EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 88

Results Generated From:
Embase <1980 to 2022 Week 33>
Embase Weekly Updates (updates since 2022-08-12)

<1>
Accession Number
638708408
Title
El efecto de diferentes tecnicas de anestesia sobre la oxigenacion
cerebral en cirugia toracica, The effect of different anesthesia
techniques on cerebral oxygenation in thoracic surgery.
Source
Cirugia y cirujanos. 90(S1) (pp 52-60), 2022. Date of Publication: 2022.
Author
Akdogan A.; Besir A.; Kutanis D.; Erturk E.; Tugcugil E.; Saylan S.
Institution
(Akdogan, Besir, Kutanis, Erturk, Tugcugil, Saylan) Department of
Anesthesiology and Intensive Care, Faculty of Medicine, Karadeniz
Technical University, Trabzon, Turkey
Publisher
NLM (Medline)

<2>
Accession Number
638690578
Title
Association of Dual Antiplatelet Therapy With Ticagrelor With Vein Graft
Failure After Coronary Artery Bypass Graft Surgery: A Systematic Review
and Meta-analysis.
Source
JAMA. 328(6) (pp 554-562), 2022. Date of Publication: 09 Aug 2022.
Author
Sandner S.; Redfors B.; Angiolillo D.J.; Audisio K.; Fremes S.E.; Janssen
P.W.A.; Kulik A.; Mehran R.; Peper J.; Ruel M.; Saw J.; Soletti G.J.;
Starovoytov A.; Ten Berg J.M.; Willemsen L.M.; Zhao Q.; Zhu Y.; Gaudino M.
Institution
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Sandner) Weill Cornell Medicine, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, United States
(Audisio, Soletti, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, NY, United States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Fremes) Institute of Health Policy Management and Evaluation, University
of Toronto, Toronto, ON, Canada
(Janssen, Peper, Ten Berg, Willemsen) Department of Cardiology, St
Antonius Hospital, Nieuwegein, Netherlands
(Kulik) Division of Cardiac Surgery, Boca Raton Regional Hospital and
Florida Atlantic Hospital, Boca Raton, United States
(Mehran) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Saw, Starovoytov) Division of Cardiology, Vancouver General Hospital, BC,
Canada
(Saw) Division of Cardiology St Paul's Hospital, University of British
Columbia, Vancouver, Canada
(Zhao, Zhu) Ruijin Hospital Shanghai Jiao Tong University School of
Medicine, Shanghai, China
Publisher
NLM (Medline)
Abstract
Importance: The role of ticagrelor with or without aspirin after coronary
artery bypass graft surgery remains unclear. Objective(s): To compare
the risks of vein graft failure and bleeding associated with ticagrelor
dual antiplatelet therapy (DAPT) or ticagrelor monotherapy vs aspirin
among patients undergoing coronary artery bypass graft surgery. Data
Sources: MEDLINE, Embase, and Cochrane Library databases from inception to
June 1, 2022, without language restriction. Study Selection: Randomized
clinical trials (RCTs) comparing the effects of ticagrelor DAPT or
ticagrelor monotherapy vs aspirin on saphenous vein graft failure. Data
Extraction and Synthesis: Individual patient data provided by each trial
were synthesized into a combined data set for independent analysis.
Multilevel logistic regression models were used. Main Outcomes and
Measures: The primary analysis assessed the incidence of saphenous vein
graft failure per graft (primary outcome) in RCTs comparing ticagrelor
DAPT with aspirin. Secondary outcomes were saphenous vein graft failure
per patient and Bleeding Academic Research Consortium (BARC) type 2, 3, or
5 bleeding events. A supplementary analysis included RCTs comparing
ticagrelor monotherapy with aspirin. Result(s): A total of 4 RCTs
were included in the meta-analysis, involving 1316 patients and 1668
saphenous vein grafts. Of the 871 patients in the primary analysis, 435
received ticagrelor DAPT (median age, 67 years [IQR, 60-72 years]; 65
women [14.9%]; 370 men [85.1%]) and 436 received aspirin (median age, 66
years [IQR, 61-73 years]; 63 women [14.5%]; 373 men [85.5%]). Ticagrelor
DAPT was associated with a significantly lower incidence of saphenous vein
graft failure (11.2%) per graft than was aspirin (20%; difference, -8.7%
[95% CI, -13.5% to -3.9%]; OR, 0.51 [95% CI, 0.35 to 0.74]; P<.001) and
was associated with a significantly lower incidence of saphenous vein
graft failure per patient (13.2% vs 23.0%, difference, -9.7% [95% CI,
-14.9% to -4.4%]; OR, 0.51 [95% CI, 0.35 to 0.74]; P<.001). Ticagrelor
DAPT (22.1%) was associated with a significantly higher incidence of BARC
type 2, 3, or 5 bleeding events than was aspirin (8.7%; difference, 13.3%
[95% CI, 8.6% to 18.0%]; OR, 2.98 [95% CI, 1.99 to 4.47]; P<.001), but not
BARC type 3 or 5 bleeding events (1.8% vs 1.8%, difference, 0% [95% CI,
-1.8% to 1.8%]; OR, 1.00 [95% CI, 0.37 to 2.69]; P=.99). Compared with
aspirin, ticagrelor monotherapy was not significantly associated with
saphenous vein graft failure (19.3% vs 21.7%, difference, -2.6% [95% CI,
-9.1% to 3.9%]; OR, 0.86 [95% CI, 0.58 to 1.27]; P=.44) or BARC type 2, 3,
or 5 bleeding events (8.9% vs 7.3%, difference, 1.7% [95% CI, -2.8% to
6.1%]; OR, 1.25 [95% CI, 0.69 to 2.29]; P=.46). Conclusions and
Relevance: Among patients undergoing coronary artery bypass graft surgery,
adding ticagrelor to aspirin was associated with a significantly decreased
risk of vein graft failure. However, this was accompanied by a
significantly increased risk of clinically important bleeding.

<3>
Accession Number
637729832
Title
Efficacy and Safety of Triiodothyronine Treatment in Cardiac Surgery or
Cardiovascular Diseases: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Thyroid : official journal of the American Thyroid Association. 32(8) (pp
879-896), 2022. Date of Publication: 01 Aug 2022.
Author
Tharmapoopathy M.; Thavarajah A.; Kenny R.P.W.; Pingitore A.; Iervasi G.;
Dark J.; Bano A.; Razvi S.
Institution
(Tharmapoopathy, Thavarajah, Dark, Razvi) Department of Endocrinology,
Translational and Clinical Research Institute, Newcastle University,
Newcastle upon Tyne, United Kingdom
(Kenny) Department of Biostatistics, Institute of Population Health
Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
(Pingitore, Iervasi) Consiglio Nazionale delle Ricerche, Pisa, Italy
(Bano) Department of Cardiology, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Bano) Department of Cardiology, Institute of Social and Preventive
Medicine (ISPM), University of Bern, Bern, Switzerland
Publisher
NLM (Medline)
Abstract
Background: Low levels of the active thyroid hormone triiodothyronine (T3)
in cardiac patients are associated with worse outcomes. The aim of this
analysis was to assess if T3 treatment is beneficial and safe in patients
undergoing cardiac surgery or those with cardiovascular diseases in whom
there is observed or expected reduction in serum T3 levels.
 Method(s): A systematic review and meta-analysis of randomized
controlled trials (RCTs) was performed as per the PRISMA guidelines.
Pubmed, EMBASE, and Web of Science databases were searched for RCTs
published between January 1, 1960 and March 30, 2022 that evaluated the
effects of T3 therapy in patients undergoing cardiac surgery or with
cardiovascular diseases. The primary outcomes were measures of cardiac
function. Weighted mean difference (MD) or relative risk was calculated
using a random effects model. PROSPERO registration number CRD42020211966.
 Result(s): Of the 3181 full-text articles screened, 34 studies with
2547 participants (number ranging between 13 and 223, mean ages between
0.5 and 73 years, mean percentage of women between 7% and 64%) were
included. In 12 RCTs with 1093 adults undergoing cardiac surgery T3
therapy was associated with improvement in cardiac index (MD [95%
confidence interval], 0.24 [0.08 to 0.40] L/min/m2, I2=74%). The quality
of evidence was high to moderate. In 3 RCTs with 188 children undergoing
cardiac surgery, 3 RCTs with 131 adult cardiac donors, 3 RCTs with 83
adult patients with heart failure, and 2 RCTs with 89 adults with acute
myocardial infarction, T3 therapy did not improve cardiac index or left
ventricular function; the quality of evidence ranged from high (pediatric
cardiac surgery) to low (other groups). No detrimental effect of T3
therapy was observed on heart rate, risk of in-hospital atrial
fibrillation, or mortality. Conclusion(s): Short-term T3 therapy is
safe and trials in adults undergoing cardiac surgical procedures to
evaluate longer term clinical endpoints are required. Current data do not
support the routine use of T3 therapy in children undergoing cardiac
surgery or in cardiac donors. Adequately designed trials are required to
determine if T3 therapy improves cardiac function and clinical outcomes in
patients with heart failure or acute myocardial infarction.

<4>
Accession Number
637150101
Title
WITHDRAWN: Low-Dose Versus Standard Warfarin After Mechanical Mitral Valve
Replacement: A Randomized Controlled Trial.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 28 Jan 2022.
Author
Chu M.W.A.; Ruel M.; Graeve A.; Gerdisch M.W.; Damiano R.J.; Smith R.L.;
Keeling W.B.; Wait M.A.; Hagberg R.C.; Quinn R.D.; Sethi G.K.; Floridia
R.; Barreiro C.J.; Pruitt A.L.; Accola K.D.; Dagenais F.; Markowitz A.H.;
Ye J.; Sekela M.E.; Tsuda R.Y.; Duncan D.A.; Swistel D.G.; Harville L.E.;
DeRose J.J.; Lehr E.J.; Puskas J.D.
Institution
(Chu) London Health Sciences Centre, Western University, London, ON,
Canada
(Ruel) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Graeve) MultiCare Health System, Tacoma, WA, United States
(Gerdisch) Franciscan St. Francis Health, Indianapolis, IN, United States
(Damiano) Washington University SL, St. Louis, MO, United States
(Smith) Heart Hospital Baylor Plano, Plano, TX, United States
(Keeling) Emory University Hospital Midtown, Atlanta, GA, United States
(Wait) UT Southwestern Medical Center (St. Paul's), Dallas, TX, United
States
(Hagberg) Hartford Hospital, Hartford, CT, United States
(Quinn) Maine Medical Center, Portland, ME
(Sethi) University of Arizona, Tucson Heart Center, Tucson, AZ, United
States
(Floridia) Loma Linda University Medical Center, Loma Linda, CA, United
States
(Barreiro) Sentara Norfolk General Hospital, Norfolk, VA, United States
(Pruitt) St. Joseph Mercy Hospital, Ann Arbor, MI, United States
(Accola) Florida Hospital, Orlando, FL, Puerto Rico
(Dagenais) Institut universitaire de cardiologie et de pneumologie de
Quebec (IUCPQ), Quebec City, QC, Canada
(Markowitz) University Hospitals-Cleveland, Cleveland, OH, United States
(Ye) St. Paul's and Vancouver General Hospital, Vancouver, BC, Canada
(Sekela) University of Kentucky, Lexington, KY, United States
(Tsuda) Southern Arizona VA Medical Center, Tucson, AZ, United States
(Duncan) Novant Clinical Research Institute, Winston-Salem, NC, United
States
(Swistel) NYU Langone Hospitals, New York, NY
(Harville) University of Oklahoma Health Sciences Center, Oklahoma City,
OK, United States
(DeRose) Montefiore Medical Center, Bronx, NY, United States
(Lehr) Swedish Medical Center, Seattle, WA, United States
(Puskas) Mount Sinai Saint Luke's, New York, NY
Publisher
NLM (Medline)
Abstract
This article has been withdrawn at the request of the author(s) and/or
editor. The Publisher apologizes for any inconvenience this may cause. The
full Elsevier Policy on Article Withdrawal can be found at
https://www.elsevier.com/about/our-business/policies/article-withdrawal.Copyright © 2022 The Society of Thoracic Surgeons. Published by
Elsevier Inc. All rights reserved.

<5>
Accession Number
2015452925
Title
Retained surgical drain fragments: A systematic review and case report.
Source
Surgical Practice. 26(3) (pp 199-207), 2022. Date of Publication: August
2022.
Author
Indja B.; Chen K.; Cheng E.; Kennedy H.; Alzahrani N.; Morris D.L.
Institution
(Indja) School of Health Sciences, Faculty of Medicine and Health, The
University of Sydney, Camperdown, NSW, Australia
(Indja, Chen, Cheng, Kennedy, Alzahrani, Morris) Hepatobilliary and
Surgical Oncology Unit, Department of Surgery, St George Hospital,
Kogarah, NSW, Australia
(Chen, Cheng, Morris) St George and Sutherland Clinical School, University
of New South Wales, Sydney, NSW, Australia
(Alzahrani) College of Medicine, Al Imam Mohammad Ibn Saud Islamic
University (IMSIU), Riyadh, Saudi Arabia
Publisher
John Wiley and Sons Inc
Abstract
Aim: Retained surgical drains are an avoidable and serious cause of
postoperative morbidity. This study aims to first report on our unit's
experience in identifying and managing retained surgical drains and then
consolidate current knowledge regarding retained surgical drains, causes
and associated complications. Patients and Methods: A systematic
review of the literature was performed through searches in electronic
databases to identify studies that described incidents involving retained
surgical drains. Data were extracted regarding patient and operative
characteristics, drain complications and management. Result(s): A
total of 36 case reports and/or series were identified in the literature,
with 39 individual cases of retained surgical drains in patients
undergoing abdominal, thoracic or orthopaedic procedures. The most common
cause for retained drain was fracture of drain tubing. Patients presented
with complications ranging from chronic pain, abscess or fistula
formation, to migration of the drain fragment into a hollow viscus. In all
cases an invasive intervention was required to remove the retained drain.
 Conclusion(s): Surgeons should be aware of retained surgical drains
as an iatrogenic cause of postoperative morbidity. Contemporary surgical
practice should include methods to prevent, identify and manage retained
drains and associated complications. Copyright © 2022 College of
Surgeons of Hong Kong.

<6>
Accession Number
638729124
Title
Redefining the epidemiology of cardiac amyloidosis. A systematic review of
screening studies.
Source
European Journal of Heart Failure. Conference: Heart Failure 2022 and the
World Congress on Acute Heart Failure. Madrid Spain. 24(Supplement 2) (pp
224), 2022. Date of Publication: July 2022.
Author
Alberto Aimo A.; Merlo M.; Porcari A.; Pagura L.; Vergaro G.; Sinagra G.;
Emdin M.; Passino C.; Rapezzi C.
Institution
(Alberto Aimo, Emdin, Passino) Sant'Anna School of Advanced Studies, Pisa,
Italy
(Merlo, Porcari, Pagura, Sinagra) United Hospitals of Trieste University
Hospital, Trieste, Italy
(Vergaro) Fondazione Toscana Gabriele Monasterio, Pisa, Italy
(Rapezzi) University Hospital of Ferrara, Ferrara, Italy
Publisher
John Wiley and Sons Ltd
Abstract
Background: Over the last years, an algorithm for non-invasive diagnosis
of amyloid transthyretin cardiac amyloidosis (ATTR-CA) and novel
disease-modifying therapies have prompted an active search of CA in
different clinical settings. Method(s): We performed a systematic
search of screening studies investigating CA. Result(s): The average
prevalence of CA in different settings were as follows: total body
scintigraphy with bone tracers for non-cardiac reasons (n = 5 studies),
1%; heart failure (HF) with preserved ejection fraction (n = 6), 12%; HF
with reduced or mildly reduced ejection fraction (n = 2), 10%, conduction
disorders warranting pacemaker implantation (n = 1), 2%; surgery for
carpal tunnel syndrome (CTS; n = 3), 7%; hypertrophic cardiomyopathy
phenotype (n = 2), 9%; aortic stenosis (AS) undergoing surgical or
transaortic valve replacement (n = 7), 10%; autopsy series of unselected
elderly individuals (n = 4), 15%. Many of these patients had ATTR-CA, but
the percentage of cases with amyloid light-chain CA was far from
negligible. Conclusion(s): Screening for CA in specific settings
allows to identify a relatively high number of cases, in agreement with
the notion that CA is not a rare disease. Many patients have ATTR-CA. Most
studies focused on elderly subjects, given the clear relationship between
age and the likelihood of CA. Men accounted for a high proportion of
patients with CA, but women were quite represented.

<7>
Accession Number
638729716
Title
Early aortic valve replacement in asymptomatic severe aortic stenosis with
preserved ejection fraction.
Source
European Journal of Heart Failure. Conference: Heart Failure 2022 and the
World Congress on Acute Heart Failure. Madrid Spain. 24(Supplement 2) (pp
239), 2022. Date of Publication: July 2022.
Author
Goncalo Costa G.; Cardoso J.; Goncalves L.; Teixeira R.T.
Institution
(Goncalo Costa) Centro hospitalar de Coimbra, Coimbra, Portugal
(Cardoso) Hospital Center of Vila Nova de Gaia/Espinho, Cardiothoracic
Surgery, Vila Nova de Gaia, Portugal
(Goncalves) Coimbra Institute for Clinical and Biomedical Research,
Coimbra, Portugal
(Teixeira) Centro Hospitalar Universitario de Coimbra, Coimbra, Portugal
Publisher
John Wiley and Sons Ltd
Abstract
Background: Aortic stenosis (AS) is themost common valvular disease in
developed countries. Specific timing of intervention for asymptomatic
patients with severe aortic stenosis and preserved ejection fraction
remains controversial. Purpose(s): To compare the outcomes of early
aortic valve replacement (AVR) versus watchful waiting (WW) in
asymptomatic AS patients with preserved ejection. Method(s): We
systematically searched PubMed, Embase and Cochrane databases, in November
2021, for both interventional or observational studies comparing early-AVR
with WW in the treatment of asymptomatic severeAS with preserved ejection
fraction criteria. Random-effects meta-analysis was performed.
 Result(s): Eight studies were included in which two were randomized
clinical trials. A total of 2672 patients were included, providing a 642
pooled death events (327 in early-AVR and 941 in watchful waiting). In our
meta-analysis, early-AVR revealed a significant lower all-cause mortality
(pooled OR, 0.39; 95% CI [0.30, 0.51], P< 0.01; I2 = 47%). Additionally,
the early-AVR group presented a lower rate of cardiovascular mortality
(pooled OR, 0.33; 95% CI [0.19, 0.56], P<0.01; I2 = 64%). Both strategies
had similar rate of stroke (pooled OR, 1.30; 95% CI [0.39, 4.27], P =
0.67; I2 =0%) and myocardial infarction (pooled OR, 0.49; 95% CI [0.14,
1.78], P = 0.28; I2 =0%). Heart Failure hospitalizations presented a lower
trend early-AVR group (pooled OR, 0.22; 95% CI [0.05, 1.08], P = 0.36; I2
= 36%). Conclusion(s): Our pooled data suggests that early-AVR
strategy is preferable for asymptomatic severe AS patients with preserved
ejection fraction.

<8>
Accession Number
638729701
Title
The effect of intravenous ferric derisomaltose on frailty score in iron
deficient patients with servere aortic stenosis undergoing transcatheter
aortic valve implantation.
Source
European Journal of Heart Failure. Conference: Heart Failure 2022 and the
World Congress on Acute Heart Failure. Madrid Spain. 24(Supplement 2) (pp
239), 2022. Date of Publication: July 2022.
Author
Sophie Foss Klove S.; Kvaslerud A.B.; Bardan S.; Andresen K.; Gullestad
L.; Broch K.
Institution
(Sophie Foss Klove, Andresen) Oslo University Hospital Rikshospitalet,
Oslo, Norway
(Kvaslerud, Gullestad, Broch) Oslo University Hospital, Rikshospitalet and
Faculty of Medicine, University of Oslo, oslo, Norway
(Bardan) University of Oslo, Faculty of Medicine, Oslo, Norway
Publisher
John Wiley and Sons Ltd
Abstract
Background: Elderly patients with severe aortic stenosis often have
multiple comorbidities, including iron deficiency (ID). ID is associated
with increased physical disability, frailty, cognitive impairment,
depression, and mortality. Higher frailty score in patients undergoing
transcatheter aortic valve implantation (TAVI) is associated with
increased one-year mortality. Whether repletion of iron stores improves
frailty score is unknown. In this trial we aim to investigate whether one
single administration of intravenous ferric derisomaltose can improve
frailty score in iron deficient patients with severe aortic stenosis
scheduled for TAVI. Method(s): This is a sub-study of the Intravenous
Iron supplement for Iron deficiency in Patients with Severe Aortic
Stenosis (IIISAS) trial. The IIISAS trial is a single site, double
blinded, randomised, placebo-controlled trial aiming to investigate the
effect of ferric derisomaltose in iron deficient patients with severe
aortic stenosis. Inclusion criteria are ID, defined as ferritin < 100
mug/L or ferritin between 100 and 300 mug/L in combination with
transferrin saturation <20%. Exclusion criteria include hemoglobin < 100
g/L, red blood cell disorders, end-stage kidney failure, intolerance to
ferric derisomaltose, and ongoing infections. The frailty score is
assessed by the Essential Frailty Toolset (EFT), which is scored from 0
(least frail) to 5 (most frail) based on 4 different items; anaemia,
hypoalbuminemia, lower-extremitymuscle weakness, and cognitive impairment.
The EFT is assessed before administration of intravenous ferric
derisomaltose, which is approximately three months before TAVI, and
repeated three months after TAVI. Result(s): Between January 2020 and
September 2021, 149 patients have been included. Of these, 93 patients
have received treatment, undergone TAVI procedure, and performed a 3-month
follow-up visit. We expect the final study visit and results, including
allocation to iron or control, by July 2022. Of the patients who have
completed the trial, 54 patients (58 %) were men, and the mean age was
80+/-7 years. The EFT score was 0-1 in 82 % of the patients, 2 in 16 % of
the patients and 3 in 2 % of the patients. None of the patients had a
frailty score > 3 at baseline. Anaemia was present at baseline in 24
patients (26 %). At follow-up, 27 % had an improvement in frailty score,
while 55 % and 17 % had no change or a worsening of the frailty score,
respectively. Conclusion(s): This will be the first trial to evaluate
whether treatment with intravenous ferric derisomaltose can improve
frailty score in patients with ID and aortic stenosis scheduled for TAVI.

<9>
Accession Number
2019658276
Title
Galectin-3 as a Predictor of Post Cardiac Surgery Atrial Fibrillation: A
Scoping Review.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 101314. Date of Publication: October 2022.
Author
King M.; Stambulic T.; Kirupaharan S.; Baranchuk A.; Rabinovich G.A.;
Payne D.; El-Diasty M.
Institution
(King, Stambulic, Kirupaharan) Queen's University School of Medicine,
Kingston, ON, Canada
(Baranchuk) Division of Cardiology, Department of Medicine, Queen's
University, Kingston, ON, Canada
(Rabinovich) Laboratorio de Glicomedicina, Instituto de Biologia y
Medicina Experimental, Consejo Nacional de Investigaciones Cientificas y
Tecnicas, Buenos Aires, Argentina
(Payne, El-Diasty) Division of Cardiac Surgery, Department of Surgery,
Queen's University, Kingston, ON, Canada
Publisher
Elsevier Inc.
Abstract
Galectin-3 is associated with myocardial fibrosis, a known risk factor for
developing re-entrant circuits associated with atrial fibrillation (AF).
Previous studies have demonstrated increased galectin levels in AF
patients. Whether preoperative galectin-3 levels can predict the incidence
of postoperative atrial fibrillation (POAF) remains unknown.This scoping
review was conducted in accordance with the 2020 Preferred Reporting Items
for Systematic Reviews and Meta-Analyses (PRISMA) statement. Electronic
searches were conducted in Medline, EMBASE, Cochrane, and Google Scholar
databases using a predetermined strategy. Methodological variables,
demographics and operative data were extracted. Data extraction was
performed manually by 3 reviewers.The search yielded 620 citations, of
which 74 underwent full text review, and 3 citations with 3 independent
samples (n=1812) met full inclusion/exclusion criteria and were included.
Of the 3 studies that reported on the association between preoperative
galectin-3 levels and POAF, 2 studies compared median galectin levels in
patients who developed POAF and those who did not. While Alexandre et al.
reported a significant difference (P=0.002), Bening et al did not find a
significant difference between POAF and non-POAF groups (P=0.3). A third
study reporting on the association between galectin-3 and atrial
fibrillation comparing third and first tercile galectin-3 levels found a
significant association between preoperative galectin levels and POAF on
univariate analysis (OR 1.54; 95% CI 1.14-2.09).Galectin-3 is an emerging
biomarker that has been associated with the development of AF. However,
there is currently not enough evidence to establish its prognostic role in
postcardiac surgery atrial fibrillation. Copyright © 2022
Elsevier Inc.

<10>
Accession Number
2019458618
Title
Coronary flow reserve and cardiovascular outcomes: a systematic review and
meta-analysis.
Source
European Heart Journal. 43(16) (pp 1582-1593), 2022. Date of Publication:
21 Apr 2022.
Author
Kelshiker M.A.; Seligman H.; Howard J.P.; Rahman H.; Foley M.; Nowbar
A.N.; Rajkumar C.A.; Shun-Shin M.J.; Ahmad Y.; Sen S.; Al-Lamee R.;
Petraco R.
Institution
(Kelshiker, Seligman, Howard, Rahman, Foley, Nowbar, Rajkumar, Sen,
Al-Lamee, Petraco) National Heart and Lung Institute, Imperial College
London, Hammersmith Campus, 72 Du Cane Road, London W12 0HS, United
Kingdom
(Ahmad) Yale School of Medicine, Yale University, 333 Cedar St, New Haven,
CT 06510, United States
Publisher
Oxford University Press
Abstract
Aims This meta-analysis aims to quantify the association of reduced
coronary flow with all-cause mortality and major adverse cardiovascular
events (MACE) across a broad range of patient groups and pathologies.
Methods and results We systematically identified all studies between 1
January 2000 and 1 August 2020, where coronary flow was measured and
clinical outcomes were reported. The endpoints were all-cause mortality
and MACE. Estimates of effect were calculated from published hazard ratios
(HRs) using a random-effects model. Seventy-nine studies with a total of
59 740 subjects were included. Abnormal coronary flow reserve (CFR) was
associated with a higher incidence of all-cause mortality [HR: 3.78, 95%
confidence interval (CI): 2.39-5.97] and a higher incidence of MACE (HR
3.42, 95% CI: 2.92-3.99). Each 0.1 unit reduction in CFR was associated
with a proportional increase in mortality (per 0.1 CFR unit HR: 1.16, 95%
CI: 1.04-1.29) and MACE (per 0.1 CFR unit HR: 1.08, 95% CI: 1.04-1.11). In
patients with isolated coronary microvascular dysfunction, an abnormal CFR
was associated with a higher incidence of mortality (HR: 5.44, 95% CI:
3.78-7.83) and MACE (HR: 3.56, 95% CI: 2.14-5.90). Abnormal CFR was also
associated with a higher incidence of MACE in patients with acute coronary
syndromes (HR: 3.76, 95% CI: 2.35-6.00), heart failure (HR: 6.38, 95% CI:
1.95-20.90), heart transplant (HR: 3.32, 95% CI: 2.34-4.71), and diabetes
mellitus (HR: 7.47, 95% CI: 3.37-16.55). Conclusion Reduced coronary flow
is strongly associated with increased risk of all-cause mortality and MACE
across a wide range of pathological processes. This finding supports
recent recommendations that coronary flow should be measured more
routinely in clinical practice, to target aggressive vascular risk
modification for individuals at higher risk. Copyright © 2022
Oxford University Press. All rights reserved.

<11>
Accession Number
2018493737
Title
Machine learning algorithms to predict major bleeding after isolated
coronary artery bypass grafting.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 881881. Date of Publication: 28 Jul 2022.
Author
Gao Y.; Liu X.; Wang L.; Wang S.; Yu Y.; Ding Y.; Wang J.; Ao H.
Institution
(Gao, Wang, Wang, Yu, Ding, Wang, Ao) Department of Anesthesiology, Fuwai
Hospital, State Key Laboratory of Cardiovascular Disease, National Center
of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Liu) Department of Anesthesiology, The Affiliated Hospital of Qingdao
University, Qingdao, China
Publisher
Frontiers Media S.A.
Abstract
Objectives: Postoperative major bleeding is a common problem in patients
undergoing cardiac surgery and is associated with poor outcomes. We
evaluated the performance of machine learning (ML) methods to predict
postoperative major bleeding. Method(s): A total of 1,045 patients
who underwent isolated coronary artery bypass graft surgery (CABG) were
enrolled. Their datasets were assigned randomly to training (70%) or a
testing set (30%). The primary outcome was major bleeding defined as the
universal definition of perioperative bleeding (UDPB) classes 3-4. We
constructed a reference logistic regression (LR) model using known
predictors. We also developed several modern ML algorithms. In the test
set, we compared the area under the receiver operating characteristic
curves (AUCs) of these ML algorithms with the reference LR model results,
and the TRUST and WILL-BLEED risk score. Calibration analysis was
undertaken using the calibration belt method. Result(s): The
prevalence of postoperative major bleeding was 7.1% (74/1,045). For major
bleeds, the conditional inference random forest (CIRF) model showed the
highest AUC [0.831 (0.732-0.930)], and the stochastic gradient boosting
(SGBT) and random forest models demonstrated the next best results [0.820
(0.742-0.899) and 0.810 (0.719-0.902)]. The AUCs of all ML models were
higher than [0.629 (0.517-0.641) and 0.557 (0.449-0.665)], as achieved by
TRUST and WILL-BLEED, respectively. Conclusion(s): ML methods
successfully predicted major bleeding after cardiac surgery, with greater
performance compared with previous scoring models. Modern ML models may
enhance the identification of high-risk major bleeding
subpopulations. Copyright © 2022 Gao, Liu, Wang, Wang, Yu, Ding,
Wang and Ao.

