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<1>
Accession Number
50469409
Title
Monitoring of mycophenolate mofetil in orthotopic heart transplant
recipients-a systematic review.
Source
Transplantation Reviews. 23(3) (pp 171-177), 2009. Date of Publication:
July 2009.
Author
Zuk D.M.; Pearson G.J.
Institution
(Zuk) Department of Medicine, University of Alberta, Edmonton, AB T6G 2B7,
Canada
(Pearson) Division of Cardiology, Department of Medicine, University of
Alberta, Edmonton, AB T6G 2B7, Canada
Publisher
W.B. Saunders
Abstract
Background: Recent attention has focused on individualizing mycophenolate
mofetil therapy via monitoring of mycophenolic acid (MPA) levels to
overcome interpatient variability in MPA exposure when standard doses are
administered. To our knowledge, no systematic review of the
pharmacokinetic data in orthotopic heart transplant recipients has been
published to date. <br/>Objective(s): The study aimed to systematically
review published studies on the MPA target concentration that is effective
at preventing rejection in cardiac transplant patients. Methodology: A
search of MEDLINE (January 1996 to July 2008) and EMBASE (January 1980 to
July 2008) was conducted for articles describing the relationship between
rejection and MPA concentration. <br/>Result(s): The literature search
yielded 7 citations for inclusion: 1 prospective, randomized controlled
study (level I); 2 prospective, nonrandomized controlled studies (level
II-1); 1 well-designed cohort study (level II-2); 2 retrospective cohort
studies (level II-3); and 1 case report (level III). <br/>Conclusion(s):
The relationship between MPA levels and rejection cannot be clearly
defined based on available evidence. Preliminary evidence suggests limited
sampling strategies may be a better predictor of rejection than a
single-time point model. Further studies must be conducted on the
relationship between the MPA area under the curve, the risk of rejection,
and adverse effects to appreciate the value of such strategies. &#xa9;
2009 Elsevier Inc. All rights reserved.

<2>
Accession Number
638247463
Title
Surgical resection, radiotherapy and percutaneous thermal ablation for
treatment of stage 1 non-small cell lung cancer: protocol for a systematic
review and network meta-analysis.
Source
BMJ Open. 12(6) (no pagination), 2022. Article Number: e057638. Date of
Publication: 16 Jun 2022.
Author
Chockalingam A.; Konstantinidis M.; Koo B.; Moon J.T.; Tran A.;
Nourouzpour S.; Lawson E.; Fox K.; Habibollahi P.; Odisio B.; Loya M.;
Bassir A.; Nezami N.
Institution
(Chockalingam) Harvard Medical School, Boston, MA, United States
(Konstantinidis) Child Health Evaluative Sciences, Hospital for Sick
Children, Toronto, ON, Canada
(Konstantinidis) Division of Biostatistics, Dalla Lana School of Public
Health, University of Toronto, Toronto, ON, Canada
(Koo) Brown University, Providence, RI, United States
(Moon, Tran, Loya) Department of Radiology and Imaging Sciences, Division
of Interventional Radiology, Emory University School of Medicine, Atlanta,
GA, United States
(Nourouzpour) University Health Network, Toronto, ON, Canada
(Lawson, Fox) Emory University, Atlanta, GA, United States
(Habibollahi, Odisio) Department of Interventional Radiology, The
University of Texas Md Anderson Cancer Center, Houston, TX, United States
(Bassir) University of California Los Angeles David Geffen, School of
Medicine, Los Angeles, CA, United States
(Nezami) Division of Vascular and Interventional Radiology, Department of
Diagnostic Radiology and Nuclear Medicine, University of Maryland School
of Medicine, Baltimore, MD, United States
(Nezami) Experimental Therapeutics Program, University of Maryland Marlene
and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, United
States
Publisher
BMJ Publishing Group
Abstract
Introduction Non-small cell lung cancer (NSCLC) makes up the majority of
lung cancer cases. Currently, surgical resection is the gold standard of
treatment. However, as patients are becoming medically more complex
presenting with advanced disease, minimally invasive image-guided
percutaneous ablations are gaining popularity. Therefore, comparison of
surgical, ablative and second-line external beam therapies will help
clinicians, as management of NSCLC changes. We will conduct a
meta-analysis, reviewing literature investigating these therapies in adult
patients diagnosed with stage 1 NSCLC, with neither hilar nor mediastinal
nodal involvement, confirmed either through cytology or histology
regardless of type. Methods and analysis We will search electronic
databases (MEDLINE, Embase, Web of Science, Scopus, ClinicalTrials.gov,
Cochrane) from their inception to January 2021 to identify randomised
controlled trials (RCTs), cluster RCTs and cohort studies comparing
survival and clinical outcomes between any two interventions (lobectomy,
wedge resection, video-assisted thoracoscopic surgery/robot-assisted
thoracoscopic surgery, radiofrequency ablation, microwave ablation,
cryoablation and consolidated radiation therapies (external beam radiation
therapy, stereotactic body radiation therapy, and 3D conformal radiation
therapy). The primary outcomes will include cancer-specific survival, lung
disease-free survival, locoregional recurrence, death, toxicity and
non-target organ injury. We will also search published and unpublished
studies in trial registries and will review references of included studies
for possible inclusion. Risk of bias will be assessed using tools
developed by the Cochrane collaboration. Two reviewers will independently
assess the eligibility of studies and conduct the corresponding risk of
bias assessments. For each outcome, given enough studies, we will conduct
a network meta-analysis. Finally, we will use the Confidence in Network
Meta-Analysis tool to assess quality of the evidence for each of the
primary outcomes. Ethics and dissemination We aim to share our findings
through high-impact peer review. As interventional techniques become more
popular, it will be important for providers in multidisciplinary teams
caring for these patients to receive continuing medical education related
to these interventions. Data will be made available to readers. PROSPERO
registration number CRD42021276629.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<3>
Accession Number
2018880616
Title
Prognostic factors of 10-year mortality after coronary artery bypass graft
surgery: a secondary analysis of the arterial revascularization trial.
Source
European Journal of Cardio-thoracic Surgery. 61(6) (pp 1414-1420), 2022.
Date of Publication: 01 Jun 2022.
Author
Dimagli A.; Benedetto U.; Gray A.; Gerry S.; Lees B.; Krzych L.; Gaudino
M.; Taggart D.P.; Flather M.; Talukder S.
Institution
(Talukder, Flather, Talukder) Norwich Medical School, University of East
Anglia, Norwich, United Kingdom
(Dimagli, Benedetto) Bristol Heart Institute, University of Bristol,
School of Clinical Sciences, Bristol, United Kingdom
(Gray) Health Economics Research Centre, Nuffield Department of Population
Health, University of Oxford, Oxford, United Kingdom
(Gerry) Centre of Statistics in Medicine, Botnar Research Centre,
University of Oxford, Oxford, United Kingdom
(Lees, Taggart) Nuffield Department of Surgical Sciences, University of
Oxford, John Radcliffe Hospital, Oxford, United Kingdom
(Krzych) Department of Anaesthesiology and Intensive Care, Medical
University of Silesia, Katowice, Poland
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York Presbyterian Hospital, New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: The objective of this investigation was to determine the
preoperative prognostic factors of long-term (10-year) mortality in
patients treated with isolated coronary artery bypass graft surgery in the
arterial revascularization trial (ART). <br/>Method(s): A post hoc
analysis of the ART was conducted. Cumulative 10-year mortality was
estimated using the Kaplan-Meier method. Prospectively collected
preoperative data were used to determine the prognostic factors of 10-year
all-cause mortality in patients who participated in the ART (Cox
proportional hazards model). <br/>Result(s): A total of 3102 patients who
participated in the ART were included in the analysis. Ten-year follow-up
was completed in 3040 patients (98%). A total of 644 patients (20.8%) had
died by 10 years. Preoperative factors that were identified as
statistically significant predictors of 10-year mortality in the
multivariable analysis (all P <= 0.01) were: left ventricular ejection
fraction, atrial fibrillation, age, diabetes, prior cerebrovascular event
(stroke or transient ischaemic attack), serum creatinine and smoking
status. The following variables were significantly associated in
univariable models but did not retain significance in the multivariable
model for mortality: non-Caucasian ethnicity, hypertension, peripheral
vascular disease, chronic obstructive pulmonary disease and prior
myocardial infarction. <br/>Conclusion(s): Independent predictors of
10-year mortality in the ART were multifactorial. Several key independent
predictors of 10-year mortality in the ART were identified including:
heart function, renal function, cerebrovascular disease, age, atrial
fibrillation, smoking status and diabetes. Understanding which
preoperative variables influence long-term outcome after coronary artery
bypass grafting may help to target treatments to those at higher risk to
reduce mortality.<br/>Copyright &#xa9; 2022 The Author(s).

<4>
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. <br/>Objective(s):
We examined whether cocoa extract supplementation decreases total
cardiovascular disease (CVD) among older adults. <br/>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.
<br/>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.
<br/>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.<br/>Copyright &#xa9; 2022 The Author(s) 2022.

<5>
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.<br/>Copyright &#xa9; 2022 Qiaonan Zhong et al.

<6>
Accession Number
2018700316
Title
The effect of statin on major adverse cardiovascular events and mortality
in patients with rheumatoid arthritis - a systematic review and
meta-analysis.
Source
European Review for Medical and Pharmacological Sciences. 26(9) (pp
3171-3178), 2022. Date of Publication: 2022.
Author
Rahmadi A.R.; Pranata R.; Raffaello W.M.; Yonas E.; Ramadhian M.P.;
Natadikarta M.R.R.; Akbar M.R.
Institution
(Rahmadi) Division of Rheumatology, Department of Internal Medicine,
Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General
Hospital, Bandung, Indonesia
(Pranata, Natadikarta, Akbar) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Padjadjaran, Rumah Sakit Umum
Pusat Hasan Sadikin, Bandung, Indonesia
(Raffaello) Faculty of Medicine, Universitas Pelita Harapan, Tangerang,
Indonesia
(Yonas) Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia
(Ramadhian) Department of Internal Medicine, Faculty of Medicine,
Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung,
Indonesia
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: The aim of this systematic review and meta-analysis is to
assess the effect of statin on major adverse cardiovascular events (MACE)
and mortality in patients with RA. MATERIALS AND METHODS: A systematic
literature search was performed using PubMed, Scopus, Embase, and
Clinicaltrials.gov for studies investigating the effect of statin on MACE
and mortality in RA patients up until 6 February 2022. The primary outcome
was MACE, which can be defined as nonfatal myocardial infarction (MI),
nonfatal presumed ischemic stroke, transient ischemic attack, any coronary
or non-coronary revascularization, or cardiovascular death. The pooled
effect estimated was reported as hazard ratio (HR). <br/>RESULT(S): There
were 40,307 patients from a total of six studies, comprising of one
double-blind placebo controlled randomized controlled trial, four
propensity-score matched cohorts, and one observational study included in
this meta-analysis. The rate of MACE was lower in RA patients receiving
statin [OR 0.67 (95%CI 0.51, 0.89), p=0.005; I²: 21.0%, p=0.29]
(Figure 2). Sensitivity analysis using fixed-effect model showed that MACE
was lower in the statin group [OR 0.73 (95%CI 0.62, 0.87), p<0.0051
I²: 21.0%, p=0.29]. Mortality was lower in RA patients
receiving statin [OR 0.73 (95%CI 0.62, 0.88), p<0.001; I²:
29.0%, p=0.25] (Figure 3). Sensitivity analysis using fixed-effect model
showed that mortality was lower in the statin group [OR 0.75 (95%CI 0.66,
0.85), p<0.001 I²: 29.0%, p=0.25]. <br/>CONCLUSION(S): This
systematic review and meta-analysis showed that statin was associated with
reduction of MACE and mortality in patients with RA.<br/>Copyright &#xa9;
2022 Verduci Editore s.r.l. All rights reserved.

<7>
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.
<br/>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). <br/>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). <br/>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).<br/>Copyright &#xa9; 2022, The Author(s).

<8>
[Use Link to view the full text]
Accession Number
2017900071
Title
Control of Postoperative Hypotension Using a Closed-Loop System for
Norepinephrine Infusion in Patients after Cardiac Surgery: A Randomized
Trial.
Source
Anesthesia and Analgesia. 134(5) (pp 964-973), 2022. Date of Publication:
01 May 2022.
Author
Desebbe O.; Rinehart J.; Van der Linden P.; Cannesson M.; Delannoy B.;
Vigneron M.; Curtil A.; Hautin E.; Vincent J.-L.; Duranteau J.; Joosten A.
Institution
(Delannoy, Hautin) Department of Anesthesiology and Perioperative Care,
Ramsay Sante, Sauvegarde Clinic, Lyon, France
(Rinehart) Department of Anesthesiology and Perioperative Care, University
of California, Irvine, Irvine, CA, United States
(Van der Linden) Department of Anesthesiology, Brugmann Hospital,
Universite Libre de Bruxelles, Brussels, Belgium
(Cannesson) Department of Anesthesiology and Perioperative Medicine David
Geffen School of Medicine University of California, Los Angeles, Los
Angeles, CA, United States
(Vigneron, Curtil) Department of Cardiac Surgery, Ramsay Sante, Sauvegarde
Clinic, Lyon, France
(Vincent) Department of Intensive Care, Erasme University Hospital,
Universite Libre de Bruxelles, Brussels, Belgium
(Duranteau, Joosten) Department of Anesthesiology, Intensive Care,
Hopitaux Universitaires Paris-Sud, Universite Paris-Sud, Universite
Paris-Saclay, Bicetre and Paul Brousse Hospitals, Assistance Publique
Hopitaux de Paris, Villejuif, France
(Desebbe, Joosten) Department of Anesthesiology, Erasme University
Hospital, Brussels, Belgium
(Joosten) Department of Anesthesiology and Perioperative Medicine, Bicetre
Hospital, 78, Rue du General Leclerc, Le Kremlin-Bicetre 94270, France
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Vasopressors are a cornerstone for the management of
vasodilatory hypotension. Vasopressor infusions are currently adjusted
manually to achieve a predefined arterial pressure target. We have
developed a closed-loop vasopressor (CLV) controller to help correct
hypotension more efficiently during the perioperative period. We tested
the hypothesis that patients managed using such a system postcardiac
surgery would present less hypotension compared to patients receiving
standard management. <br/>METHOD(S): A total of 40 patients admitted to
the intensive care unit (ICU) after cardiac surgery were randomized into 2
groups for a 2-hour study period. In all patients, the objective was to
maintain mean arterial pressure (MAP) between 65 and 75 mm Hg using
norepinephrine. In the CLV group, the norepinephrine infusion was
controlled via the CLV system; in the control group, it was adjusted
manually by the ICU nurse. Fluid administration was standardized in both
groups using an assisted fluid management system linked to an advanced
hemodynamic monitoring system. The primary outcome was the percentage of
time patients were hypotensive, defined as MAP <65 mm Hg, during the study
period. <br/>RESULT(S): Over the 2-hour study period, the percentage of
time with hypotension was significantly lower in the CLV group than that
in the control group (1.4% [0.9-2.3] vs 12.5% [9.9-24.3]; location
difference, -9.8% [95% CI, -5.4 to -15.9]; P < .001). The percentage of
time with MAP between 65 and 75 mm Hg was also greater in the CLV group
(95% [89-96] vs 66% [59-77]; location difference, 27.6% [95% CI,
34.3-19.0]; P < .001). The percentage of time with an MAP >75 mm Hg (and
norepinephrine still being infused) was also significantly lower in
patients in the CLV group than that in the control group (3.2% [1.9-5.4]
vs 20.6% [8.9-32.5]; location difference, -17% [95% CI, -10 to -24]; P <
.001). The number of norepinephrine infusion rate modifications over the
study period was greater in the CLV group than that in the control group
(581 [548-597] vs 13 [11-14]; location difference, 568 [578-538]; P <
.001). No adverse event occurred during the study period in both groups.
<br/>CONCLUSION(S): Closed-loop control of norepinephrine infusion
significantly decreases postoperative hypotension compared to manual
control in patients admitted to the ICU after cardiac surgery. (Anesth
Analg 2022;134:964-73).<br/>Copyright &#xa9; 2022 International Anesthesia
Research Society

<9>
Accession Number
2016662544
Title
Balloon-Expandable Cheatham-Platinum Stents Versus Self-Expandable Nitinol
Stents in Coarctation of Aorta: A Randomized Controlled Trial.
Source
JACC: Cardiovascular Interventions. 15(3) (pp 308-317), 2022. Date of
Publication: 14 Feb 2022.
Author
Sadeghipour P.; Mohebbi B.; Firouzi A.; Khajali Z.; Saedi S.; Shafe O.;
Pouraliakbar H.R.; Alemzadeh-Ansari M.J.; Shahdi S.; Samiei N.; Sadeghpour
A.; Babaei M.; Ghadrdoost B.; Afrooghe A.; Rokni M.; Dabbagh Ohadi M.A.;
Hosseini Z.; Abdi S.; Maleki M.; Bassiri H.-A.; Haulon S.; Moosavi J.
Institution
(Sadeghipour, Mohebbi, Firouzi, Shafe, Alemzadeh-Ansari, Ghadrdoost,
Rokni, Hosseini, Abdi, Bassiri, Moosavi) Cardiovascular Intervention
Research Center, Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Khajali, Saedi, Pouraliakbar, Shahdi, Maleki) Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Samiei, Sadeghpour, Maleki) Echocardiography Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Babaei, Afrooghe) School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Dabbagh Ohadi) Students' Scientific Research Center, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Haulon) Aortic Centre, Hopital Marie Lannelongue, Groupe Hospitalier
Paris Saint Joseph, Universite Paris-Saclay, Paris, France
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to compare the safety and efficacy of the
balloon-expandable stent (BES) and the self-expandable stent (SES) in the
endovascular treatment of coarctation of aorta. <br/>Background(s):
Coarctoplasty with stents has conferred promising results. Although
several nonrandomized studies have approved the safety and efficacy of the
BES and the SES, no high-quality evidence exists for this comparison.
<br/>Method(s): In the present open-label, parallel-group, blinded
endpoint randomized pilot clinical trial, adult patients with de novo
native aortic coarctation were randomized into Cheatham-platinum BES and
uncovered nitinol SES groups. The primary outcome of the study was a
composite of procedural and vascular complications. The secondary outcomes
of the study consisted of the incidence of aortic recoarctation, thoracic
aortic aneurysm/pseudoaneurysm formation, and residual hypertension at a
12-month follow-up. <br/>Result(s): Among 105 patients who were screened
between January 2017 and December 2019, 92 eligible patients (32 women
[34.8%]) with a median age of 30 years (IQR: 20-36 years) were randomized
equally into the BES and SES groups. The composite of procedural and
vascular complications occurred in 10.9% of the BES group and 2.2% of the
SES group (odds ratio: 0.18; 95% CI: 0.02-1.62; P = 0.20). Aortic
recoarctation occurred in 5 patients (5.4%), 3 patients (6.5%) in the BES
group and 2 patients (4.3%) in the SES group (odds ratio: 0.65; 95% CI:
0.10-4.09; P = 0.64). Only 1 patient (1.1%) was complicated by aortic
pseudoaneurysm. Hypertension control was achieved in 50% of the study
population, with an equal distribution in the 2 study groups at the
12-month follow-up. <br/>Conclusion(s): Both the BES and the SES were safe
and effective in the treatment of native coarctation.<br/>Copyright &#xa9;
2022 American College of Cardiology Foundation

<10>
Accession Number
2015687466
Title
Meta-Analysis Investigating the Role of Optical Coherence Tomography
Versus Intravascular Ultrasound in Low-Risk Percutaneous Coronary
Intervention.
Source
American Journal of Cardiology. 164 (pp 136-138), 2022. Date of
Publication: 01 Feb 2022.
Author
Saleh Y.; Al-abcha A.; Abdelkarim O.; Abdelfattah O.M.; Abela G.S.; Hashim
H.; Goel S.S.; Kleiman N.S.
Institution
(Saleh, Abdelkarim, Goel, Kleiman) Department of Cardiology, Houston
Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
(Saleh, Abdelkarim) Department of Cardiology, Alexandria University,
Alexandria, Egypt
(Al-abcha) Department of Internal Medicine, Michigan State University,
East Lansing, MI, United States
(Abdelfattah) Department of Internal Medicine, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(Abela) Department of Cardiology, Michigan State University, East Lansing,
MI, United States
(Hashim) Department of Cardiology, Medstar Washington Hospital Center,
Washington, DC, United States
Publisher
Elsevier Inc.

<11>
Accession Number
2014199640
Title
Comparison of the analgesic effect of ultrasound-guided paravertebral
block and ultrasound-guided retrolaminar block in Uniportal video-assisted
Thoracoscopic surgery: a prospective, randomized study.
Source
BMC Cancer. 21(1) (no pagination), 2021. Article Number: 1229. Date of
Publication: December 2021.
Author
Wang Q.; Wei S.; Li S.; Yu J.; Zhang G.; Ni C.; Sun L.; Zheng H.
Institution
(Wang, Wei, Li, Yu, Zhang, Ni, Zheng) Department of Anesthesiology,
National Cancer Center/National Clinical Research Center for Cancer/Cancer
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, No. 17, Panjiayuannanli, Chaoyang District, Beijing 100021, China
(Sun) Department of Anesthesiology, National Cancer Center/National
Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Shenzhen 518116, China
Publisher
BioMed Central Ltd
Abstract
Background: The optimal modality for postoperative analgesia after
uniportal video-assisted thoracoscopic surgery (UVATS) for the treatment
of lung cancer has not yet been determined. Both ultrasound-guided
paravertebral block (PVB) and retrolaminar block (RLB) have been reported
to be successful in providing analgesia after UVATS. However, which block
technique provides superior analgesia after UVATS is still unclear. This
randomized study was designed to compare the postoperative analgesic
effects and adverse events associated with ultrasound-guided PVB and RLB
after UVATS. <br/>Method(s): Sixty patients with lung cancer were
randomized to undergo ultrasound-guided PVB (group P) or ultrasound-guided
RLB (group R). In group P, 30 mL of 0.5% ropivacaine was injected at the
T3 and T5 levels via ultrasound-guided PVB (15 mL at each level on the
operative side). In group R, 30 mL of 0.5% ropivacaine was injected at the
T3 and T5 levels via ultrasound-guided RLB (15 mL at each level on the
operative side). The primary outcome was the numerical rating scale (NRS)
score within 48 h after surgery. The secondary outcomes were total
postoperative sufentanil consumption, time to first analgesic request and
adverse events. <br/>Result(s): At 3, 6, 12, 24, 36 and 48 h
postoperatively, the NRS score at rest in group P was lower than that in
group R (p < 0.05). At 3, 6, 12, 24 and 36 h postoperatively, the NRS
score while coughing in group P was lower than that in group R (p < 0.05).
The total postoperative sufentanil consumption in group P was
significantly lower than that in group R (p < 0.001). Additionally, the
time to first analgesic request was longer in group R than in group P (p <
0.0001). The incidence of nausea in group R was higher than that in group
P (p < 0.05). <br/>Conclusion(s): In patients with lung cancer undergoing
UVATS, ultrasound-guided PVB with 0.5% ropivacaine provides better
analgesia and results in less nausea than ultrasound-guided RLB. Compared
with ultrasound-guided RLB, ultrasound-guided PVB seems to be a better
technique for analgesia in UVATS. Trial registration: The name of this
study is the Effect And Mechanism Of Ultrasound-guided Multimodal Regional
Nerve Block On Acute And Chronic Pain After Thoracic Surgery. This study
was registered in the Chinese Clinical Trial Registry (ChiCTR2100044060).
The date of registration was March 9, 2021.<br/>Copyright &#xa9; 2021, The
Author(s).

<12>
Accession Number
634852832
Title
Pharmacogenomics of the Efficacy and Safety of Colchicine in COLCOT.
Source
Circulation: Genomic and Precision Medicine. 14(2) (pp E003183), 2021.
Date of Publication: 01 Apr 2021.
Author
Dube M.-P.; Legault M.-A.; Lemacon A.; Lemieux Perreault L.-P.; Fouodjio
R.; Waters D.D.; Kouz S.; Pinto F.J.; Maggioni A.P.; Diaz R.; Berry C.;
Koenig W.; Lopez-Sendon J.; Gamra H.; Kiwan G.S.; Asselin G.; Provost S.;
Barhdadi A.; Sun M.; Cossette M.; Blondeau L.; Mongrain I.; Dubois A.;
Rhainds D.; Bouabdallaoui N.; Samuel M.; De Denus S.; L'Allier P.L.;
Guertin M.-C.; Roubille F.; Tardif J.-C.
Institution
(Dube, Legault, Lemacon, Lemieux Perreault, Fouodjio, Asselin, Provost,
Barhdadi, Sun, Cossette, Blondeau, Mongrain, Dubois, Rhainds,
Bouabdallaoui, Samuel, De Denus, L'Allier, Guertin, Tardif) Montreal Heart
Institute, Universite De Montreal, Canada
(Dube, Legault, Lemacon, Lemieux Perreault, Fouodjio, Asselin, Provost,
Barhdadi, Sun, Cossette, Blondeau, Mongrain, Dubois, Rhainds,
Bouabdallaoui, Samuel, De Denus) Universite De Montreal Beaulieu-Saucier
Pharmacogenomics Centre, Universite De Montreal, Canada
(Dube, Lemacon, Sun, Bouabdallaoui, Samuel, Guertin) Department Of
Medicine, Universite De Montreal, Canada
(Legault) Departments Of Biochemistry And Molecular Medicine, Faculty Of
Medicine, Universite De Montreal, Canada
(Waters) San Francisco General Hospital, CA, United States
(Kouz) Centre Hospitalier Regional De Lanaudiere, Joliette, Canada
(S.K.)., Canada
(Pinto) Santa Maria University Hospital (CHULN), Caml, Ccul, Faculdade De
Medicina Da Universidade De Lisboa, Portugal
(Maggioni) Maria Cecilia Hospital, Gvm Care And Research, Italy
(Diaz) Estudios Clinicos Latinoamerica, Rosario, Argentina
(Berry) University Of Glasgow, Nhs Glasgow Clinical Research Facility,
United Kingdom
(Koenig) Deutsches Herzzentrum Munchen, Technische Universitat Munchen,
Munich, Germany
(Koenig) Dzhk (German Centre For Cardiovascular Research), Munich Heart
Alliance, Munich, Germany
(Koenig) Institute Of Epidemiology And Medical Biometry, University Of
Ulm, Germany
(Lopez-Sendon) H La Paz, IdiPaz, Uam, Ciber-CV, Madrid, Spain
(Gamra) Fattouma Bourguiba University Hospital, Monastir, Tunisia
(Kiwan) Bellevue Medical Centre, Beirut, Lebanon
(Cossette, Blondeau, Guertin) Montreal Health Innovation Coordinating
Centre, Canada
(De Denus) Universite De Montreal, Faculty Of Pharmacy, Canada, Canada
(Roubille) PhyMedExp (Physiologie Et Medecine Experimentale Du Coeur Et
Des Muscles), Universite De Montpellier, Inserm, Centre National De La
Recherche Scientifique, Cardiology Department, CHU de Montpellier, France
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The randomized, placebo-controlled COLCOT (Colchicine
Cardiovascular Outcomes Trial) has shown the benefits of colchicine 0.5 mg
daily to lower the rate of ischemic cardiovascular events in patients with
a recent myocardial infarction. Here, we conducted a post hoc
pharmacogenomic study of COLCOT with the aim to identify genetic
predictors of the efficacy and safety of treatment with colchicine.
<br/>Method(s): There were 1522 participants of European ancestry from the
COLCOT trial available for the pharmacogenomic study of COLCOT trial. The
pharmacogenomic study's primary cardiovascular end point was defined as
for the main trial, as time to first occurrence of cardiovascular death,
resuscitated cardiac arrest, myocardial infarction, stroke, or urgent
hospitalization for angina requiring coronary revascularization. The
safety end point was time to the first report of gastrointestinal events.
Patients' DNA was genotyped using the Illumina Global Screening array
followed by imputation. We performed a genome-wide association study in
colchicine-treated patients. <br/>Result(s): None of the genetic variants
passed the genome-wide association study significance threshold for the
primary cardiovascular end point conducted in 702 patients in the
colchicine arm who were compliant to medication. The genome-wide
association study for gastrointestinal events was conducted in all 767
patients in the colchicine arm and found 2 significant association
signals, one with lead variant rs6916345 (hazard ratio, 1.89 [95% CI,
1.52-2.35], P=7.41x10-9) in a locus which colocalizes with Crohn disease,
and one with lead variant rs74795203 (hazard ratio, 2.51 [95% CI,
1.82-3.47]; P=2.70x10-8), an intronic variant in gene SEPHS1. The
interaction terms between the genetic variants and treatment with
colchicine versus placebo were significant. <br/>Conclusion(s): We found 2
genomic regions associated with gastrointestinal events in patients
treated with colchicine. Those findings will benefit from replication to
confirm that some patients may have genetic predispositions to lower
tolerability of treatment with colchicine.<br/>Copyright &#xa9; 2021
American Heart Association, Inc.

<13>
Accession Number
2018025383
Title
Real-time ultrasound-guided versus anatomic landmark-based thoracic
epidural placement: a prospective, randomized, superiority trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 198. Date
of Publication: December 2022.
Author
Pakpirom J.; Thatsanapornsathit K.; Kovitwanawong N.; Petsakul S.;
Benjhawaleemas P.; Narunart K.; Boonchuduang S.; Karmakar M.K.
Institution
(Pakpirom, Thatsanapornsathit, Kovitwanawong, Petsakul, Benjhawaleemas,
Narunart, Boonchuduang) Department of Anesthesiology, Faculty of Medicine,
Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
(Karmakar) Department of Anaesthesia and Intensive Care, Faculty of
Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital,
Shatin, New Territories, SAR, Hong Kong
Publisher
BioMed Central Ltd
Abstract
Background: Thoracic epidural placement (TEP) using the conventional
anatomic landmark-based technique is technically challenging, may require
multiple attempts, and is associated with a high failure rate (12-40%). We
hypothesized that real-time ultrasound guidance would be superior in the
"first-pass" success rate of TEP, when compared with the conventional
technique. <br/>Method(s): This prospective, randomized, superiority trial
was conducted in a University hospital, and recruited 96 patients
undergoing elective major abdominal or thoracic surgery and scheduled to
receive a TEP for postoperative analgesia. Patients were randomly
allocated to receive TEP using either the conventional technique (Gp-Conv,
n = 48) or real-time ultrasound guidance (Gp-Usg, n = 48). The success of
TEP was defined as eliciting loss of resistance technique and being able
to insert the epidural catheter. The primary outcome variable was the
"first-pass success rate" meaning the successful TEP at the first needle
insertion without redirection or readvancement of the Tuohy needle. The
secondary outcomes included the number of skin punctures, number of
attempts, the overall success rate, TEP time, and total procedure time.
<br/>Result(s): The first-pass success rate of TEP was significantly
higher (p = 0.002) in Gp-Usg (33/48 (68.8%); 95%CI 55.6 to 81.9) than in
Gp-Conv (17/48 (35.4%); 95%CI 21.9 to 49.0). There was no statistically
significant difference (p = 0.12) in the overall success rate of TEP
between the 2 study groups (Gp-Usg; 48/48 (100%) vs. Gp-Conv; 44/48
(91.7%); 95%CI 83.9 to 99.5). Ultrasound guidance reduced the median
number of skin punctures (Gp-Usg; 1 [1, 1] vs Gp-Conv; 2 [1, 2.2], p <
0.001) and attempts at TEP (Gp-Usg; 1 [1, 2] vs Gp-Conv; 3 [1, 7.2], p <
0.001) but the procedure took longer to perform (Gp-Usg; 15.5 [14, 20] min
vs Gp-Conv; 10 [7, 14] min, p < 0.001). <br/>Conclusion(s): This study
indicates that real-time ultrasound guidance is superior to a conventional
anatomic landmark-based technique for first-pass success during TEP
although it is achieved at the expense of a marginally longer total
procedure time. Future research is warranted to evaluate the role of
real-time ultrasound guidance for TEP in other groups of patients. Trial
registration: Thai Clinical Trials Registry;
http://www.thaiclinicaltrials.org/; Trial ID: TCTR20200522002,
Registration date: 22/05/2020.<br/>Copyright &#xa9; 2022, The Author(s).

<14>
Accession Number
638322392
Title
Direct oral anticoagulants in patients with a left-sided bioprosthetic
heart valve: a systematic review and meta-analysis.
Source
Italian Journal of Medicine. Conference: 27. Congresso Nazionale della
Societa Scientifica FADOI. Roma Italy. 16(SUPPL 1) (pp 39), 2022. Date of
Publication: May 2022.
Author
Galliazzo S.; Pelitti V.; Poli D.; Squizzato A.
Institution
(Galliazzo) Internal Medicine, AULSS 2 Marca Trevigiana, Montebelluna,
Italy
(Pelitti) Internal Medicine Residency Program, School of Medicine,
University of Insubria, Varese and Como, Italy
(Poli) Thrombosis Center, Azienda Ospedaliero-Universitaria Careggi,
Florence, Italy
(Squizzato) Research Center on Thromboembolic Disorders and Antithrombotic
Therapies, ASST Lariana, University of Insubria, Como, Italy
Publisher
Page Press Publications
Abstract
Background and Aim: Currently no sound evidence exists on the use of DOACs
in patients with a bioprosthetic heart valve (BHV) and AF. Their efficacy
and safety profile is even less known during the critical prothrombotic
period of the first 3 months after BHV surgical implantation. This
systematic review aimed to compare the efficacy and safety of DOACs vs
VKAs both in patients with a previously and newly surgically implanted BHV
with or without AF. <br/>Method(s): A systematic search on MEDLINE and
EMBASE was performed till October 2021. Treatment effects were estimated
with RR and 95% CIs. <br/>Result(s): 3 RCTs (DAWA, RIVER, ENAVLE), 2
subgroup analysis from ARISTOTLE and ENGAGE AF-TIMI 48 and 3 observational
studies were included for a total of 4726 patients of whom 1528 on DOACs
and 3198 on VKAs. Overall, DOACs yielded a RR for stroke/TIA/SE of
0.70(95%CI 0.51-0.95, I2=0%) and for major bleeding (MB) of 0.50(95%CI
0.38-0.66, I2=22%) at the fixedeffect model vs VKAs in a median follow-up
of 16.85 months (IQR 26.95). In the 3 RCTs, DOACs were associated with a
RR of stroke/TIA/SE and MB of 0.38(95%CI 0.13-1.13, I2=0%) and of
0.68(95%CI 0.32-1.44, I2=5%) respectively, vs VKAs. During the first 3
months from valve surgery, DOACs were associated with a non-significant
reduction of stroke/TIA/SE vs VKAs (RR=0.28;95%CI 0.05-1.66; I2=0%).
<br/>Conclusion(s): In previously implanted BHV patients with AF, DOACs
showed a favourable risk-benefit profile at least comparable to VKAs.
DOACs showed a similar, even if underpowered, risk-benefit profile also
during the first 3 months after valve surgery.

<15>
Accession Number
638322218
Title
Pericardial effusion in patients affected by pectus excavatum, prevalence
and prognosis: A case-control study.
Source
Italian Journal of Medicine. Conference: 27. Congresso Nazionale della
Societa Scientifica FADOI. Roma Italy. 16(SUPPL 1) (pp 17-18), 2022. Date
of Publication: May 2022.
Author
Carollo C.R.G.; Pedroli A.; Pisacreta A.M.; Lorentino C.; Mascolo R.;
Casarin F.; Di Marco G.S.; Baldacci B.; Montori D.; Brucato A.L.
Institution
(Carollo, Pedroli, Pisacreta, Lorentino, Mascolo, Casarin, Di Marco,
Baldacci, Montori) Internal Medicine, Fatebenefratelli Hospital, Milano,
Italy
(Brucato) University of Milano, Department of biomedical and clinical
sciences "Luigi Sacco", Fatebenefratelli Hospital, Milano, Italy
Publisher
Page Press Publications
Abstract
Background: Pectus excavatum (PEx) has been associated with pericardial
effusion (PEF). Aim of the study was to compare incidence, evolution and
prognosis of PEF observed in a group of patients with PEx vs a control
group. <br/>Method(s): Subjects from a prospective registry of consecutive
patients who underwent chest CT for CVD with a radiological diagnosis of
PEx were retrospectively identified; from the same registry patients used
as controls without PEx were randomly selected to reach a 1:2 ratio. PEF
was quantified and follow-up was obtained for a composite end-point:
cardiac tamponade, need for pericardiocentesis, need for cardiac surgery.
<br/>Result(s): 43 patients with PEx (23 males) and a control group of 86
cases (55 males) without rib cage abnormalities were identified for
analysis. PEF evaluated at CT was significatively more prevalent in
patients with PEx vs control group, 37.2% vs 13.9% (p<0.001); four
patients with PEx (9.3%) had at least moderate PEF vs no subjects in
controls (p=0.004). PEx diagnosis was significantly associated to
pericardial effusion at multi-variate analysis (OR 95%CI 10.91
[3.47-34.29], p<0.001). At a mean follow-up of 6.5+/-3.4 years no
pericardial events were recorded. <br/>Conclusion(s): We observed a higher
prevalence of PEF in patients with PEx when compared to a control group.
The absence of adverse pericardial events at follow-up suggests the good
prognosis of these effusions, that in the appropriate clinical setting
might not be considered "idiopathic".

<16>
Accession Number
2018946078
Title
The trial to assess chelation therapy 2 (TACT2): Rationale and design.
Source
American Heart Journal. 252 (pp 1-11), 2022. Date of Publication: October
2022.
Author
Lamas G.A.; Anstrom K.J.; Navas-Acien A.; Boineau R.; Kim H.; Rosenberg
Y.; Stylianou M.; Jones T.L.Z.; Joubert B.R.; Santella R.M.; Escolar E.;
Aude Y.W.; Fonseca V.; Elliott T.; Lewis E.F.; Farkouh M.E.; Nathan D.M.;
Mon A.C.; Gosnell L.; Newman J.D.; Mark D.B.
Institution
(Lamas, Escolar, Mon) Division of Cardiology, Mount Sinai Medical Center,
Miami Beach, FL, United States
(Anstrom) Gillings School of Global Public Health, University of North
Carolina, Chapel Hill, NC, United States
(Navas-Acien, Santella) Columbia University Mailman School of Public
Health, New York, NY, United States
(Boineau) National Center for Complementary and Integrative Health,
National Institutes of Health, Bethesda, MD, United States
(Kim, Gosnell, Mark) Duke Clinical Research Institute, Duke University,
Durham, NC, United States
(Rosenberg, Stylianou) National Heart, Lung and Blood Institute, National
Institutes of Health, Bethesda, MD, United States
(Jones) National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Bethesda, MD, United States
(Joubert) National Institute of Environmental Health Sciences, National
Institutes of Health, Durham, NC, United States
(Aude) Heart and Vascular Specialists of South Texas, McAllen, TX, United
States
(Fonseca) Tulane University School of Medicine, New Orleans, LA, United
States
(Elliott) BC Diabetes, Vancouver, BC, United States
(Lewis) Stanford University School of Medicine, Palo Alto, CA, United
States
(Farkouh) Peter Munk Cardiac Centre, University of Toronto, ON, Canada
(Nathan) Massachusetts General Hospital, Harvard Medical School, Boston,
MA, United States
(Newman) New York University School of Medicine, New York, NY, United
States
Publisher
Elsevier Inc.
Abstract
Background: Intravenous edetate disodium-based infusions reduced
cardiovascular events in a prior clinical trial. The Trial to Assess
Chelation Therapy 2 (TACT2) will replicate the initial study design.
<br/>Method(s): TACT2 is an NIH-sponsored, randomized, 2x2 factorial,
double masked, placebo-controlled, multicenter clinical trial testing 40
weekly infusions of a multi-component edetate disodium (disodium
ethylenediamine tetra-acetic acid, or Na<inf>2</inf>EDTA)-based chelation
solution and twice daily oral, high-dose multivitamin and mineral
supplements in patients with diabetes and a prior myocardial infarction
(MI). TACT2 completed enrollment of 1000 subjects in December 2020, and
infusions in December 2021. Subjects are followed for 2.5 to 5 years. The
primary endpoint is time to first occurrence of all-cause mortality, MI,
stroke, coronary revascularization, or hospitalization for unstable
angina. The trial has >;85% power to detect a 30% relative reduction in
the primary endpoint. TACT2 also includes a Trace Metals and Biorepository
Core Lab, to test whether benefits of treatment, if present, are due to
chelation of lead and cadmium from patients. Design features of TACT2 were
chosen to replicate selected features of the first TACT, which
demonstrated a significant reduction in cardiovascular outcomes in the
EDTA chelation arm compared with placebo among patients with a prior MI,
with the largest effect in patients with diabetes. <br/>Result(s): Results
are expected in 2024. <br/>Conclusion(s): TACT2 may provide definitive
evidence of the benefit of edetate disodiumbased chelation on
cardiovascular outcomes, as well as the clinical importance of
longitudinal changes in toxic metal levels of participants.<br/>Copyright
&#xa9; 2022 The Authors

<17>
Accession Number
2017954462
Title
Association of Diabetes Mellitus With Postoperative Complications and
Mortality After Non-Cardiac Surgery: A Meta-Analysis and Systematic
Review.
Source
Frontiers in Endocrinology. 13 (no pagination), 2022. Article Number:
841256. Date of Publication: 26 May 2022.
Author
Zhang X.; Hou A.; Cao J.; Liu Y.; Lou J.; Li H.; Ma Y.; Song Y.; Mi W.;
Liu J.
Institution
(Zhang, Hou, Cao, Liu, Lou, Li, Ma, Song, Mi, Liu) Department of
Anesthesiology, The First Medical Center of Chinese, PLA General Hospital,
Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Although a variety of data showing that diabetes mellitus (DM)
(Type 1 or Type 2) is associated with postoperative complication, there is
still a lack of detailed studies that go through the specific diabetic
subgroups. The goal of this meta-analysis is to assess the relationship
between DM and various complications after non-cardiac surgery.
<br/>Method(s): We searched articles published in three mainstream
electronic databases (PubMed, EMBASE, Web of science) before November,
2020. A random effects model was conducted since heterogeneity always
exist when comparing results between different types of surgery.
<br/>Result(s): This paper included 125 studies with a total sample size
of 3,208,776 participants. DM was a risk factor for any postoperative
complication (Odds ratio (OR)=1.653 [1.487, 1.839]). The risk of
insulin-dependent DM (OR=1.895 [1.331, 2.698]) was higher than that of
non-insulin-dependent DM (OR=1.554 [1.061, 2.277]) for any postoperative
complication. DM had a higher risk of infections (OR=1.537 [1.322,
1.787]), wound healing disorders (OR=2.010 [1.326, 3.046]), hematoma
(OR=1.369 [1.120, 1.673]), renal insufficiency (OR=1.987 [1.311, 3.013]),
myocardial infarction (OR=1.372 [0.574, 3.278]). Meanwhile, DM was a risk
factor for postoperative reoperation (OR=1.568 [1.124, 2.188]),
readmission (OR=1.404 [1.274, 1.548]) and death (OR=1.606 [1.178, 2.191]).
<br/>Conclusion(s): DM is a risk factor for any postoperative
complications, hospitalization and death after non-cardiac surgery. These
findings underscore the importance of preoperative risk factor assessment
of DM for the safe outcome of surgical patients.<br/>Copyright &#xa9; 2022
Zhang, Hou, Cao, Liu, Lou, Li, Ma, Song, Mi and Liu.

