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<1>
Accession Number
2017046944
Title
Propensity-Matched 1-Year Outcomes Following Transcatheter Aortic Valve
Replacement in Low-Risk Bicuspid and Tricuspid Patients.
Source
JACC: Cardiovascular Interventions. 15(5) (pp 511-522), 2022. Date of
Publication: 14 Mar 2022.
Author
Deeb G.M.; Reardon M.J.; Ramlawi B.; Yakubov S.J.; Chetcuti S.J.; Kleiman
N.S.; Mangi A.A.; Zahr F.; Song H.K.; Gada H.; Mumtaz M.; Heiser J.; Merhi
W.; Murrah C.P.; Noel T.; Kirshner M.; Byrne T.; Ito S.; Huang J.; Forrest
J.K.
Institution
(Deeb) Department of Cardiac Surgery, University of Michigan Hospitals,
Ann Arbor, MN, United States
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist DeBakey
Heart and Vascular Institute, Houston, TX, United States
(Ramlawi) Department of Cardiothoracic Surgery, Valley Health, Winchester,
Virginia, United States
(Yakubov) Department of Interventional Cardiology, Riverside
Methodist-OhioHealth, Columbus, OH, United States
(Chetcuti) Department of Interventional Cardiology, University of Michigan
Hospitals, Ann Arbor, MN, United States
(Kleiman) Department of Interventional Cardiology, Houston Methodist
DeBakey Heart and Vascular Institute, Houston, TX, United States
(Mangi) Department of Surgery (Cardiac Surgery), Yale University School of
Medicine, New Haven, CT, United States
(Zahr) Department of Interventional Cardiology, Oregon Health and Science
University, Portland, OR, United States
(Song) Department of Cardiothoracic Surgery, Oregon Health and Science
University, Portland, OR, United States
(Gada) Department of Interventional Cardiology, University of Pittsburgh
Pinnacle, Wormsleyburg, Pennsylvani, United States
(Mumtaz) Department of Cardiothooracic Surgery, University of Pittsburgh
Pinnacle, Wormsleyburg, PA, United States
(Heiser) Department of Cardiothoracic Surgery, Spectrum Health, Grand
Rapids, MN, United States
(Merhi) Department of Interventional Cardiology, Spectrum Health, Grand
Rapids, MN, United States
(Murrah) Department of Cardiothoracic Surgery, Tallahassee Research
Institute, Tallahassee, FL, United States
(Noel) Department of Interventional Cardiology, Tallahassee Research
Institute, Tallahassee, FL, United States
(Kirshner) Department of Cardiothoracic Surgery, Abrazo Arizona Heart
Hospital, Phoenix, AZ, United States
(Byrne) Department of Interventional Cardiology, Abrazo Arizona Heart
Hospital, Phoenix, AZ, United States
(Ito) Division of Cardiovascular Ultrasound, Mayo Clinic, Rochester, MN,
United States
(Huang) Department of Statistics, Medtronic, Minneapolis, MN, United
States
(Forrest) Department of Internal Medicine (Cardiology), Yale University
School of Medicine, New Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to compare 1-year outcomes after
transcatheter aortic valve replacement (TAVR) in low surgical risk
patients with bicuspid aortic stenosis to patients with tricuspid aortic
stenosis. Background(s): The pivotal TAVR trials excluded patients
with bicuspid aortic valves. The Low Risk Bicuspid Study 30-day primary
endpoint of death or disabling stroke was 1.3%. Method(s): The Low
Risk Bicuspid Study is a prospective, single-arm, TAVR trial that enrolled
patients from 25 U.S. sites. A screening committee confirmed bicuspid
anatomy and valve classification on computed tomography using the Sievers
classification. Valve sizing was by annular measurements. An independent
clinical events committee adjudicated all serious adverse events, and an
independent core laboratory assessed all echocardiograms. The 150 patients
from the Low Risk Bicuspid Study were propensity matched to the TAVR
patients in the randomized Evolut Low Risk Trial using the 1:1 5-
to-1-digit greedy method, resulting in 145 pairs. Result(s):
All-cause mortality or disabling stroke at 1 year was 1.4% in the bicuspid
and 2.8% in the tricuspid group (P = 0.413). A pacemaker was implanted in
16.6% of bicuspid and 17.9% of tricuspid patients (P = 0.741). The
effective orifice area was similar between groups at 1 year (2.2 +/- 0.7
cm2 vs 2.3 +/- 0.6 cm2, P = 0.677) as was the mean
gradient (8.7 +/- 3.9 mm Hg vs 8.5 +/- 3.1 mm Hg, P = 0.754). Fewer
patients in the bicuspid group had mild or worse paravalvular leak (21.3%
vs 42.6%, P < 0.001). Conclusion(s): There were no significant
differences in clinical or forward flow hemodynamic outcomes between the
propensity-matched groups at 1 year. Copyright © 2022 American
College of Cardiology Foundation

<2>
Accession Number
2010851713
Title
Progression of Tricuspid Regurgitation After Surgery for Ischemic Mitral
Regurgitation.
Source
Journal of the American College of Cardiology. 77(6) (pp 713-724), 2021.
Date of Publication: 16 Feb 2021.
Author
Bertrand P.B.; Overbey J.R.; Zeng X.; Levine R.A.; Ailawadi G.; Acker
M.A.; Smith P.K.; Thourani V.H.; Bagiella E.; Miller M.A.; Gupta L.; Mack
M.J.; Gillinov A.M.; Giustino G.; Moskowitz A.J.; Gelijns A.C.; Bowdish
M.E.; O'Gara P.T.; Gammie J.S.; Hung J.; Taddei-Peters W.C.; Buxton D.;
Caulder R.; Geller N.L.; Gordon D.; Jeffries N.O.; Lee A.; Moy C.S.;
Gombos I.K.; Ralph J.; Weisel R.D.; Gardner T.J.; Rose E.A.; Parides M.K.;
Ascheim D.D.; Moquete E.; Chang H.; Chase M.; Foo J.; Chen Y.; Goldfarb
S.; Kirkwood K.; Dobrev E.; Levitan R.; O'Sullivan K.; Overbey J.; Santos
M.; Williams D.; Weglinski M.; Williams P.; Wood C.; Ye X.; Nielsen S.L.;
Wiggers H.; Malgaard H.; Mack M.; Adame T.; Settele N.; Adams J.; Ryan W.;
Smith R.L.; Grayburn P.; Chen F.Y.; Nohria A.; Cohn L.; Shekar P.; Aranki
S.; Couper G.; Davidson M.; Bolman R.M.; Burgess A.; Conboy D.; Lawrence
R.; Noiseux N.; Stevens L.-M.; Prieto I.; Basile F.; Dionne J.; Fecteau
J.; Blackstone E.H.; Lackner P.; Berroteran L.; Dolney D.; Fleming S.;
Palumbo R.; Whitman C.; Sankovic K.; Sweeney D.K.; Geither C.; Doud K.;
Pattakos G.; Clarke P.A.; Argenziano M.; Williams M.; Goldsmith L.; Smith
C.R.; Naka Y.; Stewart A.; Schwartz A.; Bell D.; Van Patten D.; Sreekanth
S.; Alexander J.H.; Milano C.A.; Glower D.D.; Mathew J.P.; Harrison J.K.;
Welsh S.; Berry M.F.; Parsa C.J.; Tong B.C.; Williams J.B.; Ferguson T.B.;
Kypson A.P.; Rodriguez E.; Harris M.; Akers B.; O'Neal A.; Puskas J.D.;
Guyton R.; Baer J.; Baio K.; Neill A.A.; Voisine P.; Senechal M.; Dagenais
F.; O'Connor K.; Dussault G.; Ballivian T.; Keilani S.; Speir A.M.; Magee
P.; Ad N.; Keyte S.; Dang M.; Slaughter M.; Headlee M.; Moody H.; Solankhi
N.; Birks E.; Groh M.A.; Shell L.E.; Shepard S.A.; Trichon B.H.; Nanney
T.; Hampton L.C.; Mangusan R.; Michler R.E.; D'Alessandro D.A.; DeRose
J.J.; Goldstein D.J.; Bello R.; Jakobleff W.; Garcia M.; Taub C.; Spevak
D.; Swayze R.; Sookraj N.; Perrault L.P.; Basmadjian A.-J.; Bouchard D.;
Carrier M.; Cartier R.; Pellerin M.; Tanguay J.F.; El-Hamamsy I.; Denault
A.; Demers P.; Jonathan Lacharite S.R.; Horvath K.A.; Corcoran P.C.;
Siegenthaler M.P.; Murphy M.; Iraola M.; Greenberg A.; Sai-Sudhakar C.;
Hasan A.; McDavid A.; Kinn B.; Page P.; Sirois C.; Latter D.; Leong-Poi
H.; Bonneau D.; Errett L.; Peterson M.D.; Verma S.; Feder-Elituv R.; Cohen
G.; Joyner C.; Fremes S.E.; Moussa F.; Christakis G.; Karkhanis R.; Yau
T.; Farkouh M.; Woo A.; Cusimano R.J.; David T.; Feindel C.; Garrard L.;
Fredericks S.; Mociornita A.; Mullen J.C.; Choy J.; Meyer S.; Kuurstra E.;
Young C.A.; Beach D.; Villanueva R.; Atluri P.; Woo Y.J.; Mayer M.L.;
Bowdish M.; Starnes V.A.; Shavalle D.; Matthews R.; Javadifar S.; Romar
L.; Kron I.L.; Johnston K.; Dent J.M.; Kern J.; Keim J.; Burks S.; Gahring
K.; Bull D.A.; Desvigne-Nickens P.; Dixon D.O.; Haigney M.; Holubkov R.;
Jacobs A.; Miller F.; Murkin J.M.; Spertus J.; Wechsler A.S.; Sellke F.;
McDonald C.L.; Byington R.; Dickert N.; Ikonomidis J.S.; Williams D.O.;
Yancy C.W.; Fang J.C.; Giannetti N.; Richenbacher W.; Rao V.; Furie K.L.;
Miller R.; Pinney S.; Roberts W.C.; Walsh M.N.; Kilcullen N.; Hung D.;
Keteyian S.J.; Brawner C.A.; Aldred H.; Browndyke J.; Toulgoat-Dubois Y.
Institution
(Bertrand, Zeng, Levine, Hung) Division of Cardiology, Massachusetts
General Hospital, Boston, MD, United States
(Overbey, Bagiella, Gupta, Giustino, Moskowitz, Gelijns) Department of
Population Health Science and Policy, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Ailawadi) Section of Adult Cardiac Surgery, University of Virginia,
Charlottesville, VA, United States
(Acker) Division of Cardiovascular Surgery, Department of Surgery,
University of Pennsylvania School of Medicine, Philadelphia, PA, United
States
(Smith) Department of Surgery, Duke University Medical Center, Durham, NC,
United States
(Thourani) Cardiothoracic Surgery, Piedmont Heart Institute, Atlanta, GA,
United States
(Miller) Division of Cardiovascular Sciences, National Heart, Lung, and
Blood Institute, National Institutes of Health, Bethesda, MD, United
States
(Mack) Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott &
White Health, Plano, TX, United States
(Gillinov) Department of Thoracic & Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Bowdish) Department of Surgery, Keck School of Medicine, University of
Southern California, Los Angeles, CA, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MD, United States
(Gammie) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Background: Whether to repair nonsevere tricuspid regurgitation (TR)
during surgery for ischemic mitral valve regurgitation (IMR) remains
uncertain. Objective(s): The goal of this study was to investigate
the incidence, predictors, and clinical significance of TR progression and
presence of >=moderate TR after IMR surgery. Method(s): Patients (n =
492) with untreated nonsevere TR within 2 prospectively randomized IMR
trials were included. Key outcomes were TR progression (either progression
by >=2 grades, surgery for TR, or severe TR at 2 years) and presence of
>=moderate TR at 2 years. Result(s): Patients' mean age was 66 +/- 10
years (67% male), and TR distribution was 60% <=trace, 31% mild, and 9%
moderate. Among 2-year survivors, TR progression occurred in 20 (6%) of
325 patients. Baseline tricuspid annular diameter (TAD) was not predictive
of TR progression. At 2 years, 37 (11%) of 323 patients had >=moderate TR.
Baseline TR grade, indexed TAD, and surgical ablation for atrial
fibrillation were independent predictors of >=moderate TR. However, TAD
alone had poor discrimination (area under the curve, <=0.65). Presence of
>=moderate TR at 2 years was higher in patients with MR recurrence (20%
vs. 9%; p = 0.02) and a permanent pacemaker/defibrillator (19% vs. 9%; p =
0.01). Clinical event rates (composite of >=1 New York Heart Association
functional class increase, heart failure hospitalization, mitral valve
surgery, and stroke) were higher in patients with TR progression (55% vs.
23%; p = 0.003) and >=moderate TR at 2 years (38% vs. 22%; p = 0.04).
 Conclusion(s): After IMR surgery, progression of unrepaired nonsevere
TR is uncommon. Baseline TAD is not predictive of TR progression and is
poorly discriminative of >=moderate TR at 2 years. TR progression and
presence of >=moderate TR are associated with clinical events. (Comparing
the Effectiveness of a Mitral Valve Repair Procedure in Combination With
Coronary Artery Bypass Grafting [CABG] Versus CABG Alone in People With
Moderate Ischemic Mitral Regurgitation, NCT00806988; Comparing the
Effectiveness of Repairing Versus Replacing the Heart's Mitral Valve in
People With Severe Chronic Ischemic Mitral Regurgitation,
NCT00807040) Copyright © 2021 American College of Cardiology
Foundation

<3>
Accession Number
629596918
Title
Pragmatic randomised clinical trial of proton versus photon therapy for
patients with non-metastatic breast cancer: The Radiotherapy Comparative
Effectiveness (RadComp) Consortium trial protocol.
Source
BMJ Open. 9(10) (no pagination), 2019. Article Number: e025556. Date of
Publication: 01 Oct 2019.
Author
Bekelman J.E.; Lu H.; Pugh S.; Baker K.; Berg C.D.; De Gonzalez A.B.;
Braunstein L.Z.; Bosch W.; Chauhan C.; Ellenberg S.; Fang L.C.; Freedman
G.M.; Hahn E.A.; Haffty B.G.; Khan A.J.; Jimenez R.B.; Kesslering C.; Ky
B.; Lee C.; Lu H.-M.; Mishra M.V.; Mullins C.D.; Mutter R.W.; Nagda S.;
Pankuch M.; Powell S.N.; Prior F.W.; Schupak K.; Taghian A.G.; Wilkinson
J.B.; Macdonald S.M.; Cahlon O.
Institution
(Bekelman, Lu, Freedman, Nagda) Department of Radiation Oncology,
University of Pennsylvania Perelman, School of Medicine, Philadelphia, PA,
United States
(Pugh) American College of Radiology, Philadelphia, PA, United States
(Baker, Mishra) Department of Radiation Oncology, University of Maryland,
School of Medicine, Baltimore, MD, United States
(Berg, De Gonzalez, Lee) Division of Cancer Epidemiology and Genetics,
National Cancer Institute, National Institutes of Health, Bethesda, MD,
United States
(Braunstein, Khan, Powell, Schupak, Cahlon) Department of Radiation
Oncology, Memorial Sloan Kettering Cancer Center, New York city, NY,
United States
(Bosch) Department of Radiation Oncology, Washington University in St.
Louis, St. Louis, MO, United States
(Chauhan) Mayo Clinic Minnesota, Rochester, MN, United States
(Ellenberg) Department of Biostatistics Epidemiology and Informatics,
University of Pennsylvania Perelman, School of Medicine, Philadelphia, PA,
United States
(Fang) Department of Radiation Oncology, University of Washington, School
of Medicine, Seattle, WA, United States
(Hahn) Department of Medical Social Sciences, Northwestern University,
Evanston, IL, United States
(Haffty) Department of Radiation Oncology, Rutgers Cancer Institute of New
Jersey, New Brunswick, NJ, United States
(Jimenez, Lu, Taghian, Macdonald) Department of Radiation Oncology,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Kesslering, Pankuch) Northwestern Medicine Chicago Proton Center,
Warrenville, IL, United States
(Ky) Cardio-Oncology Program, Division of Cardiovascular Medicine,
University of Pennsylvania Perelman, School of Medicine, Philadelphia, PA,
United States
(Mullins) PHSR, University of Maryland, School of Pharmacy, Baltimore, MD,
United States
(Mutter) Department of Radiation Oncology, Mayo Clinic, Rochester, MN,
United States
(Prior) Department of Biomedical Informatics, University of Arkansas for
Medical Sciences, Little Rock, AR, United States
(Wilkinson) Provision Proton Therapy Center, Knoxville, TN, United States
Publisher
BMJ Publishing Group
Abstract
Introduction A broad range of stakeholders have called for randomised
evidence on the potential clinical benefits and harms of proton therapy, a
type of radiation therapy, for patients with breast cancer. Radiation
therapy is an important component of curative treatment, reducing cancer
recurrence and extending survival. Compared with photon therapy, the
international treatment standard, proton therapy reduces incidental
radiation to the heart. Our overall objective is to evaluate whether the
differences between proton and photon therapy cardiac radiation dose
distributions lead to meaningful reductions in cardiac morbidity and
mortality after treatment for breast cancer. Methods We are conducting a
large scale, multicentre pragmatic randomised clinical trial for patients
with breast cancer who will be followed longitudinally for cardiovascular
morbidity and mortality, health-related quality of life and cancer control
outcomes. A total of 1278 patients with non-metastatic breast cancer will
be randomly allocated to receive either photon or proton therapy. The
primary outcomes are major cardiovascular events, defined as myocardial
infarction, coronary revascularisation, cardiovascular death or
hospitalisation for unstable angina, heart failure, valvular disease,
arrhythmia or pericardial disease. Secondary endpoints are urgent or
unanticipated outpatient or emergency room visits for heart failure,
arrhythmia, valvular disease or pericardial disease. The Radiotherapy
Comparative Effectiveness (RadComp) Clinical Events Centre will conduct
centralised, blinded adjudication of primary outcome events. Ethics and
dissemination The RadComp trial has been approved by the institutional
review boards of all participating sites. Recruitment began in February
2016. Current version of the protocol is A3, dated 08 November 2018.
Dissemination plans include presentations at scientific conferences,
scientific publications, stakeholder engagement efforts and presentation
to the public via lay media outlets. Trial registration number
NCT02603341. Copyright © Author(s) (or their employer(s)) 2019.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<4>
[Use Link to view the full text]
Accession Number
600686586
Title
Effects of sevoflurane and propofol on frontal electroencephalogram power
and coherence.
Source
Anesthesiology. 121(5) (pp 990-998), 2014. Date of Publication: 04 Nov
2014.
Author
Akeju O.; Westover M.B.; Pavone K.J.; Sampson A.L.; Hartnack K.E.; Brown
E.N.; Purdon P.L.
Institution
(Akeju, Pavone, Sampson, Hartnack, Brown, Purdon) Department of
Anesthesia, Critical Care, and Pain Medicine, Massachusetts General
Hospital, 149 13th Street, Rm 4005, Boston, MA 02129, United States
(Westover) Department of Neurology, Massachusetts General Hospital,
Boston, MA, United States
(Akeju, Brown, Purdon) Harvard Medical School, Boston, MA, United States
(Westover, Brown, Purdon) Department of Brain and Cognitive Science,
Massachusetts Institute of Technology, Cambridge, MA, United States
(Brown) Harvard-Massachusetts Institute of Technology Division of Health
Sciences and Technology, Massachusetts Institute of Technology, Cambridge,
MA, United States
(Brown) Institute for Medical Engineering and Sciences, Massachusetts
Institute of Technology, Cambridge, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The neural mechanisms of anesthetic vapors have not been
studied in depth. However, modeling and experimental studies on the
intravenous anesthetic propofol indicate that potentiation of
?-Aminobutyric acid receptors leads to a state of thalamocortical
synchrony, observed as coherent frontal alpha oscillations, associated
with unconsciousness. Sevoflurane, an ether derivative, also potentiates
?-Aminobutyric acid receptors. However, in humans, sevoflurane-induced
coherent frontal alpha oscillations have not been well detailed.
Methods: To study the electroencephalogram dynamics induced by
sevoflurane, the authors identified age- and sex-matched patients in which
sevoflurane (n = 30) or propofol (n = 30) was used as the sole agent for
maintenance of general anesthesia during routine surgery. The authors
compared the electroencephalogram signatures of sevoflurane with that of
propofol using time-varying spectral and coherence methods.
Results: Sevoflurane general anesthesia is characterized by alpha
oscillations with maximum power and coherence at approximately 10 Hz,
(mean +/- SD; peak power, 4.3 +/- 3.5 dB; peak coherence, 0.73 +/- 0.1).
These alpha oscillations are similar to those observed during propofol
general anesthesia, which also has maximum power and coherence at
approximately 10 Hz (peak power, 2.1 +/- 4.3 dB; peak coherence, 0.71 +/-
0.1). However, sevoflurane also exhibited a distinct theta coherence
signature (peak frequency, 4.9 +/- 0.6 Hz; peak coherence, 0.58 +/- 0.1).
Slow oscillations were observed in both cases, with no significant
difference in power or coherence.
Conclusions: The study results indicate that sevoflurane, like propofol,
induces coherent frontal alpha oscillations and slow oscillations in
humans to sustain the anesthesia-induced unconscious state. These results
suggest a shared molecular and systems-level mechanism for the unconscious
state induced by these drugs. © 2014, the American Society of
Anesthesiologists, Inc.

<5>
Accession Number
2016088230
Title
The role of electrophysiology study in risk stratification of cardiac
sarcoidosis patients: Meta-analyses and systemic review.
Source
International Journal of Cardiology. 349 (pp 55-61), 2022. Date of
Publication: 15 Feb 2022.
Author
Adhaduk M.; Paudel B.; Liu K.; Ashwath M.; Giudici M.
Institution
(Adhaduk, Paudel, Liu, Ashwath, Giudici) The University of Iowa, United
States
Publisher
Elsevier Ireland Ltd
Abstract
Background: The utility of an electrophysiologic study (EPS) in the risk
stratification of cardiac sarcoidosis (CS) patients is not clear. We
conducted a systemic review and meta-analysis to evaluate the utility of
EPS in the risk stratification of CS patients. Method(s): We searched
PubMed, Embase, and Scopus databases from their inception to 12/4/2020
with search terms "Cardiac sarcoidosis" And "Electrophysiological studies
OR ablation". The first and second authors reviewed all the studies. We
extracted the data of positive and negative EPS, and outcomes defined as
ventricular arrhythmias, implantable cardioverter defibrillator therapy,
death, left ventricular assist device placement, or heart transplantation.
Risk of bias assessment was done by the Quality Assessment of Diagnostic
Accuracy Studies-2 tool. Subgroup analysis of patients with left
ventricular ejection fraction (LVEF) >35%, and probable CS, no prior
ventricular tachycardia (VT) and LVEF >35% were performed. Result(s):
We found 544 articles after removing duplicates. A total of 52 full
articles were reviewed, and eight studies were included in the
meta-analysis. The pooled sensitivity and specificity (95% confidence
interval) of EPS in predicting clinical outcomes were 0.70 (0.51-0.85) and
0.93 (0.85-0.97), respectively. Subgroup analysis of patients with LVEF
>35% resulted in pooled sensitivity of 0.63 (0.29-0.88) and pooled
specificity of 0.97 (0.92-0.99), and subgroup analysis of patients with
probable CS, no prior VT, and LVEF >35% resulted in pooled sensitivity of
0.71 (0.33-0.93) and pooled specificity of 0.96 (0.88-0.99) in predicting
adverse clinical outcomes. Conclusion(s): EPS is an effective risk
stratification tool in patients with CS across all subgroups with high
sensitivity and specificity. Copyright © 2021 Elsevier B.V.