<12>
Accession Number
2018476588
Title
Migration of covered stents in thoracic central vein obstruction
procedures in patients with hemodialysis: Case report and literature
review.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 954443. Date of Publication: 27 Jul 2022.
Author
Chen B.; Lai Q.; Fedally S.; Wan Z.
Institution
(Chen) Department of Ultrasonography, The First Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Lai, Wan) Department of Nephrology, The First Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Fedally) Department of Nephrology, SSRN Hospital, Mauritius, Mauritius
Publisher
Frontiers Media S.A.
Abstract
Objective: The objective of the study is to present a case of hemodialysis
in which the covered stent that had migrated into the right ventricle was
retrieved by exploratory thoracotomy, and to review the literature on the
diagnosis and treatment of stent migration in thoracic central vein
obstruction (TCVO) procedures for hemodialysis patients. Method(s): A
systematic search of the PubMed database was performed to identify
clinical presentations, imaging strategies, stent types, and treatment
modalities for stent migration in hemodialysis patients. Result(s): A
total of 14 case reports on stent migration in TCVO procedures for
hemodialysis patients were included and analyzed. Ten cases included
migration to the cardiac chambers and the remainder migration to the
pulmonary artery. The common symptoms of stent migration in TCVO
procedures are reported to be chest pain and dyspnea, while three of the
cases studied involved no symptoms. Echocardiography, chest X-ray, and
computed tomography are the commonly used methods for the diagnosis of
stent migration and identification of the precise positioning of the
stent. Stent migration to the right subclavian or innominate veins was the
most prevalent case (seven cases). All were bare stents. Seven cases
involved retrieval by interventional surgery, while four cases involved
retrieval by open heart surgery. However, there were three cases in which
the "wait-and-see" approach was adopted since the patients were
asymptomatic. Conclusion(s): Stent migration in TCVO procedures is a
rare but extremely serious complication. The causes are not fully
understood. The current treatment strategies include interventional
surgery, open heart surgery, and the "wait-and-see"
approach. Copyright © 2022 Chen, Lai, Fedally and Wan.

<13>
[Use Link to view the full text]
Accession Number
2019748585
Title
Effects of perioperative interventions for preventing postoperative
delirium: A protocol for systematic review and meta-Analysis of randomized
controlled trials.
Source
Medicine (United States). 100(29) (pp E26662), 2021. Date of Publication:
23 Jul 2021.
Author
Li X.; Wang Y.; Liu J.; Xiong Y.; Chen S.; Han J.; Xie W.; Wu Q.
Institution
(Li, Wang, Liu, Xiong, Chen, Han, Xie, Wu) Department of Anaesthesiology,
Union Hospital, Tongji Medical College, Huazhong University of Science and
Technology, 1277 Jiefang Avenue, Wuhan 430022, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Postoperative delirium (POD) not only increases the medical
burden but also adversely affects patient prognosis. Although some cases
of delirium can be avoided by early intervention, there is no clear
evidence indicating whether any of these measures can effectively prevent
POD in specific patient groups. Objective(s):The aim of this
meta-Analysis was to compare the efficacy and safety of the existing
preventive measures for managing POD. Method(s):The PubMed, OVID
(Embase and MEDLINE), Web of Science, and the Cochrane Library databases
were searched for articles published before January 2020. The relevant
randomized controlled trials (RCTs) were selected based on the inclusion
and exclusion criteria. Data extraction and methodological quality
assessment were performed according to a predesigned data extraction form
and scoring system, respectively. The interventions were compared on the
basis of the primary outcome like incidence of POD, and secondary outcomes
like duration of delirium and the length of intensive care unit and
hospital stay. Result(s):Sixty-Three RCTs were included in the study,
covering interventions like surgery, anesthesia, analgesics,
intraoperative blood glucose control, cholinesterase inhibitors,
anticonvulsant drugs, antipsychotic drugs, sleep rhythmic regulation, and
multi-modal nursing. The occurrence of POD was low in 4 trials that
monitored the depth of anesthesia with bispectral index during the
operation (P<.0001). Two studies showed that supplementary analgesia was
useful for delirium prevention (P=.002). Seventeen studies showed that
perioperative sedation with alpha2-Adrenergic receptor agonists
prevented POD (P=.0006). Six studies showed that both typical and atypical
antipsychotic drugs can reduce the incidence of POD (P=.002). Multimodal
nursing during the perioperative period effectively reduced POD in 6
studies (P<.00001). Furthermore, these preventive measures can reduce the
duration of delirium, as well as the total and postoperative length of
hospitalized stay for non-cardiac surgery patients. For patients
undergoing cardiac surgery, effective prevention can only reduce the
length of intensive care unit stay. Conclusion(s):Measures including
intraoperative monitoring of bispectral index, supplemental analgesia,
alpha2-Adrenergic receptor agonists, antipsychotic drugs, and
multimodal care are helpful to prevent POD effectively. However, larger,
high-quality RCTs are needed to verify these findings and develop more
interventions and drugs for preventing postoperative
delirium. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<14>
Accession Number
2019735819
Title
Risk Factors for Postrepair Elevated Mitral Gradient: A Post-hoc Analysis
of a Randomized Trial.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Hibino M.; Pandey A.K.; Chan V.; Mazer C.D.; Rumman R.; Dhingra N.K.;
Bonneau C.; Verma R.; Yokoyama Y.; Quan A.; Teoh H.; Cheema A.; de
Varennes B.E.; Yanagawa B.; Leong-Poi H.; Connelly K.A.; Bisleri G.; Verma
S.
Institution
(Hibino) Division of Cardiac Surgery, University Hospitals Cleveland
Medical Center, Case Western Reserve University, Cleveland, Ohio, United
States
(Hibino, Dhingra, Quan, Teoh, Yanagawa, Bisleri, Verma) Division of
Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael's Hospital,
Toronto, ON, Canada
(Hibino, Yanagawa, Bisleri, Verma) Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Chan) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Chan) School of Epidemiology, Public Health and Preventive Medicine,
University of Ottawa, Ottawa, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute of St
Michael's Hospital, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Mazer, Connelly) Department of Physiology, University of Toronto,
Toronto, ON, Canada
(Rumman, Leong-Poi, Connelly) Division of Cardiology, Li Ka Shing
Knowledge Institute of St Michael's Hospital, Toronto, ON, Canada
(Bonneau) Division of Cardiac Surgery, McGill University, Montreal, QC,
Canada
(Verma) Royal College of Surgeons in Ireland, Dublin, Ireland
(Yokoyama) Department of Surgery, St Luke's University Health Network,
Bethlehem, Pennsylvania, United States
(Teoh) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute of St Michael's Hospital, Toronto, ON, Canada
(Cheema) Division of Cardiology, Southlake Regional Health Centre,
Newmarket, ON, Canada
(de Varennes) Division of Cardiac Surgery, Royal Victoria Hospital, McGill
University Health Center, Montreal, QC, Canada
(Leong-Poi, Connelly) Department of Medicine, University of Toronto,
Toronto, ON, Canada
(Verma) Department of Pharmacology and Toxicology, University of Toronto,
Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Predischarge elevated mean mitral gradients (>5 mm Hg) may
occur after repair for degenerative mitral regurgitation. We sought to
identify risk factors associated with elevated gradients and to evaluate
its impact on functional outcomes at 12 months in this subanalysis of the
Canadian Mitral Research Alliance CardioLink-2 trial. Method(s): One
hundred four patients with degenerative mitral regurgitation undergoing
mitral repair were randomized to either a leaflet resection or
preservation strategy. Logistic regression was used to identify risk
factors associated with an elevated gradient. Functional outcomes at 12
months were compared between participants with and without elevated
gradients. Result(s): Elevated gradients was identified in 15
participants (14.4%), which was not significantly different based on
allocation to each repair strategy (P =.10). Patients with elevated
gradients were more likely to be women (odds ratio [OR], 4.28; 95%
confidence interval [CI], 1.29-14.19; P =.02) and to have a lower
preoperative hemoglobin level (OR, 0.93; 95% CI, 0.89-0.98; P =.01) and
smaller intercommissural diameter (OR, 0.86; 95% CI, 0.76-0.97; P =.02)
and mitral annuloplasty size (OR, 0.71; 95% CI, 0.57-0.87; P =.001). The
ratio of intercommissural diameter-to-annuloplasty size was similar
between those with and without elevated gradients (both 0.8 +/- 0.1, P
=.69). At 12 months those with elevated gradients had a worse New York
Heart Association functional status (P =.0001), lower peak oxygen
saturation in exercise test (P =.01), smaller body weight-walk distance
product (P =.02), and higher Borg scale (P =.01) in the 6-minute walk
test. Conclusion(s): Female gender, smaller mitral anatomy sizes, and
lower preoperative hemoglobin levels were associated with postoperative
elevated mitral gradients, which was in turn were associated with reduced
functional status. Further research is warranted to investigate these
potential risk factors. Copyright © 2022 The Society of Thoracic
Surgeons

<15>
Accession Number
2019735493
Title
Geographic disparity in 10-year mortality after coronary artery
revascularization in the SYNTAXES trial.
Source
International Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Kageyama S.; Serruys P.W.; Garg S.; Ninomiya K.; Masuda S.; Kotoku N.;
Colombo A.; Mack M.J.; Banning A.P.; Morice M.-C.; Witkowski A.; Curzen
N.; Burzotta F.; James S.; van Geuns R.-J.; Davierwala P.M.; Holmes D.R.;
Wood D.A.; McEvoy J.W.; Onuma Y.
Institution
(Kageyama, Serruys, Ninomiya, Masuda, Kotoku, McEvoy, Onuma) Department of
Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
(Serruys, Wood) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Colombo) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele-Milan, Italy
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, Dallas, TX, United States
(Banning) Department of Cardiology, John Radcliffe Hospital, Oxford
University Hospitals, Oxford, United Kingdom
(Morice) Departement of Cardiologie, Hopital prive Jacques Cartier,
Generale de Sante Massy, France
(Witkowski) Department of Interventional Cardiology and Angiology,
National Institute of Cardiology, Warsaw, Poland
(Curzen) Faculty of Medicine, University of Southampton, Southampton, &
Cardiothoracic Unit, University Hospital Southampton NHS Trust,
Southampton, United Kingdom
(Burzotta) Institute of Cardiology, Fondazione Policlinico Universitario
A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy
(James) Department of Medical Sciences, Uppsala University, Sweden
(van Geuns) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Davierwala) Department of Surgery, University of Toronto, Toronto, Canada
Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto
General Hospital, Canada
(Davierwala) University Health Network, Toronto, ON, Canada
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Wood, McEvoy) National Institute of Prevention and Cardiovascular Health,
National University of Ireland, Galway, Ireland
(Colombo) Humanitas Clinical and Research Center IRCCS, Rozzano-Milan,
Italy
Publisher
Elsevier Ireland Ltd
Abstract
Aims: To investigate geographic disparity in long-term mortality following
revascularization in patients with complex coronary artery disease (CAD).
 Methods and Results: The SYNTAXES trial randomized 1800 patients with
three-vessel and/or left main CAD to percutaneous coronary intervention
(PCI) or coronary artery bypass grafting (CABG) and assessed their
survival at 10 years. Patients were stratified according to the region of
recruitment: North America (N-A, n = 245), Eastern Europe (E-E, n = 189),
Northern Europe (N-E, n = 425), Southern Europe (S-E, n = 263), and
Western Europe (W-E, n = 678), which also served as the reference group.
Compared to W-E, patients were younger in E-E (62 vs 65 years, p < 0.001),
and less frequently male in N-A (65.3% vs 79.6%, p < 0.001). Diabetes
(16.0% vs 25.4%, p < 0.001) and peripheral vascular disease (6.8% vs
10.9%, p = 0.025) were less frequent in N-E than W-E. Ejection fraction
was highest in W-E (62% vs 56%, p < 0.001). Compared to W-E, the mean
anatomic SYNTAX score was higher in S-E (29 vs 31, p = 0.008) and lower in
N-A (26, p < 0.001). Crude ten-year mortality was similar in N-A (31.6%),
and W-E (30.7%), and significantly lower in E-E (22.5%, p = 0.041), N-E
(21.9%, p = 0.003) and S-E (22.0%, p = 0.014). Compared to W-E, adjusted
mortality in N-E (HR 0.85, p = 0.019) and S-E (HR 0.72, p = 0.043) remain
significantly lower after adjustment for pre- and peri-procedural factors,
but no significant interaction (P<inf>interaction</inf> = 0.728) between
region and modality of revascularization was seen. Conclusion(s): In
the era of globalization, knowledge, and understanding of geographic
disparity are of paramount importance for the correct interpretation of
global studies. Copyright © 2022 Elsevier B.V.

<16>
Accession Number
2019734952
Title
A Comparative Study of Bilateral Erector Spinae Block Versus Intravenous
Dexmedetomidine for Perioperative Pain Management in Patients Undergoing
Off-Pump Coronary Artery Bypass Grafting - A Single-Blind Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Kodali V.R.K.; Shree S.; Prasad M.; Sambandam K.K.G.; Karthekeyan R.B.;
Vakamudi M.
Institution
(Kodali, Vakamudi) Department of Anaesthesiology, Sri Ramachandra
Institute of Higher Education and Research (SRIHER), Chennai, India
(Shree, Prasad, Sambandam, Karthekeyan) Department of Cardiac
Anaesthesiology, Sri Ramachandra Institute of Higher Education and
Research (SRIHER), Chennai, India
Publisher
W.B. Saunders
Abstract
Objective: Regional analgesia, along with general anesthesia, reduce
postoperative pain. In this study, the authors compared the erector spinae
plane (ESP) block having dexmedetomidine as an adjuvant with conventional
pain management along with intravenous dexmedetomidine. Design(s):
Prospective randomized single-blinded trial. Setting(s): Tertiary
care teaching hospital. Participant(s): All of the patients scheduled
for elective off-pump coronary artery bypass grafting with an ejection
fraction of >45%. Intervention(s): After obtaining institutional
ethical committee approval, 130 patients were randomized into Group E and
Group D. Group E patients received ESP block bilaterally with 25 mL of
bupivacaine plus 0.5 mug/kg of dexmedetomidine. The patients in Group D
received conventional intravenous analgesia, as well as a 0.7 mug/kg of
dexmedetomidine bolus, followed by a 0.3 mug/kg dexmedetomidine infusion
during surgery and continued postoperatively for 24 hours. Group E
patients received 8 mL/h of bupivacaine infusion bilaterally for 24 hours.
Measurements: The primary outcome assessed was pain scores in the
postoperative period. The secondary outcomes assessed were postoperative
rescue analgesic consumption, time to first rescue analgesia,
intraoperative fentanyl consumption, duration of mechanical ventilation,
and duration of intensive care unit (ICU) stay. Result(s): Both
groups were comparable in demographic characteristics. The postoperative
pain scores from 4 hours to 12 hours were lower in Group E compared with
Group D. The pain scores at 24 hours were not significantly different
between groups. Postoperative fentanyl consumption in Group E (99.23 +/-
50.19 mug) was significantly lower than in Group D (181.15 +/- 82.92 mug),
with a p value of 0.001. Time to first rescue analgesia was significantly
longer in Group E, with a median score of 8 hours when compared with that
of 4 hours in Group D, with a p value of 0.01. Intraoperative fentanyl
consumption was significantly lower in Group E (392.15 +/- 55.36 mug)
compared with Group D (604.00 +/- 131.87 mug; p = 0.001). There were no
significant differences in the duration of mechanical ventilation in both
groups. Duration of ICU stay was significantly lower in Group E (51.95 +/-
8.54 hours) when compared with Group D (59.06 +/- 8.68 hours) (p = 0.001).
 Conclusion(s): Erector spinae fascial plane blocks appeared to reduce
postoperative pain scores in off-pump coronary artery bypass graft
patients. Furthermore, ESP block was beneficial in terms of less
intraoperative and postoperative opioid consumption, longer time to first
rescue analgesia, and shorter ICU stay. Copyright © 2022 Elsevier
Inc.

<17>
Accession Number
2019734786
Title
Selection of vascular closure devices in transcatheter aortic valve
replacement: Systematic review and network meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Sakata T.; Kuno T.; Fujisaki T.; Yokoyama Y.; Misumida N.; Sugiura T.;
Latib A.
Institution
(Sakata) Cardiovascular Research Institute, Icahn School of Medicine at
Mount Sinai, New York, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York, United States
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, New York, United States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
PA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, United States
(Sugiura) Department of Cardiothoracic & Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, New York, United
States
Publisher
Elsevier Inc.
Abstract
Various vascular closure devices (VCDs) are commonly used for percutaneous
transcatheter aortic valve replacement (TAVR). However, superiority and
safety profile among them remain unclear. We compared periprocedural
complications among various VCDs in patients undergoing TAVR. PubMed and
EMBASE were searched through January 2022 to identify clinical studies
comparing any 2 VCDs of Prostar, Proglide and MANTA in patients who
underwent TAVR. Studies using surgical cut-down or alternative access
other than transfemoral approach were excluded. We analyzed the odds
ratios (ORs) of vascular complications (VC), bleeding, acute kidney injury
and all-cause mortality using a network meta-analysis. All outcomes were
defined by Valve Academic Research Consortium 2 criteria. Two randomized
controlled trials and 15 observational studies were identified, yielding a
total of 11,344 patients including Prostar (n = 4499), Proglide (n =
5705), or MANTA group (n = 1140). The rates of major VC and
life-threatening and major bleeding were significantly lower in Proglide
compared to Prostar (OR [95 % CI] = 0.54 [0.32-0.89], 0.68 [0.52-0.90],
and 0.49 [0.26-0.95], respectively). There was no significant difference
in major VC and bleeding between Proglide and MANTA groups. Proglide was
associated with a lower rate of acute kidney injury (0.56 [0.34-0.92]) and
red blood cell transfusion (0.39 [0.16-0.98]) compared to Prostar. There
was no significant difference in additional interventions and 30-day
overall mortality among three groups. In this network meta-analysis of VCD
in patients undergoing TAVR, MANTA and Proglide had comparable outcomes
while Proglide appears superior to Prostar in terms of major VC and
bleeding. Copyright © 2022 Elsevier Inc.

<18>
Accession Number
2018645278
Title
Anti-factor X activity levels with continuous intravenous infusion and
subcutaneous administration of enoxaparin after coronary artery bypass
grafting: A randomized clinical trial.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 2022.
Author
Parviainen M.K.; Vahtera A.; Anas N.; Tahtinen J.; Huhtala H.; Kuitunen
A.; Jarvela K.
Institution
(Parviainen, Jarvela) Tampere University Heart Hospital Tampere, Tampere,
Finland
(Vahtera, Anas, Tahtinen, Kuitunen) Tampere University Hospital, Tampere,
Finland
(Huhtala) Faculty of Social Sciences, Tampere University, Tampere, Finland
(Kuitunen) Faculty of Medicine and Health Sciences, Tampere University,
Tampere, Finland
(Jarvela) Finnish Cardiovascular Research Center Tampere, Tampere
University, Tampere, Finland
Publisher
John Wiley and Sons Inc
Abstract
Background: Low-molecular-weight heparin enoxaparin is widely used in
pharmacological thromboprophylaxis after coronary artery bypass grafting
(CABG). The aim of this study was to compare anti-factor X activity
(anti-Xa) levels when the thromboprophylactic dose of enoxaparin was
provided after CABG, with two different administration routes: continuous
intravenous infusion (CIV) and subcutaneous bolus (SCB) injection. We
hypothesized that the current standard method of SCB administration might
lead to lower anti-Xa levels than recommended in other patient groups, due
to reduced bioavailability. Method(s): In this prospective,
randomized, controlled clinical trial, 40 patients scheduled for elective
CABG were randomized to receive 40 mg of enoxaparin per day either as CIV
or SCB for 72 h. Enoxaparin was initiated 6-10 h after CABG. Anti-Xa
levels were measured 12-14 times during the study period. The primary
outcome, that is, the maximum anti-Xa concentration over 0-24 h
(C<inf>max0-24h</inf>), was calculated from these measured values.
Secondary outcomes were C<inf>max25-72h</inf> and the trough concentration
of anti-Xa after 72 h of enoxaparin initiation (C<inf>72h</inf>).
 Result(s): Twenty patients were randomized to the CIV-group and 19 to
the SCB-group. The median anti-Xa C<inf>max0-24h</inf> was significantly
lower in the CIV-group than in the SCB-group: 0.15 [interquartile range
(IQR) 0.13-0.19] IU/ml versus 0.25 (IQR 0.18-0.32) IU/ml, p <.005. The
median anti-Xa C<inf>max25-72h</inf> was 0.12 (IQR, 0.1-0.17) IU/ml versus
0.23 (IQR 0.19-0.31) IU/ml, respectively, p <.005. At 72 h, there was no
difference between the groups in their anti-Xa levels. Conclusion(s):
In this low-risk CABG patient population, SCB administration of a
thromboprophylactic dose of enoxaparin provided anti-Xa levels that are
considered sufficient for thromboprophylaxis in other patient groups. CIV
administration resulted in lower anti-Xa levels compared to the SCB
route. Copyright © 2022 Acta Anaesthesiologica Scandinavica
Foundation.

<19>
Accession Number
2018448898
Title
Preoperative hypoalbuminemia in patients undergoing cardiac surgery: a
meta-analysis.
Source
Surgery Today. (no pagination), 2022. Date of Publication: 2022.
Author
Xu R.; Hao M.; Zhou W.; Liu M.; Wei Y.; Xu J.; Zhang W.
Institution
(Xu, Hao, Zhou, Liu, Wei, Xu, Zhang) Department of Cardio-Thoracic
Surgery, The Second Affiliated Hospital of Nanchang University, 1 Minde
Road, Nanchang 330006, China
(Xu, Hao, Zhou, Liu) Jiangxi Medical College, Nanchang University,
Nanchang 330006, China
Publisher
Springer
Abstract
The preoperative serum albumin level has been shown to be associated with
adverse postoperative complications, meaning that hypoalbuminemia may also
be a risk factor. We performed a meta-analysis to evaluate the association
of serum albumin levels with survival and complication rates after cardiac
surgery. Relevant articles were identified through seven databases. Twenty
studies with 22553 patients (hypoalbuminemia group, n = 9903; normal
group, n = 12650) who underwent cardiac surgery met the inclusion criteria
after screening. The primary outcomes were that hypoalbuminemia was
significantly correlated with serious long-term all-cause mortality
(hazard ratio [HR]: 1.95 [1.54-2.48]; P < 0.00001) and increased mortality
(risk ratio [RR] = 1.91 [1.61-2.27], P < 0.00001). Hypoalbuminemic
patients with cardiopathy were more likely to suffer postoperative
complications (bleeding, infections, renal injury, and others) than those
whose serum albumin levels were normal. Furthermore, hypoalbuminemia
increased the time in the intensive-care unit (ICU) (mean difference [MD]
= 1.18 [0.49-1.87], P = 0.0008), length of hospital stay (LOS) (MD = 3.34,
95% CI: 1.88-4.80, P < 0.00001), and cardiopulmonary bypass time (CPB) (MD
= 12.40 [1.13-23.66], P = 0.03). Hypoalbuminemia in patients undergoing
cardiac surgery appears to have a poor all-cause mortality or increased
risk of complications. Adjusted perioperative serum albumin levels and
treatment strategies for this high-risk population have the potential to
improve the survival. Copyright © 2022, The Author(s) under
exclusive licence to Springer Nature Singapore Pte Ltd.

<20>
Accession Number
638727177
Title
Ventilatory Muscle Training for Early Cardiac Rehabilitation Improved
Functional Capacity and Modulated Vascular Function of Individuals
Undergoing Coronary Artery Bypass Grafting: Pilot Randomized Clinical
Trial.
Source
International journal of environmental research and public health. 19(15)
(no pagination), 2022. Date of Publication: 30 Jul 2022.
Author
Eibel B.; Marques J.R.; Dipp T.; Waclawovsky G.; Marschner R.A.; Boll
L.C.; Kalil R.A.K.; Lehnen A.M.; Sales A.R.K.; Irigoyen M.C.C.
Institution
(Eibel, Marques, Waclawovsky, Boll, Kalil, Lehnen, Irigoyen) Instituto de
Cardiologia/Fundacao, Universitaria de Cardiologia (IC/FUC), RS, Porto
Alegre 90040-371, Brazil
(Dipp) Programa de Pos-Graduacao em Saude Coletiva, Universidade do Vale
do Rio dos Sinos (UNISINOS), RS, Sao Leopoldo 93022-750, Brazil
(Marschner) Hospital de Clinicas de Porto Alegre (HCPA), Universidade
Federal do Rio Grande do Sul (UFRGS), RS, Porto Alegre 90035-903, Brazil
(Kalil) Department of Surgery, Universidade Federal de Ciencias da Saude
de Porto Alegre (UFCSPA), RS, Porto Alegre 90050-170, Brazil
(Sales) Institute DOR for Research and Education (IDOR), Sao Paulo
04501-000, Brazil
(Sales, Irigoyen) Instituto do Coracao (InCor), Universidade de Sao Paulo
(USP), Sao Paulo 05403-000, Brazil
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac rehabilitation with aerobic exercises is the first
strategy for nonpharmacological treatment in the postoperative period of
individuals undergoing coronary artery bypass grafting (CABG) to improve
functional capacity and vascular health. However, other exercise
modalities remain uncertain regarding the same benefits.
 OBJECTIVE(S): Evaluation of the effect of different modalities of
exercise, such as early cardiac rehabilitation on subjects submitted to
CABG in the six-minute walk test (6-MWT) and on the percentage of
flow-mediated dilatation (FMD) of the brachial artery. METHOD(S): A
randomized clinical trial in which 15 patients (62.7 +/- 6.7 years) who
underwent CABG were randomly assigned to the following groups: isometric
(IG, Handgrip Jamar), ventilatory muscle training (VG, PowerBreathe) and
control (CG, conventional respiratory and motor physiotherapy). All
patients were attended to physically twice a day (20 min/session) for a
consecutive week after the CABG (hospital admission). Functional capacity
was assessed by 6-MWT and endothelial function was assessed through the
technique of FMD, before and after (~7 days) admission to CABG. The
doppler ultrasound videos were analyzed by Cardiovascular Suite software
(Quipu, Pisa, Italy) to measure %FMD. STATISTICS: Generalized estimation
equation, followed by Bonferroni post hoc (p < 0.05). RESULT(S):
Systolic, diastolic and mean arterial pressure (SBP/DBP/MAP, respectively)
were 133, 76 and 95 mmHg. The groups presented walking meters (m) distance
before and after intervention of: IGbasal 357.80 +/- 47.15 m vs. IGpost
306.20 +/- 61.63 m, p = 0.401 (+51 m); VGbasal 261.50 +/- 19.91 m vs.
VGpost 300.75 +/- 26.29 m, p = 0.052 (+39 m); CG basal 487.83 +/- 83.23 m
vs. CGpost 318.00 +/- 31.08, p = 0.006 (-169 m). %FMD before and after
intervention was IGbasal 10.4 +/- 4.8% vs. IGpost 2.8 +/- 2.5%, p = 0.152;
VGbasal 9.8 +/- 5.1% vs. VGpost 11.0 +/- 6.1%, p = 0.825; CGbasal 9.2 +/-
15.8% vs. CGpost 2.7 +/- 2.6%, p = 0.710 and resting mean basal blood flow
was IGbasal 162.0 +/- 55.0 mL/min vs. IGpost 129.9 +/- 63.7 mL/min, p =
0.662; VGbasal 83.74 +/- 12.4 mL/min vs. VGpost 58.7 +/- 17.1 mL/min, p =
0.041; CGbasal 375.6 +/- 183.7 mL/min vs. CGpost 192.8 +/- 115.0 mL/min, p
= 0.459. CONCLUSION(S): Ventilatory muscle training for early cardiac
rehabilitation improved acute functional capacity and modulated mean flow
of individuals undergoing CABG.