<18>
Accession Number
638331218
Title
Autologous bone marrow stem cell transplantation for patients undergoing
coronary artery bypass grafting: a meta-analysis of 22 randomized
controlled trials.
Source
Journal of cardiothoracic surgery. 17(1) (pp 167), 2022. Date of
Publication: 25 Jun 2022.
Author
Song J.; He K.; Hou J.
Institution
(Song, He, Hou) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Chengdu, Sichuan 610041, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although the safety and feasibility of coronary artery bypass
grafting (CABG) and bone marrow stem cell (BMSC) transplantation have been
established, the effectiveness of this approach compared with CABG alone
remains controversial. The aim of this updated meta-analysis of randomized
controlled trials was to evaluate the efficacy of this procedure.
<br/>METHOD(S): A random-effects meta-analysis was conducted using studies
sourced from the PubMed, Embase, and Cochrane literature databases to
compare patients who received isolated CABG (CABG group) and BMSC
transplantation with CABG (BMSC group). 22 studies were included.
<br/>RESULT(S): A total of 22 relevant publications with 820 patients were
included. 432 patients received BMSC transplantation with CABG and 388
patients received isolated CABG. Compared with the CABG group, the BMSC
transplantation group exhibited an improvement in the left ventricular
(LV) ejection fraction (mean difference (MD)=3.87%; 95% confidence
interval (CI): 1.93-5.80%; P<0.001). <br/>CONCLUSION(S): The present
evidence suggests that autologous BMSC transplantation for patients
undergoing CABG appears to be associated with an improvement in LV
function compared with CABG alone. However, heterogeneity in the data
suggests that patients respond differently to this therapy. Further
research is needed to understand these differences.<br/>Copyright &#xa9;
2022. The Author(s).

<19>
Accession Number
638329246
Title
Long-Term Outcomes of Ross Procedure versus Mechanical Aortic Valve
Replacement: Meta-Analysis of Reconstructed Time-To-Event Data.
Source
Trends in cardiovascular medicine. (no pagination), 2022. Date of
Publication: 21 Jun 2022.
Author
Sa M.P.; Van den Eynde J.; Jacquemyn X.; Tasoudis P.; Erten O.; McDonald
C.; Weymann A.; Ruhparwar A.; Clavel M.-A.; Pibarot P.; Calhoon J.;
Ramlawi B.
Institution
(Sa) Department of Cardiothoracic Surgery, Lankenau Heart Institute,
Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA;
Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, Pennsylvania, USA. Electronic address:
michel_pompeu@yahoo.com.br
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Tasoudis, Erten) Department of Cardiothoracic Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, PA, United States
(McDonald, Calhoon) Department of Cardiothoracic Surgery, University of
Texas Health Science Center at San Antonio, Long School of Medicine, San
Antonio, TX, United States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University of Duisburg-Essen, Essen, Germany
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada;
Department of Medicine, Faculty of Medicine, Universite Laval, Quebec
City, Quebec, Canada
(Ramlawi) Department of Cardiothoracic Surgery, Lankenau Heart Institute,
Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA;
Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, Pennsylvania, USA
Publisher
NLM (Medline)
Abstract
In the era of lifetime management of aortic valve disease, the Ross
procedure emerged as an alternative to prosthetic heart valves for young
adults; however, more long-term data are warranted. We performed a
meta-analysis of reconstructed time-to-event data to compare long-term
outcomes between the Ross procedure and mechanical aortic valve
replacement (mAVR) in young adults. PubMed/MEDLINE, EMBASE and
GoogleScholar were searched for studies comparing Ross procedure with mAVR
that reported mortality/survival rates and/or reoperation rates
accompanied by at least one Kaplan-Meier curve for any of the outcomes.
Six observational studies (5 with propensity score matching) including
5024 patients (Ross: 1737; mAVR: 3287) met our inclusion criteria.
Patients who underwent Ross had a significantly lower risk of mortality in
the overall population (HR 0.38, 95%CI 0.30-0.49, P<0.001; median
follow-up of 7.2 years) and in the propensity score matched cohorts (HR
0.55, 95%CI 0.42-0.73, P<0.001; median follow-up of 10.2 years); however,
the incidence function for the cumulative risk of reoperation was higher
for the Ross procedure (HR 1.91, 95%CI 1.36-2.70, P<0.001; median
follow-up of 9.3 years). Data from observational studies suggest that the
Ross procedure is associated with lower all-cause mortality compared with
mAVR; however, there is a higher risk of reoperation. Besides serving as
basis to inform patients about benefits and risks involved in this choice,
these results call for further randomized clinical trials to determine
whether the Ross procedure can achieve its potential benefits in young
patients in need of AVR.<br/>Copyright &#xa9; 2022. Published by Elsevier
Inc.

<20>
Accession Number
638323817
Title
External Support for Saphenous Vein Grafts in Coronary Artery Bypass
Surgery: A Randomized Clinical Trial.
Source
JAMA Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Goldstein D.J.; Puskas J.D.; Alexander J.H.; Chang H.L.; Gammie J.S.;
Marks M.E.; Iribarne A.; Vengrenyuk Y.; Raymond S.; Taylor B.S.; Yarden
O.; Orion E.; Dagenais F.; Ailawadi G.; Chu M.W.A.; Dimaio J.M.; Narula
J.; Moquete E.G.; O'sullivan K.; Williams J.B.; Crestanello J.A.; Jessup
M.; Rose E.A.; Scavo V.; Acker M.A.; Gillinov M.; Mack M.J.; Gelijns A.C.;
O'gara P.T.; Moskowitz A.J.; Bagiella E.; Voisine P.
Institution
(Goldstein) Department of Cardiovascular and Thoracic Surgery, Montefiore
Medical Center, Bronx, NY, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside,
New York, NY, United States
(Alexander) Department of Medicine, Division of Cardiology, Duke
University Medical Center, Durham, NC, United States
(Chang, Marks, Raymond, Moquete, O'sullivan, Rose, Gelijns, Moskowitz,
Bagiella) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Gammie) Johns Hopkins Heart and Vascular Institute, Johns Hopkins Health
System, Baltimore, MD, United States
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
Lebanon, NH, United States
(Vengrenyuk) Division of Cardiology, Mount Sinai Hospital, Icahn School of
Medicine at Mount Sinai, New York, United States
(Taylor) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, United States
(Yarden, Orion) Vascular Graft Solutions Ltd, Tel Aviv, Israel
(Dagenais, Voisine) Department of Surgery, Institut de Cardiologie et
Pneumologie de Quebec, Quebec City, QC, Canada
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, United States
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, ON, Canada
(Dimaio, Mack) Cardiothoracic Surgery, Baylor Scott & White Health, Plano,
TX, United States
(Narula) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Williams) Cardiovascular Surgery, WakeMed Health and Hospitals, Raleigh,
NC, United States
(Crestanello) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, MN, United States
(Jessup) American Heart Association, Dallas, TX, United States
(Scavo) Cardiovascular and Thoracic Surgery, Lutheran Medical Group, Fort
Wayne, IN, United States
(Acker) Division of Cardiovascular Surgery, University of Pennsylvania,
Hospital of the University of Pennsylvania, Philadelphia, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(O'gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
Publisher
American Medical Association
Abstract
Importance: Intimal hyperplasia and subsequent saphenous vein graft
failure may have significant adverse clinical effects in patients
undergoing coronary artery bypass surgery. External support of saphenous
vein grafts has the potential to prevent vein graft dilation and hence
slow the rate of intimal hyperplasia and increase long-term vein patency.
<br/>Objective(s): To determine efficacy, as measured by intimal
hyperplasia, and safety of an external saphenous vein graft support device
in patients undergoing a coronary bypass graft procedure. <br/>Design,
Setting, and Participant(s): This within-patient randomized, open-label,
multicenter study was conducted at 17 Cardiothoracic Surgical Trials
Network centers in North America. Between January 2018 and February 2019,
224 patients with multivessel coronary artery disease undergoing isolated
bypass surgery were enrolled. For each patient, 1 of 2 vein grafts was
randomized to receive external support or no support.
<br/>Intervention(s): External vein graft support or no support. <br/>Main
Outcomes and Measures: The primary efficacy end point was intimal
hyperplasia area assessed by intravascular ultrasound at 12 months
postrandomization for each study graft. Secondary confirmatory end points
were lumen diameter uniformity assessed by angiography and graft failure
(>=50% stenosis) by quantitative coronary angiography. Major cardiac and
cerebrovascular events were collected through month 12. <br/>Result(s):
Among 224 patients (mean [SD] age, 65.8 [8.3] years; 178 [79.5%] male),
203 (90.6%) were eligible for intravascular ultrasound, of which 85
(41.9%) had at least 1 study graft occluded or severely diseased at 12
months (55 supported, 56 unsupported). After imputation of data missing
because of graft occlusion or severe disease, the estimated mean (SE)
intimal hyperplasia area was 5.11 (0.16) mm²in supported grafts
and 5.79 (0.20) mm²in unsupported grafts (P =.07). In a
sensitivity analysis of 113 patients with both grafts imaged, the mean
intimal hyperplasia area was 4.58 (0.18) mm²and 5.12 (0.23)
mm²in supported and unsupported grafts, respectively (P =.04).
By 12 months, 5 patients (2.2%) died and 16 patients (7.1%) experienced a
major cardiac or cerebrovascular event. <br/>Conclusions and Relevance:
The 12-month difference in intimal hyperplasia area between supported and
unsupported grafts did not achieve statistical significance. Cumulative
mortality and major cardiac or cerebrovascular events rates were similar
to those in other randomized coronary artery bypass trials. Further
investigation to assess the effect of external graft support devices on
long-term graft patency and clinical outcomes is warranted. Trial
Registration: ClinicalTrials.gov Identifier: NCT03209609.<br/>Copyright
&#xa9; 2022 American Medical Association. All rights reserved.

<21>
Accession Number
638321169
Title
Intraoperative epicardial echocardiography or transoesophageal
echocardiography in CHD: how much does it matter?.
Source
Cardiology in the young. (pp 1-8), 2022. Date of Publication: 24 Jun
2022.
Author
Stauffer K.J.; Brabender J.; Reddy C.D.; Selamet Tierney E.S.; Lopez L.;
Maeda K.; Navaratnam M.; Punn R.
Institution
(Stauffer, Reddy, Selamet Tierney, Lopez, Navaratnam, Punn) Division of
Pediatric Cardiology, Lucile Packard Children's Hospital, Stanford
University Medical Center, Palo Alto, CA, USA
(Brabender) University of Wisconsin - Health Kids - American Family
Children's Hospital, WI, Madison, United States
(Maeda) Children's Hospital of Philadelphia, Perelman School of Medicine
at the University of Pennsylvania - Cardiac Center, PA, Philadelphia,
United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Intraoperative imaging determines the integrity of surgical
repairs. Transoesophageal echocardiography represents standard care for
intraoperative imaging in CHD. However, some conditions preclude its use,
and epicardial echocardiography is used alternatively. Minimal literature
exists on the impact of epicardial echocardiography versus
transoesophageal echocardiography. We aimed to evaluate accuracy between
the two modalities and hypothesised higher imaging error rates for
epicardial echocardiography. <br/>METHOD(S): We retrospectively reviewed
all epicardial echocardiograms performed over 16 years and compared them
to an age- and procedure-matched, randomly selected transoesophageal
echocardiography cohort. We detected un- or misidentified cardiac lesions
during the intraoperative imaging and evaluated patient outcomes. Data are
presented as a median with a range, or a number with percentages, with
comparisons by Wilcoxon two-sample test and Fisher's exact test.
<br/>RESULT(S): Totally, 413 patients comprised the epicardial
echocardiography group with 295 transoesophageal echocardiography matches.
Rates of imaging discrepancies, re-operation, and incision infection were
similar. About 13% of epicardial echocardiography patients had imaging
discrepancies versus 16% for transoesophageal (p = 0.2352), the former
also had smaller body sizes (p < 0.0001) and more genetic abnormalities
(33% versus 19%, p < 0.0001). Death/mechanical support occurred more
frequently in epicardial echocardiography patients (16% versus 6%, p <
0.0001), while hospitalisations were longer (25 versus 19 days, p =
0.0003). <br/>CONCLUSION(S): Diagnostic accuracy was similar between
patients undergoing epicardial echocardiography and transoesophageal
echocardiography, while rates of death and mechanical support were
increased in this inherently higher risk patient population. Epicardial
echocardiography provides a reasonable alternative when transoesophageal
echocardiography is not feasible.

<22>
Accession Number
638319435
Title
Incidence, Current Guidelines and Management of Gastrointestinal Bleeding
after Transcatheter Aortic Valve Replacement: A Systematic Review.
Source
Current cardiology reviews. (no pagination), 2022. Date of Publication:
23 Jun 2022.
Author
Adalja D.; Zala H.; Victor V.; Sheth A.; Willyard C.; Suzuki E.; P Patel
H.; Majmundar M.; Vallabhajosyula S.; Doshi R.
Institution
(Adalja) Department of Internal Medicine, St Joseph\'s University Medical
Center, Paterson, United States
(Zala) Department of Clinical Research, Icahn School of Medicine at Mount
Sinai, NY, NY, United States
(Victor) Department of Internal Medicine, Canton Medical Education
Foundation, Canton, OH, USA
(Sheth) Department of Internal Medicine, Louisiana State University Health
Sciences Center, LA, Shreveport, United States
(Willyard) Department of Internal Medicine, University of Nevada Reno
School of Medicine, NV, Reno, United States
(Suzuki) Department of Pediatrics, UCSF- Fresno, Fresno, CA, USA
(P Patel) Department of Internal Medicine, Louis A Weiss Memorial
Hospital, Chicago, United States
(Majmundar) Department of Cardiology, Maimonides Medical Center, Brooklyn,
NY, United States
(Vallabhajosyula) Section of Cardiovascular Medicine, Wake Forest
University School of Medicine, Winston-Salem, United States
(Doshi) Department of Cardiology, St Joseph\'s University Medical Center,
Paterson, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: There is a significant increase in morbidity and mortality in
patients complicated by major bleeding following transcatheter aortic
valve replacement (TAVR). It has become more challenging to manage such
complications when the patient needs to be on anticoagulation or
antiplatelet agent post-procedure to prevent thrombotic/embolic
complications. <br/>METHOD(S): We performed a systematic review of all
available randomized controlled trials and observational studies to
identify incidence rates of gastrointestinal bleeding post-procedure.
After performing a systematic search, a total of 8731 patients from 15
studies (5 RCTs and 10 non-RCTs) were included in this review.
<br/>RESULT(S): The average rate of gastrointestinal bleeding during
follow-up was 3.0% in randomized controlled trials and 1.9% among
observational studies. We have also described the available current
guidelines for the management of TAVR in terms of the use of
anticoagulation / antiplatelet agents post-procedure. <br/>CONCLUSION(S):
Finally, we have discussed possible management options for
gastrointestinal bleeding in this review.<br/>Copyright&#xa9; Bentham
Science Publishers; For any queries, please email at
epub@benthamscience.net.

<23>
Accession Number
638317324
Title
Intraoperative conversion from video-assisted thoracoscopic lobectomy to
thoracotomy for non-small cell lung cancer: does it have an impact on
long-term survival?.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2022.
Date of Publication: 24 Jun 2022.
Author
Ren Z.-Z.; Deng H.-Y.; Huang W.; Zhou Q.
Institution
(Ren, Deng, Huang, Zhou) Lung Cancer Center, West China Hospital, Sichuan
University, Chengdu, China
(Ren, Deng, Huang, Zhou) Lung Cancer Institute, West China Hospital,
Sichuan University, Chengdu, China
(Ren) West China School of Medicine, Sichuan University, Chengdu, China
Publisher
NLM (Medline)
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was whether intraoperative
conversion to thoracotomy have an impact on long-term survival for
patients with non-small cell lung cancer (NSCLC) who underwent
video-assisted thoracoscopic lobectomy initially? A total of 461 papers
were found using the reported search, of which 6 retrospective cohort
studies represented the best evidence to answer the clinical question. The
authors, date of publication, journal, country of the authors, patient
group, study type, relevant outcomes, and results of these papers are
tabulated. Five cohort studies clarified that conversion did not
compromise long-term survival, while one cohort study reported worse
long-term outcomes after conversion to thoracotomy. However, the limited
samples, different characteristics between groups and selection bias due
to inherent design made it difficult to interpret a conclusion. Based on
the current evidence, we concluded that intraoperative conversion from
video-assisted thoracoscopic surgery (VATS) to thoracotomy for NSCLC might
not impact long-term survival compared to successful VATS lobectomy. The
in-hospital mortality might not be prejudiced, while a longer
hospitalization was observed. However, whether conversion would adversely
affect postoperative complication rates remained unclear because of the
conflicting results. Moreover, three studies reported no statistical
difference in short- and long-term survival between emergent and
non-emergent conversion. Therefore, we suggest that thoracic surgeons
should not hesitate to convert VATS into thoracotomy in the case of blood
vessel injury or difficult hilum.<br/>Copyright &#xa9; The Author(s) 2021.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<24>
Accession Number
2014816651
Title
Long-term outcomes after heart transplantation using ex vivo allograft
perfusion in standard risk donors: A single-center experience.
Source
Clinical Transplantation. 36(5) (no pagination), 2022. Article Number:
e14591. Date of Publication: May 2022.
Author
Chen Q.; Singer-Englar T.; Kobashigawa J.A.; Roach A.; Emerson D.; Megna
D.; Ramzy D.; Catarino P.; Patel J.K.; Kittleson M.; Czer L.; Chikwe J.;
Esmailian F.
Institution
(Chen, Roach, Emerson, Megna, Ramzy, Catarino, Chikwe, Esmailian)
Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Singer-Englar, Kobashigawa, Patel, Kittleson, Czer) Department of
Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The Organ Care System (OCS) is an ex vivo perfusion platform
for donor heart preservation. Short/mid-term post-transplant outcomes
after its use are comparable to standard cold storage (CS). We evaluated
long-term outcomes following its use. <br/>Method(s): Between 2011 and
2013, 38 patients from a single center were randomized as a part of the
PROCEED II trial to receive allografts preserved with CS (n = 19) or OCS
(n = 19). Endpoints included 8-year survival, survival free from
graft-related deaths, freedom from cardiac allograft vasculopathy (CAV),
non-fatal major adverse cardiac events (NF-MACE), and rejections.
<br/>Result(s): Eight-year survival was 57.9% in the OCS group and 73.7%
in the CS group (p =.24). Freedom from CAV was 89.5% in the OCS group and
67.8% in the CS group (p =.13). Freedom from NF-MACE was 89.5% in the OCS
group and 67.5% in the CS group (p =.14). Eight-year survival free from
graft-related death was equivalent between the two groups (84.2% vs.
84.2%, p =.93). No differences in rejection episodes were observed (all p
>.5). <br/>Conclusion(s): In select patients receiving OCS preserved
allografts, late post-transplant survival trended lower than those
transplanted with an allograft preserved with CS. This is based on a small
single-center series, and larger numbers are needed to confirm these
findings.<br/>Copyright &#xa9; 2022 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<25>
Accession Number
2015495640
Title
Pharmacist-Led Programs to Increase Statin Prescribing: A Narrative Review
of the Literature.
Source
Pharmacy. 10(1) (no pagination), 2022. Article Number: 13. Date of
Publication: February 2022.
Author
Elkomos M.; Jahromi R.; Kelly M.S.
Institution
(Elkomos, Jahromi) Chapman University School of Pharmacy, Irvine, CA
92618, United States
(Kelly) Department of Pharmacy Practice, Chapman University School of
Pharmacy, Irvine, CA 92618, United States
Publisher
MDPI
Abstract
Statins are lipid-lowing medications shown to reduce cardiovascular events
and are recommended for specific patient populations at elevated risk of
atherosclerotic cardiovascular disease (ASCVD). Despite the demonstrated
efficacy of statins for reducing ASCVD risk, and guidance on which
populations should receive statin therapy, a substantial portion of
eligible patients are not prescribed statin therapy. Pharmacists have
attempted to increase the number of eligible patients receiving
appropriate statin therapy through a variety of interventions and across
several clinical settings. In this article, we highlight multiple studies
evaluating the effectiveness of pharmacist-led interventions to improve
statin use. A total of seven studies were selected for this narrative
review, demonstrating the effectiveness and barriers of different
statin-initiation programs delivered by pharmacists to increase statin use
in eligible patients. Among the interventions assessed, a combination of
provider communicating and statin prescribing through collaborative drug
therapy management (CDTM) appear to the be the most useful at increasing
statin use. Pharmacists can significantly improve statin use rates among
eligible patients through multiple intervention types and across different
clinical settings. Further studies should evaluate continued statin
adherence and clinical outcomes among patients served by
pharmacists.<br/>Copyright &#xa9; 2022 by the authors. Licensee MDPI,
Basel, Switzerland.

<26>
Accession Number
2013155255
Title
Omecamtiv mecarbil does not prolong QTc intervals at therapeutic
concentrations.
Source
British Journal of Clinical Pharmacology. 88(1) (pp 187-198), 2022. Date
of Publication: January 2022.
Author
Trivedi A.; Hsu C.-P.; Jafarinasabian P.; Terminello B.; Zhang H.; Flach
S.; Israel S.; Brooks A.; Xue H.; Darpo B.; Abbasi S.; Dutta S.; Lee E.
Institution
(Trivedi, Hsu, Jafarinasabian, Terminello, Zhang, Abbasi, Dutta, Lee)
Amgen Inc., Thousand Oaks, CA, United States
(Flach) Covance Inc., Madison, WI, United States
(Israel, Brooks) Covance Inc., Leeds, United Kingdom
(Xue, Darpo) ERT, Rochester, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Aims: Omecamtiv mecarbil (OM) is a novel selective cardiac myosin
activator under investigation for the treatment of heart failure. This
study aimed to evaluate the effect of therapeutic concentrations of OM on
electrocardiogram (ECG) parameters and exclude a clinically concerning
effect on the rate-corrected QT (QTc) interval. <br/>Method(s): In part A,
70 healthy subjects received a 25 mg oral dose of OM, and pharmacokinetics
were assessed. Only subjects with maximum observed plasma concentration <=
350 ng/mL (n = 60) were randomized into part B, where they received a
single oral dose of placebo, 50 mg OM and 400 mg moxifloxacin in a
3-period, 3-treatment, 6-sequence crossover study with continuous ECG
collection. <br/>Result(s): After a 50-mg dose of OM, mean
placebo-corrected change from baseline QTcF (QTcF; Fridericia correction)
ranged from -6.7 ms at 1 hour postdose to -0.8 ms at 4 hours postdose. The
highest upper bound of the 1-sided 95% confidence interval (CI) was 0.7 ms
(4 h postdose). Moxifloxacin resulted in a clear increase in mean QTcF,
with a peak value of 13.1 ms (90% CI: 11.71-14.57) at 3 hours; lower bound
of the 1-sided 95% CI was > 5 ms at all of the 3 prespecified time points.
Based on a concentration-QTc analysis, an effect on QTcF exceeding 10 ms
can be excluded up to OM plasma concentrations of ~800 ng/mL. There were
no serious or treatment-emergent adverse events leading to discontinuation
from the study. <br/>Conclusion(s): OM does not have a clinically relevant
effect on the studied ECG parameters.<br/>Copyright &#xa9; 2021 British
Pharmacological Society

<27>
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. <br/>Design(s): A
systematic review and meta-analysis of randomized controlled trials
(RCTs). <br/>Setting(s): Operating room. <br/>Participant(s): Patients
undergoing thoracic surgery. <br/>Intervention(s): PNI. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<28>
Accession Number
2016662541
Title
Comparative Analysis of Patient Characteristics in Cardiogenic Shock
Studies: Differences Between Trials and Registries.
Source
JACC: Cardiovascular Interventions. 15(3) (pp 297-304), 2022. Date of
Publication: 14 Feb 2022.
Author
Megaly M.; Buda K.; Alaswad K.; Brilakis E.S.; Dupont A.; Naidu S.; Ohman
M.; Napp L.C.; O'Neill W.; Basir M.B.
Institution
(Megaly, Alaswad, O'Neill, Basir) Division of Cardiology, Henry Ford
Hospital, Detroit, MI, United States
(Buda) Department of Internal Medicine, Hennepin Healthcare, Minneapolis,
MN, United States
(Brilakis) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Dupont) Northside Hospital, Atlanta, Georgia, Georgia
(Naidu) Department of Cardiology, Westchester Medical Center, Valhalla,
New York, United States
(Ohman) Division of Cardiology, Duke Medical Center, Durham, North
Carolina, United States
(Napp) Department of Cardiology and Angiology, Hannover Medical School,
Hannover, Germany
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to evaluate the differences in cardiogenic
shock patient characteristics in trial patients and real-life patients.
<br/>Background(s): Cardiogenic shock (CS) is a leading cause of mortality
in patients presenting with acute myocardial infarction (AMI). However,
the enrollment of patients into clinical trials is challenging and may not
be representative of real-world patients. <br/>Method(s): We performed a
systematic review of studies in patients presenting with AMI-related CS
and compared patient characteristics of those enrolled into randomized
controlled trials (RCTs) with those in registries. <br/>Result(s): We
included 14 RCTs (n = 2,154) and 12 registries (n = 133,617). RCTs
included more men (73% vs 67.7%, P < 0.001) compared with registries.
Patients enrolled in RCTs had fewer comorbidities, including less
hypertension (61.6% vs 65.9%, P < 0.001), dyslipidemia (36.4% vs 53.6%, P
< 0.001), a history of stroke or transient ischemic attack (7.1% vs 10.7%,
P < 0.001), and prior coronary artery bypass graft surgery (5.4% vs 7.5%,
P < 0.001). Patients enrolled in RCTs also had lower lactate levels (4.7
+/- 2.3 mmol/L vs 5.9 +/- 1.9 mmol/L, P < 0.001) and higher mean arterial
pressure (73.0 +/- 8.8 mm Hg vs 62.5 +/- 12.2 mm Hg, P < 0.001).
Percutaneous coronary intervention (97.5% vs 58.4%, P < 0.001) and
extracorporeal membrane oxygenation (11.6% vs 3.4%, P < 0.001) were used
more often in RCTs. The in-hospital mortality (23.9% vs 38.4%, P < 0.001)
and 30-day mortality (39.9% vs 45.9%, P < 0.001) were lower in RCT
patients. <br/>Conclusion(s): RCTs in AMI-related CS tend to enroll fewer
women and lower-risk patients compared with registries. Patients enrolled
in RCTs are more likely to receive aggressive treatment with percutaneous
coronary intervention and extracorporeal membrane oxygenation and have
lower in-hospital and 30-day mortality.<br/>Copyright &#xa9; 2022 American
College of Cardiology Foundation

<29>
Accession Number
2018833873
Title
Clinical Outcomes Definitions in Cardiac Surgery: The Babel Tower.
Source
Annals of Thoracic Surgery. 114(1) (pp 353-354), 2022. Date of
Publication: July 2022.
Author
Di Franco A.; Gaudino M.
Institution
(Di Franco, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, 525 E 68th St, New York, NY 10065
Publisher
Elsevier Inc.

<30>
[Use Link to view the full text]
Accession Number
2018699650
Title
Randomized Ablation-Based Rhythm-Control Versus Rate-Control Trial in
Patients with Heart Failure and Atrial Fibrillation: Results from the
RAFT-AF trial.
Source
Circulation. 145(23) (pp 1693-1704), 2022. Date of Publication: 07 Jun
2022.
Author
Parkash R.; Wells G.A.; Rouleau J.; Talajic M.; Essebag V.; Skanes A.;
Wilton S.B.; Verma A.; Healey J.S.; Sterns L.; Bennett M.; Roux J.-F.;
Rivard L.; Leong-Sit P.; Jensen-Urstad M.; Jolly U.; Philippon F.; Sapp
J.L.; Tang A.S.L.
Institution
(Parkash, Sapp) Queen Elizabeth II Health Sciences Centre, 1796 Summer
Street, Halifax, NS B3H 3A7, Canada
(Wells) University of Ottawa, Cardiovascular Research Methods Centre, ON,
Canada
(Rouleau, Talajic, Rivard) Montreal Heart Institute, Universite de
Montreal, QC, Canada
(Essebag) McGill University Health Centre, Montreal, QC, Canada
(Skanes, Leong-Sit, Tang) Schulich School of Medicine and Dentistry,
Western University, London, ON, Canada
(Wilton) Libin Cardiovascular Institute, University of Calgary, AL, Canada
(Verma) Southlake Regional Health Centre, ON, Canada
(Healey) Population Health Research Institute, Hamilton, ON, Canada
(Sterns) Royal Jubilee Hospital, Island Health Authority, Victoria, BC,
Canada
(Bennett) Centre for Cardiovascular Innovation, Division of Cardiology,
University of British Columbia, Vancouver, Canada
(Roux) Centre Hospitalier, Universite de Sherbrooke, Sherbrooke, QC,
Canada
(Jensen-Urstad) Karolinska Institute, Stockholm, Sweden
(Jolly) St. Mary's General Hospital, Kitchener, ON, Canada
(Philippon) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec City, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Atrial fibrillation (AF) and heart failure (HF) frequently
coexist and can be challenging to treat. Pharmacologically based rhythm
control of AF has not proven to be superior to rate control.
Ablation-based rhythm control was compared with rate control to evaluate
if clinical outcomes in patients with HF and AF could be improved.
<br/>Method(s): This was a multicenter, open-label trial with blinded
outcome evaluation using a central adjudication committee. Patients with
high-burden paroxysmal (>4 episodes in 6 months) or persistent (duration
<3 years) AF, New York Heart Association class II to III HF, and elevated
NT-proBNP (N-terminal pro brain natriuretic peptide) were randomly
assigned to ablation-based rhythm control or rate control. The primary
outcome was a composite of all-cause mortality and all HF events, with a
minimum follow-up of 2 years. Secondary outcomes included left ventricular
ejection fraction, 6-minute walk test, and NT-proBNP. Quality of life was
measured using the Minnesota Living With Heart Failure Questionnaire and
the AF Effect on Quality of Life. The primary analysis was time-to-event
using Cox proportional hazards modeling. The trial was stopped early
because of a determination of apparent futility by the Data Safety
Monitoring Committee. <br/>Result(s): From December 1, 2011, to January
20, 2018, 411 patients were randomly assigned to ablation-based rhythm
control (n=214) or rate control (n=197). The primary outcome occurred in
50 (23.4%) patients in the ablation-based rhythm-control group and 64
(32.5%) patients in the rate-control group (hazard ratio, 0.71 [95% CI,
0.49-1.03]; P=0.066). Left ventricular ejection fraction increased in the
ablation-based group (10.1+/-1.2% versus 3.8+/-1.2%, P=0.017), 6-minute
walk distance improved (44.9+/-9.1 m versus 27.5+/-9.7 m, P=0.025), and
NT-proBNP demonstrated a decrease (mean change -77.1% versus -39.2%,
P<0.0001). Minnesota Living With Heart Failure Questionnaire demonstrated
greater improvement in the ablation-based rhythm-control group
(least-squares mean difference of -5.4 [95% CI, -10.5 to -0.3]; P=0.0036),
as did the AF Effect on Quality of Life score (least-squares mean
difference of 6.2 [95% CI, 1.7-10.7]; P=0.0005). Serious adverse events
were observed in 50% of patients in both treatment groups.
<br/>Conclusion(s): In patients with high-burden AF and HF, there was no
statistical difference in all-cause mortality or HF events with
ablation-based rhythm control versus rate control; however, there was a
nonsignificant trend for improved outcomes with ablation-based rhythm
control over rate control. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT01420393.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<31>
Accession Number
2018012324
Title
Impact of diabetes mellitus on all and successful percutaneous coronary
intervention outcomes for chronic total occlusions: A systematic review
and meta-analysis.
Source
Heart and Lung. 55 (pp 108-116), 2022. Date of Publication: 01 Sep 2022.
Author
Guan J.; Li X.; Gong S.; Li L.
Institution
(Guan, Li, Gong) Cardiovascular department, Qingdao Fifth People's
Hospital
(Li) Department of Endocrinology, Jingyuan people's Hospital, Gansu
Province Post code: 730600, China
Publisher
Elsevier Inc.
Abstract
Background: Diabetes mellitus (DM) is a leading cause of morbidity and
mortality globally and can affect numerous vital organs, including the
kidney, liver, heart, nervous system, and vascular system.
<br/>Objective(s): To assess the impact of type 2 diabetes mellitus (DM)
on outcome in patients undergoing percutaneous coronary intervention (PCI)
for chronic total occlusion (CTO). <br/>Method(s): Academic databases were
screened for eligible studies published prior to January 2021. Study
quality was assessed using Cochrane's risk of bias tool and the Newcastle
Ottawa scale. <br/>Result(s): Pooling studies that met inclusion criteria,
we carried out a meta-analysis with a random-effects model and reported
pooled odds ratios (ORs) with 95% confidence intervals (CIs). A total of
ten studies featuring 8,276 participants met eligibility criteria. Type 2
DM patients had significantly higher odds of mortality (pooled OR: 1.62;
95% CI: 1.10 to 2.37), revascularization (pooled OR: 1.41; 95% CI: 1.14 to
1.74) and major adverse cardiac events (MACE) (pooled OR: 1.39; 95% CI:
1.18 to 1.63) relative to non-DM patients following PCI for CTO
(regardless of PCI success or failure). Similarly, even when only looking
at patients who underwent successful PCI, type 2 DM patients had
significantly higher odds of revascularization (pooled OR: 1.54; 95% CI:
1.20 to 1.97) and MACE (pooled OR: 1.35; 95% CI: 1.13 to 1.63).
<br/>Conclusion(s): Type 2 DM significantly impacts the risk for adverse
clinical outcomes even after successful PCI for CTO. As such, clinicians
need to develop a comprehensive intervention package for DM patients with
cardiovascular disease.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<32>
Accession Number
2017836574
Title
ONE-LUNG VENTILATION PATIENTS: CLINICAL CONTEXT OF ADMINISTRATION OF
DIFFERENT DOSES OF DEXMEDETOMIDINE.
Source
Journal of Medical Biochemistry. 41(2) (pp 230-237), 2022. Date of
Publication: 2022.
Author
Jiang H.; Kang Y.; Ge C.; Zhang Z.; Xie Y.
Institution
(Jiang, Ge, Zhang, Xie) Department of Anesthesiology, Xuhui District
Central Hospital, Shanghai, China
(Kang) Department of Anesthesiology, Tongren Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
Publisher
Society of Medical Biochemists of Serbia
Abstract
Background: Open and endoscopic thoracic surgeries improve surgical
exposure by One-lung ventilation (OLV). The aim of this study was to
investigate the effects of different doses of dexmedetomidine on
inflammatory response, oxidative stress, cerebral tissue oxygen saturation
(S<inf>ct</inf>O<inf>2</inf>) and intrapulmonary shunt in patients
undergoing one-lung ventilation (OLV). <br/>Method(s): Seventy-five
patients undergoing open pulmonary lobectomy in our hospital from January
2016 to December 2017 were enrolled and randomly divided into high-dose
dexmedetomidine group (group D1, 1 mg/kg, n=25), low-dose dexmedetomidine
group (group D2, 0.5 mg/kg, n=25) and control group (group C, n=25). Then,
arterial blood and internal jugular venous blood were taken before
anesthesia induction (T0) and at 15 min after two-lung ventilation (T1)
and 5 min (T2) and 30 min (T3) after OLV for later use. Next, the changes
in hemodynamic parameters [mean arterial pressure (MAP), heart rate (HR)
and pulse oxygen saturation (SpO<inf>2</inf>)] of patients were observed
in each group. Enzyme-linked immunosorbent assay (ELISA) was carried out
to detect serum inflammatory factors such as interleukin-6 (IL-6) and
tumor necrosis factor-alpha (TNF-a) and oxidative stress indicators
[superoxide dismutase (SOD) and malondialdehyde (MDA)]. The changes in
S<inf>ct</inf>O<inf>2</inf>, arterial partial pressure of oxygen
(PaO<inf>2</inf>) and intrapulmonary shunt Qs/Qt (a measurement of
pulmonary shunt: right-to-left shunt fraction) were observed.
Additionally, the changes in lung function indicators like lung dynamic
compliance (Cdyn) and airway peak pressure (Ppeak) were determined.
<br/>Result(s): There were no statistically significant differences in the
MAP, HR and SpO<inf>2</inf> among three groups at each observation time
point (P>0.05). At T2 and T3, the levels of serum IL-6, TNF-a and IL-8
were obviously decreased in group D1 and D2 compared with those in group C
(P<0.05), and the decreases in group D1 were overtly larger than those in
group D2, and the decreases at T3 were markedly greater than those at T2
(P<0.05). In comparison with group C, group D1 and D2 had notably reduced
levels of serum reactive oxygen species (ROS) and MDA (P<0.05) and
remarkably increased SOD content (P<0.05) at T2 and T3, and the effects
were markedly better in group D1 than those in group D2. Besides, they
were significantly superior at T3 to those at T2 (P<0.05). The
S<inf>ct</inf>O<inf>2</inf> in group D1 and D2 was evidently lowered at T2
and T3 compared with that at T0, and the decrease in group D1 was
distinctly smaller than that in group D2 (P<0.05). The Qs/Qt was
significantly lower in group D1 and D2 than that in group C at T2 and T3
(P<0.05), while the PaO<inf>2</inf> content was notably raised (P<0.05),
and the decrease and increase were significantly larger in group D1 than
those in group D2, and they were obviously greater at T3 to those at T2
(P<0.05). At T0 and T1, no significant differences were detected in the
Cdyn, Pplat and Ppeak among three groups. At T2 and T3, the Cdyn was
significantly elevated, while the Pplat and Ppeak overtly declined
(P<0.05), and group D1 had greater changes in comparison with group D2,
and the changes were obviously more evident at T3 to those at T2 (P<0.05).
<br/>Conclusion(s): Dexmedetomidine effectively ameliorates inflammatory
response and oxidative stress, lowers oxygenation, Qs/Qt and the decrease
in S<inf>ct</inf>O<inf>2</inf> and improves lung function during OLV, with
good efficacy.<br/>Copyright &#xa9; 2022 Sciendo. All rights reserved.

<33>
Accession Number
638187185
Title
Real-time seizure detection in paediatric intensive care patients: the
RESET child brain protocol.
Source
BMJ Open. 12(6) (no pagination), 2022. Article Number: e059301. Date of
Publication: 03 Jun 2022.
Author
Waak M.; Gibbons K.; Sparkes L.; Harnischfeger J.; Gurr S.; Schibler A.;
Slater A.; Malone S.
Institution
(Waak, Sparkes, Harnischfeger, Slater) Queensland Children's Hospital
Paediatric Intensive Care Unit, South Brisbane, QLD, Australia
(Waak, Gibbons, Sparkes) Centre for Children's Health Research, Brisbane,
QLD, Australia
(Gibbons, Malone) The University of Queensland, Saint Lucia, QLD,
Australia
(Gurr, Malone) Neurosciences, Queensland Children's Hospital, South
Brisbane, QLD, Australia
(Schibler) St Andrew's War Memorial Hospital, Spring Hill, QLD, Australia
Publisher
BMJ Publishing Group
Abstract
Introduction Approximately 20%-40% of comatose children with risk factors
in intensive care have electrographic-only seizures; these go unrecognised
due to the absence of continuous electroencephalography (EEG) monitoring
(cEEG). Utility of cEEG with high-quality assessment is currently limited
due to high-resource requirements. New software analysis tools are
available to facilitate bedside cEEG assessment using quantitative EEG
(QEEG) trends. The primary aim of this study is to describe accuracy of
interpretation of QEEG trends by paediatric intensive care unit (PICU)
nurses compared with cEEG assessment by neurologist (standard clinical
care) in children at risk of seizures and status epilepticus utilising
diagnostic test statistics. The secondary aims are to determine time to
seizure detection for QEEG users compared with standard clinical care and
describe impact of confounders on accuracy of seizure detection. Methods
and analysis This will be a single-centre, prospective observational
cohort study evaluating a paediatric QEEG programme utilising the full 19
electrode set. The setting will be a 36-bed quaternary PICU with medical,
cardiac and general surgical cases. cEEG studies in PICU patients
identified as at risk of seizures' will be analysed. Trained bedside
clinical nurses will interpret the QEEG. Seizure events will be marked as
seizures if >3 QEEG criteria occur. Post-hoc dedicated neurologists, who
remain blinded to the QEEG analysis, will interpret the cEEG.
Determination of standard test characteristics will assess the primary
hypothesis. To calculate 95% (CIs) around the sensitivity and specificity
estimates with a CI width of 10%, the sample size needed for sensitivity
is 80 patients assuming each EEG will have approximately 9 to 18 1-hour
epochs. Ethics and dissemination The study has received approval by the
Children's Health Queensland Human Research Ethics Committee
(HREC/19/QCHQ/58145). Results will be made available to the funders,
critical care survivors and their caregivers, the relevant societies, and
other researchers. Trial registration number Australian New Zealand
Clinical Trials Registry (ANZCTR) 12621001471875.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<34>
Accession Number
2013613076
Title
A Systematic Review of Multiple Linear Regression-Based Limited Sampling
Strategies for Mycophenolic Acid Area Under the Concentration-Time Curve
Estimation.
Source
European Journal of Drug Metabolism and Pharmacokinetics. 46(6) (pp
721-742), 2021. Date of Publication: November 2021.
Author
Sobiak J.; Resztak M.
Institution
(Sobiak, Resztak) Department of Physical Pharmacy and Pharmacokinetics,
Poznan University of Medical Sciences, 6 Swiecickiego Street, Poznan
60-781, Poland
Publisher
Adis
Abstract
Background and Objective: One approach of therapeutic drug monitoring in
the case of mycophenolic acid (MPA) is a limited sampling strategy (LSS),
which allows the evaluation of the area under the concentration-time curve
(AUC) based on few concentrations. The aim of this systematic review was
to review the MPA LSSs and define the most frequent time points for MPA
determination in patients with different indications for mycophenolate
mofetil (MMF) administration. <br/>Method(s): The literature was
comprehensively searched in July 2021 using PubMed, Scopus, and Medline
databases. Original articles determining multiple linear regression
(MLR)-based LSSs for MPA and its free form (fMPA) were included. Studies
on enteric-coated mycophenolic sodium, previously established LSS,
Bayesian estimator, and different than twice a day dosing were excluded.
Data were analyzed separately for (1) adult renal transplant recipients,
(2) adults with other than renal transplantation indication, and (3) for
pediatric patients. <br/>Result(s): A total of 27, 17, and 11 studies were
found for groups 1, 2, and 3, respectively, and 126 MLR-based LSS formulae
(n = 120 for MPA, n = 6 for fMPA) were included in the review. Three
time-point equations were the most frequent. Four MPA LSSs: 2.8401 +
5.7435 x C0 + 0.2655 x C0.5 + 1.1546 x C1 + 2.8971 x C4 for adult renal
transplant recipients, 1.783 + 1.248 x C1 + 0.888 x C2 + 8.027 x C4 for
adults after islet transplantation, 0.10 + 11.15 x C0 + 0.42 x C1 + 2.80 x
C2 for adults after heart transplantation, and 8.217 + 3.163 x C0 + 0.994
x C1 + 1.334 x C2 + 4.183 x C4 for pediatric renal transplant recipients,
plus one fMPA LSS, 34.2 + 1.12 x C1 + 1.29 x C2 + 2.28 x C4 + 3.95 x C6
for adult liver transplant recipients, seemed to be the most promising and
should be validated in independent patient groups before introduction into
clinical practice. The LSSs for pediatric patients were few and not fully
characterized. There were only a few fMPA LSSs although fMPA is a
pharmacologically active form of the drug. <br/>Conclusion(s): The review
includes updated MPA LSSs, e.g., for different MPA formulations
(suspension, dispersible tablets), generic form, and intravenous
administration for adult and pediatric patients, and emphasizes the need
of individual therapeutic approaches according to MMF indication. Five
MLR-based MPA LSSs might be implemented into clinical practice after
evaluation in independent groups of patients. Further studies are
required, e.g., to establish fMPA LSS in pediatric patients.<br/>Copyright
&#xa9; 2021, The Author(s).