<6>
Accession Number
2016011064
Title
Blood conservation outcomes and safety of tranexamic acid in coronary
artery bypass graft surgery.
Source
International Journal of Cardiology. 348 (pp 50-56), 2022. Date of
Publication: 01 Feb 2022.
Author
Wang E.; Yuan X.; Wang Y.; Chen W.; Zhou X.; Hu S.; Yuan S.
Institution
(Wang, Yuan, Zhou, Hu) Department of Cardiovascular Surgery, Fuwai
Hospital, Chinese Academy of Medical Sciences, Peking Union Medical
College, Xicheng District, Beijing 100037, China
(Yuan) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences, Peking Union Medical College, Xicheng District, Beijing
100037, China
(Wang) Medical Research & Biometrics Center, National Center for
Cardiovascular Diseases, Xicheng District, Beijing 100037, China
(Chen) Information Center, Fuwai Hospital, Chinese Academy of Medical
Sciences, Peking Union Medical College, Xicheng District, Beijing 100037,
China
Publisher
Elsevier Ireland Ltd
Abstract
Background: The safety and blood management effects of Tranexamic acid
(TXA) and its dose effects in coronary artery bypass graft (CABG) were
still ambiguous. This study aimed to analyze these TXA effects.
 Method(s): Overall, 42,010 patients undergoing CABG were enrolled in
this retrospective cohort study. Patients were assigned to the TXA group
(n = 29,536) and the no-TXA group (n = 12,474). Furthermore, the TXA group
was divided into the high-dose (>=50 mg/kg) (16,488) and the low-dose (<50
mg/kg) (13,048) subgroup. Propensity score matching was performed in both
groups respectively. The primary endpoint after CABG was composed of
hospital death, perioperative myocardial infarction (PMI), stroke, acute
kidney injury (AKI), and pulmonary embolism. The secondary endpoint
included blood loss and blood transfusion after surgery. Result(s):
TXA led to a 1.40-fold risk of PMI (p < 0.001). Patients in the TXA group
had fewer re-operations for bleeding or tamponade [Odd ratio (OR) = 0.82,
p = 0.044], less blood loss after surgery (p < 0.001), and a lower risk
for blood transfusion exposure (OR = 0.45, p < 0.001) than those in the
no-TXA group. The high-dose TXA reduced blood loss after cardiac surgery
compared to the low-dose TXA (p < 0.001) with no associations with blood
exposure or adverse events. Conclusion(s): The use of TXA during CABG
increased the risk of PMI despite better blood control after surgery. The
high dose of TXA acquired better bleeding management. Meanwhile, it did
not increase the risk of primary endpoint. Copyright © 2021 The
Authors

<7>
Accession Number
2015912713
Title
Annular size and interaction with trans-catheter aortic valves for
treatment of severe bicuspid aortic valve stenosis: Insights from the BEAT
registry.
Source
International Journal of Cardiology. 349 (pp 31-38), 2022. Date of
Publication: 15 Feb 2022.
Author
Moscarella E.; Mangieri A.; Giannini F.; Tchetche D.; Kim W.-K.; Sinning
J.-M.; Landes U.; Kornowski R.; De Backer O.; Nickenig G.; De Biase C.;
Sondergaard L.; De Marco F.; Bedogni F.; Ancona M.; Montorfano M.;
Regazzoli D.; Stefanini G.; Toggweiler S.; Tamburino C.; Imme S.;
Tarantini G.; Sievert H.; Schafer U.; Kempfert J.; Woehrle J.; Latib A.;
Calabro P.; Medda M.; Tespili M.; Colombo A.; Ielasi A.
Institution
(Moscarella, Calabro) Department of Translational Medical Sciences,
University of Campania "Luigi Vanvitelli", Naples, Italy
(Mangieri, Giannini) Department of Biomedical Sciences, Humanitas
University, Pieve Emanuele, Milan 20090, Italy
(Tchetche, De Biase, Colombo) Groupe CardioVasculaire Interventionnel,
Clinique Pasteur, Toulouse, France
(Kim) Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim,
Germany
(Sinning, Nickenig) Cardiology Department, University Hospital Bonn, Bonn,
Germany
(Landes, Kornowski) Cardiology Department, Rabin Medical Center, Petah
Tikva, Israel
(De Backer, Sondergaard) The Heart Center-Rigshospitalet, Copenhagen,
Denmark
(De Marco, Bedogni) Department of Cardiology, IRCCS Policlinico San
Donato, Milan, Italy
(Ancona, Montorfano) San Raffaele Scientific Institute, Milan, Italy
(Regazzoli, Stefanini) Department of Biomedical Sciences, Humanitas
University, Pieve Emanuele, Milan, Italy
(Stefanini) Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
(Toggweiler) Heart Center Lucerne, Luzerner Kantonsspital, Lucerne,
Switzerland
(Tamburino) Cardiology Division, CAST Policlinico Hospital, University of
Catania, Catania, Italy
(Imme) Centro Cuore Morgagni, Catania, Italy
(Tarantini) Interventional Cardiology Unit, University of Padova, Italy
(Sievert) Cardiovascular Center Frankfurt, Frankfurt, Germany
(Schafer) UKE Hamburg, Hamburg, Germany
(Kempfert) Deutsches Herzzentrum Berlin, Charite Universitatsmedizin,
Berlin, Germany
(Woehrle) Ulm University, Ulm, Germany
(Latib) Department of Cardiology, Montefiore Medical Center, New York, NY,
United States
(Latib) Division of Cardiology, Department of Medicine, University of Cape
Town, Cape Town, South Africa
(Medda, Tespili, Ielasi) Clinical and Interventional Cardiology Unit,
Istituto Clinico Sant'Ambrogio, Milan, Italy
(Colombo) EMO GVM Centro Cuore Columbus, Milan, Italy
(Mangieri, Giannini) Humanitas Research Hospital IRCCS, Rozzano-Milan,
Italy
(Sievert) Anglia Ruskin University, Chelmsford, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is safe and
feasible in patients with bicuspid aortic valve (BAV), but whether annular
size may influence TAVR results in BAV patients remains unclear. We aimed
at evaluating the impact of aortic annular size on procedural and clinical
outcomes of BAV patients undergoing TAVR, as well as potential
interactions between annular dimension and trans-catheter heart valve
(THV) type (balloon-expandable (BEV) vs. self-expanding (SEV).
 Method(s): BEAT is a multicenter registry of consecutive BAV stenosis
undergoing TAVR. For this sub-study patients were classified according to
annular dimension in small-annulus (area < 400 mm2 or perimeter
<72 mm), medium-annulus (area >= 400 and < 575 mm2, perimeter
>=72 mm and< 85 mm), large-annulus (area >= 575 mm2 or
perimeter >=85 mm). Primary endpoint was Valve Academic Research
Consortium-2 (VARC-2) device success. Result(s): 45(15.5%) patients
had small, 132(45.3%) medium, and 114(39.2%) large annuli. Compared with
other groups, patients with large annuli were more frequently male,
younger, with higher body mass index, larger aortic valve area, higher
rate of moderate-severe calcification, lower mean trans-aortic valve
gradient and lower left ventricular ejection fraction. In large-annuli
SEVs were associated with a lower VARC-2 device success (75.9% vs. 90.6%,
p = 0.049) driven by a higher rate of paravalvular valvular leak (PVL)
compared to BEVs (20.7% vs. 1.2%, p < 0.001). However, no differences in
clinical outcomes were observed according to annular size nor THV type.
 Conclusion(s): TAVR in BAV patients is feasible irrespective of
annular size. However in patients with large aortic annulus SEVs were
associated with a significantly higher rate of PVLs compared to
BEVs. Copyright © 2021

<8>
Accession Number
2013785921
Title
Iron supplementation for patients undergoing cardiac surgery: a systematic
review and meta-analysis of randomized controlled trials.
Source
Canadian Journal of Anesthesia. 69(1) (pp 129-139), 2022. Date of
Publication: January 2022.
Author
Yang S.S.; Al Kharusi L.; Gosselin A.; Chirico A.; Baradari P.G.; Cameron
M.J.
Institution
(Yang, Al Kharusi, Gosselin, Chirico, Baradari, Cameron) Faculty of
Medicine, McGill University, Montreal, QC, Canada
(Yang, Cameron) Division of Critical Care, Department of Anesthesia,
Jewish General Hospital, K1400-3755, Cote Sainte Catherine, Montreal, QC
H3T 1E2, Canada
Publisher
Springer
Abstract
Purpose: Iron supplementation has been evaluated in several randomized
controlled trials (RCTs) for its potential to increase baseline hemoglobin
and decrease red blood cell transfusion during cardiac surgery. This
study's main objective was to evaluate the current evidence for iron
administration in cardiac surgery patients. Method(s): We searched
MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar
from inception to 19 November 2020 for RCTs evaluating perioperative iron
administration in adult patients undergoing cardiac surgery. The RCTs were
assessed using a risk of bias assessment and the quality of evidence was
assessed using the grading of recommendations, assessments, development,
and evaluations. Result(s): We reviewed 1,767 citations, and five
studies (n = 554) met the inclusion criteria. The use of iron showed no
statistical difference in incidence of transfusion (risk ratio, 0.86; 95%
confidence interval, 0.65 to 1.13). Trial sequential analysis suggested an
optimal information size of 1,132 participants, which the accrued
information size did not reach. Conclusion(s): The current literature
does not support or refute the routine use of iron therapy in cardiac
surgery patients. Trial registration: PROSPERO (CRD42020161927);
registered 19 December 2019. Copyright © 2021, Canadian
Anesthesiologists' Society.

<9>
Accession Number
636036098
Title
Thoracic Paravertebral Block Ameliorates Postoperative Delirium in
Geriatric Patients.
Source
Thoracic and Cardiovascular Surgeon. 70(5) (pp 439-444), 2022. Date of
Publication: 01 Aug 2022.
Author
Heng L.; Wang M.; Li L.; Zhu S.
Institution
(Heng, Zhu) Department of Anesthesia, Xuzhou Cancer Hospital, Jiangsu
Province, Xuzhou City, China
(Wang) Department of Anesthesia, Xuzhou Maternity and Child Health Care
Hospital, Jiangsu Province, Xuzhou City, China
(Wang) Department of Anesthesia, The People's Hospital of Jiawang District
of Xuzhou, Jiangsu Province, Xuzhou City, China
(Li) Intensive Care Unit, Xuzhou No. 1 People's Hospital, College Road,
Jiangsu Province, Xuzhou City, China
Publisher
Georg Thieme Verlag
Abstract
Objectives ?Thoracic surgery often causes postoperative delirium (POD) in
geriatric patients. This study aimed to explore the effect of
ultrasound-guided continuous thoracic paravertebral block (UG-TPVB) on POD
in geriatric patients undergoing pulmonary resection. Methods ?Total 128
patients who underwent pulmonary resection were randomly allocated to
either the conventional patient-controlled analgesia (PCA) group or the
UG-TPVB group (n = 64 per group). The consumption of opioid agents
(propofol and remifentanil), postoperative hospital stay, postoperative
pulmonary atelectasis, postoperative nausea/vomiting, and postoperative
itchiness were recorded. The diagnosis of delirium was dependent on the
Nursing Delirium Screening Scale. The postoperative pain was assessed by
visual analogue scale (VAS) score. The serum levels of interleukin
(IL)-1beta, IL-6, and tumor necrosis factor-alpha were used to evaluate
the postoperative neuroinflammation. Results ?The consumption of propofol
and remifentanil, postoperative hospital stay, postoperative pulmonary
atelectasis, postoperative nausea/vomiting, and postoperative itchiness in
the UG-TPVB group were lower than that in the PCA group. Compared with the
PCA group, the prevalence of POD was decreased in the UG-TPVB group. In
addition, use of UG-TPVB not only reduced postoperative pain (VAS score)
but also decreased postoperative neuroinflammation compared with PCA in
geriatric patients undergoing pulmonary resection. Conclusions ?This study
determined the benefits of UG-TPVB over PCA, providing an effectiveness
approach to alleviate POD in geriatric patients undergoing pulmonary
resection. Copyright © 2022 Georg Thieme Verlag. All rights
reserved.

<10>
Accession Number
2016917169
Title
Beta-blockers for the treatment of arrhythmias: Bisoprolol - a systematic
review.
Source
Annales Pharmaceutiques Francaises. 80(5) (pp 617-634), 2022. Date of
Publication: September 2022.
Author
Muresan L.; Cismaru G.; Muresan C.; Rosu R.; Gusetu G.; Puiu M.; Mada
R.O.; Martins R.P.
Institution
(Muresan, Muresan) Cardiology Department, Emile-Muller Hospital, Mulhouse
68100, France
(Cismaru, Rosu, Gusetu, Puiu) Cardiology Department, Rehabilitation
Hospital, Cluj-Napoca 400347, Romania
(Mada) Cardiology Department, Niculae Stancioiu Heart Institute,
Cluj-Napoca 400005, Romania
(Martins) Cardiology Department, CHU de Rennes, Rennes 35000, France
Publisher
Elsevier Masson s.r.l.
Abstract
Objectives: Beta-blockers have long been successfully used for the
treatment of both supraventricular and ventricular arrhythmias. However,
differences exist between their chemical structure, pharmacokinetic and
pharmacodynamic properties (absorption, bioavailability, metabolism,
hydrophilic or lipophilic character, selective or non-selective nature,
the presence or absence of intrinsic sympathomimetic activity), which may
confer different antiarrhythmic properties to different beta-blockers. The
aim of this study was to analyze the current existing evidence for
bisoprolol for the treatment of both supraventricular and ventricular
arrhythmias. Material(s) and Method(s): Using the keywords
"bisoprolol" and "arrhythmias" or "atrial fibrillation" or "ventricular
tachycardia" or "premature ventricular complexes" or "ventricular
fibrillation", the Medline database was searched for articles in English
or French until April 2020 assessing the role of bisoprolol in the
treatment of arrhythmias. Data was then analyzed according to the type of
arrhythmia treated and the quality of evidence using the GRADE approach.
 Result(s): A total of 325 studies were identified, of which 28 were
considered relevant to the current topic. Among these studies, 19 assessed
the role of bisoprolol for the treatment of supraventricular arrhythmias,
8 its role in treating ventricular arrhythmias and 1 its role in
supraventricular and ventricular arrhythmias. The quality of evidence
varied from low (7 studies) to high (5 studies). Conclusion(s):
Current evidence exists supporting the use of bisoprolol for the treatment
of supraventricular arrhythmias, especially for rate control during atrial
fibrillation. Evidence also exists for its efficacy in the treatment of
ventricular arrhythmias, both in primary and in secondary
prevention. Copyright © 2022 Academie Nationale de Pharmacie

<11>
Accession Number
2019632451
Title
Direct oral anticoagulants or vitamin K antagonists after TAVR: A
systematic review and meta-analysis.
Source
International Journal of Cardiology. 365 (pp 123-130), 2022. Date of
Publication: 15 Oct 2022.
Author
Oliveri F.; Montalto C.; Tua L.; Lanzillo G.; Compagnoni S.; Fasolino A.;
Gentile F.R.; Ferlini M.; Pepe A.; Oltrona Visconti L.; Bongiorno A.;
Leonardi S.
Institution
(Oliveri, Tua, Lanzillo, Compagnoni, Fasolino, Gentile, Ferlini, Pepe,
Bongiorno, Leonardi) Department of Molecular Medicine, University of
Pavia, Pavia, Italy
(Montalto) Interventional Cardiology, De Gasperis Cardio Center, Niguarda
Hospital, Milan, Italy
(Oltrona Visconti, Leonardi) Division of Cardiology, Fondazione IRCCS
Policlinico San Matteo, Pavia, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Background: Several patients undergoing transcatheter aortic valve
replacement (TAVR) also require oral anticoagulation (OAC) for atrial
fibrillation (AF) or deep vein thromboembolism. However, the optimal type
of OAC strategy (direct oral anticoagulants, DOACs, or vitamin K
antagonists, VKA) is still unclear in this setting. Method(s): We
performed systematic literature research and meta-analysis in PubMed,
Medline, and EMBASE databases for studies reporting either all-cause
mortality, major/life-threatening bleeding or stroke events.
 Result(s): Ten observational studies and two randomized controlled
trials (RCTs) including a total of 29,485 patients were eligible for
inclusion. Compared to VKA, DOACs use after TAVR was associated with a
modest but significantly lower rates of all-cause mortality (RR 0.90; 95%
CI: 0.81-0.99, p-value 0.04) with results mainly driven by observational
studies. Cardiovascular mortality (RR 1.03; 95% CI: 0.81-1.30; p-value
0.84), total stroke events (RR 0.97; 95% CI: 0.76-1.23, p-value 0.79),
major/life-threatening bleeding (RR 0.93; 95% CI: 0.72-1.21, p-value 0.61)
and minor bleeding (RR 0.96; 95% CI: 0.74-1.23; p-value 0.72) were similar
between VKA and DOACs. Conclusion(s): Considering the totality of
available evidence, in patients who underwent TAVR with a concomitant
indication for OAC, DOACs-based strategy is an effective and safe
anticoagulation strategy compared to VKA. Copyright © 2022
Elsevier B.V.

<12>
Accession Number
2018776060
Title
The Effect of Aquatic Exercise Training on Heart Rate Variability in
Patients with Coronary Artery Disease.
Source
Journal of Cardiovascular Development and Disease. 9(8) (no pagination),
2022. Article Number: 251. Date of Publication: August 2022.
Author
Jug B.; Vasic D.; Novakovic M.; Avbelj V.; Rupert L.; Ksela J.
Institution
(Jug, Novakovic) Department of Vascular Diseases, University Medical
Centre Ljubljana, Ljubljana 1000, Slovenia
(Jug, Novakovic, Ksela) Medical Faculty, University of Ljubljana,
Ljubljana 1000, Slovenia
(Vasic) Centre for Cardiac Rehabilitation Smarjeske Toplice, Smarjeske
Toplice 8220, Slovenia
(Avbelj) Department of Communication Systems, Jozef Stefan Institute,
Ljubljana 1000, Slovenia
(Rupert) Department of Anaesthesiology and Perioperative Intensive
Therapy, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
(Ksela) Department of Cardiovascular Surgery, University Medical Centre
Ljubljana, Ljubljana 1000, Slovenia
Publisher
MDPI
Abstract
(1) Background: Aquatic exercise training is a relatively understudied
exercise modality in patients with CAD; with the present study, we sought
to compare the impact of short-term 14-day water- and land-based exercise
training on heart rate variability (HRV). (2) Methods: We randomized 90
patients after a recent CAD event (myocardial infarction and/or
revascularization within 2 months prior to inclusion) to either (i)
water-based or (ii) land-based exercise training (14 days, two 30 min
sessions daily), or (iii) controls. Before and after the intervention
period, all participants underwent 20 min 12-channel high-resolution ECG
recordings with off-line HRV analysis, including conventional linear time-
and frequency-domain analysis (using the Welch method for fast-Fourier
transformation), and preselected non-linear analysis (Poincare
plot-derived parameters, sample entropy, and the short-term scaling
exponent alpha1 obtained by detrended fluctuation analysis). (3) Results:
Eighty-nine patients completed the study (mean age 60 +/- 8 years; 20 %
women). We did not detect significant differences in baseline- or
age-adjusted end-of-study HRV parameters, but aquatic exercise training
was associated with a significant increase in the linear LF/HF parameter
(from 2.6 [1.2-4.0] to 3.0 [2.1-5.5], p = 0.046) and the non-linear alpha1
parameter (from 1.2 [1.1-1.4] to 1.3 [1.2-1.5], p = 0.043). (4)
 Conclusion(s): Our results have shown that a short-term 14-day
aquatic exercise training program improves selected HRV parameters,
suggesting this mode of exercise is safe and may be beneficial in patients
with CAD. Copyright © 2022 by the authors.

<13>
Accession Number
2017873015
Title
Comparison of the Effect of Heparinized Normal Saline Solution Versus
Saline Solutions in Arterial and Central Venous Catheters on Complete
Blood Count After Cardiac Surgery.
Source
Anesthesiology and Pain Medicine. 12(4) (no pagination), 2022. Article
Number: e113345. Date of Publication: Aug 2022.
Author
Ziyaeifard M.; Ferasat-Kish R.; Azarfarin R.; Aghdaii N.; Nejatisini H.;
Ahmadabadi C.A.; Yousefi M.
Institution
(Ziyaeifard, Ferasat-Kish, Azarfarin, Aghdaii, Nejatisini, Yousefi) Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Ahmadabadi) Department of Surgery, School of Medicine, Zahedan University
of Medical Sciences, Zahedan, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Background: Heparinized and saline solutions can prevent clot formation in
arterial and central venous catheters. However, heparin can decrease the
platelet count and induce thrombocytopenia. Patients undergoing cardiac
surgeries are more likely to develop heparin-induced thrombocytopenia.
 Objective(s): This study aimed to investigate the effect of
heparinized and saline solutions of arterial and central venous catheters
on complete blood count (CBC) after cardiac surgery. Method(s): This
randomized controlled trial was conducted on 100 participants. All
subjects underwent cardiac surgery at Rajaie Cardiovascular, Medical, and
Research Center, Tehran, Iran. Patients were randomly divided into two
groups intervention (A) for whom heparinized normal saline solution was
used to maintain central arterial and venous catheters, and control (B)
for whom normal saline solution was used. The CBC of subjects was
monitored for three days (before surgery and the first and second days
after surgery). Result(s): In the present study, there were no
significant differences between CBC, white blood cell differential count,
prothrombin time, partial thromboplastin time (PTT), and international
normalized ratio in groups A and B. However, we found significant
differences in platelet count (P = 0.049), red blood cell count (P =
0.0001), hemoglobin (P = 0.0001), and hematocrit (P = 0.0001) between
before surgery and the second day after surgery in group A. Platelet count
(P = 0.027) and PTT (P = 0.0001) before and after surgery were
significantly different in group B. Conclusion(s): According to the
results of this study, normal saline solution catheters have fewer side
effects and can be a suitable replacement for heparinized
catheters. Copyright © 2022, Author(s).

<14>
Accession Number
2017850991
Title
Intraoperative Tissue-Immunosuppressive Therapy Reduces Rejection Episodes
in Heart Transplant Recipients.
Source
Experimental and Clinical Transplantation. 20(8) (pp 762-767), 2022. Date
of Publication: August 2022.
Author
Rabus M.B.; Cekmecelioglu D.; Ata P.; Salihi S.; Selcuk E.; Balkanay M.
Institution
(Rabus, Cekmecelioglu, Selcuk) Cardiovascular Surgery Department, Kartal
Kosuyolu Yuksek Ihtisas Research and Training Hospital, Istanbul, Turkey
(Ata) Medical Genetics and Immunology Department, Marmara University
Medical Faculty, Istanbul, Turkey
(Salihi) Cardiovascular Surgery Department, Okan University Medical
Faculty, Istanbul, Turkey
(Balkanay) Cardiovascular Surgery Department, Yeni Yuzyil University
Medical Faculty, Istanbul, Turkey
Publisher
Baskent University
Abstract
Objectives: Our study was conducted to determine the effects of
intraoperative antithymocyte globulin administration on donor hearts
procured after cardiocirculatory death. We evaluated the impact of
antithymocyte globulin on graft function and related parameters during
isothermic blood cardioplegia. Material(s) and Method(s): In this
prospective and randomized single center study, 30 patients with
orthotropic heart transplant were divided into 2 groups: group 1 included
15 patients who received retrograde antithymocyte globulin infusion via
coronary sinus intraoperatively and immediately after organ procurement
and group 2 included 15 patients who received traditional antithymocyte
globulin infusion after implantation. Result(s): Study patients had a
mean age of 33.8 years (range, 15-56 y). All patients had panel reactive
antibody less than 10% except for 3 patients. The cluster of
differentiation 3-positive cell count decrease was more than 20%. The
inotropic therapy dose required and the myocardial pressure (stiffness)
were less for group 1 patients. These patients had less acute rejection
episodes than group 2 (0% vs 13.3%; P <.05). Conclusion(s): Favorable
clinical outcomes were observed in terms of less acute rejection episodes
and better graft function at least during the early posttransplant period.
Intraoperative antithymocyte globulin treatment may have a preventive
effect for acute cellular rejection in heart transplant
patients. Copyright © Baskent University 2022.

<15>
Accession Number
2019980943
Title
Do patients with non-viable myocardium from ischemic cardiomyopathy
benefit from revascularization? A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Davoudi F.; Miyashita S.; Yoo T.K.; Imahira U.; Kimmelstiel C.; Huggins
G.S.; Downey B.C.
Institution
(Davoudi) Department of Medicine, Mass General Brigham-Salem Hospital, MA,
United States
(Miyashita, Kimmelstiel, Huggins, Downey) Cardiology Division, Tufts
Medical Center and Tufts University School of Medicine, MA, United States
(Yoo) Department of Medicine, MetroWest Medical Center, MA, United States
(Imahira) Inpatient Psychiatry, Tufts Medical Center, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Myocardial viability assessment is used to select patients who
will derive the greatest benefit from revascularization. It remains
controversial whether revascularization only benefits patients with
ischemic cardiomyopathy who have viable myocardium. The objective of this
meta-analysis was to compare mortality between patients with ischemic
cardiomyopathy and non-viable myocardium who underwent revascularization
and those who underwent medical therapy alone. Method(s): The MEDLINE
database was searched using PubMed to retrieve studies published up to
December 2021. Inclusion criteria were 1. studies that evaluated the
impact of revascularization (revascularization group) versus medical
therapy alone (control group) following myocardial viability assessment;
2. patients who had coronary artery disease that was amenable to coronary
artery bypass grafting or percutaneous coronary intervention; and 3.
patients who had non-viable myocardium. The main outcome measure was
all-cause mortality. Result(s): A total of 12 studies were included,
evaluating 1363 patients with non-viable myocardium, of whom 501 patients
underwent revascularization and 862 patients received medical therapy
alone. There was a significant reduction in all-cause mortality (RR 0.76,
95 % CI: 0.62-0.93, I2 = 0) in the revascularization group
compared to the control group. There was no association between the type
of viability imaging modality and the risk of all-cause mortality
(P-interaction = 0.58). Conclusion(s): The findings of this
meta-analysis suggest a benefit from revascularization compared to medical
therapy in patients with ischemic cardiomyopathy despite the lack of
myocardial viability. Copyright © 2022 Elsevier Inc.

<16>
Accession Number
638918780
Title
ALBUMIN UTILISATION AT A TERTIARY CARE HOSPITAL.
Source
Journal of the Canadian Association of Gastroenterology. Conference:
Canadian Digestive Diseases Week, CDDW 2022. Virtual. 5(Supplement 1) (no
pagination), 2022. Date of Publication: March 2022.
Author
Saad Mohammed A.; Goldshtein D.; Sarbar S.; Wong S.; Flemming J.
Institution
(Saad Mohammed, Goldshtein, Sarbar, Wong, Flemming) Queen's University,
Kingston, ON, Canada
Publisher
Oxford University Press
Abstract
Background: Albumin is a colloidal solution with usage guided by
recommendations from Canadian Blood Services (CBS). In Ontario, rates of
albumin use increased substantially from 2012 to 2018 despite the lack of
development of new indications for using over this time frame. Further, we
recently found that >50% of albumin usage in patients with cirrhosis were
non-evidence based. Albumin usage in other patient populations is not well
described. Aim(s): Our aim was to describe overall usage of albumin
stratified by clinical setting, clinical indication, and dosage at a
tertiary care hospital. Method(s): We retrospectively identified all
albumin prescriptions during two randomly selected non-consecutive months
between 2018 and 2019 at Kingston Health Sciences Centre. Data was
abstracted from each hospital chart for indication, prescriber specialty,
location of patient, amount of albumin ordered, and concentration (5% or
25%). Albumin prescriptions were then defined as either evidence-based or
non-evidence based on published literature and guidelines. Overall cost
for albumin during the study period was determined based on CBS pricing
($51.47/ 25gms). Result(s): A total of 699 albumin prescriptions were
dispensed to 317 individuals over December 2018 and May 2019, with a total
of 38,458 grams used. Overall, 36% was prescribed for evidence-based
indications. The most common indication was plasmapheresis (32%),
non-sepsis volume resuscitation (23%), and cardiac surgery (17%). The
majority of albumin was prescribed in dialysis unit (32%), ICU (23%), and
cardiac sciences unit (11%). The largest prescribers of albumin were
intensivists (26%), followed by nephrologists (17%), and cardiac surgeons
(15%). There were differences in utilization based on concentration of
albumin. Despite limited evidence of benefit, 25% albumin and 5% albumin
were used excessively for volume resuscitation and cardiac surgery
respectively. When used for an evidence-based indication, the dosing was
incorrect in 45% of orders. A total of $79,176 was spent on albumin during
the study period. Importantly, only $28,494 was spent on evidence-based
indications with appropriate dosage and concentration. Conclusion(s):
Overall, there is significant albumin use for indications lacking
substantial evidence. This study identifies the clinical contexts in which
there is opportunity to reduce non-evidence-based albumin usage and cut
unnecessary expenditure. Targeted quality improvement initiatives are
underway.

