 months.
Secondary outcome was physical capacity measured by peak oxygen uptake
(VO2) at 4 months. Exploratory outcomes were investigated. Low inclusion
rate resulted in trial termination before reaching the target sample size.
A total of 117 participants (mean age: 60 years, 81% male) were randomized
to cardiac rehabilitation (n = 58) or to control (n = 59). Mental health
and physical capacity at baseline were generally poor (MCS: 38.9-42.2
points, VO2 peak: 16.1-16.6 mL/kg/min). Cardiac rehabilitation compared
with control showed no effect on mental health (MCS: 44.6 points vs. 48.8
points, P = 0.41) or physical capacity (VO2 peak: 19.9 mL/kg/min vs. 18.0
mL/kg/min, P = 0.09). Effects favouring the intervention were identified
in exploratory outcomes including general fatigue (P = 0.005), and
physical capacity as maximal power (W) (P = 0.005). Adherence to the
intervention was 28%. Conclusion(s): Results indicate no effect of
cardiac rehabilitation in patients following endocarditis; however, lack
of statistical power and poor adherence render findings inconclusive.
Valuable insight into patients' capabilities and safety was gained, and
further investigations into rehabilitation needs and modes of delivery in
this high-need population should be a future priority. Registration: The
trial is registered at ClinicalTrials.gov, NCT01512615 Copyright
© 2021 Published on behalf of the European Society of Cardiology. All
rights reserved.

<60>
Accession Number
2011864443
Title
Clinical protocols for oral anticoagulant reversal during high risk of
bleeding for emergency surgical and nonsurgical settings: a narrative
review.
Source
Brazilian Journal of Anesthesiology (English Edition). 71(4) (pp 429-442),
2021. Date of Publication: 01 Jul 2021.
Author
Galhardo C.; Yamauchi L.H.I.; Dantas H.; Guerra J.C.D.C.
Institution
(Galhardo) Hospital Sao Lucas Copacabana, Departamento de Anestesia, Rio
de Janeiro, RJ, Brazil
(Galhardo) Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil
(Yamauchi) Centro de Pesquisas Oncologicas (CEPON), Departamento de
Anestesia, Florianopolis, SC, Brazil
(Dantas) Clinica de Anestesiologia, Departamento de Anestesia, Salvador,
BA, Brazil
(Guerra) Hospital Israelita Albert Einstein, Centro de Oncologia e
Hematologia, Setor de Hematologia e Coagulacao, Departamento de Patologia
Clinica, Sao Paulo, SP, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background and objectives: Oral anticoagulants prevent thromboembolic
events but expose patients to a significant risk of bleeding due to the
treatment itself, after trauma, or during surgery. Any physician working
in the emergency department or involved in the perioperative care of a
patient should be aware of the best reversal approach according to the
type of drug and the patient's clinical condition. This paper presents a
concise review and proposes clinical protocols for the reversal of oral
anticoagulants in emergency settings, such as bleeding or surgery.
Contents: The authors searched for relevant studies in PubMed, LILACS, and
the Cochrane Library database and identified 82 articles published up to
September 2020 to generate a review and algorithms as clinical protocols
for practical use. Hemodynamic status and the implementation of general
supportive measures should be the first approach under emergency
conditions. The drug type, dose, time of last intake, and laboratory
evaluations of anticoagulant activity and renal function provide an
estimation of drug clearance and should be taken into consideration. The
reversal agents for vitamin K antagonists are 4-factor prothrombin complex
concentrate and vitamin K, followed by fresh frozen plasma as a
second-line treatment. Direct oral anticoagulants have specific reversal
agents, such as andexanet alfa and idarucizumab, but are not widely
available. Another possibility in this situation, but with less evidence,
is prothrombin complex concentrates. Conclusion(s): The present
algorithms propose a tool to help healthcare providers in the best
decision making for patients under emergency conditions. Copyright
© 2021 Sociedade Brasileira de Anestesiologia

<61>
Accession Number
2013826394
Title
Acute Kidney Injury Following Transcatheter Edge-to-Edge Mitral Valve
Repair: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 38 (pp 29-35), 2022. Date of
Publication: May 2022.
Author
Doulamis I.P.; Tzani A.; Kampaktsis P.N.; Kaneko T.; Tang G.H.L.
Institution
(Doulamis) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
(Tzani) Brigham and Women's Hospital Heart and Vascular Center, Harvard
Medical School, Boston, MA, United States
(Kampaktsis) Division of Cardiology, New York University Langone Medical
Center, NY, United States
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Tang) Department of Cardiovascular Surgery, Mount Sinai Health System,
New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Aim of this study was to perform a systematic review a
meta-analysis of the literature in order to identify predictors of acute
kidney injury (AKI) in patients with mitral regurgitation (MR) undergoing
transcatheter edge-to-edge repair (TEER) and assess its effect on
in-hospital outcomes and mortality. Although iodinated contrast is not
typically used in TEER, these patients are still at risk for developing
AKI. Method(s): Studies reporting on the effect of incident AKI on
mortality following TEER for MR were included. Random-effects
meta-analysis was performed, comparing clinical outcomes between the
patients with or without incident AKI. Result(s): Six studies
including a total of 2057 patients (377 AKI and 1680 No-AKI) were included
and analyzed. AKI was significantly associated with 30-day mortality after
TEER (Odds ratio (OR): 8.06; 95% CI: 3.20, 20.30, p < 0.01; I2
= 18.4%) and all-cause mortality over a mean follow-up time of 30 months
(Hazard ratio (HR): 2.48; 95% CI: 1.89, 3.24, p < 0.01; I2 =
23.7%). AKI after TEER was associated with prolonged hospitalization (Mean
difference (in days): 1.41; 95% CI: 0.52, 2.31, p < 0.01; I2 =
82.4%). Stage 4 chronic kidney disease (CKD), device failure and history
of chronic obstructive pulmonary disease (COPD) were significant
predictors of AKI following TEER (CKD stage 4: OR: 2.38; 95% CI: 1.18,
4.78, p = 0.02; I2 = 0.0%; Device failure: OR: 3.15; 95% CI:
1.94, 5.12, p < 0.01; I2 = 0.0%; COPD: OR: 1.92; 95% CI: 1.16,
3.17; I2 = 26.7%). Conclusion(s): Our findings highlight
the renal vulnerability of the TEER population to renal injury and the
associated deterioration in clinical outcomes and survival. Copyright
© 2021 Elsevier Inc.

<62>
Accession Number
2011542431
Title
Spontaneous versus mechanical ventilation during video-assisted
thoracoscopic surgery for spontaneous pneumothorax: A randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(5) (pp 1702-1714.e7),
2022. Date of Publication: May 2022.
Author
Liu J.; Liang H.; Cui F.; Liu H.; Zhu C.; Liang W.; He J.; Wang W.; Jiang
S.; Dong Q.; Liang L.; Yang H.; Jin J.; Shen J.; Dai T.; He K.; Cai K.;
Feng S.; Wang H.; Zhang Z.; Huang H.; Cheng C.; Liu Z.; Qiao K.; Xia Z.;
Liu X.; Wang G.; Huang T.; Xu S.; Shen Q.; Tan W.; Ding J.; Liu Y.; Ye J.;
Yu J.; Zhang H.; Feng X.; Ma M.; Duan Z.; Li Y.; Ma H.; Ng C.S.H.;
Gonzalez-Rivas D.; Pompeo E.; Daley E.; Flores R.M.; Shargall Y.; Ismail
M.; Ang K.-L.; Ambrogi V.; Elkhouly A.
Institution
(Liu, Liang, Cui, Liang, He) National Clinical Research Center for
Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical
University, Guangzhou, China
(Liu, Liang, Cui, Liang, He) Department of Thoracic Surgery, the First
Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
(Liu) Department of Anesthesia, the First Affiliated Hospital of Guangzhou
Medical University, Guangzhou, China
(Zhu) Department of Thoracic Surgery, Taizhou Hospital, Taizhou, China
(He) Southern Medical University, Guangzhou, China
Publisher
Elsevier Inc.
Abstract
Objective: Spontaneous ventilation video-assisted thoracic surgery
(SV-VATS) is reported to have superior or equal efficacy on postoperative
recovery to mechanical ventilation VATS (MV-VATS). However, perioperative
safety of the SV-VATS blebectomy is not entirely demonstrated.
 Method(s): We performed a noninferiority, randomized controlled trial
(No. NCT03016858) for primary spontaneous pneumothorax patients aged 16 to
50 years undergoing a SV-VATS and the MV-VATS procedure. The trial was
conducted at 10 centers in China from April 2017 to January 2019. The
primary outcome was the comparison of intra- and postoperative
complications between SV-VATS and MV-VATS procedures. Secondary outcomes
included total analgesia dose, change of vital sign during surgery,
procedural duration, recovery time, postoperative visual analog pain
scores, and hospitalization length. Result(s): In this study, 335
patients were included. There was no significant difference between the
SV-VATS group and the MV-VATS group in the intra- and postoperative
complication rates (17.90% vs 22.09%; relative risk, 0.81; 95% confidence
interval, 0.52-1.26; P =.346). The SV-VATS group was associated with
significantly decreased total dose of intraoperative opioid agents; that
is, sufentanil (11.37 mug vs 20.92 mug; P <.001) and remifentanil (269.78
mug vs 404.96 mug; P <.001). The SV-VATS procedure was also associated
with shorter extubation time (12.28 minutes vs 17.30 minutes; P <.001),
postanesthesia care unit recovery time (25.43 minutes vs 30.67 minutes; P
=.02) and food intake time (346.07 minute vs 404.02 minutes; P =.002).
Moreover, the SV-VATS procedure deceased the anesthesia cost compared with
the MV-VATS ($297.81 vs $399.81; P <.001). Conclusion(s): SV-VATS was
shown to be noninferior to MV-VATS in term of complication rate and in
selected patients undergoing blebectomy for primary spontaneous
pneumothorax. Copyright © 2021

<63>
Accession Number
2007713605
Title
Machine learning improves mortality risk prediction after cardiac surgery:
Systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(6) (pp 2075-2087.e9),
2022. Date of Publication: June 2022.
Author
Benedetto U.; Dimagli A.; Sinha S.; Cocomello L.; Gibbison B.; Caputo M.;
Gaunt T.; Lyon M.; Holmes C.; Angelini G.D.
Institution
(Benedetto, Dimagli, Sinha, Cocomello, Gibbison, Caputo, Angelini)
Department of Translational Health Sciences, Bristol Heart Institute,
University of Bristol, London, United Kingdom
(Gaunt, Lyon) Population Health Sciences, University of Bristol, London,
United Kingdom
(Holmes) Department of Statistics, University of Oxford, Oxford, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Interest in the usefulness of machine learning (ML) methods
for outcomes prediction has continued to increase in recent years.
However, the advantage of advanced ML model over traditional logistic
regression (LR) remains controversial. We performed a systematic review
and meta-analysis of studies comparing the discrimination accuracy between
ML models versus LR in predicting operative mortality following cardiac
surgery. Method(s): The present systematic review followed the
Preferred Reporting Items for Systematic Reviews and Meta-Analysis
statement. Discrimination ability was assessed using the C-statistic.
Pooled C-statistics and its 95% credibility interval for ML models and LR
were obtained were obtained using a Bayesian framework. Pooled estimates
for ML models and LR were compared to inform on difference between the 2
approaches. Result(s): We identified 459 published citations of which
15 studies met inclusion criteria and were used for the quantitative and
qualitative analysis. When the best ML model from individual study was
used, meta-analytic estimates showed that ML were associated with a
significantly higher C-statistic (ML, 0.88; 95% credibility interval,
0.83-0.93 vs LR, 0.81; 95% credibility interval, 0.77-0.85; P = .03). When
individual ML algorithms were instead selected, we found a nonsignificant
trend toward better prediction with each of ML algorithms. We found no
evidence of publication bias (P = .70). Conclusion(s): The present
findings suggest that when compared with LR, ML models provide better
discrimination in mortality prediction after cardiac surgery. However, the
magnitude and clinical influence of such an improvement remains
uncertain. Copyright © 2020 The American Association for Thoracic
Surgery

<64>
Accession Number
2007403619
Title
Mechanical or biological heart valve for dialysis-dependent patients? A
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(6) (pp 2057-2071.e12),
2022. Date of Publication: June 2022.
Author
Chi K.-Y.; Chiang M.-H.; Kang Y.-N.; Li S.-J.; Chan Y.-T.; Chen Y.-C.;
Wang S.-T.
Institution
(Chi) Department of Education, Center for Evidence-Based Medicine, Taipei
Medical University Hospital, Taipei, Taiwan (Republic of China)
(Chiang) School of Medicine, College of Medicine, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Kang) Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Kang) Institute of Health Policy & Management, College of Public Health,
National Taiwan University, Taipei, Taiwan (Republic of China)
(Li) Cardiovascular Research Center, Wan Fang Hospital, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Li) Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Li) Division of Cardiovascular Surgery, Department of Surgery, Wan Fang
Hospital, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chan) Department of General Medicine, Shuang Ho Hospital, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Chen, Wang) Department of Family Medicine, Taipei Medical University
Hospital, Taipei, Taiwan (Republic of China)
(Chen, Wang) Department of Family Medicine, School of Medicine, College of
Medicine, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chen) School of Nutrition and Health Sciences, College of Nutrition,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chen) Graduate Institute of Metabolism and Obesity Sciences, Taipei
Medical University, Taipei, Taiwan (Republic of China)
(Wang) Health Management Center, Taipei Medical University Hospital,
Taipei, Taiwan (Republic of China)
Publisher
Elsevier Inc.
Abstract
Objective: The optimal selection of prosthetic heart valve for
dialysis-dependent patients remains controversial. We investigated the
comparative effectiveness and safety of mechanical prosthesis (MP) and
bioprosthesis (BP) for these patients. Method(s): After the
systematic review, we included studies that involved patients on dialysis
undergoing aortic valve replacement or mitral valve replacement (MVR) and
reported comparative outcomes of MP and BP. Meta-analysis was performed
using random-effects model. We conducted a subgroup analysis based on the
valve position and postoperative international normalized ratio (INR),
which was extracted from either tables or methods of each study. A
meta-regression was used to examine the effects of study-level covariates.
 Result(s): We included 24 retrospective studies without
randomized-controlled trials, involving 10,164 participants (MP = 6934, BP
= 3230). Patients undergoing aortic valve replacement with MP exhibited a
better long-term survival effectiveness (hazard ratio, 0.64; 95%
confidence interval [CI], 0.47-0.86). Conversely, studies including MVR
demonstrated little difference in survival (hazard ratio, 0.90; 95% CI,
0.73-1.12). A meta-regression revealed that age had little effect on
long-term survival difference between MP and BP (beta = -0.0135, P =
.433). MP had a significantly greater bleeding risk than did BP when INR
was above 2.5 (incidence rate ratio, 10.58; 95% CI, 2.02-55.41). However,
when INR was below 2.5, bleeding events were comparable (incidence rate
ratio, 1.73; 95% CI, 0.78-3.82). The structural valve deterioration rate
was significantly lower in MP (risk ratio, 0.24; 95% CI, 0.14-0.44).
 Conclusion(s): MP is a reasonable choice for dialysis-dependent
patients without additional thromboembolic risk requiring aortic valve
replacement, for its better long-term survival, durability, and
noninferior bleeding risk compared with BP. Conversely, BP might be an
appropriate selection for patients with MVR, given its similar survival
rate and lower bleeding risk. Although our meta-regression demonstrates
little influence of age on long-term survival difference between MP and
BP, further studies stratifying patients based on age cut-off are
mandatory. Copyright © 2020 The Author(s)

<65>
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.

