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<1>
Accession Number
2019638392
Title
Short- and Long-Term Clinical Outcomes Following Permanent Pacemaker
Insertion Post-TAVR: A Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 15(16) (pp 1690-1692), 2022. Date of
Publication: 22 Aug 2022.
Author
Gupta R.; Mahajan S.; Behnoush A.H.; Mahmoudi E.; Malik A.H.; Goel A.;
Bandyopadhyay D.; Vyas A.V.; Patel N.C.; Chatterjee S.; Lakkireddy D.R.;
Bhatt D.L.
Publisher
Elsevier Inc.

<2>
Accession Number
2017137725
Title
PCSK9 and Cardiovascular Disease in Individuals with Moderately Decreased
Kidney Function.
Source
Clinical Journal of the American Society of Nephrology. 17(6) (pp
809-818), 2022. Date of Publication: June 2022.
Author
Kheirkhah A.; Lamina C.; Kollerits B.; Schachtl-Riess J.F.; Schultheiss
U.T.; Forer L.; Sekula P.; Kotsis F.; Eckardt K.-U.; Kronenberg F.
Institution
(Kheirkhah, Lamina, Kollerits, Schachtl-Riess, Forer, Kronenberg)
Institute of Genetic Epidemiology, Medical University of Innsbruck,
Innsbruck, Austria
(Schultheiss, Sekula, Kotsis) Institute of Genetic Epidemiology, Faculty
of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
(Schultheiss, Kotsis) Department of Medicine IV- Nephrology and Primary
Care, Faculty of Medicine and Medical Center, University of Freiburg,
Freiburg, Germany
(Eckardt) Department of Nephrology and Hypertension, University Hospital
Erlangen, FriedrichAlexander Universitat Erlangen-Nurnberg, Erlangen,
Germany
(Eckardt) Department of Nephrology and Medical Intensive Care, Charite-
Universitatsmedizin Berlin, Berlin, Germany
(Kronenberg) Institute of Genetic Epidemiology, Medical University of
Innsbruck, Schopfstrasse 41, Innsbruck A-6020, Austria
Publisher
American Society of Nephrology
Abstract
Background and objectives Proprotein convertase subtilisin/kexin type 9
(PCSK9) is a key regulator of lipid homeostasis. Studies investigating the
association between PCSK9 and cardiovascular disease in large cohorts of
patients with CKD are limited. Design, setting, participants, &
measurements The association of PCSK9 concentrations with prevalent and
incident cardiovascular disease was investigated in 5138 White
participants of the German Chronic Kidney Disease study with a median
follow-up of 6.5 years. Inclusion criteria were eGFR of 30-60 or.60 ml/min
per 1.73 m2 in the presence of overt proteinuria (urine albumin-creatinine
ratio.300 mg/g or equivalent). Prevalent cardiovascular disease was
defined as a history of nonfatal myocardial infarction, coronary artery
bypass grafting, percutaneous transluminal coronary angioplasty, carotid
arteries interventions, and stroke. Incident major adverse cardiovascular
disease events included death from cardiovascular causes, acute nonfatal
myocardial infarction, and nonfatal stroke. Results Median PCSK9
concentration in the cohort was 285 ng/ml (interquartile range, 231-346
ng/ml). There was no association between PCSK9 concentrations and baseline
eGFR and albuminuria. With each 100-ng/ml increment of PCSK9, the odds for
prevalent cardiovascular disease (n51284) were 1.22-fold (95% confidence
interval, 1.12 to 1.34; P,0.001) higher in a model with extended
adjustment for major confounders. This association was stronger in
nonstatin than statin users (P value for interaction 50.009). During
follow-up, 474 individuals experienced a major adverse cardiovascular
disease event, and participants in PCSK9 quartiles 2-4 had a 32%-47%
higher risk compared with those in quartile 1 (P,0.05). Subgroup analysis
revealed that this association was restricted to those participants who
already had cardiovascular disease at baseline (all hazard ratios.1.75;
P50.01). In addition, PCSK9 showed a valuable gain in classification
accuracy for both prevalent cardiovascular disease (net reclassification
index 50.27; 95% confidence interval, 0.20 to 0.33) and incident major
adverse cardiovascular disease events during follow-up (net
reclassification index 50.10; 95% confidence interval, 0.01 to 0.21) when
added to an extended adjustment model. Conclusions Our findings reveal no
relation of PCSK9 with baseline eGFR and albuminuria but a significant
association between higher PCSK9 concentrations and risk of cardiovascular
disease independent of traditional risk factors, including LDL cholesterol
levels. Copyright © 2022 by the American Society of Nephrology.

<3>
Accession Number
2019699722
Title
Effects of subanaesthetic S-ketamine on postoperative delirium and
cognitive function in elderly patients undergoing non-cardiac thoracic
surgery: a protocol for a randomised, double-blinded, placebo-controlled
and positive-controlled, non-inferiority trial (SKED trial).
Source
BMJ Open. 12(8) (no pagination), 2022. Article Number: e061535. Date of
Publication: 01 Aug 2022.
Author
Wei W.; Zhang A.; Liu L.; Zheng X.; Tang C.; Zhou M.; Gu Y.; Yao Y.
Institution
(Wei, Zhang, Liu, Zheng, Tang, Gu, Yao) Department of Anesthesiology,
Affiliated Cancer Hospital and Institute of Guangzhou Medical University,
Guangdong, Guangzhou, China
(Zhou) Department of Thoracic Surgery, Affiliated Cancer Hospital and
Institute of Guangzhou Medical University, Guangdong, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a common and distressing
complication after thoracic surgery. S-ketamine has neuroprotective
properties as a dissociative anaesthetic. Emerging literature has
indicated that S-ketamine can reduce cognitive impairment in patients with
depression. However, the role of S-ketamine in preventing POD remains
unknown. Therefore, this study aims to evaluate the effect of
intraoperative prophylactic S-ketamine compared with that of
dexmedetomidine on the incidence of POD in elderly patients undergoing
non-cardiac thoracic surgery. Methods and analysis This will be a
randomised, double-blinded, placebo-controlled, positive-controlled,
non-inferiority trial that enrolled patients aged 60-90 years undergoing
thoracic surgery. The patients will be randomly allocated in a ratio of
1:1:1 to S-ketamine, dexmedetomidine or normal saline placebo groups using
computer-generated randomisation with a block size of six. The primary
outcome will be the incidence of POD within 4 days after surgery and this
will be assessed using a 3-Minute Diagnostic Confusion Assessment Method
two times per day. The severity and duration of POD, the incidence of
emergence delirium, postoperative pain, quality of sleep, cognitive
function, and the plasma concentrations of acetylcholine, brain-derived
neurotrophic factor, tumour necrosis factor-alpha and incidence of adverse
events will be evaluated as secondary outcomes. Ethics and dissemination
Ethical approval has been obtained from the Institutional Review Board of
the Cancer Hospital and the Institute of Guangzhou Medical University
(ZN202119). At the end of the trial, we commit to making a public
disclosure available, regardless of the outcome. The public disclosure
will include a publication in an appropriate journal and an oral
presentation at academic meetings. Trial registration number
ChiCTR2100052750 (NCT05242692). Copyright © 2022 Walter de
Gruyter GmbH, Berlin/Boston.

<4>
Accession Number
2019465651
Title
Does Dexmedetomidine Reduce the Risk of Atrial Fibrillation and Stroke
After Adult Cardiac Surgery? A Systematic Review and Meta-analysis of
Randomized Controlled Trials.
Source
Anatolian Journal of Cardiology. 26(5) (pp 354-365), 2022. Date of
Publication: May 2022.
Author
Jing C.; Lin L.; Zhou T.; Li Y.L.; Fu L.; Gao M.Q.
Institution
(Jing, Lin, Zhou, Gao) Department of Intensive Care Unit, Beijing Shijitan
Hospital, Capital Medical University, Beijing, China
(Li, Fu) The Eighth Affiliated Hospital, Sun Yat-Sen University,
Guangdong, Shenzhen, China
Publisher
Turkish Society of Cardiology
Abstract
Background: Postoperative atrial fibrillation is a common consequence of
cardiac surgery with increased stroke complications and mortality.
Although dexmedetomidine is thought to prevent postoperative atrial
fibrillation and stroke because of its sympatholytic and anti-inflammatory
properties, data from different studies show the effect of dexmedetomidine
on postoperative atrial fibrillation and stroke uncertain in adult
patients with cardiac surgery. Method(s): A database including
EMBASE, PubMed, and Cochrane CENTRAL was searched for randomized
controlled trials comparing dexmedetomidine with placebo or other
anesthetic drugs in adult cardiac surgery. The primary outcome was the
incidence of postoperative atrial fibrillation. The secondary outcomes
were the incidence of postoperative stroke, mechanical ventilation
duration, intensive care unit length of stay, hospital length of stay, and
mortality. Result(s): Eighteen trials with a total of 2933 patients
were enrolled in the meta-analyses. Compared with controls,
dexmedetomidine significantly reduced the incidence of postoperative
atrial fibrillation [odds ratio, 0.82; 95% CI, 0.69-0.98; P = .03]. There
was no significant difference between groups in stroke (odds ratio, 1.36;
95% CI, 0.59-3.16; P = .47), mechanical ventilation duration [weighted
mean difference, -0.17; 95% CI, -0.35 to 0.14; P = .39], intensive care
unit length of stay (weighted mean difference, -0.03; 95% CI, -0.93 to
0.87; P = .95), hospital length of stay (weighted mean difference, -0.04;
95% CI, -0.40 to 0.32; P = .83) and mortality (odds ratio, 0.72; 95% CI,
0.32-1.60; P = .42). Conclusion(s): Perioperative dexmedetomidine
reduced the incidence of postoperative atrial fibrillation in adult
patients undergoing cardiac surgery. But there was no significant
difference in the incidence of stroke, mechanical ventilation duration,
intensive care unit length of stay, hospital length of stay, and
mortality. Copyright © 2022 Turkish Society of Cardiology. All
rights reserved.

<5>
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.

<6>
Accession Number
2014601407
Title
Ultrasound-guided erector spinae plane catheter versus video-assisted
paravertebral catheter placement in minimally invasive thoracic surgery:
comparing continuous infusion analgesic techniques on early quality of
recovery, respiratory function and chronic persistent surgical pain: study
protocol for a double-blinded randomised controlled trial.
Source
Trials. 22(1) (no pagination), 2021. Article Number: 965. Date of
Publication: December 2021.
Author
Moorthy A.; Eochagain A.N.; Dempsey E.; Buggy D.
Institution
(Moorthy, Buggy) Division of Anaesthesiology & Perioperative Medicine,
Mater University Hospital, Dublin, Ireland
(Eochagain, Dempsey) Department of Anaesthesia and Critical Care, St
James's University Hospital, Dublin, Ireland
Publisher
BioMed Central Ltd
Abstract
Background: Compared to conventional thoracotomy, minimally invasive
thoracic surgery (MITS) can reduce postoperative pain, reduce tissue
trauma and contribute to better recovery. However, it still causes
significant acute postoperative pain. Truncal regional anaesthesia
techniques such as paravertebral and erector spinae blocks have shown to
contribute to postoperative analgesia after MITS. Satisfactory placement
of an ultrasound-guided thoracic paravertebral catheter can be technically
challenging compared to an ultrasound-guided erector spinae catheter.
However, in MITS, an opportunity arises for directly visualised placement
of a paravertebral catheter by the surgeon under thoracoscopic guidance.
Alongside with thoracic epidural, a paravertebral block is considered the
"gold standard" of thoracic regional analgesic techniques. To the best of
our knowledge, there are no randomised controlled trials comparing
surgeon-administered paravertebral catheter and anaesthesiologist-assisted
erector spinae catheter for MITS in terms of patient-centred outcomes such
as quality of recovery. Method(s): This trial will be a prospective,
double-blinded randomised controlled trial. A total of 80 eligible
patients will be randomly assigned to receive either an
anaesthesiologist-assisted ultrasound-guided erector spinae catheter or a
surgeon-assisted video-assisted paravertebral catheter, in a 1:1 ratio
following induction of general anaesthesia for minimally assisted thoracic
surgery. Both groups will receive the same standardised analgesia protocol
for both intra- and postoperative periods. The primary outcome is defined
as Quality of Recovery (QoR-15) score between the two groups at 24 h
postoperative. Secondary outcomes include assessment of chronic persistent
surgical pain (CPSP) at 3 months postoperative using the Brief Pain
Inventory (BPI) Short Form and Short Form McGill (SF-15) questionnaires,
assessment of postoperative pulmonary function, area under the curve for
Verbal Rating Score for pain at rest and on deep inspiration versus time
over 48 h, total opioid consumption over 48 h, QoR-15 at 48 h, and
postoperative complications and morbidity as measured by the Comprehensive
Complication Index. Discussion(s): Despite surgical advancements in
thoracic surgery, severe acute postoperative pain following MITS is still
prevailing. This study will provide recommendations about the efficacy of
an anaesthesia-administered ultrasound-guided erector spinae catheter or
surgeon-administered, video-assisted paravertebral catheter techniques for
early quality of recovery following MITS. Trial registration:
ClinicalTrials.govNCT04729712. Registered on 28 January 2021. All items
from the World Health Organization Trial Registration Data Set have been
included. Copyright © 2021, The Author(s).

<7>
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

<8>
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

<9>
Accession Number
638090034
Title
Delayed hospitalisation for heart failure after transcatheter repair or
medical treatment for secondary mitral regurgitation: a landmark analysis
of the MITRA-FR trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
18(6) (pp 514-523), 2022. Date of Publication: 19 Aug 2022.
Author
Leurent G.; Auffret V.; Donal E.; Corbineau H.; Grinberg D.; Bonnet G.;
Leroux P.-Y.; Guerin P.; Wautot F.; Lefevre T.; Messika-Zeitoun D.; Iung
B.; Armoiry X.; Trochu J.-N.; Boutitie F.; Obadia J.-F.
Institution
(Leurent, Auffret, Donal) Universite de Rennes, CHU Rennes, INSERM,
Rennes, France
(Leurent, Auffret, Donal) Service de Cardiologie, CHU Rennes, Rennes,
France
(Corbineau) Division of Thoracic and Cardiovascular Surgery, CHU Rennes,
Rennes, France
(Grinberg, Obadia) Hopital Cardiovasculaire Louis Pradel, Chirurgie
Cardio-Vasculaire et Transplantation Cardiaque, Hospices Civils de Lyon
and Claude Bernard University, Lyon, France
(Bonnet) Service de Cardiologie Interventionnelle, CHU Timone, Assistance
Publique-Hopitaux de Marseille, INSERM, Marseille, France
(Leroux) Cardiologie Medicale et Structurelle, France
(Guerin, Trochu) Universite Nantes, CHU Nantes, CNRS, INSERM, L'institut
du Thorax, Nantes, France
(Wautot) Centre Cardio-Thoracique de Monaco, Monaco
(Lefevre) Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques
Cartier, Massy, France
(Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, Canada
(Iung) Hopital Bichat - Claude Bernard, DHU FIRE, France and Universite de
Paris and INSERM 1148, Paris, France
(Armoiry) Pharmacy Department, University of Lyon, School of Pharmacy
(ISPB)/UMR CNRS 5510 MATEIS/Edouard Herriot Hospital, Lyon, France
(Armoiry) University of Warwick, Warwick Medical School, Coventry, United
Kingdom
(Boutitie) Service de Biostatistique - Bioinformatique, Pole Sante
Publique, Hospices Civils de Lyon, Lyon; and Universite Lyon 1,
Villeurbanne, France; and CNRS, UMR 5558, Laboratoire de Biometrie et
Biologie Evolutive, Equipe Biostatistique-Sante, Villeurbanne, France
Publisher
NLM (Medline)
Abstract
BACKGROUND: In the MITRA-FR trial, transcatheter mitral valve repair
(TMVR) was not associated with a 2-year clinical benefit in patients with
secondary mitral regurgitation (SMR). AIMS: This landmark analysis aimed
at investigating a potential reduction of the hospitalisation rate for
heart failure (HF) between 12 and 24 months after inclusion in the
MITRA-FR trial in patients randomised to the intervention group (TMVR with
the MitraClip device), as compared with patients randomised to the control
group (guideline-directed medical therapy [GDMT]). METHOD(S): The
MITRA-FR trial randomised 307 patients with SMR for TMVR on top of GDMT
(TMVR group; n=152) or for GDMT alone (control group; n=155). We conducted
a 12-month landmark analysis in surviving patients who were not
hospitalised for HF within the first 12 months of follow-up. The primary
endpoint was the 1-year cumulative number of HF hospitalisations.
 RESULT(S): A total of 140 patients (TMVR group: 67; GDMT group: 73)
were selected for this landmark analysis with similar characteristics at
inclusion in the trial. The primary endpoint was 28 events per 100
patient-years in the TMVR group, as compared with 60 events per 100
patient-years in the GDMT group (hazard ratio [HR] 0.46, 95% confidence
interval [CI]: 0.20-1.02; p=0.057). CONCLUSION(S): In this landmark
analysis of the MITRA-FR trial, the cumulative rate of HF hospitalisation
between 12 and 24 months among patients treated with TMVR on top of GDMT
was approximately half as many as those of patients treated with GDMT
alone, a difference which did not reach statistical significance in the
setting of a low number of events.

<10>
Accession Number
637841567
Title
Bleeding risk differences after TAVR according to the ARC-HBR criteria:
insights from SCOPE 2.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
18(6) (pp 503-513), 2022. Date of Publication: 19 Aug 2022.
Author
Garot P.; Neylon A.; Morice M.-C.; Tamburino C.; Bleiziffer S.; Thiele H.;
Scholtz S.; Schramm R.; Cockburn J.; Cunnington M.; Wolf A.; Barbanti M.;
Tchetche D.; Pagnotta P.; Gilard M.; Bedogni F.; Van Belle E.;
Vasa-Nicotera M.; Chieffo A.; Bogaerts K.; Hengstenberg C.; Capodanno D.
Institution
(Garot, Neylon, Morice) Institut Cardiovasculaire Paris-Sud, Hopital Prive
Jacques Cartier, Massy, France
(Tamburino, Capodanno) Division of Cardiology Azienda Ospedaliero
Universitaria "Policlinico-Vittorio Emanuele" University of Catania,
Catania, Italy
(Bleiziffer, Schramm) Department of Thoracic and Cardiovascular Surgery,
Heart and Diabetes Center Northrhein-Westfalia, University Hospital,
Ruhr-University Bochum, Bad Oeynhausen, Germany
(Thiele) Department of Cardiology, Leipzig Heart Center, University of
Leipzig, Leipzig, Germany
(Scholtz) Department of Interventional Cardiology, Heart and Diabetes
Center North Rhine Westfalia, Bad Oeynhausen, Germany
(Cockburn) Department of Cardiology, Brighton & Sussex University
Hospitals NHS Trust, Brighton, United Kingdom
(Cunnington) Department of Cardiology, Leeds General Infirmary, Leeds
Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Wolf) Department of Interventional Cardiology, Elisabeth Hospital Essen,
Essen, Germany
(Barbanti) Department of Cardio-Thoracic-Vascular diseases and
transplantation, Catania, Italy
(Tchetche) Groupe CardioVasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
(Pagnotta) Department of Cardiovascular Medicine, Humanitas Clinical and
Research Center, Milano, Italy
(Gilard) Department of Cardiology, Brest University Hospital, Brest,
France
(Bedogni) Cardiology Department, IRCCS Policlinico San Donato, Milano,
Italy
(Van Belle) Department of Cardiology, Lille University Hospital, Lille,
France
(Vasa-Nicotera) Department of Cardiology, Goethe University Hospital
Frankfurt, Frankfurt am Main, Germany
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Bogaerts) KU Leuven, Faculty of Medicine, I-BioStat, Leuven, Belgium and
UHasselt, I-BioStat, Hasselt, Belgium
(Hengstenberg) Department of Internal Medicine II, Medical University of
Vienna, Vienna, Austria
Publisher
NLM (Medline)
Abstract
BACKGROUND: The Academic Research Consortium - High Bleeding Risk
(ARC-HBR) initiative defined conditions associated with percutaneous
coronary intervention (PCI)-related bleeding. AIMS: We sought to further
explore these HBR conditions in the setting of transcatheter aortic valve
replacement (TAVR). METHOD(S): Patients from the SCOPE 2 trial were
stratified by their bleeding risk status based on the ARC-HBR definitions.
Baseline and procedural characteristics, as well as key clinical outcomes
including Bleeding Academic Research Consortium (BARC) 3-5 bleeding, were
compared in ARC-HBR positive (HBR+) and ARC-HBR negative (HBR-) patients.
 RESULT(S): Of 787 patients randomised in SCOPE 2 and included in this
study, 633 were HBR+ (80.4%). Compared with HBR- patients, those HBR+ were
older and more frequently presented with diabetes, a history of coronary
artery disease, atrial fibrillation, prior cerebrovascular accident, and a
Society of Thoracic Surgeons predicted risk of 30-day mortality (STS-PROM)
(4.9+/-2.9% vs 3.3%+/-2.1%; p<0.0001). In addition, HBR+ patients were
more frequently on oral anticoagulation therapy. At 1 year, HBR+ patients
had higher rates of all-cause death (12.4% vs 4.3%, respectively, risk
difference 8.09%; 95% confidence interval [CI]: 3.76-12.41; p=0.0002); the
rates of BARC 3-5 type bleeding were relatively high but not statistically
different compared with HBR- patients (7.7% vs 6.1%, risk difference
1.67%; 95% CI: -2.72 to 6.06; p=0.46). Subgroup analyses for bleeding
events showed no significant interaction in terms of STS-PROM score, age,
or medications. CONCLUSION(S): The ARC-HBR criteria failed to isolate
a subgroup of patients at higher bleeding risk in TAVR patients from a
randomised trial. These findings have potential implications, especially
for the selection of post-TAVR antithrombotic regimens based on individual
bleeding-risk profiles. Specific HBR criteria should be defined for TAVR
patients.

<11>
Accession Number
638786740
Title
Intermittent Boluses of Balanced Salt Solution for Post-operative
Intravenous Hydration Following Elective Major Abdominal and Thoracic
Surgery in Children.
Source
Pediatrics. Conference: National Conference and Exhibition Meeting of the
American Academy of Pediatrics, AAP 2021. Virtual. 149 (no pagination),
2022. Date of Publication: February 2022.
Author
Johnston W.R.; Hwang R.; Mattei P.
Publisher
American Academy of Pediatrics
Abstract
Background: Traditional protocols for maintenance intravenous fluids
(mIVF) following major abdominal or thoracic operations in children
emphasize continuous fluid administration, total volume based on the 4:2:1
rule, hypotonic solutions, and the inclusion of 5% dextrose1,2. Recent
studies questioned these tenets and argue that isotonic, balanced salt
solutions with lower doses of dextrose better maintain homeostasis3,4.
There are limited data, however, that address the use of continuous
fluids. We believe that administering maintenance fluids in the form of
intermittent boluses is more physiologic and could limit the volume of
post-operative fluids, thereby avoiding harmful effects of maintenance
fluids on electrolyte homeostasis, glucose metabolism, and organ function.
We began implementing this strategy several years ago and in this study
sought to compare patients treated with post-operative boluses to those
still managed with continuous fluids. Method(s): We included children
aged 1-21 admitted to a regular hospital bed after an elective major
abdominal or thoracic operation from 2015-2021. Operations included tumor
resection or biopsy, small and large bowel resection, J-pouch creation,
and nephrectomy. We excluded patients undergoing non-elective operations
and those who received peri-operative parenteral nutrition. We analyzed
total volume of fluid at 0-24, 24-48, 48-72, and 72-96 hours, time to
regular diet and discharge, and end-organ complications. Result(s):
We included 362 patients, 108 of whom were treated with bolus mIVF and 254
with continuous mIVF. Patients in the bolus group had significantly less
fluid up to 72h post-operatively with average rates of 0.49mL/kg/h vs
0.86mL/kg/h at 0-24h (p<<0.05), 0.57mL/kg/h vs 1.46mL/kg/h at 24-48h
(p<<0.05), 0.50 vs 0.92 mL/kg/h at 48-72h (p<<0.05), and 0.57mL/kg/h vs
0.69mL/kg/h at 72-96h (p=0.44). These differences hold true on subgroup
analysis of each operation. Additionally, the bolus group tolerated a
regular diet sooner than the continuous group (2.08 days vs 2.51 days;
p=0.0023) and averaged a shorter hospital stay (3.12 vs 4.14 days;
p=0.004). Six patients in the continuous mIVF group required temporary
supplemental oxygen, compared to two in the bolus group. Given our
practice of limiting post-operative labs, there was insufficient data to
compare creatinine, sodium, and glucose values between groups, but only
one patient in each group required free water restriction for clinically
evident fluid retention and no patients developed seizures or symptoms of
hypoglycemia. Conclusion(s): Patients in the bolus IV-fluid group
received less fluid than the continuous group up to 72 hours and achieved
a faster time to regular diet and discharge. Additionally, the bolus
strategy appears to be safe with no difference in supplemental oxygen
requirement, seizures, or need for glucose supplementation. This study
provides a proof of concept for a planned randomized trial that will be
necessary to better address the underlying questions. (Table Presented).

<12>
Accession Number
638785773
Title
EFFECTS OF A PERI-OPERATIVE MULTI-MODAL INTERVENTION ON STRESS, PAIN,
SLEEP DISTURBANCE, AND NOISE PERCEPTION IN PATIENTS UNDERGOING CORONARY
ARTERY BYPASS GRAFT SURGERY: RESULTS FROM THE RANDOMIZED-CONTROLLED I-COPE
TRIAL.
Source
Psychosomatic Medicine. Conference: 79th Annual Scientific Meeting
Achieving Health Equity: Opportunities for Psychosomatic Science. Long
Beach, CA United States. 84(5) (pp A97), 2022. Date of Publication: June
2022.
Author
Sadlonova M.; Nagel J.; Becker S.; Neumann S.; Celano C.; Fangauf S.;
Meyer T.; Kutschka I.; Friedrich M.; Herrmann-Lingen C.
Institution
(Sadlonova) Psychiatry, Massachusetts General Hospital, Harvard Medical
School, Boston, MA, United States
(Nagel, Fangauf, Meyer) Psychosomatic Medicine and Psychotherapy, Germany
(Becker, Neumann) Department of Psychosomatic Medicine and Psychotherapy,
University of Gottingen Medical Center, Gottingen, NA, Germany
(Celano) Psychiatry, Massachussets General Hospital, Harvard Medical
School, Boston, MA, United States
(Kutschka, Friedrich) Cardiovascular and Thoracic Surgery, Germany
(Herrmann-Lingen) Psychosomatic Medicine and Psychotherapy, University of
Gottingen Medical Center, Gottingen, NA, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Coronary artery bypass graft (CABG) surgery is the most
frequently performed cardiac surgery in patients with coronary heart
disease (CHD). Following CABG, patients are exposed to intensive care unit
(ICU)- and other treatment-related stressors (e.g., noise, changes in
day-night rhythm, lack of intimacy, post-operative complications), which
can lead to higher perception of pain, sleep disturbances, and acute
stress disorders. METHODS In the three-arm, monocentric I-COPE
(Intervention for CABG to Optimize Patient Experience) trial, CHD patients
undergoing elective CABG were randomized to receive standard medical care
(SMC, n=30), a psychological intervention to optimize treatment
expectations (IA group, n=30), or a multi-component intervention (IB
group, n=30), which included both the psychological intervention and a
treatment package (light therapy, noise reduction, music, and if desired,
360degree images through virtual reality) to promote recovery during and
after ICU treatment. Using multilevel mixed linear models, we assessed the
impact of these interventions on pain, sleep disturbance, stress, and
perception of noise levels, as measured with visual analog scales (VAS) on
the 2nd, 4th, 6th, and 8th post-operative day. RESULTS Eighty-eight (mean
age 64.8+/-12.5 years, 21.6% females) participants were included in the
analyses, and the results are shown in Figure 1. The multi-modal
intervention (IB) led to medium-sized greater reductions of pain
perception compared to SMC (IB vs. SMC, change from day 2 to day 8, effect
size: ES=-0.62, 95% CI [-3.00, 0.54]), reductions in sleep disturbance (IB
vs. SMC, effect size: ES=- 0.81, 95% CI [-4.26, 0.22]), and in stress
perception (IB vs. SMC, effect size: ES=-0.19, 95% CI [-2.38, 1.56]).
However, neither of these changes were statistically significant.
CONCLUSIONS A peri-operative multi-component intervention targeting
ICU-related stressors, including light therapy, noise reduction, music,
and virtual reality, can be implemented in the routine medical treatment
in CABG patients but failed to show superiority on the perception of
post-operative pain, stress, and sleep disturbances over standard medical
care in a small sample. Thus, further research is needed to investigate
these trends in larger-sized samples.

<13>
Accession Number
2019822924
Title
Timing of cardiac surgery during pregnancy: A patient-level meta-analysis.
Source
European Heart Journal. 43(29) (pp 2801-2811), 2022. Date of Publication:
01 Aug 2022.
Author
Van Steenbergen G.J.; Tsang Q.H.Y.; Van Der Heijden O.W.H.; Vart P.;
Rodwell L.; Roos-Hesselink J.W.; Van Kimmenade R.R.J.; Li W.W.L.; Verhagen
A.F.T.M.
Institution
(Van Steenbergen, Tsang, Li, Verhagen) Department of Cardiothoracic
Surgery, Radboud University Medical Centre, P.O. Box 9101, Nijmegen 6500
HB, Netherlands
(Vart, Van Kimmenade) Department of Cardiology, Radboud University Medical
Centre, P.O. Box 9101, Nijmegen 6500 HB, Netherlands
(Van Der Heijden) Department of Obstetrics and Gynaecology, Radboud
University Medical Centre, P.O. Box 9101, Nijmegen 6500 HB, Netherlands
(Rodwell) Radboud Institute for Health Sciences, Health Evidence, Section
Biostatistics, Nijmegen, Netherlands
(Roos-Hesselink) Department of Cardiology, Erasmus University Medical
Centre, Box 2040, Rotterdam 3000 CA, Netherlands
Publisher
Oxford University Press
Abstract
Aims: To investigate the association between the timing of cardiac surgery
during pregnancy and both maternal and foetal outcomes. Methods and
Results: Studies published up to 6 February 2021 on maternal and/or foetal
mortality after cardiac surgery during pregnancy that included individual
patient data were identified. Maternal and foetal mortality was analysed
per trimester for the total population and stratified for patients who
underwent caesarean section (CS) prior to cardiac surgery (Caesarean
section (CaeSe) group) vs. patients who did not (Cardiac surgery (CarSu)
group). Multivariable logistic regression analysis was performed to
evaluate predictors of both maternal and foetal mortality. In total, 179
studies were identified including 386 patients of which 120 underwent CS
prior to cardiac surgery. Maternal mortality was 7.3% and did not differ
significantly among trimesters of pregnancy (P = 0.292) nor between
subgroup CaeSe and CarSu (P = 0.671). Overall foetal mortality was 26.5%
and was lowest when cardiac surgery was performed during the third
trimester (10.3%, P < 0.01). CS prior to surgery was significantly
associated with a reduced risk of foetal mortality in a multivariable
model [odds ratio 0.19, 95% confidence interval [0.06-0.56)]. Trimester
was not identified as an independent predictor for foetal nor maternal
mortality. Conclusion(s): Maternal mortality after cardiac surgery
during pregnancy is not associated with the trimester of pregnancy.
Cardiac surgery is associated with high foetal mortality but is
significantly lower in women where CS is performed prior to cardiac
surgery. When the foetus is viable, CS prior to cardiac surgery might be
safe. When CS is not feasible, trimester stage does not seem to influence
foetal mortality. Copyright © 2022 The Author(s). Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<14>
Accession Number
2017769238
Title
Redo Coronary Artery Bypass Grafting in the era of Advanced PCI.
Source
Brazilian Journal of Cardiovascular Surgery. 37(4) (pp 546-553), 2022.
Date of Publication: 2022.
Author
Kusu-Orkar T.-E.; Masharani K.; Harky A.; Muir A.D.
Institution
(Kusu-Orkar, Masharani) School of Medicine, University of Liverpool,
Liverpool, United Kingdom
(Harky, Muir) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Thomas drive, Liverpool L14 3PE, United Kingdom
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: To review the evidence behind the role and relevance of redo
coronary artery bypass grafting (CABG) in the current practice of
percutaneous coronary intervention (PCI). Method(s): A comprehensive
electronic literature search was performed to identify articles that
discuss the practice of PCI and redo CABG in patients that require
coronary revascularization. All relevant studies are summarized in
narrative manner to reflect current indications and preference.
 Result(s): The advancement in utilization of PCI has reduced the rate
of redo CABG in patients with previous CABG that requires
revascularization of an already treated coronary disease or a new onset of
coronary artery stenosis. Redo CABG is associated with satisfactory
perioperative outcomes but higher mortality at immediate postoperative
period when compared to PCI. Conclusion(s): Redo CABG patients are
less likely to develop comorbidities associated with revascularisation,
but the operative mortality is higher and long-term survival rates are
similar in comparison to PCI. There is a need for further research into
the role of redo CABG in the current advanced practice of
PCI. Copyright © 2022, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<15>
Accession Number
2019570903
Title
Conventional sternotomy versus right mini-thoracotomy versus robotic
approach for mitral valve replacement/repair: insights from a network
meta-analysis.
Source
Journal of Cardiovascular Surgery. 63(4) (pp 492-497), 2022. Date of
Publication: August 2022.
Author
Yokoyama Y.; Kuno T.; Takagi H.; Briasoulis A.; Ota T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Fountain Hill, PA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein Medical College, Bronx, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Briasoulis) Division of Cardiovascular Medicine, Section of Heart Failure
and Transplantation, University of Iowa, Iowa City, IA, United States
(Ota) Department of Surgery, The University of Chicago Medicine, Chicago,
IL, United States
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Minimally invasive cardiac surgery (MICS) through right
mini-thoracotomy as well as robotic surgery has emerged for the last
decade for mitral valve surgery. However, their risks and benefits are not
fully understood yet. Thus, we conducted a network meta-analysis comparing
the early- and long-term outcomes of mitral valve surgery via the
conventional sternotomy, MICS, and robotic approaches. EVIDENCE
ACQUISITION: MEDLINE and EMBASE were searched through November 2020 to
identify randomized controlled trials (RCTs) and propensity-score matched
(PSM) trials that investigated early- and long-term outcomes after mitral
surgery via the conventional sternotomy, MICS, and robotic approaches. A
subanalysis focusing on only subjects who initially underwent mitral valve
repair was also conducted. EVIDENCE SYNTHESIS: Our systematic literature
search identified two RCTs and 19 PSM studies. MICS was related to
significant risk reductions of permanent pacemaker implantation, surgical
site infection, and transfusion compared to the sternotomy approach. The
robotic approach was associated with a significant increase in
re-exploration for bleeding compared to sternotomy. The subanalysis showed
that MICS was associated with a significant increase requiring mitral
valve reoperation compared to the sternotomy approach (hazard ratio 7.33
[95% CI: 1.54-34.97], P=0.012), while no significant difference was
observed between the sternotomy and the robotic approach.
 CONCLUSION(S): Our network meta-analysis demonstrated that MICS was
associated with better short-term outcomes compared to the sternotomy
approach. Mitral valve reoperation was more frequent with MICS compared
with the sternotomy approach after mitral valve repair, while no
difference was observed between the sternotomy and robotic
approaches. Copyright © 2021 EDIZIONI MINERVA MEDICA.