<21>
Accession Number
2017681659
Title
Impact of pretransplant recipient body mass index on post heart transplant
mortality: A systematic review and meta-analysis.
Source
Clinical Transplantation. 32(8) (no pagination), 2018. Article Number:
e13348. Date of Publication: 2018.
Author
Foroutan F.; Doumouras B.S.; Ross H.; Alba A.C.
Institution
(Foroutan, Doumouras, Ross, Alba) Heart Failure/Transplant Program,
Toronto General Hospital, University Health Network, Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
The ISHLT's 2016 Guidelines on the selection of heart transplant (HT)
candidates recommends weight loss prior to listing for persons with body
mass (BMI) index greater than 35 kg/m2. We conducted a
systematic review to assess the impact of BMI on all-cause mortality. We
searched to identify eligible observational studies that followed HT
recipients. We used the GRADE system to quantify absolute effects and
quality of evidence, and meta-analyzed survival curves to assess
post-transplant mortality across BMI categories. We found a significantly
increased risk of mortality in patients with BMI > 30 kg/m2
across all age categories, independently of transplant era and study
source (BMI 30-34.9: HR 1.10, 95% CI 1.04-1.17; BMI >= 35: HR 1.24, 95% CI
1.12-1.38). We also found an increased risk of death in underweight (BMI <
18.5 kg/m2) candidates over 39 years of age (Age 40-65: HR
1.24, 95% CI 1.02-1.53; Age > 65: HR 1.70, 95% 1.13-2.57). We found
obesity and underweight BMI to be associated with mortality post-HT. The
similar and overlapping increased risk of mortality in patients with BMI
30-34.9 and BMI >= 35 does not support the recently updated ISHLT
guidelines. Future evidence in the form of randomized controlled trials is
required to assess effectiveness of interventions targeting
obesity-related comorbidities and weight management. Copyright ©
2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

<22>
Accession Number
2017709683
Title
A trial of nebulised heparin to limit lung injury following cardiac
surgery.
Source
Anaesthesia and Intensive Care. 44(1) (pp 28-33), 2016. Date of
Publication: January 2016.
Author
Dixon B.; Smith R.; Santamaria J.D.; Orford N.R.; Wakefield B.J.; Ives K.;
McKenzie R.; Zhang B.; Yap C.H.
Institution
(Dixon, Smith, Santamaria) Department of Critical Care, St.Vincent's
Hospital, Melbourne, VIC, Australia
(Orford, Wakefield, Ives, McKenzie) Department of Critical Care, Barwon
Health University Hospital, Geelong, VIC, Australia
(Zhang) Department of Cardiothoracic Surgery, Barwon Health University
Hospital, Geelong, VIC, Australia
(Yap) University Hospital Geelong, Australia
(Yap) Department of Epidemiology and Preventive Medicine, Monash
University, Australia
(Yap) School of Medicine, Deakin University, Melbourne, VIC, Australia
Publisher
SAGE Publications Inc.
Abstract
Cardiac surgery with cardiopulmonary bypass triggers an acute inflammatory
response in the lungs. This response gives rise to fibrin deposition in
the microvasculature and alveoli of the lungs. Fibrin deposition in the
microvasculature increases alveolar dead space, while fibrin deposition in
alveoli causes shunting. We investigated whether prophylactic nebulised
heparin could limit this form of lung injury. We undertook a single-centre
double-blind randomised trial. Forty patients undergoing elective cardiac
surgery with cardiopulmonary bypass were randomised to prophylactic
nebulised heparin (50,000 U) or placebo. The primary endpoint was the
change in arterial oxygen levels over the operative period. Secondary
endpoints included end-tidal CO<inf>2</inf>, the alveolar dead space
fraction and bleeding complications. We found nebulised heparin did not
improve arterial oxygen levels. Nebulised heparin was, however, associated
with a lower alveolar dead space fraction (P <0.05) and lower tidal
volumes at the end of surgery (P <0.01). Nebulised heparin was not
associated with bleeding complications. In conclusion, prophylactic
nebulised heparin did not improve oxygenation, but was associated with
evidence of better alveolar perfusion and CO<inf>2</inf> elimination at
the end of surgery. Copyright © 2016, Anaesth Intensive Care. All
rights reserved.

<23>
Accession Number
638733412
Title
Outcomes of dexmedetomidine versus propofol sedation in critically ill
adults requiring mechanical ventilation: a systematic review and
meta-analysis of randomised controlled trials.
Source
British journal of anaesthesia. (no pagination), 2022. Date of
Publication: 09 Aug 2022.
Author
Heybati K.; Zhou F.; Ali S.; Deng J.; Mohananey D.; Villablanca P.;
Ramakrishna H.
Institution
(Heybati) Mayo Clinic Alix School of Medicine, Mayo Clinic - Rochester,
Rochester, MN, United States
(Zhou) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Ali) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada; Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Deng) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Mohananey) Department of Cardiology, Medical College of Wisconsin,
Milwaukee, WI, United States
(Villablanca) Department of Cardiology, Henry Ford Hospital, Detroit, MI,
United States
(Ramakrishna) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic - Rochester, Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Guidelines have recommended the use of dexmedetomidine or
propofol for sedation after cardiac surgery, and propofol monotherapy for
other patients. Further outcome data are required for these drugs.
 METHOD(S): This systematic review and meta-analysis was prospectively
registered on PROSPERO. The primary outcome was ICU length of stay.
Secondary outcomes included duration of mechanical ventilation, ICU
delirium, all-cause mortality, and haemodynamic effects. Intensive care
patients were analysed separately as cardiac surgical, medical/noncardiac
surgical, those with sepsis, and patients in neurocritical care. Subgroup
analyses based on age and dosage were conducted. RESULT(S): Forty-one
trials (N=3948) were included. Dexmedetomidine did not significantly
affect ICU length of stay across any ICU patient subtype when compared
with propofol, but it reduced the duration of mechanical ventilation (mean
difference -0.67 h; 95% confidence interval: -1.31 to -0.03 h; P=0.041;
low certainty) and the risk of ICU delirium (risk ratio 0.49; 95%
confidence interval: 0.29-0.87; P=0.019; high certainty) across cardiac
surgical patients. Dexmedetomidine was also associated with a greater risk
of bradycardia across a variety of ICU patients. Subgroup analyses
revealed that age might affect the incidence of haemodynamic side-effects
and mortality among cardiac surgical and medical/other surgical patients.
 CONCLUSION(S): Dexmedetomidine did not significantly impact ICU
length of stay compared with propofol, but it significantly reduced the
duration of mechanical ventilation and the risk of delirium in cardiac
surgical patients. It also significantly increased the risk of bradycardia
across ICU patient subsets. Copyright © 2022 British Journal of
Anaesthesia. Published by Elsevier Ltd. All rights reserved.

<24>
Accession Number
638733240
Title
Outcomes of myocardial revascularization in diabetic patients with left
main coronary artery disease: A multicenter observational study from three
gulf countries.
Source
Cardiovascular revascularization medicine : including molecular
interventions. (no pagination), 2022. Date of Publication: 06 Aug 2022.
Author
Daoulah A.; Elfarnawany A.; Al Garni T.; Hersi A.S.; Alshehri M.;
Almahmeed W.; Yousif N.; Abuelatta R.; Alasmari A.; Elsheikh-Mohamed N.E.;
Alzahrani B.; Ghani M.A.; Amin H.; Hashmani S.; Hiremath N.; Alshali K.Z.;
Elmahrouk Y.; Kazim H.M.; Refaat W.; Selim E.; Jamjoom A.; Feteih M.N.;
El-Sayed O.; Al-Faifi S.M.; Dahdouh Z.; Aithal J.; Ibrahim A.M.; Elganady
A.; Qutub M.A.; Alama M.N.; Abohasan A.; Hassan T.; Balghith M.; Hussien
A.F.; Abdulhabeeb I.A.M.; Ahmad O.; Ramadan M.; Alqahtani A.H.; Abumelha
B.K.; Qenawi W.; Shawky A.; Ghonim A.A.; Elmahrouk A.; Alhamid S.;
Maghrabi M.; Haddara M.M.; Aljohar A.; Hurley W.T.; Alshahrani S.S.; Lotfi
A.
Institution
(Daoulah, Elfarnawany, Alasmari, Elsheikh-Mohamed, Jamjoom, El-Sayed)
Department of Cardiovascular Medicine, King Faisal Specialist Hospital &
Research Center, Jeddah, Saudi Arabia
(Al Garni, Alzahrani) Department of Cardiology, Prince Sultan Cardiac
Center, Riyadh, Saudi Arabia
(Hersi, Aljohar) Department of Cardiac Sciences, King Fahad Cardiac
Center, King Saud University, Riyadh, Saudi Arabia
(Alshehri, Qenawi, Shawky) Department of Cardiology, Prince Khaled Bin
Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
(Almahmeed, Hashmani, Hiremath) Heart & Vascular Institute, Cleveland
Clinic Abu Dhabi, United Arab Emirates
(Yousif, Amin) Department of Cardiology, Mohammed Bin Khalifa Specialist
Cardiac Center, Bahrain
(Abuelatta, Ghani) Department of Cardiology, Madinah Cardiac Center, Saudi
Arabia
(Alshali) Department of Medicine, Faculty of Medicine, King Abdulaziz
University, Jeddah, Saudi Arabia
(Elmahrouk) Faculty of Medicine, Tanta University, Egypt
(Kazim, Selim, Maghrabi) Department of Cardiology, Alhada Armed Forces
Hospital, Saudi Arabia
(Refaat, Ramadan) Department of Cardiology, Prince Sultan Cardiac Center,
Al Hassa, Saudi Arabia
(Feteih, Al-Faifi) Department of Medicine, King Faisal Specialist Hospital
& Research Center, Jeddah, Saudi Arabia
(Dahdouh, Ahmad) Department of Cardiovascular Medicine, King Faisal
Specialist Hospital & Research Center, Riyadh, Saudi Arabia
(Aithal) Department of Cardiology, Khalifa City A, Abu Dhabi, United Arab
Emirates
(Ibrahim) Department of Cardiology, Saudi German Hospital, Jeddah, Saudi
Arabia
(Elganady) Department of Cardiology, Dr Erfan and Bagedo General Hospital,
Jeddah, Saudi Arabia
(Qutub, Alama, Ghonim) Cardiology Center of Excellence, Department of
Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
(Abohasan) Department of Cardiology, Prince Sultan Cardiac Center, Saudi
Arabia
(Hassan) Department of Cardiology, Bugshan General Hospital, Jeddah, Saudi
Arabia
(Balghith) King Abdulaziz Cardiac Center, College of Medicine, King Saud
Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
(Hussien) Department of Cardiology, International Medical Center, Jeddah,
Saudi Arabia
(Abdulhabeeb) Department of Cardiology, King Abdulaziz Specialist
Hospital, Al Jawf, Saudi Arabia
(Alqahtani) Department of Emergency Medicine, King Abdulaziz Medical City,
Riyadh, Saudi Arabia
(Abumelha) Department of Family Medicine, King Abdulaziz Medical City,
National Guard Hospital, Riyadh, Saudi Arabia
(Elmahrouk) Department of Cardiovascular Medicine, King Faisal Specialist
Hospital & Research Center, Jeddah, Saudi Arabia; Department of
Cardiothoracic Surgery, Tanta University, Tanta, Egypt
(Alhamid) Department of Emergency Medicine, King Fahad Medical City,
Riyadh, Saudi Arabia
(Haddara) Department of Anesthesia, King Faisal Specialist Hospital &
Research Center, Riyadh, Saudi Arabia
(Hurley) Department of Emergency Medicine, Cleveland Clinic Foundation,
Cleveland OH 44195, United States
(Alshahrani) Department of Emergency Medicine, King Faisal Specialist
Hospital & Research Center, Riyadh, Saudi Arabia
(Lotfi) Department of Cardiovascular Medicine, Baystate Medical Center,
Tufts University School of Medicine, Springfield, MA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Real-world data for managing patients with diabetes and left
main coronary artery (LMCA) disease are scarce. We compared percutaneous
coronary intervention (PCI) outcomes versus coronary artery bypass
grafting (CABG) in diabetes and LMCA disease patients. METHOD(S): We
retrospectively studied patients with LMCA presented to 14 centers from
2015 to 2019. The study included 2138 patients with unprotected LMCA
disease; 1468 (68.7 %) had diabetes. Patients were grouped into; diabetes
with PCI (n = 804) or CABG (n = 664) and non-diabetes with PCI (n = 418)
or CABG (n = 252). RESULT(S): In diabetes, cardiac (34 (5.1 %) vs. 22
(2.7 %); P = 0.016), non-cardiac (13 (2 %) vs. 6 (0.7 %); P = 0.027) and
total hospital mortality (47 (7.1 %) vs. 28 (3.5 %); P = 0.0019),
myocardial infarction (45 (6.8 %) vs. 11 (1.4 %); P = 0.001),
cerebrovascular events (25 (3.8 %) vs. 12 (1.5 %); P = 0.005) and minor
bleeding (65 (9.8 %) vs. 50 (6.2 %); P = 0.006) were significantly higher
in CABG patients compared to PCI; respectively. The median follow-up time
was 20 (10-37) months. In diabetes, total mortality was higher in CABG (P
= 0.001) while congestive heart failure was higher in PCI (P = 0.001).
There were no differences in major adverse cerebrovascular events and
target lesion revascularization between PCI and CABG. Predictors of
mortality in diabetes were high anatomical SYNTAX, peripheral arterial
disease, chronic kidney disease, and cardiogenic shock.
 CONCLUSION(S): In this multicenter retrospective study, we found no
significant difference in clinical outcomes during the short-term
follow-up between PCI with second-generation DES and CABG except for lower
total mortality and a higher rate of congestive heart failure in PCI group
of patients. Randomized trials to characterize patients who could benefit
from each treatment option are needed. Copyright © 2022 Elsevier
Inc. All rights reserved.

<25>
Accession Number
638726328
Title
15-year outcomes of the JOCRI study (JOCRIED study): a randomised
comparison of off-pump and on-pump multiple arterial coronary
revascularisation.
Source
General thoracic and cardiovascular surgery. (no pagination), 2022. Date
of Publication: 11 Aug 2022.
Author
Tadokoro N.; Fukushima S.; Minami K.; Shimahara Y.; Kawamoto N.; Kakuta
T.; Numata S.; Yaku H.; Takemura H.; Iino K.; Ochi M.; Ishii Y.; Wada H.;
Minematsu N.; Shimizu H.; Kobayashi J.; Fujita T.
Institution
(Tadokoro, Fukushima, Shimahara, Kawamoto, Kakuta, Kobayashi, Fujita)
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular
Center, Suita, Osaka, Japan
(Tadokoro, Shimizu) Department of Cardiovascular Surgery, Keio University
School of Medicine, Shinjuku-ku, Tokyo, Japan
(Minami) Department of Surgical Intensive Care, National Cerebral and
Cardiovascular Center, Suita, Osaka, Japan
(Numata, Yaku) Division of Cardiovascular Surgery, Kyoto Prefectural
University of Medicine, Kyoto, Japan
(Takemura, Iino) Department of Thoracic, Cardiovascular and General
Surgery, Kanazawa University, Takara-machi, Kanazawa, Japan
(Ochi, Ishii) Department of Cardiovascular Surgery, Nippon Medical School,
Bunkyo-Ku, Tokyo, Japan
(Wada, Minematsu) Department of Cardiovascular Surgery, Fukuoka
University, Fukuoka, Japan
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The Japanese Off-Pump Coronary Revascularization Investigation
(JOCRI) study reported a non-significant difference in early outcomes and
graft patency between off-pump coronary artery bypass grafting and on-pump
coronary artery bypass grafting in 2005. The JOCRIED study aimed to review
the long-term outcomes of the JOCRI study participants. METHOD AND
RESULTS: The JOCRIED study enrolled 123 of the JOCRI study participants
completing the clinical follow-up between August 2018 and August 2020; 61
patients in the off-pump group and 62 patients in the on-pump group. The
follow-up period was 13.8+/-2.8 years. The groups were compared regarding
mortality, the incidence of major adverse cardiac and cerebrovascular
events and repeat revascularisation. The 15-year cumulative survival rate
(off-pump vs on-pump, respectively; 77.7% vs 75.3%; p=0.85), major adverse
events-free survival rate (62.5% vs 55.6%; p=0.27) and repeat
revascularisation-free rate (84.8% vs 78.0%; p=0.16) were not
significantly different between the two groups. Revascularisation was the
most common major adverse events in the JOCRIED participants. Although
percutaneous coronary intervention was performed in 8 patients (13%) in
the off-pump group and in 14 patients (23%) in the on-pump group (p=0.23),
no patients underwent redo coronary artery bypass grafting.
 CONCLUSION(S): Off-pump coronary artery bypass grafting provides
comparable 15-year outcomes to on-pump coronary artery bypass
grafting. Copyright © 2022. The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery.

<26>
Accession Number
638725967
Title
Potential Effects of Icosapent Ethyl on Cardiovascular Outcomes in
Cigarette Smokers: REDUCE-IT Smoking.
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2022. Date of Publication: 11 Aug 2022.
Author
Miller M.; Bhatt D.L.; Steg P.G.; Brinton E.A.; Jacobson T.A.; Jiao L.;
Tardif J.-C.; Ballantyne C.M.; Budoff M.; Mason R.P.
Institution
(Miller) Corporal Michael J Crescenz Veterans Affairs Medical Center &
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Bhatt, Mason) Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Steg) ParisFrance
(Brinton) Utah Lipid Center, Salt Lake City, UT, United States
(Jacobson) Emory University School of Medicine, Atlanta, GA, United States
(Jiao) Amarin Pharma, Inc, Bridgewater, NJ, United States
(Tardif) Montreal Heart Institute, Montreal, Canada
(Ballantyne) Baylor College of Medicine, Houston, TX, United States
(Budoff) University of California Los Angeles, Los Angeles, CA, United
States
Publisher
NLM (Medline)
Abstract
AIMS: Cigarette smoking is among the most well-established risk factors
for adverse cardiovascular outcomes. We sought to determine whether
icosapent ethyl (IPE), a highly purified form of eicosapentaenoic acid
with anti-atherothrombotic properties, may reduce the excessive risk of
cardiovascular disease (CVD) attributable to smoking. METHODS AND RESULTS:
REDUCE-IT was a multinational, double-blind trial that randomized 8179
statin-treated patients with elevated triglycerides and CV risk to IPE or
placebo, with a median follow-up period of 4.9 years. IPE reduced the
primary composite endpoint (CV death, nonfatal myocardial infarction [MI],
nonfatal stroke, coronary revascularization, or hospitalization for
unstable angina) by 25% (P<0.0001). In the current analyses, the effect of
IPE was evaluated in REDUCE-IT using post hoc analyses based upon smoking
history. Groups were classified as current smokers (n = 1241), former
smokers (n = 3672) and never smokers (n = 3264). Compared with placebo,
IPE use in combined current and former smokers (n = 4913) was associated
with significant reductions in time to the primary composite endpoint
(hazard ratio, 0.77 [95% CI, 0.68-0.87]; P<0.0001) and in total events
(rate ratio, 0.71 [95% CI, 0.61-0.82]; P<0.0001). These benefits remained
significant when subdivided into current and former smokers (P = 0.04, P =
0.005), with reductions in the key secondary composite endpoint (P<0.0001)
and in the individual components of CV death or nonfatal MI (P = 0.04, P =
0.01) and fatal or nonfatal MI (P = 0.009, P = 0.01), respectively.
Benefits were consistent and significant in nonsmokers as well. Overall,
there were similar estimated rates of first occurrences of primary CVD
endpoints in current smokers (23.8%) and former smokers (23.0%) assigned
to IPE compared with never smokers on placebo (25.7%). CONCLUSION(S):
In REDUCE-IT, IPE treatment was associated with reduced risk of CV events
in current and former smokers to levels observed in never smokers. While
smoking cessation should always be recommended, these data raise the
possibility that IPE treatment may attenuate CV hazards attributable to
smoking. Copyright © The Author(s) 2022. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<27>
Accession Number
638725470
Title
Nonpharmacological Cognitive Impairment Prevention Interventions in Older
Adults Undergoing Cardiac Surgery: A Systematic Review.
Source
The Journal of cardiovascular nursing. (no pagination), 2022. Date of
Publication: 05 Aug 2022.
Author
Mulkey M.A.; Smith A.B.; Wion R.K.; House S.L.; Wierenga K.L.
Publisher
NLM (Medline)
Abstract
BACKGROUND: More than 1 million individuals undergo cardiothoracic surgery
for coronary artery bypass graft or valve repair/replacement annually in
the United States. There is an increased risk of developing serious
cognitive impairment post cardiothoracic surgery. Pharmacological
interventions and surgical techniques were associated with improvements in
cognitive function in previous systematic reviews. However, a gap in the
literature exists regarding how nonpharmacological interventions can
mitigate cognitive impairment in adults undergoing cardiac surgery.
 OBJECTIVE(S): The aim of this study was to explore the effectiveness
of nonpharmacological interventions to reduce the detrimental effects of
cardiac surgery on cognitive function in patients after cardiothoracic
surgery. METHOD(S): CINAHL, MEDLINE, PubMed, EMBASE, PsycINFO, and
Web of Science databases were searched following the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses guidelines from January
2011 to February 2022. RESULT(S): Nineteen studies were included in
this review. Researchers defined cognitive impairment differently across
studies. Various interventions were used to reduce cognitive impairment
post cardiothoracic surgery, with the most common being remote ischemic
limb conditioning. The interventions used to reduce cognitive impairment
were heterogeneous in outcomes, measurements, and time of assessment, but
only 2 interventions were associated with a reduction in cognitive
impairment. CONCLUSION(S): This review is a unique synthesis of the
quality of interventions that address broader components of cognition.
Researchers used various interventions to reduce cognitive impairment; the
outcomes, instruments, and time interval for measurements were
heterogeneous. Researchers should conduct future studies at multiple time
intervals, using a comprehensive measure of cognitive impairment to better
understand the impact of cognitive impairment interventions
postoperatively. Copyright © 2022 Wolters Kluwer Health, Inc. All
rights reserved.

<28>
Accession Number
638725447
Title
Left ventricular assist device implantation via lateral thoracotomy: A
systematic review and meta-analysis.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2022. Date of Publication: 11 Jul 2022.
Author
Ribeiro R.V.P.; Lee J.; Elbatarny M.; Friedrich J.O.; Singh S.; Yau T.;
Yanagawa B.
Institution
(Ribeiro, Lee, Elbatarny, Yanagawa) Division of Cardiovascular Surgery,
St. Michael's Hospital, Toronto, ON, Canada
(Friedrich) Critical Care and Medicine Departments and Li Ka Shing
Knowledge Institute, St. Michael's Hospital, Department of Medicine and
Interdepartmental Division of Critical Care, University of Toronto,
Toronto, ON, Canada
(Singh) Division of Cardiac Surgery, Trillium Health Partners, Toronto,
ON, Canada
(Yau) Division of Cardiac Surgery, Toronto General Hospital, Toronto, ON,
Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Left ventricular assist device (LVAD) implantation via lateral
thoracotomy can offer similar effectiveness to conventional approaches
with less perioperative adverse events. We performed a systematic review
and meta-analysis to determine the potential benefits of lateral
thoracotomy (LT) for LVAD implantation compared to median sternotomy.
 METHOD(S): We searched MEDLINE and Embase databases for studies
comparing continuous-flow LVAD implantation using LT with conventional
sternotomy. Main outcomes were perioperative mortality and complications.
 RESULT(S): Twenty-five observational studies enrolling 3072 patients
were included with a median follow-up of 10 months. Perioperative
mortality (30 day or in-hospital) was 7% (LT) and 14% (sternotomy);
however, mortality differences were no longer statistically significant in
matched/adjusted studies (RR:0.86; 95%CI:0.52-1.44; p = 0.58). LT was
associated with decreased need for blood product transfusions (mean
difference[MD]: -4.7; 95%CI: -7.2 to -2.3 units; p < 0.001), reoperation
for bleeding (RR:0.34; 95%CI:0.22-0.54; p < 0.001), postoperative RVAD
implantation (RR:0.53; 95%CI:0.36-0.77; p < 0.001), days requiring
inotropes (MD: -1.1; 95%CI: -2.1 to -0.03 inotrope days; p = 0.04), ICU
(MD: -3.3; 95%CI: -6.0 to -0.7 ICU days; p = 0.01), and hospital length of
stay (MD: -5.1; 95%CI: -10.1 to -0.1 hospital days; p = 0.04) in
matched/adjusted studies. Overall mortality during follow-up was
significantly lower for LT in unmatched/unadjusted studies but not
statistically significantly lower in matched/adjusted studies (Hazard
Ratio:0.82; 95%CI:0.59-1.14; p = 0.24). CONCLUSION(S): LVAD
implantation via LT was associated with significantly decreased need for
blood products, reoperation for bleeding, and postoperative RVAD
implantation. Furthermore, days on inotropic support were also lower,
likely contributing to the shorter length of stay. These findings support
greater use of a LT approach for carefully selected
patients. Copyright © 2022 International Society for Heart and
Lung Transplantation. Published by Elsevier Inc. All rights reserved.

<29>
Accession Number
638718162
Title
Efficacy of non-pharmacological interventions in pain relief and opioid
consumption after cardiac surgery: A systematic review and Bayesian
network meta-analysis.
Source
Journal of clinical nursing. (no pagination), 2022. Date of Publication:
10 Aug 2022.
Author
Liu M.; Ni R.; Huang S.; Yang X.; Lin Q.; Lin P.; Yang J.
Institution
(Liu, Ni, Huang, Yang, Yang) Department of Pharmacy, Fujian Medical
University Union Hospital, Fuzhou, China
(Liu, Ni, Huang, Yang, Yang) College of Pharmacy, Fujian Medical
University, Fuzhou, China
(Lin) Department of Nursing, Fujian Medical University Union Hospital,
Fuzhou, China
(Lin) Department of Anesthesiology, Fujian Medical University Union
Hospital, Fuzhou, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To investigate and rank the evidence for the efficacy of
non-pharmacological interventions in relieving pain after cardiac surgery
using comprehensive comparisons. BACKGROUND: Although several previous
systematic reviews and meta-analyses showed that non-pharmacological
interventions effectively control and reduce pain after cardiac surgery,
none quantitatively compared the effect of these different types of
interventions. DESIGN: Systematic review and Bayesian network
meta-analysis based on the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses for Network Meta-Analysis guidelines.
 METHOD(S): Six databases were searched from inception to April 2021
to collect all published evidence from randomised clinical trials. One
author extracted the relevant information from the eligible trials; a
second author independently reviewed the data. Before analysing the
extracted data, two investigators independently assessed the quality of
the included studies. Conventional meta-analysis was conducted using
either fixed- or random-effects models according to statistical
heterogeneity. The Bayesian network meta-analysis was conducted using the
consistency model. RESULT(S): We identified 42 randomised clinical
trials comparing 14 groups with 4253 patients. Transcutaneous electrical
nerve stimulation, acupressure, music and massage were effective for pain
relief, with transcutaneous electrical nerve stimulation being associated
with the best probability of successful pain relief after cardiac surgery
(cumulative ranking curve surface, 0.97; probability, 77.03%). Acupressure
(cumulative ranking curve surface, 0.79; probability, 30.69%) was the
second-best option. However, there was no evidence that any pair-up
intervention significantly reduced opioid use or anxiety.
 CONCLUSION(S): These findings suggest that transcutaneous electrical
nerve stimulation, acupressure, music and massage may effectively
alleviate postoperative cardiac pain, with transcutaneous electrical nerve
stimulation representing the best choice for pain relief. RELEVANCE TO
CLINICAL PRACTICE: The results of this network meta-analysis can guide
patients after cardiac surgery and healthcare providers to make optimal
decisions in managing postoperative cardiac pain. TRIAL REGISTRATION:
PROSPERO CRD42021246183. Copyright © 2022 John Wiley & Sons Ltd.

<30>
Accession Number
638717413
Title
Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve
Replacement in Low-risk Patients: A Meta-Analysis Based on a 2-Year
Follow-Up.
Source
Anatolian journal of cardiology. (no pagination), 2022. Date of
Publication: 11 Aug 2022.
Author
Chen C.-G.; Xi B.-B.; Deng Q.-F.; Zhang X.-Y.; Lin W.-C.; Chen L.-W.; Qiu
Z.-H.
Institution
(Chen, Xi, Deng, Zhang, Lin, Chen, Qiu) Department of Cardiovascular
Surgery, Union Hospital, Fujian Medical University, Fujian, China; Key
Laboratory of Cardio-Thoracic Surgery Fujian Medical University, Fujian
Province University, Fujian, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Previous studies have shown that transcatheter aortic valve
implantation is the best alternative therapy to surgical aortic valve
replacement in high-risk surgical patients with aortic stenosis. However,
it is not clear whether transcatheter aortic valve implantation can be
utilized in low-risk surgical patients with aortic stenosis. This
studyaimed to evaluate the safety and efficacy of transcatheter aortic
valve implantation in low-risk patients. METHOD(S): From the outset
of our initiative until April 2022, PubMed, EMBASE, and the Cochrane
database were thoroughly searched, yielding the selection of 3 randomized
controlled trials including 2644 patients with aortic stenosis, to assess
outcome measures at distinct follow-up time. RESULT(S): The mean
Society of Thoracic Surgeons Predicted Risk of Mortality score of patients
was 2.2. At the 30-day and 1-year follow-up, transcatheter aortic valve
implan- tation was associated with a lower incidence of all-cause
mortality, cardiovascular mor- tality, acute kidney injury (stage 2 or 3),
life-threatening or significant bleeding, and new atrial fibrillation but
an increased risk of permanent pacemaker implantation. At the 2-year
follow-up, transcatheter aortic valve implantation only had an advantage
in new atrial fibrillation (relative risk, 0.27; 95% CI, 0.14-0.51; P <
.0001), with no significant differ- ence in all-cause mortality or
cardiovascular mortality. CONCLUSION(S): For low-risk surgical
patients with aortic stenosis, compared to surgical aortic valve
replacement, transcatheter aortic valve implantation was associated with
lower all-cause mortality at 30-day follow-up and lower cardiovascular
mortality at 1-year follow-up. Except for the advantages in new atrial
fibrillation, transcatheter aor- tic valve implantation had no significant
impact on mortality at 2-year follow-up.