<66>
Accession Number
637675852
Title
Cardiac surgery on patients with COVID-19: a systematic review and
meta-analysis.
Source
ANZ journal of surgery. 92(5) (pp 1007-1014), 2022. Date of Publication:
01 May 2022.
Author
Gupta A.K.; Leslie A.; Hewitt J.N.; Kovoor J.G.; Ovenden C.D.; Edwards S.;
Chan J.C.Y.; Worthington M.G.
Institution
(Gupta) Department of Surgery, University of Sydney, Sydney, NSW,
Australia
(Gupta, Worthington) Department of Cardiothoracic Surgery, Royal Adelaide
Hospital, Adelaide, Australia
(Gupta, Leslie, Hewitt, Kovoor, Ovenden, Chan) University of Adelaide,
Discipline of Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
(Edwards) Adelaide Health Technology Assessment, School of Public Health,
University of Adelaide, Adelaide, SA, Australia
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The COVID-19 pandemic has had a significant impact on global
surgery. In particular, deleterious effects of SARS-CoV-2 infection on the
heart and cardiovascular system have been described. To inform surgical
patients, we performed a systematic review and meta-analysis aiming to
characterize outcomes of COVID-19 positive patients undergoing cardiac
surgery. METHOD(S): The study protocol was registered with PROSPERO
(CRD42021228533) and conformed with PRISMA 2020 and MOOSE guidelines.
PubMed, Ovid MEDLINE and Web of Science were searched between 1 January
2019 to 24 February 2022 for studies reporting outcomes on COVID-19
positive patients undergoing cardiac surgery. Study screening, data
extraction and risk of bias assessment were conducted in duplicate.
Meta-analysis was conducted using a random-effects model where at least
two studies had sufficient data for that variable. RESULT(S):
Searches identified 4223 articles of which 18 studies were included with a
total 44 patients undergoing cardiac surgery. Within these studies, 12
(66.7%) reported populations undergoing coronary artery bypass graft
(CABG) surgery, three (16.7%) aortic valve replacements (AVR) and three
(16.7%) aortic dissection repairs. Overall mean postoperative length of
ICU stay was 3.39 (95% confidence interval (CI): 0.38, 6.39) and mean
postoperative length of hospital stay was 17.88 (95% CI: 14.57, 21.19).
 CONCLUSION(S): This systematic review and meta-analysis investigated
studies of limited quality which characterized cardiac surgery in COVID-19
positive patients and demonstrates that these patients have poor outcomes.
Further issues to be explored are effects of COVID-19 on decision-making
in cardiac surgery, and effects of COVID-19 on the cardiovascular system
at a cellular level. Copyright © 2022 The Authors. ANZ Journal of
Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal
Australasian College of Surgeons.

<67>
Accession Number
2016632529
Title
Mortality after transcatheter aortic valve replacement for aortic stenosis
among patients with malignancy: a systematic review and meta-analysis.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
210. Date of Publication: December 2022.
Author
Siddiqui M.U.; Yacob O.; Junarta J.; Pasha A.K.; Mookadam F.; Mamas M.A.;
Fischman D.L.
Institution
(Siddiqui, Junarta) Department of Internal Medicine, Thomas Jefferson
University Hospitals, 833 Chestnut Street, Suite 701, Philadelphia, PA
19107, United States
(Yacob) Cardiovascular Medicine, MercyOne North Iowa Heart Center, Mason
City, IA, United States
(Pasha) Cardiovascular Medicine, UHS Wilson Medical Center, Johnson City,
NY, United States
(Mookadam) Cardiovascular Medicine, Mayo Clinic Health System, Phoenix,
AZ, United States
(Mamas) Cardiovascular Research Group, Center for Prognosis Research,
Keele University, Keele, United Kingdom
(Fischman) Cardiovascular Medicine, Thomas Jefferson University Hospital,
Philadelphia, PA, United States
Publisher
BioMed Central Ltd
Abstract
Background: With advancements in cancer treatment, the life expectancy of
oncology patients has improved. Thus, transcatheter aortic valve
replacement (TAVR) may be considered as a feasible option for oncology
patients with severe symptomatic aortic stenosis (AS). We aim to evaluate
the difference in short- and long-term all-cause mortality in cancer and
non-cancer patients treated with TAVR for severe AS. Method(s):
Medline, PubMed, and Cochrane Central Register of Controlled Trials were
searched for relevant studies. Patients with cancer who underwent
treatment with TAVR for severe AS were included and compared to an
identical population without cancer. The primary endpoints were short- and
long-term all-cause mortality. Result(s): Of 899 studies included, 8
met inclusion criteria. Cancer patients had significantly higher long-term
all-cause mortality after TAVR when compared to patients without cancer
(risk ratio [RR] 1.43; 95% confidence interval (CI) 1.26-1.62; P < 0.01).
Four studies evaluated short-term mortality after TAVR and demonstrated no
difference in it in patients with and without cancer (RR 0.72; 95% CI
0.47-1.08; P = 0.11). Conclusion(s): Patients with cancer and severe
AS have higher long-term all-cause mortality after TAVR. However, we found
no difference in short-term all-cause mortality when comparing patients
with and without cancer. The decision to perform TAVR in cancer patients
should be individualized based on life expectancy and existing
co-morbidities. Copyright © 2022, The Author(s).

<68>
Accession Number
635566190
Title
Utilization, Costs, and Outcomes of Conscious Sedation Versus General
Anesthesia for Transcatheter Aortic Valve Replacement.
Source
Circulation: Cardiovascular Interventions. 14(7) (pp E010310), 2021. Date
of Publication: 01 Jul 2021.
Author
Herrmann H.C.; Cohen D.J.; Hahn R.T.; Babaliaros V.C.; Yu X.; Makkar R.;
McCabe J.; Szerlip M.; Kapadia S.; Russo M.; Malaisrie S.C.; Webb J.G.;
Szeto W.Y.; Kodali S.; Thourani V.H.; Mack M.J.; Leon M.B.
Institution
(Herrmann, Szeto) Perelman School of Medicine of the University of
Pennsylvania, Philadelphia, PA, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Hahn, Kodali, Leon) Columbia University Medical Center, New York, NY,
United States
(Babaliaros) Emory University, Atlanta, GA, United States
(Yu) Edwards Lifesciences, Inc, Irvine, CA, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(McCabe) University of Washington, Seattle, WA, United States
(Szerlip, Mack) Baylor Scott and White Health, Plano, TX, United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Russo) Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ,
United States
(Malaisrie) Northwestern University Hospital, Chicago, IL, United States
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The potential advantages for conscious sedation (CS) as
compared to general anesthesia (GA) have not been evaluated in studies
with core laboratory echocardiographic assessments and monitored end
points. We compared CS versus GA for SAPIEN 3 transcatheter aortic valve
replacement in patients at intermediate-and low-surgical risk.
 Method(s): This analysis included patients in the PARTNER 2
(Placement of Aortic Transcatheter Valve Trial) intermediate-risk registry
and the PARTNER 3 randomized low-risk study. CS was compared to GA with
respect to death, stroke, bleeding, paravalvular regurgitation, length of
stay, and costs. Outcomes were assessed by a core echocardiographic
laboratory, and clinical events were independently adjudicated.
 Result(s): Baseline characteristics were similar between the CS and
GA groups. Postprocedure hospital length of stay was significantly shorter
for CS versus GA both in intermediate-risk patients (4.4+/-0.2 and
5.2+/-0.2 days, respectively, P<0.01) and low-risk patients (2.7+/-0.1 and
3.4+/-0.2 days, respectively, P<0.001). There were no significant
differences between CA and GA patients in either the 30-day or 1-year
rates of death, stroke, rehospitalization, or paravalvular aortic
regurgitation >=moderate. In the intermediate-risk cohort, adjusted 30-day
health care costs were $3833 lower per patient in the CS group.
 Conclusion(s): The selective use of CS is associated with shorter
procedure times, shorter intensive care unit and hospital length of stay,
lower costs, and no difference in clinical outcomes to 1 year, including
>=moderate paravalvular regurgitation. Our data demonstrate similar safety
profiles with both approaches and support the continued use of CS for most
patients undergoing the procedure. Registration: URL:
https://www.clinicaltrials.gov; Unique identifiers: NCT03222128 and
NCT02675114. Copyright © 2021 Lippincott Williams and Wilkins.
All rights reserved.

<69>
Accession Number
633714669
Title
Individualized, Intraoperative Dosing of Fibrinogen Concentrate for the
Prevention of Bleeding in Neonatal and Infant Cardiac Surgery Using
Cardiopulmonary Bypass (FIBCON): A Phase 1b/2a Randomized Controlled
Trial.
Source
Circulation: Cardiovascular Interventions. 13(12) (pp E009465), 2020. Date
of Publication: 01 Dec 2020.
Author
Siemens K.; Hunt B.J.; Harris J.; Nyman A.G.; Parmar K.; Tibby S.M.
Institution
(Siemens, Harris, Nyman, Tibby) Department of Paediatric Intensive Care,
Evelina London Children's Hospital, Westminster Bridge Rd, London SE1 7EH,
United Kingdom
(Hunt, Parmar) Department of Haematology, St Thomas' Hospital, London,
United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Mediastinal bleeding is common following pediatric
cardiopulmonary bypass surgery for congenital heart disease. Fibrinogen
concentrate (FC) represents a potential therapy for preventing bleeding.
 Method(s): We performed a single-center, phase 1b/2a, randomized
controlled trial on infants 2.5 to 12 kg undergoing cardiopulmonary bypass
surgery, aimed at (1) demonstrating the feasibility of an intraoperative
point-of-care test, rotational thromboelastometry, to screen out patients
at low risk of postoperative bleeding and then guide individualized FC
dosing in high-risk patients and (2) determining the dose, safety, and
efficacy of intraoperative FC supplementation. Screening occurred
intraoperatively 1-hour before bypass separation using the rotational
thromboelastometry variable fibrinogen thromboelastometry maximum clot
firmness (FibTEM-MCF; fibrinogen contribution to clot firmness). If
FibTEM-MCF >=7 mm, patients entered the monitoring cohort. If FibTEM-MCF
<=6 mm, patients were randomized to receive FC/placebo (2:1 ratio).
Individualized FC dose calculation included weight, bypass circuit volume,
hematocrit, and intraoperative measured and desired FibTEM-MCF. The
coprimary outcomes, measured 5 minutes post-FC administration were
FibTEM-MCF (desired range, 8-13 mm) and fibrinogen levels (desired range,
1.5-2.5 g/L). Secondary outcomes were thrombosis and thrombosis-related
major complications and postoperative 24-hour mediastinal blood loss.
 Result(s): We enrolled 111 patients (cohort, n=21; FC, n=60; placebo,
n=30); mean (SD) age, 6.4 months (5.8); weight, 5.9 kg (2.0).
Intraoperative rotational thromboelastometry screening effectively
excluded low-risk patients, in that none in the cohort arm (FibTEM-MCF,
>=7 mm) demonstrated clinically significant early postoperative bleeding
(>10 mL/kg per 4 hours). Among randomized patients, the median (range) FC
administered dose was 114 mg/kg (51-218). Fibrinogen levels increased from
a mean (SD) of 0.91 (0.22) to 1.7 g/L (0.41). The postdose fibrinogen
range was 1.2 to 3.3 g/L (72% within the desired range). The corresponding
FibTEM-MCF values were as follows: pre-dose, 5.3 mm (1.9); post-dose, 13
mm (3.2). Ten patients (8 FC and 2 placebo) exhibited 12 possible
thromboses; none were clearly related to FC. There was an overall
difference in mean (SD) 24-hour mediastinal drain loss: cohort, 12.6 mL/kg
(6.4); FC, 11.6 mL/kg (5.2); placebo, 17.1 mL/kg (14.3; ANOVA P=0.02).
 Conclusion(s): Intraoperative, individualized dosing of FC appears
feasible. The need for individualized dosing is supported by the finding
that a 4-fold variation in FC dose is required to achieve therapeutic
fibrinogen levels. Registration: URL: https://eudract.ema.europa.eu/;
Unique identifier: 2013-003532-68. URL: https://www.isrctn.com/; Unique
identifier: 50553029. Copyright © 2020 Lippincott Williams and
Wilkins. All rights reserved.