<16>
Accession Number
2018689492
Title
The effect of continuing versus withholding angiotensin-converting enzyme
inhibitors/angiotensin II receptor blockers on mortality and major adverse
cardiovascular events in hypertensive patients undergoing elective
non-cardiac surgery: study protocol for a multi-centric open-label
randomised controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 670. Date of
Publication: December 2022.
Author
Misra S.; Parida S.; Sahajanandan R.; Behera B.K.; Senthilnathan M.;
Mariappan R.; Chandy T.T.
Institution
(Misra, Behera) AIIMS Bhubaneswar, Odisha, Bhubaneswar 751019, India
(Parida, Senthilnathan) JIPMER Puducherry, Puducherry, India
(Sahajanandan, Mariappan, Chandy) CMC Vellore, Vellore, India
Publisher
BioMed Central Ltd
Abstract
Background: Angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin
receptor blockers (ARBs) are commonly prescribed to patients with
hypertension. These drugs are cardioprotective in addition to their blood
pressure-lowering effects. However, it is debatable whether hypertensive
patients who present for non-cardiac surgery should continue or
discontinue these drugs preoperatively. Continuing the drugs entails the
risk of perioperative refractory hypotension and/or angioneurotic oedema,
while discontinuing the drugs entails the risk of rebound hypertension and
myocardial ischaemia. The aim of this study is to evaluate the effect of
continuation vs withholding of ACEIs/ARBs on mortality and other major
outcomes in hypertensive patients undergoing elective non-cardiac surgery.
 Method(s): The continuing vs withholding of ACEIs/ARBs in patients
undergoing non-cardiac surgery is a prospective, multi-centric, open-label
randomised controlled trial. Two thousand one hundred hypertensive
patients receiving ACEIs/ARBs and planned for elective non-cardiac surgery
will be enrolled. They will be randomised to either continue the
ACEIs/ARBs including on the day of surgery (group A) or to withhold it
24-36 h before surgery (group B). The primary endpoint will be the
difference in the composite outcome of all-cause in-hospital/30-day
mortality and major adverse cardiovascular and non-cardiovascular events.
Secondary endpoints will be to evaluate the differences in perioperative
hypotension, angioneurotic oedema, myocardial injury, ICU and hospital
stay. The impact of the continuation vs withholding of the ACEIs/ARBs on
the incidence of case cancellation will also be studied.
 Discussion(s): The results of this trial should provide sufficient
evidence on whether to continue or withhold ACEIs/ARBs before major
non-cardiac surgery. Trial registration: Clinical Trials Registry of India
CTRI/2021/01/030199. Registered on 4 January 2021. Copyright ©
2022, The Author(s).

<17>
Accession Number
2019858414
Title
Mechanical versus bioprosthetic valve for aortic valve replacement:
Systematic review and meta-analysis of reconstructed individual
participant data.
Source
European Journal of Cardio-thoracic Surgery. 62(1) (no pagination), 2022.
Article Number: ezac268. Date of Publication: 01 Jul 2022.
Author
Tasoudis P.T.; Varvoglis D.N.; Vitkos E.; Mylonas K.S.; Sa M.P.;
Ikonomidis J.S.; Caranasos T.G.; Athanasiou T.
Institution
(Tasoudis, Varvoglis, Vitkos) Department of Cardiothoracic Surgery,
Faculty of Medicine, School of Health Sciences, University of Thessaly,
Biopolis, Larissa 41110, Greece
(Tasoudis, Varvoglis, Vitkos) Surgery Working Group, Society of Junior
Doctors, Athens, Greece
(Mylonas) Department of Cardiac Surgery, Onassis Cardiac Surgery Center,
Athens, Greece
(Sa) Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, PA, United States
(Ikonomidis, Caranasos) Division of Cardiothoracic Surgery, Department of
Surgery, School of Medicine, University of North Carolina at Chapel Hill,
Chapel Hill, NC, United States
(Athanasiou) Department of Surgery and Cancer, Imperial College London, St
Mary's Hospital, London, United Kingdom
(Athanasiou) Department of Cardiothoracic Surgery, University Hospital of
Larissa, Biopolis, Larissa, Greece
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The aim of this study was to compare biological versus
mechanical aortic valve replacement. METHOD(S): We searched MEDLINE,
Scopus and Cochrane Library databases for randomized clinical trials and
propensity score-matched studies published by 14 October 2021 according to
the Preferred Reporting Items for Systematic Reviews and Meta-analyses
statement. Individual patient data on overall survival were extracted.
One-and two-stage survival analyses and random-effects meta-analyses were
conducted. RESULT(S): A total of 25 studies were identified,
incorporating 8721 bioprosthetic and 8962 mechanical valves. In the
one-stage meta-analysis, mechanical valves cumulatively demonstrated
decreased hazard for mortality [hazard ratio (HR): 0.79, 95% confidence
interval (CI): 0.74-0.84, P < 0.0001]. Overall survival was similar
between the compared arms for patients <50 years old (HR: 0.88, 95% CI:
0.71-1.1, P = 0.216), increased in the mechanical valve arm for patients
50-70 years old (HR: 0.76, 95% CI: 0.70-0.83, P < 0.0001) and increased in
the bioprosthetic arm for patients >70 years old (HR: 1.35, 95% CI:
1.17-1.57, P < 0.0001). Meta-regression analysis revealed that the
survival in the 50-70 year-old group was not influenced by the publication
year of the individual studies. No statistically significant difference
was observed regarding in-hospital mortality, postoperative strokes and
postoperative reoperation. All-cause mortality was found decreased in the
mechanical group, cardiac mortality was comparable between the 2 groups,
major bleeding rates were increased in the mechanical valve group and
reoperation rates were increased in the bioprosthetic valve group.
 CONCLUSION(S): Survival rates seem to not be influenced by the type
of prosthesis in patients <50 years old. The survival advantage in favour
of mechanical valves is observed in patients 50-70 years old, while in
patients >70 years old bioprosthetic valves offer better survival
outcomes. Copyright © 2022 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<18>
Accession Number
2015388464
Title
Primary and metastatic primitive neuroectodermal tumor of the heart: A
systematic review.
Source
Asian Cardiovascular and Thoracic Annals. 30(7) (pp 761-771), 2022. Date
of Publication: September 2022.
Author
Hajsadeghi S.; Iranpour A.; Amouei E.; Tehrani N.H.; Ghavidel A.; Ziaie
H.; Asadi O.; Moradians V.; Tayebi A.; Mestres C.-A.; Manqoutaei S.A.
Institution
(Hajsadeghi, Iranpour) Research Center for Prevention of Cardiovascular
Disease, Institute of Endocrinology Metabolism, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Amouei, Ziaie, Manqoutaei) Department of Internal Medicine, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tehrani) East Metropolitan Health Services, Perth, Australia
(Ghavidel) Rajaie Cardiovascular Medical Research Center, Iran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Asadi) Endocrine Research Center, Institute of Endocrinology and
Metabolism, Iran University of Medical Sciences, Iran, Islamic Republic of
(Moradians) Department of Pulmonology and Critical Care, Iran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tayebi) Department of Surgery, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Mestres) Department of Cardiac Surgery, University Hospital Zurich,
Zurich, Switzerland
Publisher
SAGE Publications Inc.
Abstract
Objective: Primary and metastatic primitive neuroectodermal tumors of the
pericardium are uncommon. Two cases are presented and discussed.
 Method(s): The cases of a 17- and 38-year-old male patients with
neuroectodermal tumors of the pericardium are presented. In addition, a
systematic review was performed according to the Preferred Reporting Items
and checklist for Systematic reviews and Meta-Analyses (PRISMA). All
selected articles' quality assessment was done using the Joanna Briggs
Institute (JBI) Critical Appraisal Checklist for Case Reports.
 Result(s): The systematic review yielded 29 patients with primary or
metastatic PNET. Two patients underwent cardiac transplantation. It seems
that unlike considering total resection in other organs, pericardiectomy
in PNET patients with pericardial origin may lead to further invasion of
the lesions, and it is not recommended. The average disease-free follow-up
was 10 months. The combination of neoadjuvant and adjuvant chemotherapy
along with surgery and radiotherapy offered the best disease-free
outcomes. Conclusion(s): Neuroectodermal heart tumors are rare,
aggressive tumors requiring chemotherapy and radiotherapy in association
with tumor resection surgery to have the best disease-free
duration. Copyright © The Author(s) 2022.

<19>
Accession Number
2016733714
Title
Autologous red blood cell transfusion does not result in a more profound
increase in pulmonary capillary wedge pressure compared to saline in
critically ill patients: A randomized crossover trial.
Source
Vox Sanguinis. 117(8) (pp 1035-1042), 2022. Date of Publication: August
2022.
Author
Bosboom J.J.; Klanderman R.B.; Terwindt L.E.; Bulle E.B.; Wijnberge M.;
Eberl S.; Driessen A.H.; Winkelman T.A.; Geerts B.F.; Veelo D.P.; Hollmann
M.W.; Vlaar A.P.J.
Institution
(Bosboom, Klanderman, Terwindt, Wijnberge, Eberl, Veelo, Hollmann)
Department of Anesthesiology, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Bosboom, Klanderman, Bulle, Wijnberge, Vlaar) Department of Intensive
Care, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Klanderman, Wijnberge, Hollmann, Vlaar) Laboratory of Experimental
Intensive Care and Anesthesiology, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Driessen, Winkelman) Department of Cardiothoracic Surgery, Amsterdam UMC,
University of Amsterdam, Amsterdam, Netherlands
(Geerts) Healthplus.ai-R&D B.V., Amsterdam, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background and Objectives: Transfusion-associated circulatory overload
(TACO) is a major cause of severe transfusion-related morbidity.
Transfusion of red blood cells (RBCs) has been shown to induce hydrostatic
pressure overload. It is unclear which product-specific factors
contribute. We set out to determine the effect of autologous RBC
transfusion versus saline on pulmonary capillary wedge pressure (PCWP)
change. Material(s) and Method(s): In a randomized crossover trial,
patients who had undergone coronary bypass surgery were allocated to
treatment post-operatively in the intensive care unit with either an
initial 300 ml autologous RBC transfusion (salvaged during surgery) or 300
ml saline infusion first, followed by the other. Primary outcome was the
difference in PCWP change. Secondary outcome measures were the difference
in extra-vascular lung water index (EVLWI) and pulmonary vascular
permeability index (PVPI). Result(s): Change in PCWP was not higher
after autologous RBC transfusion compared to saline (DELTAPCWP 0.3 +/- 0.4
vs. 0.1 +/- 0.4 mmHg). DELTAEVLWI and DELTAPVPI were significantly
decreased after autologous RBC transfusion compared to saline (DELTAEVLWI
-1.6 +/- 0.6 vs. 0.2 +/- 0.4, p = 0.02; DELTAPVPI -0.3 +/- 0.1 vs. 0.0 +/-
0.1, p = 0.01). Haemodynamic variables and colloid osmotic pressure were
not different for autologous RBC transfusion versus saline.
 Conclusion(s): Transfusion of autologous RBCs did not result in a
more profound increase in PCWP compared to saline. RBC transfusion
resulted in a decrease of EVLWI and PVPI compared to saline. Our data
suggest that transfusing autologous RBCs may lead to less pulmonary oedema
compared to saline. Future studies with allogeneic RBCs are needed to
investigate other factors that may mediate the increase of PCWP, resulting
in TACO. Copyright © 2022 The Authors. Vox Sanguinis published by
John Wiley & Sons Ltd on behalf of International Society of Blood
Transfusion.

<20>
Accession Number
2019591104
Title
Point of care coagulation management in anesthesiology and critical care.
Source
Minerva Anestesiologica. 88(7-8) (pp 615-628), 2022. Date of Publication:
July 2022.
Author
Heubner L.; Mirus M.; Vicent O.; Guldner A.; Tiebel O.; Beyer-Westendorf
J.; Fries D.; Spieth P.M.
Institution
(Heubner, Mirus, Vicent, Guldner, Spieth) Department of Anesthesiology and
Critical Care Medicine, Carl Gustav Carus University Hospital, Dresden,
Germany
(Tiebel) Institute of Clinical Chemistry, Carl Gustav Carus University
Hospital, Dresden, Germany
(Beyer-Westendorf) Unit of Thrombosis Research, Division of Hematology and
Hemostasis, Department of Medicine I, Carl Gustav Carus University
Hospital, Dresden, Germany
(Fries) Department for General and Surgical Critical Care Medicine,
Innsbruck Medical University, Innsbruck, Austria
Publisher
Edizioni Minerva Medica
Abstract
Point of care (POC) devices are increasingly used in the ICU and in
anesthesia. Besides POC-devices for blood gas analysis, several devices
are available for coagulation measurements. Although basic principles for
thromboelastographic measurements are not novel, some promising
developments were made during the last decade improving both
user-friendliness and measurement reliability. For instance, POC
measurements of activated clotting time (ACT) for heparin monitoring is
still regarded as standard-of-care in cardiac interventions and surgery.
In the field of anesthesia and intensive care medicine, POC-devices for
thromboelastographic and platelet aggregation measurements are widely
used. Their impact in case of bleeding and patient blood management for
cardiothoracic and trauma surgery is well known. Moreover, there are
promising concepts for anticoagulation monitoring including new oral
anticoagulant drugs. Coagulation POC-devices may also identify patients at
specific risk for thromboembolic events quickly. On the other hand,
benefits of POC-devices need to be balanced against limitations, which
include technical restrictions and operator related errors, mainly
affecting reproducibility and interpretation of results. Therefore, it is
recommendable to consider results of POC-coagulation testing in comparison
to standard laboratory tests (SLT). Nevertheless, in urgent or emergency
situations POC results enable fast decision making to optimize patient
care. Copyright © 2022 EDIZIONI MINERVA MEDICA.

<21>
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.

<22>
Accession Number
2018315961
Title
Cost-Effectiveness of the Pharmacist-Managed Warfarin Therapy vs. Standard
Care for Patients With Mechanical Mitral Valve Prostheses: An Egyptian
Healthcare Perspective.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 889197. Date of Publication: 13 Jul 2022.
Author
Batran R.A.; Sabri N.A.; Ali I.; Fahmy S.F.
Institution
(Batran, Sabri, Fahmy) Department of Clinical Pharmacy, Faculty of
Pharmacy, Ain Shams University, Cairo, Egypt
(Ali) Department of Cardiothoracic Surgery, Cardiothoracic Surgery
Academy, Ain Shams University, Cairo, Egypt
Publisher
Frontiers Media S.A.
Abstract
Background: Despite warfarin therapy had been used for decades for
patients with mechanical mitral valve prostheses (MMVPs), serious and
life-threatening complications are still reported worldwide with a
significant economic burden. This study is aimed at assessing the clinical
and the cost-effectiveness of adopting pharmacist-managed warfarin therapy
(PMWT) services for optimizing warfarin treatment in Egypt.
 Method(s): A prospective randomized trial in which 59 patients with
MMVPs were randomly assigned to receive the PMWT services or the standard
care and followed up for 1 year. The primary outcome was percentage time
in the therapeutic range (TTR). For the cost-effectiveness analysis, a
Markov cohort process model with nine mutually exclusive health states was
developed from a medical provider's perspective. A lifetime horizon was
applied. All costs and outcomes were discounted at 3.5% annually.
 Result(s): The study results revealed a significantly higher median
TTR in the intervention group as compared to the control group; 96.8%
[interquartile range (IQR) 77.9-100%] vs. 73.1% (52.7-95.1%),
respectively, p = 0.008. A significant association between standard care
and poor anticoagulation control (p = 0.021) was demonstrated by the
multivariate regression analysis. For the cost-effectiveness analysis, the
total cumulative quality-adjusted life-years (QALYs) and total costs per
patient were 21.53 and 10.43; 436.38 and 1,242.25 United States dollar
(USD) in the intervention and the control groups, respectively, with an
incremental cost-effectiveness ratio (ICER) of -72.5796 for the
intervention group. Conclusion(s): The PMWT strategy was proven to
provide a significantly better anticoagulation control and to be a
cost-saving approach in Egyptian patients with MMVPs. Nevertheless, the
dominance of this strategy is sustained by maintaining the therapeutic
International Normalized Ratio (INR) control within the recommended range.
Our findings will benefit Egyptian policy-makers who may seek novel health
strategies for better resource allocation. Clinical Trial Registration:
[ClinicalTrials.gov], identifier [NCT04409613]. Copyright © 2022
Batran, Sabri, Ali and Fahmy.

<23>
Accession Number
2015242145
Title
Rivaroxaban Monotherapy in Patients With Atrial Fibrillation After
Coronary Stenting: Insights From the AFIRE Trial.
Source
JACC: Cardiovascular Interventions. 14(21) (pp 2330-2340), 2021. Date of
Publication: 08 Nov 2021.
Author
Yasuda S.; Nakamura M.; Miyauchi K.; Hirayama A.; Matsui K.; Koretsune Y.;
Hiro T.; Sumiyoshi T.; Hashimoto Y.; Hirano T.; Daida H.; Okada Y.;
Yamazaki T.; Nakamura A.; Tamiya E.; Yamamoto T.; Suetake S.; Noguchi T.;
Nakamura S.; Matsumura A.; Kojima J.; Suwa S.; Yamaguchi H.; Kaikita K.;
Yasu T.; Nakajima A.; Yamada T.; Arai H.; Hata Y.; Sakanashi T.; Tateishi
H.; Nakayama T.; Nozaki Y.; Akao M.; Okumura Y.; Tokue M.; Kuroki N.;
Maruyama Y.; Matoba T.; Hagiwara N.; Suzuki H.; Nishida Y.; Ajioka M.;
Yumoto K.; Shimizu S.; Aoyama T.; Shimomura H.; Takeda T.; Oshiro K.;
Sugishita N.; Shibata Y.; Otonari T.; Kihara H.; Ogawa H.; Ohno A.; Hazama
M.; Shimizu M.; Tsukahara K.; Haruta S.; Wakeyama T.; Haruna T.; Ito M.;
Fujii K.; Atsuchi N.; Sata M.; Kimura K.; Hasebe N.; Kobayasi Y.; Ohsato
K.; Hironaga K.; Naganuma Y.; Anzaki K.; Oiwa K.; Okazaki S.; Nakagawa Y.;
Tokuhiro K.; Tanaka K.; Momose T.; Fukushima Y.; Kametani R.; Kawamitsu
K.; Saito Y.; Akashi S.; Kumagai K.; Eshima K.; Tobaru T.; Seo T.; Okuhara
K.; Kozuma K.; Ikari Y.; Takahashi T.; Michishita I.; Fujikura H.;
Momomura S.; Yamamoto Y.; Otomo K.; Matsubara T.; Tashiro H.; Inoue T.;
Ishihara M.; Shiojima I.; Tachibana E.; Ako J.; Sumii K.; Yamamoto N.;
Ohmura N.; Nakamura T.; Morita Y.; Takahashi N.; Watanabe K.; Fujinaga H.;
Maruyama M.; Oka T.; Shirayama T.; Amano T.; Fukui K.; Ando K.; Oshima S.;
Kagiyama S.; Teragawa H.; Yuge M.; Ono S.; Koga T.; Fujiu K.; Kuwabara M.;
Ohya Y.; Yumoto Y.; Kuji N.; Ikemura M.; Kario K.; Chatani K.; Sato K.;
Miyagi H.; Murakami M.; Saito K.; Hoshiga M.; Sato S.; Kubo N.; Sakamoto
Y.; Ashida K.; Sakamoto H.; Murasaki S.; Uehara H.; Akasaka T.; Ooba Y.;
Nakahara S.; Hanaoka Y.; Nishimiya T.; Tsunoda R.; Onuma Y.; Higuchi S.;
Tani A.; Wada A.; Kato M.; Obata H.; Higuchi Y.; Endo T.; Katou R.;
Matsunaga T.; Matsuoka T.; Noguchi H.; Usui M.; Hayashi T.; Otsuji Y.;
Osaki T.; Zaizen H.; Yoshihara H.; Kadota K.; Hirose T.; Miyazawa T.; Mori
A.; Takano M.; Shimizu W.; Wake M.; Oriso S.; Yoshiyama M.; Kakinoki S.;
Nishioka T.; Ozaki T.; Nomoto K.; Seki K.; Kawai K.; Ozaki Y.; Miura S.;
Kawasaki M.; Funada R.; Dote K.; Nagano T.; Okamoto S.; Kubo T.; Murozono
Y.; Owada T.; Doke T.; Matsumura T.; Horiuchi M.; Takaishi A.; Yamamoto
M.; Nakashima H.; Munemasa M.; Sakata Y.; Inoue N.; Ota T.; Hamano Y.; Abe
N.; Tsubokura T.; Goto M.; Kubota I.; Yano M.; Umetani K.; Date T.;
Morimoto H.; Noda T.; Goto S.; Hibi K.; Nakano A.; Hiramitsu S.; Kihara
Y.; Sugi M.; Shiba N.; Izumi D.; Sato T.; Tayama S.; Matsui T.; Suzuki A.;
Ajiki K.; Oishi M.; Kiryu M.; Ko T.; Ando H.; Miyazaki S.; Kinugawa T.;
Otake H.; Kitaoka H.; Hirata Y.; Honda S.; Manita M.; Ishii Y.; Oka H.;
Nanba Y.; Nishino M.; Sakamoto T.; Saito T.; Sakai H.; Ichikawa M.;
Namiuchi S.; Inoue K.; Komiyama N.; Akashi Y.; Nakamura Y.; Komaru T.;
Hosokawa T.; Chikamori T.; Tanaka H.; Arasaki O.; Aonuma K.; Wakasa Y.;
Yoshizawa T.; Sugano T.; Yokota N.; Kakutani A.; Suzuki T.; Abe Y.;
Kataoka T.; Okayama H.; Yokoi H.; Chin K.; Hasegawa K.; Tomita H.; Honzyo
H.; Kawai H.; Yamamoto K.; Morino Y.; Tsujiyama S.; Hamasaki S.; Niijima
Y.; Mizuno Y.; Maki A.; Tanabe K.; Murohara T.; Naomi S.; Arikawa M.; Kato
T.; Matsumoto N.; Minamino T.; Sairenji H.; Miyamoto N.; Ito H.; Matsuura
Y.; Hata S.; Nakatsu Y.; Onodera T.; Yoshimura M.; Amano H.; Tokutake E.;
Kasao M.; Moriguchi M.; Tsuji M.; Yamamoto H.; Yanbe Y.; Iwasawa T.;
Suzuki M.; Mori H.
Institution
(Matoba) Department of Cardiovascular Medicine, Faculty of Medical
Sciences, Kyushu University, Fukuoka, Japan
(Yasuda) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Yasuda, Ogawa) National Cerebral and Cardiovascular Center, Suita, Japan
(Kaikita) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Kaikita) Division of Cardiovascular Medicine and Nephrology, Department
of Internal Medicine, Faculty of Medicine, University of Miyazaki,
Kiyotake, Japan
(Akao) Department of Cardiology, National Hospital Organization Kyoto
Medical Center, Kyoto, Japan
(Ako) Department of Cardiovascular Medicine, Kitasato University School of
Medicine, Sagamihara, Japan
(Nakamura) Division of Cardiovascular Medicine, Toho University Ohashi
Medical Center, Tokyo, Japan
(Miyauchi) Department of Cardiovascular Medicine Juntendo Tokyo Koto
Geriatric Medical Center, Tokyo, Japan
(Hagiwara) Department of Cardiology, Tokyo Women's Medical University,
Tokyo, Japan
(Kimura) Cardiovascular Center, Yokohama City University Medical Center,
Yokohama, Japan
(Hirayama) Department of Cardiology Osaka Police Hospital, Osaka, Japan
(Matsui) Department of General Medicine and Primary Care, Kumamoto
University Hospital, Kumamoto, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this AFIRE (Atrial Fibrillation and Ischemic Events
With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial
subgroup analysis was to examine rivaroxaban monotherapy benefits and
their relation to the time between stenting and enrollment among patients
after coronary stenting. Background(s): Of 2,215 patients with atrial
fibrillation and stable coronary artery disease in the AFIRE trial,
rivaroxaban monotherapy was noninferior to rivaroxaban plus antiplatelet
therapy (combination therapy) in terms of efficacy and superior for safety
endpoints. However, thrombotic risk after antiplatelet therapy cessation
remained a concern among 1,444 patients who had undergone coronary
stenting >1 year before enrollment. Method(s): The benefits of
rivaroxaban monotherapy in coronary stenting subgroups were assessed for
efficacy (a composite of stroke, systemic embolism, myocardial infarction,
unstable angina requiring revascularization, or death of any cause),
safety (major bleeding defined according to International Society on
Thrombosis and Haemostasis criteria), ischemic endpoints, net adverse
clinical event, and time between stenting and enrollment. Result(s):
Efficacy and safety endpoints for monotherapy were superior to combination
therapy, with HRs of 0.70 for efficacy (95% CI: 0.50-0.98; P = 0.036) and
0.55 for safety (95% CI: 0.33-0.92; P = 0.019). For ischemic endpoints,
the HR was 0.82 (95% CI: 0.58-1.15; P = 0.240). The HR became smaller with
longer time between stenting and enrollment (efficacy, P for interaction =
0.158; safety, P = 0.097). Conclusion(s): In patients with atrial
fibrillation after coronary stenting, the benefits of rivaroxaban
monotherapy for efficacy and safety endpoints were consistent with those
in the whole AFIRE trial population. The benefits became apparent with
longer time between stenting and enrollment. (Atrial Fibrillation and
Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery
Disease Study [AFIRE]; UMIN000016612, NCT02642419) Copyright ©
2021 American College of Cardiology Foundation

<24>
Accession Number
2018149385
Title
Safety and efficacy of transcatheter aortic valve implantation in stenotic
bicuspid aortic valve compared to tricuspid aortic valve: a systematic
review and meta-analysis.
Source
Expert Review of Cardiovascular Therapy. 20(7) (pp 581-588), 2022. Date of
Publication: 2022.
Author
Zghouzi M.; Osman H.; Ullah W.; Suleiman A.-R.; Razvi P.; Abdalrazzak M.;
Rabbat F.; Alraiyes M.; Sattar Y.; Bagur R.; Paul T.; Matetic A.; Mamas
M.A.; Lakkis N.; Alraies M.C.
Institution
(Zghouzi, Osman, Razvi) Department of Internal Medicine, Detroit Medical
Center, Detroit, MI, United States
(Ullah) Thomas Jefferson University, Philadelphia, PA, United States
(Suleiman, Abdalrazzak) Division of Cardiology, Wayne State University
School of Medicine, Detroit, MI, United States
(Rabbat) Division of Cardiolog, Internal medicine, Baptist hospital,
Miami, FL, United States
(Alraiyes) Division of Cardiology, Vernon Hills High School, Vernon Hills,
IL, United States
(Sattar) Division of cardiology, West Virginia University, Morgantown, WV,
United States
(Bagur) Division of Cardiology, London Health Sciences Centre, Western
University, London, ON, Canada
(Paul) Department of Medical Education, University of Tennessee at
Nashville, Nashville, TN, United States
(Matetic, Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Stoke-on-Trent, United Kingdom
(Lakkis, Alraies) Division of cardiology, Wayne State University/Detroit
Medical Center, Detroit, MI, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has emerged as
a safe and effective alternative to surgical replacement for tricuspid
aortic valve (TAV) stenosis. However, utilization of TAVI for aortic
stenosis in bicuspid aortic valve (BAV) compared to TAV remains
controversial. Method(s): We queried online databases with various
keywords to identify relevant articles. We compared major cardiovascular
events and procedural outcomes using a random effect model to calculate
odds ratios (OR). Result(s): We included a total of 22 studies
comprising 189,693 patients (BAV 12,669 vs. TAV 177,024). In the pooled
analysis, there were no difference in TAVI for BAV vs. TAV for all-cause
mortality, cardiovascular mortality, myocardial infarction (MI), vascular
complications, acute kidney injury (AKI), coronary occlusion, annulus
rupture, and reintervention/reoperation between the groups. The incidence
of stroke (OR 1.24; 95% CI 1.1-1.39), paravalvular leak (PVLR) (OR 1.42;
95% CI 1.26-1.61), and the need for pacemaker (OR 1.15; 95% CI 1.06-1.26)
was less in the TAV group compared to the BAV group, while incidence of
life-threatening bleeding was higher in the TAV group. Subgroup analysis
mirrored pooled outcomes except for all-cause mortality.
 Conclusion(s): The use of TAVI for the treatment of aortic stenosis
in selective BAV appears to be safe and effective. Copyright ©
2022 Informa UK Limited, trading as Taylor & Francis Group.

<25>
Accession Number
638764173
Title
Effects of eHealth Interventions on Quality of Life and Psychological
Outcomes in Cardiac Surgery Patients: Systematic Review and Meta-analysis.
Source
Journal of medical Internet research. 24(8) (pp e40090), 2022. Date of
Publication: 16 Aug 2022.
Author
Ni R.; Liu M.; Huang S.; Yang J.
Institution
(Ni, Liu, Huang, Yang) Department of Pharmacy, Fujian Medical University
Union Hospital, Fuzhou, China
(Ni, Liu, Huang, Yang) College of Pharmacy, Fujian Medical University,
Fuzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients undergoing heart surgery may experience a range of
physiological changes, and the postoperative recovery time is long.
Patients and their families often have concerns about quality of life
(QoL) after discharge. eHealth interventions may improve patient
participation, ensure positive and effective health management, improve
the quality of at-home care and the patient's quality of life, and reduce
rates of depression. OBJECTIVE(S): The purpose of this study was to
evaluate the effects of eHealth interventions on the physiology,
psychology, and compliance of adult patients after cardiac surgery to
provide a theoretical basis for clinical practice. METHOD(S): We
conducted systematic searches of the following 4 electronic databases:
PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled
Trials. Mean (SD) values were used to calculate the pooled effect sizes
for all consecutive data, including QoL, anxiety, and depression. Where
the same results were obtained using different instruments, we chose the
standardized mean difference with a 95% CI to represent the combined
effect size; otherwise, the mean difference (MD) with a 95% CI was used.
Odds ratios were used to calculate the combined effect size for all
dichotomous data. The Cohen Q test for chi-square distribution and an
inconsistency index (I2) were used to test for heterogeneity among the
studies. We chose a fixed-effects model to estimate the effect size if
there was no significant heterogeneity in the data (I2<=50%); otherwise, a
random-effects model was used. The quality of the included studies was
assessed using the Cochrane risk-of-bias tool for randomized trials (RoB
2). RESULT(S): The search identified 3632 papers, of which 19 met the
inclusion criteria. In terms of physical outcomes, the score of the
control group was lower than that of the intervention group (MD 0.15, 95%
CI 0.03-0.27, I2=0%, P=.02). There was no significant difference in the
mental outcomes between the intervention and control groups (MD 0.10, 95%
CI -0.03 to 0.24, I2=46.4%, P=.14). The control group's score was lower
than that of the intervention group for the depression outcomes (MD -0.53,
95% CI -0.89 to -0.17, I2=57.1%, P=.004). Compliance outcomes improved in
most intervention groups. The results of the sensitivity analysis were
robust. Nearly half of the included studies (9/19, 47%) had a moderate to
high risk of bias. The quality of the evidence was medium to low.
 CONCLUSION(S): eHealth improved the physical component of quality of
life and depression after cardiac surgery; however, there was no
statistical difference in the mental component of quality of life. The
effectiveness of eHealth on patient compliance has been debated. Further
high-quality studies on digital health are required. TRIAL REGISTRATION:
PROSPERO CRD42022327305;
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327305. Copyright ©Ruping Ni, Maobai Liu, Shunmin Huang, Jing Yang.
Originally published in the Journal of Medical Internet Research
(https://www.jmir.org), 16.08.2022.

<26>
Accession Number
638777739
Title
Adoption of Minimally Invasive Surgery: Publication Trends from 1980 to
2020.
Source
Surgical Endoscopy. Conference: 29th International Congress of the
European Association for Endoscopic Surgery, EAES 2021. Barcelona Spain.
36(2 Supplement) (pp S457), 2022. Date of Publication: July 2022.
Author
Abdalla M.; Abdalla S.; Jones D.
Institution
(Abdalla) Harvard Medical School, Department of Surgery, United States
(Abdalla) University of Toronto, Department of Computer Sciecne, Canada
(Jones) Beth Israel Deaconess Medical Center, Department of Surgery,
United States
Publisher
Springer
Abstract
Objective: Coined in 1986, 'minimally invasive' was (and is) used to
describe procedures that involved making very small (or no) incisions for
the surgical treatment of illness and anatomic pathologies that were
traditionally treated using open (or more invasive) approaches. Here, we
sought to examine changes in the surgical literature as a means of probing
and quantifying the adoption of this innovation, split by procedure,
organ, and procedure type. Method(s): Our analysis focused on 8 broad
categories: biliary surgery (cholecystectomy, common bile duct
exploration, cholecystojejunostomy), foregut surgery (Nissen
fundoplication, paraoesophageal hernia, heller myotomy, partial
gastrectomy, peptic ulcer disease, gastrojejunostomy), enteral access
(gastrostomy [T-fastener's technique], Janeway Permanent gastrostomy,
jejunostomy), obesity surgery (Roux-en-Y gastric bypass, adjustable
gastric banding), solid organ (hepatic resection, adrenalectomy, distal
pancreatectomy, splenectomy, nephrectomy), thoracic (pulmonary wedge
resection, esophagectomy), hernias (transabdominal preperitoneal repair
[TAPP], totally extraperitoneal repair [TEP], ventral), and colorectal
(right colectomy, left colectomy, low anterior resection [LAR],
abdominoperineal resection [APR], appendectomy). Our primary outcomes
were: (a) the count / fraction of total annual published literature,
clinical trials (including randomly controlled trials), and reviews
(including meta-analyses and systematic reviews) focused on the
description or analysis of minimally invasive approaches, further split by
laparoscopic versus robotic qualifiers; and (b) the time (in years) to the
fraction of minimally invasive articles reaching 50% of the total.
 Result(s): Among the 8 categories and 30 procedures, biliary,
foregut, and obesity surgeries had the highest and quickest rate of
adoption of minimally invasive techniques. At its peak, 67.5% of
cholecystectomy articles published in a single year (1997) described or
mentioned laparoscopic approaches, as did 72.0% of articles about Nissen
fundoplication (2002). Solid organ and thoracic procedures appear to lag
behind; at its peak, only 15.3% of articles in 2020 relating to hepatic
resection included or mentioned laparoscopic approaches; adrenalectomies
had the largest fraction of all solid organ procedures at 37.8% (in 2011).
Similarly, at its zenith, only 4.3% of articles about pulmonary wedge
resections in 2014 included, in part, laparoscopic approaches, as did only
12.4% of the esophagectomy literature (2012). Hernia repair and colorectal
procedures were more evenly split with, roughly half the literature
describing or relating to minimally invasive techniques at their peak.
More globally, we noticed two general trends to adoption of minimally
invasive approaches: (a) either a quick inflection point in which
virtually all the literature appears to switch focus overnight (e.g.
cholecystectomy), or (b) a more linear/slow rise as observed with solid
organ or thoracic surgeries (e.g. adrenalectomy). Quantitatively: In 1989,
2.3% of cholecystectomy literature described or analyzed laparoscopic
approaches, when contrasted to only 3 years later (1992), when the
fraction jumped to 51.9% of all articles. In comparison, the adoption of
laparoscopic approaches in the adrenalectomy literature was linear,
increasing from 5.8% in 1993 to 30.3% in 2003, at a rate of 2.5% per year
for that decade. Conclusion(s): Understanding the trends in
literature as a proxy for integration of minimally invasive techniques
into surgical practice is the first step to illuminating the hurdles for
adoption of surgical innovation (including minimally invasive and robotic
approaches). As we have shown, adoption of minimally invasive techniques
can be classified into two broad categories. Interrogating the factors
that drive these differences in adoption profiles will shed insight into
how best to develop and promote future surgical innovations.

<27>
Accession Number
2017760249
Title
An Echocardiographic Assessment of Cardiovascular Hemodynamics in Patients
with Large Pleural Effusion at VAMCRH, Banthra, Shahjahanpur, U.P.
Source
International Journal of Pharmaceutical and Clinical Research. 14(8) (pp
433-442), 2022. Date of Publication: 2022.
Author
Suman A.; Pathak S.
Institution
(Suman) Department of General Medicine, Varunarjun Medical College and
Rohilkhand Hospital, Banthra, Shahjahanpur (UP)., India
(Pathak) Department of General Medicine, Adesh Medical College and
Hospital, Mohri, Haryana, Shahbad, Ambala, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Background: Pleural effusion is a common medical problem existing all over
the world, especially in developing countries. Pleural effusion of
tuberculous origin is very common in India. The effect of pleural effusion
depends on the cause and the amount of fluid in pleural space. This study
aims to assess the tamponade physiology occurring in cases of large
pleural effusion even in absence of any pericardial effusion and treatment
of this condition should be thoracocentesis rather than
pericardiocentesis. Material(s) and Method(s): This cross-sectional
study was done at VAMCRH, Banthra, Shahjahanpur, U.P. from February 2020
to October 2021. 73 patients were randomly selected from patients
presented with large pleural effusion in medical emergency and medical
ward. Detail history and clinical examination were done immediately. All
patient with large pleural effusion whether unilateral or bilateral were
enrolled in this study, while patients with pleural effusion of cardiac
etiology, pericardial effusion and terminally ill were 11 cases excluded
from this study. So total 62 cases included in this study. Result(s):
Sixty two cases of large pleural effusion were selected randomly
irrespective of age, sex, etiology or sidedness of pleural effusion and
were enrolled in this study group. General clinical parameters like pulse
rate, respiratory rate, blood pressure etc. were measured. All sixty two
patients with large pleural effusion were evaluated with echocardiography
and echocardiographic parameters like chamber size of heart, Right
ventricular diastolic collapse, right atrial diastolic cpllapse and
respiratory flow variation across Mitral, Tricuspid, Pulmonary and Aortic
valve were noted. Then 1000 to 1500 ml of pleural fluid were removed by
thoracocentesis and a check x-ray was again repeated to make sure that
pleural effusion remain below half of total lung field.A repeat
echocardiography was done within 24 hour of thoracocentesis of large
pleural effusion. Echocardiographic parameters like chamber size of heart,
right ventricular diastolic collapse, right atrial diastolic collapse and
respiratory flow variation across Mitral, Tricuspid, Pulmonary and Aortic
valve were noted again. All the data were collected and kept for final
study and were statistically analysed. The result of present study was to
assess the effect of large pleural effusion on cardiovascular
haemodynamics by means of echocardiography. Conclusion(s): Patient's
with tamponade physiology who has both large pleural effusion and
pericardial effusion a pleurodesis is probably the safest initial
procedure and might result in complete recovery from tamponade
physiology. Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd.
All rights reserved.

