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<1>
Accession Number
2010930550
Title
Ticagrelor Monotherapy Versus Dual-Antiplatelet Therapy After PCI: An
Individual Patient-Level Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 14(4) (pp 444-456), 2021. Date of
Publication: 22 Feb 2021.
Author
Valgimigli M.; Mehran R.; Franzone A.; da Costa B.R.; Baber U.; Piccolo
R.; McFadden E.P.; Vranckx P.; Angiolillo D.J.; Leonardi S.; Cao D.;
Dangas G.D.; Mehta S.R.; Serruys P.W.; Gibson C.M.; Steg G.P.; Sharma
S.K.; Hamm C.; Shlofmitz R.; Liebetrau C.; Briguori C.; Janssens L.; Huber
K.; Ferrario M.; Kunadian V.; Cohen D.J.; Zurakowski A.; Oldroyd K.G.;
Yaling H.; Dudek D.; Sartori S.; Kirkham B.; Escaned J.; Windecker S.;
Pocock S.; Juni P.; Gibson M.C.; Kastrati A.; Krucoff M.; Ohman M.E.;
Gurbel P.; Henry T.D.; Moliterno D.; Heg D.; McFadden E.; Marx S.O.;
Darrow B.; Corvaja N.; DeStefano D.; Ghodsi N.; Meller J.; Franklin-Bond
T.; Cha J.Y.; Waseem Z.; Weisz G.; Kornowski R.; Oldroyd K.; Kaul U.;
Witzenbichler B.; Dzavik V.; Gil R.; Sardella G.; Benit E.; Diletti R.;
Dominici M.; Slagboom T.; Buszman P.; Bolognese L.; Tumscitz C.;
Bryniarski K.; Aminian A.; Vrolix M.; Petrov I.; Garg S.; Naber C.;
Prokopczuk J.; Steg P.G.
Institution
(Valgimigli, Windecker) Department of Cardiology, Bern University
Hospital, University of Bern, Bern, Switzerland
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Mehran, Baber, Cao, Dangas, Sharma, Sartori) Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Franzone, Piccolo) Department of Advanced Biomedical Sciences, University
of Naples Federico II, Naples, Italy
(da Costa, Kirkham, Juni) Applied Health Research Centre of the Li Ka
Shing Knowledge Institute, Department of Medicine, St. Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(McFadden) Cardialysis Core Laboratories and Clinical Trial Management,
Rotterdam, Netherlands
(McFadden) Department of Cardiology, Cork University Hospital, Cork,
Ireland
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Angiolillo, Ferrario) Division of Cardiology, University of Florida
College of Medicine, Jacksonville, FL, United States
(Leonardi) University of Pavia and Fondazione IRCCS Policlinico S. Matteo,
Pavia, Italy
(Mehta) McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Serruys) International Centre for Circulatory Health, National Heart and
Lung Institute, Imperial College, London, United Kingdom
(Gibson) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Steg) Universite de Paris and Hopital Bichat, Assistance
Publique-Hopitaux de Paris, Paris, France
(Hamm, Liebetrau) German Center for Cardiovascular Research, partner site
RheinMain, Frankfurt am Main, Germany
(Hamm, Liebetrau) Department of Cardiology, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Shlofmitz) Department of Cardiology, St. Francis Hospital, Roslyn, NY,
United States
(Briguori) Clinica Mediterranea, Naples, Italy
(Janssens) Imelda Hospital, Bonheiden, Belgium
(Huber) 3rd Medical Department, Cardiology and Intensive Care Medicine,
Wilhelminen Hospital, and Sigmund Freud University Medical School, Vienna,
Austria
(Kunadian) Translational and Clinical Research Institute, Faculty of
Medical Sciences, Newcastle University, and Cardiothoracic Centre, Freeman
Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle
upon Tyne, United Kingdom
(Cohen) Cardiovascular Research, Saint Luke's Mid America Heart Institute,
Kansas City, MO, United States
(Zurakowski) Department of Interventional Cardiology Chrzanow, Andrzej
Frycz Modrzewski Krakow University, Krakow, Poland
(Oldroyd) The West of Scotland Heart and Lung Centre, Golden Jubilee
National Hospital, Glasgow, United Kingdom
(Yaling) General Hospital of Northern Theater Command, Shenyang, Liaoning,
China
(Dudek) Institute of Cardiology, Jagiellonian University Medical College,
Krakow, Poland
(Dudek) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Escaned) Instituto de Investigacion Sanitaria del Hospital Clinico San
Carlos and Complutense University, Madrid, Spain
(Heg) Clinical Trials Unit, London School of Hygiene and Tropical
Medicine, London, United Kingdom
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to compare ticagrelor monotherapy
with dual-antiplatelet therapy (DAPT) after percutaneous coronary
intervention (PCI) with drug-eluting stents. Background(s): The role
of abbreviated DAPT followed by an oral P2Y<inf>12</inf> inhibitor after
PCI remains uncertain. Method(s): Two randomized trials, including
14,628 patients undergoing PCI, comparing ticagrelor monotherapy with
standard DAPT on centrally adjudicated endpoints were identified, and
individual patient data were analyzed using 1-step fixed-effect models.
The protocol was registered in PROSPERO (CRD42019143120). The primary
outcomes were the composite of Bleeding Academic Research Consortium type
3 or 5 bleeding tested for superiority and, if met, the composite of
all-cause death, myocardial infarction, or stroke at 1 year, tested for
noninferiority against a margin of 1.25 on a hazard ratio (HR) scale.
 Result(s): Bleeding Academic Research Consortium type 3 or 5 bleeding
occurred in fewer patients with ticagrelor than DAPT (0.9% vs. 1.7%,
respectively; HR: 0.56; 95% confidence interval [CI]: 0.41 to 0.75; p <
0.001). The composite of all-cause death, myocardial infarction, or stroke
occurred in 231 patients (3.2%) with ticagrelor and in 254 patients (3.5%)
with DAPT (HR: 0.92; 95% CI: 0.76 to 1.10; p < 0.001 for noninferiority).
Ticagrelor was associated with lower risk for all-cause (HR: 0.71; 95% CI:
0.52 to 0.96; p = 0.027) and cardiovascular (HR: 0.68; 95% CI: 0.47 to
0.99; p = 0.044) mortality. Rates of myocardial infarction (2.01% vs.
2.05%; p = 0.88), stent thrombosis (0.29% vs. 0.38%; p = 0.32), and stroke
(0.47% vs. 0.36%; p = 0.30) were similar. Conclusion(s): Ticagrelor
monotherapy was associated with a lower risk for major bleeding compared
with standard DAPT, without a concomitant increase in ischemic
events. Copyright © 2021 American College of Cardiology
Foundation

<2>
Accession Number
2018278516
Title
Prospective, randomized, controlled, noninferiority clinical trial to
evaluate the safety and efficacy of absorbable macroporous polysaccharide
composites as adjunct to hemostasis during open surgery.
Source
Journal of Cardiac Surgery. 37(10) (pp 3060-3069), 2022. Date of
Publication: October 2022.
Author
Li H.; Li Z.; He X.; Zhang F.; OuYang Z.; Wu G.; Liu P.; Yang S.; Dong L.;
Zhen M.; Xu L.
Institution
(Li, Xu) State Key Laboratory of Molecular Immunology and Molecular
Diagnostics, School of Public Health, Xiamen University, Xiamen, China
(Li) General Surgery, Peking University Third Hospital, Beijing, China
(He, Dong) General Surgery, Tianjin Medical University General Hospital,
Tianjin, China
(Zhang, OuYang) General Surgery, Breast Surgery, The First Affiliated
Hospital of Xiamen University, Xiamen, China
(Wu, Liu, Yang, Zhen) General Surgery, Hepatopancreatobiliary Surgery,
Breast Surgery, Zhongshan Hospital Affiliated to Xiamen University,
Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
Background: To address intraoperative bleeding in cardiac surgery,
reducing blood transfusion requirements, is mandatory to achieve effective
hemostasis. Hemostatic agents may limit localized persistent bleeding. The
introduction of carboxymethyl-chitosan component into the hemostatic agent
and the application of the radiation crosslinking technique maintain its
capacity for achieving intraoperative hemostasis, thus increasing the
clinical utility. Method(s): A prospective, noninferiority and
randomized controlled clinical trial to compare the safety and efficacy of
absorbable macroporous polysaccharide composites (AMPC, treatment group)
with compound microporous polysaccharide hemostatic powder (CMPHP, control
group) (2:1 ratio) as adjuncts to hemostasis in open surgery. The main
indication was used for hemostasis in various traumatic hemorrhage areas,
including cardiothoracic, vascular, and general surgery. The primary
endpoint was success rate of hemostasis within 300 s (at a 10%
noninferiority margin). The secondary endpoint was hemostasis time. Both
endpoints were assessed in the modified intention-to-treat (MITT)
population. Safety parameters were assessed. This study is fully compliant
with the CONSORT statement. Result(s): Randomized patients in AMPC
and CMPHP groups were 168 and 84, respectively. In MITT population, the
success rates of hemostasis within 300 s were 98.8% (163 of 165) in AMPC
and 94.0% (78 of 83) in CMPHP (treatment difference 4.8% [95% CI -0.57% to
10.20%]). AMPC was thus noninferior to CMPHP. Hemostasis time (median
[interquartile range]) with AMPC (87 [52.5, 180] s) was better than CMPHP
(110 [54.5, 181] s). Changes in laboratory parameters over time and shifts
to abnormal values were typical of surgeries and similar between two
groups. No noticeable adverse effects associated with AMPC or CMPHP were
observed. Conclusion(s): AMPC is well tolerated as topical hemostatic
agent, noninferior to commercial CMPHP, and exhibits excellent safety.
This study provides a novel hemostatic agent which appears to offer
significant clinical advantage in various hemorrhage areas. Copyright
© 2022 Wiley Periodicals LLC.

<3>
Accession Number
2017953489
Title
Renin-Angiotensin System Inhibitors in Patients With COVID-19: A
Meta-Analysis of Randomized Controlled Trials Led by the International
Society of Hypertension.
Source
Journal of the American Heart Association. 11(17) (no pagination), 2022.
Article Number: e026143. Date of Publication: 06 Sep 2022.
Author
Gnanenthiran S.R.; Borghi C.; Burger D.; Caramelli B.; Charchar F.;
Chirinos J.A.; Cohen J.B.; Cremer A.; Di Tanna G.L.; Duvignaud A.;
Freilich D.; Gommans D.H.F.; Gracia-Ramos A.E.; Murray T.A.; Pelorosso F.;
Poulter N.R.; Puskarich M.A.; Rizas K.D.; Rothlin R.; Schlaich M.P.;
Schreinlecher M.; Steckelings U.M.; Sharma A.; Stergiou G.S.; Tignanelli
C.J.; Tomaszewski M.; Unger T.; van Kimmenade R.R.J.; Wainford R.D.;
Williams B.; Rodgers A.; Schutte A.E.
Institution
(Gnanenthiran, Di Tanna, Rodgers, Schutte) The George Institute for Global
Health, University of New South Wales, Sydney, NSW, Australia
(Borghi) Department of Medical and Surgical Sciences, University of
Bologna, Italy
(Burger) Department of Cellular and Molecular Medicine, Kidney Research
Centre, Ottawa Hospital Research Institute, University of Ottawa, Canada
(Caramelli) Interdisciplinary Medicine in Cardiology Unit, InCor,
University of Sao Paulo, Brazil
(Charchar) School of Health and Life Sciences, Federation University
Australia, Ballarat, VIC, Australia
(Chirinos) Division of Cardiovascular Medicine, University of Pennsylvania
Perelman School of Medicine, Philadelphia, PA, United States
(Cohen) Renal-Electrolyte and Hypertension Division, Department of
Biostatistics, Epidemiology, and Informatics, University of Pennsylvania
Perelman School of Medicine, Philadelphia, PA, United States
(Cremer) Department of Cardiology and Hypertension, Hypertension
Excellence Center, Hopital Saint Andre, Centre Hospitalier Universitaire
de Bordeaux, University Bordeaux, Bordeaux, France
(Duvignaud) Department of Infectious Diseases and Tropical Medicine,
Division of Tropical Medicine and Clinical International Health, Hopital
Pellegrin, Centre Hospitalier Universitair University Bordeaux e de
Bordeaux, Bordeaux, France
(Freilich) Bassett Medical Center, Cooperstown, NY, United States
(Gommans, van Kimmenade) Department of Cardiology, Radboud University
Medical Center, Nijmegen, Netherlands
(Gommans, van Kimmenade) Netherlands Heart Institute, Utrecht, Netherlands
(Gracia-Ramos) Departamento de Medicina Interna, Hospital General, Centro
Medico Nacional "La Raza", Instituto Mexicano del Seguro Social, Mexico
City, Mexico
(Gracia-Ramos) Departamento de Medicina Interna, Hospital Regional de Alta
Especialidad de Zumpango, Estado de Mexico, Mexico
(Murray) Division of Biostatistics, School of Public Health, University of
Minnesota, Minneapolis, MN, United States
(Pelorosso, Rothlin) Asociacion Argentina de Medicamentos, Ciudad Autonoma
de Buenos Aires, Argentina
(Pelorosso) Servicio de Anatomia Patologica, Hospital de Alta Complejidad
El Calafate SAMIC, Santa Cruz, Argentina
(Poulter) Imperial Clinical Trials Unit, Imperial College London, London,
United Kingdom
(Puskarich) Department of Emergency Medicine Hennepin County Medical
Center, University of Minnesota, Minneapolis, MN, United States
(Rizas) Medizinische Klinik und Poliklinik I, Ludwig Maximilian University
Hospital Munich, Munich, Germany
(Rothlin) Sociedad Argentina de Farmacologia Clinica, Asociacion Medica
Argentina, Buenos Aires, Argentina
(Schlaich) Dobney Hypertension Centre, Medical School, Royal Perth
Hospital Unit- Royal Perth Hospital Medical Research Foundation,
University of Western Australia, Perth, Australia
(Schreinlecher) Department of Internal Medicine III, Cardiology and
Angiology, Medical University of Innsbruck, Innsbruck, Austria
(Steckelings) Department of Cardiovascular and Renal Research, University
of Southern Denmark, Odense, Denmark
(Sharma) Division of Cardiology, McGill University Health Centre,
Montreal, QC, Canada
(Stergiou) Hypertension Center STRIDE-7, School of Medicine, Third
Department of Medicine, Sotiria Hospital, National and Kapodistrian
University of Athens, Athens, Greece
(Tignanelli) Department of Surgery, University of Minnesota, Minneapolis,
MN, United States
(Tomaszewski) Division of Cardiovascular Sciences, Faculty of Medicine,
Biology and Health, University of Manchester, Manchester, United Kingdom
(Tomaszewski) Manchester Academic Health Science Centre, Manchester
University National Health Service Foundation Trust Manchester,
Manchester, United Kingdom
(Unger) Cardiovascular Research Institute Maastricht- School for
Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
(Wainford) Department of Pharmacology and Experimental Therapeutics,
Whitaker Cardiovascular Institute, Boston University School of Medicine,
Boston, MA, United States
(Williams) Institute of Cardiovascular Science, University College London
and National Institute for Health Research University College London
Hospitals Biomedical Research Centre, London, United Kingdom
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Published randomized controlled trials are underpowered for
binary clinical end points to assess the safety and efficacy of
renin-angiotensin system inhibitors (RASi) in adults with COVID-19. We
therefore performed a meta-analysis to assess the safety and efficacy of
RASi in adults with COVID-19. METHODS AND RESULTS: MEDLINE, EMBASE,
ClinicalTrials.gov, and the Cochrane Controlled Trial Register were
searched for randomized controlled trials that randomly assigned patients
with COVID-19 to RASi continuation/commencement versus no RASi therapy.
The primary outcome was all-cause mortality at <=30 days. A total of 14
randomized controlled trials met the inclusion criteria and enrolled 1838
participants (aged 59 years, 58% men, mean follow-up 26 days). Of the
trials, 11 contributed data. We found no effect of RASi versus control on
all-cause mortality (7.2% versus 7.5%; relative risk [RR], 0.95; [95% CI,
0.69-1.30]) either overall or in subgroups defined by COVID-19 severity or
trial type. Network meta-analysis identified no difference between
angiotensin-converting enzyme inhibitors versus angiotensin II receptor
blockers. RASi users had a nonsignificant reduction in acute myocardial
infarction (2.1% versus 3.6%; RR, 0.59; [95% CI, 0.33-1.06]), but
increased risk of acute kidney injury (7.0% versus 3.6%; RR, 1.82; [95%
CI, 1.05- 3.16]), in trials that initiated and continued RASi. There was
no increase in need for dialysis or differences in congestive cardiac
failure, cerebrovascular events, venous thromboembolism, hospitalization,
intensive care admission, inotropes, or mechanical ventilation.
 CONCLUSION(S): This meta-analysis of randomized controlled trials
evaluating angiotensin-converting enzyme inhibitors/angio-tensin II
receptor blockers versus control in patients with COVID-19 found no
difference in all-cause mortality, a borderline decrease in myocardial
infarction, and an increased risk of acute kidney injury with RASi. Our
findings provide strong evidence that RASi can be used safely in patients
with COVID-19. Copyright © 2022 The Authors.

<4>
Accession Number
2020161761
Title
LobE-Specific lymph node diSsectiON for clinical early-stage non-small
cell lung cancer: protocol for a randomised controlled trial (the LESSON
trial).
Source
BMJ Open. 12(8) (no pagination), 2022. Article Number: 056043. Date of
Publication: 29 Aug 2022.
Author
Huang W.; Deng H.-Y.; Ren Z.-Z.; Xu K.; Wang Y.-F.; Tang X.; Zhu D.-X.;
Zhou Q.
Institution
(Huang, Deng, Xu, Wang, Tang, Zhu, Zhou) Lung Cancer Center, West China
Hospital, Sichuan University, Sichuan, Chengdu, China
(Ren) West China School of Medicine, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
Publisher
BMJ Publishing Group
Abstract
Introduction Lung cancer was the most common malignancy and the leading
cause of cancer-related death in China or worldwide, and surgery is still
the preferred treatment for early-stage non-small cell lung cancer
(NSCLC). The pattern of lymph node metastasis was found potentially lobe
specific, and thus, lobe-specific lymph node dissection (L-SLND) was
proposed to be an alternative to systematic lymph node dissection (SLND)
for the treatment of early-stage NSCLC. Methods and analysis The
LobE-Specific lymph node diSsectiON trial is a single-institutional,
randomised, double-blind and parallel controlled trial to investigate the
feasibility of L-SLND in clinically diagnosed stage IA1-2 NSCLC with
ground-glass opacity components (>=50%). The intraoperative frozen section
examination of surgical tissues confirms the histological type of NSCLC.
We hypothesise that L-SLND (experimental group) is not inferior to SLND
(control group) and intend to include 672 participants for the
experimental group and 672 participants for the control group with a
follow-up duration of 60 months. The primary outcomes are 5-year
disease-free survival and 5-year overall survival. The secondary outcomes
are metastatic lymph node ratio, postoperative complication incidence and
mortality, duration of operation, duration of anaesthesia (min), the
volume of bleeding (mL) and drainage volume. The intention-to-treat
analysis would be performed in the trial. Ethics and dissemination This
trial was approved by the ethics committee on biomedical research, West
China Hospital of Sichuan University (2021-332). Informed consent would be
obtained from all participants, and dissemination activities would include
academic conference presentations and peer-reviewed
publications. Copyright © Author(s) (or their employer(s)) 2022.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<5>
Accession Number
2020110582
Title
European Society of Cardiology Quality Indicators for Cardiovascular
Disease Prevention: developed by the Working Group for Cardiovascular
Disease Prevention Quality Indicators in collaboration with the European
Association for Preventive Cardiology of the European Society of
Cardiology.
Source
European Journal of Preventive Cardiology. 29(7) (pp 1060-1071), 2022.
Date of Publication: 01 May 2022.
Author
Aktaa S.; Gencer B.; Arbelo E.; Davos C.H.; Desormais I.; Hollander M.;
Abreu A.; Ambrosetti M.; Back M.; Carballo D.; Crawford C.; Deaton C.;
Dendale P.; Eijsvogels T.M.H.; Galbraith M.; Piepoli M.F.; Salzwedel A.;
Smulders Y.; Wilhelm M.; Biondi-Zoccai G.; Mach F.; Visseren F.L.J.; Gale
C.P.
Institution
(Aktaa, Gale) Leeds Institute of Cardiovascular and Metabolic Medicine,
University of Leeds, Leeds LS2 9LU, United Kingdom
(Aktaa, Gale) Leeds Institute for Data Analytics, University of Leeds,
Leeds LS2 9LU, United Kingdom
(Aktaa, Gale) Department of Cardiology, Leeds Teaching Hospitals NHS
Trust, Leeds, United Kingdom
(Gencer, Mach) Division of Cardiology, Department of Medicine, Geneva
University Hospitals, Geneva, Switzerland
(Gencer) Institute of Primary Health Care (BIHAM), University of Bern,
Bern, Switzerland
(Arbelo) Arrhythmia Section, Cardiology Department, Hospital Clinic,
Universitat de Barcelona, Barcelona, Spain
(Arbelo) IDIBAPS, Institut d'Investigacio August Pi i Sunyer (IDIBAPS),
Barcelona, Spain
(Arbelo) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Davos) Cardiovascular Research Laboratory, Biomedical Research
Foundation, Academy of Athens, Athens, Greece
(Desormais) Department of Thoracic and Cardiovascular Surgery and
Angiology, Dupuytren University Hospital, Limoges, France
(Hollander) Department of General Practice, Julius Center for Health
Sciences and Primary Care, University Medical Center Utrecht, Utrecht
University, Universiteitsweg 100, Utrecht 3584 CG, Netherlands
(Abreu) Cardiology Department, Hospital Santa Maria, Centro Hospitalar
Universitario Lisboa Norte, (CHULN) Lisboa, Lisbon, Portugal
(Ambrosetti) Cardiovascular Rehabilitation Unit, ASST Crema, Rivolta
D'Adda Hospital, Rivolta D'Adda, Italy
(Back) Unit of Physiotherapy, Department of Health, Medicine and Caring
Sciences, Linkoping University, Linkoping, Sweden
(Back) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Carballo) Department of Cardiology, Cardiovascular Center, University
Hospital Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 1205, Switzerland
(Crawford, Galbraith) ESC Patient Forum, Sophia Antipolis, France
(Deaton) Department of Public Health and Primary Care, University of
Cambridge School of Clinical Medicine, Forvie Site, Cambridge Biomedical
Campus, Cambridge CB22 5DT, United Kingdom
(Dendale) Heart Centre Hasselt, Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium
(Eijsvogels) Department of Physiology, Radboud Institute for Health
Sciences, Radboud University Medical Center, Nijmegen, Netherlands
(Piepoli) Heart Failure Unit, Cardiology, Guglielmo da Saliceto Hospital,
University pof Parma, Piacenza, Italy
(Salzwedel) Department of Rehabilitation Medicine, Faculty of Health
Sciences Brandenburg, University of Potsdam, Potsdam, Germany
(Smulders) Department of Internal Medicine and Geriatrics, Amsterdam UMC,
Location VUmc, Amsterdam, Netherlands
(Wilhelm) Department of Cardiology, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(Visseren) Department of Vascular Medicine, University Medical Center
Utrecht, Utrecht University, Utrecht, Utrecht, Netherlands
Publisher
Oxford University Press
Abstract
Methods The Quality Indicator Committee of the European Society of
Cardiology (ESC) formed the Working Group for and results Cardiovascular
Disease Prevention Quality Indicators in collaboration with Task Force
members of the 2021 ESC Guidelines on Cardiovascular Disease Prevention in
Clinical Practice and the European Association of Preventive Cardiology
(EAPC). We followed the ESC methodology for QI development, which involved
(i) the identification of the key domains of care for ASCVD prevention by
constructing a conceptual framework of care, (ii) the development of
candidate QIs by conducting a systematic review of the literature, (iii)
the selection of the final set of QIs using a modified Delphi method, and
(iv) the evaluation of the feasibility of the developed QIs. In total, 17
main and 14 secondary QIs were selected across six domains of care for
ASCVD prevention: (i) structural framework, (ii) risk assessment, (iii)
care for people at risk for ASCVD, (iv) care for patients with established
ASCVD, (v) patient education and experience, and (vi) outcomes. Conclusion
We present the 2021 ESC QIs for Cardiovascular Disease Prevention, which
have been co-constructed with EAPC using the ESC methodology for QI
development. These indicators are supported by evidence from the
literature, underpinned by expert consensus and aligned with the 2021 ESC
Guidelines on Cardiovascular Disease Prevention in Clinical Practice to
offer a mechanism for the evaluation of ASCVD prevention care and
outcomes. Copyright © 2022 SAGE Publications Inc.. All rights
reserved.

<6>
Accession Number
638829264
Title
High-dose adenosine versus saline-induced cardioplegic arrest in coronary
artery bypass grafting: A randomized double-blind clinical feasibility
trial.
Source
Scandinavian journal of surgery : SJS : official organ for the Finnish
Surgical Society and the Scandinavian Surgical Society. 111(3) (pp 3-10),
2022. Date of Publication: 01 Sep 2022.
Author
Mattila M.S.; Jarvela K.M.; Rinne T.T.; Nikus K.C.; Rantanen M.J.;
Siltanen J.A.A.; Helea J.-J.; Laurikka J.O.
Institution
(Mattila) Heart Hospital Tampere University Hospital PL 2000 33521 Tampere
Finland, Finland
(Jarvela, Rantanen) Heart Hospital, Tampere University Hospital, Tampere,
Finland
(Rinne) Tampere University Hospital, Tampere, Finland
(Nikus, Laurikka) Heart Hospital, Tampere University Hospital, Finland
Faculty of Medicine and Health Technology, Tampere University, Tampere,
Finland
(Siltanen, Helea) Faculty of Medicine and Health Technology, Tampere
University, Tampere, Finland
Publisher
NLM (Medline)
Abstract
BACKGROUND AND OBJECTIVE: In this clinical trial, we evaluated if a
short-acting nucleoside, adenosine, as a high-dose bolus injection with
blood cardioplegia induces faster arrest and provides better myocardial
performance in patients after bypass surgery for coronary artery disease.
 METHOD(S): Forty-three patients scheduled for elective or urgent
coronary artery bypass grafting were prospectively recruited in two-arm
1:1 randomized parallel groups to either receive 20 mg of adenosine (in 21
patients) or saline (in 22 patients) into the aortic root during the first
potassium-enriched blood cardioplegia infusion. The main outcomes of the
study were ventricular myocardial performance measured with cardiac index,
right ventricular stroke work index, and left ventricular stroke work
index at predefined time points and time to asystole after a single bolus
injection of adenosine. Conventional myocardial biomarkers were compared
between the two groups at predefined time points as secondary endpoints.
Electrocardiographic data and other ad hoc clinical outcomes were compared
between the groups. RESULT(S): Compared with saline, adenosine
reduced the time to asystole (68 (95% confidence interval (95% CI) =
37-100) versus 150 (95% CI = 100-210) seconds, p = 0.005). With myocardial
performance, the results were inconclusive, since right ventricular stroke
work index recovered better in the adenosine group (p = 0.008), but there
were no significant overall differences in cardiac index and left
ventricular stroke work index between the groups. Only the
post-cardiopulmonary bypass cardiac index was better in the adenosine
group (2.3 (95% CI = 2.2-2.5) versus 2.1 (95% CI = 1.9-2.2) L/min/m2, p =
0.016). There were no significant differences between the groups in
cardiac biomarker values. CONCLUSION(S): A high dose adenosine bolus
at the beginning of the first cardioplegia infusion resulted in
significantly faster asystole in coronary artery bypass grafting patients
but enhanced only partially the ventricular performance.EudraCT number:
2014-001382-26.
https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-001382-26/FI.

<7>
Accession Number
638600394
Title
A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of
Preoperative Antithrombin Supplementation in Patients at Risk for
Antithrombin Deficiency After Cardiac Surgery.
Source
Anesthesia and analgesia. 135(4) (pp 757-768), 2022. Date of Publication:
01 Oct 2022.
Author
Moront M.G.; Woodward M.K.; Essandoh M.K.; Avery E.G.; Reece T.B.;
Brzezinski M.; Spiess B.; Shore-Lesserson L.; Chen J.; Henriquez W.;
Barcelo M.; Despotis G.; Karkouti K.; Levy J.H.; Ranucci M.; Mondou E.
Institution
(Moront) From the Department of Cardiothoracic Sugery, Promedical Toledo
Hospital, Toledo, Ohio
(Woodward, Chen, Henriquez, Barcelo, Mondou) Bioscience Research Group,
Grifols, Barcelona, Spain
(Essandoh) Department of Anesthesiology' Wexner Medical Center, Ohio State
University, Columbus, OH, United States
(Avery) Department of Anesthesiology and Perioperative Medicine,
University Hospital Case Medical Center, Cleveland, OH, United States
(Reece, Levy) Department of Surgery' Division of Cardiothoracic Surgery,
University of Colorado, Aurora, CO, United States
(Brzezinski) Department of Anesthesiology and Perioperative Care,
University of California, San Francisco, CA, United States
(Brzezinski) San Francisco Veterans Affairs Health Care System, San
Francisco, CA, United States
(Spiess) Department of Anesthesiology, University of Florida College of
Medicine, Gainesville, FL, Puerto Rico
(Shore-Lesserson) Department of Anesthesiology, North Shore University
Hospital, NY, United States
(Despotis) Departments of Pathology, Immunology and Anesthesiology,
Washington University School of Medicine, St. Louis, MO, United States
(Karkouti) Department of Anesthesia and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Ranucci) Department of Cardiothoracic and Vascular Anesthesia and
Intensive Care, IRCSS Policlinico San Donato, Milan, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Antithrombin (AT) activity is reduced during cardiac
operations with cardiopulmonary bypass (CPB), which is associated with
adverse outcomes. Preoperative AT supplementation, to achieve >58% and
<100% AT activity, may potentially reduce postoperative morbidity and
mortality in cardiac operations with CPB. This prospective, multicenter,
randomized, double-blind, placebo-controlled study was designed to
evaluate the safety and efficacy of preoperative treatment with AT
supplementation in patients at risk for low AT activity after undergoing
cardiac surgery with CPB. METHOD(S): A total of 425 adult patients
were randomized (1:1) to receive either a single dose of AT (n = 213) to
achieve an absolute increase of 20% above pretreatment AT activity or
placebo (n = 212) before surgery. The study duration was approximately 7
weeks. The primary efficacy end point was the percentage of patients with
any component of a major morbidity composite (postoperative mortality,
stroke, acute kidney injury [AKI], surgical reexploration, arterial or
venous thromboembolic events, prolonged mechanical ventilation, and
infection) in the 2 groups. Secondary end points included AT activity,
blood loss, transfusion requirements, duration of intensive care unit
(ICU), and hospital stays. Safety was also assessed. RESULT(S):
Overall, 399 patients (men, n = 300, 75.2%) with a mean (standard
deviation [SD]) age of 66.1 (11.7) years, with the majority undergoing
complex surgical procedures (n = 266, 67.9%), were analyzed. No
differences in the percentage of patients experiencing morbidity composite
outcomes between groups were observed (AT-treated 68/198 [34.3%] versus
placebo 58/194 [29.9%]; P = .332; relative risk, 1.15). After AT infusion,
AT activity was significantly higher in the AT group (108% [42-143])
versus placebo group (76% [40-110]), and lasted up to postoperative day 2.
At ICU, the frequency of patients with AT activity >=58% in the AT group
(81.5%) was significantly higher ( P < .001) versus placebo group (43.2%).
Secondary end point analysis did not show any advantage of AT over placebo
group. There were significantly more patients with AKI ( P < .001) in the
AT group (23/198; 11.6%) than in the placebo group (5/194, 2.6%). Safety
results showed no differences in treatment-emergent adverse events nor
bleeding events between groups. CONCLUSION(S): AT supplementation did
not attenuate adverse postoperative outcomes in our cohort of patients
undergoing cardiac surgery with CPB. Copyright © 2022
International Anesthesia Research Society.

<8>
Accession Number
637981672
Title
Society of Cardiovascular Anesthesiologists Clinical Practice Update for
Management of Acute Kidney Injury Associated With Cardiac Surgery.
Source
Anesthesia and analgesia. 135(4) (pp 744-756), 2022. Date of Publication:
01 Oct 2022.
Author
Peng K.; McIlroy D.R.; Bollen B.A.; Billings F.T.; Zarbock A.; Popescu
W.M.; Fox A.A.; Shore-Lesserson L.; Zhou S.; Geube M.A.; Ji F.; Bhatia M.;
Schwann N.M.; Shaw A.D.; Liu H.
Institution
(Peng, Liu) From the Department of Anesthesiology and Pain Medicine,
University of California Davis Health, Sacramento, CA, United States
(Peng, Ji) First Affiliated Hospital of Soochow University, Suzhou, China
(McIlroy, Billings) Department of Anesthesiology, Vanderbilt University
Medical Center, Nashville, TN, United States
(Bollen) Department of Anesthesiology, Missoula, MT, Bulgaria
(Zarbock) Department of Anesthesiology and Intensive Care Medicine,
University Hospital of Muenster, Muenster, Germany
(Popescu) Department of Anesthesiology, Yale University School of
Medicine, Easton, CT, United States
(Fox) Department of Anesthesiology and Pain Management, University of
Texas Southwestern Medical Center, Dallas, TX, United States
(Shore-Lesserson) Department of Anesthesiology, Northwell Health,
Manhasset, NY, United States
(Zhou) Department of Anesthesiology, University of Texas Medical School,
Sugar Land, TX, United States
(Geube) Department of Cardiothoracic Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Bhatia) Department of Anesthesiology, University of North Carolina,
Chapel Hill, NC, United States
(Schwann) Department of Anesthesiology, Lehigh Valley Health Network,
Allentown, PA, United States
(Shaw) Department of Intensive Care and Resuscitation, Cleveland Clinic,
Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
Cardiac surgery-associated acute kidney injury (CS-AKI) is common and is
associated with increased risk for postoperative morbidity and mortality.
Our recent survey of the Society of Cardiovascular Anesthesiologists (SCA)
membership showed 6 potentially renoprotective strategies for which
clinicians would most value an evidence-based review (ie, intraoperative
target blood pressure, choice of specific vasopressor agent, erythrocyte
transfusion threshold, use of alpha-2 agonists, goal-directed oxygen
delivery on cardiopulmonary bypass [CPB], and the "Kidney Disease
Improving Global Outcomes [KDIGO] bundle of care"). Thus, the SCA's
Continuing Practice Improvement Acute Kidney Injury Working Group aimed to
provide a practice update for each of these strategies in cardiac surgical
patients based on the evidence from randomized controlled trials (RCTs).
PubMed, EMBASE, and Cochrane library databases were comprehensively
searched for eligible studies from inception through February 2021, with
search results updated in August 2021. A total of 15 RCTs investigating
the effects of the above-mentioned strategies on CS-AKI were included for
meta-analysis. For each strategy, the level of evidence was assessed using
the Grading of Recommendations, Assessment, Development and Evaluation
(GRADE) methodology. Across the 6 potentially renoprotective strategies
evaluated, current evidence for their use was rated as "moderate," "low,"
or "very low." Based on eligible RCTs, our analysis suggested using
goal-directed oxygen delivery on CPB and the "KDIGO bundle of care" in
high-risk patients to prevent CS-AKI (moderate level of GRADE evidence).
Our results suggested considering the use of vasopressin in vasoplegic
shock patients to reduce CS-AKI (low level of GRADE evidence). The
decision to use a restrictive versus liberal strategy for perioperative
red cell transfusion should not be based on concerns for renal protection
(a moderate level of GRADE evidence). In addition, targeting a higher mean
arterial pressure during CPB, perioperative use of dopamine, and use of
dexmedetomidine did not reduce CS-AKI (a low or very low level of GRADE
evidence). This review will help clinicians provide evidence-based care,
targeting improved renal outcomes in adult patients undergoing cardiac
surgery. Copyright © 2022 International Anesthesia Research
Society.

<9>
Accession Number
636969282
Title
Expanding restrictive transfusion evidence in surgical practice: a
multicentre, prospective cohort study.
Source
Blood transfusion = Trasfusione del sangue. 20(5) (pp 382-394), 2022. Date
of Publication: 01 Sep 2022.
Author
Wang L.; Wang Z.; Huang Y.; Wang Y.; Liu Z.; Xin S.; Lei G.; Han W.; Xue
F.; Chen Y.; Wu P.; Jiang J.; Yu X.
Institution
(Wang, Wang, Han, Xue, Chen, Wu, Jiang) Department of Epidemiology and
Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of
Medical Sciences/School of Basic Medicine, Peking Union Medical College,
Beijing, China
(Huang, Yu) Anaesthesiology Department, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences, Beijing, China
(Wang) Orthopaedics Department, Peking Union Medical College Hospital,
Chinese Academy of Medical Sciences, Beijing, China
(Liu) Clinical Transfusion Research Centre, Institute of Blood
Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
(Xin) Vascular and Thyroid Surgery Department, First Hospital of China
Medical University, Shenyang, China
(Lei) Orthopaedics Department, Xiangya Hospital, Central South University,
Changsha, China
(Yu) Nephrology Department, Peking Union Medical College Hospital, Chinese
Academy of Medical Sciences, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Findings of observational studies investigating the impact of
transfusions are at odds with those of randomised controlled trials,
raising concern that observational studies may be inappropriate to inform
transfusion decisions. We examined whether observational data could
replicate evidence from randomised controlled trials on restrictive
transfusion in cardiac and orthopaedic surgery, and be generalised to
broader specialties as well as to a lower haemoglobin transfusion
threshold (7 g/dL). MATERIAL AND METHODS: A multicentre, prospective
cohort study was performed at three representative regional hospitals in
China between 2015 and 2016. Participants were surgical inpatients (>=18
years; hospital stay >=24 h) in six specialties: cardiac, cerebral,
vascular (CCV), and orthopaedic, general, thoracic (non-CCV). Patients
with a stable haemoglobin (7-10 g/dL) constituted the primary analytic
sample, while patients with >=500 mL intra-operative bleeding were
analysed separately to avoid haemoglobin instability. The association of
transfusion with surgical outcomes (death, in-hospital complications) was
evaluated. RESULT(S): The transfusion rate was 10.7% in 36,607
patients (mean age, 52.5+/-14.3 years; 52.3% female). After restriction,
stratification, and propensity score matching to reduce patients'
heterogeneity, transfusion was unrelated to death (CCV: odds ratio
[OR]=0.74, 95% confidence interval [CI]: 0.16-3.39; non-CCV: OR 0.83, 95%
CI: 0.36-1.94) and the composite complication (CCV: OR 1.31, 95% CI:
0.63-2.72; non-CCV: OR=1.24, 95% CI: 0.81-1.90). The results were
consistent in subgroups (elderly, coronary heart disease, malignant
tumour, severe illness) and applicable to patients with significant
bleeding after restoration of a stable haemoglobin. DISCUSSION:
Transfusion at a stable haemoglobin concentration of 7-10 g/dL did not
alter surgical outcomes. Our results show the feasibility of observational
data to expand restrictive transfusion to broader specialties and a lower
transfusion threshold in surgical practice.

<10>
Accession Number
2018458090
Title
A systematic review and meta-analysis of non-vitamin K antagonist oral
anticoagulants vs vitamin K antagonists after transcatheter aortic valve
replacement in patients with atrial fibrillation.
Source
European Journal of Clinical Pharmacology. 78(10) (pp 1589-1600), 2022.
Date of Publication: October 2022.
Author
Ooi A.J.Q.; Wong C.; Tan T.W.E.; Ng T.P.; Teo Y.N.; Teo Y.H.; Syn N.L.;
Djohan A.H.; Lim Y.; Yeo L.L.L.; Tan B.Y.Q.; Chan M.Y.-Y.; Poh K.-K.; Kong
W.K.F.; Chai P.; Yeo T.-C.; Yip J.W.; Kuntjoro I.; Sia C.-H.
Institution
(Ooi, Wong, Tan, Ng, Teo, Teo, Syn, Yeo, Tan, Chan, Poh, Kong, Chai, Yeo,
Yip, Sia) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Djohan, Lim, Chan, Poh, Kong, Chai, Yeo, Yip, Kuntjoro, Sia) Department
of Cardiology, National University Heart Centre, Singapore 119228,
Singapore
(Yeo, Tan) Division of Neurology, Department of Medicine, National
University Hospital, Singapore, Singapore
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Transcatheter aortic valve replacement (TAVR) is increasingly
carried out in patients with aortic valvular conditions. Atrial
fibrillation (AF) is a common comorbidity among patients undergoing TAVR.
Despite this, there remains a paucity of data and established guidelines
regarding anticoagulation use post-TAVR in patients with AF.
 Method(s): Four databases were searched from inception until 12
October 2021. A title and abstract sieve, full-text review and data
extraction were conducted by independent authors, and articles including
patients without AF were excluded. The Review Manager (Version 5.4) was
utilised in data analysis. Result(s): A total of 25,199 post-TAVR
patients with AF were included from seven articles, with 9764 patients on
non-vitamin K antagonist oral anticoagulants (NOAC) and 15,435 patients on
vitamin K antagonists (VKA). In this analysis, there was a significantly
lower risk of all-cause mortality at 1 year (RR: 0.75, CI: 0.58-0.97, p =
0.04, I2 = 56%), and bleeding at 1 year (RR: 0.73, CI:
0.68-0.79, p = < 0.00001, I2 = 0%), between patients on NOAC
and VKA. There were no detectable differences between patients on NOAC and
VKA for all-cause mortality at 2 years, stroke within 30 days, stroke
within 1 year, ischaemic stroke at 1 year and life-threatening bleeding at
30 days. Conclusion(s): While the results of this analysis reveal
NOAC as a potential alternate treatment modality to VKA in post-TAVR
patients with AF, further research is needed to determine the full safety
and efficacy profile of NOAC (PROSPERO: CRD42021283548). Copyright
© 2022, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<11>
Accession Number
2020219778
Title
Cardiac surgery's long opioid dependency: time to recalibrate pain
therapy?.
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Rong L.Q.; Shen L.; Bartels K.
Institution
(Rong, Shen) Department of Anesthesiology, Weill Cornell Medicine, New
York, NY, United States
(Bartels) Department of Anesthesia, University of Nebraska Medical Center,
Omaha, NE, United States
Publisher
Elsevier Ltd
Abstract
Opioid analgesia is the cornerstone of anaesthetic management during
cardiac surgery. However, a subset of patients use opioids persistently
after 3 months of surgery. We discuss a recent meta-analysis and
systematic review by Liu and colleagues describing both patient and
peri-procedural risk factors that contribute to this phenomenon in the
context of chronic pain after cardiac surgery. Anaesthetists for cardiac
surgery should consider opioid alternatives and individual patient risk
factors to optimise recovery and pain control. Copyright © 2022
British Journal of Anaesthesia

<12>
Accession Number
2020219751
Title
Hypothermia as an adjunctive therapy to percutaneous intervention in
ST-elevation myocardial infarction: A systematic review and meta-analysis
of randomized control trials.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Mhanna M.; Ranabothu M.; Al-Abdouh A.; Jabri A.; Sharma V.; Beran A.;
Sajdeya O.; Barbarawi M.; Hanna E.B.
Institution
(Mhanna, Sharma, Hanna) Division of Cardiology, Department of Medicine,
University of Iowa, Iowa City, IA, United States
(Ranabothu) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
(Al-Abdouh) Department of Internal Medicine, University of Kentucky,
Lexington, KY, United States
(Jabri) Department of Cardiology, Case Western Reserve
University/MetroHealth Medical Center, Cleveland, OH, United States
(Beran) Department of Gastroenterology, Indiana University, Indianapolis,
IN, United States
(Sajdeya) Department of Internal Medicine, The University of Toledo,
Toledo, OH, United States
(Barbarawi) Department of Cardiology, University of Connecticut,
Farmington, CT, United States
Publisher
Elsevier Inc.
Abstract
Introduction: In the setting of acute ST-elevation myocardial infarction
(STEMI), several randomized control trials (RCTs) suggested a potential
benefit with the use of therapeutic hypothermia (TH). However, results
from previous studies are contradictory. Method(s): We performed a
comprehensive literature search for studies that evaluated the efficacy
and safety of adjunctive TH compared to the standard percutaneous coronary
intervention (PCI) in awake patients with STEMI. The primary outcomes were
the infarct size (IS) and microvascular obstruction (MVO) assessed by
cardiac imaging at the end of follow-up. The secondary outcomes were major
adverse cardiovascular events (MACE), procedure-related complications, and
door-to-balloon time. Relative risk (RR) or the mean difference (MD) and
corresponding 95 % confidence intervals (CIs) were calculated using the
random-effects model. Result(s): A total of 10 RCTs, including 706
patients were included. As compared to standard PCI, TH was not associated
with a statistically significant improvement in the IS (MD: -0.87 %,
95%CI: -2.97, 1.23; P = 0.42) or in the MVO (MD: 0.11 %, 95%CI: -0.06,
0.27; P = 0.21). MACE and its components were comparable between the two
groups. However, the TH approach was associated with an increased risk of
infection and prolonged door-to-balloon time. Furthermore, there was a
trend in the TH group toward an increased incidence of stent thrombosis
and paroxysmal atrial fibrillation. Conclusion(s): According to our
meta-analysis of published RCTs, TH is not beneficial in awake patients
with STEMI and has a marginal safety profile with potential for care
delays. Larger-scale RCTs are needed to further clarify our
results. Copyright © 2022 Elsevier Inc.

<13>
Accession Number
639047035
Title
Minimally-invasive cardiac surgery: a bibliometric analysis of impact and
force to identify key and facilitating advanced training.
Source
Journal of cardiothoracic surgery. 17(1) (pp 236), 2022. Date of
Publication: 16 Sep 2022.
Author
Karsan R.B.; Allen R.; Powell A.; Beattie G.W.
Institution
(Karsan) Department of Cardiothoracic Surgery, Royal Victoria Hospital,
274 Grosvenor Road, Belfast BT12 6BA, United Kingdom
(Allen) Department of Cardiothoracic Surgery, University Hospital Wales,
Cardiff CF14 4XW, United Kingdom
(Powell) Division of Cancer and Genetics, University Hospital of Wales,
Cardiff CF14 4XW, United Kingdom
(Powell) Department of Surgery, University Hospital of Wales, Cardiff CF14
4XW, United Kingdom
(Beattie) Department of Cardiothoracic Surgery, Royal Victoria Hospital,
274 Grosvenor Road, Belfast BT12 6BA, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: The number of citations an article receives is a marker of its
scientific influence within a particular specialty. This bibliometric
analysis intended to recognise the top 100 cited articles in
minimally-invasive cardiac surgery, to determine the fundamental subject
areas that have borne considerable influence upon clinical practice and
academic knowledge whilst also considering bibliometric scope. This is
increasingly relevant in a continually advancing specialty and one where
minimally-invasive cardiac procedures have the potential for huge benefits
to patient outcomes. METHOD(S): The Web of Science (Clarivate
Analytics) data citation index database was searched with the following
terms: [Minimal* AND Invasive* AND Card* AND Surg*]. Results were limited
to full text English language manuscripts and ranked by citation number.
Further analysis of the top 100 cited articles was carried out according
to subject, author, publication year, journal, institution and country of
origin. RESULT(S): A total of 4716 eligible manuscripts were
retrieved. Of the top 100 papers, the median (range) citation number was
101 (51-414). The most cited paper by Lichtenstein et al. (Circulation
114(6):591-596, 2006) published in Circulation with 414 citations focused
on transapical transcatheter aortic valve implantation as a viable
alternative to aortic valve replacement with cardiopulmonary bypass in
selected patients with aortic stenosis. The Annals of Thoracic Surgery
published the most papers and received the most citations (n=35; 3036
citations). The United States of America had the most publications and
citations (n=52; 5303 citations), followed by Germany (n=27; 2598
citations). Harvard Medical School, Boston, Massachusetts, published the
most papers of all institutions. Minimally-invasive cardiac surgery
pertaining to valve surgery (n=42) and coronary artery bypass surgery
(n=30) were the two most frequent topics by a large margin.
 CONCLUSION(S): This work establishes a comprehensive and informative
analysis of the most influential publications in minimally-invasive
cardiac surgery and outlines what constitutes a citable article.
Undertaking a quantitative evaluation of the top 100 papers aids in
recognising the contributions of key authors and institutions as well as
guiding future efforts in this field to continually improve the quality of
care offered to complex cardiac patients. Copyright © 2022. The
Author(s).

<14>
Accession Number
639051578
Title
Pitfalls and limitations in the assessment of the HV interval in a
Transcatheter Aortic Valve Replacement population. A prospective analysis.
Source
Swiss Medical Weekly. Conference: Annual Meeting of Swiss Society of
Cardiology, Swiss Society for Heart and Thoracic Vascular Surgery. St.
Gallen Switzerland. 152(Supplement 260) (pp 47S), 2022. Date of
Publication: June 2022.
Author
Teres C.; Haddad C.; Pagnoni M.; Le Bloa M.; Herrera-Siklody C.;
Domenichini G.; Porretta A.; Pruvot E.; Pascale P.
Institution
(Teres, Haddad, Pagnoni, Le Bloa, Herrera-Siklody, Domenichini, Porretta,
Pruvot, Pascale) Centre Hospitalier Universitaire Vaudois, Lausanne,
Switzerland
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
Introduction: Identification of patients with new-onset conduction
disturbances at risk of AV-block remains a major unmet challenge in
Transcatheter Aortic Valve Replacement (TAVR) His-Ventricular interval
(HVI) measurement has been proposed in patients at risk. However, the HVI
assessment is often overlooked, performed as a single assessment without
active mapping, and even single-catheter assessment is some-times
performed. We observed in this specific patient population a higher
occurrence of methodological HVI measurement pitfalls and therefore aimed
to systematically evaluate them as related to outcomes. Method(s):
Consecutive patients who underwent HVI assessment post-TAVR between June
2014 and December 2021. HV interval was classified as normal if < 55 ms,
intermediate 55-70 ms and abnormal if > 70 ms. Incremental atrial pacing
to stress the His-Purkinje period was performed whenever possible. All
tracings were systematically reviewed offline by two blinded operators.
Pitfalls in the assessment of atrioventricular conduction were categorized
into types 1 to 5 as reported in Table 1. In sinus rhythm, only proximal
HVI were considered defined as the concomitant recording of a near-field
atrial signal. Result(s): 90 cases were analyzed; median age 81
years1 [76 - 86] years; 37 (41%) male. The median HV interval was 54 [50 -
65] ms. An abnormal HV interval, exceeding the 55 and 70ms cut-off values,
was found in 41 (45.9%) and 13 (14.8%) patients, respectively. At least
one pitfall was found in 11 patients (12%). Short-term AV block occurred
in 3 patients in sinus rhythm in whom no incremental pacing was performed,
and in 2 patients with AF despite normal or borderline HVI in both groups.
 Conclusion(s): Pitfalls in the assessment of the HVI are often
observed after TAVR. Identification of infra- and especially intra-His
disorders requires careful mapping and must be an active process on behalf
of the operator. HVI evaluation using a single catheter or in patients
with atrial fibrillation may often be misleading considering the value of
incremental atrial pacing and the major limitations in AF to assess the
most proximal His or intra-His block.