<35>
Accession Number
2011488061
Title
Impact of anemia on short-term outcomes after TAVR: A subgroup analysis
from the BRAVO-3 randomized trial.
Source
Catheterization and Cardiovascular Interventions. 98(6) (pp E870-E880),
2021. Date of Publication: 15 Nov 2021.
Author
Razuk V.; Camaj A.; Cao D.; Nicolas J.; Hengstenberg C.; Sartori S.; Zhang
Z.; Power D.; Beerkens F.; Chiarito M.; Meneveau N.; Tron C.; Dumonteil
N.; Widder J.D.; Ferrari M.; Violini R.; Stella P.R.; Jeger R.;
Anthopoulos P.; Mehran R.; Dangas G.D.
Institution
(Razuk, Camaj, Cao, Nicolas, Sartori, Zhang, Power, Beerkens, Chiarito,
Mehran, Dangas) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Meneveau) Department of Cardiology, University Hospital Jean Minjoz,
Besancon, France
(Tron) Division of Cardiology, Rouen University Hospital, Rouen, France
(Dumonteil) Groupe CardioVasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
(Widder) Department of Cardiology and Angiology, Hannover Medical School,
Hannover, Germany
(Ferrari) Interventional Cardiology, Helios Dr. Horst Schmidt Kliniken
Wiesbaden, Wiesbaden, Germany
(Violini) Interventional Cardiology Unit, San Camillo Hospital, Rome,
Italy
(Stella) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Jeger) Department of Cardiology, University Hospital Basel, University of
Basel, Switzerland
(Anthopoulos) European Medical, Arena Pharmaceuticals Inc, Zurich,
Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To determine the prognostic impact of anemia in patients
randomized to bivalirudin or unfractionated heparin (UFH) during
transcatheter aortic valve replacement (TAVR). <br/>Background(s): Whether
the periprocedural use of bivalirudin as compared with UFH in anemic
patients undergoing TAVR has an impact on outcomes remains unknown.
<br/>Method(s): The BRAVO-3 trial compared the use of bivalirudin versus
UFH in 802 high risk patients undergoing transfemoral TAVR for severe
symptomatic aortic stenosis. Patients were stratified according to the
presence (defined as hemoglobin levels <13 g/dl in men and <12 g/dl in
women) or absence of anemia. The primary outcomes were net adverse cardiac
events (NACE; a composite of all-cause mortality, myocardial infarction,
stroke, or bleeding) and major bleeding (Bleeding Academic Research
Consortium >=3b) at 30 days. <br/>Result(s): Among 798 patients with
available baseline hemoglobin levels, 427 (54%) were anemic of whom 221
(52%) received bivalirudin. There were no significant differences in NACE
and major bleeding at 30 days between patients with and without anemia,
irrespective of the type of anticoagulant used (p<inf>interaction</inf> =
0.71 for NACE, p<inf>interaction</inf> = 1.0 for major bleeding). However,
anemic patients had a higher risk of major vascular complications
(adjusted OR 2.43, 95% CI 1.42-4.16, p = 0.001), and acute kidney injury
(adjusted OR 1.74, 95% CI 1.16-2.59, p = 0.007) compared to non-anemic
patients at 30 days. <br/>Conclusion(s): Anemia was not associated with a
higher risk of NACE or major bleeding at 30 days after TAVR without
modification of the treatment effects of periprocedural anticoagulation
with bivalirudin versus UFH.<br/>Copyright &#xa9; 2021 Wiley Periodicals
LLC.

<36>
Accession Number
2014775064
Title
Evaluation of a paper-based checklist versus an electronic handover tool
based on the situation background assessment recommendation (Sbar) concept
in patients after surgery for congenital heart disease.
Source
Journal of Clinical Medicine. 10(24) (no pagination), 2021. Article
Number: 5724. Date of Publication: December-2 2021.
Author
Rehm C.; Zoller R.; Schenk A.; Muller N.; Strassberger-Nerschbach N.;
Zenker S.; Schindler E.
Institution
(Rehm) Department of Anesthesiology, Catholic Children's Hospital
Wilhemstift, Hamburg 22149, Germany
(Zoller, Zenker) Staff Unit for Medical and Scientific Technology
Development & Coordination, Coordination (MWTek), Commercial Directorate,
University Hospital Bonn, University of Bonn, Bonn 53127, Germany
(Schenk, Zenker) Department of Medical Biometry, Informatics and
Epidemiology, University Hospital Bonn, University of Bonn, Bonn 53127,
Germany
(Muller) Department for Pediatric Cardiology, University Hospital Bonn,
University of Bonn, Bonn 53127, Germany
(Strassberger-Nerschbach, Zenker, Schindler) Department of Anesthesiology
and Intensive Care Medicine, University Hospital Bonn, University of Bonn,
Bonn 53127, Germany
Publisher
MDPI
Abstract
(1) Background: we compare a new SBAR based electronic handover tool
versus a paper-based checklist for handover in a pediatric intensive care
unit (PICU). (2) Methods: this is a random-ized, observational study of 40
electronic vs. 40 paper checklist handovers after pediatric cardiac
surgery, with a 48 items checklist for comparison of reporting frequencies
and notification of dis-turbances and noise. PICU staff satisfaction was
evaluated by a 12-item questionnaire. (3) Results: in 14 out of 40 cases,
there were problems with data processing (incomplete or no data
processing). Some item groups (e.g., hemodynamics) were consistently
reported at higher frequencies than other groups. Items not specifically
asked for did not get reported. Some items, automatically processed in the
SBAR handover page, did not get reported. Many handovers suffered a noisy
and distracting atmosphere. There was no difference in staff satisfaction
between the two handover approaches. Nurses were highly unsatisfied with
the general approach by which the handover was performed. (4)
<br/>Conclusion(s): human error appears to be a main factor for unreliable
data processing. Software is still too complicated, and multitasking is a
stressful and error prone event. Handover is a complex task with many
factors required for a successful completion.<br/>Copyright &#xa9; 2021 by
the authors. Licensee MDPI, Basel, Switzerland.

<37>
Accession Number
2014808201
Title
Outcomes of peri-operative glucocorticosteroid use in major pancreatic
resections: a systematic review.
Source
HPB. 23(12) (pp 1789-1798), 2021. Date of Publication: December 2021.
Author
Kuan L.L.; Dennison A.R.; Garcea G.
Institution
(Kuan, Dennison, Garcea) Department of Hepatobiliary and Pancreatic
Surgery, University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Kuan) Discipline of Surgery, The University of Adelaide, The Queen
Elizabeth Hospital, Adelaide, South Australia, Australia
Publisher
Elsevier B.V.
Abstract
Background: There is increasing evidence that peri-operative
glucocorticosteroid can ameliorate the systemic response following major
surgery. Preliminary evidence suggests peri-operative usage of
glucocorticosteroid may decrease post-operative complications. These
positive associations have been observed in a range of different
operations including intra-abdominal, thoracic, cardiac, and orthopaedic
surgery. This review aims to investigate the impact of peri-operative
glucocorticosteroid in major pancreatic resections. <br/>Method(s): A
systematic review based on a search in Medline and Embase databases was
performed. PRISMA guidelines for systematic reviews were followed.
<br/>Result(s): A total of five studies were analysed; three randomised
controlled trials and two retrospective cohort studies. The total patient
population was 1042. The glucocorticosteroids used were intravenous
hydrocortisone or dexamethasone. Three studies reported significantly
lower morbidity in the peri-operative glucocorticosteroid group. The
number needed to treat to prevent one major complication with
hydrocortisone is four patients. Two studies demonstrated that
dexamethasone was associated with a statistically significantly improved
median overall survival in pancreatic cancer. <br/>Conclusion(s): This is
the first systematic review conducted to investigate the significance of
peri-operative glucocorticosteroid in patients undergoing pancreatic
resection. This review shows a correlation of positive outcomes with the
administration of glucocorticosteroid in the peri-operative setting
following a major pancreatic resection. More randomised clinical trials
are required to confirm if this is a true effect, as it would have
significant implications.<br/>Copyright &#xa9; 2021

<38>
Accession Number
2018000128
Title
Randomized trial of conventional versus radiofrequency needle transseptal
puncture for cryoballoon ablation: the CRYO-LATS trial.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2022. Date of Publication: 2022.
Author
Andrade J.G.; Macle L.; Bennett M.T.; Hawkins N.M.; Essebag V.; Champagne
J.; Roux J.-F.; Makanjee B.; Tang A.; Skanes A.; Khaykin Y.; Morillo C.;
Jolly U.; Lockwood E.; Amit G.; Angaran P.; Sapp J.; Wardell S.; Wells
G.A.; Verma A.; Deyell M.W.
Institution
(Andrade, Bennett, Hawkins, Deyell) University of British Columbia,
Vancouver, Canada
(Andrade, Hawkins, Deyell) Center for Cardiovascular Innovation, 2775
Laurel St, Vancouver, BC V5Z 1M9, Canada
(Andrade, Macle) Montreal Heart Institute, Universite de Montreal,
Montreal, Canada
(Essebag, Verma) McGill University Health Centre, Montreal, Canada
(Essebag) Hopital Sacre-Coeur de Montreal, Montreal, Canada
(Champagne) Universite Laval, Quebec, Canada
(Roux) Universite de Sherbrooke, Sherbrooke, Canada
(Makanjee) Rouge Valley Centenary Hospital, Ajax, Canada
(Tang, Skanes) University of Western Ontario, London, Canada
(Khaykin) Southlake Regional Health Center, Newmarket, Canada
(Morillo) Libin Cardiovascular Institute, University of Calgary, Calgary,
Canada
(Jolly) St. Mary's Hospital, Kitchener, Canada
(Lockwood) Royal Alexandra Hospital, Edmonton, Canada
(Amit) McMaster University, Hamilton, Canada
(Angaran) St. Michael's Hospital, University of Toronto, Toronto, Canada
(Sapp) Dalhousie University, Halifax, Canada
(Wardell) University of Saskatchewan, Saskatoon, Canada
(Wells) University of Ottawa Heart Institute, Ottawa, Canada
Publisher
Springer
Abstract
Background: Transseptal puncture to achieve left atrial access is
necessary for many cardiac procedures, including atrial fibrillation
ablation. More recently, there has been an increasing need for left atrial
access using large caliber sheaths, which increases risk of perforation
associated with the initial advancement into the left atrium. We compared
the effectiveness of a radiofrequency needle-based transseptal system
versus conventional needle for transseptal access. <br/>Method(s): This
prospective controlled trial randomized 161 patients with symptomatic
paroxysmal atrial fibrillation undergoing cryoballoon pulmonary vein
isolation to transseptal access with a commercially available transseptal
system (radiofrequency needle plus stiff pigtail wire; RF + Pigtail group)
versus conventional transseptal access (standard group). The primary
outcome was time required for left atrial access. Secondary outcomes
included failure of the assigned transseptal system, radiation exposure,
and complications. <br/>Result(s): The median transseptal puncture time
was significantly shorter using the radiofrequency needle plus stiff
pigtail wire transseptal system compared with conventional transseptal
(840 +/- 323 vs. 956 +/- 407 s, P = 0.0489). Compared to conventional
transseptal puncture, fewer transseptal attempts were required (1.0 +/-
0.5 RF applications vs. 1.3 +/- 0.8 mechanical punctures, P = 0.0123) and
the fluoroscopy time was significantly shorter (72.0 [IQR 48.0, 129.0] vs.
93.0 [IQR 60.0, 171.0] s, P = 0.0490) with the radiofrequency needle plus
stiff pigtail wire transseptal system. Failure to achieve transseptal LA
access with the assigned system was rarely observed (1.3% vs. 5.7%, P =
0.2192). There were no procedural complications observed with either
system. <br/>Conclusion(s): The use of a radiofrequency needle plus stiff
pigtail wire resulted in shorter time to left atrial access and reduced
fluoroscopy time compared to left atrial access using conventional
transseptal equipment. Trial registration: ClinicalTrials.gov identifier
NCT03199703.<br/>Copyright &#xa9; 2022, The Author(s).

<39>
Accession Number
2017999978
Title
Interdisciplinary and cross-sectoral perioperative care model in cardiac
surgery: implementation in the setting of minimally invasive heart valve
surgery (INCREASE)-study protocol for a randomized controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 528. Date of
Publication: December 2022.
Author
Klotz S.G.R.; Ketels G.; Behrendt C.A.; Konig H.-H.; Kohlmann S.; Lowe B.;
Petersen J.; Stock S.; Vettorazzi E.; Zapf A.; Zastrow I.; Zollner C.;
Reichenspurner H.; Girdauskas E.
Institution
(Klotz, Ketels) Department of Physiotherapy, University Medical Center
Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
(Behrendt) Research Group GermanVasc, Department of Vascular Medicine,
University Heart and Vascular Center, University Medical Center
Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
(Konig) Department of Health Economics and Health Services Research,
University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg
20246, Germany
(Kohlmann, Lowe) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg
20246, Germany
(Petersen, Reichenspurner) Department of Cardiovascular Surgery,
University Heart and Vascular Center, University Medical Center
Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
(Stock, Girdauskas) Department of Cardiothoracic Surgery, University
Hospital Augsburg, Stenglinstr. 2, Augsburg 86156, Germany
(Vettorazzi, Zapf) Department of Medical Biometry and Epidemiology,
University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg
20246, Germany
(Zastrow) Department of Patient and Care Management, University Medical
Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
(Zollner) Department of Anesthesiology, Center of Anesthesiology and
Intensive Care Medicine, University Medical Center Hamburg-Eppendorf,
Martinistr. 52, Hamburg 20246, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Valvular heart diseases are frequent and increasing in
prevalence. Minimally invasive heart valve surgery embedded in an
interdisciplinary enhanced recovery after surgery (ERAS) program may have
potential benefits with regard to reduced length of stay and improved
patient reported outcomes. However, no prospective randomized data exist
regarding the superiority of ERAS program for the patients' outcome.
<br/>Method(s): We aim to randomize (1:1) a total of 186 eligible patients
with minimally invasive heart valve surgery to an ERAS program vs.
standard treatment at two centers including the University Medical Center
Hamburg-Eppendorf, Germany, and the University Hospital Augsburg, Germany.
The intervention is composed out of pre-, peri-, and postoperative
components. The preoperative protocol aims at better preparation for the
operation with regard to physical activity, nutrition, and psychological
preparedness. Intraoperative anesthesiologic and surgical management are
trimmed to enable an early extubation. Patients will be transferred to a
specialized postoperative anesthesia care unit, where first mobilization
occurs 3 h after surgery. Transfer to low care ward will be at the next
day and discharge at the fifth day. Participants in the control group will
receive treatment as usual. Primary endpoints include functional discharge
at discharge and duration of in-hospital care during the first 12 months
after index surgery. Secondary outcomes include health-related quality of
life, health literacy, and level of physical activity. <br/>Discussion(s):
This is the first randomized controlled trial evaluating the effectiveness
of an ERAS process after minimally invasive heart valve surgery.
Interprofessional approach is the key factor of the ERAS process and
includes in particular surgical, anesthesiological, physiotherapeutic,
advanced nursing, and psychosocial components. A clinical implication
guideline will be developed facilitating the adoption of ERAS model in
other heart teams. Trial registration: The study has been registered in
ClinicalTrials.gov (NCT04977362 assigned July 27, 2021).<br/>Copyright
&#xa9; 2022, The Author(s).

<40>
[Use Link to view the full text]
Accession Number
638303318
Title
High Oxygenation During Normothermic Regional Perfusion After Circulatory
Death Is Beneficial on Donor Cardiac Function in a Porcine Model.
Source
Transplantation. 106(7) (pp e326-e335), 2022. Date of Publication: 01 Jul
2022.
Author
Moeslund N.; Long Zhang Z.; Bo Ilkjaer L.; Ryhammer P.; Cramer C.;
Palmfeldt J.; Pedersen M.; Erasmus M.E.; Tsui S.; Eiskjaer H.
Institution
(Moeslund, Eiskjaer) Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark
(Moeslund, Pedersen) Department for Clinical Medicine - Comparative
Medicine Lab, Aarhus University, Aarhus, Denmark
(Long Zhang, Erasmus) Department for Cardiothoracic Surgery, University
Medical Centre Groningen, Groningen, Netherlands
(Bo Ilkjaer) Department for Cardiothoracic Surgery, Aarhus University
Hospital, Aarhus, Denmark
(Ryhammer) Department for Anesthesiology, Region Hospital Silkeborg,
Silkeborg, Denmark
(Cramer) Department for Anesthesiology, Hospital Unit West, Herning,
Denmark
(Palmfeldt) Research Unit for Molecular Medicine, Institute for Clinical
Medicine, Aarhus University, Aarhus, Denmark
(Tsui) Department for Cardiothoracic Surgery, Royal Papworth Hospital NHS
Foundation Trust, Cambridge, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thoracoabdominal normothermic regional perfusion (NRP) is a
new method for in situ reperfusion and reanimation of potential donor
organs in donation after circulatory death by reperfusion of the thoracic
and abdominal organs with oxygenated blood. We investigated effects of
high oxygenation (HOX) versus low oxygenation (LOX) during NRP on donor
heart function in a porcine model. <br/>METHOD(S): Pigs (80kg) underwent a
15-min anoxic cardiac arrest followed by cardiac reanimation on NRP using
a heart-lung bypass machine with subsequent assessment 180 min post-NRP.
The animals were randomized to HOX (FiO2 1.0) or LOX (FiO2 0.21 increased
to 0.40 during NRP). Hemodynamic data were obtained by invasive blood
pressure and biventricular pressure-volume measurements. Blood gases,
biomarkers of inflammation, and oxidative stress were measured.
<br/>RESULT(S): Eight of 9 animals in the HOX group and 7 of 10 in the LOX
group were successfully weaned from NRP. Right ventricular end-systole
elastance was significantly improved in the HOX group compared with the
LOX group, whereas left ventricular end-systole elastance was preserved at
baseline levels. Post-NRP cardiac output, mean arterial, central venous,
and pulmonary capillary wedge pressure were all comparable to baseline.
Creatinine kinase-MB increased more in the LOX group than the HOX group,
whereas proinflammatory cytokines increased more in the HOX group than the
LOX group. No difference was found in oxidative stress between groups.
<br/>CONCLUSION(S): All hearts weaned from NRP showed acceptable
hemodynamic function for transplantation. Hearts exposed to LOX showed
more myocardial damage and showed poorer contractile performance than
hearts reperfused with high oxygen.<br/>Copyright &#xa9; 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<41>
[Use Link to view the full text]
Accession Number
2018928650
Title
Cardiovascular Magnetic Resonance for Rejection Surveillance After Cardiac
Transplantation.
Source
Circulation. 145(25) (pp 1811-1824), 2022. Date of Publication: 21 Jun
2022.
Author
Anthony C.; Imran M.; Pouliopoulos J.; Emmanuel S.; Iliff J.; Liu Z.;
Moffat K.; Ru Qiu M.; McLean C.A.; Stehning C.; Puntmann V.; Vassiliou V.;
Ismail T.F.; Gulati A.; Prasad S.; Graham R.M.; McCrohon J.; Holloway C.;
Kotlyar E.; Muthiah K.; Keogh A.M.; Hayward C.S.; MacDonald P.S.; Jabbour
A.
Institution
(Anthony, Imran, Pouliopoulos, Emmanuel, Iliff, Moffat, Ru Qiu, Graham,
McCrohon, Holloway, Kotlyar, Muthiah, Keogh, Hayward, MacDonald, Jabbour)
Heart And Lung Transplant Unit, St. Vincent's Hospital, Sydney, Australia
(Moffat, Muthiah) Medical Imaging Department, St. Vincent's Hospital,
Sydney, Australia
(Pouliopoulos, Emmanuel, Graham, Hayward, MacDonald, Jabbour) Victor Chang
Cardiac Research Institute, Sydney, Australia
(Pouliopoulos, Graham, Keogh, MacDonald, Jabbour) Unsw, Sydney, Australia
(Stehning) Philips GmbH Innovative Technologies, Hamburg, Germany
(Puntmann) Institute For Experimental And Translational Cardiovascular
Imaging, Goethe University Hospital, Frankfurt, Germany
(Vassiliou, Gulati, Prasad) Cmr, Royal Brompton Hospital, Imperial
College, London, United Kingdom
(McLean) Alfred Health And Monash University, Melbourne, Australia
(Ismail) King's College, London, United Kingdom
(Liu) Stats Central, Mark Wainwright Analytical Centre, Unsw, Sydney,
Australia
(Vassiliou) Norwich Medical School, University Of East Anglia, United
Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Endomyocardial biopsy (EMB) is the gold standard method for
surveillance of acute cardiac allograft rejection (ACAR) despite its
invasive nature. Cardiovascular magnetic resonance (CMR)-based myocardial
tissue characterization allows detection of myocarditis. The feasibility
of CMR-based surveillance for ACAR-induced myocarditis in the first year
after heart transplantation is currently undescribed. <br/>Method(s):
CMR-based multiparametric mapping was initially assessed in a prospective
cross-sectional fashion to establish agreement between CMR-and EMB-based
ACAR and to determine CMR cutoff values between rejection grades. A
prospective randomized noninferiority pilot study was then undertaken in
adult orthotopic heart transplant recipients who were randomized at 4
weeks after orthotopic heart transplantation to either CMR-or EMB-based
rejection surveillance. Clinical end points were assessed at 52 weeks.
<br/>Result(s): Four hundred one CMR studies and 354 EMB procedures were
performed in 106 participants. Forty heart transplant recipients were
randomized. CMR-based multiparametric assessment was highly reproducible
and reliable at detecting ACAR (area under the curve, 0.92; sensitivity,
93%; specificity, 92%; negative predictive value, 99%) with greater
specificity and negative predictive value than either T1 or T2 parametric
CMR mapping alone. High-grade rejection occurred in similar numbers of
patients in each randomized group (CMR, n=7; EMB, n=8; P=0.74). Despite
similarities in immunosuppression requirements, kidney function, and
mortality between groups, the rates of hospitalization (9 of 20 [45%]
versus 18 of 20 [90%]; odds ratio, 0.091; P=0.006) and infection (7 of 20
[35%] versus 14 of 20 [70%]; odds ratio, 0.192; P=0,019) were lower in the
CMR group. On 15 occasions (6%), patients who were randomized to the CMR
arm underwent EMB for clarification or logistic reasons, representing a
94% reduction in the requirement for EMB-based surveillance.
<br/>Conclusion(s): A noninvasive CMR-based surveillance strategy for ACAR
in the first year after orthotopic heart transplantation is feasible
compared with EMB-based surveillance. Registration: HREC/13/SVH/66 and
HREC/17/SVH/80. Australian New Zealand Clinical Trials Registry:
ACTRN12618000672257. <br/>Copyright &#xa9; 2022 American Heart
Association, Inc.

<42>
[Use Link to view the full text]
Accession Number
2018928619
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) Department of Anesthesiology and Pain
Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Choi) Department of 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, Cheonan-si, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: A high fraction of inspired oxygen (Fio<inf>2</inf>) is
administered during one-lung ventilation (OLV). However, a high
Fio<inf>2</inf>is not physiologic and may lead to various complications.
We hypothesized that continuous titration of Fio<inf>2</inf>using the
oxygen reserve index (ORI) reduces oxygen exposure compared to
conventional management during OLV. <br/>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
Fio<inf>2</inf>was titrated for a target ORI of 0.21 at 5-minute intervals
during OLV. In the control group, Fio<inf>2</inf>was adjusted using
arterial blood gas analysis measured at 15 minutes after OLV initiation.
The primary end point was the time-weighted average Fio<inf>2</inf>during
OLV. <br/>RESULT(S): Overall, time-weighted average Fio<inf>2</inf>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
Fio<inf>2</inf>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 [Spo<inf>2</inf>] <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. <br/>CONCLUSION(S): ORI-guided
continuous Fio<inf>2</inf>titration does not reduce overall oxygen
exposure during OLV.<br/>Copyright &#xa9; 2022 Lippincott Williams and
Wilkins. All rights reserved.

<43>
Accession Number
2017926216
Title
Potential Markers of Neurocognitive Disorders After Cardiac Surgery: A
Bibliometric and Visual Analysis.
Source
Frontiers in Aging Neuroscience. 14 (no pagination), 2022. Article Number:
868158. Date of Publication: 01 Jun 2022.
Author
Ji L.; Li F.
Institution
(Ji, Li) Department of Neurology, Fu Xing Hospital, Capital Medical
University, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Identifying useful markers is essential for diagnosis and
prevention of perioperative neurocognitive disorders (PNDs). Here, we
attempt to understand the research basis and status, potential hotspots
and trends of predictive markers associated with PNDs after cardiac
surgery via bibliometric analysis. <br/>Method(s): A total of 4,609
original research articles and reviews that cited 290 articles between
2001 and 2021 were obtained from the Web of Science Core Collection
(WoSCC) as the data source. We used the software CiteSpace to generate and
analyze visual networks of bibliographic information, including published
years and journals, collaborating institutions, co-cited references, and
co-occurring keywords. <br/>Result(s): The number of annual and cumulative
publications from 2001 to 2021 has been increasing on the whole. The
Harvard Medical School was a very prolific and important institution in
this field. The journal of Ann Thorac Surg (IF 4.33) had the most
publications, while New Engl J Med was the most cited journal.
Neuron-specific enolase (NSE), S100b and kynurenic acid (KYNA) were
frequently discussed as possible markers of PNDs in many references.
Cardiopulmonary bypass (CPB) was a keyword with high frequency (430) and
sigma (6.26), and inflammation was the most recent burst keyword.
<br/>Conclusion(s): Potential markers of PNDs has received growing
attention across various disciplines for many years. The research basis
mainly focuses on three classic biomarkers of S100b, NSE, and KYNA. The
most active frontiers are the inflammation-related biomarkers (e.g.,
inflammatory cells, cytokines, or mediators) and surgery-related
monitoring parameters (e.g., perfusion, oxygen saturation, and the depth
of anesthesia).<br/>Copyright &#xa9; 2022 Ji and Li.

<44>
Accession Number
2018871232
Title
Direct oral anticoagulants in atrial fibrillation following cardiac
surgery: a systematic review and meta-analysis with trial sequential
analysis.
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Koh K.K.; Ling R.R.; Tan S.Y.S.; Chen Y.; Fan B.E.; Shekar K.; Sule J.A.;
Subbian S.K.; Ramanathan K.
Institution
(Koh, Ling, Tan, Ramanathan) Yong Loo Lin School of Medicine, National
University of Singapore, Singapore
(Chen) Agency for Science, Technology and Research, Singapore
(Fan) Department of Haematology, Tan Tock Seng Hospital, Singapore
(Shekar) Adult Intensive Care Services, Prince Charles Hospital, Brisbane,
QLD, Australia
(Shekar) Queensland University of Technology, Brisbane, QLD, Australia
(Shekar) University of Queensland, Brisbane, QLD, Australia
(Shekar) Bond University, Gold Coast, QLD, Australia
(Sule, Subbian) Department of Cardiac, Thoracic, and Vascular Surgery,
National University Heart Centre, National University Hospital, Singapore
(Ramanathan) Cardiothoracic Intensive Care Unit, National University Heart
Centre, National University Hospital, Singapore
Publisher
Elsevier Ltd
Abstract
Background: Direct oral anticoagulants (DOACs) have been increasingly used
as anticoagulation therapy in the postoperative period. However, their
effectiveness in post-cardiac surgical atrial fibrillation is yet to be
determined. <br/>Method(s): We conducted a meta-analysis, searching three
international databases from 1 January 2003 to 26 January 2022 for studies
reporting on DOACs in at least 10 adult patients (>18 yr of age) with
post-cardiac surgical atrial fibrillation. The primary outcomes were major
neurological events (MNEs) and bleeding; secondary outcomes were
mortality, hospital and ICU length of stay, cost, and other complications
from therapy. We included studies of any design, including RCTs, cohort
studies with and without propensity score matching methods, and
single-armed case series. <br/>Result(s): Twelve studies (8587 DOACs; 8315
warfarin) were included in this meta-analysis. The incidences of
postoperative bleeding and MNEs with DOACs were 7.3% (95% confidence
interval [CI]: 3.4-14.7%) and 2.2% (95% CI: 0.9-4.9%), respectively. The
incidence of MNEs was lower in high-risk patients, including those with
hypertension and higher CHA<inf>2</inf>DS<inf>2</inf>-VASc score, whereas
patients with prior transient ischaemic attack or stroke had higher
incidence of bleeding. Trial sequential analysis revealed that the
cumulative Z-curve crossed the conventional boundary of benefit. Compared
with warfarin, DOACs reduced the risk of bleeding (relative risk [RR]
0.74; 95% CI: 0.62-0.89; P=0.0011) and MNEs (RR 0.63; 95% CI: 0.48-0.83;
P=0.0012) but not mortality (RR 1.02; 95% CI: 0.77-1.35; P=0.090).
<br/>Conclusion(s): DOACs reduced bleeding and MNEs in patients with
post-cardiac surgical atrial fibrillation, appearing safer than warfarin
in this context. However, which DOAC provides the most effective
anticoagulation in this patient population needs further investigation.
Clinical trial registration: PROSPERO CRD42021282777.<br/>Copyright &#xa9;
2022 British Journal of Anaesthesia

<45>
Accession Number
2018851020
Title
Resternotomy Coronary Artery Bypass 1999-2018: Insights From The Society
of Thoracic Surgeons Adult Cardiac Surgery Database.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Rappoport N.; Aviel G.; Shahian D.M.; Korach A.; Carmi S.; Keaney J.F.;
Shapira O.M.
Institution
(Rappoport) Department of Software and Information Systems Engineering,
Faculty of Engineering Sciences, Ben-Gurion University of the Negev, Beer
Sheva, Israel
(Aviel, Korach, Shapira) Department of Cardiothoracic Surgery, Hadassah
Hebrew University Medical Center, Jerusalem, Israel
(Shahian) Division of Cardiac Surgery, Department of Surgery and The
Center of Quality & Safety, Massachusetts General Hospital and Harvard
Medical School, Boston, Massachusetts
(Carmi) Braun School of Public Health and Community Medicine, The Faculty
of Medicine, The Hebrew University, Jerusalem, Israel
(Keaney) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, Massachusetts
Publisher
Elsevier Inc.
Abstract
Background: We sought to quantify the risk trend of resternotomy coronary
artery bypass grafting (CABG) over the past 2 decades. <br/>Method(s): We
compared the outcomes of 194 804 consecutive resternotomy CABG patients
and 1 445 894 randomly selected first-time CABG patients (50% of total)
reported to The Society of Thoracic Surgeons Adult Cardiac Surgery
Database between 1999 and 2018. Primary outcomes were in-hospital
mortality and overall morbidity. Using multiple logistic regression for
each outcome for each year, we computed the annual trends of risk-adjusted
odds ratios for the primary outcomes in the entire cohort and in 194 776
propensity-matched pairs. <br/>Result(s): The annual resternotomy CABG
case volume from participating centers declined by 68%, from a median of
25 (range, 14-44) to a median of 8 (range, 4-15). Compared with first-time
CABG, resternotomy CABG patients were consistently older, with higher
proportions of comorbidities. After propensity matching, primary outcomes
of resternotomy and first-time CABG were similar (mortality: 3.5% vs 2.3%,
standardized difference [SDiff], 7.5%; morbidity: 40.7% vs 40.3%, SDiff,
0.9%). Mortality of resternotomy CABG performed after prior CABG was
higher than that after prior non-CABG (4.3% vs 2.4%; SDiff, 10.8).
Morbidity was similar between these subgroups (41.0% vs 39.1%; SDiff,
2.9). The adjusted odds ratio for mortality after resternotomy CABG
declined from 1.93 (95% CI, 1.73-2.16) to 1.22 (95% CI, 0.92-1.62), and
that of morbidity declined from 1.13 (95% CI, 1.08-1.18) to 0.91 (95% CI,
0.87-0.95), P < .001 for both. <br/>Conclusion(s): The risk of
resternotomy CABG has decreased substantially over time. Resternotomy CABG
performed after a prior CABG is higher risk compared with that performed
after a non-CABG operation.<br/>Copyright &#xa9; 2022 The Society of
Thoracic Surgeons

<46>
Accession Number
2018837035
Title
Risk of Perioperative Stroke in Patients With Patent Foramen Ovale: A
Systematic Review and Meta-analysis.
Source
Canadian Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Hobbes B.; Akseer S.; Pikula A.; Huszti E.; Devereaux P.J.; Horlick E.;
Abrahamyan L.
Institution
(Hobbes) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Akseer, Huszti, Abrahamyan) Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, ON, Canada
(Pikula) Division of Neurology, Toronto Western Hospital, University
Health Network, Toronto, ON, Canada
(Huszti) Biostatistics Research Unit, UHN, Toronto, ON, Canada
(Devereaux) Population Health Research Institute, Hamilton, ON, Canada
(Devereaux) Departments of Medicine, Health Research Methods, Evidence,
and Impact, McMaster University, Hamilton, ON, Canada
(Horlick) Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac
Centre, University Health Network, Toronto, ON, Canada
(Abrahamyan) Toronto General Hospital Research Institute, University
Health Network, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Patent foramen ovale (PFO) is a common congenital cardiac
abnormality. Risk of stroke increases perioperatively, but the association
of PFO with perioperative stroke risk remains unclear. We conducted a
systematic review to inform the risk of perioperative stroke in patients
with PFO undergoing surgery. <br/>Method(s): Embase, MEDLINE, and Cochrane
databases were searched from inception to January 2020. We described
methods used for establishing PFO and perioperative stroke diagnosis. We
conducted meta-analyses to obtain pooled estimates for risk of stroke in
patients with and without PFO in different surgical populations.
<br/>Result(s): Ten articles with a total of 20,858,011 patients met the
eligibility criteria. Prevalence of PFO ranged from 0.06% to 1.4% based on
International Classification of Diseases (ICD)-code diagnosis and from
10.4% to 40.4% based on echocardiography diagnosis. Perioperative stroke
was observed in 0% to 25% of patients with PFO, and 0% to 16.7% without
PFO. Studies that used echocardiography to diagnose PFO found no
association between PFO and perioperative stroke. Studies that used ICD
codes found strong association but were highly heterogeneous. PFO was not
associated with a risk of perioperative stroke in cardiac and
transplantation surgeries. While the adjusted odds ratios for stroke were
substantial for orthopaedic, general, genitourinary, neurologic, and
thoracic surgeries (with PFO status established based on ICD codes), data
heterogeneity and quality of data create significant uncertainty.
<br/>Conclusion(s): In conclusion, PFO is likely a risk factor for
perioperative stroke in selected types of surgeries. However, this is
based on very low-quality evidence. Rigorous prospective studies are
needed to further investigate this relationship.<br/>Copyright &#xa9; 2022
Canadian Cardiovascular Society

<47>
Accession Number
2018717958
Title
Antithrombotic strategies after transcatheter aortic valve implantation: A
systematic review and network meta-analysis of randomized controlled
trials.
Source
International Journal of Cardiology. 362 (pp 139-146), 2022. Date of
Publication: 01 Sep 2022.
Author
Ke Y.; Wang J.; Wang W.; Guo S.; Dai M.; Wu L.; Bao Y.; Li B.; Ju J.; Xu
H.; Jin Y.
Institution
(Ke) Discipline of Pharmacy Administration, Anqing Medical Center
affiliated to Anhui Medical University(Anqing Municipal Hospital), Anhui,
Anqing, China
(Ke, Wu, Bao, Jin) School of Pharmacy, Anhui Medical University, Anhui,
Hefei, China
(Wang) Department of Pharmacy, The Friendship Hospital of ILY Kazak
Autonomous Prefecture, Xinjiang, Yili, China
(Wang) Department of Gastroenterology, Anqing Medical Center affiliated to
Anhui Medical University(Anqing Municipal Hospital), Anhui, Anqing, China
(Guo) Department of Pharmacy, The People's Hospital of Guangxi Zhuang
Autonomous Region, Guangxi, Nanning, China
(Dai) School of Pharmacy, China Pharmaceutical University, Jiangsu,
Nanjing 210000, China
(Li) School of Public Health, Anhui Medical University, Anhui, Hefei,
China
(Ju) Department of Equipment, Anqing Medical Center affiliated to Anhui
Medical University(Anqing Municipal Hospital), Anhui, Anqing, China
(Xu) Department of Pharmacy, Nanjing Drum Tower Hospital Affiliated to
Nanjing University Medical School, Jiangsu, Nanjing, China
Publisher
Elsevier Ireland Ltd
Abstract
Aims: Meta-analyses comparing different antithrombotic strategies were
conducted to determine the optimal therapeutic regimen post transcatheter
aortic valve implantation (TAVI). However, there were restricted
high-quality direct comparisons across the different antithrombotic
therapeutic regimens. We sought to explore the safety and efficacy of
different antithrombotic therapy strategies after TAVI using network
meta-analyses of randomized controlled trials (RCTs). <br/>Method(s): We
searched CENTRAL, PubMed, Embase and Medline through August 2021 for RCTs
that directly compared different antithrombotic schemes in adults who had
undergone TAVI. We conducted a pairwise and network meta-analysis
measuring all-cause mortality, stroke, myocardial infarction, all bleeding
and life-threatening or major bleeding events. The surface under the
cumulative ranking (SUCRA) curve was estimated to rank the therapies. We
evaluated the risk of bias and graded the quality of the evidence using
established methods. <br/>Result(s): Six RCTs of 2824 patients who
underwent TAVI were analysed. The risk of all bleeding [relative risk (RR)
1.88 (1.34-2.64)] and life-threatening or major bleeding [RR 2.03
(1.27-3.24)] was significantly higher for dual antiplatelet therapy (DAPT)
than single antiplatelet therapy (SAPT), whereas there was no significant
difference in the risk of all-cause mortality [RR 1.01 (0.61-1.68)]
between DAPT and SAPT. Oral anticoagulant (OAC) + SAPT (OACSAPT) had
significantly higher rates of all bleeding and life-threatening or major
bleeding events compared with SAPT ([RR 3.46 (2.23-5.36)], [RR 2.86
(1.50-5.45)]). The risk of all-cause mortality [RR 1.72 (1.14-2.59)] and
all bleeding [RR 1.84 (1.38-2.44)] were significantly higher for OACSAPT
than DAPT, whereas there was no significant difference in the risk of
life-threatening or major bleeding events [RR 1.41 (0.89-2.23)] between
DAPT and OACSAPT. There was no significant difference in stroke or
myocardial infarction among the different antithrombotic strategies (SAPT,
DAPT and OACSAPT). Additionally, patients receiving OACSAPT had the
highest risks for all-cause mortality (SUCRA 3.5%) and life-threatening or
major bleeding (SUCRA 2.3%). SAPT seemed to be superior to DAPT in terms
of all-cause mortality (SUCRA SAPT: 76.7%, DAPT: 69.8%) and stroke (SUCRA
69.6%, 59.7%). <br/>Conclusion(s): Except for OACSAPT having a higher
all-cause mortality than DAPT, patients who underwent TAVI had similar
all-cause mortality, stroke and myocardial infarction rates among
different antithrombotic regimens. Patients on SAPT had a significantly
lower bleeding risk than those on DAPT and OACSAPT. Our study indicates
that SAPT is the preferred therapeutic strategy when there is no
indication for OAC or DAPT. Furthermore, the application of OACSAPT was
ranked the worst among all antithrombotic regimens and should be averted
due to an increased risk of all-cause mortality and all
bleeding.<br/>Copyright &#xa9; 2022 Elsevier B.V.

<48>
Accession Number
2018221562
Title
Editorial conflicts of interest related to the management of stable
ischemic heart disease.
Source
International Journal of Cardiology. 362 (pp 1-5), 2022. Date of
Publication: 01 Sep 2022.
Author
Ferrell M.C.; Garrett E.P.; Tomlin A.; Wayant C.; Vassar M.
Institution
(Ferrell, Garrett, Vassar) Office of Medical Student Research, Oklahoma
State University Center for Health Sciences, Tulsa, OK, United States
(Tomlin) Department of Internal Medicine, Oklahoma State University
Medical Center, Tulsa, OK, United States
(Wayant) Department of Internal Medicine, Baylor College of Medicine,
Houston, TX, United States
(Vassar) Department of Psychiatry and Behavioral Sciences, Oklahoma State
University Center for Health Sciences, Tulsa, OK, United States
Publisher
Elsevier Ireland Ltd
Abstract
Objective: Our study examines the association between the favorability of
percutaneous coronary intervention (PCI) and/or coronary artery bypass
surgery (CABG) and the presence of conflicts of interest (COIs) among
authors. <br/>Method(s): We used the "Citing Articles" tool on the New
England Journal of Medicine website to identify editorials on the use of
PCI/CABG for stable ischemic heart disease. Authors were rated as
"supportive," "neutral," or "critical" of these interventions based on the
content of their editorials. COIs for each author were identified using
past publications found on Scopus, PubMed, or a general internet search.
<br/>Result(s): A total of 606 articles were identified, and data were
extracted from 56 of them. Among the 149 authors, 64 (43.0%) had a COI. Of
these 64 authors, 19 (29.7%) disclosed their COI, while 45 (70.3%) did
not. Overall, among authors with a COI, there was no association between
disclosed and undisclosed COIs and the authors' view of PCI/CABG
[chi² (2, N = 64) = 1.63, p = .44]. If an author was associated
with Medtronic, Abbott, or Boston Scientific, they were more likely to
favor PCI/CABG if they had an undisclosed COI relative to authors who
disclosed COIs [chi² (1, N = 31) = 5.04, p = .025]. Authors
publishing in a cardiology journal were more likely to view PCI/CABG
favorably relative to those publishing in a general medicine journal
[chi² (2, N = 62) = 7.17, p = .028]. <br/>Conclusion(s):
Editors should adopt policies to counteract the unbalancing effects that
COIs have on medical opinions and evidence.<br/>Copyright &#xa9; 2022
Elsevier B.V.

<49>
Accession Number
2017997068
Title
Examination of the most cited studies on transcatheter aortic valve
replacement with bibliometric analysis.
Source
Echocardiography. (no pagination), 2022. Date of Publication: 2022.
Author
Guzel T.; Arslan B.
Institution
(Guzel) Department of Cardiology, Health Science University, Gazi Yasargil
Training and Research Hospital, Diyarbakir, Turkey
(Arslan) Department of Cardiology, Ergani State Hospital, Diyarbakir,
Turkey
Publisher
John Wiley and Sons Inc
Abstract
Aim: The aim of this study is to analyze the studies on TAVI with the
bibliometric method and to perform a scientiometric analysis of the top
100 most cited articles for researchers. <br/>Method(s): The Thomson
Reuters Web of Science database was searched for all relevant articles
using the terms "TAVR" and "TAVI". The results were ordered according to
the number of citations. We also analyzed the 100 most cited articles
(T100) by annual average citation count (ACpY), years, research methods,
author, institution, journal, funding agencies, and keywords. Analyses
were also performed between the total number of citations, ACpY, impact
factors, and publication time. <br/>Result(s): The article titled
"Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients
Who Cannot Undergo Surgery" was the most cited article (n = 4616). The
article titled "Transcatheter Aortic-Valve Replacement with a
Balloon-Expandable Valve in Low-Risk Patients" had the highest ACpY count
(n = 497). The United States was the country that contributed the most to
the T100 list. While the journal that contributed the most with 32
articles was "Journal of the American College Of Cardiology", the journal
in which the top 10 most cited articles were published most frequently was
the "New England Journal of Medicine". In addition, the most publications
were made in 2012. <br/>Conclusion(s): Although this bibliometric analysis
study has some limitations, it allows the most cited publications on TAVI
to be analyzed systematically and provides scientific
contributions.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<50>
Accession Number
2017904327
Title
Validity Evidence for Procedure-Specific Competency Assessment Tools in
Cardiovascular and Thoracic Surgery: A Scoping Review: Procedure-specific
competence assessment in CVT surgery.
Source
Journal of Surgical Education. 79(4) (pp 1016-1023), 2022. Date of
Publication: 01 Jul 2022.
Author
White A.; Muller Moran H.R.; Ryan J.; Mador B.; Campbell S.; Turner S.R.
Institution
(White, Ryan, Mador, Turner) Department of Surgery, University of Alberta,
Edmonton, AB, Canada
(Muller Moran) Department of Surgery, University of Manitoba, Winnipeg,
MB, Canada
(Campbell) University of Alberta Library, Edmonton, AB, Canada
Publisher
Elsevier Inc.
Abstract
OBJECTIVE: Surgical education has shifted from a time-based approach to
the achievement and demonstration of procedural competency. High quality,
objective assessment instruments are required to support this new
approach. This study comprehensively reviewed the literature to identify
and evaluate available procedure-specific assessment instruments in
cardiothoracic and vascular surgery. DESIGN: A systematic search of 8
databases identified studies containing procedure-specific operative
assessment instruments in cardiothoracic and vascular surgery. Generic
global rating scales were excluded, unless modified to be
procedure-specific. Two reviewers independently evaluated the validity
evidence, methodological rigour and educational utility of each instrument
using objective scoring criteria. Validity evidence was evaluated with a
scoring tool aligned with the contemporary framework of validity.
Methodological rigour was evaluated using the Medical Education Research
Study Quality Instrument. Educational utility was evaluated according to
the Accreditation Council for Graduate Medical Education (ACGME)
framework. <br/>RESULT(S): There were 2130 unique studies describing
procedure-specific assessment in surgery. Of these, 9 studies evaluating 8
procedure-specific assessment instruments met inclusion criteria for
cardiothoracic and vascular surgery. Four instruments were identified in
thoracic surgery, 2 in cardiac surgery, and 2 in vascular surgery. Only 1
instrument was designed to evaluate surgeon performance, with the
remainder designed to evaluate residents. No single instrument scored the
maximum score of 15 for validity evidence. The highest score was 11, with
62.5% (n = 5) of instruments scoring greater than 10. All tools attained
high scores in content validity, with minimal evidence generally presented
regarding the consequences of assessment using a particular instrument.
All but 1 instrument scored greater than 11 out of a maximum 16.5 points
for methodological rigour. Very few studies reported on the ACGME domains
of educational utility. <br/>CONCLUSION(S): In an era where surgical
education is shifting towards the demonstration of procedural competency,
objective procedure-specific assessment is critical. This review
identified that few procedure-specific assessment instruments in
cardiothoracic and vascular surgery exist, emphasizing the need for such
instruments to ensure the success of competency-based education
models.<br/>Copyright &#xa9; 2022

<51>
Accession Number
2017847961
Title
Letter to the Editor Regarding Left Atrial Appendage Closure During
Cardiac Surgery for Atrial Fibrillation: A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 40 (pp 205), 2022. Date of
Publication: July 2022.
Author
Prasad R.M.; Saleh Y.; Al-abcha A.
Institution
(Prasad, Al-abcha) Department of Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Saleh) Department of Cardiology, Houston Methodist DeBakey Heart &
Vascular Center, Houston, TX, United States
Publisher
Elsevier Inc.