<70>
Accession Number
2018040770
Title
Minimally invasive surgery or stenting for left anterior descending artery
disease - meta-analysis.
Source
IJC Heart and Vasculature. 40 (no pagination), 2022. Article Number:
101046. Date of Publication: June 2022.
Author
Gianoli M.; de Jong A.R.; Jacob K.A.; Namba H.F.; van der Kaaij N.P.; van
der Harst P.; J.L Suyker W.
Institution
(Gianoli, de Jong, Jacob, Namba, van der Kaaij, J.L Suyker) Department of
Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht,
Netherlands
(van der Harst) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Minimally invasive direct coronary artery bypass (MIDCAB) surgery and
percutaneous coronary intervention (PCI) are both well-established
minimally invasive revascularization strategies in patients with proximal
left anterior descending (LAD) lesions. We aimed to evaluate the 20-years'
experience by performing a systematic review and meta-analysis comparing
MIDCAB versus PCI in adults with proximal LAD disease. We searched
MEDLINE, EMBASE and Cochrane on October 1st, 2021 for articles published
in the year 2000 or later. The primary outcome was all-cause mortality.
Secondary outcomes included cardiac mortality, repeat target vessel
revascularization (rTVR), myocardial infarction (MI), and cerebrovascular
accident (CVA). Outcomes were analysed at short-term, mid-term, and
long-term follow-up. Random effects meta-analyses were performed. Events
were compared using risk ratios (RR) with 95% confidence intervals (CI).
Our search yielded 17 studies pooling 3847 patients. At short-term
follow-up, cardiac mortality was higher with MIDCAB than with PCI (RR
7.30, 95% CI: 1.38 to 38.61). At long-term follow-up, MIDCAB showed a
decrease in all-cause mortality (RR 0.66, 95% CI: 0.46 to 0.93). MIDCAB
showed a decrease in rTVR at mid-term follow-up (RR 0.16, 95% CI: 0.11 to
0.23) and at long-term follow-up (RR 0.25, 95% CI: 0.17 to 0.38). MI and
CVA comparisons were not significant. In conclusion, in patients with
proximal LAD lesions, MIDCAB showed a higher short-term mortality in the
RCTs, but the cohort studies suggested a lower all-cause mortality at
long-term follow-up. We confirm a decreased rTVR at mid-term follow-up in
the RCTs and long-term follow-up in the cohort studies. Copyright
© 2022 The Author(s)

<71>
Accession Number
2018012594
Title
Effect of Xuebijing injection on myocardium during cardiopulmonary bypass:
A prospective, randomized, double blind trial.
Source
World Journal of Clinical Cases. 10(13) (pp 4110-4118), 2022. Date of
Publication: 06 May 2022.
Author
Jin Z.-H.; Zhao X.-Q.; Sun H.-B.; Zhu J.-L.; Gao W.
Institution
(Jin, Zhao, Sun, Zhu, Gao) Department of Anesthesiology, The 2nd
Affiliated Hospital of Harbin Medical University, Heilongjiang, Harbin
150001, China
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Cardiopulmonary bypass (CPB) is an essential procedure for
maintaining the blood supply to vital organs in patients undergoing
cardiac surgery. However, perioperative cardiac injury related to CPB
remains a severe complication in these patients. Cardiac protection is
important for patients undergoing CPB. AIM To evaluate the potential
cardioprotective efficacy of the Chinese medicine preparation Xuebijing
injection (XBJ) in patients undergoing CPB. METHODS Sixty patients
undergoing cardiac surgery with CPB were randomly allocated to the XBJ and
control groups (saline). XBJ was administered intravenously three times:
12 h prior to surgery, at the beginning of the surgery, and 12 h after the
second injection. Cardiac function was evaluated by echocardiography 48 h
after surgery. Circulating inflammation and oxidative-stress-related
markers were measured. Clinical outcomes related to intensive care unit
(ICU) stay were recorded. RESULTS Compared to control treatment, XBJ was
associated with improved PaO<inf>2</inf>/FiO<inf>2</inf> and cardiac
systolic function, but reduced troponin I and creatine kinase fraction
after surgery (all P < 0.05). The circulating concentrations of tumor
necrosis factor-alpha, interleukin (IL)-1beta and IL-8 in the XBJ group
were significantly lower than those in the control group (all P < 0.05),
whereas the circulating concentration of IL-10 was significantly higher in
the XBJ group (P < 0.05). In addition, the lengths of ICU stay and
hospitalization after surgery tended to be shorter in the XBJ group than
in the control group, although the differences were not significant.
CONCLUSION Perioperative administration of XBJ was associated with
attenuated cardiac injury during CPB, likely via anti-inflammatory and
antioxidative mechanisms Copyright © The Author(s) 2022.
Published by Baishideng Publishing Group Inc. All rights reserved

<72>
Accession Number
2017987430
Title
Incidence and Outcomes of Postoperative Atrial Fibrillation after Coronary
Artery Bypass Grafting of a Randomized Controlled Trial: A Blinded
End-of-cycle Analysis.
Source
Reviews in Cardiovascular Medicine. 23(4) (no pagination), 2022. Article
Number: 122. Date of Publication: 2022.
Author
Musa A.F.; Dillon J.; Taib M.E.M.; Yunus A.M.; Sanusi A.R.; Nordin M.N.;
Smith J.A.
Institution
(Musa) Jeffrey Cheah School of Medicine & Health Sciences, Monash
University Malaysia, Selangor, Subang Jaya 47500, Malaysia
(Musa) Victorian Heart Institute, Monash University, Melbourne 3168,
Australia
(Dillon, Taib, Yunus, Sanusi, Nordin) Department of Cardiothoracic
Surgery, National Heart Institute, Kuala Lumpur 50400, Malaysia
(Smith) Department of Surgery, School of Clinical Sciences at Monash
Health, Monash University, Melbourne 3168, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Melbourne
3168, Australia
Publisher
IMR Press Limited
Abstract
Objective: The objective of this study is to analyse the incidence of
postoperative atrial fibrillation (POAF), demography, post-operative
outcomes including morbidity and mortality, length of Cardiac Intensive
Care Unit (CICU) stay, High Dependency Unit (HDU) stay, and total hospital
stay in patients undergoing coronary bypass grafting (CABG) at Institut
Jantung Negana (IJN). Method(s): We conducted a prospective,
randomised, controlled trial. We supplied the treatment group with Tocovid
capsules and the control group with placebo containing palm superolein.
 Result(s): Since January 2019, we have recruited the target
population of 250 patients. However, the result is still blinded as we are
still analysing blood samples for tocotrienol levels. 89.2% of patients
completed the study with a 3.6% mortality and a 7.6% attrition rate. 35.2%
of the patients developed POAF, the mean time being 46.06 +/- 26.96 hours
post-CABG. We did not observe any statistically significant difference
when we compared left atrial size, New York Heart Association (NYHA)
functional class, ejection fraction and premorbid history, besides
EuroSCORE II (The European System for Cardiac Operative Risk Evaluation
II) status except for older age group, right atrial size, and pleural
effusion. There was also no difference in bypass time, cross clamp time or
number of anastomoses. However, we noted a significant difference in death
(p = 0.01) and renal failure requiring dialysis (p = 0.007) among patients
with POAF; those patients also had a longer CICU stay (p = 0.005), HDU
stay (p = 0.02), and total hospital stay (p = 0.001). Conclusion(s):
POAF is associated with a higher incidence of renal failure and death
while it increases CICU, HDU, and total hospital stay. It remains to be
seen whether Tocovid reduces POAF and its associated
sequelae. Copyright © 2022 IMR Press Limited. All rights
reserved.

<73>
Accession Number
2017900073
Title
Antifibrinolytic Drugs for the Prevention of Bleeding in Pediatric Cardiac
Surgery on Cardiopulmonary Bypass: A Systematic Review and Meta-analysis.
Source
Anesthesia and Analgesia. 134(5) (pp 987-1001), 2022. Date of Publication:
01 May 2022.
Author
Siemens K.; Sangaran D.P.; Hunt B.J.; Murdoch I.A.; Tibby S.M.
Institution
(Siemens, Sangaran, Murdoch, Tibby) Pediatric Intensive Care Evelina
London Children's Hospital St Thomas' Hos ital London, United Kingdom
(Hunt) Department of Hematology, St Thomas' Hospital, London, United
Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Bleeding is one of the commonest complications affecting
children undergoing cardiac surgery on cardiopulmonary bypass.
Antifibrinolytic drugs are part of a multifaceted approach aimed at
reducing bleeding, though sufficiently sized pediatric studies are sparse,
and dosing algorithms are heterogeneous. Our objective was to evaluate the
efficacy and safety of antifibrinolytic agents as well as the
effectiveness of different dosing regimens in pediatric cardiac surgery
using cardiopulmonary bypass. METHOD(S): We performed a systematic
review and meta-analysis evaluating randomized controlled trials published
between 1980 and 2019, identified by searching the databases MEDLINE,
EMBASE, PubMed, and CENTRAL. All studies investigating patients <18 years
of age without underlying hematological disorders were included. The
primary outcome was postoperative bleeding; secondary end points included
blood product transfusion, mortality, and safety (thromboses, anaphylaxis,
renal or neurological dysfunction, and seizures). Different dosing
regimens were compared. Studies were dual appraised, outcomes were
reported descriptively and, if appropriate, quantitatively using the
Review Manager 5 (REVMAN 5) software (The Cochrane Collaboration).
 RESULT(S): Thirty of 209 articles were included, evaluating the
following drugs versus control: aprotinin n = 14, tranexamic acid (TXA) n
= 12, and epsilon-aminocaproic acid (EACA) n = 4. The number of
participants per intervention group ranged from 11 to 100 (median, 25;
interquartile range [IQR], 20.5) with a wide age span (mean, 13 days to
5.8 years) and weight range (mean, 3.1-26.3 kg). Methodological quality
was low to moderate. All agents reduced mean 24-hour blood loss compared
to control: aprotinin by 6.0 mL/kg (95% confidence interval [CI], -9.1 to
-3.0; P = .0001), TXA by 9.0 mL/kg (95% CI, -11.3 to -6.8; P < .00001),
and EACA by 10.5 mL/kg (95% CI, -21.1 to 0.0; P = .05). Heterogeneity was
low for TXA (I2 = 29%; P = .19), moderate for aprotinin
(I2 = 41%; P = .11), and high for EACA (I2 = 95%; P
< .00001). All agents also reduced 24-hour blood product transfusion.
There was no clear dose-response effect for TXA nor aprotinin. Studies
were underpowered to detect significant differences in mortality,
thromboses, anaphylaxis, and renal or neurological dysfunction.
 CONCLUSION(S): The available data demonstrate efficacy for all 3
antifibrinolytic drugs. Therefore, the agent with the most favorable
safety profile should be used. As sufficient data are lacking, large
comparative trials are warranted to assess the relative safety and
appropriate dosing regimens in pediatrics. Copyright © 2021
International Anesthesia Research Society

<74>
Accession Number
2017900071
Title
Control of Postoperative Hypotension Using a Closed-Loop System for
Norepinephrine Infusion in Patients after Cardiac Surgery: A Randomized
Trial.
Source
Anesthesia and Analgesia. 134(5) (pp 964-973), 2022. Date of Publication:
01 May 2022.
Author
Desebbe O.; Rinehart J.; Van der Linden P.; Cannesson M.; Delannoy B.;
Vigneron M.; Curtil A.; Hautin E.; Vincent J.-L.; Duranteau J.; Joosten A.
Institution
(Delannoy, Hautin) Department of Anesthesiology and Perioperative Care,
Ramsay Sante, Sauvegarde Clinic, Lyon, France
(Rinehart) Department of Anesthesiology and Perioperative Care, University
of California, Irvine, Irvine, CA, United States
(Van der Linden) Department of Anesthesiology, Brugmann Hospital,
Universite Libre de Bruxelles, Brussels, Belgium
(Cannesson) Department of Anesthesiology and Perioperative Medicine David
Geffen School of Medicine University of California, Los Angeles, Los
Angeles, CA, United States
(Vigneron, Curtil) Department of Cardiac Surgery, Ramsay Sante, Sauvegarde
Clinic, Lyon, France
(Vincent) Department of Intensive Care, Erasme University Hospital,
Universite Libre de Bruxelles, Brussels, Belgium
(Duranteau, Joosten) Department of Anesthesiology, Intensive Care,
Hopitaux Universitaires Paris-Sud, Universite Paris-Sud, Universite
Paris-Saclay, Bicetre and Paul Brousse Hospitals, Assistance Publique
Hopitaux de Paris, Villejuif, France
(Desebbe, Joosten) Department of Anesthesiology, Erasme University
Hospital, Brussels, Belgium
(Joosten) Department of Anesthesiology and Perioperative Medicine, Bicetre
Hospital, 78, Rue du General Leclerc, Le Kremlin-Bicetre 94270, France
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Vasopressors are a cornerstone for the management of
vasodilatory hypotension. Vasopressor infusions are currently adjusted
manually to achieve a predefined arterial pressure target. We have
developed a closed-loop vasopressor (CLV) controller to help correct
hypotension more efficiently during the perioperative period. We tested
the hypothesis that patients managed using such a system postcardiac
surgery would present less hypotension compared to patients receiving
standard management. METHOD(S): A total of 40 patients admitted to
the intensive care unit (ICU) after cardiac surgery were randomized into 2
groups for a 2-hour study period. In all patients, the objective was to
maintain mean arterial pressure (MAP) between 65 and 75 mm Hg using
norepinephrine. In the CLV group, the norepinephrine infusion was
controlled via the CLV system; in the control group, it was adjusted
manually by the ICU nurse. Fluid administration was standardized in both
groups using an assisted fluid management system linked to an advanced
hemodynamic monitoring system. The primary outcome was the percentage of
time patients were hypotensive, defined as MAP <65 mm Hg, during the study
period. RESULT(S): Over the 2-hour study period, the percentage of
time with hypotension was significantly lower in the CLV group than that
in the control group (1.4% [0.9-2.3] vs 12.5% [9.9-24.3]; location
difference, -9.8% [95% CI, -5.4 to -15.9]; P < .001). The percentage of
time with MAP between 65 and 75 mm Hg was also greater in the CLV group
(95% [89-96] vs 66% [59-77]; location difference, 27.6% [95% CI,
34.3-19.0]; P < .001). The percentage of time with an MAP >75 mm Hg (and
norepinephrine still being infused) was also significantly lower in
patients in the CLV group than that in the control group (3.2% [1.9-5.4]
vs 20.6% [8.9-32.5]; location difference, -17% [95% CI, -10 to -24]; P <
.001). The number of norepinephrine infusion rate modifications over the
study period was greater in the CLV group than that in the control group
(581 [548-597] vs 13 [11-14]; location difference, 568 [578-538]; P <
.001). No adverse event occurred during the study period in both groups.
 CONCLUSION(S): Closed-loop control of norepinephrine infusion
significantly decreases postoperative hypotension compared to manual
control in patients admitted to the ICU after cardiac surgery. (Anesth
Analg 2022;134:964-73). Copyright © 2022 International Anesthesia
Research Society

<75>
Accession Number
2017847961
Title
Letter to the editor regarding left atrial appendage closure during
cardiac surgery for atrial fibrillation: A meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Prasad R.M.; Saleh Y.; Al-abcha A.
Institution
(Prasad, Al-abcha) Department of Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Saleh) Department of Cardiology, Houston Methodist DeBakey Heart &
Vascular Center, Houston, TX, United States
Publisher
Elsevier Inc.