<15>
Accession Number
639051563
Title
Digital interprofessional communication with families in a cardiac surgery
unit during the COVID-19 pandemia.
Source
Swiss Medical Weekly. Conference: Annual Meeting of Swiss Society of
Cardiology, Swiss Society for Heart and Thoracic Vascular Surgery. St.
Gallen Switzerland. 152(Supplement 260) (pp 12S), 2022. Date of
Publication: June 2022.
Author
Pozzoli A.; Zurfluh C.; Giuffrida S.; Crivelli D.; Torre T.; Ferrari E.;
Demertzis S.
Institution
(Pozzoli, Zurfluh, Torre, Ferrari, Demertzis) Cardiocentro Ticino
Institute, Cardiac Surgery, Lugano, Switzerland
(Giuffrida) Cardiocentro Ticino Institute, Cardiac Nursing, Lugano,
Switzerland
(Crivelli) Cardiocentro Ticino Institute, Physiotherapy, Lugano,
Switzerland
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
Background: The COVID-19 pandemic entailed cutting off any access to
hospitals, denying patients daily visits from their relatives and friends.
The standard communication between medical staff and relatives also
suffered, with a perceived negative impact on overall care. We developed
an electronic communication solution to achieve a daily digital
communication with patients' families. Method(s): The communication
software allowed families to receive daily updates by SMS, on patients'
post-operative clinical state. Appreciation and performance of this
inter-professional (medical, nursing and physio-therapy) communication was
evaluated through a prospective randomized study. Two groups were compared
(group D, 32 patients Digital receiving daily SMS and group S, 16 patients
Standard without SMS), as-sessing satisfaction through dedicated surveys
under COVID-19 restrictions. Moreover, outgoing vs incoming telephone flow
between patients and their relatives (phone calls and SMS, for the two
groups) were analyzed at different timeframes of the post-operative stay.
 Result(s): Mean age of the population was 66 +/- 7 years for both
groups. The digital communication service was successfully adopted in
group D in all cases, sending overall 155 communications (4.84 per
patient). Calls received from relatives were 13 in group D vs 22 in group
S (0.4 vs 1.4 calls per patient, p=0.002). Patients' outgoing vs incoming
traffic flow was equal in the two groups for every timeframe (first two
post-op days vs the rest), independently from digital communication.
Comparing satisfaction of communication (from 1 to 7), level of
information and understand ability resulted 6.7 in group D vs 5.6 in group
S (p=0.004). Appreciation of digital communication was highest during the
first three post-operative days. Conclusion(s): The restrictions
caused by the COVID-19 pandemic generated simple and highly effective
digital solutions for inter professional communication from our cardiac
surgery unit. Offering this digital service, which complements rather than
replaces the classic communication method, significantly enhances overall
satisfaction of patients and families.

<16>
[Use Link to view the full text]
Accession Number
2020159116
Title
Weight Gain after Heart Transplantation in Adults: Systematic Review and
Meta-Analysis.
Source
ASAIO Journal. 68(9) (pp 1107-1116), 2022. Date of Publication: Sep-22.
Author
Miura K.; Yu R.; Sivapalan K.; Liyanage U.E.; Entwistle T.; McKenzie S.C.;
Green A.C.
Institution
(Miura, Yu, Liyanage, Green) Population Health Department, QIMR Berghofer
Medical Research Institute, Herston, QLD, Australia
(Miura, Sivapalan, Liyanage, McKenzie) Faculty of Medicine, The University
of Queensland, Herston, QLD, Australia
(Entwistle) Transplant Centre, University Hospital of South Manchester NHS
Foundation Trust, Manchester, United Kingdom
(McKenzie) Advanced Heart Failure and Cardiac Transplant Unit, The Prince
Charles Hospital, Chermside, QLD, Australia
(Green) CRUK Manchester Institute and University of Manchester, Manchester
Academic Health Science Centre, Manchester, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Gain in weight is common after heart transplantation but the magnitude of
usual weight gain and whether this varies by country is unknown. We
systematically reviewed all relevant studies to quantify weight change
among heart transplant recipients (HTRs) in the years after
transplantation and assess variation with geographic location. We searched
PubMed, Cumulative Index to Nursing and Allied Health Literature, and
Excerpta Medica Database databases to September 2020. Eligible studies
reported adult HTRs' mean/median weight and/or body mass index (BMI) up to
time of transplantation (baseline) and posttransplantation in any
language. Weighted mean differences (WMDs) (95% confidence intervals
[CIs]) of weight/BMI from baseline to posttransplantation were estimated
using a random-effects model. Ten studies met the inclusion criteria.
Pooled analysis showed weight gain of 7.1 kg (95% CI, 4.4-9.8 kg) in HTRs
12 months posttransplant, with corresponding BMI increase of 1.69 kg/m2
(95% CI, 0.83-2.55 kg/m2). Greatest weight gain at 12 months
posttransplant occurred in US HTRs (WMD weight 10.42 kg, BMI 3.25 kg/m2)
and least, in European HTRs (WMD weight 3.10 kg, BMI 0.78 kg/m2). In
conclusion, HTRs gain substantial weight in the years after
transplantation, but varying widely by geographic location. Copyright
© ASAIO 2021.

<17>
Accession Number
2020270091
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. 47(12) (no pagination), 2022. Article
Number: 101355. Date of Publication: December 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, Rajasthan, Jodhpur, India
(Shariff, Stulak) Department of General Surgery, Mayo Clinic, Rochester,
MN
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH
(Kumar) Section of Cardiovascular Research, Heart, Vascular and Thoracic
Department, Cleveland Clinic Akron General, Akron, OH
(Stulak) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
Publisher
Elsevier Inc.
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
(risk ratio, RR: 1.00; 95% confidence interval, 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 Elsevier Inc.

<18>
Accession Number
2019113631
Title
Erector spinae plane block versus its combination with superficial
parasternal intercostal plane block for postoperative pain after cardiac
surgery: a prospective, randomized, double-blind study.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 295. Date
of Publication: December 2022.
Author
Dost B.; Kaya C.; Turunc E.; Dokmeci H.; Yucel S.M.; Karakaya D.
Institution
(Dost, Kaya, Turunc, Dokmeci, Karakaya) Department of Anesthesiology and
Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
(Yucel) Department of Cardiovascular Surgery, Faculty of Medicine, Ondokuz
Mayis University, Samsun, Turkey
Publisher
BioMed Central Ltd
Abstract
Background: We aimed to compare the effectiveness of bilateral erector
spinae plane (ESP) block and superficial parasternal intercostal plane
(S-PIP) + ESP block in acute post-sternotomy pain following cardiac
surgery. Method(s): Forty-seven patients aged between 18 and 80 years
of age with American Society of Anesthesiologists class II-III due to
undergo median sternotomy for cardiac surgery were included in this
prospective, randomized, double-blinded study. Following randomization
into two groups, one group received bilateral ultrasound-guided ESP and
the other S-PIP plus ESP block. Morphine consumption within the first 24 h
after surgery was the primary outcome of the study while NRS scores at
rest, NRS scores when coughing, time taken until extubation, use of rescue
analgesic, presence of nausea/vomiting, length of hospital and intensive
care unit (ICU) stay, and patient satisfaction were secondary outcome
measures. Result(s): Morphine use up to 24 h following surgery was
statistically significantly different between the ESP block and ESP +
S-PIP block groups (18.63 +/- 6.60 [15.84-21.41] mg/24 h vs 14.41 +/- 5.38
[12.08-16.74] mg/24 h, p = 0.021). The ESP + S-PIP block group had
considerably reduced pain scores compared to the ESP block group across
all time points. Rescue analgesics were required in 21 (87.5%) patients in
the ESP block group and seven (30.4%) in the ESP + S-PIP group (p <
0.001). PONV, length of stay in the ICU and hospital, and time to
extubation were similar between groups. Conclusion(s): In open
cardiac surgery, the combination of ESP and S-PIP blocks lowers pain
scores and postoperative morphine requirement of patients. Trial
registration: Clinicaltrials Registration No: NCT05191953, Registration
Date: 14/01/2022. Copyright © 2022, The Author(s).

<19>
Accession Number
2019099878
Title
Heart failure during the COVID-19 pandemic: clinical, diagnostic,
management, and organizational dilemmas.
Source
ESC Heart Failure. (no pagination), 2022. Date of Publication: 2022.
Author
Palazzuoli A.; Metra M.; Collins S.P.; Adamo M.; Ambrosy A.P.; Antohi
L.E.; Ben Gal T.; Farmakis D.; Gustafsson F.; Hill L.; Lopatin Y.;
Tramonte F.; Lyon A.; Masip J.; Miro O.; Moura B.; Mullens W.; Radu R.I.;
Abdelhamid M.; Anker S.; Chioncel O.
Institution
(Palazzuoli, Tramonte) Cardiovascular Diseases Unit, Cardio Thoracic and
Vascular Department, S. Maria alle Scotte Hospital, University of Siena,
Siena 53100, Italy
(Metra, Adamo) Cardiology, Cardio-Thoracic Department, Civil Hospitals,
Brescia, Italy; Department of Medical and Surgical Specialties,
Radiological Sciences, and Public Health, University of Brescia, Brescia,
Italy
(Collins) Department of Emergency Medicine, Vanderbilt University Medical
Centre, Nashville, TN, United States
(Ambrosy) Department of Cardiology, Kaiser Permanente San Francisco
Medical Center, San Francisco, CA, United States
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Antohi, Radu) Emergency Institute for Cardiovascular Diseases "Prof. Dr.
C.C.Iliescu" Bucharest, Bucharest, Romania
(Ben Gal) Department of Cardiology, Rabin Medical Center (Beilinson
Campus), Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv,
Israel
(Farmakis) Cardio-Oncology Clinic, Heart Failure Unit, "Attikon"
University Hospital, National and Kapodistrian University of Athens
Medical School, Athens, Greece
(Farmakis) University of Cyprus Medical School, Nicosia, Cyprus
(Gustafsson) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Hill) School of Nursing and Midwifery, Queen's University, Belfast,
United Kingdom
(Lopatin) Volgograd Medical University, Cardiology Centre, Volgograd,
Russian Federation
(Lyon) Cardio-Oncology Service, Royal Brompton Hospital and Imperial
College London, London, United Kingdom
(Masip) Intensive Care Department, Consorci Sanitari Integral, University
of Barcelona, Barcelona, Spain
(Masip) Department of Cardiology, Hospital Sanitas CIMA, Barcelona, Spain
(Miro) Emergency Department, Hospital Clinic de Barcelona, University of
Barcelona, Barcelona, Spain
(Moura) Armed Forces Hospital, Porto, & Faculty of Medicine, University of
Porto, Porto, Portugal
(Mullens) Cardiovascular Physiology, Hasselt University, Belgium, & Heart
Failure and Cardiac Rehabilitation Specialist, Ziekenhuis Oost-Limburg,
Genk, Belgium
(Abdelhamid) Cardiology Department, Kasr Alainy School of Medicine, Cairo
University, New Cairo, 5th settlement, Cairo 11865, Egypt
(Anker) Department of Cardiology (CVK), Berlin Institute of Health Center
for Regenerative Therapies (BCRT), German Centre for Cardiovascular
Research (DZHK) partner site Berlin, Charite Universitatsmedizin Berlin,
Berlin, Germany
(Chioncel) Emergency Institute for Cardiovascular Diseases "Prof. Dr. C.C.
Iliescu" Bucharest; University for Medicine and Pharmacy "Carol Davila"
Bucharest, Bucharest, Romania
Publisher
John Wiley and Sons Inc
Abstract
The coronavirus 2019 (COVID-19) infection pandemic has affected the care
of patients with heart failure (HF). Several consensus documents describe
the appropriate diagnostic algorithm and treatment approach for patients
with HF and associated COVID-19 infection. However, few questions about
the mechanisms by which COVID can exacerbate HF in patients with high-risk
(Stage B) or symptomatic HF (Stage C) remain unanswered. Therefore, the
type of HF occurring during infection is poorly investigated. The
diagnostic differentiation and management should be focused on the
identification of the HF phenotype, underlying causes, and subsequent
tailored therapy. In this framework, the relationship existing between
COVID and onset of acute decompensated HF, isolated right HF, and
cardiogenic shock is questioned, and the specific management is mainly
based on local hospital organization rather than a standardized model.
Similarly, some specific populations such as advanced HF, heart
transplant, patients with left ventricular assist device (LVAD), or valve
disease remain under investigated. In this systematic review, we examine
recent advances regarding the relationships between HF and COVID-19
pandemic with respect to epidemiology, pathogenetic mechanisms, and
differential diagnosis. Also, according to the recent HF guidelines
definition, we highlight different clinical profile identification,
pointing out the main concerns in understudied HF
populations. Copyright © 2022 The Authors. ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<20>
Accession Number
639054079
Title
Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement.
Source
The New England journal of medicine. (no pagination), 2022. Date of
Publication: 17 Sep 2022.
Author
Kapadia S.R.; Makkar R.; Leon M.; Abdel-Wahab M.; Waggoner T.; Massberg
S.; Rottbauer W.; Horr S.; Sondergaard L.; Karha J.; Gooley R.; Satler L.;
Stoler R.C.; Messe S.R.; Baron S.J.; Seeger J.; Kodali S.; Krishnaswamy
A.; Thourani V.H.; Harrington K.; Pocock S.; Modolo R.; Allocco D.J.;
Meredith I.T.; Linke A.
Institution
(Kapadia, Makkar, Leon, Abdel-Wahab, Waggoner, Massberg, Rottbauer, Horr,
Sondergaard, Karha, Gooley, Satler, Stoler, Messe, Baron, Seeger, Kodali,
Krishnaswamy, Thourani, Harrington, Pocock, Modolo, Allocco, Meredith,
Linke) From the Department of Cardiovascular Medicine (S.R.K.), Cleveland
Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai
Medical Center, Los Angeles (R. Makkar); Columbia Interventional
Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New
York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.),
Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and
German Center for Cardiovascular Research (DZHK), Munich Heart Alliance,
Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake
Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine
and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden
(A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center
Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville
(S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L.
Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and
Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart
Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre,
Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC
(L. Satler); the Department of Neurology, University of Pennsylvania,
Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington
(S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) -
both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the
London School of Hygiene and Tropical Medicine, London (S.P.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic-valve replacement (TAVR) for the
treatment of aortic stenosis can lead to embolization of debris. Capture
of debris by devices that provide cerebral embolic protection (CEP) may
reduce the risk of stroke. METHOD(S): We randomly assigned patients
with aortic stenosis in a 1:1 ratio to undergo transfemoral TAVR with CEP
(CEP group) or without CEP (control group). The primary end point was
stroke within 72 hours after TAVR or before discharge (whichever came
first) in the intention-to-treat population. Disabling stroke, death,
transient ischemic attack, delirium, major or minor vascular complications
at the CEP access site, and acute kidney injury were also assessed. A
neurology professional examined all the patients at baseline and after
TAVR. RESULT(S): A total of 3000 patients across North America,
Europe, and Australia underwent randomization; 1501 were assigned to the
CEP group and 1499 to the control group. A CEP device was successfully
deployed in 1406 of the 1489 patients (94.4%) in whom an attempt was made.
The incidence of stroke within 72 hours after TAVR or before discharge did
not differ significantly between the CEP group and the control group (2.3%
vs. 2.9%; difference, -0.6 percentage points; 95% confidence interval,
-1.7 to 0.5; P=0.30). Disabling stroke occurred in 0.5% of the patients in
the CEP group and in 1.3% of those in the control group. There were no
substantial differences between the CEP group and the control group in the
percentage of patients who died (0.5% vs. 0.3%); had a stroke, a transient
ischemic attack, or delirium (3.1% vs. 3.7%); or had acute kidney injury
(0.5% vs. 0.5%). One patient (0.1%) had a vascular complication at the CEP
access site. CONCLUSION(S): Among patients with aortic stenosis
undergoing transfemoral TAVR, the use of CEP did not have a significant
effect on the incidence of periprocedural stroke, but on the basis of the
95% confidence interval around this outcome, the results may not rule out
a benefit of CEP during TAVR. (Funded by Boston Scientific; PROTECTED TAVR
ClinicalTrials.gov number, NCT04149535.). Copyright © 2022
Massachusetts Medical Society.

<21>
Accession Number
639053524
Title
Randomized Comparison of Transcatheter Edge-to-Edge Repair for
Degenerative Mitral Regurgitation in Prohibitive Surgical Risk Patients.
Source
JACC. Cardiovascular interventions. (no pagination), 2022. Date of
Publication: 08 Sep 2022.
Author
Lim D.S.; Smith R.L.; Gillam L.D.; Zahr F.; Chadderdon S.; Makkar R.;
Stephan von Bardeleben R.; Kipperman R.M.; Rassi A.N.; Szerlip M.; Goldman
S.; Inglessis-Azuaje I.; Yadav P.; Lurz P.; Davidson C.J.; Mumtaz M.; Gada
H.; Kar S.; Kodali S.K.; Laham R.; Hiesinger W.; Fam N.P.; Kessler M.;
O'Neill W.W.; Whisenant B.; Kliger C.; Kapadia S.; Rudolph V.; Choo J.;
Hermiller J.; Morse M.A.; Schofer N.; Gafoor S.; Latib A.; Koulogiannis
K.; Marcoff L.; Hausleiter J.
Institution
(Lim) University of Virginia Health System Hospital, Charlottesville, VA,
United States
(Smith, Szerlip) Baylor Scott and White: The Heart Hospital Plano, Plano,
TX, United States
(Gillam, Kipperman, Koulogiannis, Marcoff) Atlantic Health System
Morristown Medical Center, Morristown, NJ, United States
(Zahr, Chadderdon) Oregon Health & Science University, Portland, OR
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Stephan von Bardeleben) University Medical Centre Mainz, Mainz, Germany
(Rassi) Kaiser Permanente San Francisco Medical Center, San Francisco, CA,
United States
(Goldman) Lankenau Medical Center, Wynnewood, PA, United States
(Inglessis-Azuaje) Massachusetts General Hospital, Boston, MA, United
States
(Yadav) Piedmont Heart Institute, Atlanta, GA, United States
(Lurz) University of Leipzig, Leipzig, Germany
(Davidson) Northwestern University, Chicago, IL, United States
(Mumtaz, Gada) UPMC Pinnacle, Harrisburg, PA, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kodali) Columbia University Medical Center, New York, NY
(Laham) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Hiesinger) Stanford University Medical Center, Palo Alto, Colombia
(Fam) St. Michael's Hospital, Toronto, ON, Canada
(Kesler) University of Ulm, Ulm, Germany
(O'Neill) Henry Ford Hospital, Detroit, MI, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Kliger) Northwell-Lenox Hill, New York, NY
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Rudolph) Ruhr-Universitat Bochum, Bochum, Bad Oeynhausen, Germany
(Choo) Christ Hospital, Cincinnati, OH, United States
(Hermiller) St. Vincent Heart Center of Indiana, Indianapolis, IN, United
States
(Morse) Ascension Saint Thomas Hospital, Nashville, TN, United States
(Schofer) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Gafoor) Swedish Medical Center, Seattle, WA, United States
(Latib) Montefiore Medical Center, Bronx, NY, United States
(Hausleiter) Klinikum der Universitat Munchen, Munich, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Severe symptomatic degenerative mitral regurgitation (DMR) has
a poor prognosis in the absence of treatment, and new transcatheter
options are emerging. OBJECTIVE(S): The CLASP IID randomized trial
(NCT03706833) is the first to evaluate the safety and effectiveness of the
PASCAL system compared to the MitraClip system in patients with
significant symptomatic DMR. In this report, we present the primary safety
and effectiveness endpoints for the trial. METHOD(S): Patients with
3+ or 4+ DMR at prohibitive surgical risk were assessed by a central
screening committee and randomized 2:1 (PASCAL:MitraClip). Study oversight
also included an echocardiographic core laboratory and a clinical events
committee. The primary safety endpoint was a composite major adverse event
(MAE) rate at 30 days. The primary effectiveness endpoint was the
proportion of patients with MR <=2+ at 6 months. RESULT(S): A
pre-specified interim analysis in 180 patients demonstrated
non-inferiority of the PASCAL system vs. MitraClip system for the primary
safety and effectiveness endpoints, MAE: 3.4% vs. 4.8%, MR <=2+: 96.5% vs.
96.8%, respectively. Functional and quality-of-life outcomes significantly
improved in both groups (p<0.05). The proportion of patients with MR <=1+
was durable in the PASCAL group from discharge to 6 months [PASCAL: 87.2%
and 83.7% (p=0.317 vs. discharge); MitraClip: 88.5% and 71.2% (p=0.003 vs.
discharge), respectively]. CONCLUSION(S): The CLASP IID trial
demonstrated safety and effectiveness of the PASCAL system and met
non-inferiority endpoints, expanding transcatheter treatment options for
prohibitive surgical risk patients with significant symptomatic
DMR. Copyright © 2022. Published by Elsevier Inc.

<22>
Accession Number
639052943
Title
Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary
Artery Disease: Extended Follow-up Outcomes of Multicenter Randomized
Controlled BEST Trial.
Source
Circulation. (no pagination), 2022. Date of Publication: 19 Sep 2022.
Author
Ahn J.-M.; Kang D.-Y.; Yun S.-C.; Hur S.H.; Park H.-J.; Tresukosol D.;
Kang W.C.; Kwon H.M.; Rha S.-W.; Lim D.-S.; Jeong M.-H.; Lee B.-K.; Huang
H.; Lim Y.H.; Bae J.H.; Kim B.-O.; Ong T.K.; Ahn S.G.; Chung C.-H.; Park
D.-W.; Park S.-J.
Institution
(Ahn, Kang, Park, Park) Heart Institute, Asan Medical Center, University
of Ulsan College of Medicine, Seoul, South Korea
(Yun) Division of Biostatistics, Center for Medical Research and
Information, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Hur, Chung) Keimyung University Dongsan Medical Center, Daegu, South
Korea
(Park) Catholic University of Korea, Seoul St. Mary's Hospital, Seoul,
Korea
(Tresukosol) Siriraj Hospital, Bangkok, Thailand
(Kang) Gachon University Gil Hospital, Incheon, South Korea
(Kwon) Gangnam Severance Hospital, Seoul, South Korea
(Rha) Korea University Guro Hospital, Seoul, South Korea
(Lim) Korea University Anam Hospital, Seoul, South Korea
(Jeong) Chonnam National University Hospital, Gwangju, South Korea
(Lee) Kangwon National University Hospital, Chuncheon, South Korea
(Huang) Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
(Lim) Hanyang University Hospital, Seoul, South Korea
(Bae) Konyang University Hospital, Daejeon, South Korea
(Kim) Inje University Sanggye Paik Hospital, Seoul, South Korea
(Ong) Sarawak General Hospital, Kuching, Sarawak, Malaysia
(Ahn) Yonsei University Wonju Severance Christian Hospital, Wonju, South
Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Long-term comparative outcomes after percutaneous coronary
intervention (PCI) with everolimus-eluting stent and coronary-artery
bypass grafting (CABG) are limited in patients with multivessel coronary
artery disease. METHOD(S): This prospective, multicenter, randomized,
controlled trial was conducted in 27 international heart centers and was
designed to randomly assign 1776 patients with angiographic multivessel
coronary artery disease to receive PCI with everolimus-eluting stent or
CABG. After inclusion of 880 patients (438 in the PCI group and 442 in the
CABG group) between July 2008 and September 2013, the study was terminated
early due to slow enrollment. The primary end point was the composite of
death from any cause, myocardial infarction, or target-vessel
revascularization. RESULT(S): During a median follow-up of 11.8 years
(interquartile range, 10.6 to 12.5 years, maximum 13.7 years), the primary
end point occurred in 151 patients (34.5%) in the PCI group and 134
patients (30.3%) in the CABG group (hazard ratio [HR] 1.18; 95% confidence
interval [CI], 0.88 to 1.56; P=0.26). No significant differences were seen
in the occurrence of a safety composite of death, myocardial infarction,
or stroke between groups (28.8% and 27.1%, HR 1.07; 95% CI 0.75 to 1.53;
P=0.70) as well as the occurrence of death from any cause (20.5% and
19.9%, HR 1.04; 95% CI 0.65 to 1.67; P=0.86). However, spontaneous
myocardial infarction (7.1% and 3.8%, HR 1.86; 95% CI 1.06 to 3.27;
P=0.031) and any repeat revascularization (22.6% and 12.7%, HR 1.92; 95%
CI 1.58 to 2.32; P<0.001) were more frequent after PCI than after CABG.
 CONCLUSION(S): In patients with multivessel coronary artery disease,
there were no significant differences between PCI and CABG in the
incidence of major adverse cardiac events, safety composite end point, and
all-cause mortality during extended-follow-up.

<23>
Accession Number
639052875
Title
Prognostic Value of Measuring Fractional Flow Reserve after Percutaneous
Coronary Intervention in patients with Complex Coronary Artery Disease:
Insights from the FAME 3 Trial.
Source
Circulation. Cardiovascular interventions. (no pagination), 2022. Date of
Publication: 19 Sep 2022.
Author
Piroth Z.; Otsuki H.; Zimmermann F.M.; Ferenci T.; Keulards D.; Yeung
A.C.; Pijls N.H.J.; De Bruyne B.; Fearon W.F.
Institution
(Piroth) Gottsegen National Cardiovascular Center, Hungary
(Otsuki, Yeung) Division of Cardiovascular Medicine and Stanford
Cardiovascular Institute, Stanford University, Stanford, CA, United States
(Zimmermann, Keulards, Pijls) Catharina Hospital, Eindhoven, Netherlands
(Ferenci) Physiological Controls Research Center, Obuda University and
Department of Statistics, Corvinus University of Budapest, Budapest,
Hungary
(De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium and Lausanne
University Centre Hospital, Lausanne, Switzerland
(Fearon) Division of Cardiovascular Medicine and Stanford Cardiovascular
Institute, Stanford University, Stanford, CA; VA Palo Alto Health Care
System, Palo Alto, CA
Publisher
NLM (Medline)
Abstract
Background: We evaluate the prognostic value of measuring fractional flow
reserve (FFR) after percutaneous coronary intervention (post-PCI FFR) and
intravascular imaging in patients undergoing PCI for three-vessel coronary
artery disease (CAD) in the FAME 3 trial. Method(s): The FAME 3 trial
is a multicenter, international, randomized study comparing FFR-guided PCI
with coronary artery bypass grafting (CABG) in patients with multivessel
CAD. PCI was not non-inferior with respect to the primary endpoint of
death, myocardial infarction (MI), stroke or repeat revascularization at 1
year. Post-PCI FFR data were acquired on a patient and vessel-related
basis. Intravascular imaging guidance was tracked. The primary end point
is a comparison of target vessel failure (TVF) defined as a composite of
cardiac death, target vessel MI and target vessel revascularization at one
year based on post-PCI FFR values. Cox regression with robust standard
errors was used for analysis. Result(s): Of the 757 patients
randomized to PCI, 461 (61%) had post-PCI FFR measurement and 11.1% had
intravascular imaging performed. The median post-PCI FFR was 0.89 [IQR
0.85-0.94]. On a vessel-level, post-PCI FFR was found to be a significant
predictor of TVF univariately (HR=0.67 [95% CI:0.48-0.93] for 0.1 unit
increase, p=0.0165). On a patient-level, the single lowest post-PCI FFR
value was also found to be a significant predictor of TVF univariately
(HR=0.65 [95% CI:0.48-0.89] for 0.1 unit increase, p=0.0074). Post-PCI FFR
was an independent predictor of TVF in multivariable analysis adjusted for
key clinical parameters. Outcomes were similar between patients who had
intravascular imaging guidance and those who did not. Conclusion(s):
Post-PCI FFR measurement was a significant predictor of TVF on a vessel
and patient level and an independent predictor of outcomes in a population
with complex three-vessel CAD eligible for CABG. The limited use of
intravascular imaging did not affect outcomes.

<24>
Accession Number
639049565
Title
Aortic valve neocuspidization using the Ozaki technique: A meta-analysis
of reconstructed patient-level data.
Source
American heart journal. (no pagination), 2022. Date of Publication: 14
Sep 2022.
Author
Mylonas K.S.; Tasoudis P.T.; Pavlopoulos D.; Kanakis M.; Stavridis G.T.;
Avgerinos D.V.
Institution
(Mylonas, Pavlopoulos, Stavridis, Avgerinos) Department of Cardiac
Surgery, Onassis Cardiac Surgery Center, Athens, Greece
(Tasoudis) Faculty of Medicine, School of Health Sciences, University of
Thessaly, Biopolis, Greece
(Kanakis) Department of Pediatric and Adult Congenital Cardiac Surgery,
Onassis Cardiac Surgery Center, Athens, Greece
Publisher
NLM (Medline)
Abstract
BACKGROUND: Aortic valve neocuspidization using the Ozaki technique has
shown promising results both in adults and children. METHOD(S): A
systematic search of the PubMed and Cochrane databases was performed up to
November 13th, 2021. Individual patient data were reconstructed and
analyzed from the Kaplan-Meier curves of all eligible studies for
time-to-event outcomes. RESULT(S): We included a total of 22 studies
reporting on 1,891 patients that underwent Ozaki reconstruction. Mean age
at the time of surgery was 43.2 +/- 24.5 years (65 +/- 12.3 years for
adult patients and 12.3 +/- 3.8 years for pediatric patients). The most
common indication was aortic stenosis (46.4%, 95% CI 34.1 - 58.6). Mean
cross-clamp and cardiopulmonary bypass duration were 106.8 +/- 24.8 min
and 135.2 +/- 35.1 min, respectively. Permanent pacemaker was implanted in
0.7% (95% CI 0.4 - 1.2) of the patients. At discharge, mean effective
orifice area was 2.1 +/- 0.5cm2/m2. At latest follow up, peak gradient was
15.7 +/- 7.4 mmHg and only 0.25% (95% CI 0 - 2.3) had moderate aortic
insufficiency. In-hospital mortality was 0.7% (95% CI 0.1-1.7). Late
mortality was 1.9% during a mean follow up of 38.1 +/- 23.8 months.
One-year, three-year, and five-year freedom from reoperation rates were
98.0 %, 97.0 % and 96.5%, respectively. More than half of the reoperations
were due to infective endocarditis (51.5%, 95% CI 18.3 - 84.0). In our
cohort, the risk of endocarditis per patient per year was 0.5%.
 CONCLUSION(S): The midterm outcomes of the Ozaki procedure are
excellent in terms of hemodynamics, survival, and freedom from
reoperation. Acquiring long-term follow-up will help solidify this
technique in the cardiac surgery armamentarium. Copyright © 2022.
Published by Elsevier Inc.

<25>
Accession Number
639049456
Title
Routine Ultrasonography Guidance for Femoral Vascular Access for Cardiac
Procedures: The UNIVERSAL Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2022. Date of Publication: 18 Sep 2022.
Author
Jolly S.S.; AlRashidi S.; d'Entremont M.-A.; Alansari O.; Brochu B.;
Heenan L.; Skuriat E.; Tyrwhitt J.; Raco M.; Tsang M.; Valettas N.;
Velianou J.L.; Sheth T.; Sibbald M.; Mehta S.R.; Pinilla-Echeverri N.;
Schwalm J.D.; Natarajan M.K.; Kelly A.; Akl E.; Tawadros S.; Camargo M.;
Faidi W.; Bauer J.; Moxham R.; Nkurunziza J.; Dutra G.; Winter J.
Institution
(Jolly, d'Entremont, Heenan, Skuriat, Tyrwhitt, Sheth, Mehta,
Pinilla-Echeverri, Schwalm, Natarajan) Population Health Research
Institute, Hamilton, Ontario, Canada
(Jolly, AlRashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth,
Sibbald, Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Nkurunziza,
Dutra) McMaster University, Hamilton, Ontario, Canada
(Jolly, AlRashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth,
Sibbald, Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Tawadros,
Camargo, Faidi, Bauer, Moxham, Nkurunziza, Dutra) Hamilton Health
Sciences, Hamilton, Ontario, Canada
(Jolly, AlRashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth,
Sibbald, Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Nkurunziza)
Niagara Health, St Catherines, ON, Canada
(d'Entremont) Centre Hospitalier Universitaire de Sherbrooke (CHUS),
Sherbrooke, QC, Canada
(Brochu) CK Hui Heart Centre, Royal Alexandra Hospital Edmonton, Edmonton,
AB, Canada
(Akl) McGill University Faculty of Medicine and Health Sciences, Montreal,
QC, Canada
(Winter) Departamento de enfermedades cardiovasculares, Clinica Alemana De
Santiago, Universidad del Desarrollo, Chile
Publisher
NLM (Medline)
Abstract
Importance: A significant limitation of femoral artery access for cardiac
interventions is the increased risk of vascular complications and bleeding
compared with radial access. Strategies to make femoral access safer are
needed. Objective(s): To determine whether routinely using
ultrasonography guidance for femoral arterial access for coronary
angiography/intervention reduces bleeding or vascular complications.
 Design, Setting, and Participant(s): The Routine Ultrasound Guidance
for Vascular Access for Cardiac Procedures (UNIVERSAL) randomized clinical
trial is a multicenter, prospective, open-label trial of
ultrasonography-guided femoral access vs no ultrasonography for coronary
angiography or intervention with planned femoral access. Patients were
randomized from June 26, 2018, to April 26, 2022. Patients with
ST-elevation myocardial infarction were not eligible.
 Intervention(s): Ultrasonography guidance vs no ultrasonography
guidance for femoral arterial access on a background of fluoroscopic
landmarking. Main Outcomes and Measures: The primary composite
outcome is the composite of major bleeding based on the Bleeding Academic
Research Consortium 2, 3, or 5 criteria or major vascular complications
within 30 days. Result(s): A total of 621 patients were randomized at
2 centers in Canada (mean [SD] age, 71 [10.24] years; 158 [25.4%] female).
The primary outcome occurred in 40 of 311 patients (12.9%) in the
ultrasonography group vs 50 of 310 patients (16.1%) without
ultrasonography (odds ratio, 0.77 [95% CI, 0.49-1.20]; P=.25). The rates
of Bleeding Academic Research Consortium 2, 3, or 5 bleeding were 10.0%
(31 of 311) vs 10.7% (33 of 310) (odds ratio, 0.93 [95% CI, 0.55-1.56];
P=.78). The rates of major vascular complications were 6.4% (20 of 311) vs
9.4% (29 of 310) (odds ratio, 0.67 [95% CI, 0.37-1.20]; P=.18).
Ultrasonography improved first-pass success (277 of 311 [86.6%] vs 222 of
310 [70.0%]; odds ratio, 2.76 [95% CI, 1.85-4.12]; P<.001) and reduced the
number of arterial puncture attempts (mean [SD], 1.2 [0.5] vs 1.4 [0.8];
mean difference, -0.26 [95% CI, -0.37 to -0.16]; P<.001) and venipuncture
(10 of 311 [3.1%] vs 37 of 310 [11.7%]; odds ratio, 0.24 [95% CI,
0.12-0.50]; P<.001) with similar times to access (mean [SD], 114 [185] vs
129 [206] seconds; mean difference, -15.1 [95% CI, -45.9 to 15.8]; P=.34).
All prerandomization prespecified subgroups were consistent with the
overall finding. Conclusions and Relevance: In this randomized
clinical trial, use of ultrasonography for femoral access did not reduce
bleeding or vascular complications. However, ultrasonography did reduce
the risk of venipuncture and number of attempts. Larger trials may be
required to demonstrate additional potential benefits of
ultrasonography-guided access. Trial Registration: ClinicalTrials.gov
Identifier: NCT03537118.

<26>
Accession Number
639045842
Title
Does sex impact outcomes after mitral valve surgery? A systematic review
and meta-analysis.
Source
Scandinavian journal of surgery : SJS : official organ for the Finnish
Surgical Society and the Scandinavian Surgical Society. (pp
14574969221124468), 2022. Date of Publication: 16 Sep 2022.
Author
El-Andari R.; Bozso S.J.; Fialka N.M.; Kang J.J.H.; Nagendran J.
Institution
(El-Andari, Bozso, Kang) Division of Cardiac Surgery, Department of
Surgery, University of Alberta, Edmonton, AB, Canada
(Fialka) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Nagendran) Cardiac Surgeon Minimally Invasive and Transcatheter Valve
SurgeryAssociate Professor of Surgery Division of Cardiac Surgery
Department of Surgery Mazankowski Alberta Heart Institute University of
Alberta 4-108A Li Ka Shing Health Research Centre 8602 - 112 Street
Edmonton AB T6G 2E1 Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND AND OBJECTIVE: The published literature investigating the
impact of sex on outcomes after mitral valve (MV) surgery has demonstrated
inferior outcomes for females over males. However, the true relationship
between sex and outcomes after MV surgery continues to be poorly
understood. MATERIALS: PubMed, Medline, and Embase were systematically
searched for articles published from 1 January 2005 to 1 August 2021. This
systematic review included retrospective and prospective studies
investigating the relationship between sex and outcomes after MV surgery.
In all, 2068 articles were initially screened and 12 studies were included
in this review. RESULT(S): Few studies were adequately powered or
structured to investigate this topic. Few studies propensity matched
patients or isolated for surgical approach. In individual studies, females
experienced increased rates of short-term and long-term mortality and
increased 1-year mortality in the pooled data. Males experienced increased
rates of required pacemaker insertion. The remaining rates of morbidity
and mortality did not differ significantly between males and females.
 CONCLUSION(S): This review identified increased rates of 1-year
mortality in the pooled data for females, while males had increased rates
of pacemaker insertion. Despite this, the absence of propensity matching
and isolating for surgical approach has introduced confounding variables
that impair the ability of the included studies to interpret the results
found in the current literature. Studies isolating for surgical approach,
propensity matching patients, and examining outcomes with long-term
follow-up are required to elucidate the true nature of this relationship.

<27>
Accession Number
638389022
Title
Effectiveness and Safety of Early Initiation of Poststernotomy Cardiac
Rehabilitation Exercise Training: The SCAR Randomized Clinical Trial.
Source
JAMA Cardiology. 7(8) (pp 817-824), 2022. Date of Publication: August
2022.
Author
Ennis S.; Lobley G.; Worrall S.; Evans B.; Kimani P.K.; Khan A.; Powell
R.; Banerjee P.; Barker T.; McGregor G.
Institution
(Ennis, McGregor) Warwick Clinical Trials Unit, Warwick Medical School,
University of Warwick, Coventry CV4 7AL, United Kingdom
(Ennis, Lobley, Worrall, Evans, Powell, McGregor) Department of
Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University
Hospital Coventry, Warwickshire National Health Service Trust, Coventry,
United Kingdom
(Kimani, Khan, Banerjee) Warwick Medical School, University of Warwick,
Coventry, United Kingdom
(Powell, McGregor) Centre for Sport, Exercise and Life Sciences, Research
Institute for Health & Wellbeing, Coventry University, Coventry, United
Kingdom
(Banerjee) Department of Cardiology, University Hospital Coventry,
Warwickshire National Health Service Trust, Coventry, United Kingdom
(Barker) Department of Cardiothoracic Surgery, University Hospital
Coventry, Warwickshire National Health Service Trust, Coventry, United
Kingdom
Publisher
American Medical Association
Abstract
Importance: Guidelines recommend that cardiac rehabilitation (CR) exercise
training should not start until 6 weeks after sternotomy, although this is
not evidence based. Limited data suggest that starting earlier is not
detrimental, but clinical trials are needed. Objective(s): To compare
the effectiveness and safety of CR exercise training started either 2
weeks (early CR) or 6 weeks (usual-care CR) after sternotomy. Design,
Setting, and Participant(s): This was an assessor-blind, noninferiority,
parallel-group, randomized clinical trial that conducted participant
recruitment from June 12, 2017, to March 17, 2020. Participants were
consecutive cardiac surgery sternotomy patients recruited from 2
outpatient National Health Service rehabilitation centers: University
Hospital, Coventry, UK, and Hospital of St Cross, Rugby, UK.
 Intervention(s): Participants were randomly assigned to 8 weeks of
twice-weekly supervised CR exercise training starting either 2 weeks
(early CR) or 6 weeks (usual-care CR) after sternotomy. Exercise training
adhered to existing guidelines, including functional strength and
cardiovascular components. Main Outcomes and Measures: Outcomes were
assessed at baseline (inpatient after surgery), after CR (10 or 14 weeks
after sternotomy), and 12 months after randomization. The primary outcome
was the change in 6-minute walk test distance from baseline to after CR.
Secondary outcomes included safety, functional fitness, and quality of
life. Result(s): A total of 158 participants (mean [SD] age, 63
[11.5] years, 133 male patients [84.2%]) were randomly assigned to study
groups; 118 patients (usual-care CR, 61 [51.7%]; early CR, 57 [48.3%])
were included in the primary analysis. Early CR was not inferior to
usual-care CR (noninferiority margin, 35 m); the mean change in 6-minute
walk distance from baseline to after CR was 28 m greater in the early CR
group (95% CI, -11 to 66; P =.16). Mean differences for secondary outcomes
were not statistically significant, indicating noninferiority of early CR.
There were 46 vs 58 adverse events and 14 vs 18 serious adverse events in
usual-care CR and early CR, respectively. There was no difference between
the groups in the likelihood of participants having an adverse or serious
adverse event. Conclusions and Relevance: Starting exercise training
from 2 weeks after sternotomy was as effective as starting 6 weeks after
sternotomy for improving 6-minute walk distance. With appropriate
precautions, clinicians and CR professionals can consider starting
exercise training as early as 2 weeks after sternotomy. Trial
Registration: ClinicalTrials.gov Identifier: NCT03223558. Copyright
© 2022 American Medical Association. All rights reserved.

<28>
Accession Number
638323817
Title
External Support for Saphenous Vein Grafts in Coronary Artery Bypass
Surgery: A Randomized Clinical Trial.
Source
JAMA Cardiology. 7(8) (pp 808-816), 2022. Date of Publication: August
2022.
Author
Goldstein D.J.; Puskas J.D.; Alexander J.H.; Chang H.L.; Gammie J.S.;
Marks M.E.; Iribarne A.; Vengrenyuk Y.; Raymond S.; Taylor B.S.; Yarden
O.; Orion E.; Dagenais F.; Ailawadi G.; Chu M.W.A.; Dimaio J.M.; Narula
J.; Moquete E.G.; O'Sullivan K.; Williams J.B.; Crestanello J.A.; Jessup
M.; Rose E.A.; Scavo V.; Acker M.A.; Gillinov M.; Mack M.J.; Gelijns A.C.;
O'Gara P.T.; Moskowitz A.J.; Bagiella E.; Voisine P.
Institution
(Goldstein) Department of Cardiovascular and Thoracic Surgery, Montefiore
Medical Center, Bronx, NY, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside,
New York, NY, United States
(Alexander) Department of Medicine, Division of Cardiology, Duke
University Medical Center, Durham, NC, United States
(Chang, Marks, Raymond, Moquete, O'Sullivan, Rose, Gelijns, Moskowitz,
Bagiella) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1077, New York,
NY 10029, United States
(Gammie) Johns Hopkins Heart and Vascular Institute, Johns Hopkins Health
System, Baltimore, MD, United States
(Iribarne) Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center,
Lebanon, NH, United States
(Vengrenyuk) Division of Cardiology, Mount Sinai Hospital, Icahn School of
Medicine at Mount Sinai, New York, United States
(Taylor) Division of Cardiac Surgery, University of Maryland, School of
Medicine, Baltimore, United States
(Yarden, Orion) Vascular Graft Solutions Ltd, Tel Aviv, Israel
(Dagenais, Voisine) Department of Surgery, Institut de Cardiologie et
Pneumologie de Quebec, Quebec City, QC, Canada
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, United States
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, ON, Canada
(Dimaio, Mack) Cardiothoracic Surgery, Baylor Scott & White Health, Plano,
TX, United States
(Narula) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Williams) Cardiovascular Surgery, WakeMed Health and Hospitals, Raleigh,
NC, United States
(Crestanello) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, MN, United States
(Jessup) American Heart Association, Dallas, TX, United States
(Scavo) Cardiovascular and Thoracic Surgery, Lutheran Medical Group, Ft
Wayne, IN, United States
(Acker) Division of Cardiovascular Surgery, University of Pennsylvania,
Hospital of the University of Pennsylvania, Philadelphia, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
Publisher
American Medical Association
Abstract
Importance: Intimal hyperplasia and subsequent saphenous vein graft
failure may have significant adverse clinical effects in patients
undergoing coronary artery bypass surgery. External support of saphenous
vein grafts has the potential to prevent vein graft dilation and hence
slow the rate of intimal hyperplasia and increase long-term vein patency.
 Objective(s): To determine efficacy, as measured by intimal
hyperplasia, and safety of an external saphenous vein graft support device
in patients undergoing a coronary bypass graft procedure. Design,
Setting, and Participant(s): This within-patient randomized, open-label,
multicenter study was conducted at 17 Cardiothoracic Surgical Trials
Network centers in North America. Between January 2018 and February 2019,
224 patients with multivessel coronary artery disease undergoing isolated
bypass surgery were enrolled. For each patient, 1 of 2 vein grafts was
randomized to receive external support or no support.
 Intervention(s): External vein graft support or no support. Main
Outcomes and Measures: The primary efficacy end point was intimal
hyperplasia area assessed by intravascular ultrasound at 12 months
postrandomization for each study graft. Secondary confirmatory end points
were lumen diameter uniformity assessed by angiography and graft failure
(>=50% stenosis) by quantitative coronary angiography. Major cardiac and
cerebrovascular events were collected through month 12. Result(s):
Among 224 patients (mean [SD] age, 65.8 [8.3] years; 178 [79.5%] male),
203 (90.6%) were eligible for intravascular ultrasound, of which 85
(41.9%) had at least 1 study graft occluded or severely diseased at 12
months (55 supported, 56 unsupported). After imputation of data missing
because of graft occlusion or severe disease, the estimated mean (SE)
intimal hyperplasia area was 5.11 (0.16) mm2 in supported grafts and 5.79
(0.20) mm2 in unsupported grafts (P =.07). In a sensitivity analysis of
113 patients with both grafts imaged, the mean intimal hyperplasia area
was 4.58 (0.18) mm2 and 5.12 (0.23) mm2 in supported and unsupported
grafts, respectively (P =.04). By 12 months, 5 patients (2.2%) died and 16
patients (7.1%) experienced a major cardiac or cerebrovascular event.
 Conclusions and Relevance: The 12-month difference in intimal
hyperplasia area between supported and unsupported grafts did not achieve
statistical significance. Cumulative mortality and major cardiac or
cerebrovascular events rates were similar to those in other randomized
coronary artery bypass trials. Further investigation to assess the effect
of external graft support devices on long-term graft patency and clinical
outcomes is warranted. Trial Registration: ClinicalTrials.gov Identifier:
NCT03209609. Copyright © 2022 American Medical Association. All
rights reserved.

<29>
Accession Number
2018842536
Title
Comparison of cusp-overlap projection and standard three-cusp coplanar
view during self-expanding transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 927642. Date of Publication: 17 Aug 2022.
Author
Chen Y.; Zhu G.; Liu X.; Wu W.; Chai H.; Tao M.; Kong D.; Li Y.; Wang L.
Institution
(Chen, Chai, Tao, Kong, Li, Wang) Department of Hepatobiliary Surgery,
Affiliated Hangzhou First People's Hospital, Zhejiang University School of
Medicine, Hangzhou, China
(Zhu, Liu) Department of Cardiology, Affiliated Hangzhou First People's
Hospital, Zhejiang University School of Medicine, Hangzhou, China
(Wu) Department of Endocrinology, Affiliated Hangzhou First People's
Hospital, Zhejiang University School of Medicine, Hangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Objective: Permanent pacemaker implantation (PPI) is a common complication
after transcatheter aortic valve replacement (TAVR). Recently, the
cusp-overlap projection (COP) technique was thought to be a feasible
method to reduce PPI risk. However, the evidence is still relatively
scarce. Therefore, this meta-analysis was performed to compare COP and
standard three-cusp coplanar (TCC) projection technique. Method(s):
PubMed and EMBASE databases were systematically searched for relevant
literature published from the inception (EMBASE from 1974 and PubMed from
1966) to 16 April 2022, following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary
outcome of interest was post-operative (including in-hospital and 30-day)
PPI. Result(s): Total of 3,647 subjects from 11 studies were included
in this meta-analysis. Of those, 1,453 underwent self-expanding TAVR using
COP and 2,194 using TCC technique. In a pooled analysis, the cumulative
PPI incidence was 9.3% [95% confidence interval (CI): 6.9-11.7%] and 18.9%
(95% CI: 15.5-22.3%) in the COP group and TCC group, respectively. The
application of the COP technique was associated with a significant PPI
risk reduction (I2 = 40.3% and heterogeneity Chi-square p =
0.070, random-effects OR: 0.49, 95% CI: 0.36-0.66, p < 0.001). A higher
implantation depth was achieved in the COP group compared with the TCC
group [standardized mean difference (SMD) = -0.324, 95% CI: (-0.469,
-0.180)]. There was no significant difference between the two groups in
second valve implantation, prosthesis pop-out, fluoroscopic time,
post-operative left bundle branch block, mortality, stroke,
moderate/severe paravalvular leakage, mean gradient, and length of
hospital stay. However, radiation doses were higher in the COP group [SMD
= 0.394, 95% CI: (0.216, 0.572), p < 0.001]. Conclusion(s): In
self-expanding TAVR, the application of the cusp overlap projection
technique was associated with a lower risk of PPI compared with the
standard TCC technique. Systematic review registration:
[https://inplasy.com/inplasy-2022-4-0092/], identifier
[INPLASY202240092]. Copyright © 2022 Chen, Zhu, Liu, Wu, Chai,
Tao, Kong, Li and Wang.

