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<1>
Accession Number
2008363299
Title
Systematic review and consensus definitions for the Standardized Endpoints
in Perioperative Medicine (StEP) initiative: cardiovascular outcomes.
Source
British Journal of Anaesthesia. 126(1) (pp 56-66), 2021. Date of
Publication: January 2021.
Author
Beattie W.S.; Lalu M.; Bocock M.; Feng S.; Wijeysundera D.N.; Nagele P.;
Fleisher L.A.; Kurz A.; Biccard B.; Leslie K.; Howell S.; Landoni G.;
Grocott H.; Lamy A.; Richards T.; Myles P.; Gan T.J.; Peyton P.; Sessler
D.; Tramer M.; Cyna A.; De Oliveira G.S.; Wu C.; Jensen M.; Kehlet H.;
Botti M.; Boney O.; Haller G.; Grocott M.; Cook T.; Fleisher L.; Neuman
M.; Story D.; Gruen R.; Bampoe S.; Evered L.; Scott D.; Silbert B.; van
Dijk D.; Kalkman C.; Chan M.; Eckenhoff R.; Rasmussen L.; Eriksson L.;
Bartlett R.J.; McMonnies R.; Gerstl J.; Jay M.; Kishlyansky D.; Machina
M.; Bobcock M.; Pearse R.; Mythen M.; Canet J.; Moller A.; Gin T.; Schultz
M.; Pelosi P.; Gabreu M.; Futier E.; Creagh-Brown B.; Abbott T.; Klein A.;
Corcoran T.; Cooper D.J.; Dieleman S.; Diouf E.; McIlroy D.; Bellomo R.;
Shaw A.; Prowle J.; Karkouti K.; Billings J.; Mazer D.; Jayarajah M.;
Murphy M.; Bartoszko J.; Sneyd R.; Morris S.; George R.; Moonesinghe R.;
Shulman M.; Lane-Fall M.; Nilsson U.; Stevenson N.; Cooper J.D.; van Klei
W.; Cabrini L.; Miller T.; Pace N.; Jackson S.; Buggy D.; Short T.; Riedel
B.; Gottumukkala V.; Alkhaffaf B.; Johnson M.
Institution
(Beattie) Cardiovascular Anesthesia, University Health Network, University
of Toronto, Toronto, ON, Canada
(Lalu, Bocock, Feng) Department of Anesthesia, University of Ottawa,
Ottawa, ON, Canada
(Wijeysundera) Li Ka Shing Knowledge Institute, St Michaels Hospital,
University of Toronto, Toronto, ON, Canada
(Nagele) Department of Anesthesia and Critical Care, University of
Chicago, Chicago, IL, United States
(Fleisher) Department of Anesthesiology and Critical Care, University of
Pennsylvania Health System, Philadelphia, PA, United States
(Kurz) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
(Biccard) Department of Anesthesia and Perioperative Medicine, University
of Cape Town, Cape Town, South Africa
(Leslie) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Vic., Australia
(Howell) University of Leeds School of Medicine, Leeds, United Kingdom
(Landoni) Center for Intensive Care and Anesthesiology, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Grocott) Department of Anesthesia and Perioperative Medicine, University
of Manitoba, Winnipeg, MB, Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Richards) University of Western Australia, Perth, Australia
(Myles) Alfred Health and Monash University Department of Anaesthesia and
Perioperative Medicine, Melbourne, Vic., Australia
Publisher
Elsevier Ltd
Abstract
Background: Adverse cardiovascular events are a leading cause of
perioperative morbidity and mortality. The definitions of perioperative
cardiovascular adverse events are heterogeneous. As part of the
international Standardized Endpoints in Perioperative Medicine initiative,
this study aimed to find consensus amongst clinical trialists on a set of
standardised and valid cardiovascular outcomes for use in future
perioperative clinical trials. Method(s): We identified currently
used perioperative cardiovascular outcomes by a systematic review of the
anaesthesia and perioperative medicine literature (PubMed/Ovid, Embase,
and Cochrane Library). We performed a three-stage Delphi consensus-gaining
process that involved 55 clinician researchers worldwide. Cardiovascular
outcomes were first shortlisted and the most suitable definitions
determined. These cardiovascular outcomes were then assessed for validity,
reliability, feasibility, and clarity. Result(s): We identified 18
cardiovascular outcomes. Participation in the three Delphi rounds was 100%
(n=19), 71% (n=55), and 89% (n=17), respectively. A final list of nine
cardiovascular outcomes was elicited from the consensus: myocardial
infarction, myocardial injury, cardiovascular death, non-fatal cardiac
arrest, coronary revascularisation, major adverse cardiac events,
pulmonary embolism, deep vein thrombosis, and atrial fibrillation. These
nine cardiovascular outcomes were rated by the majority of experts as
valid, reliable, feasible, and clearly defined. Conclusion(s): These
nine consensus cardiovascular outcomes can be confidently used as
endpoints in clinical trials designed to evaluate perioperative
interventions with the goal of improving perioperative
outcomes. Copyright © 2020 British Journal of Anaesthesia

<2>
Accession Number
2014888595
Title
Serratus Anterior Plane Block in Pediatric Patients Undergoing Thoracic
Surgeries: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part A. 36(8) (pp
2271-2277), 2022. Date of Publication: August 2022.
Author
Gado A.A.; Abdalwahab A.; Ali H.; Alsadek W.M.; Ismail A.A.
Institution
(Gado, Abdalwahab, Ali, Alsadek, Ismail) Anesthesia and Pain Management,
Department of Anesthesia, Kasr Alainy Faculty of Medicine, Cairo
University, Egypt
Publisher
W.B. Saunders
Abstract
Objective(s): This study was designed to evaluate the efficacy and safety
of serratus anterior plane block (SAPB) as an analgesic technique for
thoracotomies in pediatric patients. Design(s): Double-blinded
randomized controlled trial. Setting(s): A single-center study at
Aboelrish Pediatric Hospital, one tertiary hospital of Cairo University
Hospitals. Participant(s): Seventy pediatric patients aged six
months-to-three years scheduled for thoracotomies. Intervention(s):
Patients were randomized into two groups, group SF and group F. Group SF
received an ultrasound-guided SAPB (n = 35), whereas group F (n = 35) did
not. All groups received an intraoperative fentanyl infusion (at 0.5
mug/kg /h). Measurements: The primary outcome was the total dose of
postoperatively administrated fentanyl in the first 24 hours. The
secondary outcomes included the total dose of intraoperative additional
fentanyl boluses; time of the first postoperative rescue analgesia; and
postoperative Face, Legs, Activity, Cry, Consolability scale (FLACC) score
values. Main Result(s): The main results of this study showed that
the administrated fentanyl in the 24 hours postoperatively was
significantly lower in SF group than in F group (p value 0.001). In
addition, significant decreases of the postoperative FLACC pain score (p
value 0.001), reduction of intraoperative fentanyl consumption (p value
0.001), and delay of the first rescue analgesia (p value 0.001) were
recorded in SF group in relation to F group without significant
complications in both groups. Conclusion(s): Serratus anterior plane
block can provide a safe, effective, and easy-to-perform regional
technique for children undergoing thoracotomies. Copyright © 2021
Elsevier Inc.

<3>
Accession Number
2015635006
Title
Complete transcatheter versus complete surgical treatment in patients with
aortic valve stenosis and concomitant coronary artery disease: Study-level
meta-analysis with reconstructed time-to-event data.
Source
Journal of Cardiac Surgery. 37(7) (pp 2072-2083), 2022. Date of
Publication: July 2022.
Author
Michel Pompeu S.; Sun T.; Fatehi Hassanabad A.; Awad A.K.; Van den Eynde
J.; Malin J.H.; Sicouri S.; Torregrossa G.; Ruhparwar A.; Weymann A.;
Ramlawi B.
Institution
(Michel Pompeu, Sun, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Sicouri, Torregrossa, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
Wynnewood, PA, United States
(Fatehi Hassanabad) Section of Cardiac Surgery, Department of Cardiac
Sciences, Libin Cardiovascular Institute, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Van den Eynde) Helen B. Taussig Heart Center, The Johns Hopkins Hospital
and School of Medicine, Baltimore, MD, United States
(Malin) Philadelphia College of Osteopathic Medicine, Bala Cynwyd, PA,
United States
(Ruhparwar, Weymann) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To compare outcomes of complete transcatheter (TAVI plus PCI)
versus complete surgical (SAVR plus CABG) approach to treat patients with
aortic stenosis (AS) and concomitant coronary artery disease (CAD).
 Method(s): Study-level meta-analysis with reconstructed time-to-event
data including studies published by November 2021. The primary endpoints
were 30-day mortality, overall survival, and major adverse cardiovascular
and cerebrovascular events (MACCE). The secondary endpoints were 30-day
stroke, myocardial infarction, and permanent pacemaker implantation (PPI);
in-hospital major vascular events and acute kidney injury (AKI).
 Result(s): Eight studies met our eligibility criteria, including a
total of 33,286 patients (3448 for TAVI plus PCI and 29,838 for SAVR plus
CABG). The pooled risk of 30-day mortality was lower for TAVI plus PCI (OR
0.63; 95% CI 0.51-0.80; p <.001). Patients undergoing TAVI plus PCI had
lower risk of in-hospital AKI (OR 0.49; 95% CI 0.28-0.85; p =.01),
however, higher risk of major vascular events (OR 7.33; 95% CI 1.80-29.85;
p =.005) and higher risk of PPI (OR 2.96; 95% CI 1.80-4.85; p <.001). No
statistically significant difference was observed for myocardial
infarction and stroke between the groups. In the follow-up analyses, we
observed a higher risk of mortality (HR 1.64, 95% CI 1.36-1.96, p <.001)
and MACCE with TAVI plus PCI (HR 1.35 (95% CI 1.08-1.69, p =.009).
 CONCLUSION(S): Patients who undergo TAVI plus PCI (in comparison with
SAVR plus CABG) initially experience lower rates of in-hospital death and
AKI; however, they experience significantly lower survival rates and more
MACCE at 5-year follow up. Structural heart surgeons and interventional
cardiologists should consider these aspects when referring patients for
one approach or the other. Copyright © 2022 Wiley Periodicals
LLC.

<4>
Accession Number
2018337209
Title
Acute acalculous cholecystitis and cardiovascular disease, which came
first? After two hundred years still the classic chicken and eggs debate:
A review of literature.
Source
Annals of Medicine and Surgery. 78 (no pagination), 2022. Article Number:
103668. Date of Publication: June 2022.
Author
Sarago M.; Fiore D.; De Rosa S.; Amaddeo A.; Pulitano L.; Bozzarello C.;
Iannello A.M.; Sammarco G.; Indolfi C.; Rizzuto A.
Institution
(Sarago, Fiore, De Rosa, Amaddeo, Pulitano, Bozzarello, Iannello,
Sammarco, Indolfi, Rizzuto) Department of Medical and Surgical Sciences,
University Magna Graecia of Catanzaro, Italy
Publisher
Elsevier Ltd
Abstract
The existence of a close association between disease of the biliary tract
and disease of the heart is known from the mists of time. Acute acalculous
cholecystitis (AAC) can be defined as an acute necro inflammatory disease
of the gallbladder in the absence of cholelithiasis. AAC is a challenging
diagnosis. The atypical clinical onset associated to a paucity and
similarity of symptoms and to laboratory data mimicking cardiovascular
disease (CVD) often results in under and misdiagnosed cases. Moreover, AAC
has commonly a fulminant course compared to calculous cholecystitis and it
is often associated with gangrene, perforation and empyema as well as
considerable morbidity and mortality (up 50%). Early diagnosis is crucial
to a prompt treatment in order to avoid complications and to increase
survivability. Even today, although scientific evidence dating two hundred
years has shown a close association between AAC and CVD, due to the lack
of RCT, there is still a lot of confusion regarding the relationship and
consequently the clinical management AAC and CVD. In addition, emergency
physicians are not always familiar with transient ECG changes with AAC.
The aim of this review was to provide evidence regarding epidemiology,
pathophysiology, clinical presentation and treatment of the complex
association between AAC and CVD. Our main findings indicate that AAC
should be suspected after each general disease leading to hypoperfusion
such as cardiovascular diseases or cerebrovascular diseases or major heart
or aortic surgery. ECG changes in absence of significant laboratory data
for IMA (Acute myocardial infarction) could be related to a misdiagnosed
AAC. US - Ultrasonography-plays a key role in the early diagnosis and also
in the follow up of AAC. Cholecystostomy and cholecystectomy as unique or
sequential represent the two prevailing treatment options for
AAC. Copyright © 2022

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

<6>
Accession Number
2017704059
Title
Prehabilitation of elderly frail or pre-frail patients prior to elective
surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome
assessor-blinded trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 468. Date of
Publication: December 2022.
Author
Schaller S.J.; Kiselev J.; Loidl V.; Quentin W.; Schmidt K.; Morgeli R.;
Rombey T.; Busse R.; Mansmann U.; Spies C.; Marschall U.; Eckardt-Felmberg
R.; Landgraf I.; Schwantes U.
Institution
(Schaller, Kiselev, Schmidt, Morgeli, Spies) Department of Anesthesiology
and Operative Intensive Care Medicine (CVK/CCM), Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin
and Humboldt-Universitat zu Berlin, Chariteplatz 1, Berlin 10117, Germany
(Loidl, Mansmann) Institute for Medical Information Processing, Biometry,
and Epidemiology - IBE, Ludwig-Maximilians-Universitat Munchen, Munich,
Germany
(Quentin, Rombey, Busse) Department of Health Care Management, Technische
Universitat Berlin, Berlin, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Frailty is expressed by a reduction in physical capacity,
mobility, muscle strength, and endurance. (Pre-)frailty is present in up
to 42% of the older surgical population, with an increased risk for peri-
and postoperative complications. Consequently, these patients often suffer
from a delayed or limited recovery, loss of autonomy and quality of life,
and a decrease in functional and cognitive capacities. Since frailty is
modifiable, prehabilitation may improve the physiological reserves of
patients and reduce the care dependency 12 months after surgery.
 Method(s): Patients >= 70 years old scheduled for elective surgery or
intervention will be recruited in this multicenter, randomized controlled
study, with a target of 1400 participants with an allocation ratio of 1:1.
The intervention consists of (1) a shared decision-making process with the
patient, relatives, and an interdisciplinary and interprofessional team
and (2) a 3-week multimodal, individualized prehabilitation program
including exercise therapy, nutritional intervention, mobility or balance
training, and psychosocial interventions and medical assessment. The
frequency of the supervised prehabilitation is 5 times/week for 3 weeks.
The primary endpoint is defined as the level of care dependency 12 months
after surgery or intervention. Discussion(s): Prehabilitation has
been proven to be effective for different populations, including
colorectal, transplant, and cardiac surgery patients. In contrast,
evidence for prehabilitation in older, frail patients has not been clearly
established. To the best of our knowledge, this is currently the largest
prehabilitation study on older people with frailty undergoing general
elective surgery. Trial registration: ClinicalTrials.gov NCT04418271.
Registered on 5 June 2020. Universal Trial Number (UTN):
U1111-1253-4820 Copyright © 2022, The Author(s).

<7>
Accession Number
2017525595
Title
Impact of oral or enteral nutritional support on clinical outcomes of
patients subjected to cardiac surgery: A systematic review.
Source
Clinical Nutrition ESPEN. 49 (pp 28-39), 2022. Date of Publication: June
2022.
Author
Avancini L.; de abreu Silva L.; da Silva V.R.; Duarte C.K.
Institution
(Avancini, da Silva) Unidade Multiprofissional e Reabilitacao - Nutricao
Clinica, Hospital das Clinicas da Universidade Federal de Minas Gerais,
Brazil
(de abreu Silva, Duarte) Departamento de Nutricao da Escola de Enfermagem
da Universidade Federal de Minas Gerais, Brazil
Publisher
Elsevier Ltd
Abstract
Background: Cardiovascular diseases represent the leading cause of death
worldwide, in addition to having a direct negative impact on quality of
life, functional capacity and nutritional status. Studies show high
prevalence of malnutrition in patients undergoing cardiac surgery. It is
known that cardiac surgery can also lead to changes in nutritional status,
through surgical trauma, systemic inflammation and, often, delay in the
initiation of nutritional support. On the other hand, the role of
nutritional support as a driver of clinical outcomes in different surgical
populations is well described in the literature. Objective(s): To
review the literature in order to assess the effect of perioperative oral
or enteral nutritional support on clinical outcomes of cardiac patients
undergoing cardiac surgery. Methodology: The search was conducted in
February 2021 in the following databases: EMBASE, PubMed/MEDLINE, Scopus
and Web of Science. Randomized clinical trials (RCT) and retrospective
studies were selected, carried out with patients with heart disease,
undergoing cardiac surgery and aged 18 years or over. The Outcomes of
interest were: length of hospital stay, length of stay in the ICU, time on
ventilatory support, mortality rate, clinical complications and use of
vasoactive drugs in the postoperative period. Result(s): Ten studies
were included in this systematic review, of which 7 were RCTs and 3 were
cohorts. The most prevalent surgery was myocardial revascularization. Six
studies evaluated oral nutritional support, two enteral nutritional
support and two analyzed both. Two studies found a significant reduction
in the length of hospital and ICU staying associated with preoperative
intake of carbohydrate-based beverages. Only one study observed a
significant reduction in the requirement for ventilatory support after
cardiac surgery, after preoperative carbohydrate-based drinks and early
postoperative enteral nutrition. There was no influence of nutritional
support on mechanical ventilation length and mortality.
 Conclusion(s): Most studies showed that nutritional support did not
reduce hospital and ICU staying. Nutritional support benefits were
demonstrated in studies that offered preoperative oral carbohydrate
drinks. No association was observed between nutritional support and
duration of mechanical ventilation or mortality rate. Most studies did not
find any influence of nutritional support on the need and/or dosage of
vasoactive drugs in the postoperative period of cardiac
surgery. Copyright © 2022 European Society for Clinical Nutrition
and Metabolism

<8>
Accession Number
2016914134
Title
Engineering Efforts to Refine Compatibility and Duration of Aortic Valve
Replacements: An Overview of Previous Expectations and New Promises.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 863136. Date of Publication: 2022.
Author
Rizzi S.; Ragazzini S.; Pesce M.
Institution
(Rizzi, Ragazzini, Pesce) Tissue Engineering Unit, Centro Cardiologico
Monzino, Istituto di ricovero e cura a carattere scientifico (IRCCS),
Milan, Italy
(Rizzi) Department of Chemistry, Materials and Chemical Engineering
"Giulio Natta", Politecnico di Milano, Milan, Italy
Publisher
Frontiers Media S.A.
Abstract
The absence of pharmacological treatments to reduce or retard the
progression of cardiac valve diseases makes replacement with artificial
prostheses (mechanical or bio-prosthetic) essential. Given the increasing
incidence of cardiac valve pathologies, there is always a more stringent
need for valve replacements that offer enhanced performance and
durability. Unfortunately, surgical valve replacement with mechanical or
biological substitutes still leads to disadvantages over time. In fact,
mechanical valves require a lifetime anticoagulation therapy that leads to
a rise in thromboembolic complications, while biological valves are still
manufactured with non-living tissue, consisting of aldehyde-treated
xenograft material (e.g., bovine pericardium) whose integration into the
host fails in the mid-to long-term due to unresolved issues regarding
immune-compatibility. While various solutions to these shortcomings are
currently under scrutiny, the possibility to implant fully biologically
compatible valve replacements remains elusive, at least for large-scale
deployment. In this regard, the failure in translation of most of the
designed tissue engineered heart valves (TEHVs) to a viable clinical
solution has played a major role. In this review, we present a
comprehensive overview of the TEHVs developed until now, and critically
analyze their strengths and limitations emerging from basic research and
clinical trials. Starting from these aspects, we will also discuss
strategies currently under investigation to produce valve replacements
endowed with a true ability to self-repair, remodel and regenerate. We
will discuss these new developments not only considering the
scientific/technical framework inherent to the design of novel valve
prostheses, but also economical and regulatory aspects, which may be
crucial for the success of these novel designs. Copyright © 2022
Rizzi, Ragazzini and Pesce.

<9>
Accession Number
2016878048
Title
High-Density Lipoprotein Cholesterol and Cardiovascular Events in Patients
with Stable Coronary Artery Disease Treated with Statins: An Observation
from the REAL-CAD Study.
Source
Journal of Atherosclerosis and Thrombosis. 29(1) (pp 50-68), 2022. Date of
Publication: 2022.
Author
Omote K.; Yokota I.; Nagai T.; Sakuma I.; Nakagawa Y.; Kamiya K.; Iwata
H.; Miyauchi K.; Ozaki Y.; Hibi K.; Hiro T.; Fukumoto Y.; Mori H.;
Hokimoto S.; Ohashi Y.; Ohtsu H.; Ogawa H.; Daida H.; Iimuro S.; Shimokawa
H.; Saito Y.; Kimura T.; Matsuzaki M.; Nagai R.; Anzai T.
Institution
(Omote, Nagai, Kamiya, Anzai) Department of Cardiovascular Medicine,
Faculty of Medicine and Graduate School of Medicine, Hokkaido University,
Sapporo, Japan
(Yokota) Department of Biostatistics, Graduate School of Medicine,
Hokkaido University, Sapporo, Japan
(Sakuma) Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
(Nakagawa) Department of Cardiovascular Medicine, Shiga University of
Medical Science Hospital, Shiga, Japan
(Iwata, Miyauchi, Daida) Department of Cardiovascular Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Ozaki) Department of Cardiology, Fujita Health University School of
Medicine, Aichi, Japan
(Hibi) Division of Cardiology, Yokohama City University Medical Center,
Yokohama, Japan
(Hiro) Division of Cardiology, Department of Medicine, Nihon University
School of Medicine, Tokyo, Japan
(Fukumoto) Division of Cardiovascular Medicine, Department of Internal
Medicine, Kurume University School of Medicine, Fukuoka, Japan
(Mori) Department of Cardiology, Showa University Fujigaoka Hospital,
Yokohama, Japan
(Hokimoto) Department of Cardiovascular Medicine, Kumamoto University
Hospital, Kumamoto, Japan
(Ohashi) Department of Integrated Science and Technology for Sustainable
Society, Chuo University, Tokyo, Japan
(Ohtsu) National Center for Global Health and Medicine, Center for
Clinical Sciences, Tokyo, Japan
(Ogawa) National Cerebral and Cardiovascular Center, Osaka, Japan
(Iimuro) Teikyo Academic Research Center, Teikyo University, Tokyo, Japan
(Shimokawa) Department of Cardiovascular Medicine, Tohoku University
Graduate School of Medicine, Sendai, Japan
(Saito) Chiba University, Chiba, Japan
(Kimura) Department of Cardiovascular Medicine, Kyoto University Graduate
School of Medicine, Kyoto, Japan
(Matsuzaki) St. Hill Hospital, Yamaguchi, Japan
(Nagai) Jichi Medical University, Tochigi, Japan
Publisher
Japan Atherosclerosis Society
Abstract
Aim: The association between high-density lipoprotein cholesterol (HDL-C)
level after statin therapy and cardiovascular events in patients with
stable coronary artery disease (CAD) remains unclear. Thus, in this study,
we sought to determine how HDL-C level after statin therapy is associated
with cardiovascular events in stable CAD patients. Method(s): From
the REAL-CAD study which had shown the favorable prognostic effect of
high-dose pitavastatin in stable CAD patients with low-density lipoprotein
cholesterol (LDL-C) 120 mg/dL, 9,221 patients with HDL-C data at baseline
and 6 months, no occurrence of primary outcome at 6 months, and reported
non-adherence for pitavastatin, were examined. The primary outcome was a
composite of cardiovascular death, non-fatal myocardial infarction,
non-fatal ischemic stroke, or unstable angina requiring emergent admission
after 6 months of randomization. Absolute difference and ratio of HDL-C
levels were defined as (those at 6 months-at baseline) and (absolute
difference/baseline)x100, respectively. Result(s): During a median
follow-up period of 4.0 (IQR 3.2-4.7) years, the primary outcome occurred
in 417 (4.5%) patients. The adjusted risk of all HDL-C-related variables
(baseline value, 6-month value, absolute, and relative changes) for the
primary outcome was not significant (hazard ratio [HR] 0.99, 95%
confidence interval [CI] 0.91-1.08, HR 1.03, 95% CI 0.94-1.12, HR 1.05,
95% CI 0.98-1.12, and HR 1.08, 95% CI 0.94-1.24, respectively).
Furthermore, adjusted HRs of all HDL-C-related variables remained
non-significant for the primary outcome regardless of on-treatment LDL-C
level at 6 months. Conclusion(s): After statin therapy with modestly
controlled LDL-C, HDL-C level has little prognostic value in patients with
stable CAD. Copyright © 2022 Japan Atherosclerosis Society.

<10>
Accession Number
2016850565
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 Biomedica. 93(2) (no pagination), 2022. Article Number: e2022049.
Date of Publication: 2022.
Author
Maestri F.; Formica F.; Gallingani A.; Gripshi F.; Nicolini F.
Institution
(Maestri, Gallingani) Department of Cardio-Thoracic and Vascular Surgery,
Cardiac Surgery Unit, University Hospital "Azienda Ospedaliera
Universitaria" of Parma, Parma, Italy
(Formica, 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
Mattioli 1885
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).
(www.actabiomedica.it). Copyright © 2022, Mattioli 1885. All
rights reserved.

<11>
Accession Number
2016962039
Title
Tricuspid Valve Intervention at the Time of Pulmonary Valve Replacement in
Adults With Congenital Heart Disease: A Systematic Review and
Meta-Analysis.
Source
Journal of the American Heart Association. 10(24) (no pagination), 2021.
Article Number: e022909. Date of Publication: 21 Dec 2021.
Author
Van den Eynde J.; Callahan C.P.; Rito M.L.; Hussein N.; Carvajal H.;
Guariento A.; Ruhparwar A.; Weymann A.; Budts W.; Gewillig M.; Sa M.P.;
Kutty S.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, MD, United States
(Van den Eynde) Department of Cardiovascular Sciences, Department of
Cardiovascular Diseases, KU Leuven, University Hospitals Leuven, Leuven,
Belgium
(Callahan, Guariento) Division of Cardiovascular Surgery, The Hospital for
Sick Children, Toronto, Canada
(Rito) Department of Congenital Cardiac Surgery, IRCCS Policlinico San
Donato, San Donato Milanese, Italy
(Hussein) Department of Congenital Cardiac Surgery, Yorkshire Heart
Centre, Leeds General Infirmary, United Kingdom
(Carvajal) Section of Pediatric Cardiothoracic Surgery, Department of
Surgery, Washington University School of Medicine in St. Louis/St. Louis
Children's Hospital, Saint Louis, MO, 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
(Budts) Department of Cardiovascular Sciences, Congenital and Structural
Cardiology, Catholic University Leuven, University Hospitals Leuven,
Leuven, Belgium
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Sa) Department of Cardiac Surgery, Lankenau Heart Institute, Main Line
Health, Wynnewood, PA, United States
(Sa) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Main Line Health, Wynnewood, PA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Tricuspid regurgitation (TR) is a common finding in adults
with congenital heart disease referred for pulmonary valve replacement
(PVR). However, indications for combined valve surgery remain
controversial. This study aimed to evaluate early results of concomitant
tricuspid valve intervention (TVI) at the time of PVR. METHODS AND
RESULTS: Observational studies comparing TVI+PVR and isolated PVR were
identified by a systematic search of published research. Random-effects
meta-analysis was performed, comparing outcomes between the 2 groups. Six
studies involving 749 patients (TVI+PVR, 278 patients; PVR, 471 patients)
met the eligibility criteria. In the pooled analysis, both TVI+PVR and PVR
reduced TR grade, pulmonary regurgitation grade, right ventricular
end-diastolic volume, and right ventricular end-systolic volumes. TVI+PVR,
but not PVR, was associated with a decrease in tricuspid valve annulus
size (mean difference, -6.43 mm, 95% CI, -10.59 to -2.27; P=0.010).
Furthermore, TVI+PVR was associated with a larger reduction in TR grade
compared with PVR (mean difference, -0.40; 95% CI, -0.75 to -0.05;
P=0.031). No evidence could be established for an effect of either
treatment on right ventricular ejection fraction or echocardiographic
assessment of right ventricular dilatation and dysfunction. There was no
evidence for a difference in hospital mortality or reoperation for TR.
 CONCLUSION(S): While both strategies are effective in reducing TR and
right ventricular volumes, routine TVI+PVR can reduce TR grade to a larger
extent than isolated PVR. Further studies are needed to identify the
subgroups of patients who might benefit most from combined valve
surgery. Copyright © 2021 The Authors.

<12>
Accession Number
637427466
Title
Continuous Titration of Inspired Oxygen Using Oxygen Reserve Index to
Decrease Oxygen Exposure During One-Lung Ventilation: A Randomized
Controlled Trial.
Source
Anesthesia and analgesia. 135(1) (pp 91-99), 2022. Date of Publication: 01
Jul 2022.
Author
Yang M.; Kim J.A.; Ahn H.J.; Choi Y.S.; Park M.; Jeong H.; Kim K.; Lee
N.Y.
Institution
(Yang, Kim, Ahn, Park, Jeong, Lee) From the Departments of Anesthesiology
and Pain Medicine
(Choi) Thoracic and Cardiovascular Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, School of Dentistry,
Dankook University, Cheon-an, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: A high fraction of inspired oxygen (Fio2) is administered
during one-lung ventilation (OLV). However, a high Fio2 is not physiologic
and may lead to various complications. We hypothesized that continuous
titration of Fio2 using the oxygen reserve index (ORI) reduces oxygen
exposure compared to conventional management during OLV. METHOD(S):
In this randomized, double-blinded trial, patients undergoing thoracic
surgery were assigned to an ORI (n = 64) or a control group (n = 60). In
the ORI group, ORI was continuously displayed using multiwavelength pulse
co-oximetry (Masimo) between 0 and 1 (0, no reserve; 1, maximum reserve),
and Fio2 was titrated for a target ORI of 0.21 at 5-minute intervals
during OLV. In the control group, Fio2 was adjusted using arterial blood
gas analysis measured at 15 minutes after OLV initiation. The primary end
point was the time-weighted average Fio2 during OLV. RESULT(S):
Overall, time-weighted average Fio2 did not differ between the groups
(control versus ORI: median [interquartile range], 0.87 [0.73-1.00] vs
0.82 [0.68-0.93]; P = .09). However, in a subgroup analysis, the ORI group
reduced time-weighted average Fio2 after pulmonary vascular ligation
compared to the control group (control versus ORI: median [interquartile
range], 0.75 [0.70-1.00] vs 0.72 [0.59-0.89]; P = .0261). The incidence of
intraoperative hypoxia (arterial oxygen saturation [Spo2] <94%; control
versus ORI: 32% [19/60; 95% confidence interval (CI), 20-45] vs 19%
[12/64; 95% CI, 10-31]; P = .09), and postoperative complications within
the first 7 days did not differ between the groups. CONCLUSION(S):
ORI-guided continuous Fio2 titration does not reduce overall oxygen
exposure during OLV. Copyright © 2022 International Anesthesia
Research Society.

<13>
Accession Number
2018221832
Title
Effect of Intraoperative Phrenic Nerve Infiltration on Postoperative
Ipsilateral Shoulder Pain After Thoracic Surgeries: A Systematic Review
and Meta-Analysis of Randomized Controlled Studies.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part B. 36(8) (pp
3334-3343), 2022. Date of Publication: August 2022.
Author
Hung Y.-A.; Sun C.-K.; Chiang M.-H.; Chen J.-Y.; Ko C.-C.; Chen C.-C.;
Chen Y.; Teng I.-C.; Hung K.-C.
Institution
(Hung) Department of Anesthesiology, Taichung Veterans General Hospital,
Taichung City, Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung city,
Taiwan (Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung city, Taiwan
(Republic of China)
(Chiang) Department of Anesthesiology, Shin Huey Shin Hospital, Kaohsiung,
Taiwan (Republic of China)
(Chen) Division of Nephrology, Department of Internal Medicine, Chi Mei
Medical Center, Tainan, Taiwan (Republic of China)
(Chen) Department of Health and Nutrition, ChiaNai University of Pharmacy
and Science, Tainan City, Taiwan (Republic of China)
(Ko) Department of Medical Imaging, Chi Mei Medical Center, Tainan, Taiwan
(Republic of China)
(Chen) Department of Anesthesiology, Kaohsiung Chang Gung Memorial
Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
(Republic of China)
(Chen) Department of Cardiovascular and Thoracic Surgery, Kaohsiung Chang
Gung Memorial Hospital and Chang Gung University College of Medicine,
Kaohsiung, Taiwan (Republic of China)
(Ko, Teng, Hung) Department of Anesthesiology, Chi Mei Medical Center,
Tainan, Taiwan (Republic of China)
Publisher
W.B. Saunders
Abstract
Objectives: This meta-analysis was aimed at investigating the
effectiveness and safety of phrenic nerve infiltration (PNI) against
ipsilateral shoulder pain (ISP) after thoracic surgery. Design(s): A
systematic review and meta-analysis of randomized controlled trials
(RCTs). Setting(s): Operating room. Participant(s): Patients
undergoing thoracic surgery. Intervention(s): PNI. Measurements
and Main Results: MEDLINE, Cochrane Library, and EMBASE databases were
searched from inception through December 2021. The primary outcome was the
overall incidence of ISP, with secondary outcomes including incidence and
severity of ISP at postoperative 6, 24, and 48 hours. Six RCTs involving
482 patients undergoing thoracic surgery were included. Pooled results
found a significantly lower incidence of overall ISP in patients with PNI
(ie, 23.6%) compared to those without (ie, 53.2%; risk ratio: 0.46, 95%
confidence interval: 0.34-0.61; I2 = 19%; 6 RCTs; n = 474;
certainty of evidence = high). At postoperative 6, 24, and 48 hours, there
was also a significantly lower incidence of ISP in the PNI group than in
the control group (certainty of evidence for all outcomes = high).
Besides, the severity of ISP was lower in the PNI group at 6 (certainty of
evidence = moderate) and 24 hours (certainty of evidence = high), with
insufficient data for analysis at 48 hours because of only 1 trial.
 Conclusion(s): This meta-analysis showed that PNI not only reduced
the incidence but also improved the severity of ipsilateral shoulder pain
after thoracic surgery with a prophylactic effect lasting up to 48 hours.
The limited number of included studies warrants further research to
support these findings. Copyright © 2022 Elsevier Inc.