<76>
Accession Number
2017779088
Title
Predictors of cognitive dysfunction after cardiac surgery: a systematic
review.
Source
European Journal of Cardiovascular Nursing. 21(3) (pp 192-204), 2022. Date
of Publication: 01 Mar 2022.
Author
Bowden T.; Hurt C.S.; Sanders J.; Aitken L.M.
Institution
(Bowden, Hurt, Aitken) School of Health Sciences, City University of
London, Northampton Square, London EC1V 0HB, United Kingdom
(Sanders) St Bartholomew's Hospital, Barts Health Nhs Trust, West
Smithfield, London EC1V 0HB, United Kingdom
(Sanders) William Harvey Research Institute, Barts and the London School
of Medicine and Dentistry, Queen Mary University London, Charterhouse
Square, London EC1M 6BQ, United Kingdom
(Aitken) School of Nursing and Midwifery, Griffith University, 170 Kessels
Road, Nathan, QLD QLD 4111, Australia
Publisher
Oxford University Press
Abstract
Aims: Postoperative cognitive dysfunction (POCD) is often experienced by
cardiac surgery patients; however, it is not known if some groups of
patients experience this more frequently or severely than others. The aim
of this systematic review was to identify preoperative and postoperative
predictors of cognitive dysfunction in adults following cardiac surgery.
 Methods and Results: Eight bibliographic databases were searched
(January 2005 to March 2021) in relation to cardiac surgery and cognition.
Studies including adult patients who had undergone open cardiac surgery
and using a validated measurement of cognitive function were included.
Full-text review for inclusion, quality assessment, and data extraction
were undertaken independently by two authors. A total of 2870 papers were
identified, of which 36 papers met the inclusion criteria and were
included in the review. The majority were prospective observational
studies [n = 28 (75.7%)]. In total, 61 independent predictors (45
preoperative and 16 postoperative) were identified as significant in at
least one study; advancing age and education level appear important. Age
has emerged as the most common predictor of cognitive outcome.
 Conclusion(s): Although a number of predictors of POCD have been
identified, they have inconsistently been reported as significantly
affecting cognitive outcome. Consistent with previous research, our
findings indicate that older patients and those with lower educational
levels should be prioritized when developing and trialling interventions
to improve cognitive function. These findings are less than surprising if
we consider the methodological shortcomings of included studies. It is
evident that further high-quality research exploring predictors of POCD is
required. Registration: This review was registered on Prospero,
CRD42020167037 Copyright © 2021 The Author(s) 2021. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<77>
Accession Number
2017675184
Title
Potential role for pentoxifylline as an anti-inflammatory drug for
patients with acute coronary syndrome.
Source
Experimental and Therapeutic Medicine. 23(6) (no pagination), 2022.
Article Number: 378. Date of Publication: June 2022.
Author
Brie D.M.; Mornos C.; Brie D.A.; Luca C.T.; Petrescu L.; Boruga M.
Institution
(Brie, Mornos, Luca, Petrescu) Department of Interventional Cardiology,
Cardiovascular Disease Institute Timisoara, Timisoara 300310, Romania
(Mornos, Luca, Petrescu) Departments of Cardiology, 'Victor Babes'
University of Medicine and Pharmacy, Timisoara 300041, Romania
(Brie) Departments of Cellular Biology, 'Victor Babes' University of
Medicine and Pharmacy, Timisoara 300041, Romania
(Boruga) Faculty of Pharmacy, Department of Toxicology and Drug Industry,
'Victor Babes' University of Medicine and Pharmacy, Timisoara 300041,
Romania
Publisher
Spandidos Publications
Abstract
The link between inflammation and acute coronary syndrome (ACS) remains to
be sufficiently elucidated. It has been previously suggested that there is
an inflammatory process associated with ACS. Pentoxifylline, a
methylxanthine derivate, is known to delay the progression of
atherosclerosis and reduce the risk of vascular events, especially by
modu- lating the systemic inflammatory response. The present study is a
single-blind, randomized, prospective study of pentoxifyl- line 400 mg
three times a day (TID) added to standard therapy vs. standard therapy
plus placebo in ACS patients with non-ST elevation myocardial infarction
(NSTEMI). Patients with ACS were randomized to receive standard therapy
plus placebo in one arm (group A; aspirin, clopidogrel or ticagrelor,
statin) and in the other arm (group B) pentoxifylline 400 mg TID was added
to standard therapy. The primary outcome was the rate of major adverse
cardiovascular events (MACEs) at 1 year. A total of 500 patients underwent
randomization (with 250 assigned to group A and 250 to group B) and were
followed-up for a median of 20 months. The mean age of the patients was
62.3+/-10.3 years, 80.4% were male, 20.8% had diabetes, 49.4% had
hypertension, and 42% were currently smoking. The statistical analysis was
performed for 209 patients in group A and 210 patients in group B (after
dropouts due to study drug discontinuation). A primary endpoint occurred
in 12.38% (n=26) of patients in group B, as compared with 15.78% (n=33) of
those in group A [relative risk (RR), 0.78; 95% confidence interval (CI),
0.486-0.1.263; P=0.40], including cardiovas- cular death (RR, 0.93; 95%
CI, 0.48-1.80, P=0.84), non-fatal myocardial infarction (RR, 1.1; 95% CI,
0.39-3.39, P=0.78), stroke (RR, 0.99; 95% CI, 0.14-6.99, P=0.99) and
coronary revascularization (RR, 0.12; 95% CI, 0.015-0.985, P=0.048). Thus,
adding pentoxifylline to standard treatment in patients with ACS did not
improve MACE at 1 year but had some benefit on the need for coronary
revascularization. Copyright © 2022 Spandidos Publications. All
rights reserved.

<78>
Accession Number
2016329723
Title
Interleukin-6 Is an Early Plasma Marker of Severe Postoperative
Complications in Thoracic Surgery: Exploratory Results from a Substudy of
a Randomized Controlled Multicenter Trial.
Source
Anesthesia and Analgesia. 134(1) (pp 123-132), 2022. Date of Publication:
01 Jan 2022.
Author
Neff T.A.; Braun J.; Rana D.; Puhan M.; Filipovic M.; Seeberger M.; Stuber
F.; Neff S.B.; Beck-Schimmer B.; Schlapfer M.
Institution
(Neff, Neff) Department of Anesthesiology, Cantonal Hospital
Muensterlingen, Switzerland
(Braun, Puhan) Epidemiology, Biostatistics and Prevention Institute,
University of Zurich, Zurich, Switzerland
(Rana, Beck-Schimmer, Schlapfer) Institute of Anesthesiology, University
Hospital Zurich, Zurich, Switzerland
(Filipovic) Department of Anesthesiology, Cantonal Hospital St. Gallen,
St. Gallen, Switzerland
(Seeberger) Department of Anesthesiology, University Hospital Basel,
Basel, Switzerland
(Stuber) Department of Anesthesiology, University Hospital Bern, Bern,
Switzerland
(Beck-Schimmer, Schlapfer) Institute of Physiology, University Zurich,
Zurich, Switzerland
(Beck-Schimmer) Department of Anesthesiology, University of Illinois at
Chicago, Chicago, IL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Postoperative complications in surgery are a significant
burden, not only for the patients but also economically. While several
predicting factors have already been identified, it is still not well
known if increased levels of inflammatory markers in the immediate
perioperative phase correlate with a higher incidence of postoperative
complications. This study aimed to evaluate which patient characteristics
and intraoperative parameters correlate with increased plasma values of
monocyte chemoattractant protein 1 (MCP-1) and interleukin 6 (IL-6) of
thoracic surgery patients. A second goal was to explore whether MCP-1 and
IL-6 are associated with the incidence of postoperative complications. We
hypothesized that there is a positive association between inflammatory
markers and the occurrence of complications within 6 months after surgery.
 METHOD(S): This is a substudy of a recent randomized controlled
trial, which defined the effect of desflurane versus propofol anesthesia
on morbidity and mortality in patients undergoing thoracic surgery. MCP-1
and IL-6 were determined in plasma obtained before and 30 minutes after
1-lung ventilation, 6 hours after surgery, and on postoperative days 1 and
2. Complications were recorded for 6 months. Mixed linear models were used
to examine factors associated with MCP-1 and IL-6 levels. Logistic
regression models and receiver operating characteristic curves were used
to determine the association between MCP-1 and IL-6 and postoperative
complications. RESULT(S): In the original study, 460 patients were
included, MCP-1 and IL-6 levels were determined in 428 patients. MCP-1 was
positively associated with the duration of surgery (P =.016), whereas IL-6
levels increased with both the length (P <.001) and invasiveness of lung
surgery (thoracoscopic wedge resection or lobectomy versus open lobectomy,
P =.005; thoracoscopic wedge resection or lobectomy versus pneumonectomy,
P =.021). In an exploratory approach, elevated IL-6 plasma peaks were
associated with the occurrence of severe complications defined as
Clavien-Dindo score grade >=IVa during the postoperative phase up to 6
months after thoracic surgery (P =.006). CONCLUSION(S): In summary,
this substudy reveals factors, which correlate with high MCP-1 and IL-6
values. Moreover, higher IL-6 seems to be associated with postoperative
severe complications. Perioperative IL-6 monitoring might be helpful for
risk estimation in the perioperative setting of patients after lung
surgery. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<79>
Accession Number
2016000261
Title
Association between frailty and clinical outcomes in surgical patients
admitted to intensive care units: a systematic review and meta-analysis.
Source
British Journal of Anaesthesia. 128(2) (pp 258-271), 2022. Date of
Publication: February 2022.
Author
Chan R.; Ueno R.; Afroz A.; Billah B.; Tiruvoipati R.; Subramaniam A.
Institution
(Chan, Tiruvoipati, Subramaniam) Department of Intensive Care, Frankston
Hospital, Peninsula Health, Frankston, VIC, Australia
(Ueno) Department of Intensive Care, Eastern Health, Box Hill, VIC,
Australia
(Afroz, Billah) Department of Epidemiology and Preventive Medicine, School
of Public Health and Preventive Medicine, Monash University, Melbourne,
VIC, Australia
(Tiruvoipati, Subramaniam) Faculty of Medicine, Nursing and Health
Sciences, Monash University, Clayton, VIC, Australia
(Chan) Department of Anaesthesia and Pain Management, The Canberra
Hospital, ACT, Australia
(Ueno) Australian and New Zealand Intensive Care Research Centre, School
of Public Health and Preventive Medicine, Monash University, VIC,
Australia
(Tiruvoipati, Subramaniam) Monash University Peninsula Clinical School,
VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: Preoperative frailty may be a strong predictor of adverse
postoperative outcomes. We investigated the association between frailty
and clinical outcomes in surgical patients admitted to the ICU.
 Method(s): PubMed, Embase, and Ovid MEDLINE were searched for
relevant articles. We included full-text original English articles that
used any frailty measure, reporting results of surgical adult patients
(>=18 yr old) admitted to ICUs with mortality as the main outcome. Data on
mortality, duration of mechanical ventilation, ICU and hospital length of
stay, and discharge destination were extracted. The quality of included
studies and risk of bias were assessed using the Newcastle Ottawa Scale.
Data were synthesised according to the Preferred Reporting Items for
Systematic Reviews and Meta-Analysis guidelines. Result(s): Thirteen
observational studies met inclusion criteria. In total, 58 757 patients
were included; 22 793 (39.4%) were frail. Frailty was associated with an
increased risk of short-term (risk ratio [RR]=2.66; 95% confidence
interval [CI]: 1.99-3.56) and long-term mortality (RR=2.66; 95% CI:
1.32-5.37). Frail patients had longer ICU length of stay (mean difference
[MD]=1.5 days; 95% CI: 0.8-2.2) and hospital length of stay (MD=3.9 days;
95% CI: 1.4-6.5). Duration of mechanical ventilation was longer in frail
patients (MD=22 h; 95% CI: 1.7-42.3) and they were more likely to be
discharged to a healthcare facility (RR=2.34; 95% CI: 1.36-4.01).
 Conclusion(s): Patients with frailty requiring postoperative ICU
admission for elective and non-elective surgeries had increased risk of
mortality, lengthier admissions, and increased likelihood of non-home
discharge. Preoperative frailty assessments and risk stratification are
essential in patient and clinician planning, and critical care resource
utilisation. Clinical trial registration: PROSPERO
CRD42020210121. Copyright © 2021 British Journal of Anaesthesia

<80>
Accession Number
2015925337
Title
Updated Evaluation of Robotic- and Video-Assisted Thoracoscopic Lobectomy
or Segmentectomy for Lung Cancer: A Systematic Review and Meta-Analysis.
Source
Frontiers in Oncology. 12 (no pagination), 2022. Article Number: 853530.
Date of Publication: 12 Apr 2022.
Author
Zhang J.; Feng Q.; Huang Y.; Ouyang L.; Luo F.
Institution
(Zhang, Luo) Regenerative Medicine Research Center, West China Hospital,
Sichuan University, Chengdu, China
(Feng) Department of Liver Surgery and Liver Transplantation Centre, West
China Hospital, Sichuan University, Chengdu, China
(Huang) Department of Anesthesiology, The Affiliated Hospital of Guizhou
Medical University, Guizhou, China
(Ouyang) Department of Thoracic Surgery, The 3rd Affiliated Hospital of
Chengdu Medical College, Pidu District People's Hospital, Chengdu, China
(Luo) Department of Respiratory and Critical Care Medicine, West China
Hospital, Sichuan University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Objectives: Robot-assisted thoracic surgery (RATS) and video-assisted
thoracic surgery (VATS) are the two principal minimally invasive surgical
approaches for patients with lung cancer. This study aimed at comparing
the long-term and short-term outcomes of RATS and VATS for lung cancer.
 Method(s): A comprehensive search for studies that compared RATS
versus VATS for lung cancer published until November 31, 2021, was
conducted. Data on perioperative outcomes and oncologic outcomes were
subjected to meta-analysis. PubMed, Web of Science, and EMBASE were
searched based on a defined search strategy to identify eligible studies
before November 2021. Result(s): Twenty-six studies comparing 45,733
patients (14,271 and 31,462 patients who underwent RATS and VATS,
respectively) were included. The present meta-analysis showed that there
were no significant differences in operative time, any complications,
tumor size, chest drain duration, R0 resection rate, lymph station, 5-year
overall survival, and recurrence rate. However, compared with the VATS
group, the RATS group had less blood loss, a lower conversion rate to
open, a shorter length of hospital stay, more lymph node dissection, and
better 5-year disease-free survival. Conclusion(s): RATS is a safe
and feasible alternative to VATS for patients with lung
cancer. Copyright © 2022 Zhang, Feng, Huang, Ouyang and Luo.