<28>
Accession Number
638775117
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, New York, 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, New York, 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, New York, 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
American Medical Association
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. Copyright © 2022 American Medical Association. All
rights reserved.

<29>
Accession Number
2019811109
Title
Comparison of Analgesic Requirement and Pain Intensity in Lower Segment
Cesarean Section (LSCS) with Ketofol and Conventional Induction of General
Anesthesia.
Source
Pakistan Journal of Medical and Health Sciences. 16(7) (pp 269-271), 2022.
Date of Publication: July 2022.
Author
Khosa M.S.; Siddiqa A.; Ejaz S.T.; Ahmad M.S.; Aziz M.A.; Naqvi S.A.A.
Institution
(Khosa, Siddiqa, Ejaz) Obstetrics & Gynecology Dept. Ghazi Medical
College, Teaching Hospital, Dera Ghazi Khan, Pakistan
(Ahmad, Naqvi) Anesthesia Dept. Ghazi Medical College, Teaching Hospital,
Dera Ghazi Khan, Pakistan
(Aziz) Anesthesia Dept., Sahara Medical College, Narowal, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Objective: to compare the analgesic requirement and pain intensity in LSCS
with ketofol and conventional induction of general anesthesia Study Type:
randomized controlled trial Study Place and Duration: department of
Anesthesiology at Ghazi Medical College & Teaching Hospital, Dera Ghazi
Khan, from 1st January 2019 to 30th June 2019. Material(s) and
Method(s): 100 adult participants (20-40 years) ASA physical status 1 and
2, with no previous case of neurologic or cardiovascular undergoing LSCS
operations were enlisted in a randomised prospective comparative study
after receiving approval from the ethical research committee. Patients
were divided into two groups, each with 50 patients: group P (propofol)
and group KP (ketamine) (ketofol). The surgeon picked a closed envelope as
the method of randomization. Visual analogue scale was used to assess the
postoperative pain where, 0 means no pain, 1-3 means mild pain, 4-7 means
moderate pain, and 8-10 means severe pain using a visual analog scale,
where 0 means no pain, 1-3 means mild pain, 4-7 means moderate pain, and
8-10 means severe pain. Furthermore, the need for postoperative analgesia
was examined, including the need for fentanyl. Result(s): The
majority of the patient's Group P and Group KP had 0 VAS scoresof28
(56.0%) and 26 (52.0%), respectively, (p=0.475). Intra operation fentanyl
was required 3 (6.0%) in Group P and 1 (2.0%) in Group PK, (p=0.307).
While, postoperation fentanyl was required 7 (14.0) in Group P and 4 (8.0)
in Group PK, (p=0.338). Conclusion(s): Ketofol as an induction agent
can be used as an alternative which is relatively safe and show less side
effects in comparison to propofol alone. Copyright © 2022 Lahore
Medical And Dental College. All rights reserved.

<30>
Accession Number
2018676625
Title
Incidence, risk factors, and outcomes in electroencephalographic seizures
after mechanical circulatory support: A systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 872005. Date of Publication: 03 Aug 2022.
Author
Li Q.; Shen J.; Lv H.; Liu Y.; Chen Y.; Zhou C.; Shi J.
Institution
(Li, Shen, Lv, Liu, Chen, Zhou, Shi) State Key Laboratory of
Cardiovascular Disease, Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Purpose: To estimate the overall incidence, risk factors, and clinical
outcomes of electroencephalographic (EEG) seizures for adults and children
after mechanical circulatory support (MCS). Method and measurements: This
systematic review and meta-analysis were carried out in accordance with
the PRISMA (Preferred Reporting Items for Systematic Review and
Meta-Analysis) guidance document. MEDLINE EMBASE and CENTRAL were
investigated for relevant studies. The related information was retrieved
by two independent reviewers and all analyses were conducted by STATA
(version 16.0; Stata Corporation, College Station, TX, United States).
 Result(s): Sixty studies including 36,191 adult and 55,475 pediatric
patients with MCS were enrolled for evaluation. The study showed that the
overall incidence of EEG seizures in adults was 2% (95%CI: 1-3%), in which
1% (95%CI: 1-2%) after cardiopulmonary bypass (CPB), and 3% (95%CI: 1-6%)
after extracorporeal membrane oxygenation (ECMO). For pediatrics patients,
the incidence of EEG seizures was 12% (95%CI: 11-14%), among which 12%
(9-15%) after CPB and 13% (11-15%) after ECMO. The major risk factors of
EEG seizures after MCS in adults were redo surgery (coefficient = 0.0436,
p = 0.044), and COPD (coefficient = 0.0749, p = 0.069). In addition, the
gestational week of CPB (coefficient = 0.0544, p = 0.080) and respiratory
failure of ECMO (coefficient = -0.262, p = 0.019) were also indicated to
be associated with EEG seizures in pediatrics. Conclusion(s): EEG
seizures after MCS were more common in pediatrics than in adults. In
addition, the incidence of EEG seizure after ECMO was higher than CPB both
in adults and children. It is expected that appropriate measures should be
taken to control modifiable risk factors, thus improving the prognosis and
increasing the long-term survival rate of MCS patients. Systematic Review
Registration: [https://www.crd.york.ac.uk/prospero], identifier
[CRD42021287288]. Copyright © 2022 Li, Shen, Lv, Liu, Chen, Zhou
and Shi.

<31>
Accession Number
2019845400
Title
Parasternal Intercostal Nerve Blocks in Patients Undergoing Cardiac
Surgery: Evidence Update and Technical Considerations.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Schiavoni L.; Nenna A.; Cardetta F.; Pascarella G.; Costa F.; Chello M.;
Agro F.E.; Mattei A.
Institution
(Schiavoni, Pascarella, Costa, Agro, Mattei) Anesthesia, Intensive Care
and Pain Management, Universita Campus Bio-Medico di Roma, Rome, Italy
(Nenna, Cardetta, Chello) Cardiac Surgery, Universita Campus Bio-Medico di
Roma, Rome, Italy
Publisher
W.B. Saunders
Abstract
In the Enhanced Recovery After Surgery era, parasternal intercostal nerve
block has been proposed to improve pain control and reduce opioid use in
patients undergoing cardiac surgery. However current literature has
reported conflicting evidence about the effect of this multimodal pain
management, as procedural variations might pose a significant bias on
outcomes evaluation. In this setting, the infiltration of the parasternal
plane into 2 intercostal spaces, second and fifth, with a local anesthetic
spread under or above the costal plane with ultrasound guidance, seem to
be standardized in theory, but significant differences might be observed
in clinical practice. This narrative review summarizes and defines the
optimal techniques for parasternal plane blocks in patients undergoing
cardiac surgery with full median sternotomy, considering both
pectointercostal fascial block and transversus thoracic plane block. A
total of 10 randomized trials have been published, in adjunct to
observational studies, which are heterogeneous in terms of techniques,
methods, and outcomes. Parasternal block has been shown to reduce
perioperative opioid consumption and provide a more favorable analgesic
profile, with reduced postoperative opioid-related side effects. A trend
toward reduced intensive care unit stay or duration of mechanical
ventilation should be confirmed by adequately powered randomized trials or
registry studies. Differences in operative technique might impact outcomes
and, therefore, standardization of the procedure plays a pivotal role
before reporting specific outcomes. Parasternal plane blocks might
significantly improve outcomes of cardiac surgery with full median
sternotomy, and should be introduced comprehensively in Enhanced Recovery
After Surgery protocols. Copyright © 2022 Elsevier Inc.

<32>
Accession Number
638780929
Title
Neuroinvasive west nile virus infections after solid organ
transplantation: Single center experience and systematic review.
Source
Transplant infectious disease : an official journal of the Transplantation
Society. (no pagination), 2022. Date of Publication: 18 Aug 2022.
Author
Abbas A.; Qiu F.; Sikyta A.; Fey P.D.; Florescu D.F.
Institution
(Abbas, Sikyta, Florescu) Infectious Diseases Division, University of
Nebraska Medical Center, Omaha, NE, United States
(Qiu) Department of Biostatistics, College of Public Health, University of
Nebraska Medical Center, Omaha, NE, United States
(Fey) Department of Pathology and Microbiology, University of Nebraska
Medical Center, Omaha, NE, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: West Nile virus (WNv) is a major cause of viral encephalitis
in the United States. WNv infection is usually asymptomatic or a limited
febrile illness in the immunocompetent hosts, though a small percentage
can develop neuroinvasive disease. Neuroinvasive disease due to WNv in
solid organ transplant recipients occurs at higher rates than observed in
the general population and can have long term neurological sequalae.
 METHOD(S): We retrospectively reviewed medical records of all solid
organ transplant recipients at our institution who tested positive for WNv
from 2010 to 2018. Two reviewers performed electronic searches of Medline,
Embase, Cochrane Library of literature of WNv infections in SOT.
Descriptive statistics were performed on key variables. RESULT(S):
Eight recipients (mean age 54, 5 males) were diagnosed with neuroinvasive
WNv infection at our institution. Distribution of infection was as
follows: 5 kidney transplants, 1 in each kidney-pancreas, liver and lung.
Diagnoses included meningitis (3), encephalitis (1), meningo-encephalitis
(4). Median time from transplant to infection was 49.8 months (2.7-175.4).
No infections were considered donor-derived. Five patients received
treatment with IVIG. Six patients were alive at median follow up of 49.5
months (21.7-116.8). We identified 29 studies published from 2002-2019.
Median time from transplant to infection was 14.2 months, with similar
allograft distribution; 53% were donor-derived infections.
 CONCLUSION(S): West Nile virus infections in solid organ transplant
recipients can be a consequence of organ donation or can be acquired via
the community. Infections can be more severe in SOT recipients and lead to
neuroinvasive disease. This article is protected by copyright. All rights
reserved.

<33>
Accession Number
2014652912
Title
High-dose supplementation of selenium in left ventricular assist device
implant surgery: A double-blinded, randomized controlled pilot trial.
Source
Journal of Parenteral and Enteral Nutrition. 46(6) (pp 1412-1419), 2022.
Date of Publication: August 2022.
Author
Laaf E.; Benstoem C.; Rossaint R.; Wendt S.; Fitzner C.; Moza A.; Zayat
R.; Hill A.; Heyland D.K.; Schomburg L.; Goetzenich A.; Stoppe C.
Institution
(Laaf, Rossaint, Wendt, Fitzner, Hill, Stoppe) Department of
Anesthesiology, Medical Faculty RWTH Aachen University, Aachen, Germany
(Laaf, Benstoem, Wendt, Fitzner, Hill) 3CARE - Cardiovascular Critical
Care and Anesthesia Research and Evaluation, Medical Faculty RWTH Aachen
University, Aachen, Germany
(Benstoem, Hill) Department of Intensive Care Medicine, Medical Faculty
RWTH Aachen University, Aachen, Germany
(Moza, Zayat) Department of Cardiothoracic Surgery, Medical Faculty RWTH
Aachen University, Aachen, Germany
(Heyland) Department of Critical Care Medicine, Queen's University,
Kingston, ON, Canada
(Heyland) Clinical Evaluation Research Unit, Kingston General Hospital,
Kingston, ON, Canada
(Schomburg) Institute for Experimental Endocrinology,
Charite-Universtitatsmedizin Berlin, Corporate Member of Freie Universitat
Berlin, Humboldt-Universitat zu Berlin and Berlin Institute of Health,
Charite CVK, Berlin, Germany
(Goetzenich) Medical Affairs, Abiomed GmbH, Aachen, Germany
(Stoppe) Department of Anesthesiology, Intensive Care, Emergency and Pain
Medicine, University Hospital Wurzburg, Wurzburg, Germany
Publisher
John Wiley and Sons Inc
Abstract
Background: Systemic inflammation and oxidative stress remain the main
causes of complications in patients with heart failure receiving a left
ventricular assist device (LVAD). Selenoproteins are a cornerstone of
antioxidant defense mechanisms for improving inflammatory conditions.
 Method(s): In a monocentric, double-blinded pilot trial patients
scheduled for LVAD implantation were randomized to receive 300 mcg of
selenium orally the evening before surgery, followed by a high-dose of
intravenous selenium supplementation (3000 mcg after anesthesia induction,
1000 mcg upon intensive care unit [ICU] admission, and 1000 mcg daily in
the ICU for a maximum of 14 days) or placebo. The main outcomes were
feasibility and effectiveness in restoring serum selenium concentrations.
 Result(s): Twenty patients were included in the analysis. The average
duration of study intervention was 12.6 days (7-14), with 97.7% dose
compliance. No patient received open-label selenium. The supplementation
strategy was effective in compensating low serum selenium concentrations
(before surgery: control, 63.5 +/- 11.9 mcg/L vs intervention, 65.8 +/-
16.5 mcg/L; ICU admission: control, 49.0 +/- 9.8 mcg/L vs intervention,
144.2 +/- 45.4 mcg/L). Serum selenium concentrations in the intervention
group were significantly higher during the observation period (baseline:
mean of placebo (MoP), 63.1 vs mean of selenium (MoS), 64.0; ICU
admission: MoP, 49.0 vs MoS, 144.6; day 1-13: MoP, 43.6-48.5 vs MoS,
100.4-131.0). Conclusion(s): Selenium supplementation in patients
receiving LVAD implantation is feasible and effective to compensate a
selenium deficiency. Copyright © 2022 The Authors. Journal of
Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on
behalf of American Society for Parenteral and Enteral Nutrition.

<34>
Accession Number
2017400752
Title
COVID 19 Patient Who underwent Cardiac Surgery and Their Postoperative
Outcomes.
Source
NeuroQuantology. 20(6) (pp 5094-5099), 2022. Date of Publication: 2022.
Author
Hasani Z.; Zamani N.; Mansouri N.; Dayani A.; Akbarzadeh M.
Institution
(Hasani) Master of Intensive Care Nursing, Shahid Rajaei Cardiovascular
Training Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Zamani) Master of Nursing, Kashan University of Medical Sciences, Kashan,
Iran, Islamic Republic of
(Mansouri) Master of Pediatric Nursing, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Dayani) Cardiac Anesthesia Fellowship, Rajaie Cardiovascular Medical and
Research center, Iran university of medical sciences, Tehran, Iran,
Islamic Republic of
(Akbarzadeh) Bachelor of Science in Nursing, MUMS, Master of Science in
Health Administration, IAUM, Abrisham Nursing Counseling Center and Home
Care Service, Mashhad, Iran, Islamic Republic of
Publisher
Anka Publishers
Abstract
The pandemic of Coronavirus Disease 2019 (COVID19) has had a major
influence on worldwide surgery. The heart and circulatory system have been
shown to be negatively affected by SARS-CoV-2 infection. It's challenging
to decide whether to operate on urgent patients with active/recent
COVID-19 infection, especially because it's still an unknown disease
entity in the context of emergent cardiac surgery. COVID19 and cardiac
surgery have also been shown to have a deleterious influence on pulmonary
function. As a result, we wanted to see how COVID-19 positive individuals
fared following heart surgery. From 2018 to 2022, a search was conducted
in Pub Med, Scholar, and Mesh for this study. Clinical trials and
observational studies published in English were excluded from the search.
After titles and abstracts were reviewed, followed by a full text
analysis, only six papers fulfilled the inclusion criteria. These
patients' conditions may not have resulted in serious problems. However,
deciding whether or not to operate on urgent patients with active or
recent COVID-19 infection is problematic. Copyright © 2022, Anka
Publishers. All rights reserved.

<35>
Accession Number
2018309450
Title
Combined MitraClip and Left Atrial Appendage Occlusion: Is It Still a
Utopia?.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 940560. Date of Publication: 12 Jul 2022.
Author
Belli M.; Zanin F.; Macrini M.; Barone L.; Marchei M.; Muscoli S.; Prandi
F.R.; Sergi D.; Di Luozzo M.; Romeo F.; Barilla F.
Institution
(Belli, Zanin, Prandi, Barilla) Department of Systems Medicine, University
Tor Vergata, Rome, Italy
(Macrini, Barone, Marchei, Muscoli, Sergi, Di Luozzo) Division of
Cardiology, University Hospital Tor Vergata, Rome, Italy
(Romeo) Department of Departmental Faculty of Medicine, Unicamillus-Saint
Camillus International, University of Health and Medical Sciences, Rome,
Italy
Publisher
Frontiers Media S.A.
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting
32 million individuals worldwide, particularly the elderly. It is the main
cause of ischemic strokes. Oral anticoagulation (OAC) is the gold standard
strategy for stroke prevention. Still, there is a not negligible share of
patients who have contraindications to this therapy, more frequently due
to an increased risk of bleeding. AF is often associated with
moderate-severe mitral regurgitation (MR), the second most frequent
valvular disease in elderly patients. Data from the literature reported
that more than half of patients with severe mitral regurgitation are not
suitable candidates for cardiac surgery. Given the progressive aging of
the population and the simultaneous increase in the number of patients
with comorbidities, the advent of new therapeutic strategies, such as the
combined approach of Left Atrial Appendage Occlusion (LAAO) and MitraClip
procedure, is acquiring great interest. At present, the category of
patients who may benefit from combined percutaneous therapies and the
long-term risks and benefits might not have been identified. Despite the
efforts of researchers, the correct selection of patients is a very
important clinical need that has not yet been met to avoid committing
human and financial resources to interventions that may be unnecessary. It
is conceivable that the most modern and recent innovations in
cardiovascular imaging, particularly three-dimensional echocardiography
and new methods of volume imaging, could improve our ability to select
patients appropriately. Since data in the literature are scarce, future
studies will be needed to evaluate the efficacy and safety of combined
MitraClip and LAA occlusion. Copyright © 2022 Belli, Zanin,
Macrini, Barone, Marchei, Muscoli, Prandi, Sergi, Di Luozzo, Romeo and
Barilla.

<36>
Accession Number
2017595332
Title
Comparison of Analgesic Effects of Different Regional Blocks in
Video-assisted Thoracic and Breast Surgeries: A Network Meta-analysis and
Systematic Review.
Source
Pain Physician. 25(5) (pp 339-354), 2022. Date of Publication: August
2022.
Author
Luo G.; Tao J.; Zhu J.; Xie K.; Ni C.
Institution
(Luo, Tao, Zhu, Xie) Department of Anesthesiology and Pain Research
Center, The Affiliated Hospital of Jiaxing University, Jiaxing, China
(Ni) Department of Anesthesiology, The First Affiliated Hospital of
Wenzhou Medical University, Wenzhou, China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Postoperative pain management in breast surgery and
video-assisted thoracic surgeries (VATS) remains challenging. Oral or
intravenous infusion of opioids were early treatments, but they can result
in gastrointestinal reactions, respiratory inhibition, and other adverse
reactions. In recent years, various regional block techniques have been
employed for postoperative analgesia of these surgeries. However, a
pair-wise meta-analysis cannot comprehensively rank and evaluate the
analgesic effects and adverse events of various regional blocks.
 Objective(s): The purpose of this network meta-analysis (NMA) was to
compare the analgesic effects and adverse events of different regional
block techniques after breast surgery and VATS. Study Design: NMA of
randomized controlled trials (RCTs) for comparing multiple regional block
techniques in breast surgery and VATS. Method(s): Pubmed, Embase, and
Cochrane databases were searched systematically for RCTs comparing
analgesic effects and adverse events after breast surgery and VATS. After
critical appraisal, a random-effects NMA was mainly used to compare all
the regional blocks' analgesic effects and adverse events. The Population,
Interventions, Comparators, Outcomes, and Study design (PICOS) framework
was used to build the search strategies and present the results according
to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) statement guidelines. The primary endpoint was opioid consumption
within 24 hours after the operation; secondary endpoints included dynamic
and static pain scores and the incidence of nausea and vomiting. This
study is registered in the Prospective Register of Systematic Reviews
(PROSPERO) with a PROSPERO number of CRD42021283907. Result(s): A
total of 21 clinical trials, including 1,284 patients and 6 different
regional block techniques (paravertebral block pectoral nerve block
serratus anterior plane block [SAPB], intercostal nerve block [ICNB],
erector spinal plane block and thoracic epidural anesthesia), were
included and analyzed. There was no significant difference between the
consistent and the inconsistent models. Based on limited evidence, SAPB
may be the most effective regional block technique for relieving
postoperative pain, while ICNB had the lowest probability of nausea and
vomiting. There was no significant difference in the pair-wise
comparisons. In this study, we found no obvious publication bias.
 Limitation(s): Limitations include: morphine milligram equivalents
were not used to calculate opioid consumption; the scales used in the
studies were different; the number of studies and total sample size
included was limited; non-English literature and gray literature were not
included; more databases were not searched. Conclusion(s): After a
comprehensive evaluation of postoperative analgesic effects and adverse
events based on the NMA, we hypothesize that SAPB and ICNB have distinct
advantages in postoperative analgesia and reduce the incidence of nausea
and vomiting, respectively. However, conclusions drawn from more RCTs may
be more convincing. Copyright © 2022, American Society of
Interventional Pain Physicians. All rights reserved.

<37>
Accession Number
2019010269
Title
Impact of cardiopulmonary bypass duration on efficacy of fibrinogen
replacement with cryoprecipitate compared with fibrinogen concentrate: a
post hoc analysis of the Fibrinogen Replenishment in Surgery (FIBRES)
randomised controlled trial.
Source
British Journal of Anaesthesia. 129(3) (pp 294-307), 2022. Date of
Publication: September 2022.
Author
Bartoszko J.; Martinez-Perez S.; Callum J.; Karkouti K.; Farouh M.E.;
Scales D.C.; Heddle N.M.; Crowther M.; Rao V.; Hucke H.-P.; Carroll J.;
Grewal D.; Brar S.; Brussieres J.; Grocott H.; Harle C.; Pavenski K.;
Rochon A.; Saha T.; Shepherd L.; Syed S.; Tran D.; Wong D.; Zeller M.
Institution
(Bartoszko, Martinez-Perez, Karkouti) Department of Anesthesia and Pain
Management, University Health Network, Sinai Health System, Women's
College Hospital, University of Toronto, Toronto, ON, Canada
(Bartoszko, Karkouti) Peter Munk Cardiac Centre and Toronto General
Hospital Research Institute, University Health Network, Toronto, ON,
Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Queen's
University, Toronto, ON, Canada
(Karkouti) Institute of Health Policy Management and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Ltd
Abstract
Background: Coagulopathy in cardiac surgery is frequently associated with
acquired hypofibrinogenaemia, which can be treated with either purified
fibrinogen concentrate (FC) or cryoprecipitate. Because the latter is not
purified and therefore contains additional coagulation factors, it is
thought to be more effective for treatment of coagulopathy that occurs
after prolonged cardiopulmonary bypass (CPB). We examined the impact of
CPB duration on the efficacy of the two therapies in cardiac surgery.
 Method(s): This was a post hoc analysis of the Fibrinogen
Replenishment in Surgery (FIBRES) RCT comparing FC (4 g) to
cryoprecipitate (10 U) in adult patients undergoing cardiac surgery and
experiencing bleeding with acquired hypofibrinogenaemia (n=735). The
primary outcome was allogeneic blood products transfused within 24 h after
CPB. Subjects were stratified by CPB duration (<=120, 121-180, and >180
min). The interaction of treatment assignment with CPB duration was
tested. Result(s): Subjects with longer CPB duration experienced more
bleeding and transfusion. With CPB time <=120 min (FC, n=134;
cryoprecipitate, n=146), the ratio of least-squares means between the FC
and cryoprecipitate groups for total allogeneic blood products at 24 h was
0.90 (one-sided 97.5% confidence interval [CI]: 0.00-1.12); P=0.004. For
subjects with CPB time 121-180 min, it was 1.00 ([one-sided 97.5% CI:
0.00-1.22]; P=0.03], and for CPB time >180 min it was 0.91 ([one-sided
97.5% CI: 0.00-1.12]; P=0.005). Results were similar for all secondary
outcomes, with no interaction between treatment and CPB duration for all
outcomes. Conclusion(s): The haemostatic efficacy of FC was
non-inferior to cryoprecipitate irrespective of CPB duration in cardiac
surgery. Clinical trial registration: NCT03037424. Copyright ©
2022 British Journal of Anaesthesia

<38>
Accession Number
2015632070
Title
Comparison of coronary revascularization strategies in older adults
presenting with acute coronary syndromes.
Source
Journal of the American Geriatrics Society. 70(8) (pp 2235-2245), 2022.
Date of Publication: August 2022.
Author
Shah A.I.; Alabaster A.; Dontsi M.; Rana J.S.; Solomon M.D.; Krishnaswami
A.
Institution
(Shah, Rana, Solomon) Division of Cardiology, Kaiser Permanente Oakland
Medical Center, Oakland, CA, United States
(Alabaster, Dontsi, Rana, Solomon) Division of Research, Kaiser
Permanente, Oakland, CA, United States
(Krishnaswami) Division of Cardiology, Kaiser Permanente San Jose Medical
Center, San Jose, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The optimal coronary revascularization strategy to maximize
the patient-centered outcome of days alive and out of hospital (DAOH), in
multimorbid older (>=65-years) adults after an acute coronary syndrome
(ACS) is incompletely understood. Method(s): Using Kaiser Permanente
Northern California Health Plan databases, we identified 3871 patients
>=65-years presenting with ACS between 1/1/2010-3/1/2018 who underwent
coronary revascularization with either coronary artery bypass grafting
(CABG, N = 1575) or multivessel percutaneous coronary intervention (PCI, N
= 2296). Selection bias was accounted for through propensity score
modeling techniques and inverse probability of treatment weighting. Cox
proportional hazards models were fit to evaluate the association of
revascularization type with outcomes. Primary Outcomes: Absolute DAOH and
the relative risk of achieving >=90%DAOH during three time intervals.
 Secondary Outcomes: All-cause mortality, recurrent MI, stroke,
rehospitalization, repeat revascularization, and dialysis initiation.
 Result(s): CABG (compared to PCI) was associated with greater
absolute number of DAOH, significant after the first year (mean difference
at 1-year: +5.8 days, 95% confidence interval [CI], -1.6 to 13 days;
3-years: +56 days, 95%CI, +25 to +88 days; 5-years: + 131 days, 95%CI, +57
to +205 days). The relative risk of achieving >=90% DAOH significantly
favored CABG after the first year (1-year:1.02, 95%CI, 0.98-1.05;
3-years:1.06, 95%CI 1.002-1.11, 5-years:1.12, 95%CI, 1.03-1.22), and was
related to lower incidences of all-cause mortality, repeat
revascularization, rehospitalization, incident dialysis, and nonfatal MI
with CABG. Conclusion(s): In older adults with multivessel or left
main coronary artery disease who presented with ACS, CABG, after the first
year, was associated with a greater absolute number of DAOH-a geriatric
and patient-centered outcome, compared to PCI. CABG patients also had a
higher probability of achieving >=90%DAOH-with lower all-cause mortality,
recurrent MI, repeat revascularization, new dialysis, and
rehospitalization rates. Future randomized trials should study the impact
of optimal revascularization strategies on the quality of life of older
adults with multimorbidity. Copyright © 2022 The American
Geriatrics Society.

<39>
Accession Number
2015375916
Title
Efficacy of an Autologous Blood Patch for Prolonged Air Leak: A Systematic
Review.
Source
Annals of Thoracic Surgery. 114(3) (pp 1064-1071), 2022. Date of
Publication: September 2022.
Author
Hugen N.; Hekma E.J.; Claessens N.J.M.; Smit H.J.M.; Reijnen M.M.P.J.
Institution
(Hugen, Hekma, Reijnen) Department of Thoracic Surgery, Rijnstate
Hospital, Arnhem, Netherlands
(Hugen) Department of Surgery, Radboud University Medical Center,
Netherlands
(Claessens, Smit) Department of Respiratory Medicine, Rijnstate Hospital,
Arnhem, Netherlands
(Reijnen) Multi-Modality Medical Imaging Group, TechMed Center, University
of Twente, Enschede, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Prolonged air leak after pulmonary surgery remains a clinical
challenge and sometimes needs surgical reintervention. An autologous blood
patch (ABP) may provide a noninvasive method to stop air leak. Its value,
however, is debatable. The aim of this systematic review is to synthesize
evidence regarding the efficacy of ABP in patients with prolonged air
leak. Method(s): A comprehensive search for published studies was
performed in the Medline database, Embase, and the Cochrane library.
Randomized controlled trials, case-control studies, and case series in
which a postoperative ABP was performed were included. Findings from these
studies were tabulated and data were synthesized graphically (PROSPERO
registration number CRD42020157591). Result(s): A total of eight
studies was included in the analysis, comprising 151 patients. Studies
demonstrated heterogeneity in ABP timing and practice, and an intermediate
to high risk of bias was scored. The majority of studies demonstrated a
beneficial effect of the ABP, with a high rate of success of more than
89%. One randomized trial did not find a difference in time to cessation
of air leak after ABP compared with conservative tube thoracostomy. The
overall complication rate was 10%. Conclusion(s): Quality of included
studies is limited owing to lack of comparison groups. Synthesized data in
this review demonstrate a high rate of successful procedures and
acceptable complication rates, and seems encouraging enough to justify a
large randomized clinical trial on the use of ABP for patients who have
prolonged air leak after thoracic surgery. Copyright © 2022 The
Society of Thoracic Surgeons

<40>
Accession Number
637912559
Title
Mechanical Prosthetic Valve Thrombus in a Term Pregnant Woman Presenting
as Acute Heart Failure: Case Report and Review of Literature.
Source
Indian Journal of Cardiovascular Disease in Women - WINCARS. 7(1) (pp
34-38), 2022. Date of Publication: 29 Jul 2022.
Author
Gethu K.; Jha N.; Rengaraj S.; Pampapati V.; Munuswamy H.; Pillai A.A.
Institution
(Gethu, Jha, Rengaraj, Pampapati) Department of Obstetrics and
Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and
Research, Puducherry 605006, India
(Munuswamy, Pillai) Department of Cardiothoracic and Vascular Surgery,
Jawaharlal Institute of Postgraduate Medical Education and Research,
Puducherry, India
Publisher
Georg Thieme Verlag
Abstract
Cardiovascular disease in pregnancy contributes to a significant
proportion of death worldwide. Though pregnancy-associated myocardial
infarction and aortic dissection are the common causes of adverse cardiac
events in developed countries, rheumatic heart diseases continue to be the
important reason for cardiovascular morbidity and mortality in developing
countries. The risk of adverse cardiac outcome is dependent on the type
and severity of valvular abnormality, functional status, left ventricular
function, and pulmonary arterial pressure. Managing a pregnant woman with
a mechanical heart valve prosthesis is challenging because of the
difficulty in achieving optimal anticoagulation in the presence of
hypercoagulability. Mitral valve thrombus is a life-threatening event and
women can present with acute heart failure or thromboembolic events. We
report successful management of a 26-year-old primigravida with rheumatic
heart disease diagnosed to have huge thrombus on mechanical prosthetic
mitral valve presented with acute heart failure at 36 weeks. She received
multidisciplinary care and underwent concurrent cesarean section followed
by thrombectomy under cardiopulmonary bypass. She had a good recovery
following surgery and the complexity surrounds the management merit the
presentation with a review of management strategies for a women with
mechanical prosthetic heart valve in pregnancy. Copyright © 2022
Georg Thieme Verlag. All rights reserved.