<17>
Accession Number
2020029115
Title
Evaluation of the safety of paclitaxel eluting medical devices to treat
peripheral arterial disease - The DETECT "Drug EluTing dEvices FrenCh
safeTy survey" national study.
Source
Annals of Vascular Surgery. Conference: 35th Annual Meeting of the French
Society for Vascular and Endovascular Surgery. Virtual, Online. 84 (pp
74), 2022. Date of Publication: August 2022.
Author
Wargny M.; Coudol S.; Leux C.; Goronflot T.; Gourraud P.-A.; Goueffic Y.
Institution
(Wargny, Coudol, Leux, Goronflot, Gourraud, Goueffic) Nantes University
Hospital, and Groupe Hospitalier Paris Saint-Joseph, Paris, France
Publisher
Elsevier Inc.
Abstract
Objectives: A meta-analysis published in 2018 concluded that mid-term and
long-term mortality was higher in patients treated with paclitaxel eluting
balloons and stents than in those treated with bare devices after the
endovascular treatment of femoropopliteal lesions. There are no national
data concerning the safety of these devices. We designed the DETECT (Drug
EluTing dEvices FrenCh safeTy survey) study in order to compare the risk
of mortality in patients treated with paclitaxel eluting balloons and/or
stents or with bare devices. Material(s) and Method(s): The patients
were enrolled on the basis of identification in the National Health
Information System (SNDS) for the treatment of the peripheral arterial
disease with endovascular procedural codes corresponding to the use of
bare balloons, bare stents, active stents, active balloons or covered
stents between September 2011 and December 2019. Healthcare utilization
data were then extracted from the SNDS: medical consultations, ambulatory
delivery of drugs, long term illnesses, medical procedures and diagnoses
associated with the hospitalizations. Data collection began in 2011, with
a follow-up for five years after the last intervention performed, i.e. in
December 2024. Primary outcome is all-causes mortality with a minimal
follow-up of two years. Secondary outcomes are the 4-points MACE, a
composite of death, myocardial infarction or coronary revascularization,
stroke or hospitalization for cardiac failure, and MALE defined by a new
endovascular procedure or a major lower limb amputation. The hazard ratio
(HR) between the "active" and "non-active" groups will be calculated using
a Cox model with a classical adjustment or a score of propensity. Three
steps of analysis are envisaged, on the data of (I) December 2021 (proof
of concept), (II) December 2022 (principal analysis) (III) and December
2025 (long term), corresponding to a minimal follow-up of 1, 2 and 5
years, respectively. Result(s): The study was approved by the Ethical
Committee for Health Research, Studies and Evaluation (CESREES) in
November 2020, then by the National Commission for Informatics
Technologies and Civil Liberties (CNIL) in March 2021. The scope of the
data was then validated by the National Health Insurance Fund (CNAM),
making it possible to identify 290624 patients over the study period.
35.3% of the study sample consists of women, and 84.7% of the patients are
covered by the general social security regime. The next step is the
contractualization with the CNAM before the effective access to the data
and the related analyzes. Conclusion(s): DETECT will constitute the
largest international register concerning the treatment of peripheral
arterial lesions. The comparative analyzes will bring crucial information
on the safety of the active devices. This project illustrates the
potential of the medical and administrative data of the SNDS, while
underlining the need for other data sources. Copyright © 2022

<18>
Accession Number
2018860289
Title
Interventional cardiac magnetic resonance imaging: current applications,
technology readiness level, and future perspectives.
Source
Therapeutic Advances in Cardiovascular Disease. 16 (no pagination), 2022.
Date of Publication: 2022.
Author
Rier S.C.; Vreemann S.; Nijhof W.H.; van Driel V.J.H.M.; van der Bilt
I.A.C.
Institution
(Rier) Cardiology Division, Department of Cardiology, Haga Teaching
Hospital, Els Borst-Eilersplein 275, Postbus 40551, The Hague 2504 LN,
Netherlands
(Vreemann, van Driel, van der Bilt) Department of Cardiology, Haga
Teaching Hospital, The Hague, Netherlands
(Vreemann, Nijhof) Siemens Healthineers Nederland B.V., Den Haag,
Netherlands
Publisher
SAGE Publications Ltd
Abstract
Background: Cardiac magnetic resonance (CMR) provides excellent temporal
and spatial resolution, tissue characterization, and flow measurements.
This enables major advantages when guiding cardiac invasive procedures
compared with X-ray fluoroscopy or ultrasound guidance. However, clinical
implementation is limited due to limited availability of technological
advancements in magnetic resonance imaging (MRI) compatible equipment. A
systematic review of the available literature on past and present
applications of interventional MR and its technology readiness level (TRL)
was performed, also suggesting future applications. Method(s): A
structured literature search was performed using PubMed. Search terms were
focused on interventional CMR, cardiac catheterization, and other cardiac
invasive procedures. All search results were screened for relevance by
language, title, and abstract. TRL was adjusted for use in this article,
level 1 being in a hypothetical stage and level 9 being widespread
clinical translation. The papers were categorized by the type of procedure
and the TRL was estimated. Result(s): Of 466 papers, 117 papers met
the inclusion criteria. TRL was most frequently estimated at level 5
meaning only applicable to in vivo animal studies. Diagnostic right heart
catheterization and cavotricuspid isthmus ablation had the highest TRL of
8, meaning proven feasibility and efficacy in a series of humans.
 Conclusion(s): This article shows that interventional CMR has a
potential widespread application although clinical translation is at a
modest level with TRL usually at 5. Future development should be directed
toward availability of MR-compatible equipment and further improvement of
the CMR techniques. This could lead to increased TRL of interventional CMR
providing better treatment. Copyright © The Author(s), 2022.

<19>
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).

<20>
Accession Number
2018303424
Title
Key Components, Current Practice and Clinical Outcomes of ERAS Programs in
Patients Undergoing Orthopedic Surgery: A Systematic Review.
Source
Journal of Clinical Medicine. 11(14) (no pagination), 2022. Article
Number: 4222. Date of Publication: July 2022.
Author
Salamanna F.; Contartese D.; Brogini S.; Visani A.; Martikos K.; Griffoni
C.; Ricci A.; Gasbarrini A.; Fini M.
Institution
(Salamanna, Contartese, Brogini, Visani, Fini) Complex Structure Surgical
Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna
40136, Italy
(Martikos, Griffoni, Gasbarrini) Spine Surgery Unit, IRCCS Istituto
Ortopedico Rizzoli, Bologna 40136, Italy
(Ricci) Anesthesia-Resuscitation and Intensive Care, IRCCS Istituto
Ortopedico Rizzoli, Bologna 40136, Italy
Publisher
MDPI
Abstract
Enhanced recovery after surgery (ERAS) protocols have led to improvements
in outcomes in several surgical fields, through multimodal optimization of
patient pathways, reductions in complications, improved patient
experiences and reductions in the length of stay. However, their use has
not been uniformly recognized in all orthopedic fields, and there is still
no consensus on the best implementation process. Here, we evaluated pre-,
peri-, and post-operative key elements and clinical evidence of ERAS
protocols, measurements, and associated outcomes in patients undergoing
different orthopedic surgical procedures. A systematic literature search
on PubMed, Scopus, and Web of Science Core Collection databases was
conducted to identify clinical studies, from 2012 to 2022. Out of the 1154
studies retrieved, 174 (25 on spine surgery, 4 on thorax surgery, 2 on
elbow surgery and 143 on hip and/or knee surgery) were considered eligible
for this review. Results showed that ERAS protocols improve the recovery
from orthopedic surgery, decreasing the length of hospital stays (LOS) and
the readmission rates. Comparative studies between ERAS and non-ERAS
protocols also showed improvement in patient pain scores, satisfaction,
and range of motion. Although ERAS protocols in orthopedic surgery are
safe and effective, future studies focusing on specific ERAS elements, in
particular for elbow, thorax and spine, are mandatory to optimize the
protocols. Copyright © 2022 by the authors.

<21>
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..

<22>
Accession Number
2018846459
Title
Commentary to: "Comparing midterm outcomes" of Cox-Maze procedure and
pulmonary vein isolation for atrial fibrillation after concomitant mitral
valve surgery: A "systematic review".
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Moscarelli M.; Fattouch K.
Institution
(Moscarelli, Fattouch) Deparment of Cardiovascular Surgery, Maria Eleonora
Hospital, GVM Care & Research, Palermo, Italy
Publisher
John Wiley and Sons Inc
Abstract
There is no solid evidence from the literature that compare Cox-Maze with
pulmonary vein isolation techniques for atrial fibrillation in the context
of concomitant mitral valve surgery. Although the first is perhaps more
effective and linked to higher freedom from atrial fibrillation, it is
more invasive compared to the pulmonary isolation. Copyright ©
2022 Wiley Periodicals LLC.

<23>
Accession Number
2018813828
Title
The effects of preoperative focused cardiac ultrasound in high-risk
patients: A randomised controlled trial (PREOPFOCUS).
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 2022.
Author
Pallesen J.; Bhavsar R.; Fjolner J.; Bakke S.A.; Krog J.; Andersen M.A.S.;
Bondergaard M.H.; Jessing T.D.; Mortensen L.; Nielsen M.B.; Vang M.;
Malachauskiene L.; Juhl-Olsen P.
Institution
(Pallesen, Bondergaard, Jessing, Mortensen, Vang) Department of
Anaesthesiology, Randers Regional Hospital, Randers, Denmark
(Bhavsar, Bakke, Nielsen, Malachauskiene) Department of Anaesthesiology,
Hospital of Southern Jutland, Aabenraa, Denmark
(Fjolner) Department of Surgery & Intensive Care, Regional Hospital
Central Jutland, Viborg, Denmark
(Krog, Andersen) Department of Anaesthesiology, Aarhus University
Hospital, Aarhus, Denmark
(Krog, Juhl-Olsen) Department of Clinical Medicine, Aarhus University,
Aarhus, Denmark
(Juhl-Olsen) Department of Cardiothoracic and Vascular Surgery,
Anaesthesia Section, Aarhus University Hospital, Aarhus, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Surgery is the third most common cause of mortality worldwide.
Focused cardiac ultrasound (FOCUS) yields information on cardiac status
and discloses the presence of unknown pathology. Preoperative FOCUS
changes patient treatment, allowing for a patient-tailored anaesthesia. We
hypothesised that preoperative FOCUS would reduce the proportion of
patients who were either admitted to hospital for more than 10 days or who
were dead within 30 days after high-risk, non-cardiac surgery.
 Method(s): This was a randomised, controlled, multi-center study.
Patients >=65 years of age, admitted for urgent orthopaedic- or abdominal
surgery, scheduled for general- or neuraxial anaesthesia and with ASA 3/4
were eligible for inclusion. Patients were randomised in a 1:1 ratio to
preoperative FOCUS or no preoperative FOCUS performed in accordance with a
predefined protocol. Primary endpoint was the proportion of patients
admitted more than 10 days or who were dead within 30 days. Secondary
endpoints included major complications, days of admission and changes in
anaesthesia handling. Result(s): During the second COVID-19 wave the
study monitoring committee terminated the study prematurely. We included
338 patients of which 327 were included in the final analysis. In the
FOCUS group, 41/163 (25%) patients met the criteria for the primary
endpoint versus 35/164 (21%) for the control group, adjusted odds ratio
1.37 (95% CI 0.86-2.30), p =.36. The proportions of patients who developed
major complications did not differ significantly between groups. Length of
hospital stay was 4 (3-8) days in the FOCUS group and 4 (3-7) days on the
control group (adjusted p =.24). Conclusion(s): The routine
availability of preoperative FOCUS assessment in this cohort does not
appear to reduce the risk for hospitalisation exceeding 10 days or 30-day
mortality, although study enrolment was prematurely
terminated. Copyright © 2022 The Authors. Acta Anaesthesiologica
Scandinavica published by John Wiley & Sons Ltd on behalf of Acta
Anaesthesiologica Scandinavica Foundation.

<24>
Accession Number
638921465
Title
Influence of intensive lipid-lowering on CT derived fractional flow
reserve in patients with stable chest pain: Rationale and design of the
FLOWPROMOTE study.
Source
Clinical cardiology. (no pagination), 2022. Date of Publication: 03 Sep
2022.
Author
Mortensen M.B.; Sand N.-P.; Busk M.; Jensen J.M.; Grove E.L.; Dey D.;
Iraqi N.; Updegrove A.; Fonte T.; Mathiassen O.N.; Hosbond S.; Botker
H.E.; Leipsic J.; Narula J.; Norgaard B.L.
Institution
(Mortensen, Jensen, Grove, Iraqi, Mathiassen, Botker, Norgaard) Department
of Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Sand) Department of Cardiology, Southwestern Hospital, Esbjerg, Denmark
(Busk, Hosbond) Department of Cardiology, Lillebaelt Hospital, Denmark
(Grove, Botker, Norgaard) Department Clinical Medicine, Faculty of Health,
Aarhus University, Aarhus, Denmark
(Dey) Biomedical Imaging Research Institute, Cedars-Sinai Medical Center,
Los Angeles, CA, United States
(Updegrove, Fonte) HeartFlow, Redwood City, CA, United States
(Leipsic) Division of Cardiology and Radiology, St Paul's Hospital,
Vancouver, BC, Canada
(Narula) Icahn School of Medicine, Mount Sinai, NY, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Coronary CT angiography (CTA) derived fractional flow
reserve (FFRCT ) shows high diagnostic performance when compared to
invasively measured FFR. Presence and extent of low attenuation plaque
density have been shown to be associated with abnormal physiology by
measured FFR. Moreover, it is well established that statin therapy reduces
the rate of plaque progression and results in morphology alterations
underlying atherosclerosis. However, the interplay between lipid lowering
treatment, plaque regression, and the coronary physiology has not
previously been investigated. AIM: To test whether lipid lowering therapy
is associated with significant improvement in FFRCT , and whether there is
a dose-response relationship between lipid lowering intensity, plaque
regression, and coronary flow recovery. METHOD(S): Investigator
driven, prospective, multicenter, randomized study of patients with stable
angina, coronary stenosis >=50% determined by clinically indicated
first-line CTA, and FFRCT <=0.80 in whom coronary revascularization was
deferred. Patients are randomized to standard (atorvastatin 40mg daily) or
intensive (rosuvastatin 40mg + ezetimibe 10mg daily) lipid lowering
therapy for 18months. Coronary CTA scans with blinded coronary plaque and
FFRCT analyses will be repeated after 9 and 18 months. The primary
endpoint is the 18-month difference in FFRCT using (1) the FFRCT value 2cm
distal to stenosis and (2) the lowest distal value in the vessel of
interest. A total of 104 patients will be included in the study.
 CONCLUSION(S): The results of this study will provide novel insights
into the interplay between lipid lowering, and the pathophysiology in
coronary artery disease. Copyright © 2022 The Authors. Clinical
Cardiology published by Wiley Periodicals, LLC.

<25>
Accession Number
638921442
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) (pp 723), 2022. Date of Publication: 02 Sep 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
NLM (Medline)
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:
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).

<26>
Accession Number
638921419
Title
Effectiveness of rib fixation compared to pain medication alone on pain
control in patients with uncomplicated rib fractures: study protocol of a
pragmatic multicenter randomized controlled trial-the PAROS study (Pain
After Rib OSteosynthesis).
Source
Trials. 23(1) (pp 732), 2022. Date of Publication: 02 Sep 2022.
Author
Perentes J.Y.; Christodoulou M.; Abdelnour-Berchtold E.; Karenovics W.;
Gayet-Ageron A.; Gonzalez M.; Krueger T.; Triponez F.; Terrier P.; Bedat
B.
Institution
(Perentes, Abdelnour-Berchtold, Gonzalez, Krueger) Unit of Thoracic and
Endocrine Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne,
Switzerland
(Christodoulou) Unit of Thoracic and Endocrine Surgery, Hospital of
Valais, Sion, Switzerland
(Karenovics, Triponez, Terrier, Bedat) Unit of Thoracic and Endocrine
Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4,
Geneva 1205, Switzerland
(Gayet-Ageron) CRC & Division of Clinical-Epidemiology, Department of
Health and Community Medicine, University of Geneva & University Hospitals
of Geneva, Geneva, Switzerland
(Terrier) HES-SO University of Applied Sciences and Arts Western
Switzerland, Neuchatel, Switzerland
Publisher
NLM (Medline)
Abstract
BACKGROUND: Persistent pain and disability following rib fractures result
in a large psycho-socio-economic impact for health-care system. Benefits
of rib osteosynthesis are well documented in patients with flail chest
that necessitates invasive ventilation. In patients with uncomplicated and
simple rib fractures, indication for rib osteosynthesis is not clear. The
aim of this trial is to compare pain at 2 months after rib osteosynthesis
versus medical therapy. METHOD(S): This trial is a pragmatic
multicenter, randomized, superiority, controlled, two-arm, not-blinded,
trial that compares pain evolution between rib fixation and standard pain
medication versus standard pain medication alone in patients with
uncomplicated rib fractures. The study takes place in three hospitals of
Thoracic Surgery of Western Switzerland. Primary outcome is pain measured
by the brief pain inventory (BPI) questionnaire at 2 months post-surgery.
The study includes follow-up assessments at 1, 2, 3, 6, and 12 months
after discharge. To be able to detect at least 2 point-difference on the
BPI between both groups (standard deviation 2) with 90% power and
two-sided 5% type I error, 46 patients per group are required. Adjusting
for 10% drop-outs leads to 51 patients per group. DISCUSSION:
Uncomplicated rib fractures have a significant medico-economic impact.
Surgical treatment with rib fixation could result in better clinical
recovery of patients with uncomplicated rib fractures. These improved
outcomes could include less acute and chronic pain, improved pulmonary
function and quality of life, and shorter return to work. Finally,
surgical treatment could then result in less financial costs. TRIAL
REGISTRATION: ClinicalTrials.gov NCT04745520 . Registered on 8 February
2021. Copyright © 2022. The Author(s).

<27>
Accession Number
638921242
Title
Preoperative Short-Term Restriction of Sulfur-Containing Amino Acid Intake
for Prevention of Acute Kidney Injury After Cardiac Surgery: A Randomized,
Controlled, Double-Blind, Translational Trial.
Source
Journal of the American Heart Association. (pp e025229), 2022. Date of
Publication: 03 Sep 2022.
Author
Osterholt T.; Gloistein C.; Todorova P.; Becker I.; Arenskrieger K.; Melka
R.; Koehler F.C.; Faust M.; Wahlers T.; Benzing T.; Muller R.-U.;
Grundmann F.; Burst V.
Institution
(Osterholt, Gloistein, Todorova, Arenskrieger, Melka, Koehler, Benzing,
Muller, Grundmann, Burst) Department II of Internal Medicine and Center
for Molecular Medicine Cologne University of Cologne, Faculty of Medicine
and University Hospital Cologne Cologne Germany, Germany
(Becker) Institute of Medical Statistics and Computational Biology
University of Cologne, Faculty of Medicine and University Hospital Cologne
Cologne Germany, Germany
(Koehler, Benzing, Muller) Cologne Excellence Cluster on Cellular Stress
Responses in Aging-Associated Diseases (CECAD) University of Cologne,
Faculty of Medicine and University Hospital Cologne Cologne Germany,
Germany
(Faust) Polyclinic for Endocrinology Diabetes and Preventive Medicine,
University of Cologne, Faculty of Medicine and University Hospital Cologne
Cologne Germany, Germany
(Wahlers) Department of Cardiothoracic Surgery University of Cologne,
Faculty of Medicine and University Hospital Cologne Germany, Germany
Publisher
NLM (Medline)
Abstract
Background Acute kidney injury (AKI) is a major risk factor for chronic
kidney disease and increased mortality. Until now, no compelling
preventive or therapeutic strategies have been identified. Dietary
interventions have been proven highly effective in organ protection from
ischemia reperfusion injury in mice and restricting dietary intake of
sulfur-containing amino acids (SAA) seems to be instrumental in this
regard. The UNICORN trial aimed to evaluate the protective impact of
restricting SAA intake before cardiac surgery on incidence of AKI. Methods
and Results In this single-center, randomized, controlled, double-blind
trial, 115 patients were assigned to a SAA-reduced formula diet (LowS
group) or a regular formula diet (control group) in a 1:1 ratio for 7days
before scheduled cardiac surgery. The primary end point was incidence of
AKI within 72hours after surgery, secondary end points included increase
of serum creatinine at 24, 48, and 72hours as well as safety parameters.
Quantitative variables were analyzed with nonparametric methods, while
categorical variables were evaluated by means of Chi-square or Fisher
test. SAA intake in the group with SAA reduced formula diet was
successfully reduced by 77% (group with SAA reduced formula diet,
7.37[6.40-7.80] mg/kg per day versus control group, 32.33 [28.92-33.60]
mg/kg per day, P<0.001) leading to significantly lower serum levels of
methionine. No beneficial effects of SAA restriction on the rate of AKI
after surgery could be observed (group with SAA reduced formula diet, 23%
versus control group, 16%; P=0.38). Likewise, no differences were recorded
with respect to secondary end points (AKI during hospitalization,
creatinine at 24, 48, 72hours after surgery) as well as in subgroup
analysis focusing on age, sex, body mass index and diabetes. Conclusions
SAA restriction was feasible in the clinical setting but was not
associated with protective properties in AKI upon cardiac surgery.
Registration URL: https://www.clinicaltrials.gov; Unique Identifier:
NCT03715868.

<28>
Accession Number
638921104
Title
Cardiac magnetic resonance imaging versus computed tomography to guide
transcatheter aortic valve replacement: study protocol for a randomized
trial (TAVR-CMR).
Source
Trials. 23(1) (pp 726), 2022. Date of Publication: 02 Sep 2022.
Author
Klug G.; Reinstadler S.; Troger F.; Holzknecht M.; Reindl M.; Tiller C.;
Lechner I.; Fink P.; Pamminger M.; Kremser C.; Ulmer H.; Bauer A.; Metzler
B.; Mayr A.
Institution
(Klug, Reinstadler, Troger, Holzknecht, Reindl, Tiller, Lechner, Fink,
Bauer, Metzler) University Clinic of Internal Medicine III, Cardiology and
Angiology, Medical University of Innsbruck, Anichstrase 35, Innsbruck
6020, Austria
(Troger, Pamminger, Kremser, Mayr) University Clinic of Radiology, Medical
University of Innsbruck, Innsbruck, Austria
(Ulmer) Department for Medical Statistics, Informatics and Health Economy,
Medical University of Innsbruck, Innsbruck, Austria
Publisher
NLM (Medline)
Abstract
BACKGROUND: The standard procedure for the planning of transcatheter
aortic valve replacement (TAVR) is the combination of echocardiography,
coronary angiography, and cardiovascular computed tomography (TAVR-CT) for
the exact determination of the aortic valve dimensions, valve size, and
implantation route. However, up to 80% of the patients undergoing TAVR
suffer from chronic renal insufficiency. Alternatives to reduce the need
for iodinated contrast agents are desirable. Cardiac magnetic resonance
(CMR) imaging recently has emerged as such an alternative. Therefore, we
aim to investigate, for the first time, the non-inferiority of TAVR-CMR to
TAVR-CT regarding efficacy and safety end-points. METHOD(S): This is
a prospective, randomized, open-label trial. It is planned to include 250
patients with symptomatic severe aortic stenosis scheduled for TAVR based
on a local heart-team decision. Patients will be randomized in a 1:1
fashion to receive a predefined TAVR-CMR protocol or to receive a standard
TAVR-CT protocol within 2 weeks after inclusion. Follow-up will be
performed at hospital discharge after TAVR and after 1 and 2 years. The
primary efficacy outcome is device implantation success at discharge. The
secondary endpoints are a combined safety endpoint and a combined clinical
efficacy endpoint at baseline and at 1 and 2 years, as well as a
comparison of imaging procedure related variables. Endpoint definitions
are based on the updated 2012 VARC-2 consensus document. DISCUSSION:
TAVR-CMR might be an alternative to TAVR-CT for planning a TAVR procedure.
If proven to be effective and safe, a broader application of TAVR-CMR
might reduce the incidence of acute kidney injury after TAVR and thus
improve outcomes. TRIAL REGISTRATION: The trial is registered at
ClinicalTrials.gov (NCT03831087). The results will be disseminated at
scientific meetings and publication in peer-reviewed
journals. Copyright © 2022. The Author(s).

<29>
Accession Number
634023072
Title
Paravertebral Block versus Thoracic Epidural Analgesia for Postthoracotomy
Pain Relief: A Meta-Analysis of Randomized Trials.
Source
Thoracic and Cardiovascular Surgeon. 70(5) (pp 413-421), 2022. Date of
Publication: 01 Aug 2022.
Author
Xu M.; Hu J.; Yan J.; Yan H.; Zhang C.
Institution
(Xu, Yan) Department of Anesthesiology, Central Hospital of Wuhan, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
(Hu, Yan) Department of Anesthesiology, Xiangya Hospital, Central South
University, Hunan, Changsha, China
(Zhang) Department of Cardiovascular Surgery, Xiangya Hospital, Central
South University, Hunan, Changsha, China
Publisher
Georg Thieme Verlag
Abstract
Objective Paravertebral block (PVB) and thoracic epidural analgesia (TEA)
are commonly used for postthoracotomy pain management. The purpose of this
research is to evaluate the effects of TEA versus PVB for postthoracotomy
pain relief. Methods A systematic literature search was conducted in
PubMed, EMBASE, Web of Science, and the Cochrane Library (last performed
on August 2020) to identify randomized controlled trials comparing PVB and
TEA for thoracotomy. The rest and dynamic visual analog scale (VAS)
scores, rescue analgesic consumption, the incidences of side effects were
pooled. Results Sixteen trials involving 1,000 patients were included in
this meta-analysis. The pooled results showed that the rest and dynamic
VAS at 12, 24, and rest VAS at 48 hours were similar between PVB and TEA
groups. The rescue analgesic consumption (weighted mean differences: 3.81;
95% confidence interval [CI]: 0.982-6.638, p < 0.01) and the incidence of
rescue analgesia (relative risk [RR]: 1.963; 95% CI: 1.336-2.884, p <
0.01) were less in TEA group. However, the incidence of hypotension (RR:
0.228; 95% CI: 0.137-0.380, p < 0.001), urinary retention (RR: 0.392; 95%
CI: 0.198-0.776, p < 0.01), and vomiting (RR: 0.665; 95% CI: 0.451-0.981,
p < 0.05) was less in PVB group. Conclusion For thoracotomy, PVB may
provide no superior analgesia compared with TEA but PVB can reduce side
effects. Thus, individualized treatment is recommended. Further study is
still necessary to determine which concentration of local anesthetics can
be used for PVB and can provide equal analgesic efficiency to
TEA. Copyright © 2022 Georg Thieme Verlag. All rights reserved.