<52>
Accession Number
2017527001
Title
Outcomes of Coronary Artery Bypass Grafting in Patients With Poor
Myocardial Viability: A Systematic Review and Meta-Analysis of the Last
Decade.
Source
Heart Lung and Circulation. 31(7) (pp 916-923), 2022. Date of Publication:
July 2022.
Author
Sharma V.J.; Arghami A.; Pasupula D.K.; Haddad A.; Ke J.X.C.
Institution
(Sharma) Department of Cardiac Surgery, Austin Health, Heidelberg,
Melbourne, VIC, Australia
(Sharma) Department of Surgery (Austin Health), Melbourne Medical School,
Heidelberg, Melbourne, VIC, Australia
(Arghami) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
(Pasupula) Department of Cardiology, MercyOne North Iowa Medical Center,
Mason City, IA, United States
(Ke) Department of Anesthesia, Pain Management & Perioperative Medicine,
Dalhousie University, Halifax, Canada
(Ke) Department of Anesthesia, Providence Health Care, Vancouver, Canada
(Ke) Department of Anesthesiology, Pharmacology and Therapeutics, Faculty
of Medicine, University of British Columbia, Vancouver, Canada
(Sharma, Arghami, Pasupula, Haddad, Ke) Harvard T.H. Chan School of Public
Health, Harvard University, Boston, MA, United States
Publisher
Elsevier Ltd
Abstract
Objectives: Our objective is to assess whether the presence of myocardial
viability is a predictor of mortality among patients undergoing coronary
artery bypasss grafting (CABG) through a systematic review meta-analysis.
<br/>Method(s): Comprehensive review of EMBASE and PubMed in accordance
with PRISMA guidelines, including studies of patients undergoing CABG with
assessment of myocardial viability and recorded long-term mortality, age
and sex. Studies were restricted to the last decade, and data were
stratified by imaging modality (magnetic resonance imaging [MRI] or
nuclear medicine). Random-effects model for assessing pooled effect,
heterogeneity assessment using Chi-square and I² statistics,
publication bias assessed by funnel plots and Egger's test.
<br/>Result(s): Meta-analysis of contemporary data (January 2010 to
October 2020) yielded 3,621 manuscripts of which 92 were relevant, and 6
appropriate for inclusion with 993 patients. Pooled analysis showed that
patients with non-viable myocardium undergoing CABG are at 1.34 times the
risk of mortality compared to those with viable myocardium (95% CI
1.01-1.79, p=0.05). Subgroup analysis of the MRI or nuclear medicine
modalities was not statistically significant and there was no confounding
by age or sex in meta-regression. There was significant heterogeneity in
imaging modality and diagnostic criteria, but heterogeneity between study
findings was low with an I² statistic of 29%. The risk of
publication bias was moderate on the Newcastle-Ottawa Scale), but not
statistically significant (Egger's Test coefficient=1.3, 95%CI -0.35-2.61,
p=0.10). <br/>Conclusion(s): There is a multitude of methods for assessing
cardiac viability for coronary revascularisation surgery, making
meta-analyses fraught with limitations. Our meta-analysis demonstrates
that the finding of non-viable myocardium can not be used draw conclusions
for risk assessment in coronary surgery.<br/>Copyright &#xa9; 2022

<53>
Accession Number
2016907949
Title
Non-invasive Imaging in the Evaluation of Cardiac Allograft Vasculopathy
in Heart Transplantation: A Systematic Review.
Source
Current Problems in Cardiology. 47(8) (no pagination), 2022. Article
Number: 101103. Date of Publication: August 2022.
Author
Ajluni S.C.; Mously H.; Chami T.; Hajjari J.; Stout A.; Zacharias M.;
ElAmm C.; Wilson D.; Janus S.E.; Al-Kindi S.G.
Institution
(Ajluni, Hajjari) Department of Medicine, University Hospitals, Cleveland,
OH
(Mously, Zacharias, ElAmm, Wilson, Janus, Al-Kindi) Harrington Heart and
Vascular Institute, University Hospitals and School of Medicine, Case
Western Reserve University, Cleveland, OH
(Chami) Minneapolis Heart Institute, Minneapolis, MN, United States
(Stout) Core Library, University Hospitals Cleveland Medical Center,
Cleveland, OH
Publisher
Elsevier Inc.
Abstract
Cardiac allograft vasculopathy (CAV) is the leading cause of long-term
graft dysfunction in patients with heart transplantation and is linked
with significant morbidity and mortality. Currently, the gold standard for
diagnosing CAV is coronary imaging with intravascular ultrasound during
traditional invasive coronary angiography. Invasive imaging, however,
carries increased procedural risk and expense to patients in addition to
requiring an experienced interventionalist. With the improvements in
non-invasive cardiac imaging modalities such as transthoracic
echocardiography, computed tomography, magnetic resonance imaging and
positron emission tomography, an alternative non-invasive imaging approach
for the early detection of CAV may be feasible. In this systematic review,
we explored the literature to investigate the utility of non-invasive
imaging in diagnosis of CAV in >3000 patients across 49 studies. We also
discuss the strengths and weaknesses for each imaging modality. Overall,
all 4 imaging modalities show good to excellent accuracy for identifying
CAV with significant variations across studies. Majority of the studies
compared non-invasive imaging with invasive coronary angiography without
intravascular imaging. In summary, non-invasive imaging modalities offer
an alternative approach to invasive coronary imaging for CAV. Future
studies should investigate longitudinal non-invasive protocols in low-risk
patients after heart transplantation.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<54>
Accession Number
2015656918
Title
Left Atrial Appendage Closure During Cardiac Surgery for Atrial
Fibrillation: A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 40 (pp 26-36), 2022. Date of
Publication: July 2022.
Author
Prasad R.M.; Saleh Y.; Al-Abcha A.; Abdelkarim O.; Abdelfattah O.M.;
Abdelnabi M.; Almaghraby A.; Elwany M.; DeBruyn E.; Abela G.S.
Institution
(Prasad, Al-Abcha) Department of Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Saleh, Abdelkarim) Department of Cardiology, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
(Saleh, Abdelkarim, Almaghraby, Elwany) Department of Cardiology,
Alexandria University, Alexandria, Egypt
(Abdelfattah) Department of Internal Medicine, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(DeBruyn) College of Medicine, University of Illinois, Chicago, IL, United
States
(Abela) Department of Cardiology, Michigan State University, East Lansing,
MI, United States
(Abdelnabi) Internal Medicine Department, Texas Tech University Health
Science Center, Lubbock, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage closure (LAAC) during cardiac surgery in
atrial fibrillation (AF) patients has been investigated in multiple
studies with variable safety and efficacy results. <br/>Method(s): A
comprehensive review was performed of all studies comparing LAAC and
placebo arm during cardiac surgery in AF patients. A random-effect model
was used to calculate risk ratios, mean differences, and 95% confidence
intervals. <br/>Result(s): Five randomized controlled trials and 22
observational studies were included with a total of 540,111 patients. The
LAAC group had significantly decreased postoperative stroke/embolic events
as compared to the no LAAC group with all cardiac surgeries (3.74% vs
4.88%, p = 0.0002), isolated valvular surgery (1.95% vs 4.48%, p = 0.002).
However, CABG insignificantly favored the LAAC group for stroke/embolic
events (6.72% vs 8.30%, p = 0.07). There was no difference between both
groups in all-cause mortality in the perioperative period (p = 0.42), but
was significantly lower in the LAAC arm after two years (14.1% vs 18.3%, p
= 0.02). There was no difference in major bleeding, all-cause
rehospitalizations, or cross-clamp time between both groups (p = 0.53 and
p = 0.45). The bypass and the cross-clamp time were longer in the LAAC
group (4 and 9 min, respectively). <br/>Conclusion(s): In AF patients,
LAAC during cardiac surgery had a decreased risk of stroke and long-term
all-cause mortality. Additionally, there was no difference in major
bleeding, all-cause rehospitalizations, or cross-clamp time.<br/>Copyright
&#xa9; 2021

<55>
Accession Number
2015109159
Title
Comparison of ECMO vs ECpella in Patients With Non-Post-Pericardiotomy
Cardiogenic Shock: An Updated Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 40 (pp 134-141), 2022. Date of
Publication: July 2022.
Author
Iannaccone M.; Venuti G.; di Simone E.; De Filippo O.; Bertaina M.;
Colangelo S.; Boccuzzi G.; de Piero M.E.; Attisani M.; Barbero U.; Zanini
P.; Livigni S.; Noussan P.; D'Ascenzo F.; de Ferrari G.M.; Porto I.;
Truesdell A.G.
Institution
(Iannaccone, di Simone, Bertaina, Colangelo, Boccuzzi, Zanini, Noussan)
Division of Cardiology, San Giovanni Bosco Hospital, ASL Citta di Torino,
Turin, Italy
(Venuti) Division of Cardiology, A.O. Papardo, Messina, Italy
(De Filippo, Attisani, D'Ascenzo, de Ferrari) Division of Cardiology,
Citta della Scienza e della Salute, University of Turin, Turin, Italy
(de Piero, Livigni) Department of Anesthesiology and Intensive Care, San
Giovanni Bosco Hospital, ASL Citta di Torino, Turin, Italy
(Barbero) Division of Cardiology, Sevigliano ASL CN1, Italy
(Porto) Cardiovascular Disease Unit, IRCCS Policlinic Hospital San
Martino, Genova, Italy
(Truesdell) Virginia Heart/Inova Heart and Vascular Institute, Falls
Church, VA, United States
Publisher
Elsevier Inc.
Abstract
Introduction: The impact of Impella and ECMO (ECPELLA) in cardiogenic
shock (CS) remains to be defined. The aim of this meta-analysis is to
evaluate the benefit of ECPELLA compared to VA-ECMO in patients with non
post-pericardiotomy CS. <br/>Method(s): All studies reporting short term
outcomes of ECpella or VA ECMO in non post-pericardiotomy CS were
included. The primary endpoint was 30-day mortality. Vascular and bleeding
complications and LVAD implantation/heart transplant within 30-days were
assessed as secondary outcomes. <br/>Result(s): Of 407 studies identified,
13 observational studies (13,682 patients, 13,270 with ECMO and 412 with
ECpella) were included in this analysis. 30-day mortality was 55.8%
(51.6-59.9) in the VA-ECMO group and 58.3% (53.5-63.0) in the ECpella
group. At meta-regression analysis the implantation of IABP did not affect
mortality in the ECMO group. The rate of major bleeding in patients on
VA-ECMO and ECpella support were 21.3% (16.9-26.5) and 33.1% (25.9-41.2)
respectively, while the rates of the composite outcome of LVAD
implantation and heart transplantation within 30-days in patients on
VA-ECMO and ECpella support were 14.4% (9.0-22.2) and 10.8%. When directly
compared in 3 studies, ECpella showed a positive effect on 30-day
mortality compared to ECMO (OR: 1.81: 1.039-3.159). <br/>Conclusion(s):
Our data suggest that ECpella may reduce 30-day mortality and increase
left ventricle recovery, despite increased of bleeding
rates.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<56>
Accession Number
638280585
Title
Transcatheter Aortic Valve Implantation With and Without Resheathing and
Repositioning: A Systematic Review and Meta-analysis.
Source
Journal of the American Heart Association. 11(12) (pp e024707), 2022. Date
of Publication: 21 Jun 2022.
Author
Moroni F.; Azzalini L.; Sondergaard L.; Attizzani G.F.; Garcia S.; Jneid
H.; Mamas M.A.; Bagur R.
Institution
(Moroni) Division of Cardiology Pauley Heart CenterVirginia Commonwealth
University Richmond VA
(Azzalini) Division of Cardiology Department of Medicine University of
Washington Seattle WA
(Sondergaard) Heart Centre, RigshospitaletCopenhagen University Hospital
Copenhagen Denmark, Denmark
(Attizzani) Harrington Heart and Vascular InstituteUniversity Hospitals
Cleveland Medical Center Cleveland OH
(Garcia) Carl and Edyth Lindner Center for Research and Education, The
Christ Hospital Cincinnati OH
(Jneid) Division of Cardiology Baylor School of Medicine and the Michael
E. DeBakey VAMC Houston TX
(Mamas, Bagur) Keele Cardiovascular Research Group Centre for Prognosis
ResearchInstitute of Primary Care and Health SciencesKeele University
Stoke-on-Trent United Kingdom, United Kingdom
(Bagur) Department of Epidemiology and Biostatistics Schulich School of
Medicine & Dentistry Western University London Ontario Canada
Publisher
NLM (Medline)
Abstract
Background There is a concern that resheathing/repositioning of
transcatheter heart valves during transcatheter aortic valve implantation
(TAVI) may lead to an increased risk of periprocedural complications. We
aimed to evaluate the short- and long-term impact on clinical outcomes of
resheathing for repositioning of transcatheter heart valves during TAVI
procedures. Methods and Results We conducted a systematic search of
Embase, MEDLINE, and Cochrane Central Register of Controlled Trials
databases to identify studies comparing outcomes between patients
requiring resheathing/repositioning during TAVI and those who did not.
Random-effects meta-analyses were used to estimate the association of
resheathing compared with no resheathing with clinical outcomes after
TAVI. Seven studies including 4501 participants (pooled mean age,
80.9+/-7.4 years; 54% women; and 1374 [30.5%] patients requiring
resheathing/repositioning) were included in this study. No significant
differences between the 2 groups were identified with regards to safety:
30-day mortality (n=3125; odds ratio [OR], 0.74 [95% confidence interval
[CI], 0.41-1.33]; I2=0%), stroke (n=4121; OR, 1.09 [95% CI, 0.74-1.62];
I2=0%), coronary obstruction (n=3000; OR, 2.35 [95% CI, 0.17-33.47];
I2=75%), major vascular complications (n=3125; OR, 0.92 [95% CI,
0.66-1.33]; I2=0%), major bleeding (n=3125; OR, 1.13 [95% CI, 0.94-2.01];
I2=39%), acute kidney injury (n=3495; OR, 1.30 [95% CI, 0.64-2.62];
I2=44%), and efficacy outcomes: device success (n=1196; OR, 0.77 [95% CI,
0.51-1.14]; I2=0%), need for a second valve (n=3170; OR, 2.86 [95% CI,
0.96-8.48]; I2=62%), significant (moderate or higher) paravalvular leak
(n=1151; OR, 1.53 [95% CI, 0.83-2.80]; I2=0%), and permanent pacemaker
implantation (n=1908; OR, 1.04 [95% CI, 0.68-1.57]; I2=58%). One-year
mortality was similar between groups (n=1972; OR, 1.00 [95% CI,
0.68-1.47]; I2=0%). Conclusions Resheathing of transcatheter heart valves
during TAVI is associated with similar periprocedural risk compared with
no resheathing in several patient-important outcomes. These data support
the safety of current self-expanding transcatheter heart valves with
resheathing features. Registration URL:
https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42021273715.

<57>
Accession Number
637379347
Title
Serum Lactate and Mortality during Pediatric Admissions: Is 2 Really the
Magic Number?.
Source
Journal of Pediatric Intensive Care. 11(2) (pp 83-90), 2022. Date of
Publication: 01 Jun 2022.
Author
Loomba R.S.; Farias J.S.; Villarreal E.G.; Flores S.
Institution
(Loomba) Division Of Pediatric Cardiac Critical Care, Advocate Children's
Hospital, Oak Lawn, IL, United States
(Loomba) Department Of Pediatrics, Chicago Medical School, Rosalind
Franklin University Of Medicine And Science, Chicago, IL, United States
(Farias, Villarreal) Tecnologico De Monterrey, School Of Medicine And
Health Sciences, Nuevo Leon, Monterrey, Mexico
(Flores) Section Of Critical Care Medicine And Cardiology, Texas
Children's Hospital, Houston, TX, United States
(Flores) Department Of Pediatrics, Baylor College Of Medicine, Houston,
TX, United States
Publisher
Georg Thieme Verlag
Abstract
The primary objective of this study was to determine if serum lactate
level at the time of hospital admission can predict mortality in pediatric
patients. A systematic review was conducted to identify studies that
assessed the utility of serum lactate at the time of admission to predict
mortality in pediatric patients. The areas under the curve from the
receiver operator curve analyses were utilized to determine the pooled
area under the curve. Additionally, standardized mean difference was
compared between those who survived to discharge and those who did not. A
total of 12 studies with 2,099 patients were included. Out of these, 357
(17%) experienced mortality. The pooled area under the curve for all
patients was 0.74 (0.67-0.80, p < 0.01). The pooled analyses for all
admissions were higher in those who experienced mortality (6.5 vs. 3.3
mmol/L) with a standardized mean difference of 2.60 (1.74-3.51, p < 0.01).
The pooled area under the curve for cardiac surgery patients was 0.63
(0.53-0.72, p < 0.01). The levels for cardiac surgery patients were higher
in those who experienced mortality (5.5 vs. 4.1 mmol/L) with a
standardized mean difference of 1.80 (0.05-3.56, p = 0.04). Serum lactate
at the time of admission can be valuable in identifying pediatric patients
at greater risk for inpatient mortality. This remained the case when only
cardiac surgery patients were included. <br/>Copyright &#xa9; 2020.
Thieme. All rights reserved.

<58>
Accession Number
2017985983
Title
Parasternal After Cardiac Surgery (PACS): a prospective, randomised,
double-blinded, placebo-controlled trial study protocol for evaluating a
continuous bilateral parasternal block with lidocaine after open cardiac
surgery through sternotomy.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 516. Date of
Publication: December 2022.
Author
Larsson M.; Sartipy U.; Franco-Cereceda A.; Owall A.; Jakobsson J.
Institution
(Larsson, Sartipy, Franco-Cereceda, Owall) Department of Molecular
Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
(Larsson, Owall) Function Perioperative Medicine and Intensive Care,
Section for Cardiothoracic Anaesthesia and Intensive Care, Karolinska
University Hospital, Stockholm, Sweden
(Sartipy, Franco-Cereceda) Department of Cardiothoracic Surgery,
Karolinska University Hospital, Stockholm, Sweden
(Jakobsson) Institution for Clinical Sciences, Karolinska Institutet at
Danderyds Hospital, Stockholm, Sweden
(Jakobsson) Department of Anaesthesia and Intensive Care, Danderyds
Hospital, Stockholm, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Multimodal analgesia that provides optimal pain treatment with
minimal side effects is important for optimal recovery after open cardiac
surgery. Regional anaesthesia can be used to block noxious nerve signals.
Because sternotomy causes considerable pain that lasts several days, a
continuous nerve block is advantageous. Previous studies on continuous
sternal wound infusion or parasternal blocks with long-acting local
anaesthetics have shown mixed results. This study aims to determine
whether a continuous bilateral parasternal block with lidocaine, which is
a short-acting local anaesthetic that has a favourable safety/toxicity
profile, results in effective analgesia. We hypothesise that a 72-hour
continuous parasternal block with 0.5% lidocaine at a rate of 7 ml/hour on
each side provides effective analgesia and reduces opioid requirement. We
will evaluate whether recovery is enhanced. <br/>Method(s): In a
prospective, randomised, double-blinded manner, 45 patients will receive a
continuous parasternal block with either 0.5% lidocaine or saline. The
primary endpoint is cumulated intravenous morphine by patient-controlled
analgesia at 72 hours. Secondary end-points include the following: (1) the
cumulated numerical rating scale (NRS) score recorded three times daily at
72 hours; (2) the cumulated NRS score after two deep breaths three times
daily at 72 hours; (3) the NRS score at rest and after two deep breaths at
2, 4, 8 and 12 weeks after surgery; (4) oxycodone requirement at 2, 4, 8
and 12 weeks after surgery; (5) Quality of Recovery-15 score
preoperatively compared with that at 24, 48 and 72 hours, and at 2, 4, 8
and 12 weeks after surgery; (6) preoperative peak expiratory flow compared
with postoperative daily values for 3 days; and (7) serum concentrations
of interleukin-6 and lidocaine at 1, 24, 48 and 72 hours postoperatively
compared with preoperative values. <br/>Discussion(s): Adequate analgesia
is important for quality of care and vital to a rapid recovery after
cardiac surgery. This study aims to determine whether a continuous
parasternal block with a short-acting local anaesthetic improves analgesia
and recovery after open cardiac procedures. Trial registration: The study
was registered in the European Clinical Trials Database on 27/9/2019
(registration number: 2018-004672-35).<br/>Copyright &#xa9; 2022, The
Author(s).

<59>
Accession Number
2017048782
Title
Reply to Left Atrial Appendage Closure During Cardiac Surgery for Atrial
Fibrillation: A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 40 (pp 204), 2022. Date of
Publication: July 2022.
Author
Eagle G.E.; Whitlock R.P.; Belley-Cote E.P.
Institution
(Eagle, Whitlock, Belley-Cote) McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.

<60>
[Use Link to view the full text]
Accession Number
2018953024
Title
Compounding Benefits of Cholesterol-Lowering Therapy for the Reduction of
Major Cardiovascular Events: Systematic Review and Meta-Analysis.
Source
Circulation: Cardiovascular Quality and Outcomes. 15(6) (pp E008552),
2022. Date of Publication: 01 Jun 2022.
Author
Wang N.; Woodward M.; Huffman M.D.; Rodgers A.
Institution
(Wang, Woodward, Huffman, Rodgers) George Institute for Global Health,
University of New South Wales, Sydney, Australia
(Wang) Sydney Medical School, University of Sydney, Australia
(Woodward, Rodgers) George Institute for Global Health, School of Public
Health Imperial College, London, United Kingdom
(Woodward) Department of Epidemiology, Johns Hopkins University,
Baltimore, MD, United States
(Huffman) Feinberg School of Medicine, Departments of Preventive Medicine
and Medicine, Northwestern University, Chicago, IL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Mendelian randomization studies use genetic variants as
natural experiments to provide evidence about causal relations between
modifiable risk factors and disease. Recent Mendelian randomization
studies suggest each mmol/L reduction in low-density lipoprotein
cholesterol (LDL-C) sustained over a lifetime can reduce the risk of
cardiovascular disease by more than half. However, these findings have not
been replicated in randomized clinical trials, and the effect of treatment
duration on the magnitude of risk reduction remains uncertain. The aim of
this article was to evaluate the relationship between lipid-lowering drug
exposure time and relative risk reduction of major cardiovascular events
in randomized clinical trials. <br/>Method(s): We conducted a systematic
review and meta-analysis of randomized clinical trials of statins,
ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors
that report LDL-C levels and effect sizes for each year of follow-up. The
primary end point was major vascular events, defined as the composite of
cardiovascular death, myocardial infarction, stroke, and coronary
revascularization. Hazard ratios during each year of follow-up were
meta-analyzed using random-effects models. <br/>Result(s): A total of 21
trials with 184 012 patients and an average mean follow-up of 4.4 years
were included. Meta-regression showed there was greater relative risk
reduction in major vascular events with increasing duration of treatment
(P<0.001). For example, each mmol/L LDL-C lowered was associated with a
relative risk reduction in major vascular events of 12% (95% CI, 8%-16%)
for year 1, 20% (95% CI, 16%-24%) for year 3, 23% (95% CI, 18%-27%) for
year 5, and 29% (95% CI, 14%-42%) for year 7. <br/>Conclusion(s): The
benefits of LDL-C lowering do not seem to be fixed but increase steadily
with longer durations of treatment. The results from short-term randomized
trials are compatible with the very strong associations between LDL-C and
cardiovascular events seen in Mendelian randomization
studies.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<61>
Accession Number
2018851232
Title
The Effects of Targeted Changes in Systemic Blood Flow and Mean Arterial
Pressure on Urine Oximetry During Cardiopulmonary Bypass.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Hu R.; Yanase F.; McCall P.; Evans R.; Raman J.; Bellomo R.
Institution
(Hu, McCall) Department of Anaesthesia, Austin Health, Heidelberg, VIC,
Australia
(Hu, McCall) Department of Critical Care, Melbourne Medical School, The
University of Melbourne, VIC, Australia
(Yanase, Bellomo) Department of Intensive care unit, Austin Health,
Heidelberg, VIC, Australia
(Yanase) Australian and New Zealand Intensive Care Research Centre, Monash
University, Melbourne, VIC, Australia
(Evans) Cardiovascular Disease Program, Biomedicine Discovery Institute
and Department of Physiology, Monash University, Melbourne, VIC, Australia
(Evans) Pre-clinical Critical Care Unit, Florey Institute of Neuroscience
and Mental Health, University of Melbourne, Melbourne, VIC, Australia
(Raman) Department of Cardiac Surgery, St. Vincent's Hospital & Austin
Health, Melbourne, VIC, Australia
(Raman) Department of Surgery, University of Melbourne, Melbourne, VIC,
Australia
Publisher
W.B. Saunders
Abstract
Objectives: Poor medullary oxygenation is implicated in the evolution of
acute kidney injury. The authors sought to determine if increasing
systemic flow and mean arterial pressure could improve urine oxygen
tension (PuO<inf>2</inf>) measured in the bladder, a surrogate of kidney
medullary oxygenation, in patients undergoing on-pump cardiac surgery.
<br/>Design(s): Randomized crossover study. <br/>Setting(s):
University-affiliated hospital. <br/>Participant(s): Twenty adult patients
undergoing cardiopulmonary bypass (CPB) with expected cross-clamp time of
>60 minutes and estimated glomerular filtration rate of >30
mL/min/1.73m². <br/>Intervention(s): Sequential 20-minute
periods of 2 interventions: Intervention H ("High") or Intervention N
("Normal"). The order of interventions was determined by randomization.
Intervention H: targeted CPB flow 3.0 L/min/m² and mean
arterial pressure (MAP) 80 mmHg. Intervention N: targeted CPB flow 2.4
L/min/m² and MAP 65 mmHg. <br/>Measurements and Main Results:
PuO<inf>2</inf> was measured by an oxygen sensor introduced into the
bladder via a urinary catheter. Clear separation was achieved in CPB flow
and MAP between intervention periods (p < 0.001 for group-time
interaction). PuO<inf>2</inf> during Intervention H was higher than during
Intervention N (p < 0.001 for group-time interaction). After 17 minutes,
PuO<inf>2</inf> was statistically higher in Intervention H at each time
point. There were no differences in markers of hemolysis between
interventions. <br/>Conclusion(s): PuO<inf>2</inf> was higher when
systemic flow and MAP were increased during CPB. These findings suggest
that PuO<inf>2</inf> is responsive to changes in hemodynamics and that
higher flow and pressure may improve medullary oxygenation.<br/>Copyright
&#xa9; 2022

<62>
Accession Number
2018020858
Title
Fractal dimension of the aortic annulus: a novel predictor of paravalvular
leak after transcatheter aortic valve implantation.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2022.
Date of Publication: 2022.
Author
Stachel G.; Abdel-Wahab M.; de Waha-Thiele S.; Desch S.; Feistritzer
H.-J.; Kitamura M.; Farhan S.; Eitel I.; Kurz T.; Thiele H.
Institution
(Stachel, Abdel-Wahab, Desch, Feistritzer, Kitamura, Thiele) Department of
Internal Medicine/Cardiology and Leipzig Heart Institute, Heart Center
Leipzig at University of Leipzig, Leipzig, Germany
(de Waha-Thiele) Department of Cardiac Surgery, Heart Center Leipzig at
University of Leipzig, Strumpellstr. 39, Leipzig 04289, Germany
(Desch, Eitel, Kurz) University Clinic Schleswig-Holstein, University
Heart Center Luebeck, Lubeck, Germany
(Farhan) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Eitel) DZHK (German Centre for Cardiovascular Research), Partner Site
Hamburg/Luebeck/Kiel, Lubeck, Germany
Publisher
Springer Science and Business Media B.V.
Abstract
To evaluate the prognostic relevance of aortic annulus (AA) and left
ventricular outflow tract (LVOT) Fractal dimension (FD). FD is a
mathematical concept that describes geometric complexity of a structure
and has been shown to predict adverse outcomes in several contexts.
Computed tomography (CT) scans from the SOLVE-TAVI trial, which, in a 2 x
2 factorial design, randomized 447 patients to TAVI with the
balloon-expandable Edwards Sapien 3 or the self-expanding Medtronic Evolut
R, and conscious sedation or general anesthesia, were analyzed
semi-automatically with a custom-built software to determine border of AA
and LVOT. FD was measured by box counting using grid calibers between 0.8
and 6.75 mm and was compared between patients with none/trivial and
mild/moderate paravalvular regurgitation (PVR). Overall, 122 patients had
CT scans sufficient for semi-automatic PVR in 30-day echocardiography. PVR
was none in 65(53.3%) patients, trace in 9(7.4%), mild in 46(37.7%),
moderate in 2(1.6%) and severe in 0 patients. FD determined in diastolic
images was significantly higher in patients with mild/moderate PVR (1.0558
+/- 0.0289 vs. 1.0401 +/- 0.0284, p = 0.017). Annulus eccentricity was the
only conventional measure of AA and LVOT geometry significantly correlated
to FD (R = 0.337, p < 0.01). Area under the curve (AUC) of diastolic
annular FD for prediction of mild/moderate PVR in ROC analysis was 0.661
(0.542-0.779, p = 0.014). FD shows promise in prediction of PVR after
TAVI. Further evaluation using larger patient numbers and refined
algorithms to better understand its predictive performance is warranted.
Trial Registration:www.clinicaltrials.gov, identifier: NCT02737150, date
of registration: 13.04.2016.<br/>Copyright &#xa9; 2022, The Author(s).

<63>
Accession Number
2013747251
Title
A randomised controlled trial of succinylated gelatin (4%) fluid on
urinary acute kidney injury biomarkers in cardiac surgical patients.
Source
Intensive Care Medicine Experimental. 9(1) (no pagination), 2021. Article
Number: 48. Date of Publication: December 2021.
Author
Smart L.; Boyd C.; Litton E.; Pavey W.; Vlaskovsky P.; Ali U.; Mori T.;
Barden A.; Ho K.M.
Institution
(Smart, Boyd, Pavey, Ho) College of Science, Health, Engineering and
Education, Murdoch University, South St, Murdoch, WA 6150, Australia
(Smart) Centre for Clinical Research in Emergency Medicine, Perth,
Australia
(Litton) Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Australia
(Litton) Intensive Care Unit, St John of God Hospital, Subiaco, Australia
(Pavey) Department of Anaesthesia, Fiona Stanley Hospital, Murdoch,
Australia
(Vlaskovsky, Mori, Barden, Ho) Medical School, University of Western
Australia, Perth, Australia
(Ali) Department of Cardiothoracic Surgery and Transplantation, Fiona
Stanley Hospital, Murdoch, Australia
(Ho) Intensive Care Unit, Royal Perth Hospital, Perth, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Fluid resuscitation is frequently required for cardiac
surgical patients admitted to the intensive care unit. The ideal fluid of
choice in regard to efficacy and safety remains uncertain. Compared with
crystalloid fluid, colloid fluid may result in less positive fluid
balance. However, some synthetic colloids are associated with increased
risk of acute kidney injury (AKI). This study compared the effects of
succinylated gelatin (4%) (GEL) with compound sodium lactate (CSL) on
urinary AKI biomarkers in patients after cardiac surgery. <br/>Method(s):
Cardiac surgical patients who required an intravenous fluid bolus of at
least 500 mL postoperatively were randomly allocated to receive GEL or CSL
as the resuscitation fluid of choice for the subsequent 24 h. Primary
outcomes were serial urinary neutrophil gelatinase-associated lipocalin
(NGAL) and cystatin C concentrations measured at baseline, 1 h, 5 h and 24
h after enrolment, with higher concentrations indicating greater kidney
injury. Secondary biomarker outcomes included urinary clusterin,
alpha1-microglobulin and F<inf>2</inf>-isoprostanes concentrations.
Differences in change of biomarker concentration between the two groups
over time were compared with mixed-effects regression models. Statistical
significance was set at P < 0.05. <br/>Result(s): Forty cardiac surgical
patients (n = 20 per group) with similar baseline characteristics were
included. There was no significant difference in the median volume of
fluid boluses administered over 24 h between the GEL (1250 mL, Q1-Q3
500-1750) and CSL group (1000 mL, Q1-Q3 500-1375) (P = 0.42). There was a
significantly greater increase in urinary cystatin C (P < 0.001),
clusterin (P < 0.001), alpha1-microglobulin (P < 0.001) and
F<inf>2</inf>-isoprostanes (P = 0.020) concentrations over time in the GEL
group, compared to the CSL group. Change in urinary NGAL concentration (P
= 0.68) over time was not significantly different between the groups. The
results were not modified by adjustment for either urinary osmolality or
EuroSCORE II predicted risk of mortality. <br/>Conclusion(s): This
preliminary randomised controlled trial showed that use of succinylated
gelatin (4%) for fluid resuscitation after cardiac surgery was associated
with increased biomarker concentrations of renal tubular injury and
dysfunction, compared to crystalloid fluid. These results generate concern
that use of intravenous gelatin fluid may contribute to clinically
relevant postoperative AKI. Trial registration ANZCTR.org.au,
ACTRN12617001461381. Registered on 16th October, 2017,
http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373619&isR
eview=true.<br/>Copyright &#xa9; 2021, The Author(s).

<64>
Accession Number
611853326
Title
Effects of hypertonic saline (7.5%) on lactate clearance compared with
normal saline (0.9%) after on pump cardiovascular surgery. a randomized
controlled trial.
Source
Intensive Care Medicine Experimental. 3(Supplement 1) (no pagination),
2015. Article Number: A953. Date of Publication: 2015.
Author
Atehortua Lopez L.H.; Mendoza R.; Urrego A.; Escobar J.F.; Jaimes Barragan
F.A.
Institution
(Atehortua Lopez) Hospital Universitario de Sanvicente Fundacion,
Universidad de Antioquia, UCI Cardiovascular, Medellin, Colombia
(Mendoza, Urrego, Escobar) Universidad de Antioquia, Medicina Critica y
Cuidado Intensivo, Medellin, Colombia
(Jaimes Barragan) Unversidad de Antioquia, Medicina Interna, Medellin,
Colombia
Publisher
SpringerOpen

<65>
Accession Number
611853321
Title
The cardiovascular effects of hyperoxia during and after cabg surgery.
Source
Intensive Care Medicine Experimental. 3(Supplement 1) (no pagination),
2015. Article Number: A949. Date of Publication: 2015.
Author
Smit B.; Smulders Y.M.; de Waard M.C.; Boer C.; Vonk A.B.A.; Veerhoek D.;
Kamminga S.; de Grooth H.J.S.; Garcia-Vallejo J.J.; Musters R.J.P.; Girbes
A.R.J.; Oudemans-van Straaten H.M.; Spoelstra-de Man A.M.E.
Institution
(Smit, de Waard, de Grooth, Girbes, Oudemans-van Straaten, Spoelstra-de
Man) VU University Medical Center, ICaR-VU, Intensive Care, Amsterdam,
Netherlands
(Smulders) VU University Medical Center, ICaR-VU, Internal Medicine,
Amsterdam, Netherlands
(Boer, Kamminga) VU University Medical Center, ICaR-VU, Anesthesiology,
Amsterdam, Netherlands
(Vonk) VU University Medical Center, ICaR-VU, Cardiothoracal Surgery,
Amsterdam, Netherlands
(Veerhoek) VU University Medical Center, ICaR-VU, Clinical Perfusion,
Amsterdam, Netherlands
(Garcia-Vallejo) VU University Medical Center, ICaR-VU, Molecular Cell
Biology and Immunology, Amsterdam, Netherlands
(Musters) VU University Medical Center, ICaR-VU, Physiology, Amsterdam,
Netherlands
Publisher
SpringerOpen

<66>
Accession Number
611853177
Title
Effects of neuromuscular electrical stimulation on muscle mass and
strength in critically ill patients after cardiothoracic surgery (Catastim
2).
Source
Intensive Care Medicine Experimental. 3(Supplement 1) (no pagination),
2015. Article Number: A818. Date of Publication: 2015.
Author
Fischer A.; Winkler A.; Spiegl M.; Salamon A.; Altmann K.; Themessl-Huber
M.; Mouhieddine M.; Schiferer A.; Strasser E.-M.; Paternostro-Sluga T.;
Hiesmayr M.
Institution
(Fischer, Winkler, Spiegl, Salamon, Altmann, Themessl-Huber, Mouhieddine,
Schiferer, Hiesmayr) Medical University of Vienna, Vienna, Austria
(Strasser) Kaiser Franz Josef Hospital, Vienna, Austria
(Paternostro-Sluga) Donauspital, Vienna, Austria
Publisher
SpringerOpen

<67>
Accession Number
611852733
Title
Long-term effects of remote ischaemic preconditioning in high risk
patients undergoing cardiac surgery: Follow-up of a randomised clinical
trial.
Source
Intensive Care Medicine Experimental. 3(Supplement 1) (no pagination),
2015. Article Number: A411. Date of Publication: 2015.
Author
Zarbock A.; Kellum J.; Van Aken H.; Schmidt C.; Martens S.; Gorlich D.;
Meersch M.
Institution
(Zarbock, Van Aken, Schmidt, Martens, Gorlich, Meersch) University
Hospital Munster, Munster, Germany
(Kellum) University of Pittsburgh, Pittsburgh, PA, United States
Publisher
SpringerOpen

<68>
Accession Number
2014759317
Title
Biomarkers of acute kidney injury after pediatric cardiac surgery: a
meta-analysis of diagnostic test accuracy.
Source
European Journal of Pediatrics. 181(5) (pp 1909-1921), 2022. Date of
Publication: May 2022.
Author
Van den Eynde J.; Schuermans A.; Verbakel J.Y.; Gewillig M.; Kutty S.;
Allegaert K.; Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, United States
(Van den Eynde, Schuermans, Gewillig) Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Verbakel) Department of Public Health and Primary Care, KU Leuven,
Leuven, Belgium
(Verbakel) Nuffield Department of Primary Care Health Sciences, University
of Oxford, Oxford, United Kingdom
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Allegaert) Department of Development and Regeneration, KU Leuven, Leuven,
Belgium
(Allegaert) Department of Pharmacy and Pharmaceutical Sciences, KU Leuven,
Leuven, Belgium
(Allegaert) Department of Hospital Pharmacy, Erasmus Medical Center,
Rotterdam, Netherlands
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Acute kidney injury (AKI) occurs frequently after cardiac surgery in
children. Although current diagnostic criteria rely on serum creatinine
and urine output, changes occur only after considerable loss of kidney
function. This meta-analysis aimed to synthesize the knowledge on novel
biomarkers and compare their ability to predict AKI. PubMed/MEDLINE,
Embase, Scopus, and reference lists were searched for relevant studies
published by March 2021. Diagnostic accuracy parameters were extracted and
analyzed using hierarchical summary receiver operating characteristic
(HSROC) method. Pooled estimates of the area under the curve (AUC) were
calculated using conventional random-effects meta-analysis. Fifty-six
articles investigating 49 biomarkers in 8617 participants fulfilled our
eligibility criteria. Data from 37 studies were available for
meta-analysis. Of the 10 biomarkers suitable for HSROC analysis, urinary
neutrophil gelatinase-associated lipocalin (uNGAL) to creatinine (Cr)
ratio yielded the highest diagnostic odds ratio (91.0, 95% CI 90.1-91.9),
with a sensitivity of 91.3% (95% CI 91.2-91.3%) and a specificity of 89.7%
(95% CI 89.6-89.7%). These results were confirmed in pooled AUC analysis,
as uNGAL-to-Cr ratio and uNGAL were the only elaborately studied
biomarkers (> 5 observations) with pooled AUCs >= 0.800. Liver fatty
acid-binding protein (L-FABP), serum cystatin C (sCysC), serum NGAL
(sNGAL), and interleukin-18 (IL-18) all had AUCs >= 0.700.
<br/>Conclusion(s): A variety of biomarkers have been proposed as
predictors of cardiac surgery-associated AKI in children, of which uNGAL
was the most prominent with excellent diagnostic qualities. However, more
consolidatory evidence will be required before these novel biomarkers may
eventually help realize precision medicine in AKI management.What is
Known:* Acute kidney injury (AKI) occurs in about 30-60% of children
undergoing cardiac surgery and is associated with increased in-hospital
mortality and adverse short-term outcomes. However, in current clinical
practice, AKI definitions and detection often rely on changes in serum
creatinine and urine output, which are late and insensitive markers of
kidney injury.* Although various novel biomarkers have been studied for
the diagnosis of AKI in children after cardiac surgery, it remains unclear
how these compare to one another in terms of diagnostic accuracy.What is
New:* Pooled analyses suggest that for the diagnosis of AKI in children
who underwent cardiac surgery, NGAL is the most accurate among the most
frequently studied biomarkers.* A number of other promising biomarkers
have been reported, although they will require further research into their
diagnostic accuracy and clinical applicability.<br/>Copyright &#xa9; 2022,
The Author(s), under exclusive licence to Springer-Verlag GmbH Germany,
part of Springer Nature.