<41>
Accession Number
2019664305
Title
*A Novel ABCG8 Variant and Apo(A) Short Isoform Associated with Premature
Atherosclerosis and Familial Hypercholesterolemia Phenocopy.
Source
Journal of Clinical Lipidology. Conference: National Lipid Association
2022 Scientific Sessions. Scottsdale United States. 16(3 Supplement) (pp
e48-e49), 2022. Date of Publication: 01 Jul 2022.
Author
Omar A.; Lasam G.; Fishberg R.; Alam L.
Publisher
Elsevier Ltd
Abstract
Lead Author's Financial Disclosures: Nothing to disclose. Study Funding:
None. Background/Synopsis: We report a patient with a rare ABCG8 mutation,
that when combined with Apo(a) short isoforms may represent a familial
hypercholesterolemia (FH) phenocopy. Objective/Purpose: A 44-year-old
African American male with prior myocardial infarction (MI) at the age 24
with subsequent coronary artery bypass graft who had rapid progression of
atherosclerosis despite having a corrected LDL of zero. Method(s):
Lp(a) was 127 mg/dL and LDL was 40 mg/dL and he had been on evolocumab and
rosuvastatin. The corrected LDL accounts for the cholesterol contained in
Lp(a) using the formula LDLcorr =LDL- 0.3x Lp(a) mass. Thus, his LDLcorr
was zero. He underwent genetic testing with GBinsight which demonstrated
he had Apo(a) short isoforms, which is associated with elevated Lp(a). He
was also heterozygous for an extremely rare ABCG8 variant p.Gly212Glu
(rs1318623110) which has not been previously reported. This variant is
predicted to be deleterious and Gly212 is highly conserved across
vertebrates. Mutations in ABCG5 or ABCG8 can be associated with increased
LDL and risk for CAD. In addition, elevation of Lp(a) can be associated
with 3 to 4 folds increased risk. This novel mutation, along with the
elevated Lp(a) may help to explain his FH phenocopy presentation.
 Result(s): We hypothesized that his premature disease progression may
have been secondary to inflammation, atherogenesis or prothrombosis
associated with Lp(a) with the added potentially deleterious effect of the
ABCG8 mutation. His clinical course with his first MI at age 24 mimics
that of FH, thus making him a phenocopy. We enrolled him in the randomized
Lp(a)HORIZON trial evaluating the effect of pelacarsen in lowering Lp(a).
However, he subsequently had an episode of unstable angina requiring
additional intervention. Conclusion(s): When assessing patients with
suspected FH, mutations in genes other than LDLR, APOB, and PCSK9 should
be evaluated. In this case, a mutation in ABCG8 gene along with Apo(a)
short form isoforms may help explain the patient's disease progression and
FH phenocopy presentation. In addition, ezetimibe may be beneficial in
patients with ABCG5/8 mutation. His marked disease progression despite
having a LDLcorr of zero highlights the importance of considering factors
other than just LDL. Copyright © 2022

<42>
Accession Number
2017891696
Title
Management and investigation pathway for suspected ACS in pregnancy.
Source
International Journal of Obstetric Anesthesia. Conference: Obstetric
Anaesthesia Annual Scientific Meeting 2022. Newport United Kingdom.
50(Supplement 1) (pp 11), 2022. Date of Publication: May 2022.
Author
Cheong K.; Gibson P.; Burns R.
Institution
(Cheong, Gibson, Burns) NHS Lothian, United Kingdom
Publisher
Churchill Livingstone
Abstract
Introduction: Cardiac disease remains the leading cause of maternal death
in the UK and Ireland [1]. The risk of Acute Coronary Syndrome (ACS)
during pregnancy is approximately three to four times higher compared with
the equivalent non-pregnant population [2]. The pathology of ACS in
pregnancy is different and pregnancy poses additional challenges to
investigation and management. This highlights the need for a specific
investigation and management framework to ensure timely diagnosis and
treatment. Method(s): A literature reviewfor ACS in pregnancywas
identified using the PubMed search engines for the period January 2000 to
January 2021. A pathway for investigating and early management of
suspected ACS in pregnancy was proposed based on available evidence. This
pathway was subsequently peer reviewed by a cardiologist, obstetrician,
and obstetric anaesthetist, local and nationally. Result(s): For all
patients with suspected or confirmed ACS, a 12-lead ECG and blood troponin
should be immediate investigations. Oxygen saturation should be maintained
>94%. 15degree left lateral tilt or manual uterine displacement should be
used for patients >20 weeks gestation to relieve aorto-caval compression.
Aspirin 300 mg should be administered. Pain should be managed with GTN
and/or an opioid. Heart rhythm, blood pressure and O2 saturation should be
monitored and with ongoing symptoms, a repeat 12-lead ECG is advised.
There should be early escalation to senior clinicians for MDT management.
The priority for STEMI is to achieve coronary reperfusion. Thrombolysis
should not be routinely administered due to the increased risk of
spontaneous coronary artery dissection in pregnancy. Instead, immediate
referral to tertiary centre for consideration of coronary angiography
should be considered. For NSTEMI, early involvement of senior cardiologist
is advised. For both STEMI and NSTEMI, clopidogrel and/or heparin should
be considered with advice from cardiologist. Patients should be
transferred to an appropriate HDU/CCU/ICU setting with ongoing ECG
monitoring. Ongoing fetal monitoring is required for antenatal patients.
The priority is to treat ACS in a timely fashion and this should not be
delayed for delivery. If possible, delivery should be postponed for at
least two weeks following ACS to optimise medical treatment.
 Discussion(s): This evidence based, peer reviewed pathway is designed
to encourage timely diagnosis and treatment for a rare but unique patient
population. Management should be individualised with an MDT
approach. Copyright © Elsevier Ltd

<43>
Accession Number
2019758283
Title
Factors associated with health-related quality of life in patients with
coronary heart disease.
Source
Pharmacia. 69(3) (pp 771-777), 2022. Date of Publication: 2022.
Author
Gutama F.; Barliana M.I.; Puspitasari I.M.
Institution
(Gutama, Puspitasari) Department of Pharmacology and Clinical Pharmacy,
Faculty of Pharmacy Universitas Padjadjaran, Sumedang, Indonesia
(Barliana) Department of Biological Pharmacy, Faculty of Pharmacy
Universitas Padjadjaran, Sumedang, Indonesia
(Barliana, Puspitasari) Center of Excellence in Higher Education for
Pharmaceutical Innovation Care Universitas Padjadjaran, Sumedang,
Indonesia
Publisher
Pensoft Publishers
Abstract
Coronary heart disease (CHD) contributes to decreased health-related
quality of life (HRQOL). This review article investigates the factors that
can affect the HRQOL in CHD patients. A literature search from PubMed and
EBSCO databases was performed until March 2021 with predetermined
keywords. The review of 15 included articles showed that many factors that
can affect the HRQOL by using EQ-5D instrument in CHD patients, such as
education, gender, comorbidity, percutaneous coronary intervention (PCI)/
coronary artery bypass graft (CABG) intervention, patient-physician
interaction, obesity, physical activity, numbers of medication, smoking,
self-efficacy, social/family life, alcohol drinking, income, employment,
and behavioral risk factor profile. The top three factors associated with
HRQOL in CHD patients were education, gender, and comorbidity. Therefore,
we should pay more attention to CHD patients with lower education levels,
females, and comorbidity. Copyright © Gutama F et al. This is an
open access article distributed under the terms of the Creative Commons
Attribution License (CC-BY 4.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<44>
Accession Number
2019560527
Title
Tranexamic Acid and Its Potential Anti-Inflammatory Effect: A Systematic
Review.
Source
Seminars in Thrombosis and Hemostasis. 48(5) (pp 568-595), 2022. Date of
Publication: 26 Jul 2022.
Author
Okholm S.H.; Krog J.; Hvas A.-M.
Institution
(Okholm, Hvas) Department of Clinical Medicine, Health, Aarhus University,
Vennelyst Boulevard 4, Aarhus C DK 8000, Denmark
(Krog) Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Aarhus C, Denmark
(Hvas) Department of Clinical Biochemistry, Aarhus University Hospital,
Aarhus C, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Tranexamic acid (TXA) is an antifibrinolytic drug primarily used for
reducing blood loss in patients with major bleedings. Animal and cell
studies have shown that TXA might modulate the inflammatory response by
either enhancing or inhibiting cytokine levels. Furthermore, recent human
studies have found altered inflammatory biomarkers in patients receiving
TXA when compared with patients who did not receive TXA. In this
systematic review we investigated the effect of TXA on inflammatory
biomarkers in different patient groups. A systematic literature search was
conducted on the databases PubMed and Embase to identify all original
articles that investigated inflammatory biomarkers in patients receiving
TXA and compared them to a relevant control group. The review was
performed according to the PRISMA guidelines, and the literature search
was performed on November 29, 2021. Thirty-three studies were included,
among which 14 studies compared patients receiving TXA with patients
getting no medication, another 14 studies investigated different dosing
regimens of TXA, and finally five studies examined the administration form
of TXA. The present review suggests that TXA has an anti-inflammatory
effect in patients undergoing orthopaedic surgery illustrated by decreased
levels of C-reactive protein and interleukin-6 in patients receiving TXA
compared with patients receiving no or lower doses of TXA. However, the
anti-inflammatory effect was not found in patients undergoing cardiac
surgery, pediatric craniosynostosis patients, or in rheumatoid arthritis
patients. The inflammatory response was not affected by administration
form of TXA (oral, intravenous, or topical). In conclusion, an
anti-inflammatory effect of TXA was consistently found among orthopaedic
patients only. Copyright © 2022. Thieme. All rights reserved.

<45>
Accession Number
2019804991
Title
Practice-Changing Updates in Perioperative Medicine Literature 2020-2021:
A Systematic Review.
Source
American Journal of Medicine. (no pagination), 2022. Date of Publication:
2022.
Author
Khambaty M.; Silbert R.E.; Devalapalli A.P.; Kashiwagi D.T.; Regan D.W.;
Sundsted K.K.; Mauck K.F.
Institution
(Khambaty, Devalapalli, Kashiwagi, Regan) Division of Hospital Internal
Medicine, Department of Medicine
(Silbert, Sundsted, Mauck) Division of General Internal Medicine,
Department of Medicine, Mayo Clinic and Mayo Clinic College of Medicine,
Rochester, Minn, United States
(Kashiwagi) Division of, Internal Medicine, Sheikh Shakhbout Medical City
in partnership with Mayo Clinic, Abu Dhabi, United Arab Emirates
Publisher
Elsevier Inc.
Abstract
Recent literature published in a variety of multidisciplinary journals has
significantly influenced perioperative patient care. Distilling and
synthesizing the clinically important literature can be challenging. This
review summarizes practice-changing articles in perioperative medicine
from the years 2020 and 2021. Embase, Ovid, and EBM reviews databases were
queried from January 2020 to December 2021. Inclusion criteria were
original research, systematic review, meta-analysis, and important
guidelines. Exclusion criteria were conference abstracts, case reports,
letters, protocols, pediatric and obstetric articles, and cardiac surgery
literature. Two authors reviewed each reference using the Distiller SR
systematic review software (Evidence Partners Inc., Ottawa, Ont., Canada).
A modified Delphi technique was used to identify 9 practice-changing
articles. We identified another 13 articles for tabular summaries, as they
were relevant to an internist's perioperative evaluation of a patient.
Articles were selected to highlight the clinical implications of new
evidence in each field. We have also pointed out limitations of each study
and clinical populations where they are not applicable. Copyright
© 2022 Elsevier Inc.

<46>
Accession Number
2019804897
Title
Patent foramen ovale and perioperative stroke in noncardiac surgery: a
systematic review and meta-analysis.
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Rais G.; Vassallo P.; Schorer R.; Bollen Pinto B.; Putzu A.
Institution
(Rais, Schorer, Bollen Pinto, Putzu) Department of Acute Medicine,
Division of Anaesthesiology, Geneva University Hospitals, Geneva,
Switzerland
(Vassallo) Department of Clinical Neuroscience, Lausanne University
Hospital, Lausanne, Switzerland
Publisher
Elsevier Ltd
Abstract
Background: Patent foramen ovale (PFO) is associated with perioperative
stroke in noncardiac surgery. The magnitude of this association was
assessed in a systematic review and meta-analysis. Method(s):
Electronic databases were searched up to June 2022 for studies assessing
the association between patent foramen ovale and perioperative stroke in
adult patients undergoing noncardiac surgery. The primary analysis was
limited to studies reporting effect estimates adjusted for significant
clinical confounders. We calculated the adjusted odds ratio (aOR) and 95%
confidence interval (CI). Result(s): We included nine retrospective
and two prospective observational studies, including 21 257 082 patients.
The presence of a patent foramen ovale was independently associated with
stroke at 30 days after surgery (aOR=6.68 [95% CI: 3.51-12.73]; P<0.001)
and at longest follow-up available (aOR=7.36 [95% CI: 3.56-15.21];
P<0.001). The odds of stroke at 30 days varied according to surgical
specialty: neurosurgery (aOR=4.52 [95% CI: 3.17-6.43]), vascular surgery
(aOR=7.15 [95% CI: 2.52-20.22]), thoracic surgery (aOR=10.64 [95% CI:
5.97-18.98]), orthopaedic surgery (aOR=11.85 [95% CI: 5.38-26.08]),
general surgery (aOR=14.40 [95% CI: 10.88-19.06]), and genitourinary
surgery (aOR=17.28 [95% CI: 10.36-28.84]). Conclusion(s): The
presence of a patent foramen ovale is associated with a large and
consistent increase in odds of stroke across all explored surgical
settings. Prospective trials should further explore this association by
systematically assessing patent foramen ovale and stroke prevalence and
identifying a specific population at risk. This is crucial for the
elaboration of prevention plans and may improve perioperative
outcomes. Copyright © 2022 British Journal of Anaesthesia

<47>
Accession Number
2019788424
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: 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
(Caporali) 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) UZ Gasthuisberg Leuven, 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,
Quebec, 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
Elsevier Ireland Ltd
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 (21.8 days vs 47.6 days), 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 Elsevier B.V.

<48>
Accession Number
2017751607
Title
Use of Midodrine in Heart Failure: Two Case Reports and a Review of the
Literature.
Source
European Journal of Case Reports in Internal Medicine. 9(3) (no
pagination), 2022. Date of Publication: 2022.
Author
Hajjiah A.; Maadarani O.; Bitar Z.; Hanna B.; Elshabasy R.; Abdelfatah M.;
Gohar M.
Institution
(Hajjiah) Clinical Pharmacy Department, Ahmadi Hospital, Kuwait Oil
Company, Al Ahmadi, Kuwait
(Maadarani, Bitar, Hanna, Elshabasy, Abdelfatah, Gohar) Internal Medicine
Department, Ahmadi Hospital, Kuwait Oil Company, Al Ahmadi, Kuwait
Publisher
SMC Media Srl
Abstract
Hypotension in patients with heart failure is much more frequent in daily
clinical practice than the 10-15% reported in clinical trials. In patients
with heart failure with reduced ejection fraction (HFrEF), hypotension
frequently limits the initiation and up-titration of guideline-directed
medical therapy (GDMT). Midodrine is a peripheral alpha-1 agonist and a
vasopressor anti-hypotensive agent approved for the treatment of
orthostatic hypotension. We describe two cases where midodrine was
prescribed in patients with HFrEF and hypotension. Copyright European
Journal of Case Reports in Internal Medicine © EFIM 2022

<49>
[Use Link to view the full text]
Accession Number
2017207272
Title
Effect of Dexmedetomidine on Tachyarrhythmias after Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Pharmacology. 79(3) (pp 315-324), 2022. Date of
Publication: 08 Mar 2022.
Author
Wang W.; Liu J.; Ye H.; Wang M.; Wang T.
Institution
(Wang) Department of Anesthesiology, Jining No. 1 People's Hospital,
Shandong, Jining, China
(Liu) Department of Emergency, Jining No. 1 People's Hospital, Shandong,
Jining, China
(Ye) Department of Anesthesiology, Sishui County Hospital, Jining,
Shandong, China
(Wang) Department of Anesthesiology, Qingdao Municipal Hospital Group,
Shandong, Qingdao, China
(Wang) Department of Anesthesiology, The Second Affiliated Hospital of
Hainan Medical University, Hainan, Haikou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Tachyarrhythmias after cardiac surgery is a common occurrence in clinical
practice, which can be life threatening. We searched 6 databases,
including Embase, PubMed, Cochrane, CNKI, Wanfang, and Sinomed, to
evaluate the effect of dexmedetomidine on tachyarrhythmias after adult
cardiac surgery. The primary end point was the number of patients with
atrial fibrillation (AF) after cardiac surgery. The secondary end points
included the number of patients with supraventricular tachycardia or with
ventricular tachycardia or with ventricular fibrillation or with
myocardial infarction or deceased patients, the duration of mechanical
ventilation, the intensive care unit stay, hospital stay, and the number
of patients with bradycardia and those with hypotension. Among the 1388
retrieved studies, 18 studies (n = 3171 participants) met our inclusion
criteria. Dexmedetomidine reduced the incidence of AF by 17% [relative
risk (RR) = 0.83; 95% confidence interval (CI), 0.73-0.93; P = 0.002].
Through subgroup analysis, we found that when the maintenance dose of
dexmedetomidine was >0.7 microg.kg-1.h-1, the effect
of preventing AF was obvious (RR = 0.58; 95%CI 0.43-0.78; P = 0.0003).
Dexmedetomidine also reduced the incidence of supraventricular tachycardia
by approximately 70% (RR = 0.29; 95% CI, 0.11-0.77; P = 0.01) and the
incidence of ventricular tachycardia by approximately 80% (RR = 0.23; 95%
CI, 0.08-0.63; P = 0.004) but had no effect on ventricular fibrillation
(RR = 1.02; 95% CI, 0.14-7.31; P = 0.99). The major side effect of
dexmedetomidine was bradycardia. Dexmedetomidine can reduce the incidence
of AF (especially high dosages), supraventricular tachycardia, and
ventricular tachycardia after cardiac surgery in adults, but it does not
affect the occurrence of ventricular fibrillation. Copyright ©
2022 Lippincott Williams and Wilkins. All rights reserved.

<50>
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

<51>
Accession Number
638581346
Title
Effect of High-vs Low-Dose Tranexamic Acid Infusion on Need for Red Blood
Cell Transfusion and Adverse Events in Patients Undergoing Cardiac
Surgery: The OPTIMAL Randomized Clinical Trial.
Source
JAMA. 328(4) (pp 336-347), 2022. Date of Publication: 26 Jul 2022.
Author
Shi J.; Zhou C.; Pan W.; Sun H.; Liu S.; Feng W.; Wang W.; Cheng Z.; Wang
Y.; Zheng Z.
Institution
(Shi, Zhou, Sun, Liu, Feng, Wang, Zheng) Department of Cardiovascular
Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, No. 167 Beilishi Rd, Xicheng
District, Beijing 100037, China
(Pan) Department of Anesthesiology, Baylor College of Medicine, Texas
Heart Institute, Houston, United States
(Wang) Department of Anesthesiology, First Affiliated Hospital of Wenzhou
Medical University, Wenzhou, China
(Cheng) Department of Cardiovascular Surgery, Henan Province People's
Hospital, Fuwai Central China Cardiovascular Hospital, Henan
Cardiovascular Hospital, Zhengzhou University, Zhengzhou, China
(Zheng) National Health Commission Key Laboratory of Cardiovascular
Regenerative Medicine, Fuwai Central China Hospital, Central China Branch
of National Center for Cardiovascular Diseases, No. 1 Fuwai Ave, Zhengdong
New District, Zhengzhou 451464, China
Publisher
American Medical Association
Abstract
Importance: Tranexamic acid is recommended for reducing blood loss and
transfusion in cardiac surgery. However, it remains unknown whether a high
dose of tranexamic acid provides better blood-sparing effect than a low
dose without increasing the risk of thrombotic complications or seizures
in cardiac surgery. Objective(s): To compare the efficacy and adverse
events of high-dose vs low-dose tranexamic acid in patients undergoing
cardiac surgery with cardiopulmonary bypass. Design, Setting, and
Participant(s): Multicenter, double-blind, randomized clinical trial among
adult patients undergoing cardiac surgery with cardiopulmonary bypass. The
study enrolled 3079 patients at 4 hospitals in China from December 26,
2018, to April 21, 2021; final follow-up was on May 21, 2021.
 Intervention(s): Participants received either a high-dose tranexamic
acid regimen comprising a 30-mg/kg bolus, a 16-mg/kg/h maintenance dose,
and a 2-mg/kg prime (n = 1525) or a low-dose regimen comprising a 10-mg/kg
bolus, a 2-mg/kg/h maintenance dose, and a 1-mg/kg prime (n = 1506).
 Main Outcomes and Measures: The primary efficacy end point was the
rate of allogeneic red blood cell transfusion after start of operation
(superiority hypothesis), and the primary safety end point was a composite
of the 30-day postoperative rate of mortality, seizure, kidney dysfunction
(stage 2 or 3 Kidney Disease: Improving Global Outcomes [KDIGO] criteria),
and thrombotic events (myocardial infarction, ischemic stroke, deep vein
thrombosis, and pulmonary embolism) (noninferiority hypothesis with a
margin of 5%). There were 15 secondary end points, including the
individual components of the primary safety end point. Result(s):
Among 3079 patients who were randomized to treatment groups (mean age,
52.8 years; 38.1% women), 3031 (98.4%) completed the trial. Allogeneic red
blood cell transfusion occurred in 333 of 1525 patients (21.8%) in the
high-dose group and 391 of 1506 patients (26.0%) in the low-dose group
(risk difference [RD],-4.1% [1-sided 97.55% CI,- to-1.1%]; relative risk,
0.84 [1-sided 97.55% CI,- to 0.96; P =.004]). The composite of
postoperative seizure, thrombotic events, kidney dysfunction, and death
occurred in 265 patients in the high-dose group (17.6%) and 249 patients
in the low-dose group (16.8%) (RD, 0.8%; 1-sided 97.55% CI,- to 3.9%; P
=.003 for noninferiority). Fourteen of the 15 prespecified secondary end
points were not significantly different between groups, including seizure,
which occurred in 15 patients (1.0%) in the high-dose group and 6 patients
(0.4%) in the low-dose group (RD, 0.6%; 95% CI,-0.0% to 1.2%; P =.05).
 Conclusions and Relevance: Among patients who underwent cardiac
surgery with cardiopulmonary bypass, high-dose compared with low-dose
tranexamic acid infusion resulted in a modest statistically significant
reduction in the proportion of patients who received allogeneic red blood
cell transfusion and met criteria for noninferiority with respect to a
composite primary safety end point consisting of 30-day mortality,
seizure, kidney dysfunction, and thrombotic events. Trial Registration:
ClinicalTrials.gov Identifier: NCT03782350. Copyright © 2022
American Medical Association. All rights reserved.

<52>
[Use Link to view the full text]
Accession Number
2019580964
Title
Association between obstructive sleep apnea (OSA) and atrial fibrillation
(AF): A dose-response meta-analysis.
Source
Medicine (United States). 101(30) (pp E29443), 2022. Date of Publication:
29 Jul 2022.
Author
Zhang D.; Ma Y.; Xu J.; Yi F.
Institution
(Zhang, Ma, Xu, Yi) Department of Cardiology, Xijing Hospital, The Air
Force Military Medical University, Shaanxi, Xi'an 710032, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Refractory hypoxemia episodes are characteristic of
obstructive sleep apnea (OSA). Patients with OSA suffer from oxidative
stress in all systems. Atrial fibrillation (AF) is a type of arrhythmia
that may be induced by OSA. In this study, we explored the dose-response
relationship between OSA and AF. Our research provides the basis for a
novel approach to AF prevention. Method(s): We screened four
databases (PubMed, Embase, the Cochrane Library, and Web of Science) for
observational studies on OSA and AF. Studies were collected from database
establishment to November 2020. We performed a traditional subgroup
meta-analysis. Linear and spline dose-response models were applied to
assess the association between the apnea-hypopnea index, an indicator of
OSA severity, and the risk of AF. Review Manager version 5.3 software and
Stata 16.0 were used for the analysis. Result(s): Sixteen
observational studies were included in the study. We excluded a study from
the conventional meta-analysis. In the subgroup analysis, the odds ratios
for new onset AF for no obvious reason, new onset AF after surgical
operations, such as coronary artery bypass grafting, and AF after ablation
treatment were 1.71 (95% CI 1.37-2.13, P <.05), 2.65 (95% CI 2.32-3.01, P
<.05), and 2.93 (95% CI 2.47-3.49, P <.05), respectively. Linear
dose-response meta-analysis results revealed that the risk of AF increased
with increasing apnea-hypopnea index value. Conclusion(s): Through
dose-response meta-analysis, we found a potential dose-response
relationship between OSA severity and the risk of AF. This relationship
should be considered in interventions aimed at AF prevention in the
future. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<53>
Accession Number
2019346924
Title
Safety and efficacy of phage therapy in difficult-to-treat infections: a
systematic review.
Source
The Lancet Infectious Diseases. 22(8) (pp e208-e220), 2022. Date of
Publication: August 2022.
Author
Uyttebroek S.; Chen B.; Onsea J.; Ruythooren F.; Debaveye Y.; Devolder D.;
Spriet I.; Depypere M.; Wagemans J.; Lavigne R.; Pirnay J.-P.;
Merabishvili M.; De Munter P.; Peetermans W.E.; Dupont L.; Van Gerven L.;
Metsemakers W.-J.
Institution
(Uyttebroek, Van Gerven) Department of Otorhinolaryngology, UZ Leuven,
Leuven, Belgium
(Chen, Onsea, Ruythooren, Metsemakers) Department of Trauma Surgery, UZ
Leuven, Leuven, Belgium
(Debaveye) Department of Intensive Care Medicine, UZ Leuven, Leuven,
Belgium
(Devolder, Spriet) Pharmacy Department, UZ Leuven, Leuven, Belgium
(Depypere) Department of Laboratory Medicine, UZ Leuven, Leuven, Belgium
(De Munter, Peetermans) Department of General Internal Medicine, UZ
Leuven, Leuven, Belgium
(Dupont) Department of Pneumology, UZ Leuven, Leuven, Belgium
(Uyttebroek, Van Gerven) Experimental Otorhinolaryngology, Rhinology
Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
(Chen, Onsea, Metsemakers) Locomotor and Neurological Disorders,
Department of Development and Regeneration, KU Leuven, Leuven, Belgium
(Debaveye) Department of Cellular and Molecular Medicine, KU Leuven,
Leuven, Belgium
(Spriet) Clinical Pharmacology and Pharmacotherapy, Department of
Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
(Depypere) Laboratory of Clinical Bacteriology and Mycology, KU Leuven,
Leuven, Belgium
(Van Gerven) Allergy and Clinical Immunology Research Group, KU Leuven,
Leuven, Belgium
(De Munter, Peetermans) Department of Microbiology, Immunology and
Transplantation, KU Leuven, Leuven, Belgium
(Wagemans, Lavigne) Laboratory of Gene Technology, Department of
Biosystems, KU Leuven, Leuven, Belgium
(Dupont) Respiratory Diseases and Thoracic Surgery, Department of Chronic
Diseases and Metabolism, KU Leuven, Leuven, Belgium
(Pirnay, Merabishvili) Laboratory for Molecular and Cellular Technology,
Queen Astrid Military Hospital, Neder-over-Heembeek, Belgium
Publisher
Elsevier Ltd
Abstract
According to the latest reports from WHO, the incidence of
antibiotic-resistant bacterial infections is increasing worldwide,
resulting in increased morbidity and mortality and a rising pressure on
health-care systems. However, the development of new antibiotics is an
expensive and time-consuming process, urging scientists to seek
alternative antimicrobial strategies. Over the past few decades, the
concept of therapeutic administration of bacteriophages (also known as
phages) has gained popularity worldwide. Although conceptually promising,
the widespread implementation of phage therapy in routine clinical
practice is restricted by the scarcity of safety and efficacy data
obtained according to the strict standards of the applicable clinical
trial regulations. In this systematic review, we list clinical data
published between Jan 1, 2000 and Aug 14, 2021 on the safety and efficacy
of phage therapy for difficult-to-treat bacterial infections, and provide
an overview of trials and case studies on the use of phage therapy in
several medical disciplines. Copyright © 2022 Elsevier Ltd

<54>
Accession Number
2018314011
Title
High-Energy Enteral Nutrition in Infants After Complex Congenital Heart
Surgery.
Source
Frontiers in Pediatrics. 10 (no pagination), 2022. Article Number: 869415.
Date of Publication: 13 Jul 2022.
Author
Ni P.; Chen X.; Zhang Y.; Zhang M.; Xu Z.; Luo W.
Institution
(Ni, Chen, Zhang, Zhang, Xu) Department of Thoracic and Cardiovascular
Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai
Jiao Tong University, Shanghai, China
(Luo) Nursing Department, Shanghai Children's Medical Center, School of
Medicine, Shanghai Jiao Tong University, Shanghai, China
Publisher
Frontiers Media S.A.
Abstract
Background: Malnutrition is common in complex congenital heart disease
(CCHD). The purpose of this study was to compare the safety and efficacy
of early initiation of high-energy enteral nutrition (EN) with regular
energy EN in infants after surgery for CCHD. Method(s): This is a
subgroup analysis of a randomized controlled trial (RCT) which was
conducted in the cardiac intensive care unit (CICU) of the largest
pediatric heart center in China. Eighty children with CCHD after surgery
were from two groups, the intervention group (n = 40) was given
high-energy EN and the control group (n = 40) was given regular energy EN.
We analyzed the effects of the two interventions on outcomes such as
caloric attainment rate, gastrointestinal intolerance, duration of
mechanical ventilation, and anthropometry at discharge. Result(s):
There was no difference in the daily milk intake between the two groups,
but the calorie intake (50.2 vs. 33.4, P < 0.001), protein intake (1.1 vs.
0.9, P < 0.001) and caloric attainment rate were higher in the
intervention group (77.5 vs. 45.0%, P = 0.003). In addition, the incidence
of pneumonia (P = 0.003) and duration of mechanical ventilation (P =
0.008) were less in the intervention group, and biceps circumference and
triceps skinfold thickness at hospital discharge were greater than those
in the control group (P < 0.001). We have not found statistical
differences in gastrointestinal intolerance, glycemic fluctuations,
incidence of pressure ulcers, length of CICU stay and postoperative
hospital days between the two groups. Conclusion(s): Early initiation
of high-energy EN may be safe and effective in infants after complex
cardiac surgery. Low doses high-energy EN did not increase
gastrointestinal intolerance or glycemic fluctuations and also improved
post-operative nutrition by increasing caloric and protein intake without
increasing fluid intake. Copyright © 2022 Ni, Chen, Zhang, Zhang,
Xu and Luo.

<55>
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.

<56>
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.

<57>
Accession Number
2018663386
Title
Immediate and late outcomes of transcatheter aortic valve implantation
versus surgical aortic valve replacement in bicuspid valves: Meta-analysis
of reconstructed time-to-event data.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Michel Pompeu S.a.; Jacquemyn X.; Tasoudis P.T.; Van den Eynde J.; Erten
O.; Dokollari A.; Torregrossa G.; Sicouri S.; Weymann A.; Ruhparwar A.;
Athanasiou T.; Ramlawi B.
Institution
(Michel Pompeu, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Tasoudis, Erten, Dokollari, Torregrossa, Sicouri, Ramlawi)
Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University of Duisburg-Essen, Essen, Germany
(Athanasiou) Department of Surgery and Cancer, St Mary's Hospital, London,
United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Outcomes of transcatheter aortic valve implantation (TAVI)
versus surgical aortic valve replacement (SAVR) in patients with aortic
stenosis and bicuspid aortic valve (BAV) must be better investigated.
 Method(s): A meta-analysis including studies published by January
2022 reporting immediate outcomes (in-hospital death, stroke, acute kidney
injury [AKI], major bleeding, new permanent pacemaker implantation [PPI],
paravalvular leakage [PVL]), mortality in the follow-up (with Kaplan-Meier
curves for reconstruction of individual patient data). Result(s):
Five studies met our eligibility criteria. No statistically significant
difference was observed for in-hospital death, stroke, AKI, and PVL. TAVI
was associated with lower risk of major bleeding (odds ratio [OR]: 0.29;
95% confidence interval [CI]: 0.12-0.69; p =.025), but higher risk of PPI
(OR: 2.00; 95% CI: 1.05-3.77; p =.041). In the follow-up, mortality after
TAVI was significantly higher in the analysis with the largest samples
(HR: 1.24, 95% CI: 1.01-1.53, p =.043), but no statistically significant
difference was observed with risk-adjusted populations (HR: 1.06, 95% CI:
0.86-1.32, p =.57). Landmark analyses suggested a time-varying risk with
TAVI after 10 and 13 months in both largest and risk-adjusted populations
(HR: 2.13, 95% CI: 1.45-3.12, p <.001; HR: 1.7, 95% CI: 1.11-2.61, p
=.015, respectively). Conclusion(s): Considering the immediate
outcomes and comparable overall survival observed in risk-adjusted
populations, TAVI can be used safely in selected BAV patients. However, a
time-varying risk is present (favoring SAVR over TAVI at a later
timepoint). This finding was likely driven by higher rates of PPI with
TAVI. Copyright © 2022 Wiley Periodicals LLC.

<58>
Accession Number
2018649027
Title
Trachway flexible stylet facilitates the correct placement of double-lumen
endobronchial tube: a prospective, randomized study.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 260. Date
of Publication: December 2022.
Author
Hsu H.-T.; Kuo Y.-W.; Ma C.-W.; Su M.-P.; Tseng K.-Y.; Li C.-L.; Cheng
K.-I.
Institution
(Hsu, Kuo, Ma, Su, Tseng, Li, Cheng) Department of Anesthesiology,
Kaohsiung Medical University Chung-Ho Memorial Hospital, No.100, Tzyou 1st
Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan (Republic of China)
(Hsu, Cheng) Department of Anesthesiology, Faculty of Medicine, College of
Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (Republic of
China)
Publisher
BioMed Central Ltd
Abstract
Background: The mainstream facilitation of one-lung ventilation is using
double-lumen endobronchial tubes. However, it is more difficult to be
positioned properly and more likely to cause airway injuries. How to place
double-lumen endobronchial tubes rapidly and correctly is important for
thoracic anesthesiologists. Method(s): One hundred eight patients
with an American Society of Anesthesiologists physical status of I to III
were 20 years of age or over, and required one-lung ventilation for
thoracic surgery. They were randomly assigned to the conventional
technique group (n = 36), the flexible fiberoptic bronchoscopy group (n =
36), or the Trachway flexible stylet group (n = 36). The primary endpoint
was the time needed for intubation. T1, the time from the tip of the blade
passing between the patient's lips to identification of the vocal cords;
and T2, the time from identification of the vocal cords to the bronchial
lumen was in the correct position. Result(s): T1 had no significant
difference between groups, but T2 was significantly shorter in the
Trachway flexible stylet group (p < 0.0001) and longer in the conventional
technique group (p < 0.0001). Conclusion(s): Using Trachway flexible
stylet for correct placement of double-lumen endobronchial tubes not only
significantly shortened the intubation time, but also reduced incidence of
carinal injuries. It is an alternative, and a choice with good safety.
Trial registration: ClinicalTrials.gov Identifier: NCT02364622,
18/02/2015, Retrospectively registered. Copyright © 2022, The
Author(s).

<59>
Accession Number
2017997119
Title
Fraction of inspired oxygen during general anesthesia for non-cardiac
surgery: Systematic review and meta-analysis.
Source
Acta Anaesthesiologica Scandinavica. 66(8) (pp 923-933), 2022. Date of
Publication: September 2022.
Author
Hoybye M.; Lind P.C.; Holmberg M.J.; Bolther M.; Jessen M.K.; Vallentin
M.F.; Hansen F.B.; Holst J.M.; Magnussen A.; Hansen N.S.; Johannsen C.M.;
Enevoldsen J.; Jensen T.H.; Roessler L.L.; Klitholm M.P.; Eggertsen M.A.;
Caap P.; Boye C.; Dabrowski K.M.; Vormfenne L.; Henriksen J.; Karlsson M.;
Balleby I.R.; Rasmussen M.S.; Paelestik K.; Granfeldt A.; Andersen L.W.
Institution
(Hoybye, Holmberg, Jessen, Andersen) Research Center for Emergency
Medicine, Aarhus University Hospital, Aarhus, Denmark
(Hoybye, Holmberg, Jessen, Vallentin, Hansen, Magnussen, Johannsen,
Enevoldsen, Eggertsen, Boye, Vormfenne, Granfeldt, Andersen) Department of
Clinical Medicine, Aarhus University, Aarhus, Denmark
(Lind) Department of Surgical Gastroenterology, Aalborg University
Hospital, Aalborg, Denmark
(Holmberg) Department of Cardiology, Viborg Regional Hospital, Viborg,
Denmark
(Bolther, Holst, Hansen, Klitholm, Caap, Dabrowski, Henriksen, Granfeldt,
Andersen) Department of Anesthesiology and Intensive Care, Aarhus
University Hospital, Aarhus, Denmark
(Vallentin, Andersen) Prehospital Emergency Medical Services, Aarhus,
Denmark
(Jensen) Department of Internal Medicine, University Hospital of North
Norway, Narvik, Norway
(Roessler) Department of Emergency Medicine, Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
(Karlsson, Rasmussen) Department of Anesthesiology and Intensive Care,
Aalborg University Hospital, Aalborg, Denmark
(Balleby) National Hospital of the Faroe Islands, Torshavn, Faroe Islands
(Paelestik) Department of Anesthesiology and Intensive Care, Viborg
Regional Hospital, Viborg, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Controversy exists regarding the effects of a high versus a
low intraoperative fraction of inspired oxygen (FiO<inf>2</inf>) in adults
undergoing general anesthesia. This systematic review and meta-analysis
investigated the effect of a high versus a low FiO<inf>2</inf> on
postoperative outcomes. Method(s): PubMed and Embase were searched on
March 22, 2022 for randomized clinical trials investigating the effect of
different FiO<inf>2</inf> levels in adults undergoing general anesthesia
for non-cardiac surgery. Two investigators independently reviewed studies
for relevance, extracted data, and assessed risk of bias. Meta-analyses
were performed for relevant outcomes, and potential effect measure
modification was assessed in subgroup analyses and meta-regression. The
evidence certainty was evaluated using GRADE. Result(s): This review
included 25 original trials investigating the effect of a high (mostly
80%) versus a low (mostly 30%) FiO<inf>2</inf>. Risk of bias was
intermediate for all trials. A high FiO<inf>2</inf> did not result in a
significant reduction in surgical site infections (OR: 0.91, 95% CI
0.81-1.02 [p =.10]). No effect was found for all other included outcomes,
including mortality (OR = 1.27, 95% CI: 0.90-1.79 [p =.18]) and hospital
length of stay (mean difference = 0.03 days, 95% CI -0.25 to 0.30 [p
=.84). Results from subgroup analyses and meta-regression did not identify
any clear effect modifiers across outcomes. The certainty of evidence
(GRADE) was rated as low for most outcomes. Conclusion(s): In adults
undergoing general anesthesia for non-cardiac surgery, a high
FiO<inf>2</inf> did not improve outcomes including surgical site
infections, length of stay, or mortality. However, the certainty of the
evidence was assessed as low. Copyright © 2022 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<60>
Accession Number
2017598638
Title
Prognostic Impact of Pre- and Post-Procedural Renal Dysfunction on Late
All-Cause Mortality Outcome Following Transcatheter Edge-to-Edge Repair of
the Mitral Valve: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 42 (pp 6-14), 2022. Date of
Publication: September 2022.
Author
Safiriyu I.; Nagraj S.; Otulana R.; Saralidze T.; Kokkinidis D.G.;
Faillace R.
Institution
(Safiriyu, Nagraj, Saralidze, Faillace) Department of Medicine, Jacobi
Medical Center, Bronx, NY, United States
(Safiriyu, Nagraj, Saralidze, Faillace) Albert Einstein College of
Medicine, Bronx, NY, United States
(Otulana) Federal Medical Center, OG, Abeokuta, Nigeria
(Kokkinidis) Department of Cardiology, Yale University School of Medicine,
New Haven, CT, United States
(Faillace) Department of Cardiology, Jacobi Medical Center, Bronx, NY,
United States
Publisher
Elsevier Inc.
Abstract
Introduction: Impaired renal function, a well-recognized complication of
severe heart failure is associated with adverse outcomes following
cardiovascular interventions. There are conflicting data reported about
its impact on late all-cause mortality following transcatheter
edge-to-edge mitral valve repair (TEER) with MitraClip (MC) implantation.
 Aim(s): To evaluate the impact of pre- and post- procedural renal
dysfunction on late (>=12 months) all-cause mortality following TEER with
MC. Method(s): Electronic databases PubMed, Embase, and Web of
Science were systematically reviewed from inception to February 2021 for
studies evaluating MC outcomes, according to the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses guidelines. A random-effects
model meta-analysis was performed and heterogeneity of the included
studies was assessed using I-squared test. Result(s): Out of 2606
articles, 15 studies with 19,545 patients were included. Pre-procedural
renal dysfunction i.e. chronic kidney disease (CKD) was independently
associated with higher late all-cause mortality (Hazard ratio [HR] 1.57,
95% CI 1.25-1.97, I2 = 57%) after TEER with MC. A similar
association was observed irrespective of CKD severity (HR 1.62 95% CI
1.21-2.16, I2 = 0% and HR 2.86, 95% CI 1.87-4.39, I2
= 26% for CKD stage 3 and >= stage 4 respectively). In addition, the
development of post-procedural renal dysfunction was independently
associated with higher late all-cause mortality (HR = 2.32, 95% CI
1.71-3.15, I2 = 42%) after TEER with MC. Conclusion(s):
Pre- and post-procedural renal dysfunction is a strong independent
predictor of late all-cause mortality following TEER with MC and this
should be considered during periprocedural planning for these
patients. Copyright © 2022 Elsevier Inc.