<14>
Accession Number
2017958905
Title
Comparison between erector spinae plane block and paravertebral block
regarding postoperative analgesic consumption following breast surgery: a
randomized controlled study.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 189. Date
of Publication: December 2022.
Author
Elewa A.M.; Faisal M.; Sjoberg F.; Abuelnaga M.E.
Institution
(Elewa, Abuelnaga) Department of anaesthesia, critical care and pain
management, Faculty of Medicine, Suez Canal University, Ard Elgameiat,
Ismailia, Egypt
(Faisal) Department of Surgery, Faculty of Medicine, Suez Canal
University, Ismailia, Egypt
(Faisal) General Surgery Department, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Sjoberg) Department of Biomedical and Clinical Sciences (BKV), Linkoping
University Hospital, Linkoping, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Pain control following breast surgery is of utmost importance
in order to reduce the chance of chronic pain development, and facilitate
early rehabilitation. The erector spinae plane block (ESPB) is a recently
developed regional anaesthesia procedure successfully used for different
types of surgical procedures including thoracic and abdominal surgeries.
 Method(s): A double-blind, randomized, controlled trial was conducted
on 90 patients who were scheduled for modified radical mastectomy (MRM).
Patients were randomly categorized into groups I (women who underwent
ESPB), II (women who underwent paravertebral block (PVB), and III (women
who underwent general anaesthesia). Result(s): The ESPB (4.9 +/- 1.2
mg) and PVB (5.8 +/- 1.3 mg) groups had significantly lower total morphine
consumption than the control group had (16.4 +/- 3.1 mg; p < 0.001).
Notably, patients in the ESPB group had insignificantly lower morphine
consumption than those in the PVB group had (p = 0.076). Moreover,
patients in the ESPB and PVB groups had a significantly longer time to
first required anaesthesia than those in the control group (7.9 +/- 1.2
versus 7.5 +/- 0.9 versus 2 +/- 1.2 h, respectively; p < 0.001). The
postoperative visual analog scale scores were lower in the ESPB and PVB
groups than in the control group on the first 24 h after the procedure (p
< 0.001). Conclusion(s): ESPB and PVB provide effective postoperative
analgesia for women undergoing MRM. The ESPB appears to be as effective as
the PVB. Trial registration: The study was registered before the enrolment
of the first patient at the Pan African Clinical Trial Registry
(www.pactr.org) database. Identification number for the registry is
(PACTR202008836682092). Copyright © 2022, The Author(s).

<15>
Accession Number
2017955628
Title
Transposition physiology in the setting of concordant ventriculo-arterial
connections.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Chowdhury U.K.; Anderson R.H.; Spicer D.E.; George N.; Sankhyan L.K.;
Pandey N.N.; Goja S.; Chandhirasekar B.
Institution
(Chowdhury, George, Goja, Chandhirasekar) Department of Cardiothoracic and
Vascular Surgery, All India Institute of Medical Sciences, New Delhi,
India
(Anderson) Institute of Biomedical Sciences, Newcastle University,
Newcastle-upon-Tyne, United Kingdom
(Spicer) Department of Pediatric Cardiology, Heart Institute, Johns
Hopkins All Children's Hospital, University of Florida, Gainesville, FL,
United States
(Sankhyan) Department of Cardiothoracic Surgery, All India Institute of
Medical Sciences, Bilaspur, India
(Pandey) Cardiac Radiology, All India Institute of Medical Sciences,
Bilaspur, India
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim: To review the anatomical details, diagnostic
challenges, associated cardiovascular anomalies, and techniques and
outcomes of management, including re-interventions, for the rare instances
of transposition physiology with concordant ventriculo-arterial
connections. Method(s): We reviewed clinical and necropsy studies on
diagnosis and surgical treatment of individuals with transposition
physiology and concordant ventriculo-arterial connections, analyzing also
individuals with comparable flow patterns in the setting of isomerism.
 Result(s): Among reported cases, just over two-thirds were diagnosed
during surgery, after initial palliation, or after necropsy. Of the
patients, four-fifths presented in infancy with either cyanosis or
congestive cardiac failure, with complex associated cardiac malformations.
Nearly half had ventricular septal defects, and one-fifth had
abnormalities of the tricuspid valve, including hypoplasia of the
morphologically right ventricle. A small minority had common
atrioventricular junctions We included cases reported with isomerism when
the flow patterns were comparable, although the atrioventricular
connections are mixed in this setting. Management mostly involved
construction of intraatrial baffles, along with correction of coexisting
anomalies, either together or multistaged. Overall mortality was 25%, with
one-fifth of patients requiring pacemakers for surgically-induced heart
block. The majority of survivors were in good functional state.
 Conclusion(s): The flow patterns produced by discordant
atrioventricular and concordant ventriculo-arterial connections remain an
important, albeit rare, indication for atrial redirection or
hemi-Mustard's procedure with bidirectional Glenn. The procedure recruits
the morphologically left ventricle in the systemic circuit, producing good
long-term functional results. The approach can also be used for those with
isomeric atrial appendages and comparable hemodynamic
circuits. Copyright © 2022 Wiley Periodicals LLC.

<16>
Accession Number
2015265796
Title
Fate of Patients With Single Ventricles Who Do Not Undergo the Fontan
Procedure.
Source
Annals of Thoracic Surgery. 114(1) (pp 25-33), 2022. Date of Publication:
July 2022.
Author
Zheng W.C.; Lee M.G.Y.; d'Udekem Y.
Institution
(Zheng, Lee, d'Udekem) Department of Paediatrics, University of Melbourne,
Melbourne, Australia
(Zheng, Lee, d'Udekem) Department of Cardiac Surgery, The Royal Children's
Hospital, Melbourne, Australia
(Lee, d'Udekem) Heart Research, Clinical Sciences, Murdoch Children's
Research Institute, Melbourne, Australia
(Lee) Department of Medicine, The Royal Melbourne Hospital, University of
Melbourne, Melbourne, Australia
(d'Udekem) Division of Cardiac Surgery, Children's National Hospital,
Washington, DC
Publisher
Elsevier Inc.
Abstract
Background: The Fontan procedure, the last of a series of palliative
operations for patients born with single ventricles, is associated with a
significant late burden of complications. There are other strategies for
patients who are suboptimal candidates for Fontan completion; however, the
long-term outcomes of these different surgical options have not been
clearly elucidated. We performed a systematic literature review to
establish the current role of other treatment approaches besides the
Fontan procedure. Method(s): The MEDLINE and Embase databases were
systematically searched for articles describing the long-term outcomes of
patients with single ventricles who have not received the Fontan
procedure. Result(s): A total of 36 articles met all inclusion
criteria. There is a scarcity of contemporary data on the non-Fontan
cohort. Historical studies provided a significant contribution.
 Conclusion(s): Long-term survival of unoperated patients with single
ventricles is possible under the rare conditions of having balanced
hemodynamics. As many as half of patients may survive on only a
systemic-to-pulmonary artery shunt or bidirectional cavopulmonary shunt
for more than 20 years with reasonable functional status. In patients with
a failing single ventricle, the bidirectional cavopulmonary shunt is an
excellent bridge to heart transplantation and may provide better
posttransplant survival than patients with a Fontan circulation.
Currently, the Fontan procedure continues to be the best definitive
palliation for patients born with single ventricle lesions. However, for
those with borderline indications, other strategies should be carefully
considered. Copyright © 2022 The Society of Thoracic Surgeons

<17>
Accession Number
2010392950
Title
Recruitment maneuvers to reduce pulmonary atelectasis after cardiac
surgery: A meta-analysis of randomized trials.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(1) (pp 171-181.e4),
2022. Date of Publication: July 2022.
Author
Hu M.-C.; Yang Y.-L.; Chen T.-T.; Lee C.-I.; Tam K.-W.
Institution
(Hu, Chen) Graduate Institute of Clinical Medicine, College of Medicine,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Yang) School of Respiratory Therapy, College of Medicine, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Yang) Department of Respiratory Therapy, Landseed International Hospital,
Taoyuan, Taiwan (Republic of China)
(Chen) Division of Pulmonary Medicine, Department of Internal Medicine,
Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
(Republic of China)
(Lee) Division of Cardiovascular Surgery, Department of Surgery, Shuang Ho
Hospital, Taipei Medical University, New Taipei City, Taiwan (Republic of
China)
(Tam) Division of General Surgery, Department of Surgery, Shuang Ho
Hospital, Taipei Medical University, New Taipei City, Taiwan (Republic of
China)
(Tam) Division of General Surgery, Department of Surgery, School of
Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Tam) Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan (Republic
of China)
Publisher
Elsevier Inc.
Abstract
Background: Pulmonary atelectasis is a common postoperative complication
that may lead to intrapulmonary shunt, refractory hypoxemia, and
respiratory distress. Recruitment maneuvers may relieve pulmonary
atelectasis in patients undergoing cardiac surgery. We conducted a
meta-analysis of randomized controlled trials to evaluate the
effectiveness of recruitment maneuvers in these patients. Method(s):
We conducted a search in PubMed, Embase, Cochrane Library, and the
ClinicalTrials.gov registry for trials published before March 2020.
Individual effect sizes were standardized, and a meta-analysis was
performed to calculate a pooled effect size by using random-effects
models. Pulmonary atelectasis was assessed postoperatively. Secondary
outcomes included hypoxic events, arterial oxygen tension
(PaO<inf>2</inf>)/inspired oxygen fraction (FIO<inf>2</inf>) ratio,
cardiac index, mean arterial pressure, and postoperative complications
including pneumothorax and pneumonia. Result(s): We reviewed 16
trials involving 1455 patients. Patients receiving recruitment maneuvers
had a reduced incidence of pulmonary atelectasis (group with recruited
pressure >40 cmH<inf>2</inf>O: risk ratio [RR], 0.20; 95% confidence
interval [CI], 0.07-0.57; group with recruited pressure <40
cmH<inf>2</inf>O: RR, 0.54; 95% CI, 0.33-0.89), reduced incidence of
hypoxic events (RR, 0.23; 95% CI, 0.14-0.37), reduced incidence of
pneumonia (RR, 0.42; 95% CI, 0.18-0.95), and improved
PaO<inf>2</inf>/FIO<inf>2</inf> ratio (weighted mean difference [WMD];
58.87, 95% CI, 31.24-86.50) without disturbing the cardiac index (WMD,
0.22; 95% CI, -0.18 to 0.61) or mean arterial pressure (WMD, -0.30, 95%
CI, -3.19 to 2.59) as compared with those who received conventional
mechanical ventilation. The incidence of pneumothorax was nonsignificant
between the groups. Conclusion(s): Recruitment maneuvers may reduce
postoperative pulmonary atelectasis, hypoxic events, and pneumonia and
improve PaO<inf>2</inf>/FIO<inf>2</inf> ratios without hemodynamic
disturbance in patients undergoing cardiac surgery. Copyright ©
2020 The American Association for Thoracic Surgery

<18>
Accession Number
638259406
Title
ICIMH 2022 Abstracts.
Source
Global Advances in Health and Medicine. Conference: International Congress
on Integrative Medicine and Health, ICIMH 2022. Phoenix, AZ. 11 (no
pagination), 2022. Date of Publication: January - December 2022.
Author
Anonymous
Publisher
SAGE Publications Ltd
Abstract
The proceedings contain 253 papers. The topics discussed include:
battlefield acupuncture use in multimodal perioperative anesthesia care;
inpatient integrative medicine sees a dramatic reduction of 30-day
readmissions; findings from the new inpatient east-west medicine service
at UCLA; inpatient acupuncture pilot for coronary artery bypass graft
surgery; association between chiropractic spinal manipulation and
emergency visits in adults with non-urgent low back pain: retrospective
cohort study; thoracolumbar fascia mobility (shear strain) over a course
of chiropractic care for chronic low back pain; early engagement in
nonpharmacological care shortens the duration of follow-up for low back
pain in the veterans health administration; comparative efficacy of
different exercise interventions in chronic non-specific low back pain: a
systematic review and network meta-analysis; utility of health coach
training for medical students from the lens of clinical clerkships; and
moving mindfulness through the necessary research steps to instill
organizational buy-in for employer-sponsored resiliency training.

<19>
Accession Number
638263995
Title
THE PROSPECTIVE ROLES OF URINARY DICKKOPF-3 FOR DETECTING RENAL FUNCTION
DETERIORATION AND MONITORING CHRONIC KIDNEY DISEASE PROGRESSION:
SYSTEMATIC REVIEW OF COHORT STUDIES.
Source
Nephrology Dialysis Transplantation. Conference: 59th ERA Congress.
Virtual. 37(SUPPL 3) (pp i356-i357), 2022. Date of Publication: May 2022.
Author
Putra B.P.; Putra F.N.
Institution
(Putra) Department of Internal Medicine, Faculty of Medicine Universitas
Airlangga, Surabaya, Indonesia
(Putra) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Publisher
Oxford University Press
Abstract
BACKGROUND AND AIMS: Chronic kidney disease (CKD) is a worldwide health
problem whose incremental prevalence. Early detection and proper
monitoring of renal dysfunction can decrease morbidity and mortality among
CKD patients. Estimated glomerular filtration rate (eGFR) and albuminuria
have been used for monitoring CKD progression. Unfortunately, substantial
CKD patients' proportion might undergo CKD progression through
non-proteinuric pathways. Dickkopf-3 (DKK3), stress-induced renal tubular
epithelial-derived glycoprotein, is a key driver of tubulointerstitial
fibrosis through the canonical Wnt/beta-catenin signaling pathway. This
study aims to evaluate the role of DKK3 in detecting and monitoring renal
dysfunction and CKD progression. METHOD(S): Comprehensive literature
searching was performed through the online databases of PubMed, EMBASE,
ScienceDirect and The Cochrane Library. This study followed the PRISMA
guidelines. The inclusion criteria are all cohort studies that assess the
correlation and clinical implications of increased urinary DKK3 with CKD
progression. The quality of included studies was accessed by using the
Newcastle- Ottawa Scale. RESULT(S): Six cohort studies matched the
inclusion criteria. Urinary DKK3-tocreatinine >4000 pg/mg was
independently associated with annual eGFR decline among early CKD stages.
A multivariate analysis study suggested that 24-h urinary DKK3 was
independently associated with the annual Kt/V decline among peritoneal
dialysis patients. Increased urinary DKK3 was associated with a
significant eGFR decline in 6 months among IgA nephropathy patients. A
cohort study suggested that populations with microalbuminuria were
significantly susceptible to prevalent cardiovascular diseases, prevalent
CKD, and new-onset CKD risks. Urinary DKK3 was associated with significant
incremental risks for declining eGFR and proteinuria as well as CKD
progression risks in chronic obstructive pulmonary disease (COPD)
patients. In a study, involving CKD patients who underwent coronary
angiography, the baseline urinary DKK3-to-creatinine ratio was superior to
serum cystatin-C and serum and urinary neutrophil gelatinase-associated
lipocalin (NGAL), predicting both acute kidney injury (AKI) and persistent
renal dysfunction. A cardiac surgery study showed that high urinary
DKK3-to-creatinine ratio >471 pg/mg was significantly associated with AKI,
persistent renal dysfunction and dialysis dependency. CONCLUSION(S):
Dickkopf-3 shows promising prospective roles for detecting early renal
dysfunction and monitoring CKD progression. Nevertheless, further studies
are warranted to confirm its promising prospective role. (Figure
Presented).

<20>
Accession Number
638263907
Title
BENEFITS OF A NEFROVASCULAR ULTRASOUND CONSULTATION: RESULTS OF 2 YEARS OF
FOLLOW-UP.
Source
Nephrology Dialysis Transplantation. Conference: 59th ERA Congress.
Virtual. 37(SUPPL 3) (pp i561-i562), 2022. Date of Publication: May 2022.
Author
Martin J.B.; Franco M.J.M.; Heres S.V.P.; Tejederas M.A.; Lazo M.S.
Institution
(Martin, Franco, Heres, Lazo) Hospital Universitario Virgen Macarena, UGC
Nefrologia, Sevilla, Spain
(Tejederas) Hospital Universitario De Jerez, UGC Nefrologia, Jerez de la
Frontera, Spain
Publisher
Oxford University Press
Abstract
BACKGROUND AND AIMS: The main vascular access for haemodialysis patients
is the arteriovenous fistula (AVF). There is a high rate of early primary
failure and loss of primary patency, therefore, vascular access monitoring
is essential for the early diagnosis of complications and prolonging their
survival. Our objective is to analyse the results of a consultation for
the review and follow-up of AVFs using colour-Doppler ultrasound,
performed by the nephrologist. METHOD(S): Retrospective descriptive
study of vascular ultrasounds performed from January 2019 to January 2021.
Including clinical and demographic variables of the patients, as well as
ultrasound parameters. Data from the Review group were compared;
ultrasounds performed 3-4 weeks after performing vascular access; versus
Dysfunction group; whose patients were referred from the advanced chronic
kidney disease (ACKD) consultations or from the different dialysis centres
upon detecting any data of suspected vascular access dysfunction.
 RESULT(S): A total of 166 vascular ultrasounds were performed: 106
(64%) in the Review group and 60 (36%) in the Dysfunction of the AVF
group. A higher proportion of women was found in the Dysfunction group and
upper mean age, close to the significance, P = 0.06 and P = 0.059
respectively. No significant differences were found with respect to other
demographic characteristics in both groups (hypertension, diabetes,
anticoagulant treatment and aetiology of kidney disease). Regarding the
type of vascular access, a lower proportion of radiocephalic AVFs was
observed in the Revision group (65% versus 50%) and a greater number of
elbow AVFs (humero cephalic, humero basilic and humero median) in the
Dysfunction group (35% versus 50%) with differences close to significance,
P = 0.057. In the Review group, in 70.8% the findings were normal, in
24.5% lack of development was found, thrombosis in 9.4%, stenosis 6.6%,
aneurysm 6%, oedema 17% and haematoma 6.6%. A 43% of the patients did not
require to implement measures, in 42% exercise was recommended, in 6%
repose of the AVF and 6 patients were requested fistulography and 3 were
referred to cardiovascular surgery (CCV). In the Access Dysfunction group,
the ultrasound diagnosis was normal in 28%, thrombosis was objective in
25%, stenosis 37%, aneurysm 42%, oedema 17%, haematoma 22%. 37% were
referred for fistulography and 15% for revision by CCV. Regarding the
ultrasound parameters, significant differences (P > 0.05) were found in
terms of AVF flow, proximal and distal resistance index and vein calibre,
but not in terms of vein depth and anastomosis diameter. A total of 28
fistulograms were performed, finding 86% agreement with the ultrasound
findings. And in 93% the intervention was successful. Only 24% of the
patients referred to the consultation required some type of intervention,
and up to 65% were able to save the AVF, avoiding the realization of a new
vascular access. CONCLUSION(S): The systematic review after
performing the vascular access made it possible to diagnose complications
early and allow early intervention. It might be necessary to establish
predictive criteria for vascular access dysfunction to individualize the
follow-up for each patient, such as age, sex, or type of vascular access.
Systematized vascular ultrasound by the nephrologist is very useful to
preserve the functionality of the vascular access. On the other hand, the
Vascular Nephrodiagnosis Consultation can avoid performing invasive and
unnecessary procedures for the patient.

<21>
Accession Number
638261325
Title
REDEFINING THE EPIDEMIOLOGY OF CARDIAC AMYLOIDOSIS. A SYSTEMATIC REVIEW OF
SCREENING STUDIES.
Source
European Heart Journal, Supplement. Conference: 53rd Congress of the
Italian Association of Hospital Cardiologists, ANMCO 2022. Rimini Italy.
24(SUPPL C) (pp C167), 2022. Date of Publication: May 2022.
Author
Aimo A.; Merlo M.; Porcari A.; Pagura L.; Sinagra G.; Vergaro G.; Emdin
M.; Rapezzi C.
Institution
(Aimo, Merlo, Porcari, Pagura, Sinagra, Vergaro, Emdin, Rapezzi) FTGM,
PISA; OSPEDALI RIUNITI, TRIESTE; UNIVERSITA DI FERRARA, FERRARA
Publisher
Oxford University Press
Abstract
Background: Over the last years, an algorithm for non-invasive diagnosis
of amyloid transthyretin cardiac amyloidosis (ATTR-CA) and novel
disease-modifying therapies have prompted an active search of CA in
different clinical settings. Method(s): We performed a systematic
search of screening studies investigating CA. Result(s): The average
prevalence of CA in different settings were as follows: total body
scintigraphy with "bone tracers" for non-cardiac reasons (n=5 studies),
1%; heart failure (HF) with preserved ejection fraction (n=6), 12%; HF
with reduced or mildly reduced ejection fraction (n=2), 10%, conduction
disorders warranting pacemaker implantation (n=1), 2%; surgery for carpal
tunnel syndrome (CTS; n=3), 7%; hypertrophic cardiomyopathy phenotype
(n=2), 9%; aortic stenosis (AS) undergoing surgical or transaortic valve
replacement (n=7), 10%; autopsy series of "unselected" elderly individuals
(n=4), 15%. Many of these patients had ATTR-CA, but the percentage of
cases with amyloid light-chain CA was far from negligible.
 Conclusion(s): Screening for CA in specific settings allows to
identify a relatively high number of cases, in agreement with the notion
that CA is not a rare disease. Many patients have ATTR-CA. Most studies
focused on elderly subjects, given the clear relationship between age and
the likelihood of CA. Men accounted for a high proportion of patients with
CA, but women were quite represented. (Figure Presented).

<22>
Accession Number
638260170
Title
Impact of the use of cusp overlap projection technique in the incidence of
post-TAVR permanent pacemaker implantation with self-expanding valves.
Source
Europace. Conference: Annual Congress of the European Heart Rhythm
Association, EHRA 2022. Online. 24(SUPPL 1) (pp i609), 2022. Date of
Publication: May 2022.
Author
Moura A.; Rodrigues J.A.; Guerreiro C.; Pires-Morais G.; Santos L.; Melica
B.; Braga P.; Fontes-Carvalho R.
Institution
(Moura, Rodrigues, Guerreiro, Pires-Morais, Santos, Melica, Braga,
Fontes-Carvalho) District Hospital of Santarem, Santarem, Portugal;
Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de
Gaia, Portugal
Publisher
Oxford University Press
Abstract
Introduction: Current rates of new Permanent Pacemaker (PPM) Implantations
in the context of Transcatheter Aortic Valve Replacement (TAVR) range from
2-36% and that necessity is related to worse prognosis. The use of
self-expanding valves and a lower valve implantation depth are two factors
associated with an increased risk of conduction disturbances post-TAVR.
Theoretically, cusp overlap implantation technique has the potential to
enable a higher valve deployment by eliminating parallax of the delivery
catheter. Aim(s): To compare the in-hospital incidence of PPM
post-TARV using self-expandable valve according to the fluoroscopic
guidance technique. Method(s): Retrospective, single-centre study,
with evaluation of patients consecutively submitted to TAVR with
self-expanding CoreValveTM between July 2020 and December 2021
dichotomized according to the use of cusp overlap implantation technique
for fluoroscopic valve implantation guidance. Result(s): 138 patients
were included, predominantly women (57.2%), with a mean age of 78.4+/-8.0
years old, with severe aortic stenosis of the native valve being the most
common indication for TAVI (85.5%). Cusp overlap view technique was
applied in 50.7% of the patients (n=70). Frailty and co-morbidities were
the most common cause for surgical refusal (54.3%). There was a
significantly higher percentage of hypertensive patients (92.9% vs.
77.9%), lower previous aortic valve surgery (2.9% vs. 16.2%) and lower
percentage of patients previously medicated with b-blockers in the group
of patients in whom was used the cusp overlap technique; there were no
other relevant differences related to the baseline characteristics. First
degree atrioventricular block was present in 19.6% and complete right
bundle block in 13.6% of the patients. Incidence of in-hospital post-TAVR
PPM implantation wasn't significantly different between the two cohorts of
patients (cusp overlap vs. standard approach: 24.3% vs. 26.5%, p=0.77)
(71.4% implanted in the context of complete heart block). Likewise, there
were similar proportions of in-hospital new-onset of complete left bundle
branch block (35.8% vs. 37.3%, p=0.86), volume of contrast used
(140.6+/-37.5 mL vs. 145.2+/-51.5 mL, p=0.12), fluoroscopy time
(15.6+/-8.8 min vs. 19.6+/-8.9 min, p=0.40) and radiation dose
(556.3+/-320.6 mGy vs. 859.4+/-531.2 mGy, p=0.06). Conclusion(s):
This study shows that using the cusp overlap view for self-expanding valve
implantation does not seem to achieve a significant reduction in
in-hospital PPM implantation rate in comparison with the traditional 3
cusp co-planar fluoroscopic view. A larger and probably randomized
clinical trial is needed to confirm these results.

<23>
Accession Number
2017112968
Title
Reconstruction of Pharyngolaryngeal Defects with the Ileocolon Free Flap:
A Comprehensive Review and How to Optimize Outcomes.
Source
Archives of Plastic Surgery. 49(3) (pp 378-396), 2022. Date of
Publication: May 2022.
Author
Escandon J.M.; Santamaria E.; Prieto P.A.; Duarte-Bateman D.; Ciudad P.;
Pencek M.; Langstein H.N.; Chen H.-C.; Manrique O.J.
Institution
(Escandon, Pencek, Langstein, Manrique) Division of Plastic and
Reconstructive Surgery, Strong Memorial Hospital, University of Rochester
Medical Center, Rochester, NY, United States
(Santamaria) Department of Plastic and Reconstructive Surgery, Hospital
General Dr. Manuel Gea Gonzalez, National Cancer Institute, Mexico City,
Mexico
(Prieto) Surgery Department, University of Rochester Medical Center, NY,
United States
(Duarte-Bateman) Division of Plastic and Reconstructive Surgery, Cleveland
Clinic, OH, United States
(Ciudad) Department of Plastic, Reconstructive and Burn Surgery, Arzobispo
Loayza National Hospital, Lima, Peru
(Ciudad, Chen) Department of Plastic Surgery, China Medical University
Hospital, Taichung, Taiwan (Republic of China)
(Prieto) Wilmot Cancer Institute, University of Rochester Medical Center,
NY, United States
Publisher
Korean Society of Plastic and Reconstructive Surgeons
Abstract
Several reconstructive methods have been reported to restore the
continuity of the aerodigestive tract following resection of pharyngeal
and hypopharyngeal cancers. However, high complication rates have been
reported after voice prosthesis insertion. In this setting, the ileocolon
free flap (ICFF) offers a tubularized flap for reconstruction of the
hypopharynx while providing a natural phonation tube. Herein, we
systematically reviewed the current evidence on the use of the ICFF for
reconstruction of the aerodigestive tract. A systematic literature search
was conducted across PubMed MEDLINE, Web of Science, ScienceDirect,
Scopus, and Ovid MEDLINE(R). Data on the technical considerations and
surgical and functional outcomes were extracted. Twentyone studies were
included. The mean age and follow-up were 54.65 years and 24.72 months,
respectively. An isoperistaltic or antiperistaltic standard ICFF, patch
flap, or chimeric seromuscular-ICFF can be used depending on the patients'
needs. The seromuscular chimeric flap is useful to augment the closure of
the distal anastomotic site. The maximum phonation time, frequency, and
sound pressure level (dB) were higher with ileal segments of 7 to 15 cm.
The incidence of postoperative leakage ranged from 0 to 13.3%, and the
majority was occurring at the coloesophageal junction. The revision rate
of the microanastomosis ranged from 0 to 16.6%. The ICFF provides a
reliable and versatile alternative for reconstruction of middle-size
defects of the aerodigestive tract. Its three-dimensional configuration
and functional anatomy encourage early speech and deglutition without a
prosthetic valve and minimal donor-site morbidity. Copyright ©
2022. The Korean Society of Plastic and Reconstructive Surgeons.

<24>
Accession Number
2017057140
Title
The effect of ultrasound-guided bilateral thoracic retrolaminar block on
analgesia after pediatric open cardiac surgery: a randomized controlled
double-blind study.
Source
Korean Journal of Anesthesiology. 75(3) (pp 276-282), 2022. Date of
Publication: June 2022.
Author
Abdelbaser I.; Mageed N.A.; Elfayoumy S.I.; Magdy M.; Elmorsy M.M.;
Alseoudy M.M.
Institution
(Abdelbaser, Mageed, Magdy, Alseoudy) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University, 2
El-Gomhouria Street, Mansoura 35516, Egypt
(Elfayoumy) Department of Anesthesia and Surgical Intensive Care, Faculty
of Medicine, Portsaid University, Portsaid, Egypt
(Elmorsy) Department of Anesthesia and Surgical Intensive Care, Faculty of
Medicine, Damietta University, Damietta, Egypt
Publisher
Korean Society of Anesthesiologists
Abstract
Background: The thoracic retrolaminar block (TRLB) is a relatively new
regional analgesia technique that can be used as an alternative to the
thoracic paravertebral block. This study aimed to evaluate the
postoperative analgesic effects of ultrasound-guided TRLB in children
undergoing open cardiac surgery via median sternotomy incision.
 Method(s): Sixty-six patients aged 2-8 years were recruited. In the
TRLB group, 0.25% bupivacaine 0.4 ml/kg was injected into the retrolaminar
space on both sides at the level of the T4 lamina. Patients in the control
group were injected with 0.9% saline. The primary outcome measure was
fentanyl consumption in the first 24 h post-extubation. The secondary
outcome measures were the total intraoperative fentanyl consumption,
postoperative modified objective pain score (MOPS), and time to
extubation. Result(s): The total intraoperative fentanyl requirements
and fentanyl consumption in the first 24 h post-extubation were
significantly lower (P < 0.001) in the TRLB group (9.3 +/- 1.2; 6.9 +/-
2.1 mug/kg, respectively) than in the control group (12.5 +/- 1.4; 16.6
+/- 2.8, respectively). The median (Q1, Q3) time to extubation was
significantly shorter (P < 0.001) in the TRLB group (2 [1, 3] h) than in
the control group (6 [4.5, 6] h). The MOPS was significantly lower (P <
0.05) in the TRLB group than in the control group at 0, 2, 4, 8, 12 and 16
h post-extubation. Conclusion(s): Bilateral ultrasound-guided TRLB is
effective in providing postoperative analgesia in children undergoing open
cardiac surgery via median sternotomy incision. Copyright @ 2022 The
Korean Society of Anesthesiologists, 2022.

<25>
Accession Number
2015363045
Title
A randomised controlled feasibility trial of a clinical protocol to manage
hypotension during major non-cardiac surgery.
Source
Anaesthesia. 77(7) (pp 795-807), 2022. Date of Publication: July 2022.
Author
Wijeysundera D.N.; Duncan D.; Moreno Garijo J.; McCluskey S.A.;
Pazmino-Canizares J.; Carroll J.; Poonawalla H.; Beattie W.S.; Clarke
H.A.; Kulkarni G.; Sellers D.; Vidal E.; Wei A.; Jerath A.; Meineri M.;
Garijo J.M.; Parotto M.; Wasowicz M.
Institution
(Wijeysundera) Department of Anesthesia, St. Michael's Hospital, Toronto,
ON, Canada
(Wijeysundera, Duncan, Moreno Garijo, Jerath, Meineri, Parotto, Wasowicz,
McCluskey) Department of Anesthesiology and Pain Medicine, University of
Toronto, ON, Canada
(Meineri) Department of Anaesthesia and Intensive Care, Heart Centre
Leipzig, Germany
Publisher
John Wiley and Sons Inc
Abstract
Intra-operative hypotension is a risk factor for postoperative morbidity
and mortality. Minimally invasive monitors that derive other haemodynamic
parameters, such as stroke volume, may better inform the management of
hypotension. As a prelude to a multicentre randomised controlled trial, we
conducted a single-centre feasibility trial of a protocol to treat
hypotension as informed by minimally invasive haemodynamic monitoring
during non-cardiac surgery. We recruited adults aged >=40 years with
cardiovascular risk factors who underwent non-cardiac surgery requiring
invasive arterial pressure monitoring. Participants were randomly
allocated to usual care, or a clinical protocol informed by an arterial
waveform contour analysis monitor. Participants, outcome assessors,
clinicians outside operating theatres and analysts were blinded to
treatment allocation. Feasibility was evaluated based on: consent rate;
recruitment rate; structured feedback from anaesthesia providers; and
between-group differences in blood pressure, processes-of-care and
outcomes. The consent rate among eligible patients was 33%, with 30
participants randomly allocated to the protocol and 30 to usual care.
Anaesthesia providers rated the protocol to be feasible and acceptable.
The protocol was associated with reduced fluid balance and hypotension
exposure in the peri-operative setting. Postoperative complications
included: acute myocardial injury in 18 (30%); acute kidney injury in 17
(28%); and surgical site infection in 7 (12%). The severity of
complications was rated as moderate or severe in 25 (42%) participants. In
summary, this single-centre study confirmed the feasibility of a
multicentre trial to assess the efficacy and safety of a physiologically
guided treatment protocol for intra-operative hypotension based on
minimally invasive haemodynamic monitors. Copyright © 2022
Association of Anaesthetists.

<26>
Accession Number
638220825
Title
Investigation of the optimal platinum-based regimen in the postoperative
adjuvant chemotherapy setting for early-stage resected non-small lung
cancer: a Bayesian network meta-analysis.
Source
BMJ Open. 12(6) (no pagination), 2022. Article Number: e057098. Date of
Publication: 13 Jun 2022.
Author
Pang L.-L.; Gan J.-D.; Huang Y.-H.; Liao J.; Lv Y.; Ali W.A.-S.; Zhang L.;
Fang W.-F.
Institution
(Pang, Gan, Huang, Liao, Ali, Zhang, Fang) Department Of Medical Oncology,
State Key Laboratory Of Oncology In South China, Collaborative Innovation
Center For Cancer Medicine, Sun Yat-sen University Cancer Center,
Guangzhou, China
(Lv) Zhongshan School Of Medicine, Sun Yat-Sen University, Guangzhou,
China
Publisher
BMJ Publishing Group
Abstract
Objective This study aimed to compare the efficacy and safety of different
platinum adjuvant chemotherapy regimens for early-stage resected
non-small-cell lung cancer (NSCLC). Design Systematic review with network
meta-analysis of randomised trials. Data sources PubMed, EMBASE, The
Cochrane Library, Web of Science and Scopus Google Scholar were searched
through 12 March 2021. Eligibility criteria Eligible randomised controlled
trials (RCTs) comparing the postoperative platinum chemotherapy regimen
with the observation-controlled group or comparing two platinum
chemotherapy regimens head-to-head were included. Data extraction and
synthesis The primary outcome was the efficacy of adjuvant chemotherapy
regimens including relapse-free survival (RFS), overall survival (OS),
2-year, 3-year, 5-year RFS rate and OS rate. The secondary outcome was the
rate of grade 3-4 toxicity assessments. Cochrane Handbook (V.5) was used
for the risk of bias assessment. Analyses were performed using R software
V.4.3.1. Results 20 RCTs with a sample size of 5483 were enrolled in
meta-analysis. The chemotherapy group had a significant RFS and OS
advantage compared with the observation group (HR 0.67; 95% CI 0.56 to
0.81, p<0.0001; HR 0.80; 95% CI, 0.73 to 0.88, p<0.0001, respectively).
Compared with the observation arm, only the cisplatin_vinorelbine regimen
had a significant RFS and OS advantage (HR 0.63; 95% CI 0.43 to 0.87; HR
0.74; 95% CI 0.63 to 0.87, respectively) while the remaining chemotherapy
regimens had no significant difference of efficacy compared with the
observation group. In terms of the safety of adjuvant chemotherapy, the
incidence of haematological toxicities and nausea/vomiting was not
significantly higher in the cisplatin_vinorelbine arm than in other
chemotherapy group. Conclusion This study summarised the adjuvant
cytotoxicity chemotherapy regimens for patients with early-stage resected
NSCLC. Our analysis may provide some guiding significance for the
clinicians when determining the optimal chemotherapy regimen.
 Copyright © Author(s) (or their employer(s)) 2022. Re-use
permitted under CC BY. Published by BMJ.