<31>
Accession Number
2019554088
Title
Impact of Continuous Positive Airway Pressure on Postoperative Atrial
Fibrillation in Patients with Obstructive Sleep Apnea Undergoing Coronary
Artery Bypass Graft Surgery: An Exploratory Randomized Multicenter Study.
Source
American Journal of Respiratory and Critical Care Medicine. 206(3) (pp
358-360), 2022. Date of Publication: 01 Aug 2022.
Author
Chalegre S.T.; Barros M.M.; Silva B.P.G.; Furlan S.F.; Giampa S.Q.C.;
Marques J.N.; Albuquerque A.L.T.; Monteiro V.S.; Drager L.F.; Pedrosa R.P.
Institution
(Chalegre, Barros, Silva, Albuquerque, Pedrosa) University of Pernambuco,
Recife, Brazil
(Furlan, Giampa, Drager) Universidade de Sao Paulo, Sao Paulo, Brazil
(Marques, Monteiro) Instituto de Medicina Integral Professor Fernando
Figueira, Recife, Brazil
Publisher
American Thoracic Society

<32>
Accession Number
2017897059
Title
Comparison between surgery and fibrinolytic therapy in prosthetic valve
thrombosis: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(9) (pp 2776-2785), 2022. Date of
Publication: September 2022.
Author
Sadeghi R.; Ahmadzadeh K.; Sarveazad A.; Haji Aghajani M.; Forouzannia
S.A.; Yarahmadi P.
Institution
(Sadeghi, Haji Aghajani) Department of Cardiology, Prevention of
Cardiovascular Disease Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Ahmadzadeh) Department of Physiology, Physiology Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sarveazad) Department of Gastroenterology, Colorectal Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sarveazad) Deparment of Anatomy, Nursing Care Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Forouzannia) Department of Medicine, School of Medicine, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Yarahmadi) Department of Medicine, Faculty of Medicine, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Prosthetic valve thrombosis (PVT) is a rare but
life-threatening complication. Surgery and fibrinolytic therapy (FT) are
the two main treatment options for PVT. The choice between surgery and FT
has always been a matter of debate. Previous studies have shown that
although the mortality rate is higher in surgery, complications are less
frequent than in FT. We aimed to perform a systematic review and
meta-analysis to compare the results of surgery and FT in PVT.
 Method(s): A systematic review of the literature was performed
through Medline, Embase, Scopus, and Web of Science, encompassing all
studies comparing surgery and FT in PVT. The rate of each complication and
risk ratio (RR) of complications in surgery and FT were assessed using
random-effects models. Result(s): Fifteen studies with 1235 patients
were included in the meta-analysis. The pooled risk of the mortality was
not significantly different between FT and surgery in patients with PVT
(pooled RR = 0.78, 95% confidence interval [CI]: 0.38-1.60, I2 = 61.4%).
The pooled risks of thromboembolic events (pooled RR = 4.70, 95% CI:
1.83-12.07, I2 = 49.6%) and major bleeding (pooled RR = 2.45, 95% CI:
1.09-5.50, I2 = 41.1%) and PVT recurrence (pooled RR = 2.06 95% CI:
1.29-3.27, I2 = 0.0%) were significantly higher in patients who received
FT. Conclusion(s): Surgery may be safer and with fewer complications
than FT for PVT treatment. However, randomized clinical trials are needed
to determine the proper treatment for PVT. Copyright © 2022 Wiley
Periodicals LLC.

<33>
Accession Number
2017617684
Title
Prognostic Significance of Elevated Troponin in Adult Heart Transplant
Recipients: A Systematic Review and Meta-Analysis.
Source
Experimental and Clinical Transplantation. 20(7) (pp 633-641), 2022. Date
of Publication: 2022.
Author
Liu Z.; Perry L.A.; Penny-Dimri J.C.; Handscombe M.; Overmars I.; Plummer
M.; Segal R.; Smith J.A.
Institution
(Liu, Perry, Handscombe, Segal) Department of Anaesthesia, Royal Melbourne
Hospital, Parkville, Australia
(Penny-Dimri, Smith) Department of Surgery, School of Clinical Sciences at
Monash Health, Monash University, Clayton, Australia
(Overmars) Infection and Immunity Theme, Murdoch Children's Research
Institute, Parkville, Australia
(Plummer) Department of Intensive Care Medicine, Royal Melbourne Hospital,
Parkville, Australia
(Plummer, Segal) Department of Critical Care, University of Melbourne,
Parkville, Australia
Publisher
Baskent University
Abstract
Objectives: Cardiac troponin is a highly specific biomarker of myocardial
injury that is of prognostic significance in a range of cardiovascular
diseases. However, the prognostic value of elevated troponin in cardiac
transplant recipients is uncertain. We aimed to evaluate the prognostic
value of elevated cardiac troponin in predicting adverse recipient
outcomes following heart transplant. Material(s) and Method(s): We
searched MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library from
inception until December 2020 and included studies reporting associations
between elevated recipient troponin and outcomes after cardiac transplant.
We generated summary odds ratios for associations with short-and long-term
adverse events and used descriptive analyses where meta-analyses were
inappropriate. Result(s): We included 15 studies involving 1830
patients undergoing cardiac transplant. The risk of primary graft failure
was greater in recipients with elevated troponin than in those without
(odds ratio = 3.09; 95% CI, 1.08-8.87). Considerable interstudy
heterogeneity (I2 statistic 98%) was partially explained by variations in
study design, troponin subtype, and overall risk of bias. Descriptive
analyses suggested associations between elevated recipient troponin and
long-term adverse cardiac events, coronary artery disease, and mortality.
 Conclusion(s): Elevated cardiac troponin in cardiac transplant
recipients may be prognostic for primary graft failure, adverse cardiac
events, coronary artery disease, and mortality. Further high-quality,
prospective, and multicenter research is needed to demonstrate the
clinical applicability of these findings. Copyright © Baskent
University 2022.

<34>
Accession Number
2017593878
Title
Mortality and morbidity of surgical and transcatheter mitral valve repair
in octogenarians: A systematic review.
Source
Journal of Cardiac Surgery. 37(9) (pp 2752-2760), 2022. Date of
Publication: September 2022.
Author
Watkins A.R.; Fialka N.; EL-Andari R.; Kang J.J.H.; Bozso S.J.; Moon M.C.;
Nagendran J.
Institution
(Watkins, Fialka, EL-Andari) Faculty of Medicine and Dentistry, University
of Alberta, Edmonton, AB, Canada
(Kang, Bozso, Moon, Nagendran, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Valvular heart disease (VHD) is a prominent problem in
healthcare today with mitral regurgitation (MR) being the leading cause of
VHD in the elderly population. While mitral valve repair (MVr) surgery is
one of the only options for the end-stage disease, octogenarians are often
denied MVr due to concerns with operative mortality and postoperative
morbidity. To provide information on this underrepresented group of
surgical patients, a systematic approach was taken to review the mortality
and morbidity rates of octogenarians who received MVr. Method(s):
Pubmed and Medline were searched for articles containing outcomes of
octogenarians receiving surgical mitral valve repair (SMVr) or
transcatheter mitral valve repair (TMVr) published after 2000. Ten
articles met the inclusion criteria for a total of 7968 patients included
in the analysis using Microsoft Excel, Version 2105. Result(s):
Short-term mortality rates for SMVr and TMVr were 2.6% and 1.4% for
in-hospital, and 7.8% and 3.3% for 30 days, respectively. The average
incidence of stroke, acute kidney injury, infection, and major bleeding
for SMVr were 3.2%, 11.2%, 7.7%, and 24%, respectively, and 0.3%, 6.7%,
2.7%, and 7.9% for TMVr, respectively. Conclusion(s): Octogenarians
receiving SMVr or TMVr experienced similar rates of short-term mortality
and morbidity as younger populations, and when considering life
expectancy, midterm mortality was also similar. With these results,
denying octogenarians MVr operations based on age alone should be
reconsidered. Depending on risk factors and comorbidities, either SMVr or
TMVr is a viable and relatively safe option for octogenarians with severe
MR. Copyright © 2022 Wiley Periodicals LLC.

<35>
Accession Number
2016782484
Title
The Effect of Low-Dose Dexmedetomidine on Pain and Inflammation in
Patients Undergoing Laparoscopic Hysterectomy.
Source
Journal of Clinical Medicine. 11(10) (no pagination), 2022. Article
Number: 2802. Date of Publication: May-2 2022.
Author
Lee J.; Hwang H.W.; Jeong J.-Y.; Kim Y.M.; Park C.; Kim J.Y.
Institution
(Lee, Hwang, Park) Department of Anesthesiology and Pain Medicine, CHA
Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam
13496, South Korea
(Lee) Department of Medical Sciences, Graduate School of Ajou University,
164 World Cup-ro, Yeongtong-gu, Suwon 16499, South Korea
(Jeong) CHA Future Medical Research Institute, CHA Bundang Medical Center,
CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, South Korea
(Kim) Department of Obstetrics and Gynecology, CHA Bundang Medical Center,
CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Ajou University
School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon 16499, South
Korea
Publisher
MDPI
Abstract
Dexmedetomidine has sedative, sympatholytic, analgesic, and
anti-inflammatory effects. We investigated the effects of intraoperative
dexmedetomidine infusion without a loading dose in the prevention of pain
and inflammation after laparoscopic hysterectomy. In this study, 100
patients undergoing laparoscopic hysterectomy under desflurane anesthesia
were randomized to receive either 0.9% saline or dexmedetomidine (0.4
microg/kg/h) after induction to trocar removal. The primary endpoints were
postoperative pain and inflammatory response presented by the level of
tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-10, and
C-reactive protein (CRP). The secondary endpoints were hemodynamics during
the anesthesia and surgery and postoperative nausea and vomiting.
Postoperative pain was decreased in the dexmedetomidine group for every
time point, and post-anesthesia care unit (PACU) rescue fentanyl doses
were decreased in the dexmedetomidine group. The inflammatory response
representing TNF-alpha, IL-6, IL-10, and CRP were similar across the two
groups. Postoperative nausea and vomiting from PACU discharge to 24 h
post-surgery were reduced in the dexmedetomidine group. During anesthesia
and surgery, the patient's heart rate was maintained lower in the
dexmedetomidine-receiving group. Dexmedetomidine of 0.4 microg/kg/h given
as an intraoperative infusion significantly reduced postoperative pain but
did not reduce the inflammatory responses in patients undergoing
laparoscopic hysterectomy. Copyright © 2022 by the authors.
Licensee MDPI, Basel, Switzerland.

<36>
Accession Number
2014495140
Title
Feasibility and effectiveness of prone position ventilation technique for
postoperative acute lung injury in infants with congenital heart disease:
study protocol for a prospective randomized study.
Source
Trials. 22(1) (no pagination), 2021. Article Number: 929. Date of
Publication: December 2021.
Author
Xu Y.-L.; Mi Y.-P.; Zhu M.-X.; Ren Y.-H.; Gong W.-J.; Fu W.-J.; Wang
H.-M.; Ye L.; Wang Y.; Zhou X.-Y.; Chen Y.; Chen Y.-Y.; Gu L.-Q.; Gu Y.;
Jia B.; Hu J.; Hu X.-J.
Institution
(Xu, Mi, Zhu, Ren, Gong, Fu, Wang, Ye, Wang, Zhou, Chen, Chen, Gu, Gu,
Jia, Hu, Hu) Children's Hospital of Fudan University, 399 Wanyuan Road,
Minhang District, Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: Prone position ventilation is a widely used lung protection
ventilation strategy. The strategy is more convenient to implement in
children compared to adults. Due to the precise mechanism of improving
oxygenation function, development of pediatric prone ventilation
technology has been largely focused on children with acute respiratory
distress syndrome. There is a paucity of high-quality studies
investigating the effects of prone position ventilation after pediatric
cardiac surgery. The purpose of this study is to evaluate the feasibility
and effectiveness of prone position ventilation in infants who develop
postoperative acute lung injury after surgery for congenital heart
disease. Method(s): A single-center, randomized controlled trial of
pediatric patients with acute lung injury after surgery for congenital
heart disease who will receive prone position ventilation or usual care
(control group). A total of 68 children will be enrolled according to the
inclusion criteria. The main outcome measures will be lung compliance and
oxygenation index. The secondary outcomes will be duration of mechanical
ventilation, length of stay in cardiac intensive care unit, reintubation
rate, and complication rate. Discussion(s): This study will
investigate the feasibility and effectiveness of prone position
ventilation techniques in children who develop postoperative acute lung
injury after surgery for congenital heart disease. The results may help
inform strategies to improve airway management after surgery for
congenital heart disease. Trial registration: ClinicalTrials.gov
NCT04607993. Initially registered on 29 October 2020. Copyright ©
2021, The Author(s).

<37>
Accession Number
2014495104
Title
Albumin and fibrinogen kinetics in sepsis: a prospective observational
study.
Source
Critical Care. 25(1) (no pagination), 2021. Article Number: 436. Date of
Publication: December 2021.
Author
Omiya K.; Sato H.; Sato T.; Wykes L.; Hong M.; Hatzakorzian R.; Kristof
A.S.; Schricker T.
Institution
(Omiya, Sato, Sato, Hatzakorzian, Schricker) Department of Anesthesia,
McGill University Health Centre Glen Site, Royal Victoria Hospital, 1001
boulevard Decarie, C05-2000, Montreal, QC H4A 3J1, Canada
(Wykes, Hong) School of Human Nutrition, McGill University, Montreal, QC,
Canada
(Hatzakorzian) Department of Critical Care Medicine, McGill University
Health Centre Glen Site, Royal Victoria Hospital, Montreal, QC, Canada
(Kristof) Departments of Critical Care and Medicine, Meakins-Christie
Laboratories and Translational Research in Respiratory Diseases Program,
Research Institute of the McGill University Health Centre, Montreal, QC,
Canada
Publisher
BioMed Central Ltd
Abstract
Background: The measurement of circulating substrate concentrations does
not provide information about substrate kinetics. It, therefore, remains
unclear if a decrease in plasma concentration of albumin, as seen during
critical illness, is a consequence of suppressed production in the liver
or increased peripheral clearance. In this study, using stable isotope
tracer infusions, we measured albumin and fibrinogen kinetics in septic
patients and in a control group of non-septic subjects. Method(s):
With the approval from the institutional Research Ethics Board and after
obtaining written informed consent from patients or their substitute
decision maker, mechanically ventilated patients with sepsis and patients
scheduled for elective coronary artery bypass grafting were enrolled.
Patients in the non-sepsis group were studied on the day before surgery.
The stable isotope L-[ring-2H<inf>5</inf>]phenylalanine was
used to measure absolute synthesis rates (ASR) of albumin and fibrinogen.
A priming dose of L-[ring-2H<inf>5</inf>]phenylalanine (4
micromol/kg) was given followed by a six-hour infusion at a rate of 0.15
micromol/kg/min. At baseline and hourly thereafter, blood was drawn to
measure isotope enrichments by gas chromatography/mass spectrometry. Very
low density lipoprotein apolipoprotein-B 100 isotopic enrichment was used
to represent the isotopic enrichment of the phenylalanine precursor pool
from which the liver synthesizes proteins. Plasma albumin and fibrinogen
concentrations were also measured. Result(s): Mean plasma albumin in
septic patients was decreased when compared to non-septic patients, while
synthesis rates were comparable. Mean plasma fibrinogen and ASR in septic
patients was increased when compared to non-septic patients. In non-septic
patients, no statistically significant correlation between plasma albumin
and ASR was observed but plasma fibrinogen significantly correlated with
ASR. In septic patients, plasma albumin and fibrinogen significantly
correlated with ASR. Conclusion(s): While septic patients showed
lower plasma albumin levels than non-septic patients, albumin synthesis
was similar in the two groups suggesting that hypoalbuminemia during
sepsis was not caused by suppressed hepatic production but a result of
enhanced clearance from the circulation. Hyperfibrinogenemia in septic
patients was a consequence of increased fibrinogen production. Trial
registration: ClinicalTrials.gov: NCT02865408 (registered on August 12,
2016) and ClinicalTrials.gov: NCT02549443 (registered on September 15,
2015). Copyright © 2021, The Author(s).

<38>
[Use Link to view the full text]
Accession Number
638032859
Title
Statin and Postcardiac Surgery Atrial Fibrillation Prevention: A
Systematic Review and Meta-Analysis.
Source
Journal of cardiovascular pharmacology. 80(2) (pp 180-186), 2022. Date of
Publication: 01 Aug 2022.
Author
Oliveri F.; Bongiorno A.; Compagnoni S.; Fasolino A.; Gentile F.R.; Pepe
A.; Tua L.
Institution
(Oliveri) Department of Molecular Medicine, University of Pavia, Pavia,
Italy
Publisher
NLM (Medline)
Abstract
ABSTRACT: Postoperative atrial fibrillation (POAF) is a frequently
reported postcardiac surgery complication leading to increased in-hospital
and long-term mortality rates. Many randomized controlled trials (RCTs)
have recently suggested using statins to protect against POAF. Therefore,
we performed a systematic literature search and meta-analysis in
electronic databases for eligible studies published between January 2006
and January 2022. The principal inclusion criteria were as follows: RCTs'
study design, statin-naive patients, total study participants >=50 units,
and statin pretreatment started no more than 21 days before cardiac
surgery. In the primary analysis, statin pretreatment reduced the
incidence of POAF compared with placebo. Analyzing different molecules,
atorvastatin was associated with lower incidence of POAF but rosuvastatin
was not. We therefore performed a sensitivity analysis excluding RCTs
affected by important risk of biases. Thus, studies whose participants
were >=199 were those eligible for the secondary analysis. No
statistically significant difference between statin pretreatment and
placebo (OR 0.87; 95% CI: 0.71-1.07, P = 0.18) as well as for atorvastatin
(OR 0.88; 95% CI: 0.61-1.28; P = 0.48; I 2 = 84%) and rosuvastatin (OR
0.87; 95% CI: 0.68-1.12, P = 0.29) was observed. To conclude, statin
pretreatment before cardiac surgery is not associated with a significant
reduction in POAF occurrence. Copyright © 2022 Wolters Kluwer
Health, Inc. All rights reserved.

<39>
Accession Number
637675912
Title
Edoxaban Versus Dual Antiplatelet Therapy for Leaflet Thrombosis and
Cerebral Thromboembolism After TAVR: The ADAPT-TAVR Randomized Clinical
Trial.
Source
Circulation. 146(6) (pp 466-479), 2022. Date of Publication: 09 Aug 2022.
Author
Park D.-W.; Ahn J.-M.; Kang D.-Y.; Kim K.W.; Koo H.J.; Yang D.H.; Jung
S.C.; Kim B.; Wong Y.T.A.; Lam C.C.S.; Yin W.-H.; Wei J.; Lee Y.-T.; Kao
H.-L.; Lin M.-S.; Ko T.-Y.; Kim W.-J.; Kang S.H.; Yun S.-C.; Lee S.-A.; Ko
E.; Park H.; Kim D.-H.; Kang J.-W.; Lee J.-H.; Park S.-J.
Institution
(Park, Ahn, Kang, Lee, Ko, Kim, Park) Division of Cardiology (D.-W.P.,
J.-M.A., D.-Y.K., S.-A.L., E.K., D.-H.K., S.-J.P.), Asan Medical Center,
University of Ulsan College of Medicine, Seoul, Korea
(Kim) Clinical Trial Center, Asan Institute for Life Sciences, Asan
Medical Center, Seoul, South Korea
(Koo, Yang, Jung, Kang) Department of Radiology Research Institute of
Radiology (H.J.K., Asan Medical Center, University of Ulsan College of
Medicine, Seoul, South Korea
(Kim) Department of Radiology, Anam Hospital, Korea University College of
Medicine, South Korea
(Wong, Lam) Division of Cardiology, Department of Medicine, University of
Hong Kong, Queen Mary Hospital (Y.T.A.W., Hong Kong
(Yin, Wei, Lee) Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
(Republic of China)
(Kao, Lin) Division of Cardiology, Department of Internal Medicine,
National Taiwan University Hospital, Taiwan (Republic of China)
(Ko) Division of Cardiology, Department of Internal Medicine, National
Taiwan University Hospital (T.-Y.K.), Hsin-Chu Branch
(Kim, Kang) Department of Cardiology, CHA Bundang Medical Center,
Seongnam, South Korea
(Yun) Division of Biostatistics (S.-C.Y.), Asan Medical Center, University
of Ulsan College of Medicine, Seoul, South Korea
(Park) Division of Cardiology, GangNeung Asan Hospital (H.P.), University
of Ulsan College of Medicine, South Korea
(Lee) Department of Neurology (J.-H.L.), Asan Medical Center, University
of Ulsan College of Medicine, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: It is unknown whether the direct oral anticoagulant edoxaban
can reduce leaflet thrombosis and the accompanying cerebral thromboembolic
risk after transcatheter aortic valve replacement. In addition, the causal
relationship of subclinical leaflet thrombosis with cerebral
thromboembolism and neurological or neurocognitive dysfunction remains
unclear. METHOD(S): We conducted a multicenter, open-label randomized
trial comparing edoxaban with dual antiplatelet therapy (aspirin plus
clopidogrel) in patients who had undergone successful transcatheter aortic
valve replacement and did not have an indication for anticoagulation. The
primary end point was an incidence of leaflet thrombosis on 4-dimensional
computed tomography at 6 months. Key secondary end points were the number
and volume of new cerebral lesions on brain magnetic resonance imaging and
the serial changes of neurological and neurocognitive function between 6
months and immediately after transcatheter aortic valve replacement.
 RESULT(S): A total of 229 patients were included in the final
intention-to-treat population. There was a trend toward a lower incidence
of leaflet thrombosis in the edoxaban group compared with the dual
antiplatelet therapy group (9.8% versus 18.4%; absolute difference, -8.5%
[95% CI, -17.8% to 0.8%]; P=0.076). The percentage of patients with new
cerebral lesions on brain magnetic resonance imaging (edoxaban versus dual
antiplatelet therapy, 25.0% versus 20.2%; difference, 4.8%; 95% CI, -6.4%
to 16.0%) and median total new lesion number and volume were not different
between the 2 groups. In addition, the percentages of patients with
worsening of neurological and neurocognitive function were not different
between the groups. The incidence of any or major bleeding events was not
different between the 2 groups. We found no significant association
between the presence or extent of leaflet thrombosis with new cerebral
lesions and a change of neurological or neurocognitive function.
 CONCLUSION(S): In patients without an indication for long-term
anticoagulation after successful transcatheter aortic valve replacement,
the incidence of leaflet thrombosis was numerically lower with edoxaban
than with dual antiplatelet therapy, but this was not statistically
significant. The effects on new cerebral thromboembolism and neurological
or neurocognitive function were also not different between the 2 groups.
Because the study was underpowered, the results should be considered
hypothesis generating, highlighting the need for further research.
REGISTRATION: URL: https://www. CLINICALTRIALS: gov. Unique identifier:
NCT03284827.

<40>
Accession Number
638697688
Title
Quantitative angiographic assessment of aortic regurgitation post 11
different types of tavi devices: A multicentre pooled analysis of 2665
valves.
Source
Echocardiography. Conference: CSI Frankfurt 2022. Frankfurt Germany. 39(6)
(pp 865-867), 2022. Date of Publication: June 2022.
Author
Abdelshafy M.; Serruys P.W.; Kim W.-K.; Ruck A.; Wang R.; Tao L.; Elkoumy
A.; Elzomor H.; Garg S.; Onuma Y.; Mylotte D.; Soliman O.
Institution
(Abdelshafy, Serruys, Elkoumy, Elzomor, Onuma, Mylotte, Soliman)
Discipline of Cardiology, Galway University Hospital, Health Service
Executive and CORRIB Core Lab, National University of Ireland Galway
(NUIG), Galway, Ireland
(Abdelshafy) Department of Cardiology, Al-Azhar University, Cairo, Egypt
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Kim) Department of Cardiology, Kerckhoff Heart Centre, Bad Nauheim,
Germany
(Ruck) Department of Cardiology, Karolinska Institute, Stockholm, Sweden
(Wang, Tao, Soliman) Department of Cardiology, Xijing Hospital, Xi'an,
China
(Elkoumy, Elzomor) Islamic Center of Cardiology and Cardiac Surgery,
Al-Azhar University, Cairo, Egypt
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Regurgitation following TAVI impacts all-cause mortality. So
far, no quantitative comparison of regurgitation by the same core lab has
been performed among the various commercially available transcatheter
heart valves (THV). We aimed to compare quantitative angiographic aortic
regurgitation (AR) of 11 different types of THVs. Method(s): This is
a multicentre retrospective corelab pooled analysis of aortograms from
2704 consecutive patients treated with 11 different THV devices. Analysis
was done by quantitative video densitometric aortography (LVOT-AR), which
is an objective, accurate, and reproducible tool for assessment of AR
following TAVR. This method relies on time density changes in contrast
medium after injection in the ascending aorta and its regurgitation (and
subsequent density increase) in the LVOT. The ratio between the areas
under the two time density curves of these regions quantifies the AR in
absolute percentage. The valves evaluated include ACURATE neo2 (Boston
Scientific, Massachusetts, USA) (n = 120), Lotus (n = 546), Myval (Meril
Life Sciences Pvt. Ltd., India) (n = 108), Vita Flow (Micro Port,
Shanghai, China) (n = 105), Evolut PRO (Medtronic, Dublin, Ireland) (n =
95), SAPIEN 3 (Edwards Lifesciences, Irvine, CA, USA) (n = 397), Evolut R
(n = 295), SAPIEN XT (n = 239), ACURATE neo (n = 120), Venus-A (Venus
Medtech Inc., Hangzhou, China) (n = 113) and Core Valve (n = 532).
Stratification of continuous variable regurgitation into categorical
variables was performed according to the following pre-determined
threshold criteria: 1) none/trace regurgitation (LVOT-AR<6%); 2) mild
(6%<= LVOT-AR <=17%); and 3)moderate or severe (LVOT-AR >17%).
 Result(s): The cumulative percentage of LVOT-AR post-TAVI is shown in
Figure 1. The comparison of LVOT-AR after TAVI is shown in Figure 2. The
main results are 1. The addition of anti PVR sealing features to the new
generations ACURATE neo2 THV proved to be effective in reducing the
incidence of significant PVR In comparison with the first-generation
ACURATE neo. 2. Myval, Vita Flow and Venus-A THVs are showing promising
results. 3. Although the incidence of moderate/severe AR has regressed
over time with new generations of THVs, the incidence of mild AR is still
prominent with all THVs still exhibiting mild AR with an incidence ranging
between 30%- and 50% with the exception of the Lotus valve that had an 19%
incidence of mild AR. Conclusion(s): ACURATE neo2 had the lowest
severe/moderate percentage of AR showing significant improvements in
comparison to ACURATE neo. Myval, Vita Flow and Venus-A are promising
options in the THV armamentarium. These results should be confirmed in
prospective randomized, head-to-head comparisons between THVs.

<41>
[Use Link to view the full text]
Accession Number
2019708422
Title
Clinical Implications and Debates on the International Study of
Comparative Health Effectiveness with Medical and Invasive Approaches
Trial.
Source
Cardiology in Review. 30(5) (pp 234-240), 2022. Date of Publication: 01
Sep 2022.
Author
Saito Y.; Nishi T.; Saito K.; Kitahara H.; Kawase Y.; Matsuo H.; Kobayashi
Y.
Institution
(Saito, Nishi, Saito, Kitahara, Kobayashi) Department of Cardiovascular
Medicine, Chiba University, Graduate School of Medicine, 1-8-1 Inohana,
Chuo-ku, Chiba 260-8677, Japan
(Kawase, Matsuo) Department of Cardiovascular Medicine, Gifu Heart Center,
Gifu, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
The International Study of Comparative Health Effectiveness with Medical
and Invasive Approaches (ISCHEMIA) was eagerly awaited study in the field
of ischemic heart disease. Following the presentation and publication of
ISCHEMIA, multiple opinions and viewpoints get complicated. The ongoing
debates have been including the relevance of coronary revascularization,
noninvasive diagnostic methods, and invasive ischemic testing in patients
with stable ischemic heart disease (SIHD). Prior to ISCHEMIA,
observational studies indicated the potential of coronary
revascularization for improving clinical outcomes, while the randomized
Clinical Outcomes Utilizing Revascularization and Aggressive Drug
Evaluation (COURAGE) trial did not support the plausible concept. Although
the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation
(FAME) 2 trial implied the superiority of percutaneous coronary
intervention over medical therapy alone, the clinical relevance of
coronary revascularization to improve outcomes and quality of life has
been questioned. As a consequence, the ISCHEMIA trial did not demonstrate
clear benefits in reducing clinical events but showed antianginal effects
of revascularization. This landmark trial also suggested the difficulties
of noninvasive ischemia testing rather than computed tomography
angiography. Despite the complex results, the ISCHEMIA trial may simplify
the clinical indications of coronary revascularization in patients with
SIHD. Future publications from the ISCHEMIA trial and debates on the
results will sharpen our thinking and understanding. Copyright ©
2022 Lippincott Williams and Wilkins. All rights reserved.

<42>
[Use Link to view the full text]
Accession Number
2019622964
Title
Comparison of rehabilitation outcomes for transcatheter versus surgical
aortic valve replacement as redo procedure in patients with previous
cardiac surgery: Evidence based on 11 observational studies.
Source
Medicine (United States). 100(45) (pp E27657), 2021. Date of Publication:
12 Nov 2021.
Author
Wang G.; Li X.; Zhang Z.; Dong J.
Institution
(Wang, Dong) Rehabilitation Division Treatment Department, Wang Jing
Hospital, China Academy of Chinese Medical Science, Beijing, China
(Li) Department of Vascular Surgery, Wang Jing Hospital, China Academy of
Chinese Medical Science, Beijing, China
(Zhang) Department of Spinal Surgery, Wang Jing Hospital of China, Academy
of Chinese Medical Science, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Currently, the number of severe aortic stenosis (AS) patients
with a history of prior cardiac surgery (PCS) has increased. Both
transcatheter aortic valve replacement (TAVR) and traditional surgical
aortic valve replacement (sAVR) are effective therapy for AS. However, PCS
increases the risk of adverse outcomes in patients undergoing aortic valve
replacement. Thus, this meta-analysis was designed to comparatively
evaluate the impact of PCS on clinical outcomes between TAVR and sAVR.
 Method(s): A systematic search of PubMed, Embase, Cochrane Library,
and Web of Science up to February 1, 2021 was conducted for relevant
studies that comparing TAVR and sAVR for severe AS patients with a history
of PCS. The primary outcome was the non-inferiority of TAVR and sAVR in
mortality. The secondary outcomes were the other clinical outcomes. Two
reviewers assessed trial quality and extracted the data independently. All
statistical analyses were performed using the standard statistical
procedures provided in Review Manager 5.2. Result(s): A total of 11
studies including 8852 patients were identified. The pooled results
indicated that there was no difference in 30-day, and 1-year all-cause
mortality between TAVR and sAVR. No significant difference was also
observed in total follow-up and cardiovascular mortality between TAVR and
sAVR. However, subgroup analysis revealed significantly higher 1-year
all-cause mortality (OR 1.92; 95% CI 1.05-3.52; P = .04) and total
follow-up mortality (OR 2.28; 95% CI 1.09-4.77; P = .03) in TAVR than sAVR
for patients with a history of coronary artery bypass graft, aortic valve
replacement, and mitral valve reconstruction. In addition, TAVR
experienced higher pacemaker implantation than sAVR. However, compared
with sAVR, TAVR experienced shorter length of stay (MD -3.18 days; 95% CI
-4.78 to -1.57 days) and procedural time (MD -172.01 minutes; 95% CI
-251.15 to -92.88) respectively. TAVR also lead to much less bleeding than
sAVR. Conclusion(s): Our analysis shows that TAVR as a redo procedure
was equal to sAVR in mortality for severe AS patients with PCS, especially
coronary artery bypass graft. We agree the advantage of TAVR as a redo
procedure for patients with a history of PCS. Patients receiving TAVR
experienced rapid recovery, shorter operation time and less bleeding,
without increasing short and long term mortality. Copyright ©
2021 the Author(s).