<61>
Accession Number
2017586977
Title
Mechanisms of Death in Low-Risk Patients After Transcatheter or Surgical
Aortic Valve Replacement.
Source
Cardiovascular Revascularization Medicine. 42 (pp 1-5), 2022. Date of
Publication: September 2022.
Author
Ramlawi B.; Deeb G.M.; Yakubov S.J.; Markowitz A.H.; Hughes G.C.; Kiaii
R.B.; Huang J.; Kleiman N.S.; Reardon M.J.
Institution
(Ramlawi) Lankenau Heart Institute, 100 East Lancaster Ave., Suite 356,
Wynnewood, PA 19096, United States
(Deeb) Department of Cardiac Surgery, University of Michigan Hospitals,
1500 E. Medical Center Drive, 5144 Frankel Cardiovascular Center, SPC
#5864, Ann Arbor, MI 48109-5864, United States
(Yakubov) Department of Interventional Cardiology, OhioHealth-Riverside
Methodist Hospital, 3705 Olentangy River Rd Ste 100, Columbus, OH 43214,
United States
(Markowitz) Department of Cardiothoracic Surgery, University Hospitals
Cleveland Medical Center, 11100 Euclid Ave Ste 1800, Cleveland, OH 44106,
United States
(Hughes) Division of Thoracic and Cardiovascular Surgery, Duke University
Medical Center, 2301 Erwin Rd, Durham, NC 27707, United States
(Kiaii) Department of Cardiovascular and Thoracic Surgery, London Health
Sciences Centre, 800 Commissioners Rd E, London, ON N6A 5W9, Canada
(Huang) Department of Statistics, Medtronic, 8200 Coral Sea Street,
Minneapolis, MN 55112, United States
(Kleiman, Reardon) Department of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, 6550 Fannin Street, Suite 1401, Houston,
TX 77030, United States
Publisher
Elsevier Inc.
Abstract
Background: Death in high- and intermediate-risk patients after
self-expanding transcatheter (TAVR) and surgical aortic valve replacement
(surgery) differed in mechanisms and timing. In both risk groups, 1-year
all-cause mortality was lower in TAVR than in surgery patients. The
differences in mechanism and timing of death in low-risk patients has not
been studied. This report explores the mechanisms of death during 3 time
periods; 0 to 30 days (early), 31 to 120 days (recovery), and 121 to 365
days (late). Method(s): We retrospectively examined the mechanisms
and timing of death following TAVR or surgery in the randomized Evolut Low
Risk Trial. Patients were enrolled between March 2016 and November 2018
from 86 designated TAVR centers. Mechanisms of death were categorized as
due to technical reasons, failure to repair, complications linked to
death, failure to recover or other. Result(s): All-cause mortality at
1 year was 2.2% for TAVR and 2.8% for surgery, p = 0.44. Early deaths
included 3 TAVR patients, all due to technical reasons, and 8 surgery
patients (1 technical, 5 complications and 2 failed to recover). Recovery
period deaths included 6 TAVR patients (4 complications, 1 failed to
recover and 1 other), and 1 surgery patient from complications of valve
endocarditis. Late period deaths included 6 TAVR patients and 9 surgery
patients, primarily due to complications. Conclusion(s): In this
low-risk study cohort, no patient died from failure to repair the valve;
reduction in procedural complications in the TAVR and surgery groups
remain opportunities for further improvement in outcomes. Clinical Trial
Registrations (clinicaltrials.gov): NCT02701283 (Evolut Low
Risk). Copyright © 2022 Elsevier Inc.

<62>
Accession Number
2017229878
Title
Surgical Aortic Valve Replacement Versus Conservative Treatment in
Asymptomatic Severe Aortic Stenosis: An Updated Systematic Review and
Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 42 (pp 36-44), 2022. Date of
Publication: September 2022.
Author
Ismayl M.; Machanahalli Balakrishna A.; Abusnina W.; Thandra A.; Walters
R.W.; Alugubelli N.R.; Yackley S.; Betts L.; Smer A.; Goldsweig A.M.;
Dahal K.
Institution
(Ismayl, Machanahalli Balakrishna, Yackley, Betts) Department of Medicine,
Creighton University School of Medicine, Omaha, NE, United States
(Abusnina, Thandra, Alugubelli, Smer, Dahal) Department of Medicine,
Division of Cardiology, Creighton University School of Medicine, Omaha,
NE, United States
(Walters) Department of Medicine, Division of Clinical Research and
Evaluative Sciences, Creighton University School of Medicine, Omaha, NE,
United States
(Goldsweig) Department of Medicine, Division of Cardiovascular Medicine,
University of Nebraska Medical Center, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Background: While aortic valve replacement (AVR) is indicated for
symptomatic severe aortic stenosis (AS), the appropriate management of
asymptomatic severe AS remains unclear. We conducted an updated
meta-analysis to compare the outcomes of surgical AVR (SAVR) versus
conservative treatment in patients with asymptomatic severe AS.
 Method(s): We searched PubMed, EMBASE, Cochrane, clinicaltrials.gov,
and Google Scholar for studies comparing outcomes of SAVR versus
conservative treatment in asymptomatic severe AS. Risk ratios (RRs) and
95% confidence intervals (CIs) were calculated for each individual study.
Outcomes included all-cause mortality, cardiovascular and
non-cardiovascular mortality, 30-day operative mortality, sudden cardiac
death (SCD), heart failure hospitalization (HFH), myocardial infarction
(MI), and stroke. Result(s): A total of 8 studies with 2685 patients
were included. The mean age was above 60 years, and the median follow-up
duration was 4 years. Compared to conservative treatment, SAVR was
associated with significantly lower all-cause mortality (RR 0.39; 95% CI
0.23-0.64) and HFH rates (RR 0.18; 95% CI 0.05-0.71). There were no
significant differences in cardiovascular mortality (RR 0.24; 95% CI
0.03-1.67), non-cardiovascular mortality (RR 0.49; 95% CI 0.23-1.03),
30-day operative mortality (RR 0.48; 95% CI 0.10-2.32), SCD (RR 0.37; 95%
CI 0.05-2.89), MI (RR 0.48; 95% CI 0.04-5.52), and stroke rates (RR 1.20;
95% CI 0.35-4.11) between the two strategies. Conclusion(s): In
patients with asymptomatic severe AS, SAVR is associated with
significantly lower all-cause mortality and HFH compared to conservative
treatment. While SAVR is a promising option for asymptomatic severe AS,
most studies were observational and nonrandomized; randomized trials are
needed to establish a clear benefit. Copyright © 2022

<63>
Accession Number
2017001232
Title
Impact of Stent Types on In-Hospital Outcomes of Patients With Cancer
Undergoing Percutaneous Coronary Intervention: A Nationwide Analysis.
Source
Cardiovascular Revascularization Medicine. 42 (pp 102-106), 2022. Date of
Publication: September 2022.
Author
Munawar M.M.; Brgdar A.; Awan A.; Balogun A.F.; Ogunti R.; Ahmad B.;
Fatima U.; Prafulla M.; Opoku I.
Institution
(Brgdar, Ogunti, Ahmad) Department of Medicine, Howard University
Hospital, Washington, DC, United States
(Munawar, Awan, Balogun, Fatima, Prafulla, Opoku) Cardiovascular disease,
Howard University Hospital, Washington, DC, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiovascular disease and cancer frequently coexist, and
patients with cancer are at increased risk of cardiovascular events,
including myocardial infarction and stroke. However, the impact of stent
types on in-hospital outcomes of patients with malignancy is largely
unknown. Method(s): Patients with concomitant diagnosis of cancer
undergoing PCI between January 2005 and December 2014 were identified in
the National Inpatient Sample. They were then categorized into those who
have undergone coronary stenting with bare-metal stent (BMS) or
drug-eluting stent (DES). Primary outcomes were in-hospital mortality and
stent thrombosis. Adjusted and unadjusted analysis was employed on
appropriate variables of interest. Result(s): 8755 patients were
included in the BMS group and 11,611 patients in the DES group. Following
propensity matching, 4313 patients were randomly selected in both groups
using a 1:1 ratio. There was high use of BMS stent in cancer patient (BMS
43.0%, DES 57.0%) compared to general population (BMS 23.2%, DES 76.8%).
When comparing BMS to DES group, there was no statistically significant
difference in mortality (4.7% vs. 3.8%, p = 0.097), acute kidney injury
(11.3% vs. 10.6%, p = 0.425), bleeding complications (3.50% vs. 3.45%, p =
0.914), and length of hospital stay (5.4% vs. 5.2%, p = 0.119). However,
an increased incidence of stent thrombosis was observed in the DES group
(4.26% vs. 3.01%, p = 0.002). Conclusion(s): A higher incidence of
BMS placement was noted in patients with cancer than in the general
population. Paradoxically there was a high incidence of stent thrombosis
in the DES group without increasing mortality. Copyright © 2022
Elsevier Inc.

<64>
Accession Number
2014818391
Title
Higher body mass index raises immature platelet count: potential
contribution to obesity-related thrombosis.
Source
Platelets. 33(6) (pp 869-878), 2022. Date of Publication: 2022.
Author
Goudswaard L.J.; Corbin L.J.; Burley K.L.; Mumford A.; Akbari P.; Soranzo
N.; Butterworth A.S.; Watkins N.A.; Pournaras D.J.; Harris J.; Timpson
N.J.; Hers I.
Institution
(Goudswaard, Burley, Hers) School of Physiology, Pharmacology and
Neuroscience, University of Bristol, Bristol, United Kingdom
(Goudswaard, Hers) Bristol Heart Institute, Bristol, United Kingdom
(Goudswaard, Corbin, Timpson) Medical Research Council (MRC) Integrative
Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
(Goudswaard, Corbin, Timpson) Department of Population Health Sciences,
Bristol Medical School, University of Bristol, Bristol, United Kingdom
(Mumford) School of Cellular and Molecular Medicine, University of
Bristol, Bristol, United Kingdom
(Akbari, Butterworth) Department of Public Health and Primary Care,
British Heart Foundation Cardiovascular Epidemiology Unit, University of
Cambridge, Cambridge, United Kingdom
(Akbari, Soranzo, Butterworth) National Institute for Health Research
Blood and Transplant Research Unit (NIHR BTRU) in Donor Health and
Genomics, University of Cambridge, Cambridge, United Kingdom
(Akbari) MRC Biostatistics Unit, University of Cambridge, Cambridge,
United Kingdom
(Akbari, Soranzo) Human Genetics, Wellcome Sanger Institute, Hinxton,
United Kingdom
(Soranzo) Department of Haematology, School of Clinical Medicine,
University of Cambridge, Cambridge, United Kingdom
(Butterworth) British Heart Foundation Centre of Research Excellence,
University of Cambridge, Cambridge, United Kingdom
(Butterworth) NIHR Cambridge Biomedical Research Centre, University of
Cambridge and Cambridge University Hospitals, Cambridge, United Kingdom
(Butterworth) Health Data Research UK Cambridge, Wellcome Genome Campus
and University of Cambridge, Cambridge, United Kingdom
(Watkins) NHS Blood and Transplant, Cambridge Biomedical Campus,
Cambridge, United Kingdom
(Pournaras) Department of Bariatric and Metabolic Surgery, Southmead
Hospital, North Bristol NHS Trust, Bristol, United Kingdom
(Harris) Bristol Trials Centre, Faculty of Health Sciences, University of
Bristol, Bristol, United Kingdom
Publisher
Taylor and Francis Ltd.
Abstract
Higher body mass index (BMI) is a risk factor for thrombosis. Platelets
are essential for hemostasis but contribute to thrombosis when activated
pathologically. We hypothesized that higher BMI leads to changes in
platelet characteristics, thereby increasing thrombotic risk. The effect
of BMI on platelet traits (measured by Sysmex) was explored in 33 388 UK
blood donors (INTERVAL study). Linear regression showed that higher BMI
was positively associated with greater plateletcrit (PCT), platelet count
(PLT), immature platelet count (IPC), and side fluorescence (SFL, a
measure of mRNA content used to derive IPC). Mendelian randomization (MR),
applied to estimate a causal effect with BMI proxied by a genetic risk
score, provided causal estimates for a positive effect of BMI on both SFL
and IPC, but there was little evidence for a causal effect of BMI on PCT
or PLT. Follow-up analyses explored the functional relevance of platelet
characteristics in a pre-operative cardiac cohort (COPTIC). Linear
regression provided observational evidence for a positive association
between IPC and agonist-induced whole blood platelet aggregation. Results
indicate that higher BMI raises the number of immature platelets, which is
associated with greater whole blood platelet aggregation in a cardiac
cohort. Higher IPC could therefore contribute to obesity-related
thrombosis. Copyright © 2021 The Author(s). Published with
license by Taylor & Francis Group, LLC.

<65>
Accession Number
638761750
Title
Visualizing Inside Conduits - Intraoperative Screening of Grafts by
Optical Coherence Tomography.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 12 Aug 2022.
Author
Lundy E.F.; Karimi Galougahi K.; Dominguez-Sulca D.; Chowdhury E.; Thomas
S.V.; Porter C.R.; Mintz G.S.; Matsumura M.; Maehara A.; Cohen D.J.; Moses
J.W.; Shlofmitz E.S.; Jeremias A.; West N.; Robinson N.B.; Shlofmitz R.A.;
Ali Z.A.
Institution
(Lundy, Karimi Galougahi, Dominguez-Sulca, Chowdhury, Thomas, Porter,
Shlofmitz, Robinson, Shlofmitz) St. Francis Hospital & Heart Center,
Roslyn, NY, United States
(Mintz, Matsumura, Maehara) Cardiovascular Research Foundation, New York,
NY, USA
(Cohen, Moses, Jeremias, Ali) St. Francis Hospital & Heart Center, Roslyn,
NY, USA; Cardiovascular Research Foundation, New York, NY, USA
(West) Abbott Vascular, Santa Clara, CA, United States
Publisher
NLM (Medline)
Abstract
PURPOSE: Saphenous vein graft (SVG) failure is a complex phenomenon, with
technical, biological and local factors contributing to early-, medium-
and long-term failure after coronary artery bypass graft (CABG). Both
technical and conduit factors may have significant impact on the early SVG
failure. DESCRIPTION: We review the complex factors that play a pathogenic
role in SVG failure followed by reviewing the existing literature on
potential utility of high-definition optical coherence tomography (OCT) in
comprehensive intraoperative assessment of SVGs. EVALUATION: We describe a
new technique for intraoperative acquisition of OCT images in the
harvested SVGs, and introduce a classification system for pathologies that
can be detected in the harvested SVG conduits by OCT. CONCLUSION(S):
The potential impact of the exclusion of segments of SVGs that are less
optimal (i.e., containing fibroatheroma, retained thrombus, sclerotic
valves or procurement injury) on early graft failure will be examined in
the randomized controlled OCTOCAB (Optical Coherence Tomography of the
Saphenous Vein Conduit in Patients Undergoing Coronary Artery Bypass
Surgery) trial. Copyright © 2022 The Society of Thoracic
Surgeons. Published by Elsevier Inc. All rights reserved.

<66>
Accession Number
638761249
Title
Mitral valve repair for anterior/bi-leaflet versus posterior leaflet
degenerative mitral valve disease: a systematic review and meta-analysis.
Source
Current problems in cardiology. (pp 101355), 2022. Date of Publication:
12 Aug 2022.
Author
Iqbal K.; Haque I.U.; Shaikh V.F.; Rathore S.S.; Yasmin F.; Iqbal A.;
Shariff M.; Kumar A.; Stulak J.M.
Institution
(Iqbal, Haque, Shaikh, Yasmin, Iqbal) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
(Rathore) Department of Internal Medicine, Dr. Sampurnanand Medical
College, Jodhpur, Rajasthan, India
(Shariff) Department of General Surgery, Mayo Clinic, Rochester, MN,
United States
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, USA; Section of Cardiovascular Research, Heart, Vascular and
Thoracic Department, Cleveland Clinic Akron General, Akron, OH, USA
(Stulak) Department of General Surgery, Mayo Clinic, Rochester, MN, USA;
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
Publisher
NLM (Medline)
Abstract
Mitral valve repair (MVr) secondary to degenerative anterior/bi-leaflet
mitral valve disease is more challenging than posterior leaflet repair.
However, conclusive evidence is needed to make decisions based on the
outcomes rather than technical difficulties. This meta-analysis compares
anterior/bi-leaflet MVr with isolated posterior leaflet repair in patients
with mitral regurgitation (MR) due to degenerative mitral valve disease.
The outcomes of interest were long-term (>= 5 years) survival and freedom
from re-operation and moderate-to-severe MR. Meta-analysis of 10 studies
showed that there was no significant difference in long-term survival (RR:
1.00; 95% CI 0.96-1.04), freedom from moderate-to-severe MR (RR: 0.95; 95%
CI 0.87-1.03), and freedom from re-operation (RR: 0.96; 95% CI 0.90-1.02)
between anterior/bi-leaflet MVr and posterior leaflet repair. As outcomes
of anterior/bilateral repair were comparable with those of isolated
posterior leaflet repair, our findings do not support the inclination
towards replacement over repair for MR caused by anterior/bilateral
degenerative mitral disease. Copyright © 2022. Published by
Elsevier Inc.

<67>
Accession Number
2019640680
Title
Ultrathin Bioresorbable-Polymer Sirolimus-Eluting Stents Versus Thin
Durable-Polymer Everolimus-Eluting Stents in Patients Undergoing Coronary
Revascularization: Final Five-Year Outcomes From the Randomized BIOFLOW-V
Trial.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 84), 2022. Date of
Publication: July 2022.
Author
Kandzari D.E.; Koolen J.J.; Doros G.; Garcia-Garcia H.M.; Bennett J.;
Roguin A.; Gharib E.G.; Cutlip D.E.; Waksman R.
Institution
(Kandzari) Piedmont Heart Institute, Atlanta, GA
(Koolen) Catharina Hospital, Eindhoven, Netherlands
(Doros) Department of Biostatistics and Epidemiology, Boston University
School of Public Health, Baim Institute for Clinical Research, Boston, MA
(Garcia-Garcia, Waksman) MedStar Cardiovascular Research Network, MedStar
Washington Hospital Center, Washington, DC
(Bennett) Department of Cardiovascular Medicine, University Hospitals
Leuven, Leuven, Belgium
(Roguin) Department of Cardiology, Hillel Yaffe Medical Center, Hadera,
Israel
(Gharib) Charleston Area Medical Center, Charleston, WV
(Cutlip) Beth Israel Deaconess Medical Center, Baim Institute for Clinical
Research, Boston, MA
Publisher
Elsevier Inc.
Abstract
Background - Randomized clinical trials have demonstrated the superiority
of ultrathin-strut drug-eluting stents (DES) compared with alternative
stent designs. Whether these differences persist over late-term follow-up
is uncertain. Methods - BIOFLOW-V (ClinicalTrials.gov NCT02389946) was an
international, 2:1 randomized trial comparing an ultrathin-strut (60 mum)
bioresorbable-polymer sirolimus-eluting stent (BP SES) with a thin-strut
(81 mum) durable-polymer everolimus-eluting stent (DP EES) regarding the
primary endpoint of 12-month target lesion failure (TLF). Prespecified
outcomes through the study duration of 5 years were assessed. Results -
Among 1,334 patients randomized to treatment with BP SES (884 patients) or
DP EES (450 patients), the 5-year rate of TLF was 13.2% (104/787) for BP
SES and 16.5% (66/399) for DP EES (p=0.14). Revascularization with BP SES
was associated with significantly lower target vessel myocardial
infarction (TV-MI; 7.3% [56/765] versus 11.5% [45/391], p=0.02) and
numerically lower clinically driven target lesion revascularization
(CD-TLR; 6.3% [48/761] versus 8.3% [32/388], p=0.22). Cardiac death rates
were 2.7% (21/774) for BP SES versus 2.0% (8/392) for DP EES (p=0.56). At
5 years, very late definite/probable stent thrombosis was significantly
lower for BP SES versus DP EES (0.13% [1/753] for BP SES versus 1.04%
[4/384] for DP EES [p=0.047]). Conclusion - In a large, randomized trial,
TLF and the individual outcomes of cardiac death and CD-TLR at 5-year
follow-up were lower, but not statistically different, among patients
treated with BP SES versus DP EES. Both TV-MI and very late
definite/probable stent thrombosis were significantly lower among patients
treated with BP SES. The study demonstrates the excellent long-term safety
and clinical performance of this ultrathin BP SES in a complex patient
population undergoing percutaneous coronary intervention. Copyright
© 2022

<68>
Accession Number
2019638610
Title
Bicuspid Transcatheter Aortic Valve Replacement (TAVR): The Texas Tech
Experience.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 88), 2022. Date of
Publication: July 2022.
Author
Galvan B.; Holder K.G.; Ramon M.; Mittal N.; Boeger B.; Ansari M.M.
Institution
(Galvan, Holder, Ramon, Mittal, Boeger, Ansari) Texas Tech University
Health Sciences Center, Lubbock, TX, United States
Publisher
Elsevier Inc.
Abstract
Background In the last 15 years, transcatheter aortic valve replacement
(TAVR) has become an increasingly viable alternative to open surgery for
aortic valve repair in patients with aortic valve stenosis who have high
perioperative risk factors. To date, most randomized control trials of
TAVR have excluded patients with stenosed bicuspid valves. Bicuspid aortic
valves (BAV) are found in up to2% of the population and 25% of patients
over 80 years of age who require aortic valve replacement. Methods A
retrospective case series was conducted over TAVR procedure outcomes in
high-risk patients including those with bi-cuspid aortic valves. This
study analyzes clinical features and outcomes of TAVR at a tertiary
referral center and academic teaching hospital that took place between2015
and 2021. ANOVA was then run with multiple pairwise comparisons using
independent sample t-tests. Results Out of all patients who underwent TAVR
at this center, seven patients had a congenital bicuspid aortic valve. The
average age of these patients was 72 years and they have an average STS
score was 5.42. These patients all had at least one comorbidity and
averaged 3comorbidities each which include HTN, HLD, DM, PAD, CVA, AFib,
CHF, or CAD. Only one patient experienced a 3 month postoperative
complication. Conclusion While data on TAVR outcomes in bicuspid aortic
valve stenosis is limited, this small study suggests that TAVR may be a
viable alternative to open surgery in this treatment group. Randomized
control trials are needed to adequately assess TAVR's efficacy and risks,
but in the meantime, TAVR may be considered by experienced physicians
willing to treat high-risk patients with stenosed bicuspid valves as seen
in our experience. Copyright © 2022

<69>
Accession Number
2019638608
Title
The Efficacy and Safety of Manta Versus ProGlide Vascular Closure Devices
After Transcatheter Aortic Valve Replacement.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 68), 2022. Date of
Publication: July 2022.
Author
Saleh Y.; Abdelkarim O.; Al-Abcha A.
Institution
(Saleh, Abdelkarim) Houston Methodist Hospital, Houston, TX
(Al-Abcha) Michigan State University, East Lansing, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Several vascular closure devices (VCDs) including Manta and
ProGlide are utilized after transcatheter aortic valve replacement. Data
comparing the plug-based Manta to the suture-based ProGlide are limited.
 Method(s): We conducted a meta-analysis of all studies that evaluated
clinical outcomes of the Manta VCD compared to ProGlide VCD in
transcatheter aortic valve replacement. The primary outcome was device
failure. Secondary outcomes included major vascular complications, minor
vascular complications, major bleeding, and minor bleeding events.
 Result(s): We included two randomized clinical trials (RCT), and four
observational studies with a total of 1,565 patients. The rate of device
failure was similar in the MANTA arm when compared to the ProGlide arm (7%
vs 10%, respectively). There were no differences in all major or minor
vascular complications between the Manta and the ProGlide VCDs. The rate
of major and minor bleeding was also similar between the two arms.
 Conclusion(s): In the transcatheter aortic valve replacement
population, the safety profile and efficacy of the plug-based MANTA VCD is
similar to the suture-based VCDs ProGlide. [Formula
presented] Copyright © 2022

<70>
Accession Number
2019638524
Title
Five-Year Outcomes of Transcatheter Versus Surgical Aortic Valve
Replacement in Low- to Intermediate-Risk Patients.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 94-95), 2022. Date of
Publication: July 2022.
Author
Nasir U.; Waheed T.A.; Choxi R.; Sundhu M.; Ahuja K.R.
Institution
(Nasir, Waheed, Choxi, Sundhu, Ahuja) Reading Hospital - Tower Health,
Reading, PA
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an alternate
to surgical aortic valve replacement (SAVR) in patients with aortic
stenosis (AS). In patients with low to intermediate surgical risk, while
SAVR remains the procedure of choice, TAVR has shown promising results.
 Objective(s): This meta-analysis of randomized controlled trials
(RCTs) compared the outcomes of TAVR versus SAVR in low to intermediate
surgical risk candidates at five year follow up. Method(s):
Electronic databases were searched from inception to November 4, 2021.
RCTs comparing TAVR versus SAVR in low to intermediate-risk patients
(Society of Thoracic Surgeons Predicted Risk of Mortality [STS-PROM] score
<8%) were included. Primary outcome was all-cause mortality at 5 years.
Random-effects models were used to calculate pooled odds ratio (OR) and
corresponding 95% confidence intervals (CI) Results: The meta-analysis
included 4 RCTs that randomized 4722 patients (2411 to TAVR and 2311 to
SAVR). Patients had a mean age of 89.9 and mean STS score of 5.1 in TAVR
versus 5.2 in SAVR. All-cause mortality at five years was lower in SAVR
compared to TAVR (OR 1.16; 95% CI: 1.01-1.34, I2=21%, P=0.28).
There was no difference in the risk of any stroke at five years (OR 0.98;
95% CI: 0.74-1.31. I2=58%, P=0.07). The need for valve
reintervention at five years was higher in TAVR (OR 2.50; 95% CI:
1.55-4.03, I2=0%, P=0.55). There was no difference in the
composite outcome of death or disabling stroke, endocarditis, or
cardiovascular mortality. Conclusion(s): The findings of this
meta-analysis show encouraging results of TAVR at five year follow up with
non-inferiority of TAVR for cardiovascular mortality, death, or disabling
stroke. While there is inferiority of TAVR in all-cause mortality, the
difference between the two groups is minimal. [Formula
presented] Copyright © 2022

<71>
Accession Number
2019638443
Title
Self-Expandable Versus Balloon-Expandable Valve in Low Risk TAVR Patients:
30-Day Outcomes of LRT Substudy.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 104-105), 2022. Date of
Publication: July 2022.
Author
Bhogal S.; Torguson R.; Gordon P.; Ehsan A.; Wilson S.R.; Levitt R.;
Parikh P.; Bilfinger T.; Hanna N.; Buchbinder M.; Asch F.M.; Weissman G.;
Ben-Dor I.; Shults C.C.; Ali S.; Shea C.; Zhang C.; Garcia-Garcia H.M.;
Satler L.F.; Waksman R.; Rogers T.
Institution
(Bhogal, Ben-Dor, Ali, Shea, Zhang, Garcia-Garcia, Satler, Waksman,
Rogers) Section of Interventional Cardiology, MedStar Washington Hospital
Center, Washington, DC
(Torguson) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY
(Gordon) Division of Cardiology, Miriam Hospital, Providence, RI
(Ehsan) Division of Cardiothoracic Surgery, Lifespan Cardiovascular
Institute, Providence, RI
(Wilson) Department of Cardiology, North Shore University Hospital,
Manhasset, NY, United States
(Levitt) Department of Cardiology, HCA Virginia Health System, Richmond,
VA
(Parikh) Department of Medicine, Stony Brook Hospital, Stony Brook, NY,
United States
(Bilfinger) Department of Surgery, Stony Brook Hospital, Stony Brook, NY,
United States
(Hanna) St. John Heart Institute Cardiovascular Consultants, St. John
Health System, Tulsa, OK
(Buchbinder) Foundation for Cardiovascular Medicine, Stanford University,
Stanford, CA
(Asch) MedStar Health Research Institute, MedStar Washington Hospital
Center, Washington, DC
(Weissman) Department of Cardiology, MedStar Washington Hospital Center,
Washington, DC
(Shults) Department of Cardiac Surgery, MedStar Washington Hospital
Center, Washington, DC
Publisher
Elsevier Inc.
Abstract
Background: To date, there is no direct comparison of patients implanted
with balloon-expandable (BE) or self-expandable (SE) valves in the
low-risk population. Method(s): The LRT 1.0 and 2.0 trials were
prospective, investigator-initiated, multicenter studies in low-risk
patients. The current study is a post hoc analysis of combined data from
both the LRT 1.0 and 2.0 trials studying BE and SE transcatheter heart
valves. Result(s): A total of 294 patients received a BE valve
(Edwards Sapien 3) and 102 patients received an SE valve (Medtronic
CoreValve, Evolut R, Evolut PRO). The 30-day clinical outcomes were
similar across both groups except for stroke (4.9% vs. 0.7%, p=0.014) and
permanent pacemaker implantation (PPM) rate (17.8% vs. 5.8%,p<0.001),
which was higher in the SE cohort than in the BE cohort (Figure 1). No
difference was observed in terms of paravalvular leak (>= moderate)
between the groups (0% vs. 1.5%, p=0.577); however, SE patients had larger
aortic valve area (1.92+/-0.43 cm2 vs. 1.69+/-0.45
cm2; p<0.001) and lower mean gradient (8.93+/-3.53 mmHg vs.
13.41+/-4.73 mmHg; p<0.001) compared to BE patients. The rate of
subclinical leaflet thrombosis was significantly lower in SE patients
(5.6% vs. 13.8%; p=0.038) than in BE patients. Limitation(s): The key
limitation of our study is lack of randomization. The choice of valve use
was left at operators discretion, which may introduce the risk of serious
bias (as an example, patients with more left ventricular outflow tract
calcium receiving SE, which imparts higher risk of PPM and stroke that is
patient-dependent rather than valve-dependent). Conclusion(s): SE
valves are associated with better hemodynamics and lesser leaflet
thrombosis in this non-randomized study, but with increased rates of
stroke and PPM at 30 days; however, this could be due to patient-dependent
factors not fully evaluated in this study. [Formula
presented] Copyright © 2022

<72>
Accession Number
2019638426
Title
Comparison of Transfemoral Versus Subclavian/Axillary Access in
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 91-92), 2022. Date of
Publication: July 2022.
Author
Abusnina W.; Ismayl M.; Balakrishna A.M.; Latif A.; Mostafa M.R.; Ben-Dor
I.; Dahal K.
Institution
(Abusnina, Ismayl, Balakrishna, Latif, Dahal) Creighton University, Omaha,
NE, United States
(Mostafa) Rochester Regional/Unity Hospital, Rochester, NY
(Ben-Dor) MedStar Washington Hospital Center, Washington, DC
Publisher
Elsevier Inc.
Abstract
Introduction: The transfemoral (TF) approach is the gold-standard approach
for transcatheter aortic valve replacement (TAVR). In cases of iliofemoral
arterial disease, the TF approach is avoided and alternative approaches
are needed. We conducted a meta-analysis to compare the outcomes of TF
versus subclavian/axillary access (SCA) in patients undergoing TAVR.
 Method(s): We searched PubMed, Cochrane Central Register of Clinical
Trials, EMBASE, and ClinicalTrials.gov (inception through October 2021)
for studies comparing outcomes of TF versus SCA in patients undergoing
TAVR. We used random-effect model to calculate risk ratio (RR) with 95%
confidence interval (CI). Our main outcomes included short and 30-day
mortality, 1-year mortality, bleeding, and stroke. Result(s): A total
of 20 studies with 69,746 patients were included. Compared to TF access,
patients undergoing TAVR via SCA access had significantly higher risk of
1-year mortality (RR: 0.82; 95% CI: 0.69-0.96; p=0.02), bleeding (RR:
0.73; 95% CI: 0.54-0.99; P=0.05), and stroke rates (RR: 0.62; 95% CI:
0.41-0.94; p=0.02).There was no significant difference between the two
groups in 30-day mortality (RR: 0.91; 95% CI: 0.60-1.40; P=0.68) (Figure).
 Conclusion(s): In patients undergoing TAVR, SCA is associated with
significantly higher 1-year mortality, bleeding, and stroke rates compared
to TF access. The TF approach remains the preferred option for TAVR;
however, the SCA is also a feasible option in patients who cannot undergo
TF access. [Formula presented] Copyright © 2022

<73>
Accession Number
2019638304
Title
Impact of FFR Evaluation in Patients With Multivessel Coronary Artery
Disease Undergoing Coronary Artery Revascularization: A Systematic Review
and Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 45), 2022. Date of
Publication: July 2022.
Author
Sanz-Sanchez J.; Kumar S.; Sole J.M.; Gil J.L.D.; Garcia-Garcia H.M.
Institution
(Sanz-Sanchez, Sole, Gil) Hospital Universitario y Politecnico La Fe,
Valencia, Spain
(Kumar, Garcia-Garcia) MedStar Washington Hospital, Washington, DC
Publisher
Elsevier Inc.
Abstract
Background: Fractional flow reserve (FFR)-guided percutaneous coronary
intervention (PCI) is the recommended revascularization strategy in
patients presenting with multivessel coronary artery disease (CAD) by
current guidelines. However, recently published studies comparing
FFR-guided PCI with non-physiology-guided revascularization strategies
(i.e., angiography-guided, coronary artery bypass grafting) have reported
conflicting results. Method(s): PubMed and Embase databases were
searched for randomized clinical trials comparing FFR-guided PCI with
non-physiology-guided revascularization strategies in patients with
multivessel CAD. Data were pooled by meta-analysis using a random-effects
model. Result(s): Four studies (FAME, FLOWER-MI, FUTURE, and FAME 3)
enrolling 4,595 patients were included. No differences between FFR-guided
PCI and non-physiology-guided coronary revascularization were found in
patients with multivessel CAD in terms of major adverse cardiovascular
events (MACE; odds ratio [OR] 1.08, 95% confidence interval [CI]
0.73-1.62, I2=75.5%), all-cause mortality (OR 1.25, 95% CI
0.68-2.28, I2=44.4%), myocardial infarction (OR 1.1, 95% CI
0.70-1.73, I2=61.3%), and repeat revascularization (OR 1.04,
95% CI 0.68-1.59, I2=68%) (Figure 1). Conclusion(s): Among
patients with multivessel CAD, FFR-guided PCI as compared to
non-physiology-guided revascularization was not associated with a risk
reduction in any clinical outcome. [Formula presented] Copyright
© 2022