<30>
Accession Number
2020189137
Title
Postoperative recovery with continuous erector spinae plane block or
video-assisted paravertebral block after minimally invasive thoracic
surgery: a prospective, randomised controlled trial.
Source
British Journal of Anaesthesia. (no pagination), 2022. Date of
Publication: 2022.
Author
Moorthy A.; Ni Eochagain A.; Dempsey E.; Wall V.; Marsh H.; Murphy T.;
Fitzmaurice G.J.; Naughton R.A.; Buggy D.J.
Institution
(Moorthy, Wall, Murphy, Buggy) Division of Anaesthesiology, Mater
Misericordiae University Hospital, Dublin, Ireland
(Moorthy, Buggy) School of Medicine, University College, Dublin, Ireland
(Ni Eochagain, Dempsey, Marsh, Naughton) Department of Anaesthesiology, St
James's University Hospital, Dublin, Ireland
(Fitzmaurice) Department of Cardiothoracic Surgery, St James's University
Hospital, Dublin, Ireland
(Buggy) EuroPeriscope, ESA-IC Onco-Anaesthesiology Research Group,
Brussels, Belgium
(Buggy) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Ltd
Abstract
Background: PROcedure SPECific Postoperative Pain ManagemenT (PROSPECT)
guidelines recommend erector spinae plane (ESP) block or paravertebral
block (PVB) for postoperative analgesia after video-assisted thoracoscopic
surgery (VATS). However, there are few trials comparing the effectiveness
of these techniques on patient-centric outcomes, and none evaluating
chronic postsurgical pain (CPSP). Furthermore, there are no available
trials comparing ultrasound-guided ESP with surgically placed PVB in this
patient cohort. Method(s): We conducted a two-centre, prospective,
randomised, double-blind, controlled trial, comparing
anaesthesiologist-administered, ultrasound-guided ESP catheter with
surgeon-administered, video-assisted PVB catheter analgesia among 80 adult
patients undergoing VATS. Participants received a 20 ml bolus of
levobupivacaine 0.375% followed by infusion of levobupivacaine 0.15%
(10-15 ml h-1) for 48 h. Primary outcome was Quality of
Recovery-15 score (QoR-15) at 24 h. Secondary outcomes included QoR-15 at
48 h, peak inspiratory flow (ml s-1) at 24 h and 48 h, area
under the pain verbal response score vs time curve (AUC), opioid
consumption, Comprehensive Complication Index, length of stay, and CPSP at
3 months after surgery. Result(s): Median (25-75%) QoR-15 at 24 h was
higher in ESP (n=37) compared with PVB (n=37): 118 (106-134) vs 110
(89-121) (P=0.03) and at 48 h: 131 (121-139) vs 120 (111-133) (P=0.03).
There were no differences in peak inspiratory flow, AUC, Comprehensive
Complication Index, length of hospital stay, and opioid consumption.
Incidence of CPSP at 3 months was 12 (34%) for ESP and 11 (31%) for PVB
(P=0.7). Conclusion(s): Compared with video-assisted, surgeon-placed
paravertebral catheter, erector spinae catheter improved overall QoR-15
scores at 24 h and 48 h but without differences in pain or opioid
consumption after minimally invasive thoracic surgery. Clinical trial
registration: NCT04729712. Copyright © 2022 British Journal of
Anaesthesia

<31>
[Use Link to view the full text]
Accession Number
639016925
Title
Catheter ablation for treatment of bradycardia-tachycardia syndrome: is it
time to consider it the therapy of choice? A systematic review and
meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 23(10) (pp 646-654),
2022. Date of Publication: 01 Oct 2022.
Author
Magnano M.; Bissolino A.; Budano C.; Abdirashid M.; Devecchi C.; Oriente
D.; Matta M.; Occhetta E.; Gaita F.; Rametta F.
Institution
(Magnano, Abdirashid, Devecchi, Oriente, Matta, Occhetta, Rametta)
Cardiology Department, St. Andrea Hospital, Vercelli, Italy
(Bissolino, Budano, Gaita) Maria Pia Hospital, GVM Care & Research,
Torino, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial fibrillation catheter ablation (AFCA) should be
considered as a strategy to avoid pacemaker (PM) implantation for patients
with bradycardia-tachycardia syndrome (BTS), but lack of evidence is
remarkable. METHOD(S): Our aim was to conduct a random-effects model
meta-analysis on safety and efficacy data from controlled trials and
observational studies. We compared atrial fibrillation (AF) recurrence, AF
progression, procedural complication, additional procedure, cardiovascular
death, cardiovascular hospitalization, heart failure and stroke in
patients undergoing AFCA vs. PM implantation. RESULT(S):
PubMed/MEDLINE, Cochrane Database and Google Scholar were screened, and
four retrospective studies were selected. A total of 776 patients (371 in
the AFCA group, 405 in the PM group) were included. After a median
follow-up of 67.5 months, lower AF recurrence [odds ratio (OR) 0.06,
confidence interval (CI) 0.02-0.18, I2 = 82.42%, P < 0.001], AF
progression (OR 0.12, CI 0.06-0.26, I2 = 0%, P < 0.001), heart failure (OR
0.12, CI 0.04-0.34, I2 = 0%, P < 0.001), and stroke (OR 0.30, CI
0.15-0.61, I2 = 0%, P = 0.001) were observed in the AFCA group. No
differences were observed in cardiovascular death and hospitalization (OR
0.48, CI 0.10-2.28, I2 = 0%, P = 0.358 and OR 0.43, CI 0.14-1.29, I2 =
87.52%, P = 0.134, respectively). Higher need for additional procedures in
the AFCA group was highlighted (OR 3.65, CI 1.51-8.84, I2 = 53.75%, P <
0.001). PM implantation was avoided in 91% of BTS patients undergoing
AFCA. CONCLUSION(S): AFCA in BTS patients seems to be more effective
than PM implantation in reducing AF recurrence and PM implantation may be
waived in most BTS patients treated by AFCA. Need for additional
procedures in AFCA patients is balanced by long-term benefit in clinical
end points. Copyright © 2022 Italian Federation of Cardiology -
I.F.C. All rights reserved.

<32>
Accession Number
636033241
Title
Ventricular Assist Device Driveline Infections: A Systematic Review.
Source
Thoracic and Cardiovascular Surgeon. 70(6) (pp 493-504), 2022. Date of
Publication: 01 Sep 2022.
Author
Krzelj K.; Petricevic M.; Gasparovic H.; Biocina B.; McGiffin D.
Institution
(Krzelj, Gasparovic, Biocina) Department of Cardiac Surgery, University
Hospital Center Zagreb, Zagreb, Croatia
(Petricevic) Division of Health Studies, Department of Cardiac Surgery,
University of Split, University Hospital Center Zagreb, Zagreb, Croatia
(Gasparovic, Biocina) School of Medicine, University of Zagreb, Zagreb,
Croatia
(McGiffin) Department of Cardiothoracic Surgery and Transplantation,
Alfred Hospital, Melbourne, VIC, Australia
(McGiffin) Monash University, Clayton, VIC, Australia
Publisher
Georg Thieme Verlag
Abstract
Infection is the most common complication in patients undergoing
ventricular assist device (VAD) implantation. Driveline exit site (DLES)
infection is the most frequent VAD infection and is a significant cause of
adverse events in VAD patients, contributing to morbidity, even mortality,
and repetitive hospital readmissions. There are many risk factors for
driveline infection (DLI) including younger age, smaller constitution of
patients, obesity, exposed velour at the DLES, longer duration of device
support, lower cardiac index, higher heart failure score, DLES trauma, and
comorbidities such as diabetes mellitus, chronic kidney disease, and
depression. The incidence of DLI depends also on the device type. Numerous
measures to prevent DLI currently exist. Some of them are proven, whereas
the others remain controversial. Current recommendations on DLES care and
DLI management are predominantly based on expert consensus and clinical
experience of the certain centers. However, careful and uniform DLES care
including obligatory driveline immobilization, previously prepared sterile
dressing change kits, and continuous patient education are probably
crucial for prevention of DLI. Diagnosis and treatment of DLI are often
challenging because of certain immunological alterations in VAD patients
and microbial biofilm formation on the driveline surface areas. Although
there are many conservative and surgical methods described in the DLI
treatment, the only possible permanent solution for DLI resolution in VAD
patients is heart transplantation. This systematic review brings a
comprehensive synthesis of recent data on the prevention, diagnostic
workup, and conservative and surgical management of DLI in VAD
patients. Copyright © 2022 Georg Thieme Verlag. All rights
reserved.

<33>
[Use Link to view the full text]
Accession Number
2020144007
Title
Prophylactic effect of intravenous lidocaine against cognitive deficit
after cardiac surgery: A PRISMA-compliant meta-analysis and trial
sequential analysis.
Source
Medicine (United States). 101(35) (pp E30476), 2022. Date of Publication:
02 Sep 2022.
Author
Hung K.-C.; Ho C.-N.; Liu W.-C.; Yew M.; Chang Y.-J.; Lin Y.-T.; Hung
I.-Y.; Chen J.-Y.; Huang P.-W.; Sun C.-K.
Institution
(Hung, Ho, Liu, Yew, Chang, Lin, Hung, Chen) Department of Anesthesiology,
Chi Mei Medical Center, Tainan city, Taiwan (Republic of China)
(Huang) Department of Emergency Medicine, Show Chwan Memorial Hospital,
Changhua city, Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung city,
Taiwan (Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung city, Taiwan
(Republic of China)
Publisher
Lippincott Williams and Wilkins
Abstract
Background: This study aimed at providing an updated evidence of the
association between intraoperative lidocaine and risk of postcardiac
surgery cognitive deficit. Method(s): Randomized clinical trials
(RCTs) investigating effects of intravenous lidocaine against cognitive
deficit in adults undergoing cardiac surgeries were retrieved from the
EMBASE, MEDLINE, Google scholar, and Cochrane controlled trials register
databases from inception till May 2021. Risk of cognitive deficit was the
primary endpoint, while secondary endpoints were length of stay (LOS) in
intensive care unit/hospital. Impact of individual studies and cumulative
evidence reliability were evaluated with sensitivity analyses and trial
sequential analysis, respectively. Result(s): Six RCTs involving 963
patients published from 1999 to 2019 were included. In early postoperative
period (i.e., 2 weeks), the use of intravenous lidocaine (overall
incidence = 14.8%) was associated with a lower risk of cognitive deficit
compared to that with placebo (overall incidence = 33.1%) (relative risk =
0.49, 95% confidence interval: 0.32-0.75). However, sensitivity analysis
and trial sequential analysis signified insufficient evidence to arrive at
a firm conclusion. In the late postoperative period (i.e., 6-10 weeks),
perioperative intravenous lidocaine (overall incidence = 37.9%) did not
reduce the risk of cognitive deficit (relative risk = 0.99, 95% confidence
interval: 0.84) compared to the placebo (overall incidence = 38.6%).
Intravenous lidocaine was associated with a shortened LOS in intensive
care unit/hospital with weak evidence. Conclusion(s): Our results
indicated a prophylactic effect of intravenous lidocaine against cognitive
deficit only at the early postoperative period despite insufficient
evidence. Further large-scale studies are warranted to assess its use for
the prevention of cognitive deficit and enhancement of recovery (e.g.,
LOS). Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<34>
Accession Number
2018645278
Title
Anti-factor X activity levels with continuous intravenous infusion and
subcutaneous administration of enoxaparin after coronary artery bypass
grafting: A randomized clinical trial.
Source
Acta Anaesthesiologica Scandinavica. 66(9) (pp 1083-1090), 2022. Date of
Publication: October 2022.
Author
Parviainen M.K.; Vahtera A.; Anas N.; Tahtinen J.; Huhtala H.; Kuitunen
A.; Jarvela K.
Institution
(Parviainen, Jarvela) Tampere University Heart Hospital Tampere, Tampere,
Finland
(Vahtera, Anas, Tahtinen, Kuitunen) Tampere University Hospital, Tampere,
Finland
(Huhtala) Faculty of Social Sciences, Tampere University, Tampere, Finland
(Kuitunen) Faculty of Medicine and Health Sciences, Tampere University,
Tampere, Finland
(Jarvela) Finnish Cardiovascular Research Center Tampere, Tampere
University, Tampere, Finland
Publisher
John Wiley and Sons Inc
Abstract
Background: Low-molecular-weight heparin enoxaparin is widely used in
pharmacological thromboprophylaxis after coronary artery bypass grafting
(CABG). The aim of this study was to compare anti-factor X activity
(anti-Xa) levels when the thromboprophylactic dose of enoxaparin was
provided after CABG, with two different administration routes: continuous
intravenous infusion (CIV) and subcutaneous bolus (SCB) injection. We
hypothesized that the current standard method of SCB administration might
lead to lower anti-Xa levels than recommended in other patient groups, due
to reduced bioavailability. Method(s): In this prospective,
randomized, controlled clinical trial, 40 patients scheduled for elective
CABG were randomized to receive 40 mg of enoxaparin per day either as CIV
or SCB for 72 h. Enoxaparin was initiated 6-10 h after CABG. Anti-Xa
levels were measured 12-14 times during the study period. The primary
outcome, that is, the maximum anti-Xa concentration over 0-24 h
(C<inf>max0-24h</inf>), was calculated from these measured values.
Secondary outcomes were C<inf>max25-72h</inf> and the trough concentration
of anti-Xa after 72 h of enoxaparin initiation (C<inf>72h</inf>).
 Result(s): Twenty patients were randomized to the CIV-group and 19 to
the SCB-group. The median anti-Xa C<inf>max0-24h</inf> was significantly
lower in the CIV-group than in the SCB-group: 0.15 [interquartile range
(IQR) 0.13-0.19] IU/ml versus 0.25 (IQR 0.18-0.32) IU/ml, p <.005. The
median anti-Xa C<inf>max25-72h</inf> was 0.12 (IQR, 0.1-0.17) IU/ml versus
0.23 (IQR 0.19-0.31) IU/ml, respectively, p <.005. At 72 h, there was no
difference between the groups in their anti-Xa levels. Conclusion(s):
In this low-risk CABG patient population, SCB administration of a
thromboprophylactic dose of enoxaparin provided anti-Xa levels that are
considered sufficient for thromboprophylaxis in other patient groups. CIV
administration resulted in lower anti-Xa levels compared to the SCB
route. Copyright © 2022 Acta Anaesthesiologica Scandinavica
Foundation.

<35>
Accession Number
2018177077
Title
Titrated versus conventional anticoagulation management for thrombin
generation in cardiac surgery: a randomized controlled trial.
Source
Canadian Journal of Anesthesia. 69(9) (pp 1117-1128), 2022. Date of
Publication: September 2022.
Author
Li H.; Bartoszko J.; Serrick C.; Rao V.; Karkouti K.
Institution
(Li, Serrick) Perfusion Services, University Health Network, Toronto, ON,
Canada
(Bartoszko, Karkouti) Department of Anesthesia and Pain Management, Sinai
Health System, Women's College Hospital, University Health Network,
Toronto, ON, Canada
(Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Rao) Cardiovascular Surgery, University Health Network and University of
Toronto, Toronto, ON, Canada
(Bartoszko, Rao, Karkouti) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
(Karkouti) Interdepartmental Division of Critical Care, Department of
Medicine, University of Toronto, Toronto, ON, Canada
(Karkouti) Institute for Health Policy, Management, and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Optimal heparin titration during cardiopulmonary bypass (CPB) may
reduce coagulation system activation and preserve hemostatic function
post-CPB. Our objective was to assess if the Heparin Management System
(HMS) Plus improves heparin titration, thereby leading to higher thrombin
generation post-CPB compared with activated clotting time (ACT)-guided
management. Method(s): We conducted a randomized controlled trial of
100 patients undergoing cardiac surgery with CPB at a single center. A
total of 50 patients were randomized to conventional ACT-guided
management, and 50 to the HMS Plus system. The primary outcome was change
in thrombin generation post-CPB compared with baseline, as assessed by
calibrated automated thrombography. Secondary outcomes included
intraoperative blood loss, chest drain output up to 72 hr, and
transfusions. In an exploratory analysis, we compared the quintile of
patients with the highest average heparin concentration on CPB (>= 4.0
mgkg-1) with the rest of the cohort. Result(s): A total of
100 patients were included in an intent-to-treat analysis. We observed no
difference in post-CPB thrombin generation or secondary outcomes. However,
patients in the HMS Plus group had higher average heparin concentrations
while on CPB than patients in the conventional management group did (mean
difference, -0.21; 95% confidence interval, -0.42 to -0.01). The quintile
of patients with the highest average heparin concentration (4.0
mgkg-1) had higher thrombin generation post-CPB than the rest
of the cohort did. Conclusion(s): The HMS Plus system did not show
significant benefits in thrombin generation, bleeding outcomes, or
transfusion in patients undergoing cardiac surgery with CPB. Higher
average heparin concentrations on CPB were associated with higher post-CPB
thrombin generation. Study registration: www.ClinicalTrials.gov
(NCT03347201); first submitted 12 October 2017. Copyright © 2022,
Canadian Anesthesiologists' Society.

<36>
Accession Number
639030410
Title
Levosimendan with in critical care. Coronary stenting verses no coronary
stenting: An observational study.
Source
Journal of the Intensive Care Society. Conference: Intensive Care Society
State of the Art 2022. Belfast United Kingdom. 23(1 Supplement) (pp
13-14), 2022. Date of Publication: August 2022.
Author
Millen G.; Cooper L.; Snazelle M.
Institution
(Millen, Cooper, Snazelle) East Kent Hospital University Foundation Trust,
United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Introduction: Levosimendan acts as a vasodilator opening ATP-sensitive
potassium channels in vascular smooth muscle, increasing myocardial oxygen
supply, and reducing preload and afterload. It protects against
ischemiareperfusion injury and activating stunned myocardium in patients
following cardiac intervention.1 An Observational Study was designed to
review the impact of Levosimendan in the first 24 hours of treatment by
measuring Cardiac Index (CI). This data was collected in a district
general hospital which offers primary percutaneous coronary intervention.
 Objective(s): To observe the impact of Levosimendan on CI during
cardiogenic shock in patients who received coronary stenting vs no
coronary stenting. Method(s): Patients requiring Levosimendan, due to
cariogenic shock, were observed over an 8 year period. These patients were
subject to inclusion and exclusion criteria. CI studies were performed on
onset of Levosimendan, 12 hours and 24 hours from initiation.
 Result(s): Manual data of 71 patients with a median age of 62 years.
The male to female ratio was 76% vs 21% and the average organ support for
the patients consisted of three organs The overall CI in all patients
improved from onset to 24hrs of commencement of Levosimendan from a median
CI of 1.83L/min/min2 to 2.77L/min/m2 The patients' CI in Group
A, improved overall from onset of 2.23L/min/m2 to 24 hour CI of
2.535L/min/m2, however the CI at 12hrs was most improved to
2.65L/min/ m2. The overall mortality for this group of patients was 58%.
Patients in Group B show a consistenly improved median CI over the 24hrs
from a CI of 1.9L/min/m2 to 3.055L/min/ m2. The overall
mortality for this group was 39%. The data collected for patients in Group
C is comparatively small and may well be excluded for this, however, the
data showed a varying CI of onset 2.45L/min/m2 to
2.09L/min/m2. All the patients survived in this group.
 Conclusion(s): The observational data for all three groups shows an
overall improvement in CI, however there are some variations. Overall
mortality of patients in Group B are improved from Group A, however the
sample size and severity scoring is markedly different between the groups.
APACHE II scores were higher in Group A, predicting a worse mortality. By
definition, the patient groups being discussed have very high mortality
and so isolation of the true benefit of Levosimendan will only be possible
with large sample size.2 We postulate that due to cost, Levosimendan may
be used too late. Further study into timing of administration of
Levosimendan use in post coronary intervention group and use as first line
therapy is warranted. We suggest future randomised controlled trials with
larger patient groups, closer observation of the demographic data,
severity scores, timing, administration and other variables. This would
provide further evidence base to compare Levosimendan use verses standard
therapy.

<37>
Accession Number
639032266
Title
Supersized-Simulation vs Traditional Cardiothoracic Surgery Education: A
Prospective, Randomised Controlled Trial.
Source
British Journal of Surgery. Conference: ASiT Surgical Conference 2022.
Aberdeen United Kingdom. 109(Supplement 6) (pp vi109-vi110), 2022. Date of
Publication: September 2022.
Author
Hirniak J.; Adil S.; Hayes J.; Vaghela M.; Mani K.; Abbas A.; Aboulelea
Y.; Syed N.
Institution
(Hirniak, Hayes) St George's, University of London, London, United Kingdom
(Adil) University of Cambridge, Cambridge, United Kingdom
(Vaghela) Brighton and Sussex Medical School, Brighton, United Kingdom
(Mani, Aboulelea, Syed) St George's University Hospitals NHS Foundation
Trust, London, United Kingdom
(Abbas) James Cook University Hospital, Middlesbrough, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Exposure to cardiothoracic surgery is limited during medical school
in the United Kingdom. This study evaluated the effectiveness of a
supersized simulation model (SSM) compared to traditional methods (TM) in
developing coronary anastomosis surgical skills. Method(s): This was
a prospective, randomised controlled trial with a 1:1 allocation ratio.
Undergraduate medical students with no prior cardiothoracic surgical
skills training were eligible for inclusion. Both groups received a guided
didactic lecture followed by modified Objective Structured Assessment of
Technical Skills (OSATS) assessment for baseline. The control group then
received traditional teaching and the intervention group received
additional teaching with SSM before being reassessed. Modified OSATS score
were the primary outcome, adjudicated by two senior cardiothoracic
registrars. Performance time (PT), self-assessment (SA), confidence (CON)
and global rating scale (GRS) were secondary outcomes. Result(s): 48
novice medical students were randomised. OSATS scores were significantly
higher in SSM group compared to TM group (13.2 vs 9.8, p<0.01). The
secondary outcomes PT (17.7 minutes vs 22.2 minutes, p<0.01) and CON (3.04
vs 1.73, p<0.01) were also significantly different between groups,
favouring SSM. SSM participants were more likely to want to pursue a
career in cardiothoracic surgery (12 participants vs 2 participants). All
participants agreed that SSM improved visualisation and comprehension of
surgical procedure. SSM cost 0.75 per model. Conclusion(s):
Supersized simulation is effective for coronary anastomosis surgical
training with technical skills successfully transferred to a clinical
task. Supersized models can accelerate the novice trainee's surgical skill
progression and represents a valuable resource in one's educational
armamentarium.

<38>
Accession Number
639031752
Title
Redo Mitral Valve Surgery via Median Sternotomy Versus Mini-Thoracotomy: A
Systematic Review and Meta-Analysis of Clinical Outcomes.
Source
British Journal of Surgery. Conference: ASiT Surgical Conference 2022.
Aberdeen United Kingdom. 109(Supplement 6) (pp vi42), 2022. Date of
Publication: September 2022.
Author
Shirke M.; Ravikumar N.; Tan S.; Mutsonziwa N.; Soh V.; Harky A.
Institution
(Shirke, Ravikumar, Tan, Mutsonziwa, Soh) Queen's University Belfast,
Belfast, United Kingdom
(Harky) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Redo mitral valve surgery is a high-risk cardiac procedure. Median
re-sternotomy (MS) remains a common approach in many centres. However,
there is a significant risk of morbidity and mortality associated with
this approach. Alternative procedures such as the right anterolateral
minithoracotomy (MT) have been explored. This review compares the clinical
outcomes of re-sternotomy versus right mini thoracotomy in mitral valve
surgery. Method(s): A systematic, electronic search was performed
according to PRISMA guidelines to identify relevant articles that compared
outcomes of the MS versus MT procedures in redo mitral valve surgery. Data
regarding mortality, length of hospital stay, stroke, infection were
extracted and analysed Results: Thirteen studies were identified,
enrolling 4,549 patients. Length of hospital stay (MD= -3.70, 95%
CI[-4.89, -2.51]), 30-day mortality (OR=0.58, 95% CI[0.39, 0.87]),
new-onset renal failure (OR=0.38, 95% CI [0.22, 0.65], and length of ICU
stay (MD=-0.62, 95% CI[-1.21, 0.02]) were statistically significant in
favour of the MT approach. Infection rates (OR=0.52, 95% CI[0.24, 1.12])
were lower in the MT group; however, the difference was not significant.
No significant differences were observed in the CPB time (MD=-2.68, 95%
CI[-8.53, 3.17]), aortic cross-clamp time (MD=-2.40, 95% CI[-17.07,
12.27]), and rates of stroke (OR=1.03, 95% CI[0.55, 1.92]).
 Conclusion(s): Right mini thoracotomy is a safe alternative to the
traditional re-sternotomy for patients who have had previous cardiac
surgery. The approach offers a reduced length of hospital stay, ICU stay,
and a lower risk of new onset renal failure requiring dialysis. This
review calls for robust trials in the field to further strengthen the
evidence.

<39>
Accession Number
639034582
Title
Influences of Antithrombotic Elastic Socks Combined with Air Pressure in
Reducing Lower Extremity Deep Venous Thrombosis for Patients Undergoing
Cardiothoracic Surgery.
Source
Computational and mathematical methods in medicine. 2022 (pp 1338214),
2022. Date of Publication: 2022.
Author
Fu W.; Zhang Q.; Sun X.; Gu Y.
Institution
(Fu, Sun) Department of Thoracic Surgery, Affiliated Hospital of Nantong
University, Nantong, Jiangsu 226001, China
(Zhang) Department of Cardiovascular Surgery, Affiliated Hospital of
Nantong University, Nantong, Jiangsu 226001, China
(Gu) Department of Surgery, Affiliated Hospital of Nantong University,
Nantong, Jiangsu 226001, China
Publisher
NLM (Medline)
Abstract
This study was designed to investigate the application and therapeutic
effect of antithrombotic elastic socks combined with air pressure in the
prevention of lower extremity deep venous thrombosis in patients
undergoing cardiothoracic surgery. Sixty patients in cardiothoracic
surgery of our hospital from January 2019 to December 2020 were randomly
divided into a study group and control group. The control group was
treated with routine treatment intervention. Based on routine treatment
intervention, the study group was treated with antithrombotic elastic
socks combined with pneumatic treatment intervention. The activated
partial thromboplastin time (APTT), thrombin time (TT), femoral venous
blood flow velocity of both lower limbs, and the incidence of lower
extremity deep venous thrombosis (LEDVT), postoperative lower extremity
swelling, inflammatory factors, and satisfaction were measured. After
intervention, APTT (31.74 +/- 1.15s) and TT (14.58 +/- 0.24s) in the study
group were higher than those in the control group APTT (25.13 +/- 1.14s)
and TT (12.14 +/- 0.23s) (P < 0.05). The left lower limb femoral vein
blood flow velocity and the right lower limb femoral vein blood flow
velocity in the study group were better than those in the control group (P
< 0.05). The incidence of postoperative lower limb swelling and deep vein
in the study group was lower than that in the control group (P < 0.05).
Serum tumor necrosis factor alpha and interleukin-6 concentrations in the
study group were lower than those in the control group (P < 0.05). The
satisfaction rate of patients in the study group (93.33%) was
significantly higher than that in the control group (70.00%) (P < 0.05).
In conclusion, after cardiothoracic surgery, antithrombotic elastic socks
combined with air pressure can significantly reduce the incidence of LEDVT
by improving patients' coagulation function, reducing inflammatory
reaction. It is worthy of popularization and application in relevant
surgery. Copyright © 2022 Weihong Fu et al.

<40>
Accession Number
2020229727
Title
In-Hospital Outcome In Patients With Acyanotic Congenital Heart Disease
Undergoing Transcatheter Aortic Valve Replacement.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101352. Date of Publication: December 2022.
Author
Chakraborty S.; Gupta M.; Bandyopadhyay D.; Patel N.; Hajra A.; Malik A.;
Goel A.; Hassanin A.; Gupta R.; Krittanawong C.; Hasan A.
Institution
(Chakraborty) Department of Medicine, Miami Valley Hospital, Columbus, OH,
United States
(Gupta) Department of Medicine, University of Connecticut, Farmington, CT
(Bandyopadhyay, Malik, Goel, Hassanin, Hasan) New York Medical College at
Westchester Medical Center, New York, NY
(Patel) University of Kansas, Kansas City, KS
(Hajra) Montefiore Medical Center/Albert Einstein College of Medicine,
Bronx, NY, United States
(Gupta) Lehigh Valley Health Network, Allentown, PA, United States
(Krittanawong) Baylor College of Medicine, TX
Publisher
Elsevier Inc.
Abstract
The purpose of the study was to determine the in-hospital outcome and
resource utilization in patients with acyanotic congenital heart disease
(ACHD) undergoing transcatheter aortic valve replacement (TAVR). Current
guidelines from professional societies do not support TAVR in patients
with ACHD, likely from a lack of supportive evidence. Temporal trends in
patients with ACHD undergoing TAVR were determined using the 2016-2018
National Inpatient Sample database appropriate ICS-10-PCS code. Stata 16.0
was used for statistical analysis. 0.87% of patients undergoing TAVR had
concomitant ACHD, with ASD being the most common (78%). After matching,
there was no increased risk of mortality in ACHD patients undergoing TAVR
compared to patients without ACHD (OR 1.43, P = 0.59). Additionally, no
difference was found in the incidence of overall cardiac complications
between patients with ACHD and patients without ACHD, except STEMI (OR
4.16, 95% CI, 1.08-16.00, P = 0.038), which is likely due to more
comorbidity burden in the later cohort. Complications such as acute kidney
injury, ischemic stroke, and bleeding were similar. Hospital resource
utilization was higher in the ACHD group in the form of increased length
of stay and higher mean total cost. The comparable in-hospital all-cause
mortality and complication rate in ACHD patients undergoing TAVR compared
to patients without ACHD is encouraging and will be helpful to design
future randomized controlled trials. Copyright © 2022 Elsevier
Inc.

<41>
Accession Number
2018992582
Title
Infective Endocarditis by Pasteurella Species: A Systematic Review.
Source
Journal of Clinical Medicine. 11(17) (no pagination), 2022. Article
Number: 5037. Date of Publication: September 2022.
Author
Alifragki A.; Kontogianni A.; Protopapa I.; Baliou S.; Ioannou P.
Institution
(Alifragki, Kontogianni, Protopapa) School of Medicine, University of
Crete, Voutes 70013, Greece
(Baliou, Ioannou) Internal Medicine Department, University Hospital of
Heraklion, Voutes 71500, Greece
Publisher
MDPI
Abstract
Pasteurella spp. are non-motile, facultative anaerobic, Gram-negative
coccobacilli that are commonly found in the oral cavity and the
gastrointestinal tract of some animals and are known to be the cause of
infections. Usually, infections by Pasteurella spp. in humans is more
common in the context of an animal bite leading to a skin and soft tissue
infection (SSTI). Infective endocarditis (IE) is rarely caused by
Pasteurella spp.; however, it can pose diagnostic and therapeutic dilemmas
due to its rarity. The aim of the present study was to systematically
review all cases of IE by Pasteurella spp. in the literature. A systematic
review was performed of PubMed, Scopus and the Cochrane Library (through
20 December 2021) for studies providing data on epidemiology and clinical
and microbiological characteristics as well as data on treatment and
outcomes of IE by Pasteurella spp. A total of 28 studies containing data
for 28 patients were included. Prosthetic valve was present in 21.4% of
patients. The aorta was the most commonly involved intracardiac site.
Fever, sepsis, septic shock and heart failure were the most common
clinical presentations. Cephalosporins, aminopenicillins and penicillin
were the antimicrobials used most commonly. Overall mortality was
17.9%. Copyright © 2022 by the authors.

<42>
Accession Number
2018952546
Title
Dexmedetomidine and acute kidney injury following cardiac surgery in
pediatric patients-An updated systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 938790. Date of Publication: 24 Aug 2022.
Author
Wang H.; Zhang C.; Li Y.; Jia Y.; Yuan S.; Wang J.; Yan F.
Institution
(Wang, Li, Jia, Yuan, Wang, Yan) Department of Anesthesiology, Fuwai
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Zhang) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences, Shenzhen (Sun Yat-sen Cardiovascular Hospital,
Shenzhen), Shenzhen, China
Publisher
Frontiers Media S.A.
Abstract
Background: Acute kidney injury (AKI) is a common postoperative
complication in pediatric patients undergoing cardiac surgery and
associated with poor outcomes. Dexmedetomidine has the pharmacological
features of organ protection in cardiac surgery patients. The aim of this
meta-analysis is to investigate the effect of dexmedetomidine infusion on
the incidence of AKI after cardiac surgery in pediatric patients.
 Method(s): The databases of Pubmed, Embase, and Cochrane Library were
searched until April 24, 2022 following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RevMan 5.3 was
used to perform statistical analyses. Result(s): Five relevant trials
with a total of 630 patients were included. The pooled result using
fixed-effects model with OR demonstrated significant difference in the
incidence of AKI between patients with dexmedetomidine and placebo (OR =
0.49, 95% CI: [0.33, 0.73], I2 = 0%, p for effect = 0.0004).
Subgroup analyses were performed based on congenital heart disease (CHD)
types and dexmedetomidine intervention time. Pooled results did not
demonstrate considerable difference in the incidence of AKI in pediatric
patients receiving intraoperative (OR = 0.53, 95% CI: [0.29, 0.99],
I2 = 0%, p for effect = 0.05) or postoperative dexmedetomidine
infusion (OR = 0.56, 95% CI: [0.31, 1.04], p for effect = 0.07), but a
significant difference in patients receiving combination of intra- and
postoperative dexmedetomidine infusion (OR = 0.27, 95% CI: [0.09, 0.77], p
for effect = 0.01). Besides, there was no significant difference in
duration of mechanical ventilation (SMD: -0.19, 95% CI: -0.46 to 0.08, p
for effect = 0.16; SMD: -0.16, 95% CI: -0.37 to 0.06, p for effect =
0.15), length of ICU (SMD: 0.02, 95% CI: -0.41 to 0.44, p for effect =
0.93) and hospital stay (SMD: 0.2, 95% CI: -0.13 to 0.54, p for effect =
0.23), and in-hospital mortality (OR = 1.26, 95% CI: 0.33-4.84, p for
effect = 0.73) after surgery according to the pooled results of the
secondary outcomes. Conclusion(s): Compared to placebo,
dexmedetomidine could significantly reduce the postoperative incidence of
AKI in pediatric patients undergoing cardiac surgery with cardiopulmonary
bypass (CPB), but the considerable difference was reflected in the
pediatric patients receiving combination of intra- and postoperative
dexmedetomidine infusion. Besides, there was no significant difference in
duration of mechanical ventilation, length of ICU and hospital stay, or
in-hospital mortality after surgery. Copyright © 2022 Wang,
Zhang, Li, Jia, Yuan, Wang and Yan.

<43>
Accession Number
2018952338
Title
Prognostic value of ventricular longitudinal strain in patients undergoing
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 965440. Date of Publication: 24 Aug 2022.
Author
Xiao Y.; Bi W.; Qiao W.; Wang X.; Li Y.; Ren W.
Institution
(Xiao, Bi, Qiao, Wang, Li, Ren) Department of Ultrasound, Shengjing
Hospital of China Medical University, Shenyang, China
Publisher
Frontiers Media S.A.
Abstract
Introduction: Strain obtained by speckle tracking echocardiography (STE)
can detect subclinical myocardial impairment due to myocardial fibrosis
(MF) and is considered a prognostic marker. Aortic stenosis (AS) is not
only a valve disease, but also a cardiomyopathy characterized by MF. The
purpose of this study was to systematically review and analyze ventricular
strain as a predictor of adverse outcomes in patients with AS undergoing
transcatheter aortic valve replacement (TAVR). Method(s): PubMed,
Embase, and the Cochrane library were searched for studies that
investigated the prognostic value of impaired ventricular strain on
patients with AS undergoing TAVR with all-cause mortality (ACM) and major
adverse cardiovascular events (MACE). Pooled odds ratios (ORs), hazard
ratios (HRs), and 95% confidence intervals (CIs) were calculated to assess
the role of left (LVLS) and right (RVLS) ventricular longitudinal strain
in the prognostic prediction of patients with AS undergoing TAVR.
Sensitivity and subgroup analysis was performed to assess heterogeneity.
 Result(s): Twelve studies were retrieved from 571 citations for
analysis. In total, 1,489 patients with a mean age of 82 years and
follow-up periods varying between 1 year and 8.5 years were included.
Meta-analysis showed the impaired LVLS from eight studies was associated
with an increased risk for combined ACM and MACE (OR: 1.08, 95% CI:
1-1.16; p = 0.037), and ACM alone (HR: 1.08, 95% CI: 1.01-1.16; p =
0.032). Impaired RVLS from four studies was associated with an increased
risk of combined ACM and MACE (OR: 1.08, 95% CI: 1.02-1.14; p < 0.01), and
ACM alone (HR: 1.07, 95% CI: 1.02-1.12; p < 0.01). Conclusion(s):
This meta-analysis demonstrated that ventricular strain, including LVLS
and RVLS, had a substantial prognostic value in ACM or combined ACM and
MACE, which could be used as a valid marker for risk stratification in
patients with AS undergoing TAVR. Copyright © 2022 Xiao, Bi,
Qiao, Wang, Li and Ren.

<44>
[Use Link to view the full text]
Accession Number
2020240323
Title
Safety of Vitamin K in mechanical heart valve patients with
supratherapeutic INR: A systematic review and meta-analysis.
Source
Medicine (United States). 101(36) (pp E30388), 2022. Date of Publication:
09 Sep 2022.
Author
Sapapsap B.; Srisawat C.; Suthumpoung P.; Luengrungkiat O.; Leelakanok N.;
Saokaew S.; Kanchanasurakit S.
Institution
(Sapapsap, Leelakanok) Division of Clinical Pharmacy, Faculty of
Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
(Srisawat) Division of Pharmaceutical Care, Department of Pharmacy,
Banphaeo General Hospital, Samut Sakhon, Thailand
(Suthumpoung) Division of Pharmaceutical Care, Department of Pharmacy,
Fort Khuncheangthammikkarat Hospital, Phayao, Thailand
(Luengrungkiat) Division of Pharmaceutical Care, Department of Pharmacy,
Wichaivej International Omnoi Hospital, Samutsakhon, Thailand
(Saokaew) Division of Social and Administration Pharmacy, Department of
Pharmaceutical Care, School of Pharmaceutical Sciences, University of
Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Center of Health Outcomes Research and
Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences,
University of Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Unit of Excellence on Clinical Outcomes
Research and Integration (UNICORN), School of Pharmaceutical Sciences,
University of Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Unit of Excellence on Herbal Medicine, School
of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
(Saokaew) Biofunctional Molecule Exploratory Research Group, Biomedicine
Research Advancement Centre, School of Pharmacy, Monash University
Malaysia, Bandar Sunway, Selangor Darul Ehsan, Malaysia
(Saokaew) Novel Bacteria and Drug Discovery Research Group, Microbiome and
Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health
Sciences, Monash University Malaysia, Bandar Sunway, Selangor Darul Ehsan,
Malaysia
(Kanchanasurakit) Division of Clinical Pharmacy, Department of
Pharmaceutical Care, School of Pharmaceutical Sciences, University of
Phayao, Phayao, Thailand
(Kanchanasurakit) Division of Pharmaceutical Care, Department of Pharmacy,
Phrae Hospital, Phrae, Thailand
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Patients who had mechanical heart valves and an international
normalized ratio (INR) of >5.0 should be managed by temporary cessation of
vitamin K antagonist. This study aimed to investigate the safety of
low-dose vitamin K1 in patients with mechanical heart valves who have
supratherapeutic INR. Method(s): CINAHL, Cochran Library, Clinical
trial.gov, OpenGrey, PubMed, ScienceDirect, and Scopus were systematically
searched from the inception up to October 2021 without language
restriction. Studies comparing the safety of low-dose vitamin K1 treatment
in patients with placebo or other anticoagulant reversal agents were
included. We used a random-effect model for the meta-analysis. Publication
bias was determined by a funnel plot with subsequent Begg's test and
Egger's test. Result(s): From 7529 retrieved studies, 3 randomized
control trials were included in the meta-analysis. Pooled data
demonstrated that low-dose vitamin K was not associated with
thromboembolism rate (risk ratio [RR] = 0.94; 95% CI: 0.19-4.55) major
bleeding rate (RR = 0.58; 95% CI: 0.07-4.82), and minor bleeding rate (RR
= 0.60; 95% CI: 0.07-5.09). Subgroup and sensitivity analysis demonstrated
the nonsignificant effect of low-dose vitamin K on the risk of
thromboembolism. Publication bias was not apparent, according to Begg's
test and Egger's test (P =.090 and 0.134, respectively).
 Conclusion(s): The current evidence does not support the role of
low-dose vitamin K as a trigger of thromboembolism in supratherapeutic INR
patients with mechanical heart valves. Nevertheless, more well-designed
studies with larger sample sizes are required to justify this research
question. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<45>
Accession Number
639039092
Title
Heart failure during the COVID-19 pandemic: clinical, diagnostic,
management, and organizational dilemmas.
Source
ESC heart failure. (no pagination), 2022. Date of Publication: 16 Sep
2022.
Author
Palazzuoli A.; Metra M.; Collins S.P.; Adamo M.; Ambrosy A.P.; Antohi
L.E.; Ben Gal T.; Farmakis D.; Gustafsson F.; Hill L.; Lopatin Y.;
Tramonte F.; Lyon A.; Masip J.; Miro O.; Moura B.; Mullens W.; Radu R.I.;
Abdelhamid M.; Anker S.; Chioncel O.
Institution
(Palazzuoli, Tramonte) Cardiovascular Diseases Unit, Cardio Thoracic and
Vascular Department, S. Maria alle Scotte Hospital, University of Siena,
Siena 53100, Italy
(Metra, Adamo) Cardiology, Cardio-Thoracic Department, Civil Hospitals,
Brescia, Italy; Department of Medical and Surgical Specialties,
Radiological Sciences, and Public Health, University of Brescia, Brescia,
Italy
(Collins) Department of Emergency Medicine, Vanderbilt University Medical
Centre, Nashville, TN, United States
(Ambrosy) Department of Cardiology, Kaiser Permanente San Francisco
Medical Center, San Francisco, CA, United States
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Antohi, Radu) Emergency Institute for Cardiovascular Diseases "Prof. Dr.
C.C.Iliescu" Bucharest, Bucharest, Romania
(Ben Gal) Department of Cardiology, Sackler Faculty of Medicine, Tel Aviv
University, Rabin Medical Center (Beilinson Campus), Tel Aviv, Israel
(Farmakis) Heart Failure Unit, "Attikon" University Hospital, National and
Kapodistrian University of Athens Medical School, Athens, Greece
(Farmakis) University of Cyprus Medical School, Nicosia, Cyprus
(Gustafsson) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Hill) School of Nursing and Midwifery, Queen's University, Belfast,
United Kingdom
(Lopatin) Volgograd Medical University, Cardiology Centre, Volgograd,
Russian Federation
(Lyon) Cardio-Oncology Service, Royal Brompton Hospital and Imperial
College London, London, United Kingdom
(Masip) Intensive Care Department, Consorci Sanitari Integral, University
of Barcelona, Barcelona, Spain
(Masip) Department of Cardiology, Hospital Sanitas CIMA, Barcelona, Spain
(Miro) Emergency Department, Hospital Clinic de Barcelona, University of
Barcelona, Barcelona, Spain
(Moura) Armed Forces Hospital, Faculty of Medicine, University of Porto,
Porto, Portugal
(Mullens) Cardiovascular Physiology, Hasselt University, Heart Failure and
Cardiac Rehabilitation Specialist, Ziekenhuis Oost-Limburg, Genk, Belgium
(Abdelhamid) Cardiology Department, Kasr Alainy School of Medicine, Cairo
University, 5th settlement, New Cairo, Cairo, Egypt
(Anker) Department of Cardiology (CVK), Berlin Institute of Health Center
for Regenerative Therapies (BCRT), German Centre for Cardiovascular
Research (DZHK) partner site Berlin, Charite Universitatsmedizin Berlin,
Berlin, Germany
(Chioncel) Emergency Institute for Cardiovascular Diseases "Prof. Dr. C.C.
Iliescu" Bucharest; University for Medicine and Pharmacy "Carol Davila"
Bucharest, Bucharest, Romania
Publisher
NLM (Medline)
Abstract
The coronavirus 2019 (COVID-19) infection pandemic has affected the care
of patients with heart failure (HF). Several consensus documents describe
the appropriate diagnostic algorithm and treatment approach for patients
with HF and associated COVID-19 infection. However, few questions about
the mechanisms by which COVID can exacerbate HF in patients with high-risk
(Stage B) or symptomatic HF (Stage C) remain unanswered. Therefore, the
type of HF occurring during infection is poorly investigated. The
diagnostic differentiation and management should be focused on the
identification of the HF phenotype, underlying causes, and subsequent
tailored therapy. In this framework, the relationship existing between
COVID and onset of acute decompensated HF, isolated right HF, and
cardiogenic shock is questioned, and the specific management is mainly
based on local hospital organization rather than a standardized model.
Similarly, some specific populations such as advanced HF, heart
transplant, patients with left ventricular assist device (LVAD), or valve
disease remain under investigated. In this systematic review, we examine
recent advances regarding the relationships between HF and COVID-19
pandemic with respect to epidemiology, pathogenetic mechanisms, and
differential diagnosis. Also, according to the recent HF guidelines
definition, we highlight different clinical profile identification,
pointing out the main concerns in understudied HF
populations. Copyright © 2022 The Authors. ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<46>
Accession Number
2013930341
Title
Analgesic effect of intercostal nerve block given preventively or at the
end of operation in video-assisted thoracic surgery: a randomized clinical
trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 72(5) (pp 574-578),
2022. Date of Publication: 01 Sep 2022.
Author
Xiao W.; Zhou W.; Chen X.; Zhu J.; Xue Q.; Shi J.
Institution
(Xiao, Chen, Zhu, Xue, Shi) Affiliated Hospital of Nantong University,
Department of Cardiothoracic Surgery, Nantong, China
(Xiao, Shi) Affiliated Hospital of Nantong University, Nantong Key
Laboratory of Translational Medicine in Cardiothoracic Diseases, Nantong,
China
(Zhou) Affiliated Hospital of Nantong University, Department of
Anaesthesiology, Nantong, China
Publisher
Elsevier Editora Ltda
Abstract
Objective: To compare the analgesic effect of intercostal nerve block
(INB) with ropivacaine when given preventively or at the end of the
operation in patients undergoing video-assisted thoracic surgery (VATS).
 Method(s): A total of 50 patients undergoing VATS were randomly
divided into two groups. The patients in the preventive analgesia group
(PR group) were given INB with ropivacaine before the intrathoracic
manipulation combined with patient-controlled analgesia (PCA). The
patients in the post-procedural block group (PO group) were administered
INB with ropivacaine at the end of the operation combined with PCA. To
evaluate the analgesic effect, postoperative pain was assessed with the
visual analogue scale (VAS) at rest and Prince Henry Pain Scale (PHPS)
scale at 6, 12, 24, 48, and 72 hours after surgery. Result(s): At 6 h
and 12 h post-surgery, the VAS at rest and PHPS scores in the PR group
were significantly lower than those in the PO group. There were no
significant differences in pain scores between two groups at 24, 48, and
72 hours post-surgery. Conclusion(s): In patients undergoing VATS,
preventive INB with ropivacaine provided a significantly better analgesic
effect in the early postoperative period (at least through 12 h
post-surgery) than did INB given at the end of surgery. Copyright
© 2021 Sociedade Brasileira de Anestesiologia

<47>
Accession Number
2017057099
Title
Preoperative dexmedetomidine and intraoperative bradycardia in
laparoscopic cholecystectomy: a meta-analysis with trial sequential
analysis.
Source
Korean Journal of Anesthesiology. 75(3) (pp 245-254), 2022. Date of
Publication: June 2022.
Author
De Cassai A.; Sella N.; Geraldini F.; Zarantonello F.; Pettenuzzo T.;
Pasin L.; Iuzzolino M.; Rossini N.; Pesenti E.; Zecchino G.; Munari M.;
Navalesi P.; Boscolo A.
Institution
(De Cassai, Sella, Geraldini, Zarantonello, Pettenuzzo, Pasin, Munari,
Navalesi, Boscolo) Institute of Anesthesia and Intensive Care Unit,
University Hospital of Padua, Via N. Giustiniani 1, Padua 35127, Italy
(Sella, Iuzzolino, Rossini, Pesenti, Zecchino, Navalesi) Department of
Medicine-DIMED, University of Padua, Padua, Italy
Publisher
Korean Society of Anesthesiologists
Abstract
Background: While laparoscopic surgical procedures have various advantages
over traditional open techniques, artificial pneumoperitoneum is
associated with severe bradycardia and cardiac arrest. Dexmedetomidine, an
imidazole derivative that selectively binds to alpha2-receptors
and has sedative and analgesic properties, can cause hypotension and
brady-cardia. Our primary aim was to assess the association between
dexmedetomidine use and intraoperative bradycardia during laparoscopic
cholecystectomy. Method(s): We performed a systematic review with a
meta-analysis and trial sequential analysis using the following PICOS:
adult patients undergoing endotracheal intubation for laparoscopic
cholecystectomy (P); intravenous dexmedetomidine before tracheal
intuba-tion (I); no intervention or placebo administration (C);
intraoperative bradycardia (prima-ry outcome), intraoperative hypotension,
hemodynamics at intubation (systolic blood pressure, mean arterial
pressure, heart rate), dose needed for induction of anesthesia, total
anesthesia requirements (both hypnotics and opioids) throughout the
procedure, and per-centage of patients requiring postoperative analgesics
and experiencing postoperative nausea and vomiting and/or shivering (O);
randomized controlled trials (S). Result(s): Fifteen studies were
included in the meta-analysis (980 patients). Compared to patients that
did not receive dexmedetomidine, those who did had a higher risk of
devel-oping intraoperative bradycardia (RR: 2.81, 95% CI [1.34, 5.91]) and
hypotension (1.66 [0.92, 2.98]); however, they required a lower dose of
intraoperative anesthetics and had a lower incidence of postoperative
nausea and vomiting. In the trial sequential analysis for bradycardia, the
cumulative z-score crossed the monitoring boundary for harm at the tenth
trial. Conclusion(s): Patients undergoing laparoscopic
cholecystectomy who receive dexmedeto-midine during tracheal intubation
are more likely to develop intraoperative bradycardia and
hypotension. Copyright © The Korean Society of Anesthesiologists,
2022.