<81>
Accession Number
2014077915
Title
Safety of direct oral anticoagulants in solid organ transplant recipients:
A meta-analysis.
Source
Clinical Transplantation. 36(3) (no pagination), 2022. Article Number:
e14513. Date of Publication: March 2022.
Author
Zakko J.; Ganapathi A.M.; Whitson B.A.; Mokadam N.A.; Henn M.C.; Lampert
B.; Kahwash R.; Franco V.; Haas G.; Emani S.; Hasan A.; Vallakati A.
Institution
(Zakko) Department of Surgery, The Ohio State University Wexner Medical
Center, Columbus, OH, United States
(Ganapathi, Whitson, Mokadam, Henn) Department of Surgery, Division of
Cardiac Surgery, The Ohio State University Wexner Medical Center,
Columbus, OH, United States
(Lampert, Kahwash, Franco, Haas, Emani, Hasan, Vallakati) Department of
Internal Medicine, Division of Cardiology, The Ohio State University
Wexner Medical Center, Columbus, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
There is limited evidence comparing direct oral anticoagulants (DOACs) and
warfarin in solid organ transplant (SOT) recipients. We performed a pooled
analysis to study the safety and efficacy of DOACs in this patient
population. We searched PubMed, Embase, and Scopus databases using the
search terms "heart transplant" or "lung transplant" or "liver transplant"
or "kidney transplant" or "pancreas transplant" and "direct oral
anticoagulant" for literature search. Random effects model with
Mantel-Haenszel method was used to pool the outcomes. Pooled analysis
included 489 patients, of which 259 patients received DOACs and 230
patients received warfarin. When compared to warfarin, the use of DOACs
was associated with decreased risk of composite bleed (RR.49, 95%
CI.32-.76, p =.002). There were no differences in rates of major bleeding
(RR.55, 95% CI.20-1.49, p =.24) or venous thromboembolism (RR.65, 95%
CI.25-1.70, p =.38) between the two groups. Evidence from pooled analysis
suggests that DOACs are comparable to warfarin in terms of safety in SOT
recipients. Further research is warranted to conclusively determine
whether DOACs are safe alternatives to warfarin for anticoagulation in SOT
recipients. Copyright © 2021 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<82>
Accession Number
2015586194
Title
Effect of listening to music on anxiety, pain, and cardiorespiratory
parameters in cardiac surgery: study protocol for a randomized clinical
trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 278. Date of
Publication: December 2022.
Author
de Andrade E.V.; Haas V.J.; de Faria M.F.; dos Santos Felix M.M.; Ferreira
M.B.G.; Barichello E.; da Silva Pires P.; Barbosa M.H.
Institution
(de Andrade, Haas, de Faria, dos Santos Felix, Ferreira) Stricto sensu
Graduate Program in Health Care, Federal University of Triangulo Mineiro,
Av. Getulio Guarita, 107, Minas Gerais, Uberaba CEP: 38025-440, Brazil
(Barichello, Barbosa) Didactic-Scientific Department of Nursing in
Hospital Care, Institute of Health Sciences, Federal University of
Triangulo Mineiro, Av. Getulio Guarita, 107, Minas Gerais, Uberaba CEP:
38025-440, Brazil
(da Silva Pires) Multidisciplinary Health Institute, Federal University of
Bahia, Rua Hormindo Barros, 58, Quadra 17, Lote 58, Bahia, Vitoria da
Conquista CEP: 45.029-094, Brazil
Publisher
BioMed Central Ltd
Abstract
Background: Preoperative anxiety and postoperative pain are frequent in
cardiac surgeries and constitute important stressors for patients, which
can cause several complications. One strategy that aims to alleviate these
phenomena is listening to music as a non-pharmacological intervention. The
aim of this study is to evaluate the effect of listening to music on
preoperative state-anxiety, postoperative pain, at rest and when
instructed to cough, and cardiorespiratory parameters in patients
undergoing cardiac surgery. Method(s): A randomized, parallel, simple
masking clinical trial will be conducted with patients 18 years of age or
older who have undergone elective cardiac surgery by sternotomy, who agree
to participate in the research and sign a free and informed consent form.
Study participants will be randomly divided, in a 1:1 ratio, to one of the
two groups: experimental (subjected to listening to music for 20 min in
the pre- and postoperative period) or control (standard care in the pre-
and postoperative period), using a randomization scheme generated by the
Randomization.com website. The sample size calculation was obtained after
conducting a pilot study. Discussion(s): The results of the study may
contribute to the implementation of non-pharmacological interventions in
health services, highlighting the protocols for listening to music, to
minimize anxiety and pain in cardiac surgery. Trial registration: ReBEC
RBR-8mdyhd. Posted on December 10, 2019 Copyright © 2022, The
Author(s).

<83>
Accession Number
2017063403
Title
The effectiveness and safety of pulmonary autograft as living tissue in
Ross procedure: A systematic review.
Source
Translational Pediatrics. 11(2) (pp 280-297), 2022. Date of Publication:
February 2022.
Author
Nappi F.; Iervolino A.; Singh S.S.A.
Institution
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord,
Saint-Denis 93200, France
(Iervolino) Department of Internal Medicine, Federico II University,
Naples, Italy
(Singh) Department of Cardiothoracic Surgery, Golden Jubilee National
Hospital, Glasgow, United Kingdom
Publisher
AME Publishing Company
Abstract
Background: Reports on effectiveness and safety after the implant of
pulmonary autograft (PA) living tissue in Ross procedure, to treat both
congenital and acquired disease of the aortic valve and left ventricular
outflow tract (LVOT), show variable durability results. We undertake a
quantitative systematic review of evidence on outcome after the Ross
procedure with the aim to improve insight into outcome and potential
determinants. Method(s): A systematic search of reports published
from October 1979 to January 2021 was conducted (PubMed, Ovid Medline,
Ovid Embase and Cochrane library) reporting outcomes after the Ross
procedure in patients with diseased aortic valve with or without LVOT.
Inclusion criteria were observational studies reporting on mortality
and/or morbidity after autograft aortic valve or root replacement,
completeness of follow-up >90%, and study size n>=30. Forty articles
meeting the inclusion criteria were allocated to two categories: Pediatric
patient series and young adult patient series. Results were tabulated for
a clearer presentation. Result(s): A total of 342 studies were
evaluated of which forty studies were included in the final analysis as
per the eligibility criteria. A total of 8,468 patients were included
(7,796 in pediatric cohort and young adult series and 672 in pediatric
series). Late mortality rates were remarkably low alongside similar
age-matched mortality with the general population in young adults. There
were differences in implantation techniques as regard the variability in
stress and the somatic growth that recorded conflicting outcomes regarding
the miniroot vs the subcoronary approach. Discussion(s): The
adaptability of lung autograft to allow for both stress variability and
somatic growth make it an ideal conduit for Ross's operation. The use of
the miniroot technique over subcoronary implantation for better
adaptability to withstand varying degrees of stress is perhaps more
applicable to different patient subgroups. Copyright © 2022 AME
Publishing Company. All rights reserved.

<84>
Accession Number
2016531957
Title
Myocardial Protecting Role of Glutamine in Patients with Low Ejection
Fraction Undergoing Elective On-Pump Coronary Artery Bypass Graft Surgery.
Source
Vascular Health and Risk Management. 18 (pp 219-231), 2022. Date of
Publication: 2022.
Author
Parmana I.M.A.; Boom C.E.; Rachmadi L.; Hanafy D.A.; Widyastuti Y.;
Mansyur M.; Siswanto B.B.
Institution
(Parmana, Boom) Department of Anesthesiology and Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Rachmadi) Department of Anatomical Pathology, Faculty of Medicine,
Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
(Hanafy) Department of Cardiothoracic and Vascular Surgery, Faculty of
Medicine, Universitas Indonesia, National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
(Widyastuti) Department of Anesthesiology and Intensive Care, Universitas
Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
(Mansyur) Department of Community Medicine, Faculty of Medicine,
Universitas Indonesia, Jakarta, Indonesia
(Siswanto) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Indonesia, National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Myocardial injury due to on-pump coronary artery bypass grafting
(CABG) in patients with low ejection fraction (EF) is associated with poor
outcomes. This study determines whether intravenous glutamine could
protect the myocardium during on-pump CABG in patients with low EF.
 Material(s) and Method(s): This was a double-blind, randomized
controlled trial to assess glutamine as a myocardial protector during
on-pump CABG in patients with left ventricle EF of 31-50%, conducted from
January to October 2021. Patients in the glutamine group (n = 30) received
0.5 g/kg of 20% glutamine solution diluted with 0.9% NaCl up to 500 mL in
total volume over a period of 24 hours. Patients in the control group (n =
30) received 0.9% NaCl over the same period. The primary outcomes were
plasma troponin I and plasma glutamine levels. Secondary outcomes included
alpha-ketoglutarate (alpha-KG) levels and histopathology scoring of the
right atrial appendage tissue, plasma lactate levels, hemodynamic
measurement, and morbidity. Result(s): Twenty-nine patients from each
group (58 in total) were included in the analysis. Plasma troponin I
levels at 6 and 24 hours after cardiopulmonary bypass (CPB) were
significantly lower in the glutamine than the control group (mean 3.43 +/-
1.51 ng/mL vs mean 4.41 +/- 1.89 ng/mL; p = 0.034; median 3.08 ng/mL
[min-max: 1.30-6.59] vs median 3.77 ng/mL [min-max: 0.00-36.53]; p =
0.038, respectively). Plasma glutamine levels at 24 hours after CPB were
significantly higher in the glutamine than the control group (mean 935.42
+/- 319.10 mumol/L vs mean 634.79 +/- 243.89 mumol/L, p = 0.001). Plasma
lactate levels at 6 and 24 hours after CPB were significantly lower in the
glutamine than the control group (median 5.30 mmol/L [min-max: 1.20-9.50]
vs median 5.70 mmol/L [min-max: 2.80-11.30], p = 0.042; mean 2.08 +/- 0.67
mmol/L vs mean 2.46 +/- 0.69 mmol/L, p = 0.044, respectively). Myocardial
injury score was significantly lower in the glutamine than the control
group (mean 1.30 +/- 0.24 vs mean 1.48 +/- 0.26, p = 0.011).
 Conclusion(s): Perioperative administration of 0.5 g/kg intravenous
glutamine solution over the period of 24 hours has myocardial protection
effect in patients with low EF who undergo elective on-pump
CABG. Copyright © 2022 Parmana et al.

<85>
Accession Number
2016544904
Title
The effect of vitamin D therapy in the improvement of cardiac performance
and exercise capacity in patients with heart failure: A double-blind,
randomized, placebo-controlled trial.
Source
ARYA Atherosclerosis. 17(1) (no pagination), 2021. Article Number: 2135.
Date of Publication: January and February 2021.
Author
Garakyaraghi M.; Siavash M.; Kerdegari M.
Institution
(Garakyaraghi) Herat Failure Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Siavash) Isfahan Endocrine and Metabolism Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Kerdegari) Cardiac Rehabilitation Research Center, Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
Publisher
Isfahan University of Medical Sciences(IUMS)
Abstract
BACKGROUND: Low vitamin D status may contribute to the pathogenesis of
heart failure (HF), but therapeutic roles of vitamin D on cardiac
performance are not well known. We evaluated vitamin D effects on left
ventricular ejection fraction (LVEF) and New York Heart Association (NYHA)
functional class in patients with HF for the first time. METHOD(S):
This study was a double-blind, randomized, placebo-controlled trial. 110
patients with HF admitted to Shahid Chamran and Khorshid Hospitals,
Isfahan, Iran, randomly received 500 mg calcium daily plus either 50000 IU
vitamin D3 per week (case group) or placebo (control group) for 6 months.
Biochemical variables, LVEF, and NYHA functional class were assessed at
baseline and after 6 months. RESULT(S): 81 patients completed the
study. Vitamin D supplementation increased mean serum 25-hydroxyvitamin D
[25(OH)D] concentration in the case group by 33.9 ng/ml (P < 0.001). After
6 months of treatment, both groups showed improvement in LVEF, but the
extent of improvement was significant only in the case group (5.48% versus
0.44%, P < 0.001). The NYHA functional class improved in the case group
but remained constant in the control group (P < 0.001).
 CONCLUSION(S): Vitamin D3 improved LVEF and NYHA functional class in
patients with HF and might serve as a new agent for the future treatment
of this disease. Copyright © 2021, Isfahan University of Medical
Sciences(IUMS). All rights reserved.

<86>
Accession Number
2016544630
Title
Evaluation of the Effect of Modafinil on Respiratory and Cerebral Outcomes
after Coronary Artery Bypass Graft Surgery.
Source
ARYA Atherosclerosis. 17(2) (no pagination), 2021. Date of Publication:
January and February 2021.
Author
Mansouri M.; Massoumi G.; Rezaei-Hoseinabadi M.K.
Institution
(Mansouri, Massoumi, Rezaei-Hoseinabadi) Research Center of Anesthesia and
Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
Publisher
Isfahan University of Medical Sciences(IUMS)
Abstract
BACKGROUND: Pulmonary complications following cardiopulmonary bypass (CPB)
pump during coronary artery bypass grafting (CABG) are relatively common
and the incidence of cognitive dysfunction is reported as ranging in rate
from 30% to 80% in the early postoperative period. The purpose of this
study was to assess the effect of modafinil administration on the
prevention of pulmonary and cerebral complications and shortening the
hospital stay after CABG surgery. METHOD(S): This randomized
double-blind intervention-controlled clinical trial was performed on 74
patients (37 in the intervention group and 37 in the control group)
undertaking CABG surgery. The intervention group was orally treated with
doses of 200 mg of modafinil on the day of surgery, and on the morning of
the day after surgery, the second dose of modafinil 200 mg was given to
patients. The control group underwent a placebo with the same intervals.
 RESULT(S): Administration of modafinil in intervention group
significantly decreased the time to reach consciousness (P = 0.001),
ventilator time in intensive care unit (ICU) (P < 0.001), length of stay
in ICU (P = 0.009), duration of hospitalization (P = 0.008), and arterial
blood carbon dioxide pressure (PaCO2) (P = 0.047). In the intervention
group, no patients with delirium, agitation, respiratory depression,
non-invasive respiratory ventilation, and endotracheal re-intubation were
observed. CONCLUSION(S): Modafinil tablet as a respiratory and brain
stimulant through the central nervous system (CNS) can improve the quality
of breathing and arterial blood gases (ABGs) and also can increase the
level of consciousness and shorten the recovery time. Copyright ©
2021, Isfahan University of Medical Sciences(IUMS). All rights reserved.