<74>
Accession Number
2019638197
Title
Early Outcomes and Peri-Procedural Complications of Transcatheter Aortic
Valve Replacement in Patients With Previous Coronary Artery Bypass Graft
Surgery.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 90-91), 2022. Date of
Publication: July 2022.
Author
Balakrishna A.M.; Ismayl M.; Abusnina W.; Srinivasamurthy R.; Butt D.N.;
Butt K.N.; Gowda R.; Dahal K.
Institution
(Balakrishna, Ismayl, Abusnina, Butt, Butt, Dahal) Creighton University
School of Medicine, Omaha, NE, United States
(Srinivasamurthy) Saint Louis University School of Medicine, St. Louis, MO
(Gowda) Icahn School of Medicine at Mount Sinai, New York, NY
Publisher
Elsevier Inc.
Abstract
Background: Patients who underwent a previous coronary artery bypass graft
(CABG) surgery are at increased peri-operative risk when undergoing a redo
cardiac operation such as Transcatheter Aortic Valve Replacement (TAVR).
Recent studies have showed no risk difference in 30-day mortality and
conflicting data with respect to periprocedural complications. We
performed a systematic review and meta-analysis to compare the early
outcomes and peri-procedural complications of TAVR in patients with or
without previous CABG. Method(s): A search was made in the PubMed and
Cochrane databases using the search terms "TAVR" and "CABG". The major
outcomes were 30-day mortality and peri-procedural complications. We used
random effects model to perform statistical analyses. Result(s): A
total of 9 studies (6441 patients) were included, of which 6 studies
reported 30-day mortality. Compared to patients without previous CABG,
patients with previous CABG undergoing TAVR had no difference in terms of
risk of 30-day mortality (RR: 0.67; 95% CI: 0.36-1.25; p = 0.21),
Periprocedural mortality (RR: 0.78; 95% CI: 0.38-1.60; p = 0.49), Stroke
(RR: 0.76; 95% CI: 0.54-1.07; p = 0.12), AKI (RR: 0.98; 95% CI: 0.71-1.36;
p = 0.92), Cardiac tamponade (RR: 0.82; 95% CI: 0.26-2.58; p = 0.74),
Aortic regurgitation (RR: 0.79; 95% CI: 0.63-1.00; p = 0.05). Patients
with previous CABG had lower risk of Vascular complications (RR: 0.76; 95%
CI: 0.62-0.95; p = 0.01), Bleeding (RR: 0.67; 95% CI: 0.53-0.86; p =
0.001), and higher risk of MI (RR: 1.98; 95% CI: 1.17-3.34; p = 0.01) and
Pacemaker implantation (RR: 1.19; 95% CI: 1.03-1.39; p = 0.02).
 Conclusion(s): Patients with or without previous CABG undergoing TAVR
had mostly similar outcomes with exception of vascular complications,
bleeding, MI, and pacemaker implantation. These factors should be
considered while planning for TAVR in such patients. [Formula presented]
[Formula presented] Copyright © 2022

<75>
Accession Number
2019638173
Title
Outcomes of Aortic Valve Replacement Versus Conservative Treatment in
Asymptomatic Severe Aortic Stenosis: An Updated Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 102), 2022. Date of
Publication: July 2022.
Author
Ismayl M.; Balakrishna A.M.; Abusnina W.; Thandra A.; Smer A.; Dahal K.
Institution
(Ismayl, Balakrishna, Abusnina, Thandra, Smer, Dahal) Creighton University
School of Medicine, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Background: The current American College of Cardiology/American Heart
Association guidelines recommend conservative treatment for patients with
isolated asymptomatic severe aortic stenosis (AS). We conducted an updated
meta-analysis to compare the outcomes of early aortic valve replacement
(AVR) versus conservative treatment in patients with asymptomatic severe
AS. Method(s): We searched PubMed, Cochrane Central Register of
Clinical Trials, EMBASE, and ClinicalTrial.gov (inception through October
2021) for studies comparing outcomes of early AVR versus conservative
treatment in patients with asymptomatic severe AS. We used random-effect
model to calculate risk ratio (RR) with 95% confidence interval (CI). Our
main outcomes included all-cause mortality, cardiac and non-cardiac
mortality, sudden cardiac death (SCD), myocardial infarction (MI), stroke,
and heart failure hospitalization (HFH). Result(s): A total of 12
studies (2 randomized and 10 observational studies) with 5,245 patients
were included. Compared to conservative treatment in patients with
asymptomatic severe AS, AVR was associated with significantly lower
all-cause mortality (RR: 0.38; 95% CI: 0.30-0.48; p<0.01), cardiac
mortality (RR: 0.34; 95% CI: 0.26-0.45; p<0.01), non-cardiac mortality
(RR: 0.40; 95% CI: 0.31-0.50; p<0.01), SCD (RR: 0.44; 95% CI: 0.26-0.75;
p<0.01), and HFH rates (RR: 0.17; 95% CI: 0.10-0.31; p<0.01). There was no
significant difference between both groups in MI (RR: 1.08; 95% CI:
0.20-5.73; p=0.93) and stroke rates (RR: 0.85; 95% CI 0.43-1.65; p=0.62).
 Conclusion(s): In patients with asymptomatic severe AS, AVR is
associated with significantly lower mortality and HFH rates compared to
conservative treatment. This meta-analysis supports early AVR in all
patients with severe AS, regardless of symptoms. [Formula
presented] Copyright © 2022

<76>
Accession Number
2019638170
Title
Early Aortic Valve Replacement Versus Conservative Management in
Asymptomatic Severe Aortic Stenosis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 102), 2022. Date of
Publication: July 2022.
Author
Nasir U.; Qasim M.
Institution
(Nasir) Reading Hospital - Tower Health, Reading, PA
(Qasim) Indiana University Hospital, Bloomington, IN, United States
Publisher
Elsevier Inc.
Abstract
Background Aortic stenosis continues to grow as one of the leading causes
of valvular heart disease. Severe but asymptomatic aortic stenosis (AS) is
a perplexing entity without clear consensus of opinion on management. In
this study, we examined the total weight of early aortic valve replacement
(AVR) versus conservative management. Methods Electronic databases were
searched from inception through November 18, 2021. Comparative studies of
early AVR versus conservative management in asymptomatic severe aortic
stenosis patients were included. Random-effects models were used to
calculate pooled odds ratio (OR) with corresponding 95% confidence
interval (CI) Results Ten observational studies (OS) and two randomized
controlled trials (RCTs) including a total of 4460 patients, 1436 in the
early AVR and 3024 in the conservative management arm were analyzed. Early
AVR was associated with lower all-cause mortality (OR: 0.27; 95% CI:
0.19-0.38; I2=67%; P<0.00001), and lower cardiovascular
mortality (OR: 0.30; 95% CI: 0.13-0.72; I2=60%; P=0.04)
compared to conservative management. Subgroup analysis for RCTs only
showed no difference in cardiovascular mortality. Conclusion This
meta-analysis adds further evidence for the benefits of early AVR in
patients with asymptomatic severe AS. Due to the paucity of RCT's, further
studies are needed to better compare early AVR and conservative
management. [Formula presented] Copyright © 2022

<77>
Accession Number
2019638134
Title
Clinical Outcomes of MANTA vs Suture-Based Closure Devices After TAVR: An
Updated Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 98-99), 2022. Date of
Publication: July 2022.
Author
Vasudev R.; Guragai N.; Doshi R.; Kumar A.; Shariff M.; Majmundar M.;
Doshi P.; Altabaqchali S.; Virk H.; Bikkina M.; Shamoon F.; Pasala T.
Institution
(Vasudev, Altabaqchali, Pasala) Hackensack University Medical Center,
Hackensack, NJ, United States
(Guragai, Doshi) St Joseph University Medical Center, Paterson, NJ
(Kumar) Cleveland Clinic Akron General Hospital, Akron, OH
(Shariff) Mayo Clinic, Rochester, MN
(Majmundar) Maimonides Medical Center, Brooklyn, NY
(Doshi) Ramaiah Medical College, Bangaluru, India
(Virk, Bikkina, Shamoon) St Joseph's University Medical Center, Paterson,
NJ
Publisher
Elsevier Inc.
Abstract
Background: There have been a recently published randomized control trial
showing better results with suture-based vascular closure device (VCD)
than plug-based VCD in patient undergoing transfemoral trans catheter
aortic valve replacement (TAVR). The learning curve for MANTA device is
steep while learning curve for suture-based VCD is shallow as the devices
are quite different. In this meta-analysis, we have compared suture-based
vs plug-based VCDs using most up-to-date studies. Suture-based VCD
included ProGlide and Prostar XL. Method(s): We performed
meta-analysis of all published studies (Using PubMed and EMBASE) reporting
the clinical outcome of MANTA (plug-based) vs suture-based VCD in
transfemoral TAVR patients. Primary outcome was a combination of major and
minor bleeding. Result(s): We included nine studies with a total of
2865 patients (MANTA n= 1631, suture-based n= 1234). There was no
significant difference in primary outcome when using MANTA as opposed to
suture-based VCD (RR 1.54 [0.83-2.86]I2 = 69 %) (Panel A).
There was no difference in major life threatening bleeding (RR 1.01
[0.61-1.67] I2= 32%) (Panel B), vascular complications (RR 1.42
[0.63-3.23] I2=58%) (Panel C), pseudo aneurysm (RR 1.46
[0.18-11.87] I2= 43%) (Panel D), dissection (RR 1.08
[0.54-2.15] I2=0%) (Panel E), VCD failure (RR 1.71 [0.96-3.04]
I2= 0%) (Panel F). Conclusion(s): In this transfemoral
TAVR population, there was no significant difference in safety or efficacy
when using MANTA as compared to suture-based VCD. There was significant
heterogeneity in our primary outcome and these results needs to be
confirmed with upcoming RCTs in patients with significantly higher burden
of calcification. There was very frequent use of secondary VCDs in
suture-based VCD group which is not possible when using MANTA. [Formula
presented] Copyright © 2022

<78>
Accession Number
2019638124
Title
Comparison of Various Transcatheter Aortic Valves for Aortic Stenosis - A
Network Meta-Analysis of Randomized Controlled Trials.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 97), 2022. Date of
Publication: July 2022.
Author
Hiltner E.P.; Shah M.; Schwabe-Warf D.; Haik B.; Hakeem A.; Russo M.;
Sethi A.
Institution
(Hiltner, Schwabe-Warf, Haik, Hakeem, Russo, Sethi) Robert Wood Johnson
University Hospital, New Brunswick, NJ, United States
(Shah) St. Peter's University Hospital, New Brunswick, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an
established treatment for many patients with severe aortic stenosis,
however there is limited data comparing available TAVR valves. Our aim was
to compare available valves using direct and indirect evidence from
randomized controlled trials (RCTs) for patients with severe symptomatic
native aortic valve stenosis. Method(s): We performed a systematic
search of electronic databases for RCTs comparing a TAVR valve to a valve
or surgery. A Bayesian network meta-analysis was performed to compile
evidence from both direct and indirect comparisons at 30 days and at one
year. The outcomes which met the convergence and consistency criteria were
reported. Result(s): Eleven studies with 10,307 patients eligible for
TAVR met the criteria and were included. Self-expanding valve CoreValve
type (SEV_C) was associated with higher risk of pacemaker (PPM)
implantation and use of >=1 valve, SEV Accurate type (SEV_A) was
associated with higher risk of >= moderate aortic regurgitation (AR) and
death at 30 days, and mechanically expandable valve (MEV) was associated
with lower risk of >= moderate AR at 30 days but higher risk of PPM
implantation at 30 days and 1 year compared to balloon expandable valve
(BEV) (Figure). SEV_C and MEV were associated with higher PPM implantation
rates compared BEV at 1 year. There was no difference among the valves in
stroke at 30 days and 1 year. Conclusion(s): BEV was superior on one
or more outcomes of PPM implantation, >= 1 valve implantation, and >=
moderate AR compared to other valves except the higher rate >= moderate AR
compared to MEV at 30 days. At one year, BEV was associated with lower
odds of PPM implantation compared to SEV_C and MEV but not different on
other end points. More RCTs comparing available TAVR devices are needed.
[Formula presented] Copyright © 2022

<79>
Accession Number
2019638118
Title
Review of Post-TAVR Annular Injury and Fistula Formation.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 88), 2022. Date of
Publication: July 2022.
Author
Merrin C.; Patel T.R.; Alkhayru A.; Ebrahimi A.; Jabbar A.A.
Institution
(Merrin, Patel, Alkhayru, Ebrahimi, Jabbar) Northside Hospital/Tampa Bay
Heart Institute, St. Petersburg, FL
Publisher
Elsevier Inc.
Abstract
DP EES Annular injury after TAVR is a feared complication that carries a
high mortality rate. It is not well reported in most randomized clinical
trials and registry reported incidence is less than 1%, however, this rate
is likely underestimated. Post-TAVR annular injury is a spectrum that
encompasses different procedural-related injuries in the region of the
aortic root and the left ventricular outflow tract during transcatheter
aortic valve replacement. Method(s): We conducted a literature search
for case-reports and case-series on annular injuries post trans-catheter
aortic valve replacement in MEDLINE, PubMed, and Google Scholar. All
articles published from 2009 through 2019 were included in our search.
Patients' procedural outcomes and follow-up were compared when reported.
The literature search was conducted between June 2019 and May 2020.
 Result(s): Of the included patients, 45% were male, 47% were female,
with 7% of the patients not having gender available for review. The mean
age of patients included in the analysis was 81 years of age at the time
of review. The Edwards Sapien-XT valve was implanted in 40% of patients,
31% underwent implantation with an Edwards Sapien valve, 10% underwent
implantation with an Edwards Sapien-3 valve, 14% underwent implantation
with a CoreValve prosthesis, and 5% were unknown during the review. Of the
cases, 50% involved a fistula or communication with the right ventricle,
50% involved a ventricular septal defect, and 16% involved communications
to alternative sites. The mean follow-up interval reported was 9.5 months,
with a median follow-up period of 6 months based on the reported data.
There was a 45% reported in-hospital survival rate based on the pooled
data, a 19% in-hospital mortality rate, and an unknown outcome in 35% of
included patient cases Conclusion(s): Post TAVR annular injuries are
uncommon but frequently missed complications. A multi- modality imaging is
needed to define the extent and location of these defects. When
intervention is needed, percutaneous device closure appears to be safe and
feasible in most patients. Open surgery should be reserved for those with
associated aortic root injuries. Copyright © 2022

<80>
Accession Number
2019638104
Title
Pre-Procedural Tricuspid Regurgitation in TMVr: Patient-Centric Outcomes.
Source
Cardiovascular Revascularization Medicine. Conference: CRT 2022.
Washington, DC United States. 40(Supplement) (pp 113), 2022. Date of
Publication: July 2022.
Author
Dave P.; Milden J.; Abunassar J.; Abuzeid W.
Institution
(Dave, Milden, Abunassar, Abuzeid) Queen's University, Kingston, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Severe TR and MR often co-exist in patients. Transcatheter
mitral valve repair (TMVr) is an option in the management of severe MR.
Studies have not yet clearly identified the role of baseline TR in
prognostication of TMVr patients. We assessed the impact of pre-procedural
TR on patient-centric outcomes such as mortality, need for Heart Failure
Hospitalization (HFH), or need for re-intervention. Method(s): Three
databases on the Ovid platform (Ovid MEDLINE, EMBASE, EBM reviews) were
searched until October 2021. A random-effects model was used to estimate
the pooled odds ratio across the included studies. Result(s): A total
of 924 articles were identified, of which 9 articles were included based
on pre-specified inclusion criteria. A total of 5259 patients undergoing
TMVr from 2010 to 2018 were included in analysis. 20% of patients were
identified as having moderate/severe TR at baseline. Moderate/severe TR at
baseline was associated with increased 12 month mortality as compared to
mild TR at baseline, Figure 1A (OR: 2.59, [95%CI 2.12, 3.17] p<0.001). HFH
were included in 5 studies, showing no statistically significant
association with moderate/severe TR at baseline, Figure 1B (OR: 1.81,
[95%CI 0.96, 3.42] p=0.07). 4 studies commented on re-intervention rates
including repeat TMVr or surgery, showing no statistically significant
association with moderate/severe TR at baseline, Figure 1C (OR: 0.70,
[95%CI 0.38, 1.27] p=0.24). Conclusion(s): Moderate or severe
pre-procedural TR is associated with increased mortality compared to mild
TR at 12 months in patients undergoing TMVr. There is a signal towards
increased HFH post TMVr with worse pre-procedural TR however more studies
need to be done to delineate this. Data regarding re-intervention rates
remains limited and is also an area requiring further investigation.
[Formula presented] Copyright © 2022

<81>
Accession Number
2019089518
Title
Early vs. late treatment for hepatitis C virus discordant solid organ
transplantation and direct acting antivirals: a meta-analysis.
Source
Journal of Hepatology. Conference: The International Liver Congress.
London United Kingdom. 77(Supplement 1) (pp S592), 2022. Date of
Publication: July 2022.
Author
Gunn M.; Agyapong G.; Eligah V.; Chung E.; Young S.; Hulshof L.; Mills C.;
Gorham A.; Feld J.; Chung R.
Institution
(Gunn) Schulich School of Medicine & Dentistry, London, Canada
(Agyapong) Yale School of Medicine, Internal Medicine, New Haven, United
States
(Eligah) Howard University, Pharmaceutical Sciences, Washington DC, United
States
(Chung, Young) Boston University School of Medicine, Boston, United States
(Hulshof) Northeastern University, Boston, United States
(Mills, Chung) Harvard Medical School, Boston, United States
(Mills) Boston Children's Hospital, Pediatric Gastroenterology,
Hepatology, & Nutrition, Boston, United States
(Gorham) Johns Hopkins University, Baltimore, United States
(Feld) Toronto Center for Liver Disease, Toronto, Canada
Publisher
Elsevier B.V.
Abstract
Background and aims: The advent of curative direct-acting antiviral (DAA)
therapy for hepatitis C virus (HCV) has broadened the donor pool for solid
organ transplants, allowing the use of organs from HCV + donors thatwere
previously discarded. Although many centers have embraced this practice,
the optimal timing of DAA initiation remains unclear. This study aims to
summarize the virologic and clinical outcomes of DAA therapy in HCV
donor+/recipient- solid organ transplants. Method(s): Bibliographic
databases were searched for studies published in English between Jan 2013
and Sept 2020. Using random effects models, meta-analysis was performed to
pool estimates for sustained virologic response (SVR) and a composite
adverse outcome of acute cellular rejection (ACR) and HCV-related
complications (fibrosing cholestatic hepatitis and glomerulonephritis).
Risk of bias was assessed using a modified Ottawa-Newcastle score.
 Result(s): We included 25 non-randomized trials and observational
studies with 635 participants, including 32 observations by organ type: 9
studies reported on heart transplantation (n = 185), 4 on lung (n = 93),
12 on kidney (n = 278) and 7 on liver (n = 79). 16 studies started DAAs
<28 days after transplant (early) while 9 initiated DAAs >28 days
post-transplant (late). The overall pooled SVR for all organ types was
0.96 (CI 0.95-0.98). SVR for non-liver organs was 0.97 (CI 0.94-0.98) and
0.96 (CI 0.91-1.0) for liver. For studies that had available data, the
overall proportion of ACR was 0.10 (CI 0.06-0.15). In subgroup analyses,
the SVR for early treatment was 0.97 (CI 0.96- 0.99), while the SVR for
late treatment was 0.95 (0.91-0.98). The proportion of the composite
adverse outcomewas 0.06 (CI 0.02-0.09) for early treatment and 0.18
(0.06-0.30) for late treatment. Proportion of ACR was 0.06 (CI 0.02-0.09)
for early treatment compared to 0.17 (CI 0.01-0.28) for late treatment.
Proportion of HCV-related complications for early treatment was 0.02
(0.01-0.04) and for late treatment was 0.02 (0.002-0.03). There were no
cases of glomerulonephritis reported and only 5 cases of FCH. Of the FCH
cases, 4/5 occurred in patients treated >28 after transplant. Early
treatment was associated with 30% lower incidence of detectable viremia.
 Conclusion(s): Overall, early DAA initiation (within 28 days) and
late initiation (after 28 days) achieved similar SVR rates, although the
early strategy reported 30% lower incidence of viremia. Early DAA
initiation strategies reported a lower proportion of ACR than the delayed
strategy, but this estimatewas not statistically significant. On balance
these results would support current guidelines recommending early
treatment initiation, however randomized clinical trials may be required
to more clearly define short-term responses and longterm clinical outcomes
for these strategies. Copyright © 2022 European Association for
the Study of the Liver

<82>
Accession Number
2019796389
Title
Intraoperative conversion from video-assisted thoracoscopic lobectomy to
thoracotomy for non-small-cell lung cancer: Does it have an impact on
long-term survival?.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(2) (no pagination),
2022. Article Number: ivac176. Date of Publication: 01 Aug 2022.
Author
Ren Z.-Z.; Deng H.-Y.; Huang W.; Zhou Q.
Institution
(Ren, Deng, Huang, Zhou) Lung Cancer Center, West China Hospital, Sichuan
University, No.37 Guoxue Alley, Chengdu 610041, China
(Ren, Deng, Huang, Zhou) Lung Cancer Institute, West China Hospital,
Sichuan University, Chengdu, China
(Ren) West China School of Medicine, Sichuan University, Chengdu, China
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was whether intraoperative
conversions to thoracotomy have an impact on long-term survival for
patients with non-small-cell lung cancer who underwent video-assisted
thoracoscopic lobectomy initially. A total of 461 papers were found using
the reported search, of which 6 retrospective cohort studies represented
the best evidence to answer the clinical question. The authors, date of
publication, journal, country of the authors, patient group, study type,
relevant outcomes and results of these papers were tabulated. Five cohort
studies clarified that conversion did not compromise long-term survival,
whereas 1 cohort study reported worse long-term outcomes after conversion
to thoracotomy. However, the limited samples, different characteristics
between groups and selection bias due to inherent design made it difficult
to make a conclusion. Based on the current evidence, we concluded that
intraoperative conversion from video-assisted thoracoscopic surgery (VATS)
to thoracotomy for non-small-cell lung cancer might not impact long-term
survival compared to a successful VATS lobectomy. In-hospital mortality
might not be prejudiced, whereas longer hospitalizations were observed.
However, whether conversion would adversely affect postoperative
complication rates remained unclear because of the conflicting results.
Moreover, 3 studies reported no statistical differences in short-and
long-term survival between emergency and non-emergency conversions.
Therefore, we suggest that thoracic surgeons should not hesitate to
convert VATS into thoracotomy in the case of blood vessel injury or
difficult hilum. Copyright © 2022 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<83>
Accession Number
2018639863
Title
Evaluation of the recovery after heart surgery following preoperative
supplementation with a combination of beta-hydroxy-beta-methylbutyrate,
l-arginine, and l-glutamine: a double-blind randomized placebo-controlled
clinical trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 649. Date of
Publication: December 2022.
Author
Norouzi M.; Nadjarzadeh A.; Maleki M.; Khayyatzadeh S.S.; Hosseini S.;
Yaseri M.; Fattahi H.
Institution
(Norouzi, Nadjarzadeh, Khayyatzadeh) Nutrition and Food Security Research
Center, Shahid Sadoughi University of Medical Sciences, Shohadaye gomnam
BLD., ALEM square, Yazd, Iran, Islamic Republic of
(Norouzi) Department of Nutrition, International Campus of Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Nadjarzadeh, Khayyatzadeh) Department of Nutrition, Faculty of Health,
Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic
Republic of
(Maleki) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Hosseini) Heart Valve Disease Research Center, Shahid Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Yaseri) Department of Epidemiology and Biostatistics, Tehran University
of Medical Science, Tehran, Iran, Islamic Republic of
(Fattahi) Cardiovascular Medical and Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: The preoperative period is a good time to improve nutrition
status, compensate for nutrient deficiencies, and optimize immune function
in patients' underlying surgery. In some medical conditions,
supplementation with a combination of l-glutamine (Gln),
beta-hydroxy-beta-methylbutyrate (HMB), and l-arginine (Arg) had promising
effects on improving recovery. The present study aimed to evaluate the
effect of supplementation with Gln/Arg/HMB in patients undergoing heart
surgery. Method(s): This randomized clinical trial was conducted on
70 patients undergoing cardiac surgery. Participants were requested to
consume 2 sachets of a combination of 7 g l-arginine, 7 g l-glutamine, and
1.5 g daily HMB or placebo 30 days before operation. At the baseline and
end of the study, left ventricular ejection fraction and the serum levels
of troponin, creatine phosphokinase (CPK), CPK-MB, alanine
aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin
were measured. Also, the Sequential Organ Failure Assessment (SOFA) score,
time of stay in hospital and intensive care unit (ICU), and postoperative
complications were recorded after surgery. Result(s): In total, 60
preoperative patients (30 in each group) with a mean age of 53.13 +/-
14.35 years completed the study (attrition rate = 85.7%). Subjects in the
Gln/Arg/HMB group had lower serum levels of CPK-MB (median [IQR] = 49
[39.75] vs. 83 [64.55]; P = 0.011), troponin (median [IQR] = 2.13 [1.89]
vs. 4.34 [1.99]; P < 0.001), bilirubin (median [IQR] = 0.50 [0.20] vs.
0.40 [0.22]; P < 0.001), and SOFA score (median [IQR] = 2 [2] vs. 5 [2]; P
< 0.001) at end of the study compared to the placebo. Also, the time of
stay in the hospital (median [IQR] = 5 [1] vs. 6 [3]; P < 0.001) and ICU
(median [IQR] = 2.50 [1.00] vs. 3.50 [1.50]; P = 0.002) was lower in the
Gln/Arg/HMB group. Conclusion(s): The present study showed that
perioperative supplementation with a combination of Gln, Arg, and HMB
enhances the recovery, reduces myocardial injury, and decreases the time
of hospital and ICU stay in cardiac surgery patients. These results need
to be confirmed in a larger trial. Trial registration: IRCT.ir
IRCT20120913010826N31. Registered on 13 October 2020. Copyright ©
2022, The Author(s).

<84>
Accession Number
2019773976
Title
The Effect of Preoperative Oral Trimetazidine on Ischemic Injury and
Hemodynamic Function in Coronary Artery Bypass Grafting: A Double-Blinded,
Prospective, Randomized Controlled Trial.
Source
Journal of the Medical Association of Thailand. 105(8) (pp 674-682), 2022.
Date of Publication: August 2022.
Author
Phothikun A.; Woragidpoonpol S.; Tepsuwan T.; Tantraworasin A.;
Rimsukcharoenchai C.; Taksaudom N.
Institution
(Phothikun, Woragidpoonpol, Tepsuwan, Rimsukcharoenchai, Taksaudom)
Cardiovascular and Thoracic Surgery Unit, Department of Surgery, Faculty
of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Tantraworasin) General Thoracic Surgery Unit, Department of Surgery,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Tantraworasin) Clinical Epidemiology and Clinical Statistic Center,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Publisher
Medical Association of Thailand
Abstract
Background: Ischemic and reperfusion injury can occur during coronary
artery bypass grafting (CABG), leading to poor post-operative hemodynamic
function. Pre-operative administration of oral Trimetazidine has been
shown to reduce ischemic and reperfusion injury, however, the effects
about hemodynamic function are still controversial. Material(s) and
Method(s): Ninety patients that underwent CABG were randomly divided into
two groups. The Trimetazidine group received oral Trimetazidine 35 mg
twice a day for at least five days before the operation, and the control
group received a placebo. Invasive cardiac output monitoring using a Swan
Ganz catheter was performed in every case. The cardiac markers and
hemodynamic parameters were evaluated before the operation, immediately
after the operation, and then at 12 hours and 24 hours postoperatively.
 Result(s): There were no statistically significant differences in the
rise of all cardiac markers from the preoperative values to the immediate
postoperative values between the groups (p=0.471, 0.907 and 0.863 in
Troponin T, CK-MB, and total CK, respectively). For postoperative cardiac
marker levels, the level of CK-MB in the postoperative follow up period
increased +1.51 mcg/L (95% CI -1.11, +4.12), in the Trimetazidine group
and increased +0.93 mcg/L (95% CI; -1.78, +3.64) per follow up in the
placebo group, but the rising rate between both groups had no
statistically significant differences (p=0.670). Moreover, there were no
statistically significant differences in the increased of the preoperative
and postoperative cardiac index between the groups (p=0.102).
 Conclusion(s): The pre-operative administration of oral Trimetazidine
did not significantly reduce ischemic and reperfusion injury during CABG,
nor improve the postoperative hemodynamic function. Copyright ©
2022 Medical Association of Thailand. All rights reserved.

<85>
Accession Number
2019743032
Title
Volatile versus Total Intravenous Anesthesia for Coronary Artery Bypass
Graft Surgery: Analysis of 1586 MYRIAD Trial Patients Managed with the
Same Perioperative Protocol.
Source
Reviews in Cardiovascular Medicine. 23(8) (no pagination), 2022. Article
Number: 265. Date of Publication: August 2022.
Author
Lomivorotov V.; Ruzankin P.S.; Lembo R.; Tarasenko A.S.; Chernyavskiy A.;
Crivellari M.; Monaco F.; Ruggeri L.; Pieri M.; Lomivorotova L.; Belletti
A.
Institution
(Lomivorotov, Chernyavskiy, Lomivorotova) Department of Anesthesiology and
Intensive Care, E. Meshalkin National Medical Research Center, Novosibirsk
630055, Russian Federation
(Lomivorotov) Department of Anesthesiology anf Intensive Care, Novosibirsk
State University, Novosibirsk 630090, Russian Federation
(Ruzankin, Tarasenko) Sobolev Institute of Mathematics, Siberian Branch of
the Russian Academy of Sciences, Novosibirsk 630090, Russian Federation
(Ruzankin, Tarasenko) Department of Mathematics and Mechanics, Novosibirsk
State University, Novosibirsk 630090, Russian Federation
(Lembo, Crivellari, Monaco, Pieri, Belletti) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan 20132,
Italy
(Ruggeri) Instituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan
20156, Italy
Publisher
IMR Press Limited
Abstract
Background: This study investigated the influence of volatile anesthesia
(VA) on major complications and mortality in patients undergoing coronary
artery bypass graft surgery (CABG). Method(s): This post-hoc analysis
included 1586 patients from the MYRIAD trial managed using the same
perioperative protocol at a single institution. Patients were randomized
to receive either volatile anesthesia (sevoflurane, isoflurane, or
desflurane) or total intravenous anesthesia (TIVA). The assessed study
outcomes were the rate of complications, including: myocardial infarction,
stroke, acute kidney injury, prolonged ventilation (>24 h), receipt of
high-dose inotropic support (inotropic score >10), and need for mechanical
circulatory support. The duration of intensive care unit (ICU) stay,
length of hospitalization, hospital readmission during follow-up, 30-days
and 1-year mortality were also analyzed. Result(s): 1586 patients
were enrolled between September 2014-September 2017 and randomly assigned
to the volatile anesthesia group (n = 794) and the TIVA group (n = 792).
The median patient age was 63 years, with a median ejection fraction of
60%. There were no significant differences in the rates of major
complications, duration of ICU stay, and hospitalization between the
groups. The median total dose of fentanyl was 12.0 mcg/kg in volatile
group and 14.4 mcg/kg in TIVA group (p < 0.001). One-year mortality rates
were 2.5% (n = 20) and 3.2% (n = 25) in the volatile and TIVA groups,
respectively. Two patients were lost at the 30-day and 1-year follow-ups
in the volatile group compared to four patients in TIVA group. Regression
analysis showed that cardiopulmonary bypass (CPB) duration, fentanyl dose,
and baseline serum creatinine level were associated with 30-days
mortality, while ejection fraction was associated with 1-year mortality.
 Conclusion(s): The use of VA in patients undergoing CABG did not
result in a reduction in major complications or mortality compared with
TIVA. A higher dose of fentanyl was used in the TIVA group and was
associated with an increase in the 30-days mortality. These findings
warrant further investigation. Copyright: © 2022 The Author(s).

<86>
[Use Link to view the full text]
Accession Number
2019708205
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: 30 Aug 2022.
Author
Oliveri F.; Bongiorno A.; Compagnoni S.; Fasolino A.; Gentile F.R.; Pepe
A.; Tua L.
Institution
(Oliveri, Bongiorno, Compagnoni, Fasolino, Gentile, Pepe, Tua) Department
of Molecular Medicine, University of Pavia, Pavia, Italy
Publisher
Lippincott Williams and Wilkins
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; I2 = 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.

<87>
Accession Number
2019708145
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, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
(Koo, Yang, Jung, Kang) Department of Radiology Research Institute of
Radiology, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Yun) Division of Biostatistics, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Lee) Department of Neurology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Kim) Asan Image Metrics, Clinical Trial Center, Asan Institute for Life
Sciences, Asan Medical Center, Seoul, South Korea
(Kim) Department of Radiology, Anam Hospital, Korea University College of
Medicine, Seoul, South Korea
(Wong, Lam) Division of Cardiology, Department of Medicine, University of
Hong Kong, Queen Mary Hospital, 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, Taipei, Taiwan (Republic of China)
(Ko) Division of Cardiology, Department of Internal Medicine, Hsin-Chu
Branch, National Taiwan University Hospital, Taiwan (Republic of China)
(Kim, Kang) Department of Cardiology, Cha Bundang Medical Center,
Seongnam, South Korea
(Park) Division of Cardiology, GangNeung Asan Hospital, University of
Ulsan College of Medicine, South Korea
Publisher
Lippincott Williams and Wilkins
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.
 Copyright © 2022 the Author(s). Published by Wolters Kluwer
Health, Inc.

<88>
Accession Number
2019706457
Title
Enhanced rehabilitation intervention improves postoperative recovery and
quality of life of patients after heart valve replacement surgery.
Source
American Journal of Translational Research. 14(7) (pp 5132-5138), 2022.
Date of Publication: 2022.
Author
Hao J.
Institution
(Hao) Department of Cardiothoracic, Cangzhou Central Hospital, Hebei
Province, China
Publisher
E-Century Publishing Corporation
Abstract
Objective: To explore the application value of enhanced recovery after
surgery (ERAS) for heart valve replacement surgery. Method(s): A
total of 86 patients with heart valve diseases admitted to our hospital
from Jan. 2018 to Mar. 2020 were selected, and randomized into the control
group (n=43) with regular nursing care and the observation group (n=43)
with ERAS. The postoperative recovery, rate of adverse events, quality of
life, visual analogue scale (VAS) score and nursing care satisfaction rate
were compared between the two groups. Result(s): After surgery, the
time to first bowel movement and the first flatulence in the observation
group were earlier than those in the control group, and the hospital stay
of patients in the observation group was shorter than that in the control
group. The rate of adverse events in the observation group was 4.65%,
which was lower than that in the control group (18.60%). In addition, the
observation group obtained higher life quality scores but lower VAS,
self-rating anxiety scale (SAS) and self-rating depression scale (SDS)
scores than the control group, and the observation group showed lower
serum levels of corticotropin and cortisol and exhibited a longer 6-minute
walking distance than the control group. Moreover, the nursing care
satisfaction rate of the observation group was 95.35%, which was higher
than that (76.74%) of the control group (all P<0.05). Conclusion(s):
ERAS can reduce adverse events and pain for patients with heart valve
replacement and improve their postoperative recovery, quality of life, and
nursing care satisfaction. Copyright © 2022 E-Century Publishing
Corporation. All rights reserved.