<30>
Accession Number
2015687216
Title
Meta-Analysis of Nonrandomized Studies to Assess the Optimal Timing of
Coronary Artery Bypass Grafting After Acute Myocardial Infarction.
Source
American Journal of Cardiology. 164 (pp 44-51), 2022. Date of Publication:
01 Feb 2022.
Author
Weigel F.; Nudy M.; Krakowski G.; Ahmed M.; Foy A.
Institution
(Weigel, Ahmed) Department of Internal Medicine
(Nudy, Krakowski, Foy) Division of Cardiology, Penn State Milton S.
Hershey Medical Center, Hershey, PA, United States
Publisher
Elsevier Inc.
Abstract
The optimal timing of coronary artery bypass grafting (CABG) in patients
after an acute myocardial infarction (MI) is unknown. We performed a
systematic review and meta-analysis of studies comparing mortality rates
in patients who underwent CABG at different time intervals after acute MI.
Bias assessments were completed for each study, and summary of proportions
of all-cause mortality were calculated based on CABG at various time
intervals after MI. A total of 22 retrospective studies, which included a
total of 137,373 patients were identified. The average proportion of
patients who died when CABG was performed within 6 hours of MI was 12.7%,
within 6 to 24 hours of MI was 10.9%, within 1 day of MI was 9.8%, any
time after 1 day of MI was 3.0%, within 7 days of MI was 5.9%, and any
time after 7 days of MI was 2.7%. Interstudy heterogeneity, assessed using
I2 values, showed significant heterogeneity in death rates
within subgroups. Only 1 study accounted for immortal time bias, and there
was a serious risk of selection bias in all other studies. Confounding was
found to be a serious risk for bias in 55% of studies because of a lack of
accounting for type of MI, MI severity, or other verified cardiac risk
factors. The current publications comparing timing of CABG after MI is at
serious risk of bias because of patient selection and confounding, with
heterogeneity in both study populations and intervention time
intervals. Copyright © 2021 Elsevier Inc.

<31>
Accession Number
2019773976
Title
The Effect of Preoperative Oral Trimetazidine on Ischemic Injury and
Hemodynamic Function in Coronary Artery Bypass Grafting: A Double-Blinded,
Prospective, Randomized Controlled Trial.
Source
Journal of the Medical Association of Thailand. 105(8) (pp 674-682), 2022.
Date of Publication: August 2022.
Author
Phothikun A.; Woragidpoonpol S.; Tepsuwan T.; Tantraworasin A.;
Rimsukcharoenchai C.; Taksaudom N.
Institution
(Phothikun, Woragidpoonpol, Tepsuwan, Rimsukcharoenchai, Taksaudom)
Cardiovascular and Thoracic Surgery Unit, Department of Surgery, Faculty
of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Tantraworasin) General Thoracic Surgery Unit, Department of Surgery,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Tantraworasin) Clinical Epidemiology and Clinical Statistic Center,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Publisher
Medical Association of Thailand
Abstract
Background: Ischemic and reperfusion injury can occur during coronary
artery bypass grafting (CABG), leading to poor post-operative hemodynamic
function. Pre-operative administration of oral Trimetazidine has been
shown to reduce ischemic and reperfusion injury, however, the effects
about hemodynamic function are still controversial. Material(s) and
Method(s): Ninety patients that underwent CABG were randomly divided into
two groups. The Trimetazidine group received oral Trimetazidine 35 mg
twice a day for at least five days before the operation, and the control
group received a placebo. Invasive cardiac output monitoring using a Swan
Ganz catheter was performed in every case. The cardiac markers and
hemodynamic parameters were evaluated before the operation, immediately
after the operation, and then at 12 hours and 24 hours postoperatively.
 Result(s): There were no statistically significant differences in the
rise of all cardiac markers from the preoperative values to the immediate
postoperative values between the groups (p=0.471, 0.907 and 0.863 in
Troponin T, CK-MB, and total CK, respectively). For postoperative cardiac
marker levels, the level of CK-MB in the postoperative follow up period
increased +1.51 mcg/L (95% CI -1.11, +4.12), in the Trimetazidine group
and increased +0.93 mcg/L (95% CI; -1.78, +3.64) per follow up in the
placebo group, but the rising rate between both groups had no
statistically significant differences (p=0.670). Moreover, there were no
statistically significant differences in the increased of the preoperative
and postoperative cardiac index between the groups (p=0.102).
 Conclusion(s): The pre-operative administration of oral Trimetazidine
did not significantly reduce ischemic and reperfusion injury during CABG,
nor improve the postoperative hemodynamic function. Copyright ©
2022 Medical Association of Thailand. All rights reserved.

<32>
Accession Number
2018729232
Title
Outcomes of postoperative delirium in patients undergoing cardiac surgery:
A systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 884144. Date of Publication: 09 Aug 2022.
Author
Lin L.; Zhang X.; Xu S.; Peng Y.; Li S.; Huang X.; Chen L.; Lin Y.
Institution
(Lin, Zhang, Xu) Department of Nursing, Fujian Medical University, Fuzhou,
China
(Lin, Peng, Li, Huang, Chen, Lin) Department of Cardiac Surgery, Fujian
Medical University Union Hospital, Fuzhou, China
(Lin) Department of Nursing, Fujian Medical University Union Hospital,
Fuzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Postoperative delirium (POD) is an acute brain dysfunction
that is frequently observed in patients undergoing cardiac surgery.
Increasing evidence indicates POD is related to higher mortality among
cardiac surgical patients, but the results remain controversial. Moreover,
a quantitative evaluation of the influence of POD on hospital days,
intensive care unit (ICU) time, and mechanical ventilation (MV) time has
not been performed. Objective(s): This study aimed to evaluate the
correlation between POD and outcomes in patients undergoing cardiac
surgery by a systematic review and meta-analysis. Material(s) and
Method(s): A total of 7 electronic databases (Cochrane Library, PubMed,
EMBASE, CINAHL Complete, MEDLINE, Wan-fang database, and China National
Knowledge Infrastructure) were searched from January 1980 to July 20,
2021, with language restrictions to English and Chinese, to estimate the
impact of the POD on outcome in patients who underwent cardiac surgery.
The meta-analysis was registered with PROSPERO (Registration:
CRD42021228767). Result(s): Forty-two eligible studies with 19785
patients were identified. 3368 (17.0%) patients were in the delirium group
and 16417 (83%) were in the non-delirium group. The meta-analysis showed
that compared to patients without POD, patients with POD had 2.77-fold
higher mortality (OR = 2.77, 95% CI 1.86-4.11, P < 0.001), 5.70-fold
higher MV (>24h) rate (OR = 5.70, 95% CI 2.93-11.09, P < 0.001); and
longer MV time (SMD = 0.83, 95% CI 0.57-1.09, P < 0.001), ICU time (SMD =
0.91, 95% CI 0.60-1.22, P < 0.001), hospital days (SMD = 0.62, 95% CI
0.48-0.76, P < 0.001). Conclusion(s): The synthesized evidence
suggests that POD is causally related to the increased risk of mortality,
prolonged length of ICU and hospital stay, and a longer duration of MV
time. Future research should focus on the interventions for POD, to reduce
the incidence. Systematic review registration:
[www.crd.york.ac.uk/PROSPERO], identifier [CRD42021228767]. Copyright
© 2022 Lin, Zhang, Xu, Peng, Li, Huang, Chen and Lin.

<33>
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.

<34>
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.

<35>
Accession Number
2018452289
Title
Outcome after percutaneous coronary intervention with contemporary stents
in patients with concomitant peripheral arterial disease: A patient-level
pooled analysis of four randomized trials.
Source
Atherosclerosis. 355 (pp 52-59), 2022. Date of Publication: August 2022.
Author
Pinxterhuis T.H.; Ploumen E.H.; Zocca P.; Doggen C.J.M.; Schotborgh C.E.;
Anthonio R.L.; Roguin A.; Danse P.W.; Benit E.; Aminian A.; Stoel M.G.;
Linssen G.C.M.; Geelkerken R.H.; von Birgelen C.
Institution
(Pinxterhuis, Ploumen, Zocca, Stoel, von Birgelen) Department of
Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede,
Netherlands
(Pinxterhuis, Ploumen, Doggen, von Birgelen) Department of Health
Technology and Services Research, Faculty BMS, Technical Medical Centre,
University of Twente, Enschede, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Anthonio) Department of Cardiology, Treant Zorggroep, Scheper Hospital,
Emmen, Netherlands
(Roguin) Department of Cardiology, Hillel Yaffe Medical Center, Hadera and
B. Rappaport-Faculty of Medicine, Institute of Technology, Israel, Haifa,
Israel
(Danse) Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands
(Benit) Department of Cardiology, Jessa Hospital, Hasselt, Belgium
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Linssen) Department of Cardiology, Ziekenhuisgroep Twente, Almelo,
Hengelo, Netherlands
(Geelkerken) Department of Vascular Surgery, Medisch Spectrum Twente,
Enschede, Netherlands
(Geelkerken) Department of Multi-modality Medical Imaging (M3I) Group,
Faculty of Science and Technology, Technical Medical Centre, University of
Twente, Enschede, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: A considerable number of patients who undergo
percutaneous coronary intervention (PCI) also have peripheral arterial
disease (PAD) - a signal of more advanced atherosclerosis. After bare
metal and early-generation drug-eluting coronary stent implantation, PAD
patients showed inferior outcome. As stents and medical treatment were
further improved, we aimed to assess the impact of PAD on outcome of PCI
with contemporary new-generation stents. Method(s): We analyzed
3-year pooled patient-level data from 4 large-scale randomized
new-generation stent trials to compare all-comer patients with and without
(core lab-verified) history of symptomatic PAD, defined as obstructive
lesions in peripheral locations including lower and upper extremities,
carotid, vertebral, mesenteric and renal arteries. Main endpoint was
target vessel failure: cardiac death, target vessel-related myocardial
infarction, or clinically indicated target vessel revascularization.
 Result(s): Of all 9204 patients, 695 (7.6%) had a history of
symptomatic PAD. They were older and had more often diabetes, renal
failure, hypertension, hypercholesterolemia, and prior stroke. PAD was an
independent risk factor for target vessel failure (adjusted-HR:1.42,
95%-CI:1.12-1.73, p = 0.001). Target vessel revascularization
(adjusted-HR:1.37, 95%-CI:1.04-1.80, p = 0.026), death (adjusted-HR:1.52,
95%-CI:1.17-1.99, p = 0.002), and major adverse cardiovascular event risks
(adjusted-HR:1.36, 95%-CI:1.13-1.64, p = 0.001) were also substantially
higher. Conclusion(s): A history of symptomatic PAD still allows to
simply identify patients with increased risk of unfavorable clinical
outcome after PCI, including a higher risk of repeated coronary
revascularization, despite using contemporary stents. In clinical
practice, this knowledge about higher event risks of PAD patients is
helpful both during Heart Team discussions and when informing patients
about the procedural risk. Copyright © 2022 The Authors

<36>
Accession Number
638907331
Title
RECOMMENDATIONS for NURSES in the MANAGEMENT of RA PATIENTS on TREATMENT
with JAKINIBS.
Source
Annals of the Rheumatic Diseases. Conference: European Congress of
Rheumatology, EULAR 2022. Copenhagen Denmark. 81(Supplement 1) (pp 139),
2022. Date of Publication: June 2022.
Author
Martin Martin J.M.; Garcia-Diaz S.; Molina A.; Dominguez C.; Carmona L.;
Cano Garcia L.
Institution
(Martin Martin) Hospital Universitario Nuestra Senora de la Candelaria,
Rheumatology, Santa Cruz de Tenerife, Spain
(Garcia-Diaz) Consorci Sanitari Integral, Rheumatology, L'Hospitalet de
Llobregat, Spain
(Molina) University Hospital of Gran Canaria Dr. Negrin, Rheumatology, Las
Palmas de Gran Canaria, Spain
(Dominguez) Hospital Universitario Virgen Macarena, Rheumatology, Sevilla,
Spain
(Carmona) Instituto de Salud Musculoesqueletica (Inmusc), Madrid, Spain
(Cano Garcia) Hospital Regional Universitario de Malaga, Rheumatology,
Malaga, Spain
Publisher
BMJ Publishing Group
Abstract
Background: The number of new treatments available in rheumatology
continues to increase. Kinase inhibitors, or jakinibs, pose an added
challenge due to their variety and because they are oral. The most
important role of the rheumatology nurse is patient education, especially
on how to take the medication. The better the nurse understands the drugs,
the better their practical recommendations and decisions will be and the
better they will be able to respond to the patient. Guidelines or
recommendations for infammatory diseases do not usually include key
practical details for nurses. It is our understanding that these points
that will subsequently determine adherence and safety should be specially
addressed in a specifc document for nurses. Objective(s): To
establish practical, evidence-based nursing recommendations for the
management of people with RA undergoing treatment with jakinibs.
 Method(s): To reach an evidence-based consensus we used systematic
review and Delphi survey. A multidisciplinary panel of experts was formed
with 6 rheumatology nurses, 2 rheumatologists, 1 psychologist, 1
dietician-nutritionist and 1 patient on treatment with jakinibs. This
panel met on 2 occasions and was kept informed at all times of the
progress of the project through the Miro platform. At the preparatory
meeting the scope and users, structure and PICOt questions were
established (these included efficacy and adverse effects, infections,
cardiovascular risk, surgery, vaccination, pregnancy and breastfeeding,
interactions and switches between jakinibs). The steering group made
recommendations based on the issues raised at the frst meeting. Only those
that achieved 65% in favour were included as items in a Delphi survey. The
Delphi survey was sent to all members of the society nurses and
rheumatologists (n=60). Voting ranged from 0 to 10 (strongly disagree to
strongly agree). Items with more than 75% agreement in the frst round did
not proceed to a second round. Result(s): The Table 1 shows the
recommendations with their level of evidence and level of agreement after
the Delphi (n=40; 67%). One item with only 50% agreement was rejected and
did not proceed to a second round. Conclusion(s): These
recommendations will allow a practical approach to the management of
jakinibs by nurses and enjoy an adequate consensus among potential users.

<37>
Accession Number
2018506974
Title
Ventilatory Muscle Training for Early Cardiac Rehabilitation Improved
Functional Capacity and Modulated Vascular Function of Individuals
Undergoing Coronary Artery Bypass Grafting: Pilot Randomized Clinical
Trial.
Source
International Journal of Environmental Research and Public Health. 19(15)
(no pagination), 2022. Article Number: 9340. Date of Publication: August
2022.
Author
Eibel B.; Marques J.R.; Dipp T.; Waclawovsky G.; Marschner R.A.; Boll
L.C.; Kalil R.A.K.; Lehnen A.M.; Sales A.R.K.; Irigoyen M.C.C.
Institution
(Eibel, Marques, Waclawovsky, Boll, Kalil, Lehnen, Irigoyen) Instituto de
Cardiologia/Fundacao, Universitaria de Cardiologia (IC/FUC), RS, Porto
Alegre 90040-371, Brazil
(Dipp) Programa de Pos-Graduacao em Saude Coletiva, Universidade do Vale
do Rio dos Sinos (UNISINOS), RS, Sao Leopoldo 93022-750, Brazil
(Marschner) Hospital de Clinicas de Porto Alegre (HCPA), Universidade
Federal do Rio Grande do Sul (UFRGS), RS, Porto Alegre 90035-903, Brazil
(Kalil) Department of Surgery, Universidade Federal de Ciencias da Saude
de Porto Alegre (UFCSPA), RS, Porto Alegre 90050-170, Brazil
(Sales) Institute DOR for Research and Education (IDOR), SP, Sao Paulo
04501-000, Brazil
(Sales, Irigoyen) Instituto do Coracao (InCor), Universidade de Sao Paulo
(USP), SP, Sao Paulo 05403-000, Brazil
Publisher
MDPI
Abstract
Background: Cardiac rehabilitation with aerobic exercises is the first
strategy for nonpharmacological treatment in the postoperative period of
individuals undergoing coronary artery bypass grafting (CABG) to improve
functional capacity and vascular health. However, other exercise
modalities remain uncertain regarding the same benefits.
 Objective(s): Evaluation of the effect of different modalities of
exercise, such as early cardiac rehabilitation on subjects submitted to
CABG in the six-minute walk test (6-MWT) and on the percentage of
flow-mediated dilatation (FMD) of the brachial artery. Method(s): A
randomized clinical trial in which 15 patients (62.7 +/- 6.7 years) who
underwent CABG were randomly assigned to the following groups: isometric
(IG, Handgrip Jamar), ventilatory muscle training (VG,
PowerBreathe) and control (CG, conventional respiratory and
motor physiotherapy). All patients were attended to physically twice a day
(20 min/session) for a consecutive week after the CABG (hospital
admission). Functional capacity was assessed by 6-MWT and endothelial
function was assessed through the technique of FMD, before and after (~7
days) admission to CABG. The doppler ultrasound videos were analyzed by
Cardiovascular Suite software (Quipu, Pisa, Italy) to measure
%FMD. Statistics: Generalized estimation equation, followed by Bonferroni
post hoc (p < 0.05). Result(s): Systolic, diastolic and mean arterial
pressure (SBP/DBP/MAP, respectively) were 133, 76 and 95 mmHg. The groups
presented walking meters (m) distance before and after intervention of:
IG<inf>basal</inf> 357.80 +/- 47.15 m vs. IG<inf>post</inf> 306.20 +/-
61.63 m, p = 0.401 (+51 m); VG<inf>basal</inf> 261.50 +/- 19.91 m vs.
VG<inf>post</inf> 300.75 +/- 26.29 m, p = 0.052 (+39 m); CG
<inf>basal</inf> 487.83 +/- 83.23 m vs. CG<inf>post</inf> 318.00 +/-
31.08, p = 0.006 (-169 m). %FMD before and after intervention was
IG<inf>basal</inf> 10.4 +/- 4.8% vs. IG<inf>post</inf> 2.8 +/- 2.5%, p =
0.152; VG<inf>basal</inf> 9.8 +/- 5.1% vs. VG<inf>post</inf> 11.0 +/-
6.1%, p = 0.825; CG<inf>basal</inf> 9.2 +/- 15.8% vs. CG<inf>post</inf>
2.7 +/- 2.6%, p = 0.710 and resting mean basal blood flow was
IG<inf>basal</inf> 162.0 +/- 55.0 mL/min vs. IG<inf>post</inf> 129.9 +/-
63.7 mL/min, p = 0.662; VG<inf>basal</inf> 83.74 +/- 12.4 mL/min vs.
VG<inf>post</inf> 58.7 +/- 17.1 mL/min, p = 0.041; CG<inf>basal</inf>
375.6 +/- 183.7 mL/min vs. CG<inf>post</inf> 192.8 +/- 115.0 mL/min, p =
0.459. Conclusion(s): Ventilatory muscle training for early cardiac
rehabilitation improved acute functional capacity and modulated mean flow
of individuals undergoing CABG. Copyright © 2022 by the authors.

<38>
Accession Number
638915249
Title
Efficacy of Intraoperative Low Dose Intravenous Amiodarone in
Pharmacologic Cardioversion in Patients with Preoperative Atrial
Fibrillation Presenting for Mitral Valve Replacement Surgery Randomized
Control Trial.
Source
The heart surgery forum. 25(4) (pp E564-E570), 2022. Date of Publication:
27 Jul 2022.
Author
Kamal F.; Abd Al Jawad M.N.; Gamal M.
Institution
(Kamal) Department of Anesthesiology, Ain Shams University, Cairo, Egypt
(Abd Al Jawad) Department of Cardiothoracic Surgery, Ain Shams University,
Cairo, Egypt
(Gamal) Department of Cardiothoracic Surgery, Ain Shams University, Cairo,
Egypt
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial fibrillation (AF) is the most common form of
dysrhythmia observed in the clinical field, causing multiple morbidities,
such as thromboembolic complications. Hence, the maintenance of sinus
rhythm is superior to rate control. This study tests the efficacy of
single- and low-dose amiodarone on the persistence of AF after surgery
before transfer to the intensive care unit. METHOD(S): A
double-blinded, randomized controlled trial assessed 113 patients who
underwent mitral valve surgery with preoperative chronic AF. Patients were
divided into two groups: the control group (N = 55) who received 50 mL of
5% dextrose over 10 min after general anesthesia induction, and the
amiodarone group (N = 58) who received 1 mg/kg of amiodarone diluted in 50
mL of 5% dextrose over 10 min shortly after anesthesia induction.
 RESULT(S): The amiodarone group had a statistically significant
successful conversion of preoperative AF to normal sinus rhythm in 40
patients (72.73%). The control group demonstrated spontaneous conversion
from AF to a normal sinus rhythm in seven patients (12.73%). The sinus
rhythm was maintained in 60% of patients (36), as four patients reverted
to AF during the hospital stay despite the initial normal sinus rhythm
after the operation. In contrast, 53 (96.36%) patients in the control
group were discharged from the hospital with a controlled rate of AF. In
addition, low-dose amiodarone caused a statistically significant reduction
in heart rates at 10, 30, and 60 min after declamping, extended throughout
the first 24 h with mean heart rates of 97.233+/-7.311, 99.509+/-8.482,
and 97.940+/-7.715 bpm, respectively. In comparison, the control group had
heart rates of 115.382+/-7.547, 115.055+/-13.919, and 113.618+/-8.765 bpm
at these times. The mean postoperative heart rate at the end of the first
24 h was 97.793+/-7.189 bpm in the amiodarone group and 113.036+/-9.737
bpm in the control group. No mortality or need for mechanical support was
recorded in either group. CONCLUSION(S): Single and low-dose
intraoperative intravenous amiodarone during mitral valve surgery may be
practical to aid in pharmacological cardioversion of patients with
preoperative chronic AF presenting for mitral valve surgery.

<39>
Accession Number
638914207
Title
The application of 3D printing in preoperative planning for transcatheter
aortic valve replacement: a systematic review.
Source
Biomedical engineering online. 21(1) (pp 59), 2022. Date of Publication:
01 Sep 2022.
Author
Xenofontos P.; Zamani R.; Akrami M.
Institution
(Xenofontos, Zamani) Medical School, College of Medicine and Health,
Exeter, United Kingdom
(Akrami) Department of Engineering, College of Engineering, Mathematics,
Physical Sciences, University of Exeter, Exeter, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Recently, transcatheter aortic valve replacement (TAVR) has
been suggested as a less invasive treatment compared to surgical aortic
valve replacement, for patients with severe aortic stenosis. Despite the
attention, persisting evidence suggests that several procedural
complications are more prevalent with the transcatheter approach.
Consequently, a systematic review was undertaken to evaluate the
application of three-dimensional (3D) printing in preoperative planning
for TAVR, as a means of predicting and subsequently, reducing the
incidence of adverse events. METHOD(S): MEDLINE, Web of Science and
Embase were searched to identify studies that utilised patient-specific 3D
printed models to predict or mitigate the risk of procedural
complications. RESULT(S): 13 of 219 papers met the inclusion criteria
of this review. The eligible studies have shown that 3D printing has most
commonly been used to predict the occurrence and severity of paravalvular
regurgitation, with relatively high accuracy. Studies have also explored
the usefulness of 3D printed anatomical models in reducing the incidence
of coronary artery obstruction, new-onset conduction disturbance and
aortic annular rapture. CONCLUSION(S): Patient-specific 3D models can
be used in pre-procedural planning for challenging cases, to help deliver
personalised treatment. However, the application of 3D printing is not
recommended for routine clinical practice, due to practicality
issues. Copyright © 2022. The Author(s).

<40>
Accession Number
638913360
Title
A meta-analysis of colchicine in prevention of atrial fibrillation
following cardiothoracic surgery or cardiac intervention.
Source
Journal of cardiothoracic surgery. 17(1) (pp 224), 2022. Date of
Publication: 01 Sep 2022.
Author
Zhao H.; Chen Y.; Mao M.; Yang J.; Chang J.
Institution
(Zhao, Chen, Mao) Department of Cardiology, First Affiliated Hospital of
Chongqing Medical University, Yuzhong District, Chongqing 40000, China
(Yang) Department of General Practice, First Affiliated Hospital of
Chongqing Medical University, Yuzhong District, Chongqing 40000, China
(Chang) Department of Cardiology, First Affiliated Hospital of Chongqing
Medical University, Yuzhong District, Chongqing 40000, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is the most common
complication after cardiothoracic surgery or cardiac intervention.
Colchicine is an anti-inflammatory agent that was associated with improved
cardiovascular outcomes. However, its effect on POAF prevention was
inconsistent across studies. Therefore, the aim of this meta-analysis was
to evaluate the efficacy of colchicine in prevention of POAF.
 METHOD(S): We searched PubMed, Embase, ClinicalTrials.gov, Cochrane
Library database and Google Scholar for randomized controlled trials
(RCTs), using terms "atrial fibrillation" and "colchicine". The primary
end point was the occurrence of clinically diagnosed atrial fibrillation.
The relative risk (RR) and 95% confidence interval (CI) were evaluated.
Estimates were pooled using DerSimonian-Laird random-effects model. We
also performed subgroup analyses based on the duration and dose of
colchicine treatment. RESULT(S): A total of 9 RCTs were included in
this meta-analysis, enrolling a total of 2031 patients. Colchicine
significantly reduces the incidence of POAF (RR 0.62; 95% CI, 0.52-0.74,
P<0.001, I2=0%). Subgroup analyses indicated that the protective effect of
colchicine on POAF was slightly stronger in the long-duration group (RR
0.60; 95% CI, 0.48-0.75, P<0.001, I2=0%) than in the short-duration group
(RR 0.65; 95% CI, 0.49-0.86, P<0.001, I2=0%). CONCLUSION(S):
Colchicine is effective in preventing the occurrence of POAF. The efficacy
of colchicine can be slightly increased over treatment duration, with no
obvious adverse reactions. Copyright © 2022. The Author(s).