<87>
Accession Number
2013256909
Title
TEE image quality improvement with our devised probe cover.
Source
Echocardiography. 38(9) (pp 1496-1502), 2021. Date of Publication:
September 2021.
Author
Morita Y.; Kariya T.; El-Bashir J.; Galusca D.; Guruswamy J.; Tanaka K.
Institution
(Morita) Department of Anesthesiology, University of Maryland, Baltimore,
MD, United States
(Kariya) Department of Anesthesiology, University of Tokyo, Tokyo, Japan
(El-Bashir, Galusca, Guruswamy) Department of Anesthesiology, Henry Ford
Hospital, Detroit, MI, United States
(Tanaka) Department of Anesthesiology, Oklahoma University, Oklahoma, OK,
United States
Publisher
John Wiley and Sons Inc
Abstract
Objective(s): Our hypothesis was that our devised transesophageal
echocardiography probe cover with the capacity for pinpoint suction would
improve image quality. Design(s): Prospective cohort study.
 Setting(s): Single tertiary medical center. Participant(s):
Patients undergoing surgery requiring intraoperative transesophageal
echocardiography. Intervention(s): Suctioning with inserted
orogastric tube. Measurements and Main Results: Changes in image
quality with suctioning were assessed by 2 methods. In method #1,
investigators categorized the quality of all acquired images on a numeric
scale based on each investigator's impression (1: very poor, 2: poor, 3:
acceptable, 4: good, and 5: very good). In method #2, the reproducibility
of the left ventricular fraction area change (LV FAC) was assessed,
assuming that improved transgastric midpapillary short-axis view image
quality would yield better LV FAC reproducibility. With method #1, for
midesophageal views, 26.5%, 70.5%, and 3.0% of images showed improved, the
same, and worsened image quality, respectively. For transgastric views,
55.3%, 43.3%, and 1.4% showed improved, the same, and worsened image
quality, respectively. For deep transgastric views, 60.0%, 38.0%, and 2.0%
showed improved, the same, and worsened image quality, respectively. With
method #2, the presuction group had an ICC of 0.942 (95% CI: 0.91, 0.965).
The postsuction group had an ICC of 0.988 (95% CI: 0.981, 0.993).
 Conclusion(s): Our investigation validates the potential image
quality improvement withour devised TEE probe cover. However, its clinical
validity needs to be confirmed by further studies. Copyright ©
2021 Wiley Periodicals LLC

<88>
Accession Number
2014256223
Title
Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic
review and meta-analysis.
Source
eClinicalMedicine. 38 (no pagination), 2021. Article Number: 100997. Date
of Publication: August 2021.
Author
Khan S.U.; Lone A.N.; Khan M.S.; Virani S.S.; Blumenthal R.S.; Nasir K.;
Miller M.; Michos E.D.; Ballantyne C.M.; Boden W.E.; Bhatt D.L.
Institution
(Khan, Lone) Department of Medicine, West Virginia University, Morgantown,
WV, United States
(Khan) Department of Medicine, University of Mississippi Medical Center,
Jackson, MS, United States
(Virani, Ballantyne) Michael E. DeBakey Veterans Affair Medical Center &
Department of Medicine, Baylor College of Medicine, Houston, TX, United
States
(Blumenthal, Michos) Ciccarone Center for the Prevention of Cardiovascular
Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States
(Blumenthal, Michos) Division of Cardiology, Johns Hopkins School of
Medicine, Baltimore, MD, United States
(Nasir) Outcomes Research, Houston Methodist, Houston, TX, United States
(Nasir) Division of Cardiovascular Prevention and Wellness, Department of
Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston,
TX, United States
(Miller) Department of Medicine, Division of Cardiology, University of
Maryland Medical Center, Baltimore, MD, United States
(Boden) VA New England Healthcare System, Boston University School of
Medicine, Boston, MA, United States
(Bhatt) Brigham and Women's Hospital Heart and Vascular Center, Harvard
Medical School, 75 Francis Street, Boston, MA 02115, United States
Publisher
Elsevier Ltd
Abstract
Background: The effects of omega-3 fatty acids (FAs), such as
eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, on cardiovascular
outcomes are uncertain. We aimed to determine the effectiveness of omega-3
FAs on fatal and non-fatal cardiovascular outcomes and examine the
potential variability in EPA vs. EPA+DHA treatment effects.
 Method(s): We searched EMBASE, PubMed, ClinicalTrials.gov, and
Cochrane library databases through June 7, 2021. We performed a
meta-analysis of 38 randomized controlled trials of omega-3 FAs,
stratified by EPA monotherapy and EPA+DHA therapy. We estimated
random-effects rate ratios (RRs) with (95% confidence intervals) and rated
the certainty of evidence using GRADE. The key outcomes of interest were
cardiovascular mortality, non-fatal cardiovascular outcomes, bleeding, and
atrial fibrillation (AF). The protocol was registered in PROSPERO
(CRD42021227580). Finding(s): In 149,051 participants, omega-3 FA was
associated with reducing cardiovascular mortality (RR, 0.93 [0.88-0.98]; p
= 0.01), non-fatal myocardial infarction (MI) (RR, 0.87 [0.81-0.93]; p =
0.0001), coronary heart disease events (CHD) (RR, 0.91 [0.87-0.96]; p =
0.0002), major adverse cardiovascular events (MACE) (RR, 0.95 [0.92-0.98];
p = 0.002), and revascularization (RR, 0.91 [0.87-0.95]; p = 0.0001). The
meta-analysis showed higher RR reductions with EPA monotherapy (0.82
[0.68-0.99]) than with EPA + DHA (0.94 [0.89-0.99]) for cardiovascular
mortality, non-fatal MI (EPA: 0.72 [0.62-0.84]; EPA+DHA: 0.92
[0.85-1.00]), CHD events (EPA: 0.73 [0.62-0.85]; EPA+DHA: 0.94
[0.89-0.99]), as well for MACE and revascularization. Omega-3 FA increased
incident AF (RR, 1.26 [1.08-1.48]). EPA monotherapy vs. control was
associated with a higher risk of total bleeding (RR: 1.49 [1.20-1.84]) and
AF (RR, 1.35 [1.10-1.66]). Interpretation(s): Omega-3 FAs reduced
cardiovascular mortality and improved cardiovascular outcomes. The
cardiovascular risk reduction was more prominent with EPA monotherapy than
with EPA+DHA. Funding(s): None. Copyright © 2021 The
Author(s)

<89>
Accession Number
637719520
Title
Aggressive intraoperative warming versus routine thermal management during
non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority
trial.
Source
Lancet (London, England). 399(10337) (pp 1799-1808), 2022. Date of
Publication: 07 May 2022.
Author
Sessler D.I.; Pei L.; Li K.; Cui S.; Chan M.T.V.; Huang Y.; Wu J.; He X.;
Bajracharya G.R.; Rivas E.; Lam C.K.M.
Institution
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, USA; Population Health Research
Institute, McMaster University, ON, Canada. Electronic address: DS@OR.org
(Pei) Department of Anesthesiology, Peking Union Medical College Hospital,
Beijing, China
(Li, Cui) China-Japan Union Hospital of Jilin University, Jilin, China
(Chan) Chinese University of Hong Kong, Hong Kong Special Administrative
Region, China
(Huang) Department of Anesthesiology, Peking Union Medical College
Hospital, Beijing, China
(Wu) Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai,
China
(He) West China Hospital, Sichuan University, Sichuan, China
(Bajracharya) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, USA
(Rivas) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, USA; Department of Anesthesia, Hospital
Clinic of Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
(Lam) Tuen Mun Hospital, Hong Kong Special Administrative Region, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Moderate intraoperative hypothermia promotes myocardial
injury, surgical site infections, and blood loss. Whether aggressive
warming to a truly normothermic temperature near 37degreeC improves
outcomes remains unknown. We aimed to test the hypothesis that aggressive
intraoperative warming reduces major perioperative complications.
 METHOD(S): In this multicentre, parallel group, superiority trial,
patients at 12 sites in China and at the Cleveland Clinic in the USA were
randomly assigned (1:1) to receive either aggressive warming to a target
core temperature of 37degreeC (aggressively warmed group) or routine
thermal management to a target of 35.5degreeC (routine thermal management
group) during non-cardiac surgery. Randomisation was stratified by site,
with computer-generated, randomly sized blocks. Eligible patients (aged
>=45 years) had at least one cardiovascular risk factor, were scheduled
for inpatient non-cardiac surgery expected to last 2-6 h with general
anaesthesia, and were expected to have at least half of the anterior skin
surface available for warming. Patients requiring dialysis and those with
a body-mass index exceeding 30 kg/m2 were excluded. The primary outcome
was a composite of myocardial injury (troponin elevation, apparently of
ischaemic origin), non-fatal cardiac arrest, and all-cause mortality
within 30 days of surgery, as assessed in the modified intention-to-treat
population. This study is registered with ClinicalTrials.gov, NCT03111875.
FINDINGS: Between March 27, 2017, and March 16, 2021, 5056 participants
were enrolled, of whom 5013 were included in the intention-to-treat
population (2507 in the aggressively warmed group and 2506 in the routine
thermal management group). Patients assigned to aggressive warming had a
mean final intraoperative core temperature of 37.1degreeC (SD 0.3) whereas
the routine thermal management group averaged 35.6degreeC (SD 0.3). At
least one of the primary outcome components (myocardial injury after
non-cardiac surgery, cardiac arrest, or mortality) occurred in 246 (9.9%)
of 2497 patients in the aggressively warmed group and in 239 (9.6%) of
2490 patients in the routine thermal management group. The common effect
relative risk of aggressive versus routine thermal management was an
estimated 1.04 (95% CI 0.87-1.24, p=0.69). There were 39 adverse events in
patients assigned to aggressive warming (17 of which were serious) and 54
in those assigned to routine thermal management (30 of which were
serious). One serious adverse event, in an aggressively warmed patient,
was deemed to be possibly related to thermal management. INTERPRETATION:
The incidence of a 30-day composite of major cardiovascular outcomes did
not differ significantly in patients randomised to 35.5degreeC and to
37degreeC. At least over a 1.5degreeC range from very mild hypothermia to
full normothermia, there was no evidence that any substantive outcome
varied. Keeping core temperature at least 35.5degreeC in surgical patients
appears sufficient. FUNDING: 3M and the Health and Medical Research Fund,
Food and Health Bureau, Hong Kong. TRANSLATION: For the Chinese
translation of the abstract see Supplementary Materials
section. Copyright © 2022 Elsevier Ltd. All rights reserved.

<90>
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)

<91>
Accession Number
2015502851
Title
Intraarterial papaverine for relief of catheter-induced peripheral
arterial vasospasm during pediatric cardiac surgery: A randomized
double-blind controlled trial.
Source
Paediatric Anaesthesia. 32(6) (pp 764-771), 2022. Date of Publication:
June 2022.
Author
Gautam N.K.; Griffin E.; Hubbard R.; Pawelek O.; Edmonds K.; Rydalch E.;
Zhang X.; Sharma S.; Hoffmann C.
Institution
(Gautam, Griffin, Hubbard, Pawelek, Edmonds, Rydalch, Zhang, Hoffmann)
Department of Anesthesiology, McGovern Medical School, UT Health Houston,
Houston, TX, United States
(Sharma) Mayo Clinic, Scottsdale, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Maintaining the patency of peripheral arterial lines in
pediatric patients during surgery can be challenging due to multiple
factors, and catheter-related arterial vasospasm is a potentially
modifiable cause. Papaverine, a potent vasodilator, improves arterial line
patency when used as a continuous infusion in the pediatric intensive care
setting, but this method is not convenient during surgery. Aim(s):
Extrapolating from the benefit seen in the intensive care unit, the
authors hypothesize that a small-volume intraarterial bolus of papaverine
immediately after arterial line placement will reduce vasospasm-related
arterial line malfunction. Method(s): This was a prospective,
randomized, double-blind study. Patients less than 17 years of age
undergoing cardiac surgery were enrolled. Patients were randomized into
the heparin or papaverine groups. Immediately after arterial line
insertion, an intraarterial bolus of heparin (2 units/ml, 1 ml) or
papaverine (0.12 mg/ml, 1 ml) was administered (T1, Figure 1). An optimal
waveform was defined as the ease of aspirating a standardized blood sample
within 30 s, absence of cavitation when sampling, absence of color change
at the catheter site during injection, and presence of a dicrotic notch.
The primary outcome evaluated was the presence of an optimal arterial
waveform at 5 min after the first randomized dose (T1 + 5 min). The
secondary outcomes were the presence of optimal arterial waveform an hour
after the first dose and the ability of papaverine to rescue suboptimal
waveforms. Result(s): A total of 100 patients were enrolled in the
study. Twelve patients were excluded from the analysis. Complete datasets
after randomization were available in 88 patients (heparin group, n = 46;
papaverine group, n = 42). At baseline, groups were similar for age,
weight, arterial vessel size, and arterial line patency. At T1 + 5 min, an
improvement in the waveform characteristics was observed in the papaverine
group (heparin,39% [8/46] vs. papaverine, 64% [27/42]; p =.02; odds ratio,
2.8; 95% CI, 1.2 to 6.6, Figure 3, Table 2). At the end of 1 h, both
groups showed continued improvement in arterial line patency. After the
second dose, a higher number of patients in the heparin group had
suboptimal waveforms and were treated with papaverine (heparin,37% [17/46]
vs. papaverine,17% [7/42], p =.05). Patients in the heparin group treated
with papaverine showed significant improvement in patency (13/17 vs. 3/7,
p =.01). No serious adverse events were reported. Conclusion(s): In
pediatric patients, papaverine injection immediately after peripheral
arterial catheter placement was associated with relief of vasospasm and
improved initial arterial line patency. Further, papaverine can be used as
a rescue to improve and maintain arterial line patency. Copyright
© 2022 John Wiley & Sons Ltd.

<92>
Accession Number
637953635
Title
Coronary CT Angiography in Asymptomatic Patients with Transposition of the
Great Arteries After Arterial Switch Operation.
Source
Cardiology in the Young. Conference: 54th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology, AEPC 2021.
Online. 32(SUPPL 1) (pp S107-S108), 2022. Date of Publication: April 2022.
Author
Kis E.; Fontos M.; Czibere R.; Kozma I.; Vertesaljai M.; Ablonczy L.
Institution
(Kis, Fontos, Czibere, Kozma, Vertesaljai, Ablonczy) Gottsegen Gyorgy
Hungarian Institute of Cardiology, Budapest, Hungary
Publisher
Cambridge University Press
Abstract
Introduction: In patients with transposition of the great arteries (TGA)
after arterial switch operation (ASO) neoaortic dilatation, pulmonary
artery stenosis and coronary disorders are the most common complications.
The need for routine screening for anomalies of the orifice regions of the
reimplanted coronary arteries as the most dangerous long term complication
in patients after the ASO still remains debatable. The aim of our study
was to present the results of coronary computed tomography angiography
(CCTA) in asymptomatic patients with TGA after an ASO. Method(s): We
reviewed 21 CCTA scans performed after ASO randomly selected from
asymptomatic patients in Gottsegen Gyorgy Hungarian Institute of
Cardiology in 2020. Retrospective ECG gated CT acquisitions were performed
with a 256-slice CT scanner (Revolution GE Medical Systems, Milwaukee,
USA) with intravenous contrast enhancement. The analysis included
measurements of aortic and pulmonary diameters, multiplanar
reconstructions of the main coronary arteries, localization of the origin
of the coronary arteries in the neoaortic sinus. In order to normalize our
results base as per pediatric age and/or body size data were expressed as
Standard Deviation Score (SDS). Result(s): 10.2 (+ 3.5) years after
the ASO aortic annulus dilation averaged 2.7 SDS according to normal
aortic diameter and 1.5 SDS according to normal pulmonary annulus. Mean
left pulmonary artery (LPA) diameter was -1.9 (+/- 1.6) SDS, mean right
pulmonary artery (RPA) diameter was -1.8 (+1.7) SDS. 8/21 patients had
hypoplastic (- 2 SDS) LPA and 9/21 had hypoplastic RPA. Localization of
the origin of the coronary arteries in the neoaortic sinus (determined by
the angle between the connecting axis of the aortic and pulmonary valves
and the orifice of the coronary arteries) were LCA 38.6+10.5degree and
RCA64.5+10.2degree respectively. Potentially critical (<23degree) LCA
angulation was found in 5/21, while potentially critical LCA first
centimeter angle <23degree in 4/ 21 patients. Ellipticity-index (coronary
height-width ratio) was 1.3+0.1 in LCA and 1.2+0.1 in RCA.
 Conclusion(s): CCTA performed in asymptomatic patients with TGA after
ASO provides useful information for postoperative follow-up. The frequency
of coronary anomalies is high in this patient group. The role of
potentially dangerous anatomical features and their impact on late
complications should been evaluated with follow-up studies.