<27>
Accession Number
2018778415
Title
Effect of a low dose of empagliflozin on short-term outcomes in type 2
diabetics with acute coronary syndrome after percutaneous coronary
intervention.
Source
Saudi Medical Journal. 43(5) (pp 458-464), 2022. Date of Publication: 01
May 2022.
Author
Adel S.M.H.; Jorfi F.; Mombeini H.; Rashidi H.; Fazeli S.
Institution
(Adel, Jorfi, Mombeini, Fazeli) Department of Cardiology, Ahvaz, Iran,
Islamic Republic of
(Adel, Jorfi, Mombeini) Atherosclerosis Research Center, Ahvaz, Iran,
Islamic Republic of
(Rashidi) Department of Internal Medicine, Ahvaz Jundishapur University of
Medical Sciences, Imam Khomeini Hospital, Ahvaz, Iran, Islamic Republic of
Publisher
Saudi Arabian Armed Forces Hospital
Abstract
Objectives: To study the effects of low dose of empagliflozin on improving
outcomes in diabetic patients with acute coronary syndrome (ACS) after
percutaneous coronary intervention (PCI). Method(s): This
double-blind controlled clinical trial was carried out on 93 diabetic
patients (56 males and 37 females, mean age of 56.55 years) with ACS who
underwent PCI at 2 university teaching hospitals in 2020, Ahvaz, Iran. The
patients were randomly assigned to receive empagliflozin (10 mg once
daily) or placebo at similar doses for 6 months after PCI. In addition, to
standard treatments with another hypoglycemic agent. Cardiovascular
outcomes (including all-cause mortality, coronary revascularization,
rehospitalization due to unstable angina, hospitalization due to heart
failure, cardiovascular death, non-fetal myocardial infarction, and
non-fetal stroke) were evaluated during period of 6 months follow-up after
the empagliflozin treatment. Result(s): There was no significant
difference between the low dose empagliflozin and placebo groups after
treatment in terms of cardiovascular mortality (2.2% versus [vs.] 4.2%;
p=0.598), rehospitalization due to unstable angina (4.5% vs. 8.7%;
p=0.433), and coronary revascularization (2.2% vs. 0%; p=0.312).
 Conclusion(s): The results of this study showed that adding low dose
empagliflozin to standard care of ACS diabetic patients after PCI was
associated with no significant reduction in negative cardiovascular
outcomes during 6 months. Copyright © 2022 Saudi Arabian Armed
Forces Hospital. All rights reserved.

<28>
Accession Number
2018874133
Title
Effect of Clemastine Fumarate on Perioperative Hemodynamic Instability
Mediated by Anaphylaxis During Cardiopulmonary Bypass Surgery.
Source
Medical Science Monitor. 28 (no pagination), 2022. Article Number:
e936367. Date of Publication: 02 Jul 2022.
Author
Tian L.; Liu Y.; Fei Y.; Lv H.; Yan F.; Li L.; Shi J.
Institution
(Tian, Liu, Lv, Yan, Li, Shi) Department of Anesthesiology, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
(Fei) Department of Anesthesiology, Peking Union Medical College Hospital,
Chinese Academy of Medical Sciences, Peking Union Medical College,
Beijing, China
Publisher
International Scientific Information, Inc.
Abstract
Background: Perioperative hemodynamic instability mediated by anaphylaxis
is a life-threatening complication in patients undergoing cardiac surgery
with cardiopulmonary bypass (CPB). This study aimed to evaluate the effect
of clemastine fumarate in this specific patient population.
Material/Methods: We enrolled 100 participants who met the inclusion
criteria and randomly allocated them to the treatment group and the
placebo group. Participants in the treatment group and the placebo group
were treated separately with an injection of clemastine fumarate and
saline, respectively. Plasma histamine concentration and blood pressure
were quantified at 5 timepoints during the perioperative period, and
differences between the 2 groups were assessed by repeated-measures ANOVA.
The postoperative complications and in-hospital mortality also were
evaluated. All participants were followed up for 7 days after cardiac
surgery. Result(s): Plasma histamine concentrations increased in both
groups but were statistically significantly lower in the treatment group
during the perioperative period (P=0.007). Diastolic blood pressure
(P=0.014) and mean arterial pressure (P=0.024) in the treatment group were
significantly higher than in the placebo group during the perioperative
period. The coefficients of variation for systolic (13.9+/-4.2% vs
17.2+/-4.4%, P<0.01) and diastolic (12.9+/-4.9% vs 15.3+/-5.2%, P=0.02)
blood pressure were significantly lower in the treatment group compared
with the placebo group. Conclusion(s): Pretreatment with clemastine
fumarate restrains the increase in histamine concentration and provides
safer hemodynamics in patients undergoing cardiac surgery with
CPB. Copyright © 2022 International Scientific Information, Inc..
All rights reserved.

<29>
Accession Number
2018847596
Title
Effect of cocoa flavanol supplementation for the prevention of
cardiovascular disease events: The COcoa Supplement and Multivitamin
Outcomes Study (COSMOS) randomized clinical trial.
Source
American Journal of Clinical Nutrition. 115(6) (pp 1490-1500), 2022. Date
of Publication: 01 Jun 2022.
Author
Johnson L.G.; Moorthy M.V.; Carrick W.R.; Manson J.E.; Sesso H.D.; Rist
P.M.; Bassuk S.S.; Leboff M.S.; Okereke O.I.; Cook N.R.; Friedenberg G.;
Copeland T.; Hanna J.; Clar A.; D'Agostino D.; Vinayagamoorthy M.; Gibson
H.; Kim E.; Van Denburgh M.; Kotler G.; Li C.; Bubes V.; Sarkissian A.;
Smith D.; Pereira E.C.; Okeke M.; Roche E.; Ridge C.; Phillips A.; Salvo
B.; Wilson A.; Hall L.; Baez J.; Sim Y.-H.; Cardoso H.; Senor G.; Rudnicki
C.; Huynh H.; Nguyen V.; Terrell N.; Holman B.A.; Walter J.; Johnson L.F.;
Casarella A.; O'Connell J.; Christen W.; Lagerstrom S.R.; Djousse L.;
Chandler P.D.; Hazra A.; Tobias D.K.; Farukhi Z.M.; Wang L.; Zhang X.;
Breen K.; Menjin Jr G.V.; Rodriguez R.; Curry S.; Arsenault L.; Solano O.;
Weinberg A.; Coates J.; Kilroe M.; Zernicke L.; Hasson K.; Matthew K.;
Mora S.; Pfeffer C.; Duszlak J.; Bates D.; Guzman V.; Falcon J.; Romero
A.; Kupets H.; Cortez F.; Lesuer J.C.; Hrbek A.; Bowes E.; Quinn P.; Mele
M.; Anderson G.L.; Johnson L.; Tinker L.F.; Aragaki A.K.; Herndon M.; Mann
S.L.; Pettinger M.; Hunt R.P.; Carrick B.; Szyperski K.; Proulx-Burns L.;
Burrows E.; Limacher M.; Hsia J.; Asaithambi G.; Khan M.; Nagaraja N.;
Ocava L.C.; Wold J.; Silver B.; Connelly S.; Van Lom G.; Garvida C.;
Hightower K.; Spaulding P.; Lin W.; Schoenberg J.; Olee P.; Cohen L.S.;
Colton T.; Henderson I.C.; Hulley S.; Lichtenstein A.H.; Passamani E.R.;
Silliman R.A.; Wenger N.; Ludlam S.E.; Schroeter H.; Fare M.; Ottawani J.;
Kwik-Uribe C.; Arnaiz C.; Costanza A.; Greene J.; Hennessey P.; Vadlamani
S.; Karmsetty M.; Martini P.; Van Klinken J.-W.; Shah A.; Stern L.
Institution
(Sesso, Manson, Rist, Friedenberg, Copeland, Clar, Mora, Moorthy,
Sarkissian) Division of Preventive Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sesso, Manson, Rist) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, United States
(Aragaki, Johnson, Carrick, Anderson) Division of Public Health Sciences,
Fred Hutchinson Cancer Research Center, Seattle, WA, United States
(Mora) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Arnaiz, Costanza, Greene, Hennessey) Contract Pharmacal Corp, United
States
(Vadlamani, Karmsetty, Martini, Van Klinken, Shah, Stern) Pfizer Consumer
Healthcare, United States
(Manson, Sesso, Rist, Lagerstrom, Bassuk, Wang, Hazra, Gibson, Leboff,
Mora, Okereke, Tobias, Cook, Chandler, Christen, Friedenberg, Copeland,
Hanna, Clar, D'Agostino, Vinayagamoorthy, Gibson, Kim, Van Denburgh,
Kotler, Li, Bubes, Sarkissian, Smith, Pereira, Okeke, Roche, Bates, Ridge,
Phillips, Salvo, Wilson, Hall, Baez, Sim, Cardoso, Senor, Rudnicki, Huynh,
Nguyen, Terrell, Holman, Walter, Johnson, Casarella, O'Connell, Christen,
Lagerstrom, Djousse, Chandler, Hazra, Tobias, Farukhi, Wang, Zhang, Breen,
Menjin Jr, Rodriguez, Curry, Mora, Arsenault, Solano, Weinberg, Coates,
Kilroe, Zernicke, Hasson, Matthew, Mora, Pfeffer, Duszlak, Bates, Guzman,
Falcon, Romero, Kupets, Cortez, Lesuer, Hrbek, Bowes, Quinn, Mele) Brigham
and Women's Hospital, United States
(Anderson, Johnson, Tinker, Aragaki, Herndon, Mann, Pettinger, Hunt,
Carrick, Szyperski, Proulx-Burns, Burrows, Limacher, Hsia, Asaithambi,
Khan, Nagaraja, Ocava, Wold, Silver, Connelly, Van Lom, Garvida,
Hightower, Spaulding, Lin, Schoenberg, Olee) Fred Hutchinson Cancer
Research Center, Women's Health Initiative, United States
Publisher
Oxford University Press
Abstract
Background: Cocoa extract is a source of flavanols that favorably
influence vascular risk factors in small and short-term trials, yet
effects on clinical cardiovascular events are untested. Objective(s):
We examined whether cocoa extract supplementation decreases total
cardiovascular disease (CVD) among older adults. Method(s): We
conducted a randomized, double-blind, placebo-controlled, 2-by-2 factorial
trial of cocoa extract supplementation and multivitamins for prevention of
CVD and cancer among 21,442 US adults (12,666 women aged >=65 y and 8776
men aged >=60 y), free of major CVD and recently diagnosed cancer. The
intervention phase was June 2015 through December 2020. This article
reports on the cocoa extract intervention. Participants were randomly
assigned to a cocoa extract supplement [500 mg flavanols/d, including 80
mg (-)-epicatechin] or placebo. The primary outcome was a composite of
confirmed incident total cardiovascular events, including myocardial
infarction (MI), stroke, coronary revascularization, cardiovascular death,
carotid artery disease, peripheral artery surgery, and unstable angina.
 Result(s): During a median follow-up of 3.6 y, 410 participants
taking cocoa extract and 456 taking placebo had confirmed total
cardiovascular events (HR: 0.90; 95% CI: 0.78, 1.02; P = 0.11). For
secondary endpoints, HRs were 0.73 (95% CI: 0.54, 0.98) for CVD death,
0.87 (95% CI: 0.66, 1.16) for MI, 0.91 (95% CI: 0.70, 1.17) for stroke,
0.95 (95% CI: 0.77, 1.17) for coronary revascularization, neutral for
other individual cardiovascular endpoints, and 0.89 (95% CI: 0.77, 1.03)
for all-cause mortality. Per-protocol analyses censoring follow-up at
nonadherence supported a lower risk of total cardiovascular events (HR:
0.85; 95% CI: 0.72, 0.99). There were no safety concerns.
 Conclusion(s): Cocoa extract supplementation did not significantly
reduce total cardiovascular events among older adults but reduced CVD
death by 27%. Potential reductions in total cardiovascular events were
supported in per-protocol analyses. Additional research is warranted to
clarify whether cocoa extract may reduce clinical cardiovascular events.
 Copyright © 2022 The Author(s) 2022.

<30>
Accession Number
2018833866
Title
Outcome Reporting in Cardiac Surgery Systematic Reviews.
Source
Annals of Thoracic Surgery. 114(1) (pp 353), 2022. Date of Publication:
July 2022.
Author
Tyson N.; Kutywayo K.
Institution
(Tyson) Department of Cardiac Surgery, Nottingham University Hospitals,
Nottingham City Hospital, Hucknall Rd, UK, Nottingham NG5 1PB, United
Kingdom
(Kutywayo) Department of Thoracic Surgery, University Hospitals of
Leicester, Glenfield Hospital, Leicester, United Kingdom
Publisher
Elsevier Inc.

<31>
Accession Number
2018831639
Title
Lack of Clinical Equipoise Renders Randomized-Trial Execution of Ross vs
Prosthetic Valves an Impossible Task.
Source
Journal of the American College of Cardiology. 80(1) (pp e7), 2022. Date
of Publication: 05 Jul 2022.
Author
Jahanyar J.; Mastrobuoni S.; Said S.M.; El Khoury G.; de Kerchove L.
Publisher
Elsevier Inc.

<32>
Accession Number
2018723594
Title
Digital Education in General Thoracic Surgery: A Narrative Review.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Tokuno J.; Fried G.M.
Institution
(Tokuno, Fried) Division of Experimental Surgery, McGill University,
Montreal, QC, Canada
(Tokuno, Fried) Steinberg Centre for Simulation and Interactive Learning,
Faculty of Medicine and Health Science, Montreal, QC, Canada
(Fried) Department of Surgery, McGill University, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Since advanced technologies were introduced into surgical
education, a variety of new programs have been developed. However, a
comprehensive review of digital education in general thoracic surgery has
not been performed. This narrative review was conducted was to identify
the current applications of digital education in general thoracic surgery.
 Method(s): A literature search was performed using keywords related
to general thoracic surgery and digital education, including e-learning
and virtual simulation, up to September 2021. Studies published in English
investigating the effect of digital education in general thoracic surgery
were included. Result(s): Thirteen studies met the criteria. The
settings were in undergraduate (n = 6) and postgraduate education
(residency) (n = 5) and mixed audience with other disciplines (n = 2).
Theoretical knowledge (n = 5), technical skills (n = 4), and both
knowledge and technical skills (n = 4) were the stated educational
objectives for the studies. The didactic materials were transferred to
hardware, software, or online platforms and delivered with multimedia
materials. Technical skills training for bronchoscopy and chest tube
insertion (n = 5) were offered using virtual reality and computer-based
simulations. Subjective evaluation was done in 10 studies. Although after
the digital education training there was observed improvement in knowledge
or skills in 8 studies, studies were not designed to test for superiority
compared with controls through randomized controlled studies.
 Conclusion(s): This review summarizes the current applications of
digital education in general thoracic surgery and helps establish the
needs for future studies in this field. Copyright © 2022 The
Society of Thoracic Surgeons

<33>
Accession Number
638267231
Title
Effect of bariatric surgery on long-term cardiovascular outcomes: a
systematic review and meta-analysis of population-based cohort studies.
Source
Surgery for obesity and related diseases : official journal of the
American Society for Bariatric Surgery. (no pagination), 2022. Date of
Publication: 16 May 2022.
Author
Tang B.; Zhang Y.; Wang Y.; Wang X.; An Z.; Yu X.
Institution
(Tang, Zhang, An, Yu) Department of Pharmacy, Beijing Chao-Yang Hospital,
Capital Medical University, Beijing, China
(Wang) Department of Pharmacy, Beijing An-Zhen Hospital, Capital Medical
University, Beijing, China
(Wang) Department of Pharmacy, Beijing Obstetrics and Gynecology Hospital,
Capital Medical University, Beijing, China
Publisher
NLM (Medline)
Abstract
This meta-analysis aimed to compare the effects of bariatric surgery and
nonsurgery on cardiovascular outcomes in patients with obesity. A
systematic literature search of the Medline (via PubMed), Embase, and
Cochrane Central Register of Controlled Trials databases was performed
until August 18th, 2021. Population-based cohort studies comparing
long-term cardiovascular outcomes for patients with obesity undergoing
bariatric surgery or not were included. A meta-analysis of relative risks
(RRs) was performed for all outcomes. We conducted subgroup analyses and
meta-regression to explore sources of heterogeneity and the stability of
the results. Twenty-one population-based cohort studies involving
2,857,016 participants were identified. The major adverse cardiovascular
event (MACE) RR in the bariatric surgery group was .53 (95% confidence
interval [CI] = .45-.62, P < .001) relative to the nonsurgical group.
Relative to the nonsurgical group, the risk of myocardial infarction (MI)
(RR = .40, 95% CI = .30-.52, P < .001), stroke (RR = .60, 95% CI =
.46-.79, P < .001), cardiovascular death (RR = .43, 95% CI = .35-.54, P <
.001), and all-cause death (RR = .44, 95% CI = .32-.59, P < .001) was
significantly reduced for patients who underwent bariatric surgery. In
subgroup analyses, as the proportion of patients with diabetes mellitus
increased, lower RRs for MACE, MI, and stroke were observed in the surgery
group relative to the nonsurgical group. The decreased risk of MACE was
also observed in the subgroup with median follow-up duration >=5
years.Bariatric surgery improves cardiovascular outcomes in patients with
obesity, especially providing long-term benefits, and this effect is more
pronounced in patients with comorbid diabetes. Copyright © 2022.
Published by Elsevier Inc.

<34>
Accession Number
638267131
Title
Can the prophylactic administration of tranexamic acid reduce the blood
loss after robotic-assisted radical prostatectomy? Robotic Assisted
Radical Prostatectomy with tranEXamic acid (RARPEX): study protocol for a
randomized controlled trial.
Source
Trials. 23(1) (pp 508), 2022. Date of Publication: 18 Jun 2022.
Author
Balik M.; Kosina J.; Husek P.; Pacovsky J.; Brodak M.; Cecka F.
Institution
(Balik, Kosina, Husek, Pacovsky, Brodak) Department of Urology, Charles
University, Faculty of Medicine in Hradec Kralove, Simkova 870, Hradec
Kralove 500 03, Czechia
(Cecka) Department of Surgery, Charles University, Faculty of Medicine in
Hradec Kralove, Simkova 870, Hradec Kralove 500 03, Czechia
Publisher
NLM (Medline)
Abstract
BACKGROUND: The prophylactic administration of tranexamic acid reduces
blood loss during procedures at high risk of perioperative bleeding.
Several studies in cardiac surgery and orthopedics confirmed this finding.
The aim of this prospective, double-blind, randomized study is to evaluate
the effect of tranexamic acid on peri-and postoperative blood loss and on
the incidence and severity of complications. METHODS/DESIGN: Based on the
results of our pilot study, we decided to conduct this prospective,
double-blind, randomized trial to confirm the preliminary data. The
primary endpoint is to analyze the effect of tranexamic acid on
perioperative and postoperative blood loss (decrease in hemoglobin levels)
in robotic-assisted radical prostatectomy. The additional endpoint is to
analyze the effect of tranexamic acid on postoperative complications and
confirm the safety of tranexamic acid in robotic-assisted radical
prostatectomy. DISCUSSION: No study to date has tested the prophylactic
administration of tranexamic acid at the beginning of robotic-assisted
radical prostatectomy. This study is designed to answer the question of
whether the administration of tranexamic acid might lower the blood loss
after the procedure or increase the rate and severity of complications.
TRIAL REGISTRATION: ClinicalTrials.gov NCT04319614. Registered on 25 March
2020. Copyright © 2022. The Author(s).

<35>
Accession Number
638252947
Title
Staged Versus Synchronous Carotid Endarterectomy and Coronary Artery
Bypass Grafting: A Meta-Analysis and Systematic Review.
Source
Annals of vascular surgery. (no pagination), 2022. Date of Publication:
11 Jun 2022.
Author
Peng C.; Yang Y.-F.; Zhao Y.; Yang X.-Y.
Institution
(Peng, Yang, Zhao, Yang) Department of Neurosurgery, Tianjin Medical
University General Hospital, Tianjin, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: There are several treatment options for patients with
concomitant carotid and coronary artery disease, and it is difficult to
identify an optimal treatment strategy that has consensus. Here, we
performed a meta-analysis to compare the early and long-term outcomes of
staged and synchronous carotid endarterectomy and coronary artery bypass
grafting approaches. METHOD(S): We performed a meta-analysis that
compared staged and synchronous carotid endarterectomy and coronary artery
bypass grafting approaches between July 1976 and September 2021. PubMed,
EMBASE, and the Cochrane Library were systematically searched for related
articles. RESULT(S): Nineteen studies were identified with a total of
39269 and 30066 patients in the synchronous and staged groups,
respectively. Early mortality was lower in the staged group than in the
synchronous group (OR 1.256, 95% CI 1.006-1.569, P= P<0.05, I2=54.5%), and
stroke rates were significantly higher in the synchronous group (OR 1.356,
95% CI 1.232-1.493, P<0.05, I2=33.3%). The rate of myocardial ischemia was
significantly higher in the staged group than in the synchronous group (OR
0.757, 95% CI 0.635-0.903, P<0.05, I2=51.5%), and this meta-analysis also
showed a significantly higher risk of transient ischemic attacks (TIAs) in
the synchronous group (OR 1.335, 95% CI 1.055-1.688, P<0.05, I2=0.00%).
The secondary outcomes, including the rate of reoperation, were
significantly lower for the staged procedure than for the synchronous
procedure (OR 1.177, 95% CI 1.052-1.318, P<0.05, I2=4.2%), and the rate of
wound infection was significantly higher in the synchronous group than in
the staged group (OR 0.457, 95% CI 0.403-0.519, P<0.05, I2=0.0%). There
was no significant difference in the rate of cardiac arrhythmia between
the two groups (OR 0.544, 95% CI 0.265-1.117, P>0.05, I2=12.7%). There was
also no statistical significance in the long-term results regarding the
incidence of stroke, myocardial ischemia, and mortality between the
synchronous and staged groups (P>0.05). CONCLUSION(S): Patients
treated with the synchronous approach had a significantly higher risk of
early mortality, stroke, TIA, wound infection, and reoperation and a lower
risk of myocardial ischemia than those treated with the staged approach.
There was no significant difference in the long-term results between the
two groups. Copyright © 2022 Elsevier Inc. All rights reserved.

<36>
Accession Number
2017904214
Title
Development of a protocol for conducting a randomized control trial on
effects of artificial intelligence on nutritional status of children post
cardiac surgery.
Source
Journal of the Pakistan Medical Association. 72(5) (pp 908-911), 2022.
Date of Publication: May 2022.
Author
Zahid M.; Sughra U.
Institution
(Zahid, Sughra) Al Shifa Trust Eye Hospital, School of Public Health,
Rawalpindi, Pakistan
Publisher
Pakistan Medical Association
Abstract
Objectives: To assess the effect of diet-related mobile application based
on artificial intelligence on the nutritional status of children
post-cardiac surgery, and to compare their diet-related problems with
their counterparts having the usual diet. Method(s): The two-arm
double-blind randomised controlled trial will be conducted at a tertiary
care hospital in Rawalpindi, Pakistan, over an expected duration of 6
months from March to August 2021. Intervention group A will be given a
diet-related mobile application based on artificial intelligence, while
usual-care group B will be handed a pamphlet with instructions related to
post-operative diet on discharge. Result(s): The findings will
improve perception about the influence of artificial intelligence on
nutritional status of children post-cardiac surgery. If proven to be
effective, this mobile application can be used in other hospitals.
 Conclusion(s): The study protocol will give an indication that
whether diet-related mobile application can contribute to improving the
nutritional status of children post-cardiac surgery. As the pandemic has
forced people to minimise hospital visits, this is the right time to
evaluate the utility of such an application. Copyright © 2022
Pakistan Medical Association. All rights reserved.

<37>
Accession Number
2014769926
Title
Adherence to immunosuppression in adult heart transplant recipients: A
systematic review.
Source
Transplantation Reviews. 35(4) (no pagination), 2021. Article Number:
100651. Date of Publication: December 2021.
Author
Hussain T.; Nassetta K.; O'Dwyer L.C.; Wilcox J.E.; Badawy S.M.
Institution
(Hussain) Department of Internal Medicine, Northwestern University McGaw
Medical Center, 251 E. Huron St., Ste. 16-738, Chicago, IL 60611, United
States
(Nassetta) Department of Pediatrics, Lurie Children's Hospital, 225 E.
Chicago Ave., Chicago, IL 60611, United States
(O'Dwyer) Galter Health Sciences Library & Learning Center, Northwestern
University Feinberg School of Medicine, 320 E. Superior Street, Chicago,
IL 60611, United States
(Wilcox) Department of Cardiology, Northwestern Memorial Hospital,
NMH/Arkes Family Pavilion, Ste. 600; 676 N. St. Clair Ave., Chicago, IL
60611, United States
(Badawy) Division of Hematology, Oncology, and Stem Cell Transplant, Lurie
Children's Hospital of Chicago, Chicago, IL 60611, United States
(Badawy) Department of Pediatrics, Northwestern University Feinberg School
of Medicine, 225 E. Chicago Ave., Chicago, IL 60611, United States
Publisher
W.B. Saunders
Abstract
Background: Successful maintenance of a heart transplant (HTx) graft
requires adherence to a triple-drug regimen of immunosuppression. However,
achieving adequate adherence can be difficult secondary to complicated
dosing regimens, side effects, and mental/emotional barriers. A detailed
review of current patterns of adherence to immunosuppression in adult HTx
recipients is lacking. Objective(s): This systematic review aims to
detail the current landscape of adherence to immunosuppression in adult
heart transplant patients, including the measurement of adherence,
correlates to adherence, health outcomes associated with nonadherence, as
well as strategies to improve adherence in HTx patients. Method(s):
We conducted searches in PubMed MEDLINE, Embase, CENTRAL register of
Controlled Trials (Wiley), and Scopus, from inception to March 2020.
Studies were eligible if they outlined an aspect of adherence (as noted
above in the objective) to immunosuppression in adult HTx patients. The
HTx cohort had to contain at least 10 patients and measurement of
adherence had to be done with an objective or otherwise validated measure
of adherence (e.g. drug levels, automated pill bottles or adherence
questionnaires). Two authors independently screened the articles for
inclusion, then subsequently reviewed the full texts of the included
articles. Data was extracted into standardized forms and bias evaluations
were done using the Newcastle-Ottawa or modified Newcastle-Ottawa tools,
depending on the study type. The authors followed all guidelines for the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) statement. Result(s): The titles/abstracts of 880 articles
were reviewed. Ultimately, 23 articles were included in the final review.
The median number of participants was 101, with a range of 19 to 1397.
Studies provided information on baseline levels of adherence (17 studies),
correlates to adherence (14 studies), health outcomes related to
nonadherence (3 studies) and interventions to improve adherence (3
studies). Baseline adherence estimates varied greatly depending on the
adherence measure. Multiple significant correlates to nonadherence exist
and appear to affect patients with certain sociodemographic backgrounds,
those with psychological/psychiatric comorbidities and those with poor
support structures. Nonadherence is associated with transplant coronary
artery disease and acute late rejection; it may also be associated with
long-term mortality. Finally, a simplified dosing regimen with once-a-day
tacrolimus as well as use of a mobile phone-based intervention were
associated with improved adherence. Bias scores were most deficient due to
self-reported outcomes in 18 studies, and lack of controls/adjustments for
confounders, in 7 studies. Conclusion(s): Adherence to
immunosuppression in transplant patients varies, but is associated with
observable and modifiable factors which are worth addressing. Further
high-quality studies regarding strategies to improve adherence are needed
in the literature. Copyright © 2021 Elsevier Inc.

<38>
Accession Number
2014571380
Title
Self-reported poor quality of sleep in solid organ transplant: A
systematic review.
Source
Transplantation Reviews. 35(4) (no pagination), 2021. Article Number:
100650. Date of Publication: December 2021.
Author
Cordoza M.; Koons B.; Perlis M.L.; Anderson B.J.; Diamond J.M.; Riegel B.
Institution
(Cordoza, Riegel) School of Nursing, University of Pennsylvania, Claire M.
Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104, United States
(Koons) M. Lousie Fitzpatrick College of Nursing, Villanova University,
800 E. Lancaster Ave, Villanova, PA 19085 and Clinical Nurse, Heart and
Vascular ICU, Hospital of the University of Pennsylvania, 3400 Spruce
Street, Philadelphia, PA 19104, United States
(Perlis) Behavioral Sleep Medicine Program, Perelman School of Medicine,
University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104,
United States
(Anderson) Hospital of the University of Pennsylvania, 3400 Spruce Street,
5036 Gates Building, Philadelphia, PA 19104, United States
(Diamond) Lung Transplantation, Hospital of the University of
Pennsylvania, 3400 Spruce Street, 9039 West Gates, Philadelphia, PA 19104,
United States
Publisher
W.B. Saunders
Abstract
Background: High quality sleep of sufficient duration is vital to overall
health and wellbeing. Self-reported poor quality of sleep, sleep reported
as irregular in timing, marked by frequent awakenings, or shortened in
duration, is common across the solid-organ transplant trajectory.
 Aim(s): This Systematic Review aimed to summarize available
literature on rates of self-reported poor quality of sleep among solid
organ transplant candidates and recipients. Method(s): A systematic
search of published literature was conducted in PubMed/MEDLINE, Embase,
Web of Science, CINHAL, and PsychInfo databases with no date restrictions.
Original articles in the English language describing self-reported quality
of sleep using standardized questionnaires in adults either waitlisted
for, or who received a solid organ transplant (heart, lung, kidney, liver,
pancreas, or multi-solid organ) were included. Result(s): Of a
potential 2054 articles identified, 44 were included (63.6% renal
transplant, 20.5% liver transplant, 11.4% lung transplant, and 4.5%
included multiple organ transplant populations), with the majority (68.2%)
focusing only on post-transplant populations. No included articles focused
solely on heart or pancreas transplant populations. On average, the
transplant population with the greatest improvement in quality of sleep
(reported as poor sleep quality, insomnia, sleep disturbance, or sleep
dissatisfaction) from transplant candidacy to post-transplantation were
renal transplant (from 53.5% pre, to 38.9% post) followed by liver
transplant patients (from 52.8% pre, to 46.3% post), while lung transplant
patients remained similar pre- to post-transplantation (55.6% pre, to 52%
post). Poor quality of sleep was frequently associated with anxiety and
depression, poorer quality of life, restless legs syndrome, and higher
comorbidity. Conclusion(s): Reports of poor quality of sleep are
highly prevalent across all solid-organ transplant populations, both pre-
and post-transplantation. Future studies should assess quality of sleep
longitudinally throughout all phases of the transplantation trajectory,
with more research focusing on how to optimize sleep in solid organ
transplant populations. Copyright © 2021 Elsevier Inc.

<39>
Accession Number
2011438402
Title
Identifying the association between tacrolimus exposure and toxicity in
heart and lung transplant recipients: A systematic review.
Source
Transplantation Reviews. 35(2) (no pagination), 2021. Article Number:
100610. Date of Publication: April 2021.
Author
Braithwaite H.E.; Darley D.R.; Brett J.; Day R.O.; Carland J.E.
Institution
(Braithwaite, Darley, Brett, Day) St Vincent's Clinical School, UNSW
Medicine, University of New South Wales, Sydney, Australia
(Darley) Lung Transplant Unit, St Vincent's Hospital Darlinghurst, Sydney,
Australia
(Brett, Day, Carland) Department of Clinical Pharmacology and Toxicology,
St Vincent's Hospital, Sydney, Australia
(Carland) Department of Pharmacology, School of Medical Sciences,
University of New South Wales, Sydney, Australia
Publisher
W.B. Saunders
Abstract
Aims: Tacrolimus is the cornerstone of immunosuppression management in
heart and lung transplant recipients, improving overall survival. However,
tacrolimus-associated toxicities, including nephrotoxicity, neurotoxicity,
new-onset diabetes mellitus after transplant (NODAT), and gastrointestinal
toxicity, are known contributors to increased post-transplant morbidity
outcomes and reduced graft and recipient survival rates. The aim of this
systematic review was to identify correlations between pharmacokinetic
measures of tacrolimus exposure in heart and lung recipients and
tacrolimus toxicities. Method(s): MEDLINE, Embase, the Cochrane
Library, CENTRAL and WHO Clinical Trial Registries were searched for
published studies evaluating tacrolimus toxicities and their correlation
to pharmacokinetic monitoring parameters in thoracic transplant
recipients. Studies were reviewed by two authors, with data extracted for
evaluation. Risk of bias was assessed using the PEDro scale for randomised
control trials and the Newcastle Ottawa Scale for non-randomised cohort
studies. Result(s): Eighteen studies were eligible; a randomised
control trial, 11 observational cohort studies, and 6 case series or
studies. Of these, 9 studies were in heart transplant recipients alone and
5 in lung transplant recipients alone, 2 studies were in heart and lung
transplant recipients and 2 were heart, lung, liver or renal transplant
recipients. Studies used variable criteria to define toxicities.
Tacrolimus trough concentration (C<inf>0</inf>) was the marker of
tacrolimus exposure most commonly used. Ten studies reported on
nephrotoxicity. Elevated tacrolimus C<inf>0</inf> was associated with
acute kidney injury occurrence and severity in three observational
studies. Increasing C<inf>0</inf> was a predictor of renal impairment in 6
studies. One study found that for each 5 ng/mL per year of tacrolimus
exposure, defined by consecutive AUC, eGFR declined by 1.3
mL/min/1.73m2 (p < 0.001). Comparatively, 2 studies failed to
find a significant association between nephrotoxicity and tacrolimus
exposure. Seven studies reported on neurotoxicity, including
neuro-encephalopathies, polyneuropathies and symptomatic change in
neurological status. Neurotoxicity occurred both with tacrolimus
C<inf>0</inf> within therapeutic range and with supratherapeutic
C<inf>0</inf>. No significant association was found between NODAT and
tacrolimus C<inf>0</inf> in two studies. One study reported on
gastrointestinal toxicity, with supratherapeutic C<inf>0</inf> and
elevated peak concentration in one lung transplant recipient three days
prior to symptom development. Conclusion(s): No clearly defined
relationship between tacrolimus exposure and toxicities is described in
the literature. Studies with clear toxicity criteria and pharmacokinetic
markers of tacrolimus exposure are required to provide valuable
information that may optimise tacrolimus therapy, helping to reduce
toxicities in heart and lung transplant recipients. Copyright ©
2021 Elsevier Inc.