<69>
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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2022 The Society of Thoracic Surgeons

<70>
Accession Number
2018009862
Title
Neuroprotective effect of memantine on serum S100-B levels after on-pump
coronary artery bypass graft surgery: A randomized clinical trial.
Source
Caspian Journal of Internal Medicine. 13(2) (pp 412-417), 2022. Date of
Publication: 01 Mar 2022.
Author
Tabary S.Z.; Tabary P.Z.; Motlagh A.S.
Institution
(Tabary) Department of Cardiac Surgery, Cardiovascular Research Center,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Tabary) Faculty of Specialized Veterinary Sciences, Islamic Azad
University, Science and Research Branch, Tehran, Iran, Islamic Republic of
(Motlagh) Mazandaran University of Medical Sciences, Sari, Iran, Islamic
Republic of
Publisher
Babol University of Medical Sciences
Abstract
Background: Brain injury is one of the complications of open heart
surgery. Glutamate plays a key role in this process. In this study, we
evaluated the neuroprotective effect of memantine as NMDAR inhibitor in
patients undergoing on-pump coronary artery bypass graft surgery (CABG).
<br/>Method(s): From July 2019 to May 2020, thirty-four consecutive
patients selected for elective isolated on-pump coronary artery bypass
graft surgery (CABG) enrolled in the trial. Patients were randomly
assigned into two groups; memantine and the control group. For the
memantine group, 10 mg of memantine twice daily was administered at least
72 h before surgery. Venous blood samples were collected before surgery
(T1), at the end of cardiopulmonary bypass (CPB) (T2), 6h and 24h after
CPB (T3 and T4). Serum concentration of S100-B was measured by
enzyme-linked immunosorbent assay (ELISA) technique. <br/>Result(s): Serum
S100-B increased during CPB with a peak plasma concentration at the
termination of CPB. Then it gradually decreased during the first 24 hours
in both groups (P=0.001). The mean S100-B levels were significantly lower
in the memantine group compared to the control group at the termination of
CPB (0.863+/-0.203 mug/l vs 1.117+/-0.304 mug/l), at 6 hours post-CPB
(0.731+/-0.168 mug/l vs 0.938+/-0.206 mug/l), and 24 hours post-CPB
(0.595+/-0.189 mug/l vs 0.852+/-0.227 mug/l), respectively (P=0.023). The
mean level of serum S100-B in memantine group was about 0.19 mug/l less
than the control group during the study (CI, 0.07 to 0.30; P=0.001). One
(6.2%) patient in the control group had post-operative left arm
paresthesia <br/>Conclusion(s): Administration of memantine before on-pump
CABG can attenuate the postoperative concentrations of serum S100-B, which
may reduce cerebral damage during surgery.<br/>Copyright &#xa9; The
Author(s).

<71>
Accession Number
2007545174
Title
Cerebral oximetry in adult cardiac surgery to reduce the incidence of
neurological impairment and hospital length-of-stay: A prospective,
randomized, controlled trial.
Source
Journal of the Intensive Care Society. 23(2) (pp 109-116), 2022. Date of
Publication: May 2022.
Author
Bennett S.R.; Smith N.; Bennett M.R.
Institution
(Bennett) King Faisal Cardiac Center, National Guard Hospital, King
Abdulaziz Medical City, Jeddah, Saudi Arabia
(Smith) Department of Anaesthesia and Intensive Care, Castle Hill
Hospital, Hull and East Yorkshire Hospital Trust, Cottingham, United
Kingdom
(Bennett) Department of Medicine, Manchester University Foundation Trust,
Manchester, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Background: Cerebral oximetry using near-infrared spectroscopy (NIRS) has
been shown to reduce neurological dysfunction and hospital length-of-stay
after adult cardiac surgery in some but not all studies. We audited
maintaining cerebral saturations at or above baseline and showed improved
neurological and length-of-stay outcomes. Our hypothesis for this study
was that our NIRS protocol would improve neurological and length-of-stay
outcomes. <br/>Method(s): This prospective, single centre, double-blinded
controlled study randomized 182 consecutive patients, scheduled for
cardiac surgery using cardiopulmonary bypass. Participants were randomized
by concealed envelope prior to anaesthesia. NIRS study group were managed
perioperatively using our NIRS protocol of 8 interventions, increase
cardiac output, normocapnia, increase mean arterial pressure, increase
inspired oxygen, depth of anaesthesia, blood transfusion, correction of
bypass cannula, change of surgical plan to restore levels equal to or
above baseline. The control group had standard management without NIRS.
Primary outcomes were neurological impairment (early and late) and
hospital length-of-stay. Secondary outcomes were ventilation times,
intensive care length-of-stay, major organ dysfunction and mortality.
<br/>Result(s): 91 patients entered each group. There was a significant
improvement in self-reported six-month general functionality in the NIRS
group (p = 0.016). Early neurological dysfunction and hospital
length-of-stay was the same in both groups. Of the secondary outcomes only
Intensive Care length-of-stay was statistically significant, being shorter
in the NIRS group (p = 0.026). <br/>Conclusion(s): Maintaining cerebral
saturations above baseline reduces time spent in Intensive Care and may
improve long term functional recovery but not stroke, major organ
dysfunction and mortality.<br/>Copyright &#xa9; The Intensive Care Society
2020.

<72>
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.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<73>
Accession Number
2016796356
Title
Possible effects of melatonin on reperfusion injury following coronary
artery bypass graft surgery.
Source
ARYA Atherosclerosis. 18(1) (no pagination), 2022. Article Number: 2208.
Date of Publication: January 2022.
Author
Hajhossein-Talasaz A.; Ghaeli P.; Salehiomran A.; Dianatkhah M.
Institution
(Hajhossein-Talasaz) Department of Clinical Pharmacy, School of Pharmacy
AND Tehran Heart Center, Tehran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Dianatkhah) Department of Clinical Pharmacy, School of Pharmacy AND
Chamran Hospital, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Ghaeli) Department of Clinical Pharmacy, School of Pharmacy, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Salehiomran) Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Dianatkhah) 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: Although coronary artery bypass graft (CABG) surgery has been
reported to be one of the most effective internentions in terms of
myocardial salvage, reperfusion itself can cause additional damage to the
myocardium. Since there is strong evidence that free radicals are the
principal offender in ischemia-reperfusion (I/R) injury, it has been
suggested that treatment with antioxidant agents can be protective.
Investigations have shown that melatonin secretion is partially disturbed
in CABG patients. The aim of this study was to evaluate the protective
effect of melatonin as an antioxidant agent on I/R injury. <br/>METHOD(S):
164 elective CABG candidates participated in this randomized clinical
trial during the preoperative period. The candidates were randomized to
receive 3 mg of melatonin tablets (physiologic dose) from 3 days before
surgery until the day of discharge. Cardiac biomarkers [troponin and
creatine kinase myocardial band (CKMB)] were assessed once before surgery
(24 hours before surgery), and 8 and 24 hours after surgery.
<br/>RESULT(S): Finally, 130 patients, 65 (50%) patients in the melatonin
group and 65 (50%) in the control arm finished our study. Mean age of
melatonin and control groups was 59.90 +/- 9.59 and 60.80 +/- 8.00 years,
respectively; moreover, 47 (72.30%) in melatonin and 45 (69.23%) in
control group were men. No significant difference was seen in baseline
cardiac biomarkers between two groups (P > 0.05). In both groups, cardiac
biomarkers (CKMB and troponin) elevated after surgery in comparison to
their preoperative values. There was no statistically significant
difference between the control and melatonin groups regarding the 8-hour
and 24-hour troponin and CKMB when adjusted for interacting factors (P >
0.05). <br/>CONCLUSION(S): Although physiological concentration of
melatonin is protective against I/R injury, substitution of endogenous
melatonin with the oral supplement which creates physiologic concentration
may not prevent I/R injury. In order to have antioxidant effect,
pharmacologic doses of melatonin should be employed.<br/>Copyright &#xa9;
2022, Isfahan University of Medical Sciences(IUMS). All rights reserved.

<74>
Accession Number
2016662545
Title
Ticagrelor Monotherapy After PCI in High-Risk Patients With Prior MI: A
Prespecified TWILIGHT Substudy.
Source
JACC: Cardiovascular Interventions. 15(3) (pp 282-293), 2022. Date of
Publication: 14 Feb 2022.
Author
Chiarito M.; Baber U.; Cao D.; Sharma S.K.; Dangas G.; Angiolillo D.J.;
Briguori C.; Cohen D.J.; Dudek D.; Dzavik V.; Escaned J.; Gil R.; Hamm
C.W.; Henry T.; Huber K.; Kastrati A.; Kaul U.; Kornowski R.; Krucoff M.;
Kunadian V.; Mehta S.R.; Moliterno D.; Ohman E.M.; Oldroyd K.; Sardella
G.; Zhongjie Z.; Sartori S.; Stefanini G.; Shlofmitz R.; Steg P.G.; Weisz
G.; Witzenbichler B.; Han Y.-L.; Pocock S.; Gibson C.M.; Mehran R.
Institution
(Chiarito, Baber, Cao, Sharma, Dangas, Zhongjie, Sartori, Mehran) Zena and
Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at
Mount Sinai, New York, New York, United States
(Chiarito, Stefanini) Department of Biomedical Sciences, Humanitas
University, Pieve Emanuele-Milan, Italy
(Chiarito, Stefanini) Cardio Center, Humanitas Clinical and Research
Hospital IRCCS, Rozzano, Milan, Italy
(Baber) University of Oklahoma Health Sciences Center, Oklahoma City, OK,
United States
(Angiolillo) University of Florida College of Medicine, Jacksonville,
Florida, United States
(Briguori) Clinica Mediterranea, Naples, Italy
(Cohen) Cardiovascular Research Foundation, New York, New York, United
States
(Cohen, Shlofmitz) St. Francis Hospital, Roslyn, New York, United States
(Dudek) 2nd Department of Cardiology Jagiellonian University Medical
College, Krakow, Poland
(Dzavik) Research and Innovation in Interventional Cardiology and Cardiac
Intensive Care, Peter Munk Cardiac Centre, University Health Network,
Toronto, Ontario, Canada
(Escaned) Instituto de Investigacion Sanitaria del Hospital Clinico San
Carlos and Complutense University, Madrid, Spain
(Gil) Department of Invasive Cardiology, Center of Postgraduate Medical
Education, Central Clinical Hospital of the Ministry of Interior and
Administration, Warsaw, Poland
(Hamm) Kerckhoff Clinic, Bad Nauheim, Germany
(Henry) Carl and Edyth Lindner Center for Research and Education at the
Christ Hospital, Cincinnati, Ohio, United States
(Huber) Wilhelminenhospital, Vienna, Austria
(Kastrati) Deutsches Herzzentrum Munchen, Munich, Germany
(Kaul) Batra Hospital and Medical Research Centre, New Delhi, India
(Kornowski) Rabin Medical Center, Petach Tikva, Israel
(Krucoff, Ohman) Duke University Medical Center-Duke Clinical Research
Institute, Durham, North Carolina, United States
(Kunadian) Institute of Cellular Medicine, Faculty of Medical Sciences,
Newcastle University, Newcastle upon Tyne, United Kingdom
(Kunadian) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne
Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
(Mehta) Hamilton Health Sciences, Hamilton, Ontario, Canada
(Moliterno) University of Kentucky, Lexington, Kentucky, United States
(Oldroyd) West of Scotland Heart and Lung Centre, Golden Jubilee National
Hospital, Glasgow, United Kingdom
(Sardella) Policlinico Umberto I University, Rome, Italy
(Steg) Groupe Hospitalier Bichat-Claude-Bernard, Paris, France
(Weisz) Montefiore Medical Center, New York, New York, United States
(Witzenbichler) Helios Amper-Klinikum, Dachau, Germany
(Han) Shenyang North Hospital, Shenyang, China
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
(Gibson) Beth Israel Deaconess Medical Center, Boston, Massachusetts,
United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to evaluate if patients with prior
myocardial infarction (MI) could benefit from ticagrelor monotherapy in
terms of bleeding reduction without any compromise in ischemic event
prevention. <br/>Background(s): Patients with history of MI who undergo
percutaneous coronary intervention (PCI) remain at risk for recurrent
ischemic events. The optimal antithrombotic strategy for this cohort
remains debated. <br/>Method(s): In this prespecified analysis of the
randomized TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk
Patients after Coronary Intervention) trial, the authors evaluated the
impact of history of MI on treatment effect of ticagrelor monotherapy
versus ticagrelor plus aspirin in patients undergoing PCI with
drug-eluting stent with at least 1 clinical and 1 angiographic high-risk
feature and free from adverse events at 3 months after index PCI. The
primary endpoint was Bleeding Academic Research Consortium type 2, 3, or 5
bleeding, and the key secondary endpoint was the composite of all-cause
death, MI, or stroke, both at 12 months after randomization.
<br/>Result(s): A total of 1,937 patients (29.7%) with and 4,595 patients
(70.3%) without prior MI were randomized to ticagrelor and placebo or
ticagrelor and aspirin. At 1 year after randomization, patients with prior
MI experienced higher rates of death, MI, or stroke (5.7% vs 3.2%; P <
0.001) but similar BARC types 2 to 5 bleeding (5.0% vs 5.5%; P = 0.677)
compared with patients without prior MI. Ticagrelor monotherapy
consistently reduced the risk for the primary bleeding outcome in patients
with (3.4% vs 6.7%; HR: 0.50; 95% CI: 0.33-0.76) and without (4.2% vs
7.0%; HR: 0.58; 95% CI: 0.45-0.76; P<inf>interaction</inf> = 0.54) prior
MI. Rates of the key secondary ischemic outcome were not significantly
different between treatment groups irrespective of history of MI (prior
MI, 6.0% vs 5.5% [HR: 1.09; 95% CI: 0.75-1.58]; no prior MI, 3.1% vs 3.3%
[HR: 0.92; 95% CI: 0.67-1.28]; P<inf>interaction</inf> = 0.52).
<br/>Conclusion(s): Ticagrelor monotherapy is associated with
significantly lower risk for bleeding events compared with ticagrelor plus
aspirin, without any compromise in ischemic prevention, among high-risk
patients with history of MI undergoing PCI. (Ticagrelor With Aspirin or
Alone in High-Risk Patients After Coronary Intervention [TWILIGHT];
NCT02270242)<br/>Copyright &#xa9; 2022 American College of Cardiology
Foundation

<75>
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. <br/>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). <br/>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. <br/>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).<br/>Copyright &#xa9; 2022, The
Author(s).

<76>
[Use Link to view the full text]
Accession Number
635139209
Title
Postoperative Cerebral Oxygen Saturation in Children After Congenital
Cardiac Surgery and Long-Term Total Intelligence Quotient: A Prospective
Observational Study.
Source
Critical Care Medicine. 49(6) (pp 967-976), 2021. Date of Publication: 01
Jun 2021.
Author
Carra G.; Flechet M.; Jacobs A.; Verstraete S.; Vlasselaers D.; Desmet L.;
Van Cleemput H.; Wouters P.; Vanhorebeek I.; Van Den Berghe G.; Guiza F.;
Meyfroidt G.
Institution
(Carra, Flechet, Jacobs, Verstraete, Vlasselaers, Desmet, Van Cleemput,
Wouters, Vanhorebeek, Van Den Berghe, Guiza, Meyfroidt) Clinical Division
And Laboratory Of Intensive Care Medicine, Department Of Cellular And
Molecular Medicine, Uz Leuven, Ku Leuven, Leuven, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: During the early postoperative period, children with
congenital heart disease can suffer from inadequate cerebral perfusion,
with possible long-term neurocognitive consequences. Cerebral tissue
oxygen saturation can be monitored noninvasively with near-infrared
spectroscopy. In this prospective study, we hypothesized that reduced
cerebral tissue oxygen saturation and increased intensity and duration of
desaturation (defined as cerebral tissue oxygen saturation < 65%) during
the early postoperative period, independently increase the probability of
reduced total intelligence quotient, 2 years after admission to a PICU.
DESIGN: Single-center, prospective study, performed between 2012 and 2015.
SETTING: The PICU of the University Hospitals Leuven, Belgium. PATIENTS:
The study included pediatric patients after surgery for congenital heart
disease admitted to the PICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN
RESULTS: Postoperative cerebral perfusion was characterized with the mean
cerebral tissue oxygen saturation and dose of desaturation of the first 12
and 24 hours of cerebral tissue oxygen saturation monitoring. The
independent association of postoperative mean cerebral tissue oxygen
saturation and dose of desaturation with total intelligence quotient at
2-year follow-up was evaluated with a Bayesian linear regression model
adjusted for known confounders. According to a noninformative prior,
reduced mean cerebral tissue oxygen saturation during the first 12 hours
of monitoring results in a loss of intelligence quotient points at 2
years, with a 90% probability (posterior beta estimates [80% credible
interval], 0.23 [0.04-0.41]). Similarly, increased dose of cerebral tissue
oxygen saturation desaturation would result in a loss of intelligence
quotient points at 2 years with a 90% probability (posterior beta
estimates [80% credible interval],-0.009 [-0.016 to-0.001]).
<br/>CONCLUSION(S): Increased dose of cerebral tissue oxygen saturation
desaturation and reduced mean cerebral tissue oxygen saturation during the
early postoperative period independently increase the probability of
having a lower total intelligence quotient, 2 years after PICU
admission.<br/>Copyright &#xa9; 2021 The Author(s).

<77>
Accession Number
634871232
Title
Treatment of asymptomatic blunt cerebrovascular injury (BCVI): A
systematic review.
Source
Trauma Surgery and Acute Care Open. 6(1) (no pagination), 2021. Article
Number: e000668. Date of Publication: 26 Apr 2021.
Author
Murphy P.B.; Severance S.; Holler E.; Menard L.; Savage S.; Zarzaur B.L.
Institution
(Murphy) Medical College of Wisconsin, Milwaukee, WI, United States
(Severance) Surgery, Indiana University School of Medicine, Indianapolis,
IN, United States
(Holler) Surgery, Eskenazi Health, Indianapolis, IN, United States
(Menard) Medical Education and Access Services, Indiana University, School
of Medicine, Indianapolis, IN, United States
(Savage, Zarzaur) Surgery, University of Wisconsin, Madison School of
Medicine and Public Health, Madison, WI, United States
Publisher
BMJ Publishing Group
Abstract
Background The management of asymptomatic blunt cerebrovascular injury
(BCVI) with respect to stroke prevention and vessel healing is
challenging. Objectives The aim of this systematic review was to determine
if a specific treatment results in lower stroke rates and/or improved
vessel healing in asymptomatic BCVI. Data sources An electronic literature
search of MEDLINE, EMBASE, Cochrane Library, CINAHL, SCOPUS, Web of
Science, and ClinicalTrials.gov performed from inception to March 2020.
Study eligibility criteria Studies were included if they reported on a
comparison of any treatment for BCVI and stroke and/or vessel healing
rates. Participants and interventions Adult patients diagnosed with
asymptomatic BCVI(s) who were treated with any preventive medication or
procedure. Study appraisal and synthesis methods All studies were
systematically reviewed and bias was evaluated by the Newcastle-Ottawa
Scale. No meta-analysis was performed secondary to significant
heterogeneity across studies in patient population, screening protocols,
and treatment selection. The main outcomes were stroke and healing rate.
Results Of 8781 studies reviewed, 19 reported on treatment effects for
asymptomatic BCVI and were included for review. Any choice of medical
management was better than no treatment, but no specific differences
between choice of medical management and stroke outcomes were found.
Vessel healing was rare and the majority of healed vessels were following
low-grade injuries. Limitations Majority of the included studies were
retrospective and at high risk of bias. Conclusions or implications of key
findings Asymptomatic BCVI should be treated medically using a consistent,
local protocol. High-quality studies on the effect of individual
antithrombotic agents on stroke rates and vessel healing for asymptomatic
BCVI are required.<br/>Copyright &#xa9; BMJ Publishing Group Limited 2021.

<78>
Accession Number
638274126
Title
Spanish Society of Thoracic Surgery (SECT) consensus document. Long-term
follow-up for operated patients with lung cancer.
Source
Cirugia espanola. 100(6) (pp 320-328), 2022. Date of Publication: 01 Jun
2022.
Author
Cilleruelo Ramos A.; Figueroa Almanzar S.; Lopez Castro R.; Martinez
Hernandez N.J.; Mezquita Perez L.; Moreno Casado P.; Zabaleta Jimenez J.
Institution
(Cilleruelo Ramos) Servicio de Cirugia Toracica, Hospital Clinico
Universitario de Valladolid, Valladolid, Spain
(Figueroa Almanzar) Servicio de Cirugia Toracica, Hospital Clinico
Universitario de Valencia, Valencia, Spain
(Lopez Castro) Servicio de Oncologia Medica, Hospital Clinico
Universitario de Valladolid, Valladolid, Spain
(Martinez Hernandez) Servicio de Cirugia Toracica, Hospital Universitario
de la Ribera, Alzira, Valencia, Spain
(Mezquita Perez) Servicio de Oncologia Medica, Hospital Clinic de
Barcelona, Barcelona, Spain
(Moreno Casado) Servicio de Cirugia Toracica, Hospital Universitario Reina
Sofia de Cordoba, Cordoba, Spain
(Zabaleta Jimenez) Servicio de Cirugia Toracica, Hospital Universitario de
Donostia, San Sebastian, Spain
Publisher
NLM (Medline)
Abstract
The most effective treatment for lung cancer is complete lung resection,
although recurrences reach up to 10% and the appearance of second
neoplasms, up to 6%. Therefore, the follow-up of these patients will be
essential for the early detection and treatment of these events; however
there is no definition of the form, time and cadence of these follow-ups.
In this consensus document, we try to define them based on the available
scientific evidence. A critical review of the literature is carried out
(meta-analysis, systematic reviews, reviews, consensus recommendations of
scientific societies, randomized controlled studies, non-randomized
controlled studies, observational studies and case series studies) and
communications to the main congresses on oncology and thoracic surgery in
Spanish, English and French. The evidences found are classified following
the GRADE system. It is defined according to the existing evidence that
the patient resected for lung cancer should be followed up, as well as
that this follow-up should be close during the first years and with CT
(not being necessary to follow up with PET-CT, biomarkers or
bronchoscopy). Cessation of smoking is also recommended in this
follow-up.<br/>Copyright &#xa9; 2021 AEC. Published by Elsevier Espana,
S.L.U. All rights reserved.

<79>
Accession Number
637817488
Title
Predictive Value of Increased Perioperative Heart Rate for All-Cause
Mortality After Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Biological research for nursing. 24(3) (pp 379-387), 2022. Date of
Publication: 01 Jul 2022.
Author
Xu S.; Lin Y.; Lin L.; Peng Y.; Chen L.
Institution
(Xu, Lin) School of Nursing, 74551Fujian Medical University, Fuzhou, China
(Lin) Department of Nursing, Union Hospital, 117890Fujian Medical
University, Fuzhou, China
(Peng, Chen) Department of Cardiac Surgery, Union Hospital, 117890Fujian
Medical University, Fuzhou, China
Publisher
NLM (Medline)
Abstract
Background: Accumulated studies have revealed that heart rates are
associated with all-cause mortality in cardiac surgery patients, but the
results remain controversial. This meta-analysis aimed to evaluate the
predictive value of increased perioperative heart rate for all-cause
mortality after cardiac surgery. <br/>Method(s): We searched PubMed,
Embase, Web of Science, and Cumulative Index of Nursing and Allied Health
Literature (CINAHL) databases for studies from inception to October 11,
2021. Two researchers independently screened the studies. Titles, authors,
publication years, and hazard ratios were extracted. We used a
random-effects model to combine the HRs and 95% confidence intervals.
Several subgroup analyses were conducted. Statistical significance was set
at p < .05. <br/>Result(s): Eleven studies were included in the
meta-analysis of 33,849 patients and 3166 (9.4%) deaths. The HR of higher
perioperative heart rates was 2.09 (95% CI 1.53-2.86, p < .001, I2 = 81%).
The HR with a 10-bpm increase in preoperative heart rate was 1.19 (95% CI
1.11-1.26, p < .001, I2 = 51%). Subgroup analysis showed patients with
higher preoperative heart rates had an HR of 1.88 (95% CI 1.51-2.34, p <
.001, I2 = 0%), and patients with a higher postoperative heart rate had an
HR of 2.29 (95% CI 1.28- 4.09, p < .0001, I2 = 91%) compared to patients
with lower postoperative heart rates. <br/>Conclusion(s): Increased
perioperative heart rate is associated with all-cause mortality in
patients undergoing cardiac surgery.

<80>
Accession Number
636935149
Title
A Blinded Randomized Trial Comparing Standard Activated Clotting Time
Heparin Management to High Target Active Clotting Time and Individualized
Hepcon HMS Heparin Management in Cardiopulmonary Bypass Cardiac Surgical
Patients.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 28(3) (pp
204-213), 2022. Date of Publication: 20 Jun 2022.
Author
Nuttall G.A.; Smith M.M.; Smith B.B.; Christensen J.M.; Santrach P.J.;
Schaff H.V.
Institution
(Nuttall, Smith, Smith, Christensen) Department of Anesthesiology and
Perioperative Medicine, Mayo Clinic, MN, Rochester, United States
(Santrach) Department of Laboratory Medicine and Pathology, Mayo Clinic,
MN, Rochester, United States
(Schaff) Department of Cardiovascular Surgery, Mayo Clinic, MN, Rochester,
United States
Publisher
NLM (Medline)
Abstract
PURPOSE: High-dose heparin has been suggested to reduce consumption
coagulopathy. MATERIALS AND METHODS: In a randomized, blinded, prospective
trial of patients undergoing elective, complex cardiac surgery with
cardiopulmonary bypass, patients were randomized to one of three groups:
1) high-dose heparin (HH) receiving an initial heparin dose of 450 u/kg,
2) heparin concentration monitoring (HC) with Hepcon Hemostasis Management
System (HMS; Medtronic, Minneapolis, MN, USA) monitoring, or 3) a control
group (C) receiving a standard heparin dose of 300 u/kg. Primary outcome
measures were blood loss and transfusion requirements. <br/>RESULT(S):
There were 269 patients block randomized based on primary versus redo
sternotomy to one of the three groups from August 2001 to August 2003.
There was no difference in operative bleeding between the groups. Chest
tube drainage did not differ between treatment groups at 8 hours (median
[25th percentile, 75th percentile] for control group was 321 [211, 490]
compared to 340 [210, 443] and 327 [250, 545], p = 0.998 and p = 0.540,
for HH and HC treatment groups, respectively). The percentage of patients
receiving transfusion was not different among the groups.
<br/>CONCLUSION(S): Higher heparin dosing accomplished by either activated
clot time or HC monitoring did not reduce 24-hour intensive care unit
blood loss or transfusion requirements.

<81>
Accession Number
2016140820
Title
Effect of Cyclosporine on Cytokine Production in Elective Coronary Artery
Bypass Grafting: A Sub-Analysis of the CiPRICS (Cyclosporine to Protect
Renal Function in Cardiac Surgery) Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(7) (pp 1985-1994),
2022. Date of Publication: July 2022.
Author
Grins E.; Ederoth P.; Bjursten H.; Dardashti A.; Bronden B.; Metzsch C.;
Erdling A.; Nozohoor S.; Mokhtari A.; Hansson M.J.; Elmer E.; Algotsson
L.; Shrestha N.M.; Jovinge S.
Institution
(Grins, Ederoth, Dardashti, Bronden, Metzsch, Erdling, Algotsson)
Department of Cardiothoracic Anesthesia and Intensive Care, Department of
Clinical Sciences, Lund University, Skane University Hospital, Lund,
Sweden
(Bjursten, Nozohoor, Mokhtari) Department of Cardiothoracic Surgery,
Department of Clinical Sciences Lund University, Skane University
Hospital, Lund, Sweden
(Hansson, Elmer) Mitochondrial Medicine, Department of Clinical Sciences
Lund, Lund University, Lund, Sweden
(Shrestha, Jovinge) DeVos Cardiovascular Research Program, Fredrik Meijer
Heart and Vascular Institute Spectrum Health/Van Andel Institute, Grand
Rapids, MI, United States
(Jovinge) Cardiovascular Institute, Stanford University, Palo Alto, CA
Publisher
W.B. Saunders
Abstract
Objectives: The augmented inflammatory response to cardiac surgery is a
recognized cause of postoperative acute kidney injury. The present study
aimed to investigate the effects of preoperative cyclosporine treatment on
cytokine production and delineate factors associated with postoperative
kidney impairment. <br/>Design(s): A randomized, double-blind,
placebo-controlled, single-center study. <br/>Setting(s): At a tertiary
care, university hospital. <br/>Participant(s): Patients eligible for
elective coronary artery bypass grafting surgery; 67 patients were
enrolled. <br/>Intervention(s): Patients were randomized to receive 2.5
mg/kg cyclosporine or placebo before surgery. Cytokine levels were
measured after the induction of anesthesia and 4 hours after the end of
cardiopulmonary bypass. <br/>Measurements and Main Results:
Tissue-aggressive (interleukin [IL]-1beta, macrophage inflammatory protein
[MIP]-1beta, granulocyte colony-stimulating factor [G-CSF], IL-6, IL-8,
IL-17, MCP-1), as well tissue-lenient (IL-4) cytokines, were significantly
elevated in response to surgery. Changes in cytokine levels were not
affected by cyclosporine pretreatment. <br/>Conclusion(s): Elective
coronary artery bypass grafting surgery with cardiopulmonary bypass
triggers cytokine activation. This activation was not impacted by
preoperative cyclosporine treatment.<br/>Copyright &#xa9; 2021 Elsevier
Inc.

<82>
Accession Number
2016140587
Title
Network Meta-Analysis Comparing the Short- and Long-Term Outcomes of
Alternative Access for Transcatheter Aortic Valve Replacement.
Source
Cardiovascular Revascularization Medicine. 40 (pp 1-10), 2022. Date of
Publication: July 2022.
Author
Ranka S.; Lahan S.; Chhatriwalla A.K.; Allen K.B.; Chiang M.; O'Neill B.;
Verma S.; Wang D.D.; Lee J.; Frisoli T.; Eng M.; Bagur R.; O'Neill W.;
Villablanca P.
Institution
(Ranka) Department of Cardiovascular Medicine, University of Kansas
Medical Center, Kansas City, KS, United States
(Lahan) Division of Cardiovascular Prevention & Wellness, Department of
Cardiology, Houston Methodist, Houston, TX, United States
(Chhatriwalla, Allen) Department of Cardiothoracic Surgery, Saint Luke's
Mid America Heart Institute and University of Missouri-Kansas City, Kansas
City, MO, United States
(Chiang, O'Neill, Wang, Lee, Frisoli, O'Neill, Villablanca) Department of
Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI,
United States
(Verma) Department of Family Medicine, Henry Ford Allegiance Health,
Jackson, MI, United States
(Eng) Department of Cardiology, Banner University Medical Center, Phoenix,
AZ, United States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, Western University, London, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Several studies have pair-wise compared access sites for
transcatheter aortic valve replacement (TAVR) but pooled estimate of
overall comparative efficacy and safety outcomes are not well known. We
sought to compare short- and long-term outcomes following various
alternative access routes for TAVR. <br/>Method(s): Thirty-four studies
with a pooled sample size of 32,756 patients were selected by searching
PubMed and Cochrane library databases from inception through 11th June
2021 for patients undergoing TAVR via 1 of 6 different access sites:
Transfemoral (TF), Transaortic (TAO), Transapical (TA), Transcarotid (TC),
Transaxillary/Subclavian (TSA), and Transcaval (TCV). Data were extracted
to conduct a frequentist network meta-analysis with a random-effects model
using TF access as a reference group. <br/>Result(s): Compared with TF,
both TAO [RR 1.91, 95% CI (1.46-2.50)] and TA access [RR 2.12, 95% CI
(1.84-2.46)] were associated with an increased risk of 30-day mortality.
No significant difference was observed for stroke, myocardial infarction,
major bleeding, conversion to open surgery, and major adverse
cardiovascular or cerebrovascular events at 30 days between different
accesses. Major vascular complications were lower in TA [RR 0.43, (95% CI,
0.28-0.67)] and TC [RR 0.51, 95% CI (0.35-0.73)] access compared to TF.
The 1-year mortality was higher in TAO [RR of 1.35, (95% CI, 1.01-1.81)]
and TA [RR 1.44, (95% CI, 1.14-1.81)] groups. <br/>Conclusion(s):
Non-thoracic alternative access site utilization for TAVR implantation
(TC, TSA and TCV) is associated with outcomes similar to conventional TF
access. Thoracic TAVR access (TAO and TA) translates into increased short
and long-term mortality.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<83>
Accession Number
2015583993
Title
High-dose preoperative glucocorticoid for prevention of emergence and
postoperative delirium in liver resection: A double-blinded randomized
clinical trial substudy.
Source
Acta Anaesthesiologica Scandinavica. 66(6) (pp 696-703), 2022. Date of
Publication: July 2022.
Author
Awada H.N.; Steinthorsdottir K.J.; Schultz N.A.; Hillingso J.G.; Larsen
P.N.; Jans O.; Kehlet H.; Aasvang E.K.
Institution
(Awada, Steinthorsdottir, Jans, Aasvang) Department of Anesthesiology,
Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University
Hospital, Copenhagen, Denmark
(Awada, Steinthorsdottir, Kehlet) Surgical Pathophysiology Unit,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Schultz, Hillingso, Larsen) Department of Gastrointestinal Surgery and
Transplantation, Centre for Cancer and Organ Diseases, Rigshospitalet
Copenhagen University Hospital, Copenhagen, Denmark
(Aasvang) Department of Clinical Medicine, Faculty of Health and Medical
Sciences, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Emergence delirium (ED) and postoperative delirium (POD) are
associated with increased morbidity and mortality and occur in up to
one-third of patients undergoing major non-cardiac surgery, where the
underlying pathogenesis is multifactorial, including increased
inflammation. We aimed to assess the effect of pre-operative high- versus
low-dose glucocorticoid on the occurrence of ED and POD. <br/>Method(s):
This was a substudy from a randomized, double-blinded clinical trial.
Patients >=18 years, undergoing open liver resection were randomized 1:1
to high-dose (HD, 10 mg/kg methylprednisolone) or low-dose (LD, 8 mg
dexamethasone) glucocorticoid and assessed for ED and POD for a maximum of
4 days during hospitalization. The 3-min Diagnostic Interview for
CAM-defined delirium (3D-CAM) was used for assessment, 15 and 90 min after
arrival in the post-anesthesia care unit (PACU), and subsequently once
daily in the ward. <br/>Result(s): Fifty-three patients were included in
this secondary substudy (26 HD-group and 27 LD-group). ED occurred in n =
5 HD versus n = 6 LD patients 15 min after PACU arrival. At 90 min after
PACU arrival, 4 patients had ED, all from LD-group, and resulted in
significantly longer PACU admission, 273 versus 178 min in ED versus
Non-ED patients. During the first 4 days in the ward, n = 5 patients had
at least one occurrence of POD, all from LD-group. <br/>Conclusion(s): The
primary finding of the current substudy was a lower occurrence of ED/POD
in the PACU 90 min after arrival and during the first four postoperative
days in patients receiving high-dose glucocorticoid compared with patients
receiving low-dose glucocorticoid. The two study groups were not evenly
balanced concerning known explanatory factors, i.e., age and size of
surgery, which calls for larger studies to elucidate the
matter.<br/>Copyright &#xa9; 2022 The Authors. Acta Anaesthesiologica
Scandinavica published by John Wiley & Sons Ltd on behalf of Acta
Anaesthesiologica Scandinavica Foundation.

<84>
Accession Number
2018357814
Title
Effect of S-ketamine on Postoperative Quality of Recovery in Patients
Undergoing Video-Assisted Thoracic Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part B. 36(8) (pp
3049-3056), 2022. Date of Publication: August 2022.
Author
Cheng X.; Wang H.; Diao M.; Jiao H.
Institution
(Cheng, Wang, Diao, Jiao) Department of Anesthesiology, The Affiliated
Hospital of Xuzhou Medical University, Jiangsu, Xuzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: S-ketamine is associated with effective postoperative
analgesia and enhanced quality of recovery (QoR). The study aimed to
investigate the effect of perioperative S-ketamine on postoperative
quality of recovery in patients undergoing video-assisted thoracic surgery
(VATS). <br/>Design(s): A prospective, randomized, double-blinded,
placebo-controlled trial. <br/>Setting(s): Single institution, tertiary
university hospital. <br/>Participant(s): Eighty adult patients aged
18-to-65 undergoing VATS were eligible for participation.
<br/>Intervention(s): Patients enrolled in this study were randomized to
receive either S-ketamine (a bolus of 0.25 mg/kg, followed by an infusion
of 0.125 mg/kg/h until 15 minutes before the end of the surgical
procedure), or identical volumes and rates of 0.9% saline.
<br/>Measurements and Main Results: Postoperative quality of recovery was
measured with QoR-40 score 48 hours after surgery. The postoperative pain
was assessed postoperatively using the numeric rating scale at 0.5, 6, 24,
and 48 hours. Hospital Anxiety and Depression Scale Depression subscale
(HADS-D) scores and other secondary outcomes also were recorded. The final
analysis included 77 patients. The global QoR-40 score at 48 hours
postoperatively was higher in the S-ketamine group compared with the
saline group (median [interquartile range]: 181.5 [178-184] v 174.5
[169-177]), estimated median difference 7 (95% confidence interval 5-10, p
< 0.001). Patients who received S-ketamine treatment had lower pain scores
at rest (p = 0.017 and p = 0.006, respectively) and coughing (p < 0.001
and p = 0.007, respectively) at 24 and 48 hours postoperatively than those
who received saline treatment. The requirement and consumption of opioid
for rescue analgesic were lower in the S-ketamine (p = 0.045 and p =
0.047, respectively). Compared with the saline group, S-ketamine reduced
HADS-D scores (p = 0.003) at 48 hours after surgery. <br/>Conclusion(s):
The present study's findings suggested that perioperative S-ketamine
enhanced the quality of recovery in patients undergoing VATS. S-ketamine
also improved postoperative analgesia and postoperative
depression.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<85>
Accession Number
2018221467
Title
A clinical profile of infective endocarditis in patients with recent
COVID-19: A systematic review.
Source
American Journal of the Medical Sciences. 364(1) (pp 16-22), 2022. Date of
Publication: July 2022.
Author
Quintero-Martinez J.A.; Hindy J.-R.; Mahmood M.; Gerberi D.J.; DeSimone
D.C.; Baddour L.M.
Institution
(Quintero-Martinez, Hindy, Mahmood, DeSimone, Baddour) Division of
Infectious Diseases, Departments of Medicine and Cardiovascular Diseases,
Mayo Clinic College of Medicine and Science, 200 First St. SW, Rochester,
MN 55905, United States
(Gerberi) Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, United States
Publisher
Elsevier B.V.
Abstract
Background: Coronavirus disease 2019 (COVID-19) can progress to
cardiovascular complications which are linked to higher in-hospital
mortality rates. Infective endocarditis (IE) can develop in patients with
recent COVID-19 infections, however, characterization of IE following
COVID-19 infection has been lacking. To better characterize this disease,
we performed a systematic review with descriptive analysis of the clinical
features and outcomes of these patients. <br/>Method(s): Our search was
conducted in 8 databases for all published reports of probable or definite
IE in patients with a prior COVID-19 confirmed diagnosis. After ensuring
an appropriate inclusion of the articles, we extracted data related to
clinical characteristics, modified duke criteria, microbiology, outcomes,
and procedures. <br/>Result(s): Searches generated a total of 323
published reports, and 20 articles met our inclusion criteria. The mean
age of patients was 52.2 +/- 16.9 years and 76.2% were males.
Staphylococcus aureus was isolated in 8 (38.1%) patients, Enterococcus
faecalis in 3 patients (14.3%) and Streptococcus mitis/oralis in 2 (9.5%)
patients. The mean time interval between COVID-19 and IE diagnoses was
16.7 +/- 15 days. Six (28.6%) patients required critical care due to IE, 7
patients (33.3%) underwent IE-related cardiac surgery and 5 patients
(23.8%) died during their IE hospitalization. <br/>Conclusion(s): Our
systematic review provides a profile of clinical features and outcomes of
patients with a prior COVID-19 infection diagnosis who subsequently
developed IE. Due to the ongoing COVID-19 pandemic, it is essential that
clinicians appreciate the possibility of IE as a unique complication of
COVID-19 infection.<br/>Copyright &#xa9; 2022 Southern Society for
Clinical Investigation

<86>
Accession Number
2018058067
Title
Tricuspid valve repair concomitant with pulmonary valve replacement in
repaired Tetralogy of Fallot. When and how?.
Source
Cirugia Cardiovascular. 29(3) (pp 176-179), 2022. Date of Publication: 01
May 2022.
Author
Rios L.; Bellot R.; Portela F.
Institution
(Rios, Bellot, Portela) Servicio de Cirugia Cardiaca Congenita, Hospital
Materno-Infantil y Hospital Dr. Negrin, Gran Canaria, Las Palmas de Gran
Canaria, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
According to the series, approximately 30% of corrected Fallot with
transannular patch surgery may have compromised tricuspid valve
functionality at the time of pulmonary valve replacement. This tricuspid
regurgitation is secondary to the progressive dilation of the right
ventricle, and there may be intrinsic causes of the initial corrective
surgery. At present it is clearly established that tricuspid regurgitation
darkens the prognosis of patients with left pathology and the trend is to
increasingly correct this valve in the interest of better survival and
functional class. In the case of patients corrected for Fallot at the time
of pulmonary valve replacement, there is not such clear evidence in this
regard. Various studies try to address the issue, all of them
retrospective, most with a small number of patients, with limited
statistical power and susceptible to errors and biases, reaching disparate
conclusions. Taking advantage of a typical clinical case, we will review
the studies carried out so far, trying to clarify some aspects in the
management of this type of patients. To repair or not to repair the
tricuspid?<br/>Copyright &#xa9; 2022 Sociedad Espanola de Cirugia
Cardiovascular y Endovascular