<93>
Accession Number
2018080721
Title
Surrogates of Patients With Severe Acute Brain Injury Experience
Persistent Anxiety and Depression Over the 6 Months After ICU Admission.
Source
Journal of Pain and Symptom Management. 63(6) (pp e633-e639), 2022. Date
of Publication: June 2022.
Author
Wendlandt B.; Olm-Shipman C.; Ceppe A.; Hough C.L.; White D.B.; Cox C.E.;
Carson S.S.
Institution
(Wendlandt, Ceppe, Carson) Division of Pulmonary Diseases and Critical
Care Medicine, University of North Carolina School of Medicine, Chapel
Hill, NC, United States
(Olm-Shipman) Division of Neurocritical Care, Departments of Neurology and
Neurosurgery, University of North Carolina School of Medicine, Chapel
Hill, NC, United States
(Cox) Division of Pulmonary and Critical Care, Department of Medicine,
Oregon Health and Science University, Portland, OR, United States
(Hough) Department of Critical Care Medicine, University of Pittsburgh
School of Medicine, Pittsburgh, PA, United States
(White) Division of Pulmonary, Allergy, and Critical Care Medicine,
Department of Medicine, Duke University, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Context: Severe Acute Brain Injury (SABI) is neurologically devastating,
and surrogates for these patients may struggle with particularly complex
decisions due to substantial prognostic uncertainty. Objective(s): To
compare anxiety and depression symptoms over time between SABI surrogates
and non-SABI surrogates for patients requiring prolonged mechanical
ventilation (PMV). Method(s): We conducted a secondary analysis of
the data from a multicenter randomized trial of a decision aid
intervention for surrogates of adults experiencing PMV. Eligible patients
were enrolled from medical, surgical, trauma, cardiac, and neurologic
intensive care units (ICUs). ICU admitting diagnoses were used to identify
patients experiencing SABI. We compared anxiety and depression symptoms as
measured by the Hospital Anxiety and Depression Scale score 6 months after
trial enrollment between surrogates of patients with SABI and surrogates
of patients experiencing PMV for other reasons. Result(s): Our
analysis included 206 patients, 60 (29%) with SABI and 146 (71%) without
SABI, and their primary surrogate decision makers. After adjusting for
potential confounders including surrogate demographics, surrogate
financial distress, patient severity of illness baseline GCS, and patient
health status at 6 months, we found that surrogates of patients
experiencing SABI had higher symptoms of anxiety and depression than
surrogates of non-SABI patients (adjusted mean difference 3.6, 95% CI
1.2-6.0). Conclusion(s): Surrogates of PMV patients with SABI
experience persistently elevated anxiety and depression symptoms over 6
months compared to surrogates of PMV patients without SABI. Further work
is needed to understand contributors to prolonged distress in this higher
risk population. Copyright © 2022 American Academy of Hospice and
Palliative Medicine

<94>
Accession Number
2018067656
Title
The effects of using a micro-infusion pump without accompanying fluid at a
low flow rate on patients undergoing cardiac surgery.
Source
Transplant Immunology. 73 (no pagination), 2022. Article Number: 101611.
Date of Publication: August 2022.
Author
Meng H.; Chen F.; He L.-H.; Wan J.-H.
Institution
(Meng) Department of Orthopaedics, The Second Hospital, Cheeloo college of
Medicine, Shandong University, Jinan 250033, China
(Chen, He, Wan) Department of Cardiovascular Surgery, The Second Hospital,
Cheeloo college of Medicine, Shandong University, Jinan 250033, China
Publisher
Elsevier B.V.
Abstract
Background: Since a micro-infusion pump continuously pumps drugs at a low
speed, it has the risk of complications including venous blood return,
indwelling needle blockage, and the lack of regular delivery of drugs.
This study aimed to investigate venous blood return and indwelling needle
blockage after cardiac surgery when a micro-infusion pump was used at a
very low flow rate of only 2 ml/h without any accompanying fluid.
 Method(s): A total of 215 patients, who were hospitalized at the
Second Hospital of Shandong University between May and December 2020,
received a continuous intravenous administration of drugs via a
micro-infusion pump at 2 ml/h without or with accompanying fluid. These
patients were randomly divided into an observation group (108 patients)
and a control group (107 patients). In the observation group, drugs were
administered at 2 ml/h without any additional fluid. In contrast, the
control group received drugs also at 2 ml/h but with a normal saline
through an intravenous drip. The venous backflow, blockage of the
indwelling needle and catheter, and other adverse reactions were evaluated
In addition, the volume of an accompanying fluid as well as the mean of
nursing work time and additional costs were calculated. Result(s):
The main finding of this analysis showed no statistically significant
differences in the number of complications such as venous backflow,
blockage of the indwelling needle or catheter, or any adverse reactions
between the observational and control groups (P > 0.05). Compared to the
control group, the observation group had significantly reduced the amount
of fluid intake (P< 0.001). In addition, the 2 ml/h infusion tempo without
any additional fluid shortened nursing hours (P < 0.001), and thus reduced
costs for the observation group vs. the control group. Conclusion(s):
It is feasible and safe to administer drugs via a micro-infusion pump at
the slow 2 ml/h tempo without any accompanying fluid to patients after
surgery requiring minimal volume of fluids. Copyright © 2022
Elsevier B.V.

<95>
Accession Number
2018058067
Title
Tricuspid valve repair concomitant with pulmonary valve replacement in
repaired Tetralogy of Fallot. When and how?.
Source
Cirugia Cardiovascular. (no pagination), 2022. Date of Publication: 2022.
Author
Rios L.; Bellot R.; Portela F.
Institution
(Rios, Bellot, Portela) Servicio de Cirugia Cardiaca Congenita, Hospital
Materno-Infantil y Hospital Dr. Negrin, Gran Canaria, Las Palmas de Gran
Canaria, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
According to the series, approximately 30% of corrected Fallot with
transannular patch surgery may have compromised tricuspid valve
functionality at the time of pulmonary valve replacement. This tricuspid
regurgitation is secondary to the progressive dilation of the right
ventricle, and there may be intrinsic causes of the initial corrective
surgery. At present it is clearly established that tricuspid regurgitation
darkens the prognosis of patients with left pathology and the trend is to
increasingly correct this valve in the interest of better survival and
functional class. In the case of patients corrected for Fallot at the time
of pulmonary valve replacement, there is not such clear evidence in this
regard. Various studies try to address the issue, all of them
retrospective, most with a small number of patients, with limited
statistical power and susceptible to errors and biases, reaching disparate
conclusions. Taking advantage of a typical clinical case, we will review
the studies carried out so far, trying to clarify some aspects in the
management of this type of patients. To repair or not to repair the
tricuspid? Copyright © 2022 Sociedad Espanola de Cirugia
Cardiovascular y Endovascular

<96>
Accession Number
2018016667
Title
Combined Programmed Intermittent Bolus Infusion with Continuous Infusion
For The Thoracic Paravertebral Block in Patients Undergoing Thoracoscopic
Surgery: A Prospective, Randomized, and Double-blinded Study.
Source
Clinical Journal of Pain. (no pagination), 2022. Date of Publication:
2022.
Author
Huang X.; Cui Y.; Xiao Y.; Zhao X.; Xu J.; Yang L.
Institution
(Huang, Cui, Xiao, Zhao, Xu, Yang) Department of Anesthesiology, The
Second Xiangya Hospital, Central South University, 139 Middle Renmin Road,
Hunan Province, Changsha, China
(Huang, Cui, Xiao, Xu, Yang) Hunan Province Center for Clinical Anesthesia
and Anesthesiology, Research Institute of Central South University, Hunan
Province, Changsha, China
(Zhao) Department of Anesthesiology, The First Affiliated Hospital, Sun
Yat-sen University, Guangdong Province, Guangzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Continuous thoracic paravertebral block (TPVB) connected with
a patient-controlled analgesia (PCA) pump is an effective modality to
reduce postoperative pain following thoracic surgery. For the PCA
settings, the programmed intermittent bolus infusion (PIBI) and continuous
infusion (CI) are commonly practiced. However, the comparative
effectiveness between the two approaches has been inconsistent. Thus, the
aim of this study was to explore the optimal PCA settings to treat
post-thoracotomy pain by combing PIBI and CI together. Method(s): All
enrolled patients undergoing thoracoscopic surgery accepted ultrasound
guided TPVB catheterization before the surgery, and then were randomly
allocated in to three groups depending on different settings of the PCA
pump connecting to the TPVB catheter: the PIBI+CI, PIBI, and CI groups.
the Numeric Rating Scales (NRS) were evaluated for each patient at T1 (one
hour after extubation), T2 (12h after the surgery), T3 (24h after the
surgery), T4 (36h after the surgery), and T5 (48h after the surgery).
Besides, the consumptions of patient-controlled analgesia (PCA)
ropivacaine, the number of blocked dermatomes at T3, and the requirement
for extra dezocine for pain relief among the three groups were also
compared. Result(s): Firstly, the NRS scores in the PIBI + CI group
were lower than the CI group at T2 and T3 (P<0.05) when patients were at
rest, and were also lower than the CI group at T2, T3, and T4 (P<0.01) and
the PIBI group at T3 when patients were coughing (P<0.01). Secondly, the
two-day cumulative dosage of PCA in the PIBI + CI group was lower than
both the CI and PIBI groups (P<0.01). Thirdly, the number of blocked
dermatomes in the PIBI and PIBI + CI groups were comparable, and were both
wider than the CI group at T3 (P<0.01). Finally, a smaller proportion (not
statistically significant) of patients in the PIBI + CI group (5.26%,
2/38) had required dezocine for pain relief when compared with the PIBI
group (19.44%, 7/36) and the CI group (15.79%, 6/38). Conclusion(s):
The combination of PIBI and CI provides superior analgesic modality to
either PIBI or CI alone in patients undergoing thoracoscopic surgery.
Therefore, it should be advocated to improve the management of
postoperative pain, clinical outcomes, and ultimately patient
satisfaction. Copyright © 2022 Lippincott Williams and Wilkins.
All rights reserved.

<97>
Accession Number
2017900097
Title
Comprehensive Quality-of-Life Outcomes With Invasive Versus Conservative
Management of Chronic Coronary Disease in ISCHEMIA.
Source
Circulation. 145(17) (pp 1294-1307), 2022. Date of Publication: 26 Apr
2022.
Author
Mark D.B.; Spertus J.A.; Bigelow R.; Anderson S.; Daniels M.R.; Anstrom
K.J.; Baloch K.N.; Cohen D.J.; Held C.; Goodman S.G.; Bangalore S.; Cyr
D.; Reynolds H.R.; Alexander K.P.; Rosenberg Y.; Stone G.W.; Maron D.J.;
Hochman J.S.
Institution
(Mark, Bigelow, Anderson, Daniels, Anstrom, Baloch, Cyr, Alexander) Duke
Clinical Research Institute, Duke University, Durham, NC, United States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, United States
(Cohen) Cardiovascular Research Foundation, New York, United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Held) Department of Medical Sciences, Cardiology, Uppsala Clinical
Research Center, Uppsala University, Sweden
(Goodman) St. Michael's Hospital, University of Toronto, Canadian Heart
Research Centre, ON, Canada
(Goodman) Canadian Vigour Centre, University of Alberta, Edmonton, Canada
(Bangalore, Reynolds, Hochman) Nyu Grossman School of Medicine, New York,
United States
(Rosenberg) National Heart, Lung, and Blood Institute, National Institutes
of Health, Bethesda, MD, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine, Mount Sinai, NY, United States
(Maron) Department of Medicine, Stanford University School of Medicine,
CA, United States
(Mark) 300 W Morgan St, Durham, NC 27701, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: ISCHEMIA (International Study of Comparative Health
Effectiveness with Medical and Invasive Approaches) compared an initial
invasive treatment strategy (INV) with an initial conservative strategy in
5179 participants with chronic coronary disease and moderate or severe
ischemia. The ISCHEMIA research program included a comprehensive
quality-of-life (QOL) substudy. Method(s): In 1819 participants (907
INV, 912 conservative strategy), we collected a battery of
disease-specific and generic QOL instruments by structured interviews at
baseline; at 3, 12, 24, and 36 months postrandomization; and at study
closeout. Assessments included angina-related QOL (19-item Seattle Angina
Questionnaire), generic health status (EQ-5D), depressive symptoms
(Patient Health Questionnaire-8), and, for North American patients,
cardiac functional status (Duke Activity Status Index). Result(s):
Median age was 67 years, 19.2% were female, and 15.9% were non-White. The
estimated mean difference for the 19-item Seattle Angina Questionnaire
Summary score favored INV (1.4 points [95% CI, 0.2-2.5] over all
follow-up). No differences were observed in patients with rare/absent
baseline angina (SAQ Angina Frequency score >80). Among patients with more
frequent angina at baseline (SAQ Angina Frequency score <80, 744 patients,
41%), those randomly assigned to INV had a mean 3.7-point higher 19-item
Seattle Angina Questionnaire Summary score than conservative strategy (95%
CI, 1.6-5.8) with consistent effects across SAQ subscales: Physical
Limitations 3.2 points (95% CI, 0.2-6.1), Angina Frequency 3.2 points (95%
CI, 1.2-5.1), Quality of Life/Health Perceptions 5.3 points (95% CI,
2.8-7.8). For the Duke Activity Status Index, no difference was estimated
overall by treatment, but in patients with baseline SAQ Angina Frequency
scores <80, Duke Activity Status Index scores were higher for INV (3.2
points [95% CI, 0.6-5.7]), whereas patients with rare/absent baseline
angina showed no treatment-related differences. Moderate to severe
depression was infrequent at randomization (11.5%-12.8%) and was
unaffected by treatment assignment. Conclusion(s): In the ISCHEMIA
comprehensive QOL substudy, patients with more frequent baseline angina
reported greater improvements in the symptom, physical functioning, and
psychological well-being dimensions of QOL when treated with an invasive
strategy, whereas patients who had rare/absent angina at baseline reported
no consistent treatment-related QOL differences. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT01471522. Copyright © 2022 Lippincott Williams and Wilkins.
All rights reserved.