<48>
Accession Number
2020148905
Title
Rotational Atherectomy or Balloon-Based Techniques to Prepare Severely
Calcified Coronary Lesions.
Source
JACC: Cardiovascular Interventions. 15(18) (pp 1864-1874), 2022. Date of
Publication: 26 Sep 2022.
Author
Rheude T.; Fitzgerald S.; Allali A.; Mashayekhi K.; Gori T.; Cuculi F.;
Kufner S.; Hemetsberger R.; Sulimov D.S.; Rai H.; Ayoub M.; Bossard M.;
Xhepa E.; Fusaro M.; Toelg R.; Joner M.; Byrne R.A.; Richardt G.; Kastrati
A.; Cassese S.; Abdel-Wahab M.
Institution
(Rheude, Kufner, Xhepa, Fusaro, Joner, Kastrati, Cassese) Klinik fur Herz-
und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Munich, Germany
(Fitzgerald, Sulimov, Abdel-Wahab) Department of Cardiology, Heart Center
Leipzig at University of Leipzig, Leipzig, Germany
(Fitzgerald, Rai, Byrne) School of Pharmacy and Biomolecular Sciences,
RCSI University of Medicine and Health Sciences, Dublin, Ireland
(Allali, Toelg, Richardt) Heart Center, Segeberger Kliniken, Bad Segeberg,
Germany
(Mashayekhi, Ayoub) Division of Cardiology and Angiology II, University
Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
(Gori) Medizinische Klinik und Poliklinik, Universitatsmedizin Mainz,
Mainz, Germany
(Cuculi, Bossard) Department of Cardiology, Kantonspital Luzern,
Switzerland
(Hemetsberger) Klinik fur Kardiologie und Angiologie,
Berufsgenossenschaftliches Universitatsklinikum Bergmannsheil Bochum,
Bochum, Germany
(Rai, Byrne) Cardiovascular Research Institute Dublin, Mater Private
Network, Dublin, Ireland
(Fusaro) Klinik fur Kardiologie und Angiologie, Zollernalb-Klinikum,
Albstadt, Germany
(Joner, Kastrati) DZHK (German Centre for Cardiovascular Research),
Partner site Munich Heart Alliance, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Background: The comparative efficacy of percutaneous techniques for the
preparation of calcified lesions before stenting remains poorly studied.
 Objective(s): This study sought to compare the performance of
up-front rotational atherectomy (RA) or balloon-based techniques before
drug-eluting stent implantation in severely calcified coronary lesions as
assessed by angiography and optical coherence tomography (OCT).
 Method(s): Patient-level data from the PREPARE-CALC (Comparison of
Strategies to Prepare Severely Calcified Coronary Lesions) and ISAR-CALC
(Comparison of Strategies to Prepare Severely Calcified Coronary Lesions)
randomized trials were pooled. The primary endpoint was stent expansion as
assessed by OCT imaging. The secondary endpoints included stent
eccentricity, stent asymmetry, angiographic acute lumen gain, strategy
success and in-hospital occurrence of cardiac death, target vessel
myocardial infarction, and repeat revascularization. Result(s): Among
274 patients originally randomized, 200 participants with available OCT
data after lesion preparation with RA (n = 63), a modified balloon (MB, n
= 103), or a super high-pressure balloon (n = 34) before stenting were
analyzed. The use of RA versus MB or a super high-pressure balloon led to
comparable stent expansion (73.2% +/- 11.6% vs 70.8% +/- 13.6% vs 71.8%
+/- 12.2%, P = 0.49) and stent asymmetry (P = 0.83). Compared with RA or
MB, a super high-pressure balloon was associated with less stent
eccentricity (P = 0.03) with a numerically higher acute lumen gain, albeit
not significantly different (P = 0.08). Strategy success was more frequent
with RA versus MB (P = 0.002) and numerically more frequent with RA versus
a super high-pressure balloon (P = 0.06). Clinical outcomes did not differ
between groups. Conclusion(s): In patients with severely calcified
lesions undergoing drug-eluting stent implantation, lesion preparation
with RA, MB, or a super high-pressure balloon was associated with
comparable stent expansion. A super high-pressure balloon is associated
with less stent eccentricity, whereas strategy success is more frequent
with RA. Copyright © 2022 American College of Cardiology
Foundation

<49>
Accession Number
2020148769
Title
Apixaban and Valve Thrombosis After Transcatheter Aortic Valve
Replacement: The ATLANTIS-4D-CT Randomized Clinical Trial Substudy.
Source
JACC: Cardiovascular Interventions. 15(18) (pp 1794-1804), 2022. Date of
Publication: 26 Sep 2022.
Author
Montalescot G.; Redheuil A.; Vincent F.; Desch S.; De Benedictis M.;
Eltchaninoff H.; Trenk D.; Serfaty J.-M.; Charpentier E.; Bouazizi K.;
Prigent M.; Guedeney P.; Salloum T.; Berti S.; Cequier A.; Lefevre T.;
Leprince P.; Silvain J.; Van Belle E.; Neumann F.-J.; Portal J.-J.; Vicaut
E.; Collet J.-P.
Institution
(Montalescot, Guedeney, Salloum, Silvain, Collet) Sorbonne Universite,
ACTION Group, INSERM UMRS 1166, Hopital Pitie-Salpetriere (AP-HP),
Institut de Cardiologie, Paris, France
(Redheuil, Charpentier, Bouazizi, Prigent) Sorbonne Universite,
Laboratoire Imagerie Biomedicale, ICAN, ACTION Group, Hopital
Pitie-Salpetriere (AP-HP), Institut de Cardiologie, Paris, France
(Vincent, Van Belle) CHU Lille, Institut Coeur Poumon, Pole
Cardiovasculaire et Pulmonaire, ACTION Group, Inserm U1011, Institut
Pasteur de Lille, EGID, Universite de Lille, Lille, France
(Desch) Department of Internal Medicine/Cardiology, Heart Center Leipzig
at University of Leipzig, Leipzig, Germany
(De Benedictis) Azienda Ospedaliera Ordine Mauriziano di Torino, Torino,
Italy
(Eltchaninoff) Normandie Universite, UNIROUEN, U1096, CHU Rouen,
Departement de Cardiologie, FHU CARNAVAL, Rouen, France
(Trenk, Neumann) Division of Cardiology and Angiology II, University Heart
Centre Freiburg, Bad Krozingen, Germany
(Serfaty) Hopital Guillaume et Rene Laennec, Institut du Thorax-Clinique
Cardiologique, Unite d'Imagerie Cardiaque et Vasculaire Diagnostique,
Nantes, France
(Berti) Fondazione Toscana G. Monasterio, Ospedale del Cuore G.
Pasquinucci, Massa, Italy
(Cequier) Hospital Universitario de Bellvitge, University of Barcelona,
Heart Disease Institute, L'Hospitalet de Llobregat, Barcelona, Spain
(Lefevre) Hopital Prive Jacques Cartier, Institut Cardiovasculaire Paris
Sud, Massy, France
(Leprince) Sorbonne Universite, Hopital Pitie-Salpetriere (AP-HP),
Institut de Cardiologie, Chirurgie Cardiaque, Paris, France
(Portal, Vicaut) Unite de Recherche Clinique Lariboisiere St-Louis, ACTION
Group, Hopital St-Louis & Fernand Widal, Paris, France
Publisher
Elsevier Inc.
Abstract
Background: Subclinical obstructive valve thrombosis after transcatheter
aortic valve replacement (TAVR) is of uncertain frequency and clinical
impact. Objective(s): The aim of this study was to determine the
effects of apixaban vs standard of care on post-TAVR valve thrombosis
detected by 4-dimensional (4D) computed tomography. Method(s): The
randomized ATLANTIS (Anti-Thrombotic Strategy to Lower All Cardiovascular
and Neurologic Ischemic and Hemorrhagic Events After Trans-Aortic Valve
Implantation for Aortic Stenosis) trial demonstrated that apixaban 5 mg
twice daily was not superior to standard of care (vitamin K antagonists or
antiplatelet therapy) after successful TAVR and was associated with
similar safety but with more noncardiovascular deaths. Three months after
randomization, 4D computed tomography was proposed to all patients to
determine the percentage of patients with >=1 prosthetic valve leaflet
with grade 3 or 4 reduced leaflet motion or grade 3 or 4 hypoattenuated
leaflet thickening (the primary endpoint) in the intention-to-treat
population. Result(s): Seven hundred sixty-two participants had
complete multiphase datasets and were included in the 4D computed
tomographic analysis. The primary endpoint occurred in 33 (8.9%) and 51
(13.0%) patients in the apixaban and standard-of-care groups,
respectively. It was reduced with apixaban vs antiplatelet therapy (OR:
0.51; 95% CI: 0.30-0.86) but not vs vitamin K antagonists (OR: 1.80; 95%
CI: 0.62-5.25) (P<inf>interaction</inf> = 0.037). The composite of death,
myocardial infarction, any stroke, or systemic embolism at 1 year occurred
in 10.7% (n = 9 of 84) and 7.1% (n = 48 of 178) of patients with and
without subclinical valve thrombosis at 90 days, respectively (HR: 1.68;
95% CI: 0.82-3.44). Conclusion(s): Apixaban reduced subclinical
obstructive valve thrombosis in the majority of patients who underwent
TAVR without having an established indication for anticoagulation. This
study was not powered for clinical outcomes. (Anti-Thrombotic Strategy
After Trans-Aortic Valve Implantation for Aortic Stenosis [ATLANTIS];
NCT02664649) Copyright © 2022 American College of Cardiology
Foundation

<50>
[Use Link to view the full text]
Accession Number
2019993573
Title
Routine Pressure Wire Assessment Versus Conventional Angiography in the
Management of Patients With Coronary Artery Disease: The RIPCORD 2 Trial.
Source
Circulation. 146(9) (pp 687-698), 2022. Date of Publication: 30 Aug 2022.
Author
Stables R.H.; Mullen L.J.; Elguindy M.; Nicholas Z.; Aboul-Enien Y.H.;
Kemp I.; O'Kane P.; Hobson A.; Johnson T.W.; Khan S.Q.; Wheatcroft S.B.;
Garg S.; Zaman A.G.; Mamas M.A.; Nolan J.; Jadhav S.; Berry C.; Watkins
S.; Hildick-Smith D.; Gunn J.; Conway D.; Hoye A.; Fazal I.A.; Hanratty
C.G.; De Bruyne B.; Curzen N.
Institution
(Stables, Mullen, Elguindy, Aboul-Enien, Kemp) Liverpool Heart and Chest
Hospital, United Kingdom
(Nicholas) Coronary Research Group, University Hospital Southampton,
United Kingdom
(O'Kane) Royal Bournemouth Hospital, United Kingdom
(Hobson) Queen Alexandra Hospital, Portsmouth, United Kingdom
(Johnson) Bristol Heart Institute, United Kingdom
(Khan) Queen Elizabeth Hospital, Birmingham, United Kingdom
(Wheatcroft) Leeds General Infirmary, United Kingdom
(Garg) Royal Blackburn Teaching Hospital, United Kingdom
(Zaman) Freeman Hospital, Newcastle, United Kingdom
(Mamas, Nolan) Royal Stoke University Hospital, Stoke-on-Trent, United
Kingdom
(Jadhav) City Hospital, Nottingham, United Kingdom
(Berry) British Heart Foundation Glasgow Cardiovascular Research Centre,
University of Glasgow, United Kingdom
(Watkins) Golden Jubilee National Hospital, Glasgow, United Kingdom
(Hildick-Smith) Brighton and Sussex University Hospitals Nhs Trust,
Brighton, United Kingdom
(Gunn) Northern General Hospital, Sheffield, United Kingdom
(Conway) Pinderfields Hospital, Wakefield, United Kingdom
(Hoye) Castle Hill Hospital, Hull, United Kingdom
(Fazal) Kings Mill Hospital, Mansfield, United Kingdom
(Hanratty) Belfast City Hospital, United Kingdom
(De Bruyne) Cardiovascular Research Centre, Aalst, Belgium
(Curzen) Faculty of Medicine, University of Southampton, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Measurement of fractional flow reserve (FFR) has an
established role in guiding percutaneous coronary intervention. We tested
the hypothesis that, at the stage of diagnostic invasive coronary
angiography, systematic FFR-guided assessment of coronary artery disease
would be superior, in terms of resource use and quality of life, to
assessment by angiography alone. Method(s): We performed an
open-label, randomized, controlled trial in 17 UK centers, recruiting 1100
patients undergoing invasive coronary angiography for the investigation of
stable angina or non-ST-segment-elevation myocardial infarction. Patients
were randomized to either angiography alone (angiography) or angiography
with systematic pressure wire assessment of all epicardial vessels >2.25
mm in diameter (angiography+FFR). The coprimary outcomes assessed at 1
year were National Health Service hospital costs and quality of life.
Prespecified secondary outcomes included clinical events. Result(s):
In the angiography+FFR arm, the median number of vessels examined was 4
(interquartile range, 3-5). The median hospital costs were similar:
angiography, 4136 (interquartile range, 2613-7015); and angiography+FFR,
4510 (2721-7415; P=0.137). There was no difference in median quality of
life using the visual analog scale of the EuroQol EQ-5D-5L: angiography,
75 (interquartile range, 60-87); and angiography+FFR, 75 (interquartile
range, 60-90; P=0.88). The number of clinical events was as follows:
deaths, 5 versus 8; strokes, 3 versus 4; myocardial infarctions, 23 versus
22; and unplanned revascularizations, 26 versus 33, with a composite
hierarchical event rate of 8.7% (48 of 552) for angiography versus 9.5%
(52 of 548) for angiography+FFR (P=0.64). Conclusion(s): A strategy
of systematic FFR assessment compared with angiography alone did not
result in a significant reduction in cost or improvement in quality of
life. Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT01070771. Copyright © 2022 Lippincott Williams and
Wilkins. All rights reserved.

<51>
Accession Number
2018861660
Title
Effect of postoperative ultrasound-guided internal superior laryngeal
nerve block on sore throat after intubation of double-lumen bronchial
tube: a randomized controlled double-blind trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 276. Date
of Publication: December 2022.
Author
Wang J.; Chai B.; Zhang Y.; Zheng L.; Geng P.; Zhan L.
Institution
(Wang, Zhang, Zheng, Geng, Zhan) Department of Anesthesiology, Lu'an
Affiliated Hospital of Anhui Medical University, No.21 West Wanxi Road,
Jinan District, Anhui, Lu'an 237000, China
(Chai) Department of Anesthesiology, Zhongshan Hospital Affiliated to
Xiamen University, Fujian, Xiamen, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative sore throat (POST) is one of the main adverse
postoperative outcome after tracheal intubation using double-lumen
endobronchial tubes (DLTs). The aim of this study was to investigate the
effectiveness and safety of ultrasound (US)-guided block of the internal
branch of the superior laryngeal nerve (iSLN) for alleviating POST after
intubation of DLTs. Method(s): Patients undergoing thoracic surgery
between August 2019 and August 2021 were randomized into two groups
depending on whether they received US-guided iSLN block immediately after
the operation. In the control group, the patients underwent a thoracic
surgery under general anesthesia (GA) with DLTs without any special
treatment, while the patients in the experimental group received US-guided
iSLN block bilaterally with 2 ml of 0.25% ropivacaine on either side
immediately after the operation. The primary outcome was the grading of
sore throat at three-time points after the operation, i.e., immediate
extubation, 2 h after extubation, and 24 h after extubation. Secondary
outcomes included the rate of nausea and vomiting, hoarseness, dyspnea,
and choking cough after swallowing saliva at 2 h after extubation.
 Result(s): The incidence and severity of sore throat were
significantly lower in the experimental group than the control group at
all time intervals (all P < 0.01). The rate of nausea and vomiting,
hoarseness, dyspnea, and choking cough after swallow saliva at 2 h after
extubation had no statistical difference (all P > 0.05).
 Conclusion(s): The use of US-guided iSLN block can be effectively and
safely applied to relieve POST after intubation of DLTs on thoracic
surgery. Trial registration: The study protocol was registered at the
Chinese Clinical Trial Registry (http://www.chictr.org.cn, NO.
ChiCTR2000032188, 22/04/2020). Copyright © 2022, The Author(s).

<52>
Accession Number
2014191705
Title
The MITRA-HR study: design and rationale of a randomised study of
MitraClip transcatheter mitral valve repair in patients with severe
primary mitral regurgitation eligible for high-risk surgery.
Source
EuroIntervention. 15(4) (pp E329-E335), 2019. Date of Publication: July
2019.
Author
Piriou N.; Al Habash O.; Donal E.; Senage T.; Tourneau T.L.; Pattier S.;
Guyomarch B.; Roussel J.C.; Trochu J.N.; Vahanian A.; Obadia J.F.; Iung
B.; Guerin P.
Institution
(Piriou, Al Habash, Senage, Tourneau, Pattier, Guyomarch, Roussel, Trochu,
Guerin) Institut du Thorax, Centre Hospitalier Universitaire de Nantes,
Nantes, France
(Donal) Centre Hospitalier Universitaire de Rennes, Service de
Cardiologie, Rennes, France
(Vahanian, Iung) Assistance Publique-Hopitaux de Paris, Hopital Bichat,
DHU Fire, Universite Paris Diderot, Paris, France
(Obadia) Service de Chirurgie Cardiothoracique et Transplantation, Hopital
Cardiothoracique Louis Pradel, Lyon-Bron, France
Publisher
Europa Group
Abstract
Aims: Percutaneous mitral valve repair has become an alternative to
conventional surgery in patients suffering primary mitral regurgitation
(MR) with a contraindication to surgery and could benefit patients at high
surgical risk. The aim of the MITRA-HR study is to raise the level of
evidence supporting the use of the MitraClip device in primary MR patients
with a predefined high risk for surgery. Methods and Results:
MITRA-HR is a prospective, multicentre, randomised study designed to
compare mitral valve repair using the MitraClip with conventional surgery
in patients with severe primary mitral regurgitation at high risk for
surgery. The surgical risk is defined by age, Society of Thoracic Surgeons
(STS) risk estimate score, frailty, major organ system dysfunction, and
procedure-specific impediments. The study will enrol 330 patients
randomised between conventional surgery and MitraClip with a 1:1 ratio.
The composite primary endpoint includes all-cause mortality, unplanned
rehospitalisation for cardiovascular reasons, and mitral valve
reintervention at 12 months. The main secondary safety endpoint is a major
adverse event composite assessment evaluated 30 days after the procedure.
 Conclusion(s): The randomised MITRA-HR study is designed to provide
additional supportive evidence of non-inferiority in efficacy and
superiority in safety for percutaneous mitral valve repair using the
MitraClip compared to conventional surgery in high surgical risk
patients. Copyright © Europa Digital & Publishing 2019.

<53>
Accession Number
2014915415
Title
A meta-analysis of pharmacological neuroprotection in noncardiac surgery:
Focus on statins, lidocaine, ketamine, and magnesium sulfate.
Source
European Review for Medical and Pharmacological Sciences. 22(6) (pp
1798-1811), 2018. Date of Publication: 2018.
Author
ZENG Z.-W.; ZHANG Y.-N.; LIN W.-X.; ZHANG W.-Q.; LUO R.
Institution
(ZENG, ZHANG, LIN, ZHANG, LUO) First Anesthesia Department, Meizhou
People's Hospital, Guangdong Province, China
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: Non-cardiac surgery is associated with perioperative cerebral
complications (delirium, postoperative cognition dysfunction, stroke).
While rare, these complications can lead to disabilities and deaths.
Information is ambiguous as to whether pharmacological preoperative
treatment exerts neuroprotection. We wished to systematically assess
potential modulation by statins, lidocaine, ketamine or magnesium sulfate
of the relative risk of cerebral complications in noncardiac surgery.
Selection of these pharmacological agents was based on their known
neuroprotective abilities. PATIENTS AND METHODS: By searching
Medline, EMBASE and Cochrane databases, we identified 4 suitable
publications that collectively enrolled 1358 patients (intent-to-treat
population), of which 679 patients were treated preoperatively with
statins (404 patients on atorvastatin and 275 on rosuvastatin) and 679
patients with preoperative placebo. The reported cerebral outcome was
stroke, assessed either within 30 days (4 publications) or 6 months (2
publications) after surgery. RESULT(S): Episodes of stroke within 30
days and 6 months postoperatively were observed in several publications,
enabling aggregate analyses. No modulation by statins of the relative risk
of stroke at 30 days was observed (risk ratio 1.59, 95% confidence
interval 0.08-30.97; p = 0.76). At 6 months, statins showed an
insignificant trend toward neuroprotection (risk ratio 0.33, 95%
confidence interval 0.05-2.10; p = 0.24). CONCLUSION(S): The
available clinical data are still scarce. Our analyses indicate no
protective effects by statins against perioperative stroke but some
favorable trends toward delayed stroke. Further randomized trials are
needed to unequivocally assess the neuroprotective potential of current
pharmacological agents in non-cardiac surgery. Copyright © 2018
Verduci Editore s.r.l. All rights reserved.

<54>
Accession Number
2019075225
Title
Feasibility and oncological outcomes of video-assisted thoracic surgery
versus thoracotomy for pathologic N2 disease in non-small cell lung
cancer: A comprehensive systematic review and meta-analysis.
Source
Thoracic Cancer. (no pagination), 2022. Date of Publication: 2022.
Author
Li X.; Huang K.; Deng H.; Zheng Q.; Xiao T.; Yu J.; Zhou Q.
Institution
(Li, Huang, Deng, Zheng, Xiao, Yu, Zhou) Lung Cancer Center, West China
Hospital of Sichuan University, Chengdu, China
(Yu) Department of Radiation Oncology and Shandong Provincial Key
Laboratory of Radiation Oncology, Shandong First Medical University and
Shandong Academy of Medical Sciences, Jinan, China
(Yu) Research Unit of Radiation Oncology, Chinese Academy of Medical
Sciences, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
This meta-analysis aimed to evaluate the feasibility and oncological
outcomes between video-assisted thoracic surgery (VATS) and thoracotomy
for non-small cell lung cancer (NSCLC) patients with pathologic N2 (pN2)
disease. Data for analysis included short-term outcomes and long-term
outcomes. We calculated the weighted mean differences (WMDs) for
continuous data and the results of overall survival (OS) and disease free
survival (DFS) were pooled using the hazard ratios (HRs) with 95%
confidence intervals (CIs). Heterogeneity was assessed using the Q-test
and I2-test. Sensitivity analysis was performed to further
examine the stability of pooled HRs and WMDs. In the pooled analyses of 10
eligible studies, results showed that VATS for NSCLC patients with pN2
disease yielded significantly less blood loss (WMD = -61.43; 95%
confidence intervals [CI], [-87.69, -35.18]; p < 0.001), less
post-operation hospital stay (WMD, -1.62; 95% CI, [-2.96, -0.28]; p =
0.02), and comparable operation time (WMD, -8.32; 95% CI, [-23.88, 7.23];
p = 0.29), post-operation complication rate (risk ratio [RR], 0.95; 95%
CI, [0.78, 1.15]; p = 0.59), chest tube duration to thoracotomy (WMD,
-0.64; 95% CI, [-1.45, 0.17]; p = 0.12), extent of lymph node dissection
(WMD, -1.46; 95% CI, [-3.87, 0.95]; p = 0.23) and 1-year OS (HR, 1.30; 95%
CI, [0.96, 1.76]; p = 0.09) than thoracotomy. However, VATS may improve
3-year OS (HR, 1.26; 95% CI, [1.12, 1.42]; p = 0.0002) and yield
comparable 1-year DFS (HR, 1.14; 95% CI, [0.89, 1.46]; p = 0.32) and
3-year DFS (HR, 1.03; 95% CI, [0.88, 1.22]; p = 0.70) for NSCLC patients
with pN2 disease than thoracotomy. VATS could yield less surgical trauma
and improve post-operative recovery than thoracotomy. Moreover, VATS may
improve the oncological outcomes of those patients. Copyright ©
2022 The Authors. Thoracic Cancer published by China Lung Oncology Group
and John Wiley & Sons Australia, Ltd.

<55>
Accession Number
2018727633
Title
Intraoperative respiratory and hemodynamic strategies for reducing nausea,
vomiting, and pain after surgery: Systematic review and meta-analysis.
Source
Acta Anaesthesiologica Scandinavica. 66(9) (pp 1051-1060), 2022. Date of
Publication: October 2022.
Author
Holst J.M.; Klitholm M.P.; Henriksen J.; Vallentin M.F.; Jessen M.K.;
Bolther M.; Holmberg M.J.; Hoybye M.; Lind P.C.; Granfeldt A.; Andersen
L.W.
Institution
(Holst, Klitholm, Henriksen, Bolther, Lind, Granfeldt, Andersen)
Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Aarhus, Denmark
(Vallentin, Jessen, Holmberg, Hoybye, Lind, Granfeldt, Andersen)
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
(Vallentin, Andersen) Prehospital Emergency Medical Services, Central
Denmark Region, Aarhus, Denmark
(Jessen, Holmberg, Hoybye, Andersen) Research Center for Emergency
Medicine, Aarhus University Hospital, Aarhus, Denmark
(Holmberg) Department of Anesthesiology and Intensive Care, Randers
Regional Hospital, Randers, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Despite improved medical treatment strategies, postoperative
pain, nausea, and vomiting remain major challenges. This systematic review
investigated the relationship between perioperative respiratory and
hemodynamic interventions and postoperative pain, nausea, and vomiting.
 Method(s): PubMed and Embase were searched on March 8, 2021 for
randomized clinical trials investigating the effect of perioperative
respiratory or hemodynamic interventions in adults undergoing non-cardiac
surgery. Investigators reviewed trials for relevance, extracted data, and
assessed risk of bias. Meta-analyses were performed when feasible. GRADE
was used to assess the certainty of the evidence. Result(s): This
review included 65 original trials; of these 48% had pain, nausea, and/or
vomiting as the primary focus. No reduction of postoperative pain was
found in meta-analyses when comparing recruitment maneuvers with no
recruitment, high (80%) to low (30%) fraction of oxygen, low (5-7 ml/kg)
to high (9-12 ml/kg) tidal volume, or goal-directed hemodynamic therapy to
standard care. In the meta-analysis comparing recruitment maneuvers with
no recruitment maneuvers, patients undergoing laparoscopic gynecological
surgery had less shoulder pain 24 h postoperatively (mean difference in
the numeric rating scale from 0 to 10: -1.1, 95% CI: -1.7, -0.5). In
meta-analyses, comparing high to low fraction of inspired oxygen and
goal-directed hemodynamic therapy to standard care in patients undergoing
abdominal surgery, the risk of postoperative nausea and vomiting was
reduced (odds ratio: 0.45, 95% CI: 0.24, 0.87 and 0.48, 95% CI: 0.27,
0.85). The certainty in the evidence was mostly very low to low. The
results should be considered exploratory given the lack of prespecified
hypotheses and corresponding risk of Type 1 errors. Conclusion(s):
There is limited evidence regarding the impact of intraoperative
respiratory and hemodynamic interventions on postoperative pain or nausea
and vomiting. More definitive trials are needed to guide clinical care
within this area. Copyright © 2022 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<56>
Accession Number
2018426224
Title
The current practice of transcatheter aortic valve replacement in China.
Source
Journal of Cardiac Surgery. 37(10) (pp 3168-3177), 2022. Date of
Publication: October 2022.
Author
Xie C.-M.; Yao Y.-T.
Institution
(Xie) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming,
China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: The purpose of this study is to summarize the current practice
and experience of transcatheter aortic valve replacement in China.
 Method(s): The relevant articles were identified through computerized
searches of the CNKI, WANFANG, VIP, and PubMed databases through February
1, 2022, using the search terms: "transcatheter aortic valve replacement,"
"transcatheter aortic valve implantation," "China.". Result(s): The
database searches identified 22 articles, 2092 patients, 57.65% were male,
with a mean age of 74.2 +/- 6.0 years, 71.51% of patients were classified
by New York Heart Association as class III/IV, Society of Thoracic
Surgeons score 8.4 +/- 4.1, mean left ventricular ejection fraction 52.8
+/- 14.2%, mean transvalvular aortic pressure gradient 59.9 +/- 18.9 mmHg.
The overall procedural success rate was 97.85%, and 2.15% of patients were
converted to sternotomy, mainly due to transcatheter aortic bioprosthesis
dislocation. The most common vascular access approach was transfemoral
(1071 patients, 51.20%). General anesthesia (48.90%) was the commonly used
anesthesia technique. The incidence of postprocedural complications was as
follows: permanent pacemaker implantation (10.47%), bleeding events
(8.60%), mild paravalvular leakage (17.73%), moderate and severe
paravalvular leakage (4.16%), vascular complications (3.30%), stroke
(1.43%), respectively. The overall periprocedural period and
postprocedural 30-day mortality was 2.72%. Conclusion(s): Among
patients undergoing transcatheter aortic valve replacement in China,
device implantation success was achieved in 97.85% of cases. The most
common vascular access approach was transfemoral. General anesthesia was
the most commonly used anesthetic technique. Paravalvular leakage (458
patients, 21.89%) was the most common complication. Copyright ©
2022 Wiley Periodicals LLC.

<57>
Accession Number
2018288368
Title
Mortality and adverse events of hemoadsorption with CytoSorb in critically
ill patients: A systematic review and meta-analysis of randomized
controlled trials.
Source
Acta Anaesthesiologica Scandinavica. 66(9) (pp 1037-1050), 2022. Date of
Publication: October 2022.
Author
Heymann M.; Schorer R.; Putzu A.
Institution
(Heymann, Schorer, Putzu) Division of Anesthesiology, Department of Acute
Medicine, Geneva University Hospitals, Geneva, Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Background: The effects and safety of extracorporeal hemoadsorption with
CytoSorb in critically ill patients with inflammatory conditions are
controversial. Method(s): We performed a systematic review with
meta-analysis and trial sequential analysis (TSA) of randomized-controlled
trials to assess the mortality and safety of CytoSorb therapy in
critically ill patients with inflammatory conditions. Electronic databases
were searched up to April 2022. The primary outcome was mortality at
longest follow-up and secondary outcomes included various adverse event
(AE) outcomes. Conflict of interest and funding of each trial were
assessed. We calculated relative risk (RR) and 95% confidence interval
(CI). Result(s): Fourteen published (n = 764) and 4 unpublished (n =
111) trials were included. Eight trials were performed in medical ICU
patients and 10 in complex cardiac surgery. Ten trials had significant
industrial funding or an author conflict of interest. Hemoadsorption with
CytoSorb was associated with higher mortality at latest follow-up (16
trials, n = 807, 120 of 402 [29.85%] patients in the CytoSorb group vs. 98
of 405 [24.20%] patients in the control group, RR = 1.24 [95% CI,
1.04-1.49], p =.02, [TSA-adjusted CI, 0.92-1.68]) and at 30-days or
in-hospital (11 trials, n = 727; RR = 1.41 [95% CI, 1.06-1.88], p =.02,
[TSA-adjusted CI, 0.44-4.62]). Only one trial reported the definition of
adverse event, while detailed results were reported in 3 trials; the risk
of adverse events was not higher with CytoSorb. Certainty of evidence
ranged from low to very low. Conclusion(s): Low certainty of evidence
showed that the use of CytoSorb might increase mortality in critically ill
patients with inflammatory conditions. Adverse events were frequent but
underreported and not systematically evaluated. Industrial funding and
conflict of interest were common. Considerable uncertainty about the
findings does not allow firm conclusions and suggests a need for
high-quality randomized trials to clarify mortality and adverse events
related to CytoSorb. Editorial Comment: Hemoadsorption with CytoSorb have
been used in critically ill patients despite lack of high quality data
from RCTs suggesting any patient-important benefits. The findings from
this systematic review and meta-analysis suggests an increased risk of
adverse events including mortality. With no apparent benefits and at the
same time risk of harm, use of hemoadsorption with CytoSorb in daily
clinical practice cannot be recommended at this time. Copyright ©
2022 The Authors. Acta Anaesthesiologica Scandinavica published by John
Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica
Foundation.

<58>
Accession Number
2018222019
Title
Standardized Aortic Valve Neocuspidization for Treatment of Aortic Valve
Diseases.
Source
Annals of Thoracic Surgery. 114(4) (pp 1108-1117), 2022. Date of
Publication: October 2022.
Author
Amabile A.; Krane M.; Dufendach K.; Baird C.W.; Ganjoo N.; Eckstein F.S.;
Albertini A.; Gruber P.J.; Mumtaz M.A.; Bacha E.A.; Benedetto U.; Chikwe
J.; Geirsson A.; Holfeld J.; Iida Y.; Lange R.; Morell V.O.; Chu D.
Institution
(Amabile, Krane, Geirsson) Division of Cardiac Surgery, Department of
Surgery, Yale University School of Medicine, New Haven, Connecticut
(Dufendach, Ganjoo, Morell, Chu) Division of Cardiac Surgery, Department
of Cardiothoracic Surgery, University of Pittsburgh School of Medicine,
Pittsburgh, Pennsylvania
(Mumtaz, Morell, Chu) University of Pittsburgh Medical Center Heart and
Vascular Institute, Pittsburgh, Pennsylvania
(Baird) Department of Cardiac Surgery, Boston Children's Hospital, Harvard
Medical School, Boston, Massachusetts
(Eckstein) Department of Cardiac Surgery, University Hospital Basel,
University of Basel, Switzerland
(Albertini) Cardiovascular Surgery Department, Maria Cecilia Hospital GVM
Care and Research, Cotignola, Revenna, Italy
(Gruber, Bacha) Division of Cardiac, Thoracic, and Vascular Surgery,
Section of Pediatric and Congenital Heart Surgery, Columbia University
Medical Center/New York-Presbyterian Hospital, New York, New York
(Benedetto) Department of Cardiac Surgery, University Chieti-Pescara,
Chieti, Italy
(Chikwe) Department of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt
Heart Institute, Los Angeles, California
(Holfeld) Department of Cardiac Surgery, Innsbruck Medical University,
Innsbruck, Austria
(Iida) Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu
Hospital, Yokohama, Japan
(Lange) Department of Cardiovascular Surgery, German Heart Center, Munich,
Germany
Publisher
Elsevier Inc.
Abstract
Background: Aortic valve replacement is the traditional surgical treatment
for aortic valve diseases, yet standardized aortic valve neocuspidization
(AVNeo) is a promising alternative that is gaining popularity. The purpose
of this article is to review the available published literature of AVNeo
using glutaraldehyde-treated autologous pericardium, also known as the
Ozaki procedure, including indications, outcomes, potential benefits, and
modes of failure for the reconstructed valve. Method(s): A
comprehensive literature search was performed using keywords related to
aortic valve repair, AVNeo, or Ozaki procedure. All articles describing
performance of AVNeo were reviewed. Result(s): Reported early
mortality after AVNeo varies from 0% to 5.88%. The largest cohort of
patients in the literature includes 850 patients with an inhospital
mortality rate of 1.88%. Cumulative incidence of aortic valve reoperation
was 4.2% in the largest series. Reoperation was uncommon and mainly due to
infective endocarditis or degeneration of the reconstructed valve (most
commonly due to aortic valve regurgitation, rather than stenosis).
 Conclusion(s): Aortic valve neocuspidization is a versatile and
standardized alternative to aortic valve replacement with a biological
prosthesis. Early to midterm outcomes from a number of centers are
excellent and demonstrate the safety and durability of the procedure.
Long-term outcomes and clinical trial data are necessary to determine
which patients benefit the most from this procedure. Copyright ©
2022 The Society of Thoracic Surgeons

<59>
Accession Number
2018146572
Title
Practice patterns of ABO-matching for cryoprecipitate and patient outcomes
after ABO-compatible versus incompatible cryoprecipitate.
Source
Vox Sanguinis. 117(9) (pp 1105-1111), 2022. Date of Publication: September
2022.
Author
Raycraft T.; Bartoszko J.; Karkouti K.; Callum J.; Lin Y.
Institution
(Raycraft) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Bartoszko, Karkouti) Department of Anesthesia and Pain Management, Sinai
Health System, Women's College Hospital, University Health Network,
Toronto, ON, Canada
(Karkouti) Peter Munk Cardiac Centre, University Health Network, Toronto,
ON, Canada
(Karkouti) Interdepartmental Division of Critical Care, Department of
Medicine, University of Toronto, Toronto, ON, Canada
(Karkouti) Institute for Health Policy, Management, and Evaluation,
University of Toronto, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, ON, Canada
(Callum, Lin) University of Toronto Quality in Utilization, Education and
Safety in Transfusion Research Program, Toronto, ON, Canada
(Lin) Precision Diagnostics and Therapeutics Program, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background and Objectives: This sub-study of the FIBRES trial sought to
examine the patterns of ABO-compatible cryoprecipitate administration and
to identify adverse consequences of ABO-incompatible cryoprecipitate.
 Material(s) and Method(s): This was a post hoc analysis of data
collected from the FIBRES randomized clinical trial comparing fibrinogen
concentrate with cryoprecipitate in the treatment of bleeding related to
hypofibrinogenemia after cardiac surgery. The primary outcome was the
percentage of administered cryoprecipitate that was ABO-compatible.
Secondary outcomes were adverse events at 28 days. A follow-up survey was
distributed to the FIBRES participating sites to examine the rationale
behind the identified cryoprecipitate ABO-matching practice patterns.
 Result(s): A total of 363 patients were included: 53 (15%) received
ABO-incompatible cryoprecipitate and 310 (85%) received ABO-compatible
cryoprecipitate. There was an increased incidence of post-operative
anaemia in the ABO-incompatible group (15; 28.3%) in comparison to the
ABO-compatible (44; 14.2%) group (p = 0.01) at 28 days, which was
unrelated to haemolysis, without a significant difference in transfusion
requirement. In the multivariable logistic regression models accounting
for clustering by site, there was no observed statistically significant
association between the administration of ABO-incompatible cryoprecipitate
and any other adverse outcomes. Nine out of 11 sites did not have a policy
requiring ABO-matched cryoprecipitate. Conclusion(s): This sub-study
demonstrated that most cryoprecipitate administered in practice is
ABO-compatible, despite the absence of guidelines or blood bank policies
to support this practice. A signal towards increased risk of
post-operative anaemia may be explained by higher rates of urgent surgery
(vs. elective) in the ABO-incompatible group. Future studies should
prospectively examine the impact of ABO-compatible versus incompatible
cryoprecipitate to conclusively establish if there is a meaningful
clinical impact associated with the administration of ABO-incompatible
cryoprecipitate. Copyright © 2022 International Society of Blood
Transfusion.

<60>
Accession Number
2017565871
Title
A Randomized Clinical Trial of Perfusion Modalities in Pediatric
Congenital Heart Surgery Patients.
Source
Annals of Thoracic Surgery. 114(4) (pp 1404-1411), 2022. Date of
Publication: October 2022.
Author
Undar A.; Patel K.; Holcomb R.M.; Clark J.B.; Ceneviva G.D.; Young C.A.;
Spear D.; Kunselman A.R.; Thomas N.J.; Myers J.L.
Institution
(Undar, Patel, Holcomb, Clark, Ceneviva, Young, Spear, Kunselman, Thomas,
Myers) Departments of Pediatrics, Penn State Hershey Pediatric
Cardiovascular Research Center, Hershey, Pennsylvania
(Undar, Patel, Holcomb, Clark, Myers) Department of Surgery, Penn State
Hershey Pediatric Cardiovascular Research Center, Hershey, Pennsylvania
(Undar) Department of Biomedical Engineering, Penn State Hershey Pediatric
Cardiovascular Research Center, Hershey, Pennsylvania
(Ceneviva, Young, Spear) Division of Pediatric Critical Care Medicine,
Penn State Health Children's Hospital, Penn State College of Medicine,
Hershey, Pennsylvania
(Kunselman, Thomas) Department of Public Health Sciences, Penn State
Health Children's Hospital, Penn State College of Medicine, Hershey,
Pennsylvania
Publisher
Elsevier Inc.
Abstract
Background: The objective of this randomized clinical trial was to
investigate the effects of perfusion modalities on cerebral hemodynamics,
vital organ injury, quantified by the Pediatric Logistic Organ
Dysfunction-2 (PELOD-2) Score, and clinical outcomes in risk-stratified
congenital cardiac surgery patients. Method(s): This randomized
clinical trial included 159 consecutive congenital cardiac surgery
patients in whom pulsatile (n = 83) or nonpulsatile (n = 76) perfusion was
used. Cerebral hemodynamics were assessed using transcranial Doppler
ultrasound. Multiple organ injury was quantified using the PELOD-2 score
at 24, 48, and 72 hours. Clinical outcomes, including intubation time,
intensive care unit length of stay (LOS), hospital LOS, and mortality,
were also evaluated. Result(s): The Pulsatility Index at the middle
cerebral artery and in the arterial line during aortic cross-clamping was
consistently better maintained in the pulsatile group. Demographics and
cardiopulmonary bypass characteristics were similar between the 2 groups.
While risk stratification with The Society of Thoracic Surgeons-European
Association for Cardio-Thoracic Surgery (STAT) Mortality Categories was
similar between the groups, Mortality Categories 1 to 3 demonstrated more
patients than Mortality Categories 4 and 5. There were no differences in
clinical outcomes between the groups. The PELOD-2 scores showed a
progressive improvement from 24 hours to 72 hours, but the results were
not statistically different between the groups. Conclusion(s): The
Pulsatillity Index for the pulsatile group demonstrated a more physiologic
pattern compared with the nonpulsatile group. While pulsatile perfusion
did not increase plasma-free hemoglobin levels or microemboli delivery, it
also did not demonstrate any improvements in clinical outcomes or PELOD-2
scores, suggesting that while pulsatile perfusion is a safe method, it not
a "magic bullet" for congenital cardiac operations. Copyright ©
2022 The Society of Thoracic Surgeons

<61>
Accession Number
2020113411
Title
TCT-536 Percutaneous Transcatheter Aspiration in Endocarditis: A
Systematic Review and Compilation of Patient Characteristics and Outcomes
From Published Reports.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B219-B220), 2022. Date of
Publication: 20 Sep 2022.
Author
Gill G.S.; Chakrala T.; Alla V.M.
Institution
(Gill) Creighton University School of Medicine, NE, Omaha, United States
(Chakrala) University of Florida, Gainesville, Florida, United States
(Alla) Creighton University Medical Center, NE, Omaha, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aspiration is utilized for removal of thrombi
and vegetations in inoperable patients and high-risk surgical candidates
where medical therapy alone is unlikely to achieve the desired outcome. A
number of case reports and series have been published since the
introduction of the AngioVac system (AngioDynamics Inc) in 2012, where
this technology was used to treat endocarditis; however, there is a lack
of consolidated data providing ideal patient selection characteristics and
outcomes. Method(s): PubMed and Google Scholar databases were queried
for publications reporting cases in which transcatheter aspiration was
used for endocarditis vegetation debulking or removal. Data on patient
selection, characteristics, outcomes, and complications from the selected
reports were extracted. Result(s): Data from 42 publications with 316
patients were included in the final analyses. Of these, 187 had lead
vegetation, 121 had valvular vegetation, 6 had both lead and valvular
vegetation aspiration, and 2 patients underwent aspiration of infected
thrombi. Among the 121 valvular endocarditis cases, 118 (97.5%) patients
had right-sided vegetation removal. Patients with valvular endocarditis
were younger (mean age 35 years) vs patients with lead vegetations (mean
age 54 years). Among the valvular endocarditis cases, there was a 50% to
85% reduction in size, in-hospital mortality (7%), worsening regurgitation
(14%), persistent bacteremia (7%), and surgical valve repair or
replacement (6%). Thirty-two percent of patients required blood
transfusion. Among patients with lead infection, procedural success rate
was reported at 89%, and most common complications included in-hospital
mortality (5%) and vascular complications (3%). Persistent bacteremia,
renal failure requiring hemodialysis, cardiac arrest, and pulmonary
embolism had about 1% incidence each. Conclusion(s): Percutaneous
transcatheter aspiration of vegetations in endocarditis has acceptable
success rates in vegetation debulking but is associated with high
morbidity or mortality. Large prospective multicenter registries are
necessary to identify predictors of complications and the patients likely
to benefit most. Categories: STRUCTURAL: Valvular Disease:
Tricuspid Copyright © 2022

<62>
Accession Number
2020113297
Title
TCT-497 Impact of Medicare Advantage Enrollment on the Linkage of Trials
to Medicare Claims: Implications for Pragmatic Clinical Trials.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B201-B202), 2022. Date of
Publication: 20 Sep 2022.
Author
Chung M.; Almarzooq Z.; Song Y.; Strom J.; Secemsky E.; Yeh R.
Institution
(Chung) Massachusetts General Hospital, MA, Cambridge, United States
(Almarzooq) Brigham and Women's Hospital, Division of Cardiology, MA,
Boston, United States
(Song, Secemsky, Yeh) Beth Israel Deaconess Medical Center, Boston, MA,
United States
(Strom) Beth Israel Deaconess Medical Center, MA, Milton, United States
Publisher
Elsevier Inc.
Abstract
Background: Linkage of randomized controlled trials to administrative
claims can extend follow-up and potentially reduce costs. Centers for
Medicare & Medicaid Services (CMS) Fee-For-Service (FFS) is the largest
U.S. data set that can support passive follow-up for patients aged >=65
years. However, an increasing number of individuals are enrolling in
Medicare Advantage (MA), for which claims are incompletely captured. To
evaluate the impact of this change in CMS coverage on pragmatic clinical
trial design, we assessed how linkage of trial data to CMS claims has
changed over 3 consecutive transcatheter aortic valve replacement trials
spanning the past decade. Method(s): We linked data from the U.S.
CoreValve High Risk (2011-2012), SURTAVI (Intermediate Risk) (2012-2016),
and Evolut Low Risk (2016-2018) trials to CMS files. We calculated initial
linkage rates and then determined the rates of linkage to FFS
beneficiaries and exclusion due to MA enrollment at baseline and 1 year.
 Result(s): Of 750 high-risk trial participants, 15 were excluded due
to age <65 years or procedures performed in a Veterans Affairs or non-U.S.
hospital; 355 of 1,660 intermediate-risk and 274 of 1,413 low-risk
participants were also excluded for similar reasons (Table 1). Initial CMS
linkage rates were similar in the 3 cohorts (77.0%-81.6%). FFS linkage
rates ranged from 52.6% to 62.0% at baseline and 1 year. MA exclusion
rates trended upward over time at baseline (high risk 19.6%; intermediate
risk 23.2%; low risk 23.5%; P = 0.06) and increased at 1 year (high risk
20.4%: intermediate risk: 24.4%; low risk 24.7%; P = 0.048). [Formula
presented] Conclusion(s): During linkage of 3 consecutive randomized
controlled trials to CMS claims data, the inability to link patients due
to MA enrollment increased marginally over time. Increasing MA enrollment
or Medicare insurance plan switches may create challenges for the use of
CMS FFS data alone to support pragmatic trial design. Categories: OTHER:
Statistics and Trial Design Copyright © 2022

<63>
Accession Number
2020113218
Title
TCT-517 Late Outcomes of Valve-in-Valve Transcatheter Aortic Valve
Implantation vs Redo Surgical Aortic Valve Replacement: Meta-Analysis of
Kaplan-Meier-Derived Individual Patient Data of Matched Studies.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B210-B211), 2022. Date of
Publication: 20 Sep 2022.
Author
Sa M.P.; Van den Eynde J.; Simonato M.; Hirji S.; Erten O.; Dokollari A.;
Sicouri S.; Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Sa, Ramlawi) Lankenau Heart Institute, PA, Philadelphia, United States
(Van den Eynde) KU Leuven, Leuven, Belgium
(Simonato) Cardiovascular Research Foundation, New York, New York, United
States
(Hirji) Brigham and Women's Hospital, MA, Boston, United States
(Erten, Dokollari, Sicouri) Lankenau Institute for Medical Research,
Wynnewood, PA, United States
(Clavel) Institut Universitaire De Cardiologie Et De Pneumologie De
Quebec, Quebec, Quebec, Canada
(Pibarot) Quebec Heart and Lung Institute, Quebec City, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Valve-in-valve (ViV) transcatheter aortic valve replacement
(TAVR) in patients with bioprosthetic surgical structural valve
degeneration arose as an alternative to conventional redo surgical aortic
valve replacement (SAVR). ViV-TAVR is associated with higher rates of
severe prosthesis-patient mismatch (PPM), which might have a detrimental
effect over time. Method(s): We performed a study-level meta-analysis
of reconstructed time-to-event data from Kaplan-Meier curves of matched
studies. Result(s): Six studies met our eligibility criteria and
included a total of 2,286 patients (ViV-TAVR: 1,143 patients; redo SAVR:
1,143 patients), collectively contributing 4,183 patient-years. As for the
main analysis (Figure 1A), Cox regression revealed no significant
difference between both treatment arms (HR: 0.99; 95% CI: 0.83-1.19; P =
0.945), although evidence for a strong violation of the proportional
hazards assumption was found (Grambsch-Therneau test: P < 0.001). The
analysis of time-varying HRs again showed 3 distinct phases, this time
with 0.15 and 0.58 year as the inflection time points (Figure 1B). In
agreement with the main analysis, landmark analysis of the matched studies
revealed the following effect sizes for the 3 phases (Figure 1C): HR of
0.63 (95% CI: 0.45-0.89; P < 0.001) for the early phase; HR of 0.85 (95%
CI: 0.54-1.35; P = 0.499) for the intermediate phase; and HR of 1.57 (95%
CI: 1.22-2.03; P < 0.001) for the late phase. Data on the incidence of
severe PPM after the procedure were available in 4 studies with a median
follow-up of 1.00 (1.00-2.73) years, collectively contributing 1,681
patient-years. The Cox regression model showed a statistically significant
association of PPM with all-cause mortality during follow-up (HR 1.03 per
percentage increase in the study- and treatment arm-level proportion of
PPM; 95% CI: 1.01-1.04; P < 0.001). Because the Grambsch-Therneau test
suggested a time-invariant effect (P < 0.001), the Schoenfeld residuals
plot was investigated. The latter revealed that PPM began to be associated
with all-cause mortality beyond 0.67 year of follow-up. The timing and
pattern correspond well with the late hazard phase found in our previous
analyses (in which ViV-TAVR was associated with increased all-cause
mortality beyond 0.54 year). Our analyses found a similar pattern
specifically for ViV-TAVR (HR: 1.03; 95% CI: 1.02-1.05; P < 0.001.)
[Formula presented] Conclusion(s): ViV-TAVR is associated with a
protective effect immediately after the procedure compared with redo SAVR;
however, this initial advantage reverses over time, and redo SAVR seems to
be a protective factor for all-cause mortality after 6 months. Considering
that these results are the fruit of pooling data from observational
studies, they should be interpreted with caution, and trials are
warranted. Categories: STRUCTURAL: Valvular Disease: Aortic Copyright
© 2022

<64>
Accession Number
2020112857
Title
TCT-504 Quantitative Angiographic Assessment of Post-TAVR Residual Aortic
Regurgitation in Patients Treated With Portico vs Navitor Transcatheter
Heart Valve: Independent Core Lab Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B205), 2022. Date of Publication: 20
Sep 2022.
Author
Elkoumy A.; Corcione N.; Abdelshafy M.; Elzomor H.; Albanese M.; Morello
A.; Revaiah P.C.; Cimmino M.; Kim W.-K.; Serruys P.; Soliman O.
Institution
(Elkoumy, Abdelshafy) National University of Ireland Galway, Galway,
Ireland
(Corcione) Presidio Ospedaliero Pineta Grande, Castel Volturno, Caserta,
Italy
(Elzomor) National University of Ireland Galway, Galway, Ireland
(Albanese) Pineta Grande Hospital, Santa Maria Capua Vetere, Naples,
Caserta, Italy
(Morello) Pineta Grande Hospital, Santa Maria Capua Vetere, Caserta, Italy
(Revaiah) National University of Ireland Galway, Galway, Ireland
(Cimmino) Presidio Ospedaliero Pineta Grande, Castel Volturno, Caserta,
Italy, Naples, Caserta, Italy
(Kim) Kerckhoff Heart Center, Bad Soden, Germany
(Serruys) National University of Ireland Galway, Galway, Ireland
(Soliman) National University of Ireland Galway, Galway, Ireland
Publisher
Elsevier Inc.
Abstract
Background: The recently introduced CE-marked Navitor transcatheter heart
valve has many improvements compared with the Portico (Abbott).The new
features such as the outer NaviSeal fabric cuff and the fabric material
within the inner cuff could reduce paravalvular leak (PVL). We aimed to
compare the residual PVL on aortography after Navitor and Portico
transcatheter aortic valve replacement based on a single-center
experience. Method(s): This is a retrospective Core Lab analysis
(CORRIB Core Lab, NUIG) of consecutive patients treated with transcatheter
aortic valve replacement using the Portico and Navitor transcatheter heart
valve, in Pineta Grande Hospital, Italy. Final aortograms were analyzed by
trained cardiologists using CAAS-A Valve software (Pie Medical) for the
quantification of PVL in the form of regurgitation fraction %. We used
previously validated cutoff values to identify >=moderate aortic
regurgitation (AR) (>17%), mild AR (7% to <=17%), and none/trace (<=6%).
 Result(s): A total of 124 aortograms after Portico and 20 after
Navitor implantation were analyzed. Assessment results were reported in 5
(4%) patients with >=moderate AR, 34 (27.4%) with mild AR, and 85 (68.6%)
with none/trace AR, with a median (IQR) of 3% (2-8) in the Portico cohort.
In the Navitor cohort, no single patient with >=moderate AR, 4 (20%) with
mild AR, and 16 (80%) with none/trace AR, with a median (IQR) of 4%
(0.5-6), were reported. [Formula presented] Conclusion(s): This is
the first report comparing the objective quantitative assessment of
residual AR after Portico and Navitor devices using a novel validated
quantitative videodensitometric technology. Our results show that the
improvements in Navitor design resulted in a reduction of PVL compared
with the Portico design. These findings are to be confirmed in a
prospective randomized study. Categories: STRUCTURAL: Valvular Disease:
Aortic Copyright © 2022

<65>
Accession Number
2020112820
Title
TCT-503 Objective Quantification of Post-TAVR Aortic Regurgitation in the
Real World Using 12 Different Types of Transcatheter Heart Valves: A
Multicenter Pooled Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B204-B205), 2022. Date of
Publication: 20 Sep 2022.
Author
Abdelshafy M.; Serruys P.; Elkoumy A.; Elzomor H.; Revaiah P.C.; Corcione
N.; Belluschi I.; Kim W.-K.; Ruck A.; Maisano F.; Onuma Y.; Mylotte D.;
Soliman O.
Institution
(Abdelshafy, Elkoumy) National University of Ireland Galway, Galway,
Ireland
(Serruys) National University of Ireland Galway, Galway, Ireland
(Elzomor) National University of Ireland Galway, Galway, Ireland
(Revaiah) National University of Galway Ireland, Galway, Ireland
(Corcione) Presidio Ospedaliero Pineta Grande, Castel Volturno, Caserta,
Italy
(Belluschi) San Raffaele University Hospital, Monza and Brianza, Italy
(Kim) Kerckhoff Heart Center, Bad Soden, Germany
(Ruck) Karolinska University Hospital, Stockholm, Sweden
(Maisano) San Raffaele Hospital, Milan, Italy
(Onuma) National University of Ireland Galway, Galway, Ireland
(Mylotte) University College Hospital Galway, Galway, Ireland
(Soliman) National University of Ireland Galway, Galway, Ireland
Publisher
Elsevier Inc.
Abstract
Background: Even mild aortic regurgitation after transcatheter aortic
valve replacement (TAVR) is linked to excess mortality. We aimed to
compare quantitative angiographic aortic regurgitation (AR) of 12
different TAVR devices. Method(s): This is a multicenter
retrospective corelab pooled analysis of post-TAVR aortograms from 2,852
consecutive patients treated with 12 different TAVR devices. Regurgitation
fraction was quantified from videodensitometry time-density curves (left
ventricular outflow tract-aortic regurgitation [LVOT-AR]). This method
relies on time density changes in contrast medium after injection in the
ascending aorta and its regurgitation in the LVOT. The ratio between the
areas under the two-time density curves of these regions quantifies the AR
in absolute percentage. The valves evaluated include ACURATE neo2 (Boston
Scientific) (n = 120), Lotus (n = 546), Myval (Meril Life Sciences) (n =
108), Portico (Abbott) (n = 187), VitaFlow (MicroPort) (n = 105), Evolut
PRO (Medtronic) (n = 95), SAPIEN 3 (Edwards Lifesciences) (n = 397),
Evolut R (n = 295), SAPIEN XT (n = 239), ACURATE neo (n = 120), Venus-A
(Venus Medtech Inc) (n = 113), and CoreValve (n = 532). The cutoff
criteria for none/trace regurgitation (LVOT-AR <6%); mild (6% <= LVOT-AR
<=17%); and moderate/severe (LVOT-AR >17%). Result(s): Results are
presented in Figures 1 and 2. [Formula presented] Conclusion(s): The
Lotus valve had the lowest mean AR, while the ACURATE neo2 had the lowest
percentage of moderate/severe AR, with significant improvements seen
compared with ACURATE neo. Moreover, the incidence of mild AR is still
prominent, and its long-term prognosis requires further investigations.
These results should be confirmed in a prospective randomized study.
Categories: STRUCTURAL: Valvular Disease: Aortic Copyright © 2022

<66>
Accession Number
2020223816
Title
Efficacy and Safety of Concomitant Tricuspid Repair in Patients Undergoing
Mitral Valve Surgery: a Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101360. Date of Publication: December 2022.
Author
Yasmin F.; Najeeb H.; Naeem U.; Moeed A.; Zaidi F.; Asghar M.S.; Aamir M.
Institution
(Yasmin, Najeeb, Naeem, Moeed, Zaidi) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, MN,
Rochester, Pakistan
(Aamir) Leyhigh Valley Heart Institute, Leyhigh Valley Health Network,
Allentown, PA, United States
Publisher
Elsevier Inc.
Abstract
Tricuspid valve repair (TVR) is recommended for patients with moderate
primary tricuspid regurgitation (TR), those with moderate TR, and a
history of heart failure without annular dilation, while being essential
for patients with severe secondary TR undergoing MVS. The meta-analysis
aimed to evaluate the efficacy and safety of tricuspid valve repair in
patients undergoing MVS. We systematically searched PubMed, Embase, and
Google Scholar through January 2022, and studies comparing patients with
TVR and those without TVR were selected. The primary outcomes were 30-day,
and all-cause mortality. In this meta-analysis, 20 studies were included
with a patient population of 72,422. No significant differences were
observed between patients undergoing TVR with MVS, in comparison to MVS
group only for the primary outcomes i.e., 30-day mortality (RR: 1.14, 95%
CI [0.69, 1.87], and all-cause mortality (RR: 1.16, 95% CI [0.86, 1.57].
From the secondary outcomes, pacemaker insertion (RR: 2.62, 95% CI [2.24,
3.06]), new-onset TR or progression (RR: 0.32, 95% CI [0.16, 0.66]),
stroke (RR: 1.22, 95% CI [1.05, 1.42]), cross-clamp time (WMD: 17.67, 95%
CI [13.96, 21.37]), surgery time (WMD: 43.59, 95% CI [37.07, 50.10]), ICU
time (WMD: 19.50, 95% CI [9.31, 29.67]), and ventilation time (WMD: 6.62,
95% CI [0.69, 12.55]) were significant. However, major bleeding events,
atrial fibrillation, renal failure, heart failure hospitalization,
postoperative MI, wound infection, early or prolonged morbidity,
cardiopulmonary bypass time, and duration of hospital stay were
non-significant. Our meta-analysis has furthered the discussion for
weighing the risks and benefits of pursuing TVR during MVS. Copyright
© 2022 Elsevier Inc.