<40>
Accession Number
2010726516
Title
Comparison of the effect of single vs dual antiplatelet agents on
post-operative haemorrhage after renal transplantation: A systematic
review and meta-analysis.
Source
Transplantation Reviews. 35(1) (no pagination), 2021. Article Number:
100594. Date of Publication: January 2021.
Author
Lee T.; D'Souza K.; Hameed A.; Yao J.; Lam S.; Chadban S.; Ying T.;
Celermajer D.; Sandroussi C.; Pleass H.C.C.; Laurence J.M.
Institution
(Sandroussi, Laurence) RPA Institute of Academic Surgery, University of
Sydney, RPA Institute of Academic Surgery, Level 9 E, Tranplantation
Services, Missenden Road, Camperdwon, NSW 2050, Australia
(Lee, Hameed, Pleass, Laurence) Department of Surgery, Westmead Hospital,
Corner of Hawkesbury Rd and Darcy, Westmead, NSW 2145, Australia
(Lee, Yao, Lam, Sandroussi, Pleass, Laurence) Royal Prince Alfred
Hospital, Missenden Road, Camperdwon, NSW 2050, Australia
(Chadban, Ying) Department of Renal Medicine, Royal Prince Alfred
Hospital, Camperdwon, NSW 2050, Australia
(D'Souza, Chadban, Ying, Celermajer) University of Sydney Medical School,
Australia
(Celermajer) Department of Cardiology, Royal Prince Alfred Hospital,
Camperdwon, NSW 2050, Australia
Publisher
W.B. Saunders
Abstract
Objectives: A significant proportion of renal transplant patients have
cardiovascular comorbidities for which they receive treatment with
antiplatelet agents. The aim of this study was to systematically review
the current literature reporting perioperative outcomes for patients
receiving dual antiplatelet therapy compared to single antiplatelet
therapy at the time of kidney transplantation with particular reference to
the risks of postoperative haemorrhage. Material(s) and Method(s):
Embase, Medline and Cochrane databases were utilized to identify articles
reporting outcomes of renal transplant recipients on single antiplatelet
therapy and dual antiplatelet therapy. These outcomes were compared using
a random effects model meta-analysis where appropriate. Result(s):
Six articles were incorporated in the analysis, including 130 receiving
dual antiplatelet therapy, and 781 in the single antiplatelet therapy
group. There was a significantly higher risk of post-operative
haemorrhagic events in the dual antiplatelet therapy group compared to the
single antiplatelet therapy group (RR 1.58, 95% CI 1.19-2.09, p = 0.001).
Post-operative cardiovascular event rates were similar between both groups
in individual studies, although this could not be quantitatively analysed.
 Conclusion(s): The use of dual antiplatelet therapy was associated
with a higher risk of post-operative haemorrhage compared to the use of
single antiplatelet therapy without increased rates of surgical
intervention. However, the use of dual antiplatelet therapy may provide
protection from cardiovascular events in an inherently higher risk patient
group. Copyright © 2020

<41>
[Use Link to view the full text]
Accession Number
2010096536
Title
COVID-19 in solid organ transplant recipients: A systematic review and
meta-analysis of current literature.
Source
Transplantation Reviews. 35(1) (no pagination), 2021. Article Number:
100588. Date of Publication: January 2021.
Author
Raja M.A.; Mendoza M.A.; Villavicencio A.; Anjan S.; Reynolds J.M.;
Kittipibul V.; Fernandez A.; Guerra G.; Camargo J.F.; Simkins J.; Morris
M.I.; Abbo L.A.; Natori Y.
Institution
(Raja, Anjan, Fernandez, Camargo, Simkins, Morris, Abbo, Natori)
Department of Medicine, Division of Infectious Disease, University of
Miami Miller School of Medicine, Miami, FL, United States
(Mendoza, Villavicencio, Kittipibul) Department of Medicine, Division of
Internal Medicine, University of Miami Miller School of Medicine, Miami,
FL, United States
(Anjan, Guerra, Simkins, Abbo, Natori) Miami Transplant Institute, Jackson
Health System, Miami, FL, United States
(Reynolds) Department of Health Informatics, Calder Memorial Library,
University of Miami Miller School of Medicine Miami, FL, United States
(Guerra) Department of Medicine, Division of Nephrology, University of
Miami Miller School of Medicine Miami, FL, United States
Publisher
W.B. Saunders
Abstract
Severe acute respiratory virus syndrome 2 (SARS-CoV-2) has led to a
worldwide pandemic. Early studies in solid organ transplant (SOT)
recipients suggested a wide variety of presentations, however, there
remains a paucity of robust data in this population. We conducted a
systematic review and meta-analysis of SOT recipients with SARS-CoV-2
infection from January 1st t October 9th, 2020.
Pooled incidence of symptoms, treatments and outcomes were assessed. Two
hundred and fifteen studies were included for systematic review and 60 for
meta-analysis. We identified 2,772 unique SOT recipients including 1,500
kidney, 505 liver, 141 heart and 97 lung. Most common presenting symptoms
were fever and cough in 70.2% and 63.8% respectively. Majority (81%)
required hospital admission. Immunosuppressive medications, especially
antimetabolites, were decreased in 76.2%. Hydroxychloroquine and
interleukin six antagonists were administered in59.5% and 14.9%
respectively, while only few patients received remdesivir and convalescent
plasma. Intensive care unit admission was 29% from amongst hospitalized
patients. Only few studies reported secondary infections. Overall
mortality was 18.6%. Our analysis shows a high incidence of hospital
admission in SOT recipients with SARS-CoV-2 infection. As management of
SARS-CoV-2 continues to evolve, long-term outcomes among SOT recipients
should be assessed in future studies. Copyright © 2020

<42>
Accession Number
2005874574
Title
Machine perfusion of circulatory determined death hearts: A scoping
review.
Source
Transplantation Reviews. 34(3) (no pagination), 2020. Article Number:
100551. Date of Publication: July 2020.
Author
Saemann L.; Guo Y.; Ding Q.; Zhou P.; Karck M.; Szabo G.; Wenzel F.
Institution
(Saemann, Guo, Ding, Zhou, Karck, Szabo) Department of Cardiac Surgery,
University Hospital Heidelberg, Im Neuenheimer Feld 326, Heidelberg 69120,
Germany
(Saemann, Wenzel) Faculty Medical and Life Sciences, Furtwangen
University, Jakob-Kienzle-Strase 17, Villingen-Schwenningen 78054, Germany
Publisher
W.B. Saunders
Abstract
Background: Ex vivo machine perfusion (EVMP) is reported to can
successfully be applied for donor heart preservation. To respond to the
organ shortage, some centres also accept hearts from marginal donors such
as non-heart beating donors (NHBD) or hearts donated after cardiac death
(DCD) for heart transplantation (HTx). Clinical as well as preclinical
science on EVMP of DCD hearts seems to be promising but the ideal
perfusion practice itself appears unclear. Objective(s): In
accordance with the Preferred Reporting Items for Systematic reviews and
Meta-Analyses extension for Scoping Reviews (PRISMA), this systematic
review scopes all EVMP techniques for human and animal DCD heart
preservation and addresses three specific questions, which refer to (a)
the perfusion solutions, (b) the perfusion parameters and respective
target values and (c) if possible, a direct comparison between cold static
storage (CSS) and EVMP. Result(s): Search results predominantly
consisted of animal studies. Either perfusion with a crystalloid or
blood-based solution, each with cardioplegic or non-cardioplegic
properties was used. Some perfusates were supplemented with specific
pharmacological medication to block pathophysiological pathways, which are
involved in ischemia/reperfusion injury or edema formation. Besides
normothermic EVMP with oxygenated blood, a wide range of temperature was
applied in all approaches, with the lowest temperature at 4 degreeC.
Pressure controlled anterograde Langendorff perfusion was applied mostly.
If investigated, crystalloid machine perfusion was presented superior to
CSS. Conclusion(s): Only blood based EVMP was introduced into
clinical practice. More research, clinical as well as preclinical, is
needed to develop the ideal EVMP technique, in terms of blood or
crystalloid perfusion. Copyright © 2020 Elsevier Inc.

<43>
Accession Number
2001307535
Title
Correlates and outcomes of alcohol use after single solid organ
transplantation: A systematic review and meta-analysis.
Source
Transplantation Reviews. 33(1) (pp 17-28), 2019. Date of Publication:
January 2019.
Author
Dobbels F.; Denhaerynck K.; Klem M.L.; Sereika S.M.; De Geest S.; De
Simone P.; Berben L.; Binet I.; Burkhalter H.; Drent G.; Duerinckx N.;
Engberg S.J.; Glass T.; Gordon E.; Kirsch M.; Kugler C.; Lerret S.;
Rossmeissl A.; Russell C.; Schmidt-Trucksass A.; de Almeida S.S.
Institution
(Berben) Institute of Nursing Science, University of Basel, Switzerland
(Binet) Nephrology and Transplantation Medicine, Cantonal Hospital St.
Gallen, Switzerland
(Burkhalter) Centre of Sleep Medicine, Hirslanden Group Zurich,
Switzerland
(Drent) Department of Gastroenterology and Hepatology, University Medical
center Groningen, Groningen, Netherlands
(Duerinckx) Academic Centre for Nursing and Midwifery, KU Leuven, Leuven,
Belgium
(Duerinckx) Heart Transplantation Program, University Hospitals Leuven,
Leuven, Belgium
(Sereika, Engberg) School of Nursing, University of Pittsburgh, United
States
(Glass) Department of Biostatistics, Swiss Tropical and Public Health
Institute, University of Basel, Basel, Switzerland
(Gordon) Department of Surgery, Center for Healthcare Studies, Center for
Bioethics and Medical Humanities, Northwestern University Feinberg School
of Medicine, Chicago, United States
(Kirsch) Department of Anaesthesiology, University Hospital of Basel,
Switzerland
(Kugler) Nursing Science, University of Witten/Herdecke, Germany
(Lerret) Department of Pediatric Gastroenterology and Transplant Surgery,
Medical College of Wisconsin, United States
(Rossmeissl) Departement fur Sport, Bewegung und Gesundheit, University
Hospital of Basel, Basel, Switzerland
(Russell) School of Nursing and Health Studies, University of Missouri
Kansas City, United States
(Schmidt-Trucksass) Departement fur Sport, Bewegung und Gesundheit,
University Hospital of Basel, Switzerland
(de Almeida) Transplantation program, Hospital Israelita Albert Einstein,
Sao Paulo, Brazil
(Dobbels, De Geest) Academic Centre for Nursing and Midwifery KU, Leuven,
Belgium
(Dobbels, Denhaerynck, De Geest) Institute of Nursing Science, Department
of Public Health, University of Basel, Switzerland
(Klem) Health Sciences Library System, University of Pittsburgh, United
States
(De Simone) Hepatobiliary surgery and liver Transplantation, University of
Pisa Medical School Hospital, Italy
Publisher
W.B. Saunders
Abstract
Background: Reviews on alcohol use in transplant recipients focus on liver
recipients and their risk of post-transplant rejection, but do not assess
alcohol use in kidney, heart, or lung transplant recipients. This
systematic review and meta-analysis aims to synthesize the evidence on
correlates and outcomes of any alcohol use and at-risk drinking after
solid organ transplantation (Tx). Method(s): We searched 4 databases
for quantitative studies in adult heart, liver, kidney and lung Tx
recipients, investigating associations between post-Tx alcohol use and
correlates and/or clinical, economic or quality of life outcomes. Paper
selection, data extraction and quality assessment were performed by 2
reviewers independently. A pooled odds ratio (OR) was computed for each
correlate/outcome reported >=5 times. Result(s): Of the 5331 studies
identified, 76 were included in this systematic review (93.3% on liver Tx;
mean sample size 148.9 (SD = 160.2); 71.9% male; mean age 48.9 years (SD =
6.5); mean time post-Tx 57.7 months (SD = 23.1)). On average, 23.6% of
patients studied used alcohol post-transplant. Ninety-three correlates of
any post-Tx alcohol use were identified, and 9 of the 19 pooled ORs were
significantly associated with a higher odds for any post-Tx alcohol use:
male gender, being employed post-transplant, smoking pre-transplant,
smoking post-transplant, a history of illicit drug use, having
first-degree relatives who have alcohol-related problems, sobriety <6
months prior to transplant, a history of psychiatric illness, and having
received treatment for alcohol-related problems pre-transplant. On average
15.1% of patients had at-risk drinking. A pooled OR was calculated for 6
of the 47 correlates of post-Tx at risk drinking investigated, of which
pre-transplant smoking was the only correlate being significantly
associated with this behavior. None of the outcomes investigated were
significantly associated with any use or at-risk drinking.
 Conclusion(s): Correlates of alcohol use remain under-investigated in
solid organ transplant recipients other than liver transplantation.
Further research is needed to determine whether any alcohol use or at-risk
drinking is associated with poorer post-transplant outcomes. Our
meta-analysis highlights avenues for future research of higher
methodological quality and improved clinical care. Protocol
Registration: PROSPERO protocol CRD42015003333 Copyright © 2018
Elsevier Inc.

<44>
Accession Number
2000731187
Title
Challenges of immunosuppressive and antitrypanosomal drug therapy after
heart transplantation in patients with chronic Chagas disease: A
systematic review of clinical recommendations.
Source
Transplantation Reviews. 32(3) (pp 157-167), 2018. Date of Publication:
July 2018.
Author
Nogueira S.S.; Felizardo A.A.; Caldas I.S.; Goncalves R.V.; Novaes R.D.
Institution
(Nogueira, Felizardo, Caldas, Novaes) Institute of Biomedical Sciences,
Federal University of Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
(Caldas) Department of Pathology and Parasitology, Federal University of
Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
(Nogueira, Felizardo, Novaes) Department of Structural Biology, Federal
University of Alfenas, Alfenas, Minas Gerais 37130-001, Brazil
(Goncalves) Department of Animal Biology, Federal University of Vicosa,
Vicosa, Minas Gerais 36570-000, Brazil
Publisher
W.B. Saunders
Abstract
Background: Although contraindicated for decades, heart transplantation
(HT) has finally become a feasible therapeutic option for the treatment of
Chagasic patients with end-stage heart failure. Part of the success in
achieving acceptable survival rates after HT is due to the enhancement of
the pharmacological management of allograft rejection and reactivation of
Trypanosoma cruzi infection. Method(s): By using the framework of a
systematic review, we investigated if Chagasic patients who have undergone
a HT are treated with similar immunosuppressive and antitrypanosomal
regimens in endemic and non-endemic countries and exhibits similar T.
cruzi reactivation, allograft rejection and survival rates. From a
structured search in PubMed/Medline, Scopus, and Web of Sciences
databases, 30 clinical studies were reviewed. Result(s) and
Conclusion(s): Although immunosuppressive regimens are variable in endemic
and non-endemic countries, the current evidence supports the
administration of lower doses of corticosteroids, adjusted cyclosporine
levels (100-150 ng/mL) 3 months after HT, and azathioprine rather than
mycophenolate mofetil to reduce the risk of T. cruzi reactivation and
rejection episodes. Antitrypanosomal therapy exclusively based on
benznidazole, nifurtimox, and allopurinol was consistent in endemic and
non-endemic countries, achieving effective results in the control of
infection reactivation. The evidence that supports prophylactic
antitrypanosomal therapy or administration of allopurinol alone is
limited. By highlighting the main sources of research bias, we hope that
our critical analysis can help to expedite clinical research and to reduce
methodological bias, thereby improving the quality of evidence in new
research initiatives. Copyright © 2018 Elsevier Inc.

<45>
Accession Number
619944647
Title
Clinical impact of culture-positive preservation fluid on solid organ
transplantation: A systematic review and meta-analysis.
Source
Transplantation Reviews. 32(2) (pp 85-91), 2018. Date of Publication:
April 2018.
Author
Oriol I.; Sabe N.; Tebe C.; Veroux M.; Boin I.F.S.F.; Carratala J.
Institution
(Oriol, Sabe, Carratala) Infectious Disease Department, Hospital
Universitari de Bellvitge - IDIBELL, Spanish Network for Research in
Infectious Diseases (REIPI), and Clinical Science Department, Faculty of
Medicine, University of Barcelona, Barcelona, Spain
(Tebe) Statistical Assessment Service at Bellvitge Biomedical Research
Institute (IDIBELL) and Department of Basic Sciences, Universitat Rovira I
Virgili, Spain
(Veroux) Organ Transplant Unit, Department of Medical and Surgical
Sciences and Advanced Technologies, Gf. Ingrassia University of Catania,
Catania, Italy
(Boin) Unit of Liver Transplantation, State University of Campinas, Sao
Paulo, Brazil
Publisher
W.B. Saunders
Abstract
Contamination of the preservation fluid (PF) used for donated organs is a
potential source of post-transplant infection. However, the information on
this issue is scarce. We therefore conducted a systematic review and
meta-analysis to assess the incidence of culture-positive PF and its
impact on solid organ transplant (SOT) recipients. Seventeen studies were
identified and included. The overall incidence of culture-positive PF was
37% (95% CI: 27% to 49%), and the incidence of PF-related infections among
SOT recipients with PF cultures that grew pathogenic microorganisms was
10% (95% CI: 7% to 15%). There were differences in the rates of infections
due to pathogenic microorganisms between SOT recipients who received
pre-emptive treatment and those who did not, but without statistical
significance. The mortality rate among SOT recipients with PF-related
infection was 35% (95% CI: 21% to 53%). In conclusion, although
contamination of the PF of donated organs is frequent, the incidence of
PF-related infection is relatively low. A closely clinical and
microbiologic monitoring of the SOT recipient in case of culture-positive
PF, regardless of the type of microorganism isolated might be do in order
to establish a prompt diagnosis of PF-related infection. Copyright
© 2017 Elsevier Inc.

<46>
Accession Number
616869226
Title
Remote ischemic preconditioning of transplant recipients to reduce graft
ischemia and reperfusion injuries: A systematic review.
Source
Transplantation Reviews. 32(1) (pp 10-15), 2018. Date of Publication:
January 2018.
Author
Farooqui W.; Pommergaard H.C.; Rasmussen A.
Institution
(Farooqui) Department of Surgery, Nordsjaellands Hospital, Dyrehavevej 29,
Hillerod 3400, Denmark
(Pommergaard, Rasmussen) Department of Surgical Gastroenterology and
Transplantation, Abdominal Centre, Rigshospitalet, Blegdamsvej 9,
Kobehnavn O 2100, Denmark
Publisher
W.B. Saunders
Abstract
Background Solid organ transplantation is an accepted treatment for
end-stage solid organ diseases. During the procedure, ischemia and
reperfusion injury may affect graft and patient outcomes. Remote ischemic
preconditioning (rIC) has been shown to reduce ischemia and reperfusion
injury and can be performed safely. Thus, rIC may potentially improve
outcomes after solid organ transplantation. Traditionally, the focus of
rIC has been on the donor. However, preconditioning the recipient may be a
more suitable approach in transplant settings. The current review analyzed
previously published studies where rIC was performed on transplant
recipients. Methods PubMed and EMBASE databases were searched for eligible
clinical and animal studies evaluating rIC of recipients. Articles were
analyzed and compared qualitatively. Risk of bias was assessed using the
Cochrane Collaboration's tool for interventional clinical studies and
SYRCLEs risk of bias tool for animal studies. Results A total of 12
studies were included. Overall, these studies were heterogeneous due to
differences in populations and intervention set-up. Some of the studies
suggested improvement of graft function, while other studies did not show
any effect. The quality of the 12 included studies was predominantly low.
Conclusion Due to the heterogeneity and quality of the included studies
the result, that rIC may be beneficial in transplantation of some organs,
should be interpreted with caution. The result must be confirmed by
further clinical studies. Copyright © 2017 Elsevier Inc.

<47>
Accession Number
615245057
Title
Handle with care: A systematic review on frailty in cardiac care and its
usefulness in heart transplantation.
Source
Transplantation Reviews. 31(3) (pp 218-224), 2017. Date of Publication:
July 2017.
Author
Mauthner O.; Claes V.; Deschodt M.; Jha S.R.; Engberg S.; Macdonald P.S.;
Newton P.J.; De Geest S.
Institution
(Mauthner, Claes, Deschodt, De Geest) Institute of Nursing Science,
Faculty of Medicine, University of Basel, Switzerland
(Claes, Deschodt, De Geest) Academic Centre for Nursing and Midwifery,
Department of Public Health and Primary Care, KU Leuven, Belgium
(Jha, Macdonald) Heart Transplant Program, St Vincent's Hospital, Sydney,
Australia
(Jha, Newton) Centre for Cardiovascular and Chronic Care, Faculty Health,
University of Technology Sydney, Australia
(Engberg) School of Nursing, University of Pittsburgh, United States
(Macdonald) Victor Chang Cardiac Research Institute, Sydney, NSW,
Australia
Publisher
W.B. Saunders
Abstract
Background There is growing consensus that frailty, a state of
vulnerability and a decline in functioning across multiple physiological
body systems, is a valuable criterion to guide clinicians' risk prediction
for poor outcomes in adult transplant candidates. In its 2016 listing
criteria for heart transplantation the International Society for Heart
Lung Transplantation recommends frailty assessment. We aimed to summarize
the usefulness of frailty assessment in heart transplant candidates or
recipients reported throughout the literature. Methods We performed a
systematic literature search in PubMed to identify papers reporting on
frailty in transplantation, chronic heart failure, and ventricualr assist
device implantation published over the last 10 years in English.
Additionally, a hand search was conducted, including manually searching
the reference lists and a citation search of relevant papers. Results
Eleven primary research articles were included in this systematic review.
Frailty is a risk factor for morbidity, hospitalization, and mortality in
patients with advanced heart failure and individuals being considered for
ventricualr assist device implantation. Of the patients being considered
for transplantation, 33% are frail. The Frailty Phenotype by Fried is a
particularly useful tool to quickly identify higher risk patients for
adverse outcomes. Conclusion A lack of standardization and limited
evidence on frailty in transplantation limit its use as a definitive
listing criterion. Future research efforts should focus on systematic
integration of frailty measures in transplant practice. Copyright
© 2017 Elsevier Inc.

<48>
Accession Number
612700970
Title
Safety, adherence and efficacy of exercise training in solid-organ
transplant candidates: A systematic review.
Source
Transplantation Reviews. 30(4) (pp 218-226), 2016. Date of Publication: 01
Oct 2016.
Author
Wallen M.P.; Skinner T.L.; Pavey T.G.; Hall A.; Macdonald G.A.; Coombes
J.S.
Institution
(Wallen, Skinner, Coombes) Centre for Research on Exercise, Physical
Activity and Health (CRExPAH), School of Human Movement and Nutrition
Sciences, The University of Queensland, Brisbane, Queensland, Australia
(Macdonald) School of Medicine, The University of Queensland, Brisbane,
Queensland, Australia
(Macdonald) Department of Gastroenterology and Hepatology, Princess
Alexandra Hospital, Brisbane, Queensland, Australia
(Hall) Department of Anaesthesia, Princess Alexandra Hospital, Brisbane,
Queensland, Australia
(Pavey) School of Exercise and Nutrition Sciences, Queensland University
of Technology, Brisbane, Queensland, Australia
Publisher
W.B. Saunders
Abstract
Background Patients awaiting solid-organ transplantation may be encouraged
to undertake exercise training to improve pre- and post-transplant
outcomes. However, the safety, adherence and efficacy of exercise training
in this population remain unclear. Methods All randomized, non-randomized
and non-controlled trials of exercise training interventions in
solid-organ transplant candidates were included. The Cochrane risk of bias
tool and a modified Newcastle-Ottawa scale were used to assess procedural
quality. Safety was defined as the number of reported adverse events
during exercise training. Adherence was evaluated from session attendance,
and efficacy as changes in cardiorespiratory fitness (CRF), exercise
capacity, muscular strength, health-related quality of life (HR-QoL) and
lung function. Results Eleven studies involving 874 patients were
included: four randomized controlled, one non-randomized controlled and
six non-controlled trials. Six studies included heart transplant
candidates and five involved patients awaiting lung transplantation. Three
trials included aerobic-only training, one incorporated resistance-only
exercise and seven combined modalities. Twelve adverse events were
reported with four due to exercise, although methods to collect these data
were often omitted. Exercise adherence ranged from 82.5% to 100%, but was
poorly described. No significant between-group changes attributable to
exercise training were demonstrated. However, significant within-group
improvements in CRF, exercise capacity, muscular strength, lung function
and HR-QoL were observed. Conclusions Patients awaiting heart or lung
transplant appear to tolerate exercise training despite the larger number
of adverse events compared to other high-risk populations. Exercise
training demonstrated within-group benefits for several outcomes, with no
significant between-group differences. Randomized controlled trials with
sufficient statistical power are required for all solid-organ transplant
candidates. Copyright © 2016 Elsevier Inc.

<49>
[Use Link to view the full text]
Accession Number
610921974
Title
Effects of intraoperative dexmedetomidine on postoperative pain in highly
nicotine-dependent patients after thoracic surgery.
Source
Medicine (United States). 95(22) (no pagination), 2016. Article Number:
e3814. Date of Publication: 01 May 2016.
Author
Cai X.; Zhang P.; Lu S.; Zhang Z.; Yu A.; Liu D.; Wu S.
Institution
(Cai, Zhang, Lu, Zhang, Yu, Liu, Wu) Department of Anesthesiology,
Liaocheng People's Hospital, 67 Dongchang West Road, Liaocheng City,
Shandong 252000, China
(Wu) Xuzhou Medical College, Xuzhou, Jiangsu, China
Publisher
Lippincott Williams and Wilkins
Abstract
To investigate the effects of intraoperative dexmedetomidine on pain in
highly nicotine-dependent patients after thoracic surgery. Highly
nicotine-dependent men underwent thoracic surgery and received
postoperative patient-controlled intravenous analgesia with sufentanil. In
dexmedetomidine group (experimental group, n=46), dexmedetomidine was
given at a loading dose of 1mug/kg for 10 minutes, followed by continuous
infusion at 0.5mug/kg/h until 30 minutes before the end of surgery. The
saline group (control group, n=48) received the same volume of saline.
General anesthesia was administered via a combination of inhalation and
intravenous anesthetics. If necessary, patients were administered a
loading dose of sufentanil by an anesthesiologist immediately after
surgery (0hours). Patient-controlled analgesia was started when the
patient's resting numerical rating scale (NRS) score was less than 4.
Resting and coughing NRS scores and sufentanil dosage were recorded 0, 1,
4hours, and every 4hours until 48hours after surgery. Dosages of other
rescue analgesics were converted to the sufentanil dosage. Surgical data,
adverse effects, and degree of satisfaction were obtained. Cumulative
sufentanil dosage, resting NRS, and coughing NRS in the first 24hours
after surgery and heart rate were lower in the experimental compared with
the control group (P<0.05). No patient experienced sedation or respiratory
depression. Frequency of nausea and vomiting and degree of satisfaction
were similar in both groups. Intraoperative dexmedetomidine was associated
with reduced resting and coughing NRS scores and a sufentanil-sparing
effect during the first 24hours after thoracic surgery. Copyright
© 2016 Wolters Kluwer Health, Inc.

<50>
Accession Number
602584748
Title
The prevalence and implications of BK virus replication in non-renal solid
organ transplant recipients: A systematic review.
Source
Transplantation Reviews. 29(3) (pp 175-180), 2015. Date of Publication:
2015.
Author
Viswesh V.; Yost S.E.; Kaplan B.
Institution
(Viswesh) College of Pharmacy, California Northstate University, 9700 West
Taron Drive, Elk Grove, CA 95757, United States
(Yost) Department of Pharmacy, The University of Arizona Medical Center,
University Campus, 1501 N. Campbell Ave, Tucson, AZ 85724, United States
(Kaplan) Division of Nephrology and Hypertension, Department of Internal
Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard,
Kansas City, KS 66160, United States
Publisher
W.B. Saunders
Abstract
The significance of BK viruria and viremia in non-renal solid organ
transplants is poorly understood. A systematic review was performed
reviewing the incidence and implications of BK virus replication in
non-renal solid organ transplants. Ninety-seven studies were identified,
of which 18 including lung, heart, liver and pancreas transplants were
included. The overall incidence of BK viruria and viremia was 20% and 3%
respectively and 17 cases of BK nephropathy were identified. Heart
transplant recipients had a higher overall incidence of BK viremia than
other non-renal organ types, and the majority of cases of BK
virus-associated nephropathy were in heart transplant recipients. The
incidence of BK viremia was significantly lower in non-renal solid organ
transplants than that of renal transplant recipients and BK
virus-associated nephropathy was rare. BK virus-associated nephropathy may
be considered in heart transplant recipients who have unexplained and
persistent renal dysfunction not attributable to other
causes. Copyright © 2015 Elsevier Inc.

<51>
Accession Number
2013292614
Title
Feasibility and efficacy of cryoneurolysis analgesia in robotic-assisted
thoracoscopic surgery (CARTS): a pilot study.
Source
Journal of Robotic Surgery. 16(3) (pp 597-600), 2022. Date of Publication:
June 2022.
Author
Tung J.; Patel R.; Rajwani T.; Han S.; Hanson N.; Sternbach J.; Hubka M.
Institution
(Tung, Patel, Rajwani, Han, Hanson, Sternbach, Hubka) Virginia Mason
Medical Center, Virginia Mason Hospital, Seattle, WA, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Opioid therapy has been the mainstay therapy of post-operative pain
management in thoracic surgery patients. With the high incidence of
chronic pain in thoracic surgery patients and adverse effects of opioids,
we examined the safety and efficacy of cryoneurolysis as an adjunct for
narcotic-free pain management in robotic-assisted thoracoscopic
lobectomies. Ten consecutive patients undergoing robotic-assisted
(DaVinci) pulmonary resection and cryoneurolysis were compared to ten
patients managed without intraoperative cryoneurolysis. All patients
received multimodal pain regimen including paravertebral blocks as per our
institutional enhanced recovery pathway. Patients with chronic pain and
chronic opioid use were excluded. We compared inpatient and outpatient
opioid consumption measured in morphine equivalents (mme), incidence of
opioid-free outpatient recovery, and adverse events. The two groups did
not differ significantly in terms of baseline demographics. Both inpatient
(88.13 vs 26.92 mme) and outpatient (118.5 vs 34.5 mme) use of narcotics
were significantly lower in the cryoneurolysis group (p < 0.05) with seven
of ten patients receiving cryoneurolysis able to recover without the use
of opioids in the outpatient setting, compared to two in the control
group. One patient reported post-operative neuralgia in each
cryoneurolysis and control group. There were no readmissions in either
group and mean length of stay was identical at 1.7 days in control group
and 1.1 days in experimental group (p = 0.33). The use of intraoperative
intercostal cryoneurolysis may safely reduce the utilization of outpatient
opioids in patients undergoing robotic-assisted thoracoscopic surgery. A
randomized controlled trial is warranted to validate these findings in a
larger cohort of patients. Copyright © 2021, The Author(s), under
exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

<52>
Accession Number
638149505
Title
Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve
Replacement on All-Cause Mortality in Patients With Aortic Stenosis: A
Randomized Clinical Trial.
Source
JAMA - Journal of the American Medical Association. 327(19) (pp
1875-1887), 2022. Date of Publication: 17 May 2022.
Author
Toff W.D.; Hildick-Smith D.; Kovac J.; Mullen M.J.; Wendler O.; Mansouri
A.; Rombach I.; Abrams K.R.; Conroy S.P.; Flather M.D.; Gray A.M.;
MacCarthy P.; Monaghan M.J.; Prendergast B.; Ray S.; Young C.P.; Crossman
D.C.; Cleland J.G.F.; De Belder M.A.; Ludman P.F.; Jones S.; Densem C.G.;
Tsui S.; Kuduvalli M.; Mills J.D.; Banning A.P.; Sayeed R.; Hasan R.;
Fraser D.G.W.; Trivedi U.; Davies S.W.; Duncan A.; Curzen N.; Ohri S.K.;
Malkin C.J.; Kaul P.; Muir D.F.; Owens W.A.; Uren N.G.; Pessotto R.;
Kennon S.; Awad W.I.; Khogali S.S.; Matuszewski M.; Edwards R.J.; Ramesh
B.C.; Dalby M.; Raja S.G.; Mariscalco G.; Lloyd C.; Cox I.D.; Redwood
S.R.; Gunning M.G.; Ridley P.D.
Institution
(Toff, Kovac, Mariscalco) Department Of Cardiovascular Sciences,
University Of Leicester, Leicester, United Kingdom
(Toff, Kovac, Mariscalco) National Institute For Health Research Leicester
Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
(Hildick-Smith, Trivedi) Sussex Cardiac Centre, Brighton And Sussex
University Hospitals Nhs Trust, Brighton, United Kingdom
(Mullen) Institute Of Cardiovascular Science, University College London,
London, United Kingdom
(Wendler) Department Of Cardiothoracic Surgery, King's College Hospital
Nhs Foundation Trust, London, United Kingdom
(Mansouri, Rombach) Oxford Clinical Trials Research Unit, Nuffield
Department Of Orthopedics, Rheumatology, And Musculoskeletal Sciences,
University Of Oxford, Oxford, United Kingdom
(Abrams) Centre For Health Economics, University Of York, York, United
Kingdom
(Abrams) Department Of Statistics, University Of Warwick, Coventry, United
Kingdom
(Abrams, Conroy) Department Of Health Sciences, University Of Leicester,
Leicester, United Kingdom
(Flather) Norwich Medical School, University Of East Anglia, Norwich,
United Kingdom
(Gray) Health Economics Research Centre, Nuffield Department Of Population
Health, University Of Oxford, Oxford, United Kingdom
(MacCarthy, Monaghan) Department Of Cardiology, King's College Hospital
Nhs Foundation Trust, London, United Kingdom
(Prendergast) Department Of Cardiology, St Thomas' Hospital, London,
United Kingdom
(Ray) Department Of Cardiology, Manchester University Nhs Foundation
Trust, Manchester, United Kingdom
(Young) Department Of Cardiothoracic Surgery, St Thomas' Hospital, London,
United Kingdom
(Crossman) School Of Medicine, University Of St Andrews, Scotland, Fife,
United Kingdom
(Cleland) Robertson Centre For Biostatistics And Glasgow Clinical Trials
Unit, Institute Of Health And Wellbeing, University Of Glasgow, Scotland,
Fife, United Kingdom
(De Belder) National Institute For Cardiovascular Outcomes Research, Barts
Health Nhs Trust, London, United Kingdom
(Ludman) Institute Of Cardiovascular Sciences, Birmingham University,
Birmingham, United Kingdom
(Jones) Surgical Intervention Trials Unit, Nuffield Department Of Surgical
Sciences, University Of Oxford, Oxford, United Kingdom
(Densem) Department Of Cardiology, Royal Papworth Hospital, Cambridge,
United Kingdom
(Tsui) Department Of Cardiothoracic Surgery, Royal Papworth Hospital,
Cambridge, United Kingdom
(Kuduvalli) Department Of Cardiothoracic Surgery, Liverpool Heart And
Chest Hospital Nhs Foundation Trust, Liverpool, United Kingdom
(Mills) Department Of Cardiology, Liverpool Heart And Chest Hospital Nhs
Foundation Trust, Liverpool, United Kingdom
(Banning) Department Of Cardiology, John Radcliffe Hospital, Oxford
University Hospitals Nhs Foundation Trust, Oxford, United Kingdom
(Sayeed) Department Of Cardiothoracic Surgery, John Radcliffe Hospital,
Oxford University Hospitals Nhs Foundation Trust, Oxford, United Kingdom
(Hasan) Department Of Cardiothoracic Surgery, Manchester University Nhs
Foundation Trust, Manchester, United Kingdom
(Fraser) Department Of Cardiovascular Medicine, University Of Manchester,
Manchester, United Kingdom
(Davies, Duncan) Cardiac Department, Royal Brompton Hospital, Royal
Brompton And Harefield Nhs Foundation Trust, London, United Kingdom
(Curzen, Ohri) Wessex Cardiothoracic Centre, University Hospital
Southampton, Southampton, United Kingdom
(Malkin) Department Of Cardiology, Leeds Teaching Hospitals Nhs Trust,
Leeds, United Kingdom
(Kaul) Department Of Cardiac Surgery, Leeds Teaching Hospitals Nhs Trust,
Leeds, United Kingdom
(Muir) Department Of Cardiology, James Cook University Hospital, South
Tees Hospitals Nhs Foundation Trust, Middlesbrough, United Kingdom
(Owens) Department Of Cardiothoracic Surgery, James Cook University
Hospital, South Tees Hospitals Nhs Foundation Trust, Middlesbrough, United
Kingdom
(Uren, Pessotto) Edinburgh Heart Centre, Royal Infirmary Of Edinburgh,
Scotland, Edinburgh, United Kingdom
(Kennon, Awad) Barts Heart Centre, Barts Health Nhs Trust, London, United
Kingdom
(Khogali, Matuszewski) Heart And Lung Centre, New Cross Hospital,
Wolverhampton, United Kingdom
(Edwards, Ramesh) Cardiothoracic Department, Newcastle Upon Tyne
Hospitals, Newcastle upon Tyne, United Kingdom
(Dalby) Department Of Cardiology, Harefield Hospital, Royal Brompton And
Harefield Nhs Foundation Trust, London, United Kingdom
(Raja) Department Of Cardiac Surgery, Harefield Hospital, Royal Brompton
And Harefield Nhs Foundation Trust, London, United Kingdom
(Lloyd) Department Of Cardiothoracic Surgery, Derriford Hospital,
Plymouth, United Kingdom
(Cox) Department Of Cardiology, Derriford Hospital, Plymouth, United
Kingdom
(Redwood) Cardiovascular Division, King's College London, British Heart
Foundation Centre Of Research Excellence, Rayne Institute, St Thomas'
Hospital, London, United Kingdom
(Gunning) Cardiology Department, Royal Stoke University Hospital,
Stoke-on-Trent, United Kingdom
(Ridley) Department Of Cardiothoracic Surgery, Royal Stoke University
Hospital, Stoke-on-Trent, United Kingdom
Publisher
American Medical Association
Abstract
Importance: Transcatheter aortic valve implantation (TAVI) is a less
invasive alternative to surgical aortic valve replacement and is the
treatment of choice for patients at high operative risk. The role of TAVI
in patients at lower risk is unclear. Objective(s): To determine
whether TAVI is noninferior to surgery in patients at moderately increased
operative risk. Design, Setting, and Participant(s): In this
randomized clinical trial conducted at 34 UK centers, 913 patients aged 70
years or older with severe, symptomatic aortic stenosis and moderately
increased operative risk due to age or comorbidity were enrolled between
April 2014 and April 2018 and followed up through April 2019.
 Intervention(s): TAVI using any valve with a CE mark (indicating
conformity of the valve with all legal and safety requirements for sale
throughout the European Economic Area) and any access route (n = 458) or
surgical aortic valve replacement (surgery; n = 455). Main Outcomes
and Measures: The primary outcome was all-cause mortality at 1 year. The
primary hypothesis was that TAVI was noninferior to surgery, with a
noninferiority margin of 5% for the upper limit of the 1-sided 97.5% CI
for the absolute between-group difference in mortality. There were 36
secondary outcomes (30 reported herein), including duration of hospital
stay, major bleeding events, vascular complications, conduction
disturbance requiring pacemaker implantation, and aortic regurgitation.
 Result(s): Among 913 patients randomized (median age, 81 years [IQR,
78 to 84 years]; 424 [46%] were female; median Society of Thoracic
Surgeons mortality risk score, 2.6% [IQR, 2.0% to 3.4%]), 912 (99.9%)
completed follow-up and were included in the noninferiority analysis. At 1
year, there were 21 deaths (4.6%) in the TAVI group and 30 deaths (6.6%)
in the surgery group, with an adjusted absolute risk difference of-2.0%
(1-sided 97.5% CI,- to 1.2%; P <.001 for noninferiority). Of 30
prespecified secondary outcomes reported herein, 24 showed no significant
difference at 1 year. TAVI was associated with significantly shorter
postprocedural hospitalization (median of 3 days [IQR, 2 to 5 days] vs 8
days [IQR, 6 to 13 days] in the surgery group). At 1 year, there were
significantly fewer major bleeding events after TAVI compared with surgery
(7.2% vs 20.2%, respectively; adjusted hazard ratio [HR], 0.33 [95% CI,
0.24 to 0.45]) but significantly more vascular complications (10.3% vs
2.4%; adjusted HR, 4.42 [95% CI, 2.54 to 7.71]), conduction disturbances
requiring pacemaker implantation (14.2% vs 7.3%; adjusted HR, 2.05 [95%
CI, 1.43 to 2.94]), and mild (38.3% vs 11.7%) or moderate (2.3% vs 0.6%)
aortic regurgitation (adjusted odds ratio for mild, moderate, or severe
[no instance of severe reported] aortic regurgitation combined vs none,
4.89 [95% CI, 3.08 to 7.75]). Conclusions and Relevance: Among
patients aged 70 years or older with severe, symptomatic aortic stenosis
and moderately increased operative risk, TAVI was noninferior to surgery
with respect to all-cause mortality at 1 year. Copyright © 2022
American Medical Association. All rights reserved.