<41>
Accession Number
2019962628
Title
A comparison of regional anesthesia techniques in patients undergoing
video-assisted thoracic surgery: A network meta-analysis.
Source
International Journal of Surgery. 105 (no pagination), 2022. Article
Number: 106840. Date of Publication: September 2022.
Author
Sandeep B.; Huang X.; Li Y.; Xiong D.; Zhu B.; Xiao Z.
Institution
(Sandeep, Li, Xiong, Xiao) Department of Cardio-Thoracic Surgery, Chengdu
Second People's Hospital, Sichuan, Chengdu 610017, China
(Huang) Department of Anesthesiology, West China Hospital of Sichuan
University, Sichuan Province, Chengdu 610041, China
(Zhu) Department of Anesthesiology, Chengdu Second People's Hospital,
Sichuan, Chengdu 610017, China
Publisher
Elsevier Ltd
Abstract
Background: Postoperative pain control remains challenging in patients
undergoing video-assisted thoracoscopic surgery (VATS). This study aimed
to investigate the relative efficacy of different regional anesthesia
interventions for VATS using a Network Meta analysis (NMA).
 Method(s): A literature search was conducted for NMA using Pubmed,
The Cochrane Library, Embase, and the Web of Science databases to identify
all randomized controlled trials (RCTs) that compared the analgesic
effects of different regional analgesia techniques from inception to
February 2022. The primary outcome was opioid consumption during the first
24 h postoperatively. The secondary outcomes were morphine consumption at
48 h postoperatively, pain intensity, postoperative nausea and vomiting,
and hospital length of stay. Pain scores at two different intervals from
different regional analgesia techniques were measured and investigated in
this NMA. Result(s): A total of 38 RCTs (2224 patients) were
included. Two studies compared three arm interventions of intercostal
nerve block (ICNB) vs. thoracic paravertebral block (TPVB) vs. erector
spinae plane block (ESPB) in intravenous morphine consumption at 24 h and
48 h postoperatively, and showed patients who received TPVB had less
demand for morphine than ICNB and ESPB (P = 0.001, P = 0.001). For resting
pain scores at 24 h postoperatively, ESPB was superior to serratus
anterior plane block (SAPB) (P = 0.01), and TPVB provided effective
analgesia compared to ICNB, retrolaminar block (RLB), and ESPB (P = 0.05,
P = 0.01, P = 0.03). Similarly, pain scores at rest at 48 h, SAPB and TPVB
showed the best results (P = 0.04, P = 0.001, P = 0.01) compared with
local infiltration analgesia (LIA), ICNB, RLB, and ESPB. Additionally,
pain scores at coughing at 24 h and 48 h, TPVB showed superior results
compared with RLB,ESPB(P = 0.02, P = 0.02, P = 0.03). SAPB was superior to
LIA in reducing the incidence of postoperative nausea and vomiting (P =
0.04). Conclusion(s): In regional anaesthesia, TPVB is a better
option than other analgesic methods, and its combination with other
methods can be beneficial. However, our findings can only provide
objective evidence. Clinicians should choose the treatment course based on
the individual patient's condition and clinical situation. Copyright
© 2022 IJS Publishing Group Ltd

<42>
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.

<43>
Accession Number
638914832
Title
Angiographic Patency of Coronary Artery Bypass Conduits: An Updated
Network Meta-Analysis of Randomized Trials.
Source
Brazilian journal of cardiovascular surgery. 37(1) (pp 7-31), 2022. Date
of Publication: 02 Sep 2022.
Author
Deng M.X.; Lia H.; Lee G.; Rahouma M.; Franco A.D.; 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, Franco, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, NY, United States
(Demetres) Weill Cornell Medicine, Samuel J. Wood Library & C.V. Starr
Biomedical Information Center, NY, United States
(Angelini) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
Publisher
NLM (Medline)
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.

<44>
Accession Number
2014353569
Title
Paravalvular Leak After Transcatheter Aortic Valve Implantation Its
Incidence, Diagnosis, Clinical Implications, Prevention, Management, and
Future Perspectives: A Review Article.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 100957. Date of Publication: October 2022.
Author
Bhushan S.; Huang X.; Li Y.; He S.; Mao L.; Hong W.; Xiao Z.
Institution
(Bhushan, Li, He, Mao, Hong, Xiao) Department of Cardiothoracic Surgery,
Chengdu Second People's Hospital, Sichuan, Chengdu 610017, China
(Huang) Department of Anesthesiology, West China Hospital of Medicine,
Sichuan University, Sichuan 610017, China
Publisher
Elsevier Inc.
Abstract
Paravalvular leak (PVL) is very common after TAVI and has been reported to
have a negative impact on both short- and long-term survival. The current
study identified incidence, diagnosis, clinical implications, and
prevention, management and future perspectives for post-TAVI paravalvular
leak. A systematic literature search was conducted using PubMed and
EMBASE, using the MeSH terms and key words "paravalvular leak,"
"diagnostic criteria," "implication," "influencing factors," and
"prevention strategies." Studies were retained for review after meeting
strict inclusion criteria that included only prospective studies
evaluating Paravalvular leak in patients who had TAVI. Thirty articles
were selected for inclusion, incidence of PVL across the studies ranged
from 7% to 40%. Many factors have been associated with incidence and
increased risk of PVL, including AVC volume, larger annulus dimensions,
pre-TAVI transvalvular peak velocity, under sizing of the prosthesis,
surgical, and other factors. PVL after TAVI is common and can be predicted
by aortic root calcification volume, larger annulus dimensions, and
pre-TAVI transvalvular peak velocity, with calcification volume being an
independent predictor for PVL. The strength and nature of the association
of various degrees of post-TAVI PVL and mortality are still to be further
evaluated. Copyright © 2021 The Author(s)

<45>
Accession Number
638475639
Title
Comparison of Airtraq DL TM and Macintosh laryngoscope for double-lumen
tube placement in simulated difficult airway: A randomised study.
Source
Indian Journal of Anaesthesia. 66(6) (pp 442-448), 2022. Date of
Publication: June 2022.
Author
Mounika K.; Kar P.; Padhy S.; Pathy A.; Durga P.
Institution
(Mounika, Kar, Padhy, Pathy, Durga) Department of Anaesthesia and
Intensive Care, Nizams Institute of Medical Sciences, Telangana,
Hyderabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: The Airtraq DL TM is a prototype channeled video
laryngoscope, designed specifically for endobronchial intubation with a
double-lumen tube (DLT). Evidence on its superiority over Macintosh
laryngoscope for DLT placement in the difficult airway is limited. This
study compared the efficacy of both these laryngoscopes in the simulated
difficult airway. Method(s): A prospective randomised controlled
study was conducted on 52 patients undergoing elective thoracic surgery
with lung isolation using a left-sided DLT. The patients were randomised
into Airtraq DL TM group (group A) and Macintosh group (group M). The
primary objective was to compare the time required for intubation, and the
secondary objectives were to evaluate time to best glottic view,
Cormack-Lehane (CL) grading, intubation difficulty score (IDS),
manoeuvres, attempts at intubation, haemodynamic response and
complications. Operating anaesthesiologists were also asked to grade the
ease of laryngoscopy and intubation for both devices on a 4-point Likert
scale. Result(s): The mean time to intubation was found to be lesser
in group A than in group M (18 +/- 6.91 s vs 25.48 +/- 9.47 s, P = 0.003).
Group A showed better CL grading (P <= 0.001), lesser requirement of
manoeuvres (P = 0.02) and lower IDS (P = 0.003). Also, group A had
significantly better Likert scale results as compared to group M.
 Conclusion(s): The Airtraq DL TM is superior to Macintosh
laryngoscope as it requires lesser time for intubation and provides
favourable intubating conditions (better CL grading, lesser manoeuvres,
lower IDS and improved Likert scales) for double-lumen placement in the
simulated difficult airway. Copyright © 2022 Indian Journal of
Anaesthesia.

<46>
Accession Number
2015687437
Title
Meta-Analysis of New-Onset Atrial Fibrillation Versus No History of Atrial
Fibrillation in Patients With Noncardiac Critical Care Illness.
Source
American Journal of Cardiology. 164 (pp 57-63), 2022. Date of Publication:
01 Feb 2022.
Author
Shah K.B.; Saado J.; Kerwin M.; Mazimba S.; Kwon Y.; Mangrum J.M.; Salerno
M.; Haines D.E.; Mehta N.K.
Institution
(Shah, Haines, Mehta) Department of Cardiovascular Medicine, Beaumont
Hospital, Oakland University William Beaumont School of Medicine, Royal
Oak, MI, United States
(Saado) Department of Internal Medicine, Virginia Commonwealth University,
Richmond, VA, United States
(Kerwin) Division of Internal Medicine
(Mazimba, Mangrum, Salerno, Mehta) Division of Cardiovascular Medicine,
University of Virginia, Charlottesville, VA, United States
(Kwon) Division of Cardiovascular Medicine and Critical care medicine,
Harborview Medical Center, University of Washington Medical Center,
Seattle, WA, United States
Publisher
Elsevier Inc.
Abstract
The incidence of new-onset secondary atrial fibrillation (NOSAF) is as
high as 44% in noncardiac critical illness. A systematic review and
meta-analysis were performed to evaluate the impact of NOSAF, compared
with history of prior atrial fibrillation (AF) and no history of AF in
noncardiac critically ill patients. Patients undergoing cardiothoracic
surgery were excluded. NOSAF incidence, intensive care unit (ICU)/hospital
length of stay (LOS), and mortality outcomes were analyzed. Of 2,360
studies reviewed, 19 studies met inclusion criteria (n = 306,805
patients). NOSAF compared with no history of AF was associated with
increased in-hospital mortality (risk ratio [RR] 2.06, 95% confidence
interval [CI] 1.76 to 2.41, p <0.001), longer ICU LOS (standardized
difference in means [SMD] 0.66, 95% CI 0.41 to 0.91, p <0.001), longer
hospital LOS (SMD 0.31, 95% CI 0.07 to 0.56, p = 0.001) and increased risk
of long-term (>1 year) mortality (RR 1.76, 95% CI 1.29 to 2.40, p <0.001).
NOSAF compared with previous AF was also associated with higher
in-hospital mortality (RR 1.29, 95% CI 1.12 to 1.49, p <0.001), longer ICU
LOS (SMD 0.37, 95% CI 0.03 to 0.70, p = 0.03) but no difference
in-hospital LOS (SMD -0.18, 95% CI -0.66 to 0.31, p = 0.47). In
conclusion, NOSAF, in the setting of noncardiac critical illness is
associated with increased in-hospital mortality compared with no history
of AF and previous AF. NOSAF (vs no history of AF) is also associated with
increased long-term mortality. Copyright © 2021 Elsevier Inc.

<47>
Accession Number
2015452925
Title
Retained surgical drain fragments: A systematic review and case report.
Source
Surgical Practice. 26(3) (pp 199-207), 2022. Date of Publication: August
2022.
Author
Indja B.; Chen K.; Cheng E.; Kennedy H.; Alzahrani N.; Morris D.L.
Institution
(Indja) School of Health Sciences, Faculty of Medicine and Health, The
University of Sydney, Camperdown, NSW, Australia
(Indja, Chen, Cheng, Kennedy, Alzahrani, Morris) Hepatobilliary and
Surgical Oncology Unit, Department of Surgery, St George Hospital,
Kogarah, NSW, Australia
(Chen, Cheng, Morris) St George and Sutherland Clinical School, University
of New South Wales, Sydney, NSW, Australia
(Alzahrani) College of Medicine, Al Imam Mohammad Ibn Saud Islamic
University (IMSIU), Riyadh, Saudi Arabia
Publisher
John Wiley and Sons Inc
Abstract
Aim: Retained surgical drains are an avoidable and serious cause of
postoperative morbidity. This study aims to first report on our unit's
experience in identifying and managing retained surgical drains and then
consolidate current knowledge regarding retained surgical drains, causes
and associated complications. Patients and Methods: A systematic
review of the literature was performed through searches in electronic
databases to identify studies that described incidents involving retained
surgical drains. Data were extracted regarding patient and operative
characteristics, drain complications and management. Result(s): A
total of 36 case reports and/or series were identified in the literature,
with 39 individual cases of retained surgical drains in patients
undergoing abdominal, thoracic or orthopaedic procedures. The most common
cause for retained drain was fracture of drain tubing. Patients presented
with complications ranging from chronic pain, abscess or fistula
formation, to migration of the drain fragment into a hollow viscus. In all
cases an invasive intervention was required to remove the retained drain.
 Conclusion(s): Surgeons should be aware of retained surgical drains
as an iatrogenic cause of postoperative morbidity. Contemporary surgical
practice should include methods to prevent, identify and manage retained
drains and associated complications. Copyright © 2022 College of
Surgeons of Hong Kong.

<48>
Accession Number
2019879887
Title
Pre-surgery optimization of patients' expectations to improve outcome in
heart surgery: Study protocol of the randomized controlled multi-center
PSY-HEART-II trial.
Source
American Heart Journal. 254 (pp 1-11), 2022. Date of Publication: December
2022.
Author
Salzmann S.; Laferton J.A.C.; Shedden-Mora M.C.; Horn N.; Gartner L.;
Schroder L.; Rau J.; Schade-Brittinger C.; Murmann K.; Rastan A.; Andrasi
T.B.; Boning A.; Salzmann-Djufri M.; Lowe B.; Brickwedel J.; Albus C.;
Wahlers T.; Hamm A.; Hilker L.; Albert W.; Falk V.; Zimmermann T.; Ismail
I.; Strauss B.; Doenst T.; Schedlowski M.; Moosdorf R.; Rief W.
Institution
(Salzmann, Horn, Gartner, Schroder, Rief) Division of Clinical Psychology
and Psychotherapy, Philipps University of Marburg, Marburg, Germany
(Laferton) Department of Medicine, Health and Medical University, Potsdam,
Germany
(Shedden-Mora) Department of Psychology, Medical School Hamburg, Hamburg,
Germany
(Shedden-Mora, Lowe) Department of Psychosomatic Medicine and
Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg,
Germany
(Rau, Schade-Brittinger, Murmann) Coordination Center for Clinical Trials
(KKS), University of Marburg, Marburg, Germany
(Rastan, Andrasi, Moosdorf) Department for Cardiovascular Surgery, Heart
Center, Philipps University of Marburg, Marburg, Germany
(Boning, Salzmann-Djufri) Department of Cardiovascular Surgery, University
Hospital Giessen, Giessen, Germany
(Brickwedel) Department of Cardiovascular Surgery, University Heart &
Vascular Center Hamburg, Hamburg, Germany
(Albus) Department of Psychosomatics and Psychotherapy, Medical Faculty
and University Hospital, University of Cologne, Cologne, Germany
(Wahlers) Department of Cardiothoracic Surgery, University Hospital of
Cologne, Cologne, Germany
(Hamm) Department of Physiological and Clinical Psychology/ Psychotherapy,
University of Greifswald, Greifswald, Germany
(Hilker) Department of Cardiovascular Surgery, Clinic Karlsburg, Heart and
Diabetes Center Mecklenburg-Western Pommerania, Karlsburg, Germany
(Albert) Psychosomatics, German Heart Center Berlin, Berlin, Germany
(Falk) Department of Cardiothoracic and Vascular Surgery, German Heart
Center Berlin, Berlin, Germany
(Zimmermann) Department of Psychosomatic Medicine and Psychotherapy,
Hannover Medical School, Hannover, Germany
(Ismail) Division of Cardiac, Thoracic, Transplantation and Vascular
Surgery, Hannover Medical School, Hannover, Germany
(Straus) Institute of Psychosocial Medicine, Psychotherapy, and
Psychooncology, University Hospital Jena, Germany
(Doenst) Jena University Hospital, Friedrich-Schiller-University of Jena,
Jena, Germany
(Schedlowski) Institute of Medical Psychology and Behavioral
Immunobiology, University Clinic Essen, Department of Clinical
Neuroscience, Osher Center for Integrative Medicine, Karolinska Institute,
Essen, Germany
Publisher
Elsevier Inc.
Abstract
The PSY-HEART-I trial indicated that a brief expectation-focused
intervention prior to heart surgery improves disability and quality of
life 6 months after coronary artery bypass graft surgery (CABG). However,
to investigate the clinical utility of such an intervention, a large
multi-center trial is needed to generalize the results and their
implications for the health care system. The PSY-HEART-II study aims to
examine whether a preoperative psychological intervention targeting
patients' expectations (EXPECT) can improve outcomes 6 months after CABG
(with or without heart valve replacement). EXPECT will be compared to
Standard of Care (SOC) and an intervention providing emotional support
without targeting expectations (SUPPORT). In a 3-arm multi-center
randomized, controlled, prospective trial (RCT), N = 567 patients
scheduled for CABG surgery will be randomized to either SOC alone or SOC
and EXPECT or SOC and SUPPORT. Patients will be randomized with a fixed
unbalanced ratio of 3:3:1 (EXPECT: SUPPORT: SOC) to compare EXPECT to SOC
and EXPECT to SUPPORT. Both psychological interventions consist of 2
in-person sessions (a 50 minute), 2 phone consultations (a 20 minute)
during the week prior to surgery, and 1 booster phone consultation
post-surgery 6 weeks later. Assessment will occur at baseline approx. 3-10
days before surgery, preoperatively the day before surgery, 4-6 days
later, and 6 months after surgery. The study's primary end point will be
patients' illness-related disability 6 months after surgery. Secondary
outcomes will be patients' expectations, subjective illness beliefs,
quality of life, length of hospital stay and blood sample parameters (eg,
inflammatory parameters such as IL-6, IL-8, CRP). This large multi-center
trial has the potential to corroborate and generalize the promising
results of the PSY-HEART-I trial for routine care of cardiac surgery
patients, and to stimulate revisions of treatment guidelines in heart
surgery. Copyright © 2022 The Authors

<49>
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Accession Number
2019870918
Title
Perfusion Imaging for Endovascular Thrombectomy in Acute Ischemic Stroke
Is Associated With Improved Functional Outcomes in the Early and Late Time
Windows.
Source
Stroke. 53(9) (pp 2770-2778), 2022. Date of Publication: 01 Sep 2022.
Author
Dhillon P.S.; Butt W.; Podlasek A.; McConachie N.; Lenthall R.; Nair S.;
Malik L.; Booth T.C.; Bhogal P.; Makalanda H.L.D.; Spooner O.; Mortimer
A.; Lamin S.; Chavda S.; Chew H.S.; Nader K.; Al-Ali S.; Butler B.;
Rajapakse D.; Appleton J.P.; Krishnan K.; Sprigg N.; Smith A.; Lobotesis
K.; White P.; James M.A.; Bath P.M.; Dineen R.A.; England T.J.
Institution
(Dhillon, McConachie, Lenthall, Nair, Malik) Interventional
Neuroradiology, Queens Medical Centre, Nottingham University Hospitals Nhs
Trust, United Kingdom
(Krishnan, Sprigg, Bath) Stroke, Queens Medical Centre, Nottingham
University Hospitals Nhs Trust, United Kingdom
(Podlasek, Dineen) National Institute for Health and Care Research
Nottingham Biomedical Research Centre, University of Nottingham, United
Kingdom
(Sprigg, Bath, England) Stroke Trials Unit, Mental Health and Clinical
Neuroscience, University of Nottingham, United Kingdom
(Dineen) Radiological Sciences, Mental Health and Clinical Neuroscience,
University of Nottingham, United Kingdom
(Butt, Lamin, Chavda, Chew, Nader, Al-Ali, Butler, Rajapakse)
Interventional Neuroradiology, Queen Elizabeth Hospital, University
Hospitals Birmingham Nhs Trust, United Kingdom
(Booth) Department of Neuroradiology, King's College Hospital Nhs
Foundation Trust, London, United Kingdom
(Booth) School of Biomedical Engineering and Imaging Sciences, King's
College London, United Kingdom
(Bhogal, Makalanda) Interventional Neuroradiology, The Royal London
Hospital, Barts Health Nhs Trust, United Kingdom
(Spooner) Stroke, The Royal London Hospital, Barts Health Nhs Trust,
United Kingdom
(Mortimer) Interventional Neuroradiology, Southmead Hospital, North
Bristol Nhs Trust, United Kingdom
(Appleton) Stroke, University Hospitals Birmingham Nhs Foundation Trust,
Edgbaston, United Kingdom
(Appleton) Institute of Applied Health Research, College of Dental and
Medical Sciences, University of Birmingham, United Kingdom
(Smith) Interventional Neuroradiology, Hull Royal Infirmary, Hull and East
Yorkshire Hospitals Nhs Trust, United Kingdom
(Lobotesis) Interventional Neuroradiology, Charing Cross Hospital,
Imperial College Healthcare Nhs Trust, London, United Kingdom
(White) Translational and Clinical Research Institute, Faculty of Medical
Sciences, Newcastle University and Newcastle Upon Tyne Hospitals Nhs
Foundation Trust, United Kingdom
(James) University of Exeter Medical School, United Kingdom
(James) Royal Devon and Exeter Nhs Foundation Trust, United Kingdom
(James) Sentinel Stroke National Audit Programme, King's College London,
United Kingdom
(England) Stroke, University Hospitals of Derby and Burton Nhs Foundation
Trust, United Kingdom
Publisher
Wolters Kluwer Health
Abstract
Background: The impact on clinical outcomes of patient selection using
perfusion imaging for endovascular thrombectomy (EVT) in patients with
acute ischemic stroke presenting beyond 6 hours from onset remains
undetermined in routine clinical practice. Method(s): Patients from a
national stroke registry that underwent EVT selected with or without
perfusion imaging (noncontrast computed tomography/computed tomography
angiography) in the early (<6 hours) and late (6-24 hours) time windows,
between October 2015 and March 2020, were compared. The primary outcome
was the ordinal shift in the modified Rankin Scale score at hospital
discharge. Other outcomes included functional independence (modified
Rankin Scale score <=2) and in-hospital mortality, symptomatic
intracerebral hemorrhage, successful reperfusion (Thrombolysis in Cerebral
Infarction score 2b-3), early neurological deterioration, futile
recanalization (modified Rankin Scale score 4-6 despite successful
reperfusion) and procedural time metrics. Multivariable analyses were
performed, adjusted for age, sex, baseline stroke severity, prestroke
disability, intravenous thrombolysis, mode of anesthesia (Model 1) and
including EVT technique, balloon guide catheter, and center (Model 2).
 Result(s): We included 4249 patients, 3203 in the early window (593
with perfusion versus 2610 without perfusion) and 1046 in the late window
(378 with perfusion versus 668 without perfusion). Within the late window,
patients with perfusion imaging had a shift towards better functional
outcome at discharge compared with those without perfusion imaging
(adjusted common odds ratio [OR], 1.45 [95% CI, 1.16-1.83]; P=0.001).
There was no significant difference in functional independence (29.3% with
perfusion versus 24.8% without; P=0.210) or in the safety outcome measures
of symptomatic intracerebral hemorrhage (P=0.53) and in-hospital mortality
(10.6% with perfusion versus 14.3% without; P=0.053). In the early time
window, patients with perfusion imaging had significantly improved odds of
functional outcome (adjusted common OR, 1.51 [95% CI, 1.28-1.78];
P=0.0001) and functional independence (41.6% versus 33.6%, adjusted OR,
1.31 [95% CI, 1.08-1.59]; P=0.006). Perfusion imaging was associated with
lower odds of futile recanalization in both time windows (late: adjusted
OR, 0.70 [95% CI, 0.50-0.97]; P=0.034; early: adjusted OR, 0.80 [95% CI,
0.65-0.99]; P=0.047). Conclusion(s): In this real-world study,
acquisition of perfusion imaging for EVT was associated with improvement
in functional disability in the early and late time windows compared with
nonperfusion neuroimaging. These indirect comparisons should be
interpreted with caution while awaiting confirmatory data from prospective
randomized trials. Copyright © 2022 Lippincott Williams and
Wilkins. All rights reserved.