<89>
Accession Number
2015330419
Title
Proactive Management of Intraoperative Hypotension Reduces Biomarkers of
Organ Injury and Oxidative Stress during Elective Non-Cardiac Surgery: A
Pilot Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 11(2) (no pagination), 2022. Article Number:
392. Date of Publication: January-2 2022.
Author
Murabito P.; Astuto M.; Sanfilippo F.; La Via L.; Vasile F.; Basile F.;
Cappellani A.; Longhitano L.; Distefano A.; Li Volti G.
Institution
(Murabito, Astuto, Sanfilippo, La Via, Vasile, Basile, Cappellani)
Department of General Surgery and Surgical-Medical Specialties, Section of
Anesthesia, University of Catania, Via S. Sofia 72, Catania 95125, Italy
(Longhitano, Distefano, Li Volti) Department of Biomedical and
Biotechnological Sciences, University of Catania, Via S. Sofia 97, Catania
95125, Italy
(Li Volti) Center of Excellence for the Acceleration of Harm
Reduction-CoEHAR, University of Catania, Via S. Sofia 97, Catania 95131,
Italy
Publisher
MDPI
Abstract
Background: Intraoperative hypotension is associated with increased
postoperative morbidity and mortality. Method(s): We randomly
assigned patients undergoing major general surgery to early warning system
(EWS) and hemodynamic algorithm (intervention group, n = 20) or standard
care (n = 20). The primary outcome was the difference in hypotension
(defined as mean arterial pressure < 65 mmHg) and as secondary outcome
surrogate markers of organ injury and oxidative stress. Result(s):
The median number of hypotensive episodes was lower in the intervention
group (-5.0 (95% CI: -9.0, -0.5); p < 0.001), with lower time spent in
hypotension (-12.8 min (95% CI: -38.0, -2.3 min); p = 0.048),
correspondent to -4.8% of total surgery time (95% CI: -12.7, 0.01%; p =
0.048).The median time-weighted average of hypotension was 0.12 mmHg
(0.35) in the intervention group and 0.37 mmHg (1.11) in the control
group, with a median difference of -0.25 mmHg (95% CI: -0.85, -0.01; p =
0.025). Neutrophil Gelatinase-Associated Lipocalin (NGAL) correlated with
time-weighted average of hypotension (R = 0.32; p = 0.038) and S100B with
number of hypotensive episodes, absolute time of hypotension, relative
time of hypotension and time-weighted average of hypotension (p < 0.001
for all). The intervention group showed lower Neuronal Specific Enolase
(NSE) and higher reduced glutathione when compared to the control group.
 Conclusion(s): The use of an EWS coupled with a hemodynamic algorithm
resulted in reduced intraoperative hypotension, reduced NSE and oxidative
stress. Copyright © 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<90>
Accession Number
2016925588
Title
Practical Review of Mechanical Ventilation in Adults and Children in the
Operating Room and Emergency Department.
Source
Reviews on Recent Clinical Trials. 17(1) (pp 20-33), 2022. Date of
Publication: February 2022.
Author
Zanza C.; Longhitano Y.; Leo M.; Romenskaya T.; Franceschi F.; Piccioni
A.; Pabon I.M.; Santarelli M.T.; Racca F.
Institution
(Zanza, Longhitano) Foundation "Ospedale Alba-Bra ONLUS", Verduno, Italy
(Zanza, Longhitano, Leo, Romenskaya, Racca) Department of Anesthesiology
and Critical Care Medicine-AON SS Antonio e Biagio e Cesare Arrigo,
Alessandria, Italy
(Zanza, Longhitano, Pabon) Department of Emergency Medicine, Anesthesia
and Critical Care Medicine, Michele and Pietro Ferrero Hospital, Verduno,
Italy
(Zanza, Franceschi, Piccioni) Department of Emergency Medicine, Fondazione
Policlinico A. Gemelli/Catholic University of Sacred Heart, Rome, Italy
(Santarelli) Department of Sensory Organs, Sapienza University of Rome,
Rome, Italy
Publisher
Bentham Science Publishers
Abstract
Background: During general anesthesia, mechanical ventilation can cause
pulmonary damage through mechanism of ventilator-induced lung injury,
which is a major cause of post-opera-tive pulmonary complications, which
varies between 5 and 33% and increases the 30-day mortality of the
surgical patient significantly. Objective(s): The aim of this review
is to analyze different variables which played a key role in the safe
application of mechanical ventilation in the operating room and emergency
setting. Method(s): Also, we wanted to analyze different types of the
population that underwent intraopera-tive mechanical ventilation like
obese patients, pediatric and adult population and different strategies
such as one lung ventilation and ventilation in trendelemburg position.
The peer-reviewed articles analyzed were selected according to PRISMA
(Preferred Reporting Items for Systematic re-views and Meta-Analyses) from
Pubmed/Medline, Ovid/Wiley and Cochrane Library, combining key terms such
as: "pulmonary post-operative complications", "protective ventilation",
"alveolar recruitment maneuvers", "respiratory compliance",
"intraoperative paediatric ventilation", "best peep", "types of
ventilation". Among the 230 papers identified, 150 articles were selected,
after ti-tle-abstract examination and removing the duplicates, resulting
in 94 articles related to mechanical ventilation in operating room and
emergency setting that were analyzed. Result(s): Careful preoperative
patient's evaluation and protective ventilation (i.e., use of low tidal
volumes, adequate PEEP and alveolar recruitment maneuvers) has been shown
to be effective not only in limiting alveolar de-recruitment, alveolar
overdistension and lung damage, but also in re-ducing the onset of
Pulmonary Post-operative Complications (PPCs). Conclusion(s):
Mechanical ventilation is like "Janus Bi-front" because it is essential
for surgical pro-cedures, for the care of critical care patients and in
life-threatening conditions, but it can be harm-ful to the patient if
continued for a long time and where an excessive dose of oxygen is
adminis-tered into the lungs. Low tidal volume is associated with a minor
rate of PPCs and other complications and every complication can increase
the length of Stay, adding cost to NHS between 1580 and 1650 per day in
Europe and currently the prevention of PPCS is the only weapon that we
pos-sess. Copyright © 2022 Bentham Science Publishers.

<91>
Accession Number
638522348
Title
Preoperative anxiety among cardiac surgery patients and its impact on
major adverse cardiac events and mortality- A randomized, parallel-group
study.
Source
Annals of Cardiac Anaesthesia. 25(3) (pp 293-296), 2022. Date of
Publication: July-September 2022.
Author
Mudgalkar N.; Kandi V.; Baviskar A.; Kasturi R.; Bandurapalli B.
Institution
(Mudgalkar) Department and Anaesthesia and Cardiac Anaesthesia, Prathima
Institute of Medical Sciences, Nagnur Road, Telangana, Karimnagar, India
(Kandi) Department and Microbiology, Prathima Institute of Medical
Sciences, Nagnur Road, Telangana, Karimnagar, India
(Baviskar) Department and Cardiac Surgery, Prathima Institute of Medical
Sciences, Nagnur Road, Telangana, Karimnagar, India
(Kasturi) Department and Cardiology, Prathima Institute of Medical
Sciences, Nagnur Road, Telangana, Karimnagar, India
(Bandurapalli) Department and Cardiac Anaesthesia, Prathima Institute of
Medical Sciences, Nagnur Road, Telangana, Karimnagar, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Patients undergoing elective cardiac surgery often experience
pre-operative anxiety. Preoperative anxiety influences surgical outcome.
There are very few studies which have assessed the impact of clonidine and
Gabapentin in the treatment of anxiety especially in Indian populations
and its implications on major adverse cardiac events (MACE) and 30 days
mortality. Material(s) and Method(s): Adult patients aged 18 to 80
years old who were scheduled to have an elective coronary artery by-pass
graft (CABG) were included in the study. Those who satisfied the inclusion
criteria were given either Gabapentin (800 mg) or Clonidine (300 mcg)
90-120 minutes before the induction. State trait anxiety inventory (STAI)
was used to assess anxiety in baseline and taking just before operating
room. The primary endpoint was a reduction in the STAI associated with the
study drug, while the secondary endpoint was the incidence of MACE in the
perioperative period (30 days), which included composite episodes of
non-fatal cardiac arrest, chaotic rhythm, acute myocardial infarction,
congestive heart failure, cardiac arrhythmia, angina, and death.
 Result(s): A total of 75 patients were considered for the statistical
analysis. The demographic and clinical features of the study participants
were similar in both groups. Nearly 75-80% of participants had severe
anxiety in the preoperative period while 10-20% had moderate anxiety.
While both the drugs showed a reduction in the anxiety levels, the
clonidine group fared better (statistically insignificant). The incidence
of MACE was similar in both groups. Conclusion(s): The preoperative
anxiety levels were high among cardiac surgery patients. Both clonidine
and gabapentin were equally effective in reducing the levels of
preoperative anxiety. Preoperative STAI scores in the range of 32-53 is
not associated with MACE and 30-day mortality among cardiac surgery
patients. Copyright © 2022 Wolters Kluwer Medknow Publications.
All rights reserved.

<92>
Accession Number
638522319
Title
Intubation with vivasight double-lumen tube versus conventional
double-lumen tube in adult patients undergoing lung resection: A
retrospective analysis.
Source
Annals of Cardiac Anaesthesia. 25(3) (pp 279-285), 2022. Date of
Publication: July-September 2022.
Author
Granell M.; Petrini G.; Kot P.; Murcia M.; Morales J.; Guijarro R.; De
Andres J.
Institution
(Granell, Kot, Murcia, Morales, De Andres) Department of Anesthesia,
Critical Care and Pain Medicine, University General Hospital Consortium of
Valencia, Spain
(Granell, Guijarro, De Andres) University of Valencia, University General
Hospital Consortium of Valencia, Spain
(Guijarro) Department of Thoracic Surgery, University General Hospital
Consortium of Valencia, Spain
(Petrini) Department of Anesthesia, Critical Care and Pain Medicine, Citt
della Salute e della Scienza, Torino, Italy
Publisher
Wolters Kluwer Medknow Publications
Abstract
Objectives: The present study was designed to compare outcomes in patients
undergoing thoracic surgery using the VivaSight double-lumen tube (VDLT)
or the conventional double-lumen tube (cDLT). Design(s): A
retrospective analysis of 100 patients scheduled for lung resection
recruited over 21 consecutive months (January 2018-September 2019).
 Setting(s): Single-center university teaching hospital investigation.
 Participant(s): A randomized sample of 100 patients who underwent
lung resection during this period were selected for the purpose to compare
50 patients in the VDLT group and 50 in the cDLT group.
 Intervention(s): After institutional review board approval, patients
were chosen according to inclusion and exclusion criteria and we created a
general database. The 100 patients have been chosen through a random
process with the Microsoft Excel program (Microsoft 2018, Version
16.16.16). Measurements and Main Results: The primary endpoint of the
study was to analyze the need to use fiberoptic bronchoscopy to confirm
the correct positioning of VDLT or the cDLT used for lung isolation.
Secondary endpoints were respiratory parameters, admission to the
intensive care unit, length of hospitalization, postoperative
complications, readmission, and 30-day mortality rate. The use of
fiberoptic bronchoscopy was lower in the VDLT group, and the size of the
tube was smaller. The intraoperative respiratory and hemodynamics
parameters were optimal. There were no other preoperative, intraoperative,
or postoperative differences between both groups. Conclusion(s): The
VDLT reduces the need for fiberoptic bronchoscopy, and it seems that a
smaller size is needed. Finally, VDLT is cost-effective using disposable
fiberscopes. Copyright © 2022 Wolters Kluwer Medknow
Publications. All rights reserved.

<93>
Accession Number
638522306
Title
Effect of perioperative use of oral triidothyronine for infants undergoing
complex congenital cardiac surgeries under cardiopulmonary bypass: A
double-blinded randomised controlled study.
Source
Annals of Cardiac Anaesthesia. 25(3) (pp 270-278), 2022. Date of
Publication: July-September 2022.
Author
Karri S.; Mandal B.; Kumar B.; Puri G.; Thingnam S.; Kumar H.;
Unnikrishnan V.
Institution
(Karri, Mandal, Kumar, Puri) Department of Cardiac Anaesthesia, Pgimer,
Chandigarh, India
(Thingnam) Department of Cardiothoracic Surgery, Pgimer, Chandigarh, India
(Kumar) Department of Cardiothoracic Surgery Icu, Pgimer, Chandigarh,
India
(Unnikrishnan) Department of Pediatric Cardiac Surgery Icu, Pgimer,
Chandigarh, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Thyroid hormone metabolism disrupts after cardiopulmonary
bypass both in adults and pediatric patients. This is known as Euthyroid
sick syndrome, and it is more evident in pediatric patients who were
undergoing complex cardiac surgeries compared to adults. This decrease in
serum T3 levels increases the incidence of low cardiac output, requirement
of inotropes, prolonged mechanical ventilation, and prolonged intensive
care unit (ICU) stay. Aims and Objectives: The primary objective was to
compare the mean Vasoactive-inotropic score (VIS) at 72 hours
postoperatively between T3 and Placebo groups. Material(s) and
Method(s): One hundred patients were screened, and 88 patients were
included in the study. Triidothyronine 1 mic/kg 10 doses 8 th hourly was
given orally postoperatively to cases and sugar sachets to controls. The
blood samples for analysis of FT3, FT4, and TSH were taken every 24 hours
postoperatively, and baseline values were taken after induction. Mean VIS
scores, ejection Fraction (EF), Left ventricular outflow tract velocity
time integral (LVOT VTi), hemodynamics and partial pressure of oxygen/
fraction of inspired oxygen(PaO2/FiO2) were recorded daily.
 Result(s): The Mean VIS scores at 72 Hours postoperatively were
significantly less in the T3 group (5.49 +/- 6.2) compared to the Placebo
group (13.6 +/- 11.7). The PaO2/FiO2 ratios were comparatively more in the
T3 group than the Placebo group. The serum levels of FT3 FT4 were
significantly higher in the T3-supplemented group than the Placebo group.
The VIS scores were significantly lower from 48 hours postoperatively in
children < 6 months of age. Conclusion(s): In this study, we observed
that supplementing T3 postoperatively decreases the ionotropic requirement
from 72 hours postoperatively. This is more useful in children <6 months
of age undergoing complex cardiac surgeries. Copyright © 2022
Wolters Kluwer Medknow Publications. All rights reserved.

<94>
Accession Number
2016947725
Title
Management of Postoperative Hypoxemia.
Source
Respiratory Care. 66(7) (pp 1136-1149), 2021. Date of Publication: 01 Jul
2021.
Author
Liu K.; Scott J.B.; Jing G.; Li J.
Institution
(Liu) Department of Critical Care Medicine, Zhongshan Hospital, Fudan
University, Shanghai, China
(Scott, Li) Division of Respiratory Care, Department of Cardiopulmonary
Sciences, Rush University, 600 S Paulina St, Suite 765, Chicago, IL 60612,
United States
(Jing) Department of Pulmonary and Critical Care Medicine, Binzhou Medical
University Hospital, Shandong, Binzhou, China
Publisher
American Association for Respiratory Care
Abstract
Hypoxemia is common in postoperative patients and is associated with
prolonged hospital stays, high costs, and increased mortality. This review
discusses the postoperative management of hypoxemia in regard to the use
of conventional oxygen therapy, high-flow nasal cannula oxygen therapy,
CPAP, and noninvasive ventilation. The recommendations made are based on
the currently available evidence. Copyright © 2021 Daedalus
Enterprises.

<95>
Accession Number
2018294635
Title
Early Aortic Valve Replacement vs. Conservative Management in Asymptomatic
Severe Aortic Stenosis Patients With Preserved Ejection Fraction: A
Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 7 (no pagination), 2021. Article
Number: 621149. Date of Publication: 03 Feb 2021.
Author
Yuan T.; Lu Y.; Bian C.; Cai Z.
Institution
(Yuan, Lu, Bian, Cai) Department of Cardiology, The Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, China
(Cai) Jiaxing Key Laboratory of Cardiac Rehabilitation, Jiaxing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Aortic stenosis (AS) is the most common valvular disease in
developed countries. Until now, the specific timing of intervention for
asymptomatic patients with severe aortic stenosis and preserved ejection
fraction remains controversial. Method(s): A systematic search of
four databases (Pubmed, Web of science, Cochrane library, Embase) was
conducted. Studies of asymptomatic patients with severe AS or very severe
AS and preserved left ventricular ejection fraction underwent early aortic
valve replacement (AVR) or conservative care were included. The end points
included all-cause mortality, cardiac mortality, and non-cardiac
mortality. Result(s): Four eligible studies were identified with a
total of 1,249 participants. Compared to conservative management, patients
who underwent early AVR were associated with lower all-cause mortality,
cardiac mortality, and non-cardiac mortality rate (OR 0.16, 95% CI
0.09-0.31, P < 0.00001; OR 0.12, 95% CI 0.02-0.62, P = 0.01; OR 0.36, 95%
CI 0.21-0.63, P = 0.0003, respectively). Conclusion(s): Early AVR is
preferable for asymptomatic severe AS patients with preserved ejection
fraction. Copyright © 2021 Yuan, Lu, Bian and Cai.

<96>
Accession Number
2018294589
Title
Transcatheter and Surgical Aortic Valve Replacement in Patients With
Previous Cardiac Surgery: A Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 7 (no pagination), 2021. Article
Number: 612155. Date of Publication: 10 Feb 2021.
Author
Li Y.-M.; Tsauo J.-Y.; Jia K.-Y.; Liao Y.-B.; Xia F.; Zhao Z.-G.; Chen M.;
Peng Y.
Institution
(Li, Tsauo, Jia, Liao, Zhao, Chen, Peng) Department of Cardiology, West
China Hospital, Sichuan University, Chengdu, China
(Xia) Department of Neurosurgery, West China Hospital, Sichuan University,
Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Background: Many patients who have aortic stenosis and are transcatheter
aortic valve replacement (TAVR) candidates have underwent prior cardiac
surgery (PCS). The aim of this study was to provide a robust summary
comparison between patients with PCS who underwent TAVR vs. surgical
aortic valve replacement (SAVR). Method(s): We conducted a systematic
review and meta-analysis of all published articles on PubMed/Medline,
Ovid, EMBASE, and Scopus from 2002 to 2019. Result(s): A total of 13
studies were finally included, yielding a total of 23,148 participants.
There was no statistical difference with 30-day [OR: 1.02 (0.86-1.21)] or
1-year mortality [OR: 1.18 (0.86-1.61)] between the two groups. Subgroup
analysis revealed that high-risk patients who underwent TAVR with the
transapical approach were associated with increased risk of mortality [OR:
1.45 (1.00-2.11)]. However, those who underwent TAVR with endovascular
approach had a comparable outcome with SAVR. Conclusion(s): Primary
outcomes after endovascular TAVR were similar to those with SAVR and
superior to transapical TAVR treatment group in patients with
PCS. Copyright © 2021 Li, Tsauo, Jia, Liao, Xia, Zhao, Chen and
Peng.

<97>
Accession Number
2018294324
Title
State-of-the-Art Review: Anatomical and Imaging Considerations During
Transcatheter Tricuspid Valve Repair Using an Annuloplasty Approach.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 619605. Date of Publication: 05 Feb 2021.
Author
Wunderlich N.C.; Landendinger M.; Arnold M.; Achenbach S.; Swaans M.J.;
Siegel R.J.; Ho S.Y.
Institution
(Wunderlich) Cardiovasclar Center Darmstadt, Darmstadt, Germany
(Landendinger, Arnold, Achenbach) Department of Cardiology,
Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
(Swaans) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Siegel) Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles,
CA, United States
(Ho) Cardiac Morphology Unit, Royal Brompton Hospital, London, United
Kingdom
Publisher
Frontiers Media S.A.
Abstract
Transcatheter techniques for the treatment of tricuspid regurgitation (TR)
are being more frequently used and several new devices are in development.
Since 90% of patients with TR have secondary TR, catheter based systems
which reduce the dilated tricuspid annulus area are of particular
interest. In order to perform an annuloplasty procedure effectively and
safely, knowledge about the anatomy of the tricuspid valve apparatus and
especially of the annulus in relation to the important neighboring
structures such as the aortic root, the RCA, the electrical pathways and
the CS is fundamental. In addition, comprehensive understanding of the
device itself, the delivery system, its maneuverability and the individual
procedural steps is required. Furthermore, the use of multi-modality
imaging is important. For each step of the procedure the appropriate
imaging modality as well as the optimal; imaging planes are crucial to
provide the necessary information to best guide the individual procedural
step. Copyright © 2021 Wunderlich, Landendinger, Arnold,
Achenbach, Swaans, Siegel and Ho.

<98>
Accession Number
2014493517
Title
Long-term hospital-based secondary prevention of coronary artery disease:
a randomized controlled trial.
Source
BMC Cardiovascular Disorders. 21(1) (no pagination), 2021. Article Number:
600. Date of Publication: December 2021.
Author
Kaldal A.; Tonstad S.; Jortveit J.
Institution
(Kaldal) Department of Research, Sorlandet Hospital HF, Lundsiden, Box
416, Kristiansand S 4604, Norway
(Tonstad) Department of Endocrinology, Obesity and Preventive Medicine,
Section of Preventive Cardiology, Oslo University Hospital, Oslo, Norway
(Jortveit) Department of Cardiology, Sorlandet Hospital Arendal, Arendal,
Norway
Publisher
BioMed Central Ltd
Abstract
Background and aims: Despite established guidelines on secondary
prevention of cardiovascular disease, practical implementation of
treatment targets is deficient even in high-income countries. This study
compared long-term hospital-based treatment with follow-up at primary
health care regarding new cardiovascular events and achievement of
treatment targets. Method(s): This randomized controlled trial at
Sorlandet Hospital, Norway 2007-2021 included patients hospitalized due to
myocardial infarction (n = 760) or after scheduled percutaneous coronary
intervention (PCI) (n = 677) or coronary artery bypass grafting (n = 103).
Patients were randomized to hospital-based secondary preventive care with
consultations 2 weeks, 3 months, 6 months and 1 year after the index event
and annually for up to 5 years, or follow-up at primary health care. Final
data was collected after 10 years and hazard ratios were calculated using
Cox regression analyses. Result(s): Composite endpoint-free survival
due to a lower rate of PCI improved in patients with hospital-based
follow-up (n = 788) compared to patients followed-up at primary health
care (n = 752) (HR 0.80, 95% CI 0.66-0.96; p = 0.02) but all-cause
mortality was not reduced (HR 0.96, 95% CI 0.59-1.56; p = 0.86). At 1
year, LDL-cholesterol (2.1 [SD 0.7] versus 2.3 [SD 0.8] mmol/l; p < 0.001)
and systolic blood pressure (132 [SD 16] versus 142 [SD 20] mm/Hg; p <
0.001) were lower in the hospital-based group, and the differences
remained significant during the first 5 years. Other secondary preventive
measures (smoking cessation, physical activity, body weight, glucose
control, drug adherence) did not differ. Conclusion(s): Long-term
hospital-based secondary preventive follow-up improved composite
endpoint-free survival, but not mortality. Substantial risk factors
remained unaddressed. The beneficial effects on blood pressure and
LDL-cholesterol disappeared after annual consultations ceased. Trial
registration: The study is registered in ClinicalTrials.gov (NCT00679237)
May 16, 2008. Copyright © 2021, The Author(s).

<99>
Accession Number
2014470244
Title
Safety of biologic treatments in solid organ transplant recipients: A
systematic review.
Source
Seminars in Arthritis and Rheumatism. 51(6) (pp 1263-1273), 2021. Date of
Publication: December 2021.
Author
Meyer F.; Weil-Verhoeven D.; Prati C.; Wendling D.; Verhoeven F.
Institution
(Meyer, Prati, Wendling, Verhoeven) Department of Rheumatology, CHRU Jean
Minjoz, 2 Boulevard Fleming, Besancon 25030, France
(Weil-Verhoeven) Department of Hepatology, CHRU Bourgogne, Besancon,
France
(Weil-Verhoeven, Wendling) EA 4266; "EPILAB", FHU increase, Universite
Bourgogne - Franche Comte, UFR SMP, Besancon, France
(Prati, Verhoeven) EA 4267: "PEPITE", FHU increase, Universite Bourgogne -
Franche Comte, UFR SMP, Besancon, France
Publisher
W.B. Saunders
Abstract
Background: The development of biological treatments has transformed the
management of a broad spectrum of autoimmune/inflammatory diseases.
However, little is known about their use in solid-organ transplant
recipients. This study aimed to evaluate complications occurring with
biologic treatments in solid-organ transplant recipients. Method(s):
A systematic review of the literature was performed in the Medline, Embase
and Cochrane databases, up to 01/10/2020, to identify published case
reports or series reporting the use of biologic treatments in solid organ
transplant recipients with chronic inflammatory diseases. We collected
data on patient characteristics and reported complications.
 Result(s): In total, 57 articles were included, totalling 187
patients (141 liver, 42 kidney, 3 heart, and 1 liver-kidney transplant
recipients). Inflammatory bowel diseases represented the most common
indication for biologic treatment initiation (80.7%), followed by
rheumatic diseases (7.5%), hereditary periodic fever syndromes (5.9%) and
psoriasis (4.8%). Anti-TNFalpha were mainly used (77.5%; mainly monoclonal
antibodies (70%) compared to soluble receptor etanercept (7.5%)), followed
by the anti-alpha4beta7 integrin, vedolizumab (27.3%) and the anti-IL-1R,
anakinra (6.9%). Median treatment duration was 12 months. Infections
occurred in 54 patients (28.9%) through 88 recorded events. No therapeutic
or demographic factors were associated with occurrence of infection.
Sixteen patients (8.6%) developed malignancies, and acute graft rejections
occurred in 5 patients (2.7%). Among the 187 patients, 9 deaths were
reported (4.8%). Conclusion(s): This review assembles the largest
number of published reports regarding the use of biological treatments in
solid organ transplant recipients, providing data about their safety.
Further comparative studies are needed to assess the safety of biological
treatments in transplanted patients. Copyright © 2021 Elsevier
Inc.

<100>
Accession Number
2013301210
Title
Safety of Direct Oral Anticoagulants Compared to Warfarin for Atrial
Fibrillation after Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 34(3) (pp 947-957), 2022.
Date of Publication: Autumn 2022.
Author
Hage A.; Dolan D.P.; Nasr V.G.; Castelo-Branco L.; Motta-Calderon D.;
Ghandour H.; Hage F.; Papatheodorou S.; Chu M.W.A.
Institution
(Hage, Dolan, Nasr, Castelo-Branco, Motta-Calderon, Hage, Papatheodorou)
Epidemiology, Harvard T.H. Chan School of Public Health, Boston,
Massachusetts
(Hage, Hage, Chu) Division of Cardiac Surgery, Western University, London,
ON, Canada
(Dolan) Division of Thoracic Surgery, Brigham and Women's Hospital,
Boston, Massachusetts
(Nasr) Division of Cardiac Anesthesia, Department of Anesthesiology,
Critical Care and Pain Medicine, Boston Children's Hospital, Boston,
Massachusetts
(Castelo-Branco) Neuroscience, Neuromodulation Center, Spaulding
Rehabilitation Hospital, Boston, Massachusetts
(Motta-Calderon) Division of General Internal Medicine, Brigham and
Women's Hospital, Boston, Massachusetts
(Ghandour) Global Surgery, Harvard Medical School, Boston, Massachusetts
Publisher
W.B. Saunders
Abstract
The evidence for use of direct oral anticoagulants (DOACs) in the
management of post-operative cardiac surgery atrial fibrillation is
limited and mostly founded on clinical trials that excluded this patient
population. We performed a systematic review and meta-analysis of clinical
trials and observational studies to evaluate the hypothesis that DOACs are
safe compared to warfarin for the anticoagulation of patients with
post-operative cardiac surgery atrial fibrillation. We searched PubMed,
EMBASE, Web of Science, clinicaltrials.gov, and the Cochrane Library for
clinical trials and observational studies comparing DOAC with warfarin in
patients >=18 years old who had post-cardiac surgery atrial fibrillation.
Primary outcomes included stroke, systemic embolization, bleeding, and
mortality. We performed a random-effects meta-analysis of all outcomes.
The meta-analysis for the primary outcomes showed significantly lower risk
of stroke with DOAC use (6 studies, 7143 patients, RR 0.64; 95% CI
0.50-0.81, I2: 0.0%) compared to warfarin, a trend towards
lower risk of systemic embolization (4 studies, 7289 patients, RR 0.64,
95% CI 0.41-1.01, I2: 31.99%) and similar risks of bleeding (14
studies, 10182 patients, RR 0.91; 95% CI 0.74-1.10, I2: 26.6%)
and mortality (12 studies, 9843 patients, relative risk [RR] 1.01; 95% CI
0.74-1.37, I2: 26.5%). Current evidence suggests that DOACs,
compared to warfarin, in the management of atrial fibrillation after
cardiac surgery is associated with lower risk of stroke and a strong trend
for lower risk of systemic embolization, and no evidence of increased risk
for hospital readmission, bleeding and mortality. Copyright ©
2021 Elsevier Inc.

<101>
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.

<102>
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.

<103>
Accession Number
638738649
Title
AN UNUSUAL CASE OF REFRACTORY ANGINA.
Source
Journal of General Internal Medicine. Conference: 2022 Annual Meeting of
the Society of General Internal Medicine. Orlando, FL United States.
37(Supplement 2) (pp S406), 2022. Date of Publication: June 2022.
Author
Kashyap R.; Pasha M.A.; Isaac S.; Anjum S.
Institution
(Kashyap, Pasha, Isaac, Anjum) Internal Medicine, North Alabama Medical
Center, Florence, AL, United States
Publisher
Springer New York LLC
Abstract
CASE: A 57-year-old male presented with complaints of chest pain for 2:30
hours. He had an extensive history of coronary artery disease (CAD)
diagnosed 15 years ago requiring multiple percutaneous coronary
interventions (PCI) resulting in 29 stent placements. His most recent
coronary angiography (CA) performed 3 months ago for angina demonstrated
chronic total occlusion (CTO) of pre-existing stents in the left anterior
descending (LAD) artery and obtuse marginal (OM) branch and a lesion in
the left circumflex artery (LCx). He subsequently underwent PCI for CTO of
distal LAD followed by brachytherapy to this area along with balloon
angioplasty of LCx. IMPACT/DISCUSSION: Refractory angina (RA) is defined
as reversible myocardial ischemia, for >=3 months unrelieved by a
combination of optimal medical therapy (OMT), coronary angioplasty, or
bypass surgery. The ACC/ AHA 2012 along with European Society of
Cardiology 2013 guidelines recommend Enhanced External Counter Pulsation
(EECP) therapy for RA. We present a case of RA and briefly discuss the
role of Cardiac Shockwave Therapy (CSWT) in RA. Debilitating angina
episodes with negative cardiac biomarkers and angiography, resulting in
recurrent hospitalization despite OMT, multiple PCI, and CABG, warrants
consideration of other modalities like CSWT to improve quality of life.
 CONCLUSION(S): RA has a mortality rate of 1-2 % at 1 year. With the
exhaustion of serial treatment modalities, CSWT is the only non-invasive
therapy with proven benefits as per meta-analysis which could be
considered. CSWT utilizes high voltage spark underwater to generate shock
waves which are delivered using an applicator after identifying the
treatment area with an ultrasound. Alternatively, transmyocardial laser
revascularization, percutaneous myocardial laser revascularization, spinal
cord stimulation stem cell therapy, EECP, and coronary sinus reducer have
shown some beneficial effects in patients with RA.

<104>
Accession Number
2019685108
Title
Biomarker Prediction of Complex Coronary Revascularization Procedures in
the FOURIER Trial.
Source
Journal of the American College of Cardiology. 80(9) (pp 887-897), 2022.
Date of Publication: 30 Aug 2022.
Author
Fagundes A.; Morrow D.A.; Oyama K.; Furtado R.H.M.; Zelniker T.A.; Tang
M.; Kuder J.F.; Murphy S.A.; Hamer A.; Keech A.C.; Sever P.; Giugliano
R.P.; Sabatine M.S.; Bergmark B.A.
Institution
(Fagundes) IDOR -D'Or Institute for Research and Education, Sao Paolo,
Brazil, Brazil
(Fagundes, Morrow, Oyama, Furtado, Zelniker, Tang, Kuder, Murphy,
Giugliano, Sabatine, Bergmark) Thrombolysis in Myocardial Infarction
(TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and
Women's Hospital, Harvard Medical School, Boston, Massachusetts, United
States
(Oyama) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Furtado) Hospital Israelita Albert Einstein and Instituto do Coracao da
Faculdade de Medicina da U.S.P., Sao Paulo, Brazil
(Zelniker) Division of Cardiology, Vienna General Hospital and Medical
University of Vienna, Vienna, Austria
(Hamer) Cardiol Therapeutics, Oakville, ON, Canada
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Sydney Medical School, University of Sydney, Sydney, NSW,
Australia
(Sever) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Biomarkers are known to predict major adverse cardiovascular
events. However, the association of biomarkers with complex coronary
revascularization procedures or high-risk coronary anatomy at the time of
revascularization is not understood. Objective(s): We examined the
associations between baseline biomarkers and major coronary events (MCE)
and complex revascularization procedures. Method(s): FOURIER was a
randomized trial of the proprotein convertase subtilisin-kexin type 9
inhibitor evolocumab vs placebo in 27,564 patients with stable
atherosclerosis. We analyzed adjusted associations among the biomarkers,
MCE (coronary death, myocardial infarction, or revascularization), and
complex revascularization (coronary artery bypass graft or complex
percutaneous coronary intervention) using a multimarker score with 1 point
assigned for each elevated biomarker (high-sensitivity C-reactive protein
>=2 mg/L; N-terminal pro-B-type natriuretic peptide >=450 pg/mL;
high-sensitivity troponin I >=6 ng/L; growth-differentiation factor-15
>=1,800 pg/mL). Result(s): When patients were grouped by the number
of elevated biomarkers (0 biomarkers, n = 6,444; 1-2 biomarkers, n =
12,439; >=3 biomarkers, n = 2,761), there was a significant graded
association between biomarker score and the risk of MCE (intermediate
score: HR<inf>adj</inf>: 1.57 [95% CI: 1.38-1.78]; high score:
HR<inf>adj</inf>: 2.90 [95% CI: 2.47-3.40]), and for complex
revascularization (intermediate: HR<inf>adj</inf>: 1.33 [95% CI:
1.06-1.67]; high score: HR<inf>adj</inf>: 2.07 [95% CI: 1.52-2.83]) and
its components (P<inf>trend</inf> <0.05 for each). The number of elevated
biomarkers also correlated with the presence of left main disease,
multivessel disease, or chronic total occlusion at the time of
revascularization (P < 0.05 for each). Conclusion(s): A
biomarker-based strategy identifies stable patients at risk for coronary
events, including coronary artery bypass graft surgery and complex
percutaneous coronary intervention, and predicts high-risk coronary
anatomy at the time of revascularization. These findings provide insight
into the relationships between cardiovascular biomarkers, coronary
anatomical complexity, and incident clinical events. (Further
Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With
Elevated Risk [FOURIER]; NCT01764633) Copyright © 2022 American
College of Cardiology Foundation

<105>
[Use Link to view the full text]
Accession Number
2019748622
Title
Impact of chronic kidney disease on the prognosis of transcatheter aortic
valve replacement in patients with aortic stenosis: A protocol for
systematic review and meta-Analysis.
Source
Medicine (United States). 100(29) (pp E26696), 2021. Date of Publication:
23 Jul 2021.
Author
Wang J.; Liu S.; Han X.; Wan Z.; Chen Y.; Chen H.; Song B.
Institution
(Wang, Han, Chen, Chen) First Clinical Medical College of Lanzhou
University, Lanzhou University, Lanzhou, China
(Liu, Wan, Song) Department of Cardiovascular Surgery, First Hospital of
Lanzhou University, Lanzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:The prognosis of patients with aortic stenosis, in conjunction
with chronic kidney disease (CKD), after transcatheter aortic valve
replacement (TAVR) remains unclear. This study assessed the impact of CKD,
and different stages of CKD, on prognosis of patients undergoing TAVR.
 Method(s):The protocol was written following the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses Protocols statement
guidelines. As of June 2021, we performed a comprehensive literature
search on studies related to CKD and TAVR, using databases such as PubMed,
Embase, Cochrane Library, and Web of Science. Two researchers
independently screened the literature, extracted the data, and evaluated
the risk of bias in the included studies. Then, Stata 15.0 software was
used for meta-Analysis.Results and Conclusion(s):The purpose of this
study was to evaluate the effect of CKD and different stages of CKD on the
prognosis of patients with TAVR. It is hoped to provide a comprehensive
reference for clinical practice and related clinical trials in the
future. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<106>
Accession Number
2019734816
Title
Risk Factors for Hospital Readmission Post-Transcatheter Aortic Valve
Implantation in the Contemporary Era: A Systematic Review.
Source
CJC Open. (no pagination), 2022. Date of Publication: 2022.
Author
Patel R.V.; Ravindran M.; Manoragavan R.; Sriharan A.; Wijeysundera H.C.
Institution
(Patel, Ravindran) Temerty Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
(Patel, Sriharan, Wijeysundera) Institute for Health Policy, Management,
and Evaluation, University of Toronto, Toronto, ON, Canada
(Manoragavan, Wijeysundera) Division of Cardiology, Department of
Medicine, Schulich Heart Program, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Wijeysundera) Sunnybrook Research Institute, University of Toronto,
Toronto, ON, Canada
(Wijeysundera) Institute for Clinical Evaluative Sciences, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Despite transcatheter aortic valve implantation (TAVI)
becoming a widely accepted therapeutic option for the management of aortic
stenosis, post-procedure readmission rates remain high. Rehospitalization
is associated with negative patient outcomes, as well as increased
healthcare costs, and has therefore been identified as an important target
for quality improvement. Strategies to reduce the post-TAVI readmission
rate are needed but require the identification of patients at high risk
for rehospitalization. Our systematic review aims to identify predictors
of post-procedure readmission in patients eligible for TAVI.
 Method(s): We conducted a comprehensive search of the MEDLINE,
Embase, and Cochrane Central Register of Controlled Trials (CENTRAL)
databases for the time period from 2015 to the present for articles
evaluating risk factors for rehospitalization post-TAVI with a follow-up
period of at least 30 days in adults age >= 70 years with aortic stenosis.
The quality of included studies was evaluated using the Newcastle-Ottawa
Scale. We present the results as a qualitative narrative review.
 Result(s): We identified 49 studies involving 828,528 patients.
Post-TAVI readmission is frequent, and rates vary (14.9% to 54.3% at 1
year). The most-frequent predictors identified for both 30-day and 1-year
post-TAVI readmission are atrial fibrillation, lung disease, renal
disease, diabetes mellitus, in-hospital life-threatening bleeding, and
non-femoral access. Conclusion(s): This systematic review identifies
the most-common predictors for 30-day and 1-year readmission post-TAVI,
including comorbidities and potentially modifiable procedural approaches
and complications. These predictors can be used to identify patients at
high-risk for readmission who are most likely to benefit from increased
support and follow-up post-TAVI. Copyright © 2022 The Authors

<107>
Accession Number
2018635316
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: 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, 6-1 Kishibeshimmachi, Osaka, Suita, 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, Osaka, Suita, Japan
(Numata, Yaku) Division of Cardiovascular Surgery, Kyoto Prefectural
University of Medicine, Kyoto, 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
Springer
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.