<87>
Accession Number
2018058027
Title
Late Outcomes After Aortic Root Enlargement During Aortic Valve
Replacement: Meta-Analysis With Reconstructed Time-To-Event Data.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part B. 36(8) (pp
3065-3073), 2022. Date of Publication: August 2022.
Author
Sa M.P.; Van den Eynde J.; Amabile A.; Malin J.H.; Jacquemyn X.; Tasoudis
P.; Sicouri S.; Schena S.; Torregrossa G.; Ramlawi B.
Institution
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood,
Panama
(Sa, Tasoudis, Sicouri, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood,
Panama
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Amabile) Division of Cardiac Surgery, Department of Surgery, Yale School
of Medicine, New Haven, CT
(Malin) Philadelphia College of Osteopathic Medicine, Bala Cynwyd, PA
(Schena) Division of Cardiac Surgery, The Johns Hopkins Hospital,
Baltimore, Moldova
Publisher
W.B. Saunders
Abstract
Objectives: The present authors aimed to assess the late outcomes of
patients undergoing aortic root enlargement (ARE) at the time of surgical
aortic valve replacement (SAVR). <br/>Design(s): Study-level meta-analysis
with reconstructed time-to-event data. <br/>Setting(s): Follow-up of
patients after surgical procedure. <br/>Participant(s): Adult patients
with aortic valve disease requiring surgery. <br/>Intervention(s): SAVR
with ARE versus SAVR without ARE. <br/>Measurements and Main Results: This
study followed the Preferred Reporting Items for Systematic Reviews and
Meta-analyses reporting guideline. The following databases were searched
for studies meeting the authors' inclusion criteria and published by
November 30, 2021: PubMed/MEDLINE, Embase, SciELO, LILACS, CCTR/CENTRAL,
and Google Scholar. Nine nonrandomized studies met the authors'
eligibility criteria. All studies were nonrandomized. A total of 213,134
patients (SAVR with ARE: 7,556 patients; SAVR without ARE: 205,578
patients) were included from studies published from 1997 to 2021. The
total rate of AAE was 3.7%, varying in the studies from 2.9% to 28.1%. The
studies consisted of patients whose mean age varied from 63 to 79 years.
Patients in the SAVR with ARE group had a significantly better overall
survival (hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.90-0.99,
p = 0.016) in the unmatched populations, but the matched analysis revealed
no difference between SAVR with/without ARE in terms of overall survival
(HR, 1.06; 95% CI, 0.90-1.25; p = 0.474). <br/>Conclusion(s): In the
context of patients undergoing SAVR with or without ARE, patients who
undergo ARE do not experience worse late outcomes. Further randomized
controlled trials are needed to confirm or refute the authors' current
findings.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<88>
Accession Number
2017527510
Title
Effects of Landiolol on Macrocirculatory Parameters and Left and Right
Ventricular Performances Following Cardiac Surgery: A Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part B. 36(8) (pp
2864-2869), 2022. Date of Publication: August 2022.
Author
Ferraris A.; Jacquet-Lagreze M.; Cazenave L.; Fornier W.; Jalalzai W.;
Rousseau-Saine N.; Pozzi M.; Fellahi J.-L.
Institution
(Ferraris, Jacquet-Lagreze, Cazenave, Fornier, Jalalzai, Rousseau-Saine,
Fellahi) Service d'Anesthesie-Reanimation, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
(Jacquet-Lagreze, Pozzi, Fellahi) Laboratoire CarMeN, Lyon, France
(Pozzi) Service de Chirurgie Cardiaque, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
Publisher
W.B. Saunders
Abstract
Objectives: Postoperative atrial fibrillation (POAF) is a major
complication after cardiac surgery, and an early postoperative
introduction of beta-blockers is recommended to reduce its incidence.
Landiolol, a new intravenous short-acting beta-1 blocker, could present a
useful and safe macrohemodynamic profile after cardiac surgery. Detailed
metabolic and hemodynamic effects of landiolol on cardiac performance,
however, remain poorly documented. The authors aimed to investigate the
dose-dependent hemodynamic and metabolic effects of landiolol in that
specific setting. <br/>Design(s): A prospective, randomized, double-blind
study versus placebo. <br/>Setting(s): A tertiary university hospital.
<br/>Participant(s): Adult patients scheduled for elective cardiac surgery
with cardiopulmonary bypass. <br/>Intervention(s): Incremental doses of
intravenous landiolol (0.5, 1, 2, 5, and 10 mug/kg/min) were given within
the 2 hours after arrival in the intensive care unit. Macrocirculatory
parameters and cardiac performances were derived from transpulmonary
thermodilution and transthoracic echocardiography. Metabolic data were
obtained from arterial blood tests. <br/>Measurements and Main Results:
From January to November 2019, 58 patients were analyzed and divided into
a landiolol group (n = 30) and a control group (n = 28). Heart rate
significantly decreased in the landiolol group (p < 0.01), whereas mean
arterial pressure and stroke volume remained unchanged. No significant
modification was found in both left and right systolic and diastolic
performances. Metabolic variables were similar in both groups. New-onset
POAF occurred in 9 (32%) versus 5 (17%) patients in the control and
landiolol groups, respectively (p = 0.28). <br/>Conclusion(s): Infusion of
landiolol in the range of 0.5-to-10 mug/kg/min during the early
postoperative period presents a good macrohemodynamic safety profile in
cardiac surgical patients and could be useful to prevent
POAF.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<89>
Accession Number
2017103678
Title
The Effect of Erector Spinae Plane Block and Combined Deep and Superficial
Serratus Anterior Plane Block on Acute Pain After Video-Assisted
Thoracoscopic Surgery: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part B. 36(8) (pp
2991-2999), 2022. Date of Publication: August 2022.
Author
Zengin M.; Sazak H.; Baldemir R.; Ulger G.; Alagoz A.
Institution
(Zengin, Sazak, Baldemir, Ulger, Alagoz) University of Health Sciences,
Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research
Hospital, Anesthesiology and Reanimation Clinic, Ankara, Turkey
Publisher
W.B. Saunders
Abstract
Objective: The study aimed to compare the analgesic effects of erector
spinae plane block (ESPB) and a combination of the deep and superficial
serratus anterior plane block (C-SAPB) methods in patients who underwent
video-assisted thoracoscopic surgery (VATS). <br/>Design(s): A
prospective, randomized study. <br/>Setting(s): At a single-center,
high-volume, tertiary thoracic surgery center. <br/>Participant(s): Adult
patients undergoing VATS. <br/>Intervention(s): Ultrasound-guided ESPB and
C-SAPB. <br/>Measurements and Main Results: Patients were assigned to ESPB
(group 1) or C-SAPB (group 2) groups according to the analgesia protocol.
All interventions were performed with single-needle insertion. Multimodal
analgesia was achieved via paracetamol, dexketoprofen, and intravenous
morphine for both study groups. Pain scores were assessed by the visual
analog scale (VAS). Morphine consumption, rescue analgesic requirements,
and side effects were recorded postoperatively for 24 hours. The primary
outcome was determined as VAS scores at rest and coughing. The secondary
outcomes of this study were postoperative morphine consumption and the
requirement of rescue analgesics. There was no statistically significant
difference between the groups in terms of VAS scores (p > 0.05). The
groups also were similar in terms of demographic characteristics, side
effects, morphine consumption, additional analgesic use, and duration of
block procedures (p > 0.05). There also were comparable results in terms
of hemodynamic variables (p > 0.05). <br/>Conclusion(s): Patients who
underwent VATS receiving ESPB or C-SAPB had similar pain scores, opioid
consumption, and side effects during the first postoperative 24 hours. At
the same time, the fact that the duration of the block procedure was
similar in both groups showed that multisite serratus anterior plane block
can be an effective alternative method in analgesic treatment after VATS,
considering that it easily can be applied. The authors here think that
C-SAPB can be a good alternative to ESPB because the outcomes of both
applications are similar, and C-SAPB easily can be seen and applied with
ultrasound.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<90>
Accession Number
2017049955
Title
Role of Hypothermia in Adult Cardiac Surgery Patients: A Systematic Review
and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(7) (pp 1883-1890),
2022. Date of Publication: July 2022.
Author
Abbasciano R.G.; Koulouroudias M.; Chad T.; Mohamed W.; Leeman I.; Pellowe
C.; Kunst G.; Klein A.; Murphy G.J.
Institution
(Abbasciano, Koulouroudias, Chad, Mohamed, Murphy) Department of
Cardiovascular Sciences, Clinical Sciences Wing, Glenfield Hospital,
University of Leicester, Leicester, United Kingdom
(Leeman, Pellowe) National Cardiac Surgery Clinical Trials Initiative,
Case Study Group 5 -Organ Protection, University of Leicester, Leicester,
United Kingdom
(Kunst) Department of Anaesthetics and Pain Medicine, King's College
Hospital NHS Foundation Trust, School of Cardiovascular Medicine &
Sciences, King's College London British Heart Foundation Centre of
Excellence, London, United Kingdom
(Klein) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital, Cambridge, United Kingdom
Publisher
W.B. Saunders
Abstract
Objective: To review studies that assessed systemic hypothermia as an
organ protection strategy in adults undergoing cardiac surgery with
cardiopulmonary bypass. <br/>Design(s): A systematic review and
meta-analysis. Setting and Participants: Randomized controlled trials,
irrespective of blinding, language, publication status, and date of
publication, were identified by searching the Cochrane Central register of
Controlled Trials, MEDLINE, and Embase until November 2020. Risk of bias
assessment was performed according to Cochrane methodology. Treatment
effects were expressed as risk ratios and 95% confidence intervals.
Heterogeneity was expressed as I². <br/>Intervention(s):
Systemic hypothermia. <br/>Measurements and Main Results: Forty-eight
trials enrolling 6,690 patients were included in the analysis.
Methodologic quality of the studies included was low, mostly due to
insufficient allocation concealment or blinding. Random-effects
meta-analysis did not resolve uncertainty as to the risks and benefits for
hypothermia versus normothermia for key primary and secondary outcomes,
including mortality (1.21, 0.94 to 1.56, I² = 0%) and brain
injury (0.87, 0.67 to 1.14, I² = 0%). Sensitivity analyses
restricted to trials at low risk of important bias demonstrated higher
mortality with hypothermia (1.70, 1.05 to 2.75, I² = 0%), with
little or no treatment effect on brain injury (1.01, 0.69 to 1.49,
I² = 0%). There was no interaction between cardioplegia
temperature and the effects of cardiopulmonary bypass temperature on
outcomes. There was insufficient evidence to assess the effects of
hypothermia in noncoronary artery bypass graft surgery.
<br/>Conclusion(s): The existing evidence for an organ-protective effect
of hypothermia in adult cardiac surgery is of low quality and
inconsistent.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<91>
Accession Number
2016601258
Title
The use of FEIBA for refractory bleeding in cardiac surgery - a systematic
review.
Source
Expert Review of Cardiovascular Therapy. 20(5) (pp 403-408), 2022. Date of
Publication: 2022.
Author
Khoury W.; Servito M.; Wang L.; Baranchuk A.; Callum J.; Payne D.;
El-Diasty M.
Institution
(Khoury, Servito) School of Medicine, Queen's University, Kingston, ON,
Canada
(Wang) Department of Anesthesiology, Queen's University, Kingston, ON,
Canada
(Baranchuk) Division of Cardiology, Queen's University, Kingston, ON,
Canada
(Callum) Department of Pathology and Molecular Medicine, Queen's
University, Kingston, ON, Canada
(Payne, El-Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Significant blood loss during cardiac surgery is associated
with a dramatic increase in morbidity and mortality. Factor Eight
Inhibitor Bypassing Activity (FEIBA), a hemostatic bypassing agent mainly
used in hemophiliac patients, has also been used for intractable bleeding
during cardiac surgical procedures in non-hemophiliac patients. However,
concerns exist that its use may be linked to increased incidence of
perioperative adverse effects including thrombotic complications. Areas
covered: A systematic literature search was performed on MEDLINE, EMBASE,
and the Cochrane Central Register of Controlled Trials databases for all
studies that reported the administration of FEIBA for treatment of
bleeding during adult cardiac surgery in non-hemophiliac patients. After
selecting the title and abstracts, two authors assessed the methodological
quality of the full-text articles prior to final inclusion in the
manuscript. Expert opinion: The safety profile of FEIBA was determined
through an aggregate count of adverse events. Major complications included
renal failure, re-operation for unresolved bleeding, postoperative
mortality, and thromboembolic events. Overall, there is insufficient
robust evidence to make a definitive conclusion about the safety or
efficacy of using of FEIBA as a hemostatic agent in the setting of cardiac
surgery.<br/>Copyright &#xa9; 2022 Informa UK Limited, trading as Taylor &
Francis Group.

<92>
[Use Link to view the full text]
Accession Number
2014921656
Title
Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and
Ischemia Severity.
Source
Circulation. (pp 1024-1038), 2021. Date of Publication: 2021.
Author
Reynolds H.R.; Shaw L.J.; Min J.K.; Page C.B.; Berman D.S.; Chaitman B.R.;
Picard M.H.; Kwong R.Y.; O'Brien S.M.; Huang Z.; Mark D.B.; Nath R.K.;
Dwivedi S.K.; Smanio P.E.P.; Stone P.H.; Held C.; Keltai M.; Bangalore S.;
Newman J.D.; Spertus J.A.; Stone G.W.; Maron D.J.; Hochman J.S.
Institution
(Reynolds, Bangalore, Newman, Hochman) Leon H. Charney Division of
Cardiology, Department of Medicine, New York University, Grossman School
of Medicine, 30 First Ave, SKI-9R, New York, NY 10016, United States
(Shaw) Weill Cornell Medicine, New York Presbyterian Hospital, United
States
(Min) Cleerly Inc, New York, NY, United States
(Page, O'Brien, Huang, Mark) Duke Clinical Research Institute, Durham, NC,
United States
(Berman) Cedars-Sinai Medical Centerc, Los Angeles, CA, United States
(Chaitman) St. Louis University, School of Medicine, Center for
Comprehensive Cardiovascular Care, MO, United States
(Picard) Massachusetts General Hospital, Harvard Medical School, Boston,
United States
(Kwong, Stone) Brigham and Women's Hospital, Boston, MA, United States
(Nath) Dr. Ram Manohar Lohia Hospital, New Delhi, India
(Dwivedi) King George's Medical University, Lucknow, India
(Smanio) Instituto Dante Pazzanese de Cardiologia e Fleury Medicina e
Saude, Sao Paulo, Brazil
(Held) Department of Medical Sciences, Cardiology, Uppsala University,
Uppsala Clinical Research Center, Sweden
(Keltai) Semmelweis University, Budapest, Hungary
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, United States
(Stone) Icahn School of Medicine at Mount Sinai, Cardiovascular Research
Foundation, New York, United States
(Maron) Department of Medicine, Stanford University, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) postulated that
patients with stable coronary artery disease (CAD) and moderate or severe
ischemia would benefit from revascularization. We investigated the
relationship between severity of CAD and ischemia and trial outcomes,
overall and by management strategy. <br/>Method(s): In total, 5179
patients with moderate or severe ischemia were randomized to an initial
invasive or conservative management strategy. Blinded, core
laboratory-interpreted coronary computed tomographic angiography was used
to assess anatomic eligibility for randomization. Extent and severity of
CAD were classified with the modified Duke Prognostic Index (n=2475, 48%).
Ischemia severity was interpreted by independent core laboratories
(nuclear, echocardiography, magnetic resonance imaging, exercise tolerance
testing, n=5105, 99%). We compared 4-year event rates across subgroups
defined by severity of ischemia and CAD. The primary end point for this
analysis was all-cause mortality. Secondary end points were myocardial
infarction (MI), cardiovascular death or MI, and the trial primary end
point (cardiovascular death, MI, or hospitalization for unstable angina,
heart failure, or resuscitated cardiac arrest). <br/>Result(s): Relative
to mild/no ischemia, neither moderate ischemia nor severe ischemia was
associated with increased mortality (moderate ischemia hazard ratio [HR],
0.89 [95% CI, 0.61-1.30]; severe ischemia HR, 0.83 [95% CI, 0.57-1.21];
P=0.33). Nonfatal MI rates increased with worsening ischemia severity (HR
for moderate ischemia, 1.20 [95% CI, 0.86-1.69] versus mild/no ischemia;
HR for severe ischemia, 1.37 [95% CI, 0.98-1.91]; P=0.04 for trend, P=NS
after adjustment for CAD). Increasing CAD severity was associated with
death (HR, 2.72 [95% CI, 1.06-6.98]) and MI (HR, 3.78 [95% CI, 1.63-8.78])
for the most versus least severe CAD subgroup. Ischemia severity did not
identify a subgroup with treatment benefit on mortality, MI, the trial
primary end point, or cardiovascular death or MI. In the most severe CAD
subgroup (n=659), the 4-year rate of cardiovascular death or MI was lower
in the invasive strategy group (difference, 6.3% [95% CI, 0.2%-12.4%]),
but 4-year all-cause mortality was similar. <br/>Conclusion(s): Ischemia
severity was not associated with increased risk after adjustment for CAD
severity. More severe CAD was associated with increased risk. Invasive
management did not lower all-cause mortality at 4 years in any ischemia or
CAD subgroup. Registration: URL: https://www.clinicaltrials.gov. Unique
identifier: NCT01471522.<br/>Copyright &#xa9; 2021 Lippincott Williams and
Wilkins. All rights reserved.

<93>
Accession Number
638292361
Title
Feasibility and effectiveness of home-based phase III exercise program for
frail patients after heart surgery: results of a pilot study.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i344), 2022. Date of Publication:
May 2022.
Author
Tamuleviciute-Prasciene E.; Beigiene A.; Barasaite V.; Poskaite P.;
Juozupaityte G.; Kubilius R.; Bjarnason-Wehrens B.
Institution
(Tamuleviciute-Prasciene, Beigiene, Barasaite, Poskaite, Juozupaityte,
Kubilius, Bjarnason-Wehrens) Lithuanian University of Health Sciences,
Department of Rehabilitation, Kaunas, Lithuania; Hospital of Lithuanian
University of Health Sciences, Rehabilitation hospital of Kulautuva,
Kaunas, Lithuania; Lithuanian University of Health Sciences, Kaunas,
Lithuania; German Sports University Cologne, Institute for Cardiology and
Sports Medicine, Dep. Preventive and Rehabilitative Sport Medicine and ,;
Cologne, Germany
Publisher
SAGE Publications Inc.
Abstract
Introduction: The number of elderly frail patients after cardiac surgery
is increasing. Frailty has become an important burden to be treated in
cardiac rehabilitation (CR). <br/>Purpose(s): To evaluate feasibility and
effectiveness of home-based exercise program including endurance,
flexibility, sensomotoric and resistance training specially tailored for
elderly frail patients after open heart surgery. <br/>Method(s): A pilot
study of a prospective, single-center, randomized controlled trial.
Inclusion criteria: CR after open heart surgery, age >= 65 years, Edmonton
frailty scale (EFS) score >= 4, patient's agreement to participate in the
study. A sample of 30 Patients (73.1+/-4.16 years, 73% male, EFS-score
5.68+/-0.28) were randomly assigned to intervention group (IG n=17) or
control group (CG n=13). All patients completed comprehensive 20-days
inpatient CR program, including aerobic cycle ergometer training (30 min,
6 sessions/week), sensomotoric and flexibility training (15 min. 3d/w for
each), resistance training (25 min, 3 d/w) and respiratory exercises (15
min, 5 days/week). After completion of inpatient-CR, the intervention
group (IG) participated in a 12-week home-based exercise program including
30 to 45 minutes exercise sessions on 5 days/week, with endurance,
flexibility, balance, and resistance training of low to moderate
intensity. IG-participants received baseline instructions and the
participation was monitored by telephone calls every second week. The CG
received usual care. The 6-minutes-walking-test (6MWT) was used to assess
functional capacity, the EFS to assess frailty level. Examination times
were baseline, after 20-days CR and 12 weeks after completion of CR.
Repeated measures ANOVA was used for statistical analysis. <br/>Result(s):
Baseline evaluation revealed good comparability of the groups showing
significant difference only in the gender distribution (age IG 73.2+/-0.97
years vs. CG 73.5+/-1.59 years), p=0.722), frailty level (EFS score CG
6.3+/-0.4 vs. 5.58+/-0.35, p=0.56), functional capacity (6MWD IG
285.94+/-19.92 m. vs. CG 309.62+/-21.55 m, p=0.430, gender distribution IG
were 9 (53%) males vs. CG 13 (100%), p=0.04). Main results are summarized
in Table 1. The results show significant improvements in EFS-score and
6MWD over the observation time with no differences between the groups. The
home-based program was feasible and safe for the IG, and no adverse
effects or events occurred that led to premature discontinuation of study
participation. <br/>Conclusion(s): The specially tailored
home-based-program for elderly frail patients after open heart surgery was
well accepted and tolerated by the patients. The results are promising,
but probably because of the small sample size, no significant differences
were found between the groups in the degree of frailty or functional
capacity. (Table Presented).

<94>
Accession Number
638292288
Title
Impact of a comprehensive cardiac rehabilitation programme versus coronary
revascularization in patients with stable angina pectoris: protocol for
the PRO-FIT randomised controlled trial.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i58), 2022. Date of Publication:
May 2022.
Author
Heutinck J.M.; De Koning I.A.; Vromen T.; Thijssen D.H.J.; Kemps H.M.C.
Institution
(Heutinck, De Koning, Vromen, Thijssen, Kemps) Eindhoven University of
Technology, Eindhoven, Netherlands (The); Radboud University Medical
Center, Nijmegen, Netherlands (The); Maastricht University Medical Centre
(MUMC), Maastricht, Netherlands (The); Maxima Medical Centre, Eindhoven,
Netherlands (The)
Publisher
SAGE Publications Inc.
Abstract
Background: Stable angina pectoris (SAP) is a highly common condition.
Despite optimal medical treatment (OMT) patients often remain symptomatic
and at high risk for cardiovascular morbidity and mortality. In daily
practice the standard treatment consists of OMT usually followed by an
invasive strategy, consisting of coronary angiography and subsequent
coronary revascularization. However, recent studies showed that these
costly and invasive procedures do not result in superior effects on
re-events and prognosis as compared to drug therapy alone in patients with
SAP. On the other hand, the effect of lifestyle-related interventions on
vascular function and the progression of atherosclerotic coronary artery
disease is well-known. Yet, contemporary RCTs comparing lifestyle
interventions with coronary revascularization in patients with SAP are
lacking. <br/>Purpose(s): To compare the impact of a 12-month cardiac
rehabilitation (CR) programme versus a routinely applied invasive approach
(including coronary angiography and subsequent coronary revascularization)
on anginal complaints and cost-effectiveness in SAP patients. We
hypothesize that CR is at least equally effective as an invasive approach.
<br/>Method(s): 216 SAP patients with residual anginal complaints under
OMT will be randomized to usual care or a 12-month CR intervention aiming
at angina relief and sustainable behavioural change for long-lasting
improvement in cardiovascular health. The CR programme consists of
multiple lifestyle interventions including an exercise programme, a
dietary intervention and a psychoeducation module with a stepped decline
in guidance by health care professionals. Patients in the CR group will
receive access to an online platform, a chatbot and a smartwatch enabling
patients and professionals to monitor the progress and adherence to
lifestyle advices. During the first 3 months patients will receive face to
face guidance, the next 3 months will consist of telerehabilitation using
the smartwatch with weekly video consulting and the last 6 months will be
focussed on relapse prevention and guidance on demand. The primary outcome
will be the quantity of anginal complaints (evaluated by the Seattle
Angina Questionnaire-7) following the 12-month intervention. Secondary
outcomes include cost-effectiveness, the ischemic threshold during
exercise, cardiovascular events, exercise capacity, quality of life and
psychosocial wellbeing. Future implications This will be the first study
evaluating a comprehensive disease-specific multimodal lifestyle
intervention as a primary treatment for patients with SAP. If proven
successful this study will have a great impact on the daily care of these
patients as coronary revascularizations can partly be replaced by a less
invasive, less costly and better sustainable treatment.

<95>
Accession Number
638292140
Title
CRYPTIC PREGNANCY, SYPHILIS AND CONSTITUTIONAL SYMPTOMS IN AN IV DRUG USER
DURING THE COVID-19 OUTBREAK.
Source
Journal of Paediatrics and Child Health. Conference: Perinatal Society of
Australia and New Zealand Annual Congress, PSANZ 2022. Adelaide, SA
Australia. 58(SUPPL 2) (pp 123), 2022. Date of Publication: May 2022.
Author
Sharma P.; Anvardeen K.
Institution
(Sharma) Department of Obstetrics and Gynaecology, King Edward Memorial
Hospital for Women, Subiaco, WA, Australia
(Anvardeen) St John of God Midland Public and Private Hospitals, Midland,
WA, Australia
Publisher
Blackwell Publishing
Abstract
Background Infective endocarditis (IE) during pregnancy is rare and is
associated with high maternal and fetal morbidity and mortality. We report
the case of a 30-year-old patient with IE who was incidentally found to be
24 weeks pregnant during the COVID outbreak. We also reviewed the relevant
literature. Case An active intravenous drug user presented with a 2-week
history of constitutional symptoms (myalgias, fever) and lower back pain
during the COVID outbreak. Initial investigations revealed bilateral
consolidations on chest X-ray. After she tested negative for COVID-19, CT
chest showed septic pulmonary emboli and grew MSSA on blood cultures. An
echocardiogram revealed a large (1.6 x 1.0 cm) mass attached to the
tricuspid valve suggestive of IE with severe tricuspid regurgitation. She
was also incidentally found to be 24 weeks pregnant (G1P0) and positive
for syphilis. Viable intrauterine pregnancy was confirmed at 25 weeks on
an ultrasound. She was treated with 5-weeks course of IV flucloxacillin,
however a repeat echocardiogram demonstrated an increase in vegetation
size (> 3 cm). As her vegetation size had increased, a surgical opinion
for IE was sought. Cardiac operation under cardiopulmonary bypass in a
pregnant woman is associated with high maternal and fetal morbidity and
mortality. She was managed conservatively with oral antibiotics, regular
echocardiographic and obstetrics reviews and delivered a healthy baby at
37 weeks following induction of labour. <br/>Conclusion(s): The review of
literature confirms that if IE in pregnancy is diagnosed early, an
uncomplicated outcome is possible with a multidisciplinary team approach.

<96>
Accession Number
638291763
Title
Tricuspid valve repair versus a conservative approach in patients with
functional tricuspid regurgitation undergoing mitral valve surgery. A
systematic review and meta-analysis.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i93), 2022. Date of Publication:
May 2022.
Author
K Awad A.; Elseidy S.; Elgenidy A.; Elbadawy A.M.; Mohamad T.
Institution
(K Awad, Elseidy, Elgenidy, Elbadawy, Mohamad) Ain Shams University,
Cairo, Egypt; University of Texas health sciences, Texas City, United
States of America; Cairo University, Cairo, Egypt; Wayne State University,
Detroit, United States of America
Publisher
SAGE Publications Inc.
Abstract
Background: Tricuspid valve repair (TVR) at the time of mitral valve (MV)
surgery is still a debatable part of literature whether to do a
concomitant valve repair or not, and if TVR is indicated, whether to
perform it in patients with severe functional tricuspid regurgitation (TR)
or mild-to-moderate TR. We assessed the benefits of a concomitant TVR
during MV surgery, focusing on mortality and echocardiographic TR-related
outcomes. <br/>Method(s): Electronic databases were systematically
searched to identify any observational or interventional studies that
compared the effects of concomitant TVR during MV surgery on all causes,
cardiovascular, non-cardiovascular mortality. Pooled risk ratios (RR) and
their 95% confidence intervals (CI) were calculated using random-effects
models. <br/>Result(s): 27 studies were included for a total of 5460
patients with mean follow up period of 80 months. During MV surgery doing
a concomitant TVR has been associated with significant reduction in
all-cause mortality (RR: 0.35, 95% CI [0.21 to 0.52], p<0.00001),
cardiac-related mortality (RR: 0.34, 95% CI [0.30 to 0.42], p<0.00001),
and non-cardiac related mortality (RR: 0.42, 95% CI [0.31 to 0.72],
p=0.005). Furthermore, regarding echocardiographic TR outcomes, the
presence of more-than-moderate TR (RR: 0.19; 95% CI [0.11-0.34], p =
0.001), TR progression (RR 0.04; 95% CI [0.01-0.07], p =0.001) were
significantly lower in the TV repair group at a mean weighted follow-up of
60 months. <br/>Conclusion(s): A concomitant TVR during MV surgery showed
a significant improvement not only in cardiac-related mortality,
non-cardiac-related mortality, but also in TR echocardiographic outcomes
with long period of follow up.

<97>
Accession Number
638291727
Title
Asymptomatic severe aortic stenosis, conservative treatment or early valve
replacement? a systematic review and meta-analysis.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i92), 2022. Date of Publication:
May 2022.
Author
K Awad A.; Elseidy S.; Elgenidy A.; Elbadawy A.M.; Sayed A.; Mohamad T.
Institution
(K Awad, Elseidy, Elgenidy, Elbadawy, Sayed, Mohamad) Ain Shams
University, Cairo, Egypt; University of Texas health sciences, Texas City,
United States of America; Cairo University, Cairo, Egypt; Wayne State
University, Detroit, United States of America
Publisher
SAGE Publications Inc.
Abstract
Background: Asymptomatic aortic stenosis' management is not only a daily
practice challenge but also an area of clinical research controversy. As
evidence on conservative versus early aortic valve replacement (AVR) is
debatable, we conducted a systematic review and meta-analysis to compare
the efficacy of conservative management versus AVR in asymptomatic aortic
stenosis (AS). <br/>Method(s): Electronic databases were systematically
searched to identify any observational or interventional studies that
compared the effects of conservative management versus AVR on all causes,
cardiovascular, non-cardiovascular mortality. Pooled risk ratios (RR) and
their 95% confidence intervals (CI) were calculated using random-effects
models. <br/>Result(s): A total of 6216 patients were included from 12
studies (observational=9, and randomized clinical trial=3) with a mean
follow-up duration of 50 months. When compared to early AVR, conservative
management has statistically significant higher risk of all causes
mortality (RR: 0.36, 95%CI [0.31 to 0.42], p<0.00001, figure 1),
cardiovascular mortality (RR: 0.32, 95%CI [0.24 to 0.41], p<0.00001,
figure 2), and non-cardiovascular mortality (RR: 0.42, 95%CI [0.24 to
0.56], p=0.0005). Regarding other complications, conservative treatment
showed significant higher risk of sudden cardiac death (RR: 0.46, 95%CI
[0.15 to 0.90], p=0.005), yet with no difference over AVR in stroke and
myocardial infarction (RR: 0.79, 95% CI [0.17 to 3.64], p=0.61) and (RR:
0.67, 95% CI [0.39 to 1.16], p=0.15), respectively. A subgroup sensitivity
analysis based on surgical AVR vs. transcatheter AVR and severe vs. very
severe AS reflected the findings of the overall results.
<br/>Conclusion(s): Patients with asymptomatic aortic valve stenosis,
managed with early AVR, have a lower risk of all-cause, cardiovascular,
and non-cardiovascular mortality when compared to conservative management.
(Figure Presented).

<98>
Accession Number
638291726
Title
Traditional versus extended hybrid cardiac rehabilitation based on the
continuous care model for coronary artery bypass surgery patients in a
middle-income country: an embedded mixed method.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i307), 2022. Date of Publication:
May 2022.
Author
Pakrad F.; Ahmadi F.; Grace S.; Oshvandi K.; Kazemnejad A.
Institution
(Pakrad, Ahmadi, Grace, Oshvandi, Kazemnejad) Hamadan University of
Medical Sciences, Hamadan, Iran (Islamic Republic of); Tarbiat Modares
University, Tehran, Iran (Islamic Republic of) York University, Toronto,
Canada
Publisher
SAGE Publications Inc.
Abstract
Introduction: Cardiac rehabilitation (CR) is a proven method to reduce the
risk of disease, but unfortunately in low-and middle-income countries
(LMICs), it is either unavailable or done in small quantities.
<br/>Purpose(s): To compare traditional (1-month supervised) vs hybrid
cardiac rehabilitation (CR; usual care) with an additional 3 months
offered remotely based on the continuous care model (intervention) in
patients who have undergone coronary artery bypass graft (CABG).
<br/>Method(s): The embedded method has been used for the conduction of
this study in two phases. The first phase of the study was carried out
using a randomised clinical trial. Of 107 eligible patients who were
referred to CR during the period of study, 82.2% (N=88) were enrolled
(target sample size). Participants were randomly assigned 1:1 (concealed;
44 per parallel arm). After CR, participants were given a mobile
application and communicated biweekly with the nurse from months 1-4 to
control risk factors. Quality of life (QOL, Short Form-36, primary
outcome); functional capacity (treadmill test); and the Depression,
Anxiety and Stress Scale were evaluated pre-CR, after 1 month, and 3
months after CR (end of intervention), as well as re-hospitalisation. In
the second phase, a qualitative study was conducted using the conventional
content analysis method. 17 patients from the intervention group and 3
members of their families were interviewed. <br/>Result(s): The results of
the quantitative stage showed the analysis of variance interaction effects
for the physical and mental component summary scores of QOL were <.001,
favoring intervention (per protocol); there were also significant
increases from pre-CR to 1 month, and from 1 month to the final assessment
in the intervention arm (P<.001), with change in the control arm only to 1
month. The effect sizes were 0.115 and 0.248, respectively. Similarly, the
interaction effect for functional capacity was significant (P<.001), with
a clinically significant 1.5 metabolic equivalent of task increase in the
intervention arm. There were trends for group effects for the psychosocial
indicators, with paired t tests revealing significant increases in each at
both assessment points in the intervention arm. At 4 months, there were 4
(10.3%) re-hospitalisations in the control arm and none in intervention
(P=.049). Intended theoretical mechanisms were also affected by the
intervention. From the analysis of qualitative data, 20 subcategories, 6
categories, and three themes, including promotion and continuity of
self-care, self-efficacy enhancement, belief, and lifestyle modification
were extracted. Finally, qualitative findings supported quantitative
findings. <br/>Conclusion(s): Extending CR in this accessible manner,
rendering it more comprehensive was effective in improving outcomes.
Therefore, using the CCM can greatly reduce the gap due to cardiac
rehabilitation in LMICs.

<99>
Accession Number
638291682
Title
LDL goal as a risk factor target in the post-intervention outpatient
cardiology population.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i88-i89), 2022. Date of
Publication: May 2022.
Author
Mustafa M.; Sanmugathas N.; Mcintosh K.; Kumar N.
Institution
(Mustafa, Sanmugathas, Mcintosh, Kumar) Whitby Cardiovascular, Oshawa,
Canada
Publisher
SAGE Publications Inc.
Abstract
Background: The relationship between an acute coronary event and
cholesterol levels has been immensely researched, specifically the
low-density lipoprotein (LDL) component of cholesterol. According to the
Canadian guidelines, LDL cholesterol should be below 1.8 mmol/L if the
patient has suffered an acute cardiac event. The European guidelines
suggests that LDL target concentration should be below 1.4 mmol/L if the
patient has had a previous cardiac event. European guidelines also lowered
the LDL recommendations to less than 1 mmol/L if the patient has had 2
previous cardiac event in the previous 2 years. <br/>Purpose(s): Assess
the concordance of one Canadian cardiology clinic to the European LDL
guidelines in patients with coronary artery disease. <br/>Method(s):
Patients were randomly selected from a single centre outpatient Cardiology
practice between January and June 2021. All patients were selected by 1
researcher. The patients selected must have been diagnosed with coronary
artery disease by Angiography and undergone intervention in the form of
percutaneous coronary intervention (PCI) or coronary artery bypass graft
(CABG). The blood cholesterol levels were evaluated before and after
intervention. <br/>Result(s): 101 patients were randomly selected for this
study. Data encompassed 83 males and 18 females ages 43 to 88. Before the
intervention, 15 patients had an LDL level below 1.4 mmol/L, 29 patients
had an LDL level below 1.8 mmol/L. After the intervention, the number of
patients with LDL <1.4 mmol/L was 50 and LDL<1.8 was 85. This population
was divided by risk factors and the LDL levels were compared before and
after intervention. 9 patients were known to be smokers, their LDL levels
were on average 2.73 mmol/L before intervention and 1.3 mmol/L after
intervention. 31 patients were known diabetic, their LDL levels were on
average 2.15 mmol/L before intervention and 1.43 mmol/L after
intervention. 69 patients had hypertension, their LDL levels were 2.36
mmol/L before intervention and 1.46 mmol/L after intervention. Of the 30
patient who had a positive family history, the LDL on average was 2.39
mmol/L before intervention and 1.84 mmol/L after intervention. Positive
family history was contingent on having an immediate female relative with
age <65 or immediate male relative with age <55 having had a cardiac event
or coronary intervention. <br/>Conclusion(s): The number of individuals on
appropriate cholesterol medications after intervention increased thereby
reducing the LDL concentration. The data shows that in a sample of the
typical Canadian population, 84% of patients were adequately managed after
a coronary artery intervention according to the Canadian guidelines.
According to the UK guidelines, only 29.5% are being adequately managed.
The North American guidelines will likely incorporate the new LDL targets
into upcoming revisions and therefore more aggressive risk factor
management will be required to meet the new target goals. (Figure
Presented).

<100>
Accession Number
638291612
Title
Rehabilitation of the unmotivated: remote cardiac rehabilitation among
patients of all risk levels who reported unwillingness to participate in
hospital-based rehabilitation.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i444-i445), 2022. Date of
Publication: May 2022.
Author
Nabutovsky I.; Levin C.; Yeshayahu S.; Gang N.; Nachshon A.; Heller A.;
Breitner D.; Klempfner R.
Institution
(Nabutovsky, Levin, Yeshayahu, Gang, Nachshon, Heller, Breitner,
Klempfner) Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv,
Israel; The Jerusalem College of Technology, Faculty of School of Life and
Health Sciences, Jerusalem, Israel; Chaim Sheba Medical Center, Cardiac
Rehabilitation Institute, Tel Hashomer, Israel
Publisher
SAGE Publications Inc.
Abstract
Introduction: Remote cardiac rehabilitation (RCR) is recognized as a
viable alternative to conventional, center-based rehabilitation. However,
to achieve meaningful functional improvement, a high level of adherence
and motivation to collaborate with the healthcare team, is necessary. The
feasibility of RCR among patients who actively avoid hospital
rehabilitation has not been adequately investigated by randomized studies.
<br/>Method(s): This year-long prospective study enrolled 60 cardiac
patients at various risk levels, including those with heart transplants
and heart failure, who refused to participate in conventional
rehabilitation. Accordingly, 40 participants were randomized to a 6-month
RCR program, while the remaining 20 received usual care in the community.
Both groups were monitored for activity and self-reported outcomes. RCR is
based on behavioral theories, includes multidisciplinary support,
motivational and educational content, regular exercise, controlled by a
smart sports watch, and transmitted to both the medical operations center
and the patients mobile phone application. The main outcome was the change
in Peak VO2, measured by the Cardiopulmonary Exercise Testing, after 4
months of intervention compared to baseline. <br/>Result(s): The study
included 60 patients, 82% men, aged 55 (+/-12), who were admitted to the
6-month RCR program mainly after myocardial infarction or coronary
interventions (44%), heart failure (29%), cardiomyopathy (13.5%) and heart
transplantation (10.5%). After RCR, there was a significant increase in
Peak VO2 in the intervention group (+2.46+/-7.1 mL/(kg min) compared to
the control group (-0.72+/-7.9 mL/(kg min) (p<0.001). High-density
lipoprotein (HDL) levels also improved significantly. The average minutes
per week of aerobic exercise was 221 (+/-124.74), which was 147% of the
goal. The average minutes at the recommended target heart rate was 117.38
(+/-78.36), and the percentage of intensity of training was 69.39%
(+/-15.11) of the maximum capacity. The average aerobic sessions per week
was 5 (+/-3), while the resistance sessions was 0.8 (+/-0.74). The average
daily step count in the intervention group was 9145 (+/-3860) versus 4445
(+/-3005; p<0.001). The surveys showed a significant improvement in
patients' mental and physical perception of health in the intervention vs.
control group. <br/>Conclusion(s): The adherence and results achieved by
patients in RCR who avoided conventional rehabilitation were well within
guideline recommendations, resulting in a significant improvement in
physical capacity. Risk level, age, and lack of motivation at the
beginning of the program were not barriers to achieving goals and
cooperation. (Figure Presented).

<101>
Accession Number
638291593
Title
Current lipid-lowering approach and LDL target achievement in very
high-risk patients: in-hospital results of a high-volume primary
percutaneous coronary intervention tertiary center.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i80), 2022. Date of Publication:
May 2022.
Author
Ciatti F.; Di Muro F.M.; Mattesini A.; Ristalli F.; Stolcova M.; Meucci
F.; Di Mario C.
Institution
(Ciatti, Di Muro, Mattesini, Ristalli, Stolcova, Meucci, Di Mario) Careggi
University Hospital (AOUC), Florence, Italy
Publisher
SAGE Publications Inc.
Abstract
Background: Low-density lipoprotein-cholesterol (LDL-C) is a well-accepted
causal risk factor for atherothrombotic cardiovascular disease. Several
randomized controlled trials and meta-analyses have shown that
lipid-lowering therapies reduce cardiovascular events and have a positive
effect in reducing vulnerable plaques. In particular, the recommended
target for LDL-C has become more and more stringent, moving to 1.4 mmol/l
(55 mg/dl) for very high-risk patients. According to the 2019 ESC/EAS
Guidelines, the current paradigm for lipid management favors a stepwise
approach consisting of early initiation of high-intensity statin, followed
by subsequent addition of ezetimibe, and ultimately a consideration of
PCSK9 inhibitor treatment if LDL-C levels remain elevated. <br/>Method(s):
We recruited 307 patients admitted for acute coronary syndrome (ACS)
during the COVID-19 pandemic from March 2020 to December 2020. Baseline
LDL-C concentration and prescribed hypolipemiant treatment at hospital
admission and discharge were registered. Therefore, we included all
consecutive patients identified as very-high cardiovascular risk,
according to 2019 ESC guidelines. We stratified our population through
variables independently associated with non-attainment of LDL-cholesterol
such as hypertension, diabetes, peripheral arterial disease, clinical
manifestations of ACS, number of main vessels treated, and complexity of
the atherosclerotic disease. <br/>Result(s): 274 patients were included.
Mean age was 69,9 years (SD 11,4), 20,8%were women, 23,7%had diabetes,
16,4%had PAD and 32,1 % suffered from valvular disease, mainly with mitral
regurgitation or aortic stenosis no more than mild or moderate. Of 25.1%
with a previous history of acute myocardial infarction, the 33,3% of whom
didn't have statin therapy pre-ACS index (p =0,001). At admission, medium
cholesterol levels of patients that underwent previous coronary
revascularization (25,5% of the total population) were 84,21 +/- 31,2
mg/dL, not in range according to both 2016 and 2019 ESC guidelines. At
discharge, 77,37 % of all the patients included received only statin
therapy VS 22,63% with statin plus ezetimibe. In the subpopulation of
patients with recurring ACS events with LDL pre-admission > 100
mg/dL,despite high dose statin, only 25% of this population were
discharged adding ezetimibe (VS 75% who kept on the treatment of high dose
statin without up-titration). <br/>Conclusion(s): Management of
dyslipidemia is frequently suboptimal and the gap between guidelines and
clinical practice for lipid management across Europe has been exacerbated
by the 2019 guidelines. A greater utilization of non-statin lipid-lowering
therapies is likely needed to reach the LDL-C optimal target. A correct
stratification of the risk class would help to identify, in a personalized
perspective of treatment, patients at very high risk that would take
advantage of more aggressive therapy to reach the lowest target of LDL-C
('the lower is better'). (Figure Presented).

<102>
Accession Number
638291444
Title
Beyond nursing programming: preventing adverse events in patients with
implantable cardiac devices undergoing invasive procedures and MRI after
lean healthcare method.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2022. Online. 29(SUPPL 1) (pp i430-i432), 2022. Date of
Publication: May 2022.
Author
Flores Soler J.; Garcia Gonzalez F.; Casas De La Cal L.; Herreros Gil M.;
Salgado Aranda R.; Perez-Castellano N.; Perez-Villacastin Dominguez J.
Institution
(Flores Soler, Garcia Gonzalez, Casas De La Cal, Herreros Gil, Salgado
Aranda, Perez-Castellano, Perez-Villacastin Dominguez) Hospital Clinico
San Carlos, Madrid, Spain
Publisher
SAGE Publications Inc.
Abstract
Introduction: Follow-up in patients with cardiovascular implantable
electronic devices (CIED) is essential to avoid adverse events and
complications, such as arrhythmias, device dysfunction, and infections,
among other events. Prevention plays a fundamental role, especially when
these patients undergo non-cardiological invasive tests and/or procedures
(e.g., surgeries) or magnetic resonance imaging (MRI). These situations
sometimes require the reprogramming of the device. In our Arrhythmia's
Unit, after developing a healthcare management model based on the Lean
methodology, 2 processes were identified that implied a reduction in
activity, a threat to efficiency and a risk to patients who would undergo
invasive non-cardiological procedures or MRI. One of them was a
significant number of "urgent" consultations and calls to evaluate and/or
reprogram CIED in patients that underwent invasive non-cardiological
procedures the same day, many of them without indication of reprogramming
according to the type of procedure. Another one was the increase in
consultations of people with CIED who require MRI, was often
contraindicated because it produces adverse effects on the patient and/or
device. <br/>Objective(s): To implement action protocols, depending on the
type of device and dependant on stimulation, for patients with CIED who
undergo surgery and invasive non-cardiac procedures and MRI. To evaluate
the number of urgent calls and adverse events before and after
implementation. <br/>Method(s): A single-centre, not randomized study has
been designed. A year before and after the implementation of the protocol
the following variables were quantified a) number of urgent calls b)
number of adverse events (persistence of the special programming of the
device more than 24 h after the end of the procedure: asynchronous
stimulation, ICD therapies off, CIED dysfunction or unnecessary
programming). Two protocols were developed: a) management of CIED carriers
undergoing invasive non-cardiological procedures according to recent
clinical practice guidelines. b) risk of dysfunction after MRI based on
type/compatibility with MRI of the device, implanted leads, and
stimulation dependence, using a colour scale, from safe (in green) to high
risk of dysfunction (in black) Pictures 1,2. The protocols for action in
the anaesthesia and radiology services were disseminated through sessions
given by the arrhythmia unit staff. <br/>Result(s): In the year prior to
implementing the protocol, 185 urgent calls/year were quantified, (15.1
calls/month) and the number of adverse events was 4 (0.2 events/month).
One year after the implementation of the protocol, urgent calls were
reduced to 4calls/year, representing 0.33 calls/month (p <0.001) and there
was an absence of adverse events (zero events/month). Conclusions. The
implementation of protocols based on recent clinical practice guidelines
can reduce urgent calls and adverse events related to reprogramming in our
centre, thus increasing patient safety. (Figure Presented).