<53>
Accession Number
2015561189
Title
STEMI: Considerations for Left Main Culprit Lesions.
Source
Current Cardiology Reports. 24(6) (pp 645-651), 2022. Date of Publication:
June 2022.
Author
Ahmed A.; Aguirre F.V.; Chambers J.; Sharkey S.W.; Tannenbaum M.A.; Yildiz
M.; Garberich R.; Garcia S.; Henry T.D.
Institution
(Ahmed) Cardiovascular Institute of Northern Colorado, Banner Health,
Loveland, United States
(Aguirre, Chambers) Prairie Education and Research Cooperative,
Springfield, IL, United States
(Sharkey, Garberich, Garcia) Minneapolis Heart Institute Foundation at
Abbott Northwestern Hospital, Minneapolis, United States
(Tannenbaum) Iowa Heart Center, West Des Moines, United States
(Yildiz, Henry) The Carl and Edyth Lindner Center for Research and
Education, The Christ Hospital, Cincinnati, OH, United States
Publisher
Springer
Abstract
Purpose of Review: There is a paucity of data regarding the prevalence,
clinical characteristics, and outcomes of patients presenting with ST
elevation myocardial infarction (STEMI) due to left main (LM) culprit
vessel. Recent Findings: LM culprit STEMI (LMCSTEMI) is an uncommon, but
frequently catastrophic event. Prior meta-analyses and registries have
described a varying prevalence of LMCSTEMI, associated cardiogenic shock,
and in-hospital mortality among those surviving to hospital presentation.
These observed clinical discrepancies may be partially attributable to
diverse clinical and angiographical subsets among this STEMI population.
 Summary: STEMI due to LM culprit artery disease represents a
clinically high-risk subset of patients with substantial in-hospital
mortality. In this paper, we summarize the available clinical data
pertaining to STEMI with LM culprit, discuss unique ECG characteristics,
and discuss contemporary revascularization therapy. We also report the
preliminary findings from a contemporary, STEMI database describing
clinical characteristics and angiographically defined subsets of LM
culprit STEMI. Copyright © 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<54>
Accession Number
2017056741
Title
Medical therapy versus percutaneous coronary intervention or coronary
artery bypass graft in stable coronary artery disease; a systematic review
and meta-analysis of randomized clinical trials.
Source
ARYA Atherosclerosis. 18(May) (no pagination), 2022. Article Number: 2288.
Date of Publication: May 2022.
Author
Davari M.; Sorato M.M.; Fatemi B.; Rezaei S.; Sanei H.
Institution
(Davari, Sorato, Fatemi, Rezaei) Department of Pharmacoeconomics and
Pharma Administration, School of Pharmacy, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Sanei) Isfahan Cardiovascular Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
Publisher
Isfahan University of Medical Sciences(IUMS)
Abstract
BACKGROUND: Ischemic heart disease (IHD) is the first cause of mortality
in the world. Stable coronary artery disease (CAD) is the most common IHD.
Medical therapy (MT), percutaneous coronary intervention (PCI), and
coronary artery bypass grafting (CABG) are three strategies for the
management of this disease. The main aim of this study was the comparison
of MT with PCI or CABG in terms of cardiovascular (CV) mortality,
myocardial infarction (MI), unplanned revascularization (UR), stroke, and
freedom from angina in managing stable CAD. METHOD(S): The Cochrane
Central Register of Controlled Trials, Embase, PubMed, and Scopus were
searched. Two reviewers independently appraised the titles and abstracted
data of the identified studies. After the Full-text reviewing phase,
eligible studies were analyzed through the random-effect meta-analysis
method. Finally, a sensitivity analysis was conducted for the robustness
of findings. RESULT(S): Nine randomized controlled trials (RCTs) were
included. The pooled RR of CV mortality associated with MT compared with
PCI and CABG was 1.22 and 1.385, respectively. Overall, The RR of MT
associated with MI, UR, stroke, and freedom from angina compared with PCI
was 1.001, 1.151, 0.799, and 0.801, respectively. CONCLUSION(S): Our
results revealed no statistically significant difference between MT and
PCI in terms of studied primary outcomes. The findings also highlighted
that there is no statistically significant difference between MT and CABG
in terms of CV mortality. Copyright © 2022, Isfahan University of
Medical Sciences(IUMS). All rights reserved.

<55>
Accession Number
2017931855
Title
Automated versus conventional perioperative glycemic control in adult
diabetic patients undergoing open heart surgery.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 184. Date
of Publication: December 2022.
Author
Kaddoum R.; Khalili A.; Shebbo F.M.; Ghanem N.; Daher L.A.; Ali A.B.;
Chehade N.E.H.; Maroun P.; Aouad M.T.
Institution
(Kaddoum, Khalili, Shebbo, Ghanem, Daher, Ali, Chehade, Aouad) Department
of Anesthesiology and Pain Medicine, American University of Beirut Medical
Center, Beirut, Lebanon
(Maroun) Faculty of Medicine, American University of Beirut, Beirut,
Lebanon
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative glycemic variability is associated with
increased risks of mortality and morbidity and an increased incidence of
hyperglycemia after cardiac surgery. Accordingly, clinicians tend to use a
tight glucose control to maintain perioperative blood glucose levels and
therefore the need to develop a less laborious automated glucose control
system is important especially in diabetic patients at a higher risk of
developing complications. Method(s): Patients, aged between 40 and 75
years old, undergoing open heart surgery were randomized to either an
automated protocol (experimental) or to the conventional technique at our
institution (control). Result(s): We showed that the percentage of
patients maintained between 7.8-10 mmol.l-1 was not
statistically different between the two groups, however, through an
additional analysis, we showed that the proportion of patients whose
glucose levels maintained between a safety level of 6.7-10
mmol.l-1 was significantly higher in the experimental group
compared to control group, 14 (26.7%) vs 5 (17.2%) P = 0.025. In addition,
the percentage of patients who had at least one intraoperative
hyperglycemic event was significantly higher in the control group compared
to the experimental group, 17 (58.6%) vs 5 (16.7%), P < 0.001 with no
hypoglycemic events in the experimental group compared to two events in
the control group. We also showed that longer surgeries can benefit more
from using the automated glucose control system, particularly surgeries
lasting more than 210 min. Conclusion(s): We concluded that the
automated glucose control pump in diabetic patients undergoing open heart
surgeries maintained most of the patients within a predefined glucose
range with a very low incidence of hyperglycemic events and no incidence
of hypoglycemic events. Trial registration: Registered with
clinicaltrials.gov (NCT #NCT03314272, Principal investigator Roland
Kaddoum, date of registration: 19/10/2017). Copyright © 2022, The
Author(s).

<56>
Accession Number
2015701745
Title
Infective endocarditis following heart transplantation: A systematic
review.
Source
Transplantation Reviews. 36(1) (no pagination), 2022. Article Number:
100672. Date of Publication: January 2022.
Author
Jordan A.M.; Tatum R.; Ahmad D.; Patel S.V.; Maynes E.J.; Weber M.P.; Moss
S.; Royer T.L.; Tchantchaleishvili V.; Massey H.T.; Rame J.E.; Zurlo J.J.;
Aburjania N.
Institution
(Jordan, Tatum, Ahmad, Patel, Maynes, Weber, Tchantchaleishvili, Massey)
Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia,
PA, United States
(Moss, Royer, Zurlo, Aburjania) Division of Infectious Disease, Thomas
Jefferson University, Philadelphia, PA, United States
(Rame) Department of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
W.B. Saunders
Abstract
Purpose: Infective endocarditis (IE) is a rare but potentially fatal
complication following heart transplantation (HTx). There is a lack of
literature regarding the patterns and clinical course of IE development
following HTx. We sought to pool the existing data in regards to defining
characteristics, management options, and outcomes of IE following HTx.
 Method(s): An electronic search of Cochrane Central Register of
Controlled Trials, Cumulative Index to Nursing and Allied Health
Literature, Ovid Medline, and the Scopus databases were performed to
identify all articles in the English literature that report IE following
HTx in adult patients. Patient-level data were extracted and analyzed.
 Result(s): Systematic search yielded 57 patients from 32 articles.
Median patient age was 52 [IQR 43, 59] and 75% of patients (43/57) were
male. Median time to IE presentation post-HTx was 8.4 [IQR 3.0, 35.8]
months. IE of the mitral valve was observed in 36.8% (21/57) of patients,
followed by mural IE in 24.6% (14/57), and tricuspid valve IE in 21.1%
(12/57). The most common organisms were Staphylococcus aureus in 26.3%
(15/57), Aspergillus fumigatus in 19.3% (11/57), Enterococcus faecalis in
12.3% (7/57), and an undetermined or unspecified organism in 14.0% (8/57)
patients. Overall case fatality was 44.6% (25/56). Fungal IE was
associated with a significantly higher case fatality 75.0% (9/12) than
that of bacterial IE 36.1% (13/36) (p = 0.02). Surgical management of
post-HTx IE was observed in 35.1% (20/57) of patients. This included valve
surgery for 70.0% (14/20), including the mitral valve in 50.0% (7/14),
aortic valve in 35.7% (5/14), and the tricuspid valve in 14.3% (2/14) of
patients. Conclusion(s): In addition to bacterial organisms, fungi
also represent a frequent cause of IE in post-HTx patients. Overall HTx
patient survival in the setting of IE is poor and may be worse if caused
by A. fumigatus. Copyright © 2021 Elsevier Inc.

<57>
Accession Number
2011040130
Title
Contemporary review of exercise in heart transplant recipients.
Source
Transplantation Reviews. 35(2) (no pagination), 2021. Article Number:
100597. Date of Publication: April 2021.
Author
Guimaraes G.V.; Ribeiro F.; Arthuso F.Z.; Castro R.E.; Cornelissen V.;
Ciolac E.G.
Institution
(Guimaraes, Castro) Heart Institute, School of Medicine, University of Sao
Paulo (USP), Sao Paulo, Brazil
(Ribeiro) School of Health Sciences and Institute of Biomedicine - iBiMED,
University of Aveiro, Aveiro, Portugal
(Arthuso, Ciolac) Department of Physical Education, School of Sciences,
Sao Paulo State University (UNESP), Bauru, Brazil
(Cornelissen) Department of Rehabilitation Science, KU Leuven, Leuven,
Belgium
Publisher
W.B. Saunders
Abstract
Heart transplantation (HTx) is a therapeutic option for a selected group
of patients with end-stage heart failure. Although secondary prevention
including exercise therapy is recommended in the management of patients
following HTx, little information is available on their metabolic and
physiological consequences in HTx. Therefore, we aimed to conduct a
contemporary review the effectiveness of exercise therapy on functional
capacity, cardiovascular health and health-related quality of life for
adult HTx patients. We searched the database MEDLINE for articles
published between January 2015 and October 2020 and were able to include 6
studies involving 202 patients. Larger improvements in exercise capacity
were seen after high-intensity interval training and in patients with
evidence of cardiac reinnervation. Clinically relevant reductions were
observed for daytime and 24 h ambulatory blood pressure after exercise
training and following a single bout of aerobic exercise. Finally, limited
data suggest that quality of life is higher in HTx patients following
high-intensity training. In summary, the available evidence shows the
potential for exercise as a vital treatment in patients following HTx.
Yet, the scant data calls for more well-designed and adequately powered
studies to support its effectiveness and to unravel optimal exercise
characteristics, which would allow for more effective and person-tailored
exercise prescription. Copyright © 2021 Elsevier Inc.

<58>
Accession Number
2002198071
Title
Concomitant vs staged orthotopic liver transplant after cardiac surgical
procedures.
Source
Transplantation Reviews. 33(4) (pp 231-236), 2019. Date of Publication:
October 2019.
Author
Reddy H.G.; Choi J.H.; Maynes E.J.; Carlson L.A.; Gordon J.S.; Horan D.P.;
Khan J.; Weber M.P.; Bodzin A.S.; Morris R.J.; Massey H.T.;
Tchantchaleishvili V.
Institution
(Reddy, Choi, Maynes, Carlson, Gordon, Horan, Khan, Weber, Morris, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Bodzin) Division of Transplant Surgery, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
W.B. Saunders
Abstract
Background: In patients who require orthotopic liver transplant (OLT),
cardiac surgery may be needed to optimize preoperative cardiac status for
OLT. The aim of this systematic review was to evaluate patient
characteristics and outcomes of those undergoing staged versus concomitant
cardiac procedures with OLT. Method(s): An electronic search was
performed to identify all case reports and series, from which
patient-level data was extracted regarding cardiac procedures associated
with OLT. After assessment for inclusion and exclusion criteria, 26
articles were pooled for systematic review. Result(s): Overall, 49
patients were included in the analysis, of whom 12 (24%) underwent staged
procedures and 37 (76%) underwent concomitant procedures. The median age
was lower in the staged group [staged: 51 (IQR, 43.8-59.2) years vs.
concomitant: 60 (IQR, 55.0-64.0) years, p = .02]. Other baseline
characteristics were comparable between the two groups. For staged
procedures, the median time between heart procedures and OLT was 2 (IQR,
1.0-3.5) months. The most commonly reported cardiac procedures were
coronary artery bypass graft (CABG) [staged: 4/12 (33.3%) vs. concomitant:
21/37 (56.8%), p = .28], aortic valve replacement (AVR) [staged: 3/12
(25.0%) vs. concomitant: 19/37 (51.2%), p = .21], and transcatheter aortic
valve replacement (TAVR) [staged: 4/12 (33.3%) vs. concomitant: 0/37 (0%),
p = .002]. Regarding outcomes, there was a significantly shorter post-OLT
hospital stay for those who had staged procedures versus those who had
concomitant procedures [staged: 8 (IQR, 5-13) days vs. concomitant: 17
(IQR, 14-24) days, p = .007]. However, both groups had similar in-hospital
mortality rates [staged: 1/12 (8.3%) vs. concomitant: 4/37 (10.8%), p =
1.0]. Overall survival stratified between the two groups was comparable.
 Conclusion(s): Patients who underwent the staged approach had a
shorter post-transplant hospital stay, but comparable survival with
respect to those who underwent concomitant cardiac procedures and
OLT. Copyright © 2019 Elsevier Inc.

<59>
Accession Number
638187189
Title
Lidocaine Infusion for the Management of Postoperative Pain and Delirium
(LIMPP): protocol for a randomised control trial.
Source
BMJ Open. 12(6) (no pagination), 2022. Article Number: e059416. Date of
Publication: 06 Jun 2022.
Author
Buren M.A.; Theologis A.; Zuraek A.; Behrends M.; Clark A.J.; Leung J.M.
Institution
(Buren, Zuraek, Behrends, Leung) Anesthesia and Perioperative Care,
University of California San Francisco, San Francisco, CA, United States
(Theologis) Orthopedic Surgery, University of California San Francisco,
San Francisco, CA, United States
(Clark) Neurological Surgery, University of California San Francisco, San
Francisco, CA, United States
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium is a frequent adverse event following
elective non-cardiac surgery. The occurrence of delirium increases the
risk of functional impairment, placement to facilities other than home
after discharge, cognitive impairment at discharge, as well as in-hospital
and possibly long-term mortality. Unfortunately, there is a dearth of
effective strategies to minimise the risk from modifiable risk factors,
including postoperative pain control and the analgesic regimen. Use of
potent opioids, currently the backbone of postoperative pain control,
alters cognition and has been associated with an increased risk of
postoperative delirium. Literature supports the intraoperative use of
lidocaine infusions to decrease postoperative opioid requirements,
however, whether the use of postoperative lidocaine infusions is
associated with lower opioid requirements and subsequently a reduction in
postoperative delirium has not been investigated. Methods and analysis The
Lidocaine Infusion for the Management of Postoperative Pain and Delirium
trial is a randomised, double-blinded study of a postoperative 48-hour
infusion of lidocaine at 1.33 mg/kg/hour versus placebo in older patients
undergoing major reconstructive spinal surgery at the University of
California, San Francisco. Our primary outcome is incident delirium
measured daily by the Confusion Assessment Method in the first three
postoperative days. Secondary outcomes include delirium severity, changes
in cognition, pain scores, opioid use, incidence of opioid related side
effects and functional benefits including time to discharge and improved
recovery from surgery. Lidocaine safety will be assessed with daily
screening questionnaires and lidocaine plasma levels. Ethics and
dissemination This study protocol has been approved by the ethics board at
the University of California, San Francisco. The results of this study
will be published in a peer-review journal and presented at national
conferences as poster or oral presentations. Participants wishing to know
the results of this study will be contacted directly on data publication.
Trial registration number NCT05010148. Copyright © Author(s) (or
their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<60>
Accession Number
638187137
Title
Intraoperative haemodynamic optimisation using the Hypotension Prediction
Index and its impact on tissular perfusion: a protocol for a randomised
controlled trial.
Source
BMJ Open. 12(6) (no pagination), 2022. Article Number: e051728. Date of
Publication: 02 Jun 2022.
Author
Lorente J.V.; Jimenez I.; Ripolles-Melchor J.; Becerra A.; Wesselink W.;
Reguant F.; Mojarro I.; Fuentes M.D.L.A.; Abad-Motos A.; Agudelo E.;
Herrero-Machancoses F.; Callejo P.; Bosch J.; Monge M.I.
Institution
(Lorente, Mojarro) Anesthesia and Critical Care, Hospital Juan Ramon
Jimenez, Huelva, Spain
(Lorente, Reguant, Bosch) School of Medicine and Health Science,
Universitat Internacional de Catalunya, Barcelona, Spain
(Jimenez, Fuentes) Anesthesia and Critical Care, Virgen Del Rocio
University Hospital, Sevilla, Spain
(Ripolles-Melchor, Abad-Motos) Anesthesia and Critical Care, Infanta
Leonor University Hospital, Madrid, Spain
(Becerra, Agudelo) Anesthesia and Critical Care, Complejo Hospitalario
Universitario de Badajoz, Badajoz, Spain
(Wesselink) Edwards Lifesciences Corp, Irvine, CA, United States
(Reguant) Anesthesia, Fundacio Althaia de Manresa, Manresa, Spain
(Herrero-Machancoses) Predepartamental Unit of Medicine, Science Health
Faculty, Universitat Jaume, Castello de la Plana, Spain
(Callejo) Fundacion Progreso y Salud, Sevilla, Spain
(Monge) Intensive Care Unit, Hospital Universitario de Jerez de la
Frontera, Jerez de la Frontera, Spain
Publisher
BMJ Publishing Group
Abstract
Introduction Intraoperative arterial hypotension is associated with poor
postoperative outcomes. The Hypotension Prediction Index (HPI) developed
using machine learning techniques, allows the prediction of arterial
hypotension analysing the arterial pressure waveform. The use of this
index may reduce the duration and severity of intraoperative hypotension
in adults undergoing non-cardiac surgery. This study aims to determine
whether a treatment protocol based on the prevention of arterial
hypotension using the HPI algorithm reduces the duration and severity of
intraoperative hypotension compared with the recommended goal-directed
fluid therapy strategy and may improve tissue oxygenation and organ
perfusion. Methods and analysis We will conduct a multicentre, randomised,
controlled trial (N=80) in high-risk surgical patients scheduled for
elective major abdominal surgery. All participants will be randomly
assigned to a control or intervention group. Haemodynamic management in
the control group will be based on standard haemodynamic parameters.
Haemodynamic management of patients in the intervention group will be
based on functional haemodynamic parameters provided by the HemoSphere
platform (Edwards Lifesciences), including dynamic arterial elastance,
dP/dt max and the HPI. Tissue oxygen saturation will be recorded
non-invasively and continuously by using near-infrared spectroscopy
technology. Biomarkers of acute kidney stress (cTIMP2 and IGFBP7) will be
obtained before and after surgery. The primary outcome will be the
intraoperative time-weighted average of a mean arterial pressure <65 mm
Hg. Ethics and dissemination Ethics committee approval was obtained from
the Ethics Committee of Hospital Gregorio Maranon (Meeting of 27 July
2020, minutes 18/2020, Madrid, Spain). Findings will be widely
disseminated through peer-reviewed publications and conference
presentations. Trial registration number NCT04301102. Copyright ©
Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<61>
Accession Number
2018710810
Title
Surgical Treatment for Advanced Thoracic Spinal Tuberculosis in Infants:
Case Series and Literature Review.
Source
International Journal of Spine Surgery. 16(2) (pp 393-403), 2022. Date of
Publication: 01 Apr 2022.
Author
Egea-Gamez R.M.; Galan-Olleros M.; Gonzalez-Menocal A.; Martinez-Gonzalez
C.; Gonzalez-Diaz R.
Institution
(Egea-Gamez, Martinez-Gonzalez, Gonzalez-Diaz) Orthopaedic Surgery, Spinal
Unit, Hospital Universitario Nino Jesus, Madrid, Spain
(Galan-Olleros) Neuro-Orthopaedic Surgery, Hospital Universitario Nino
Jesus, Madrid, Spain
(Gonzalez-Menocal) Orthopaedic Surgery, Hospital Universitario Infanta
Elena, Madrid, Spain
Publisher
ISASS
Abstract
Background: Spinal tuberculosis (TB), or Pott's disease, is the most
common form of osteoarticular TB. Early diagnosis and anti-TB drug therapy
are the mainstays of treatment. However, in advanced stages, surgery is
essential to correct spinal deformities and avoid neurological damage.
Very few cases in young children requiring surgical treatment have been
described. We present 2 cases of surgically treated thoracic spinal TB in
patients under 2 years of age and review the literature on this entity in
young children. Case Description: Two male toddlers, aged 21 (patient 1)
and 23 (patient 2) months, were admitted due to insidious systemic
deterioration associated with neck stiffness and nonspecific abdominal
pain in patient 1 and limping in patient 2. The findings of laboratory
tests were unremarkable despite an increase in acute-phase reactants.
After an extensive workup, results of a magnetic resonance imaging were
consistent with spinal TB in both patients. Patient 1 underwent
costotransversectomy of the left third and fourth ribs, debridement, T3-T4
corpectomy, and T2-T6 posterior fusion, to which an anterior rib autograft
was added. Patient 2 had a right-sided thoracotomy performed at the apex
in addition to debridement and T8 corpectomy; the resected rib was used as
anterior structural autograft. Several samples of purulent, caseous
material were sent for study. On follow-up, progression of proximal
junctional kyphosis was evidenced in patient 1, requiring revision surgery
to restore sagittal alignment; the patient was asymptomatic at 2-year
follow-up. Patient 2 evolved satisfactorily without neurological sequelae
and was asymptomatic at 4-year follow-up. Conclusion(s): Spinal TB in
young children requires appropriate surgical treatment when presenting at
advanced stages or having severe deformity or neurological compromise.
Despite the challenges associated with young age and ongoing growth,
surgery can be performed safely provided proper surgical expertise. After
extensive debridement and decompression, priority should be given to
restoring sagittal alignment and balance with stable and durable spinal
reconstructions. Copyright © International Society for the
Advancement of Spine Surgery

<62>
Accession Number
2017088089
Title
Review of Contemporary Invasive Treatment Approaches and Critical
Appraisal of Guidelines on Hypertrophic Obstructive Cardiomyopathy:
State-of-the-Art Review.
Source
Journal of Clinical Medicine. 11(12) (no pagination), 2022. Article
Number: 3405. Date of Publication: June-2 2022.
Author
Lebowitz S.; Kowalewski M.; Raffa G.M.; Chu D.; Greco M.; Gandolfo C.;
Mignosa C.; Lorusso R.; Suwalski P.; Pilato M.
Institution
(Lebowitz) University of Pittsburgh School of Medicine, Pittsburgh, PA
15213, United States
(Kowalewski, Lorusso) Cardio-Thoracic Surgery Department, Heart and
Vascular Centre, Maastricht University Medical Centre (MUMC), Maastricht
6200 MD, Netherlands
(Kowalewski, Suwalski) Clinical Department of Cardiac Surgery, Central
Clinical Hospital of the Ministry of Interior and Administration, Centre
of Postgraduate Medical Education, Warsaw 00-213, Poland
(Kowalewski) Thoracic Research Centre, Collegium Medicum, Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz 87-100, Poland
(Raffa, Greco, Gandolfo, Mignosa, Pilato) Department for the Treatment and
Study of Cardiothoracic Diseases and Cardiothoracic Transplantation,
IRCCS-ISMETT, Palermo 90127, Italy
(Chu) Department of Cardiothoracic Surgery, Division of Cardiac Surgery,
University of Pittsburgh Medical Center Heart & Vascular Institute,
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United
States
Publisher
MDPI
Abstract
Background: Hypertrophic obstructive cardiomyopathy (HOCM) is a
heterogeneous disease with different clinical presentations, albeit
producing similar dismal long-term outcomes if left untreated. Several
approaches are available for the treatment of HOCM; e.g., alcohol septal
ablation (ASA) and surgical myectomy (SM). The objectives of the current
review were to (1) discuss the place of the standard invasive treatment
modalities (ASA and SM) for HOCM; (2) summarize and compare novel
techniques for the management of HOCM; (3) analyze current guidelines
addressing HOCM management; and (4) offer suggestions for the treatment of
complex HOCM presentations. Method(s): We searched the literature and
attempted to gather the most relevant and impactful available evidence on
ASA, SM, and other invasive means of treatment of HOCM. The literature
search yielded thousands of results, and 103 significant publications were
ultimately included. Result(s): We critically analyzed available
guidelines and provided context in the setting of patient selection for
standard and novel treatment modalities. This review offers the most
comprehensive analysis to-date of available invasive treatments for HOCM.
These include the standard treatments, SM and ASA, as well as novel
treatments such as dual-chamber pacing and radiofrequency catheter
ablation. We also account for complex pathoanatomic presentations and
current guidelines to offer suggestions for tailored care of patients with
HOCM. Finally, we consider promising future therapies for HOCM.
 Conclusion(s): HOCM is a heterogeneous disease associated with poor
outcomes if left untreated. Several strategies for treatment of HOCM are
available but patient selection for the procedure is
crucial. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<63>
Accession Number
2018825759
Title
Dexmedetomidine Reduces Incidences of Ventricular Arrhythmias in Adult
Patients: A Meta-Analysis.
Source
Cardiology Research and Practice. 2022 (no pagination), 2022. Article
Number: 5158362. Date of Publication: 2022.
Author
Zhong Q.; Kumar A.; Deshmukh A.; Bennett C.
Institution
(Zhong) Department Of Medicine, Mayo Clinic, Rochester, NY, United States
(Kumar) Department Of Medicine, Department Of Internal Medicine, Cleveland
Clinic Akron General Hospital, Akron, OH, United States
(Deshmukh, Bennett) Department Of Cardiovascular Medicine, Mayo Clinic,
Rochester, NY, United States
Publisher
Hindawi Limited
Abstract
Purpose. To assess the antiarrhythmic properties of dexmedetomidine in
patients in the intensive care unit. Methods. A literature review was
conducted with Ovid MEDLINE (R), Cochrane Central Register of Controlled
Trials, Cochrane Database of Systematic Reviews, Embase, and Scopus. Study
Selection. Randomized controlled trials were included, examining the
incidence of ventricular arrhythmias, ventricular tachycardia, or
ventricular fibrillation with dexmedetomidine compared to placebo or an
alternative sedative agent. For each publication that met the selection
criteria, the patient demographics, incidence of arrhythmias, mortality,
and adverse events were collected. Data extraction was carried out by two
authors independently. Results. We identified 6 out of 126 studies that
met the selection criteria for our meta-analysis, all of which focused on
the perioperative cardiac surgery period. Patients receiving
dexmedetomidine demonstrated a significant reduction of the overall
incidence of ventricular arrhythmias (RR 0.35, 95% CI 0.16, 0.76). In
particular, dexmedetomidine significantly decreased the risk of
ventricular tachycardia compared with control (RR 0.25, 95% CI 0.08, 0.80,
I2 0%). Regarding adverse events, dexmedetomidine significantly increased
the frequency of bradycardia (RR 2.78 95% CI 2.00, 3.87). However, there
was no significant difference in mortality (RR 0.59 95% CI 0.12, 3.02).
Conclusion. From this meta-analysis, we report a decreased incidence of
ventricular tachycardia with dexmedetomidine in critically ill patients.
This result favors the use of dexmedetomidine for its antiarrhythmic
properties. Copyright © 2022 Qiaonan Zhong et al.

<64>
Accession Number
2017959294
Title
Machine learning and artificial intelligence in cardiac transplantation: A
systematic review.
Source
Artificial Organs. (no pagination), 2022. Date of Publication: 2022.
Author
Naruka V.; Arjomandi Rad A.; Subbiah Ponniah H.; Francis J.; Vardanyan R.;
Tasoudis P.; Magouliotis D.E.; Lazopoulos G.L.; Salmasi M.Y.; Athanasiou
T.
Institution
(Naruka, Athanasiou) Department of Cardiothoracic Surgery, Imperial
College NHS Trust, Hammersmith Hospital, London, United Kingdom
(Naruka, Arjomandi Rad, Subbiah Ponniah, Vardanyan, Salmasi, Athanasiou)
Department of Surgery and Cancer, Faculty of Medicine, Imperial College
London, London, United Kingdom
(Francis) Faculty of Medicine, University of Edinburgh, Edinburgh, United
Kingdom
(Tasoudis, Magouliotis, Lazopoulos, Athanasiou) Department of
Cardiothoracic Surgery, University Hospital Thessaly, Larissa, Greece
(Lazopoulos) Department of Cardiac Surgery, University Hospital of
Heraklion, Crete, Greece
Publisher
John Wiley and Sons Inc
Abstract
Background: This review aims to systematically evaluate the currently
available evidence investigating the use of artificial intelligence (AI)
and machine learning (ML) in the field of cardiac transplantation.
Furthermore, based on the challenges identified we aim to provide a series
of recommendations and a knowledge base for future research in the field
of ML and heart transplantation. Method(s): A systematic database
search was conducted of original articles that explored the use of ML
and/or AI in heart transplantation in EMBASE, MEDLINE, Cochrane database,
and Google Scholar, from inception to November 2021. Result(s): Our
search yielded 237 articles, of which 13 studies were included in this
review, featuring 463 850 patients. Three main areas of application were
identified: (1) ML for predictive modeling of heart transplantation
mortality outcomes; (2) ML in graft failure outcomes; (3) ML to aid
imaging in heart transplantation. The results of the included studies
suggest that AI and ML are more accurate in predicting graft failure and
mortality than traditional scoring systems and conventional regression
analysis. Major predictors of graft failure and mortality identified in ML
models were: length of hospital stay, immunosuppressive regimen,
recipient's age, congenital heart disease, and organ ischemia time. Other
potential benefits include analyzing initial lab investigations and
imaging, assisting a patient with medication adherence, and creating
positive behavioral changes to minimize further cardiovascular risk.
 Conclusion(s): ML demonstrated promising applications for improving
heart transplantation outcomes and patient-centered care, nevertheless,
there remain important limitations relating to implementing AI into
everyday surgical practices. Copyright © 2022 The Authors.
Artificial Organs published by International Center for Artificial Organ
and Transplantation (ICAOT) and Wiley Periodicals LLC.