<67>
Accession Number
2018960853
Title
Comparative study of a modified double-lumen tube ventilation control
connector and traditional connector in clinical use: a
randomised-controlled trial.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 281. Date
of Publication: December 2022.
Author
Liu C.; Zhao Y.; Li Y.; Guan H.; Feng J.; Cheng S.; Wang X.; Wang Y.; Sun
X.
Institution
(Liu, Zhao, Li, Guan, Feng, Cheng, Wang, Wang, Sun) Department of
Anesthesiology, The Second Hospital of Jilin University, No.218, Ziqiang
street, Nanguan District, Jilin Province, Changchun City 130000, China
Publisher
BioMed Central Ltd
Abstract
Background: A Y-shaped rotatable connector (YRC) for double-lumen tubes
(DLT) is invented and compared with the traditional connector (Y-shaped
connector, YC). Method(s): Sixty patients with ASA grade I-III, aged
>= 18 years, who needed to insert a DLT for thoracic surgery were
recruited and assigned into the YRC group (n = 30) and the YC group (n =
30) randomly. The primary endpoints included the inhaled air concentration
(Fi) and the exhaled air concentration (Et) of sevoflurane before and
after the switch between two-lung ventilation and one-lung ventilation at
different times, positioning time, and switching time. The secondary
endpoints were the internal gas volume of the two connectors, airway
pressure, and the sputum suction time. Result(s): The Et and Fi of
the YRC group and the YC group were significantly different (all p < 0.05)
at 5s, 10s, and 30s after the patient switched from two-lung ventilation
to one-lung ventilation. The positioning time of the YRC group was less
than YC group (89.75 +/- 14.28 s vs 107.80 +/- 14.96 s, p < 0.05), as well
as the switching time (3.60 +/- 1.20 s vs 9.05 +/- 2.53 s, p < 0.05) and
the internal gas volume (17.20 ml vs 24.12 ml). There was no difference in
airway pressure and the sputum suction time in two groups.
 Conclusion(s): Compared with YC, YRC was beneficial for maintaining
depth of anesthesia, improves efficiency for the switch between one-lung
and two-lung ventilation, and shortens the tube positioning
time. Copyright © 2022, The Author(s).

<68>
Accession Number
2020221049
Title
Use of Anticoagulation Therapy in Patients With Perioperative Atrial
Fibrillation After Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
CJC Open. (no pagination), 2022. Date of Publication: 2022.
Author
Wang M.K.; Heo R.; Meyre P.; Park L.; Blum S.; McIntyre W.F.; Belley-Cote
E.; Birchenough L.; Vuong K.; Healey J.S.; Devereaux P.J.; Lamy A.; Conen
D.
Institution
(Wang, McIntyre, Belley-Cote, Healey, Devereaux, Conen) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Wang, Blum, McIntyre, Belley-Cote, Healey, Devereaux, Lamy, Conen)
Population Health Research Institute, McMaster University, Hamilton, ON,
Canada
(Wang, McIntyre, Belley-Cote, Healey, Devereaux, Lamy, Conen) Department
of Health Research Methods, Evidence & Impact, McMaster University,
Hamilton, ON, Canada
(Heo) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Meyre, Blum) Division of Cardiology and Cardiovascular Research Institute
Basel, University Hospital Basel, Basel, Switzerland
(Park, Birchenough) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Vuong) Faculty of Sciences, Western University, London, ON, Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Perioperative atrial fibrillation (POAF) after cardiac surgery
is associated with an increased risk of stroke. However, the efficacy and
safety of using anticoagulation therapy in this population are unknown.
 Method(s): We performed a systematic review and meta-analysis of
studies comparing use of anticoagulation therapy vs no anticoagulation
therapy in patients with POAF after cardiac surgery. Outcomes included
arterial thromboembolism (ie, stroke +/- systemic embolism) and bleeding.
Data were pooled using fixed-effects models. We reported summary risk
ratios (RRs) for studies with multivariable adjustment and estimated
absolute risk differences with 95% confidence intervals (CIs).
 Result(s): Nine observational studies met eligibility criteria. No
randomized trials were identified. Of the 254,200 POAF patients included,
27.3% received anticoagulation. Six studies reported outcomes after
long-term follow-up (median 5.0 years; range 4.2-10.0). The risk of
arterial thromboembolism was lower in patients receiving anticoagulation
therapy (RR 0.83; 95% CI, 0.69-0.99; I2 = 57%; P = 0.04; 6
studies). The estimated short-term and long-term absolute risk reductions
in arterial thromboembolism with use of anticoagulation therapy were 0.8%
(95% CI, 0.4-1.4) and 2 events per 1000 person-years (95% CI, 0-4),
respectively. The risk of bleeding was higher in patients receiving
anticoagulation therapy (RR 3.22; 95% CI, 2.82-3.68; I2 = 98%;
P < 0.001; 2 studies). The estimated short-term and long-term absolute
risk increases in bleeding with use of anticoagulation therapy were 0.5%
(95% CI, 0.4-0.6) and 42 events per 1000 person-years (95% CI, 35-51),
respectively. Conclusion(s): Use of anticoagulation therapy is
associated with a small reduction in the risk of arterial thromboembolism,
but also an increased risk of bleeding. Randomized controlled trials are
needed to address this issue. Copyright © 2022 The Authors

<69>
Accession Number
639024622
Title
Advanced Cardiovascular Imaging for the Diagnosis of Mycobacterium
chimaera Prosthetic Valve Infective Endocarditis After Open-heart Surgery:
A Contemporary Systematic Review.
Source
Current problems in cardiology. (pp 101392), 2022. Date of Publication:
10 Sep 2022.
Author
Sanchez-Nadales A.; Diaz-Sierra A.; Mocadie M.; Asher C.; Gordon S.; Xu B.
Institution
(Sanchez-Nadales, Asher) Department of Cardiovascular Disease, Cleveland
Clinic Florida, Weston FL 33324
(Diaz-Sierra) Department of Medicine, Advocate Illinois Masonic Medical
Center, Chicago, IL 60657, United States
(Mocadie) Department of Infectious Diseases, University Hospitals,
Cleveland, OH 44106, United States
(Gordon) Department of Infectious Diseases, Cleveland Clinic, Cleveland,
OH 44195, United States
(Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
44195, United States
Publisher
NLM (Medline)
Abstract
Mycobacterium chimaera is an opportunistic and emerging pathogen, which
has been recognized to cause prosthetic valve infective endocarditis and
disseminated infection following open-chest cardiac surgery with certain
contaminated heater-cooler systems. Diagnostic evaluation of suspected
prosthetic valve infective endocarditis due to Mycobacterium chimaera is
challenging and requires a very high index of suspicion. This systematic
review aims to evaluate prosthetic valve infective endocarditis due to
Mycobacterium chimaera. Based on the current literature review,
transesophageal echocardiography and 18F-fluorodeoxyglucose positron
emission tomography/computed tomography are the most common imaging
modalities used to establish the diagnosis. Based on twenty-two published
cases, the reported cases of Mycobacterium chimaera endocarditis have
occurred almost entirely in males. Within this cohort, the patients
developed endocarditis on average 2.7 years after exposure to contaminated
heater-cooler systems during cardiac surgery. Mycobacterium chimaera
infection is associated with significant morbidity and
mortality. Copyright © 2022. Published by Elsevier Inc.

<70>
Accession Number
615452596
Title
Cardiovascular efficacy and safety of bococizumab in high-risk patients.
Source
New England Journal of Medicine. 376(16) (pp 1527-1539), 2017. Date of
Publication: 20 Apr 2017.
Author
Ridker P.M.; Revkin J.; Amarenco P.; Brunell R.; Curto M.; Civeira F.;
Flather M.; Glynn R.J.; Jukema J.W.; Karpov Y.; Kastelein J.J.P.; Koenig
W.; Lorenzatti A.; Manga P.; Masiukiewicz U.; Miller M.; Mosterd A.; Murin
J.; Nicolau J.C.; Nissen S.; Ponikowski P.; Santos R.D.; Schwartz P.F.;
Soran H.; White H.; Wright R.S.; Vrablik M.; Yunis C.; Shear C.L.; Tardif
J.-C.; Conde D.; Colquhoun D.; Missault L.; Gregoire J.; Gao R.;
Urina-Triana M.A.; Solar M.; Jensen H.K.; Grobbee D.; Savolainen M.;
Schiele F.N.; Montalescot G.; Edes I.; Blake G.; Lotan C.; Maggioni A.;
Savonitto S.; Lee C.W.; Leiva Pons J.L.; Dan G.A.; Cortada J.B.; Mellbin
L.; Kahan T.; Noble S.; Hwang J.J.; Sritara P.; Tokgozoglu L.; Tarasenko
L.; Borer J.S.; Black H.; Carmena R.; Furie K.L.; McMurray J.; Neaton J.;
Zannad F.; O'Neill B.; Welty F.; McNamara R.; Chun H.; Abbott J.D.; Jacoby
D.; McPherson C.; Jadbabaie F.; Pinto D.; McCullough L.; Silverman I.E.;
Sansing L.H.; Dearborn-Tomazos J.; Foody J.; Schindler J.; Piazza G.;
Chakrabarti A.; Pride Y.; Gelfand E.; Baultrukonis D.; Chaudhuri S.;
Frederich R.; Johnson M.; Mridha K.; Powell C.; Wang E.; Wei C.; Anderson
P.; Buonanno M.; Epsley C.; Evans B.; Frolova M.; Goetsch M.; Hessinger
D.; Ikehara E.; Ivanac K.; Kizko J.; Le K.; McNally-Dufort C.; Morocco T.;
Nadkarni S.; Nye R.; Pak R.; Pence D.; Redifer P.; Sattler C.; Schade R.;
Sullivan B.; Wegner J.; Alvarez C.A.; Budassi N.; Vogel D.R.; Avaca H.;
Conde D.G.; Estol C.C.; Gelersztein E.; Glenny J.A.; Hershson A.R.; Bruno
R.L.; Maffei L.E.; Soler J.M.; Zaidman C.J.; Carnero G.S.; Colombo H.R.;
Jure H.O.; Luquez H.A.; Ramos H.R.; Resk J.H.; Rusculleda M.M.; Ulla M.R.;
Caccavo A.; Farias E.F.; Wenetz L.M.; Cabella P.R.; Cuadrado J.A.; Chahin
M.; Mackinnon I.J.; Zarandon R.B.; Schmidberg J.; Fernandez A.A.; Montana
O.; Codutti O.R.; Gorosito V.M.; Maldonado N.; Sala J.; De La Fuente R.A.;
Casabella T.E.; Di Gennaro J.P.; Guerrero R.A.; Alvarez M.S.; Berli M.;
Botta C.E.; Montenegro E.E.; Vico M.L.; Begg A.; Lehman R.; Gilfillan
C.P.; d'Emden M.; Markovic T.P.; Sullivan D.; Aroney C.; Stranks S.N.;
Crimmins D.S.; Arstall M.; Van Gaal W.; Davis T.; Aylward P.E.; Amerena
J.; William M.; Proietto J.; Purnell P.W.; Singh B.; Arya K.W.; Dart A.M.;
Thompson P.; Davis S.M.; Carroll P.A.; De Looze F.; Jayasinghe R.; Bhindi
R.; Buysschaert I.; Sarens T.; van de Borne P.; Scott B.P.; Roosen J.;
Cools F.; Missault L.H.; Debroye C.; Schoors D.F.; Hollanders G.; Schroe
H.H.; De Sutter J.; Hermans K.; Carlier M.; van Landegem P.; Verwerft J.;
Mulleners T.; Delforge M.D.; Soufflet V.; Elegeert I.; Descamps O.S.;
Janssens S.; Lemmens R.C.; Desfontaines P.; Scheen A.; Heijmans S.; Capiau
L.; Vervoort G.; Carlier S.G.; Faes D.; Alzand B.; Keuleers S.; De Wolf
L.; Thoeng J.; De Bruyne L.; de Santos M.O.; Felicio J.S.; Areas C.A.;
Figueiredo E.L.; Michalaros Y.L.; Neuenschwander F.C.; Reis G.; Saad J.A.;
Kormann A.P.; Nascimento C.V.; Precoma D.B.; Abib E.; dos Santos F.R.;
Mello Y.G.; Saraiva J.F.; Rech R.L.; Cerci R.; Fortes J.A.; Rossi P.R.; de
Lima e Silva F.A.; Hissa M.; Silva R.P.; de Souza W.K.; Guimaraes Filho
F.V.; Mangili O.C.; de Oliveira Paiva M.S.; Tumelero R.; Abrantes J.A.;
Caramori P.R.; Dutra O.P.; Leaes P.E.; Manenti E.R.; Polanczyk C.A.;
Bandeira e Farias F.A.; de Moraes Junior J.B.; Russo L.A.; Alves A.R.;
Dracoulakis M.D.; Ritt L.E.; Saporito W.F.; Herdy A.H.; Maia L.N.;
Sternieri M.V.; Ayoub J.C.; Bianco H.T.; da Costa F.A.; Eliaschewitz F.G.;
Fonseca F.A.; Nakandakare E.R.; Bonansea T.C.; Castro N.M.; de Barros e
Silva P.G.; Smith P.; Botelho R.V.; Resende E.S.; Barbieri D.S.; Hernandes
M.E.; Bajaj H.; Beaudry P.; Berlingieri J.C.; Salter T.J.; Ajala B.;
Anderson T.J.; Nanji A.; Ross S.; Pandey S.; Desrosiers D.; Gaudet D.;
Moran G.; Csanadi M.A.; St-Amour E.; Cusimano S.; Halperin F.A.; Babapulle
M.; Vizel S.; Petrella J.; Spence J.D.; Gupta N.; Tellier G.; Bourgeois
R.; Gregoire J.C.; Wesson T.; Zadra R.; Twum-Barima D.Y.; Cha J.Y.;
Hartleib M.C.; Bergeron J.; Chouinard G.; McPherson T.P.; Searles G.;
Peterson S.R.; Mukherjee A.; Lepage S.; Conway J.R.; Kouz S.M.; Dion D.;
Pesant Y.; Cheung S.S.; Goldenberg R.M.; Aronson R.; Gupta A.K.; O'Mahoney
M.; Pliamm L.; Teitelbaum I.; Hoag G.N.; Nadra I.J.; Yared Z.; Yao L.C.;
Nguyen T.; Saunders K.K.; Potthoff S.; Varleta P.; Assef V.; Godoy J.G.;
Olivares C.; Roman O.; Vejar M.; Montecinos H.; Pincetti C.; Li Y.; Wang
D.; Li J.; Yang X.; Du Y.; Wang G.; Yang P.; Zhang X.; Xu P.; Zhao Y.;
Chen J.; Li S.; Li W.; Zhang L.; Zhu Y.; Zhang Y.; Zhou C.; Wang Y.; Liu
F.; Ma Y.; Ti Z.; Zeng X.; Zhou Y.; Cui G.; Li D.; Xue L.; Jiang J.; Lian
Y.; He Y.; Mendoza J.A.; Bonfanti J.A.; Dada F.A.; Rodriguez W.R.; Sanchez
M.L.; Lozno H.Y.; Triana E.H.; Arambula R.M.; Rico-Carrillo A.E.; Gallo
H.J.; Catano J.S.; Jattin F.G.; Plazas J.A.; Gomez J.E.; Botero-Lopez R.;
Gomez N.I.; Munoz C.F.; Pelaez S.V.; Eraso A.M.; Goyes A.R.; Elbl L.;
Fiserova N.; Vesely J.; Wasserburger B.; Blaha V.; Vojacek J.; Maskova P.;
Hutyra M.; Vrkoc J.; Hala T.; Vodnansky P.; Bocek P.; Cifkova R.; Bufka
V.; Ceska R.; Machkova M.; Zidkova E.; Lukac M.; Mikusova T.; Kellnerova
I.; Kuchar L.; Ferkl R.; Cech V.; Zemek S.; Monhart Z.; Davidsen F.;
Joensen A.; Lihn A.S.; Rasmussen T.K.; Wiggers H.; Lindgren L.M.; Schmidt
U.; Galatius S.; Sillesen H.; Bronnum Schou J.; Thomsen K.K.; Urhammer S.;
Jeppensen J.; Schou M.; May O.; Steffensen R.; Nielsen W.B.; Nielesen T.;
Jepsen J.M.; Rai A.; Sykulski R.; Andersen L.T.; Rickers H.; Frost L.;
Lomholdt J.; Egstrup K.; Wermuth S.; Klausen L.; Lassus J.; Palomaki A.;
Khari J.; Tatlisumak T.; Kekki S.; Vanttinen E.; Strandberg A.; Valtonen
M.; Sia S.M.; Nerg O.; Puhakka M.; Strand J.; Timonen M.; Levola J.;
Arstila L.; Taurio J.; Kantola I.; Suomi J.; Humaloja K.; Askonen K.;
Schiele F.; Sibon I.; Zemour G.; Goube P.; Petit C.; Chati Z.; Range G.;
Rabahi F.; Rihani R.; Bergerot C.; Roubille F.; Boye A.; Probst V.;
Ferrari E.; Cayla G.; Thouvenot E.; Delarche N.; Couffinhal T.; Coisne D.;
Paillard F.; Elbaz M.; Decoulx E.; Angoulvant D.; Agraou B.; Caudmont S.;
Berrouschot J.; Lauer B.; Schoell I.; Trenk D.; Derwahl K.M.; Khariouzov
A.; Proepper F.; Stawowy P.; Da Stephan U.; Stoessel J.; Voehringer H.F.;
Dorsel T.; Stellbrink C.; Rinke A.; Northroff J.; Bourhaial H.; Stratmann
M.; Wetzel T.; Axthelm C.; Guenzel A.; Weigmann I.; Faghih M.; Hagemann
D.; Schaefer A.; Weber D.; Luedemann J.; Contzen C.; Kornmann M.O.;
Winkelmann B.; Simon J.; Felix S.; Brauer C.; Laufs U.; Schmidt E.; Marten
I.; Licka M.; Heisters J.; Appel K.F.; Kleinecke-Pohl U.; Klein C.; von
Hodenberg E.F.; Maus O.; Sigal H.; Taeschner H.; Schwimmbeck P.; Lemke B.;
Perings C.; Illies G.; Pfuetzner A.; Salbach P.; Hengstenberg C.; Kohler
A.; Mudra H.; Behnke T.; Baar M.; Jeserich M.; Scholz G.; Naudts I.;
Voller H.; Herrmann H.J.; von Engelhardt C.B.; Gerke S.; Pohlmeier L.;
Schaufele T.; Woehrle J.; Al-Zoebi A.; Horacek T.; Peterfai E.; Kemeny V.;
Lakatos F.; Bod E.; Andrassy P.; Andreka P.; Balo T.; Davidovits Z.;
Laszlo Z.; Nagy K.; Papp A.; Somogyi A.; Toldy-Schedel E.; Vertes A.;
Voros P.; Paragh G.; Martyin T.; Hajdu C.; Deak L.; Farago K.; Nagy A.;
Kirschner R.; Koszegi Z.; Zilahi Z.; Toth K.; Wittmann I.; Bajcsi D.;
Reiber I.; Toth L.; Benczur B.; Nagy L.; Sydo T.; Lupkovics G.; Oroszlan
T.; Crean P.; Mahon N.G.; McAdam B.; MacNeill B.; Katz A.; Tsalihin D.;
Vazan A.; Eitan A.; Lewis B.S.; Gavish D.; Wainstein J.; Mosenzon O.;
Mosseri M.; Vishlitzky V.; Atar S.; Nseir W.B.; Brenner H.; Elis A.; Fuchs
S.; Shimon I.; Solodky A.; Goldhaber A.; Tanne D.; Knobler H.; Kracoff
O.H.; Hussein O.; Auriel E.; Chorin E.; Sharir T.; Bitzur R.; Shechter M.;
Antonicelli R.; Franceschini E.; Porcu M.; Sesti G.; Maggiolini S.;
Salvioni A.; Filardi P.P.; Trimarco B.; Averna M.; Pasqualini L.; Pirro
M.; Pantaleoni M.; Piovaccari G.; Arca M.; Fedele F.; Roncon L.; Anselmi
M.; Sganzerla P.; Morocutti G.; Bonora E.; Dimas A.L.; Esperon G.A.;
Morales-Villegas E.; Isunza J.M.; Beltran L.G.; Molina C.A.; Garcia D.K.;
Ruiz L.A.; Reyna L.S.; De los Rios Ibarra M.O.; Soto J.R.; Gonzalez-Ortiz
M.; Herrera-Marmolejo M.; Ramos S.A.; Ramos-Lopez G.A.; Stobschinski C.A.;
AguilarSalinas C.A.; Alpizar-Salazar M.; Jimenez-Sanchez M.; Sanchez
Mijangos J.H.; Elizondo Moreno E.R.; Garcia Castillo A.; Garcia Hernandez
P.A.; Gonzalez-Gonzalez J.G.; Riojas Charles C.M.; Valdez Lopez H.G.;
Nuriulu Escobar P.L.; Lechuga Martin del Campo A.; Castro Montes B.E.;
Mendez Bucio A.; Rodriguez-Briones I.; Torre Amione G.; Violante Ortiz R.;
Luna Ceballos R.I.; Lopez Rosas E.; Bax W.A.; Alhakim M.; van de Wiel A.;
Liem S.S.; Groutars R.G.; Herrman J.P.; Hovingh G.K.; van de Wetering
M.L.; van Royen N.; Groenemeijer B.E.; Hoedemaker G.; Schaap J.; Ronner
E.; Angun M.; Mairuhu A.T.; Van Alem A.P.; Martens F.M.; Heijmeriks J.A.;
van Hal J.M.; Schoofs M.W.; den Hartog F.R.; Kentgens S.; Post J.C.;
Louwerenburg J.W.; van Rossum P.; Viergever E.P.; Donders S.H.; Kamphuisen
P.W.; van Beek E.; Nijmeijer R.; Lenderink T.; Schreuder T.; Kuijper A.F.;
The S.H.; Van het Hof-Wiersma J.J.; Tichelaar P.; Westerndorp I.;
Breedveld R.W.; Karalis I.; Romer T.J.; Bogaard K.; Van Koningsbruggen P.;
Kroon A.A.; Hoogslag P.A.; Rensing B.J.; Cramer E.; Remmen J.J.; Riksen
N.P.; Bokern M.J.; Cabezas M.C.; Mulder H.; Nierop P.R.; van Kempen W.W.;
Zoet-Nugteren S.K.; van Daele M.E.; Swart H.P.; van der Zwaan C.T.;
Hermans W.R.; Magro M.; van de Wal R.M.; Hassink R.J.; Visseren F.;
Veenendaal A.; De Nooijer C.; Troquay R.P.; Imholz B.P.; van der Meer P.;
Visser R.P.; van Leendert R.J.; Gosselink M.A.; Baker J.; Benatar J.R.;
Kerr J.; Pryke J.R.; Scott R.S.; Millar-Corte G.D.; Williams M.;
Montgomery B.; Venter D.J.; Ternouth I.F.; DeCaigney S.C.; Hart H.H.;
Corin A.; Garden P.I.; Sheahan D.; Harding S.A.; Korecki J.; Supronik J.;
Styczkiewicz M.; Bijata-Bronisz R.; Rusicka T.; Walczak M.; Krolikowski
Z.; Ostrowski J.; Lukaszewicz M.; Przekwas-Jaruchowska M.; Zieba B.;
Miekus P.; Orkwiszewska-Nalewajko A.; Piepiorka M.; Kubalski P.; Wychota
K.; Blach E.; Ochala A.; Okopien B.; Wronska D.; Janion M.; Czarnecka D.;
Kolodziejczyk J.; Konieczynska M.; Landa K.; Mirek-Bryniarska E.; Necki
M.; Pasternak D.A.; Rozpondek P.; Trebacz J.; Walczewska J.; Sidor M.;
Broncel M.; Drozdz J.; Kosmider M.; Saryusz-Wolska M.; Kucharska D.;
Opalinska E.; Pijanowski Z.; Wozniak I.; Banaszkiewicz K.; Klecha A.;
Horodecki M.; Piskorz-Wapinska J.; Kobielusz-Gembala I.; Kim M.H.; Kim
D.K.; Cho B.R.; Kim K.S.; Her S.H.; Lee S.Y.; Rhee M.Y.; Kim K.; Kang
W.C.; Kim D.H.; Cho Y.S.; Kim S.H.; Rim S.J.; Tahk S.J.; Jeon H.K.; Yoon
J.; Mociran M.; Pop C.F.; Minescu B.; Andrei L.D.; Radoi M.; Calin A.;
Ciomag R.M.; Copaci I.; Fruntelata A.G.; Popescu M.; Tivadar S.; Roman G.;
Avram R.I.; Mistodie C.V.; Morosanu M.; Popa A.R.; Popescu M.L.; Popoviciu
M.S.; Tase A.; Busegeanu M.; Popescu A.; Szilagyi I.; Sitterli-Natea C.N.;
Maximov D.M.; Munteanu M.; Negrisanu G.D.; Kuzin A.; Popov D.; Shapovalova
J.; Vishneva E.; Shutemova E.; Pasechnik E.; Bogdanov E.; Khasanov N.;
Barbarash O.L.; Shangina O.A.; Tarasov N.; Solonev O.; Kosmacheva E.;
Chernyatina M.A.; Ginzburg M.; Blokhin A.; Bulanova N.; Drapkina O.M.;
Gordeev I.G.; Libov I.A.; Lomakin N.; Panchenko E.; Shogenov Z.S.;
Zateyshchikov D.; Klein G.; Motylev I.; Belenkiy D.I.; Demin A.; Nikolaev
K.Y.; Oleynikov V.; Zrazhevskiy K.; Katelnitskiy I.; Khaisheva L.;
Aksentiev S.; Nedoshivin A.; Popova V.B.; Agafina A.S.; Ballyuzek M.;
Baranova E.; Burova N.; Eryshev S.; Filippov A.; Goloshchekin B.M.;
Konstantinov V.; Kostenko V.A.; Simanenkov V.I.; Volkova A.; Duplyakov D.;
Reshetko O.; Shvarts Y.; Kuznetsov V.A.; Samoylova Y.G.; Tolkacheva V.;
Shalaev S.V.; Khokhlov A.L.; Malygin A.; Shilkina N.P.; Yakusevich V.V.;
Margoczy R.; Zubek V.; Dzupina A.; Dubrava J.; Dulkova K.; Fabryova L.;
Gaspar L.; Kamensky G.; Kokles M.; Raslova K.; Soosova I.; Stevlik J.;
Strbova J.; Sumbal J.; Uhliar R.; Micik J.; Truban J.; Fedacko J.;
Pastrnakova E.; Pella D.; Fazekas F.; Ambrovicova V.; Kycina P.; Martinka
E.; Nociar J.; Belicova M.; Banik M.; Kanderkova D.; Hranai M.; Duris T.;
Krahulec B.; Benacka J.; Vinanska D.; Roskova E.; Skripova D.; Macek V.;
Vohnout B.; Buganova I.; Engelbrecht J.M.; Pretorius M.M.; Ebrahim I.O.;
Bayat J.; Ganesh S.; Ranjith N.; Coetzer T.F.; Jacovides A.; Distiller
L.A.; Hellig F.S.; Engelbrecht I.V.; Mahomed A.A.; Blignault S.C.; Burgess
L.J.; Kotze H.J.; van Nieuwenhuizen E.; Musungaie D.B.; Emanuel S.; van
der Walt E.; Pretorius C.E.; Roos J.S.; Roux S.M.; Badat A.E.; Fouche L.;
Vahed Y.A.; Jansen van Resburg D.; van Zyl L.J.; Soto Gonzalez A.; Diaz
J.L.; Segura T.; Botella Serrano M.; Botas Rodrigues J.; Molto-Jorda J.M.;
Dominguez Escribano J.R.; Sogorb Garri F.; Blanco Coronado J.L.;
Gaztambide Saenz M.S.; Brotons Cuixart C.; Bruguera Cortada J.;
Garcia-Moll Marimon X.; Gonzalbez Morgaez J.D.; Maisterra Santos O.;
Roquer Gonzalez J.; Sobrino-Martinez J.; Chueca Fernandez J.E.; Narejos
S.; Suarez Garcia S.; Perez Martinez P.; Figueras Camos R.; Medrano
Martinez V.; Bellido Guerrero D.; Martinez Deben F.; Vila Belmonte A.;
Mediavilla Garcia J.D.; Romero Hinojosa J.A.; Martorell Mateu E.; Cequier
Fillat A.R.; Pinto Sala X.; Adroer Martori R.; Bueno Diez M.; Lopez Cano
C.; Worner Diz F.; Gonzalez Juanatey C.; Alvarez-Sala Walther L.A.; De
Dios Garcia Diaz J.; Garcia Puig J.; Jodar Gimeno E.; Plaza Perez I.;
Suarez-Fernandez C.; Tunon J.; Zamorano Gomez J.L.; Brito Sanfiel M.A.;
Escudier Villa J.M.; de Mora Martin M.; Dominguez Lopez M.; Hernandez
Garcia J.M.; Tinahones Madueno F.J.; Perez Paredes M.; Aracil Villar J.;
Barreda Gonzalez M.J.; Ripoll Vera T.V.; Tofe Povedano S.; Sanchez Alvarez
J.; Martinez Via L.; Robles Iniesta A.; Masana L.; Vinyoles Bargallo E.;
Calvo Gomez C.; Gonzalez Juanatey J.R.; Cruz Fernandez J.M.; De La Cuesta
Mayor C.; Duran Garcia S.; Jimenez Hernandez M.D.; Morales Portillo C.;
Muniz Grijalvo O.; De Castro R.; Taverna Llaurado E.; Pons Amate J.M.;
Terns Riera M.; Linderfalk C.; Curiac D.; Saldeen-Nilehn K.; Koskinen P.;
Khalili P.; Tortensson I.; Lindholm C.J.; Luts A.; Koskinen P.T.;
Gottsater A.; Persson B.E.; Mooe T.; Larnefeldt H.; Boman K.; Crisby M.;
Rasmanis G.; Tengmark B.O.; Witt N.; Hagstrom E.; Viklund J.; Muller C.;
Mach F.; Burnier M.; Nanchen D.; Wuerzner G.; Banyai M.; Moccetti T.;
Miserez A.R.; Bilz S.; Weber K.; Lai W.T.; Chang K.C.; Ueng K.C.; Tsai
W.C.; Chiang C.E.; Hou C.; Pei D.; Krittayaphong R.; Kiatchoosakun S.;
Srimahachota S.; Boonyavarakul A.; Jintapakorn W.; Gullu H.; Onrat E.;
Erkan A.F.; Demirci D.; Sari R.; Ceyhan C.; Ari H.; Araz M.; Degertekin
M.; Goktekin O.; Uresin A.Y.; Yigit Z.; Akdeniz B.; Comlekci A.;
Kayikcioglu M.; Sahin T.; Ozcan T.; Durakoglugil E.; Asamoah-Owusu N.;
Reed R.; Bakhai A.; Dixon L.; Sharma R.; Avornyo A.A.; Jones A.F.; Lip G.;
Clark R.; Banerjee M.; Wakeling J.; Arden C.; Blagden M.D.; Walukiewica
P.; Marshall A.; Maxwell T.G.; Gunstone A.E.; Kadr H.H.; Patle R.; Arif
I.; Jhund P.S.; McKaig G.; Douglas F.; Mierzejewski L.; Turner W.;
Sathyapalan T.; Ivan P.; Manoj A.; Rice S.; Collier D.J.; Nair D.R.; Thom
S.; Fiore G.; De Belder M.; Price D.; Sobolewska J.; Martin S.; Takhar A.;
Moriarty A.; Kondagunta V.; Myhill T.; Gibson J.M.; Cecil J.T.; Halcox J.;
Annamalai N.; Gorog D.A.; McCormack T.; Pegge N.; Field A.; Adams F.;
Klein J.J.; Busch R.S.; Bretton E.M.; Jaffrani N.; Salacata A.;
Assadourian A.; Gogia H.S.; Dyke C.K.; Rubenfire M.; Essandoh L.K.; Welker
J.A.; Ledesma G.; Lupovitch S.; Delgado J.P.; Hendrix E.L.; Quyyumi A.A.;
Riesenberg R.A.; Robertson D.G.; Weinstein D.L.; Weiss R.; Casaubon L.;
Gammon R.S.; Brar H.S.; Bittar G.D.; Guarnieri T.T.; Ince C.S.; Quraishi
A.M.; Saeed S.; Albert M.; Sotolongo R.P.; Bernard J.V.; Karlsbergg R.P.;
Lepor N.E.; Kirby W.E.; McLean B.; Ovalle F.; Townsend J.C.; Beckett P.L.;
Eaves W.B.; West S.H.; Kosinski E.J.; Zarich S.W.; Mahal S.S.; Maw K.;
Maynard K.M.; Chen J.C.; Gelormini J.; Gottlieb D.W.; Gabra N.W.; Narayan
P.; Sparks J.; Field J.C.; Willits V.L.; O'Steen M.B.; Pasquini J.A.;
Sensebrenner J.W.; Yarows S.A.; Hiotis L.; Jagielo T.J.; Levinson D.J.;
Diller P.M.; Kereiakes D.J.; Turner T.A.; Vincent S.; Camp A.D.; Denker
P.S.; Manning M.B.; Rocco M.B.; Stamps H.B.; Strader J.R.; Uusinarkaus
K.T.; Kennett J.D.; Leichter S.B.; McNeil D.L.; Schumacher D.R.; Chang
A.R.; Ellison H.S.; Updegrove J.D.; Hamroff G.S.; Kay J.S.; Marar I.E.;
Flores E.; Saini S.; Abdullah S.; Berk M.R.; Fordan S.; Joshi P.H.;
McCullough P.A.; Reynolds R.D.; Rosenstock J.; Sachson R.A.; Shammas N.;
Fishbein G.J.; Randall W.J.; Henderson D.A.; Nash M.L.; Barker B.A.; Cohen
S.S.; Seidman B.; Odekirk L.L.; Grillo R.S.; Martinez L.M.; Multani P.;
Alwine L.K.; McGarvey J.F.; Mollerus M.E.; Miller A.B.; Kotek L.W.;
Changlani M.; Zavaro S.H.; Munoz F.; Mehta P.M.; Helm R.J.; Farhat N.Z.;
Farsad R.; Raoof T.J.; Shultz J.H.; Geohas J.G.; Allaw M.A.; Dela Llana
A.; Gutmann J.E.; Inzerello A.T.; Alappat P.; George A.R.; Haddad T.M.;
Lillestol M.J.; Grodman R.; Peniston J.H.; Wadud K.; Garcia B.; Hamilton
M.E.; Lerman S.; Perloff D.E.; Graff A.; Saxena S.; Alvarado O.P.; Malik
A.; Reddy R.D.; Kinzfogl G.; Cornett G.M.; Norwood P.C.; Gilbert J.M.;
Willis J.G.; McGrew F.; Sharma S.; Castro M.A.; Cucher F.H.; Altafullah
I.M.; Khurana S.; Knutson T.J.; Kinnaman S.J.; Stuckey T.; Pudi K.K.;
Mayfield R.K.; Funk G.S.; Nixon W.A.; Dor I.; Boyett B.E.; Srivastava S.;
Elosegui A.M.; Isserman S.M.; Cheek H.B.; Promisloff S.D.; Tami L.F.; Zeig
S.; fitz-Patrick D.; Dave K.N.; Ahmad A.; Arain S.; Ballantyne C.M.; Doshi
A.; El Hafi S.E.; Feldman J.; Fragoso V.G.; Gilford T.; Hoffman A.S.;
Pouzar J.E.; Vivekananthan K.; Ansari S.H.; Strzinek R.A.; Crater T.A.;
Robinson J.G.; Fulmer J.J.; Patel A.M.; Pereira E.S.; Stich M.A.; Sultan
S.; Geskin G.; Ruoff G.E.; Gillespie E.; Bybee K.A.; Moriarty P.M.; Savin
V.; Agaiby J.M.; Melucci M.B.; Jantzi C.M.; Davidson E.; Smith W.B.;
Treasure C.B.; Wakefield P.H.; Deck K.; Edris M.A.; Gilmore R.M.; Seep
M.K.; Andersen J.L.; Detweiler R.O.; Rosenfeld J.C.; Strobl D.J.;
Steinhoff J.P.; Adams A.; Estevez R.; Molin C.J.; Kim C.Y.; Dy J.; Fox
K.E.; Farris N.R.; Wayne J.D.; Whitney R.T.; Randhawa P.M.; Mego D.M.;
MacDolnald L.; Caputo R.P.; Rigolosi R.; VanNatta B.; Pacheco T.R.;
El-Shahawy M.; Gonzalez E.J.; Guice M.J.; Cherlin R.S.; Bays H.E.;
Shoukfeh M.; Morris F.H.; Loy J.; Vora S.K.; Staab P.K.; Frisoli A.;
Kimmel M.A.; Cohen A.J.; Green C.B.; Whitlock L.; Butuk D.J.; McCartney
M.J.; Ables L.R.; Acosta R.; Alvarez J.G.; Barrera C.M.; Benitez O.;
Berenguer R.A.; Breton C.F.; Chiong R.; Delgado M.I.; Dufreny A.; Fialkow
J.A.; Franczek S.; Frias J.J.; Iglesias C.; Landron-Garcia L.; Llerena
S.N.; Martinez R.F.; Miranda A.A.; Morytko J.A.; Rodriguez I.J.; Sotolongo
R.; Suarez-Sarmiento A.; Terrelonge A.E.; Vaca C.E.; Venereo J.M.; Verdeza
C.; Zeno M.L.; Chilka S.; Felten W.R.; Hartman A.N.; Shayani S.S.; Duprez
D.; Knickelbine T.; Chambers J.D.; Cone C.L.; Broughton R.; Napoli M.C.;
Seaton B.L.; Smith S.K.; Reedy M.A.; Kesani M.K.; Nicol P.R.; Stringam
S.O.; Talano J.V.; Barnum O.; Desai V.; Montero M.; Jacks R.K.; Kostis
J.B.; Owen J.G.; Makam S.K.; Grosman I.; Underberg J.A.; Masri B.E.;
Peters S.S.; Serje J.; Lenhard M.J.; Glover R.; Paraboschi C.F.; Lim E.H.;
Connery L.; Kipgen W.; Bravo P.; DiGiovanna M.J.; Tayoum H.; Gabriel J.D.;
Ariani M.K.; Robinson M.F.; Clemens P.C.; Corder C.N.; Schifferdecker B.;
Tahirkheli N.K.; Hurling R.T.; Rendell M.S.; Shivaswamy V.; Madu I.J.;
Dahl C.F.; Ayesu K.; Kim C.; Barettella M.B.; Jamidar H.A.; Bloom S.A.;
Vora K.N.; Ong S.T.; Aggarwala G.; Sack G.; Blaze K.; Krichmar P.; Murcia
A.; Teltser M.; Villaman-Bencosme Y.; Fahdi I.E.; Williams D.G.; Lain
E.L.; Garcia H.L.; Karim S.N.; Francyk D.M.; Gordon M.B.; Palchick B.A.;
McKenzie M.E.; Gimness M.P.; Greiff J.; Ruiz-R L.; Vazquez-Tanus J.B.;
Schlager D.; Connelly T.; Soroka E.; Hastings W.L.; O'Dea D.J.; Purdy
D.A.; Jackson B.; Arcanese M.L.; Strain J.E.; Schmedtje J.F.; Davis M.G.;
Prasada S.; Scott D.L.; Vukotic G.; Akhtar N.; Larsen D.C.; Rhudy J.M.;
Zebrack J.S.; Bailey S.R.; Grant D.C.; Mora A.; Perez J.A.; Reyes R.G.;
Sutton J.C.; Brandon D.M.; First B.P.; Risser J.A.; Claudio J.;
Figueroa-Cruz W.L.; Sosa-Padilla M.A.; Tan A.E.; Traboulssi M.A.; Morcos
N.C.; Glaser L.A.; Bredlau C.E.; El Shahawy M.; Ramos M.J.; Kandath D.D.;
Kaluski E.; Akright L.; Rictor K.W.; Pluto T.M.; Hermany P.R.; Bellingar
B.; Clark G.B.; Herrod J.N.; Goisse M.; Hook M.; Barrington P.; Lentz
J.D.; Singal D.K.; Gleason G.P.; Lipetz R.S.; Schuchard T.N.; Bonner J.H.;
Forgosh L.B.; Lefebvre G.C.; Pierpoint B.E.; Radin D.M.; Stoller S.R.;
Segall N.; Shah S.A.; Ramstad D.S.; Nisnisan J.M.; Trippett J.M.; Benjamin
S.A.; Labissiere J.C.; Nashed A.N.; Maaieh M.; Aslam A.A.; Mandviwala M.;
Budoff M.J.; French W.J.; Vlach J.J.; DeStefano P.; Bayron C.J.; Fraser
N.J.; Sandberg J.H.; Fagan T.C.; Peart B.C.; Suryanarayana P.G.; Gupta
D.K.; Lee M.W.; Bertolet B.D.; Hartley P.A.; Kelberman M.; Behmanesh B.;
Buynak R.J.; Chochinov R.H.; Steinberg A.A.; Chandna H.; Bjasker K.R.;
Perlman R.L.; Ball E.M.; Pock J.; Singh S.; Baldari D.; Kaster S.; Lovell
J.P.; Horowitz B.S.; Gorman T.A.; Pham D.N.; Landzberg J.S.; Mootoo K.I.;
Moon E.; Krawczyk J.; Alfieri A.D.; Janik M.J.; Herrington D.M.;
Koilpillai R.N.; Waxler A.R.; Hoffman D.A.; Sahul Z.H.; Gumbiner B.; Cropp
A.; Fujita K.; Garzone P.; Imai K.; Levisetti M.; Plowchalk D.; Sasson S.;
Skaggs J.; Sweeney K.; Vincent J.
Institution
(Ridker, Glynn) Center for Cardiovascular Disease Prevention, Brigham and
Women's Hospital, Harvard Medical School, 900 Commonwealth Ave., Boston,
MA 02215, United States
(Revkin, Brunell, Curto, Masiukiewicz, Schwartz, Yunis, Shear) Pfizer, New
York, United States
(Amarenco) Paris-Diderot Sorbonne Paris Cite University, Paris, France
(Civeira) Universidad de Zaragoza, IIS Aragon, Zaragoza, Spain
(Flather) University of East Anglia, Norwich, United Kingdom
(Soran) Central Manchester University Hospital, Manchester, United Kingdom
(Gregoire, Tardif) Montreal Heart Institute, Universite de Montreal,
Montreal, Canada
(Jukema) Leiden University Medical Center, Leiden, Netherlands
(Kastelein) Academic Medical Center, University of Amsterdam, Amsterdam,
Netherlands
(Mosterd) Meander Medical Center, Amersfoort, Netherlands
(Karpov) Russian Cardiology Research and Production Center, Moscow,
Russian Federation
(Koenig) Deutsches Herzzentrum Munchen, Technische Universitat Munchen,
Munich Heart Alliance, Munich, Germany
(Lorenzatti) Cordoba Hospital, Cordoba, Argentina
(Manga) University of the Witwatersrand, Johannesburg, South Africa
(Miller) University of Maryland, Baltimore, United States
(Murin) University of Comenius, Bratislava, Slovakia
(Nicolau) Heart Institute, University of Sao Paulo Medical School, Sao
Paulo, Brazil
(Santos) Lipid Clinic Heart Institute, University of Sao Paulo Medical
School Hospital, Sao Paulo, Brazil
(Nissen) Cleveland Clinic Foundation, Cleveland, United States
(Ponikowski) Wroclaw Medical University, Wroclaw, Poland
(White) Green Lane Cardiovascular Service, Auckland City Hospital,
Auckland, New Zealand
(Wright) Mayo Clinic, Rochester, MN, United States
(Vrablik) First Faculty of Medicine, Charles University, Prague, Czechia
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Bococizumab is a humanized monoclonal antibody that inhibits
proprotein convertase subtilisin- kexin type 9 (PCSK9) and reduces levels
of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the
efficacy of bococizumab in patients at high cardiovascular risk. METHODS
In two parallel, multinational trials with different entry criteria for
LDL cholesterol levels, we randomly assigned the 27,438 patients in the
combined trials to receive bococizumab (at a dose of 150 mg)
subcutaneously every 2 weeks or placebo. The primary end point was
nonfatal myocardial infarction, nonfatal stroke, hospitalization for
unstable angina requiring urgent revascularization, or cardiovascular
death; 93% of the patients were receiving statin therapy at baseline. The
trials were stopped early after the sponsor elected to discontinue the
development of bococizumab owing in part to the development of high rates
of antidrug antibodies, as seen in data from other studies in the program.
The median follow-up was 10 months. RESULTS At 14 weeks, patients in the
combined trials had a mean change from baseline in LDL cholesterol levels
of -56.0% in the bococizumab group and +2.9% in the placebo group, for a
between-group difference of -59.0 percentage points (P<0.001) and a median
reduction from baseline of 64.2% (P<0.001). In the lower-risk,
shorter-duration trial (in which the patients had a baseline LDL
cholesterol level of >=70 mg per deciliter [1.8 mmol per liter] and the
median follow-up was 7 months), major cardiovascular events occurred in
173 patients each in the bococizumab group and the placebo group (hazard
ratio, 0.99; 95% confidence interval [CI], 0.80 to 1.22; P = 0.94). In the
higher-risk, longer-duration trial (in which the patients had a baseline
LDL cholesterol level of >=100 mg per deciliter [2.6 mmol per liter] and
the median follow-up was 12 months), major cardiovascular events occurred
in 179 and 224 patients, respectively (hazard ratio, 0.79; 95% CI, 0.65 to
0.97; P = 0.02). The hazard ratio for the primary end point in the
combined trials was 0.88 (95% CI, 0.76 to 1.02; P = 0.08). Injection-site
reactions were more common in the bococizumab group than in the placebo
group (10.4% vs. 1.3%, P<0.001). CONCLUSIONS In two randomized trials
comparing the PCSK9 inhibitor bococizumab with placebo, bococizumab had no
benefit with respect to major adverse cardiovascular events in the trial
involving lower-risk patients but did have a significant benefit in the
trial involving higher-risk patients. Copyright © 2017
Massachusetts Medical Society. All rights reserved.