<98>
Accession Number
2016638363
Title
Early Mobilization Prescription in Patients Undergoing Cardiac Surgery:
Systematic Review.
Source
Brazilian Journal of Cardiovascular Surgery. 37(2) (pp 227-238), 2022.
Date of Publication: 2022.
Author
Borges M.G.B.; Borges D.L.; Ribeiro M.O.; Lima L.S.S.; Macedo K.C.M.; Nina
V.J.D.S.
Institution
(Borges, Borges) Department of Physiotherapy, Hospital Universitario da
Universidade Federal do Maranhao (UFMA), Maranhao, Sao Luis, Brazil
(Borges, Nina) Postgraduate Program in Health Sciences, Universidade
Federal do Maranhao (UFMA), Maranhao, Sao Luis, Brazil
(Ribeiro) Faculty of Physiotherapy, Faculdade Pitagoras, Maranhao, Sao
Luis, Brazil
(Lima) Multiprofessional Residency Program, Hospital Universitario da
Universidade Federal do Maranhao (UFMA), Maranhao, Sao Luis, Brazil
(Macedo) Department of Physiotherapy, Faculdade Pitagoras, Maranhao, Sao
Luis, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Early mobilization of patients in the postoperative period
of cardiac surgery who are hospitalized in the intensive care unit (ICU)
is a practice that has a positive impact. Method(s): This is a
systematic review of studies published until September 2020 in the Medical
Literature Analysis and Retrieval System Online (or MEDLINE), Embase,
Physiotherapy Evidence Database (or PEDro), Scientific Electronic Library
Online (or SciELO), and Latin American and Caribbean Health Sciences
Literature (or LILACS) databases. Randomized clinical trials describing
mobilization protocols performed early in ICU patients after cardiac
surgery were included. Result(s): According to the eligibility
criteria, only 14 of the 1,128 articles found were included in the
analysis. Early mobilization protocols were initiated in the immediate
postoperative period or first postoperative day. The resources and
technics used were progressive mobilization, cycle ergometer, early bed
activities, walking protocols, resistance exercise, and virtual reality.
Intensity of the mobilization activities was determined using the Borg
scale and heart rate. Conclusion(s): Early mobilization protocols are
generalist (not individual), and low-intensity exercises are used, through
progressive mobilization, with two daily physical therapy sessions, during
10 to 30 minutes. Copyright © 2022, Sociedade Brasileira de
Cirurgia Cardiovascular.

<99>
Accession Number
2016374315
Title
A new model to predict acute kidney injury after cardiac surgery in
patients with renal insufficiency.
Source
Renal Failure. 44(1) (pp 767-776), 2022. Date of Publication: 2022.
Author
Wang X.; Guo N.; Chen Y.; Dai H.
Institution
(Wang, Guo, Dai) Department of Nephrology, Affiliated Hospital of Nantong
University, Nantong Jiangsu, China
(Chen) Department of Epidemiology and Medical Statistics, Nantong
University School of Public Health, Nantong Jiangsu, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: To establish a simple model for predicting postoperative acute
kidney injury (AKI) requiring renal replacement therapy (RRT) in patients
with renal insufficiency (CKD stages 3-4) who underwent cardiac surgery.
 Method(s): A total of 330 patients were enrolled. Among them, 226
were randomly selected for the development group and the remaining 104 for
the validation group. The primary outcome was AKI requiring RRT. A
nomogram was constructed based on the multivariate analysis with variables
selected by the application of the least absolute shrinkage and selection
operator. Meanwhile, the discrimination, calibration, and clinical power
of the new model were assessed and compared with those of the Cleveland
Clinic score and Simplified Renal Index (SRI) score in the validation
group. Result(s): The rate of RRT in the development group was 10.6%
(n = 24), while the rate in the validation group was 14.4% (n = 15). The
new model included four variables such as postoperative creatinine, aortic
cross-clamping time, emergency, and preoperative cystatin C, with a
C-index of 0.851 (95% CI, 0.779-0.924). In the validation group, the areas
under the receiver operating characteristic curves for the new model, SRI
score, and Cleveland Clinic score were 0.813, 0.791, and 0.786,
respectively. Furthermore, the new model demonstrated greater clinical net
benefits compared with the Cleveland Clinic score or SRI score.
 Conclusion(s): We developed and validated a powerful predictive model
for predicting severe AKI after cardiac surgery in patients with renal
insufficiency, which would be helpful to assess the risk for severe AKI
requiring RRT. Copyright © 2022 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<100>
Accession Number
2016663062
Title
Evaluating the Effect of Acetazolamide on the Prevention of Post-operative
Acute Kidney Injury after Coronary Artery Bypass Grafting Surgery: A
Randomized, Open-labeled Clinical Trial.
Source
Iranian Journal of Pharmaceutical Research. 20(4) (pp 71-79), 2021. Date
of Publication: Oct 2021.
Author
Afzal G.; Aval Z.A.; Monfared M.B.; Khesali H.; Ziaie S.; Barati S.;
Dastan F.
Institution
(Afzal, Ziaie, Barati, Dastan) Department of Clinical Pharmacy, School of
Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Aval) Clinical Research and Development Center at Shahid Modarress
Hospital, Department of Cardiac Surgery, Shahid Beheshti of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Monfared, Khesali) Department of Cardiovascular Surgery, Shahid Modarres
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Ziaie) Department of Nephrology and Kidney Transplantation, Shahid
Labbafinejad Medical Center, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Dastan) Chronic Respiratory Diseases Research center, National Research
Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Briefland
Abstract
Acute kidney injury (AKI) is a common complication after coronary artery
bypass grafting (CABG) surgery and can be linked to the increased
morbidity and mortality. Therefore, in the present study, the effect of
preoperative administration of acetazolamide was evaluated to investigate
whether it could prevent occurrence of post-operative AKI after CABG
surgery. In this randomized controlled clinical trial, 130 patients who
were candidates to undergo elective CABG surgery from January 21, 2020 to
February 8, 2021 were randomly allocated to intervention group (receiving
500 mg of acetazolamide orally 2 h preoperatively) and control group. The
patients were evaluated for AKI based on the kidney disease-improving
global outcomes (KDIGO) criteria based on their serum creatinine (SCr)
level and urine output until 7 days postoperatively. There was no
significant difference in baseline demographics between the two groups.
The total incidence of AKI was measured as 43%. Analysis of post-operative
AKI incidence showed no statistically significant difference between the
two groups (P = 0.860). Mean post-operative SCr level on day 1 was
significantly higher in the acetazolamide group (P = 0.036). A significant
difference was found in length of hospitalization stay between the groups,
which was higher in the control group (P = 0.006). Our results did not
demonstrate a significant protective effect of acetazolamide on incidence
of post-operative AKI in the patients undergone elective on-pump CABG
surgery. Copyright © 2021, Briefland. All rights reserved.

<101>
Accession Number
637957657
Title
Effect of glutamate infusion on NT-proBNP after coronary artery bypass
grafting in high-risk patients (GLUTAMICS II): A randomized controlled
trial.
Source
PLoS medicine. 19(5) (pp e1003997), 2022. Date of Publication: 09 May
2022.
Author
Holm J.; Ferrari G.; Holmgren A.; Vanky F.; Friberg O.; Vidlund M.;
Svedjeholm R.
Institution
(Holm, Vanky, Svedjeholm) Department of Thoracic and Vascular Surgery,
Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular
Medicine, Linkoping University, Linkoping, Sweden
(Ferrari, Friberg, Vidlund) Department of Cardiothoracic and Vascular
Surgery, Faculty of Medicine and Health, Health Care Research Center,
Orebro University, Sweden
(Holmgren) Heart Center and Department of Public Health and Clinical
Medicine, Medicine, Umea University, Umea, Sweden
(Vidlund) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
Publisher
NLM (Medline)
Abstract
BACKGROUND: Animal and human data suggest that glutamate can enhance
recovery of myocardial metabolism and function after ischemia. N-terminal
pro-brain natriuretic peptide (NT-proBNP) reflects myocardial dysfunction
after coronary artery bypass surgery (CABG). We investigated whether
glutamate infusion can reduce rises of NT-proBNP in moderate- to high-risk
patients after CABG. METHODS AND FINDINGS: A prospective, randomized,
double-blind study enrolled patients from November 15, 2015 to September
30, 2020, with a 30-day follow-up at 4 academic cardiac surgery centers in
Sweden. Patients underwent CABG +/- valve procedure and had left
ventricular ejection fraction <=0.30 or EuroSCORE II >=3.0. Intravenous
infusion of 0.125 M L-glutamic acid or saline at 1.65 mL/kg/h started 10
to 20 minutes before releasing the aortic cross-clamp, then continued for
another 150 minutes. Patients, staff, and investigators were blinded to
the treatment. The primary endpoint was the difference between
preoperative and day-3 postoperative NT-proBNP levels. Analysis was
intention to treat. We studied 303 patients (age 74 +/- 7 years; females
26%, diabetes 47%), 148 receiving glutamate group and 155 controls. There
was no significant difference in the primary endpoint associated with
glutamate administration (5,390 +/- 5,396 ng/L versus 6,452 +/- 5,215
ng/L; p = 0.086). One patient died <=30 days in the glutamate group
compared to 6 controls (0.7% versus 3.9%; p = 0.12). No adverse events
linked to glutamate were observed. A significant interaction between
glutamate and diabetes was found (p = 0.03). Among patients without
diabetes the primary endpoint (mean 4,503 +/- 4,846 ng/L versus 6,824 +/-
5,671 ng/L; p = 0.007), and the incidence of acute kidney injury (11%
versus 29%; p = 0.005) was reduced in the glutamate group. These
associations remained significant after adjusting for differences in
baseline data. The main limitations of the study are: (i) it relies on a
surrogate marker for heart failure; and (ii) the proportion of patients
with diabetes had almost doubled compared to the cohort used for the
sample size estimation. CONCLUSION(S): Infusion of glutamate did not
significantly reduce postoperative rises of NT-proBNP. Diverging results
in patients with and without diabetes agree with previous observations and
suggest that the concept of enhancing postischemic myocardial recovery
with glutamate merits further evaluation. TRIAL REGISTRATION:
ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT02592824.
European Union Drug Regulating Authorities Clinical Trials Database (Eudra
CT number 2011-006241-15).

<102>
Accession Number
637957605
Title
Iron homeostasis in heart transplant recipients randomized to ferric
derisomaltose or placebo.
Source
Clinical transplantation. (pp e14695), 2022. Date of Publication: 09 May
2022.
Author
Englund K.V.B.; Ostby C.M.; Ueland T.; Aukrust P.; Gude E.; Andreassen
A.K.; Gullestad L.; Broch K.
Institution
(Englund, Ostby, Gude, Andreassen, Gullestad, Broch) Department of
Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
(Englund, Aukrust) Department of Rheumatology, Dermatology and Infectious
Disease, Oslo University Hospital, Oslo, Norway
(Englund, Gude, Andreassen, Gullestad, Broch) K.G. Jebsen Cardiac Research
Center and Center for Heart Failure Research, Faculty of Medicine,
University of Oslo, Oslo, Norway
(Ueland, Aukrust) Research Institute of Internal Medicine, Oslo University
Hospital Rikshospitalet, Oslo, Norway
(Aukrust, Gullestad) Institute of Clinical Medicine, Faculty of Medicine,
University of Oslo, Oslo, Norway
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The randomized IronIC trial evaluated the effect of
intravenous ferric derisomaltose on physical capacity in iron deficient,
maintenance heart transplant (HTx) recipients. Iron deficiency was defined
as in heart failure with high cut-points for ferritin to compensate for
inflammation. However, intravenous iron did not improve physical capacity
except in patients with ferritin <30 mug/l. We aimed to explore
determinants of iron status in the 102 IronIC participants to better
define iron deficiency in the HTx population. METHOD(S): We assessed
key governors of iron homeostasis, such as hepcidin, soluble transferrin
receptor (sTfR), and interleukin-6 (IL-6). We also measured growth factors
and inflammatory markers with relevance for iron metabolism. The results
were compared to those of 21 healthy controls. RESULT(S): Hepcidin
did not differ between HTx recipients and controls, even though markers of
inflammation were modestly elevated. However, HTx recipients with ferritin
<30 mug/l or sTfR above the reference range had significantly reduced
hepcidin levels suggestive of true iron deficiency. In these patients,
intravenous iron improved peak oxygen uptake. Hepcidin correlated
positively with ferritin and negatively with sTfR. CONCLUSION(S): HTx
recipients with iron deficiency as defined in heart failure do not have
elevated hepcidin levels, although inflammatory markers are modestly
increased. The high ferritin cut-offs used in heart failure may not be
suitable to define iron deficiency in the HTx population. We suggest that
hepcidin and sTfR should be measured to identify patients with true iron
deficiency, who might benefit from treatment with intravenous iron. This
article is protected by copyright. All rights reserved.

<103>
Accession Number
2016545459
Title
The early and long-term outcomes of coronary artery bypass grafting added
to aortic valve replacement compared to isolated aortic valve replacement
in elderly patients: a systematic review and meta-analysis.
Source
Heart and Vessels. (no pagination), 2022. Date of Publication: 2022.
Author
D'Alessandro S.; Tuttolomondo D.; Singh G.; Hernandez-Vaquero D.; Pattuzzi
C.; Gallingani A.; Maestri F.; Nicolini F.; Formica F.
Institution
(D'Alessandro) Cardiac Surgery Unit, San Gerardo Hospital, Monza, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, AB, Canada
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Pattuzzi, Gallingani, Maestri, Nicolini, Formica) Cardiac Surgery Unit,
University Hospital of Parma, Parma, Italy
(Nicolini, Formica) Department of Medicine and Surgery, University of
Parma, Parma, Italy
(Formica) UOC Cardiochirurgia, Azienda Ospedaliera Universitaria di Parma,
Via A. Gramsci, 14, Parma 43126, Italy
Publisher
Springer Japan
Abstract
In aged population, the early and long-term outcomes of coronary
revascularization (CABG) added to surgical aortic valve replacement (SAVR)
compared to isolated SAVR (i-SAVR) are conflicting. To address this
limitation, a meta-analysis comparing the early and late outcomes of SAVR
plus CABG with i-SAVR was performed. Electronic databases from January
2000 to November 2021 were screened. Studies reporting early-term and
long-term comparison between the two treatments in patients over 75 years
were analyzed. The primary endpoints were in-hospital/30-day mortality and
overall long-term survival. The pooled odd ratio (OR) and hazard ratio
(HR) with 95% confidence interval (CI) were calculated for in-early
outcome and long-term survival, respectively. Random-effect model was used
in all analyses. Forty-four retrospective observational studies reporting
on 74,560 patients (i-SAVR = 36,062; SAVR + CABG = 38,498) were included
for comparison. The pooled analysis revealed that i-SAVR was significantly
associated with lower rate of early mortality compared to SAVR plus CABG
(OR = 0.70, 95% CI 0.66-0.75; p < 0.0001) and with lower incidence of
postoperative acute renal failure (OR = 0.65; 95% CI 0.50-0.91; p = 0.02),
need for dialysis (OR = 0.65; 95% CI 0.50-0.86; p = 0.002) and prolonged
mechanical ventilation (OR = 0.57; 95% CI 0.42-0.77; p < 0.0001).
Twenty-two studies reported data of long-term follow-up. No differences
were reported between the two groups in long-term survival (HR = 0.95; 95%
CI 0.87-1.03; p = 0.23). CABG added to SAVR is associated with worse early
outcomes in terms of early mortality, postoperative acute renal failure,
and prolonged mechanical ventilation. Long-term survival was comparable
between the two treatments. Copyright © 2022, The Author(s).

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