<65>
Accession Number
2017928061
Title
Transcatheter aortic valve implantation in patients with severe
symptomatic aortic valve stenosis: systematic review of cost-effectiveness
analysis.
Source
European Journal of Health Economics. (no pagination), 2022. Date of
Publication: 2022.
Author
Chotnoppharatphatthara P.; Yoodee V.; Taesotikul S.; Yadee J.; Permsuwan
U.
Institution
(Chotnoppharatphatthara, Yoodee, Taesotikul, Yadee, Permsuwan) Department
of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang
Mai 50200, Thailand
(Yadee, Permsuwan) Center for Medical and Health Technology Assessment
(CM-HTA), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200,
Thailand
(Yoodee, Taesotikul) Pharmaceutical Care Training Center (PCTC), Faculty
of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a less
invasive and costly treatment for patients with severe aortic stenosis
(AS). This study aimed to systematically review the published literature
focusing on economic evaluation of TAVI compared with other alternative
treatments in AS populations. Method(s): A systematic review was
conducted from inception until May 2021 using PubMed, Scopus, Web of
science and Embase databases. The qualities of included studies were
evaluated using Consolidated Health Economic Evaluation Reporting Standard
(CHEERS) criteria. Data of costs, outcomes, incremental cost-effectiveness
ratio (ICER) and willingness to pay were extracted. To compare results,
ICERs were converted to the 2020 United States dollar (USD) rate.
 Result(s): Of the 29 included cost-effectiveness studies, TAVI was
cost-effective in all studies in the low-risk group (3/3), 77% of studies
(7/9) in the intermediate-risk group, half of the studies (6/12) in the
high-risk group, and 83% of studies (10/12) in the inoperable group. When
adjusted to USD 2020, ICERs ranged from USD 2741 to 1027,674 USD per
quality-adjusted life-year gained. The overall quality of the studies
ranged from moderate to high. Conclusion(s): TAVI is potentially a
cost-effective alternative to surgical aortic valve replacement (SAVR) for
patients with operable AS with low, intermediate or high risk compared
with medical management (MM) for patients with inoperable AS. TAVI was
associated with a significant gain in quality-adjusted life-years in
almost all studies compared to either SAVR or MM. TAVI is a costly
procedure; therefore, justifying its cost-effectiveness depends on the
acceptable threshold in each country. Copyright © 2022, The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature.

<66>
Accession Number
638257646
Title
Heart Rehabilitation for All (HeRTA): Protocol for a feasibility study and
pilot randomized trial.
Source
PloS one. 17(6) (pp e0270159), 2022. Date of Publication: 2022.
Author
Birke H.; Foxvig I.; Burns K.; Toft U.; Hansen A.B.G.; Hauge P.I.; Foghmar
S.; Mindegaard R.B.; Jakobsen L.M.
Institution
(Birke, Foxvig, Burns, Toft, Hansen, Jakobsen) Center for Clinical
Research and Prevention, Frederiksberg Hospital, Frederiksberg, Denmark
(Toft) Section of Social Medicine, Department of Public Health, University
of Copenhagen, Copenhagen, Denmark
(Hauge) Danish Heart Association, Copenhagen, Denmark
(Foghmar) Cardiology Department, University Hospital Hvidovre, Hvidovre,
Denmark
(Mindegaard) Rehabilitation Center, Albertslund Municipality, Albertslund,
Denmark
(Jakobsen) Capital RegionDenmark
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Today, 50% of people with cardiac disease do not participate
in rehabilitation. The HeRTA-study aims to develop and test a sustainable
rehabilitation model supporting vulnerable patients in participating in
rehabilitation and long-term physical activity. METHOD(S): A
feasibility study with a non-blinded pilot randomized trial was developed
in collaboration with partners and cardiac patients to test a
multi-component rehabilitation intervention across hospital, municipality,
and civil society. The study runs from January 2020 to December 2024.
Eligibility criteria for participants: a) diagnosed with either ischemic
heart disease, persistent atrial fibrillation, heart failure, or have had
cardiac valve surgery, b) residents in Hvidovre Hospitals uptake area, c)
cognitively functional, d) physically able to participate in
rehabilitation. Patient recruitment will be located at Hvidovre Hospital,
Capital Region of Denmark, data collection at Hvidovre Hospital,
Rehabilitation Center Albertslund, the Danish Heart Association, and in
two municipalities (Hvidovre and Brondby). Patients in the control group
have access to usual care at the hospital:
rehabilitation-needs-assessment, patient education, and physical training.
After or instead of hospital rehabilitation, the patient can be referred
to municipal rehabilitation with patient education, and a total of 12
weeks of physical training across sectors. Patients in the intervention
group will in addition to usual care, have access to an information book
about cardiac disease, patient supporters from the Danish Heart
Association, Information materials to inform employers about the
employees' rehabilitation participation, a rehabilitation goal setting
plan, a support cafe for relatives, and follow-up phone calls from
physiotherapists 1 and 3 months after rehabilitation to support physical
activities. Patients with vulnerabilities will additionally receive
patient education conducted in small groups, pro-active counselling by a
cardiac nurse, psychologist, or social worker, paid transportation to
rehabilitation, and paid membership in a sports association. Patients are
computer block-randomized so patients with vulnerability are distributed
evenly in the two study arms by stratifying on a) a cut-off score of >= 5
in the Tilburg Frailty Indicator questionnaire and/or b) need of language
translator support. A power calculation, based on an estimated 20%
difference in participation proportion between groups, 80% power, a type 1
error of 5% (two-tailed), results in 91 participants in each study arm.
The primary outcome: rehabilitation participation (attending >= two
activities: patient education, smoking cessation, dietary counseling, and
physical training) and reaching at least 50% attendance. Secondary
Outcomes: health-related quality of life, coping strategies, level of
physical activities, and sustainability regarding participation in active
communities after rehabilitation. The study is registered at
ClinicalTrials.gov (NCT05104658). RESULT(S): Differences between
changes in outcomes between groups will be analyzed according to the
intention-to-treat principle. Sensitivity analysis and analysis of the
effect of the combined activities will be made. A process evaluation will
clarify the implementation of the model, the partnership, and patients'
experiences. CONCLUSION(S): Cross-sectoral collaborations between
hospitals, municipalities, and organizations in civil society may lead to
sustainable and affordable long-term physical activities for persons with
chronic illness. The results can lead to improve cross-sectoral
collaborations in other locations and patient groups.

<67>
Accession Number
2015266762
Title
Comparison of Ultrasound-Guided Pecto-intercostal Fascial Block and
Transversus Thoracic Muscle Plane Block for Acute Poststernotomy Pain
Management After Cardiac Surgery: A Prospective, Randomized, Double-Blind
Pilot Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part A. 36(8) (pp
2313-2321), 2022. Date of Publication: August 2022.
Author
Kaya C.; Dost B.; Dokmeci O.; Yucel S.M.; Karakaya D.
Institution
(Kaya, Dost, Dokmeci, Karakaya) Department of Anaesthesiology and
Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
(Yucel) Department of Cardiovascular Surgery, Ondokuz Mayis University
Faculty of Medicine, Samsun, Turkey
Publisher
W.B. Saunders
Abstract
Objective: The objective of the present study was to evaluate morphine
consumption and pain scores 24 hours postoperatively to compare the
effects of a bilateral pectointercostal fascial block (PIFB) with those of
a transversus thoracic muscle plane block (TTMPB) on acute poststernotomy
pain in cardiac surgery patients who have undergone median sternotomy.
 Design(s): Prospective, randomized, double-blinded. Setting(s):
The operating room, intensive care unit, and patient ward at a university
hospital. Participant(s): Thirty-nine American Society of
Anesthesiologists II-to-III patients aged 18- to-80 years, scheduled for
elective cardiac surgery via median sternotomy. Intervention(s):
Patients randomly were allocated to groups scheduled to receive bilateral
ultrasound-guided PIFB or TTMPB. Measurements and Main Results: The
primary outcome was postoperative morphine use within the first 24 hours.
Secondary outcomes were the numerical pain rating scale (NRS) scores at
rest and during coughing, time of first analgesic demand from the
patient-controlled analgesia (PCA) device, and rescue analgesia use. The
nausea/vomiting scores, time to extubation, length of stays in intensive
care and the hospital, patient satisfaction scores, and complications were
also recorded. The first 24-hour morphine use did not significantly differ
between the PIFB and TTMPB groups (mean +/- standard deviation [95% CI],
13.89 +/- 6.80 [10.83-16.95] mg/24 h and 15.08 +/- 7.42 [11.83-18.33]
mg/24 h, respectively, p = 0.608). No significant difference between the
two groups in the NRS scores at rest and during coughing was observed; the
groups had similar requirements for rescue analgesia in the first 24 hours
(n [%], three [15.8] and seven [35], p = 0.273, respectively). The time
from PCA to the first analgesia request was longer in the PIFB than in the
TTMPB group (median [interquartile range], 660 [540-900] minutes, and 240
[161-525] minutes, respectively, p = 0.002). Conclusion(s): PIFB and
TTMPB showed similar effectiveness for morphine consumption within 24
hours postoperatively and in pain scores in cardiac surgery
patients. Copyright © 2021 Elsevier Inc.

<68>
Accession Number
2016133072
Title
Predicting outcomes of mesenteric ischemia postcardiac surgery: A
systematic review.
Source
Journal of Cardiac Surgery. 37(7) (pp 2025-2039), 2022. Date of
Publication: July 2022.
Author
Kayali F.; Sarodaya V.; Shah H.I.; Hayat M.Y.; Leung M.S.T.; Harky A.
Institution
(Kayali) UCLan Medical School, University of Central Lancashire, Preston,
United Kingdom
(Sarodaya) Department of Critical Care Medicine, Barts Health NHS Trust,
London, United Kingdom
(Shah) UCL Medical School, University College London, London, United
Kingdom
(Hayat) Faculty of Medicine, St George's Hospital Medical School, London,
United Kingdom
(Leung) Department of Surgery, Imperial Healthcare Trust, London, United
Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Objective: This systematic review aims to identify predictors of outcomes
of mesenteric ischemia in patients following cardiac surgery.
 Method(s): A comprehensive literature search was done on EMBASE,
PubMed, Ovid MEDLINE, and SCOPUS using keywords relating to bowel ischemia
and cardiac surgery. Database search results were screened by at least two
authors and 32 articles were selected for inclusion in this review.
 Result(s): Data on 1907 patients were analyzed. The mean age was 70.0
+/- 2.99 years and the prevalence of bowel ischemia was 1.74%. Advanced
age was a significant risk factor. 63.16% of patients reported were men,
and 58.4% of patients died in hospital. There was heterogeneity in the
reported significance of the following preoperative risk factors:
hypertension, smoking status, type 2 diabetes mellitus, end-stage renal
disease, preoperative left ventricular ejection fraction <35%.
Cardiopulmonary bypass (CPB) time, preoperative/operative intra-aortic
balloon pump (IABP) support, and inotrope usage were significantly
associated with the development of mesenteric ischemia; however, other
intraoperative factors including the type of cardiac surgery and duration
of aortic cross-clamping had varying levels of reported significance.
There were discrepancies in the reported significance of leukocytosis and
metabolic acidosis (pH <7.3) as postoperative markers. Postoperative
vasopressor use, prolonged ventilation time, and elevation in lactate,
transaminases, creatinine, and intestinal fatty acid-binding protein
(IFABP) levels were found to be strongly associated with bowel ischemia.
 Conclusion(s): This systematic review found the strongest
associations of mesenteric ischemia postcardiac surgery to be advanced
age, CPB time, rise in lactate, transaminases, creatinine, and IFABP. IABP
support, vasopressor, and inotrope use as well as prolonged ventilation
were strongly linked too. Copyright © 2022 Wiley Periodicals LLC.

<69>
Accession Number
2015508193
Title
Impact of High-Frequency Oscillatory Ventilation Combined With Volume
Guarantee on Lung Inflammatory Response in Infants With Acute Respiratory
Distress Syndrome After Congenital Heart Surgery: A Randomized Controlled
Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part A. 36(8) (pp
2368-2375), 2022. Date of Publication: August 2022.
Author
Zheng Y.-R.; Xie W.-P.; Liu J.-F.; Wu H.-L.; Xu N.; Huang S.-T.; Cao H.;
Chen Q.
Institution
(Zheng, Xie, Liu, Wu, Xu, Huang, Cao, Chen) Department of Cardiac Surgery,
Fujian branch of Shanghai Children's Medical Center, Fuzhou, China
(Zheng, Xie, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Children's Hospital,
Fuzhou, China
(Zheng, Xie, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Maternity and Child
Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou,
China
(Zheng, Xie, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Key Laboratory of Women
and Children's Critical Diseases Research, Fujian Maternity and Child
Health Hospital, Fuzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: Congenital heart disease (CHD) after cardiopulmonary bypass
can cause systemic inflammation, and its degree is closely related to the
incidence of acute respiratory distress syndrome (ARDS). The purpose of
this study was to determine the effectiveness of high-frequency
oscillatory ventilation (HFOV) combined with volume guarantee (VG) in
reducing systemic inflammation in infants with ARDS after cardiopulmonary
bypass for congenital heart surgery. Design(s): A randomized
controlled trial. Setting(s): Single-center study in a tertiary
teaching hospital. Participant(s): A total of 58 infants with ARDS
after congenital heart surgery were eligible and were randomized to the
HFOV (n = 29) or the HFOV-VG (n = 29) between January 2020 and January
2021. Intervention(s): Tracheal aspirate samples for the measurement
of interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha (TNF-alpha)
were obtained on days one, two, and three of HFOV or HFOV-VG ventilation.
 Measurements and Main Results: The authors found a significantly
increasing trend in the HFOV group mean values of IL-6, IL-8, and
TNF-alpha (p < 0.05 on days two and three v day one), and IL-6, IL-8, and
TNF-alpha levels were significantly higher on day three in the HFOV group
versus the HFOV+VG group (p < 0.05). In addition, the incidences of
hypocapnia and hypercapnia in infants supported with HFOV-VG were
significantly lower (p < 0.05). Furthermore, the postoperative mechanical
ventilation duration in the HFOV-VG group also was shorter than that in
the HFOV group (p < 0.05). Conclusion(s): Compared with HFOV alone,
HFOV-VG reduced proinflammatory systemic reactions after congenital
cardiac surgery, decreased the incidences of hypercapnia and hypocapnia,
and shortened the postoperative mechanical ventilation
duration. Copyright © 2021 Elsevier Inc.

<70>
Accession Number
2017108954
Title
Evolocumab administration prior to Coronary Artery Bypass Grafting in
patients with multivessel coronary artery disease (EVOCABG): study
protocol for a randomized controlled clinical trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 430. Date of
Publication: December 2022.
Author
Na H.R.; Kwon O.S.; Kang J.K.; Kim Y.H.; Lim J.Y.
Institution
(Na, Kim, Lim) Department of Cardiothoracic Surgery, The Catholic
University of Korea Seoul St. Mary's Hospital, Seoul, South Korea
(Kwon) Department of Cardiology, The Catholic University of Korea
Eunpyeong St. Mary's Hospital, Seoul, South Korea
(Kang) Department of Cardiothoracic Surgery, The Catholic University of
Korea Eunpyeong St. Mary's Hospital, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Despite advances in surgical and postoperative care,
myocardial injury or infarction (MI) is still a common complication in
patients undergoing coronary artery bypass surgery (CABG). Several studies
that aimed to reduce postoperative myocardial injury, including those
investigating statin loading, have been conducted but did not indicate any
clear benefits. Evolocumab, a PCSK9 inhibitor, has been reported to lower
lipids and prevent ischemic events in various medical conditions. However,
the effect of evolocumab in cardiovascular surgery has not been evaluated.
The objective of this trial is to evaluate the cardioprotective effects of
evolocumab in elective CABG patients with multivessel coronary artery
disease. Method(s): EVOCABG is a prospective, randomized, open,
controlled, multicenter, superiority, phase III clinical trial. Patients
with multivessel coronary artery disease without initial cardiac enzyme
elevation will be recruited (n=100). Participants will be randomly
allocated into two groups: a test group (evolocumab (140mg) administration
once within 72 h before CABG) and a control group (no administration). The
primary outcome is the change in peak levels of serum cardiac marker
(troponin-I) within 3 days of CABG surgery compared to the baseline.
Secondary outcomes include post-operative clinical events including death,
myocardial infarction, heart failure, stroke, and atrial fibrillation.
 Discussion(s): This trial is the first prospective randomized
controlled trial to demonstrate the efficacy of evolocumab in reducing
ischemic-reperfusion injury in patients undergoing CABG. This trial will
provide the first high-quality evidence for preoperative use of evolocumab
in mitigating or preventing ischemic-reperfusion-related myocardial injury
during the surgery. Trial registration: Clinical Research Information
Service (CRIS) of the Republic of Korea KCT0005577. Registered on 4
November 2020. Copyright © 2022, The Author(s).

<71>
Accession Number
2018058225
Title
Selected 2021 Highlights in Congenital Cardiac Anesthesia.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part A. 36(8) (pp
2265-2270), 2022. Date of Publication: August 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
(Kreeger) Department of Anesthesia, Cincinnati Children's Hospital,
University of Cincinnati, Cincinnati, OH
(Nasr) Department of Anesthesiology, Critical Care and Pain Medicine,
Boston Children's Hospital, Boston, MA
(Mittnacht) Department of Anesthesiology, Westchester Medical Center, New
York Medical College, Valhalla, NY
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.

<72>
Accession Number
2010407138
Title
Balloon versus self-expandable transcatheter aortic valve implantation for
bicuspid aortic valve stenosis: A meta-analysis of observational studies.
Source
Catheterization and Cardiovascular Interventions. 98(5) (pp E746-E757),
2021. Date of Publication: 01 Nov 2021.
Author
Michel Pompeu B.O. S.a.; Simonato M.; Van den Eynde J.; Cavalcanti L.R.P.;
Alsagheir A.; Tzani A.; Fovino L.N.; Kampaktsis P.N.; Gallo M.; Laforgia
P.L.; Ruhparwar A.; Weymann A.; Hirji S.A.; Kaneko T.; H. L. Tang G.
Institution
(Michel Pompeu B.O., Cavalcanti) Division of Cardiovascular Surgery of
Pronto Socorro Cardiologico de Pernambuco-PROCAPE, University of
Pernambuco, Recife, Pernambuco, Brazil
(Simonato) Division of Cardiac Surgery, Escola Paulista de
Medicina-UNIFESP, Sao Paulo, Sao Paulo, Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Alsagheir) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Alsagheir) Division of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Tzani) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Fovino) Department of Cardiac, Thoracic and Vascular Sciences and Public
Health, University of Padova, Padova, Italy
(Kampaktsis) NYU Langone Medical Center, United States
(Gallo) Department of Cardiac Surgery, Cardiocentro Ticino, Lugano,
Switzerland
(Laforgia) I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan,
Italy
(Ruhparwar, Weymann) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
(Hirji, Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(H. L. Tang) Department of Cardiovascular Surgery, Mount Sinai Medical
Center, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: There is a rising trend for transcatheter aortic valve
implantation (TAVI) in bicuspid aortic stenosis patients. Data on the use
of self-expandable (SEV) vs. balloon-expandable (BEV) valves in these
patients are scarce. Therefore, we systematically compared clinical
outcomes in bicuspid aortic stenosis patients treated with SEV and BEV.
 Method(s): Data were extracted from PubMed/MEDLINE, EMBASE,
CENTRAL/CCTR, ClinicalTrials.gov, SciELO, LILACS, Google Scholar and
reference lists of relevant articles. Eight studies published from 2013 to
2020 including a total of 1,080 patients (BEV: n = 620; SEV: n = 460) were
selected. Primary endpoints were procedural, 30-day and 1-year mortality.
Secondary endpoints were new pacemaker implantation, annular rupture,
coronary obstruction, moderate-to-severe paravalvular leak, need of second
valve, stroke and acute kidney injury. Result(s): We found no
statistically significant difference in mortality between patients treated
with BEV vs. SEV during index procedure, at 30 days and at 1 year. BEVs
showed a statistically significant higher risk of annulus rupture (2.5%)
in comparison with SEV (0%) (OR 5.81 [95% CI, 3.78-8.92], p <.001). New
generation BEVs were also associated with significantly less paravalvular
leak when compared to new generation SEVs (OR 0.08 [95% CI, 0.02-0.35], p
=.001). Conclusion(s): This meta-analysis of observational studies of
TAVI for bicuspid valves, showed no difference in short- and mid-term TAVI
mortality with BEVs and SEVs. BEVs presented a higher risk of annular
rupture in comparison with SEV. Copyright © 2021 Wiley
Periodicals LLC.

<73>
Accession Number
2013147668
Title
Pericarditis as a manifestation of IgG4-related disease.
Source
Rheumatology International. 42(7) (pp 1287-1295), 2022. Date of
Publication: July 2022.
Author
Doumen M.; Vankelecom B.; Westhovens R.; Michiels S.
Institution
(Doumen, Westhovens) Department of Development and Regeneration, Skeletal
Biology and Engineering Research Centre, KU Leuven, ON IV Herestraat
49-bus 805, Leuven 3000, Belgium
(Doumen, Westhovens) Rheumatology, University Hospitals Leuven, Leuven,
Belgium
(Vankelecom) Cardiology, Imelda Hospital, Bonheiden, Belgium
(Michiels) Rheumatology, Imelda Hospital, Bonheiden, Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
IgG4-related disease (IgG4-RD) is a systemic, immune-mediated
fibro-inflammatory disease that can affect virtually every organ system.
It is usually insidious in onset and often mimics malignant or other
inflammatory disorders. Diagnosis frequently requires a combination of
clinical, serological, radiographic, and histopathological features,
including increased serum-IgG4 levels and tissue infiltration of
IgG4-positive plasma cells with associated fibrosis. Unlike more
frequently affected sites, including the hepatobiliary system, salivary
glands and retroperitoneum, pericardial involvement of IgG4-RD has only
rarely been described. We report the case of a 76-year-old woman
presenting with refractory pericarditis and imminent cardiac tamponade,
successfully treated with therapeutic pericardiectomy. A diagnosis of
IgG4-RD was made based on elevated serum-IgG4 levels and the presence of
typical pericardial histopathological findings, meeting all 3 of the 2011
comprehensive diagnostic criteria for IgG4-RD. Following pericardiectomy,
the patient remained in remission without a need for glucocorticoids or
additional immunosuppressive therapy. Adding to this case, we reviewed the
literature for previously described cases of IgG4-RD presenting with
pericarditis and described their characteristics and the available
treatment options. Our case-based literature review provides a clear
overview of the diagnostic process for IgG4-RD and the need to apply
classification criteria with the necessary caution, particularly in the
case of rare disease manifestations, including pericarditis. Copyright
© 2021, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<74>
Accession Number
2017160570
Title
Effect of remote ischaemic preconditioning on mortality and morbidity
after non-cardiac surgery: Meta-analysis.
Source
BJS Open. 5(2) (no pagination), 2021. Article Number: zraa026. Date of
Publication: 01 Mar 2021.
Author
Wahlstrom K.L.; Bjerrum E.; Gogenur I.; Burcharth J.; Ekeloef S.
Institution
(Wahlstrom, Bjerrum, Gogenur, Burcharth, Ekeloef) Department of Surgery,
Centre for Surgical Science, Zealand University Hospital, Koege, Denmark
Publisher
Oxford University Press
Abstract
Background: Remote ischaemic preconditioning (RIPC) has been shown to have
a protective role on vital organs exposed to reperfusion injury. The aim
of this systematic review was to evaluate the effects of non-invasive RIPC
on clinical and biochemical outcomes in patients undergoing non-cardiac
surgery Methods: A systematic literature search of PubMed, EMBASE, Scopus,
and Cochrane databases was carried out in February 2020. RCTs
investigating the effect of non-invasive RIPC in adults undergoing
non-cardiac surgery were included. Meta-analyses and trial sequential
analyses (TSAs) were performed on cardiovascular events, acute kidney
injury, and short- and long-term mortality. Result(s): Some 43 RCTs
including 3660 patients were included. The surgical areas comprised
orthopaedic, vascular, abdominal, pulmonary, neurological, and urological
surgery. Meta-analysis showed RIPC to be associated with fewer
cardiovascular events in non-cardiac surgery (13 trials, 1968 patients,
421 events; odds ratio (OR) 0.68, 95 per cent c.i. 0.47 to 0.96; P=0.03).
Meta-analyses of the effect of RIPC on acute kidney injury (12 trials,
1208 patients, 211 events; OR 1.14, 0.78 to 1.69; P=0.50; I2 = 9 per
cent), short-term mortality (7 trials, 1239 patients, 65 events; OR 0.65,
0.37 to 1.12; P=0.12; I2 = 0 per cent), and long-term mortality (4 trials,
1167 patients, 9 events; OR 0.67, 0.18 to 2.55; P=0.56; I2 = 0 per cent)
showed no significant differences for RIPC compared with standard
perioperative care in non-cardiac surgery. However, TSAs showed that the
required information sizes have not yet been reached. Conclusion(s):
Application of RIPC to non-cardiac surgery might reduce cardiovascular
events, but not acute kidney injury or all-cause mortality, but currently
available data are inadequate to confirm or reject an assumed intervention
effect. Copyright © 2020 The Author(s).

<75>
Accession Number
2006085386
Title
Minimally invasive techniques for transthoracic oesophagectomy for
oesophageal cancer: systematic review and network meta-analysis.
Source
BJS Open. 4(5) (pp 787-803), 2020. Date of Publication: 01 Oct 2020.
Author
Siaw-Acheampong K.; Kamarajah S.K.; Gujjuri R.; Bundred J.R.; Singh P.;
Griffiths E.A.
Institution
(Siaw-Acheampong, Gujjuri, Bundred) College of Medical and Dental
Sciences, Newcastle upon Tyne, United Kingdom
(Kamarajah) Department of Hepatobiliary, Pancreatic and Transplant
Surgery, Freeman Hospital, Newcastle University NHS Foundation Trust
Hospitals, Newcastle upon Tyne, United Kingdom
(Kamarajah) Institute of Cellular Medicine, University of Newcastle,
Newcastle upon Tyne, United Kingdom
(Singh) Regional Oesophago-Gastric Unit, Royal Surrey County Hospital NHS
Foundation Trust, Guildford, United Kingdom
(Griffiths) Institute of Cancer and Genomic Sciences, College of Medical
and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
(Griffiths) Department of Upper Gastrointestinal Surgery, University
Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Oesophagectomy is a demanding operation that can be performed
by different approaches including open surgery or a combination of minimal
access techniques. This systematic review and network meta-analysis aimed
to evaluate the clinical outcomes of open, minimally invasive and robotic
oesophagectomy techniques for oesophageal cancer. Method(s): A
systematic literature search was conducted for studies reporting open
oesophagectomy, laparoscopically assisted oesophagectomy (LAO),
thoracoscopically assisted oesophagectomy (TAO), totally minimally
invasive oesophagectomy (MIO) or robotic MIO (RAMIO) for oesophagectomy. A
network meta-analysis of intraoperative (operating time, blood loss),
postoperative (overall complications, anastomotic leaks, chyle leak,
duration of hospital stay) and oncological (R0 resection, lymphadenectomy)
outcomes, and survival was performed. Result(s): Ninety-eight studies
involving 32 315 patients were included in the network meta-analysis (open
17 824, 55.2 per cent; LAO 1576, 4.9 per cent; TAO 2421 7.5 per cent; MIO
9558, 29.6 per cent; RAMIO 917, 2.8 per cent). Compared with open
oesophagectomy, both MIO and RAMIO were associated with less blood loss,
significantly lower rates of pulmonary complications, shorter duration of
stay and higher lymph node yield. There were no significant differences
between surgical techniques in surgical-site infections, chyle leak, and
30- and 90-day mortality. MIO and RAMIO had better 1- and 5-year survival
rates respectively compared with open surgery. Conclusion(s):
Minimally invasive and robotic techniques for oesophagectomy are
associated with reduced perioperative morbidity and duration of hospital
stay, with no compromise of oncological outcomes but no improvement in
perioperative mortality. Copyright © 2020 The Authors. BJS Open
published by John Wiley & Sons Ltd on behalf of British Journal of Surgery
Society.

<76>
Accession Number
2005091991
Title
Anastomotic techniques for oesophagectomy for malignancy: systematic
review and network meta-analysis.
Source
BJS Open. 4(4) (pp 563-576), 2020. Date of Publication: 01 Aug 2020.
Author
Kamarajah S.K.; Bundred J.R.; Singh P.; Pasquali S.; Griffiths E.A.
Institution
(Kamarajah) Department of Hepatobiliary, Pancreatic and Transplant
Surgery, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation
Trust, Newcastle upon Tyne, United Kingdom
(Kamarajah) Institute of Cellular Medicine, University of Newcastle,
Newcastle upon Tyne, United Kingdom
(Bundred) College of Medical and Dental Sciences, Birmingham, United
Kingdom
(Griffiths) Institute of Cancer and Genomic Sciences, College of Medical
and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
(Bundred, Singh, Griffiths) Department of Upper Gastrointestinal Surgery,
University Hospitals Birmingham NHS Foundation Trust, Birmingham, United
Kingdom
(Singh) Regional Oesophago-Gastric Unit, Royal Surrey NHS Foundation
Trust, Guildford, United Kingdom
(Pasquali) Department of Surgery, Fondazione IRCCS Istituto Nazionale dei
Tumori, Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Current evidence on the benefits of different anastomotic
techniques (hand-sewn (HS), circular stapled (CS), triangulating stapled
(TS) or linear stapled/semimechanical (LSSM) techniques) after
oesophagectomy is conflicting. The aim of this study was to evaluate the
evidence for the techniques for oesophagogastric anastomosis and their
impact on perioperative outcomes. Method(s): This was a systematic
review and network meta-analysis. PubMed, EMBASE and Cochrane Library
databases were searched systematically for randomized and non-randomized
studies reporting techniques for the oesophagogastric anastomosis. Network
meta-analysis of postoperative anastomotic leaks and strictures was
performed. Result(s): Of 4192 articles screened, 15 randomized and 22
non-randomized studies comprising 8618 patients were included. LSSM (odds
ratio (OR) 0.50, 95 per cent c.i. 0.33 to 0.74; P = 0.001) and CS (OR
0.68, 0.48 to 0.95; P = 0.027) anastomoses were associated with lower
anastomotic leak rates than HS anastomoses. LSSM anastomoses were
associated with lower stricture rates than HS anastomoses (OR 0.32, 0.19
to 0.54; P < 0.001). Conclusion(s): LSSM anastomoses after
oesophagectomy are superior with regard to anastomotic leak and stricture
rates. Copyright © 2020 The Authors. BJS Open published by John
Wiley & Sons Ltd on behalf of British Journal of Surgery Society

<77>
Accession Number
2015506459
Title
Postcardiotomy Extracorporeal Membrane Oxygenation: Narrative Review
Navigating the Ethical Issues.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part A. 36(8) (pp
2628-2635), 2022. Date of Publication: August 2022.
Author
Zaaqoq A.M.; Pottash M.; Ahlstrom E.; Brodie D.
Institution
(Zaaqoq, Ahlstrom) Department of Critical Care Medicine, MedStar
Washington Hospital Center, Georgetown University, Washington, DC
(Zaaqoq, Pottash, Ahlstrom) Department of Medicine, MedStar Washington
Hospital Center, Georgetown University, Washington, DC
(Pottash) Division of Palliative Medicine, MedStar Washington Hospital
Center, Georgetown University, Washington, DC
(Brodie) Department of Medicine, Columbia University College of Physicians
and Surgeons, New York, New York
(Brodie) Center for Acute Respiratory Failure, New York-Presbyterian
Hospital, New York, New York
Publisher
W.B. Saunders
Abstract
Postcardiotomy shock (PCS) is an uncommon and life-threatening surgical
complication. Extracorporeal membrane oxygenation (ECMO) is the first line
of mechanical circulatory support for treating PCS when medical therapies
are insufficient. Reaching a "therapeutic ceiling" or a "bridge to
nowhere" is a common clinical scenario in which medical avenues for
recovery have been exhausted. These situations pose emotional and ethical
challenges for patients, their surrogates, and clinicians. To shed light
on these ethically challenging situations in PCS and potential approaches,
the authors conducted a narrative review of the literature. Publications
were utilized to describe current trends in the diagnosis and management
of the patient with PCS, with particular emphasis on the therapeutic
ceiling for life support. Most of the recommendations came from practice
parameters or expert opinions to support specific interventions. The
authors proposed a stepwise multidisciplinary approach to reduce
PCS-associated ethical and emotional challenges. Their proposed algorithm
was based on the likelihood of the need for ECMO support based on the
mortality risk stratification of cardiac surgery. They suggested focused
discussions around the commencement of ECMO or other life-sustaining
therapies-ideally preoperatively at the time of consent-through shared
decision-making and, subsequently, proactive multidisciplinary education
and updates to the surrogate decision-makers relying on realistic
prognosis and consideration of the patient wishes during the ECMO
run. Copyright © 2021 Elsevier Inc.

<78>
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.

<79>
[Use Link to view the full text]
Accession Number
2018105574
Title
The performance of HEAR score for identification of low-risk chest pain: a
systematic review and meta-analysis.
Source
European Journal of Emergency Medicine. 29(3) (pp 173-187), 2022. Date of
Publication: 01 Jun 2022.
Author
Khaleghi Rad M.; Pirmoradi M.M.; Doosti-Irani A.; Thiruganasambandamoorthy
V.; Mirfazaelian H.
Institution
(Khaleghi Rad, Pirmoradi, Mirfazaelian) Department of Emergency Medicine,
Tehran University of Medical Sciences, Tehran 1419733141, Iran, Islamic
Republic of
(Doosti-Irani) Department of Epidemiology, School of Public Health and
Modeling of Non-communicable Diseases Research Center, Hamadan University
of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Thiruganasambandamoorthy) Department of Emergency Medicine, Ottawa
Hospital, Canada
(Thiruganasambandamoorthy) School of Epidemiology and Public Health,
University of Ottawa, Ottawa, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Chest pain is one of the most common presentations to the emergency
department (ED) and HEART score (history, ECG, age, risk factors, and
cardiac troponin) is recommended for risk stratification. It has been
proposed that the sum of four items with no troponin (HEAR score) below 2
can be used safely to lower testing and reduce length of stay. To assess
the performance of the HEAR score in hospital and prehospital settings, we
performed a systematic review and meta-analysis. English studies on the
performance of the HEAR score in patients with acute chest pain were
included. They were excluded if data are inaccessible. MEDLINE, Embase,
Evidence-Based Medicine Reviews, Scopus, and web of science were searched
from 1946 to July 2021. The quality of studies was assessed using Quality
Assessment of Diagnostic Accuracy Studies version 2. Acute coronary
syndrome or major adverse cardiac events prediction were outcomes of
interest. The performance indices with 95% confidence intervals (CIs) were
extracted. Inverse variance and the random-effects model were used to
report the results. Of the 692 articles on the HEAR score, 10 studies were
included in the analysis with 33 843 patients. Studies were at low to
moderate risk of bias. Three studies were in prehospital and three were
retrospective. The pooling of data on the HEAR score showed that the
sensitivity at the HEAR<2, <3, and <4 cutoffs in the ED were 99.03% (95%
CI, 98.29-99.77), 97.54% (95% CI, 94.50-100), and 91.80% (95% CI,
84.62-98.98), respectively. The negative predictive values (NPVs) for the
above cutoffs were 99.84% (95% CI, 99.72-99.95), 99.75% (95% CI,
99.65-99.85), and 99.57% (95% CI, 99.11-100), respectively. Of note, for
the HEAR<2, negative likelihood ratio was 0.07 (95% CI, 0.02-0.12). In the
prehospital, at the HEAR<4 cutoff, the pooled sensitivity and NPV were
85.01% (95% CI, 80.56-89.47) and 91.48% (95% CI, 87.10-95.87),
respectively. This study showed that in the ED, the HEAR score<2 can be
used for an early discharge strategy. Currently, this score cannot be
recommended in prehospital setting. Prospero
(CRD42021273710). Copyright © 2022 Lippincott Williams and
Wilkins. All rights reserved.