<50>
[Use Link to view the full text]
Accession Number
2019708145
Title
Edoxaban Versus Dual Antiplatelet Therapy for Leaflet Thrombosis and
Cerebral Thromboembolism After TAVR: The ADAPT-TAVR Randomized Clinical
Trial.
Source
Circulation. 146(6) (pp 466-479), 2022. Date of Publication: 09 Aug 2022.
Author
Park D.-W.; Ahn J.-M.; Kang D.-Y.; Kim K.W.; Koo H.J.; Yang D.H.; Jung
S.C.; Kim B.; Wong Y.T.A.; Lam C.C.S.; Yin W.-H.; Wei J.; Lee Y.-T.; Kao
H.-L.; Lin M.-S.; Ko T.-Y.; Kim W.-J.; Kang S.H.; Yun S.-C.; Lee S.-A.; Ko
E.; Park H.; Kim D.-H.; Kang J.-W.; Lee J.-H.; Park S.-J.
Institution
(Park, Ahn, Kang, Lee, Ko, Kim, Park) Division of Cardiology, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
(Koo, Yang, Jung, Kang) Department of Radiology Research Institute of
Radiology, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Yun) Division of Biostatistics, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Lee) Department of Neurology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Kim) Asan Image Metrics, Clinical Trial Center, Asan Institute for Life
Sciences, Asan Medical Center, Seoul, South Korea
(Kim) Department of Radiology, Anam Hospital, Korea University College of
Medicine, Seoul, South Korea
(Wong, Lam) Division of Cardiology, Department of Medicine, University of
Hong Kong, Queen Mary Hospital, Hong Kong
(Yin, Wei, Lee) Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
(Republic of China)
(Kao, Lin) Division of Cardiology, Department of Internal Medicine,
National Taiwan University Hospital, Taipei, Taiwan (Republic of China)
(Ko) Division of Cardiology, Department of Internal Medicine, Hsin-Chu
Branch, National Taiwan University Hospital, Taiwan (Republic of China)
(Kim, Kang) Department of Cardiology, Cha Bundang Medical Center,
Seongnam, South Korea
(Park) Division of Cardiology, GangNeung Asan Hospital, University of
Ulsan College of Medicine, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background: It is unknown whether the direct oral anticoagulant edoxaban
can reduce leaflet thrombosis and the accompanying cerebral thromboembolic
risk after transcatheter aortic valve replacement. In addition, the causal
relationship of subclinical leaflet thrombosis with cerebral
thromboembolism and neurological or neurocognitive dysfunction remains
unclear. Method(s): We conducted a multicenter, open-label randomized
trial comparing edoxaban with dual antiplatelet therapy (aspirin plus
clopidogrel) in patients who had undergone successful transcatheter aortic
valve replacement and did not have an indication for anticoagulation. The
primary end point was an incidence of leaflet thrombosis on 4-dimensional
computed tomography at 6 months. Key secondary end points were the number
and volume of new cerebral lesions on brain magnetic resonance imaging and
the serial changes of neurological and neurocognitive function between 6
months and immediately after transcatheter aortic valve replacement.
 Result(s): A total of 229 patients were included in the final
intention-to-treat population. There was a trend toward a lower incidence
of leaflet thrombosis in the edoxaban group compared with the dual
antiplatelet therapy group (9.8% versus 18.4%; absolute difference,-8.5%
[95% CI,-17.8% to 0.8%]; P=0.076). The percentage of patients with new
cerebral lesions on brain magnetic resonance imaging (edoxaban versus dual
antiplatelet therapy, 25.0% versus 20.2%; difference, 4.8%; 95% CI,-6.4%
to 16.0%) and median total new lesion number and volume were not different
between the 2 groups. In addition, the percentages of patients with
worsening of neurological and neurocognitive function were not different
between the groups. The incidence of any or major bleeding events was not
different between the 2 groups. We found no significant association
between the presence or extent of leaflet thrombosis with new cerebral
lesions and a change of neurological or neurocognitive function.
 Conclusion(s): In patients without an indication for long-term
anticoagulation after successful transcatheter aortic valve replacement,
the incidence of leaflet thrombosis was numerically lower with edoxaban
than with dual antiplatelet therapy, but this was not statistically
significant. The effects on new cerebral thromboembolism and neurological
or neurocognitive function were also not different between the 2 groups.
Because the study was underpowered, the results should be considered
hypothesis generating, highlighting the need for further
research. Copyright © 2022 the Author(s). Published by Wolters
Kluwer Health, Inc.

<51>
Accession Number
2018701801
Title
Comparison of the accuracy of three methods measured the length of the
right main stem bronchus by chest computed tomography as a guide to the
use of right sided double-lumen tube.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 264. Date
of Publication: December 2022.
Author
Liu Z.; Liu M.; Zhao L.; Qi X.; yu Y.; Liang S.; Yang X.; Ma Z.
Institution
(Liu, Liu, Qi, yu, Liang, Yang) Department of Anesthesiology, First
Hospital of Qinhuangdao, N.O. 258, Wenhua Road, Hebei, Qinhuangdao, China
(Liu) Graduate School of Hebei Medical University, Hebei, Shijiazhuang,
China
(Zhao) Department of Thoracic surgery, First Hospital of Qinhuangdao, N.O.
258, Wenhua Road, Hebei, Qinhuangdao, China
(Ma) Department of General Surgery, First Hospital of Qinhuangdao, N.O.
258, Wenhua Road, Hebei, Qinhuangdao, China
Publisher
BioMed Central Ltd
Abstract
Background: The variation of right main stem bronchus leads to the orifice
of the right upper lobe bronchus may be obstructed or increase the
incidence of malposition intraoperatively when the right sided
double-lumen tube is used. Therefore, the aim of this study was to compare
the accuracy of three methods measured the length of the right main stem
bronchus via chest computed tomography as a guide to the use of right
sided double-lumen tube. Method(s): In this study, 168 adult patients
undergoing left sided thoracic surgery were included. All these patients
were allocated to carina-proximal (C-P) group, carina-distal (C-D) group
and carina-carina (C-C) group. The position of endobronchial cuff observed
via Fiberoptic bronchoscopy after successful initial placement and after
turning the patients to the lateral decubitus position, as well as the
incidence of malposition of right sided double-lumen tube intraoperative
were recorded to assess the accuracy of three methods in predicting the
position of right sided double-lumen tube. Result(s): The distance
between the carina to the proximal margin of the right upper lobe orifice,
carina to the distal margin of the right upper lobe orifice and carina to
the first right interlobar carina of the right upper lobe orifice were
17.2 +/- 2.3 mm, 25.4 +/- 3.7 mm and 28.5 +/- 3.1 mm (P < 0.05). In the
C-D group, the number of endobronchial cuffs seen to be herniating out of
the carina, the number of bronchoscopies during initial placement and on
the lateral position, the number of total malposition intraoperative and
the number of reposition manoeuvres intraoperative were significantly less
than the C-P group or the C-C group (P < 0.05). Conclusion(s): The
length of the right main stem bronchus measured by the carina to distal
margin of right upper lobe orifice method was more accurate than the other
two methods in guiding the use of right sided double-lumen tube. Trials
registration: Clinical Trials. gov. no. NCT04127903. Registered at
https://register.clinicaltrials.gov on 16/10/2019. Copyright ©
2022, The Author(s).

<52>
Accession Number
637678956
Title
Paediatric brain MRI findings following congenital heart surgery: A
systematic review.
Source
Archives of Disease in Childhood. 107(9) (pp 818-825), 2022. Date of
Publication: 01 Sep 2022.
Author
Alablani F.J.; Chan H.S.A.; Beishon L.; Patel N.; Almudayni A.; Bu'lock
F.; Chung E.M.L.
Institution
(Alablani, Chan, Beishon, Almudayni, Chung) Department of Cardiovascular
Sciences, University of Leicester, Leicester, United Kingdom
(Alablani, Almudayni) College of Applied Medical Sciences, Prince Sattam
Bin Abdulaziz University, Al-Kharj, Saudi Arabia
(Patel) Department of Clinical Neuroscience, St George's University of
London, London, United Kingdom
(Bu'lock) East Midlands Congenital Heart Centre, Glenfield Hospital,
Leicester, United Kingdom
(Chung) Faculty of Life Sciences and Medicine, King's College London,
London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objective This systematic review aimed to establish the relative incidence
of new postoperative brain MRI findings following paediatric congenital
cardiac surgery. Design To distinguish perioperative changes from
pre-existing MR findings, our systematic search strategy focused on
identifying original research studies reporting both presurgery and
postsurgery brain MRI scans. Patient demographics, study methods and brain
MR findings were extracted. Results Twenty-one eligible publications,
including two case-control and one randomised controlled trial, were
identified. Pre-existing brain MRI findings were noted in 43% (513/1205)
of neonates prior to surgery, mainly white matter injuries (WMI). Surgery
was performed at a median age of 8 days with comparison of preoperative
and postoperative MR scans revealing additional new postoperative findings
in 51% (550/1075) of patients, mainly WMI. Four studies adopted a brain
injury scoring system, but the majority did not indicate the severity or
time course of findings. In a subgroup analysis, approximately 32% of
patients with pre-existing lesions went on to develop additional new
lesions postsurgery. Pre-existing findings were not found to confer a
higher risk of acquiring brain lesions postoperatively. No evidence was
identified linking new MR findings with later neurodevelopmental delay.
Conclusion This systematic review suggests that surgery approximately
doubles the number of patients with new brain lesions. Copyright
© 2022 Author(s) (or their employer(s)). Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

<53>
Accession Number
638899839
Title
Efficacy and Safety of Triiodothyronine Treatment in Cardiac Surgery or
Cardiovascular Diseases: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Thyroid. 32(8) (pp 879-896), 2022. Date of Publication: August 2022.
Author
Tharmapoopathy M.; Thavarajah A.; Kenny R.P.W.; Pingitore A.; Iervasi G.;
Dark J.; Bano A.; Razvi S.
Institution
(Tharmapoopathy, Thavarajah, Dark, Razvi) Department of Endocrinology,
Translational and Clinical Research Institute, Newcastle University,
Newcastle upon Tyne, United Kingdom
(Kenny) Department of Biostatistics, Institute of Population Health
Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
(Pingitore, Iervasi) Consiglio Nazionale Delle Ricerche, Pisa, Italy
(Bano) Department of Cardiology, Inselspital Bern University Hospital,
University of Bern, BERN, Switzerland
(Bano) Department of Cardiology, Institute of Social and Preventive
Medicine (ISPM), University of Bern, BERN, Switzerland
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Low levels of the active thyroid hormone triiodothyronine (T3)
in cardiac patients are associated with worse outcomes. The aim of this
analysis was to assess if T3 treatment is beneficial and safe in patients
undergoing cardiac surgery or those with cardiovascular diseases in whom
there is observed or expected reduction in serum T3 levels.
 Method(s): A systematic review and meta-Analysis of randomized
controlled trials (RCTs) was performed as per the PRISMA guidelines.
Pubmed, EMBASE, and Web of Science databases were searched for RCTs
published between January 1, 1960 and March 30, 2022 that evaluated the
effects of T3 therapy in patients undergoing cardiac surgery or with
cardiovascular diseases. The primary outcomes were measures of cardiac
function. Weighted mean difference (MD) or relative risk was calculated
using a random effects model. PROSPERO registration number CRD42020211966.
 Result(s): Of the 3181 full-Text articles screened, 34 studies with
2547 participants (number ranging between 13 and 223, mean ages between
0.5 and 73 years, mean percentage of women between 7% and 64%) were
included. In 12 RCTs with 1093 adults undergoing cardiac surgery T3
therapy was associated with improvement in cardiac index (MD [95%
confidence interval], 0.24 [0.08 to 0.40] L/min/m2, I2 = 74%). The quality
of evidence was high to moderate. In 3 RCTs with 188 children undergoing
cardiac surgery, 3 RCTs with 131 adult cardiac donors, 3 RCTs with 83
adult patients with heart failure, and 2 RCTs with 89 adults with acute
myocardial infarction, T3 therapy did not improve cardiac index or left
ventricular function; the quality of evidence ranged from high (pediatric
cardiac surgery) to low (other groups). No detrimental effect of T3
therapy was observed on heart rate, risk of in-hospital atrial
fibrillation, or mortality. Conclusion(s): Short-Term T3 therapy is
safe and trials in adults undergoing cardiac surgical procedures to
evaluate longer term clinical endpoints are required. Current data do not
support the routine use of T3 therapy in children undergoing cardiac
surgery or in cardiac donors. Adequately designed trials are required to
determine if T3 therapy improves cardiac function and clinical outcomes in
patients with heart failure or acute myocardial infarction. ©
Copyright 2022, Mary Ann Liebert, Inc., publishers 2022.

<54>
Accession Number
2018846516
Title
Comparing mid-term outcomes of Cox-Maze procedure and pulmonary vein
isolation for atrial fibrillation after concomitant mitral valve surgery:
A systematic review.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Sef D.; Trkulja V.; Raja S.G.; Hooper J.; Turina M.I.
Institution
(Sef, Raja) Department of Cardiac Surgery, Harefield Hospital, Royal
Brompton and Harefield Hospitals, Part of Guy's and St. Thomas' NHS
Foundation Trust, London, United Kingdom
(Trkulja) Department of Pharmacology, Zagreb University School of
Medicine, Zagreb, Croatia
(Hooper) Bristol Royal Infirmary, University Hospitals Bristol and Weston
NHS Foundation Trust, Bristol, United Kingdom
(Turina) University of Zurich, Zurich, Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Background: Although concomitant pulmonary vein isolation (PVI) is used
more frequently than the Cox-Maze procedure, which is currently the gold
standard treatment for atrial fibrillation (AF), data on the comparative
effectiveness of the two procedures after concomitant mitral valve (MV)
surgery are still limited. Objective(s): We conducted a systematic
review to identify randomized controlled trials (RCTs) and observational
studies comparing the mid-term mortality and recurrence of AF after
concomitant Cox-Maze and PVI in patients with AF undergoing MV surgery
based on 12-month follow-up. Method(s): Medline, EMBASE databases,
and the Cochrane Library were searched from 1987 up to March 2022 for
studies comparing concomitant Cox-Maze and PVI. Additionally, a
meta-analysis of RCTs was performed to compare the mid-term clinical
outcomes between these two surgical ablation techniques. Result(s):
Three RCTs and three observational studies meeting the inclusion criteria
were included in this systematic review with 790 patients in total (532
concomitant Cox-Maze and 258 PVI during MV surgery). Most studies reported
that the concomitant Cox-Maze procedure was associated with higher freedom
from AF at 12-month follow-up than PVI. Regarding AF recurrence, estimates
pooled across the three RCTs indicated large heterogeneity and high
uncertainty. In the largest and highest quality RCT, 12-month AF
recurrence was higher in the PVI arm (risk ratio = 1.58, 95% CI:
0.91-2.73). In two out of three higher-quality observational studies,
12-month AF recurrence was higher in PVI than in the Cox-Maze arm
(estimated adjusted probabilities 11% vs. 8% and 35% vs. 17%,
respectively). RCTs demonstrated comparable 12-month mortality between
concomitant Cox-Maze and PVI, while observational studies demonstrated the
survival benefit of Cox-Maze. Conclusion(s): Concomitant Cox-Maze in
AF patients undergoing MV surgery is associated with better mid-term
freedom from AF when compared to PVI with comparable mid-term survival.
Large observational studies suggest that there might be a mid-term
survival benefit among patients after concomitant Cox-Maze. Further large
RCTs with longer standardized follow-up are required to clarify the
benefits of concomitant Cox-Maze in AF patients during MV
surgery. Copyright © 2022 The Authors. Journal of Cardiac Surgery
published by Wiley Periodicals LLC.

<55>
Accession Number
2018846168
Title
Renal outcomes in valve-in-valve transcatheter versus redo surgical aortic
valve replacement: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Arjomandi Rad A.; Naruka V.; Vardanyan R.; Salmasi M.Y.; Tasoudis P.T.;
Kendall S.; Casula R.; Athanasiou T.
Institution
(Arjomandi Rad, Vardanyan) Department of Medicine, Imperial College
London, Faculty of Medicine, London, United Kingdom
(Naruka, Casula, Athanasiou) Department of Cardiothoracic Surgery,
Imperial College NHS Trust, Hammersmith Hospital, London, United Kingdom
(Salmasi, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Tasoudis) Department of Cardiothoracic Surgery, University of Thessaly,
Biopolis, Larissa, Greece
(Kendall) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesborough, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative acute kidney injury (AKI) and the requirement
for renal replacement therapy (RRT) remain common and significant
complications of both transcatheter valve-in-valve aortic valve
replacement (ViV-TAVR) and redo surgical aortic valve replacement (SAVR).
Nevertheless, the understanding of renal outcomes in the population
undergoing either redo SAVR or ViV-TAVR remains controversial.
 Method(s): A systematic database search with meta-analysis was
conducted of comparative original articles of ViV-TAVR versus redo SAVR in
EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to
September 2021. Primary outcomes were AKI and RRT. Secondary outcomes were
stroke, major bleeding, pacemaker implantation rate, operative mortality,
and 30-day mortality. Result(s): Our search yielded 5435 relevant
studies. Eighteen studies met the inclusion criteria with a total of
11,198 patients. We found ViV-TAVR to be associated with lower rates of
AKI, postoperative RRT, major bleeding, pacemaker implantation, operative
mortality, and 30-day mortality. No significant difference was observed in
terms of stroke rate. The mean incidence of AKI in ViV-TAVR was 6.95%
(+/-6%) and in redo SAVR was 15.2% (+/-9.6%). For RRT, our data showed
that VIV-TAVR to be 1.48% (+/-1.46%) and redo SAVR to be 8.54% (+/-8.06%).
 Conclusion(s): Renoprotective strategies should be put into place to
prevent and reduce AKI incidence regardless of the treatment modality.
Patients undergoing re-intervention for the aortic valve constitute a
high-risk and frail population in which ViV-TAVR demonstrated it might be
a feasible option for carefully selected patients. Long-term follow-up
data and randomized control trials will be needed to evaluate mortality
and morbidity outcomes between these 2 treatments. Copyright ©
2022 The Authors. Journal of Cardiac Surgery published by Wiley
Periodicals LLC.

<56>
Accession Number
2018817098
Title
Neuroinvasive West Nile virus infections after solid organ
transplantation: Single center experience and systematic review.
Source
Transplant Infectious Disease. (no pagination), 2022. Date of
Publication: 2022.
Author
Abbas A.; Qiu F.; Sikyta A.; Fey P.D.; Florescu D.F.
Institution
(Abbas, Sikyta, Florescu) Infectious Diseases Division, University of
Nebraska Medical Center, Omaha, NE, United States
(Qiu) Department of Biostatistics, College of Public Health, University of
Nebraska Medical Center, Omaha, NE, United States
(Fey) Department of Pathology and Microbiology, University of Nebraska
Medical Center, Omaha, NE, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: West Nile virus (WNv) is a major cause of viral encephalitis
in the United States. WNv infection is usually asymptomatic or a limited
febrile illness in the immunocompetent hosts, although a small percentage
can develop neuroinvasive disease. Neuroinvasive disease due to WNv in
solid organ transplant recipients occurs at higher rates than observed in
the general population and can have long term neurological sequalae.
 Method(s): We retrospectively reviewed medical records of all solid
organ transplant recipients at our institution who tested positive for WNv
from 2010 to 2018. Two reviewers performed electronic searches of Medline,
Embase, Cochrane Library of literature of WNv infections in SOT.
Descriptive statistics were performed on key variables. Result(s):
Eight recipients (mean age 54, five males) were diagnosed with
neuroinvasive WNv infection at our institution. Distribution of infection
was as follows: five kidney transplants, one in each kidney-pancreas,
liver, and lung. Diagnoses included meningitis (3), encephalitis (1),
meningo-encephalitis (4). Median time from transplant to infection was
49.8 months (2.7-175.4). No infections were considered donor-derived. Five
patients received treatment with IVIG. Six patients were alive at median
follow-up of 49.5 months (21.7-116.8). We identified 29 studies published
from 2002 to 2019. Median time from transplant to infection was 14.2
months, with similar allograft distribution; 53% were donor-derived
infections. Conclusion(s): WNv infections in solid organ transplant
recipients can be a consequence of organ donation or can be acquired via
the community. Infections can be more severe in SOT recipients and lead to
neuroinvasive disease. Copyright © 2022 The Authors. Transplant
Infectious Disease published by Wiley Periodicals LLC.

<57>
Accession Number
2019595018
Title
Percutaneous coronary intervention vs. coronary artery bypass graft for
left main coronary artery disease: a never-ending debate.
Source
European Heart Journal. 43(15) (pp 1455-1456), 2022. Date of Publication:
14 Apr 2022.
Author
Liuzzo G.; Volpe M.
Institution
(Liuzzo) Department of Cardiology, Fondazione Policlinico Universitario A.
Gemelli - Irccs, Largo A. Gemelli 8, Rome 00168, Italy
(Liuzzo) Department of Cardiovascular Science, Catholic University of the
Sacred Heart, Largo F. Vito 1, Rome 00168, Italy
(Volpe) Department of Clinical and Molecular Medicine, Sapienza University
of Rome, Sant 'Andrea Hospital, Via di Grottarossa 1035-1039, Rome 00189,
Italy
Publisher
Oxford University Press

<58>
Accession Number
638701122
Title
Comparative study to assess the effect of priming solutions (Plasmalyte-A
and Ringer Lactate) on Acid-base balance during cardiopulmonary bypass for
adult cardiac surgery.
Source
Research in Cardiovascular Medicine. 11(2) (pp 49-53), 2022. Date of
Publication: April-June 2022.
Author
Vashisth A.; Saleem Y.; Darbari A.; Gupta A.; Lahiri R.; Kumar A.
Institution
(Vashisth, Saleem, Darbari, Gupta, Lahiri) Department of CTVS, AIIMS,
Uttarakhand, Rishikesh, India
(Kumar) Department of Cardiac Anaesthesia, AIIMS, Uttarakhand, Rishikesh,
India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Priming solution used in cardiopulmonary bypass has different
impact on body, primarily on the metabolic acidosis and electrolytes. This
observational comparative study was done to find the metabolic effects of
Ringer lactate and Plasmalyte-A as priming solutions for various metabolic
parameters during adult cardiac surgery. Material(s) and Method(s):
In the present study, 52 subjects were included who received different
priming solutions. Subjects were categorized into two groups. Group P
received Plasmalyte-A as prime and Group R received Ringer lactate. From
all these cases, samples were collected at predefined time durations, and
results were compared between both groups. Observation and Results: A
total of 52 patients were evaluated for the metabolic changes concerning
different priming solutions. Group P included the subject who received
Plasmalyte-A as pump prime (n = 26), and Ringer lactate was used as pump
prime in Group R (n = 26). We compared various parameters such as pH: In
Group R, a decrease in pH was statistically significant with P < 0.05 at
40 min of bypass (T40) and P < 0.05 at 6 h of postbypass (T6). Base
Excess: The mean value in Group P was - 1.72 +/- 2.18 and - 3.16 +/- 2.48
and in Group R at 30 min of bypass (T30). A statistically significance was
found between the two groups for this parameter (P < 0.05). Lactate and
Strong Ions Difference: A statistically significant data were found
between the two groups for this parameter throughout the bypass as well as
postoperative hours with the P < 0.05. Conclusion(s): Plasmalyte-A is
more favorable crystalloid solution as a pump prime fluid as it helped to
maintain satisfactory metabolic parameters with less metabolic acidosis
during adult cardiac surgeries. Copyright © 2022 Research in
Cardiovascular Medicine.

<59>
Accession Number
2019858414
Title
Mechanical versus bioprosthetic valve for aortic valve replacement:
Systematic review and meta-analysis of reconstructed individual
participant data.
Source
European Journal of Cardio-thoracic Surgery. 62(1) (no pagination), 2022.
Article Number: ezac268. Date of Publication: 01 Jul 2022.
Author
Tasoudis P.T.; Varvoglis D.N.; Vitkos E.; Mylonas K.S.; Sa M.P.;
Ikonomidis J.S.; Caranasos T.G.; Athanasiou T.
Institution
(Tasoudis, Varvoglis, Vitkos) Department of Cardiothoracic Surgery,
Faculty of Medicine, School of Health Sciences, University of Thessaly,
Biopolis, Larissa 41110, Greece
(Tasoudis, Varvoglis, Vitkos) Surgery Working Group, Society of Junior
Doctors, Athens, Greece
(Mylonas) Department of Cardiac Surgery, Onassis Cardiac Surgery Center,
Athens, Greece
(Sa) Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, PA, United States
(Ikonomidis, Caranasos) Division of Cardiothoracic Surgery, Department of
Surgery, School of Medicine, University of North Carolina at Chapel Hill,
Chapel Hill, NC, United States
(Athanasiou) Department of Surgery and Cancer, Imperial College London, St
Mary's Hospital, London, United Kingdom
(Athanasiou) Department of Cardiothoracic Surgery, University Hospital of
Larissa, Biopolis, Larissa, Greece
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The aim of this study was to compare biological versus
mechanical aortic valve replacement. METHOD(S): We searched MEDLINE,
Scopus and Cochrane Library databases for randomized clinical trials and
propensity score-matched studies published by 14 October 2021 according to
the Preferred Reporting Items for Systematic Reviews and Meta-analyses
statement. Individual patient data on overall survival were extracted.
One-and two-stage survival analyses and random-effects meta-analyses were
conducted. RESULT(S): A total of 25 studies were identified,
incorporating 8721 bioprosthetic and 8962 mechanical valves. In the
one-stage meta-analysis, mechanical valves cumulatively demonstrated
decreased hazard for mortality [hazard ratio (HR): 0.79, 95% confidence
interval (CI): 0.74-0.84, P < 0.0001]. Overall survival was similar
between the compared arms for patients <50 years old (HR: 0.88, 95% CI:
0.71-1.1, P = 0.216), increased in the mechanical valve arm for patients
50-70 years old (HR: 0.76, 95% CI: 0.70-0.83, P < 0.0001) and increased in
the bioprosthetic arm for patients >70 years old (HR: 1.35, 95% CI:
1.17-1.57, P < 0.0001). Meta-regression analysis revealed that the
survival in the 50-70 year-old group was not influenced by the publication
year of the individual studies. No statistically significant difference
was observed regarding in-hospital mortality, postoperative strokes and
postoperative reoperation. All-cause mortality was found decreased in the
mechanical group, cardiac mortality was comparable between the 2 groups,
major bleeding rates were increased in the mechanical valve group and
reoperation rates were increased in the bioprosthetic valve group.
 CONCLUSION(S): Survival rates seem to not be influenced by the type
of prosthesis in patients <50 years old. The survival advantage in favour
of mechanical valves is observed in patients 50-70 years old, while in
patients >70 years old bioprosthetic valves offer better survival
outcomes. Copyright © 2022 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<60>
Accession Number
2018837035
Title
Risk of Perioperative Stroke in Patients With Patent Foramen Ovale: A
Systematic Review and Meta-analysis.
Source
Canadian Journal of Cardiology. 38(8) (pp 1189-1200), 2022. Date of
Publication: August 2022.
Author
Hobbes B.; Akseer S.; Pikula A.; Huszti E.; Devereaux P.J.; Horlick E.;
Abrahamyan L.
Institution
(Hobbes) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Akseer, Huszti, Abrahamyan) Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, ON, Canada
(Pikula) Division of Neurology, Toronto Western Hospital, University
Health Network, Toronto, ON, Canada
(Huszti) Biostatistics Research Unit, UHN, Toronto, ON, Canada
(Devereaux) Population Health Research Institute, Hamilton, ON, Canada
(Devereaux) Departments of Medicine, and Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Horlick) Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac
Centre, University Health Network, Toronto, ON, Canada
(Abrahamyan) Toronto General Hospital Research Institute, University
Health Network, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Patent foramen ovale (PFO) is a common congenital cardiac
abnormality. Risk of stroke increases perioperatively, but the association
of PFO with perioperative stroke risk remains unclear. We conducted a
systematic review to inform the risk of perioperative stroke in patients
with PFO undergoing surgery. Method(s): Embase, MEDLINE, and Cochrane
databases were searched from inception to January 2020. We described
methods used for establishing PFO and perioperative stroke diagnosis. We
conducted meta-analyses to obtain pooled estimates for risk of stroke in
patients with and without PFO in different surgical populations.
 Result(s): Ten articles with a total of 20,858,011 patients met the
eligibility criteria. Prevalence of PFO ranged from 0.06% to 1.4% based on
International Classification of Diseases (ICD)-code diagnosis and from
10.4% to 40.4% based on echocardiography diagnosis. Perioperative stroke
was observed in 0% to 25% of patients with PFO, and 0% to 16.7% without
PFO. Studies that used echocardiography to diagnose PFO found no
association between PFO and perioperative stroke. Studies that used ICD
codes found strong association but were highly heterogeneous. PFO was not
associated with a risk of perioperative stroke in cardiac and
transplantation surgeries. While the adjusted odds ratios for stroke were
substantial for orthopaedic, general, genitourinary, neurologic, and
thoracic surgeries (with PFO status established based on ICD codes), data
heterogeneity and quality of data create significant uncertainty.
 Conclusion(s): In conclusion, PFO is likely a risk factor for
perioperative stroke in selected types of surgeries. However, this is
based on very low-quality evidence. Rigorous prospective studies are
needed to further investigate this relationship. Copyright © 2022
Canadian Cardiovascular Society