<43>
Accession Number
2019632272
Title
Preliminary Report from a Randomized Controlled Trial Comparing Two Bovine
Pericardial Valves.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2022. Date of
Publication: 2022.
Author
Sohn S.H.; Choi J.W.; Lee J.H.; Kim J.S.; Lim C.; Hwang H.Y.
Institution
(Sohn, Kim, Choi, Hwang) Department of Thoracic and Cardiovascular
Surgery, Seoul National University Hospital, Seoul, South Korea
(Lee, Kim, Lim) Department of Thoracic and Cardiovascular Surgery, Seoul
National University Bundang Hospital, Seongnam, South Korea
Publisher
Georg Thieme Verlag
Abstract
Background A randomized controlled trial was designed to compare 1-year
hemodynamic profiles and clinical outcomes after bioprosthetic aortic
valve replacement (AVR) using a recently introduced (study group) and
world-widely used (control group) bovine pericardial bioprostheses. This
study evaluated early postoperative outcomes as a preliminary analysis.
Methods The primary end point of the trial was the mean pressure gradient
across the aortic valve (AVMPG) at 1 year after surgery. Patients were
screened to enroll 70 patients in each group based on a noninferiority
design. Early postoperative hemodynamic and clinical outcomes were
compared between the two groups. Results There were no differences in
baseline characteristics, including sex and body surface area (1.64 +/-
0.18 vs. 1.65 +/- 0.15 m 2) between the two groups. The AVMPG on early
postoperative echocardiography was 15.2 +/- 4.6 mm Hg and 16.5 +/- 6.2 mm
Hg in the study and control groups, respectively (p = 0.177). Although
AVMPG of the 19 mm prostheses was lower in the study group than in the
control group (17.0 +/- 6.3 mm Hg vs. 22.8 +/- 6.6 mm Hg, p = 0.039),
there were no significant differences in the effective orifice area in all
patients (1.57 +/- 0.41 cm 2 vs. 1.53 +/- 0.34 cm 2, p = 0.568), and each
valve size. The effective orifice area index was also similar between the
two groups in overall (p = 0.352), and in each valve size. There were no
significant differences in clinical outcomes including operative mortality
and postoperative complications between the two groups. Conclusion Early
postoperative hemodynamic and clinical results after AVR using a recently
introduced bovine pericardial valve were comparable with those using the
control valve (NCT03796442) Copyright © 2022 Thieme. All rights
reserved.

<44>
Accession Number
2018480294
Title
Late Infective Endocarditis After Transcatheter Mitral Valve
Reconstruction (MitraClip) :A Case Report and a Review of the Literature.
Source
Angiology. (no pagination), 2022. Date of Publication: 2022.
Author
Chourdakis E.; Koniari I.; Osman N.; Kounis N.; Hahalis G.; Werner N.
Institution
(Chourdakis, Osman, Werner) Krankenhaus der Barmherzigen Bruder, Trier,
Germany
(Koniari) University Hospital of South Manchester, Manchester, United
Kingdom
(Kounis, Hahalis) Patras University Hospital, Patras, Greece
Publisher
SAGE Publications Inc.
Abstract
Percutaneous transcatheter mitral valve reconstruction in edge to edge
fashion is a well-established option in inoperable or high peri-operative
risk patients with severe, symptomatic mitral valve regurgitation.
MitraClip in combination with medical treatment improves survival and
reduces hospitalization rates compared with optimal medical therapy alone
in well selected patients. Clip-associated endocarditis is a rare
complication with only few reported cases in the literature. We present a
case of late infective endocarditis post Mitral Clip implantation and also
review the literature regarding this new rare condition. Copyright
© The Author(s) 2022.

<45>
Accession Number
2018458090
Title
A systematic review and meta-analysis of non-vitamin K antagonist oral
anticoagulants vs vitamin K antagonists after transcatheter aortic valve
replacement in patients with atrial fibrillation.
Source
European Journal of Clinical Pharmacology. (no pagination), 2022. Date of
Publication: 2022.
Author
Ooi A.J.Q.; Wong C.; Tan T.W.E.; Ng T.P.; Teo Y.N.; Teo Y.H.; Syn N.L.;
Djohan A.H.; Lim Y.; Yeo L.L.L.; Tan B.Y.Q.; Chan M.Y.-Y.; Poh K.-K.; Kong
W.K.F.; Chai P.; Yeo T.-C.; Yip J.W.; Kuntjoro I.; Sia C.-H.
Institution
(Ooi, Wong, Tan, Ng, Teo, Teo, Syn, Yeo, Tan, Chan, Poh, Kong, Chai, Yeo,
Yip, Sia) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Djohan, Lim, Chan, Poh, Kong, Chai, Yeo, Yip, Kuntjoro, Sia) Department
of Cardiology, National University Heart Centre, Singapore 119228,
Singapore
(Yeo, Tan) Division of Neurology, Department of Medicine, National
University Hospital, Singapore, Singapore
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Transcatheter aortic valve replacement (TAVR) is increasingly
carried out in patients with aortic valvular conditions. Atrial
fibrillation (AF) is a common comorbidity among patients undergoing TAVR.
Despite this, there remains a paucity of data and established guidelines
regarding anticoagulation use post-TAVR in patients with AF.
 Method(s): Four databases were searched from inception until 12
October 2021. A title and abstract sieve, full-text review and data
extraction were conducted by independent authors, and articles including
patients without AF were excluded. The Review Manager (Version 5.4) was
utilised in data analysis. Result(s): A total of 25,199 post-TAVR
patients with AF were included from seven articles, with 9764 patients on
non-vitamin K antagonist oral anticoagulants (NOAC) and 15,435 patients on
vitamin K antagonists (VKA). In this analysis, there was a significantly
lower risk of all-cause mortality at 1 year (RR: 0.75, CI: 0.58-0.97, p =
0.04, I2 = 56%), and bleeding at 1 year (RR: 0.73, CI:
0.68-0.79, p = < 0.00001, I2 = 0%), between patients on NOAC
and VKA. There were no detectable differences between patients on NOAC and
VKA for all-cause mortality at 2 years, stroke within 30 days, stroke
within 1 year, ischaemic stroke at 1 year and life-threatening bleeding at
30 days. Conclusion(s): While the results of this analysis reveal
NOAC as a potential alternate treatment modality to VKA in post-TAVR
patients with AF, further research is needed to determine the full safety
and efficacy profile of NOAC (PROSPERO: CRD42021283548). Copyright
© 2022, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<46>
Accession Number
638711833
Title
Effect of a Decision Aid on Agreement Between Patient Preferences and
Repair Type for Abdominal Aortic Aneurysm: A Randomized Clinical Trial.
Source
JAMA surgery. (pp e222935), 2022. Date of Publication: 10 Aug 2022.
Author
Eid M.A.; Barry M.J.; Tang G.L.; Henke P.K.; Johanning J.M.; Tzeng E.;
Scali S.T.; Stone D.H.; Suckow B.D.; Lee E.S.; Arya S.; Brooke B.S.;
Nelson P.R.; Spangler E.L.; Murebee L.; Dosluoglu H.H.; Raffetto J.D.;
Kougais P.; Brewster L.P.; Alabi O.; Dardik A.; Halpern V.J.; O'Connell
J.B.; Ihnat D.M.; Zhou W.; Sirovich B.E.; Metha K.; Moore K.O.; Voorhees
A.; Goodney P.P.
Institution
(Eid, Stone, Suckow, Sirovich, Metha, Moore, Voorhees, Goodney) Department
of Surgery and VA Outcomes Group, White River Junction VA Medical Center,
White River Junction, VT, United States
(Eid, Stone, Suckow, Sirovich, Metha, Goodney) Geisel School of Medicine
at Dartmouth, Hanover, New Hampshire
(Barry) Massachusetts General Hospital Center for Shared Decision Making,
Boston, United Kingdom
(Tang) Seattle VA Medical Center, Seattle, WA, United States
(Henke) Ann Arbor VA Medical Center, Ann Arbor, MI, United States
(Johanning) Omaha VA Medical Center, Omaha, NE, United States
(Tzeng) Pittsburgh VA Medical Center, Pittsburgh, PA, United States
(Scali) Gainesville VA Medical Center, Gainesville, FL, Puerto Rico
(Lee) Sacramento VA Medical Center, Mather, CA, United States
(Arya) Palo Alto VA Medical Center, Palo Alto, CA, United States
(Brooke) Salt Lake City VA, Salt Lake City, UT, United States
(Nelson) Muskogee VA Medical Center, Muskogee, OK, United States
(Spangler) Birmingham VA, Birmingham, AL, United States
(Murebee) Durham VA Medical Center, Durham, NC, United States
(Dosluoglu) Buffalo VA Medical Center, Buffalo, NY, United States
(Raffetto) West Roxbury VA, Boston, MA, United States
(Kougais) Houston VA Medical Center, Houston, TX, United States
(Brewster, Alabi) Atlanta VA Medical Center, Atlanta, Georgia
(Dardik) West Haven VA Medical Center, West Haven, CT, United States
(Halpern) Phoenix VA Medical Center, Phoenix, AZ, United States
(O'Connell) Los Angeles VA Medical Center, Los Angeles, CA, United States
(Ihnat) Minneapolis VA Medical Center, Minneapolis, MN, United States
(Zhou) Tucson VA Medical Center, Tucson, AZ, United States
Publisher
NLM (Medline)
Abstract
Importance: Patients with abdominal aortic aneurysm (AAA) can choose open
repair or endovascular repair (EVAR). While EVAR is less invasive, it
requires lifelong surveillance and more frequent aneurysm-related
reinterventions than open repair. A decision aid may help patients receive
their preferred type of AAA repair. Objective(s): To determine the
effect of a decision aid on agreement between patient preference for AAA
repair type and the repair type they receive. Design, Setting, and
Participant(s): In this cluster randomized trial, 235 patients were
randomized at 22 VA vascular surgery clinics. All patients had AAAs
greater than 5.0 cm in diameter and were candidates for both open repair
and EVAR. Data were collected from August 2017 to December 2020, and data
were analyzed from December 2020 to June 2021. Intervention(s):
Presurgical consultation using a decision aid vs usual care. Main
Outcomes and Measures: The primary outcome was the proportion of patients
who had agreement between their preference and their repair type, measured
using chi2 analyses, kappa statistics, and adjusted odds ratios.
 Result(s): Of 235 included patients, 234 (99.6%) were male, and the
mean (SD) age was 73 (5.9) years. A total of 126 patients were enrolled in
the decision aid group, and 109 were enrolled in the control group. Within
2 years after enrollment, 192 (81.7%) underwent repair. Patients were
similar between the decision aid and control groups by age, sex, aneurysm
size, iliac artery involvement, and Charlson Comorbidity Index score.
Patients preferred EVAR over open repair in both groups (96 of 122 [79%]
in the decision aid group; 81 of 106 [76%] in the control group; P=.60).
Patients in the decision aid group were more likely to receive their
preferred repair type than patients in the control group (95% agreement
[93 of 98] vs 86% agreement [81 of 94]; P=.03), and kappa statistics were
higher in the decision aid group (kappa=0.78; 95% CI, 0.60-0.95) compared
with the control group (kappa=0.53; 95% CI, 0.32-0.74). Adjusted models
confirmed this association (odds ratio of agreement in the decision aid
group relative to control group, 2.93; 95% CI, 1.10-7.70).
 Conclusions and Relevance: Patients exposed to a decision aid were
more likely to receive their preferred AAA repair type, suggesting that
decision aids can help better align patient preferences and treatments in
major cardiovascular procedures. Trial Registration: ClinicalTrials.gov
Identifier: NCT03115346.

<47>
Accession Number
638711239
Title
The effect of tranexamic acid on myocardial injury in cardiac surgical
patients: a systematic review and meta-analysis.
Source
Blood coagulation & fibrinolysis : an international journal in haemostasis
and thrombosis. (no pagination), 2022. Date of Publication: 10 Aug 2022.
Author
Wang X.; Li L.; He L.; Yao Y.
Institution
(Wang, Li) Department of Anesthesiology, Fuwai Yunnan Cardiovascular
Hospital, Yunnan Province, Kunming, China
(He, Yao) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking Union Medical College and Chinese
Academy of Medical Sciences, Beijing, China
Publisher
NLM (Medline)
Abstract
Tranexamic acid (TXA) is one of the most commonly used antifibrinolytic
agents for surgical patients. However, the effect of TXA on myocardial
injury remains controversial. We systemically reviewed literature
regarding the effectiveness of TXA on myocardial injury in patients who
have undergone a cardiac surgery. We included all randomized controlled
trials (RCTs) comparing TXA and control (saline) in cardiac surgical
patients. Relevant studies were identified by a comprehensive electronic
literature search from database inception to 15 August 2021. A
standardized data extraction form was used to collect methodological and
outcome variables from each eligible study. We conducted a meta-analysis
to estimate the pooled effect size of TXA administration on myocardial
injury. In total, eight RCTs were identified, with 292 patients in the TXA
group, and 241 patients in saline or control group. The meta-analysis
demonstrated that patients in the TXA group had lower levels of CK-MB and
cTnI within 24 h postoperatively (CK-MB: P = 0.005; cTnI: P = 0.01),
compared with the saline group. No significant difference was found with
respect to AST level (P = 0.71) between TXA and saline groups within 24 h
postoperatively. TXA administration was found to be associated with less
myocardial injury among patients who have undergone cardiac surgery.
High-quality randomized controlled trials are warranted to further examine
the cardioprotective effects of TXA. Copyright © 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<48>
Accession Number
638708547
Title
Antithrombotic Strategy After Transcatheter Aortic Valve Replacement: A
Network Meta-Analysis.
Source
Current problems in cardiology. (pp 101348), 2022. Date of Publication:
06 Aug 2022.
Author
Mahalwar G.; Kumar A.; Majmundar M.; Adebolu O.; Yendamuri R.; Lao N.;
Barve N.; Kreutz R.P.; Reed G.W.; Puri R.; Dani S.S.; Kalra A.
Institution
(Mahalwar, Kumar, Adebolu, Yendamuri, Lao, Barve) Department of Medicine,
Cleveland Clinic Akron General
(Majmundar) Department of Cardiovascular Medicine, Maimonides Medical
Center, NYC
(Kreutz) Division of Cardiovascular Medicine, Krannert Cardiovascular
Research Center, Indiana University School of Medicine, Indianapolis, IN,
United States
(Reed, Puri) Department of Cardiovascular Medicine, Heart, Vascular,
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Dani) Department of Cardiovascular Medicine, Lahey Hospital & Medical
Center, Burlington, MA, United States
(Kalra) Cardiovascular Institute, Kalra Hospitals, Tulsi Dass Kalra Marg,
New Delhi 110015, India
Publisher
NLM (Medline)
Abstract
The ideal antithrombotic therapy post transcatheter aortic valve
replacement (TAVR) remains uncertain. We performed a network meta-analysis
of RCTs to report the outcomes with various antithrombotic strategies to
determine the optimal therapy. A systematic search of the PubMed/Medline
and Cochrane databases was performed through January 6th, 2022. The
primary outcome was stroke and the secondary outcomes were
major/life-threatening bleeding, myocardial infarction, all-cause
mortality, and cardiac mortality. A network meta-analysis was conducted
with a random-effects model. All analysis was carried out using R version
4.0.3. Six RCTs were included in the final analysis. SAPT when compared
with DAPT was associated with a reduced risk of major or life-threatening
bleeding [OR: 0.42; 95% CI: 0.25-0.70]. Other antithrombotic strategies
were associated with similar odds of major and life-threatening bleeding
post TAVR compared with DAPT. There was no difference in the incidence of
stroke, myocardial infarction, all-cause and cardiac mortality between the
various antithrombotic strategies post TAVR. The present analysis reported
SAPT as the preferred antithrombotic regimen post TAVR compared with other
regimens in patients who do not have other indications for
anticoagulation. Additional studies such as ADAPT-TAVR, CLOE and ATLANTIS
trials will further add to our understanding of the adequate
antithrombotic regimen post TAVR in patients with otherwise no indication
for anticoagulation. Copyright © 2022. Published by Elsevier Inc.

<49>
Accession Number
638708307
Title
Randomized controlled trial between conventional versus sutureless
bioprostheses for aortic valve replacement: Impact of mini and full
sternotomy access at 1-year follow-up.
Source
International journal of cardiology. (no pagination), 2022. Date of
Publication: 06 Aug 2022.
Author
Fischlein T.; Caporali E.; Folliguet T.; Kappert U.; Meuris B.; Shrestha
M.L.; Roselli E.E.; Bonaros N.; Fabre O.; Corbi P.; Troise G.; Andreas M.;
Pinaud F.; Pfeiffer S.; Kueri S.; Tan E.; Voisine P.; Girdauskas E.; Rega
F.; Garcia-Puente J.; Lorusso R.
Institution
(Fischlein, Pfeiffer) Klinikum Nurnberg, Cardiovascular Center, Paracelsus
Medical University, Nuremberg, Germany
(Caporali) Cardiology, Istituto Cardiocentro Ticino, EOC, Lugano,
Switzerland; Cardiac Surgery, Istituto Cardiocentro Ticino, EOC, Lugano,
Switzerland
(Folliguet) Department of Cardiac Surgery, Hopital Henri Mondor,
Universite Paris 12, Creteil, Paris, France
(Kappert) Herzzentrum Dresden GmbH Universitatsklinik, Dresden, Germany
(Meuris, Rega) University Hospital, Leuven, Belgium
(Shrestha) Hannover Medical School, Hannover, Germany
(Roselli) Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Bonaros) Medical University of Innsbruck, Innsbruck, Austria
(Fabre) Lens Hospital and Bois Bernard Private Hospital, Lens, France
(Corbi) Poitiers University Hospital, Poitiers, France
(Troise) Cardiac Surgery, Poliambulanza Foundation Hospital, Brescia,
Italy
(Andreas) Medical University of Vienna, Vienna, Austria
(Pinaud) Department of Cardiac Surgery, University Hospital Angers,
Angers, France
(Kueri) University Heart Center Freiburg, Bad Krozingen, Germany
(Tan) Catharina Ziekenhuis, Eindhoven, Netherlands
(Voisine) Division of Cardiac Surgery, Quebec Heart and Lung Institute,
QC, Canada
(Girdauskas) University Heart Center Hamburg, Universitatsklinikum Hamburg
Eppendorf (UKE), Hamburg, Germany
(Garcia-Puente) University General Hospital Virgen de la Arrixaca, Murcia,
Spain
(Lorusso) Cardio-Thoracic Surgery Department, Heart and Vascular Center,
Maastricht University Medical Center (MUMC+), Cardiovascular Research
Institute Maastricht (CARIM), Maastricht, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: The present study is a sub-analysis of the multicenter,
randomized PERSIST-AVR trial (PERceval Sutureless Implant versus Standard
Aortic Valve Replacement) comparing the in-hospital and 1-year results of
sutureless versus conventional stented bioprostheses in isolated surgical
aortic valve replacement (SAVR) within two different surgical approaches:
mini-sternotomy (MS) and full-sternotomy (FS). METHOD(S): A total of
819 patients (per-protocol population) underwent preoperative
randomization to sutureless or stented biological valve at 47 centers
worldwide. Sub-analysis on isolated SAVR was performed. Results were
compared between sutureless and stented within the two different surgical
approaches. RESULT(S): 285 patients were implanted with Perceval (67%
in MS) and 293 with stented valves (65% in MS). Sutureless group showed
significantly reduced surgical times both in FS and MS. In-hospital
results show no differences between Perceval and stented valves in FS,
while a lower incidence of new-onset of atrial fibrillation (3.7% vs
10.8%) with Perceval in MS. After 1-year, use of sutureless valve showed a
significant reduction of MACCE (5.2% vs 10.8%), stroke rate (1.0% vs
5.4%), new-onset of atrial fibrillation (4.2% vs 11.4%) and
re-hospitalizations (21.8days vs 47.6days), compared to stented valves but
presented higher rate of pacemaker implantation (11% vs 1.6%).
 CONCLUSION(S): Sutureless bioprosthesis showed significantly reduced
procedural times during isolated SAVR in both surgical approaches.
Patients with sutureless valves and MS access showed also better 1-year
outcome regarding MACCEs, stroke, re-hospitalization and new-onset atrial
fibrillation, but presented a higher rate of permanent pacemaker
implantation compared to patients with stented
bioprosthesis. Copyright © 2022. Published by Elsevier B.V.

<50>
Accession Number
2013891006
Title
Getting immunosuppression just right: the role of clinical biomarkers in
predicting patient response post solid organ transplantation.
Source
Expert Review of Clinical Pharmacology. 14(12) (pp 1467-1479), 2021. Date
of Publication: 2021.
Author
Brunet M.; Millan O.
Institution
(Brunet, Millan) Pharmacology and Toxicology Section, CDB, IDIBAPS,
Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
(Brunet, Millan) Biomedical Research Center in Hepatic and Digestive
Diseases (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Actually, immunosuppression selection isn't based on
individual immune alloreactivity, and immunosuppressive drug dosing is
mainly based on the development of toxicity and the achievement of
specific target concentrations. Since a successful outcome requires
optimal patient risk stratification and treatment, several groups have
evaluated candidate biomarkers that have shown promise in the assessment
of individual immune responses, the prediction of personal pharmacodynamic
effects of immunosuppressive drugs and the prognosis and diagnosis of
graft outcomes. Areas covered: This review includes biomarkers that the
Scientific Community in Solid Organ Transplantation currently considers to
have potential as diagnostic and prognostic biomarkers of graft evolution.
We have focused on recent scientific advances and expert recommendations
regarding the role of specific and non-specific pharmacodynamic biomarkers
that are mainly involved in the T-cell-mediated response. Expert opinion:
Integral pharmacologic monitoring that combines pharmacokinetics,
pharmacogenetics and predictive pharmacodynamic biomarkers may provide
crucial information and allow personal adjustment of immunosuppressive
drugs at an early stage before severe adverse events ensue. Multicentre,
randomized, prospective and interventional trials are needed to fine tune
the established cut-off values for each biomarker and the optimal
monitoring frequency for each biomarker and to accurately evaluate
possible clinical confounding factors to enable correct clinical
qualification. Copyright © 2021 Informa UK Limited, trading as
Taylor & Francis Group.

<51>
Accession Number
638580239
Title
Colchicine for cardiovascular medicine: A systematic review and
meta-analysis.
Source
Future Cardiology. 18(8) (pp 647-659), 2022. Date of Publication: August
2022.
Author
Casula M.; Andreis A.; Avondo S.; Vaira M.P.; Imazio M.
Institution
(Casula, Andreis, Avondo, Vaira) University Cardiology, A.O.U. Citta Della
Salute E Della Scienza Di Torino, Turin, Italy
(Imazio) Cardiology, Cardiothoracic Department, University Hospital "santa
Maria Della Misericordia", Asufc, Udine, Italy
Publisher
Future Medicine Ltd.
Abstract
Aim: Colchicine, a microtubule-disassembling (antitubulin) agent used for
centuries for the treatment of gout and autoimmune diseases, is a drug of
growing interest in the cardiovascular field. While in the last decades it
has become cornerstone of pericarditis treatment, it has also emerged in
the last few years as a promising drug in the management of coronary
artery disease, atrial fibrillation and heart failure. This systematic
review and meta-analysis aimed to assess the efficacy of colchicine in
patients with cardiovascular diseases. Method(s): Systematic search
in electronic databases (MEDLINE/PubMed, Scopus, BioMed Central, the
Cochrane Collaboration Database of Randomized Trials, ClinicalTrials.gov,
EMBASE, Google Scholar) was performed to identify randomized controlled
trials (RCTs) up to February 2021. Random-effects meta-analysis was
performed to assess the risk of cardiovascular events, defined according
to clinical setting. Result(s): Among 15,569 pooled patients from 21
RCTs, colchicine was superior to placebo in the reduction of
cardiovascular events. In the setting of pericardial diseases, it was
associated with a lower risk of recurrent pericarditis (17 vs 34%, RR =
0.50, 95% CI: 0.42-0.60, I2 = 10%). In other studies assessing coronary
artery disease patients, colchicine was associated with a reduced risk of
major adverse cardiovascular events (MACE) such as myocardial infarction,
stroke, cardiovascular death, coronary revascularisation and
hospitalization (6.3 vs 9%, RR = 0.67, 95% CI: 0.54-0.84, I2 = 55). Among
patients with atrial fibrillation, it was associated with lower rates of
recurrence (20 vs 30%, RR = 0.68, 95% CI: 0.58-0.81, I2 = 0). In the
single RCT on heart failure, colchicine was not associated with improved
NYHA class. Conclusion(s): Colchicine is a valuable anti-inflammatory
agent for the prevention of cardiovascular events in patients with
inflammatory cardiac conditions such as pericardial diseases, coronary
artery disease and atrial fibrillation. Copyright © 2022 Future
Medicine Ltd.

<52>
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. Copyright © 2020. Thieme.
All rights reserved.

<53>
Accession Number
2015881163
Title
The impact of the COVID-19 pandemic on care delivery and quality of life
in lung cancer surgery.
Source
Journal of Surgical Oncology. 126(3) (pp 407-416), 2022. Date of
Publication: September 1, 2022.
Author
Teteh D.K.; Barajas J.; Ferrell B.; Zhou Z.; Erhunmwunsee L.; Raz D.J.;
Kim J.Y.; Sun V.
Institution
(Teteh) Department of Health Sciences, Crean College of Health and
Behavioral Sciences, Chapman University, Orange, CA, United States
(Barajas, Ferrell, Zhou, Sun) Division of Nursing Research and Education,
Department of Population Sciences, City of Hope Comprehensive Cancer
Center, Duarte, CA, United States
(Erhunmwunsee, Raz, Kim, Sun) Department of Surgery, City of Hope
Comprehensive Cancer Center, Duarte, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) (COVID-19) pandemic and associated restrictions have altered
the delivery of surgical care. The purpose of this study was to explore
the impact of COVID-19 on care delivery and quality of life (QOL) from the
perspectives of lung cancer surgery patients, family caregivers (FCGs),
and thoracic surgery teams. Method(s): Patients/FCGs enrolled in a
randomized trial of a self-management intervention for lung cancer surgery
preparation/recovery were invited to participate in this qualitative
study. Patients/FCGs data were collected separately 1-month postdischarge.
Interviews were also conducted with thoracic surgery team members. Content
analysis approaches were used to develop themes. Result(s): Forty-one
respondents including 19 patients, 18 FCGs, three thoracic surgeons, and
one nurse practitioner participated in the study. Patient themes included
isolation, psychological distress, delayed/impacted care, and financial
impact. FCGs themes included caregiving challenges, worry about COVID-19,
financial hardship, isolation, and physical activity limitations. Surgical
team themes included witnessing patient/FCG's distress, challenges with
telehealth, communication/educational challenges, and delays in treatment.
 Conclusion(s): COVID-19 had a varied impact on care delivery and QOL
for lung cancer surgery dyads. Some dyads reported minimal impact, while
others experienced added psychological distress, isolation, and caregiving
challenges. Surgical teams also experienced challenges in the approach
used to provide care. Copyright © 2022 The Authors. Journal of
Surgical Oncology published by Wiley Periodicals LLC.

<54>
Accession Number
2017459666
Title
Ultrasound-Guided Oblique Sagittal Anterior Quadratus Lumborum Block in
Total Hip Arthroplasty: A Randomized Controlled Trial.
Source
Pain Physician. 25(4) (pp E609-E617), 2022. Date of Publication: July
2022.
Author
Wang N.; Ruan B.; Wang M.; Chen L.; Ying T.; Ye W.; Li H.
Institution
(Wang, Ruan, Wang, Chen, Ying, Ye, Li) Department of Anesthesiology,
Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: The anterior quadratus lumborum block (QLB) is gaining
popularity in total hip arthroplasty (THA) surgeries for postoperative
pain management and this technique rarely results in lower limb muscle
weakness. However, no studies have described the range of its blockade.
 Objective(s): The aim of the study was to confirm the range of cold
temperature sensory blockades, observe the opioid consumption after THA
surgery, assess the pain of the patients, and assess the safety of this
technique. Study Design: Randomized controlled study.
 Setting(s): Taizhou Hospital of Zhejiang Province. Method(s):
Patients who underwent primary THAs were randomized to take an oblique
sagittal anterior QLB with 30 mL of 0.375% ropivacaine (QLB+G group) or
with 30 mL of 0.9% saline (G group). The main purpose of the study was to
confirm the range of cold hypoesthesia. The other aim included the average
blood pressure, heart rate, surgical pleth index, and bispectral index
values fluctuation during the intraoperative period of expanding the
medullary cavity, the sufentanil, and remifentanil consumption during the
operation, the amount of time the patients stayed in the Postanesthesia
Care Unit, the 8 hours, 16 hours, and 24 hours total dosage of oxycodone,
the resting and exercise Visual Analog Scale (VAS) pain scores at 8 hours,
16 hours, and 24 hours after surgery, postoperative adverse events, and
safety. Result(s): The QLB+G group identified areas of cold
hypoesthesia after the block, but there were no areas of cold hypoesthesia
in the G group. The consumption of oxycodone in the 8 hours, 16 hours, and
24 hours after the surgery and the consumption of sufentanil during the
surgery were significantly smaller in the QLB+G group (P < 0.05). The
QLB+G group have lower pain scores at the resting 8 hours and exercise 8
hours, 16 hours, and 24 hours after the surgery (P < 0.05). The 2 groups
have comparable safety in the study. Limitation(s): This study only
tested the areas of cold hypoesthesia after the QLB, but not tested the
area of sensory loss. Using ice to test for hypoesthesia is subjective,
and may not reflect the actual area of the block. Conclusion(s):
Ultrasound-guided oblique sagittal anterior QLB can reduce the analgesics
required after and during THA and the postoperative VAS pain scores, but
it rarely affects muscle strength. Copyright © 2022, American
Society of Interventional Pain Physicians. All rights reserved.