<71>
Accession Number
2015803674
Title
Perioperative Fully Closed-Loop Insulin Delivery in Patients Undergoing
Elective Surgery: An Open-Label, Randomized Controlled Trial.
Source
Diabetes Care. 45(9) (pp 2076-2083), 2022. Date of Publication: September
2022.
Author
Herzig D.; Suhner S.; Roos J.; Schurch D.; Cecchini L.; Nakas C.T.; Weiss
S.; Kadner A.; Kocher G.J.; Guensch D.P.; Wilinska M.E.; Raabe A.;
Siebenrock K.A.; Beldi G.; Gloor B.; Hovorka R.; Vogt A.P.; Bally L.
Institution
(Herzig, Suhner, Roos, Schurch, Bally) Department of Diabetes,
Endocrinology, Nutritional Medicine and Metabolism, University Hospital of
Bern, Bern, Switzerland
(Cecchini, Guensch, Vogt) Department of Anaesthesiology and Pain Medicine,
University Hospital of Bern, Bern, Switzerland
(Nakas) Laboratory of Biometry, School of Agriculture, University of
Thessaly, Magnesia, Nea Ionia-Volos, Greece
(Nakas) University Institute of Clinical Chemistry, University Hospital of
Bern, Bern, Switzerland
(Weiss, Kadner) Department of Cardiovascular Surgery, University Hospital
of Bern, Bern, Switzerland
(Kocher) Department of General Thoracic Surgery, University Hospital of
Bern, Bern, Switzerland
(Wilinska, Hovorka) Wellcome-MRC Institute of Metabolic Science,
University of Cambridge, Cambridge, United Kingdom
(Raabe) Department of Neurosurgery, University Hospital of Bern, Bern,
Switzerland
(Siebenrock) Department of Orthopaedic Surgery and Traumatology,
University Hospital of Bern, Bern, Switzerland
(Beldi, Gloor) Department of Visceral Surgery and Medicine, University
Hospital of Bern, Bern, Switzerland
Publisher
American Diabetes Association Inc.
Abstract
OBJECTIVE Perioperative management of glucose levels remains challenging.
We aimed to assess whether fully closed-loop subcutaneous insulin delivery
would improve glycemic control compared with standard insulin therapy in
insulin-requiring patients undergoing elective surgery. RESEARCH DESIGN
AND METHODS We performed a single-center, open-label, randomized
controlled trial. Patients with diabetes (other than type 1) undergoing
elective surgery were recruited from various surgical units and randomly
assigned using a minimization schedule (stratified by HbA<inf>1c</inf> and
daily insulin dose) to fully closed-loop insulin delivery with fast-acting
insulin aspart (closed-loop group) or standard insulin therapy ac-cording
to local clinical practice (control group). Study treatment was
adminis-tered from hospital admission to discharge (for a maximum of 20
days). The primary end point was the proportion of time with sensor
glucose in the target range (5.6-10.0 mmol/L). RESULTS Forty-five patients
were enrolled and assigned to the closed-loop (n 5 23) or the control (n 5
22) group. One patient (closed-loop group) withdrew from the study before
surgery and was not analyzed. Participants underwent abdominal (57%),
vascular (23%), orthopedic (9%), neuro (9%), or thoracic (2%) surgery. The
mean proportion of time that sensor glucose was in the target range was
76.7 +/- 10.1% in the closed-loop and 54.7 +/- 20.8% in the control group
(mean difference 22.0 percentage points [95% CI 11.9; 32.0%]; P < 0.001).
No episodes of severe hypoglycemia (<3.0 mmol/L) or hyperglycemia with
ketonemia or any study-related adverse events occurred in either group.
CONCLUSIONS In the context of mixed elective surgery, the use of fully
closed-loop subcutaneous insulin delivery improves glucose control without
a higher risk of hypoglycemia. Copyright © 2022 by the American
Diabetes Association..

<72>
Accession Number
2017612143
Title
Intramuscular stimulation as a new modality to control postthoracotomy
pain: A randomized clinical trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(4) (pp 1236-1245),
2022. Date of Publication: October 2022.
Author
Moon D.H.; Park J.; Park Y.G.; Kim B.J.; Woo W.; Na H.; Oh S.; Lee H.S.;
Lee S.
Institution
(Moon, Kim, Woo, Na, Oh, Lee) Department of Thoracic and Cardiovascular
Surgery, Gangnam Severance Hospital, Yonsei University College of
Medicine, Seoul, South Korea
(Park, Park) Department of Rehabilitation Medicine, Gangnam Severance
Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei
University College of Medicine, Seoul, South Korea
(Lee) Biostatistics Collaboration Unit, Department of Research Affairs,
Yonsei University College of Medicine, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Objective: Postoperative pain after thoracic surgery primarily hinders
patients' mobility, decreasing the quality of life. To date, various
modalities have been suggested to improve postoperative pain. However,
pain alleviation still remains a challenge, resulting in continued
reliance on opioids. To tackle this problem, this study introduces a
needle electrical twitch obtaining intramuscular stimulation (NETOIMS) as
a new effective treatment modality for postoperative pain after
thoracoscopic surgery. Method(s): This randomized clinical trial
analyzed patients receiving video-assisted thoracoscopic surgery pulmonary
resection between March 2018 and June 2020 at a single institution. A
total of 77 patients (NETOIMS, 36; intravenous patient-controlled
analgesia, 41) were included. NETOIMS was conducted on the retracted
intercostal muscle immediately following the main procedure, just before
skin closure. Postoperative pain (numeric rating scale) and oral opioid
morphine milligram equivalent were assessed daily until postoperative day
5. Result(s): The NETOIMS group had a significantly lower numeric
rating scale score on postoperative day (POD) 0 (P < .01), POD2 (P <
.001), POD4 (P < .001), and POD5 (P = .01). The predicted time to complete
pain resolution was 6.15 days in the NETOIMS group and 20.7 days in the
intravenous patient-controlled analgesia group. The oral opioid morphine
milligram equivalent was significantly lower in the NETOIMS group on POD0
(P < .001) and POD1 (P < .001). Conclusion(s): NETOIMS appears to be
an effective modality in alleviating postoperative pain after
thoracoscopic surgery, thereby reducing the reliance on opioid
use. Copyright © 2022 The American Association for Thoracic
Surgery

<73>
[Use Link to view the full text]
Accession Number
2020088126
Title
Resistance Training in Patients With Coronary Artery Disease, Heart
Failure, and Valvular Heart Disease: A REVIEW WITH SPECIAL EMPHASIS ON OLD
AGE, FRAILTY, AND PHYSICAL LIMITATIONS.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 42(5) (pp
304-315), 2022. Date of Publication: Sep-22.
Author
Bjarnason-Wehrens B.; Schwaab B.; Reiss N.; Schmidt T.
Institution
(Bjarnason-Wehrens) Department of Preventive and Rehabilitative Sport and
Exercise Medicine, Institute for Cardiology and Sports Medicine, German
Sports University Cologne, Cologne, Germany
(Schwaab) Curschmann Klinik, Timmendorfer Strand, Germany
(Reiss, Schmidt) Schuchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde,
Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: Current guidelines recommend individually adapted resistance
training (RT) as a part of the exercise regime in patients with
cardiovascular diseases. The aim of this review was to provide insights
into current knowledge and understanding of how useful, feasible, safe,
and effective RT is in patients with coronary artery disease (CAD), heart
failure (HF), and valvular heart disease (VHD), with particular emphasis
on the role of RT in elderly and/or frail patients. Review Methods: A
review based on an intensive literature search: systematic reviews and
meta-analyses published in 2010 or later; recent studies not integrated
into meta-analyses or systematic reviews; additional manual searches.
 Summary: The results highlight the evaluation of effects and safety
of RT in patients with CAD and HF with reduced ejection fraction (HFrEF)
in numerous meta-analyses. In contrast, few studies have focused on RT in
patients with HF with preserved ejection fraction (HFpEF) or VHD.
Furthermore, few studies have addressed the feasibility and impact of RT
in elderly cardiac patients, and data on the efficacy and safety of RT in
frail elderly patients are limited. The review results underscore the high
prevalence of age-related sarcopenia, disease-related skeletal muscle
deconditioning, physical limitations, and frailty in older patients with
cardiovascular diseases (CVD). They underline the need for individually
tailored exercise concepts, including RT, aimed at improving functional
status, mobility, physical performance and muscle strength in older
patients. Furthermore, the importance of the use of assessment tools to
diagnose frailty, mobility/functional capacity, and physical performance
in the elderly admitted to cardiac rehabilitation is
emphasized. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<74>
Accession Number
2019983200
Title
Percutaneous Repair of Mitral Regurgitation: A Comprehensive Review of
Literature.
Source
Current Problems in Cardiology. 47(11) (no pagination), 2022. Article
Number: 101338. Date of Publication: November 2022.
Author
Salehin S.; Hasan S.M.; Mai S.; Rasmussen P.; Shahzad A.; Abdelmaseih R.;
Jazar D.A.; Shalaby M.; Motiwala A.; Gilani S.; Khalife W.I.
Institution
(Salehin, Mai, Rasmussen, Jazar) Internal Medicine, University of Texas
Medical Branch, Galveston, TX
(Hasan, Shahzad, Abdelmaseih, Shalaby, Motiwala, Gilani, Khalife)
Cardiology, University of Texas Medical Branch, Galveston, TX
Publisher
Elsevier Inc.
Abstract
Mitral regurgitation is the most common valvular disease in the US and the
second most common worldwide. Left untreated, it can lead to the
development of heart failure, giving rise to increased mortality rates.
Mitral valve intervention is usually indicated in severe mitral
regurgitation at the onset of symptoms, even if the function of the left
ventricle is preserved. A surgical approach is generally favored according
to current guidelines, with excellent clinical outcomes. However, the
emergence of novel data from contemporary trials indicates that
percutaneous, catheter-based approach may have similar improvements in
mortality outcomes while maintaining a superior safety profile when
compared to the surgical approach. Here, we discuss transcatheter mitral
valve repair as a treatment option for mitral regurgitation and summarize
the major clinical trials which were recently conducted on transcatheter
repair. Copyright © 2022 Elsevier Inc.

<75>
Accession Number
2019890043
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. 18(6) (pp 514-523), 2022. Date of Publication: August
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, LTSI,
UMR 1099, 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,
Claude Bernard University, Lyon, France
(Bonnet) Service de Cardiologie Interventionnelle, CHU Timone, Assistance
Publique-Hopitaux de Marseille, Marseille, France
(Leroux) Cardiologie Medicale et Structurelle, Medipole Lyon-Villeurbanne,
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, Ramsay Sante, Massy, France
(Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, Canada
(Iung) Hopital Bichat, Claude Bernard, DHU FIRE, 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, France
(Boutitie) CNRS, UMR 5558, Laboratoire de Biometrie et Biologie Evolutive,
Equipe Biostatistique-Sante, Villeurbanne, France
(Bonnet) Aix-Marseille Universite, INSERM, Marseille, France
(Iung) Universite de Paris, INSERM 1148, Paris, France
(Boutitie) Universite Lyon 1, Villeurbanne, France
Publisher
Europa Group
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). Aim(s): 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. Copyright © Europa Digital &
Publishing 2022. All rights reserved.

<76>
Accession Number
2019347447
Title
Effect of Volatile Anesthesia Versus Total Intravenous Anesthesia on
Postoperative Pulmonary Complications in Patients Undergoing Cardiac
Surgery: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(10) (pp 3758-3765),
2022. Date of Publication: October 2022.
Author
He L.-L.; Li X.-F.; Jiang J.-L.; Dai S.-H.; Jing W.-W.; Yu H.
Institution
(He, Li, Jiang, Yu, Dai, Yu) Department of Anesthesiology, West China
Hospital, Sichuan University, Chengdu, China
(He) Department of Anesthesiology, Sichuan Jinxin Women and Children's
Hospital, Chengdu, China
(Jing) Department of Anesthesiology, West China Second University
Hospital, Sichuan University, Chengdu, China
Publisher
W.B. Saunders
Abstract
Objectives: The purpose of this study was to evaluate the effect of
volatile anesthesia and propofol-based total intravenous anesthesia (TIVA)
on postoperative pulmonary complications (PPCs) among patients undergoing
cardiac surgery. Design(s): Parallel-group, randomized controlled
trial. Setting(s): Single-center tertiary care hospital.
 Participant(s): Five hundred twenty-four patients undergoing cardiac
surgery with cardiopulmonary bypass. Intervention(s): The patients
were assigned randomly (1:1) to receive anesthesia maintenance with a
volatile anesthetic (sevoflurane or desflurane) or propofol-based TIVA.
 Measurements and Main Results: The primary outcome was a composite of
postoperative pulmonary complications within the first 7 postoperative
days. The PPCs occurred in 118 of 262 patients (45.0%) in the volatile
anesthesia group compared with 105 of 262 patients (40.1%) in the
propofol-based intravenous anesthesia group (relative risk: 1.17 [95% CI
0.96-1.42], p = 0.123). There were no significant differences in the
severity of PPCs within 7 days postoperatively, the occurrence and
severity grade of PPCs within 30 days, the incidence of hypoxia, and
30-day mortality. Conclusion(s): In adult patients undergoing cardiac
surgery with cardiopulmonary bypass, general anesthesia with a volatile
anesthetic compared with propofol-based TIVA had not reduced pulmonary
complications within the first 7 days after surgery. Copyright ©
2022 Elsevier Inc.

<77>
Accession Number
2019194733
Title
Effect of High-Frequency Oscillatory Ventilation, Combined With Prone
Positioning, in Infants With Acute Respiratory Distress Syndrome After
Congenital Heart Surgery: A Prospective Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(10) (pp 3847-3854),
2022. Date of Publication: October 2022.
Author
Zheng Y.-R.; Chen Y.-K.; Lin S.-H.; Cao H.; Chen Q.
Institution
(Zheng, Chen, Lin, Cao, Chen) Department of Cardiac Surgery, Fujian Branch
of Shanghai Children's Medical Center, Fuzhou, China
(Zheng, Chen, Lin, Cao, Chen) Fujian Children's Hospital, Fuzhou, China
(Zheng, Chen, Lin, Cao, Chen) Fujian Maternity and Child Health Hospital
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics,
Fujian Medical University, Fuzhou, China
(Zheng, Chen, Lin, Cao, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: This study aimed to evaluate the effect of high-frequency
oscillatory ventilation, (HFOV) combined with prone positioning, on
oxygenation and pulmonary ventilation in infants with acute respiratory
distress syndrome (ARDS) after congenital heart surgery. Design(s): A
randomized controlled trial. Setting(s): A single-center study at a
tertiary teaching hospital. Participant(s): Patients with
postoperative ARDS after congenital heart disease were divided randomly
into the following 2 groups: HFOV combined with prone position (HFOV-PP),
and HFOV combined with supine position (HFOV-SP). Intervention(s):
The primary outcomes were the PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf>
ratio and the oxygenation index after the intervention, and the secondary
outcomes were respiratory variables, hemodynamics, complications, and
other short-term outcomes. Result(s): Sixty-five eligible infants
with ARDS were randomized to either the HFOV-PP (n = 32) or HFOV-SP (n =
33) group. No significant difference in baseline data was found between
the 2 groups (p > 0.05). Oxygenation was improved in both groups after
HFOV intervention. Compared with the HFOV-SP group, the HFOV-PP group had
significantly increased PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf> and
oxygenation index and a shorter duration of invasive ventilation and
length of cardiac intensive care unit stay. No serious complications
occurred in the 2 groups. Conclusion(s): HFOV-PP significantly
improved oxygenation in infants with ARDS after cardiac surgery and had no
serious complications. Copyright © 2022 Elsevier Inc.

<78>
Accession Number
2019194096
Title
The effect of melatonin on cardiac biomarkers after coronary artery bypass
graft surgery: A double-blind, randomized pilot study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(10) (pp 3800-3805),
2022. Date of Publication: October 2022.
Author
Nasseh N.; Khezri M.B.; Farzam S.; Shiravandi S.; Shafikhani A.A.
Institution
(Nasseh, Khezri, Shiravandi) Department of Anesthesiology, Faculty of
Medicine, Metabolic Diseases Research Center, Qazvin University of Medical
Sciences, Shahid Bahonar Ave., PO Box 3419759811, Qazvin, Iran, Islamic
Republic of
(Farzam) Department of Cardiovascular surgery, Faculty of Medicine, Qazvin
University of Medical Sciences, Qazvin, Iran, Islamic Republic of
(Shafikhani) Department of Occupational safety and Health Engineering,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
W.B. Saunders
Abstract
Objectives: Melatonin has emerged as an anti-inflammatory agent, potent
direct free-radical scavenger, and an indirect antioxidant in preventing
ischemia-reperfusion injury. This study aimed to evaluate melatonin's
effect on cardiac biomarkers after coronary artery bypass grafting (CABG).
 Design(s): A double-blind, randomized placebo-controlled pilot
clinical study. Setting(s): Booali Sina Hospital, Qazvin University
of Medical Sciences, Qazvin, Iran. Participant(s): One hundred
patients undergoing elective CABG. The patients were divided randomly into
control (C) and melatonin (M) groups (50 patients per group).
 Intervention(s): The M group received 3 mg of melatonin the night
before surgery, 3 mg in the morning, and routine cardiac surgery
medications. The C group received 1 placebo tablet rather than melatonin.
After surgery, the patients in the M group received 3 mg of melatonin, and
the C group received 1 placebo tablet at bedtime until the third day after
CABG. Measurements and Main Results: In both groups, creatine
kinase-MB (CPK-MB), cardiac troponin I, erythrocyte sedimentation rate
(ESR), and C-reactive protein (CRP) were measured before surgery and on
the first, second, and third postoperative days. Serum CPK-MB levels on
the second and third day after CABG were significantly lower in the M
group than in the C group (p < 0.05). Regarding cardiac troponin I, CRP,
and ESR markers, there were no significant changes in serum concentration
before surgery and on the first, second, and third days after surgery
between the 2 groups (p > 0.05). The mean length of hospitalization in the
ICU was lower in the M group (3.4 +/- 1.05) compared with the C group
(3.96 +/- 1.06, p = 0.01). Conclusion(s): Melatonin reduced the
postoperative level of CPK-MB and the length of hospitalization in the ICU
in patients who underwent cardiac surgery. Copyright © 2022

<79>
Accession Number
2017961952
Title
Evaluation of pain and opioid consumption in local preemptive anesthesia
and the erector spine plane block in thoracoscopic surgery: A randomized
clinical trial.
Source
Revista do Colegio Brasileiro de Cirurgioes. 49 (no pagination), 2022.
Article Number: e20223291. Date of Publication: 2022.
Author
Pallu I.; Boscoli S.S.; Zaleski T.; de Andrade D.P.; Cherubini G.R.L.;
Czepula A.I.S.; de Souza J.M.
Institution
(Pallu, Boscoli, Zaleski, de Andrade, Czepula, de Souza) Faculdades
Pequeno Principe, Curso de Medicina, PR, Curitiba, Brazil
(Cherubini) Hospital Nossa Senhora das Gracas, Departamento de
Anestesiologia, PR, Curitiba, Brazil
(de Souza) Hospital Nossa Senhora das Gracas, Departamento de Cirurgia
Toracica, PR, Curitiba, Brazil
Publisher
Colegio Brasileiro de Cirurgioes
Abstract
Objective: assess pain and opioid consumption in patients undergoing
anesthetic techniques of spinal erector plane block and local anesthetic
block in video-assisted thoracic surgery in the immediate postoperative
period. Method(s): ninety-two patients undergoing video assisted
thoracic surgery were randomized to receive ESPB or BAL before starting
the surgical procedure. Using the numerical verbal scale, the primary
outcome assessed was the patient's pain in the immediate postoperative
period (POI). The secondary outcome comprises the assessment of opioid
consumption in the IPP by quantifying the medication used in an
equianalgesic dose of morphine expressed in milligrams, in the immediate
post-anesthetic recovery period, 6h, 12h, and 24h after surgery.
 Result(s): the EVN scores in the LBA and ESPB group in the POI had a
mean of 0,8 (+/-1,89) vs 0,58 (+/-2,02) in the post-anesthesia care room
(REPAI), 1,06 (+/-2,00) vs 1,30 (+/-2,30) in 6 hours of POI, 0,84
(+/-1,74) vs 1,19 (+/-2,01) within 12 hours of POI and 0,95 (+/-1,88) vs 1
( +/-1,66) within 24 hours of POI, all with p>0.05. Mean opioid
consumption in the BAL and ESPB groups in the POI was 12.9 (+/- 10.4) mg
vs 14.9 (+/-10.2) mg, respectively, with p = 0.416. Sixteen participants
in the ESPB group and seventeen in the BAL group did not use opioids
during the first 24 hours of the PO analyzed. Conclusion(s): local
anesthesic block and ESP block techniques showed similar results in terms
of low pain scores and opioid consumption during the period
evaluated. Copyright © 2022, Colegio Brasileiro de Cirurgioes.
All rights reserved.

<80>
Accession Number
2017908567
Title
Angiographic Patency of Coronary Artery Bypass Conduits: An Updated
Network Meta-Analysis of Randomized Trials.
Source
Brazilian Journal of Cardiovascular Surgery. 37(Special Issue 1) (pp
7-31), 2022. Date of Publication: 2022.
Author
Deng M.X.; Lia H.; Lee G.; Rahouma M.; Di Franco A.; Demetres M.; Angelini
G.D.; Gaudino M.; Fremes S.E.
Institution
(Deng, Fremes) Division of Cardiac Surgery, Schulich Heart Centre,
Department of Surgery, Sunnybrook Health Sciences Centre, University of
Toronto, Toronto, ON, Canada
(Lia, Lee) Temerty School of Medicine, University of Toronto, Toronto, ON,
Canada
(Rahouma, Di Franco, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, NY, United States
(Demetres) Samuel J. Wood Library & C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Angelini) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The second best conduit for coronary artery bypass grafting
is uncertain. The objective of this study is to determine the second best
conduit according to graft patency results from randomized controlled
trials using a network meta-analysis. Method(s): A systematic
literature search was conducted for randomized controlled trials comparing
the angiographic patency rate of the no-touch saphenous vein (NT-SV), the
radial artery (RA), the right internal thoracic artery (RITA), and the
gastroepiploic artery (GEA) in reference to the conventionally harvested
saphenous vein (CON-SV). The primary outcome was graft occlusion, and the
secondary outcome was all-cause mortality. Result(s): A total of 859
studies were retrieved, of which 18 were included. A total of 6,543
patients and 8,272 grafts were analyzed. The weighted mean angiographic
follow-up time was 3.5 years. Compared with CON-SV, RA (incidence rate
ratio [IRR] 0.56; 95% confidence interval [CI], 0.43-0.74) and NT-SV (IRR
0.56; 95% CI, 0.44-0.70) demonstrated lower graft occlusion. NT-SV and RA
were ranked as the best conduits (rank score for NT-SV 0.88 vs. 0.87 for
RA, 0.29 for GEA, 0.27 for CON-SV, and 0.20 for RITA). There was no
significant difference in late mortality between different conduit types.
 Conclusion(s): RA and NT-SV are associated with significantly lower
graft occlusion rates and are comparably ranked as the best conduit for
patency. Copyright © 2022, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<81>
Accession Number
2016490472
Title
A systematic review and pooled analysis of septal myectomy and
edge-to-edge mitral valve repair in obstructive hypertrophic
cardiomyopathy.
Source
Reviews in Cardiovascular Medicine. 22(4) (pp 1471-1477), 2021. Date of
Publication: 22 Dec 2021.
Author
Mihos C.G.; Escolar E.; Fernandez R.; Nappi F.
Institution
(Mihos, Fernandez) Echocardiography Laboratory, Columbia University
Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL
33140, United States
(Escolar) Coronary Care Unit, Columbia University Division of Cardiology,
Mount Sinai Heart Institute, Miami Beach, FL 33140, United States
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord de
Saint-Denis, Paris 93200, France
Publisher
IMR Press Limited
Abstract
Left ventricular outflow tract (LVOT) obstruction and systolic anterior
motion (SAM) of the mitral valve (MV) occurs in 70% of hypertrophic
cardiomyopathy (HCM) patients. In individuals undergoing septal myectomy,
concomitant MV surgery is considered for SAM with residual LVOT
obstruction or mitral regurgitation (MR); however, the optimal approach
remains debated. A literature search was performed in Pubmed, EMBASE,
Ovid, and the Cochrane library of published articles through June 2021
reporting on combined septal myectomy and edge-to-edge MV repair for
obstructive HCM. Continuous variables were weighted and compared using a
student's t-test, and categorical variables using a chi-square test with
Yates correction. Six studies with 158 total patients were included. The
mean follow-up was 2.8 +/- 2.7 years. Compared with pre-operative values,
there were significant reductions in the LV ejection fraction (69 +/- 10
vs 59 +/- 8%), peak LVOT gradient (82 +/- 34 vs 16 +/- 13 mmHg),
prevalence of moderate or greater MR (84 vs 5 %), and presence of SAM (96%
vs 0) (p < 0.001 for all). There was no change in LV internal diastolic
diameter (4.2 +/- 1.3 vs 4.4 +/- 1.5 cm, p = 0.32). There were 2 (1%)
operative mortalities. At follow-up, the survival rate was 97%, there were
3 (2%) re-operative MV replacements, 4 (3%) patients remained in New York
Heart Association functional class III/IV, and 8 (6%) required permanent
pacemaker implantation. In conclusion, combined septal myectomy and
edge-to-edge MV repair is a safe and effective treatment strategy in
carefully selected patients requiring surgical HCM
management. Copyright ©2021 The Author(s). Published by IMR
Press.

<82>
Accession Number
2016458033
Title
Efficacy and Safety of Emergent Transcatheter Aortic Valve Implantation in
Patients with Acute Decompensated Aortic Stenosis: Systematic Review and
Meta-Analysis.
Source
Journal of Interventional Cardiology. 2021 (no pagination), 2021. Article
Number: 7230063. Date of Publication: 2021.
Author
Shao R.; Li J.; Qu T.; Fu X.; Liao Y.; Chen M.
Institution
(Shao, Li, Chen) Laboratory of Heart Valve Disease, West China Hospital,
Sichuan University, Chengdu, China
(Shao, Fu) Department of Cardiology, West China Hospital, Sichuan
University, Chengdu, China
(Qu) West China School of Medicine, Sichuan University, Chengdu, China
(Liao, Chen) Department of Clinical Research Management, West China
Hospital, Sichuan University, Chengdu, China
Publisher
Hindawi Limited
Abstract
Introduction. The aim of this systematic review and meta-analysis was to
investigate the efficacy and safety of emergent transcatheter aortic valve
implantation (TAVI) in patients with decompensated aortic stenosis (AS) by
comparing the clinical outcomes with the patients who had received the
elective TAVI. Methods. By searching PubMed, EMBASE, and Cochrane
databases, we obtained the studies comparing the clinical outcomes of
emergent TAVI and elective TAVI. Finally, 14 studies were included.
Results. A total of 14 eligible articles with 73,484 patients were
included in this meta-analysis. Emergent TAVI was associated with a higher
mortality during hospitalization (HR 2.09, 95% CI [1.39 to 3.14]), 30 days
(HR 2.29, 95% CI [1.69 to 3.10]), and 1 year (HR 1.96, 95% CI [1.55 to
2.49]). Consistently, the incidence of acute kidney injury (AKI) (RR 2.48,
95% CI [1.85 to 3.32]), dialysis (RR 2.37, 95% CI [1.95 to 2.88]),
bleeding (RR 1.62, 95% CI [1.27 to 2.08]), major bleeding (RR 1.05, 95% CI
[1.00 to 1.10]), and 30-day rehospitalization (RR 1.30, 95% CI [1.07,
1.58]) were more common in patients receiving emergent TAVI. No
statistical differences were found in the occurrence rate of vascular
complications (RR 1.11, 95% CI [0.90, 1.36]), major vascular complications
(RR 1.14, 95% CI [0.52, 2.52]), permanent pacemaker (PPM) placement (RR
1.05, 95% CI [0.99, 1.11]), cerebrovascular events (RR 1.11, 95% CI [0.98,
1.25]), moderate to severe paravalvular leakage (PVL) (RR 1.23, 95% [CI
0.94 to 1.61]), and device success (RR 0.99, 95% CI [0.97, 1.01]).
Conclusion. Emergent TAVI is associated with some postoperative
complications and increased mortality compared with elective TAVI.
Emergent TAVI should be implemented cautiously and
individually. Copyright © 2021 Ruochen Shao et al.

<83>
Accession Number
2016693209
Title
Vaptans for oedematous and hyponatraemic disorders in childhood: A
systematic literature review.
Source
British Journal of Clinical Pharmacology. 88(10) (pp 4474-4480), 2022.
Date of Publication: October 2022.
Author
Piffer A.; Bianchetti M.G.; Leoni-Foglia C.; Simonetti G.D.; Milani G.P.;
Lava S.A.G.
Institution
(Piffer, Leoni-Foglia, Simonetti) Pediatric Institute of Southern
Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
(Bianchetti) Family Medicine, Faculty of Biomedical Sciences, Universita
della Svizzera Italiana, Lugano, Switzerland
(Bianchetti, Simonetti) Faculty of Biomedical Sciences, Universita della
Svizzera Italiana, Lugano, Switzerland
(Milani) Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore
Policlinico, Milan, Italy
(Milani) Department of Clinical Sciences and Community Health, Universita
degli Studi di Milano, Milan, Italy
(Lava) Pediatric Cardiology Unit, Department of Pediatrics, Centre
Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne,
Switzerland
(Lava) Heart Failure and Transplantation, Department of Pediatric
Cardiology, Great Ormond Street Hospital, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Aims: The aim of this study was to systematically review the use of
vaptans (nonpeptide vasopressin receptor antagonists) in children.
 Method(s): Through a database search (Web of Science, the National
Library of Medicine, Excerpta Medica), we identified case series and case
reports and extracted clinical and laboratory data. Result(s):
Twenty-six articles, published since 2008, reported on 226 patients. Among
115 children with hyponatraemic (n = 63) and oedematous disorders (n =
52), a 48 hour course of tolvaptan with an initial dose of 0.38 +/- 0.27
mg/kg was administered in 106 cases, while intravenous conivaptan was
reported in nine cases. An increase (P <.02) in urine output was shown in
both oedematous (from 3.2 +/- 2.0 to 5.3 +/- 6.7 mL/kg/day) and
hyponatraemic (from 3.0 +/- 1.5 to 4.4 +/- 2.3 mL/kg/day) patients. In
these latter, sodium increased from 125 +/- 6 to 133 +/- 6 mmol/L (P
<.0001). The increase in sodium level correlated with its basal value, but
not with the administered vaptan dose. Among 111 children undergoing
cardiac surgery, after tolvaptan 0.21 +/- 0.01 mg/kg/day, mostly combined
with conventional diuretics, an increase in diuresis by 41 +/- 4% was seen
within 24 hours (P <.0001). Similarly, a single add-on dose of tolvaptan
0.45 mg/kg allowed a reduced additional intravenous furosemide
administration (0.26 +/- 0.23 vs 0.62 +/- 0.48 mg/kg, P <.005). Side
effects were rarely reported, and included excessive thirst and xerostomia
in seven, skin rash in one and elevated aminotransferases in one
patient(s). Conclusion(s): Vaptans appear to be safe for oedematous
and hyponatraemic disorders also in children. Although they increase
diuresis and natraemia, no superiority to traditional diuretics and sodium
supplements has been demonstrated. Reported side effects are rare and
non-serious. Copyright © 2022 British Pharmacological Society.

<84>
Accession Number
2019072124
Title
Are there differences in cardiothoracic surgery performed by trainees
versus fully trained surgeons?.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Comanici M.; Salmasi M.Y.; Schulte K.L.; Raja S.G.; Attia R.Q.
Institution
(Comanici, Salmasi, Raja, Attia) Department of Cardiac Surgery, Harefield
Hospital, London, United Kingdom
(Comanici) Faculty of Medicine and Pharmacy, Dunarea de Jos University of
Galati, Galati, Romania
(Schulte) Department of Surgery, Sana Hospital Berlin Lichtenberg, Berlin,
Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We sought to assess the safety of training in cardiothoracic
surgery comparing outcomes of cases performed by trainees versus fully
trained surgeons. Method(s): EmBase, Scopus, PubMed, and OVID MEDLINE
were searched in August 2021 independently by two authors. A third author
arbitrated decisions to resolve disagreements. Inclusion criteria were
articles on cardiothoracic surgery reporting on outcomes for trainees.
Studies were assessed for appropriateness as per CBEM criteria. Eight
hundred and ninety-two results were obtained, 27 represented best evidence
(2-meta-analyses, 1-RCT, and 24 retrospective cohort studies).
 Result(s): In all 474,160 operative outcomes were assessed for
434,535 coronary artery bypass grafting (CABG) (431,329 on-pump vs. 3206
off-pump), 3090 AVR, 1740 MVR/repair, 26,433 mixed, 3565 congenital, and
4797 thoracic procedures. In all 398,058 cases were performed by trainees
and 75,943 by consultants. One hundred fifty-nine cases were
indeterminate. There were no statistically significant differences in the
patients' preoperative risk scores. All studies excluded extreme high-risk
patients in emergency setting, patients with poor left ventricular
function, and reoperation cases that were undertaken by consultants. There
were no differences in cardiopulmonary bypass and clamp times for CABG.
Times for valve replacement and repair cases were longer for trainees.
There were no differences in the postoperative outcomes including
perioperative myocardial infarction, resternotomy for bleeding, stroke,
renal failure, intensive therapy unit length of stay, and total length of
stay. One study reported no differences on angiographic graft patency at 1
year. There were no differences in in-hospital or midterm mortality out to
5-years. Discussion(s): Trainees can perform cardiothoracic surgery
in dedicated high-volume units with outcomes comparable to those of fully
trained surgeons. Copyright © 2022 Wiley Periodicals LLC.

<85>
Accession Number
2019072045
Title
Median sternotomy pain after cardiac surgery: To block, or not? A
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
King M.; Stambulic T.; Hassan S.M.A.; Norman P.A.; Derry K.; Payne D.M.;
El Diasty M.
Institution
(King, Stambulic, Hassan) Queen's School of Medicine, Kingston, ON, Canada
(Norman) Kingston General Health Research Institute, Kingston, ON, Canada
(Derry) Department of Anesthesiology, Queen's University, Kingston, ON,
Canada
(Payne, El Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Inadequate pain control after median sternotomy leads to
reduced mobilization, increased respiratory complications, and longer
hospital stays. Typically, postoperative pain is controlled by opioid
analgesics that may have several adverse effects. Parasternal intercostal
block (PSB) has emerged as part of a multimodal strategy to control pain
after median sternotomy. However, the effectiveness of this intervention
on postoperative pain control and analgesic use has not been fully
established. Methods and Results: We conducted a meta-analysis to
assess the effect of PSB on postoperative pain and analgesic use in adult
cardiac surgery patients undergoing median sternotomy. PubMed, Embase,
Google Scholar, and the Cochrane database were searched with the following
search strategy: ([postoperative pain] or [pain relief] OR [analgesics] or
[analgesia] or [nerve block] or [regional block] or [local block] or
[regional anesthesia] or [local anesthetic] or [parasternal block] and
[sternotomy]) and (humans [filter]). Inclusion criteria were: patients who
underwent cardiac surgery via median sternotomy, age >18 and parasternal
block (continuous and single dose). Exclusion criteria were: noncardiac
surgery, nonparasternal nerve blocks, and the use of NSAIDS in parasternal
block. Quality assessment was performed by three independent reviewers via
the Cochrane risk of bias assessment tool. Of 1165 total citations, 18
were found to be relevant. Of these 18 citations, 7 citations (N = 2223
patients) reported postoperative pain scores in an extractable format and
11 citations (N = 2155 patients) reported postoperative opioid use in an
extractable format. For postoperative opioid use, morphine equivalent
doses were calculated for all studies and postoperative pain scores were
standardized to a 10-point visual analog scale for comparison between
studies; both these were reported as total opioid use or cumulative score
ranging from 24 to 72 h postoperative. All data analyses were run using a
random effects model, using a restricted maximum likelihood estimator, to
obtain summary standardized mean differences with 95% confidence interval
(CI's). For studies which only reported median and interquatile range
(IQR), the median was standard deviation was estimated by IQR/1.35.
Following median sternotomy both postoperative pain (SMD [95% CI] -0.49
[-0.92 to -0.06]) and postoperative morphine equivalent use (SMD [95% CI]
-1.68 [-3.11 to -0.25]) were significantly less in the PSB group.
 Conclusion(s): Our meta-analysis suggests that parasternal nerve
block significantly reduces postoperative pain and opioid
use. Copyright © 2022 Wiley Periodicals LLC.

<86>
Accession Number
2018350800
Title
Transcatheter aortic valve implantation and frailty.
Source
Cardiovascular Intervention and Therapeutics. 37(4) (pp 626-634), 2022.
Date of Publication: October 2022.
Author
Shimura T.; Yamamoto M.
Institution
(Shimura, Yamamoto) Department of Cardiology, Gifu Heart Center, 4-14-4
Yabutaminami, Gifu, Gifushi 500-8384, Japan
(Shimura, Yamamoto) Department of Cardiology, Toyohashi Heart Center, 21-1
Gobutori, Oyamacho, Aichi, Toyohashishi 441-8530, Japan
(Yamamoto) Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
Publisher
Springer
Abstract
Over the last decade, transcatheter aortic valve implantation (TAVI) has
emerged as a treatment option for patients with severe aortic stenosis.
With exponential increase in the number of TAVI procedures, frailty
assessments have been considered important for patients undergoing TAVI,
and a number of studies have indicated a relationship between the frailty
and post-TAVI outcomes. In this review, using studies searched
systematically in the PubMed database, we review important frailty
assessment tools that can be used as prognostic factors for patients
before TAVI. The assessment tools were categorized as quantitative single
marker, semi-quantitative single marker, or quantitative combined marker.
Studies were further stratified by whether they used frailty markers to
predict patients' prognosis pre-TAVI or to evaluate frailty improvement
post-TAVI. The Clinical Frailty Scale (CFS), a semi-quantitative
assessment, is one of the frailty assessment tools discussed. It may be
easily used even in an outpatient consultation room. The CFS classifies
patients' activity into nine categories, based on a simple interview and
the patient's appearance. Gait speed and serum albumin levels were
considered as qualitative frailty assessment tools. Compared to other
methods, the Essential Frailty Toolset had the highest inter-rater
reliability for accuracy in predicting mortality, thereby allowing better
identification of vulnerable old age people and optimization of outcomes.
A few studies have also focused on changes in frailty pre- and post-TAVI.
Serum albumin-level measurements are important for assessing the frailty
improvement in the chronic phase. Each frailty assessment tool had its own
characteristics, strengths, and weaknesses, and therefore, these tools
need to be selected based on where they are being used and the patient's
condition. Copyright © 2022, The Author(s) under exclusive
licence to Japanese Association of Cardiovascular Intervention and
Therapeutics.

<87>
Accession Number
2020140721
Title
Immediate versus staged complete myocardial revascularization in patients
with ST-segment elevation myocardial infarction and multivessel disease: A
post hoc analysis of the randomized FLOWER-MI trial.
Source
Archives of Cardiovascular Diseases. (no pagination), 2022. Date of
Publication: 2022.
Author
Tea V.; Morelle J.-F.; Gallet R.; Cayla G.; Lemesle G.; Lhermusier T.;
Dillinger J.-G.; Ducrocq G.; Angouvant D.; Cottin Y.; Chamandi C.; le Bras
A.; Steg P.G.; Montalescot G.; Nelson A.C.; Simon T.; Chatellier G.;
Danchin N.; Puymirat E.
Institution
(Tea, Chamandi, Danchin, Puymirat) Department of Cardiology, Hopital
Europeen Georges Pompidou, AP-HP, Paris 75015, France
(Morelle) Clinique St. Martin, Caen 14000, France
(Gallet) Service de cardiologie, Hopitaux Universitaires Henri Mondor,
AP-HP, Creteil 94000, France
(Cayla) Centre Hospitalier Universitaire de Nimes, Nimes 30900, France
(Cayla, Lemesle, Dillinger, Ducrocq, Angouvant, Steg, Simon, Danchin,
Puymirat) French Alliance for Cardiovascular Trials (FACT), Paris 75018,
France
(Lemesle) Cardiac Intensive Care Unit, CHU de Lille, Lille 59000, France
(Lhermusier) Department of Cardiology, Intensive Cardiac Care Unit,
Rangueil University Hospital, Toulouse 31059, France
(Dillinger) Department of Cardiology, Hopital Lariboisiere, AP-HP, Inserm
U-942, Universite de Paris, Paris 75010, France
(Ducrocq, Steg) Department of Cardiology, Hopital Bichat, AP-HP, Paris
75018, France
(Angouvant) Cardiology Department, University Hospital of Tours, Tours
37000, France
(Cottin) PEC2, EA 7460, University of Bourgogne Franche-Comte, Dijon
21000, France
(le Bras) Clinical Research Unit Eco Ile de France, Hopital Hotel Dieu,
AP-HP, Paris 75004, France
(Montalescot) Sorbonne Universite, ACTION Study Group, Institut de
Cardiologie (AP-HP), Inserm UMRS 1166, Hopital Pitie-Salpetriere, Paris
75013, France
(Nelson, Chatellier) Clinical Research Unit and CIC 1418 Inserm, Hopital
Europeen Georges Pompidou, AP-HP, Paris 75015, France
(Simon) Department of Clinical Pharmacology and Unite de Recherche
Clinique (URCEST), Hopital Saint Antoine, AP-HP, Paris 75012, France
(Tea, Chamandi, Danchin, Puymirat) Universite de Paris, Paris 75006,
France
(Gallet) U955-IMRB, Equipe 03, Inserm, Universite Paris Est Creteil
(UPEC), Ecole Nationale Veterinaire D'Alfort (EnVA), Maisons-Alfort 94700,
France
(Lemesle) Heart and Lung Institute, CHU de Lille, Institut Pasteur of
Lille, Inserm U1011, Lille 59000, France
(Lhermusier) Medical School, Toulouse III Paul Sabatier University,
Toulouse 31059, France
(Ducrocq, Steg) Inserm U1148, Laboratory for Vascular Translational
Science, Paris 75018, France
(Ducrocq, Steg) Universite de Paris, Paris 75005, France
(Cottin) Cardiology Department, University Hospital Centre of Dijon
Bourgogne, Dijon 21000, France
(Simon) Universite Pierre et Marie Curie (UPMC-Paris 06), Paris 75005,
France
(Simon) Inserm U-698, Paris 75012, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: In patients with ST-segment elevation myocardial infarction
and multivessel disease, percutaneous coronary intervention for
non-culprit lesions is superior to treatment of the culprit lesion alone.
The optimal timing for non-infarct-related artery revascularization -
immediate versus staged - has not been investigated adequately.
 Aim(s): We aimed to assess clinical outcomes at 1 year in patients
with ST-segment elevation myocardial infarction with multivessel disease
using immediate versus staged non-infarct-related artery
revascularization. Method(s): Outcomes were analysed in patients from
the randomized FLOWER-MI trial, in whom, after successful primary
percutaneous coronary intervention, non-culprit lesions were assessed
using fractional flow reserve or angiography during the index procedure or
during a staged procedure during the initial hospital stay, <= 5 days
after the index procedure. The primary outcome was a composite of
all-cause death, non-fatal myocardial infarction and unplanned
hospitalization with urgent revascularization at 1 year. Result(s):
Among 1171 patients enrolled in this study, 1119 (96.2%) had complete
revascularization performed during a staged procedure, and 44 (3.8%) at
the time of primary percutaneous coronary intervention. During follow-up,
a primary outcome event occurred in one of the patients (2.3%) with an
immediate strategy and in 55 patients (4.9%) with a staged strategy
(adjusted hazard ratio 1.44, 95% confidence interval 0.39-12.69; P =
0.64). Conclusion(s): Staged non-infarct-related artery complete
revascularization was the strategy preferred by investigators in practice
in patients with ST-segment elevation myocardial infarction with
multivessel disease. This strategy was not superior to immediate
revascularization, which, in the context of this trial, was used in a
small proportion of patients. Further randomized studies are needed to
confirm these observational findings. Copyright © 2022 Elsevier
Masson SAS

<88>
Accession Number
2020161846
Title
Use of intraoperative haemostatic checklists on blood management in
patients undergoing cardiac surgery: A scoping review protocol.
Source
BMJ Open. 12(8) (no pagination), 2022. Article Number: e064098. Date of
Publication: 24 Aug 2022.
Author
Irabor B.E.; Kothari A.; Hong J.; Burnette-Chiang B.; Kent D.; Duhamel T.;
Arora R.C.
Institution
(Irabor) Cumming School of Medicine, University of Calgary, Calgary, AB,
Canada
(Kothari) Max Rady College of Medicine, University of Manitoba, Winnipeg,
MB, Canada
(Hong) Department of Cardiac Surgery, University of Manitoba Max Rady
College of Medicine, Winnipeg, MB, Canada
(Burnette-Chiang) Libraries and Cultural Resources, University of Calgary,
Calgary, AB, Canada
(Kent, Duhamel) Institute of Cardiovascular Sciences, St. Boniface
Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
(Duhamel) Faculty of Kinesiology and Recreation Management, University of
Manitoba, Winnipeg, MB, Canada
(Arora) Department of Surgery, Section of Cardiac Surgery, Max Rady
College of Medicine, University of Manitoba, Winnipeg, MB, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction A major complication of cardiac surgery is bleeding which can
require surgical re-exploration and the transfusion of allogeneic blood
products. Re-operative procedures for bleeding have been associated with
higher rates of mortality and morbidity, therefore an intervention to
reduce this complication would be important. Previous investigation has
demonstrated that low-cost solutions, such as the use of an intraoperative
haemostatic checklist may result in the reduction of bleeding and
subsequent transfusion. The goals of this scoping review aim to assess the
efficacy of the use of intraoperative haemostatic checklists on blood
management in patients undergoing cardiac surgery. Specifically, the
objective is to understand if the use of intraoperative haemostatic
checklists has been associated with a reduction in bleeding and blood
product utilisation in patients undergoing non-emergent cardiac surgery.
Methods and analysis A scoping review of literature identifying randomised
control and observational trials, reporting on haemostatic checklists in
cardiac surgery, will be undertaken. The proposed review will be guided by
the methodological framework proposed by Arksey and O'Malley. A search
will be conducted for published and unpublished (grey) literature.
Published literature will be searched in the following electronic
databases: Scopus, MEDLINE, EMBASE and the Cochrane Library. Relevant grey
literature will be identified through conference abstracts. Outcomes
chosen are patient centred to ensure reduced bleeding and overall positive
experience that reduces complications intraoperatively. Ethics and
dissemination This study does not require ethical approval as the data
used are from available publications. Our dissemination strategy includes
peer-review publication, presentation at conferences and relevant
stakeholders. Copyright ©

<89>
Accession Number
2018969711
Title
Impact of tight glycemic control and hypoglycemia after pediatric cardiac
surgery on neurodevelopmental outcomes at three years of age: Findings
from a randomized clinical trial.
Source
BMC Pediatrics. 22(1) (no pagination), 2022. Article Number: 531. Date of
Publication: December 2022.
Author
Sadhwani A.; Asaro L.A.; Goldberg C.S.; Ware J.; Butcher J.; Gaies M.;
Smith C.; Alexander J.L.; Wypij D.; Agus M.S.D.
Institution
(Sadhwani) Departments of Psychiatry and Behavioral Sciences, Boston
Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston,
MA 02115, United States
(Asaro, Wypij) Department of Cardiology, Boston Children's Hospital,
Boston, MA, United States
(Goldberg, Gaies, Smith) Division of Cardiology, C.S. Mott Children's
Hospital, Ann Arbor, MI, United States
(Goldberg, Butcher, Gaies) Department of Pediatrics, University of
Michigan Medical School, Ann Arbor, MI, United States
(Ware) Department of Medicine, Boston Children's Hospital and Harvard
Medical School, Boston, United States
(Butcher) Division of Pediatric Psychology, C.S. Mott Children's Hospital
and University of Michigan Medical School, Ann Arbor, MI, United States
(Alexander, Agus) Division of Medical Critical Care, Boston Children's
Hospital and Harvard Medical School, Boston, MA, United States
(Wypij) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
BioMed Central Ltd
Abstract
Background: Studies examining the impact of randomization As per standard
instruction, city is required for affiliations; however, this information
is missing in affiliation 6. Please check if the provided city is correct
and amend if necessary. to tight glycemic control (TGC) and resultant
hypoglycemia on later neurodevelopmental outcomes have produced mixed
results. Our study examined this association in children undergoing
cardiac surgery. Method(s): Participants who were enrolled in the
Safe Pediatric Euglycemia after Cardiac Surgery (SPECS) trial returned for
neurodevelopmental (ND) follow-up between 30 to 42.5 months of age. ND
outcomes were assessed using the Bayley Scales of Infant and Toddler
Development, Third Edition. ND scores were compared between the TGC and
standard care treatment groups and between patients with moderate to
severe and no to mild hypoglycemia. As a secondary analysis, to increase
sample size and power, we combined the three-year-old assessments with
previously collected assessments done at < 30 months of age to further
examine differences between groups longitudinally. Result(s): Among
the 269 participants who completed neurodevelopmental evaluation
(in-person testing or questionnaires) at three years of age (follow-up
rate, 31%), there were no statistically significant differences in ND
outcomes according to treatment group or hypoglycemia status. In the
combined analysis of all evaluations (from 9 to 42.5 months of age), we
found no treatment group differences. However, in these longitudinal
analyses, children who experienced moderate to severe hypoglycemia had
lower scores on the Bayley-III cognitive and motor domains compared to
children with no to mild hypoglycemia. Conclusion(s): For infants
undergoing cardiac surgery, there was no impact of tight glycemic control
on neurodevelopmental outcomes. Moderate to severe hypoglycemia was
associated with worse ND outcomes in longitudinal analyses. Trial
registration: ClinicalTrials.gov NCT00443599. Registered: November
2016. Copyright © 2022, The Author(s).