<108>
Accession Number
638745161
Title
Edoxaban vs. Vitamin K Antagonist for Atrial Fibrillation After
Transcatheter Aortic Valve Replacement in Japanese Patients- A Subanalysis
of the ENVISAGE-TAVI AF Trial.
Source
Circulation journal : official journal of the Japanese Circulation
Society. (no pagination), 2022. Date of Publication: 11 Aug 2022.
Author
Watanabe Y.; Hayashida K.; Yamamoto M.; Yamanaka F.; Yamasaki K.; Naganuma
T.; Ohno Y.; Yamawaki M.; Morioka N.; Mizutani K.; Tada N.; Ueno H.;
Nishina H.; Izumo M.; Nakajima Y.; Ando K.; Takagi K.; Kimura T.; Sugio
K.; Dangas G.; Van Mieghem N.M.; Hengstenberg C.; Chen C.; Jin J.;
Unverdorben M.; Saito S.
Institution
(Watanabe) Division of Cardiology, Teikyo University Hospital
(Hayashida) Department of Cardiology, Keio University School of Medicine
(Yamamoto) Department of Cardiology, Toyohashi Heart Center
(Yamanaka) Shonan Kamakura General Hospital
(Yamasaki) Sapporo Higashi Tokushukai Hospital
(Naganuma) New Tokyo Hospital
(Ohno) Tokai University Hospital
(Yamawaki) Saiseikai Yokohama City Eastern Hospital
(Morioka) Department of Cardiology, Kishiwada Tokushukai Hospital
(Mizutani) Department of Cardiovascular Medicine, Osaka City University
Hospital
(Tada) Department of Cardiology, Sendai Kousei Hospital
(Ueno) Department of Cardiology, Toyama University Hospital
(Nishina) Department of Cardiology, Tsukuba Medical Center Hospital
(Izumo) Division of Cardiology, St. Marianna University School of Medicine
Hospital
(Nakajima) Division of Cardiology, Iwate Medical University
(Ando) Department of Cardiology, Kokura Memorial Hospital
(Takagi) Department of Cardiology, Ogaki Municipal Hospital
(Kimura, Sugio) Daiichi Sankyo Co., Ltd
(Dangas) Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai
Hospital
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Thoraxcenter
(Hengstenberg) Division of Cardiology, Vienna General Hospital, Medical
University
(Chen, Jin, Unverdorben) Daiichi Sankyo, Inc
(Saito) Division of Cardiology & Catheterization Laboratories, Shonan
Kamakura General Hospital
Publisher
NLM (Medline)
Abstract
BACKGROUND: Japanese patients undergoing transcatheter aortic valve
replacement (TAVR) are often female and have a small body size,
potentially impacting bleeding risk with antithrombotic therapy. Outcomes
of direct oral anticoagulant use in these patients with atrial
fibrillation (AF) need to be clarified.Methods and Results: This
prespecified analysis included Japanese patients from ENVISAGE-TAVI AF, a
prospective, randomized, open-label, adjudicator-masked trial that
compared treatment with edoxaban and vitamin K antagonists (VKAs) in
patients with AF after TAVR. The primary efficacy and safety outcomes were
net adverse clinical events (NACE; composite of all-cause death,
myocardial infarction, ischemic stroke, systemic embolic event, valve
thrombosis, and International Society on Thrombosis and Haemostasis
[ISTH]-defined major bleeding) and ISTH-defined major bleeding,
respectively. Intention-to-treat (ITT) and on-treatment analyses were
performed. Overall, 159 Japanese patients were enrolled (edoxaban group:
82, VKA group: 77) and followed for on average 483 days. Mean patient age
was 83.8 years; 52.2% were female. In the ITT analysis, NACE rates were
10.9%/year with edoxaban and 12.5%/year with VKA (hazard ratio [HR], 0.85;
95% confidence interval [CI], 0.38-1.90); major bleeding occurred in
8.9%/year and 7.3%/year, respectively (HR, 1.17; 95% CI, 0.45-3.05). In
edoxaban- and VKA-treated patients, rates of ischemic stroke were
1.8%/year and 1.0%/year, respectively; fatal bleeding rates were 0.9%/year
and 2.0 %/year. On-treatment results were similar to ITT.
 CONCLUSION(S): In Japanese patients with AF after successful TAVR,
edoxaban and VKA treatment have similar safety and efficacy profiles.

<109>
Accession Number
2017379566
Title
Choice of Respiratory Support During Cardiac Bypass in Cardiac Surgical
Patients (Pilot Study).
Source
Obshchaya Reanimatologiya. 18(3) (pp 4-10), 2022. Date of Publication:
2022.
Author
Kirillov A.Yu.; G.yavorovsky A.; A.vyzhigina M.; Komarov R.N.; Nogtev
P.V.; Bagdasarov P.S.; Yavorovskaya D.A.; Khalikova E.Yu.; Bulanova E.L.;
Miyerbekov Y.M.
Institution
(Kirillov, G.yavorovsky, A.vyzhigina, Komarov, Nogtev, Bagdasarov,
Yavorovskaya, Khalikova, Bulanova) I. M. Sechenov First Moscow State
Medical University, Ministry of Health of Russia, 8 Trubetskaya Str.,
Bldg. 2, Moscow 119991, Russian Federation
(Miyerbekov) A.N. Syzganov National Scientific Center for Surgery, 62
Zheltoksan Str, Almaty 050000, Kazakhstan
Publisher
V.A. Negovsky Research Institute of General Reanimatology
Abstract
Currently, there is no uniform respiratory support strategy during
cardiopulmonary bypass (CPB) in cardiac anesthesiology. The aim of the
study was to examine possible variants of respiratory support during CPB
and determine the most effective technique capable to reduce the incidence
of postoperative pulmonary complications. Material and methods. Ninety
cardiac surgery patients were enrolled in the pilot study and divided into
groups (CPAP, VC, and apnea). In the CPAP group, positive airway pressure
of + 5 cm H<inf>2</inf>O was maintained during CPB. The VC group patients
underwent mechanical ventilation during CPB with a reduced tidal volume of
3 mL/kg, respiratory rate of 6/min, and REER of + 5 cm H<inf>2</inf>O. In
the apnea group, patients received no respiratory support (non-rebreathing
system). Results. In both the apnea and CPAP (constant positive airway
pressure) group, there was a decrease in oxygenation index (OI) at the end
of the CPB compared with baseline values. In the apnea group, the OI
dropped from 316.31+/-81.76 to 230.10+/-102.48, while in the CPAP group it
decreased from 319.37+/-80.01 to 223.17+/-152.36 (P<0.001). No significant
changes in this parameter were observed in the VC group. The frequency of
recruitment maneuvers after CPB to correct the impaired respiratory
oxygenation was maximal in patients from apnea group (22 cases (73%)
versus 13 cases (43%) in the CPAP group and 5 cases (16%) in the VC group)
(P<0.001). Frequency of pulmonary atelectasis on chest radiology in
postoperative period was 47, 37, 10% in apnea, CPAP, and VC groups,
respectively, and the difference was also significant (P=0.006).
Conclusion. Low-volume ventilation is the preferable method of respiratory
support in cardiac surgery patients during CPB. Copyright © 2022,
V.A. Negovsky Research Institute of General Reanimatology. All rights
reserved.

<110>
Accession Number
2017204219
Title
New-Onset Atrial Fibrillation After Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 15(6) (pp 603-613), 2022. Date of
Publication: 28 Mar 2022.
Author
Ryan T.; Grindal A.; Jinah R.; Um K.J.; Vadakken M.E.; Pandey A.; Jaffer
I.H.; Healey J.S.; Belley-Cote E.P.; McIntyre W.F.
Institution
(Ryan, Grindal, Jinah, Um, Healey, Belley-Cote, McIntyre) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Vadakken, Healey, Belley-Cote, McIntyre) Population Health Research
Institute, McMaster University, Hamilton, ON, Canada
(Pandey) Department of Medicine, University of Ottawa, Ottawa, ON, Canada
(Jaffer) Department of Surgery, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: The authors aimed to identify risk factors and outcomes
associated with new-onset atrial fibrillation (NOAF) after transcatheter
aortic valve replacement (TAVR). Background(s): NOAF is a common
complication after TAVR, although estimates of the precise occurrence are
variable. This study sought to quantify the occurrence of NOAF after TAVR
and to explore the outcomes and predictors associated with this
complication. Method(s): We searched Medline, EMBASE, and the
Cochrane database from 2016 to 2020 for articles that reported NOAF after
TAVR. We extracted data for studies published before 2016 from a previous
systematic review. We pooled data using a random effects model.
 Result(s): We identified 179 studies with 241,712 total participants
(55,271 participants with pre-existing atrial fibrillation (AF) were
excluded) that reported NOAF from 2008 to 2020. The pooled occurrence of
NOAF after TAVR was 9.9% (95% CI: 8.1%-12%). NOAF after TAVR was
associated with a longer index hospitalization (mean difference = 2.66
days; 95% CI: 1.05-4.27), a higher risk of stroke in the first 30 days
(risk ratio [RR]: 2.35; 95% CI: 2.12-2.61), 30-day mortality (RR: 1.76;
95% CI: 1.12-2.76), major or life-threatening bleeding (RR: 1.60; 95% CI:
1.39-1.84), and permanent pacemaker implantation (RR: 1.12; 95% CI:
1.05-1.18). Risk factors for the development of NOAF after TAVR included
higher Society of Thoracic Surgeons score, transapical access, pulmonary
hypertension, chronic kidney disease, peripheral vascular disease, and
severe mitral regurgitation, suggesting that the risk for NOAF is highest
in more comorbid TAVR patients. Conclusion(s): NOAF is common after
TAVR. Whether AF after TAVR is a causal factor or a marker of sicker
patients remains unclear. Copyright © 2022 American College of
Cardiology Foundation

<111>
Accession Number
2016606595
Title
Acetate- versus lactate-buffered crystalloid solutions: A systematic
review with meta-analysis and trial sequential analysis.
Source
Acta Anaesthesiologica Scandinavica. 66(7) (pp 782-794), 2022. Date of
Publication: August 2022.
Author
Ellekjaer K.L.; Perner A.; Sivapalan P.; Moller M.H.
Institution
(Ellekjaer, Perner, Sivapalan, Moller) Department of Intensive Care 4131,
Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Objective: There is a widespread use of buffered crystalloid solutions in
clinical practice. However, guidelines do not distinguish between specific
types of buffered solutions and clinical equipoise exists. We aimed to
assess the desirable and undesirable effects of acetate- versus
lactate-buffered solutions in hospitalised patients. Method(s): We
conducted a systematic review with meta-analysis and trial sequential
analysis of randomised clinical trials assessing the use of acetate-
versus lactate-buffered solutions for intravenous administration in
hospitalised adults and children. The primary outcome was all-cause
short-term mortality. We adhered to our published protocol, the Preferred
Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)
statement, the Cochrane Handbook and the Grading of Recommendations,
Assessment, Development and Evaluation (GRADE) methodology.
 Result(s): We included five RCTs enrolling 390 patients. We found no
statistically significant difference in short-term mortality (random
effects, risk ratio [RR] 0.29; 95% confidence interval [CI] 0.06-1.51, p
=.14, I2 = 0%) or hospital length of stay (LOS) (random
effects, mean difference [MD]-1.31, 95% CI -3.66 to 1.05, p =.28,
I2 = 0%) between acetate- versus lactate-buffered solutions.
The quality of evidence was very low. Data regarding intensive care unit
LOS were reported by three trials and duration of vasopressor treatment by
one trial; none of these data allowed for pooling in meta-analyses. No
trials reported data on long-term mortality, health-related quality of
life, adverse events, duration of mechanical ventilation or renal
replacement therapy. Conclusion(s): In this systematic review, we
found very low quantity and quality of evidence on the use of acetate-
versus lactate-buffered solutions in hospitalised patients. Copyright
© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by
John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica
Foundation.

<112>
Accession Number
2019333025
Title
Etiology, Pathophysiology and Mortality of Shock in Children in Low
(Middle) Income Countries: A Systematic Review.
Source
Journal of Tropical Pediatrics. 68(4) (no pagination), 2022. Date of
Publication: 01 Aug 2022.
Author
Assies R.; Snik I.; Kumwenda M.; Chimalizeni Y.; Langton J.; Van Woensel
J.B.M.; Doctor A.; Calis J.C.J.
Institution
(Assies, Snik, Van Woensel, Calis) Amsterdam Umc Location University Of
Amsterdam, Picu, Emma Children's Hospital, Meibergdreef 9, Amsterdam,
Netherlands
(Assies, Van Woensel, Calis) Amsterdam Centre For Global Child Health,
Amsterdam, Netherlands
(Assies, Kumwenda, Chimalizeni, Langton, Calis) Department Of Paediatrics
And Child Health, Kamuzu University Of Health Sciences KUHeS Malawi,
Blantyre, Malawi
(Doctor) University Of Maryland School Of Medicine, Baltimore, MD, United
States
Publisher
Oxford University Press
Abstract
Objectives: Shock is a life-threatening condition in children in low- and
middle-income countries (LMIC), with several controversies. This
systematic review summarizes the etiology, pathophysiology and mortality
of shock in children in LMIC. Method(s): We searched for studies
reporting on children with shock in LMIC in PubMed, Embase and through
snowballing (up to 1 October 2019). Studies conducted in LMIC that
reported on shock in children (1 month-18 years) were included. We
excluded studies only containing data on neonates, cardiac surgery
patients or iatrogenic causes. We presented prevalence data, pooled
mortality estimates and conducted subgroup analyses per definition, region
and disease. Etiology and pathophysiology data were systematically
collected. Result(s): We identified 959 studies and included 59
studies of which six primarily studied shock. Definitions used for shock
were classified into five groups. Prevalence of shock ranged from 1.5% in
a pediatric hospital population to 44.3% in critically ill children.
Pooled mortality estimates ranged between 3.9-33.3% for the five
definition groups. Important etiologies included gastroenteritis, sepsis,
malaria and severe anemia, which often coincided. The pathophysiology was
poorly studied but suggests that in addition to hypovolemia, dissociative
and cardiogenic shock are common in LMIC. Conclusion(s): Shock is
associated with high mortality in hospitalized children in LMIC. Despite
the importance few studies investigated shock and as a consequence limited
data on etiology and pathophysiology of shock is available. A uniform
bedside definition may help boost future studies unravelling shock
etiology and pathophysiology in LMIC. Copyright © 2022 The
Author(s). Published by Oxford University Press. All rights reserved.

<113>
Accession Number
2019315413
Title
Levosimendan in paediatric cardiac anaesthesiology: A systematic review
and meta-analysis.
Source
European Journal of Anaesthesiology. 39(8) (pp 646-655), 2022. Date of
Publication: 01 Aug 2022.
Author
Lapere M.; Rega F.; Rex S.
Institution
(Lapere, Rex) Department of Anaesthesiology, University Hospitals Leuven,
Herestraat 49, Leuven 3000, Belgium
(Lapere, Rex) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Rega) Department of Cardiac Surgery, University Hospitals Leuven, Leuven,
Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDLow cardiac output syndrome (LCOS) after congenital cardiac
surgery has an incidence of up to 25%. Preventing and treating LCOS is of
pivotal importance as LCOS is associated with excess morbidity and
mortality.OBJECTIVESThis systematic review assesses the safety and
efficacy of peri-operative levosimendan administration in the setting of
paediatric cardiac surgery.DESIGNSystematic review of randomised
controlled trials. Meta-analyses were performed on efficacy and
exploratory outcomes.DATA SOURCESLiterature was searched in the following
databases (MEDLINE, EMBASE, Web of Science and CENTRAL) from inception to
July 2021.ELIGIBILITY CRITERIARandomised controlled trials comparing
levosimendan with other inotropes or placebo in children younger than 18
years of age undergoing cardiac surgery.RESULTSNine studies enrolling a
total of 539 children could be included in the systematic review. All
trials study the prophylactic administration of levosimendan in comparison
with placebo (n = 2), milrinone (n = 6) or dobutamine (n = 1).
Levosimendan dosing varied considerably with only three studies using a
loading dose. Levosimendan reduced the incidence of LCOS [risk ratio (RR)
0.80] [95% confidence interval (CI), 0.40 to 0.89, P = 0.01] and increased
cardiac index (MD 0.17 l min-1 m-2) (95% CI, 0.06 to
0.28, P = 0.003) without affecting other outcomes (mortality, ICU length
of stay, hospital length of stay, duration of mechanical ventilation,
serum lactate, central venous oxygen saturation, serum creatine or acute
kidney injury).CONCLUSIONThe prophylactic use of levosimendan in children
undergoing cardiac surgery reduced the incidence of LCOS and increased
cardiac index compared with other inotropes or placebo. This effect did
not translate into an improvement of other clinical
endpoints. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<114>
Accession Number
2019229475
Title
Bartonella and Coxiella infections presenting as systemic vasculitis: Case
series and review of literature.
Source
Rheumatology (United Kingdom). 61(6) (pp 2609-2618), 2022. Date of
Publication: 01 Jun 2022.
Author
Beydon M.; Rodriguez C.; Karras A.; Cez A.; Rafat C.; Jourde-Chiche N.;
Fain O.; Philipponnet C.; Puechal X.; Dossier A.; Dupin N.; Levy D.;
Aureau I.; Guillevin L.; Terrier B.
Institution
(Beydon, Puechal, Guillevin, Terrier) Departement de Medecine Interne,
Centre de Reference National Pour les Maladies Auto-immunes Systemiques
Rares, Hopital Cochin, Assistance Publique-Hopitaux de Paris, Paris,
France
(Rodriguez) Departement de Virologie, Hopital Henri Mondor, Universite
Paris-Est, Creteil, France
(Karras) Unite de Nephrologie, Hopital Europeen Georges-Pompidou,
Assistance Publique-Hopitaux de Paris, Paris, France
(Karras, Terrier) Universite de Paris, Faculte de Medecine, Paris, France
(Cez) Service de Nephrologie et Dialyse, Hopital Tenon (AP-HP), Paris,
France
(Rafat) Service des Urgences Nephrologiques et Transplantation Renale,
Assistance Publique-Hopital de Paris, Paris, France
(Jourde-Chiche) Aix-Marseille Univ, C2VN, INSERM, INRAE, Centre de
Nephrologie et de Transplantation Renale, Hopital de la Conception AP-HM,
Marseille, France
(Fain) Departement de Medecine Interne, Hopital Saint-Antoine, Assistance
Publique-Hopitaux de Paris, Paris, France
(Philipponnet) Departement de Nephrologie et de Dialyse, Chu Clermont
Ferrand, Clermont-Ferrand, France
(Dossier) Service de Medecine Interne, Hopital Bichat, Paris, France
(Dupin) Departement de Dermatologie, Hopital Cochin, Assistance
Publique-Hopitaux de Paris, Paris, France
(Levy) Service de Rhumatologie, Chu Strasbourg, Strasbourg, France
(Aureau) Service de Medecine Interne, Centre Hospitalier de Pau, Pau,
France
Publisher
Oxford University Press
Abstract
Objectives: Coxiella and Bartonella spp. display particular tropism for
endothelial or endocardial tissues and an abnormal host response to
infections with induced autoimmunity. We aimed, through a case series
combined with a comprehensive literature review, to outline
characteristics of Coxiella and Bartonella infections presenting as
systemic vasculitis. Method(s): We retrospectively included cases of
definite Coxiella and Bartonella infections presenting with vasculitis
features and performed a comprehensive literature review. Result(s):
Six cases of Bartonella infections were added to 18 cases from literature
review. Causative pathogens were mainly B. henselae. Bartonella infection
mimicked ANCA-Associated vasculitis in 83% with PR3-ANCA and presented as
cryoglobulinaemic vasculitis in 8%. GN was present in 92%, and 88% had
endocarditis. Complement fractions were low in 82% and rheumatoid factor
positive in 85%. Kidney biopsies showed cell proliferation, mostly
crescentic, with pauci-immune GN in 29%. Outcome was favourable, with the
use of antibiotics alone in one-Third. Five cases of Coxiella infections
were added to 16 from literature review. Sixteen had small-vessel
vasculitides, mainly cryoglobulinaemia vasculitis in 75%. One patient had
polyarteritis nodosa-like vasculitis and four large-vessel vasculitis.
Outcome was good except for one death. A highly sensitive next generation
sequencing analysis on three Coxiella-and two Bartonella-related
vasculitides biopsies did not find any bacterial DNA. Conclusion(s):
Coxiella and Bartonella are both able to induce vasculitis but display
distinct vasculitis features. Bartonella mimics PR3-ANCA-Associated
vasculitis in the setting of endocarditis, whereas Coxiella may induce
vasculitis involving all vessel sizes. Copyright © 2021 The
Author(s) 2021. Published by Oxford University Press on behalf of the
British Society for Rheumatology. All rights reserved.

<115>
Accession Number
2018871232
Title
Direct oral anticoagulants in atrial fibrillation following cardiac
surgery: a systematic review and meta-analysis with trial sequential
analysis.
Source
British Journal of Anaesthesia. 129(2) (pp 154-162), 2022. Date of
Publication: August 2022.
Author
Koh K.K.; Ling R.R.; Tan S.Y.S.; Chen Y.; Fan B.E.; Shekar K.; Sule J.A.;
Subbian S.K.; Ramanathan K.
Institution
(Koh, Ling, Tan, Ramanathan) Yong Loo Lin School of Medicine, National
University of Singapore, Singapore
(Chen) Agency for Science, Technology and Research, Singapore
(Fan) Department of Haematology, Tan Tock Seng Hospital, Singapore
(Shekar) Adult Intensive Care Services, Prince Charles Hospital, Brisbane,
QLD, Australia
(Shekar) Queensland University of Technology, Brisbane, QLD, Australia
(Shekar) University of Queensland, Brisbane, QLD, Australia
(Shekar) Bond University, Gold Coast, QLD, Australia
(Sule, Subbian) Department of Cardiac, Thoracic, and Vascular Surgery,
National University Heart Centre, National University Hospital, Singapore
(Ramanathan) Cardiothoracic Intensive Care Unit, National University Heart
Centre, National University Hospital, Singapore
Publisher
Elsevier Ltd
Abstract
Background: Direct oral anticoagulants (DOACs) have been increasingly used
as anticoagulation therapy in the postoperative period. However, their
effectiveness in post-cardiac surgical atrial fibrillation is yet to be
determined. Method(s): We conducted a meta-analysis, searching three
international databases from 1 January 2003 to 26 January 2022 for studies
reporting on DOACs in at least 10 adult patients (>18 yr of age) with
post-cardiac surgical atrial fibrillation. The primary outcomes were major
neurological events and bleeding; secondary outcomes were mortality,
hospital and ICU length of stay, cost, and other complications from
therapy. We included studies of any design, including RCTs, cohort studies
with and without propensity score matching methods, and single-armed case
series. Result(s): Twelve studies (8587 DOACs; 8315 warfarin) were
included in this meta-analysis. The incidences of postoperative bleeding
and major neurological events with DOACs were 7.3% (95% confidence
interval [CI]: 3.4-14.7%) and 2.2% (95% CI: 0.9-4.9%), respectively. The
incidence of major neurological events was lower in high-risk patients,
including those with hypertension and higher
CHA<inf>2</inf>DS<inf>2</inf>-VASc score, whereas patients with prior
transient ischaemic attack or stroke had higher incidence of bleeding.
Trial sequential analysis revealed that the cumulative Z-curve crossed the
conventional boundary of benefit. Compared with warfarin, DOACs reduced
the risk of bleeding (relative risk [RR] 0.74; 95% CI: 0.62-0.89;
P=0.0011) and major neurological events (RR 0.63; 95% CI: 0.48-0.83;
P=0.0012) but not mortality (RR 1.02; 95% CI: 0.77-1.35; P=0.090).
 Conclusion(s): DOACs reduced bleeding and major neurological events
in patients with post-cardiac surgical atrial fibrillation, appearing
safer than warfarin in this context. However, which specific DOAC provides
the most effective anticoagulation in this patient population needs
further investigation. Clinical trial registration: PROSPERO
CRD42021282777. Copyright © 2022 British Journal of Anaesthesia

<116>
Accession Number
2018285367
Title
Effect of preoperative ultrasound mapping of the saphenous vein on leg
wound complications after coronary artery bypass surgery: a systematic
review.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 21.
Date of Publication: December 2022.
Author
Media A.S.; Rajendran R.; Kimose H.H.; El-Akkawi A.I.
Institution
(Media, Rajendran, Kimose, El-Akkawi) Department of Cardiothoracic and
Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Blvd 99,
Aarhus N 8200, Denmark
(Kimose) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The long saphenous vein is one of the most used conduits for
coronary artery bypass graft surgery. The aim of this study was to assess
the existing evidence regarding the effects of preoperative ultrasound
mapping of the long saphenous vein with special attention to leg wound
complications in patients undergoing elective coronary artery bypass graft
surgery. Main text: A systematic literature search was conducted in
PubMed, Cochrane, and Embase databases. Extraction of relevant data was
performed including study characteristics, patient characteristics, and
all reported outcomes. The Cochrane Risk of Bias tool was used to evaluate
the risk of bias of the included studies. The primary outcome measure was
leg wound infections. Of 4514 papers screened in this systematic review,
36 papers underwent full-text assessment with final inclusion of 5
studies; 3 observational studies, and 2 randomized trials. The two
randomized controlled trials showed no effects of preoperative ultrasound.
Data from the three non-randomized studies was pooled in a meta-analysis,
which suggested a significant reduction in the risk of harvest wound
complications by ultrasound mapping prior to surgery (RR 0.32; 95%CI =
[0.19-0.55]). Conclusion(s): The main findings of this systematic
review showed, that (1) the evidence in this field is limited and of low
quality, i.e., low power or methodology and (2) despite limitations of the
included studies, preoperative ultrasound mapping of the saphenous vein
seems to be beneficial in terms of reducing the risk of postoperative leg
wound complications. Copyright © 2022, The Author(s).

<117>
Accession Number
2018027342
Title
Fibrinolytic therapy for prosthetic valve thrombosis: Is the end of
controversial story?.
Source
Journal of Cardiac Surgery. 37(9) (pp 2931-2932), 2022. Date of
Publication: September 2022.
Author
Guner A.; Gunduz S.; Ozkan M.
Institution
(Guner) Department of Cardiology, University of Health Sciences, Mehmet
Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research
Hospital, Istanbul, Turkey
(Gunduz) Department of Cardiology, Faculty of Medicine, Bahcesehir
University, Istanbul, Turkey
(Ozkan) Department of Health Sciences, Faculty of Health Sciences, Ardahan
University, Ardahan, Turkey
Publisher
John Wiley and Sons Inc

<118>
Accession Number
2017926205
Title
When the description of physiology adds to the morphological diagnosis and
guides the analysis of clinical and surgical management.
Source
Journal of Cardiac Surgery. 37(9) (pp 2835-2836), 2022. Date of
Publication: September 2022.
Author
Aiello V.D.; Assad R.S.
Institution
(Aiello) Laboratory of Pathology, Heart Institute (InCor), Faculdade de
Medicina da Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil
(Assad) Division of Cardiac Surgery, Heart Institute (InCor), University
of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc

<119>
Accession Number
2017586995
Title
Clinical Impact of Tricuspid Regurgitation on Transcatheter Edge-to-Edge
Mitral Valve Repair for Mitral Regurgitation.
Source
Cardiovascular Revascularization Medicine. 41 (pp 1-9), 2022. Date of
Publication: August 2022.
Author
Chitturi K.R.; Bhardwaj B.; Murtaza G.; Karuparthi P.R.; Faza N.N.; Goel
S.S.; Reardon M.J.; Kleiman N.S.; Aggarwal K.
Institution
(Chitturi, Bhardwaj, Murtaza, Karuparthi, Aggarwal) Division of
Cardiovascular Medicine, University of Missouri-Columbia School of
Medicine, Columbia, MO, United States
(Karuparthi, Aggarwal) Harry S. Truman Memorial Veterans Hospital,
Columbia, MO, United States
(Faza, Goel, Kleiman) Department of Cardiology, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study aimed to evaluate whether baseline tricuspid
regurgitation (TR) impacted clinical outcomes after mitral valve
transcatheter edge-to-edge repair (M-TEER) for severe secondary mitral
regurgitation (MR). Background(s): Baseline TR is common among
patients undergoing M-TEER for secondary MR, although its impact on
clinical outcomes is unclear. Method(s): The Cochrane Library,
PubMed/MEDLINE, and Google Scholar were searched according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines from January 1, 2011 through January 31, 2021. Randomized
controlled trials and nonrandomized prospective studies that evaluated
baseline TR by echocardiography before M-TEER for MR were included. The
primary outcome was a composite of mortality and heart failure
hospitalization (HFH) at 1-year. Result(s): A total of 5 studies (n =
1395 patients) were included in the primary analysis. Concurrent
moderate/severe TR was associated with a worse 1 year composite of
all-cause mortality and HFH (OR: 2.13; 95% CI: 1.12-4.05; p = 0.02) after
M-TEER for severe MR. In studies that reported TR grade pre- and
post-M-TEER for severe MR, 32% of patients with moderate-to-severe
baseline TR had a reduction in TR severity after the intervention.
 Conclusion(s): Baseline moderate-to-severe TR was associated with
increased 1-year mortality and heart failure hospitalizations among
patients undergoing M-TEER. Further randomized studies are needed to
assess the interaction of TR among patients undergoing
M-TEER. Copyright © 2022

<120>
Accession Number
636644938
Title
Psychological and pharmacological interventions for depression in patients
with coronary artery disease.
Source
Cochrane Database of Systematic Reviews. 2021(12) (no pagination), 2021.
Article Number: CD008012. Date of Publication: 15 Dec 2021.
Author
Tully P.J.; Ang S.Y.; Lee E.J.L.; Bendig E.; Bauereiss N.; Bengel J.;
Baumeister H.
Institution
(Tully, Ang, Lee) School of Medicine, University of Adelaide, Adelaide,
Australia
(Bendig, Bauereis, Baumeister) Department of Clinical Psychology and
Psychotherapy Institute of Psychology and Education, Ulm University, Ulm,
Germany
(Bengel) Department of Rehabilitation Psychology and Psychotherapy,
Institute of Psychology, University of Freiburg, Freiburg, Germany
Publisher
John Wiley and Sons Ltd
Abstract
Background: Depression occurs frequently in individuals with coronary
artery disease (CAD) and is associated with a poor prognosis.
 Objective(s): To determine the effects of psychological and
pharmacological interventions for depression in CAD patients with comorbid
depression. Search Method(s): We searched the CENTRAL, MEDLINE,
Embase, PsycINFO, and CINAHL databases up to August 2020. We also searched
three clinical trials registers in September 2021. We examined reference
lists of included randomised controlled trials (RCTs) and contacted
primary authors. We applied no language restrictions. Selection
Criteria: We included RCTs investigating psychological and pharmacological
interventions for depression in adults with CAD and comorbid depression.
Our primary outcomes included depression, mortality, and cardiac events.
Secondary outcomes were healthcare costs and utilisation, health-related
quality of life, cardiovascular vital signs, biomarkers of platelet
activation, electrocardiogram wave parameters, non-cardiac adverse events,
and pharmacological side effects. Data Collection and Analysis: Two
review authors independently examined the identified papers for inclusion
and extracted data from the included studies. We performed random-effects
model meta-analyses to compute overall estimates of treatment outcomes.
 Main Result(s): Thirty-seven trials fulfilled our inclusion criteria.
Psychological interventions may result in a reduction in end-of-treatment
depression symptoms compared to controls (standardised mean difference
(SMD) -0.55, 95% confidence interval (CI) -0.92 to -0.19, I2 =
88%; low certainty evidence; 10 trials; n = 1226). No effect was evident
on medium-term depression symptoms one to six months after the end of
treatment (SMD -0.20, 95% CI -0.42 to 0.01, I2 = 69%; 7 trials;
n = 2654). The evidence for long-term depression symptoms and depression
response was sparse for this comparison. There is low certainty evidence
that psychological interventions may result in little to no difference in
end-of-treatment depression remission (odds ratio (OR) 2.02, 95% CI 0.78
to 5.19, I2 = 87%; low certainty evidence; 3 trials; n = 862).
Based on one to two trials per outcome, no beneficial effects on mortality
and cardiac events of psychological interventions versus control were
consistently found. The evidence was very uncertain for end-of-treatment
effects on all-cause mortality, and data were not reported for
end-of-treatment cardiovascular mortality and occurrence of myocardial
infarction for this comparison. In the trials examining a head-to-head
comparison of varying psychological interventions or clinical management,
the evidence regarding the effect on end-of-treatment depression symptoms
is very uncertain for: cognitive behavioural therapy compared to
supportive stress management; behaviour therapy compared to person-centred
therapy; cognitive behavioural therapy and well-being therapy compared to
clinical management. There is low certainty evidence from one trial that
cognitive behavioural therapy may result in little to no difference in
end-of-treatment depression remission compared to supportive stress
management (OR 1.81, 95% CI 0.73 to 4.50; low certainty evidence; n = 83).
Based on one to two trials per outcome, no beneficial effects on
depression remission, depression response, mortality rates, and cardiac
events were consistently found in head-to-head comparisons between
psychological interventions or clinical management. The review suggests
that pharmacological intervention may have a large effect on
end-of-treatment depression symptoms (SMD -0.83, 95% CI -1.33 to -0.32,
I2 = 90%; low certainty evidence; 8 trials; n = 750).
Pharmacological interventions probably result in a moderate to large
increase in depression remission (OR 2.06, 95% CI 1.47 to 2.89,
I2 = 0%; moderate certainty evidence; 4 trials; n = 646). We
found an effect favouring pharmacological intervention versus placebo on
depression response at the end of treatment, though strength of evidence
was not rated (OR 2.73, 95% CI 1.65 to 4.54, I2 = 62%; 5
trials; n = 891). Based on one to four trials per outcome, no beneficial
effects regarding mortality and cardiac events were consistently found for
pharmacological versus placebo trials, and the evidence was very uncertain
for end-of-treatment effects on all-cause mortality and myocardial
infarction. In the trials examining a head-to-head comparison of varying
pharmacological agents, the evidence was very uncertain for
end-of-treatment effects on depression symptoms. The evidence regarding
the effects of different pharmacological agents on depression symptoms at
end of treatment is very uncertain for: simvastatin versus atorvastatin;
paroxetine versus fluoxetine; and escitalopram versus Bu Xin Qi. No trials
were eligible for the comparison of a psychological intervention with a
pharmacological intervention. Authors' conclusions: In individuals with
CAD and depression, there is low certainty evidence that psychological
intervention may result in a reduction in depression symptoms at the end
of treatment. There was also low certainty evidence that pharmacological
interventions may result in a large reduction of depression symptoms at
the end of treatment. Moderate certainty evidence suggests that
pharmacological intervention probably results in a moderate to large
increase in depression remission at the end of treatment. Evidence on
maintenance effects and the durability of these short-term findings is
still missing. The evidence for our primary and secondary outcomes, apart
from depression symptoms at end of treatment, is still sparse due to the
low number of trials per outcome and the heterogeneity of examined
populations and interventions. As psychological and pharmacological
interventions can seemingly have a large to only a small or no effect on
depression, there is a need for research focusing on extracting those
approaches able to substantially improve depression in individuals with
CAD and depression. Copyright © 2021 The Cochrane Collaboration.
Published by John Wiley & Sons, Ltd.

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