<80>
Accession Number
2017930598
Title
Religious-based interventions for depression: A systematic review and
meta-analysis of experimental studies.
Source
Journal of Affective Disorders. 309 (pp 289-296), 2022. Date of
Publication: 15 Jul 2022.
Author
Marques A.; Ihle A.; Souza A.; Peralta M.; de Matos M.G.
Institution
(Marques, Peralta) CIPER, Faculdade de Motricidade Humana, Universidade de
Lisboa, Lisboa, Portugal
(Marques, Peralta, de Matos) ISAMB, Universidade de Lisboa, Lisboa,
Portugal
(Ihle) Center for the Interdisciplinary Study of Gerontology and
Vulnerability, University of Geneva, Geneva, Switzerland
(Ihle) Swiss National Centre of Competence in Research LIVES - Overcoming
Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
(Ihle) Department of Psychology, University of Geneva, Geneva, Switzerland
(Souza) Seminario Teologico Baptista, Queluz, Portugal
(de Matos) Faculdade de Motricidade Humana, Universidade de Lisboa,
Lisboa, Portugal
Publisher
Elsevier B.V.
Abstract
Background: Depression is the most prevalent mental disorder. In the
treatment of depressive symptoms, patients' religious practices and
beliefs are often not considered. We carried out a systematic review and
meta-analysis of RCTs to analyse the effect of religious interventions on
depression. Method(s): A literature screening was performed on August
2021, using the Cochrane Collaboration, PubMed, Scopus, and Web of Science
databases. Primary source articles published from 2015 to August 2021 in
peer-reviewed journals were eligible for inclusion if data were presented
on religious interventions' effects on depression. Result(s): The
literature search yielded 208 potentially relevant publications. Eight
articles were identified and included in the review. One of the articles
was excluded from the meta-analysis because it did not report the mean
data for the baseline and follow-up assessment results. From the 7 out of
8 included studies, the results consistently indicated that
religious-based interventions effectively reduced depressive symptoms
among vulnerable persons with chronic medical illness, pregnant women,
haemodialysis patients, elderly nursing home residents, people with major
depressive disorders or dysthymia, and coronary artery bypass graft
surgery patients. Limitation(s): The definition of the
religious-based intervention varied substantially among the trials. These
differences can make interpretation and comparing implications on the
treatment of depression difficult. Conclusion(s): Compared to
standard/other usual therapies for treating depression, religious-based
interventions provide superior effects. This review and meta-analysis
strongly suggest that patients' religious beliefs should be considered
when diagnosing and treating depression. Copyright © 2022
Elsevier B.V.

<81>
Accession Number
2016884193
Title
Effect of Volatile Anesthetics on Myocardial Infarction After Coronary
Artery Surgery: A Post Hoc Analysis of a Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part A. 36(8) (pp
2454-2462), 2022. Date of Publication: August 2022.
Author
Zangrillo A.; Lomivorotov V.V.; Pasyuga V.V.; Belletti A.; Gazivoda G.;
Monaco F.; Nigro Neto C.; Likhvantsev V.V.; Bradic N.; Lozovskiy A.; Lei
C.; Bukamal N.A.R.; Silva F.S.; Bautin A.E.; Ma J.; Yong C.Y.; Carollo C.;
Kunstyr J.; Wang C.Y.; Grigoryev E.V.; Riha H.; Wang C.; El-Tahan M.R.;
Scandroglio A.M.; Mansor M.; Lembo R.; Ponomarev D.N.; Bezerra F.J.L.;
Ruggeri L.; Chernyavskiy A.M.; Xu J.; Tarasov D.G.; Navalesi P.;
Yavorovskiy A.; Bove T.; Kuzovlev A.; Hajjar L.A.; Landoni G.
Institution
(Zangrillo, Belletti, Monaco, Scandroglio, Lembo, Ruggeri, Landoni)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Zangrillo, Landoni) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Lomivorotov, Ponomarev, Chernyavskiy) Department of Anesthesiology and
Intensive Care, E. Meshalkin National Medical Research Center,
Novosibirsk, Russian Federation
(Lomivorotov) Department of Anesthesiology and Intensive Care, Novosibirsk
State University, Novosibirsk, Russian Federation
(Pasyuga) Department of Anesthesiology and Intensive Care, Federal Center
for Cardiovascular Surgery Astrakhan, Astrakhan, Russian Federation
(Gazivoda) Department of Anaesthesia and Intensive Care, Cardiovascular
Institute Dedinje, Belgrade, Serbia
(Nigro Neto, Bezerra) Anesthesia Section, Department of Cardiovascular
Surgery, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Likhvantsev) Department of Anesthesiology and Intensive Care, First
Moscow State Medical University, Moscow, Russian Federation
(Likhvantsev, Kuzovlev) V. Negovsky Reanimatology Research Institute,
Moscow, Russian Federation
(Bradic) Department of Cardiovascular Anesthesiology and Intensive Care
Medicine, Clinical Department of Anesthesiology, Resuscitation and
Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia
(Bradic) Department of Biomedical Sciences, University North, Varazdin,
Croatia
(Lozovskiy) Department of Anesthesia and Intensive Care, Ural Institute of
Cardiology, Ekaterinburg, Russian Federation
(Lei) Department of Anesthesiology and Perioperative Medicine, Xijing
Hospital, Shaanxi, Xi'an, China
(Bukamal) Cardiothoracic ICU and Anesthesia Department, Mohammed Bin
Khalifa Cardiac Center, Riffa, Bahrain
(Silva) Department of Anaesthesiology, Hospital de Santa Maria, Lisboa,
Portugal
(Bautin) Laboratory for Anesthesiology and Intensive Care, Almazov
National Medical Research Center, Saint Petersburg, Russian Federation
(Ma, Wang) Center for Anesthesiology, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China
(Yong) Department of Anaesthesiology and Intensive Care, Hospital Pulau
Pinang, Pulau Pinang, Malaysia
(Carollo, Navalesi) Institute of Anesthesia and Intensive Care, Padua
University Hospital, Padua, Italy
(Kunstyr) Department of Anesthesiology and Intensive Care, First Faculty
of Medicine Charles University and General University Hospital, Prague,
Czechia
(Wang, Mansor) Department of Anaesthesiology, Faculty of Medicine,
University of Malaya, Kuala Lumpur, Malaysia
(Grigoryev) Intensive Care Unit, Scientific Research Institute for Complex
Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
(Riha) Cardiothoracic Anesthesiology and Intensive Care Medicine,
Department of Anesthesiology and Intensive Care Medicine, Institute for
Clinical and Experimental Medicine, Prague, Czechia
(El-Tahan) Department of Anesthesiology, Imam Abdulrahman Bin Faisal
University, Dammam, Saudi Arabia
(Xu) Department of Anesthesiology, The Second Xiangya Hospital of Central
South University, Changsha, China
(Tarasov) Department of Cardiac Surgery, Federal Center for Cardiovascular
Surgery Astrakhan, Astrakhan, Russian Federation
(Navalesi) Department of Medicine, University of Padua, Padua, Italy
(Yavorovskiy) Federal Research and Clinical Center of Resuscitation and
Rehabilitation, Moscow, Russian Federation
(Bove) Department of Medicine (DAME), University of Udine, Udine, Italy
(Bove) Department of Anesthesia and Intensive Care Medicine, ASUFC
University-Hospital of Central Friuli, Udine, Italy
(Hajjar) Department of Cardiopneumology, Instituto do Coracao,
Universidade de Sao Paulo, Sao Paulo, Brazil
(Hajjar) Intensive Care Unit, Hospital SirioLibanes, Sao Paulo, Brazil
Publisher
W.B. Saunders
Abstract
Objective: To investigate the effect of volatile anesthetics on the rates
of postoperative myocardial infarction (MI) and cardiac death after
coronary artery bypass graft (CABG). Design(s): A post hoc analysis
of a randomized trial. Setting(s): Cardiac surgical operating rooms.
 Participant(s): Patients undergoing elective, isolated CABG.
 Intervention(s): Patients were randomized to receive a volatile
anesthetic (desflurane, isoflurane, or sevoflurane) or total intravenous
anesthesia (TIVA). The primary outcome was hemodynamically relevant MI (MI
requiring high-dose inotropic support or prolonged intensive care unit
stay) occurring within 48 hours from surgery. The secondary outcome was
1-year death due to cardiac causes. Measurements and Main Results: A
total of 5,400 patients were enrolled between April 2014 and September
2017 (2,709 patients randomized to the volatile anesthetics group and
2,691 to TIVA). The mean age was 62 +/- 8.4 years, and the median baseline
ejection fraction was 57% (50-67), without differences between the 2
groups. Patients in the volatile group had a lower incidence of MI with
hemodynamic complications both in the per-protocol (14 of 2,530 [0.6%] v
27 of 2,501 [1.1%] in the TIVA group; p = 0.038) and as-treated analyses
(16 of 2,708 [0.6%] v 29 of 2,617 [1.1%] in the TIVA group; p = 0.039),
but not in the intention-to-treat analysis (17 of 2,663 [0.6%] v 28 of
2,667 [1.0%] in the TIVA group; p = 0.10). Overall, deaths due to cardiac
causes were lower in the volatile group (23 of 2,685 [0.9%] v 40 of 2,668
[1.5%] than in the TIVA group; p = 0.03). Conclusion(s): An
anesthetic regimen, including volatile agents, may be associated with a
lower rate of postoperative MI with hemodynamic complication in patients
undergoing CABG. Furthermore, it may reduce long-term cardiac
mortality. Copyright © 2022 Elsevier Inc.

<82>
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
Brieflands
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.

<83>
Accession Number
636368741
Title
Efficacy and Safety of Lipid-Lowering Drugs of Different Intensity on
Clinical Outcomes: A Systematic Review and Network Meta-Analysis.
Source
Frontiers in Pharmacology. 12 (no pagination), 2021. Article Number:
713007. Date of Publication: 21 Oct 2021.
Author
Ma W.; Pan Q.; Pan D.; Xu T.; Zhu H.; Li D.
Institution
(Ma, Pan, Li) Institute of Cardiovascular Disease Research, Xuzhou Medical
University, Xuzhou, China
(Pan, Xu, Zhu, Li) Xuzhou Medical University Affiliated Hospital, Xuzhou,
China
Publisher
Frontiers Media S.A.
Abstract
There have been many meta-analyses for statins, ezetimibe and proprotein
convertase subtilisin/kexin type 9 inhibitors (PCSK9i) to evaluate
clinical outcomes, but the efficacy and safety of different intensity of
these three drugs on clinical outcomes was absent. PCSK9i, ezetimibe, and
statins were divided into seven interventions as follows: including PCSK9i
+ high-intensity statins (P9i+HT), PCSK9i + moderate-intensity statins
(P9i+MT), ezetimibe + high-intensity statins (Eze+HT), ezetimibe +
moderate-intensity statins (Eze+MT), high-intensity statins (HT),
moderate-intensity statins (MT), and low-intensity statins (LT). The risk
ratios (RR) and 95% confidence intervals (CI) were calculated to evaluate
the clinical outcomes in all randomized controlled trials included. In
traditional meta-analysis, the more intensive treatment had a lower risk
of all-cause mortality (RR 0.91, 95% CI 0.88-0.95), cardiovascular
mortality (RR 0.89, 95% CI 0.86-0.92), myocardial infarction (RR 0.79, 95%
CI 0.77-0.81), coronary revascularization (RR 0.80, 95% CI 0.76-0.84), and
cerebrovascular events (RR 0.84, 95% CI 0.80-0.88) compared with the less
intensive treatment. However, the more intensive treatment had a higher
risk of new-onset diabetes (RR 1.08, 95% CI 1.04-1.12). The network
meta-analysis demonstrated that P9i+HT, P9i+MT, HT, and MT were
significantly associated with a risk reduction in coronary
revascularization and cerebrovascular events compared with PLBO. LT could
effectively reduce the risk of cardiovascular mortality (RR 0.71, 95% CI
0.54-0.92), MI (RR 0.67, 95% CI 0.54-0.82), and coronary revascularization
(RR 0.77, 95% CI 0.65-0.91) compared with PLBO. P9i+HT was superior to HT
in reducing the risk of MI (RR 0.78, 95% CI 0.68-0.90), coronary
revascularization (RR 0.84, 95% CI 0.73-0.96), and cerebrovascular events
(RR 0.78, 95% CI 0.64-0.95). However, compared with PLBO, P9i+HT, HT, and
MT could increase the risk of new-onset diabetes (RR 1.23, 95% CI
1.11-1.37; RR 1.23, 95% CI 1.14-1.33; RR 1.09, 95% CI 1.02-1.15,
respectively). In conclusion, PCSK9i added to background statins may be
recommended as preferred lipid-lowering therapy, and did not increase the
additional risk of new-onset diabetes. The safety and efficacy of
ezetimibe was not superior to that of statins. LT can be recommended as
the initial therapy. © Copyright © 2021 Ma, Pan, Pan, Xu,
Zhu and Li.

<84>
Accession Number
2016005077
Title
Novel oral anticoagulants versus vitamin K antagonists in patients with
atrial fibrillation after transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(7) (pp 2101-2110),
2022. Date of Publication: June 1, 2022.
Author
Memon M.M.; Siddiqui A.A.; Amin E.; Shaikh F.N.; Khan M.S.; Doukky R.;
Krasuski R.A.
Institution
(Memon, Siddiqui, Amin, Shaikh) Department of Medicine, Dow University of
Health Sciences, Karachi, Pakistan
(Khan, Krasuski) Division of Cardiology, Duke University Medical Center,
Durham, NC, United States
(Doukky) Division of Cardiology, Cook County Health and Hospitals System,
Chicago, IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The efficacy and safety of novel oral anticoagulants (NOACs)
compared to the current guideline-recommended vitamin K antagonists (VKAs)
in atrial fibrillation (AF) patients undergoing transcatheter aortic valve
replacement (TAVR) has not been well established. We pooled evidence from
all available studies to assess the risks and benefits of this drug class.
 Method(s): We queried electronic databases (MEDLINE, Scopus, and
Cochrane central) up until January 28th, 2022 for studies comparing NOACs
to VKAs in AF patients undergoing TAVR. Results from studies were
presented as risk ratios (RR) and pooled using a random-effects model.
Subgroup analysis by study design and meta-regression analysis were
performed to explore heterogeneity. Result(s): A total of 12 studies
(3 RCTs and 9 observational) containing 12,203 patients (mean age 81.2
years; 50.5% men) were identified and included in the analysis. Pooled
analysis revealed no significant difference between NOACs and VKAs in
terms of stroke or systemic embolism (RR: 0.78; p = 0.18), major bleeding
(RR: 0.84; p = 0.32), intracranial hemorrhage (RR 0.61; p = 0.06),
all-cause mortality (RR: 0.69; p = 0.07), and myocardial infarction (RR:
1.60; p = 0.24) at a mean length of follow-up of 15.1 months. RCTs and
observational studies did not significantly differ across outcomes on
subgroup analysis. Meta-regression analysis found heterogeneity in
all-cause mortality to be significantly explained by percentage of males
(coefficient: 0.049, p = 0.007), mean age (coefficient: 0.221, p < 0.001),
and CHA2DS2-VASc score (coefficient: -1.657, p < 0.001).
 Conclusion(s): This meta-analysis suggests that outcomes with NOACs
do not significantly differ compared to VKAs following TAVR in patients
with AF. Copyright © 2022 Wiley Periodicals LLC.

<85>
Accession Number
2015504119
Title
When coronary imaging and physiology are discordant, how best to manage
coronary lesions? An appraisal of the clinical evidence.
Source
Catheterization and Cardiovascular Interventions. 99(7) (pp 2008-2015),
2022. Date of Publication: June 1, 2022.
Author
Fernandez-Peregrina E.; Ahmad H.; Mintz G.S.; Garcia-Garcia H.M.
Institution
(Fernandez-Peregrina, Ahmad, Mintz, Garcia-Garcia) Division of Section of
Interventional Cardiology, MedStar Washington Hospital Center, Washington,
DC, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Discordant physiology and anatomy may occur when nonsevere
angiographic stenosis has positive physiology as well as the opposite
situation. Aim(s): To underline the reasons behind the discrepancy in
physiology and anatomy and to summarize the information that coronary
imaging may add to physiology. Method(s): A review of the published
literature on physiology and intravascular imaging assessment of
intermediate lesions was carried out. Result(s): The limitations of
angiography, the possibility of an underlying diffuse disease, the
presence of a "grey zone" in both techniques, the amount of myocardial
mass that subtends the stenosis, and plaque vulnerability may play a role
in such discrepancy. Intracoronary imaging has a poor diagnostic accuracy
compared to physiology. However, it may add information about plaque
vulnerability that might be useful in deciding whether to treat or not a
certain lesion. Conclusion(s): Coronary revascularization is
recommended for patients with ischemia based on physiology. Intracoronary
imaging adds information on plaque vulnerability and can help on the
decision whether to revascularize or not a lesion. Copyright ©
2022 Wiley Periodicals LLC.

<86>
[Use Link to view the full text]
Accession Number
634814107
Title
Safety and Efficacy of Human Chorionic Gonadotropin Hormone-Derivative
EA-230 in Cardiac Surgery Patients: A Randomized Double-Blind
Placebo-Controlled Study.
Source
Critical Care Medicine. 49(5) (pp 790-803), 2021. Date of Publication: 01
May 2021.
Author
Van Groenendael R.; Beunders R.; Hemelaar P.; Hofland J.; Morshuis W.J.;
Van Der Hoeven J.G.; Gerretsen J.; Wensvoort G.; Kooistra E.J.; Claassen
W.J.; Waanders D.; Lamberts M.G.A.; Buijsse L.S.E.; Kox M.; Van Eijk L.T.;
Pickkers P.
Institution
(Van Groenendael, Beunders, Hemelaar, Van Der Hoeven, Gerretsen, Kooistra,
Claassen, Waanders, Lamberts, Buijsse, Kox, Pickkers) Department Of
Intensive Care Medicine, Radboud University Medical Center, Nijmegen,
Netherlands
(Van Groenendael, Beunders, Hemelaar, Van Der Hoeven, Gerretsen, Kooistra,
Kox, Van Eijk, Pickkers) Radboud Center For Infectious Diseases (RCI),
Radboud University Medical Center, Nijmegen, Netherlands
(Van Groenendael, Beunders, Van Der Hoeven, Kooistra, Kox, Van Eijk,
Pickkers) Radboud Institute For Molecular Life Sciences (RIMLS), Radboud
University Medical Center, Nijmegen, Netherlands
(Van Groenendael, Hofland, Van Eijk) Department Of Anesthesiology, Pain
And Palliative Medicine, Radboud University Medical Center, Nijmegen,
Netherlands
(Morshuis) Department Of Cardiothoracic Surgery, Radboud University
Medical Center, Nijmegen, Netherlands
(Wensvoort) Exponential Biotherapies, Inc. (EBI), The Hague, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: To determine the safety and efficacy of human chorionic
gonadotropin hormone-derivative EA-230 in cardiac surgery patients.
Cardiac surgery induces systemic inflammation and may impair renal
function, affecting patient outcome. EA-230 exerted immunomodulatory and
renoprotective effects in preclinical models and was safe and showed
efficacy in phase I and II human studies. DESIGN: Double-blinded,
placebo-controlled, randomized study. SETTING: Collaboration of the
Cardiothoracic Surgery, Anesthesiology, and the Intensive Care departments
of a tertiary hospital in the Netherlands. PATIENTS: One hundred eighty
patients undergoing an on-pump coronary artery bypass procedure with or
without concomitant valve surgery. INTERVENTIONS: Ninety mg/kg/hr EA-230
or placebo administered during surgery. MEASUREMENTS AND MAIN RESULTS:
During the study, no safety concerns emerged. EA-230 did not modulate
interleukin-6 plasma concentrations (area under the curve 2,730 pg/mL x hr
[1,968-3,760] vs 2,680 pg/mL x hr [2,090-3,570] for EA-230 and placebo
group, respectively; p = 0.80). Glomerular filtration rate increased
following surgery (mean +/- sem increase in the EA-230 vs placebo groups:
glomerular filtration rateiohexol measured using iohexol plasma clearance:
19 +/- 2 vs 16 +/- 2 mL/min/1.73 m2; p = 0.13 and estimated glomerular
filtration rate with the Modification of Diet in Renal Disease equation
using creatinine: 6 +/- 1 vs 2 +/- 1 mL/min/1.73 m2; p = 0.01). The
"injury"stage of the Risk, Injury, Failure, Loss of kidney function, and
End-stage kidney disease criteria for acute kidney injury was 7% in the
EA-230 group versus 18% in the placebo group (p = 0.07). In addition,
EA-230-treated patients had a less positive fluid balance compared with
placebo-treated patients (217 +/- 108 vs 605 +/- 103 mL; p = 0.01), while
the use of vasoactive agents was similar in both groups (p = 0.39).
Finally, hospital length of stay was shorter in EA-230 treated patients (8
d [7-11] vs 10 d [8-12]; p = 0.001). Efficacy results were more pronounced
in patients that had longer duration of surgery and thus longer duration
of study drug infusion. CONCLUSION(S): EA-230 was safe in patients
undergoing on-pump cardiac surgery. It did not modulate interleukin-6
plasma concentrations but appeared to exert beneficial renal and
cardiovascular effects and shortened in-hospital length of
stay. Copyright © 2021 The Author(s).

<87>
Accession Number
638237115
Title
Extracorporeal membrane oxygenation in transcatheter aortic valve
implantation: A systematic review and meta-analysis.
Source
Perfusion. Conference: 10th EuroELSO Congress. London United Kingdom. 37(1
SUPPL) (pp 16), 2022. Date of Publication: May 2022.
Author
Mak J.H.H.; Ling R.R.; Yong B.S.J.; Ramanathan K.
Institution
(Mak, Yong) Lee Kong Chian School of Medicine, Singapore, Singapore
(Ling, Ramanathan) Yong Loo Lin School Of Medicine, Singapore, Singapore
(Ramanathan) National University Hospital, Cardiothoracic Intensive Care
Unit, Singapore, Singapore
Publisher
SAGE Publications Inc.
Abstract
Objectives: Extracorporeal membrane oxygenation (ECMO) has been used in
the management of patients undergoing transcatheter aortic valve
implantation (TAVI). Despite this, the indications for the use of ECMO
concurrently with TAVI has not been clearly elucidated. We reviewed the
literature for the survival outcomes in such patients undergoing TAVI with
ECMO support. Method(s): We conducted a systematic review and
metaanalysis, searching four international databases for studies reporting
on the outcomes of patients receiving ECMO and TAVI concurrently. Random
effects (DerSimonian and Laird) meta-analyses were conducted. We rated the
intrastudy risk of bias using the Joanna Briggs Institute checklist, and
the certainty of evidence using the Grading of Recommendations,
Assessment, Development, and Evaluations (GRADE) approach. Result(s):
From 640 references, 9 studies comprising 958 patients receiving ECMO and
TAVI were included. The pooled age was 82.6 years (95%-CI: 79.5-86.5), and
45.6% (95%-CI: 28.4%-63.8%) of patients were male. The mean aortic valve
area was 0.65 cm2 (95%-CI: 0.50- 0.79), while pooled EuroSCORE
was 31.6 (95%-CI: 19.3- 43.9). Pooled mortality amongst patients requiring
ECMO and TAVI was 28.1% (95%-CI: 18.5%-42.0%, moderate certainty). Among
five studies which provided a comparator group that did not receive ECMO,
patients receiving ECMO had a significantly higher risk of mortality (risk
ratio: 5.22, 95%-CI: 1.30-20.96, p = 0.020, high certainty). Pooled ICU
length of stay (LOS) was 5.7 days (95%-CI: 1.7-9.7, low certainty) while
pooled hospital LOS was 22.4 days (95%-CI: 12.7-32.1, low certainty).
 Conclusion(s): ECMO is a viable adjunctive therapy in TAVI
procedures. ECMO for TAVI was predominantly used in octogenarians with
mortality less than 30%. (Figure Presented).

<88>
Accession Number
2018772210
Title
Approach to stable angina in patients with advanced chronic kidney
disease.
Source
Current Opinion in Nephrology and Hypertension. 30(3) (pp 339-345), 2021.
Date of Publication: 01 May 2021.
Author
Arif H.; Yadav A.
Institution
(Arif, Yadav) Division of Nephrology, Sidney Kimmel Medical School, Thomas
Jefferson University, Philadelphia, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewChronic kidney disease is one of the major risk factors
for coronary artery disease. Both end-stage renal disease (ESRD) and
advanced chronic kidney disease patients have atypical presentations of
coronary artery disease (CAD) due to modifications in cardinal symptoms
and clinical presentation. Data on evaluation and management of coronary
artery or stable angina is limited in advanced chronic kidney disease
(CKD) patients due to a limited number of trials. There are sparse data
supporting either percutaneous coronary intervention (PCI) or coronary
artery bypass graft in advanced CKD patients.Recent findingsThe
ISCHEMIA-CKD trial to date is the most extensive prospective randomized
study looking at advanced CKD patients study looking at advanced CKD stage
4/5 patients randomized to medical treatment alone vs. invasive strategy
for moderate to severe myocardial ischemia. There was no evidence found
that an initial invasive strategy compared with conservative strategy with
maximal medical management resulted in reduced risk of death or nonfatal
myocardial infarction in patients with advanced CKD and coronary artery
disease with stable angina.SummaryIn this review, we will discuss the
existing data on assessment and management of stable coronary artery
disease/stable angina. And how this extrapolates to the application in
advanced CKD patients awaiting kidney transplant. Copyright ©
2021 Lippincott Williams and Wilkins. All rights reserved.

<89>
Accession Number
2018771551
Title
The Use of Central Venous to Arterial Carbon Dioxide Tension Gap for
Outcome Prediction in Critically Ill Patients: A Systematic Review and
Meta-Analysis*.
Source
Critical Care Medicine. 48(12) (pp 1855-1861), 2020. Date of Publication:
01 Dec 2020.
Author
Al Duhailib Z.; Hegazy A.F.; Lalli R.; Fiorini K.; Priestap F.;
Iansavichene A.; Slessarev M.
Institution
(Al Duhailib, Hegazy, Fiorini, Priestap, Slessarev) Division of Critical
Care, Department of Medicine, Western University, London Health Sciences
Centre, London, ON, Canada
(Al Duhailib) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Al Duhailib) Department of Critical Care Medicine, King Faisal Specialist
Hospital and Research Centre, Riyadh, Saudi Arabia
(Hegazy) Department of Anesthesia and Perioperative Medicine, Western
University, London Health Sciences Centre, London, ON, Canada
(Lalli) Department of Pediatrics, Western University, London Health
Sciences Centre, London, ON, Canada
(Iansavichene) Health Science Library, London Health Sciences Centre,
Victoria Campus, London, ON, Canada
(Slessarev) Department of Medical Biophysics, Western University, London,
ON, Canada
(Slessarev) Brain and Mind Institute, Western University, London, ON,
Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: In this systematic review and meta-analysis, we assessed
whether a high Co<inf>2</inf>gap predicts mortality in adult critically
ill patients with circulatory shock. Data Sources: A systematic
search of MEDLINE and EMBASE electronic databases from inception to
October 2019. Study Selection: Studies from adult (age >= 18 yr) ICU
patients with shock reporting Co<inf>2</inf>gap and outcomes of interest.
Case reports and conference abstracts were excluded. Data Extraction:
Data extraction and study quality assessment were performed independently
in duplicate. Data Synthesis: We used the Newcastle-Ottawa Scale to
assess methodological study quality. Effect sizes were pooled using a
random-effects model. The primary outcome was mortality (28 d and
hospital). Secondary outcomes were ICU length of stay, hospital length of
stay, duration of mechanical ventilation, use of renal replacement
therapy, use of vasopressors and inotropes, and association with cardiac
index, lactate, and central venous oxygen saturation. Conclusion(s):
We included 21 studies (n = 2,155 patients) from medical (n = 925),
cardiovascular (n = 685), surgical (n = 483), and mixed (n = 62) ICUs. A
high Co<inf>2</inf>gap was associated with increased mortality (odds
ratio, 2.22; 95% CI, 1.30-3.82; p = 0.004) in patients with shock, but
only those from medical and surgical ICUs. A high Co<inf>2</inf>gap was
associated with higher lactate levels (mean difference 0.44 mmol/L; 95%
CI, 0.20-0.68 mmol/L; p = 0.0004), lower cardiac index (mean
difference,-0.76 L/min/m2; 95% CI,-1.04 to-0.49
L/min/m2; p = 0.00001), and central venous oxygen saturation
(mean difference,-5.07; 95% CI,-7.78 to-2.37; p = 0.0002). A high
Co<inf>2</inf>gap was not associated with longer ICU or hospital length of
stays, requirement for renal replacement therapy, longer duration of
mechanical ventilation, or higher vasopressors and inotropes use. Future
studies should evaluate whether resuscitation aimed at closing the
Co<inf>2</inf>gap improves mortality in shock. Copyright © 2020
Lippincott Williams and Wilkins. All rights reserved.

<90>
Accession Number
2014644893
Title
Changes in eicosapentaenoic acid and docosahexaenoic acid and risk of
cardiovascular events and atrial fibrillation: A secondary analysis of the
OMEMI trial.
Source
Journal of Internal Medicine. 291(5) (pp 637-647), 2022. Date of
Publication: May 2022.
Author
Myhre P.L.; Kalstad A.A.; Tveit S.H.; Laake K.; Schmidt E.B.; Smith P.;
Nilsen D.W.T.; Tveit A.; Solheim S.; Arnesen H.; Seljeflot I.
Institution
(Myhre, Tveit, Smith) Department of Cardiology, Division of Medicine,
Akershus University Hospital, Lorenskog, Norway
(Myhre, Kalstad, Tveit, Smith, Tveit, Arnesen, Seljeflot) Institute of
Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
(Kalstad, Laake, Solheim, Arnesen, Seljeflot) Center for Clinical Heart
Research, Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(Schmidt) Department of Cardiology, Aalborg University Hospital and
Aalborg University, Aalborg, Denmark
(Nilsen) Department of Cardiology, Stavanger University Hospital,
Stavanger, Norway
(Nilsen) Department of Clinical Science, Faculty of Medicine, University
of Bergen, Bergen, Norway
(Tveit) Department of Medical Research, Vestre Viken Hospital Trust,
Baerum Hospital, Gjettum, Norway
Publisher
John Wiley and Sons Inc
Abstract
Background: The cardiovascular benefit from n-3 polyunsaturated fatty
acids (PUFAs) after acute myocardial infarction (AMI) is controversial,
and the importance of serum eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA) concentrations for clinical events is unclear.
 Objective(s): To assess changes in EPA and DHA serum concentrations
during n-3 PUFA supplementation and their association with incident
cardiovascular events. Method(s): In the OMEMI trial, elderly
patients with a recent AMI were randomized to 1.8 g/day of EPA/DHA or
control (corn oil) for 2 years. The primary outcome was a composite of
AMI, coronary revascularization, stroke, heart failure hospitalization, or
all-cause death (major adverse cardiovascular event [MACE]) and the
secondary outcome was new-onset atrial fibrillation (AF). Result(s):
EPA and DHA measurements were available in 881 (92% of survivors)
participants at randomization and study completion. EPA and DHA increased
in the active treatment arm (n = 438) by a median of 87% and 16%,
respectively. Greater on-treatment increases in EPA and DHA were
associated with decreasing triglycerides, increasing high-density
lipoprotein cholesterol, and lower baseline EPA and DHA concentrations.
Greater on-treatment increases in EPA were associated with lower risk of
MACE (adjusted hazard ratio 0.86 [95% confidence interval, CI, 0.75-0.99],
p = 0.034), and higher risk of AF (adjusted hazard ratio (HR) 1.36 [95% CI
1.07-1.72], p = 0.011). Although there were similar tendencies for DHA
changes and outcomes, these associations were not statistically
significant (HR 0.84 [0.66-1.06] for MACE and 1.39 [0.90-2.13] for AF).
 Conclusion(s): Greater on-treatment increases in EPA were associated
with lower risk of MACE and higher risk of new-onset AF. These data
suggest that the cardiovascular effects of increasing n-3 PUFA levels
through supplements are complex, involving both potential benefits and
harm. Copyright © 2021 The Authors. Journal of Internal Medicine
published by John Wiley & Sons Ltd on behalf of Association for
Publication of The Journal of Internal Medicine.

<91>
Accession Number
638215930
Title
Aortic valve intervention for aortic stenosis and cardiac amyloidosis: A
systematic review and meta-analysis.
Source
Future Cardiology. 18(6) (pp 477-486), 2022. Date of Publication: June
2022.
Author
De Campos D.; Saleiro C.; Botelho A.; Costa M.; Goncalves L.; Teixeira R.
Institution
(De Campos, Saleiro, Botelho, Costa, Goncalves, Teixeira) Centro
Hospitalar e Universitario de Coimbra-Hospital Geral, Quinta Dos Vales,
Sao Martinho do Bispo 108, Coimbra 3041-801, Portugal
(Goncalves, Teixeira) Faculdade de Medicina, Universidade de Coimbra, R.
Larga 2, Coimbra 3000-370, Portugal
(Goncalves) Coimbra Institute for Clinical & Biomedical Research (ICBR),
Azinhaga Santa Comba, Celas, Coimbra 3000-548, Portugal
Publisher
Future Medicine Ltd.
Abstract
Aortic stenosis with cardiac amyloidosis (CA-AS) is common in the elderly.
We provide an overview and a meta-analysis of outcomes after aortic valve
(AV) intervention. The primary end point was all-cause mortality. Weighted
pooled analysis showed a non-significant higher risk of death in CA-AS
patients following surgical or transcatheter AV replacement. After
transcatheter AV replacement, the risk of death in CA-AS patients was
comparable to that associated with aortic stenosis alone (risk ratio:
1.23; 95% CI: 0.77-1.96; p = 0.39; I2 = 0%). An AV intervention is
possibly not futile in CA-AS and should not be denied to patients with
this condition. Plain language summary Dual presentation of aortic
stenosis (AS) and cardiac amyloidosis (CA) is common in the elderly.
Patients with CA-AS face a dismal prognosis. Clinical outcomes after an
aortic valve intervention are conflicting. Our data showed that there is
no increased risk of death in CA-AS patients compared with patients with
only AS after an aortic valve replacement. In particular, our analysis
unveils that following less invasive percutaneous aortic valve
replacement, rates of death of patients with concomitant CA were not
significantly different from those in patients who had AS without CA.
Based on this data, an aortic valve substitution procedure should not be
withheld in patients with CA. Copyright © 2022 Future Medicine
Ltd.