<90>
[Use Link to view the full text]
Accession Number
2020144164
Title
Letter by Condello Regarding Article, "Cytokine Hemadsorption During
Cardiac Surgery Versus Standard Surgical Care for Infective Endocarditis
(REMOVE): Results From a Multicenter Randomized Controlled Trial".
Source
Circulation. 146(10) (pp E138-E139), 2022. Date of Publication: 06 Sep
2022.
Author
Condello I.
Institution
(Condello) Department of Cardiac Surgery, Anthea Hospital, Gvm Care &
Research, Bari, Italy
Publisher
Lippincott Williams and Wilkins

<91>
Accession Number
2016336132
Title
Management of venous ulceration (interventional treatments) with
perspectives from a recent metaanalysis and recommendations.
Source
Phlebolymphology. 28(3) (pp 119-127), 2021. Date of Publication: 2021.
Author
Neaume N.
Institution
(Neaume) Clinique Pasteur, Toulouse, France
Publisher
Les Laboratoires Seriver
Abstract
Venous leg ulcers still affect about 1% of the adult population despite
recent advances in chronic venous insufficiency treatment, and they
represent a significant public health cost, estimated at between 1% and 2%
of the annual health budget of Western European countries. Venous leg
ulcers may be treated conservatively, with compression bandaging and wound
care, medically, surgically, or with a combination of approaches,
depending on the severity of the ulcer and available resources. The
randomized trial of early endovenous ablation in venous ulceration
demonstrated that early removal of a superficial venous reflux in patients
with leg ulcer, combined with appropriate elastic compression, reduces
healing time and increases time to recurrence without ulcer, assessed at
1-year follow-up. Thus, current National Institute for Health and Care
Excellence (NICE) clinical guidelines recommend early endovenous treatment
in patients with venous ulcers. However, the relative benefit or
indications for use of these interventional treatments (surgery, thermal
ablation, nonthermal nontumescent techniques, subfascial endoscopic
perforator surgery [SEPS], valvuloplasty, and stenting) remain to be
definitively shown. Copyright © LLS SAS. All rights reserved.

<92>
Accession Number
639017687
Title
Long-Term Consequences of Acute Kidney Injury after Pediatric Cardiac
Surgery: A Systematic Review.
Source
The Journal of pediatrics. (no pagination), 2022. Date of Publication: 09
Sep 2022.
Author
Van den Eynde J.; Rotbi H.; Schuermans A.; Hassanabad A.F.; Gewillig M.;
Budts W.; Kutty S.; Mekahli D.
Institution
(Van den Eynde) Helen B. Taussig Heart Center, The Johns Hopkins Hospital
and School of Medicine, Baltimore, United States; Department of
Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, The
Netherlands; Radboud Institute for Health Sciences, Department of
Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
(Schuermans) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Hassanabad) Section of Cardiac Surgery, Department of Cardiac Sciences,
Libin Cardiovascular Institute, Cumming School of Medicine, Calgary, AB,
Canada
(Gewillig) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium; Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Budts) Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium;
Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium
(Kutty) Helen B. Taussig Heart Center, Johns Hopkins Hospital and School
of Medicine, Baltimore, United States
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium; PKD Research Group, GPURE, Department of
Development and Regeneration, KU Leuven, Leuven, Belgium
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the available data on long-term kidney dysfunction,
hypertension, and mortality after cardiac surgery-associated acute kidney
injury (AKI) in the pediatric population. STUDY DESIGN: PubMed/MEDLINE,
Embase, Scopus, and reference lists of relevant articles were searched for
eligible studies published from inception through March 2022. Long-term
outcomes after pediatric cardiac surgery complicated by AKI and those
without were investigated. RESULT(S): We identified 14 studies
published between 2013 and 2022 that included a total of 6,701 patients
(AKI: 1,376 patients; no AKI: 5,325 patients). These studies used
different well-established classifications to define AKI. All the studies
suggested that AKI after heart surgery is common in the pediatric patient
population and reported a potential link between cardiac
surgery-associated AKI and important clinical outcomes. However, only 4
out of 11 studies found a strong association between (absence of recovery
from) cardiac surgery-associated AKI and risk of developing chronic kidney
disease, and 3 out of 5 studies found a significant increase in mortality
rates for pediatric patients who developed AKI after cardiac surgery. Only
one out of 4 studies found an association between AKI and hypertension at
12 months postoperatively, but found no association at later follow-up
times. CONCLUSION(S): Although there is a trend, evidence on the
long-term consequences of cardiac surgery-associated AKI in the pediatric
population is mixed. Genetic syndromes, pre-existing kidney disease,
univentricular or cyanotic heart conditions, and/or high-complexity
surgery may be more important for the development of kidney dysfunction by
adolescence and early adulthood. Regardless, these children may benefit
from long-term kidney follow-up. Copyright © 2022 Elsevier Inc.
All rights reserved.

<93>
Accession Number
639016436
Title
Consequences of Preoperative Oral Carbohydrate Consumption in Septal
Deviation Patients Undergoing Endoscopic Septoplasty: A Retrospective
Cohort Study.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2022. Date of
Publication: 09 Sep 2022.
Author
Zhu J.; Sun L.; Liu Y.-G.; Ding X.-J.; Deng J.-H.; Gong Y.-Q.; Xia Y.-W.;
Jin X.-Q.
Institution
(Zhu, Sun, Jin) Department of Nursing, Affiliated Kunshan Hospital of
Jiangsu University, Suzhou, Jiangsu, China
(Liu, Ding, Deng) Department of Otolaryngology, Affiliated Kunshan
Hospital of Jiangsu University, Suzhou, Jiangsu, China
(Gong) Information Department, Affiliated Kunshan Hospital of Jiangsu
University, Suzhou, Jiangsu, China
(Xia) Department of Nutriology, Affiliated Kunshan Hospital of Jiangsu
University, Suzhou, Jiangsu, China
Publisher
NLM (Medline)
Abstract
PURPOSE: Multiple reports have demonstrated the benefits of preoperative
oral carbohydrates (CHO) in patients receiving open abdominal, thoracic,
and orthopedic surgeries. However, thus far, no reports have investigated
the benefits of CHO in patients undergoing nasal endoscopic surgery. Our
goal was to evaluate the outcome of preoperative oral of administration of
CHO in septal deviation patients, undergoing endoscopic septoplasty, under
general anesthesia. DESIGN: A retrospective cohort study from a
prospectively collected database. METHOD(S): Consecutive 400 septal
deviation patients, undergoing endoscopic septoplasty, were randomly
assigned to receive CHO or plain water (80 CHO cohort vs. 320 control
cohort) before general anesthesia. The primary outcome was the risk of
acute postoperative hypertension (APH). The secondary outcomes included
length of hospital stay (LOS), hospitalization cost, sleep time the day
before surgery, fluid infusion volume on surgical day, as well the
incidence of postoperative nausea and vomiting (PONV) and aspiration.
FINDINGS: Patients in the CHO cohort experienced a lower risk of both
diastolic blood pressure (DBP)-based APH (OR, 0.49; 95% CI, 0.25 to 0.96;
P = 0.0375) and total APH (OR, 0.49; 95% CI, 0.26 to 0.92; P = 0.0258),
lower LOS, lower hospitalization cost, longer sleep time and less fluid
infusion volume after adjusting for gender, age, BMI, preoperative blood
pressure and pulse. Besides, data showed no significant differences in the
incidence of (P = 0.4173) and aspiration (P > 0.99). CONCLUSION(S):
Preoperative CHO administration can reduce APH risk in patients undergoing
endoscopic septoplasty under general anesthesia. Besides, preoperative CHO
administration can improve other clinical outcomes, such as, LOS,
hospitalization cost, sleep time, and fluid infusion volume. Moreover, CHO
safety was confirmed in our study. In the future, additional investigation
is necessary to confirm our results. Copyright © 2022 American
Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights
reserved.

<94>
Accession Number
2017046937
Title
The PARTNER 3 Bicuspid Registry for Transcatheter Aortic Valve Replacement
in Low-Surgical-Risk Patients.
Source
JACC: Cardiovascular Interventions. 15(5) (pp 523-532), 2022. Date of
Publication: 14 Mar 2022.
Author
Williams M.R.; Jilaihawi H.; Makkar R.; O'Neill W.W.; Guyton R.; Malaisrie
S.C.; Brown D.L.; Blanke P.; Leipsic J.A.; Pibarot P.; Hahn R.T.; Leon
M.B.; Cohen D.J.; Bax J.J.; Kodali S.K.; Mack M.J.; Lu M.; Webb J.G.
Institution
(Williams, Jilaihawi) NYU Langone Medical Center, New York, NY, United
States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(O'Neill) Center for Structural Heart Disease, Henry Ford Health System,
Detroit, MI, United States
(Guyton) Emory University Medical Center, Atlanta, GA, United States
(Malaisrie) Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Brown, Mack) Baylor Scott and White Health, Plano, TX, United States
(Blanke, Leipsic, Webb) St. Paul's Hospital, University of British
Columbia, Vancouver, BC, Canada
(Pibarot) Department of Medicine, Laval University, Quebec City, QC,
Canada
(Hahn, Leon, Kodali) Columbia University Irving Medical
Center/NewYork-Presbyterian Hospital, New York, NY, United States
(Hahn, Leon, Cohen) Cardiovascular Research Foundation, New York, NY,
United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Bax) Leiden University Medical Center, Leiden, Netherlands
(Lu) Edwards Lifesciences, Irvine, CA, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The study compared 1-year outcomes between transcatheter
aortic valve replacement (TAVR) patients with bicuspid aortic valve (BAV)
morphology and clinically similar patients having tricuspid aortic valve
(TAV) morphology. Background(s): There are limited prospective data
on TAVR using the SAPIEN 3 device in low-surgical-risk patients with
severe, symptomatic aortic stenosis and bicuspid anatomy. Method(s):
Low-risk, severe aortic stenosis patients with BAV were candidates for the
PARTNER 3 (Placement of Aortic Transcatheter Valves 3) (P3) bicuspid
registry or the P3 bicuspid continued access protocol. Patients treated in
these registries were pooled and propensity score matched to TAV patients
from the P3 randomized TAVR trial. Outcomes were compared between groups.
The primary endpoint was the 1-year composite rate of death, stroke, and
cardiovascular rehospitalization. Result(s): Of 320 total submitted
BAV patients, 169 (53%) were treated, and most were Sievers type 1. The
remaining 151 patients were excluded caused by anatomic or clinical
criteria. Propensity score matching with the P3 TAVR cohort (496 patients)
yielded 148 pairs. There were no differences in baseline clinical
characteristics; however, BAV patients had larger annuli and they
experienced longer procedure duration. There was no difference in the
primary endpoint between BAV and TAV (10.9% vs 10.2%; P = 0.80) or in the
rates of the individual components (death: 0.7% vs 1.4%; P = 0.58; stroke:
2.1% vs 2.0%; P = 0.99; cardiovascular rehospitalization: 9.6% vs 9.5%; P
= 0.96). Conclusion(s): Among highly select bicuspid aortic stenosis
low-surgical-risk patients without extensive raphe or subannular
calcification, TAVR with the SAPIEN 3 valve demonstrated similar outcomes
to a matched cohort of patients with tricuspid aortic
stenosis. Copyright © 2022 American College of Cardiology
Foundation

<95>
Accession Number
2016140745
Title
Minimally invasive repair of pectus carinatum by the Abramson method: A
systematic review.
Source
Journal of Pediatric Surgery. 57(10) (pp 325-332), 2022. Date of
Publication: October 2022.
Author
Geraedts T.C.M.; Daemen J.H.T.; Vissers Y.L.J.; Hulsewe K.W.E.; Van Veer
H.G.L.; Abramson H.; de Loos E.R.
Institution
(Geraedts, Daemen, Vissers, Hulsewe, de Loos) Department of Surgery,
Division of General Thoracic Surgery, Zuyderland Medical Center, Heerlen,
Netherlands
(Daemen) Faculty of Health, Medicine and Life Sciences (FHML), School for
Oncology and Developmental Biology (GROW), Maastricht, Netherlands
(Van Veer) Department of Thoracic Surgery, University Hospitals Leuven,
Leuven, Belgium
(Van Veer) BREATHE Laboratory, Department of Chronic Diseases and
Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
(Abramson) Surgical Thoracic Service, Hospital Antonio Cetrangolo, Vicente
Lopez, Buenos Aires, Argentina
Publisher
W.B. Saunders
Abstract
Background: The aim of this review is to provide an overview of the
outcomes after minimally invasive pectus cartinatum repair (MIRPC) by the
Abramson method to determine its effectiveness. Method(s): The PubMed
and Embase databases were systematically searched. Data concerning
subjective postoperative esthetic outcomes after initial surgery and bar
removal were extracted. In addition, data on recurrence, complications,
operative times, blood loss, post-operative pain, length of hospital stay,
planned time to bar removal and reasons for early bar removal were
extracted. The postoperative esthetic result, was selected as primary
outcome since the primary indication for repair in pectus carinatum is of
cosmetic nature. Result(s): Six cohort studies were included based on
eligibility criteria, enrolling a total of 396 patients. Qualitative
synthesis showed excellent to satisfactory esthetic results in nearly all
patients after correctional bar placement (99.5%, n = 183/184). A high
satisfaction rate of 91.0% (n = 190/209) was found in patients after bar
removal. Recurrence rates were low with an incidence of 3.0% (n = 5/168).
The cumulative postoperative complication rate was 26.5% (n = 105/396), of
whom 25% required surgical re-intervention. There were no cases of
mortality. Conclusion(s): Minimally invasive repair of pectus
carinatum through the Abramson method is effective and safe. Its efficacy
is demonstrated by the excellent to satisfactory esthetic results in 99.5%
and 91.0% of patients after respectively correctional bar placement and
implant removal. Future studies should aim to compare different treatment
options for pectus carinatum in order to elucidate the approach of choice
for different patient groups. Copyright © 2021

<96>
Accession Number
2018506405
Title
Impact of Physical Contact on Preterm Infants' Vital Sign Response to Live
Music Therapy.
Source
International Journal of Environmental Research and Public Health. 19(15)
(no pagination), 2022. Article Number: 9524. Date of Publication: August
2022.
Author
Kobus S.; Diezel M.; Dewan M.V.; Huening B.; Dathe A.-K.;
Felderhoff-Mueser U.; Bruns N.
Institution
(Kobus, Diezel, Dewan, Huening, Dathe, Felderhoff-Mueser, Bruns)
Department of Paediatrics I, University Hospital, University of
Duisburg-Essen, Essen 45147, Germany
(Kobus, Diezel, Dewan, Huening, Dathe, Felderhoff-Mueser, Bruns) Centre
for Translational Neuro- and Behavioural Sciences (C-TNBS), Faculty of
Medicine, University of Duisburg-Essen, Essen 45147, Germany
(Dathe) Department of Health and Nursing, Occupational Therapy,
Ernst-Abbe-University of Applied Sciences Jena, Jena 07745, Germany
Publisher
MDPI
Abstract
Evidence that music therapy stabilises vital parameters in preterm infants
is growing, but the optimal setting for therapy is still under
investigation. Our study aimed to quantify the effect of physical contact
during live music therapy in preterm infants born < 32 weeks' gestational
age (GA) on post-therapy vital sign values. Live music therapy was
delivered twice-weekly until discharge from hospital to 40 stable infants
< 32 weeks' GA. Baseline and post-therapy heart rate, respiratory rate,
oxygen saturation and physical contact during each session were recorded.
159 sessions were performed with, and 444 sessions without, physical
contact. Descriptive and multivariable regression analyses based on
directed acyclic graphs were performed. The mean GA was 28.6 +/- 2.6
weeks, and 26 (65%) infants were male. Mean absolute values for heart and
respiratory rates lowered during music therapy regardless of physical
contact. The mean post-therapy SaO2 was higher compared to baseline values
regardless of physical contact (mean differences -8.6 beats/min; -13.3
breaths/min and +2.0%). There were no clinically relevant changes in vital
sign responses between therapy sessions, with or without physical contact,
or adjusted post-therapy values for any of the studied vital signs.
Physical contact caused better baseline and post-therapy vital sign values
but did not enhance the vital sign response to music therapy. Thus, the
effect of music therapy on preterm infants' vital signs is independent of
physical contact and parents' presence during music therapy in the
neonatal intensive care unit. Copyright © 2022 by the authors.

<97>
Accession Number
2020113227
Title
TCT-351 Management of De Novo Aortic Insufficiency in LVAD Patients: A
Systematic Review and Meta-analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B142), 2022. Date of Publication: 20
Sep 2022.
Author
Nouthe B.; Sossou C.; Spaziano M.
Institution
(Nouthe) Fraser Health Authority, Delta, BC, Canada
(Sossou) The University of Nevada Las Vegas, NV, Las Vegas, United States
(Spaziano) McGill University Health Center, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: The frequent use of left ventricular assist device (LVAD) is
associated to an increasing prevalence of worsening/de novo aortic
insufficiency (AI). However, incidence and risk factors of de novo LVAD AI
are not yet fully elucidated. If surgery is not possible, transcatheter
aortic valve repair (TAVR) is now considered as a treatment option.
 Method(s): We aim to summarize data on the incidence and factors
associated with the development of de novo LVAD AI. We systematically
reviewed all treated cases with TAVR. We queried MEDLINE, EMBASE, and Web
of Science for all studies of at least 20 adult cases of de novo LVAD AI
(epidemiology) and for cases of TAVR in LVAD patients from inception
through May 15, 2022. A random-effects meta-analysis method was used to
pool estimates. Result(s): Of 2,230 articles obtained from the
initial search, 32 studies reported on a pooled population of 4,037
patients (1,982 having HeartMate 2), with an overall male predominance
(73.2%). All were cohort studies with a duration of follow-up ranging from
6 to 81.1 months; 1 was an abstract, and 1 did not give the number of
cases of de novo AI. At an average of 1 year, 23.9% of the patients had at
least mild de novo LVAD AI. Risk factors for developing de novo LVAD AI
were, by order of frequency, larger aortic dimensions (HR: 1.1-14.73; 95%
CI: 1.02-16.9), closed aortic valve, older age, and female sex. We found
116 reported cases of TAVR for de novo LVAD AI with 31% females, and there
were 12 case series, the largest involving 18 patients. Age ranged from 28
to 80 years old, and 81% were discharged home post-TAVR. Access was
reported in 92 cases (80.4% being femoral), valve migration occurred in 6
cases, and secondary valve-in-valve was required in 16 patients.
 Conclusion(s): Data on pure de novo LVAD AI are scarce, and the use
of TAVR has been increasing in the last decade with high success rates.
Further research is needed to fully elucidate the prevalence of LVAD de
novo AI and its consequences and refine management options. Categories:
STRUCTURAL: Valvular Disease: Aortic Copyright © 2022

<98>
Accession Number
2020113207
Title
TCT-423 Effect of Low Versus High Mitral Valve Gradients on Outcomes of
Functional and Degenerative Mitral Valve Disease Post Transcatheter Edge
to Edge Repair.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B171), 2022. Date of Publication: 20
Sep 2022.
Author
Sohal S.; Aroke D.; Cohen M.; Visveswaran G.; Waxman S.
Institution
(Sohal) Newark Beth Israel Medical Center, Roselle Park, NJ, United States
(Aroke) RWJBH-Newark Beth Israel Medical Center, NJ, Newark, United States
(Cohen, Visveswaran, Waxman) Newark Beth Israel Medical Center, NJ,
Newark, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter edge-to-edge repair (TEER) has been shown to
improve outcomes in high surgical risk patients with severe symptomatic
degenerative mitral regurgitation (DMR) or functional mitral regurgitation
(FMR) despite maximally tolerated medical therapy. In an attempt to reduce
residual mitral regurgitation, patients may develop increased mitral valve
gradients (MVGs) post-TEER, but the long-term outcomes of an elevated MVG
have been inconsistent. This study was designed to compare the effect of
low versus high MVGs post-TEER in patients with DMR and FMR.
 Method(s): We performed a detailed search on PubMed, MEDLINE, EMBASE,
Google Scholar, and Cochrane Library databases for all studies on MVGs
post-TEER in DMR and FMR patients. Outcomes of interest were a composite
of all-cause mortality, heart failure hospitalization, mitral valve
reintervention, or left ventricular assist device implantation. A random
effects model was used to calculate the risk ratio using the inverse
variance method with RevMan 5.2 software (The Cochrane Collaboration).
 Result(s): Four studies including 1,634 patients with MR who
underwent TEER were included in this analysis. Of 1,634 patients, 788
(48.23%) had DMR. The average gradient used to define high MVG in these 4
studies was a value >5.1 mm Hg. A 36% higher rate of the composite
endpoint was noted in patients with DMR who underwent TEER with a higher
MVG compared with a lower MVG (RR: 1.36; 95% CI: 1.16-1.59; P = 0.0002;
I2 = 0%). In FMR patients undergoing TEER, we noted a 19% lower
chance of the composite endpoint with a higher MVG compared with a lower
MVG (RR: 0.81; 95% CI: 0.71-0.92; P = 0.001; I2 = 0%). Overall,
on analysis of combined FMR and DMR patients, the composite endpoint was
similar in patients with higher or lower MVGs (RR: 1.06; 95% CI:
0.83-1.35; P = 0.62; I2 = 81%). Conclusion(s): Our
meta-analysis demonstrated that patients with DMR undergoing TEER who end
up with a higher MVG have worse outcomes, whereas FMR patients
counterintuitively appear to have fewer outcome events with high compared
with low post-TEER MVGs. Further study is needed to understand the
mechanistic basis of these observations, which will need validation in
large-scale studies. Categories: STRUCTURAL: Valvular Disease:
Mitral Copyright © 2022

<99>
Accession Number
2020113202
Title
TCT-487 Mid-Term Outcome of Transcatheter Aortic Valve Replacement Using
Myval in Severe Bicuspid Aortic Stenosis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B197), 2022. Date of Publication: 20
Sep 2022.
Author
Elkoumy A.; Terkelsen C.; Nissen H.; Jose J.; Abdelshafy M.; Gunasekaran
S.; Elzomor H.; Alfonso lelasi; Unic D.; Bedogni F.; Baumbach A.; Serruys
P.; Soliman O.
Institution
(Elkoumy, Abdelshafy) National University of Ireland Galway, Galway,
Ireland
(Terkelsen) Aarhus University Hospital, Aarhus, Denmark
(Nissen) Cardiology, Odense, Denmark
(Jose) Christian Medical College Hospital, Tamil Nadu, Vellore, India
(Gunasekaran) Apollo Hospitals, Tamil Nadu, Chennai, India
(Elzomor) National University of Ireland Galway, Galway, Ireland
(Alfonso lelasi) Istituto Clinico Sant'Ambrogio, Milan, Italy
(Unic) Dubrava University Hospital, Zagreb, Croatia
(Bedogni) Policlinico San Donato, Milan, Italy
(Baumbach) Barts Health Centre, London, United Kingdom
(Serruys) National University of Ireland Galway, Galway, Ireland
(Soliman) National University of Ireland Galway, Galway, Ireland
Publisher
Elsevier Inc.
Abstract
Background: Mid-term outcomes of transcatheter aortic valve replacement
(TAVR) using the balloon-expandable Myval THV (Meril Life Sciences Pvt
Ltd) are unknown. We sought to investigate mid-term outcomes (up to 3
years) of Myval TAVR in patients with severe bicuspid aortic stenosis.
 Method(s): This is a retrospective, multicenter registry of patients
with severe bicuspid aortic stenosis, who were treated with TAVR using
Myval THV in 5 European and 4 Indian centers. Outcomes were analyzed
according to the Valve Academic Research Consortium-3 endpoint
definitions. Result(s): Our study comprised 60 patients with a median
(IQR) of 13.5 (12.2-19.6) months of follow-up; 41 (71%) were men, the
median age was 74 years, and the median Society of Thoracic Surgeons risk
score was 2.7 (1.6-4.7). The majority (77%) of patients had type 1a, 18%
had type 0, and 5% had type 2 bicuspid aortic valve. All-cause mortality
was 11.6%, including 5% cardiovascular mortality. Cardiovascular
rehospitalization not related to the device was seen in 5 (8%), ischemic
stroke was seen in 2 (3.5%), and permanent pacemaker implantation was
performed in 6 (10%) patients. The echocardiographic assessment revealed
EOA of 1.7 (1.4-2.0) cm2, transprosthetic mean pressure
gradient of 10 (8-17) mm Hg, aortic valve maximum velocity of 2.1
(1.6-2.6) m/s, and DVI of 0.47 (0.38-0.50). Only one patient had moderate
aortic regurgitation. Bioprosthetic valve deterioration was observed in 4
(7%) patients, including 1 (25%) patient with morphologic valve
deterioration with valve thrombosis that was resolved after thrombolysis;
the other 3 (75%) patients developed stage 2 moderate hemodynamic
deterioration with an increase in mean pressure gradient >=10 mm Hg with
net gradient >20 mm Hg, with a concomitant decrease in EOA over a median
duration of 10 (7.3-13.0) months. No patient required valve-related
reintervention, and no endocarditis was reported Conclusion(s): These
preliminary data on mid-term outcomes confirm the previously reported
30-day safety and efficacy of TAVR using the Myval system in bicuspid
anatomy. These findings are comparable to published data on TAVR with
other balloon and self-expandable devices in bicuspid aortic stenosis
(Zhou et al, 2022). However, the results need to be confirmed in a
prospective randomized study Categories: STRUCTURAL: Valvular Disease:
Aortic Copyright © 2022

<100>
Accession Number
2020113173
Title
TCT-595 Alternative Peripheral vs Transfemoral Access for Transcatheter
Aortic Valve Replacement: A Meta-Analysis of Propensity-Matched Studies.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B244-B245), 2022. Date of
Publication: 20 Sep 2022.
Author
McGrath D.; Sun C.; Kawabori M.; Zhan Y.
Institution
(McGrath, Sun, Kawabori, Zhan) Tufts Medical Center, MA, Boston, United
States
Publisher
Elsevier Inc.
Abstract
Background: While the femoral artery remains the preferred access for
transcatheter aortic valve replacement (TAVR), alternative access via
peripheral arteries such as the carotid or axillary artery may be desired
when the feasibility of femoral access is in doubt. We compared outcomes
of transfemoral (TF) and alternative peripheral (AP) TAVR by conducting a
search and analysis of propensity-matched studies to evaluate their
relative safety and efficacy. Method(s): The PubMed, EMBASE, and
Cochrane Library databases from inception up to and including February
2022 were searched to identify articles reporting propensity-matched,
comparative data on TF vs AP approaches for TAVR. Patients' clinical
outcomes were extracted from the articles and pooled for analysis.
 Result(s): Seven studies, including a total of 9,004 patients, were
included in the study, with 6,729 patients in the TF group and 2,275
patients in the AP group. Within each study, the baseline characteristics
of the patients were propensity matched. Meta-analysis revealed higher
in-hospital/30-day mortality (P = 0.02) as well as incidence of stroke (P
= 0.003) for the AP group. There were no significant differences in
clinical outcomes when comparing the TF and AP groups for major vascular
complications, pacemaker implantation, bleeding, or acute kidney injury.
[Formula presented] Conclusion(s): Our analysis of propensity-matched
studies found worse short-term mortality and stroke in patients who
underwent TAVR via AP access compared with TF access. This supports
careful consideration of AP access only as an alternative when TF access
is deemed too risky. Categories: OTHER: Vascular Access:
Structural Copyright © 2022

<101>
Accession Number
2020113165
Title
TCT-359 Continued Oral Anticoagulation With Non-Vitamin K Antagonist Oral
Anticoagulants Versus Vitamin K Antagonists in Transcatheter Aortic Valve
Implantation.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B145), 2022. Date of Publication: 20
Sep 2022.
Author
Mangner N.; Brinkert M.; Keller L.; Moriyama N.; Haussig S.; Woitek F.;
Crusius L.; Kobza R.; Abdel-Wahab M.; Stortecky S.; Pilgrim T.;
Nietlispach F.; Ruschitzka F.; Thiele H.; Toggweiler S.; Linke A.
Institution
(Mangner, Linke) Herzzentrum Dresden, TU Dresden, Dresden, Germany
(Brinkert) Kantonsspital Aarau, Alberta, Zurich, Switzerland
(Keller) Quebec Heart and Lung Institute, Laval University, Quebec City,
QC, Canada
(Moriyama) Shonan Kamakura General Hospital, Kamakura, Japan
(Haussig, Woitek) Heart Center Dresden, Technical University Dresden,
Dresden, Germany
(Crusius) Heart Center Dresden, Leipzig, Germany
(Kobza) Heart Center Luzerner Kantonsspital, Luzern, Switzerland
(Abdel-Wahab) Heart Center Leipzig, University Hospital, Leipzig, Germany
(Stortecky, Pilgrim) Bern University Hospital, Bern, Switzerland
(Nietlispach) Klinik im Park, Hirslanden Zuerich, Zurich, Switzerland
(Ruschitzka) University Hospital Zurich, Zurich, Switzerland
(Thiele) Heart Center Leipzig at University of Leipzig, Leipzig, Germany
(Toggweiler) Luzerner Kantonsspital, Luzern, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: To investigate if a continued oral anticoagulation (OAC) with
non-vitamin K antagonist oral anticoagulants (NOAC) compared with vitamin
K antagonists (VKAs) in patients undergoing transcatheter aortic valve
implantation (TAVI) is equally safe and effective. Method(s):
Consecutive patients on OAC with either a NOAC or a VKA undergoing
transfemoral TAVI at 5 European centers were enrolled. The primary outcome
measure was a composite of major/life-threatening bleeding, stroke, and
all-cause mortality at 30 days. Result(s): Of 1317 TAVI patients, 584
patients underwent TAVI under continued OAC with 294 (50.3%) patients
receiving VKA and 290 (49.7%) patients receiving NOAC. Groups were well
balanced regarding age and sex, but there were higher rates of previous
myocardial infarction and cardiac surgery as well as higher creatinine
values in patients treated with continued VKA compared with continued
NOAC. The main indication for anticoagulation was atrial fibrillation
(96.7%). At 30 days, the composite primary outcome had occurred in 51
(17.3%) versus 36 (12.4%) patients with continued VKA and with continued
NOAC, respectively (adjusted OR: 0.68; 95% CI: 0.43-1.07; P = 0.092).
Rates of major/life-threatening bleeding (adjusted OR: 0.87; 95% CI:
0.52-1.47; P = 0.606) and stroke (adjusted OR: 1.02; 95% CI: 0.29-3.59; P
= 0.974) were not different between groups, whereas 30-day all-cause
mortality was lower in patients treated under continued NOAC compared with
continued VKA (adjusted OR: 0.13; 95% CI: 0.03-0.58; P = 0.007). In a
multivariate Cox regression analysis, continued NOAC tended to be
associated with a lower 1-year all-cause mortality (HR: 0.62; 95% CI:
0.38-1.01; P = 0.053). Conclusion(s): Continued NOAC compared with
continued VKA during TAVI led to comparable outcomes with regard to the
composite outcome measure of major/life-threatening bleeding, stroke, and
30-day mortality indicating that continued OAC with both drugs is feasible
and safe. These hypothesis-generating results need to be confirmed by a
randomized controlled trial. Categories: STRUCTURAL: Valvular Disease:
Aortic Copyright © 2022

<102>
Accession Number
2020113125
Title
TCT-335 Mitral Regurgitation Severity to Left Atrial Volume Ratio in Heart
Failure Patients With Secondary Mitral Regurgitation: The COAPT Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B135), 2022. Date of Publication: 20
Sep 2022.
Author
Coisne A.; Scotti A.; Granada J.; Kotinkaduwa L.; Cohen D.; Kar S.; Lim
S.; Lindenfeld J.; Grayburn P.; Mack M.; Asch F.; Stone G.
Institution
(Coisne, Scotti, Granada, Kotinkaduwa) Cardiovascular Research Foundation,
New York, New York, United States
(Cohen) St. Francis Hospital, New York, New York, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks and Bakersfield
and Bakersfield Heart Hospital, CA, Los Angeles, United States
(Lim) University of Virginia Health System Hospital, Charlottesville,
Virginia, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, TN, Nashville,
United States
(Grayburn) Baylor Scott and White Heart and Vascular Hospital Plano, TX,
Plano, United States
(Mack) Baylor Scott and White Heart Hospital, TX, Dallas, United States
(Asch) Medstar Health Research Institute, DC, Washington, United States
(Stone) Mount Sinai Heart Health System, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: The impact of mitral regurgitation severity to left atrial
volume (LAV) ratio in patients with heart failure (HF) and secondary
mitral regurgitation (SMR) is unknown. We aimed to investigate this ratio
among HF patients with severe SMR randomized to transcatheter edge-to-edge
repair (TEER) with MitraClip (Abbott Vascular) plus guideline-directed
medical therapy (GDMT) versus GDMT alone in the COAPT (Cardiovascular
Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart
Failure Patients With Functional Mitral Regurgitation) trial.
 Method(s): The ratio of preprocedural regurgitant volume (RVol) to
LAV was calculated from transthoracic echocardiograms. Endpoints including
HF hospitalization (HFH), cardiovascular death, and health status at 2
years were compared according to Rvol/LAV median. Outcomes were adjusted
for age, sex, diabetes, hypertension, history of atrial
fibrillation/flutter, chronic kidney disease, and left ventricular
ejection fraction. Result(s): Among 567 patients analyzed, the median
Rvol/LAV was 0.67 (IQR: 0.48-0.91). In patients randomized to GDMT alone,
lower Rvol/LAV was independently associated with an increased risk for HFH
(adjusted HR: 1.57; 95% CI: 1.10-2.24) and cardiovascular death or HFH
(adjusted HR: 1.52; 95% CI: 1.10-2.11). Rvol/LAV was a stronger predictor
of adverse outcomes than LAV alone. Treatment with TEER + GDMT compared
with GDMT alone was associated with lower 2-year rates of HFH and
cardiovascular death or HFH both in patients with low and high Rvol/LAV
(P<inf>int</inf> = 0.28 and 0.12, respectively). Baseline Rvol/LAV ratio
had no impact on 2-year health status or symptoms. [Formula presented]
 Conclusion(s): Low Rvol/LAV ratio independently predicted 2-year
adverse outcomes in HF patients with severe SMR randomized to GDMT alone
in COAPT. Benefits of TEER were observed regardless of the baseline
Rvol/LAV ratio. Categories: STRUCTURAL: Valvular Disease:
Mitral Copyright © 2022

<103>
Accession Number
2020113062
Title
TCT-362 Direct-Acting Oral Anticoagulants Versus Vitamin K Antagonists in
Patients Undergoing Transcatheter Aortic Valve Replacement: A Systematic
Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B146), 2022. Date of Publication: 20
Sep 2022.
Author
Akhtar K.; Nasir Y.; Akhtar H.H.; Jafry A.; Baber U.; Agarwal S.; Mathew
D.
Institution
(Akhtar) University of Oklahoma Health Sciences Center, OK, Oklahoma City,
United States
(Nasir) Montefiore Medical Center, New York, New York, United States
(Akhtar) King Edward Medical University, Lahore Pakistan., Lahore,
Pakistan
(Jafry) OU Health Sciences Center, OK, Oklahoma City, United States
(Baber) Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai
Hospital, New York, New York, United States
(Agarwal) University of Oklahoma, OK, Oklahoma City, United States
(Mathew) University of Pittsburgh Medical Center, PA, Pittsburgh, United
States
Publisher
Elsevier Inc.
Abstract
Background: Approximately one-third of patients undergoing transcatheter
aortic valve replacement (TAVR) have an indication for long-term
anticoagulation. We have compared the efficacy and safety of direct-acting
oral anticoagulants (DOACs) versus vitamin K antagonists (VKA) in patients
undergoing TAVR with an indication of long-term oral anticoagulation.
 Method(s): A systematic search was conducted by 2 independent
researchers using PubMed, EMBASE, Ovid Medline, and Cochrane Database from
inception until May 2022 for studies comparing DOACs with VKA in patients
undergoing TAVR. Outcomes of interest included all-cause mortality, any
bleeding complication, stroke, cardiovascular mortality, major vascular
complications, and risk of acute coronary syndrome. Result(s): A
total of 14 studies (4 randomized control trials and 10 observational
studies) with 36,182 patients were included for final analysis. DOACs were
used by 13,077 patients, and 22,465 patients received VKA. Patients
receiving DOACs had statistically significantly lower all-cause mortality
(RR: 0.84; CI: 0.73-0.97; P = 0.02), and major vascular complications (RR:
0.69; CI: 0.52-0.90; P < 0.01) compared with those receiving VKA. Patients
receiving DOACs did not show a statistically significant difference in
terms of any bleeding complication (RR: 0.99; CI: 0.73-1.34; P = 0.95),
stroke (RR: 0.87; CI: 0.66-1.15; P = 0.32), cardiovascular mortality (RR:
0.95; CI: 0.72-1.26; P = 0.74), or acute coronary syndrome (RR: 0.91; CI:
0.51-1.60; P = 0.73). Conclusion(s): In patients undergoing TAVR who
require long-term anticoagulation, the use of DOACs provides comparable
safety, and is associated with lower all-cause mortality and major
vascular complications compared with patients receiving VKA therapy.
Categories: ENDOVASCULAR: Aortic Disease and Aortic
Intervention Copyright © 2022

<104>
Accession Number
2020113052
Title
TCT-328 Low-Dose or Standard-Dose Edoxaban versus Dual Antiplatelet
Therapy for Leaflet Thrombus and Cerebral Thromboembolism after
Transcatheter Aortic Valve Replacement (TAVR): Subgroup Analysis of the
Randomized ADAPT-TAVR Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B131-B132), 2022. Date of
Publication: 20 Sep 2022.
Author
Kim M.; Lee J.; Park J.; Kim H.; Choi Y.; Ko E.; Yun S.-C.; Kang S.H.; Kim
W.-J.; Lee S.-A.; Kang D.-Y.; Ahn J.-M.; Park S.-J.; Park D.-W.
Institution
(Kim, Lee, Kim, Ko, Lee, Park) Asan Medical Center, Seoul, South Korea
(Choi, Kang, Ahn, Park) Division of Cardiology, Asan Medical Center,
University of Ulsan College of Medicine, Seoul, South Korea
(Park) Division of Biostatistics, Asan Medical Center, Seoul, South Korea
(Yun) CHA Bundang Medical Center, Seongnam-si, South Korea
(Kang, Kim) CHA University, CHA Bundang Medical Cente, Seongnam-Si,
Gyeonggi-do, South Korea
Publisher
Elsevier Inc.
Abstract
Background: Several studies have suggested that anticoagulation was more
effective than antiplatelet therapy in the prevention of leaflet
thrombosis. However, it is unknown whether there are differences in the
incidence of leaflet thrombosis and cerebral thromboembolic risk after
transcather aortic valve replacement (TAVR) depending on the dose of
edoxaban. Method(s): The ADAPT-TAVR (Anticoagulant Versus Dual
Antiplatelet Therapy for Preventing Leaflet Thrombosis and Cerebral
Embolization After Transcatheter Aortic Valve Replacement) trial is a
multicenter, randomized trial comparing edoxaban with dual antiplatelet
therapy (DAPT) in patients who had undergone successful TAVR and did not
have an indication for anticoagulation. In this study, the edoxaban group
received 60 mg as a standard dose or 30 mg once daily as a low dose with
dose-reduction criteria. We compared an incidence of leaflet thrombosis
and cerebral thromboembolism in low-dose or standard-dose edoxaban with
DAPT. Result(s): A total of 229 patients were included in the final
intention-to-treat population. There was a significantly lower incidence
of leaflet thrombosis in the standard-dose edoxaban group than in the DAPT
group (2.4 vs 18%; OR: 0.11; 95% CI: 0.01-0.84; P = 0.033), but there was
no significant difference between low-dose edoxaban and the DAPT group
(15% vs 18%; OR: 0.79; 95% CI: 0.33-1.85; P = 0.58) (Figure). Also, the
percentage of patients with new cerebral lesions on brain magnetic
resonance imaging and worsening neurologic function were not significantly
different among the groups. [Formula presented] Conclusion(s): In
patients without an indication for anticoagulation after successful TAVR,
the incidence of leaflet thrombosis was significantly lower in the
standard-dose edoxaban group than the DAPT group, but there was no
difference between low-dose edoxaban and the DAPT group. Categories:
STRUCTURAL: Valvular Disease: Aortic Copyright © 2022

<105>
Accession Number
2020113017
Title
TCT-462 Impact of Paravalvular Leak on Outcomes After TAVR: Meta-Analysis
of Kaplan-Meier-Derived Individual Patient Data.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B186), 2022. Date of Publication: 20
Sep 2022.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Tasoudis P.; Erten O.; Sicouri
S.; Macedo F.; Pasala T.; Kaple R.; Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Sa, Ramlawi) Lankenau Heart Institute, PA, Philadelphia, United States
(Jacquemyn, Van den Eynde) KU Leuven, Leuven, Belgium
(Tasoudis, Erten, Sicouri) Lankenau Institute for Medical Research,
Wynnewood, PA, United States
(Macedo, Kaple) Hackensack University Medical Center, Hackensack, NJ,
United States
(Pasala) Hackensack University Medical Center, Hackensack, NJ, United
States
(Clavel) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, Quebec, Canada
(Pibarot) Quebec Heart and Lung Institute, Quebec City, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Paravalvular leak (PVL) after transcatheter aortic valve
replacement (TAVR) is frequent, and the impact of mild PVL on outcomes
remains uncertain. Our study aimed to evaluate the impact of PVL on TAVR
outcomes. Method(s): To analyze late outcomes of patients after TAVR
according to the presence and severity of PVL, PubMed/MEDLINE, EMBASE, and
Google Scholar were searched for studies that reported rates of all-cause
mortality/survival and/or rehospitalization and/or cardiovascular
mortality accompanied by at least one Kaplan-Meier curve for any of these
outcomes. We adopted a 2-stage approach to reconstruct individual patient
data based on the published Kaplan-Meier graphs. Result(s):
Thirty-eight studies with Kaplan-Meier curves met our eligibility criteria
including >25,000 patients. Patients with any degree of PVL after TAVR had
a significantly higher risk of overall mortality (HR: 1.52; 95% CI:
1.43-1.61; P < 0.001), rehospitalization (HR: 1.81; 95% CI: 1.54-2.12; P <
0.001), and cardiovascular mortality (HR: 1.52; 95% CI: 1.33-1.75; P <
0.001) over time. These findings remained consistent when we stratified
the results for the methods of assessment of PVL (ie, echocardiography vs
angiography) and PVL severity. Both moderate/severe PVL and mild PVL were
associated with increased risk of overall mortality (P < 0.001),
rehospitalization (P < 0.001), and cardiovascular mortality (P < 0.001)
during follow-up. Conclusion(s): Patients with PVL, even if mild,
experience higher risk of all-cause mortality, rehospitalization, and
cardiovascular mortality after TAVR. These findings provide support to the
implementation of procedural strategies to prevent any degree of PVL at
the time of TAVR. Categories: STRUCTURAL: Valvular Disease:
Aortic Copyright © 2022

<106>
Accession Number
2020112983
Title
TCT-329 Cerebral Embolic Protection Devices for Prevention of
Post-Procedural Ischemic Stroke With Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B132), 2022. Date of Publication: 20
Sep 2022.
Author
Mandava S.; Ayyalu T.; Charles F.; Gade A.; Salagundla N.; Thambidorai S.;
Aragon J.
Institution
(Mandava) Santa Barbara Cottage Hospital, Santa Barbara, CA, United States
(Ayyalu) Northwell LIJ Forest Hills, Forest Hills, New York, United States
(Charles) Detroit Medical Center, MI, Detroit, United States
(Gade) Medical City Fort Worth, Keller, TX, United States
(Salagundla, Thambidorai) Medical City Fort Worth, TX, Fort Worth, United
States
(Aragon) Sansum Clinic, Santa Barbara, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: As transcatheter aortic valve replacement (TAVR) volumes
increase, there have been efforts to reduce its associated stroke risk
secondary to inadvertent dislodgement of calcified material. Multiple
studies have used cerebral embolic protection devices with the goal of
mitigating this risk, resulting in varied outcomes. Currently, only 1
device is Food and Drug Administration approved for this purpose.
 Method(s): In this study, a systematic literature review was
conducted using a search for randomized controlled trials from 2015 to
2021 that evaluated the impact of cerebral embolic protective devices used
for the purpose of reducing the incidence of cerebral embolic events in
patients post-TAVR. PubMed, Scopus, Cochrane Library, and JSTOR were the
sources used. After screening for the determined preset inclusion and
exclusion criteria, 7 studies were deemed eligible for inclusion. A
meta-analysis of the relative odds based on the random effect model using
the Mantel-Haenszel method for the major outcome of all-cause mortality or
any stroke at 30 days was conducted. The Comprehensive Meta-analysis
software (Version 3) was used for the statistical analysis.
 Result(s): A total of 1,116 patients from all 7 studies were
included. After analysis, it was found that the OR for the outcome was
0.943 (95% CI: 0.584-1.521), the P value was 0.810, and the z value was
-0.241 (Figure). [Formula presented] Conclusion(s): Our meta-analysis
showed there was no statistical significance in the odds of all-cause
mortality or stroke at 30 days in the cerebral embolic protection device
group compared with the noncerebral embolic group post-TAVR. Categories:
ENDOVASCULAR: Stroke, Stroke Prevention, Carotid
Intervention Copyright © 2022

<107>
Accession Number
2020112952
Title
TCT-481 Oral Anticoagulation vs Dual Antiplatelet Therapy After
Transcatheter Aortic Valve Replacement Without an Established Indication
for Oral Anticoagulation.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B194-B195), 2022. Date of
Publication: 20 Sep 2022.
Author
Rout A.; Garg A.; Lohana V.; Damluji A.; Singh V.
Institution
(Rout) University of Louisville, Kingsley, KY, United States
(Garg) Brown University, RI, Providence, United States
(Lohana) University of Louisville, KY, Louisville, United States
(Damluji) Johns Hopkins University, Baltimore, MD, United States
(Singh) University of Louisville, KY, Louisville, United States
Publisher
Elsevier Inc.
Abstract
Background: The role of oral anticoagulation (OAC) in patients after
transcatheter aortic valve replacement (TAVR) without an indication for
OAC remains questionable. We conducted this meta-analysis to evaluate the
cumulative evidence of efficacy of OAC vs dual antiplatelet therapy (DAPT)
in TAVR patients without any indication for OAC. Method(s): An
electronic search was conducted of randomized controlled trials comparing
OAC vs DAPT in TAVR patients without indications for OAC. Endpoints of
interest were all-cause death, cardiovascular death, stroke, myocardial
infarction (MI), and major bleeding. Random effect meta-analysis was
conducted to estimate ORs with 95% CIs for individual endpoints.
 Result(s): Four studies with 3,045 patients (OAC: 1,524; DAPT: 1,521)
and a mean follow-up of 10.25 months were included in the final analysis.
Compared with DAPT, OAC was associated with increased odds of all-cause
death (OR: 1.68; 95% CI: 1.22-2.33; P = 0.002). The odds of cardiovascular
death (OR: 1.35; 0.89-2.04; P = 0.16), stroke (OR: 1.30; 0.80-2.12; P =
0.29), MI (OR: 1.09; 95% CI: 0.41-2.88; P = 0.87), and major bleeding (OR:
1.27; 95% CI: 0.93-1.73; P = 0.13) were similar in both groups. [Formula
presented] Conclusion(s): In patients without an established
indication for OAC after TAVR, use of OAC was associated with increased
risk of all-cause death without any difference in cardiovascular death,
stroke, MI, and major bleeding compared with DAPT. Categories: STRUCTURAL:
Valvular Disease: Aortic Copyright © 2022

<108>
Accession Number
2020112935
Title
TCT-488 Transcatheter Aortic Valve Replacement in Low-Surgical-Risk
Patients With Bicuspid Aortic Valves: A Systematic Review and
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B197-B198), 2022. Date of
Publication: 20 Sep 2022.
Author
Gupta R.; Mahmoudi E.; Behnoush A.H.; Malik A.H.; Vyas A.; Patel N.
Institution
(Gupta) Lehigh Valley Health Network, Macungie, PA, United States
(Mahmoudi, Behnoush) Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Malik) Westchester Medical Center, Harriman, New York, United States
(Vyas, Patel) Lehigh Valley Health Network, PA, Allentown, United States
Publisher
Elsevier Inc.
Abstract
Background: There are limited data on the use of transcatheter aortic
valve replacement (TAVR) in low-surgical-risk bicuspid aortic valve (BAV)
with aortic stenosis (AS). We aimed to perform a systematic review and
meta-analysis to compare the outcomes of TAVR in low-surgical-risk BAV vs
tricuspid aortic valve (TAV) patients. Method(s): A systematic search
was conducted in PubMed, EMBASE, and Cochrane until April 2022 to identify
relevant studies. Meta-analysis was conducted by Stata software, and
Higgins' I2 was calculated for heterogeneity. Result(s):
Five studies comparing post-TAVR outcomes of 3,721 BAV and 3,569 TAV
patients were included in the analysis. BAV patients were younger, with a
lower prevalence of hypertension and diabetes mellitus. BAV patients were
found to have a lower incidence of 1-year all-cause mortality (OR: 0.67;
95% CI: 0.49-0.91; P = 0.01) but a higher incidence of 30-day paravalvular
leak (OR: 1.62; 95% CI: 1.00-2.26; P = 0.05). There was no significant
difference in the incidence of 30-day all-cause mortality, stroke, device
success, conversion to open surgery, valve migration, second valve
implementation, coronary obstruction, permanent pacemaker implantation,
major vascular complications, major or life-threatening bleeding, acute
kidney injury, new-onset atrial fibrillation, procedure time, and mean
aortic gradient in the 2 groups. [Formula presented] Conclusion(s):
Low-surgical-risk BAV patients had a lower incidence of 1-year all-cause
mortality, with similar incidence of clinical outcomes compared with TAV.
TAVR appears to be a safe and effective method for the treatment of AS in
low-surgical-risk BAV patients. Categories: STRUCTURAL: Valvular Disease:
Aortic Copyright © 2022

<109>
Accession Number
2020112929
Title
TCT-104 Impact of Left Ventricular Ejection Fraction (EF) on 10-Year
Mortality After Percutaneous Coronary Intervention (PCI) or Coronary
Artery Bypass Grafting (CABG): Is CABG Safer Than PCI in All Patients With
Reduced EF?.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B42-B43), 2022. Date of Publication:
20 Sep 2022.
Author
Serruys P.; Masuda S.; Ninomiya K.; Kageyama S.; Gao C.; Mack M.; Holmes
D.; Milojevic M.; Morice M.-C.; Garg S.; Onuma Y.
Institution
(Serruys, Masuda, Ninomiya, Kageyama, Onuma) National University of
Ireland, Galway, Ireland
(Gao) Xijing Hospital, Xi'an, Shaanxi, China
(Mack) Baylor Scott and White Heart Hospital, TX, Dallas, United States
(Holmes) Mayo Clinic, MN, Rochester, United States
(Mack, Milojevic) Dedinje Cardiovascular Institute Belgrade, Belgrade,
Serbia
(Morice) Cardiovascular European Research Center, Paris, France
(Garg) Royal Blackburn Hospital, Blackburn, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: The impact of reduced left ventricular ejection fraction
(LVEF) on long-term all-cause mortality after either PCI or CABG has been
established. Method(s): In the SYNTAX trial, 1,800 randomized
patients were categorized into 3 groups according to their LVEF: 1)
reduced EF (rEF: <=40%), 2) mildly reduced EF (mrEF: 41%-49%), 3)
preserved EF (pEF: >=50%). The primary end point was 10-year all-cause
mortality. The SYNTAX score 2020 (SS-2020) was applied to the patients
with EF <50% and >=50% and their individual predicted and observed
all-cause mortality assessed. Result(s): Ten year mortality were
44.0% with rEF (n = 168), 31.8% with mrEF (n = 179), and 22.6% with pEF (n
= 1,453) (P < 0.001). No significant interaction was found between EF
classification and treatment (P-interaction = 0.183). In patients with rEF
and mrEF, mortality was numerically higher with PCI than with CABG (52.9%
vs 39.6%, P = 0.054; and 36.0% vs 28.6%, P = 0.273) whereas in patients
with pEF mortality was similar (23.9% vs 22.2%, P = 0.275). According to
the SS-2020, PCI was an equally safe modality of revascularization in
37.8% of the patients with reduced EF <50%. In patients with preserved EF
>=50%, the proportion of patients eligible to either PCI or CABG with
individual predicted equipoise in mortality was 57.5%. [Formula presented]
 Conclusion(s): EF is a determinant factor in the choice of a
revascularization strategy in patients presenting with complex coronary
artery disease and altered EF. Prediction of individualized 10-year
prognosis using the SS-2020 may add precision in the decision-making
process. Categories: CORONARY: Cardiac and Coronary Artery Surgery and
Hybrid Revascularization Copyright © 2022