<55>
Accession Number
2017294373
Title
Coaxial Drainage versus Standard Chest Tube after Pulmonary Lobectomy: A
Randomized Controlled Study.
Source
Current Oncology. 29(7) (pp 4455-4463), 2022. Date of Publication: July
2022.
Author
Bassi M.; Mottola E.; Mantovani S.; Amore D.; Pagini A.; Diso D.; Vannucci
J.; Poggi C.; De Giacomo T.; Rendina E.A.; Venuta F.; Anile M.
Institution
(Bassi, Mottola, Mantovani, Amore, Pagini, Diso, Vannucci, Poggi, De
Giacomo, Venuta, Anile) Division of Thoracic Surgery, Department of
General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico
Umberto I, Sapienza University of Rome, Rome 00161, Italy
(Rendina) Thoracic Surgery Unit, Sant'Andrea Hospital, Universita La
Sapienza, Rome 00189, Italy
Publisher
MDPI
Abstract
Chest tubes are routinely inserted after thoracic surgery procedures in
different sizes and numbers. The aim of this study is to assess the
efficacy of Smart Drain Coaxial drainage compared with two standard chest
tubes in patients undergoing thoracotomy for pulmonary lobectomy.
Ninety-eight patients (57 males and 41 females, mean age 68.3 +/- 7.4
years) with lung cancer undergoing open pulmonary lobectomy were
randomized in two groups: 50 received one upper 28-Fr and one lower 32-Fr
standard chest tube (ST group) and 48 received one 28-Fr Smart Drain
Coaxial tube (SDC group). Hospitalization, quantity of fluid output, air
leaks, radiograph findings, pain control and costs were assessed. SDC
group showed shorter hospitalization (7.3 vs. 6.1 days, p = 0.02), lower
pain in postoperative day-1 (p = 0.02) and a lower use of analgesic drugs
(p = 0.04). Pleural effusion drainage was lower in SDC group in the first
postoperative day (median 400.0 +/- 200.0 mL vs. 450.0 +/- 193.8 mL, p =
0.04) and as a mean of first three PODs (median 325.0 +/- 137.5 mL vs.
362.5 +/- 96.7 mL, p = 0.01). No difference in terms of fluid retention,
residual pleural space, subcutaneous emphysema and complications after
chest tubes removal was found. In conclusion, Smart Drain Coaxial chest
tube seems a feasible option after thoracotomy for pulmonary lobectomy.
The SDC group showed a shorter hospitalization and decreased analgesic
drugs use and, thus, a reduction of costs. Copyright © 2022 by
the authors. Licensee MDPI, Basel, Switzerland.

<56>
Accession Number
2019390809
Title
The Application of the Nurse-Led Sedation and Analgesia Management in ICU
after Heart Surgeries.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 7706172. Date of Publication: 2022.
Author
Lu R.; Song H.; Wang L.; Xiong H.; Chen Z.; Liu X.; Wang S.; Xie C.; Jia
P.
Institution
(Lu, Wang, Xiong, Chen) Department of SICU, Sichuan Academy of Medical
Sciences and Sichuan Provincial People's Hospital, School of Medicine,
University of Electronic Science and Technology of China, Sichuan,
Chengdu, China
(Lu, Wang, Chen, Xie, Jia) Chinese Academy of Sciences Sichuan
Translational Medicine Research Hospital, Sichuan, Chengdu, China
(Song) Department of Nursing, Sichuan Provincial People's Hospital and
QiongLai Hospital, Sch. of Med., Univ. of Electronic Science and
Technology of China, Chengdu, Sichuan Uestc.edu.cn, China
(Xiong) Department of Neurosurgery, Sichuan Academy of Medical Sciences
and Sichuan Provincial People's Hospital, School of Medicine, University
of Electronic Science and Technology of China, Sichuan, Chengdu, China
(Liu) Department of ICU, Deyang People's Hospital, Sichuan, Deyang, China
(Wang) School of Nursing, North Sichuan Medical College, Sichuan,
Nanchong, China
(Xie) Department of Nursing, Sichuan Academy of Medical Sciences and
Sichuan Provincial People's Hospital, School of Medicine, University of
Electronic Science and Technology of China, Sichuan, Chengdu, China
(Jia) Department of NICU, Sichuan Academy of Medical Sciences and Sichuan
Provincial People's Hospital, School of Medicine, University of Electronic
Science and Technology of China, Sichuan uestc.edu.cn, Chengdu, China
Publisher
Hindawi Limited
Abstract
Aim. Traditional sedation management consists of doctors adjusting the
dosage of sedative drugs or adding other drugs in combination according to
the evaluation of nurses; the nurses then execute the orders. The nurses'
passive execution in the process is not the ideal model for continuous
evaluation and observation of sedation. This study aims to investigate the
application and effects of nurse-provided procedural sedation and
analgesia for patients in intensive care unit. Methods. The experimental
group consisted of 354 heart surgery patients who received procedural
sedation and analgesia from nurses from November 2020 to August 2021. The
control group consisted of 301 patients who had had heart surgery and
received the traditional sedation management program from January to
October 2020. The differences in levels of the sedative effect, delirium,
and unplanned extubation of patients between these two groups were
compared. Results. There were no significant differences in baseline
characteristics between the two groups (P>0.05). It was found that both
insufficient sedation and excessive sedation decreased in the experimental
group when compared to the control group, while the appropriate proportion
of sedation increased (72.41% versus 37.98%); the difference was
statistically significant (P<0.05). The incidence of delirium was lower
for patients in the experimental group than for patients in the control
group (37.01% versus 66.45%); the difference was statistically significant
(P<0.05). The incidence of unplanned extubation caused by patient factors
was lower for the experimental group than for the control group, but the
difference was not statistically significant (P>0.05). Conclusion. The
programmed sedation scheme led by nurses can improve the sedation effect
and reduce the incidence of delirium. Implications for Practice. The
management team gives the sedative goal and establishes the standard
flowchart. The sedation management led by the nurse according to the goal
and flowchart is better than the traditional sedation
management. Copyright © 2022 Rong Lu et al.

<57>
Accession Number
2019010459
Title
Prevalence, determinants and prognostic value of high coronary artery
calcium score in asymptomatic patients with diabetes: A systematic review
and meta-analysis.
Source
Journal of Diabetes and its Complications. 36(8) (no pagination), 2022.
Article Number: 108237. Date of Publication: August 2022.
Author
Sow M.A.; Magne J.; Salle L.; Nobecourt E.; Preux P.-M.; Aboyans V.
Institution
(Sow, Magne, Salle, Preux, Aboyans) EpiMaCT, INSERM U1094, and IRD U270,
University of Limoges, Limoges, France
(Sow, Magne, Aboyans) Department of Cardiology, Dupuytren-2 University
Hospital, Limoges, France
(Salle) Department of Endocrinology, Dupuytren-2 University Hospital,
Limoges, France
(Nobecourt) Inserm U1188 Diabete Atherothrombose Therapies Reunion Ocean
Indien, France
(Nobecourt) Inserm U1410, Reunion University Hospital, Reunion Island,
France
Publisher
Elsevier Inc.
Abstract
Background: The pharmacological management of diabetes is mostly based on
its cardiovascular risk assessment. For this purpose, coronary artery
calcium score (CACS) is proposed with a soft (class IIb) recommendation,
as its prognostic implication requires further evidence in different
subsets. Thus, we carried-out a systematic review and meta-analysis to
address the prevalence of high CACS, its determinants and prognostic value
in asymptomatic patients with diabetes, with a special focus on different
sex and ethnic groups. Method(s): We carried out a systematic review
of the published literature in several databases between 01/2000 and
01/2021. Original studies were included if they presented data on the
prevalence, determinants and prognosis of high CACS in patients with
diabetes without known cardiovascular disease. Using random effects
models, we calculated pooled odds ratios (OR) for CACS determinants and
Relative Risk (RR) for CACS prognostic value on all-cause mortality and/or
fatal and non-fatal CV events in different categories. Result(s): We
included 23 studies (n = 20,999 patients). Female sex and black ethnicity
presented the lowest prevalence of CACS>0. Age, male sex, non-black
ethnicity and diabetes duration were identified as risk factors for high
CACS. Among the 10 studies (n = 110,396 person-years) with prognostic
data, the pooled RR for the occurrence of all-cause death and/or
cardiovascular events were 4.03 (95%CI: 3.04-5.34), 5.87 (95%CI:
4.32-7.99) and 9.04 (95%CI: 5.81-14.06) respectively for CACS>0 vs. CACS =
0, CACS>=100 vs. CACS<10 and CACS>=400 vs. CACS<10. For similar CACS,
these RR were greater in women than in men. Conclusion(s): Our
meta-analysis demonstrates that the increase in CACS is strongly
associated with an increased risk for all-cause mortality and/or fatal and
non-fatal CV events in asymptomatic patients with diabetes. Copyright
© 2022

<58>
Accession Number
2018229004
Title
Mid- to Long-Term Clinical and Echocardiographic Effects of
Post-procedural Permanent Pacemaker Implantation After Transcatheter
Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 911234. Date of Publication: 28 Jun 2022.
Author
Xu S.; Zhang E.; Qian Z.; Sun J.; Zou F.; Wang Y.; Hou X.; Zou J.
Institution
(Xu, Zhang, Qian, Sun, Wang, Hou, Zou) Department of Cardiology, The First
Affiliated Hospital of Nanjing Medical University, Nanjing, China
(Zou) Montefiore Medical Center, Bronx, NY, United States
Publisher
Frontiers Media S.A.
Abstract
Aims: To date, the prognostic effects of permanent pacemaker implantation
(PPI) after transcatheter aortic valve replacement (TAVR) remain
controversial. The purpose of this meta-analysis was to investigate the
mid- (1 year) to long-term (> 1 year) clinical and echocardiographic
effects of post-procedural PPI in patients after TAVR. Method(s):
PubMed, Embase, Web of Science, and Cochrane Library databases were
systematically searched from the establishment of databases up to 1
December 2021. Studies comparing clinical and echocardiographic outcomes
between patients with and without post-TAVR PPI of >= 1-year follow-up
were collected for further meta-analysis. Result(s): A total of 39
studies comprising of 83,082 patients were included in this meta-analysis.
At mid-term follow-up (1 year), the pooled results demonstrated a higher
risk of all-cause mortality in patients with post-procedural PPI than
those without following TAVR (relative risk (RR), 1.17; 95% CI, 1.10-1.24;
P < 0.00001). No significant differences were observed in cardiovascular
mortality (RR, 0.86; 95% CI, 0.71-1.03; P = 0.10) or heart failure
rehospitalization (RR, 0.91; 95% CI, 0.58-1.44; P = 0.69) at 1-year
follow-up. At long-term follow-up (> 1 year), post-TAVR PPI had negative
effects on all-cause mortality (RR, 1.18; 95% CI, 1.09-1.28; P < 0.0001)
and heart failure rehospitalization (RR, 1.42; 95% CI, 1.18-1.71; P =
0.0002). There was no difference in long-term cardiovascular mortality
between the two groups (RR, 1.15; 95% CI, 0.97-1.36; P = 0.11). Left
ventricular ejection fraction (LVEF) was not significantly different at
baseline (mean difference, 1.40; 95% CI, -0.13-2.93; P = 0.07), but was
significantly lower in the PPI group at 1-year follow-up (mean difference,
-3.57; 95% CI, -4.88 to -2.26; P < 0.00001). Conclusion(s): Our
meta-analysis provides evidence that post-TAVR PPI has negative clinical
and echocardiographic effects on patients at mid- to long-term follow-up.
Further studies are urgently needed to explore the cause of these
complications and optimize the treatment and management of patients
requiring permanent pacing after TAVR. Systematic Review Registration:
[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021289935]
, identifier [CRD42021289935]. Copyright © 2022 Xu, Zhang, Qian,
Sun, Zou, Wang, Hou and Zou.

<59>
Accession Number
2019595085
Title
Telehealth education improves parental care ability and postoperative
nutritional status of infants after CHD surgery: A prospective randomized
controlled study.
Source
Paediatrics and Child Health (Canada). 27(3) (pp 154-159), 2022. Date of
Publication: 01 Jun 2022.
Author
Zhang Q.-L.; Lei Y.-Q.; Liu J.-F.; Chen Q.; Cao H.
Institution
(Zhang, Lei, Liu, Chen, Cao) Department of Cardiac Surgery, Fujian
Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical
University, Fuzhou, China
(Zhang, Lei, Liu, Chen, Cao) Fujian Branch of Shanghai Children's Medical
Center, Fuzhou, China
(Zhang, Lei, Liu, Chen, Cao) Fujian Children's Hospital, Fuzhou, China
(Zhang, Lei, Liu, Chen, Cao) Fujian Key Laboratory of Women and Children's
Critical Diseases Research, Fujian Maternity and Child Health Hospital,
Fuzhou, China
Publisher
Oxford University Press
Abstract
Objective: This study aimed to explore the effect of telehealth education
on improving the parental care ability and postoperative nutritional
status of infants after congenital heart disease surgery. Method(s):
A prospective randomized controlled study was conducted at a provincial
maternal and child hospital in southeastern China. A total of 84 infants
were enrolled in the study, with 42 infants in the intervention group and
42 infants in the control group. Result(s): Body weight, albumin,
prealbumin, and hemoglobin of infants in the intervention group were
significantly higher than those in the control group one month after
discharge (P<0.05). The STRONGkids score of infants in the intervention
group was significantly higher than that of those in the control group one
month after discharge (P<0.05). The Family Caregiver Task Inventory score
of infants in the intervention group was significantly lower than that of
those in the control group one month after discharge (P<0.05).
 Conclusion(s): Performing telehealth education about home feeding and
care guidance for parents of infants after congenital heart disease
surgery can greatly improve parental care ability so that infants get
better feeding and care, which can effectively improve the postoperative
nutritional status of the infants. Copyright © 2022 The
Author(s). Published by Oxford University Press on behalf of the Canadian
Paediatric Society. All rights reserved.

<60>
Accession Number
2019542111
Title
Surgical management of tricuspid regurgitation: a new algorithm to
minimise recurrent tricuspid regurgitation.
Source
Open Heart. 9(2) (no pagination), 2022. Article Number: e002011. Date of
Publication: 25 Jul 2022.
Author
Torres D.R.; Torres Quintero L.; Segura Rodriguez D.; Garrido Jimenez
J.M.; Esteban Molina M.; Gomera Martinez F.; Moreno Escobar E.; Garcia
Orta R.
Institution
(Torres) Universidad de Granada, Granada, Spain
(Torres Quintero, Garcia Orta) Cardiology, Hospital Universitario Virgen
de Las Nieves, Granada, Spain
(Segura Rodriguez, Moreno Escobar) Cardiology, Hospital Universitario San
Cecilio, Granada, Spain
(Garrido Jimenez, Esteban Molina, Gomera Martinez) Cardiovascular Surgery,
Hospital Universitario Virgen de Las Nieves, Granada, Spain
Publisher
BMJ Publishing Group
Abstract
Introduction Recurrent tricuspid regurgitation (TR) is frequently observed
after cardiac surgery; however, the correct approach remains
controversial. We developed an algorithm for action on the tricuspid valve
(TV) and conducted a 1-year follow-up study. The aim was to assess the
efficacy of the algorithm to minimise residual TR after TV surgery. The
hypothesis was that the TR rate at 1 year would be reduced by selecting
the surgical approach in accordance with a set of preoperative clinical
and echocardiographic variables. Methods A prospective, observational,
single-centre study was performed in 76 consecutive patients with TV
involvement. A protocol was designed for their inclusion, and data on
their clinical and echocardiographic characteristics were gathered at 3
months and 1-year postsurgery. The treatment of patients depended on the
degree of TR. Surgery was performed in all patients with severe or
moderate-to-severe TR and in those with mild or moderate TR alongside the
presence of certain clinical or echocardiographic factors. They underwent
annuloplasty or extended valve repair when the TV was distorted. If repair
techniques were not feasible, a prosthesis was implanted. Residual TR
rates were compared with published reports, and predictors of early/late
mortality and residual TR were evaluated. Results TR was functional in
69.9% of patients. Rigid ring annuloplasty was performed in 35.7% of
patients, De Vega annuloplasty in 27.1%, extended repair in 11.4% and
prosthetic replacement in 25.7%. TR was moderate or worse in 8.19% of
patients (severe in 3.27%) at 1 year postintervention. No clinical,
surgical or epidemiological variables were significantly associated with
residual TR persistence, although annulus diameter showed a
close-to-significant association. Total mortality was 12.85% for all
causes and 10% for cardiovascular causes. In multivariate analysis, left
ventricular ejection fraction was related to both early and late
mortality. Conclusions Severe residual TR was significantly less frequent
than reported in other series, being observed in less than 4% of patients
at 1-year postsurgery. Copyright © 2022 BMJ Publishing Group. All
rights reserved.

<61>
Accession Number
2019495371
Title
Distal Radial Artery Access in comparison to Forearm Radial Artery Access
for Cardiac Catheterization: A Randomized Controlled Trial (DARFORA
Trial).
Source
Journal of Interventional Cardiology. 2022 (no pagination), 2022. Article
Number: 7698583. Date of Publication: 2022.
Author
Daralammouri Y.; Nazzal Z.; Mosleh Y.S.; Abdulhaq H.K.; Khayyat Z.Y.;
Hamshary Y.E.; Azamtta M.; Ghanim A.; Awwad F.; Majadla S.; Maree M.;
Hamaida J.; Ismail Y.
Institution
(Daralammouri, Mosleh, Abdulhaq, Khayyat, Hamshary, Azamtta, Ghanim,
Awwad, Majadla, Maree, Hamaida, Ismail) Department of Medicine, Faculty of
Medicine and Health Sciences, An-Najah National University, Nablus,
Palestine
(Daralammouri, Azamtta, Majadla, Ismail) Department of Cardiology,
An-Najah National University Hospital, Nablus, Palestine
(Nazzal) Department of Family and Community Medicine, Faculty of Medicine
and Health Sciences, An-Najah National University, Nablus, Palestine
(Hamshary) Department of Internal Medicine, An-Najah National University
Hospital, Nablus, Palestine
(Ghanim, Maree, Hamaida) Department of Radiology, An-Najah National
University Hospital, Nablus, Palestine
Publisher
Hindawi Limited
Abstract
Background. In our clinical practice, conventional radial access has been
employed routinely for coronary procedures. The distal radial artery (DRA)
access site has recently emerged as a novel technique in cardiac
procedures. Objectives. This study compares distal radial access to
standard forearm radial access (FRA) in terms of feasibility, outcomes,
and complications. Method. This prospective, randomized trial was
conducted at a single center. The patients were chosen from An-Najah
National University Hospital's catheterization laboratory between December
2019 and November 2020. A total of 209 patients were randomized into two
groups: DRA group (n = 104) and FRA group (n = 105). Results. Access was
successful in 98% of patients in both the groups. The DRA group had a
longer puncture duration and a higher number of attempts (duration: 56.6
+/- 61.1 s DRA vs. 20.0 +/- 18.4 s FRA, p<0.001, attempts: 1.9 +/- 1.3 DRA
vs. 1.2 +/- 0.60 FRA, p<0.001). Puncture-associated pain was greater in
the DRA group (4 +/- 2.2 DRA vs. 3 +/- 2.1 FRA, p=0.001). There were two
radial artery occlusions in the FRA group and none in the DRA group
(p=0.139). Percutaneous coronary intervention (PCI) was performed in 26%
of the DRA group and 37.1% of the FRA group. The DRA group had
significantly shorter procedure times (p=0.006), fluoroscopy times
(p=0.002), and hemostasis times (p=0.002). Over time, the learning curve
demonstrated improved puncture duration and a decrease in the number of
puncture attempts. Conclusions. DRA is a safe and practical alternative to
FRA for coronary angiography and intervention. The overtime learning curve
is expected to improve puncture-related outcomes. Copyright ©
2022 Yunis Daralammouri et al.

<62>
Accession Number
2014067987
Title
Meta-analysis of clinical outcomes of PCSK9 modulators in patients with
established ASCVD.
Source
Pharmacotherapy. 41(12) (pp 1009-1023), 2021. Date of Publication:
December 2021.
Author
Talasaz A.H.; Ho A.-C.; Bhatty F.; Koenig R.A.; Dixon D.L.; Baker W.L.;
Van Tassell B.W.
Institution
(Talasaz, Ho, Bhatty, Koenig, Dixon, Van Tassell) Department of
Pharmacotherapy & Outcomes Science, Virginia Commonwealth University
School of Pharmacy, Richmond, VA, United States
(Baker) Department of Pharmacy Practice, University of Connecticut School
of Pharmacy, Storrs, CT, United States
Publisher
Pharmacotherapy Publications Inc.
Abstract
The advent of monoclonal antibodies targeting proprotein convertase
subtilisin/kexin type 9 (PCSK9) ushered in a new era of dyslipidemia
pharmacotherapy. The first two antibodies targeting PCSK9 (evolocumab,
alirocumab) approved by the United States Food and Drug Administration
(FDA) provided significant and sustained reductions in atherogenic lipids
and a reduced risk of atherosclerotic cardiovascular disease (ASCVD)
events. More recently, phase 3 trials of inclisiran-a small interfering
RNA-based agent targeting PCSK9-reported similar lipid-lowering effects
and preliminary evidence of ASCVD risk reduction, although significant
questions remain regarding the extent of benefits across cardiovascular
outcomes. We conducted a systematic review and meta-analysis
(random-effects model) of the available data on lipid lowering, incidence
of atherosclerotic cardiovascular disease (ASCVD) events, and safety of
pharmacologic agents targeting PCSK9. A significant and consistent
reduction in low-density lipoprotein cholesterol (LDL-C) was observed
across all agents (-51% [95% confidence interval {CI}: -61%, -41%]).
Despite the impressive reduction in LDL-C, the individual effects on
mortality, cardiovascular death, myocardial infarction (MI), and stroke
remained nonsignificant. However, a consistent reduction was observed in
the composite outcomes of MI, stroke, and cardiovascular death [relative
risk {RR} (95% CI): 0.80 (0.73-0.87)] and MI, stroke, unstable angina
(requiring revascularization), and cardiovascular death [RR (95% CI): 0.85
(0.74-0.97)]. In terms of safety outcomes, there was no significant
difference in severe adverse events, new onset diabetes, neurocognitive
disorders, or myalgia. Meanwhile, injection site reaction was more
frequent in patients receiving these agents compared to placebo [RR 2.11
(95% CI): 1.26-3.54]. These findings suggest a class effect for favorable
lipid changes and a low risk of serious adverse events among pharmacologic
agents targeting PCSK9. Although there is compelling evidence that
PCSK9-targeting agents reduce the risk of some cardiovascular outcomes,
adequately powered studies with longer follow-up may be needed to fully
characterize the magnitude of benefits across the cardiovascular
spectrum. Copyright © 2021 Pharmacotherapy Publications, Inc.

<63>
Accession Number
2016104951
Title
Geographic barriers to children's surgical care: A systematic review of
existing evidence.
Source
Journal of Pediatric Surgery. 57(9) (pp 107-117), 2022. Date of
Publication: September 2022.
Author
Buss R.; SenthilKumar G.; Bouchard M.; Bowder A.; Marquart J.;
Cooke-Barber J.; Vore E.; Beals D.; Raval M.; Rich B.S.; Goldstein S.; Van
Arendonk K.
Institution
(Buss, SenthilKumar, Bowder, Marquart, Van Arendonk) Division of Pediatric
Surgery, Department of Surgery, Medical College of Wisconsin, 999 North
92nd StreetSuite CCC 320, Milwaukee, WI 53226, United States
(Bouchard, Raval, Goldstein) Division of Pediatric Surgery, Ann and Robert
H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave. Chicago, IL
60611, United States
(Cooke-Barber) Division of Pediatric General and Thoracic Surgery,
Cincinnati Children's Hospital, 3333 Burnet Ave. ML 2023, Cincinnati, OH
45229, United States
(Vore, Beals) Department of Surgery, Marshall University Medical Center,
1600 Medical Center DriveSuite 2500, Huntington, WV 25701, United States
(Rich) Division of Pediatric Surgery, Cohen Children's Medical Center, 450
Lakeville Rd, North New Hyde Park, NY 11042, United States
Publisher
W.B. Saunders
Abstract
Background: Ensuring that children have access to timely and appropriate
surgical care is a vital component of comprehensive pediatric care. This
study systematically reviews the existing evidence related to geographic
barriers in children's surgery. Method(s): Medline and Scopus
databases were searched for any English language studies that examined
associations between geographic burden (rural residence or distance to
care) and a quantifiable outcome within pediatric surgical subspecialties.
Two independent reviewers extracted data from each study. Result(s):
From 6331 studies screened, 22 studies met inclusion criteria. Most
studies were retrospective analyses and conducted in the U.S. or Canada
(14 and three studies, respectively); five were conducted outside North
America. In transplant surgery (seven studies), greater distance from a
transplant center was associated with higher waitlist mortality prior to
kidney and liver transplantation, although graft outcomes were generally
similar. In congenital cardiac surgery (five studies), greater travel was
associated with higher neonatal mortality and older age at surgery but not
with post-operative outcomes. In general surgery (eight studies), rural
residence was associated with increased rates of perforated appendicitis,
higher frequency of negative appendectomy, and increased length of stay
after appendectomy. In orthopedic surgery (one study), rurality was
associated with decreased post-operative satisfaction. No evidence for
disparate outcomes based upon distance or rurality was identified in
neurosurgery (one study). Conclusion(s): Substantial evidence
suggests that geographic barriers impact the receipt of surgical care
among children, particularly with regard to transplantation, congenital
cardiac surgery, and appendicitis. Copyright © 2021

<64>
Accession Number
2014119140
Title
Valve-in-Valve Transcatheter Aortic Valve Implantation for the Failing
Surgical Perceval Bioprosthesis.
Source
Cardiovascular Revascularization Medicine. 40(Supplement) (pp 148-153),
2022. Date of Publication: July 2022.
Author
Suleiman T.; Tanseco K.; Arunothayaraj S.; Michail M.; Cockburn J.;
Hadjivassilev S.; Hildick-Smith D.
Institution
(Suleiman, Tanseco, Arunothayaraj, Michail, Cockburn, Hadjivassilev,
Hildick-Smith) Sussex Cardiac Centre, University Hospitals Sussex,
Brighton, United Kingdom
Publisher
Elsevier Inc.
Abstract
Introduction: The Perceval Valve has been increasingly used in Surgical
Aortic Valve Replacement (SAVR) recently due to ease of implantation.
However, we have seen some cases of relatively early haemodynamic failure
of the Perceval valve and these patients may then present for
valve-in-valve transcatheter aortic valve implantation (ViV-TAVI).
Experience of ViV-TAVI in the Perceval valve is limited. Method(s):
We report our experience of VIV-TAVI in four cases of early-failing
Perceval valves, two with stenosis and two with regurgitation. We also
review the literature with regard to ViV-TAVI for this indication.
 Result(s): Four patients aged between 66 and 78 years presented with
Perceval valve dysfunction an average of 4.6 years following SAVR. All
cases underwent Heart Team discussion and a ViV-TAVI procedure was planned
thereafter. Strategies to ensure crossing through the centre of the valve
and not outside any portion of the frame were found to be essential. Three
patients had self-expanding valves implanted and one had a
balloon-expandable prosthesis. The average aortic valve area (AVA)
improved from 0.8 cm2 pre-procedure to 1.5 cm2
post-procedure*. The mean gradient (MG) improved from 35.5 mmHg (range
19.7-53 mmHg) pre-procedure to 14.8 mmHg (range 7-30 mmHg) post-procedure.
In one patient a MG of 30 mmHg persisted following valve deployment. There
were no significant peri-procedural complications. Conclusion(s):
ViV-TAVI is a useful option for failed Perceval prostheses and appears
safe and effective in this small series. Crossing inside the whole frame
of the Perceval valve is essential. Copyright © 2021 Elsevier
Inc.