<92>
Accession Number
638215923
Title
Evaluating the effect of multivalvular disease on mortality after
transcatheter aortic valve replacement for aortic stenosis: A
meta-analysis and systematic review.
Source
Future Cardiology. 18(6) (pp 487-496), 2022. Date of Publication: June
2022.
Author
Siddiqi T.J.; Usman M.S.; Ahmed J.; Shahid I.; Ahmed W.; Alkhouli M.
Institution
(Siddiqi, Usman) Department of Medicine, University of Mississippi,
Jackson, MS 39216, United States
(Ahmed) Department of Medicine, Dow University of Health Sciences, Karachi
74200, Pakistan
(Shahid) Department of Medicine, Ziauddin Medical University, Karachi
7500, Pakistan
(Ahmed) Medical College, Aga Khan University, Karachi 74800, Pakistan
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
Publisher
Future Medicine Ltd.
Abstract
Aims: To determine the prognosis of multivalvular disease in patients
undergoing transcatheter aortic valve replacement (TAVR) for severe aortic
stenosis. Method(s): Patients undergoing TAVR for aortic stenosis
with covariate-adjusted risk of mortality associated with concomitant
valve disease (mitral regurgitation [MR], mitral stenosis [MS] or
tricuspid regurgitation [TR]) were included. Result(s):
Moderate-to-severe MR was associated with increased mortality at 30 days
(hazard ratio [HR]: 1.60; 95% CI: 1.11-2.30; p = 0.01) and 1 year (HR:
1.87; 95% CI: 1.22-2.87; p = 0.004). The presence of all-grade MS did not
impact 30-day or 1-year mortality (HR, 30 days: 1.60; 95% CI: 0.71-3.63; p
= 0.26; and HR, 1 year: 1.90; 95% CI: 0.98-3.69; p = 0.06); however, an
increased risk of 1-year mortality (HR: 1.67; 95% CI: 1.03-2.70; p = 0.04)
was observed with severe MS compared with no MS. Moderate-to-severe TR had
a higher risk of all-cause mortality at 1 year (HR: 1.49; 95% CI:
1.24-1.78; p < 0.001) compared with no or mild TR. Conclusion(s):
Moderate-to-severe MR or TR, and severe MS, significantly increase
mid-term mortality after TAVR. Plain language summary Transcatheter aortic
valve replacement (TAVR) is a minimally invasive heart procedure to
replace a thickened aortic valve (aortic stenosis). In the current era,
the use of TAVR has increased in patients suffering from uncomfortable and
potentially life-threatening symptoms of severe aortic stenosis who are at
increased risk for undergoing a surgical procedure to replace their
valves. However, accompanying valve diseases like mitral regurgitation
(mitral valve cannot close tightly), mitral stenosis (a narrowed mitral
valve) and tricuspid regurgitation (tricuspid valve cannot close tightly)
are highly common in these patients. Therefore in this paper we assessed
the effect of accompanying valvular disorders on the likelihood of death
following TAVR in this patient population. Our findings suggest that
accompanying moderate-to-severe mitral regurgitation and tricuspid
regurgitation leads to an increase in deaths post-TAVR. Likewise, severe
mitral stenosis also increased the risk of deaths after TAVR. Tweetable
abstract TAVR in patients with multivalvular disease. Copyright ©
2022 Future Medicine Ltd.

<93>
Accession Number
2016797563
Title
Erector Spinae Plane Block for Children Undergoing Cardiac Surgeries via
Sternotomy: A Randomized Controlled Trial.
Source
Anesthesiology and Pain Medicine. 12(2) (no pagination), 2022. Article
Number: e123723. Date of Publication: Apr 2022.
Author
Gado A.A.; Alsadek W.M.; Ali H.; Ismail A.A.
Institution
(Gado, Alsadek, Ali, Ismail) Anesthesia Department, Faculty of Medicine,
Cairo University, Giza, Egypt
Publisher
Kowsar Medical Institute
Abstract
Background: Ineffective management of postoperative pain following
pediatric cardiac surgeries adversely affects a patient's postoperative
course. The erector spinae plane (ESP) block has been described in the
literature regarding perioperative pain manage-ment. We hypothesized that
bilateral ESP blocks in pediatric patients would decrease intraoperative
fentanyl consumption, reduce the need for postoperative morphine
consumption, and improve pain scores. Objective(s): The aim of this
double-blinded randomized controlled trial was to assess the efficacy and
safety of bilateral ESP blocks in pediatric patients undergoing cardiac
surgeries through a median sternotomy. Method(s): The study involved
98 children aged 6 months to 7 years who were American Society of
Anesthesiologists (ASA) II and III and scheduled for cardiac surgery
through a median sternotomy. Patients were divided randomly into 2 groups:
the ES group (n = 50) who received bilateral ultrasound-guided ESP blocks,
and the N group (n = 48) who received no block. The primary outcome was
the total dose of administered fentanyl intraoperatively. Secondary
outcomes included morphine consumption in the first 24 hours
postoperatively; the length of time before the first need for
postoperative analgesia; and FLACC (face, legs, activity, consolability,
and cry) scores at the first and second hours postoperatively and every 4
hours, with readings taken for a period of 24 hours. Result(s): There
were statistically significantly higher levels of administered fentanyl
intraoperatively (6.7 +/- 3 vs 4.3 +/- 1.9 microg.kg-1) and
postoperative morphine consumption (0.5 +/- 0.2 vs 0.4 +/- 0.2
mg.kg-1) in the N group compared with the ES group (P < 0.001).
Moreover, the timing of the first rescue analgesia was significantly
delayed in the ES group compared with the N group (231.6 +/- 104.5 vs
108.8 +/- 47.8 minutes). Conclusion(s): Bilateral ultrasound-guided
ESP blocks can be used to reduce perioperative opioid consumption in
pediatric patients undergoing cardiac surgery through a sternotomy. It
also can be used to decrease postoperative pain scores. Copyright
© 2022, Author(s).

<94>
Accession Number
2016680137
Title
Multicentre analysis of practice patterns regarding benzodiazepine use in
cardiac surgery.
Source
British Journal of Anaesthesia. 128(5) (pp 772-784), 2022. Date of
Publication: May 2022.
Author
Janda A.M.; Spence J.; Dubovoy T.; Belley-Cote E.; Mentz G.; Kheterpal S.;
Mathis M.R.
Institution
(Janda, Dubovoy, Mentz, Kheterpal, Mathis) Department of Anesthesiology,
University of Michigan, Ann Arbor, MI, United States
(Spence) Departments of Anesthesia and Critical Care, McMaster University,
Hamilton, ON, Canada
(Spence, Belley-Cote) Population Health Research Institute, McMaster
University, Hamilton, ON, Canada
(Belley-Cote) Divisions of Cardiology and Critical Care, Department of
Medicine, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Ltd
Abstract
Background: There is controversy regarding optimal use of benzodiazepines
during cardiac surgery, and it is unknown whether and to what extent there
is variation in practice. We sought to describe benzodiazepine use and
sources of variation during cardiac surgeries across patients, clinicians,
and institutions. Method(s): We conducted an analysis of adult
cardiac surgeries across a multicentre consortium of USA academic and
private hospitals from 2014 to 2019. The primary outcome was
administration of a benzodiazepine from 2 h before anaesthesia start until
anaesthesia end. Institutional-, clinician-, and patient-level variables
were analysed via multilevel mixed-effects models. Result(s): Of 65
508 patients cared for by 825 anaesthesiology attending clinicians
(consultants) at 33 institutions, 58 004 patients (88.5%) received
benzodiazepines with a median midazolam-equivalent dose of 4.0 mg
(inter-quartile range [IQR], 2.0-6.0 mg). Variation in benzodiazepine
dosage administration was 54.7% attributable to institution, 14.7% to
primary attending anaesthesiology clinician, and 30.5% to patient factors.
The adjusted median odds ratio for two similar patients receiving a
benzodiazepine was 2.68 between two randomly selected clinicians and 4.19
between two randomly selected institutions. Factors strongly associated
(adjusted odds ratio, <0.75, or >1.25) with significantly decreased
likelihoods of benzodiazepine administration included older age (>80 vs
<=50 yr; adjusted odds ratio=0.04; 95% CI, 0.04-0.05), university
affiliation (0.08, 0.02-0.35), recent year of surgery (0.42, 0.37-0.49),
and low clinician case volume (0.44, 0.25-0.75). Factors strongly
associated with significantly increased likelihoods of benzodiazepine
administration included cardiopulmonary bypass (2.26, 1.99-2.55), and drug
use history (1.29, 1.02-1.65). Conclusion(s): Two-thirds of the
variation in benzodiazepine administration during cardiac surgery are
associated with institutions and attending anaesthesiology clinicians
(consultants). These data, showing wide variations in administration,
suggest that rigorous research is needed to guide evidence-based and
patient-centred benzodiazepine administration. Copyright © 2021
British Journal of Anaesthesia

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

<96>
Accession Number
2015804538
Title
Surgical versus medical treatment for infective endocarditis in patients
on dialysis: a systematic review and meta-analysis.
Source
Renal Failure. 44(1) (pp 706-713), 2022. Date of Publication: 2022.
Author
Ting S.-W.; Chen J.-J.; Lee T.-H.; Kuo G.
Institution
(Ting) Department of Dermatology, New Taipei City Municipal Tucheng
Hospital, New Taipei City, Taiwan (Republic of China)
(Chen, Lee, Kuo) Department of Nephrology, Kidney Research Center, Linkou
Chang Gung Memorial Hospital, Taoyuan, Taiwan (Republic of China)
(Lee) Department of Nephrology, New Taipei City Municipal Tucheng
Hospital, New Taipei City, Taiwan (Republic of China)
Publisher
Taylor and Francis Ltd.
Abstract
Infective endocarditis (IE) is a serious infection and causes significant
morbidity and mortality. However, the benefit of surgery for endocarditis
besides antibiotic treatment in dialysis patients remains controversial.
We performed a systematic review of studies published between 1960 and
February 2022. Meta-analysis was conducted with a random-effects model to
explore the in-hospital, 30, 60, 90, 180-d, and 1-year mortality rates in
adult dialysis patients with IE. Sensitivity analysis, subgroup analysis,
and meta-regression were performed to explore potential sources of
heterogeneity. Confidence of evidence was evaluated by the GRADE system.
Thirteen studies were included. The pooled odds ratio of in-hospital
mortality was 0.62 (95% confidence interval [CI]: 0.30-1.28, p =.17), with
moderate heterogeneity (I 2 = 62%, p <.01). Three studies
reported 30-d mortality, and the pooled odds ratio for surgery compared
with medical treatment was even lower (0.36; 95% CI: 0.22-0.61, p <.01),
with low heterogeneity (I 2 = 0%, p =.86). With studies on
fewer than 30 patients excluded, the sensitivity analysis revealed a low
odds ratio of in-hospital mortality for surgery versus medical treatment
(0.52; 95% CI: 0.27-0.99, p =.047), with moderate heterogeneity (I
2 = 63%, p <.01). Subgroup analysis revealed no significant
differences between any two comparator subgroups. Based on a very low
strength of evidence, compared with medical treatment, surgical treatment
for IE in patients on dialysis is not associated with lower in-hospital
mortality. When studies on fewer than 30 patients were excluded, surgical
treatment was associated with better survival. Copyright © 2022
The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<97>
Accession Number
636379653
Title
Exercise-based cardiac rehabilitation for coronary heart disease.
Source
Cochrane Database of Systematic Reviews. 2021(11) (no pagination), 2021.
Article Number: CD001800. Date of Publication: 06 Nov 2021.
Author
Dibben G.; Faulkner J.; Oldridge N.; Rees K.; Thompson D.R.; Zwisler
A.-D.; Taylor R.S.
Institution
(Dibben) MRC/CSO Social and Public Health Sciences Unit, Institute of
Health and Well Being, University of Glasgow, Glasgow, United Kingdom
(Faulkner) Faculty Health and Wellbeing, School of Sport, Health and
Community, University of Winchester, Winchester, United Kingdom
(Oldridge) College of Health Sciences, University of Wisconsin-Milwaukee,
Milwaukee, WI, United States
(Rees) Division of Health Sciences, Warwick Medical School, University of
Warwick, Coventry, United Kingdom
(Thompson) School of Nursing and Midwifery, Queen's University Belfast,
Belfast, United Kingdom
(Zwisler) REHPA, The Danish Knowledge Centre for Rehabilitation and
Palliative Care, Odense University Hospital, Nyborg, Denmark
(Zwisler) Department of Clinical Research, University of Southern Denmark,
Odense, Denmark
(Taylor) MRC/CSO Social and Public Health Sciences Unit & Robertson Centre
for Biostatistics, Institute of Health and Well Being, University of
Glasgow, Glasgow, United Kingdom
(Taylor) National Institute of Public Health, University of Southern
Denmark, Copenhagen, Denmark
Publisher
John Wiley and Sons Ltd
Abstract
Background: Coronary heart disease (CHD) is the most common cause of death
globally. However, with falling CHD mortality rates, an increasing number
of people living with CHD may need support to manage their symptoms and
prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve the
health and outcomes of people with CHD. This is an update of a Cochrane
Review previously published in 2016. Objective(s): To assess the
clinical effectiveness and cost-effectiveness of exercise-based CR
(exercise training alone or in combination with psychosocial or
educational interventions) compared with 'no exercise' control, on
mortality, morbidity and health-related quality of life (HRQoL) in people
with CHD. Search Method(s): We updated searches from the previous
Cochrane Review, by searching CENTRAL, MEDLINE, Embase, and two other
databases in September 2020. We also searched two clinical trials
registers in June 2021. Selection Criteria: We included randomised
controlled trials (RCTs) of exercise-based interventions with at least six
months' follow-up, compared with 'no exercise' control. The study
population comprised adult men and women who have had a myocardial
infarction (MI), coronary artery bypass graft (CABG) or percutaneous
coronary intervention (PCI), or have angina pectoris, or coronary artery
disease. Data Collection and Analysis: We screened all identified
references, extracted data and assessed risk of bias according to Cochrane
methods. We stratified meta-analysis by duration of follow-up: short-term
(6 to 12 months); medium-term (> 12 to 36 months); and long-term (> 3
years), and used meta-regression to explore potential treatment effect
modifiers. We used GRADE for primary outcomes at 6 to 12 months (the most
common follow-up time point). Main Result(s): This review included 85
trials which randomised 23,430 people with CHD. This latest update
identified 22 new trials (7795 participants). The population included
predominantly post-MI and post-revascularisation patients, with a mean age
ranging from 47 to 77 years. In the last decade, the median percentage of
women with CHD has increased from 11% to 17%, but females still account
for a similarly small percentage of participants recruited overall (<
15%). Twenty-one of the included trials were performed in low- and
middle-income countries (LMICs). Overall trial reporting was poor,
although there was evidence of an improvement in quality over the last
decade. The median longest follow-up time was 12 months (range 6 months to
19 years). At short-term follow-up (6 to 12 months), exercise-based CR
likely results in a slight reduction in all-cause mortality (risk ratio
(RR) 0.87, 95% confidence interval (CI) 0.73 to 1.04; 25 trials; moderate
certainty evidence), a large reduction in MI (RR 0.72, 95% CI 0.55 to
0.93; 22 trials; number needed to treat for an additional beneficial
outcome (NNTB) 75, 95% CI 47 to 298; high certainty evidence), and a large
reduction in all-cause hospitalisation (RR 0.58, 95% CI 0.43 to 0.77; 14
trials; NNTB 12, 95% CI 9 to 21; moderate certainty evidence).
Exercise-based CR likely results in little to no difference in risk of
cardiovascular mortality (RR 0.88, 95% CI 0.68 to 1.14; 15 trials;
moderate certainty evidence), CABG (RR 0.99, 95% CI 0.78 to 1.27; 20
trials; high certainty evidence), and PCI (RR 0.86, 95% CI 0.63 to 1.19;
13 trials; moderate certainty evidence) up to 12 months' follow-up. We are
uncertain about the effects of exercise-based CR on cardiovascular
hospitalisation, with a wide confidence interval including considerable
benefit as well as harm (RR 0.80, 95% CI 0.41 to 1.59; low certainty
evidence). There was evidence of substantial heterogeneity across trials
for cardiovascular hospitalisations (I2 = 53%), and of small
study bias for all-cause hospitalisation, but not for all other outcomes.
At medium-term follow-up, although there may be little to no difference in
all-cause mortality (RR 0.90, 95% CI 0.80 to 1.02; 15 trials), MI (RR
1.07, 95% CI 0.91 to 1.27; 12 trials), PCI (RR 0.96, 95% CI 0.69 to 1.35;
6 trials), CABG (RR 0.97, 95% CI 0.77 to 1.23; 9 trials), and all-cause
hospitalisation (RR 0.92, 95% CI 0.82 to 1.03; 9 trials), a large
reduction in cardiovascular mortality was found (RR 0.77, 95% CI 0.63 to
0.93; 5 trials). Evidence is uncertain for difference in risk of
cardiovascular hospitalisation (RR 0.92, 95% CI 0.76 to 1.12; 3 trials).
At long-term follow-up, although there may be little to no difference in
all-cause mortality (RR 0.91, 95% CI 0.75 to 1.10), exercise-based CR may
result in a large reduction in cardiovascular mortality (RR 0.58, 95% CI
0.43 to 0.78; 8 trials) and MI (RR 0.67, 95% CI 0.50 to 0.90; 10 trials).
Evidence is uncertain for CABG (RR 0.66, 95% CI 0.34 to 1.27; 4 trials),
and PCI (RR 0.76, 95% CI 0.48 to 1.20; 3 trials). Meta-regression showed
benefits in outcomes were independent of CHD case mix, type of CR,
exercise dose, follow-up length, publication year, CR setting, study
location, sample size or risk of bias. There was evidence that
exercise-based CR may slightly increase HRQoL across several subscales
(SF-36 mental component, physical functioning, physical performance,
general health, vitality, social functioning and mental health scores) up
to 12 months' follow-up; however, these may not be clinically important
differences. The eight trial-based economic evaluation studies showed
exercise-based CR to be a potentially cost-effective use of resources in
terms of gain in quality-adjusted life years (QALYs). Authors'
conclusions: This updated Cochrane Review supports the conclusions of the
previous version, that exercise-based CR provides important benefits to
people with CHD, including reduced risk of MI, a likely small reduction in
all-cause mortality, and a large reduction in all-cause hospitalisation,
along with associated healthcare costs, and improved HRQoL up to 12
months' follow-up. Over longer-term follow-up, benefits may include
reductions in cardiovascular mortality and MI. In the last decade, trials
were more likely to include females, and be undertaken in LMICs,
increasing the generalisability of findings. Well-designed,
adequately-reported RCTs of CR in people with CHD more representative of
usual clinical practice are still needed. Trials should explicitly report
clinical outcomes, including mortality and hospital admissions, and
include validated HRQoL outcome measures, especially over longer-term
follow-up, and assess costs and cost-effectiveness. Copyright ©
2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<98>
Accession Number
2017872048
Title
The management of paravalvular leaks post aortic valve replacement.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Kananathan S.; Perera L.A.; Mohanarajan M.; Sherif M.; Harky A.
Institution
(Kananathan, Perera, Mohanarajan) Dnipro Medical Institute of Traditional
and Non-Traditional Medicine, Dnipro, Ukraine
(Sherif) Department of Cardiothoracic Surgery, Northern General Hospital,
Sheffield, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Paravalvular leak (PVL) is uncommon but can lead to severe
complications after surgical or transcatheter aortic valve implantation.
Conditions associated with PVLs such as heart failure, hemolysis, and
infective endocarditis can lead to catastrophic results if not treated
promptly; the therapeutic goals differ according to the presentation. It
is vital that PVLs are diagnosed early using various imaging modalities.
Different approaches have been studied in managing PVLs; there is an
increased interest in the transcatheter aortic valve closure procedure as
it is minimally invasive and decreases the occurrence of further
reinterventions. Aim(s): To discuss the classification of PVLs,
diagnostic approaches, and available management options. Method(s): A
literature review was performed using 28 studies. Result(s): This
review evaluated the relationship between the time of diagnosis,
management of PVL and the resulting outcomes. Discussion(s): Patients
with PVL should be assessed through a multidisciplinary team approach and
a patient-selective plan should be in place. Conclusion(s): Open
surgical intervention is reserved for complex cases where minimally
invasive techniques cannot be utilized. Copyright © 2022 Wiley
Periodicals LLC.

<99>
Accession Number
2014241792
Title
Safety and efficacy of cerebral embolic protection devices in patients
undergoing transcatheter aortic valve replacement: a meta-analysis of
in-hospital outcomes.
Source
Cardiovascular Intervention and Therapeutics. 37(3) (pp 549-557), 2022.
Date of Publication: July 2022.
Author
Shimamura J.; Kuno T.; Malik A.; Yokoyama Y.; Gupta R.; Ahmad H.;
Briasoulis A.
Institution
(Shimamura) Division of Cardiac Surgery, Sunnybrook Health Sciences
Centre, Toronto, ON, Canada
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein Medical College, Bronx, NY, United States
(Malik) Department of Cardiology, Westchester Medical Center and New York
Medical College, Valhalla, NY, United States
(Yokoyama) Department of Surgery, Easton Hospital, Easton, PA, United
States
(Gupta) Department of Cardiology, Lehigh Valley Heart Institute, Lehigh
Valley Health Network, Allentown, PA, United States
(Ahmad) Division of Cardiology, Westchester Medical Center, Valhalla, NY,
United States
(Briasoulis) Section of Heart Failure and Transplant, Division of
Cardiovascular Diseases, University of Iowa Hospitals and Clinics, 200
Hawkins Dr, Iowa City, IA 52242, United States
Publisher
Springer Japan
Abstract
The evidence regarding the impact of cerebral embolic protection devices
(EPDs) on outcomes following transcatheter aortic valve replacement (TAVR)
is limited. The objective of this study was to evaluate in-hospital
outcomes with the use of cerebral EPDs in TAVR. We performed a
comprehensive EMBASE and PUBMED search to investigate randomized control
studies or propensity score-matched retrospective studies which assessed
patients undergoing TAVR with or without EPD up to April 2021. Endpoints
of interest were in-hospital mortality, stroke, acute kidney injury,
pacemaker implantation, major bleeding, vascular complication, length of
stay. Ten studies involving 173,002 patients with EPD (n = 16,898, 9.8%)
and those without (n = 156,104, 90.2%) fulfilled the inclusion criteria.
The use of EPD was associated with significantly lower risk of in-hospital
stroke (odds ratio [95% confidential interval]: 0.64 [0.46; 0.89]), but
similar rate of in-hospital mortality (odds ratio [95% confidential
interval]: 0.75 [0.54; 1.05]). No differences were observed in acute
kidney injury, pacemaker implantation, major bleeding, vascular
complication, length of stay. EPD during TAVR was associated with lower
in-hospital stroke but did not affect procedural complications and length
of stay. Copyright © 2021, Japanese Association of Cardiovascular
Intervention and Therapeutics.

<100>
Accession Number
638213977
Title
Influence on Depression, Anxiety, and Satisfaction of the Relatives' Visit
to Intensive Care Units prior to Hospital Admission for Elective Cardiac
Surgery: A Randomized Clinical Trial.
Source
International journal of clinical practice. 2022 (pp 1746782), 2022. Date
of Publication: 2022.
Author
Gonzalez-Martin S.; Becerro-de-Bengoa-Vallejo R.; Rodriguez-Garcia M.;
Losa-Iglesias M.E.; Mazoteras-Pardo V.; Palomo-Lopez P.; Rodriguez-Sanz
D.; Calvo-Lobo C.; Lopez-Lopez D.
Institution
(Gonzalez-Martin, Becerro-de-Bengoa-Vallejo, Rodriguez-Garcia,
Rodriguez-Sanz, Calvo-Lobo) Faculty of Nursing, Physiotherapy and
Podiatry, Universidad Complutense de Madrid, Madrid, Spain
(Losa-Iglesias) Faculty of Health Sciences, Universidad Rey Juan Carlos,
Mostoles, Spain
(Mazoteras-Pardo) Department of Nursing, Physiotherapy and Occupational
Therapy, School of Physiotherapy and Nursing, University of Castilla-La
Mancha, Toledo, Spain
(Palomo-Lopez) University Center of Plasencia, Universidad de Extremadura,
Plasencia, Spain
(Lopez-Lopez) Research, Health and Podiatry Group, Department of Health
Sciences, Faculty of Nursing and Podiatry, Universidade da Coruna,
Industrial Campus of Ferrol, A Coruna, Spain
Publisher
NLM (Medline)
Abstract
Background: Intensive care units (ICUs) may produce stress on the
relatives of patients that have long-term physiological and psychological
implications. Objective(s): This study aimed to evaluate the effects
of the relatives' visit prior to hospital admission(s) on the patient's
scheduled cardiac surgery regarding depression, anxiety, and satisfaction
of the patient's family in an ICU. Method(s): A randomized clinical
trial [NCT03605420] was carried out according to the CONSORT criteria.
Thirty-eight relatives of ICU patients were recruited at an ICU and
randomized into study groups. Experimental group participants (n=19)
consisted of relatives who received 1 ICU visit prior to the patient's
admission. Control group participants (n=19) consisted of patients'
relatives who received standard care alone. A self-report test battery,
including the Impact of Event Scale-Revised (IES-R) and the Hospital
Anxiety and Depression Scale (HADS), was completed by the patient's
relative prior to the patient's ICU admission and again three and 90days
after ICU discharge. Furthermore, the Family Satisfaction with Care in the
Intensive Care Unit (FS-ICU) and Critical Care Family Needs Inventory
(CCFNI) were administered to help determine the respondents' satisfaction
three days after the patient's ICU discharge. Result(s):
Statistically significant differences in FS-ICU results were found between
control and experimental groups; no statistically significant differences
were found in IES-R, HADS, and CCFNI results. Thus, members in the control
group were more satisfied with the time elapsed to raise their concerns
(p=0.005), emotional support provided (p=0.020), quality of care
(p=0.035), opportunities to express concerns and ask questions (p=0.005),
and general satisfaction with the ICU's decision-making (p=0.003).
 Conclusion(s): Relatives' satisfaction during patients' ICU admission
may be impaired after their prior visit to the hospital admission.
Relative's anxiety and depression scores did not seem to be significantly
affected. Relatives' visit prior to elective cardiac surgery hospital
admission impaired their satisfaction in an ICU and may not be advisable
for healthcare practice. Copyright © 2022 Sara Gonzalez-Martin et
al.

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Accession Number
635533310
Title
Extracorporeal Cytokine Adsorption Therapy As a Preventive Measure in
Cardiac Surgery and As a Therapeutic Add-On Treatment in Sepsis: An
Updated Systematic Review of Comparative Efficacy and Safety.
Source
Critical Care Medicine. 49(8) (pp 1347-1357), 2021. Date of Publication:
01 Aug 2021.
Author
Goetz G.; Hawlik K.; Wild C.
Institution
(Goetz, Wild) Hta Austria-Austrian Institute for Health Technology
Assessment GmbH, Ludwig Boltzmann Institute for Hta, Vienna, Austria
(Hawlik) Klinik Favoriten, Wiener Gesundheitsverbund, Vienna, Austria
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: Evaluating whether there is a clinical benefit of using
extracorporeal cytokine adsorption therapy in two indications. DESIGN:
Systematic review. SETTING: Search on four databases, Medline, Embase, The
Cochrane Library, and the European Network for Health Technology
Assessment planned and ongoing projects database. PATIENTS: Patients with
sepsis/septic shock; patients undergoing cardiac surgery INTERVENTIONS:
Cytokine adsorption. MEASUREMENTS AND MAIN RESULTS: Randomized controlled
trials and prospective studies with concurrent control were eligible for
the evidence synthesis. The quality of the individual studies and the
strength of the available evidence were assessed using the Cochrane risk
of bias tool and the Grading of Recommendations, Assessment, Development,
and Evaluation approach, respectively. For the preventive treatment of
extracorporeal cytokine adsorption therapy in patients undergoing cardiac
surgery, we found very low-quality inconclusive evidence for mortality
(five randomized controlled trials, n = 163), length of stay in the ICU
(five randomized controlled trials, n = 163), and length of
hospitalization (three randomized controlled trials, n = 101). Very
low-quality inconclusive evidence was found for (serious) adverse events
(four randomized controlled trials, n = 148). For the therapeutic
treatment of extracorporeal cytokine adsorption therapy in patients with
sepsis/septic shock, we found very low-quality inconclusive evidence for
mortality up to 60-day follow-up (two randomized controlled trials, n =
117), organ function (two randomized controlled trials, n = 117) and
length of stay in the ICU (one randomized controlled trial, n = 20). Very
low-quality inconclusive evidence was found for (serious) adverse events
(two randomized controlled trials, n = 117). CONCLUSION(S): Given the
available evidence, the efficacy and safety of extracorporeal cytokine
adsorption therapy in combination with standard care in the investigated
indications was not established. We strongly recommend considering
well-powered studies with patient-relevant endpoints instead of investing
further research funds on studies that may not shed light on the clinical
benefit of extracorporeal cytokine adsorption therapy. Copyright
© 2021 Lippincott Williams and Wilkins. All rights reserved.

<102>
Accession Number
638226178
Title
Patients' Satisfaction with Local or General Anaesthesia for
Video-Assisted Thoracic Surgery - First Results of the Randomized PASSAT
Trial.
Source
European Surgical Research. Conference: 139th Congress of the German
Society of Surgery, DGCH 2022. Leipzig Germany. 63(SUPPL 1) (pp 17), 2022.
Date of Publication: April 2022.
Author
Galetin T.; Eckermann C.; Julika M.A.; Lopez A.P.; Schnell J.; Koryllos
A.; Stoelben E.
Institution
(Galetin) Thoraxchirurgie, Helios Klinikum Hildesheim, Hildesheim, Germany
(Julika, Lopez, Schnell, Koryllos, Stoelben) Thoraxchirurgie, Lungenklinik
Koln Merheim, Koln, Germany
(Eckermann) Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz,
Koblenz, Germany
Publisher
S. Karger AG
Abstract
Background: Video-assisted thoracic surgery (VATS) in local anaesthesia
and analgosedation (LA) is advantageous over general anaesthesia and
one-lung-ventilation (GA) regarding cardiopulmonary, inflammatory, and
neurocognitive consequences for the patient. However, the impact of
anaesthesia on patient satisfaction remains unclear. We report the results
of PASSAT ("PAientS' SATisfaction"), the first randomised-controlled trial
in surgery using valid methods to investigate the patients' satisfaction.
 Material(s) and Method(s): Patients presenting for minor VATS
(pleural disorders, wedge resections) were randomised to LA (intervention
group) or GA (control group). The primary endpoint was patient
satisfaction according to psychometrically validated questionnaires;
secondary endpoints were physicians' satisfaction, capnometry,
complication rates, and cost-effectiveness. The trial was registered under
ID DRKS00013661. Result(s): Fifty (LA) und 56 (GA) patients completed
the trial. Patient satisfaction with anaesthesiologic care was 2.4 vs. 2.6
(p=0.2), with general perioperative care 2.2 vs. 2.3 (p=0.8), with
recovery after surgery 2.1 vs. 1.9 (p=0.2; 3-point-Likert-scales).
Patient's overall satisfaction with anaesthesia was 8.9 vs. 8.8 (p=0.7).
The physicians's satisfaction with feasibility was 7.6 vs 9.4 (p<0.01) for
the surgeons and 7.3 vs. 9.0 (p<0.01) for the anaesthesiologists
(10-point-Likert-scales). The operation time was 35 vs. 34min (p=0.7),
pCO2 thirty minutes after surgery 44 vs. 44mmHg (p=0.9), pain on the 5th
day 0.7 vs. 1.3 (p=0.2, 10-point numeric rating scale). The rates of
postoperative delirium were 2% vs. 4% (p=1), of complications 0% vs. 4%
(p=0.5). The length of hospital stay was significantly shorter in the LA
group (3.9 vs. 6.0 days, p<0.01). Conclusion(s): Patients'
satisfaction with anaesthesia is a neglected aspect not only in thoracic
surgery. The PASSAT trial demonstrates that the patients are as satisfied
with LA as with GA, but their anaesthesiologists and surgeons are not. LA
is at least as safe as GA but is correlated with significantly shorter
length of hospital stay. Considering its pathophysiologic benefits and its
equivalent contentment, more efforts should be taken to re-establish VATS
in LA. The results of PASSAT may also be of interest for other surgical
disciplines.

<103>
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Accession Number
2018732635
Title
Effects of on-pump versus off-pump coronary artery bypass grafting on
myocardial metabolism.
Source
Medicine (United States). 98(17) (no pagination), 2019. Article Number:
e15351. Date of Publication: 01 Apr 2019.
Author
Xie H.-T.; Kang X.-Q.; Zhang S.; Tian Y.-C.; Liu D.-J.; Bai B.-J.
Institution
(Xie, Kang, Zhang, Tian, Liu, Bai) Department of Cardiac Surgery, The
Second Affiliated Hospital, Shaanxi University of Chinese Medicine,
Xianyang, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: On-pump coronary artery bypass grafting (ON-PCABG) and
off-pump coronary artery bypass grafting (OF-PCABG) greatly affect
myocardial metabolism (MCMB). However, no study has systematically
explored and compared the impacts of ON-PCABG and OF-PCABG on MCMB. This
study will aim to explore and to compare the effects of ON-PCABG and
OF-PCABG on MCMB systematically. Method(s): We will conduct the
comprehensive literature search from the following electronic databases
from inception to the present: Cochrane Library, EMBASE, MEDILINE, CINAHL,
AMED and 4 Chinese databases without language restrictions. This
systematic review will only concern randomized controlled trials (RCTs)
and case-control studies of ON-PCABG and OF-PCABG on MCMB. The
methodological quality of each entered study will be assessed by using
Cochrane risk of bias tool. Result(s): Primary outcomes include
myocardial cellular markers, myocardial lactate, oxygen utilization,
pyruvate, and intramyocardial concentrations of glucose, urea and lactate.
Secondary outcome comprises of glutathione, superoxide dismutase,
myeloperoxidase, and oxidative stress and any other complications post
surgery. Conclusion(s): This study will provide a high-quality
synthesis and will assess and compare the effects of ON-PCABG and OF-PCABG
on MCMB based on the current relevant literature evidence. Dissemination
and ethics: The results will be submitted to peer-reviewed journals for
publication. This study does not require ethic approval, because it only
analyzes the data from published literature. Systematic review
registration: PROSPERO CRD42019125381. Abbreviations: AMED = Allied and
Complementary Medicine Database, CABG = coronary artery bypass grafting,
CINAHL = Cumulative Index to Nursing and Allied Health Literature MCMB =
myocardial metabolism RCTs = randomized controlled trials. Copyright
© 2019 the Author(s).

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