<103>
[Use Link to view the full text]
Accession Number
638288035
Title
SYSTOLIC BLOOD PRESSURE VARIABILITY AS PREDICTOR OF ADVERSE OUTCOMES IN
PATIENTS UNDERWENT MYOCARDIAL REVASCULARIZATION: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of Hypertension. Conference: 16th Scientific Meeting of Indonesian
Society of Hypertension, INASH 2022. Virtual. 40(SUPPL 2) (pp e5-e6),
2022. Date of Publication: May 2022.
Author
Anantawikrama W.P.; Handayani R.; Ransun T.; Candrasatria R.M.; Iustitia
S.P.
Institution
(Anantawikrama) Abdul Moeloek General Hospital, Indonesia
(Handayani, Ransun, Candrasatria, Iustitia) Abdul Moeloek General
Hospital, Indonesia, Indonesia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Coronary Arterial Disease (CAD) has large morbidity and
mortality burden, becoming the leading cause of death worldwide. High
Systolic Blood Pressure (SBP) Variability has been associated with
increased cardiovascular disease risk. However, the evidence of its impact
on myocardial revascularization outcome is still lacking.
<br/>Objective(s): This study aimed to investigate the SBP variability
prognostic value in patients who received myocardial revascularization.
<br/>Method(s): Literature search was conducted on PubMed, EMBASE,
Cochrane Library, Google Scholar, and ProQuest. The outcomes were
all-cause mortality and major adverse cardiovascular events (MACEs).
<br/>Result(s): Five cohort studies involving a total of 11,214 patients
received myocardial revascularization were included, of which three
studies reported data in Percutaneous Coronary Intervention (PCI) and two
studies analyze the outcome on Coronary Arterial Bypass Grafting (CABG).
On pooled analysis of PCI group, elevated SBP variability significantly
associated with higher all-cause mortality (Hazard ratio [HR] 1.63; 95%
confidence interval [CI] 1.34-1.98; p < 0.0001; I² = 0%) and
increased MACEs (Hazard ratio [HR] 1.38; 95% confidence interval [CI]
1.19-1.62; p < 0.0001; I² = 12%). On pooled analysis of CABG
group, increased SBP variability have non-significant association with
higher mortality (Hazard ratio [HR] 1.29; 95% confidence interval [CI]
0.85- 1.94; p <=0.24; I² = 85%) <br/>Conclusion(s): Increased
SBP variability was significantly associated with higher all-cause
mortality and MACEs in patients undergoing PCI, but its association is
insignificant to all-cause mortality in patients who received CABG.

<104>
Accession Number
2018880514
Title
Long-term safety and efficacy of anacetrapib in patients with
atherosclerotic vascular disease.
Source
European Heart Journal. 43(14) (pp 1416-1424), 2022. Date of Publication:
07 Apr 2022.
Author
Sammons E.; Hopewell J.C.; Chen F.; Stevens W.; Wallendszus K.;
Valdes-Marquez E.; Dayanandan R.; Knott C.; Murphy K.; Wincott E.; Baxter
A.; Goodenough R.; Lay M.; Hill M.; Macdonnell S.; Fabbri G.; Lucci D.;
Fajardo-Moser M.; Brenner S.; Hao D.; Zhang H.; Liu J.; Wuhan B.;
Mosegaard S.; Herrington W.; Wanner C.; Angermann C.; Ertl G.; Maggioni
A.; Barter P.; Mihaylova B.; Mitchel Y.; Blaustein R.; Goto S.; Tobert J.;
Delucca P.; Chen Y.; Chen Z.; Gray A.; Haynes R.; Armitage J.; Baigent C.;
Wiviott S.; Cannon C.; Braunwald E.; Collins R.; Bowman L.; Landray M.
Institution
(Sammons) REVEAL Central Coordinating Office, Clinical Trial Service Unit,
Epidemiological Studies Unit, Nuffield Department of Population Health,
University of Oxford, Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: REVEAL was the first randomized controlled trial to demonstrate that
adding cholesteryl ester transfer protein inhibitor therapy to intensive
statin therapy reduced the risk of major coronary events. We now report
results from extended follow-up beyond the scheduled study treatment
period. <br/>Methods and Results: A total of 30 449 adults with prior
atherosclerotic vascular disease were randomly allocated to anacetrapib
100 mg daily or matching placebo, in addition to open-label atorvastatin
therapy. After stopping the randomly allocated treatment, 26 129 survivors
entered a post-trial follow-up period, blind to their original treatment
allocation. The primary outcome was first post-randomization major
coronary event (i.e. coronary death, myocardial infarction, or coronary
revascularization) during the in-trial and post-trial treatment periods,
with analysis by intention-to-treat. Allocation to anacetrapib conferred a
9% [95% confidence interval (CI) 3-15%; P = 0.004] proportional reduction
in the incidence of major coronary events during the study treatment
period (median 4.1 years). During extended follow-up (median 2.2 years),
there was a further 20% (95% CI 10-29%; P < 0.001) reduction. Overall,
there was a 12% (95% CI 7-17%, P < 0.001) proportional reduction in major
coronary events during the overall follow-up period (median 6.3 years),
corresponding to a 1.8% (95% CI 1.0-2.6%) absolute reduction. There were
no significant effects on non-vascular mortality, site-specific cancer, or
other serious adverse events. Morbidity follow-up was obtained for 25 784
(99%) participants. <br/>Conclusion(s): The beneficial effects of
anacetrapib on major coronary events increased with longer follow-up, and
no adverse effects emerged on non-vascular mortality or morbidity. These
findings illustrate the importance of sufficiently long treatment and
follow-up duration in randomized trials of lipid-modifying agents to
assess their full benefits and potential harms. Trial registration:
International Standard Randomized Controlled Trial Number (ISRCTN)
48678192; ClinicalTrials.gov No. NCT01252953; EudraCT No. 2010-023467-18.
<br/>Copyright &#xa9; 2021 The Author(s). Published by Oxford University
Press on behalf of the European Society of Cardiology.

<105>
[Use Link to view the full text]
Accession Number
2018842882
Title
Effect of ulinastatin on the inflammatory response after video-assisted
thoracic lobectomy in patients with lung cancer: a randomized controlled
study.
Source
Chinese Medical Journal. 135(7) (pp 806-812), 2022. Date of Publication:
05 Apr 2022.
Author
Hwang W.J.; Joo M.A.; Joo J.; Ni J.
Institution
(Hwang, Joo, Joo) Department of Anesthesiology and Pain Medicine, Seoul
St. Mary's Hospital, College of Medicine, Catholic University of Korea,
222, Banpo-daero, Seocho-gu, Seoul 06591, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background:The first-line treatment for lung cancer is surgical resection,
and one-lung ventilation (OLV) is the most basic anesthetic management
method in lung surgery. During OLV, inflammatory cytokines are released in
response to the lung tissue damage and promote local and contralateral
lung damage through the systemic circulation. We designed a randomized,
prospective study to evaluate the effect of the urinary trypsin inhibitor
(UTI) ulinastatin on the inflammatory response after video-assisted
thoracic lobectomy in patients with lung cancer. <br/>Method(s):Adult
patients aged 19 to 70 years, who were scheduled for video-assisted
thoracic lobectomy surgery to treat lung cancer between May 2020 and
August 2020, were enrolled in this randomized, prospective study. UTI
(300,000 units) mixed with 100 mL of normal saline in the ulinastatin
group and 100 mL of normal saline in the control group was administered
over 1 h after inducing anesthesia. <br/>Result(s):The baseline (T0)
interferon-gamma (IFN-gamma)/interleukin-4 (IL-4) ratio was not different
between the groups (6941.3 +/- 2778.7 vs. 6954.3 +/- 2752.4 pg/mL,
respectively; P > 0.05). The IFN-gamma/IL-4 ratio was significantly higher
in ulinastatin group at 30 min after entering the recovery room than
control group (20,148.2 +/- 5054.3 vs. 6674.0 +/- 2963.6, respectively;
adjusted P < 0.017). <br/>Conclusion(s):Administering UTI attenuated the
anti-inflammatory response, in terms of INF-gamma expression and the
IFN-gamma/IL-4 ratio, after video-assisted thoracic surgery in lung cancer
patients.Trial registration:Clinical Research Information Service of Korea
National Institute of Health (CRIS), KCT0005533.<br/>Copyright &#xa9; 2022
Lippincott Williams and Wilkins. All rights reserved.

<106>
Accession Number
2018833865
Title
Mitral Valve Replacement: Time for a Patient-Level Meta-Analysis?.
Source
Annals of Thoracic Surgery. 114(1) (pp 350), 2022. Date of Publication:
July 2022.
Author
Deutsch C.; Bramlage K.; Bramlage P.
Institution
(Deutsch, Bramlage, Bramlage) Institute for Pharmacology and Preventive
Medicine, Bahnhofstrasse 20, 49661, Cloppenburg, Germany
Publisher
Elsevier Inc.

<107>
Accession Number
2018831637
Title
Reply: 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 e9), 2022. Date
of Publication: 05 Jul 2022.
Author
Mazine A.; Ouzounian M.
Publisher
Elsevier Inc.

<108>
Accession Number
2018851546
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. (no pagination), 2022. Date of
Publication: 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
Elsevier Inc.
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.<br/>Copyright &#xa9; 2022

<109>
Accession Number
2018719690
Title
White Cord Syndrome After Cervical or Thoracic Spinal Cord Decompression.
Hemodynamic Complication or Mechanical Damage? An Underestimated
Nosographic Entity.
Source
World Neurosurgery. 164 (pp 243-250), 2022. Date of Publication: August
2022.
Author
Gerardi R.M.; Giammalva G.R.; Basile L.; Guli C.; Pino M.A.; Messina D.;
Umana G.E.; Graziano F.; di Bonaventura R.; Sturiale C.L.; Visocchi M.;
Iacopino D.G.; Maugeri R.
Institution
(Gerardi, Giammalva, Basile, Guli, Pino, Messina, Iacopino, Maugeri)
Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency
Program in Neurologic Surgery, Department of Biomedicine Neurosciences and
Advanced Diagnostics, School of Medicine, University of Palermo, Palermo,
Italy
(Umana) Department of Neurosurgery, Cannizzaro Hospital, Trauma Center,
Gamma Knife Center, Catania, Italy
(Graziano) Department of Neurosurgery, Garibaldi Hospital, Catania, Italy
(di Bonaventura, Sturiale, Visocchi) Fondazione Policlinico Universitario
A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy
Publisher
Elsevier Inc.
Abstract
The ischemia/reperfusion mechanism is believed to be responsible for
parenchymal damage caused by temporary hypoperfusion and worsened by the
subsequent attempt of reperfusion. This represents a true challenge for
physicians of several fields, including neurosurgeons. A limited number of
papers have shed the light on a rare pathologic condition that affects
patients experiencing an unexplained neurologic deficit after spine
surgery, the so-called "white cord syndrome." This entity is believed to
be caused by an "ischemia/reperfusion" injury on the spinal cord,
documented by a postoperative intramedullary hyperintensity on T2-weighted
magnetic resonance imaging sequences. To date, the cases of white cord
syndrome reported in literature mostly refer to cervical spine surgery.
However, the analysis of several reviews focusing on spine surgery outcome
suggests postoperative neurologic deficits of new onset could be charged
to a mechanism of ischemia/reperfusion, even if the physiopathology of
this event is seldom explored or at least discussed. The same
neuroradiologic finding can suggest mechanical damage due to inappropriate
surgical manipulation. On this purpose, we performed a systematic review
of the literature with the aim to identify and analyze all the factors
potentially contributing to ischemic/reperfusion damage of the spinal cord
that may potentially complicate any spinal surgery, without distinction
between cervical or thoracic segments. Finally, we believe that
postoperative neurologic deficit after spinal surgery constituting the
"white cord syndrome" could be under-reported; both neurosurgeons and
patients should be fully aware of this rare but potentially devasting
complication burdening cervical and thoracic spine surgery.<br/>Copyright
&#xa9; 2022 Elsevier Inc.

<110>
Accession Number
2017955121
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) (no pagination), 2022. Article Number: 508. Date of
Publication: December 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
BioMed Central Ltd
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. <br/>Discussion(s): 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.<br/>Copyright &#xa9; 2022, The Author(s).

<111>
Accession Number
2017861578
Title
High-sensitivity cardiac troponin and the diagnosis of myocardial
infarction in patients with kidney impairment.
Source
Kidney International. 102(1) (pp 149-159), 2022. Date of Publication: July
2022.
Author
Gallacher P.J.; Miller-Hodges E.; Shah A.S.V.; Farrah T.E.; Halbesma N.;
Blackmur J.P.; Chapman A.R.; Adamson P.D.; Anand A.; Strachan F.E.; Ferry
A.V.; Lee K.K.; Berry C.; Findlay I.; Cruickshank A.; Reid A.; Gray A.;
Collinson P.O.; Apple F.S.; McAllister D.A.; Maguire D.; Fox K.A.A.;
Keerie C.; Weir C.J.; Newby D.E.; Mills N.L.; Dhaun N.; Tuck C.; Bularga
A.; Wereski R.; Lowry M.T.H.; Taggart C.; Sandeman D.; Stables C.L.;
Vallejos C.A.; Tsanas A.; Marshall L.; Stewart S.D.; Fujisawa T.;
McPherson J.; McKinlay L.; Walker S.; Ford I.; Cruikshank A.; Amoils S.;
Stevens J.; Norrie J.; Andrews J.P.M.; Moss A.; Anwar M.S.; Hung J.; Malo
J.; Fischbacher C.M.; Croal B.L.; Leslie S.J.; Parker R.A.; Walker A.;
Harkess R.; Wackett T.; Weir C.; Armstrong R.; Stirling L.; MacDonald C.;
Sadat I.; Finlay F.; Charles H.; Linksted P.; Young S.; Alexander B.;
Duncan C.
Institution
(Gallacher, Miller-Hodges, Shah, Farrah, Blackmur, Chapman, Adamson,
Anand, Strachan, Ferry, Lee, Fox, Newby, Mills, Dhaun) British Heart
Foundation Centre for Cardiovascular Science, University of Edinburgh, UK,
Edinburgh, United Kingdom
(Miller-Hodges, Farrah, Dhaun) Department of Renal Medicine, Royal
Infirmary of Edinburgh, UK, Edinburgh, United Kingdom
(Halbesma, Keerie, Weir, Mills) Usher Institute, University of Edinburgh,
UK, Edinburgh, United Kingdom
(Adamson) Christchurch Heart Institute, University of Otago, Christchurch,
New Zealand, Australia
(Berry) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, UK, Glasgow, United Kingdom
(Findlay) Department of Cardiology, Royal Alexandra Hospital, UK, Paisley,
United Kingdom
(Cruickshank, Reid) Department of Biochemistry, Queen Elizabeth University
Hospital, UK, Glasgow, United Kingdom
(Gray) Emergency Medicine Research Group Edinburgh, Royal Infirmary of
Edinburgh, UK, Edinburgh, United Kingdom
(Collinson) Departments of Clinical Blood Sciences and Cardiology, St.
George's, University Hospitals National Health Service Trust and St.
George's University of London, UK, London, United Kingdom
(Apple) Department of Laboratory Medicine and Pathology, Hennepin
Healthcare/Hennepin County Medical Center, Minneapolis, MN, United States
(Apple) University of Minnesota, Minneapolis, MN, United States
(McAllister) Institute of Health and Wellbeing, University of Glasgow, UK,
Glasgow, United Kingdom
(Maguire) Emergency Medicine Department, Glasgow Royal Infirmary, UK,
Glasgow, United Kingdom
(Keerie, Weir) Edinburgh Clinical Trials Unit, University of Edinburgh,
UK, Edinburgh, United Kingdom
Publisher
Elsevier B.V.
Abstract
The benefit and utility of high-sensitivity cardiac troponin (hs-cTn) in
the diagnosis of myocardial infarction in patients with kidney impairment
is unclear. Here, we describe implementation of hs-cTnI testing on the
diagnosis, management, and outcomes of myocardial infarction in patients
with and without kidney impairment. Consecutive patients with suspected
acute coronary syndrome enrolled in a stepped-wedge, cluster-randomized
controlled trial were included in this pre-specified secondary analysis.
Kidney impairment was defined as an eGFR under 60mL/min/1.73m².
The index diagnosis and primary outcome of type 1 and type 4b myocardial
infarction or cardiovascular death at one year were compared in patients
with and without kidney impairment following implementation of hs-cTnI
assay with 99th centile sex-specific diagnostic thresholds. Serum
creatinine concentrations were available in 46,927 patients (mean age 61
years; 47% women), of whom 9,080 (19%) had kidney impairment. hs-cTnIs
were over 99th centile in 46% and 16% of patients with and without kidney
impairment. Implementation increased the diagnosis of type 1 infarction
from 12.4% to 17.8%, and from 7.5% to 9.4% in patients with and without
kidney impairment (both significant). Patients with kidney impairment and
type 1 myocardial infarction were less likely to undergo coronary
revascularization (26% versus 53%) or receive dual anti-platelets (40%
versus 68%) than those without kidney impairment, and this did not change
post-implementation. In patients with hs-cTnI above the 99th centile, the
primary outcome occurred twice as often in those with kidney impairment
compared to those without (24% versus 12%, hazard ratio 1.53, 95%
confidence interval 1.31 to 1.78). Thus, hs-cTnI testing increased the
identification of myocardial injury and infarction but failed to address
disparities in management and outcomes between those with and without
kidney impairment.<br/>Copyright &#xa9; 2022 International Society of
Nephrology

<112>
Accession Number
2017057095
Title
Regional analgesia techniques for video-assisted thoracic surgery: a
frequentist network meta-analysis.
Source
Korean Journal of Anesthesiology. 75(3) (pp 231-244), 2022. Date of
Publication: June 2022.
Author
Jo Y.; Park S.; Oh C.; Pak Y.; Jeong K.; Yun S.; Noh C.; Chung W.; Kim
Y.-H.; Ko Y.K.; Hong B.
Institution
(Jo, Oh, Pak, Jeong, Yun, Noh, Chung, Kim, Ko, Hong) Department of
Anesthesiology and Pain Medicine, Chungnam National University Hospital,
282 Munhwa-ro, Jung-gu, Daejeon 35015, South Korea
(Jo, Oh, Pak, Yun, Noh, Chung, Kim, Ko, Hong) Department of Anesthesiology
and Pain Medicine, College of Medicine, Chungnam National University,
South Korea
(Park) Department of Nursing, College of Nursing, Chungnam National
University, South Korea
(Ko, Hong) Biomedical Research Institute, Chungnam National University,
Daejeon, South Korea
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Various regional analgesia techniques are used to reduce
postoperative pain in patients undergoing video-assisted thoracic surgery
(VATS). This study aimed to determine the relative efficacy of regional
analgesic interventions for VATS using a network meta-analysis.
<br/>Method(s): We searched the Medline, EMBASE, Cochrane Controlled Trial
Register, Web of Science, and Google Scholar databases to identify all
randomized controlled trials (RCTs) that compared the analgesic effects of
the following interventions: control, thoracic paravertebral block (TPVB),
erector spinae plane block (ESPB), serratus plane block (SPB), and
intercostal nerve block (INB). The primary outcome was opioid consumption
during the first 24 h postoperative period. Pain scores were also
collected during three different postoperative periods: the early (0-6 h),
middle (6-18 h), and late (18-24 h) periods. <br/>Result(s): A total of 21
RCTs (1,391 patients) were included. TPVB showed the greatest effect on
opioid consumption compared with the control (mean difference [MD]: -13.2
mg, 95% CI [-16.2, -10.1]). In terms of pain scores in the early period,
ESPB had the greatest effect compared to control (MD: -1.6, 95% CI [-2.3,
-0.9]). In the middle and late periods, pain scores showed that TPVB, ESPB
and INB had superior analgesic effects compared to controls, while SPB did
not. <br/>Conclusion(s): TPVB had the best analgesic efficacy following
VATS, though the analgesic efficacy of ESPBs was comparable. However,
further studies are needed to determine the optimal regional analgesia
technique to improve postoperative pain control following
VATS.<br/>Copyright &#xa9; The Korean Society of Anesthesiologists, 2022.

<113>
Accession Number
2018723597
Title
Deep Sternal Wound Infection and Mortality in Cardiac Surgery: A
Meta-analysis.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Perezgrovas-Olaria R.; Audisio K.; Cancelli G.; Rahouma M.; Ibrahim M.;
Soletti G.J.; Chadow D.; Demetres M.; Girardi L.N.; Gaudino M.
Institution
(Perezgrovas-Olaria, Audisio, Cancelli, Rahouma, Soletti, Chadow, Girardi,
Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, New York
(Ibrahim) Department of General Surgery, Maimonides Medical Center,
Brooklyn, New York
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, New York
Publisher
Elsevier Inc.
Abstract
Background: Deep sternal wound infection (DSWI) is a rare but severe
complication after cardiac surgical procedures and has been associated
with increased early morbidity and mortality. Studies reporting long-term
outcomes in patients with DSWI have shown contradictory results. We
performed a study-level meta-analysis evaluating the impact of DSWI on
short- and long-term clinical outcomes. <br/>Method(s): A systematic
literature search was conducted to identify studies comparing short- and
long-term outcomes of patients submitted to cardiac surgical procedures
who developed DSWI and patients who did not. The primary outcome was
overall mortality. Secondary outcomes were in-hospital mortality,
follow-up mortality, major adverse cardiovascular events, myocardial
infarction, and repeat revascularization. Postoperative outcomes were also
investigated. <br/>Result(s): Twenty-four studies totaling 407 829
patients were included. Overall, 6437 (1.6%) patients developed DSWI. Mean
follow-up was 3.5 years. DSWI was associated with higher overall mortality
(incidence rate ratio [IRR], 1.99; 95% CI, 1.66-2.38; P < .001),
in-hospital mortality (odds ratio, 3.30; 95% CI, 1.88-5.81; P < .001),
follow-up mortality (IRR, 2.02; 95% CI, 1.39-2.94; P = .001), and major
adverse cardiovascular events (IRR, 2.04; 95% CI, 1.60-2.59; P < .001). No
differences in myocardial infarction and repeat revascularization were
found, but limited studies reported those outcomes. DSWI was associated
with longer postoperative hospitalization, stroke, myocardial infarction,
and respiratory and renal failure. Sensitivity analyses on isolated
coronary artery bypass grafting studies and by adjustment method were
consistent with the main analysis. <br/>Conclusion(s): Compared with
patients who did not develop DSWI, patients with DSWI after cardiac
surgical procedures had increased risk of death as well as short- and
long-term adverse clinical outcomes.<br/>Copyright &#xa9; 2022 The Society
of Thoracic Surgeons

<114>
Accession Number
2018513564
Title
The Relation of Grit and Surgical Specialty Interest Among Medical
Students.
Source
Journal of Surgical Education. (no pagination), 2022. Date of
Publication: 2022.
Author
Huo B.; Dow T.; Helyer L.
Institution
(Huo) Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
(Dow) Division of Plastic Surgery, Department of Surgery, Dalhousie
University, Halifax, NS, Canada
(Helyer) Division of General Surgery, Department of Surgery, Dalhousie
University, Halifax, NS, Canada
Publisher
Elsevier Inc.
Abstract
Objective: The assessment of Grit among medical students applying to
surgical residency programs may be useful, but the relationship between
student Grit and surgical specialty interest is not clear. This study
investigated whether medical student Grit differs based on interest in
direct-entry surgical specialties. <br/>Design(s): A literature search
informed the development of a cross-sectional study assessing medical
student ratings of the validated 6-item Short-Grit scale. Medical students
also indicated their career preferences. <br/>Setting(s): Faculty of
Medicine, Dalhousie University, Halifax, NS, Canada; a tertiary medical
center. <br/>Participant(s): Surgical specialty interest and Grittiness
were assessed among 297 (50.4%) pre-clerkship medical students in their
first or second year of training. Data was collected from program
applicants over 4 years. <br/>Result(s): Medical students had high levels
of Grit (M = 4.029, SD = 0.517). There was a significant difference in
Grit level between medical students interested in cardiac surgery ([M =
4.197, SD = 0.471 vs M = 3.919, 0.518]; t(295) = 4.674, p < 0.001; Cohen's
D = 0.556), general surgery ([M = 4.178, SD = 0.466 vs M = 3.916, 0.527];
t(295) = 4.434, p < 0.001; Cohen's D = 0.520), neurosurgery ([M = 4.238,
SD = 0.457 vs M = 3.950, 0.518]; t(295) = 4.412, p < 0.001; Cohen's D =
0.575), plastic surgery ([M = 4.138, SD = 0.497 vs M = 3.967, 0.520];
t(295) = 2.747, p = 0.006; Cohen's D = 0.333), and vascular surgery (M =
4.248, SD = 0.368 vs M = 3.948, 0.541); t(295) = 4.570, p < 0.001; Cohen's
D = 0.501). <br/>Conclusion(s): Medical students with a career interest in
"poor lifestyle" surgical specialties have higher Grit than their peers.
These findings may be noteworthy for surgical residency programs with high
rates of attrition and burnout.<br/>Copyright &#xa9; 2022

<115>
Accession Number
2017997119
Title
Fraction of inspired oxygen during general anesthesia for non-cardiac
surgery: Systematic review and meta-analysis.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 2022.
Author
Hoybye M.; Lind P.C.; Holmberg M.J.; Bolther M.; Jessen M.K.; Vallentin
M.F.; Hansen F.B.; Holst J.M.; Magnussen A.; Hansen N.S.; Johannsen C.M.;
Enevoldsen J.; Jensen T.H.; Roessler L.L.; Klitholm M.P.; Eggertsen M.A.;
Caap P.; Boye C.; Dabrowski K.M.; Vormfenne L.; Henriksen J.; Karlsson M.;
Balleby I.R.; Rasmussen M.S.; Paelestik K.; Granfeldt A.; Andersen L.W.
Institution
(Hoybye, Holmberg, Jessen, Andersen) Research Center for Emergency
Medicine, Aarhus University Hospital, Aarhus, Denmark
(Hoybye, Holmberg, Jessen, Vallentin, Hansen, Magnussen, Johannsen,
Enevoldsen, Eggertsen, Boye, Vormfenne, Granfeldt, Andersen) Department of
Clinical Medicine, Aarhus University, Aarhus, Denmark
(Lind) Department of Surgical Gastroenterology, Aalborg University
Hospital, Aalborg, Denmark
(Holmberg) Department of Cardiology, Viborg Regional Hospital, Viborg,
Denmark
(Bolther, Holst, Hansen, Klitholm, Caap, Dabrowski, Henriksen, Granfeldt,
Andersen) Department of Anesthesiology and Intensive Care, Aarhus
University Hospital, Aarhus, Denmark
(Vallentin, Andersen) Prehospital Emergency Medical Services, Aarhus,
Denmark
(Jensen) Department of Internal Medicine, University Hospital of North
Norway, Narvik, Norway
(Roessler) Department of Emergency Medicine, Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
(Karlsson, Rasmussen) Department of Anesthesiology and Intensive Care,
Aalborg University Hospital, Aalborg, Denmark
(Balleby) National Hospital of the Faroe Islands, Torshavn, Faroe Islands
(Paelestik) Department of Anesthesiology and Intensive Care, Viborg
Regional Hospital, Viborg, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Controversy exists regarding the effects of a high versus a
low intraoperative fraction of inspired oxygen (FiO<inf>2</inf>) in adults
undergoing general anesthesia. This systematic review and meta-analysis
investigated the effect of a high versus a low FiO<inf>2</inf> on
postoperative outcomes. <br/>Method(s): PubMed and Embase were searched on
March 22, 2022 for randomized clinical trials investigating the effect of
different FiO<inf>2</inf> levels in adults undergoing general anesthesia
for non-cardiac surgery. Two investigators independently reviewed studies
for relevance, extracted data, and assessed risk of bias. Meta-analyses
were performed for relevant outcomes, and potential effect measure
modification was assessed in subgroup analyses and meta-regression. The
evidence certainty was evaluated using GRADE. <br/>Result(s): This review
included 25 original trials investigating the effect of a high (mostly
80%) versus a low (mostly 30%) FiO<inf>2</inf>. Risk of bias was
intermediate for all trials. A high FiO<inf>2</inf> did not result in a
significant reduction in surgical site infections (OR: 0.91, 95% CI
0.81-1.02 [p =.10]). No effect was found for all other included outcomes,
including mortality (OR = 1.27, 95% CI: 0.90-1.79 [p =.18]) and hospital
length of stay (mean difference = 0.03 days, 95% CI -0.25 to 0.30 [p
=.84). Results from subgroup analyses and meta-regression did not identify
any clear effect modifiers across outcomes. The certainty of evidence
(GRADE) was rated as low for most outcomes. <br/>Conclusion(s): In adults
undergoing general anesthesia for non-cardiac surgery, a high
FiO<inf>2</inf> did not improve outcomes including surgical site
infections, length of stay, or mortality. However, the certainty of the
evidence was assessed as low.<br/>Copyright &#xa9; 2022 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<116>
Accession Number
638299167
Title
A randomized trial of non-fasting vs. fasting for cardiac implantable
electronic device procedures (Fast-CIED Study).
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2022. Date of Publication: 21 Jun 2022.
Author
Bode K.; Gerhards M.; Doering M.; Lucas J.; Tijssen J.; Dagres N.; Hilbert
S.; Richter S.; Nedios S.; Lurz J.; Moscoso-Luduena C.; Arya A.; Shamloo
A.S.; Hindricks G.
Institution
(Bode, Gerhards, Doering, Lucas, Dagres, Hilbert, Richter, Nedios, Lurz,
Moscoso-Luduena, Arya, Shamloo, Hindricks) Department of
Electrophysiology, Heart Center Leipzig at University of Leipzig,
Naumburger Str. 76, Germany
(Bode) Department of Cardiology, Asklepios Clinic Weisenfels, Germany
(Tijssen, Shamloo) Leipzig Heart Institute, Leipzig, Germany
Publisher
NLM (Medline)
Abstract
AIMS: Data on safety and efficacy of a non-fasting strategy in minimal
invasive cardiac procedures are lacking. We assessed a non-fasting
strategy compared with a fasting strategy regarding patient's well-being
and safety in elective cardiac implantable electronic device (CIED)
procedures. METHODS AND RESULTS: In this randomized, single-blinded
clinical trial, 201 patients (non-fasting=100, fasting=101) with a mean
age of 72.0+/-11.6 years (66.7% male) were assigned to a non-fasting
strategy (solids/fluids allowed up to 1 h) or a fasting strategy (at least
6 h no solids and 2 h no fluids) before the procedure and analysed on an
intention-to-treat basis. The co-primary outcomes were patients'
well-being scores (based on numeric rating scale, 0-10) and incidence of
intra-procedural food-related adverse events, including vomiting,
perioperative pulmonary aspiration, and emergency intubation. Renal,
haematological, and metabolic blood parameters and 30-day follow-up data
were gathered. The summed pre-procedural patients' well-being score was
significantly lower in the non-fasting group [non-fasting: 13.1+/-9.6 vs.
fasting: 16.5+/-11.4, 95% confidence interval (CI) of mean difference (MD)
-6.35 to -0.46, P=0.029], which was mainly driven by significantly lower
scores for hunger and tiredness in the non-fasting group (non-fasting vs.
fasting; hunger: 0.9+/-1.9 vs. 3.1+/-3.2, 95% CI of MD -2.86 to -1.42,
P<0.001; tiredness: 1.6+/-2.3 vs. 2.6+/-2.7, 95% CI of MD -1.68 to -0.29,
P=0.023). No intra-procedural food-related adverse events were observed.
Relevant blood parameters and 30-day follow-up did not show significant
differences. <br/>CONCLUSION(S): These results showed that a non-fasting
strategy is beneficial to a fasting one regarding patient's well-being and
comparable in terms of safety for CIED procedures
(NCT04389697).<br/>Copyright &#xa9; The Author(s) 2022. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please email:
journals.permissions@oup.com.

<117>
Accession Number
2014808521
Title
Comparison of Two Noninvasive Ventilation Strategies (NHFOV Versus NIPPV)
as Initial Postextubation Respiratory Support in High-Risk Infants After
Congenital Heart Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(7) (pp 1962-1966),
2022. Date of Publication: July 2022.
Author
Wu H.-L.; Lei Y.-Q.; Lin W.-H.; Huang S.-T.; Chen Q.; Zheng Y.-R.
Institution
(Wu, Lei, Lin, Huang, Chen, Zheng) Department of Cardiac Surgery, Fujian
Branch of Shanghai Children's Medical Center, Fuzhou, China
(Wu, Lei, Lin, Huang, Chen, Zheng) Fujian Children's Hospital, Fuzhou,
China
(Wu, Lei, Lin, Huang, Chen, Zheng) Fujian Maternity and Child Health
Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
(Wu, Lei, Lin, Huang, Chen, Zheng) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
Publisher
W.B. Saunders
Abstract
Objective: This study aimed to compare the effects of nasal high-frequency
oscillatory ventilation (NHFOV) and noninvasive positive-pressure
ventilation (NIPPV) as the initial postextubation therapies on preventing
extubation failure (EF) in high-risk infants younger than three months
after congenital heart surgery (CHS). <br/>Design(s): This was a
single-center, randomized, unblinded clinical trial. <br/>Setting(s): The
study was performed in a teaching hospital. <br/>Participant(s): Between
January 2020 and January 2021, a total of 150 infants underwent CHS in the
authors' hospital. <br/>Intervention(s): Infants younger than three months
with a high risk for extubation failure who were ready for extubation were
randomized to either an NHFOV therapy group or an NIPPV therapy group, and
received the corresponding noninvasive mechanical ventilation to prevent
EF. Measurements: Primary outcomes were reintubation, long-term
noninvasive ventilation (NIV) support (more than 72 hours), and the time
in NIV therapy. The secondary outcomes were adverse events, including
mild-moderate hypercapnia, severe hypercapnia, severe hypoxemia, treatment
intolerance, signs of discomfort, unbearable dyspnea, inability to clear
secretions, emesis, and aspiration. <br/>Main Result(s): Of 92 infants, 45
received NHFOV therapy, and 47 received NIPPV therapy after extubation.
There were no significant differences between the NHFOV and the NIPPV
therapy groups in the incidences of reintubation, long-term NIV support,
and total time under NIV therapy. No significant difference was found of
the severe hypercapnia between the two groups, but NHFOV treatment
significantly decreased the rate of mild-moderate hypercapnia (p < 0.05).
Other outcomes were similar in the two groups. <br/>Conclusion(s): Among
infants younger than three months after CHS who had undergone extubation,
NIPPV therapy and NHFOV therapy were the equivalent NIV strategies for
preventing extubation failure, and NHFOV therapy was more effective in
avoiding mild-moderate hypercapnia.<br/>Copyright &#xa9; 2021 Elsevier
Inc.

<118>
Accession Number
2018379322
Title
Extensive complex thoracoabdominal aortic aneurysm salvaged by surgical
graft providing landing zone for endovascular graft: A case report.
Source
World Journal of Clinical Cases. 10(15) (pp 5005-5011), 2022. Date of
Publication: 26 May 2022.
Author
Jang A.Y.; Oh P.C.; Kang J.M.; Park C.H.; Kang W.C.
Institution
(Jang) Department of Cardiology, Gachon University Gil Medical Center,
Incheon 1198, South Korea
(Oh) Department of Internal Medicine, Gil Medical Center, Gachon
Cardiovascular Research Institute, Gachon University College of Medicine,
Incheon 1198, South Korea
(Kang) Division of Vascular Surgery, Gachon University Gil Medical Center,
Incheon 1198, South Korea
(Park) Department of Thoracic and Cardiovascular Surgery, Gachon
University Gil Medical Center, Incheon 1198, South Korea
(Kang) Division of Cardiology, Gil Medical Center, Gachon University of
Medicine and Science, Incheon 1198, South Korea
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Surgical repair of complex abdominal aortic aneurysm is
associated with a higher perioperative mortality and morbidity. The advent
of endovascular aortic repair (EVAR) has reduced perioperative
complications, although the utilization of such techniques is limited by
lesion characteristics, such as involvement of the visceral or renal
arteries (RA) and/or presence of a sealing zone. CASE SUMMARY A
60-year-old male presented with a Crawford type IV complex
thoracoabdominal aortic aneurysm (CAAA) starting directly distal to the
diaphragm extending to both common iliac arteries (CIAs). The CAAA consist
of a proximal and distal aneurysmal sac separated by a 1 cm-healthy zone
in the infrarenal level. Due to the poor performance of the patient and
the expansive disease, we planned a stepwise-combined surgery and EVAR to
minimize invasiveness. A branched graft was implanted after surgical
debranching of the visceral and RA. Since the patient had renal and liver
injury after surgery, the second stage EVAR was performed 10 mo later. The
stent graft was implanted from the distal portion of surgical branched
graft to both CIAs during EVAR. The patient has been uneventful for
5-years after discharge and is being followed in the outpatient clinic.
CONCLUSION The current case demonstrates that the surgical graft can
provide a landing zone for second stage EVAR to avoid aggressive surgery
in patients with poor performance with a long hostile CAAA.<br/>Copyright
&#xa9; The Author(s) 2022. Published by Baishideng Publishing Group Inc.
All rights reserved.

<119>
Accession Number
2017939744
Title
Effect of hyperglycemia treatment on complications rate after pediatric
cardiac surgery.
Source
Journal of Cardiovascular and Thoracic Research. 14(1) (pp 18-22), 2022.
Date of Publication: March 2022.
Author
Naghipour B.; Bagerpour M.; Shadvar K.; Golzari S.E.J.; Faridaalaee G.
Institution
(Naghipour, Shadvar, Golzari) Department of Anesthesiology and Intensive
Care, Medical Faculty, Tabriz University of Medical Sciences, Tabriz,
Iran, Islamic Republic of
(Bagerpour) Department of Gynecology and obestetric, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
(Faridaalaee) Emergency Medicine Research Team, Faculty of Medicine,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Faridaalaee) Department of Emergency Medicine, Maragheh University of
Medical Sciences, Maragheh, Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: The goal of this study was to elucidate harmful
complications of intraoperative hyperglycemia following children cardiac
surgery and benefits of insulin administration for accurate blood sugar
controlling. <br/>Method(s): this study is a Randomized clinical trial. We
conducted this study in the operating room of shahid madani hospital.
Fifty patients who were children under 12 years old undergone cardiac
surgery using cardiopulmonary bypass (CPB). Intraoperative insulin
infusion was administered intravenously targeting blood sugar levels of
110-140 mg/dL. Blood sugar and arterial blood gas (ABG) were measured
every 30 min during operation. <br/>Result(s): Inotropes were used less in
the study than the placebo group during surgery. The means of
hospitalization and extubation time were more in the placebo group than
the study group (P= 0.03) and (P= 0.005), respectively. However, the mean
time of hospitalization in the ICU ward did not differ significantly
between the two groups. <br/>Conclusion(s): Hyperglycemia has a relation
with long time of intubation and hospitalization in ICU. These findings
suggest the positive effect of accurate blood sugar control on reducing
complication and hospitalization time in children undergoing cardiac
surgery.<br/>Copyright &#xa9; 2022 The Author(s). This is an open access
article distributed under the terms of the Creative Commons Attribution
License (http://creativecommons.org/licenses/by/4.0), which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.

<120>
Accession Number
2016942978
Title
Pre-Treatment and Preoperative Neutrophil-to-Lymphocyte Ratio Predicts
Prognostic Value of Glioblastoma: A Meta-Analysis.
Source
Brain Sciences. 12(5) (no pagination), 2022. Article Number: 675. Date of
Publication: May 2022.
Author
Guo X.; Jiao H.; Zhang T.; Zhang Y.
Institution
(Guo, Jiao, Zhang) Department of Graduate Work, Hanguang Campus of Xi'an
Medical University, Xi'an 710068, China
(Zhang) Vice President of Xi'an Medical University, Weiyang Campus of
Xi'an Medical University, Xi'an 710068, China
Publisher
MDPI
Abstract
Objective: Although some meta-analyses have shown a correlation between a
high neu-trophil-to-lymphocyte ratio (NLR) and low survival in patients
with gliomas, their conclusions are controversial, and no study has
specifically explored the relationship between a high pre-treatment and
pre-operative NLR and low survival in patients with glioblastoma (GBM).
Therefore, we further investigated this correlation through meta-analysis.
<br/>Method(s): We searched the PubMed, Metstr, and Cochrane databases in
March 2022 for published literature related to high pre-treatment and
pre-operative NLR and low survival in patients with GBM. The literature
was rigorously searched according to inclusion and exclusion criteria to
calculate the overall hazard ratio (HR) and 95% con-fidence interval (CI)
corresponding to a high NLR using a random effects model. <br/>Result(s):
The total HR for the pre-treatment and pre-operative NLR was 1.46 (95% CI:
1.17-1.75, p = 0.000, I² = 76.5%), indicating a significant
association between a high pre-treatment and pre-operative NLR, and low
overall survival in patients with GBM. Sub-group analysis was performed
because of the high het-erogeneity. The results for the sub-group with a
cut-off value of 4 showed an HR of 1.39 (95% CI: 1.12-1.65, p = 0.000,
I² = 22.2%), with significantly low heterogeneity, whereas
those for the sub-group without a cut-off value of 4 showed an HR of 1.45
(95% CI: 1.01-1.89, p = 0.000, I² = 83.3%). <br/>Conclusion(s):
The results of this study demonstrate that a high pre-treatment and
pre-operative NLR suggests low survival in patients with GBM based on data
from a large sample. Furthermore, the meta-regression analysis results
indicate that underlying data, such as age and extent of surgical
resection, lead to a high degree of heterogeneity, providing a theoretical
basis for further research.<br/>Copyright &#xa9; 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<121>
Accession Number
2016871051
Title
Ultrasound-guided versus anatomic landmark-guided vascular access in
cardiac electrophysiology procedures: A systematic review and
meta-analysis: Meta-analysis of ultrasound-guided vascular access in
electrophysiology procedures.
Source
Indian Pacing and Electrophysiology Journal. 22(3) (pp 145-153), 2022.
Date of Publication: 01 May 2022.
Author
Triantafyllou K.; Karkos C.D.; Fragakis N.; Antoniadis A.P.; Meletidou M.;
Vassilikos V.
Institution
(Triantafyllou, Fragakis, Antoniadis, Meletidou, Vassilikos) 3rd
Cardiology Department, Hippokration General Hospital of Thessaloniki,
Aristotle University of Thessaloniki, Greece
(Karkos) Vascular Unit, 5th Surgery Department, Hippokration General
Hospital of Thessaloniki, Aristotle University of Thessaloniki, Greece
Publisher
Indian Pacing and Electrophysiology Group
Abstract
Introduction: Electrophysiology (EP) procedures are nowadays the
gold-standard method for tachyarrhythmia treatment with impressive success
rates, but also with a considerable risk of complications, mainly
vascular. A systematic review and meta-analysis was performed to evaluate
the safety of ultrasound (US)-guided femoral vein access in EP procedures
compared to the traditional anatomic landmark-guided method.
<br/>Method(s): We searched Pubmed (MEDLINE), Embase, Web of Science, and
Cochrane electronic databases for relevant entries, dated from January
1st, 2000 to June 30th, 2021. Only observational studies and randomized
controlled trials were included in this analysis. Data extraction included
study details, patient characteristics, procedure details, and all types
of vascular complications. Complications were classified as major if any
intervention, prolongation of hospitalization, or readmission was
required. <br/>Result(s): 9 studies (1 randomized controlled trial and 8
observational), with 7858 participants (3743 in the US-guided group, 4115
in the control group), were included in the meta-analysis. Overall
vascular complication rates were significantly decreased in the US-guided
group compared to the control group (1.2 versus 3.2%, RR = 0.38, 95% CI,
0.27-0.53), in all EP procedures. Sub-group analysis of AF ablation
procedures yielded similar results (RR 0.41, 95% CI, 0.29-0.58, p <
0.00001). The event reduction effect was significant for both major and
minor vascular complications. <br/>Conclusion(s): US-guided vascular
access in EP procedures is associated with significantly reduced vascular
complications, compared to the standard anatomic landmark-guided approach,
regardless of procedure complexity.<br/>Copyright &#xa9; 2022 Indian Heart
Rhythm Society

<122>
[Use Link to view the full text]
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). <br/>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.<br/>Copyright
&#xa9; 2021 Lippincott Williams and Wilkins. All rights reserved.