<65>
Accession Number
2018975238
Title
Significant Valvular Dysfunction and Outcomes in Cardiogenic Shock:
Insights From the Randomized DOREMI Trial.
Source
Canadian Journal of Cardiology. 38(8) (pp 1211-1219), 2022. Date of
Publication: August 2022.
Author
Parlow S.; Weng W.; Di Santo P.; Jung R.G.; Lepage-Ratte M.F.; Motazedian
P.; Prosperi-Porta G.; Abdel-Razek O.; Simard T.; Chan V.; Labinaz M.;
Froeschl M.; Mathew R.; Hibbert B.
Institution
(Parlow, Weng, Di Santo, Jung, Lepage-Ratte, Motazedian, Prosperi-Porta,
Abdel-Razek, Labinaz, Froeschl, Mathew, Hibbert) CAPITAL Research Group,
Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Parlow, Weng, Di Santo, Motazedian, Prosperi-Porta, Abdel-Razek, Labinaz,
Froeschl, Mathew, Hibbert) Division of Cardiology, University of Ottawa
Heart Institute, Ottawa, ON, Canada
(Di Santo) School of Epidemiology and Public Health, University of Ottawa,
Ottawa, ON, Canada
(Jung, Hibbert) Department of Cellular and Molecular Medicine, University
of Ottawa, Ottawa, ON, Canada
(Jung) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
(Lepage-Ratte) Department of Medicine, University of Ottawa, Ottawa, ON,
Canada
(Simard) Department of Cardiovascular Diseases, Mayo Clinic School of
Medicine, Rochester, Minnesota, United States
(Chan) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Patients with cardiogenic shock (CS) suffer high rates of
in-hospital mortality, with little evidence guiding management. The impact
of valvular heart disease in patients with CS remains unclear. We
therefore conducted a post hoc analysis of the randomized Dobutamine
Compared to Milrinone (DOREMI) trial to determine the impact of valvular
disease on outcomes in patients with CS. Method(s): We defined
significant valvular disease as moderate to severe or greater valvular
stenosis or regurgitation and divided participants into a group of those
with significant valvular disease and those without. Our primary outcome
was all-cause in-hospital mortality. Secondary endpoints included
resuscitated cardiac arrest; cardiac transplantation or mechanical
circulatory support; nonfatal myocardial infarction; stroke; initiation of
renal replacement therapy; as well as changes in renal function,
perfusion, and hemodynamics over time. Result(s): One hundred
eighty-nine (98.4%) participants from the DOREMI trial were included in
our analysis, and 74 (39.2%) had significant valvular dysfunction.
Thirty-six (48.7%) patients with valvular disease died in hospital,
compared with 37 (32.2%) in the comparator group (relative risk, 1.5; 95%
confidence interval 1.06-2.15; P = 0.02). Patients with aortic stenosis
(2.42, 1.56-3.75; P < 0.01) and patients with mitral regurgitation (1.63,
1.1-2.43; P = 0.02) also had increased incidence of in-hospital mortality.
There was no significant difference in any secondary outcomes among
groups, apart from variances in mean arterial pressure observed in
patients with valvular disease (P < 0.01). Conclusion(s): Significant
valvular dysfunction is associated with increased in-hospital mortality in
patients with CS. Randomized clinical trial data are needed to further
elucidate the role of transcatheter valvular interventions as a
therapeutic target in this population. Copyright © 2022 Canadian
Cardiovascular Society

<66>
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. 38(8) (pp 1189-1200), 2022. Date of
Publication: August 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, and 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. 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.
 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.
 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. Copyright © 2022
Canadian Cardiovascular Society

<67>
Accession Number
2018669768
Title
TAVI with the ACURATE neo transcatheter heart valve in special
populations: A systematic review.
Source
Hellenic Journal of Cardiology. 66 (pp 67-71), 2022. Date of Publication:
01 Jul 2022.
Author
Koliastasis L.; Doundoulakis I.; Kokkinidis D.G.; Milkas A.; Drakopoulou
M.; Benetos G.; Latsios G.; Synetos A.; Aggeli K.; Tousoulis D.; Tsioufis
K.; Toutouzas K.
Institution
(Koliastasis, Doundoulakis, Drakopoulou, Benetos, Latsios, Synetos,
Aggeli, Tousoulis, Tsioufis, Toutouzas) First Department of Cardiology,
National and Kapodistrian University, "Hippokration" Hospital, Athens,
Greece
(Koliastasis, Milkas) Athens Naval and Veterans Hospital, Athens, Greece
(Doundoulakis) Department of Cardiology, 424 General Military Training
Hospital, Thessaloniki, Greece
(Kokkinidis) Section of Cardiovascular Medicine, Yale University School of
Medicine, Yale New Haven Hospital, New Haven, CT, United States
Publisher
Hellenic Cardiological Society
Abstract
The ACURATE neo transcatheter aortic valve is a self-expanding device
suitable for both transfemoral and transapical approach, but specific
groups of patients are under-represented in clinical trials. We aim to
provide a comprehensive systematic review on TAVI with ACURATE neo in
those special populations. TAVI in bicuspid aortic valve, TAVI in patients
with small aortic annulus, TAVI for pure aortic regurgitation and
valve-in-valve procedures, were systematically reviewed. The primary
endpoint was device success as defined by VARC-2 criteria. The secondary
endpoints were safety and performance outcomes according to VARC-2
consensus document.ACURATE neo exhibited similar outcomes in bicuspid vs
tricuspid aortic valve except for pre and post-dilatation rates in one
observational study. Lower mean aortic gradient and higher pre-dilatation
rates with comparable safety outcomes were described for ACURATE neo when
compared to Lotus and Evolut-R for bicuspid aortic valve stenosis. 2
studies compared ACURATE in small aortic annuli. ACURATE neo showed lower
transvalvular gradients and lower patient prosthesis mismatch rates
compared to Sapien 3 and when compared to Evolut R/ Evolut PRO/ Portico,
results were similar except for pre-dilatation rates. 3 studies
investigated ACURATE neo for pure aortic regurgitation and one for
valve-in-valve procedure and demonstrated safety and efficacy, with the
exception of malposition events in patients designated for higher valve
deployment in the valve-in-valve implantation study.ACURATE neo valve may
be a feasible and safe option for patients with bicuspid anatomy, small
aortic annulus, previously implanted bioprosthetic aortic valve and pure
aortic regurgitation. Registration number: Available at
https://osf.io/aus26 (DOI 10.17605/OSF.IO/AUS26). Copyright ©
2022 Hellenic Society of Cardiology

<68>
Accession Number
638697214
Title
Meta-Analysis of AKI-CKD Transition in Perioperative Patients.
Source
Journal of the American College of Surgeons. Conference: American College
of Surgeons 2019 Annual Clinical Congress. San Francisco, CA United
States. 229(4 Supplement 2) (pp e234), 2019. Date of Publication: October
2019.
Author
Abdala P.; Swanson E.; Hutchens M.
Institution
(Abdala, Swanson, Hutchens) Oregon Health & Science University (OHSU),
Portland, OR, United States
Publisher
Elsevier Inc.
Abstract
INTRODUCTION: Recent research shows AKI increases the risk of incident
CKD. We hypothesized that perioperative AKI may confer increased risk of
subsequent CKD compared to nonperio-perative AKI. METHOD(S): MEDLINE
search for "AKI, CKD, chronic renal insufficiency, burns, nephrotoxins,
sepsis, systemic inflammatory response, surgical procedures" yielded 5209
articles. 1048 relevant studies were reviewed. 1002 were excluded because
they were review, animal, or pediatric studies. 30 of 42 were excluded
because they did not meet inclusion criteria. 12 underwent analysis. 2x2
tables were constructed from AKI +/-and CKD +/-data. The R package metafor
was employed. Estimates of odds ratio (OR) were calculated, and a
random-effects model used to calculate weighted ORs. Heterogeneity was
assessed. Leave-1-out and funnel analysis were used to estimate study
heterogeneity and bias. RESULT(S): Nonperioperative studies included
studies of oncology, percutaneous coronary intervention, and myocardial
infarction patients. Perioperative studies comprised patients from cardiac
surgery, vascular surgery, and burns. There was significant heterogeneity
but publication bias was not evident. The OR for AKI [95% CI] vs non-AKI
patients developing CKD in all studies was 5.52 [3.15-9.67].
Nonperioperative populations demonstrated OR 3.85 [1.71-8.69] whilst
perioperative populations demonstrated OR 6.64 [3.17-13.91].
 CONCLUSION(S): Increasing literature supports association of AKI with
subsequent CKD such that subgroup analysis may be applied. While there is
significant heterogeneity, surgical patients may experience increased risk
of AKI-CKD transition over nonsurgical patients.

<69>
Accession Number
638697189
Title
Effect of Left Lateral Decubitus Positioning on Urine Output in
Postoperative Patients.
Source
Journal of the American College of Surgeons. Conference: American College
of Surgeons 2019 Annual Clinical Congress. San Francisco, CA United
States. 229(4 Supplement 2) (pp e113), 2019. Date of Publication: October
2019.
Author
Desai H.A.; Markowiak S.; Casabianca A.; Brunicardi F.C.; Allison D.; Jain
S.; Tang J.
Institution
(Desai, Markowiak, Casabianca, Brunicardi, Allison, Jain, Tang) University
of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
Publisher
Elsevier Inc.
Abstract
INTRODUCTION: Compression of major abdominal vessels leads to decreased
venous return, cardiac output, renal perfusion and increased fluid
retention. This is well documented in pregnant, hypovolemic patients,
where it may be relieved by left lateral decubitus positioning which off
loads the weight of the gravid uteri. We hypothesize that postoperative
fluid retention may also occur by this mechanism and report preliminary
results of our randomized study. METHOD(S): A prospective,
IRB-approved trial studied adult patients immediately after completing
non-cardiac surgical procedures in the recovery room. Exclusion criteria
were renal failure and age<40 years. Patients were randomly assigned to
either supine or left-lateral decubitus groups. All patients spent the
first and last 15-minutes of the study in the supine position, while
patients in the left lateral decubitus group spent the middle 30 minutes
in the left-lateral decubitus position. Overall fluid balances and average
urine outputs were recorded at 15 minute intervals and compared by
Chi-square analysis with a p-value<0.02 considered significant.
 RESULT(S): Twenty-four patients gave consent and completed the study.
There was a significant difference in average urine output between the two
groups, although the difference in overall fluid balance between the
lateral and supine groups did not reach significance (p=0.16).
 CONCLUSION(S): Left lateral decubitus positioning may reduce fluid
overload in the immediate postoperative period. Further work is needed to
see if patient positioning might be a useful adjunct for reducing
postoperative fluid retention in critically ill patients at longer
intervals after surgery.

<70>
Accession Number
638698030
Title
Research Productivity and National Institutes of Health Funding within
Academic Surgery: A Gender Perspective.
Source
Journal of the American College of Surgeons. Conference: 2018 Owen
Wangensteen Scientific Forum of the American College of Surgeons. Boston,
MA United States. 227(4 Supplement 1) (pp S227-S228), 2018. Date of
Publication: October 2018.
Author
Adib H.; Ibraheem K.; Hoof M.A.; Farag M.; Haddad A.; Saparova L.; Downing
N.; Kandil E.; Killackey M.T.
Institution
(Adib, Ibraheem, Hoof, Farag, Haddad, Saparova, Downing, Kandil,
Killackey) Tulane University School of Medicine, New Orleans, LA, United
States
Publisher
Elsevier Inc.
Abstract
INTRODUCTION: Research output is integral to career advancement. Despite
more women in academic surgery, advancement in academic rank is lagging.
We examine gender representation, research productivity, and National
Institutes of Health (NIH) funding in academic surgery. METHOD(S): We
included 9 surgical specialties. Research productivity was measured by
h-index, collected from Web of Science. Trends in NIH funding from 2007
until 2017 were collected from the online NIH research portfolio.
 RESULT(S): We included 3,988 faculty (79.3% men, 20.7% women). The
highest and lowest distributions of women were observed in endocrine
surgery and thoracic surgery, respectively. Of chairs, 90.1% were men;
however, there was no difference between mean h-indices of men and women:
27.9+/-2.2 and 23.2+/-1.7 (p = 0.37), respectively. When stratified by
academic rank, there were no significant gender differences in h-indices.
The highest h-index of women was 13.9+/-0.9 in endocrine surgery and
surgical oncology, and the lowest was 3.0+/-3.0 in thoracic surgery. Mean
NIH funding of women is $2,630,361 compared with $8,101,405 for men.
However, between 2007 and 2017, there was an increase in NIH funding by
63% for women compared to 27% for men (Table). CONCLUSION(S): Despite
similar research productivity earlier in the academic ranks, advancement
is less common for women. Furthermore, though men and women are equally
productive in academic surgery, there remains a disproportionate gender
representation in leadership positions.

<71>
Accession Number
638696772
Title
Altmetric vs Bibliometric Perspective Regarding Publication Impact and
Force.
Source
Journal of the American College of Surgeons. Conference: 2018 Owen
Wangensteen Scientific Forum of the American College of Surgeons. Boston,
MA United States. 227(4 Supplement 1) (pp S94), 2018. Date of Publication:
October 2018.
Author
Powell A.G.; Bevan V.V.; Brown C.; Egan R.J.; Robinson D.; Hopkins L.G.R.;
Lewis W.G.
Institution
(Powell, Bevan, Brown, Egan, Robinson, Hopkins, Lewis) Cardiff University,
Cardiff, United Kingdom
Publisher
Elsevier Inc.
Abstract
INTRODUCTION: Bibliometric and Altmetric analyses highlight key
publications, which have been considered to be the most influential in
their field. The hypothesis was that highly cited articles would correlate
positively with levels of evidence and Altmetric scores (AS) and rank.
 METHOD(S): Surgery as a search term was entered into Thomson Reuter's
Web of Science database to identify all English language full articles.
The 100 most cited articles were analyzed by topic, journal, author, year,
institution, and AS. RESULT(S): By bibliometric criteria, eligible
articles numbered 286,122 and the median citation number was 574 (range
446 to 5,746). The most cited article (Dindo and colleagues) classified
surgical complications by severity score (5,746 citations). Annals of
Surgery published most articles and received most citations (26,457). The
country and year with most publications were the US (n = 50) and 1999 (n =
11). By Altmetric criteria, the article with the highest AS was by Bigelow
and colleagues (AS = 53, Hypothermia's role in cardiac surgery); Annals of
Surgery published most articles, and the country and year with most
publications were US (n = 4) and 2007 (n = 3). Level I evidence articles
numbered 13, but no correlation was found between evidence level and
citation number (Spearman's correlation coefficient [SCC] 0.094, p =
0.352) or AS (SCC = 0.149, p = 0.244). Median AS was 0 (0 to 53) and in
articles published after the year 2000, AS was associated with citation
number (r = 0.461, p = 0.001), and citation rate index (r = 0.455, p =
0.002). The AS was not associated with journal impact factor (r = 0.160, p
= 0.118). CONCLUSION(S): Bibliometric and Altmetric analyses provide
important but different perspectives about article impact, which are
unrelated to evidence level.

<72>
Accession Number
2017682482
Title
A Study of the Nursing Intervention Based on Self-Efficacy Theory for
Patients After Mechanical Heart Valve Replacement: A Randomized Controlled
Trial.
Source
International Journal of General Medicine. 15 (pp 6539-6547), 2022. Date
of Publication: 2022.
Author
Jiang F.; Lin Y.; Li S.; Peng Y.; Huang X.; Chen L.
Institution
(Jiang, Li, Peng, Huang, Chen) Heart Medicine Research Center, Fujian
Medical University Union Hospital, Fujian, Fuzhou 350001, China
(Lin) Nursing Department, Fujian Medical University Union Hospital,
Fujian, Fuzhou 350001, China
Publisher
Dove Medical Press Ltd
Abstract
Aim: To explore the practicability and efficiency of self-efficacy
intervention on the nursing for patients after mechanical heart valve
replacement (MHVR), so as to provide a theoretical and data foundation for
the implementation of self-efficacy intervention in clinical practice.
 Method(s): This study adopted a randomized controlled trial (RCT). A
total of 140 patients undergoing MHVR were randomly divided into the
experimental group (normal nursing + self-efficacy intervention) or the
control group (normal nursing only) based on a random number table. The
primary goal was to evaluate the effect of self-efficacy theory on the
self-efficacy of postoperative MHVR patients by General Self-Efficacy
Scale (GSES). The secondary goal was to assess the improvement of mental
health of postoperative patients as well as their pain through Symptom
Checklist 90 (SCL-90) and the visual analogue scale (VAS). The incidence
of infection during hospitalization was analyzed, as well as the
medication compliance of patients during 3-month follow-up after
discharge. Result(s): Finally, 136 patients completed the whole
trial. The GSES score of the experimental group was notably superior over
the control group (p < 0.001), and the SCL-90 scores were lower over the
control group. The VAS score of the experimental group was remarkably
lower than that of the control group (p < 0.001). The incidence of
infection in the experimental group was lower than that in the control
group (p = 0.026). The medication compliance of the experimental group was
superior to that of the control group (p = 0.030). Conclusion(s):
Self-efficacy intervention for patients after MHVR could mobilize their
self-efficacy, enhance their postoperative medication compliance, and
improve their postoperative recovery. This study provides evidence-based
medicine (EBM) evidence for the application of self-efficacy theory to
postoperative nursing for patients receiving MHVR. Copyright ©
2022 Jiang et al.

<73>
Accession Number
2019638398
Title
Impact of Moderate Aortic Stenosis on Long-Term Clinical Outcomes: A
Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 15(16) (pp 1664-1674), 2022. Date of
Publication: 22 Aug 2022.
Author
Coisne A.; Scotti A.; Latib A.; Montaigne D.; Ho E.C.; Ludwig S.; Modine
T.; Genereux P.; Bax J.J.; Leon M.B.; Bauters C.; Granada J.F.
Institution
(Coisne, Scotti, Ludwig, Leon, Granada) Cardiovascular Research
Foundation, New York, New York, United States
(Coisne, Scotti, Latib, Ho) Montefiore-Einstein Center for Heart and
Vascular Care, Montefiore Medical Center, Albert Einstein College of
Medicine, Bronx, NY, United States
(Coisne, Montaigne) INSERM U1011-EGID, Centre Hospitalier Universitaire de
Lille, Institut Pasteur de Lille, Universite de Lille, Lille, France
(Ludwig) Department of Cardiology, University Heart and Vascular Center
Hamburg, Hamburg, Germany
(Modine) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Bordeaux,
France
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Bax) Leiden University Medical Center, Leiden, Netherlands
(Bauters) INSERM U1167, Centre Hospitalier Universitaire de Lille,
Institut Pasteur de Lille, Universite de Lille, Universite Lille, Lille,
France
Publisher
Elsevier Inc.
Abstract
Background: The clinical course of patients with moderate aortic stenosis
(AS) remains incompletely defined. Objective(s): This study sought to
analyze the clinical course of moderate AS and compare it with other
stages of the disease. Method(s): Multiple electronic databases were
searched to identify studies on adult moderate AS. Random-effects models
were used to derive pooled estimates. The primary endpoint was all-cause
death. The secondary endpoints were cardiac death, heart failure, sudden
death, and aortic valve replacement. Result(s): Among a total of 25
studies (12,143 moderate AS patients, 3.7 years of follow-up), pooled
rates per 100 person-years were 9.0 (95% CI: 6.9 to 11.7) for all-cause
death, 4.9 (95% CI: 3.1 to 7.5) for cardiac death, 3.9 (95% CI: 1.9 to
8.2) for heart failure, 1.1 (95% CI: 0.8 to 1.5) for sudden death, and 7.2
(95% CI: 4.3 to 12.2) for aortic valve replacement. Meta-regression
analyses detected that diabetes (P = 0.019), coronary artery disease (P =
0.017), presence of symptoms (P < 0.001), and left ventricle (LV)
dysfunction (P = 0.009) were associated with a significant impact on the
overall estimate of all-cause death. All-cause mortality was higher in
patients with reduced LV ejection fraction (<50%) than with normal LV
ejection fraction: 16.5 (95% CI: 5.2 to 52.3) and 4.2 (95% CI: 1.4 to
12.8) per 100 person-years, respectively. Compared with moderate AS, the
incidence rate difference of all-cause mortality was -3.9 (95% CI: -6.7 to
-1.1) for no or mild AS and +2.2 (95% CI: +0.8 to +3.5) for severe AS
patients. Conclusion(s): Moderate AS appears to be associated with a
mortality risk higher than no or mild AS but lower than severe AS, which
increases in specific population subsets. The impact of early intervention
in moderate AS patients having high-risk features deserves further
investigation. Copyright © 2022 American College of Cardiology
Foundation

<74>
Accession Number
2019638395
Title
Study Evaluating the Use of RenalGuard to Protect Patients at High Risk of
AKI.
Source
JACC: Cardiovascular Interventions. 15(16) (pp 1639-1648), 2022. Date of
Publication: 22 Aug 2022.
Author
Mauler-Wittwer S.; Sievert H.; Ioppolo A.-M.; Mahfoud F.; Carrie D.;
Lipiecki J.; Nickenig G.; Fajadet J.; Eckert S.; Morice M.-C.; Garot P.
Institution
(Mauler-Wittwer, Ioppolo, Morice, Garot) Hopital Prive Jacques Cartier,
Institut Cardiovasculaire Paris-Sud, Massy, Ramsay-Sante, France
(Mauler-Wittwer, Ioppolo, Morice, Garot) Hopital Prive Claude Galien,
Institut Cardiovasculaire Paris-Sud, Quincy, Ramsay-Sante, France
(Sievert) CardioVascular Center, Frankfurt, Germany
(Mahfoud) Klinik fur Innere Medizin III, Kardiologie, Angiologie une
Internistische Intensivmedizin, Universitatsklinikum des Saarlandes,
Saarland University, Homburg/Saar, Germany
(Carrie) Department of Cardiology, Centre Hospitalier Universitaire de
Toulouse, Hopital Rangueil, Toulouse, France
(Lipiecki) Pole Sante-Republique, Clermont-Ferrand, France
(Nickenig) Department of Internal Medicine and Polyclinic II, University
Hospital Bonn, Germany
(Fajadet) Clinique Pasteur, Toulouse, France
(Eckert) Universitatsklinik der Ruhruniversitat Bochum-Klinik fur
Allgemeine und Interventionelle Kardiologie/Angiologie, Bad Oeynhausen,
Germany
(Morice) Cardiovascular European Research Center, Massy, France
Publisher
Elsevier Inc.
Abstract
Background: Contrast-induced nephropathy (CIN) can occur after
cardiovascular procedures using contrast media, which is associated with
increased morbidity and mortality. RenalGuard is a closed-loop system
designed to match intravenous hydration with diuretic-induced diuresis
that has shown mixed results in the prevention of CIN in previous
randomized controlled trials. Objective(s): The STRENGTH (Study
Evaluating the Use of RenalGuard to Protect Patients at High Risk of AKI)
study assessed whether RenalGuard (PLC Medical Systems) is superior to
standard intravenous hydration for CIN prevention in patients with chronic
kidney disease undergoing complex cardiovascular procedures.
 Method(s): STRENGTH is a multicenter, international, open-label,
postmarket, prospective, randomized (1:1) study monitored by the
Cardiovascular European Research Center (Massy, France) that included a
total of 259 patients with moderate to severe chronic kidney disease
(estimated glomerular filtration 15-40 mL/min/m2) requiring a
complex coronary, structural, or peripheral procedure with an expected
contrast injection of at least 3 times the estimated glomerular filtration
rate. Patients were randomized to either RenalGuard or intravenous saline
hydration according to current guidelines. Result(s): The primary
endpoint, the incidence of CIN at day 3 after the procedure, was similar
between the 2 groups (17/107 [15.9%] in the RG group vs 15/110 [13.9%] in
the control group; P = 0.62). In addition, none of the secondary endpoints
differed between the 2 groups. Conclusion(s): In high-risk patients
undergoing complex cardiovascular interventions in experienced centers,
furosemide-induced high urine output with matched hydration using the
RenalGuard system did not reduce the risk of CIN and adverse outcomes at
12 months compared with conventional intravenous hydration. Copyright
© 2022 American College of Cardiology Foundation

<75>
Accession Number
2019591122
Title
Efficacy of ultrasound-guided parasternal block in adult cardiac surgery:
a meta-analysis of randomized controlled trials.
Source
Minerva Anestesiologica. 88(9) (pp 719-728), 2022. Date of Publication:
September 2022.
Author
Li J.; Lin L.; Peng J.; He S.; Wen Y.; Zhang M.
Institution
(Li, Peng, He) Department of Anesthesiology, People's Hospital of Yilong
County, Nanchong, China
(Lin) Department of Anesthesiology, The General Hospital of Western
Theater Command Hospital, Chengdu, China
(Wen) Department of Anesthesiology, Traditional Chinese Medicine Hospital
of Nanchong, Nanchong, China
(Zhang) Department of Neurology, People's Hospital of Yilong County,
Nanchong, China
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Pain after cardiac surgery is a common and severe
postoperative complication. As a new regional nerve block method,
ultrasound-guided parasternal block (PSB) has been increasingly used to
supplement the analgesic effects of opioids in order to eliminate
opioid-related adverse drug events, but its efficacy still remains
controversial. In the present meta-analysis, we aim to screen all eligible
randomized controlled trials (RCTs) and give a comprehensive summary of
the clinical value of PSB after adult cardiac surgery. EVIDENCE
ACQUISITION: We searched all RCTs about PSB after cardiac surgery in the
database of PubMed, Embase, Cochrane, CNKI and Wanfang with no limitation
of language from inception to September 2021. Two reviewers were
independently involved in the process of data extraction. Meta-analysis
was performed by using Review Manager software. The quality of included
RCTs were assessed by using Cochrane's risk of bias assessment tool, and
funnel plots were drawn to assess publication bias. EVIDENCE SYNTHESIS: A
total of 12 RCTs with 366 patients in PSB group and 364 patients in
control group were included in the present meta-analysis. Pooled analysis
revealed that intraoperative and postoperative consumption of sufentanil
were significantly decreased with the addition of PSB (P<0.05). Numerical
rating scale (NRS) scores in PSB group were found to be significantly
lower than that of control group at extubation, postoperative 4 h and 8 h
(P<0.05) instead of postoperative 24 h or longer. PSB could reduce the
incidence of postoperative nausea and vomiting (PONV) (P<0.05). In
addition, we demonstrated that PSB was significantly related to decreased
mechanical ventilation time, total length of ICU stay and hospital days
(P<0.05). CONCLUSION(S): Through decreasing the consumption of
opioids, ultrasound-guided PSB could relieve pain and limit opioid-related
complications. Clinical outcomes, such as mechanical ventilation time,
total length of ICU stay and hospital days, will also be improved. Our
findings prove that ultrasound-guided PSB is an effective regional
analgesic method after adult cardiac surgery. Copyright © 2022
EDIZIONI MINERVA MEDICA.

<76>
Accession Number
2019157247
Title
Impact of Short-Term Heart Rate Variability in Patients with STEMI Treated
by Delayed versus Immediate Stent in Primary Percutaneous Coronary
Intervention: A Prospective Cohort Study.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 2533664. Date of Publication: 2022.
Author
Lin S.; Yang X.; Guo X.; Ye J.; Hu X.; Dong H.; Zhou Y.
Institution
(Lin, Zhou) School of Medicine, South China University of Technology,
Guangzhou Higher Education Mega Centre, Panyu District, Guangzhou 510006,
China
(Yang, Guo, Ye) Guangdong Provincial People's Hospital, Zhuhai Hospital,
No. 2 Hongyang Road, Jinwan District, Zhuhai 519094, China
(Yang, Guo, Ye, Hu, Dong, Zhou) Guangdong Cardiovascular Institute,
Guangdong Provincial People's Hospital, Guangdong Academy of Medical
Sciences, No. 106 Zhongshan Second Road, Yuexiu District, Guangzhou
510080, China
Publisher
Hindawi Limited
Abstract
Objective. Patients with ST-segment elevated myocardial infarction (STEMI)
have been treated with the delayed stent strategy to reduce the occurrence
of postoperative no-reflow and improve the recovery of postoperative
cardiac function. However, the effects of electrocardiac activity and
autonomic nerve function after primary percutaneous coronary intervention
(pPCI) have been rarely reported. The purpose of this study was to
investigate the effects of short-term heart rate variability (HRV) in
patients with STEMI treated by immediate stent (IS) and delayed stent (DS)
strategy. Methods. A total of 178 patients with STEMI were divided into
124 cases (69.66%) in the IS group and 54 cases (30.34%) in the DS group
from July 2019 to September 2021. The mean heart rate, premature
ventricular contraction (PVC), left ventricular ejection fraction (LVEF),
left ventricular end-diastolic diameter (LVED), and HRV indexes were
compared between the two groups. Results. In terms of cardiac electrical
stability, the number of PVCs, the percentage of PVCs, and the number of
paired PVCs in the DS group were lower than those in the IS group. In
terms of HRV, high frequency (HF) and standard deviation of all NN (SDNN)
intervals were higher in the patients with DS strategy than IS strategy.
There were no significant differences in the LVED and LVEF between the two
groups. Conclusion. Compared to the IS strategy, the DS strategy in pPCI
in patients with STEMI has advantages in postoperative cardiac electrical
stability and short-term cardiac autonomic nerve function, with no
difference in postoperative short-term cardiac function. Copyright
© 2022 Shaojie Lin et al.