<61>
Accession Number
2018645265
Title
Clinical Outcomes Following Simple or Complex Stenting for Coronary
Bifurcation Lesions: A Meta-Analysis.
Source
Clinical Medicine Insights: Cardiology. 16 (no pagination), 2022. Date of
Publication: 2022.
Author
Zhang Q.; Huan H.; Han Y.; Liu H.; Sun S.; Wang B.; Wei S.
Institution
(Zhang, Huan, Han, Liu, Sun, Wei) Department of Emergency and Chest Pain
Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University,
Shandong, Jinan, China
(Zhang, Han, Liu, Sun, Wei) Clinical Research Center for Emergency and
Critical Care Medicine of Shandong Province, Qilu Hospital, Cheeloo
College of Medicine, Shandong University, Shandong, Jinan, China
(Zhang, Han, Liu, Sun, Wei) Key Laboratory of Emergency and Critical Care
Medicine of Shandong Province, Key Laboratory of Cardiopulmonary-Cerebral
Resuscitation Research of Shandong Province, Qilu Hospital, Cheeloo
College of Medicine, Shandong University, Shandong, Jinan, China
(Huan) The Forth People's Hospital of Linyi, Shandong, Linyi, China
(Wang) Clinical Trial Center, Qilu Hospital, Cheeloo College of Medicine,
Shandong University, Shandong, Jinan, China
Publisher
SAGE Publications Ltd
Abstract
Background: Stent placement remains a challenge for coronary bifurcation
lesions. While both simple and complex stenting strategies are available,
it is unclear which one results in better clinical outcomes. This
meta-analysis aims to explore the long-term prognosis following treatment
with the 2 stenting strategies. Method(s): Randomized controlled
trials found from searches of the PubMed, EMBASE, and Cochrane Central
Register of Controlled Trials were included in this meta-analysis. The
complex stent placement strategy was identified as the control group, and
the simple stent placement strategy was identified as the experimental
group. Data were synthesized with a random effects model. The quality of
the randomized controlled trials was assessed by Jadad scale scores. The
clinical endpoints at 6 months, 1 year, and 5 years were analyzed.
 Result(s): A total of 11 randomized controlled trials met the
inclusion criteria. A total of 2494 patients were included in this
meta-analysis. The odds ratio [OR] of the major adverse cardiac events
(MACEs) at 6 months was 0.85 (95% confidence interval [CI] 0.53-1.35; P
=.49, I2 = 0%). The OR of the MACEs at 1 year was 0.61 (95% CI
0.36-1.05; P =.08, I2 = 0%). The OR of the MACEs at 5 years was
0.69 (95% CI 0.51-0.92; P =.01, I2 = 0%). Compared with the
complex strategy, the simple strategy was associated with a lower
incidence of MACEs at 5 years. Conclusion(s): Compared to the complex
stenting strategy, the simple stenting strategy can better reduce the
occurrence of long-term MACEs for coronary bifurcation
lesions. Copyright © The Author(s) 2022.

<62>
Accession Number
2018449006
Title
The effect of reparixin on survival in patients at high risk for
in-hospital mortality: a meta-analysis of randomized trials.
Source
Frontiers in Immunology. 13 (no pagination), 2022. Article Number: 932251.
Date of Publication: 25 Jul 2022.
Author
Landoni G.; Zangrillo A.; Piersanti G.; Scquizzato T.; Piemonti L.
Institution
(Landoni, Zangrillo, Piersanti, Scquizzato) Department of Anesthesia and
Intensive Care, Istituti di Ricovero e Cura a Carattere Scientifico
(IRCCS) San Raffaele Scientific Institute, Milan, Italy
(Landoni, Zangrillo, Piemonti) Faculty of Medicine, Vita-Salute San
Raffaele University, Milan, Italy
(Piemonti) Diabetes Research Institute, Istituti di Ricovero e Cura a
Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan,
Italy
Publisher
Frontiers Media S.A.
Abstract
Introduction: A great number of anti-inflammatory drugs have been
suggested in the treatment of SARS-CoV-2 infection. Reparixin, a
non-competitive allosteric inhibitor of the CXCL8 (IL-8) receptors C-X-C
chemokine receptor type 1 (CXCR1) and C-X-C chemokine receptor type 2
(CXCR2), has already been tried out as a treatment in different critical
settings. Due to the contrasting existing literature, we decided to
perform the present meta-analysis of randomized controlled trials (RCTs)
to investigate the effect of the use of reparixin on survival in patients
at high risk for in-hospital mortality. Method(s): We created a
search strategy to include any human RCTs performed with reparixin
utilization in patients at high risk for in-hospital mortality, excluding
oncological patients. Two trained, independent authors searched PubMed,
EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL)
for appropriate studies. Furthermore, references of review articles and
included RCTs were screened to identify more studies. No language
restrictions were enforced. To assess the risk of bias of included trials,
the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was
used. Result(s): Overall, six studies were included and involved 406
patients (220 received reparixin and 186 received the comparator). The
all-cause mortality in the reparixin group was significantly lower than
that in the control group [5/220 (2.3%) in the reparixin group vs. 12/186
(6.5%) in the control group, odds ratio = 0.33 (95% confidence interval
0.12 to 0.96), p-value for effect 0.04, p for heterogeneity 0.20,
I2 = 36%]. In addition, no difference in the rate of pneumonia,
sepsis, or non-serious infections was shown between the two groups.
 Conclusion(s): Our meta-analysis of randomized trials suggests that
short-term inhibition of CXCL8 activity improved survival in patients at
high risk for in-hospital mortality without increasing the risk of
infection. Meta-analysis registration: PROSPERO, identifier
CRD42021254467. Copyright © 2022 Landoni, Zangrillo, Piersanti,
Scquizzato and Piemonti.

<63>
[Use Link to view the full text]
Accession Number
2019622964
Title
Comparison of rehabilitation outcomes for transcatheter versus surgical
aortic valve replacement as redo procedure in patients with previous
cardiac surgery: Evidence based on 11 observational studies.
Source
Medicine (United States). 100(45) (pp E27657), 2021. Date of Publication:
12 Nov 2021.
Author
Wang G.; Li X.; Zhang Z.; Dong J.
Institution
(Wang, Dong) Rehabilitation Division Treatment Department, Wang Jing
Hospital, China Academy of Chinese Medical Science, Beijing, China
(Li) Department of Vascular Surgery, Wang Jing Hospital, China Academy of
Chinese Medical Science, Beijing, China
(Zhang) Department of Spinal Surgery, Wang Jing Hospital of China, Academy
of Chinese Medical Science, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Currently, the number of severe aortic stenosis (AS) patients
with a history of prior cardiac surgery (PCS) has increased. Both
transcatheter aortic valve replacement (TAVR) and traditional surgical
aortic valve replacement (sAVR) are effective therapy for AS. However, PCS
increases the risk of adverse outcomes in patients undergoing aortic valve
replacement. Thus, this meta-analysis was designed to comparatively
evaluate the impact of PCS on clinical outcomes between TAVR and sAVR.
 Method(s): A systematic search of PubMed, Embase, Cochrane Library,
and Web of Science up to February 1, 2021 was conducted for relevant
studies that comparing TAVR and sAVR for severe AS patients with a history
of PCS. The primary outcome was the non-inferiority of TAVR and sAVR in
mortality. The secondary outcomes were the other clinical outcomes. Two
reviewers assessed trial quality and extracted the data independently. All
statistical analyses were performed using the standard statistical
procedures provided in Review Manager 5.2. Result(s): A total of 11
studies including 8852 patients were identified. The pooled results
indicated that there was no difference in 30-day, and 1-year all-cause
mortality between TAVR and sAVR. No significant difference was also
observed in total follow-up and cardiovascular mortality between TAVR and
sAVR. However, subgroup analysis revealed significantly higher 1-year
all-cause mortality (OR 1.92; 95% CI 1.05-3.52; P = .04) and total
follow-up mortality (OR 2.28; 95% CI 1.09-4.77; P = .03) in TAVR than sAVR
for patients with a history of coronary artery bypass graft, aortic valve
replacement, and mitral valve reconstruction. In addition, TAVR
experienced higher pacemaker implantation than sAVR. However, compared
with sAVR, TAVR experienced shorter length of stay (MD -3.18 days; 95% CI
-4.78 to -1.57 days) and procedural time (MD -172.01 minutes; 95% CI
-251.15 to -92.88) respectively. TAVR also lead to much less bleeding than
sAVR. Conclusion(s): Our analysis shows that TAVR as a redo procedure
was equal to sAVR in mortality for severe AS patients with PCS, especially
coronary artery bypass graft. We agree the advantage of TAVR as a redo
procedure for patients with a history of PCS. Patients receiving TAVR
experienced rapid recovery, shorter operation time and less bleeding,
without increasing short and long term mortality. Copyright ©
2021 the Author(s).

<64>
Accession Number
2019950106
Title
Use of Cytokine Filters During Cardiopulmonary Bypass: Systematic Review
and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2022. Date of Publication:
2022.
Author
Naruka V.; Salmasi M.Y.; Arjomandi Rad A.; Marczin N.; Lazopoulos G.;
Moscarelli M.; Casula R.; Athanasiou T.
Institution
(Naruka, Salmasi, Arjomandi Rad, Marczin, Moscarelli, Athanasiou)
Department of Surgery and Cancer, Imperial College, London, United Kingdom
(Naruka, Casula, Athanasiou) Department of Cardiothoracic Surgery,
Hammersmith Hospital, London, United Kingdom
(Lazopoulos) Department of Cardiothoracic Surgery, University Hospital of
Heraklion, Crete, Greece
Publisher
Elsevier Ltd
Abstract
Introduction: Cardiac surgery involving cardiopulmonary bypass (CPB)
activates an inflammatory response releasing cytokines that are associated
with less favourable outcomes. This study aims to compare i) CPB during
cardiac surgery (control) versus ii) CPB with haemoadsorption therapy; and
assess the effect of adding this therapy in reducing the inflammatory
cytokines burden. Method(s): A systematic literature review with
metanalysis was conducted regarding the main outcomes (operative
mortality, ventilation duration, intensive care unit [ICU] and hospital
stays) and day-1 inflammatory markers levels post-surgery. Fifteen (15)
studies were included for final analysis (eight randomised controlled
trials, seven observational studies) with no evidence of publication bias.
 Result(s): Subgroup analysis of non-elective surgeries across
observational studies (emergency and infective endocarditis) significantly
favoured cytokine filters in terms of 30-day mortality (OR 0.40, 95% CI
0.20, 0.83; p=0.01) and shorter ICU stay (MD -42.36, 95% CI -68.07,
-16.65; p=0.001). At day-1 post-surgery, there was a significant
difference favouring the cytokine filter group in c-reactive protein (CRP)
(MD -0.71, 95% CI -0.84, -0.59; p<0.001) with no differences in white
blood count (WBC), procalcitonin (PCT), tumour necrosis factor-alpha
(TNF-alpha), IL-6, IL-8 and lactate. When comparing cytokine filters and
control across all studies there was no significant difference in
operative mortality, ventilation duration, hospital stay and ICU length of
stay. Also, there were no statistical differences in randomised controlled
trials (RCTs) using haemadsorption filters. Conclusion(s): A
significant reduction in 30-day mortality and ICU stay could be obtained
by using haemadsorption therapy during non-elective cardiac surgery,
especially emergency surgery and in patients with higher inflammatory
burden such as infective endocarditis. Copyright © 2022

<65>
Accession Number
638891276
Title
Wearable technology for preconditioning before thoracic surgery: a
feasibility study.
Source
CMAJ. Canadian Medical Association Journal. Conference: Canadian Surgery
Forum 2019. Montreal, QC Canada. 62(4 Supplement 2) (pp S134-S135), 2019.
Date of Publication: August 2019.
Author
Patel Y.; Hylton D.; Rok M.; Beauchamp M.; Wald J.; Mbuagbaw L.; Finley
C.; Agzarian J.; Shargall Fahim Y.; Hanna W.
Institution
(Patel, Hylton, Beauchamp, Wald, Mbuagbaw, Finley, Agzarian, Shargall
Fahim, Hanna) McMaster University, Hamilton, ON, Canada
(Rok) Western University, London, ON, Canada
Publisher
Canadian Medical Association
Abstract
Preconditioning before surgery can lower complication rates, but there are
significant barriers to its adoption in the lung cancer population, which
is characteristically older, suffers multiple comorbidities and is averse
to exercise. In an effort to overcome these barriers, we designed Move For
Surgery (MFS), a home-based, pragmatic and wearable technology enhanced
aerobic exercise preconditioning program. We aimed to test the feasibility
of MFS in preparation for a randomized controlled clinical trial. Patients
undergoing lung resection for non-small cell lung carcinoma (NSCLC) were
preoperatively enrolled and provided with a wearable activity tracker and
a booklet describing various aerobic and deep breathing exercises and
nutritional and smoking cessation tips. Daily step count, sleep cycle and
calories burned were synced and tracked remotely. Daily step goals were
set by increasing the participants' baseline step count by 600 steps each
week until surgery. The EQ-5D-5L instrument was completed at baseline and
day of surgery. Continuous variables were compared using the Student t
test, and categorical variables were compared using chi2 or
Fisher exact tests with a level of significance of p < 0.05. Of the 40
patients screened, 62.5% (25/40) were eligible and enrolled and 37.5%
(15/40) were ineligible. Median (min-max) age and days on trial were 62
(33-82) years and 25 (8-55) days, respectively. Fitbits were worn 94.6% of
the time, and step goals were achieved on 41.1% +/- 28.0% of days. Mean
baseline daily step count was 7786 +/- 4007. Participants with higher
baseline step counts (> 6000/day) were more likely to achieve step goals
(48.3% v. 22.9%, p = 0.046). Overall, 100% (25/25) recommended MFS for
future patients, and 96.0% (24/25) stated they will buy their own wearable
activity tracker and continue this lifestyle after surgery. MFS motivates
patients to undergo preconditioning before lung resection and continue
with a healthy lifestyle after surgery. Revision of the daily step goal is
required to improve compliance. A randomized trial is in progress to
determine the impact of MFS on postoperative outcomes.

<66>
Accession Number
2018804630
Title
Comparison of efficacy and safety between VKAs and DOACs in patients with
atrial fibrillation after transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Clinical Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Yan J.; Liu M.; Zhang Y.; Yang D.; An F.
Institution
(Yan, Liu, Zhang, Yang, An) The Key Laboratory of Cardiovascular
Remodeling and Function Research, Chinese Ministry of Education, Chinese
National Health Commission and Chinese Academy of Medical Sciences, The
State and Shandong Province Joint Key Laboratory of Translational
Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of
Shandong University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
In the past decade, direct oral anticoagulants (DOACs) have proven to be
the best option for patients with nonvalvular atrial fibrillation.
Nevertheless, evidence for the use of DOACs for anticoagulation in
valvular atrial fibrillation, particularly after aortic valve replacement,
remains inadequate. Thus, we conducted a meta-analysis to compare the
efficacy and safety of vitamin K antagonists (VKAs) and DOACs in patients
with atrial fibrillation after transcatheter aortic valve replacement
(TAVR). We conducted a comprehensive search of online databases, and 11
studies were included in the final analysis. The primary endpoint was
all-cause mortality. Secondary endpoints included stroke and
cardiovascular death. The safe endpoint is major and/or life-threatening
bleeding. Subgroup analysis was conducted according to the different
follow-up time of each study. Random-effects models were used for all
outcomes. Statistical heterogeneity was assessed using chi2
tests and quantified using I2 statistics. Patients in the DOACs
group had a significantly lower risk of all-cause mortality compared with
patients in the VKAs group (relative risk [RR]: 1.20, 95% confidence
interval [CI]: 1.01-1.43, p =.04). This benefit may be greater with longer
follow-up. In a subgroup analysis based on the length of follow-up, a
significantly lower risk of all-cause mortality was found in the DOACs
group in the subgroup with a follow-up time of >12 months (RR: 1.50, 95%
CI: 1.07-2.09, p =.001). There were no significant differences between the
two groups in cardiovascular death, stroke, and major and/or
life-threatening bleeding. For patients with atrial fibrillation after
TAVR, the use of DOACs may be superior to VKAs, and the benefit may be
greater with longer follow-up. The anticoagulant strategy for atrial
fibrillation after TAVR is a valuable direction for future
research. Copyright © 2022 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<67>
Accession Number
638894923
Title
Management of Infective Endocarditis in People Who Inject Drugs: A
Scientific Statement From the American Heart Association.
Source
Circulation. (pp 101161CIR0000000000001090), 2022. Date of Publication:
31 Aug 2022.
Author
Baddour L.M.; Weimer M.B.; Wurcel A.G.; McElhinney D.B.; Marks L.R.;
Fanucchi L.C.; Esquer Garrigos Z.; Pettersson G.B.; DeSimone D.C.
Publisher
NLM (Medline)
Abstract
BACKGROUND: The American Heart Association has sponsored both guidelines
and scientific statements that address the diagnosis, management, and
prevention of infective endocarditis. As a result of the unprecedented and
increasing incidence of infective endocarditis cases among people who
inject drugs, the American Heart Association sponsored this original
scientific statement. It provides a more in-depth focus on the management
of infective endocarditis among this unique population than what has been
provided in prior American Heart Association infective
endocarditis-related documents. METHOD(S): A writing group was named
and consisted of recognized experts in the fields of infectious diseases,
cardiology, addiction medicine, and cardiovascular surgery in October
2021. A literature search was conducted in Embase on November 19, 2021,
and multiple terms were used, with 1345 English-language articles
identified after removal of duplicates. CONCLUSION(S): Management of
infective endocarditis in people who inject drugs is complex and requires
a unique approach in all aspects of care. Clinicians must appreciate that
it requires involvement of a variety of specialists and that consultation
by addiction-trained clinicians is as important as that of more
traditional members of the endocarditis team to improve infective
endocarditis outcomes. Preventive measures are critical in people who
inject drugs and are cured of an initial bout of infective endocarditis
because they remain at extremely high risk for subsequent bouts of
infective endocarditis, regardless of whether injection drug use is
continued.

<68>
Accession Number
2016802330
Title
Ticagrelor Monotherapy After 3-Month Dual Antiplatelet Therapy in Acute
Coronary Syndrome by High Bleeding Risk: The Subanalysis From the TICO
Trial.
Source
Korean Circulation Journal. 52 (no pagination), 2022. Article Number:
:e19. Date of Publication: January 2022.
Author
Lee Y.-J.; Suh Y.; Kim J.-S.; Cho Y.-H.; Yun K.H.; Kim Y.H.; Cho J.Y.; Her
A.-Y.; Cho S.; Jeon D.W.; Yoo S.-Y.; Cho D.-K.; Hong B.-K.; Kwon H.; Hong
S.-J.; Ahn C.-M.; Shin D.-H.; Nam C.-M.; Kim B.-K.; Ko Y.-G.; Choi D.;
Hong M.-K.; Jang Y.
Institution
(Lee, Kim, Hong, Ahn, Shin, Kim, Ko, Choi, Hong) Division of Cardiology,
Severance Cardiovascular Hospital, Yonsei University College of Medicine,
Seoul, South Korea
(Suh, Cho) Division of Cardiology, Department of Internal Medicine,
Myongji Hospital, Hanyang University College of Medicine, Goyang, South
Korea
(Yun, Cho) Division of Cardiology, Wonkwang University Hospital, Iksan,
South Korea
(Kim, Her) Division of Cardiology, Kangwon National University School of
Medicine, Chuncheon, South Korea
(Cho) Division of Cardiology, Dankook University Hospital, Dankook
University College of Medicine, Cheonan, South Korea
(Jeon) Division of Cardiology, National Health Insurance Service Ilsan
Hospital, Goyang, South Korea
(Yoo) Division of Cardiology, Gangneung Asan Hospital, University of Ulsan
College of Medicine, Gangneung, South Korea
(Cho) Division of Cardiology, Yongin Severance Hospital, Yonsei University
College of Medicine, Yongin, South Korea
(Hong, Kwon) Division of Cardiology, Gangnam Severance Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(Nam) Department of Preventive Medicine and Biostatistics, Yonsei
University College of Medicine, Seoul, South Korea
(Jang) Division of Cardiology, CHA Bundang Medical Center, CHA University
College of Medicine, Seongnam, South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: Identifying patients with high bleeding risk
(HBR) is important when making decisions for antiplatelet therapy
strategy. This study evaluated the impact of ticagrelor monotherapy after
3-month dual antiplatelet therapy (DAPT) according to HBR in acute
coronary syndrome (ACS) patients treated with drug eluting stents (DESs).
 Method(s): In this post-hoc analysis of the TICO trial, HBR was
defined by 2 approaches: meeting Academic Research Consortium for HBR
(ARC-HBR) criteria or Predicting Bleeding Complications in Patients
Undergoing Stent Implantation and Subsequent DAPT (PRECISE-DAPT) score
>=25. The primary outcome was a 3-12 months net adverse clinical event
(composite of major bleeding and adverse cardiac and cerebrovascular
events). Result(s): Of the 2,980 patients without adverse events
during the first 3 months after DES implantation, 453 (15.2%) were HBR by
ARC-HBR criteria and 504 (16.9%) were HBR by PRECISE-DAPT score. The
primary outcome rate was higher in HBR versus non-HBR patients (by ARC-HBR
criteria: hazard ratio [HR], 2.87; 95% confidence interval [CI],
1.76-4.69; p<0.001; by PRECISE-DAPT score: HR, 3.09; 95% CI, 1.92-4.98;
p<0.001). Ticagrelor monotherapy after 3-month DAPT was associated with
lower primary outcome rate than ticagrelor-based 12-month DAPT regardless
of HBR by ARC-HBR criteria, with similar magnitudes of therapy effect for
HBR and non-HBR patients (p-interaction=0.400). Results were consistent by
PRECISE-DAPT score (p-interaction=0.178). Conclusion(s): In ACS
patients treated with DESs, ticagrelor monotherapy after 3-month DAPT was
associated with lower rate of adverse clinical outcomes regardless of HBR,
with similar magnitudes of therapy effect between HBR and
non-HBR. Copyright © 2022. The Korean Society of Cardiology This
is an Open Access article distributed under the terms of the Creative
Commons Attribution Non-Commercial License
(https://creativecommons.org/licenses/by-nc/4.0) which permits
unrestricted noncommercial use, distribution, and reproduction in any
medium, provided the original work is properly cited.

<69>
Accession Number
2015283750
Title
A first-in-man clinical evaluation of sirolimus and ascorbic acid-eluting
stent systems: A multicenter, subject-blinded, randomized study.
Source
Korean Circulation Journal. 51 (no pagination), 2021. Article Number:
e116. Date of Publication: September 2020.
Author
Lim Y.-H.; Youn J.H.; Hong S.-J.; Ahn T.-H.; Yoon J.; Park J.-K.; Kim
H.-S.
Institution
(Lim) Division of Cardiology, Department of Internal Medicine, Hanyang
University Colloge of Medicine, Seoul, South Korea
(Youn, Park) CG Bio Co. Ltd, 211, Itaewon-ro, Yongsan-gu, Seoul 04349,
South Korea
(Hong, Ahn) Division of Cardiology, Cardiovascular Center, Korea
University Anam Hospital, Seoul, South Korea
(Yoon) Department of Cardiology, Yonsei University Wonju Severance
Christian Hospital, Wonju, South Korea
(Kim) Department of Internal Medicine, Cardiovascular Center, Seoul
National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul
03080, South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: This clinical trial was conducted to evaluate
the safety and efficacy of D+StormTM drug-eluting stent (DES) and
BioMatrix FlexTM DES. Method(s): This study was a multicenter,
subject-single-blind, randomized, and confirmed comparative clinical
trial. According to the inclusion criteria, those diagnosed with stable
angina, unstable angina, silent ischemia, or non-ST-segment myocardial
infarction were selected among patients with coronary artery stenosis as
subjects. Among the subjects with 50% stenosis on coronary angiography,
the experiment was performed on those who had a lesion with reference
vessel 2.5-4.0 mm in diameter and <=40 mm in length. The primary endpoint
was an in-segment late loss and the secondary endpoints were in-stent late
lumen loss, stent malapposition, the incidence of mortality, myocardial
infarction, reoperation, and stent thrombosis at 36 weeks. Result(s):
57 patients in the D+StormTM DES group and 55 patients in the BioMatrix
FlexTM DES group were enrolled in the study. Fifty-seven patients in the
D+StormTM DES group and Fifty-five patients in the BioMatrix FlexTM DES
group were enrolled in the study. An average of in-segment late lumen loss
was 0.08+/-0.13 mm in the D+StormTM DES group and 0.14+/-0.32 mm in the
BioMatrix FlexTM DES group with no significant difference between the 2
groups (p=0.879). In addition, there was no significant difference in
adverse events between D+StormTM DES and BioMatrix FlexTM DES.
 Conclusion(s): This study demonstrated the clinical effectiveness and
safety of D+StormTM DES implantation in patients with coronary artery
disease over a 36-week follow-up period. Copyright © 2021. The
Korean Society of Cardiology

<70>
Accession Number
2004735569
Title
Management of complications of cardiac amyloidosis: 10 questions and
answers.
Source
European Journal of Preventive Cardiology. 28(9) (pp 1000-1005), 2021.
Date of Publication: 01 Sep 2021.
Author
Aimo A.; Rapezzi C.; Vergaro G.; Giannoni A.; Spini V.; Passino C.; Emdin
M.
Institution
(Aimo, Vergaro, Giannoni, Passino, Emdin) Institute of Life Sciences,
Scuola Superiore Sant'Anna, Italy
(Rapezzi) University of Ferrara, Italy
(Vergaro, Giannoni, Spini, Passino, Emdin) Fondazione Toscana Gabriele
Monasterio, Italy
Publisher
Oxford University Press
Abstract
Amyloidosis is a systemic disorder characterized by extracellular
deposition of insoluble fibrils. The most common forms are amyloid light
chain and amyloid transthyretin (ATTR) amyloidoses. Cardiac involvement
may be found in both these forms, and is an important cause of morbidity
and mortality. The clinical presentation of cardiac amyloidosis (CA) may
be represented by congestive heart failure (HF), possibly progressing to
end-stage HF, as well as atrial fibrillation with possible thromboembolic
events, and also conduction disturbances related to amyloid infiltration
of conduction fibres. Beyond therapies targeting the blood dyscrasia or
the ATTR amyloidogenic cascade, a careful choice of drug therapies, need
for device implantation, and possibly treatments for advanced HF is then
warranted. In the present review, we try to provide a useful guide to
clinicians treating patients with CA by enucleating 10 main questions and
answering them based on the evidence available as well as expert opinion
and our clinical experience. Copyright © 2021 SAGE Publications
Inc.. All rights reserved.