<110>
Accession Number
2020112861
Title
TCT-338 Malnutrition in Patients With Heart Failure and Secondary Mitral
Regurgitation: The COAPT Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B136-B137), 2022. Date of
Publication: 20 Sep 2022.
Author
Scotti A.; Coisne A.; Granada J.; Asch F.; Driggin E.; Zhou Z.; Kar S.;
Lim S.; Cohen D.; Lindenfeld J.; Abraham W.; Mack M.; Stone G.
Institution
(Scotti, Coisne, Granada, Zhou) Cardiovascular Research Foundation, New
York, New York, United States
(Asch) Medstar Health Research Institute, DC, Washington, United States
(Driggin) Columbia University Medical Center, New York, New York, United
States
(Kar) Los Robles Regional Medical Center, Thousand Oaks and Bakersfield
and Bakersfield Heart Hospital, CA, Los Angeles, United States
(Lim) University of Virginia Health System Hospital, Charlottesville,
Virginia, United States
(Cohen) St. Francis Hospital, New York, New York, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, TN, Nashville,
United States
(Abraham) The Ohio State University Wexner Medical Center, OH, Columbus,
United States
(Mack) Baylor Scott & White Heart Hospital, TX, Dallas, United States
(Stone) Mount Sinai Heart Health System, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: The geriatric nutritional risk index (GNRI) is a
well-validated tool for assessment of malnutrition. Malnutrition is
associated with poor prognosis in a wide range of diseases, but its
prognostic impact in patients with heart failure (HF) and secondary mitral
regurgitation (SMR) is unknown. We aimed to assess the prevalence and
impact of malnutrition in HF patients with severe SMR randomized to
transcatheter edge-to-edge repair (TEER) with MitraClip (Abbott Vascular)
plus guideline-directed medical therapy (GDMT) versus GDMT alone in the
COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous
Therapy for Heart Failure Patients With Functional Mitral Regurgitation)
trial. Method(s): Baseline malnutrition risk was calculated using
GNRI. Patients were categorized as "malnutrition" (GNRI <98) versus "no
malnutrition" (GNRI >=98). Outcomes were assessed through the 2-year
follow-up. The primary endpoint was all-cause mortality. Result(s):
Among 571 patients analyzed, the median baseline GNRI was 108 (IQR:
101-116); 102 (17.9%) had malnutrition (65 mild [GNRI 92-<=98]; 37
moderate/severe [GNRI <92]). By multivariable analysis, both baseline
malnutrition (HR: 1.48; 95% CI: 1.02-2.16; P = 0.04) and randomization to
GDMT alone versus TEER + GDMT (HR: 1.72; 95% CI: 1.28-2.38; P = 0.0002)
independently predicted 2-year death. The prognostic impact of
malnutrition was limited to patients randomized to GDMT alone (Figure).
The survival benefit conferred by TEER was consistent in patients with
(adjusted HR: 0.28; 95% CI: 0.13-0.63) and without (adjusted HR: 0.63; 95%
CI: 0.45-0.88) malnutrition (P<inf>interaction</inf> = 0.76). [Formula
presented] Conclusion(s): Among HF patients with SMR treated with
GDMT alone, malnutrition was independently associated with increased
2-year mortality. The relative survival benefit of TEER with the MitraClip
in this population was independent of baseline malnutrition status.
Categories: STRUCTURAL: Valvular Disease: Mitral Copyright © 2022

<111>
Accession Number
2020112837
Title
TCT-327 Clinical and Radiographic Measures of Stroke-Related Outcomes With
Cerebral Embolic Protection Devices During TAVR: A Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B131), 2022. Date of Publication: 20
Sep 2022.
Author
Kaur A.; Dhaliwal A.; Sohal S.; Kliger C.; Velagapudi P.; Basman C.;
Dominguez A.C.
Institution
(Kaur) Icahn School of Medicine at Mount Sinai Morningside/West, New York,
New York, United States
(Dhaliwal) New York Hand Surgery, New York, New York, United States
(Sohal) Newark Beth Israel Medical Center, Roselle Park, NJ, United States
(Kliger) Hofstra School of Medicine, New York, New York, United States
(Velagapudi) University of Nebraska Medical Center, Omaha, NE, United
States
(Basman) Lenox Hill Hospital, New York, New York, United States
(Dominguez) Mount Sinai Morningside, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: Magnetic resonance imaging (MRI) detected silent cerebral
infarctions secondary to atheroembolic phenomenon during transcatheter
aortic valve replacement (TAVR) may have long-term neurologic
consequences. It is hypothesized that the use of cerebral embolic
protection devices (CEPD) during TAVR could curtail cerebral embolization,
thereby decreasing the incidence of both clinically significant stroke and
silent cerebral infarctions. Method(s): A comprehensive review of
electronic databases (PubMed, Embase, Scopus, Cochrane) was performed
using keywords CEPD and TAVR from inception through April 2022. The
primary clinical outcomes included the following: 1) worsening NIH Stroke
Scale (NIHSS) 7 days post-TAVR and 2) all-cause stroke at 30 days.
Secondary radiographic outcomes included the presence and number of
cerebral ischemic lesions detected on diffusion-weighted (DWI)-MRI. Random
effects meta-analysis was used to estimate the pooled RR, standardized
mean difference, and 95% CI. Heterogeneity was assessed using the Higgins
I2 statistic. All statistical analyses were performed using
RevMan 5.4.1 software. Result(s): Six eligible randomized controlled
trials were identified, including 1,091 patients (CEPD n = 729, no-CEPD n
= 362). There was no statistically significant difference in the primary
clinical outcomes of worsening NIHSS 7 days post-TAVR (RR: 1.25; CI:
0.79-1.98; P > 0.05; I2 = 0%) or all-cause stroke at 30 days
(RR: 1.01; CI: 0.63-1.60; P > 0.05; I2 = 0%), the presence of
cerebral ischemic lesions (RR: 1.00; CI: 0.92-1.08; P > 0.05;
I2 = 0%), or the number of cerebral ischemic lesions on DWI-MRI
(standardized mean difference: 0.14; CI: -0.6 to 0.34; P > 0.05;
I2 = 0%) between the CEPD and no-CEPD groups (Figure). [Formula
presented] Conclusion(s): This meta-analysis shows the use of CEPD
did not impact the clinical or radiographic stroke-related outcomes in
patients undergoing TAVR. Categories: STRUCTURAL: Valvular Disease:
Aortic Copyright © 2022

<112>
Accession Number
2020112830
Title
TCT-286 Rates of Percutaneous Coronary Revascularization in Morphological-
vs Functional-Guided Arms of the INTERCLIMA (Interventional Strategy for
Non-Culprit Lesions With Major Vulnerability Criteria Identified by OCT in
Patients With ACS) Randomized Controlled Trial: Preliminary Data.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B115), 2022. Date of Publication: 20
Sep 2022.
Author
Biccire F.G.; carmine musto; ugo limbruno; Fabbiocchi F.; Turturo M.; Boi
A.; Cassano F.; Calligaris G.; Benenati S.; Budassi S.; Cesario V.;
Bortone A.; Porto I.; Arbustini E.; Kedhi E.; Alfonso F.; Raber L.; Prati
F.
Institution
(Biccire) CLI Foundation, Rome, Italy, Sapienza University of Rome, Rome,
Italy
(carmine musto) San Camillo, Rome, Italy
(ugo limbruno) ASL Sudest, Pisa, Italy
(Fabbiocchi) Centro Cardiologico Monzino, Milan, Italy
(Turturo, Cassano) "Di Venere" Hospital, Bari, Italy
(Boi) Brotzu Hospital, Cagliari, Italy
(Calligaris) Monzino, Milan, Italy
(Benenati) San Martino Hospital, IRCCS, Genoa, Italy
(Budassi) Cardiology Department San Giovanni Addolorata Hospital, Rome,
Italy
(Cesario) San Camillo Forlanini Hospital, Rome, Italy
(Bortone) Interventional Lab Cardiac Surgery, University of Bari, Bari,
Italy
(Porto) Universita di Genova, Genoa, Italy
(Arbustini) IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
(Kedhi) Erasme Hospital Universite Libre de Bruxelles, Brussels, Belgium
(Alfonso) Hospital Universitario de la Princesa, Madrid, Spain
(Raber) University Hospital Bern, Bern, Switzerland
(Prati) San Giovanni Addolorata Hospital, CLI Foundation, Rome, Italy
Publisher
Elsevier Inc.
Abstract
Background: Recently, the COMPLETE trial showed that complete
revascularization of nonculprit coronary lesions in patients with
ST-segment elevation myocardial infarction (STEMI) significantly improves
clinical outcomes. In this preliminary analysis of the INTERCLIMA
(Interventional Strategy for Non-Culprit Lesions With Major Vulnerability
Criteria Identified by Optical Coherence Tomography [OCT] in Patients with
Acute Coronary Syndrome [ACS]) trial, we sought to compare the number of
percutaneous coronary interventions (PCIs) performed in the functional vs
morphologic group. Method(s): The INTERCLIMA trial (NCT05027984) is a
multicenter randomized head-to-head controlled trial comparing morphologic
(as assessed by OCT) vs functional invasive assessment in guiding complete
revascularization of patients with ACS. Patients with intermediate lesions
in nonculprit coronary vessels are randomized, in a 1:1 ratio, to undergo
either functional (significant if <=0.80 with the use of a hyperemic agent
or <=0.89 without) or morphologic (presence of a thin fibrous cap < 75 mum
plus at least 2 criteria among a minimum luminal area < 3.5
mm2, lipid arc > 180degree, and macrophage infiltration) guided
PCI with 2- and 5-year clinical follow-up. Result(s): During the
initial recruitment period (July 2021 to May 2022), 87 patients (mean age
64.4 +/- 11 years, 19.5% women) were randomized at 13 centers. ACS
presentation was STEMI in 58.6% of cases, non-STEMI in 27.6%, and unstable
angina in 13.8%. Overall, 47 lesions have been allocated to the OCT group
and 49 lesions to the functional group (hyperemic agent administered in
36.4% of cases). The right coronary artery was evaluated in 35.4% of
cases, the left anterior descending coronary artery in 24%, the obtuse
marginal artery in 18.7%, the left circumflex coronary artery in 14.6%,
and the ramus in 7.3%. Compared with the functional group, a significantly
larger number of lesions underwent PCI in the OCT group (68.1% vs 20% in
the functional group; P < 0.001). In all cases, lesions were treated with
second-generation drug-eluting stents. No periprocedural adverse events
were registered. Conclusion(s): In this preliminary analysis of the
INTERCLIMA trial, the prevalence of PCI was significantly higher in the
OCT arm. Categories: CORONARY: Acute Coronary Syndromes Copyright
© 2022

<113>
Accession Number
2020112762
Title
TCT-337 Repeat Mitral Valve Interventions After Transcatheter Edge-to-Edge
Repair in Heart Failure: The COAPT Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B136), 2022. Date of Publication: 20
Sep 2022.
Author
Shahim B.; Cohen D.; Asch F.; Bax J.; George I.; Ruck A.; Ben-Yehuda O.;
Kar S.; Lim S.; Saxon J.; Zhou Z.; Lindenfeld J.; Abraham W.; Mack M.;
Stone G.
Institution
(Shahim, Ben-Yehuda, Zhou) Cardiovascular Research Foundation, New York,
United States
(Cohen) St. Francis Hospital, New York, United States
(Asch) Medstar Health Research Institute, DC, Washington, United States
(Bax) Leiden University Medical Center, Leiden, Netherlands
(George) Columbia University Irving Medical Center, New York, United
States
(Ruck) Department of Cardiology, Karolinska University Hospital,
Stockholm, Sweden
(Kar) Los Robles Regional Medical Center, Thousand Oaks and Bakersfield
and Bakersfield Heart Hospital, CA, Los Angeles, United States
(Lim) University of Virginia Health System Hospital, Virginia, United
States
(Saxon) Mid America Heart Institute, MO, Kansas City, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, TN, Nashville,
United States
(Abraham) The Ohio State University Wexner Medical Center, OH, Columbus,
United States
(Mack) Baylor Scott & White Heart Hospital, TX, Dallas, United States
(Stone) Mount Sinai Heart Health System, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: The frequency and implications of repeat mitral valve (MV)
interventions after transcatheter edge-to-edge repair (TEER) for severe
secondary mitral regurgitation (MR) in the contemporary era is unknown.
 Method(s): The COAPT (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation) trial randomized heart failure patients with 3+ or
4+ secondary MR to TEER with the MitraClip (Abbott Vascular) +
guideline-directed medial therapy (GDMT) versus GDMT alone. We evaluated
characteristics and outcomes of patients who had a repeat MV intervention
(RMVI) after their index procedure. Result(s): Among 302 patients
randomized to TEER + GDMT, within the 4-year follow-up, 10 (3.3%)
underwent RMVI (9 repeat TEER and 1 surgical MV replacement).
Prerandomization RMVI patients had larger body mass index, were more often
in New York Heart Association functional class III or IV, had a larger
anterior-posterior mitral annulus diameter, larger tenting area, had fewer
clips implanted, and were more likely to have >=3+ MR at discharge
compared with patients who did not require RMVI during follow-up. RMVI was
performed at a median of 182 days after initial transcatheter mitral valve
repair (range: 17-629 days; Figure, left). Reasons for RMVI included
failed index procedure due to difficult transseptal puncture (n = 2) or
tamponade (n = 1), recurrent severe MR after an initially successful
procedure (n = 6), and development of mitral stenosis (n = 1). MR severity
after RMVI was reduced from >=3+ in 9 cases to <=2+ in 7 (Figure, right).
Within the 4-year follow-up, patients with RMVI had higher rates of heart
failure hospitalization (HFH) but similar mortality compared with those
without RMVI. [Formula presented] Conclusion(s): Only 3.3% of COAPT
patients required RMVI within 4 years. The need for RMVI was associated
with increased HFH but not mortality. Categories: STRUCTURAL: Valvular
Disease: Mitral Copyright © 2022

<114>
Accession Number
2020112719
Title
TCT-424 Percutaneous Mitral Valve Repair Outcomes in Octogenerians: A
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B171-B172), 2022. Date of
Publication: 20 Sep 2022.
Author
Kanitsoraphan C.; Techorueangwiwat C.; Shah P.; Nagamine T.
Institution
(Kanitsoraphan, Techorueangwiwat, Shah, Nagamine) University of Hawaii,
HI, Honolulu, United States
Publisher
Elsevier Inc.
Abstract
Background: Mitral regurgitation is a common cardiac problem that portends
significant morbidity and mortality. Percutaneous edge-to-edge mitral
valve repair (PMVR) is an emerging procedure in specific patient
populations. Although elderly patients represent a large population that
may benefit from the procedure, there were limited data on outcomes in
percutaneous mitral valve repair. We conducted a meta-analysis to evaluate
the outcomes of PMVR in octogenarians. Method(s): We conducted a
literature search from inception through June 2022 in the databases of
EMBASE and MEDLINE. We included randomized controlled trials or cohorts
that compared PMVR outcomes in octogenarians versus nonoctogenarians. Data
were combined using the random-effect, generic inverse variance method of
DerSomonian and Laird to calculate the OR and 95% CI. Result(s):
Three studies were included in the study (2,393 patients, including 988
octogenarians and 1,405 nonoctogenarians). There were no significant
differences in in-hospital mortality (OR: 0.959; 95% CI: 0.571-1.612; P =
0.875) or device success (OR: 1.599; 95% CI: 0.904-2.827; P = 0.107).
[Formula presented] Conclusion(s): PMVR can be pursued safely in
selected octogenarians with no significant differences in in-hospital
mortality or device success compared with nonoctogenarians. Nonetheless,
more data would be needed to further risk stratify octogenarian patients
undergoing TMVR. Categories: STRUCTURAL: Valvular Disease:
Mitral Copyright © 2022

<115>
Accession Number
2020112713
Title
TCT-334 Pulmonary Venous Flow Pattern as a Predictor of Outcomes in
Patients With Secondary Mitral Regurgitation: The COAPT Trial.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B134-B135), 2022. Date of
Publication: 20 Sep 2022.
Author
Bohra C.; Asch F.; Lerakis S.; Little S.; Redfors B.; Li Y.; Weissman N.;
Grayburn P.; Kar S.; Lim S.; Abraham W.; Lindenfeld J.; Mack M.; Stone G.
Institution
(Bohra) Mount Sinai St Luke's, New York, New York, United States
(Asch) Medstar Health Research Institute, DC, Washington, United States
(Lerakis) The Mount Sinai Hospital, New York, New York, United States
(Little) Houston Methodiest DeBakey Heart & Vascular Center, TX, Houston,
United States
(Redfors, Li) Cardiovascular Research Foundation, New York, New York,
United States
(Weissman) MedStar Health, MD, Annapolis, United States
(Grayburn) Baylor Scott & White Heart & Vascular Hospital Plano, TX,
Plano, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks and Bakersfield
and Bakersfield Heart Hospital, CA, Los Angeles, United States
(Lim) University of Virginia Health System Hospital, Charlottesville,
Virginia, United States
(Abraham) The Ohio State University Wexner Medical Center, OH, Columbus,
United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, TN, Nashville,
United States
(Mack) Baylor Scott & White Heart Hospital, TX, Dallas, United States
(Stone) Mount Sinai Heart Health System, New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: Pulmonary venous flow (PVF) patterns reflect hemodynamic
changes in patients with mitral regurgitation (MR) and in those with heart
failure (HF) and are known to predict cardiovascular outcomes in these
groups individually. However, implications of PVF patterns when HF and MR
coexist are unknown. We thus studied PVF patterns in patients with HF and
secondary MR (sMR) to examine outcomes after transcatheter edge-to-edge
repair (TEER) with MitraClip (Abbott Vascular) compared with
guideline-directed medical therapy (GDMT) alone in the COAPT
(Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Functional Mitral Regurgitation) trial.
 Method(s): COAPT patients with evaluable PVF were categorized by the
presence or absence of pulmonary venous systolic flow reversal (PVSFR) at
baseline, defined as systolic flow reversal in 1 or more pulmonary veins
on transthoracic echocardiography. Differences in rates of 2-year
mortality and HF hospitalization (HFH) were studied with interaction
analysis of treatment and PVSFR. Result(s): Among 614 patients, 480
(78.3%) had evaluable baseline PVF, 222 (46.3%) of whom had PVSFR. By
multivariable analysis, in patients assigned to GDMT alone, PVSFR
predicted 2-year all-cause death (adjusted HR: 1.56; 95% CI: 1.03-2.35)
and HFH (adjusted HR: 1.05; 95% CI: 0.73-1.49). Randomization to TEER +
GDMT improved all-cause death and HFH in patients with and without PVSFR
compared with GDMT alone. The benefit of TEER in reducing all-cause death
was greater in patients with versus without PVSFR (P<inf>int</inf> = 0.03)
with no effect modification on HFH (Figure). [Formula presented]
 Conclusion(s): PVSFR was an independent predictor of all-cause death
in patients with HF and severe sMR in COAPT. The addition of TEER to GDMT
reduced death and HFH regardless of the PVF pattern. The survival benefit
of TEER over GDMT alone was strongest in patients with PVSFR. Categories:
STRUCTURAL: Valvular Disease: Mitral Copyright © 2022

<116>
Accession Number
2020112648
Title
TCT-604 Outcomes in Single vs Double Perclose ProGlide Device Technique
During Transfemoral Transcatheter Aortic Valve Implantation:
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B248), 2022. Date of Publication: 20
Sep 2022.
Author
Aggarwal G.; Reddy A.K.; Bansal S.; Aggarwal S.; Thandra A.; Delcore M.
Institution
(Aggarwal) Creighton University Medical Center, NE, Omaha, United States
(Reddy, Aggarwal) Creighton University Medical Center, NE, Omaha, United
States
(Bansal) Maharishi Markandeshwar Institute of Medical Sciences and
Research, NE, Omaha, United States
(Thandra) CHI-Creighton University Medical Center, NE, Omaha and the,
United States
(Delcore) CHI Health Creighton University Medical Center, NE, Omaha,
United States
Publisher
Elsevier Inc.
Abstract
Background: Use of suture-based vascular closure devices have contributed
immensely to the decline in vascular complications during transfemoral
transcatheter aortic valve replacement (TAVR). One of the most used
vascular closure devices is the Perclose ProGlide. Wherein most centers
utilize a double Perclose technique, few recent studies have demonstrated
that a single preclose technique has more advantages in terms of reduced
complications, and cost. We performed a meta-analysis of published studies
to assess outcomes related to procedural success, vascular and bleeding
complications, and 30-day mortality. Method(s): We searched PubMed,
EMBASE, Google Scholar, and Ovid databases for studies comparing outcomes
for single vs double preclose technique in TAVR patients. Pooled risk
ratios (RRs) with 95% CIs were calculated. Result(s): Five studies
with 2,844 patients were included. Compared with double preclose
technique, TAVR patients who underwent single preclose had significantly
lower risk of dissection (RR: 0.23; 95% CI: 0.1-0.55; P < 0.001) and major
bleeding (RR: 0.67; 95% CI: 0.47-0.94; P < 0.001). There were no
differences in rates of procedural success and 30-day mortality. [Formula
presented] Conclusion(s): This is the first meta-analysis comparing
use of Single vs Double Perclose ProGlide technique in TAVR patients.
Single Perclose technique is associated with significantly reduced risk of
arterial dissection and major bleeding events. However, there are no
differences in procedural success or 30-day mortality rates. Further
randomized studies need to be carried out to confirm these findings.
Categories: STRUCTURAL: Valvular Disease: Aortic Copyright © 2022

<117>
Accession Number
2020112635
Title
TCT-510 Percutaneous Coronary Intervention Before Transcatheter Aortic
Valve Replacement: A Propensity Score-Weighted Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B207-B208), 2022. Date of
Publication: 20 Sep 2022.
Author
Khan S.; Dani S.; Ganatra S.; Agalan A.; Zaid S.; Arshad H.; Little S.;
Shah A.; Kleiman N.
Institution
(Khan) Houston Methodist DeBakey Heart and Vascular Institute, TX,
Houston, United States
(Dani, Ganatra) Lahey Hospital and Medical Center, Burlington, MA, United
States
(Agalan) Lahey Hospital and Medical Center, Burlington, MA, United States
(Zaid, Kleiman) Houston Methodist DeBakey Heart & Vascular Center, TX,
Houston, United States
(Arshad) Houston Methodist Hospital, TX, Houston, United States
(Little) Houston Methodist DeBakey Heart & Vascular Center, TX, Houston
and the, United States
(Shah) Houston Methodist Hospital, TX, Houston, United States
Publisher
Elsevier Inc.
Abstract
Background: Limited data exist concerning percutaneous coronary
intervention (PCI) in patients with aortic stenosis who undergo
transcatheter aortic valve replacement (TAVR). Method(s): We used
TriNetX data (January 2012-December 2020) to identify patients undergoing
TAVR and PCI using Current Procedural Terminology and International
Classification of Diseases-10th Revision codes. We stratified patients
undergoing TAVR into PCI (<3 months before TAVR) and no PCI groups. We
identified 22,831 patients and performed propensity score matching for
demographic and clinical characteristics. Survival analysis was performed
by using Kaplan-Meier methods. The main outcomes were all-cause mortality
and myocardial infarction (MI) at 1 year. Result(s): Among 2,268 in
the propensity score-matching cohort (2,234 patients in each group), mean
age was 79 years (8.1), 63% were male, and 91% were non-Hispanic White
adults. Most patients had ischemic heart disease (94%), whereas 43% had
diabetes, 65% had heart failure, and 36% had atrial fibrillation/flutter.
Overall, 92% of patients were on antiplatelet therapies (90% aspirin, 75%
clopidogrel), 73% on beta-blockers, and 81% on lipid-lowering agents. At 1
year, PCI was not associated with improved all-cause mortality (HR: 0.98;
95% CI: 0.82-1.18) or MI (HR: 0.94; 95% CI: 0.80-1.10). However, PCI was
associated with a higher incidence of pacemaker/implantable
cardioverter-defibrillator implants (HR: 1.28; 95% CI: 1.05-1.56).
[Formula presented] Conclusion(s): In this analysis, PCI was not
associated with improved survival or MI at 1 year. Well-powered randomized
controlled trials with longer follow-up duration should assess the effects
of PCI in patients undergoing TAVR. Categories: STRUCTURAL: Valvular
Disease: Tricuspid Copyright © 2022

<118>
Accession Number
2020112605
Title
TCT-425 Long-Term Outcome of Transcatheter Aortic Valve Replacement for
Native Aortic Regurgitation With the Use of Newer- Versus Early-Generation
Devices: A Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B172), 2022. Date of Publication: 20
Sep 2022.
Author
Vutthikraivit W.; Leelaviwat N.; Arustamyan M.; Sami F.; Hanna E.
Institution
(Vutthikraivit) University of Iowa, Coralville, IA, United States
(Leelaviwat) Texas Tech University Health Sciences Center, St Lubbock, TX,
United States
(Arustamyan) University of Iowa Hospitals and Clinics, Iowa City, IA,
United States
(Sami) University of Iowa Hospitals and Clinics, Coralville, IA, United
States
(Hanna) University of Iowa, Iowa City, IA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has emerged as
an alternative treatment for aortic regurgitation (AR). Several studies
have shown an acceptable 30-day mortality post-TAVR. However, there are
limited reports in the literature on long-term outcomes. Method(s):
We comprehensively searched the databases of MEDLINE and EMBASE from
inception to June 2022. Included studies were published cohort,
case-control, or cross-sectional studies and randomized controlled trials
reporting the incidence of long-term (>=1 year) all-cause mortality in
patients undergoing TAVR for native AR. Data from each study were combined
using the random-effects model. The effect of newer- versus
early-generation devices on the rate of long-term mortality and procedural
success rate was explored with a meta-regression analysis. Result(s):
Nine studies were included involving 821 patients. Overall, long-term
mortality was 20% (95% CI: 14%-26%; I2 = 76.5%). The procedural
success rate was 82% (95% CI: 73%-90%; I2 = 92.3%). In the
newer-generation group, long-term mortality was 16% (95% CI: 9%-23%;
I2 = 75.6%). The procedural success rate was 93% (95% CI:
86%-100%; I2 = 87.0%). Compared with early-generation devices,
newer-generation devices were not significantly associated with decreased
long-term morality but with a significantly higher procedural success rate
(r = -0.09; P = 0.09 and r = 0.26; P = 0.01, respectively) (Figure).
[Formula presented] Conclusion(s): Our study demonstrated that TAVR
for native AR has a good long-term outcome and procedural success rate.
Newer-generation devices are associated with a better outcome and should
be considered as an alternative in patients deemed inoperable. Categories:
STRUCTURAL: Valvular Disease: Aortic Copyright © 2022

<119>
Accession Number
2020112597
Title
TCT-561 Sex Differences in Bleeding and Ischemic Risks After Transcatheter
Aortic Valve Implantation: A POPular TAVI Subanalysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B231), 2022. Date of Publication: 20
Sep 2022.
Author
van Bergeijk K.; Ginkel D.-J.V.; Voors A.; Wykrzykowska J.; Berg J.T.
Institution
(van Bergeijk) UMCG, Groningen, Netherlands
(Ginkel, Berg) St. Antonius Hospital, Nieuwegein, Netherlands
(Voors, Wykrzykowska) University Medical Center Groningen, Groningen,
Netherland
Publisher
Elsevier Inc.
Abstract
Background: Stroke and bleeding are frequent complications after
transcatheter aortic valve replacement (TAVR). Previous studies have shown
a higher incidence of bleeding and stroke in women. However, the net
balance of these 2 outcomes and the role of antithrombotic management has
not been studied before. The aim of our study was to compare bleeding and
ischemic complications after TAVR between men and women stratified by
antiplatelet and oral anticoagulant (OAC) regimen. Method(s): The
POPular TAVI Trial was a randomized controlled trial to test the
hypothesis that monotherapy with aspirin or OAC after TAVR is safer than
the addition of clopidogrel. The 2 primary endpoints of our subanalysis
were: 1) all bleedings; and 2) a composite of stroke and myocardial
infarction. The secondary endpoints were: 1) nonprocedural bleeding; 2)
major or life-threatening bleedings; 3) stroke; 4) myocardial infarction;
and 5) death. Result(s): A total of 665 patients were included in the
aspirin cohort (A) and 313 patients in the OAC cohort (B). In cohort A,
323 (48.6%) were female; 142 (45.4%) were female in cohort B. After 1
year, 106 (22.8%) bleedings had occurred in women vs 121 (23.6%) in men (P
= 0.815), and 26 (5.6%) ischemic events occurred in women vs 36 (7.0%) in
men (P = 0.429). However, major or life-threatening bleeding had occurred
in 58 women (12.5%) vs in 38 (7.4%) men (P = 0.011). This difference was
mainly driven by a higher rate of major or life-threatening bleeding in
women in the aspirin monotherapy group of cohort A (38 events in women
[11.8%] vs 17 events in men [5.0%]; P = 0.002). Conclusion(s): There
were no statistically significant differences in the rate of bleeding and
stroke risk between men and women after TAVR. However, the risk of major
life-threatening bleeding after TAVR was higher in women compared with
men, and was mainly driven by the higher risk of major or life-threatening
bleeding in women than men on aspirin monotherapy. Categories: STRUCTURAL:
Valvular Disease: Aortic Copyright © 2022

<120>
Accession Number
2020112586
Title
TCT-529 In-Hospital Outcomes of Tricuspid Transcatheter Edge-to-Edge
Repair: An Analysis From the National Inpatient Sample.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B216-B217), 2022. Date of
Publication: 20 Sep 2022.
Author
Torres C.; Lozier M.; Davidson C.; Ailawadi G.; Donatelle M.; Vedantam K.
Institution
(Torres, Lozier, Vedantam) Columbia University, Division of Cardiology,
Mount Sinai Medical Center, Florida, United States
(Davidson) Northwestern Memorial Hospital, IL, Chicago, United States
(Ailawadi) University of Michigan Cardiovascular Center, MI, Ann Arbor and
the, United States
(Donatelle) Mount Sinai Medical Center, FL, Miami, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with severe tricuspid regurgitation carry an elevated
surgical risk, resulting in increasing adoption of less invasive
transcatheter therapies such as tricuspid transcatheter edge-to-edge
repair (TTEER); however, data are limited. Method(s): The National
Inpatient Sample (NIS) was queried (2016-2019) to identify all patients
undergoing TTEER (International Classification of Diseases-Tenth Revision
code 02UJ3JZ) alone (iTTEER) or in combination with mitral TEER (code
02UG3JZ) (cTTEER). The primary aim was to define clinical characteristics,
time trends, in-hospital outcomes, and predictors of all-cause in-hospital
mortality. Secondary outcomes included predictors of increased
hospitalization costs and length of stay (LOS) (> the 75th percentile).
 Result(s): We identified 925 patients who underwent TTEER (460
[49.7%] iTTEER, 465 [50.3%] cTTEER). There was a 6.5-fold increase in
TTEER adoption (<0.001). Patients were older (78 +/- 10 years), female
(63.2%), and White (72.7%), with frequent comorbidities. Mortality
occurred in 2.2%, acute kidney injury in 16.8%, respiratory failure in
13.0%, vascular complications in 10.3%, and major bleeding in 3.3%.
Predictors of mortality were acute kidney injury (OR: 5.25; P < 0.001),
major bleeding (2.81; P < 0.001), pericardiocentesis (2.15; P < 0.001),
and chronic liver disease (1.40; P < 0.001). The predictors of increased
LOS or hospitalization costs included coronary artery disease, atrial
arrhythmias, pulmonary hypertension, chronic liver disease, and procedural
complications. Table 1 presents the baseline characteristics,
comorbidities, and procedural complications among patients who underwent
iTTEER or cTTEER. [Formula presented] Conclusion(s): TTEER showed
increased adoption with elevated but acceptable mortality and
complications considering this high-risk population. Results of randomized
trials are awaited. Categories: STRUCTURAL: Valvular Disease:
Tricuspid Copyright © 2022

<121>
Accession Number
2020112522
Title
TCT-363 Incidence and Timing of Device-Related Thrombus in Percutaneous
Implantable Cardiac Devices: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Thirty-Fourth
Annual Symposium Transcatheter Cardiovascular Therapeutics (TCT). Boston
United States. 80(12 Supplement) (pp B146-B147), 2022. Date of
Publication: 20 Sep 2022.
Author
Jung R.; Simard T.; Gillmore T.; Rizk M.; Di Santo P.; Joseph J.; Stotts
C.; Motazedian P.; Prosperi-Porta G.; Abdel-Razek O.; Parlow S.;
Lepage-Ratte M.; Shorr R.; Ramirez F.; Alkhouli M.; Rodes-Cabau J.; Holmes
D.; Hibbert B.
Institution
(Jung, Hibbert) University Of Ottawa Heart Institute, Ottawa, ON, Canada
(Simard, Alkhouli, Holmes) Mayo Clinic, MN, Rochester, United States
(Gillmore, Di Santo, Stotts, Prosperi-Porta, Lepage-Ratte, Ramirez)
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Rizk, Joseph) Ottawa Heart Institute, Ottawa, Canada
(Motazedian, Abdel-Razek) Ottawa Heart Institute, Ottawa, ON, Canada
(Parlow) University of Ottawa, Ottawa, ON, Canada
(Shorr) The Ottawa Hospital, Ottawa, ON, Canada
(Rodes-Cabau) University of Laval, Quebec, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Reported rates of device-related thrombus (DRT) in
percutaneous implantable cardiac devices (PICDs) is infrequent and
discerning the incidence has been hampered by variations in methodologies
and inconsistent follow-up. The objective of this study was to evaluate
the available data on the incidence of DRT formation within each
percutaneous implantable cardiac devices, measured in events per
patient-years by evaluating the published literature. Method(s): A
systematic review was performed by searching MEDLINE, Embase, and Cochrane
Central Register of Controlled Trials until September 28, 2020. The
Preferred Reporting Items for Systematic Review and Meta-Analysis
guidelines was used to obtain all available data from published literature
for DRT rates and outcomes of DRT. Result(s): Of the 4,875 studies
screened by titles and abstracts, a total of 301 studies with 81,943
patients were identified. Atrial septal defect (ASD)/patent foramen ovale
(PFO) closure was evaluated in 74 studies (n = 14,982), LAAO in 156
studies (n = 31,845), TAVR in 43 studies (n = 27,966), pacemaker in 19
studies (n = 4,347), and transcatheter mitral valve or tricuspid valve
replacement in 9 studies (n = 301). The mean follow-up ranged from less
than 1 to 12 years. DRT occurred in 1,882 patients (2.3%) and varied
according to the device (ASD/PFO 0.7% [95% CI: 0.6%-0.9%], LAAO 3.0% [95%
CI, 2.8%-3.2%], TAVI 2.2% [95% CI: 2.0%-2.3%], and pacemakers 4.9% [95%
CI, 4.2%-5.5%]). DRT was associated with an increased risk of stroke in
all structural heart devices, including pacemakers. Atrial fibrillation,
prior stroke, single antiplatelet therapy, and non-Amplatzer devices were
associated with an increased risk of DRT. Finally, there remains
heterogeneity in imaging modality, frequency of screening, and
antithrombotic regimen prescribed following device implantation.
 Conclusion(s): Our systematic review of all PICDs reveals DRT rate
ranging from 2% to 5%. Significant variability exists in the detection and
reporting of DRT in percutaneous implantable cardiac devices, with
variations in imaging modality and follow-up period to capture DRT.
Standardized surveillance and protocols are needed for all PICDs to better
quantify risk, prevention, and treatment during device development.
Categories: STRUCTURAL: Left Atrial Appendage Exclusion Copyright
© 2022

<122>
Accession Number
2018992521
Title
Healthcare-Associated Infective Endocarditis-Surgical Perspectives.
Source
Journal of Clinical Medicine. 11(17) (no pagination), 2022. Article
Number: 4957. Date of Publication: September 2022.
Author
Musci T.; Grubitzsch H.
Institution
(Musci, Grubitzsch) Charite-Universita Berlin, Klinik Fu Kardiovaskula
Chirurgie, Augustenburger Platz 1, Berlin 13353, Germany
Publisher
MDPI
Abstract
Health-care-associated infective endocarditis (HCA-IE), a disease with a
poor prognosis, has become increasingly important. As surgical treatment
is frequently required, this review aims to outline surgical perspectives
on HCA-IE. We searched PubMed to identify publications from January 1980
to March 2022. Reports were evaluated by the authors against a priori
inclusion/exclusion criteria. Studies reporting on surgical treatment of
HCA-IE including outcome were selected. Currently, HCA-IE accounts for up
to 47% of IE cases. Advanced age, cardiac implants, and comorbidity are
important predispositions, and intravascular catheters or frequent
vascular access are significant sources of infection. Staphylococci and
enterococci are the leading causative microorganisms. Surgery, although
frequently indicated, is rejected in 24-69% because of prohibitive risk.
In-hospital mortality is significant after surgery (29-50%) but highest in
patients rejected for operation (52-83%). Furthermore, the length of
hospital stay is prolonged. With aging populations, age-dependent
morbidity, increasing use of cardiac implants, and growing healthcare
utilization, HCA-IE is anticipated to gain further importance. A better
understanding of pathogenesis, clinical profile, and outcomes is
paramount. Further research on surgical treatment is needed to provide
more comprehensive information for defining the most suitable treatment
option, finding the optimal time for surgery, and reducing morbidity and
mortality. Copyright © 2022 by the authors.

<123>
Accession Number
2018866778
Title
Preoperative oral diazepam for intraoperative blood pressure stabilisation
in hypertensive patients undergoing vitrectomy under retrobulbar nerve
block anaesthesia: study protocol for a randomised controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 723. Date of
Publication: December 2022.
Author
Qian T.; Gong Q.; Chen C.; Wu X.; Xue L.; Fan Y.; Wang W.; Zhang Z.; Cao
H.; Xu X.
Institution
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) Department of
Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University,
Shanghai, China
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) National Clinical
Research Center for Eye Diseases, Shanghai, China
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) Shanghai Key
Laboratory of Ocular Fundus Diseases, Shanghai, China
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) Shanghai
Engineering Center for Visual Science and Photomedicine, Shanghai, China
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) Shanghai
Engineering Center for Precise Diagnosis and Treatment of Eye Disease,
Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: As a type of local anaesthesia, retrobulbar nerve block is
often used in vitrectomy, with patients remaining conscious during the
operation. The increase in systolic blood pressure (SBP) caused by tension
and fear during the operation-especially in patients with a history of
hypertension-can negatively impact the safety of the procedure, resulting
in suprachoroidal haemorrhage or retinal haemorrhage. Diazepam has a
sedative effect and can relieve tension during surgery. This study aims to
evaluate the efficacy and safety of diazepam for intraoperative BP
stabilisation in hypertensive patients under retrobulbar anaesthesia
during surgery. Method(s): This single-centre, double-blind,
randomised controlled and parallel clinical trial will include 180
hypertensive patients who will undergo vitrectomy with nerve block
anaesthesia. Study participants will be randomly allocated in a 1:1 ratio
to intervention (patients receiving oral diazepam before the operation)
and control (patients receiving oral placebo before the operation) groups.
The primary outcome is the effective rate of intraoperative BP control
(systolic BP during operation maintained at <160mmHg at all timepoints).
The secondary outcomes are the proportion of patients with SBP >=180 mmHg
at any timepoint from operation to 1 h post-operation, the change of mean
systolic blood pressure and mean heart rate during operation from
baseline, as well as the number of patients with intraoperative and
post-operative adverse reactions within 12 weeks of surgery. The logistic
regression model will be performed to compare the outcomes.
 Discussion(s): This study will evaluate the efficacy and safety of
diazepam for intraoperative BP stabilisation in hypertensive patients
under nerve block anaesthesia during surgery. The results of this trial
will reveal whether diazepam has a significant effect on intraoperative BP
stability in patients with a history of hypertension who require
vitrectomy. If the results of this trial are significant, a large-scale
multi-centre clinical trial can be designed. Trial registration: Chinese
Clinical Trial Registry (ChiCTR) ChiCTR2100041772. Registered on 5 January
2021. Copyright © 2022, The Author(s).

<124>
Accession Number
2018949577
Title
Double-lung versus heart-lung transplantation for end-stage
cardiopulmonary disease: a systematic review and meta-analysis.
Source
Surgery Today. (no pagination), 2022. Date of Publication: 2022.
Author
Yan H.-J.; Zheng X.-Y.; Huang H.; Xu L.; Tang H.-T.; Wang J.-J.; Li C.-H.;
Zhang S.-X.; Fu S.-Y.; Wen H.-Y.; Tian D.
Institution
(Yan, Tian) Department of Thoracic Surgery, West China Hospital, Sichuan
University, 37 Guo Xue Xiang, Chengdu 610041, China
(Yan, Zheng, Huang, Xu, Tang, Wang, Li, Zhang, Fu, Tian) Heart and Lung
Transplant Research Laboratory, Affiliated Hospital of North Sichuan
Medical College, Nanchong 637000, China
(Wen) Department of Cardiothoracic Intensive Care Unit, Affiliated
Hospital of North Sichuan Medical College, Nanchong 637000, China
Publisher
Springer
Abstract
We compared posttransplant outcomes following double-lung transplantation
(DLTx) and heart-lung transplantation (HLTx), based on a search of PubMed,
Cochrane Library, and Embase, from inception to March 8, 2022, for studies
that report outcomes of these procedures. We then performed a
meta-analysis of baseline characteristics and posttransplant outcomes.
Subgroup analyses were implemented according to indication, publication
year, and center. This study was registered on PROSPERO (number
CRD42020223493). Ten studies were included in this meta-analysis,
involving 1230 DLTx patients and 1022 HLTx patients. The DLTx group was
characterized by older donors (P = 0.04) and a longer allograft ischemia
time (P < 0.001) than the HLTx group. The two groups had comparable
1-year, 3-year, 5-year, 10-year survival rates (all P > 0.05), with
similar results identified in subgroup analyses. We found no significant
differences in 1-year, 5-year, and 10-year chronic lung allograft
dysfunction (CLAD)-free survival, length of intensive care unit stay and
hospital stay, length of postoperative ventilation, in-hospital mortality,
or surgical complications between the groups (all P > 0.05). Thus, DLTx
provides similar posttransplant survival to HLTx for end-stage
cardiopulmonary disease. These two procedures have a comparable risk of
CLAD and other posttransplant outcomes. Copyright © 2022, The
Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

<125>
Accession Number
639000786
Title
Is the world ready for the STICH 3.0 trial?.
Source
Current opinion in cardiology. (no pagination), 2022. Date of
Publication: 13 Sep 2022.
Author
Vervoort D.; Jolicoeur M.E.; Marquis-Gravel G.; Fremes S.E.
Institution
(Vervoort, Fremes) Institute of Health Policy, Management and Evaluation
(Vervoort, Fremes) Division of Cardiac Surgery, University of Toronto,
Toronto, ON, Canada
(Jolicoeur, Marquis-Gravel) Montreal Heart Institute, University of
Montreal, Montreal, QC, Canada
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Coronary artery disease (CAD) is responsible for >50%
of heart failures cases. Patients with ischemic left ventricular systolic
dysfunction (iLVSD) are known to have poorer outcomes after percutaneous
coronary intervention (PCI) and coronary artery bypass grafting (CABG)
compared to patients with a normal ejection fraction. Nevertheless, <1% of
patients in coronary revascularization trials to date had iLVSD. The
purpose of this review is to describe coronary revascularization
modalities in patients with iLVSD and highlight the need for randomized
controlled trial evidence comparing these treatments in this patient
population. RECENT FINDINGS: Network meta-analytic findings of
observational studies suggest that PCI is associated with higher rates of
mortality, cardiac death, myocardial infarction, and repeat
revascularization but not stroke compared to CABG in iLVSD. In recent
years, outcomes for patients undergoing PCI have improved as a result of
advances in technologies and techniques. SUMMARY: The optimal coronary
revascularization modality in patients with iLVSD remains unknown. In
observational studies, CABG appears superior to PCI; however, direct
randomized evidence is absent and developments in PCI techniques have
improved post-PCI outcomes in recent years. The Surgical Treatment for
Ischemic Heart Failure 3.0 consortium of trials will seek to address the
clinical equipoise in coronary revascularization in patients with
iLVSD. Copyright © 2022 Wolters Kluwer Health, Inc. All rights
reserved.

<126>
Accession Number
639000111
Title
Effect of a balanced colloid on acute kidney injury in paediatric cardiac
surgery: A post hoc analysis of a randomised controlled trial.
Source
European journal of anaesthesiology. (no pagination), 2022. Date of
Publication: 13 Sep 2022.
Author
Willems A.; Arend S.; Schmartz D.; Van der Linden P.
Institution
(Willems) From the Paediatric Intensive Care Unit, Department of Intensive
Care, Leiden University Medical Centre, Leiden, The Netherlands (AW),
Department of Anaesthesiology, University Hospital Brugmann and Queen
Fabiola University Children's Hospital, Brussels, Belgium (SA, DS, PVL)
Publisher
NLM (Medline)

<127>
Accession Number
638999739
Title
Comparison of transcatheter aortic valve replacement with the ACURATE neo2
versus Evolut PRO/PRO+ devices.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2022. Date of Publication: 12 Sep 2022.
Author
Baggio S.; Pagnesi M.; Kim W.-K.; Scotti A.; Barbanti M.; Costa G.; Adamo
M.; Kornowski R.; Vaknin-Assa H.; Estevez-Loureiro R.; Cedeno R.A.; De
Marco F.; Casenghi M.; Toggweiler S.; Veulemans V.; Mylotte D.; Lunardi
M.; Regazzoli D.; Reimers B.; Sondergaard L.; Vanhaverbeke M.; Nuyens P.;
Maffeo D.; Buono A.; Saccocci M.; Giannini F.; Di Ienno L.; Ferlini M.;
Lanzillo G.; Ielasi A.; Schofer J.; Brinkmann C.; Van Der Heyden J.;
Buysschaert I.; Eitan A.; Wolf A.; Adamaszek M.M.; Colombo A.; Latib A.;
Mangieri A.
Institution
(Baggio, Regazzoli, Reimers, Colombo, Mangieri) Department of Biomedical
Sciences, Humanitas University, Pieve Emanuele, Milan, Italy and Cardio
Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
(Pagnesi, Adamo) Cardiothoracic Department, ASST Spedali Civili di
Brescia, Italy and Department of Medical Surgical Specialties,
Radiological Sciences, Public Health, University of Brescia, Brescia,
Italy
(Kim) Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
(Scotti, Latib) Montefiore-Einstein Center for Heart and Vascular Care,
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
(Barbanti, Costa) Division of Cardiology, Catania, Italy
(Kornowski, Vaknin-Assa) Department of Cardiology, Faculty of Medicine,
Tel-Aviv University, Rabin Medical Center, Tel Aviv, Israel
(Estevez-Loureiro, Cedeno) Cardiology Department, University Hospital
Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain
(De Marco, Casenghi) Department of Clinical and Interventional Cardiology,
IRCCS Policlinico San Donato, Milan, Italy
(Toggweiler) Department of Cardiology, Heart Center Lucerne, Luzerner
Kantonsspital, Lucerne, Switzerland
(Veulemans) Division of Cardiology, Pulmonology and Vascular Medicine,
Heinrich Heine University, Medical Faculty, Dusseldorf, Germany
(Mylotte, Lunardi) Galway University Hospital, SAOLTA Health Care Group,
National University of Ireland, Galway, Ireland
(Sondergaard, Vanhaverbeke, Nuyens) Department of Cardiology,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Maffeo, Buono, Saccocci) Fondazione Poliambulanza, Brescia, Italy
(Giannini, Di Ienno) Interventional Cardiology Unit, GVM Care & Research,
Maria Cecilia Hospital, Cotignola, Italy
(Ferlini, Lanzillo) Division of Cardiology, Fondazione IRCCS Policlinico
San Matteo, Pavia, Italy
(Ielasi) Clinical and Interventional Cardiology Unit, Milan, Italy
(Schofer, Brinkmann) Medizinisches Versorgungszentrum, Hamburg, Germany
(Van Der Heyden, Buysschaert) Interventional Cardiology Unit, AZ Sint-Jan
Hospital, Brugge, Belgium
(Eitan) Department of Cardiology, Carmel Medical Center, Haifa, Israel
(Wolf, Adamaszek) Klinik fur Kardiologie, Elisabeth-Krankenhaus Essen,
Essen, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: The ACURATE neo2 (NEO2) and Evolut PRO/PRO+ (PRO)
bioprostheses are new-generation self-expanding valves developed for
transcatheter aortic valve replacement (TAVR). AIMS: We sought to compare
the performance of the ACURATE neo2 and Evolut PRO/PRO+ devices.
 METHOD(S): The NEOPRO-2 registry retrospectively included patients
who underwent TAVR for severe aortic stenosis with either the NEO2 or PRO
devices between August 2017 and December 2021 at 20 centres. In-hospital
and 30-day Valve Academic Research Consortium (VARC)-3 defined outcomes
were evaluated. Propensity score (PS) matching and binary logistic
regression were performed to adjust the treatment effect for PS quintiles.
A subgroup analysis assessed the impact of aortic valve calcification.
 RESULT(S): A total of 2,175 patients (NEO2: n=763; PRO: n=1,412) were
included. The mean age was 82+/-6.2 years and the mean Society of Thoracic
Surgeons score was 4.2%. Periprocedural complications were low, and both
groups achieved high rates of technical success (93.1% vs 94.1%; p=0.361)
and predischarge intended valve performance (96.0% vs 94.1%; p=0.056),
both in the unmatched and matched analysis (452 pairs). Device success at
30 days was comparable (84.3% vs 83.6%; p=0.688), regardless of aortic
valve calcification severity (p>0.05 for interaction). A suggestion for
higher VARC-3 early safety in the NEO2 group was mainly driven by reduced
rates of new permanent pacemaker implantation (7.7% vs 15.6%; p<0.001).
 CONCLUSION(S): This retrospective analysis reports a similar
short-term performance of the ACURATE neo2 platform compared with the
new-generation Evolut PRO/PRO+ devices. Randomised studies are needed to
confirm our exploratory findings.

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