<77>
Accession Number
2019048428
Title
Kernohan Woltman notch phenomenon caused by subdural chronic hematoma:
Systematic review and an illustrative case.
Source
Annals of Medicine and Surgery. 79 (no pagination), 2022. Article Number:
104006. Date of Publication: July 2022.
Author
Laaidi A.; Hmada S.; Naja A.; Lakhdar A.
Institution
(Laaidi, Hmada, Naja, Lakhdar) NEUROSURGERY Department, University
Hospital Center IBN ROCHD, Casablanca, Morocco
Publisher
Elsevier Ltd
Abstract
Kernohan Woltman Notch Phenomenon (KWNP) is caused by a supratentorial
lesion pressing the contralateral cerebral peduncle against the free edge
of the tentorium of the cerebellum. It is manifested by neurological signs
of ipsilateral localization; cerebral MRI is the most sensitive
examination for KWNP. Our patient is a 50-year-old woman, operated in 2011
for aortic and mitral valve replacement by mechanical prosthesis, under
oral anticoagulant, consults for headaches evolving for 20 days without
any notion of head trauma with installation of a progressively worsening
left hemibody deficit. Glasgow coma scale was 14 (E3 V5 M6) with left
anisocoria 4mm left/2mm right with left hemiplegia. CT shows a chronic
left hemispheric subdural hematoma 13.5mm thick with subfalcorial and
ipsilateral temporal involvement of the deficit. The cardiovascular
examination as well as the biological assessment was unremarkable. The
patient was operated on with a total recovery in 12 days, the
anticoagulant is resumed on day 20 postoperatively, with close monitoring.
KWNP may contribute to misdiagnosis in patients with bilateral
corticospinal tract lesions, and anticoagulation poses a problem in
stopping and restarting treatment due to the risk of bleeding on one side
and thrombosis on the other side. Copyright © 2022

<78>
Accession Number
2018873601
Title
Warm humidified CO<inf>2</inf> insufflation improves pericardial integrity
for cardiac surgery: a randomized control study.
Source
Journal of Cardiovascular Surgery. 63(3) (pp 369-375), 2022. Date of
Publication: June 2022.
Author
Segal R.; Mezzavia P.M.; Krieser R.B.; Sampurno S.; Taylor M.; Ramsay R.;
Kluger M.; Lee K.; Loh F.L.; TaToulis J.; O'Keefe M.; Chen Y.; Sindoni T.;
Ng I.
Institution
(Segal, Mezzavia, Krieser, Kluger, Lee, Loh, TaToulis, O'Keefe, Chen,
Sindoni, Ng) Department of Anesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Australia
(Segal, Ramsay, Lee, TaToulis, O'Keefe, Ng) University of Melbourne,
Melbourne, Australia
(Sampurno, Taylor, Ramsay) Peter MacCallum Cancer Centre, Melbourne,
Australia
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Flooding the surgical field with dry cold CO<inf>2</inf>
during open-chamber cardiac surgery has been used to mitigate air
entrainment into the systemic circulation. However, exposing epithelial
surfaces to cold, dry gas causes tissue desiccation. This randomized
controlled study was designed to investigate whether the use of humidified
warm CO<inf>2</inf> insufflation into the cardiac cavity could reduce
pericardial tissue damage and the incidence of micro-emboli when compared
to dry cold CO<inf>2</inf> insufflation. METHOD(S): Forty adult
patients requiring elective open-chamber cardiac surgery were randomized
to have either dry cold CO<inf>2</inf> insufflation via a standard
catheter or humidified warm CO<inf>2</inf> insufflation via the HumiGard
device (Fisher & Paykel Healthcare, Panmure, Auckland, New Zealand). The
primary endpoint was biopsied pericardial tissue damage, assessed using
electron microscopy. We assessed the percentage of microvilli and
mesothelial damage, using a damage severity score (DSS) system. We
compared the proportion of patients who had less damage, defined as DSS<2.
Secondary endpoints included the severity of micro-emboli, by visual
assessment of bubble load on transesophageal echocardiogram; lowest near
infrared spectroscopy; total de-airing time; highest cardio-pulmonary
bypass sweep speed; hospital length of stay and complications.
 RESULT(S): A higher proportion of patients in the humidified warm
CO<inf>2</inf> group displayed conserved microvilli (47% vs. 11%, P=0.03)
and preserved mesothelium (42% vs. 5%, P=0.02) compared to the control
group. There were no differences in the secondary outcomes.
 CONCLUSION(S): Humidified warm CO<inf>2</inf> insufflation
significantly reduced pericardial epithelial damage when compared to dry
cold CO<inf>2</inf> insufflation in open-chamber cardiac surgery. Further
studies are warranted to investigate its potential clinical
benefits. Copyright COPYRIGHT© 2022 EDIZIONI MINERVA MEDICA

<79>
Accession Number
2018873596
Title
Hybrid revascularization vs. coronary bypass for coronary artery disease:
A systematic review and meta-analysis.
Source
Journal of Cardiovascular Surgery. 63(3) (pp 353-368), 2022. Date of
Publication: June 2022.
Author
Hinojosa-Gonzalez D.E.; Bueno-Gutierrez L.C.; Salan-Gomez M.;
Tellez-Garcia E.; Ramirez-Mulhern I.; Sepulveda-Gonzalez D.; Ramonfaur D.;
Roblesgil-Medrano A.; Flores-Villalba E.
Institution
(Hinojosa-Gonzalez, Bueno-Gutierrez, Salan-Gomez, Tellez-Garcia,
Ramirez-Mulhern, Sepulveda-Gonzalez, Roblesgil-Medrano, Flores-Villalba)
School of Medicine and Health Sciences TecSalud ITESM, Monterrey, Mexico
(Ramonfaur) Harvard Medical School, Boston, MA, United States
(Flores-Villalba) School of Engineering and Sciences TecSalud ITESM,
Monterrey, Mexico
(Flores-Villalba) Laboratorio Nacional de Manufactura Aditiva y Digital
(MADIT), Monterrey, Apodaca, Mexico
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Coronary artery bypass graft is the mainstay of treatment
for multivessel coronary artery disease and is superior to percutaneous
coronary intervention. Combined approaches such as hybrid coronary
revascularization integrate coronary artery bypass grafting with
percutaneous coronary intervention during the same procedure or weeks
apart. These attempt to improve surgical morbidity and long-term outcomes.
EVIDENCE ACQUISITION: Per PRISMA criteria, a systematic review of keywords
"Hybrid Revascularization," "Hybrid Coronary Revascularization,"
"Surgical," "Surgery," "Treatment," "CABG," "HCR" and "PCI" was conducted
in PubMed, EMBASE and SCOPUS. Studies comparing this technique's
performance on either single or two-stage approach against traditional
multiple vessel coronary artery bypass grafting were screened and analyzed
for our review. EVIDENCE SYNTHESIS: Twenty-two studies totaling 6981
participants were ultimately included for analysis. Mean differences in
operative time, bleeding, ventilator time and length of stay were
significantly lower in the hybrid coronary revascularization group. Odds
ratios in transfusions and in-hospital myocardial infarction were also
lower in the hybrid coronary revascularization group. Results for
in-hospital and all-cause mortality, major adverse cardiac events (MACE),
stroke, reintervention, and complete revascularization were not
significantly different. CONCLUSION(S): Our analysis shows hybrid
coronary revascularization is a feasible alternative to traditional
coronary artery bypass grafting. Short-and long-term outcomes including
mortality, MACE, and postoperative morbidity are similar between both
groups, while hybrid approaches are associated with decreased
perioperative morbidity. Copyright © 2022 EDIZIONI MINERVA MEDICA

<80>
Accession Number
2018277988
Title
Objectively measured preoperative physical activity and sedentary
behaviour among Finnish patients scheduled for elective cardiac
procedures: baseline results from randomized controlled trial.
Source
BMC Sports Science, Medicine and Rehabilitation. 14(1) (no pagination),
2022. Article Number: 130. Date of Publication: December 2022.
Author
Vasankari S.; Hartikainen J.; Vasankari V.; Anttila V.; Tokola K.;
Vaha-Ypya H.; Husu P.; Sievanen H.; Vasankari T.; Halonen J.
Institution
(Vasankari) Derpartment of Clinical Medicine, University of Turku, Turku,
Finland
(Hartikainen, Halonen) Heart Center, Kuopio University Hospital (KUH),
Kuopio, Finland
(Vasankari) Department of Neurosurgery, Helsinki University Hospital,
University of Helsinki, Helsinki, Finland
(Anttila) Heart Center, Turku University Hospital, Turku, Finland
(Tokola, Vaha-Ypya, Husu, Sievanen, Vasankari) The UKK Institute for
Health Promotion Research, Tampere, Finland
(Vasankari) The Faculty of Medicine and Health Technology, Tampere
University, Tampere, Finland
Publisher
BioMed Central Ltd
Abstract
Background: We investigated preoperative physical activity (PA) and
sedentary behaviour (SB) in patients scheduled for elective cardiac
procedures and compared them with population-based sample of Finnish
adults. Method(s): Cardiac patients (n = 139) undergoing cardiac
operations carried a triaxial accelerometer for seven days during the
month before the procedure. Patients were categorised into four groups
according to the procedure: percutaneous coronary intervention or coronary
angiography (PCI-CA), coronary artery bypass grafting (CABG), aortic valve
replacement (AVR) and mitral valve surgery (MVS). The raw accelerometer
data was analyzed with dedicated algorithms to determine metabolic
equivalents (METs, 3.5 mL/kg/min of oxygen consumption) of PA. The
intensity of PA was divided into two categories: light (LPA, 1.5-2.9 METs)
and moderate-to-vigorous (MVPA, >= 3.0 METs), while SB represented
intensity < 1.5 MET without movements. SB and PA were described as daily
means and accumulation from different bout lengths. Daily standing, steps
and mean and peak MET-values were calculated. The results were compared
between the patient groups and against the reference group from a
population-based study FinFit2017. Result(s): Cardiac patients had
fewer daily steps than the FinFit population (p = 0.01), and less SB
accumulating from < 20 min bouts (p = 0.002) but more from 20 to 60 min
bouts (p = 0.002). Particularly, CABG group had less daily MVPA (p =
0.002) and MVPA accumulating from > 10 min bouts (p < 0.001) than the
FinFit population. Conclusion(s): We found large differences in PA
and SB between the patient groups and the FitFit population, CABG group
having the worst activity profile. Also, the variation within the patient
groups was wide, which should be considered to individualise the
rehabilitation programs postoperatively. Trial registration
clinicaltrials.gov (NCT03470246). Registered 19 March 2018,
https://clinicaltrials.gov/ct2/show/NCT03470246. Copyright ©
2022, The Author(s).

<81>
Accession Number
636658239
Title
Pharmacological interventions for the treatment of aortic root and heart
valve disease.
Source
Cochrane Database of Systematic Reviews. 2021(12) (no pagination), 2021.
Article Number: CD014767. Date of Publication: 13 Dec 2021.
Author
Morselli F.; McNally R.; Nesti L.; Liu B.; Khan H.; Thomson R.J.;
Stevenson A.; Banerjee A.; Ahmad M.; Hanif M.; Steeds R.; Khan M.
Institution
(Morselli) School of Cardiovascular Medicine and Sciences, King's College
London, London, United Kingdom
(Morselli) Department of Cardiology, East Kent Hospitals Univestity NHS
Foundation Trust, Kent, United Kingdom
(McNally) Department of Clinical Pharmacology, King's College London,
London, United Kingdom
(Nesti) Department of Clinical and Experimental Medicine, University of
Pisa, Pisa, Italy
(Liu, Steeds) Department of Cardiology, University Hospitals Birmingham
(Queen Elizabeth) NHS Foundation Trust, Birmingham, United Kingdom
(Khan) Department of Renal Medicine, Guys and St Thomas NHS Foundation
Trust, London, United Kingdom
(Thomson, Hanif) William Harvey Research Institute, Barts and The London
School of Medicine and Dentistry, Queen Mary University of London, London,
United Kingdom
(Stevenson) Department of Acute Medicine, Royal Free NHS Foundation Trust,
London, United Kingdom
(Banerjee) Institute of Health Informatics Research, University College
London, London, United Kingdom
(Ahmad) Department of Cardiology, Royal Free Hospital, Royal Free London
NHS Foundation Trust, London, United Kingdom
(Khan) School of Medicine, Keele University, Keele, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. The purpose of this review is to examine the
benefits and harms of pharmacological intervention acting directly or
indirectly on the cardiovascular system to treat aortic root and valve
disease, versus placebo. Copyright © 2021 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<82>
Accession Number
2017808482
Title
New challenges of fetal therapy in Japan.
Source
Journal of Obstetrics and Gynaecology Research. 48(8) (pp 2100-2111),
2022. Date of Publication: August 2022.
Author
Wada S.; Ozawa K.; Sago H.
Institution
(Wada, Ozawa, Sago) Center for Maternal-Fetal, Neonatal and Reproductive
Medicine, National Center for Child Health and Development, Tokyo, Japan
Publisher
John Wiley and Sons Inc
Abstract
Aim: To review new challenges of fetal therapy in Japan after the
establishment of four existing fetal therapies as standard prenatal care
with National Health Insurance coverage over the past 20 years.
 Method(s): Reported studies and our current research activities
related to four fetal therapies newly performed in Japan were reviewed.
 Result(s): Fetoscopic endoluminal tracheal occlusion (FETO) for
congenital diaphragmatic hernia (CDH) aims to occlude the trachea using a
detachable balloon to promote lung growth. Following the recent successful
completion of an international randomized controlled trial for CDH, in
which we participated, FETO is offered for severe left CDH to perform
balloon insertion at 27-29 weeks and removal at 34 weeks of gestation.
Fetal cystoscopy (FC) for low urinary tract obstruction was introduced to
overcome the demerits of vesicoamniotic shunting. FC may provide a proper
diagnosis by visual observation of the urethra and physiological treatment
of the posterior urethral valve. The effectiveness of open fetal surgery
for myelomeningocele (MMC), direct surgery with laparotomy and
hysterotomy, for ameliorating hindbrain herniation and the motor function
was demonstrated, but it was also associated with substantial maternal and
fetal risks. Fetal aortic valvuloplasty (FAV), ultrasound-guided fetal
aortic balloon dilation for critical aortic stenosis with evolving
hypoplastic left heart syndrome may improve left heart development and
maintain biventricular circulation. Feasibility and safety studies for FC,
MMC open fetal surgery, and FAV are currently ongoing. Conclusion(s):
Clinical research on FETO, FC, MMC open fetal surgery, and FAV has
proceeded with careful preparations in Japan. Copyright © 2022
The Authors. Journal of Obstetrics and Gynaecology Research published by
John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics
and Gynecology.

<83>
Accession Number
2017683184
Title
Implementation of patient-reported outcome measures in a heart transplant
recipient registry: First step toward a patient-centered approach.
Source
Clinical Transplantation. 36(8) (no pagination), 2022. Article Number:
e14708. Date of Publication: August 2022.
Author
Mahmoudi R.; Moitie T.; Dorent R.; Guillemin F.; Couchoud C.
Institution
(Mahmoudi, Moitie, Dorent, Couchoud) Direction medicale et scientifique,
Agence de la biomedecine, Saint Denis La Plaine, France
(Dorent) Departement de cardiologie, Hopital Bichat - Claude-Bernard,
Assistance Publique Hopitaux de Paris, Paris, France
(Guillemin) Universite de Lorraine, APEMAC, Nancy, France
Publisher
John Wiley and Sons Inc
Abstract
Background: Heart transplantation (HTX) is a well-established treatment
for suitable patients with end-stage heart failure, intended to prolong
their survival and improve their health-related quality of life (HR-QoL).
No international consensus exists, however, about the preferred
patient-reported outcomes (PROs) and their measures (PROMs) for heart
transplant recipients. The purpose of this study, the first step in a
mixed-method investigation, was to review the PROMs developed and used in
this population to identify the instruments for measuring HR-QoL and
adherence to immunosuppressive medications most appropriate for heart
transplant patients. Method(s): This systematic search of the
literature in the PubMed database focused on the assessment of PROMs for
patients after HTX. We analyzed 66 studies with cross-sectional, 28 with
longitudinal, and 2 with mixed-methods designs, as well as 6 literature
reviews. Result(s): These 102 articles used 115 different PROMs,
which we categorized as generic HR-QoL instruments (n = 19),
domain-specific instruments (n = 71), heart disease-specific instruments
(n = 9), and heart transplant-specific instruments (n = 16). They cover
different dimensions of HR-QoL and of immunosuppressive-drug experience,
with diverse numbers of items, types of scales, and psychometric
properties. Conclusion(s): Despite the abundance of instruments,
PROMs for HTX can be improved to meet other patient expectations (i.e., by
including important issues such as coping strategies, employment, social
support, sexual relationships, spirituality, and beliefs), while paying
attention to ease of use, reliability, validity, and the contribution of
new technologies. A qualitative approach will complete our project of
developing a patient-centered instrument for HTX patients. Copyright
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

<84>
Accession Number
638673341
Title
Comment on "The effect of preoperative chest physiotherapy on oxygenation
and lung function in cardiac surgery patients: a randomized controlled
study".
Source
Annals of Saudi medicine. 42(4) (pp 288-289), 2022. Date of Publication:
01 Jul 2022.
Author
Kashoo F.Z.; Ahmad M.; Sidiq M.; Shahood H.
Institution
(Kashoo) From the Department of Physical Therapy and Health
Rehabilitation, Majmaah University College of Applied Medical Sciences,
King Khalid Hospital Majmaah, Riyadh, Saudi Arabia
(Ahmad) From the Department of Nursing, Majmaah University College of
Applied Medical Sciences, King Khalid Hospital Majmaah, Riyadh, Saudi
Arabia
(Sidiq) From the Faculty of Physiotherapy, Madhav University, Rajasthan,
India
(Shahood) From the Doctoral School of Health Sciences, University of Pecs
Medical School, Pecs, Hungary
Publisher
NLM (Medline)

<85>
Accession Number
638690647
Title
Leadless pacemaker implantation in dextrocardia with situs viscerum
inversus: a case report and literature review.
Source
Pacing and clinical electrophysiology : PACE. (no pagination), 2022. Date
of Publication: 08 Aug 2022.
Author
Bontempi L.; Fundaliotis A.; Moretti M.; Sammartino A.M.; Saino A.T.;
Arabia G.; Piti A.; Curnis A.; Dell'Aquila A.
Institution
(Bontempi, Fundaliotis, Moretti, Sammartino, Saino, Dell'Aquila) Unit of
Cardiology, Cardiac Electrophysiology and Electrostimulation Laboratory,
"Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo, Italy
(Bontempi, Sammartino, Arabia, Piti, Curnis, Dell'Aquila) Institute of
Cardiology, Department of Medical and Surgical Specialties, Radiological
Sciences, Public Health, ASST Spedali Civili Hospital of Brescia and
University of Brescia, Brescia, Italy
Publisher
NLM (Medline)
Abstract
Leadless pacemaker implantation (LPI) has fewer device complications and
reduced chance of infection compared to conventional pacemakers.
Dextrocardia with situs viscerum inversus (DC+SVI) is a rare condition,
which seldom leads to cardiac complications. However, its presence poses a
challenge to operators in cardiac procedures. LPI reports in DC patients
are scarce. We report a case of LPI in a DC+SVI patient, followed by a
brief but comprehensive literature review. This article is protected by
copyright. All rights reserved.

<86>
Accession Number
638690607
Title
Impact of moderate or severe left ventricular outflow tract calcification
on clinical outcomes of patients with severe aortic stenosis undergoing
transcatheter aortic valve implantation with self- and balloon-expandable
valves: a post hoc analysis from the SOLVE-TAVI trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2022. Date of Publication: 09 Aug 2022.
Author
Farhan S.; Stachel G.; Desch S.; Kurz T.; Feistritzer H.-J.; Hartung P.;
Eitel I.; Nef H.; Doerr O.; Lauten A.; Landmesser U.; Sandri M.; Holzhey
D.; Borger M.; Ince H.; Oner A.; Meyer-Saraei R.; Wienbergen H.; Fach A.;
Frey N.; de Waha-Thiele S.; Thiele H.
Institution
(Farhan) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
(Stachel, Desch, Feistritzer, Hartung, Sandri, Thiele) Department of
Internal Medicine and Cardiology, Heart Center Leipzig, University of
Leipzig, Leipzig, Germany
(Stachel, Desch, Feistritzer, Hartung, Sandri, Holzhey, Borger, de
Waha-Thiele, Thiele) Department of Cardiology, Heart Center Leipzig at
University of Leipzig, Leipzig, Germany; Leipzig Heart Institute, Leipzig,
Germany
(Desch, Kurz, Eitel, Meyer-Saraei) University Clinic Schleswig-Holstein,
Kiel, Germany and University Heart Center Lubeck, Lubeck, Germany
(Desch, Kurz, Eitel, Landmesser, Meyer-Saraei, Frey) German Center for
Cardiovascular Research (DZHK), Campus Lubeck, Lubeck, Germany
(Nef, Doerr) Abteilung fur Kardiologie, Medizinische Klinik IGiesen,
Germany
(Lauten) Department of Cardiology and Intensive Care Medicine, Helios
Klinikum Erfurt, Erfurt, Germany
(Landmesser) Universitatsklinikum Charite, Campus Benjamin Franklin,
Berlin, Germany
(Holzhey, Borger, de Waha-Thiele) Department of Cardiac Surgery, Heart
Center Leipzig at University of Leipzig, Leipzig, Germany
(Ince, Oner) Medizinische Klinik I im Zentrum fuer Innere Medizin (ZIM),
Rostock, Germany
(Wienbergen, Fach) Klinikum Links der Weser, Herzzentrum Bremen, Bremen,
Germany
(Frey) Department of Cardiology, Angiology and Pneumology, University
Hospital Heidelberg, Heidelberg, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Left ventricular outflow tract (LVOT) calcification has been
associated with worse outcomes in patients undergoing transcatheter aortic
valve implantation (TAVI) and may influence the selection of prosthetic
valve type. AIMS: We aimed to evaluate the impact of LVOT calcification on
outcomes after TAVI with a self-expanding valve (SEV) versus a
balloon-expandable valve (BEV). METHOD(S): Patients of the SOLVE-TAVI
trial, randomised to Edwards SAPIEN 3 or Medtronic Evolut R, were divided
according to LVOT calcification into no/mild (<=1 calcium nodule extending
<5 mm and covering <10% of the LVOT perimeter) and moderate/severe LVOT
calcification groups. The primary endpoint was a composite of death,
stroke, moderate/severe paravalvular regurgitation, permanent pacemaker
implantation and annulus rupture at 30 days. Additional endpoints included
all-cause and cardiovascular mortality at 1 year. RESULT(S): Out of
416 eligible patients, moderate/severe LVOT calcification was present in
143 (34.4%). Moderate/severe LVOT calcification was associated with
significantly longer fluoroscopy time and higher rates of pre- and
post-dilation. Regardless of the LVOT calcification group, there was no
significant difference in the primary endpoint associated with the valve
type (no/mild LVOT calcification group: SEV 25.0% vs BEV 27.0%; hazard
ratio [HR] 1.10, 95% confidence interval [95% CI]: 0.68-1.73; p=0.73 and
moderate/severe LVOT calcification group: SEV 25.0% vs BEV 19.4%; HR 0.76,
95% CI: 0.38-1.61; p=0.49), no significant interaction between LVOT
calcification and valve type (pint=0.29) and no differences between SEV vs
BEV within LVOT calcification groups regarding 1-year all-cause and
cardiovascular mortality. CONCLUSION(S): Moderate/severe LVOT
calcification was associated with longer fluoroscopy time and an increased
need for pre- and post-dilation, but not with a higher incidence of early
and mid-term adverse clinical outcomes, regardless of valve type.
(ClinicalTrials.gov: NCT02737150).

<87>
Accession Number
638688632
Title
Pre-surgery optimization of patients' expectations to improve outcome in
heart surgery: Study protocol of the randomized controlled multi-center
PSY-HEART-II trial.
Source
American heart journal. (no pagination), 2022. Date of Publication: 05
Aug 2022.
Author
Salzmann S.; Laferton J.A.C.; Shedden-Mora M.C.; Horn N.; Gartner L.;
Schroder L.; Rau J.; Schade-Brittinger C.; Murmann K.; Rastan A.; Andrasi
T.B.; Boning A.; Salzmann-Djufri M.; Lowe B.; Brickwedel J.; Albus C.;
Wahlers T.; Hamm A.; Hilker L.; Wolfgang A.; Volkmar F.; Zimmermann T.;
Ismail I.; Strauss B.; Doenst T.; Schedlowski M.; Moosdorf R.; Rief W.
Institution
(Salzmann, Horn, Gartner, Schroder, Rief) Division of Clinical Psychology
and Psychotherapy, Philipps University of Marburg, Marburg, Germany
(Laferton) Department of Medicine, Health and Medical University, Potsdam,
Germany
(Shedden-Mora) Department of Psychology, Medical School Hamburg, Hamburg,
Germany; Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Rau, Schade-Brittinger, Murmann) Coordination Center for Clinical Trials
(KKS), University of Marburg, Marburg, Germany
(Rastan, Andrasi, Moosdorf) Department for Cardiovascular Surgery, Heart
Center, Philipps University of Marburg, Marburg, Germany
(Boning, Salzmann-Djufri) Department of Cardiovascular Surgery, University
Hospital Giessen, Giessen, Germany
(Lowe) Department of Psychosomatic Medicine and Psychotherapy, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Brickwedel) Department of Cardiovascular Surgery, University Heart &
Vascular Center Hamburg, Hamburg, Germany
(Albus) Department of Psychosomatics and Psychotherapy, Medical Faculty
and University Hospital, University of Cologne, Cologne, Germany
(Wahlers) Department of Cardiothoracic Surgery, University Hospital of
Cologne, Cologne, Germany
(Hamm) Department of Physiological and Clinical Psychology/ Psychotherapy,
University of Greifswald, Greifswald, Germany
(Hilker) Department of Cardiovascular Surgery, Heart and Diabetes Center
Mecklenburg-Western Pommerania, Karlsburg, Germany
(Wolfgang) Psychosomatics, German Heart Center Berlin, Berlin, Germany
(Volkmar) Department of Cardiothoracic and Vascular Surgery, German Heart
Center Berlin, Berlin, Germany
(Zimmermann) Department of Psychosomatic Medicine and Psychotherapy,
Hannover Medical School, Hannover, Germany
(Ismail) Division of Cardiac, Thoracic, Transplantation and Vascular
Surgery, Hannover Medical School, Hannover, Germany
(Straus) Institute of Psychosocial Medicine, Psychooncology, University
Hospital Jena, Germany
(Doenst) Jena University Hospital, Friedrich-Schiller-University of Jena,
Jena, Germany
(Schedlowski) Institute of Medical Psychology and Behavioral
Immunobiology, University Clinic Essen, Department of Clinical
Neuroscience, Osher Center for Integrative Medicine, Karolinska Institute,
Essen, Stockholm 17177, Sweden
Publisher
NLM (Medline)
Abstract
The PSY-HEART-I trial indicated that a brief expectation-focused
intervention prior to heart surgery improves disability and quality of
life 6 months after coronary artery bypass graft surgery (CABG). However,
to investigate the clinical utility of such an intervention, a large
multi-center trial is needed to generalize the results and their
implications for the health care system. The PSY-HEART-II study aims to
examine whether a preoperative psychological intervention targeting
patients' expectations (EXPECT) can improve outcomes 6 months after CABG
(with or without heart valve replacement). EXPECT will be compared to
Standard of Care (SOC) and an intervention providing emotional support
without targeting expectations (SUPPORT). In a 3-arm multi-center
randomized, controlled, prospective trial (RCT), N=567 patients scheduled
for CABG surgery will be randomized to either SOC alone or SOC and EXPECT
or SOC and SUPPORT. Patients will be randomized with a fixed unbalanced
ratio of 3:3:1 (EXPECT: SUPPORT: SOC) to compare EXPECT to SOC and EXPECT
to SUPPORT. Both psychological interventions consist of 2 in-person
sessions (a 50 min), two phone consultations (a 20 min) during the week
prior to surgery, and one booster phone consultation post-surgery 6 weeks
later. Assessment will occur at baseline approx. 3-10 days before surgery,
preoperatively the day before surgery, 4-6 days later, and 6 months after
surgery. The study's primary endpoint will be patients' illness-related
disability 6 months after surgery. Secondary outcomes will be patients'
expectations, subjective illness beliefs, quality of life, length of
hospital stay and blood sample parameters (e.g., inflammatory parameters
such as IL-6, IL-8, CRP). This large multi-center trial has the potential
to corroborate and generalize the promising results of the PSY-HEART-I
trial for routine care of cardiac surgery patients, and to stimulate
revisions of treatment guidelines in heart surgery. Copyright ©
2022. Published by Elsevier Inc.

<88>
Accession Number
638685707
Title
Surgical Management of Aortic Regurgitation in Takayasu's Arteritis: A
Systematic Review of Techniques and Outcomes.
Source
The Permanente journal. (pp 1-11), 2022. Date of Publication: 02 Aug
2022.
Author
Fath A.R.; Mookadam F.; Aglan A.; Eldaly A.S.; Jahanyar J.; Shamoun F.;
Lee H.R.; Solsi A.; Israr S.; Mihyawi N.; Agasthi P.; Arsanjani R.
Institution
(Fath, Mihyawi) Cardiovascular Diseases, University of Texas, San Antonio,
TX, United States
(Mookadam, Shamoun, Lee, Agasthi, Arsanjani) Department of Cardiovascular
Diseases, Mayo Clinic, Phoenix, AZ, United States
(Aglan) Department of Medicine, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
(Eldaly) Plastic and Reconstructive Surgery Department, Tanta University
Hospitals, Egypt
(Jahanyar) Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, AZ,
United States
(Solsi, Israr) Department of Internal Medicine, Creighton University,
Phoenix, AZ, United States
Publisher
NLM (Medline)
Abstract
Introduction Takayasu's arteritis (TA) is an inflammatory condition that
affects large vessels and frequently involves the aortic valve causing
valve regurgitation. Surgical management is recommended for symptomatic
severe aortic regurgitation (AR); however, the optimal surgical approach
is yet unclear. This study aims to review surgical treatment options for
AR in TA and determine which procedure has a lower chance of late
postoperative events and/or mortality. Methods An electronic database
search was performed within PubMed, EMBASE, Web of Science, and SCOPUS to
identify articles from 1975 to 2016 focusing on surgical management of the
AR in TA. Results Twenty seven studies encompassing a total of 194 cases
(77% females) were included. Isolated aortic valve replacement (AVR) was
performed in 105/194 cases (54%) (Group A), while combined aortic valve
and root replacement (CAVRR) was performed in 87/194 (45%) (Group B).
Prosthetic valve detachment was reported in 10/105 cases (9.5%) in group A
and 1/87 cases (1.2%) in group B (p = 0.02). Dilation of the residual
aorta was reported in 10/105 cases (9.5%) in group A and 1/87 cases (1.2%)
in group B (p = 0.02). Any late (>= 30 d) postoperative cardiac event was
reported in 26/105 cases (24.8%) in group A, and in 7/87 cases (8.1%) in
group B (p = 0.003). Conclusions Although CAVRR is a more complex
procedure, it might offer a better outcome in terms of late postoperative
cardiac events compared to isolated AVR procedure. Future prospective
studies are required to help determine the best surgical approach in such
a population.

EPICORE Embase Updates

Saturday, August 20, 2022

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

No comments:

Post a Comment

Followers

Blog Archive

About Me