<123>
[Use Link to view the full text]
Accession Number
634773715
Title
Reduction in Revascularization With Icosapent Ethyl Insights From
REDUCE-IT Revascularization Analyses.
Source
Circulation. 143(1) (pp 33-44), 2021. Date of Publication: 05 Jan 2021.
Author
Peterson B.E.; Bhatt D.L.; Steg Ph.G.; Miller M.; Brinton E.A.; Jacobson
T.A.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz C.;
Gibson C.M.; Pinto D.; Giugliano R.P.; Budoff M.J.; Tardif J.-C.; Verma
S.; Ballantyne C.M.
Institution
(Peterson, Bhatt, Giugliano) Brigham and Women's Hospital Heart and
Vascular Center, Harvard Medical School, Boston, MA, United States
(Steg) Universite de Paris, AP-HP (Assistance Publique-Hopitaux de Paris),
Hopital Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM,
U-1148, France
(Miller) Department of Medicine, University of Maryland, School of
Medicine, Baltimore, United States
(Brinton) Utah Lipid Center, Salt Lake City, United States
(Jacobson) Office of Health Promotion and Disease Prevention, Department
of Medicine, Emory University, School of Medicine, Atlanta, GA, United
States
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc (Amarin),
Bridgewater, NJ, United States
(Gibson, Pinto) Baim Clinical Research Institute, Boston, MA, United
States
(Budoff) David Geffen School of Medicine, Lundquist Institute, Torrance,
CA, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Verma) Division of Cardiac Surgery, St Michael's Hospital, University of
Toronto, ON, Canada
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Patients with elevated triglycerides despite statin therapy
have increased risk for ischemic events, including coronary
revascularizations. <br/>METHOD(S): REDUCE-IT (The Reduction of
Cardiovascular Events with Icosapent Ethyl-Intervention Trial), a
multicenter, double-blind, placebo-controlled trial, randomly assigned
statin-treated patients with elevated triglycerides (135-499 mg/dL),
controlled low-density lipoprotein (41-100 mg/dL), and either established
cardiovascular disease or diabetes plus other risk factors to receive
icosapent ethyl 4 g/d or placebo. The primary and key secondary composite
end points were significantly reduced. Prespecified analyses examined all
coronary revascularizations, recurrent revascularizations, and
revascularization subtypes. <br/>RESULT(S): A total of 8179 randomly
assigned patients were followed for 4.9 years (median). First
revascularizations were reduced to 9.2% (22.5/1000 patient-years) with
icosapent ethyl versus 13.3% (33.7/1000 patient-years) with placebo
(hazard ratio, 0.66 [95% CI, 0.58-0.76]; P<0.0001; number needed to treat
for 4.9 years=24); similar reductions were observed in total (first and
subsequent) revascularizations (negative binomial rate ratio, 0.64 [95%
CI, 0.56-0.74]; P<0.0001), and across elective, urgent, and emergent
revascularizations. Icosapent ethyl significantly reduced percutaneous
coronary intervention (hazard ratio, 0.68 [95% CI, 0.59-0.79]; P<0.0001)
and coronary artery bypass grafting (hazard ratio, 0.61 [95% CI,
0.45-0.81]; P=0.0005). <br/>CONCLUSION(S): Icosapent ethyl reduced the
need for first and subsequent coronary revascularizations in
statin-treated patients with elevated triglycerides and increased
cardiovascular risk. To our knowledge, icosapent ethyl is the first
non-low-density lipoprotein-lowering treatment that has been shown to
reduce coronary artery bypass grafting in a blinded, randomized
trial.<br/>Copyright &#xa9; 2020 The Authors

<124>
Accession Number
2011266692
Title
Dexmedetomidine reduces postoperative cognitive and behavioral dysfunction
in adults submitted to general anesthesia for non-cardiac surgery:
meta-analysis of randomized clinical trials.
Source
Brazilian Journal of Anesthesiology (English Edition). 71(4) (pp 413-420),
2021. Date of Publication: 01 Jul 2021.
Author
Goveia C.S.; Miranda D.B.D.; Oliveira L.V.D.B.; Praxedes F.B.; Moreira
L.G.; Guimaraes G.M.N.
Institution
(Goveia, Oliveira, Praxedes, Moreira, Guimaraes) Universidade de Brasilia,
Centro de Ensino e Treinamento - Centro de Anestesiologia, Brasilia, DF,
Brazil
(Goveia, Moreira, Guimaraes) Sociedade Brasileira de Anestesiologia,
Brazil
(Goveia) Universidade de Brasilia, Brasilia, DF, Brazil
(Miranda) Universidade Federal de Goias, Instituto de Medicina Tropical e
Saude Publica, Goiania, GO, Brazil
(Guimaraes) Universidade de Sao Paulo (USP), Sao Paulo, SP, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Introduction and objectives: Dexmedetomidine (DEX) has been associated
with a decrease in postoperative cognitive and behavioral dysfunction in
patients submitted to general anesthesia, whether inhalation or total
intravenous anesthesia. Consequently, the DEX effects on postoperative
agitation and delirium in patients submitted to general anesthesia for
non-cardiac surgery have been investigated. <br/>Method(s): A systematic
review and meta-analysis of randomized and double-blind clinical trials
(RCTs) was undertaken assessing adults submitted to elective procedures
under general anesthesia receiving DEX or placebo. The search included
articles published in English in the Pubmed and Web of Science databases
using keywords such as dexmedetomidine, delirium, and agitation. Duplicate
publications, studies involving cardiac surgery or using active control
(other than saline solution) were included. A random effects model was
adopted using the DerSimonian-Laird method and estimate of Odds Ratio (OR)
for dichotomous variables, and weighted mean difference for continuous
variables, with their respective 95% Confidence Intervals (95% CI).
<br/>Result(s): Of the 484 articles identified, 15 were selected
comprising 2,183 patients (1,079 and 1,104 patients in the DEX and control
group, respectively). The administration of DEX was considered a
protective factor for postoperative cognitive and behavioral dysfunction
(OR = 0.36; 95% CI 0.23-0.57 and p < 0.001), regardless of the anesthesia
technique used. <br/>Conclusion(s): Dexmedetomidine administration reduced
by at least 43% the likelihood of postoperative cognitive and behavioral
dysfunction in adult patients submitted to general anesthesia for
non-cardiac surgery.<br/>Copyright &#xa9; 2021

<125>
Accession Number
2013836987
Title
Use of Incentive Spirometry in Adults following Cardiac, Thoracic, and
Upper Abdominal Surgery to Prevent Post-Operative Pulmonary Complications:
A Systematic Review and Meta-Analysis.
Source
Respiration. 100(11) (pp 1114-1127), 2021. Date of Publication: 01 Nov
2021.
Author
Sullivan K.A.; Churchill I.F.; Hylton D.A.; Hanna W.C.
Institution
(Sullivan, Churchill, Hylton, Hanna) Department of Health Research Methods
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Sullivan, Churchill, Hylton, Hanna) Division of Thoracic Surgery, St.
Joseph's Healthcare Hamilton, Hamilton, ON, Canada
Publisher
S. Karger AG
Abstract
Background: Currently, consensus on the effectiveness of incentive
spirometry (IS) following cardiac, thoracic, and upper abdominal surgery
has been based on randomized controlled trials (RCTs) and systematic
reviews of lower methodological quality. To improve the quality of the
research and to account for the effects of IS following thoracic surgery,
in addition to cardiac and upper abdominal surgery, we performed a
meta-analysis with thorough application of the Grading of Recommendations
Assessment, Development and Evaluation scoring system and extensive
reference to the Cochrane Handbook for Systematic Reviews of
Interventions. <br/>Objective(s): The objective of this study was to
determine, with rigorous methodology, whether IS for adult patients (18
years of age or older) undergoing cardiac, thoracic, or upper abdominal
surgery significantly reduces30-day post-operative pulmonary complications
(PPCs), 30-day mortality, and length of hospital stay (LHS) when compared
to other rehabilitation strategies. <br/>Method(s): The literature was
searched using Cochrane Central Register of Controlled Trials, MEDLINE,
EMBASE, CINAHL, and Web of Science for RCTs between the databases'
inception and March 2019. A random-effect model was selected to calculate
risk ratios (RRs) with 95% confidence intervals (CIs). <br/>Result(s):
Thirty-one RCTs involving 3,776 adults undergoing cardiac, thoracic, or
upper abdominal surgery were included. By comparing the use of IS to other
chest rehabilitation strategies, we found that IS alone did not
significantly reduce 30-day PPCs (RR = 1.00, 95% CI: 0.88-1.13) or 30-day
mortality (RR = 0.73, 95% CI: 0.42-1.25). Likewise, there was no
difference in LHS (mean difference =-0.17,95% CI:-0.65 to 0.30) between IS
and the other rehabilitation strategies. None of the included trials
significantly impacted the sensitivity analysis and publication bias was
not detected. <br/>Conclusion(s): This meta-analysis showed that IS alone
likely results in little to no reduction in the number of adult patients
with PPCs, in mortality, or in the LHS, following cardiac, thoracic, and
upper abdominal surgery.<br/>&#xa9; 2021 S. Karger AG, Basel. Copyright:
All rights reserved.

<126>
Accession Number
2017978118
Title
Negative interaction between nitrates and remote ischemic preconditioning
in patients undergoing cardiac surgery: the ERIC-GTN and ERICCA studies.
Source
Basic Research in Cardiology. 117(1) (no pagination), 2022. Article
Number: 31. Date of Publication: December 2022.
Author
Hamarneh A.; Ho A.F.W.; Bulluck H.; Sivaraman V.; Ricciardi F.; Nicholas
J.; Shanahan H.; Hardman E.A.; Wicks P.; Ramlall M.; Chung R.; McGowan J.;
Cordery R.; Lawrence D.; Clayton T.; Kyle B.; Xenou M.; Ariti C.; Yellon
D.M.; Hausenloy D.J.
Institution
(Hamarneh, Sivaraman, Ramlall, Chung, McGowan, Xenou, Yellon, Hausenloy)
Institute of Cardiovascular Sciences, The Hatter Cardiovascular Institute,
University College London, London WC1E 6HX, United Kingdom
(Ho) Department of Emergency Medicine, Singapore General Hospital,
Singapore, Singapore
(Ho) Pre-Hospital and Emergency Research Centre, Health Services and
Systems Research, Duke-NUS Medical School, Singapore, Singapore
(Bulluck) Leeds Institute of Cardiovascular and Metabolic Medicine,
University of Leeds, Leeds, United Kingdom
(Bulluck) Department of Cardiology, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
(Ricciardi) Department of Statistical Science, University College London,
London, United Kingdom
(Nicholas, Clayton) Clinical Trials Unit and Department of Medical
Statistics, London School of Hygiene and Tropical Medicine, London, United
Kingdom
(Shanahan, Lawrence, Kyle) University College London Hospitals NHS
Foundation Trust, London, United Kingdom
(Hardman, Wicks) University Hospital Southampton NHS Foundation Trust,
London, United Kingdom
(Cordery) Barts Heart Centre, King's College London, London, United
Kingdom
(Ariti) University Hospital of Wales, Heath Park, Cardiff CF14 4YS, United
Kingdom
(Hausenloy) Cardiovascular and Metabolic Disorders Program, Duke-National
University of Singapore Medical School, Singapore, Singapore
(Hausenloy) National Heart Research Institute Singapore, National Heart
Centre Singapore, Singapore, Singapore
(Hausenloy) Yong Loo Lin School of Medicine, National University
Singapore, Singapore, Singapore
(Hausenloy) Cardiovascular Research Center, College of Medical and Health
Sciences, Asia University, Taichung City, Taiwan (Republic of China)
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Remote ischaemic preconditioning (RIPC) using transient limb ischaemia
failed to improve clinical outcomes following cardiac surgery and the
reasons for this remain unclear. In the ERIC-GTN study, we evaluated
whether concomitant nitrate therapy abrogated RIPC cardioprotection. We
also undertook a post-hoc analysis of the ERICCA study, to investigate a
potential negative interaction between RIPC and nitrates on clinical
outcomes following cardiac surgery. In ERIC-GTN, 185 patients undergoing
cardiac surgery were randomized to: (1) Control (no RIPC or nitrates); (2)
RIPC alone; (3); Nitrates alone; and (4) RIPC + Nitrates. An intravenous
infusion of nitrates (glyceryl trinitrate 1 mg/mL solution) was commenced
on arrival at the operating theatre at a rate of 2-5 mL/h to maintain a
mean arterial pressure between 60 and 70 mmHg and was stopped when the
patient was taken off cardiopulmonary bypass. The primary endpoint was
peri-operative myocardial injury (PMI) quantified by a 48-h
area-under-the-curve high-sensitivity Troponin-T (48 h-AUC-hs-cTnT). In
ERICCA, we analysed data for 1502 patients undergoing cardiac surgery to
investigate for a potential negative interaction between RIPC and nitrates
on clinical outcomes at 12-months. In ERIC-GTN, RIPC alone reduced 48
h-AUC-hs-cTnT by 37.1%, when compared to control (ratio of AUC 0.629 [95%
CI 0.413-0.957], p = 0.031), and this cardioprotective effect was
abrogated in the presence of nitrates. Treatment with nitrates alone did
not reduce 48 h-AUC-hs-cTnT, when compared to control. In ERICCA there was
a negative interaction between nitrate use and RIPC for all-cause and
cardiovascular mortality at 12-months, and for risk of peri-operative
myocardial infarction. RIPC alone reduced the risk of peri-operative
myocardial infarction, compared to control, but no significant effect of
RIPC was demonstrated for the other outcomes. When RIPC and nitrates were
used together they had an adverse impact in patients undergoing cardiac
surgery with the presence of nitrates abrogating RIPC-induced
cardioprotection and increasing the risk of mortality at 12-months
post-cardiac surgery in patients receiving RIPC.<br/>Copyright &#xa9;
2022, The Author(s).

<127>
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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2022 The Authors.
Artificial Organs published by International Center for Artificial Organ
and Transplantation (ICAOT) and Wiley Periodicals LLC.

<128>
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. <br/>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.
<br/>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. <br/>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.<br/>Copyright &#xa9; 2022, The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature.

<129>
Accession Number
2017526732
Title
Whole Blood Adsorber During CPB and Need for Vasoactive Treatment After
Valve Surgery in Acute Endocarditis: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Part B. 36(8) (pp
3015-3020), 2022. Date of Publication: August 2022.
Author
Holmen A.; Corderfeldt A.; Lannemyr L.; Dellgren G.; Hansson E.C.
Institution
(Holmen, Corderfeldt, Lannemyr, Hansson) Department of Cardiothoracic
Surgery, Sahlgrenska University Hospital, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Lannemyr) Department of Anesthesia and Intensive Care, Institution of
Clinical Sciences, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Dellgren) The Transplant Institute, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Dellgren, Hansson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
Publisher
W.B. Saunders
Abstract
Objectives: Patients with endocarditis requiring urgent valvular surgery
with cardiopulmonary bypass are at a high risk of developing systemic
inflammatory response syndrome and septic shock, necessitating intensive
use of vasopressors after surgery. The use of a cytokine hemoadsorber
(CytoSorb, CytoSorbents Europe GmbH, Germany) during cardiac surgery has
been suggested to reduce the risk of inflammatory activation. The study
authors hypothesized that adding a cytokine adsorber would reduce cytokine
burden, which would translate into improved hemodynamic stability.
<br/>Design(s): A randomized, controlled, nonblinded clinical trial.
<br/>Setting(s): At a university hospital, tertiary referral center.
<br/>Participant(s): Nineteen patients with endocarditis undergoing valve
surgery. <br/>Intervention(s): A cytokine hemoadsorber integrated into the
cardiopulmonary bypass circuit. <br/>Measurements and Main Results: The
accumulated norepinephrine dose in the intervention group was half or less
at all postoperative time points compared to the control group, although
it did not reach statistical significance; at 24 and 48 hours (median 36
[25-75 percentiles; 12-57] mug v 114 [25-559] mug, p = 0.11 and 36 [12-99]
mug v 261 [25-689] mug, p = 0.09). There was no significant difference in
chest tube output, but there was a significantly lower need for the
transfusion of red blood cells (285 [0-657] mL v 1,940 [883-2,148] mL, p =
0.03). <br/>Conclusion(s): There was no statistically significant
difference between the groups with regard to vasopressor use after surgery
for endocarditis with the use of a cytokine hemoadsorber during
cardiopulmonary bypass. Additional, larger randomized controlled trials
are needed to definitely assess the potential effect.<br/>Copyright &#xa9;
2022 Elsevier Inc.

<130>
Accession Number
2014996387
Title
Evaluation of Citation Inaccuracies in Surgical Literature by Journal
Type, Study Design, and Level of Evidence: Towards Safeguarding the
Peer-Review Process.
Source
American Surgeon. 88(7) (pp 1590-1600), 2022. Date of Publication: July
2022.
Author
Sauder M.; Newsome K.; Zagales I.; Autrey C.; Das S.; Ang D.; Elkbuli A.
Institution
(Sauder, Das) NSU NOVA Southeastern University, Dr Kiran, C. Patel College
of Allopathic Medicine, Fort Lauderdale, FL, United States
(Newsome, Zagales, Autrey) Florida International University, Miami, FL,
United States
(Ang, Elkbuli) Departments of Surgery and Surgical Education, Orlando
Regional Medical Center, Orlando, FL, United States
(Ang) University of Central Florida, Ocala, FL, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Accurate citation practices are key to furthering knowledge in
an efficient and valid manner. The aim of this study is to investigate the
prevalence of citation inaccuracies in original research from the
top-ranked surgical journals and to evaluate the impact level of evidence
has on citation inaccuracy. <br/>Method(s): A retrospective study
evaluating the citation accuracy of the top 10 ranked surgical journals
using the SJCR indicators. For each year between 2015 and 2020, the top 10
cited studies were selected, totaling 60 studies from each journal. From
each individual study, 10 citations were randomly selected and evaluated
for accuracy. Categories of inaccuracy included fact not found, study not
found, contradictory conclusion, citation of a citation, and inaccurate
population. <br/>Result(s): A total of 5973 citations were evaluated for
accuracy. Of all the citations analyzed, 15.2% of them had an inaccuracy.
There was no statistically significant difference in citations inaccuracy
rates among the years studied (P =.38) or study level of evidence (P
=.21). Annals of Surgery, Plastic and Reconstructive Surgery and Annals of
Surgical Oncology had significantly more citation inaccuracies than other
journals evaluated (P <.05). JAMA Surgery, The Journal of Endovascular
Therapy and The Journal of Thoracic and Cardiovascular Surgery had
significantly fewer citation inaccuracies. <br/>Conclusion(s): Although
84.8% of citations from 2015-2020 were determined to be accurate, citation
inaccuracies continue to be prevalent throughout highly-ranked surgical
literature. There were no significant differences identified in citation
inaccuracy rates between the years evaluated or based on study level of
evidence.<br/>Copyright &#xa9; The Author(s) 2022.

<131>
Accession Number
638272363
Title
Costs of Endoscopic vs Open Vein Harvesting for Coronary Artery Bypass
Grafting: A Secondary Analysis of the REGROUP Trial.
Source
JAMA Network Open. (pp E2217686), 2022. Date of Publication: 2022.
Author
Wagner T.H.; Hattler B.; Stock E.M.; Biswas K.; Bhatt D.L.; Bakaeen F.G.;
Gujral K.; Zenati M.A.
Institution
(Wagner, Gujral) Health Economics Resource Center, Veterans Affairs Palo
Alto Health Care System, 795 Willow Rd, 152-MPD, Menlo Park, CA 94025,
United States
(Wagner) Department of Surgery, Stanford University, Stanford, CA, United
States
(Hattler) Rocky Mountain Regional Veterans Affairs Medical Center, Aurora,
CO, United States
(Hattler) Division of Cardiology, University of Colorado, Denver, United
States
(Stock, Biswas) Office of Research and Development, VA Cooperative Studies
Program Coordinating Center, Perry Point, MD, United States
(Bhatt) Division of Cardiovascular Medicine, Brigham and Women's Hospital
and Harvard Medical School, Boston, MA, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Zenati) Division of Cardiac Surgery, Brigham and Women's Hospital and
Harvard Medical School, Boston, MA, United States
(Zenati) Veterans Affairs Boston Healthcare System, Boston, MA, United
States
Publisher
American Medical Association
Abstract
Importance: Value-based purchasing creates pressure to examine whether
newer technologies and care processes, including new surgical techniques,
yield any economic advantage. <br/>Objective(s): To compare health care
costs and utilization between participants randomized to receive
endoscopic vein harvesting (EVH) or open vein harvesting (OVH) during a
coronary artery bypass grafting (CABG) procedure. <br/>Design, Setting,
and Participant(s): This secondary economic analysis was conducted
alongside the 16-site Randomized Endo-Vein Graft Prospective (REGROUP)
clinical trial funded by the Department of Veterans Affairs (VA)
Cooperative Studies Program. Adults scheduled for urgent or elective
bypass involving a vein graft were eligible. The first participant was
enrolled in September 2013, with most sites completing enrollment by March
2014. The last participant was enrolled in April 2017. A total of 1150
participants were randomized, with 574 participants receiving OVH and 576
receiving EVH. For this secondary analysis, cost and utilization data were
extracted through September 30, 2020. Participants were linked to
administrative data in the VA Corporate Data Warehouse and activity-based
cost data starting with the index procedure. <br/>Intervention(s): EVH vs
OVH, with comparisons based on intention to treat. <br/>Main Outcomes and
Measures: Discharge costs for the index procedure as well as follow-up
costs (including intended and unintended events; mean [SD] follow-up time,
33.0 [19.9] months) were analyzed, with results from different statistical
models compared to test for robustness (ie, lack of variation across
models). All costs represented care provided or paid by the VA,
standardized to 2020 US dollars. <br/>Result(s): Among 1150 participants,
the mean (SD) age was 66.4 (6.9) years; most participants (1144 [99.5%]
were male. With regard to race and ethnicity, 6 participants (0.5%)
self-reported as American Indian or Alaska Native, 10 (0.9%) as Asian or
Pacific Islander, 91 (7.9%) as Black, 62 (5.4%) as Hispanic, 974 (84.7%)
as non-Hispanic White, and 6 (0.5%) as other race and/or ethnicity; data
were missing for 1 participant (0.1%). The unadjusted mean (SD) costs for
the index CABG procedure were $76607 ($43 883) among patients who received
EVH and $75368 ($45900) among those who received OVH, including facility
costs, insurance costs, and physician-related costs (commonly referred to
as provider costs in Centers for Medicare and Medicaid and insurance
data). No significant differences were found in follow-up costs; per
90-day follow-up period, EVH was associated with a mean (SE) added cost of
$302 ($225) per patient. The results were highly robust to the statistical
model. <br/>Conclusions and Relevance: In this study, EVH was not
associated with a reduction in costs for the index CABG procedure or
follow-up care. Therefore, the choice to provide EVH may be based on
surgeon and patient preferences. Trial Registration: ClinicalTrials.gov
Identifier: NCT01850082.<br/>Copyright &#xa9; 2022 American Medical
Association. All rights reserved.

<132>
Accession Number
2018873248
Title
Heart Rehabilitation for All (HeRTA): Protocol for a feasibility study and
pilot randomized trial.
Source
PLoS ONE. 17(6 June) (no pagination), 2022. Article Number: e0270159. Date
of Publication: June 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) The Danish Heart Association, Copenhagen, Denmark
(Foghmar) Cardiology Department, University Hospital Hvidovre, Hvidovre,
Denmark
(Mindegaard) Rehabilitation Center, Albertslund Municipality, Albertslund,
Denmark
(Jakobsen) Capital Region, Hillerod, Denmark
Publisher
Public Library of Science
Abstract
Introduction Today, 50% of people with cardiac disease do not participate
in rehabilitation. The HeRTAstudy aims to develop and test a sustainable
rehabilitation model supporting vulnerable patients in participating in
rehabilitation and long-term physical activity. Methods 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. <br/>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). Results 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 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. <br/>Copyright &#xa9; 2022 Birke et
al. This is an open access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<133>
Accession Number
2017967478
Title
Addressing unmeasured confounding bias with a prior knowledge guided
approach: coronary artery bypass grafting (CABG) versus percutaneous
coronary intervention (PCI) in patients with stable ischemic heart
disease.
Source
Health Services and Outcomes Research Methodology. (no pagination), 2022.
Date of Publication: 2022.
Author
Duan L.; Lee M.-S.; Doctor J.N.; Adams J.L.
Institution
(Duan) Department of Research and Evaluation, Kaiser Permanente Southern
California, 100 S Los Robles Ave, 5th Floor, Pasadena, CA 91101, United
States
(Lee) Department of Cardiology, Kaiser Permanente Los Angeles Medical
Center, Los Angeles, CA, United States
(Doctor) Price School of Public Policy, University of Southern California,
Los Angeles, CA, United States
(Adams) Kaiser Permanente Center for Effectiveness and Safety Research and
the Bernard J. Tyson School of Medicine, Pasadena, CA, United States
Publisher
Springer
Abstract
Unmeasured confounding undermines the validity of observational studies.
Although randomized clinical trials (RCTs) are considered the "gold
standard" of study types, we often observe divergent findings between RCTs
and empirical settings. We present the "L-table", a simulation-based,
prior knowledge (e.g., RCTs) guided approach that estimates the true
effect adjusting for the potential influence of unmeasured confounders
when using observational data. Using electronic health record data from
Kaiser Permanente Southern California, we compare the effectiveness of
coronary artery bypass grafting (CABG) and percutaneous coronary
intervention (PCI) on endpoints at 1, 3, 5, and 10 years for patients with
stable ischemic heart disease. We applied the L-table approach to the
propensity score adjusted cohort to derive the omitted-confounder-adjusted
estimated effects. After the L-table adjustment, CABG patients are 57.6%
less likely to encounter major adverse cardiac and cerebrovascular event
(MACCE) at 1 year (OR [95% CI] 0.424 [0.396, 0.517]), 56.4% less likely at
3 years (OR [95% CI] 0.436 [0.369, 0.527]), and 48.9% less likely at 5
years (OR [95% CI] 0.511 [0.451, 0.538]). CABG patients are also 49.5%
less likely to die by the end of 10 years than PCI patients (OR [95% CI]
0.505 [0.446, 0.582]). We found the estimated true effects all shifted
towards CABG as a more effective procedure that led to better health
outcomes compared to PCI. Unlike existing sensitivity tools, the L-table
approach explicitly lays out probable values and can therefore better
support clinical decision-making. We recommend using L-table as a
supplement to available techniques of sensitivity analysis.<br/>Copyright
&#xa9; 2022, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<134>
Accession Number
2017138103
Title
DEXMEDETOMIDINE ALONE OR WITH KETAMINE IN ADDITION TO ROUTINE FENTANYL
ADMINISTRATION IN POST CARDIAC SURGERY PATIENTS: A RANDOMIZED CONTROLLED
TRIAL.
Source
Journal of Postgraduate Medical Institute. 36(1) (pp 39-43), 2022. Date of
Publication: 31 Mar 2022.
Author
Rai S.A.; Furqan A.; Khan M.I.; Farwa K.U.; Adnan A.; Afzal W.
Institution
(Rai, Furqan, Khan, Farwa, Adnan, Afzal) Department of Anaesthesia and
Critical Care, Ch. Pervaiz Elahi Institute of Cardiology, Punjab, Multan,
Pakistan
Publisher
Postgraduate Medical Institute
Abstract
Objective: To compare the effects of dexmedetomidine alone (DA) with
dexmedetomidine plus ketamine (KD) combination in addition to routine
fentanyl administration in post-cardiac surgery patients Methodology: The
trial was conducted at the Department of Anaesthesia and Critical Care,
Chaudhary Pervaiz Elahi Institute of Cardiology Multan, from July 2020 to
December 2020. A total of 40 patients planned for elective coronary artery
bypass grafting (CABG) were randomized by lottery method for
dexmedetomidine alone (Group DA, n=20) or dexmedetomidine plus Ketamine
(Group KD, n=20) to maintain Ramsay sedation score >=4 during assist-ed
ventilation. All patients received fentanyl for postoperative analgesia.
The mean arterial blood pressure, heart rate, sedation score, pain score,
and mean extubation time were compared between two groups and analyzed by
using SPSS version 23. <br/>Result(s): Total fentanyl dose was 45.65 +/-
8.23 microg in group KD and 146.01 +/- 14.18 microg in group DA (p
<0.001). The time of weaning was 344.65 +/- 43.89 minutes and 446.60 +/-
73.75 minutes in groups KD and DA, respectively (p <0.001). The time of
Extubation was 389.90 +/- 35.89 minutes and 535.30 +/- 36.25 minutes in
groups KD and DA, respectively (p <0.001). The ICU stay, heart rate, mean
arterial pressure, Ramsay score, and non-verbal Pain score was comparable
in both study groups (p>0.05). <br/>Conclusion(s): Utilizing Ketamine plus
dexmedetomidine for sedation post-Coronary Artery Bypass Graft (CABG)
procedure gave a brief term of mechanical ventilation and early extubation
with less fentanyl requirement than dexmedetomidine alone. Hemodynamic
stability was present in both groups.<br/>Copyright &#xa9; 2022,
Postgraduate Medical Institute. All rights reserved.

<135>
Accession Number
2017093663
Title
Total Cardiovascular and Limb Events and the Impact of Polyvascular
Disease in Chronic Symptomatic Peripheral Artery Disease.
Source
Journal of the American Heart Association. 11(11) (no pagination), 2022.
Article Number: e025504. Date of Publication: 07 Jun 2022.
Author
Szarek M.; Hess C.; Patel M.R.; Jones W.S.; Berger J.S.; Baumgartner I.;
Katona B.; Mahaffey K.W.; Norgren L.; Blomster J.; Rockhold F.W.; Hsia J.;
Fowkes F.G.R.; Bonaca M.P.
Institution
(Szarek, Hess, Hsia, Bonaca) CPC Clinical Research, Aurora, CO, United
States
(Szarek, Hess, Hsia, Bonaca) Department of Medicine, University of
Colorado, Aurora, CO, United States
(Szarek) SUNY Downstate Health Sciences University, Brooklyn, NY, United
States
(Patel, Jones, Rockhold) Duke Clinical Research Institute, Durham, NC,
United States
(Patel, Jones) Division of Cardiology, Duke University Medical Cente r,
Durham, NC, United States
(Berger) New York University School of Medicine, New York, NY, United
States
(Baumgartner) Swiss Cardiovascular Center, Inselspital, Bern University
Hospital, University of Bern, Switzerland
(Katona) AstraZeneca Gaithersburg, Gaithersburg, MD, United States
(Mahaffey) Stanford Center for Clinical Research, Stanford University
School of Medicine, Stanford, CA, United States
(Norgren) Faculty of Medicine and Health, Orebro University, Orebro,
Sweden
(Blomster) Turku University Hospital, Turku, Finland
(Fowkes) Usher Institute of Population Health Sciences and Informatics,
University of Edinburgh, Edinburgh, United Kingdom
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Peripheral artery disease (PAD) is associated with heightened
risk for major adverse cardiovascular and limb events, but data on the
burden of risk for total (first and potentially subsequent) events, and
the association with polyvascular disease, are limited. This post hoc
analysis of the EUCLID (Examining Use of Ticagrelor in Peripheral Artery
Disease) trial evaluated total cardiovascular and limb events among
patients with symptomatic PAD, overall and by number of symptomatic
vascular territories. METHODS AND RESULTS: In the EUCLID trial, patients
with symptomatic PAD (lower extremity revascularization >30 days before
randomization or ankle-brachial index <=0.80) were randomized to treatment
with ticagrelor or clopidogrel. Relative effects on total events
(cardiovascular death; nonfatal myocardial infarction and ischemic stroke;
acute limb ischemia, unstable angina, and transient ischemic attack
requiring hospitalization; coronary, carotid, and peripheral
revascularization procedures; and amputation for symptomatic PAD) were
summarized by hazard ratios (HRs), whereas absolute risks were estimated
by inci-dence rates and mean cumulative functions. Among 13 885 randomized
patients, 7600 total cardiovascular and limb events occurred during a
median 2.7 years of follow-up, translating to 60.0 and 62.5 events per 100
patients through 3 years for the ticagrelor and clopidogrel groups,
respectively (HR, 0.96; 95% CI, 0.89-1.03; P=0.27). Among 1393 patients
with disease in 3 vascular territories, event accrual rates through 3
years for the ticagrelor and clopidogrel groups were 87.3 and 97.7 events
per 100 patients, respectively. Absolute risk reductions for ticagrelor
relative to clopidogrel at 3 years were -0.2, 6.7, and 10.3 events per 100
patients for 1, 2, and 3 affected vascular territories, respectively
(P<inf>interaction</inf> =0.09). <br/>CONCLUSION(S): Patients with
symptomatic PAD have nearly double the number of total events than first
events, with rates re-flecting the number of affected vascular
territories. These findings highlight the clinical relevance of
quantifying disease burden in terms of total events and the need for
long-term preventive treatments in high-risk patient
populations.<br/>Copyright &#xa9; 2022 The Authors. Published on behalf of
the American Heart Association, Inc., by Wiley.

<136>
Accession Number
638277136
Title
Preclinical Large Animal In-Vivo Experiments for Surgically Implanted
Atrioventricular Valve: Reappraisal and Systematic Review.
Source
Current cardiology reviews. (no pagination), 2022. Date of Publication:
17 Jun 2022.
Author
Sazzad F.; Kr R.; Beverly C.L.X.; Kiat T.Y.; Ganesh G.; Kofidis T.
Institution
(Sazzad, Beverly, Kiat, Kofidis) Department of Surgery, Yong Loo Lin
School of Medicine, National University of Singapore, Singapore
(Sazzad, Kr, Ganesh, Kofidis) Cardiac Surgery Research Laboratory, Centre
for Translational Medicine, National University of Singapore, Singapore
(Sazzad, Kr, Kofidis) Cardiovascular Disease Translational Research
Programme, Cardiovascular Research Institute, National University of
Singapore, Singapore
(Beverly, Kiat) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
Publisher
NLM (Medline)
Abstract
BACKGROUND: The development of atrioventricular bioprosthesis has
witnessed an increasing drive toward clinical translation over the last
few decades. A significant challenge in the clinical translation of an
atrioventricular bioprosthesis from bench to bedside is the appropriate
choice of a large animal model to test the safety and effectiveness of the
device. <br/>METHOD(S): We conducted a systematic review of preclinical in
vivo studies that would enable us to synthesize a recommended framework.
PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalyses)
guidelines were followed to identify and extract relevant articles.
<br/>RESULT(S): Sheep was the most common choice of animal, with nine out
of the 12 included studies being conducted on sheep. There were acute and
chronic studies based on our search criteria. An average of ~20 and 5
animals were used for chronic and acute studies. One out of three acute
studies and eight out of nine chronic studies were on stented heart valve
bioprosthesis. All analyses were conducted on the implantation of
atrioventricular valves with trileaflet, except for one chronic study on
unileaflet valves and one chronic and acute study on bileaflet valves.
<br/>CONCLUSION(S): Understanding the variance in past preclinical study
designs may increase the appropriate utilization of large animal models.
This synthesized evidence provides a preclinical Invivo studies framework
for future research with an atrioventricular
bioprosthesis.<br/>Copyright&#xa9; Bentham Science Publishers; For any
queries, please email at epub@benthamscience.net.

<137>
Accession Number
638281516
Title
Effectiveness and Safety of Early Initiation of Poststernotomy Cardiac
Rehabilitation Exercise Training: The SCAR Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2022. Date of Publication: 22 Jun 2022.
Author
Ennis S.; Lobley G.; Worrall S.; Evans B.; Kimani P.K.; Khan A.; Powell
R.; Banerjee P.; Barker T.; McGregor G.
Institution
(Ennis, McGregor) Warwick Clinical Trials Unit, Warwick Medical School,
University of Warwick, Coventry, United Kingdom
(Ennis, Lobley, Worrall, Evans, Powell, McGregor) Department of
Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University
Hospital Coventry and Warwickshire National Health Service Trust,
Coventry, United Kingdom
(Kimani, Khan, Banerjee) Warwick Medical School, University of Warwick,
Coventry, United Kingdom
(Powell, McGregor) Centre for Sport, Exercise and Life Sciences, Research
Institute for Health & Wellbeing, Coventry University, Coventry, United
Kingdom
(Banerjee) Department of Cardiology, University Hospital Coventry and
Warwickshire National Health Service Trust, Coventry, United Kingdom
(Barker) Department of Cardiothoracic Surgery, University Hospital
Coventry and Warwickshire National Health Service Trust, Coventry, United
Kingdom
Publisher
NLM (Medline)
Abstract
Importance: Guidelines recommend that cardiac rehabilitation (CR) exercise
training should not start until 6weeks after sternotomy, although this is
not evidence based. Limited data suggest that starting earlier is not
detrimental, but clinical trials are needed. <br/>Objective(s): To compare
the effectiveness and safety of CR exercise training started either 2
weeks (early CR) or 6 weeks (usual-care CR) after sternotomy. <br/>Design,
Setting, and Participant(s): This was an assessor-blind, noninferiority,
parallel-group, randomized clinical trial that conducted participant
recruitment from June 12, 2017, to March 17, 2020. Participants were
consecutive cardiac surgery sternotomy patients recruited from 2
outpatient National Health Service rehabilitation centers: University
Hospital, Coventry, UK, and Hospital of St Cross, Rugby, UK.
<br/>Intervention(s): Participants were randomly assigned to 8weeks of
twice-weekly supervised CR exercise training starting either 2weeks (early
CR) or 6 weeks (usual-care CR) after sternotomy. Exercise training adhered
to existing guidelines, including functional strength and cardiovascular
components. <br/>Main Outcomes and Measures: Outcomes were assessed at
baseline (inpatient after surgery), after CR (10 or 14 weeks after
sternotomy), and 12 months after randomization. The primary outcome was
the change in 6-minute walk test distance from baseline to after CR.
Secondary outcomes included safety, functional fitness, and quality of
life. <br/>Result(s): A total of 158 participants (mean [SD] age, 63
[11.5] years, 133 male patients [84.2%]) were randomly assigned to study
groups; 118 patients (usual-care CR, 61 [51.7%]; early CR, 57 [48.3%])
were included in the primary analysis. Early CR was not inferior to
usual-care CR (noninferiority margin, 35 m); the mean change in 6-minute
walk distance from baseline to after CR was 28 m greater in the early CR
group (95% CI, -11 to 66; P=.16). Mean differences for secondary outcomes
were not statistically significant, indicating noninferiority of early CR.
There were 46 vs 58 adverse events and 14 vs 18 serious adverse events in
usual-care CR and early CR, respectively. There was no difference between
the groups in the likelihood of participants having an adverse or serious
adverse event. <br/>Conclusions and Relevance: Starting exercise training
from 2 weeks after sternotomy was as effective as starting 6 weeks after
sternotomy for improving 6-minute walk distance. With appropriate
precautions, clinicians and CR professionals can consider starting
exercise training as early as 2 weeks after sternotomy. Trial
Registration: ClinicalTrials.gov Identifier: NCT03223558.

<138>
Accession Number
638280711
Title
Infant's difficult temperament characteristics predict poor quality of
life in parents of infants with complex congenital heart defects
post-cardiac surgery.
Source
Cardiology in the young. (pp 1-17), 2022. Date of Publication: 22 Jun
2022.
Author
Golfenshtein N.; Lisanti A.J.; Medoff-Cooper B.
Institution
(Golfenshtein) University of Haifa, Department of Nursing. 199 Abba Hushi
Ave. 3498838. Haifa, Israel
(Golfenshtein, Lisanti, Medoff-Cooper) University of Pennsylvania, School
of Nursing; 418 Curie Blvd, Claire M. Fagin Hall, Philadelphia, PA 19104
(Lisanti) Children's Hospital of Philadelphia. 3401 Civic Center Blvd, PA
19104. USA., Philadelphia, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND & AIMS: Parents of infants with complex congenital heart
defects (CHD) often describe their infants as especially fussy, irritable,
and difficult to sooth, which together with the illness caretaking
demands, add to their stress. Little is known about how the behavioral
style or temperament in the early months after discharge relates to
parental quality of life. This study aimed to explore the associations
between early infant temperament characteristics and parental quality of
life in parents of infants with complex congenital heart disease.
<br/>METHOD(S): This descriptive, cross-sectional study, utilized data
collected in a previously described multisite randomized clinical trial in
the United States. Multivariable linear regression models were used to
examine the associations of interest. FINDINGS: Results demonstrated
negative significant associations between most infant temperament
subscales and parental quality of life. Higher scores on the Activity
(beta=-3.03, P=0.021), Approach (beta=-1.05, P=0.021), Adaptability
(beta=-3.47, P=0.004), Intensity (beta=-2.78, P=0.008), Mood (beta= -4.65,
P<0.001), and Distractibility (beta=-3.36, P=0.007 were all significantly
associated with lower parental quality of life scores, adjusting for
parental dyadic adjustment, insurance type, number of medications, and
number of unscheduled cardiologist visits. <br/>CONCLUSION(S): Parental
perceptions of infant's difficult behavioral style or temperament
characteristics appear to be associated with poorer quality of life in
parents of infants with complex CHD post-cardiac surgery. Findings can be
used in the screening process of families at potential risk of increased
stress and poor illness adaptation and in the design of interventions to
target parental mental health in this vulnerable patient population.

<139>
Accession Number
638279975
Title
The impact of coronary artery bypass grafting added to aortic valve
replacement on long-term outcomes in octogenarian patients. A
reconstructed time-to-event meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2022.
Date of Publication: 20 Jun 2022.
Author
Gallingani A.; D'Alessandro S.; Singh G.; Hernandez-Vaquero D.; Celik M.;
Ceccato E.; Nicolini F.; Formica F.
Institution
(Gallingani) Cardiac Surgery Unit, Parma University Hospital, Italy
(D'Alessandro) Cardiac Surgery Unit, San Gerardo Hospital, Monza, Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, University of Alberta, Canada
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Celik) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam, Netherlands
(Ceccato, Nicolini, Formica) University of Parma, Medical Library, Italy
(Nicolini, Formica) University of Parma, Department of Medicine and
Surgery, Italy
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The long-term results in studies comparing octogenarian
patients who received either isolated surgical aortic valve replacement
(i-SAVR) or coronary artery bypass grafting (CABG) in addition to SAVR are
still debated. We performed a reconstructed time-to-event data
meta-analysis of studies comparing i-SAVR and CABG+SAVR to evaluate the
impact of CABG and to analyse the time-varying effects on long-term
outcome. <br/>METHOD(S): We performed a systematic review of the
literature from January 2000 through November 2021, including studies
comparing i-SAVR and CABG+SAVR which reported at least 3-years follow-up
and that plotted Kaplan-Meier curves of overall survival. The primary
endpoint was overall long-term survival; secondary endpoints were
in-hospital/30-day mortality and postoperative outcomes. The pooled hazard
ratio (HR) and odd ratio (OR) with 95% confidence interval (CI) were
calculated for primary and secondary endpoints, respectively.
Random-effect model was used in all analyses. <br/>RESULT(S): Sixteen
retrospective studies were included (5382 patients, i-SAVR=2,568 and
CABG+SAVR=2,814). I-SAVR showed a lower incidence of in-hospital mortality
compared to CABG+SAVR (OR=0.73; 95% CI=0.60-0.89; p=0.002). Landmark
analyses showed a significantly higher all-cause mortality within 1-year
from surgery in CABG+SAVR (HR=1.17; 95% CI=1.01-1.36; p=0.03); after
1-year, no significant difference was observed (HR=0.95; 95% CI=0.87-1.04;
p=0.35). Landmark analysis was confirmed by time-varying-trend of hazard
ratio. <br/>CONCLUSION(S): Late survival of octogenarians did not differ
significantly between the two interventions. Interestingly, CABG added to
SAVR was associated with both higher in-hospital and within 1-year
mortality after surgery, whereas this difference was statistically
non-significant at long-term follow-up.<br/>Copyright &#xa9; The Author(s)
2022. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.