<71>
Accession Number
2004212660
Title
Impact of bedtime dosing of antihypertensives compared to morning therapy:
A meta-Analysis of randomised controlled trials.
Source
European Journal of Preventive Cardiology. 28(11) (pp E5-E8), 2021. Date
of Publication: 01 Nov 2021.
Author
Gupta R.; Malik A.H.; Popli T.; Ranchal P.; Yandrapalli S.; Aronow W.S.
Institution
(Gupta, Malik, Ranchal, Aronow) Department of Internal Medicine,
Westchester Medical Center, United States
(Popli) Department of Infectious Diseases, Westchester Medical Center,
United States
(Yandrapalli, Aronow) Department of Cardiology, Westchester Medical
Center, United States
Publisher
Oxford University Press

<72>
Accession Number
2003985950
Title
Residential greenness and increased physical activity in patients after
coronary artery bypass graft surgery.
Source
European Journal of Preventive Cardiology. 28(11) (pp 1184-1191), 2021.
Date of Publication: 01 Nov 2021.
Author
Sadeh M.; Brauer M.; Chudnovsky A.; Ziv A.; Dankner R.
Institution
(Sadeh, Dankner) Department of Epidemiology and Preventive Medicine,
School of Public Health, Tel Aviv University, Israel
(Brauer) School of Population and Public Health, University of British
Columbia, Canada
(Chudnovsky) AIR-O Lab, Porter School of Environment and Geosciences,
Department of Geography and Human Environment, Israel
(Ziv) Unit for Data Management and Computerization, Gertner Institute for
Epidemiology and Health Policy Research, Sheba Medical Center, Israel
(Dankner) Unit for Cardiovascular Epidemiology, Gertner Institute for
Epidemiology and Health Policy Research, Sheba, Israel
Publisher
Oxford University Press
Abstract
Aims: Physical activity is a fundamental component of rehabilitation
following coronary artery bypass (CABG) surgery. Proximity to
neighbourhood green spaces may encourage physical activity. We
investigated the association between residential greenness and
exercise-related physical activity post-CABG surgery. Method(s):
Participants in a prospective cohort study of 846 patients (78% men) who
underwent CABG surgery at seven cardiothoracic units during the time
period 2004-2007 were interviewed regarding their physical activity habits
one day before and one year after surgery. Exposure to residential
neighbourhood greenness (within a 300 m buffer around their place of
residence) was measured using the Normalized Difference Vegetative Index.
Participation in exercise-related physical activity (yes/no), weekly
duration of exercise-related physical activity and the change in
exercise-related physical activity between baseline and follow-up were
examined for associations with residential greenness, adjusting for
socio-demographic factors, propensity score adjusted participation in
cardiac rehabilitation and health-related covariates after multiple
imputation for missing variables. Result(s): Living in a higher
quartile of residential greenness was associated with a 52% greater odds
of being physically active (OR 1.52, 95% CI 1.22-1.90). This association
persisted only (OR 1.75, 95% CI 1.35-2.27) among patients who did not
participate in cardiac rehabilitation following surgery and was stronger
in women (OR 2.38, 95% CI 1.40-4.07) than in men (OR 1.37, 95% CI
1.07-1.75). Participants who lived in greener areas were more likely to
increase their post-surgical physical activity than those who lived in
less green areas (OR 1.59, 95% CI 1.25-2.01). Conclusion(s):
Residential greenness appears to be beneficial in increasing
exercise-related physical activity in cardiac patients, especially those
not particpating in cardiac rehabilitation after CABG
surgery. Copyright © 2019 Published on behalf of the European
Society of Cardiology. All rights reserved.

<73>
Accession Number
2002725056
Title
The effects of preoperative aspirin on coronary artery bypass surgery: A
systematic meta-analysis.
Source
Korean Circulation Journal. 49(6) (pp 498-510), 2019. Date of Publication:
2019.
Author
Hwang D.; Lee J.M.; Rhee T.-M.; Kim Y.-C.; Park J.; Ahn C.; Song Y.B.;
Hahn J.-Y.; Kim K.-B.; Lee Y.-T.; Koo B.-K.
Institution
(Hwang, Rhee, Kim, Park, Park, Koo) Department of Internal Medicine,
Cardiovascular Center, Seoul National University Hospital, 101, Daehak-ro,
Jongno-gu, Seoul 03080, South Korea
(Lee, Song, Hahn) Department of Internal Medicine, Cardiovascular Center,
Samsung Medical Center, Sungkyunkwan University, School of Medicine,
Seoul, South Korea
(Ahn) Division of Biostatistics, Center for Devices and Radiological
Health, Food and Drug Administration, Silver Spring, MD, United States
(Kim) Department of Thoracic and Cardiovascular Surgery, Seoul National
University Hospital, Seoul, South Korea
(Lee) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
(Koo) Institute of Aging, Seoul National University, Seoul, South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: Aspirin plays an important role in the
maintenance of graft patency and the prevention of thrombotic event after
coronary artery bypass graft surgery (CABG). However, the use of
preoperative aspirin is still under debate due to the risk of bleeding.
 Method(s): From PubMed, EMBASE, and Cochrane Central Register of
Controlled Trials, data were extracted by 2 independent reviewers.
Meta-analysis using random effect model was performed. Result(s): We
performed a systemic meta-analysis of 17 studies (12 randomized controlled
studies and 5 non-randomized registries) which compared clinical outcomes
of 9,101 patients who underwent CABG with or without preoperative aspirin
administration. Preoperative aspirin increased chest tube drainage
(weighted mean difference 177.4 mL, 95% confidence interval [CI],
41.3-313.4; p=0.011). However, the risk of re-operation for bleeding was
not different between the preoperative aspirin group and the control group
(3.2% vs. 2.4%; odds ratio [OR], 1.23; 95% CI, 0.94-1.60; p=0.102). There
was no difference in the rates of all-cause mortality (1.6% vs. 1.5%; OR,
0.98; 95% CI, 0.64-1.49; p=0.920) and myocardial infarction (MI) (8.7% vs.
10.4%; OR, 0.83; 95% CI, 0.66-1.04; p=0.102) between patients with and
without preoperative aspirin administration. Conclusion(s): Although
aspirin increased the amount of chest tube drainage, it was not associated
with increased risk of re-operation for bleeding. In addition, the risks
of early postoperative all-cause mortality and MI were not reduced by
using preoperative aspirin. Copyright © 2019. The Korean Society
of Cardiology This is an Open Access article distributed under the terms
of the Creative Commons Attribution Non-Commercial License
(https://creativecommons.org/licenses/by-nc/4.0) which permits
unrestricted noncommercial use, distribution, and reproduction in any
medium, provided the original work is properly cited.

<74>
Accession Number
611448951
Title
Effect of n-3 polyunsaturated fatty acids on regression of coronary
atherosclerosis in statin treated patients undergoing percutaneous
coronary intervention.
Source
Korean Circulation Journal. 46(4) (pp 481-489), 2016. Date of Publication:
July 2016.
Author
Ahn J.; Park S.K.; Park T.S.; Kim J.H.; Yun E.; Kim S.-P.; Lee H.W.; Oh
J.-H.; Choi J.H.; Cha K.S.; Hong T.J.; Lee S.Y.; Lee H.C.
Institution
(Ahn, Park, Park, Lee, Oh, Choi, Cha, Hong, Lee) Division of Cardiology,
Department of Internal Medicine, Pusan National University Hospital, 179
Gudeok-ro, Seo-gu, Busan 49241, South Korea
(Kim) Department of Internal Medicine, Busan Medical Center, Busan, South
Korea
(Yun) Department of Biostatistics, Pusan National University Hospital,
Busan, South Korea
(Kim) Department of Cardiovascular Surgery, Pusan National University
Hospital, Busan, South Korea
(Lee) Family Medicine Clinic and Research Institute of Convergence of
Biomedical Science and Technology, Pusan National University Yangsan
Hospital, Yangsan, South Korea
(Lee) Medical Education Unit and Medical Research Institute, Pusan
National University, School of Medicine, Yangsan, South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: Statins remain the mainstay of secondary
coronary artery disease (CAD) prevention, but n-3 polyunsaturated fatty
acids (omega-3 PUFA) display biological effects that may also reduce the
risk of atherosclerosis and CAD. However, data on the possible
antiatherosclerotic benefits of adding omega-3 PUFA to statin therapy are
limited. This study aimed to investigate the potential additive effects of
omega-3 PUFA on regression of atherosclerosis in CAD patients receiving
statin therapy and stent implantation. Subjects and Methods: Seventy-four
CAD patients undergoing percutaneous coronary intervention (PCI) with
stent implantation were enrolled, prescribed statins, and randomly
assigned to two groups: n-3 group (omega-3 PUFA 3 g/day, n=38) or placebo
group (placebo, n=36). All patients completed the study follow-up
consisting of an intravascular ultrasound at baseline and at 12 months.
 Result(s): There was no difference in the baseline characteristics
and distribution of other medications. No significant differences were
observed in primary endpoints, including changes in atheroma volume index
(-12.65% vs. -8.51%, p=0.768) and percent atheroma volume (-4.36% vs.
-9.98%, p=0.526), and in secondary endpoints including a change in
neointimal volume index (7.84 vs. 4.94 mm3/mm, p=0.087).
 Conclusion(s): omega-3 PUFA had no definite additional effect on the
regression of coronary atherosclerosis when added to statin in CAD
patients undergoing PCI. Copyright © 2016 The Korean Society of
Cardiology.

<75>
Accession Number
606161970
Title
Stepwise approach using combined management in patients with congenital
heart disease and borderline pulmonary vascular disease.
Source
Korean Circulation Journal. 45(5) (pp 408-415), 2015. Date of Publication:
01 Sep 2015.
Author
Lee S.-Y.; Kim S.-J.; Son J.S.; Kim S.-H.; Lee C.-H.
Institution
(Lee, Kim, Lee) Department of Pediatrics, Department of Thoracic and
Cardiovascular Surgery, Sejong Cardiovascular Institute, Bucheon, South
Korea
(Kim, Son) Division of Pediatric Cardiology, Department of Pediatrics,
Konkuk University Hospital, 120-1, Neungdong-ro, Gwangjin-gu, Seoul 05030,
South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: Despite remarkable advances in pediatric
cardiology, pulmonary arterial hypertension associated with congenital
heart disease remains a major problem. In the past decade new vasodilators
have been introduced and appear to be effective in reducing pulmonary
vascular resistance (PVR). Subjects and Methods: From 2000 to 2011, we
retrospectively reviewed the records of 22 patients who had congenital
septal defects and borderline pulmonary vascular disease (PVD). The PVR in
these patients was from 6 to 16 wood units m2, and/or the systolic
pulmonary arterial pressure was more than 2/3 of the systemic arterial
pressure. Result(s): The median age was 16 years (range, 9 months-46
years). The median duration of follow-up was 7.4 years (range, 1.4-11.7
years). According to hemodynamic data and clinical symptoms, the initial
management comprised targeted medical therapy in four (18%), complete
closure in four (18%), and partial closure in 14 patients (63.6%). In the
four patients who had a high PVR and negative vasoreactivity, the PVR
decreased and vasoreactivity increased after targeted medical therapy;
three of these patients underwent cardiac surgery later. Finally, 11 (50%)
received targeted medical therapy and 21 patients (95.4%) underwent
cardiac surgery. Complete closure resulted in six patients and partial
closure in 17 patients. Mortality was observed in two patients. The other
19 patients (91%) had New York Heart Association functional class I.
 Conclusion(s): Targeted medical therapy may be effective in reducing
PVR in patients with congenital heart disease and borderline PVD. A
stepwise approach may help to achieve improved outcomes in these
patients. Copyright © 2015 The Korean Society of Cardiology.

<76>
Accession Number
364430390
Title
Comparison of the radial artery and saphenous vein as composite grafts in
off-pump coronary artery bypass grafting in elderly patients: A randomized
controlled trial.
Source
Korean Circulation Journal. 42(2) (pp 107-112), 2012. Date of Publication:
February 2012.
Author
Song S.-W.; Sul S.-Y.; Lee H.-J.; Yoo MD K.-J.
Institution
(Song) Department of Thoracic and Cardiovascular Surgery, Gangnam
Severance Hospital, Yonsei University College of Medicine, Seoul, South
Korea
(Sul, Lee, Yoo MD) Department of Thoracic and Cardiovascular Surgery,
Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro,
Seodaemun-gu, Seoul 120-752, South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: Arterial grafts have a better long-term patency
rate than saphenous vein (SV) when used in off-pump coronary artery bypass
surgery (OPCAB). However, arterial grafts in elderly patients are often
diseased. We sought to compare the early outcomes achieved by using the
two different types of composite grafts. Subjects and Methods: We
conducted a randomized trial to compare radial artery (RA) and SV
composite grafts based on the in situ left internal mammary artery in 60
elderly (>70 years old) patients, who were scheduled to undergo OPCAB.
Clinical outcomes and 1-year post-operative CT angiography results were
compared. The quality of the conduit was evaluated by employing vascular
ultrasonography, optical coherence tomography (OCT), and histologic
examination. Result(s): No differences in immediate postoperative
morbidity and mortality were observed between the two groups. Early
postoperative CT angiography revealed a SV patency rate of 100%, which was
not different from that of RA composite grafts (99.1%). CT angiography
after a year showed an overall patency rate of 96.3%. The overall patency
rate of the SV group at 1 year was 94.7%, which was similar to that of the
RA group (97.4%). Also, there was no difference in overall survival rate
between the two groups. Vascular ultrasonographic images showed strong
correlations between OCT and histopathology. Conclusion(s): Our
analysis of early outcomes revealed that the SV could be used as an
alternative composite graft to the RA in elderly patients. Vascular
ultrasonography is an accurate, real-time, and reproducible method for
assessing the quality of the RA conduit. Copyright © 2012 The Korean
Society of Cardiology.

<77>
Accession Number
354412631
Title
Is stem cell-based therapy going on or out for cardiac disease?.
Source
Korean Circulation Journal. 39(3) (pp 87-92), 2009. Date of Publication:
March 2009.
Author
Byun K.H.; Kim S.-W.
Institution
(Byun) Division of Cardiology, Department of Internal Medicine, Kwandong
University College of Medicine, Goyang, South Korea
(Byun, Kim) Division of Cardiology, Department of Medicine, Emory
University School of Medicine, 1639 Pierce Dr., Atlanta, GA 30322, United
States
Publisher
Korean Society of Circulation
Abstract
Acute myocardial infarction and subsequent heart failure are leading
causes of death Worldwide. Stem cell-based therapies have improved cardiac
function in recent clinical trials, but cardiomyocyte regeneration has not
been demonstrated in human hearts. Angiogenesis and restoration of cardiac
perfusion have been successfully performed using bone marrow derived stem
cells and other adult stem cells. Resident cardiac stem cells are known to
differentiate into multiple heart cell types, including cardiomyocytes.
Furthermore, induced pluripotent stem cells are a focus of research due to
the great potential for customized stem cell therapy. Copyright ©
2009 The Korean Society of Cardiology.

<78>
[Use Link to view the full text]
Accession Number
2019871110
Title
Cochrane in CORR: Negative Pressure Wound Therapy for Surgical Wounds
Healing by Primary Closure.
Source
Clinical Orthopaedics and Related Research. 480(9) (pp 1646-1652), 2022.
Date of Publication: 01 Sep 2022.
Author
Qiu R.; Johal H.
Institution
(Qiu) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Johal) Division of Orthopedic Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
Publisher
Lippincott Williams and Wilkins

<79>
Accession Number
2015434575
Title
Transcatheter edge-to-edge repair of tricuspid regurgitation in the
Netherlands: state of the art and future perspectives.
Source
Netherlands Heart Journal. 30(9) (pp 393-399), 2022. Date of Publication:
September 2022.
Author
Krikken J.A.; van den Heuvel A.F.M.; Willemsen H.M.; Voors A.A.; Lipsic E.
Institution
(Krikken, van den Heuvel, Willemsen, Voors, Lipsic) Department of
Cardiology, University Medical Centre Groningen, University of Groningen,
Groningen, Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Despite the high prevalence and adverse clinical outcomes of severe
tricuspid regurgitation (TR), conventional treatment options, surgical or
pharmacological, are limited. Surgery is associated with a high
peri-operative risk and medical treatment has not clearly resulted in
clinical improvements. Therefore, there is a high unmet need to reduce
morbidity and mortality in patients with severe TR. During recent years,
several transcatheter solutions have been studied. This review focuses on
the transcatheter edge-to-edge repair of TR (TTVR) with respect to patient
selection, the procedure, pre- and peri-procedural echocardiographic
assessments and clinical outcomes. Furthermore, we highlight the current
status of TTVR in the Netherlands and provide data from our initial
experience at the University Medical Centre Groningen. Copyright
© 2022, The Author(s).

<80>
Accession Number
638775117
Title
Association of Dual Antiplatelet Therapy With Ticagrelor With Vein Graft
Failure After Coronary Artery Bypass Graft Surgery: A Systematic Review
and Meta-analysis.
Source
JAMA. 328(6) (pp 554-562), 2022. Date of Publication: 09 Aug 2022.
Author
Sandner S.; Redfors B.; Angiolillo D.J.; Audisio K.; Fremes S.E.; Janssen
P.W.A.; Kulik A.; Mehran R.; Peper J.; Ruel M.; Saw J.; Soletti G.J.;
Starovoytov A.; Ten Berg J.M.; Willemsen L.M.; Zhao Q.; Zhu Y.; Gaudino M.
Institution
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Sandner) Weill Cornell Medicine, New York, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, United States
(Audisio, Soletti, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, United States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Fremes) Institute of Health Policy Management and Evaluation, University
of Toronto, Toronto, ON, Canada
(Janssen, Peper, Ten Berg, Willemsen) Department of Cardiology, St
Antonius Hospital, Nieuwegein, Netherlands
(Kulik) Division of Cardiac Surgery, Boca Raton Regional Hospital and
Florida Atlantic Hospital, Boca Raton, United States
(Mehran) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Saw, Starovoytov) Division of Cardiology, Vancouver General Hospital, BC,
Canada
(Saw) Division of Cardiology St Paul's Hospital, University of British
Columbia, Vancouver, Canada
(Zhao, Zhu) Ruijin Hospital Shanghai Jiao Tong University School of
Medicine, Shanghai, China
Publisher
American Medical Association
Abstract
Importance: The role of ticagrelor with or without aspirin after coronary
artery bypass graft surgery remains unclear. Objective(s): To compare
the risks of vein graft failure and bleeding associated with ticagrelor
dual antiplatelet therapy (DAPT) or ticagrelor monotherapy vs aspirin
among patients undergoing coronary artery bypass graft surgery. Data
Sources: MEDLINE, Embase, and Cochrane Library databases from inception to
June 1, 2022, without language restriction. Study Selection: Randomized
clinical trials (RCTs) comparing the effects of ticagrelor DAPT or
ticagrelor monotherapy vs aspirin on saphenous vein graft failure. Data
Extraction and Synthesis: Individual patient data provided by each trial
were synthesized into a combined data set for independent analysis.
Multilevel logistic regression models were used. Main Outcomes and
Measures: The primary analysis assessed the incidence of saphenous vein
graft failure per graft (primary outcome) in RCTs comparing ticagrelor
DAPT with aspirin. Secondary outcomes were saphenous vein graft failure
per patient and Bleeding Academic Research Consortium (BARC) type 2, 3, or
5 bleeding events. A supplementary analysis included RCTs comparing
ticagrelor monotherapy with aspirin. Result(s): A total of 4 RCTs
were included in the meta-analysis, involving 1316 patients and 1668
saphenous vein grafts. Of the 871 patients in the primary analysis, 435
received ticagrelor DAPT (median age, 67 years [IQR, 60-72 years]; 65
women [14.9%]; 370 men [85.1%]) and 436 received aspirin (median age, 66
years [IQR, 61-73 years]; 63 women [14.5%]; 373 men [85.5%]). Ticagrelor
DAPT was associated with a significantly lower incidence of saphenous vein
graft failure (11.2%) per graft than was aspirin (20%; difference, -8.7%
[95% CI, -13.5% to -3.9%]; OR, 0.51 [95% CI, 0.35 to 0.74]; P <.001) and
was associated with a significantly lower incidence of saphenous vein
graft failure per patient (13.2% vs 23.0%, difference, -9.7% [95% CI,
-14.9% to -4.4%]; OR, 0.51 [95% CI, 0.35 to 0.74]; P <.001). Ticagrelor
DAPT (22.1%) was associated with a significantly higher incidence of BARC
type 2, 3, or 5 bleeding events than was aspirin (8.7%; difference, 13.3%
[95% CI, 8.6% to 18.0%]; OR, 2.98 [95% CI, 1.99 to 4.47]; P <.001), but
not BARC type 3 or 5 bleeding events (1.8% vs 1.8%, difference, 0% [95%
CI, -1.8% to 1.8%]; OR, 1.00 [95% CI, 0.37 to 2.69]; P =.99). Compared
with aspirin, ticagrelor monotherapy was not significantly associated with
saphenous vein graft failure (19.3% vs 21.7%, difference, -2.6% [95% CI,
-9.1% to 3.9%]; OR, 0.86 [95% CI, 0.58 to 1.27]; P =.44) or BARC type 2,
3, or 5 bleeding events (8.9% vs 7.3%, difference, 1.7% [95% CI, -2.8% to
6.1%]; OR, 1.25 [95% CI, 0.69 to 2.29]; P =.46). Conclusions and
Relevance: Among patients undergoing coronary artery bypass graft surgery,
adding ticagrelor to aspirin was associated with a significantly decreased
risk of vein graft failure. However, this was accompanied by a
significantly increased risk of clinically important
bleeding. Copyright © 2022 American Medical Association. All
rights reserved.

<81>
[Use Link to view the full text]
Accession Number
2019708422
Title
Clinical Implications and Debates on the International Study of
Comparative Health Effectiveness with Medical and Invasive Approaches
Trial.
Source
Cardiology in Review. 30(5) (pp 234-240), 2022. Date of Publication: 01
Sep 2022.
Author
Saito Y.; Nishi T.; Saito K.; Kitahara H.; Kawase Y.; Matsuo H.; Kobayashi
Y.
Institution
(Saito, Nishi, Saito, Kitahara, Kobayashi) Department of Cardiovascular
Medicine, Chiba University, Graduate School of Medicine, 1-8-1 Inohana,
Chuo-ku, Chiba 260-8677, Japan
(Kawase, Matsuo) Department of Cardiovascular Medicine, Gifu Heart Center,
Gifu, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
The International Study of Comparative Health Effectiveness with Medical
and Invasive Approaches (ISCHEMIA) was eagerly awaited study in the field
of ischemic heart disease. Following the presentation and publication of
ISCHEMIA, multiple opinions and viewpoints get complicated. The ongoing
debates have been including the relevance of coronary revascularization,
noninvasive diagnostic methods, and invasive ischemic testing in patients
with stable ischemic heart disease (SIHD). Prior to ISCHEMIA,
observational studies indicated the potential of coronary
revascularization for improving clinical outcomes, while the randomized
Clinical Outcomes Utilizing Revascularization and Aggressive Drug
Evaluation (COURAGE) trial did not support the plausible concept. Although
the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation
(FAME) 2 trial implied the superiority of percutaneous coronary
intervention over medical therapy alone, the clinical relevance of
coronary revascularization to improve outcomes and quality of life has
been questioned. As a consequence, the ISCHEMIA trial did not demonstrate
clear benefits in reducing clinical events but showed antianginal effects
of revascularization. This landmark trial also suggested the difficulties
of noninvasive ischemia testing rather than computed tomography
angiography. Despite the complex results, the ISCHEMIA trial may simplify
the clinical indications of coronary revascularization in patients with
SIHD. Future publications from the ISCHEMIA trial and debates on the
results will sharpen our thinking and understanding. Copyright ©
2022 Lippincott Williams and Wilkins. All rights reserved.

<82>
Accession Number
2019638394
Title
FFR-Guided PCI Optimization Directed by High-Definition IVUS Versus
Standard of Care: The FFR REACT Trial.
Source
JACC: Cardiovascular Interventions. 15(16) (pp 1595-1607), 2022. Date of
Publication: 22 Aug 2022.
Author
Neleman T.; van Zandvoort L.J.C.; Tovar Forero M.N.; Masdjedi K.; Ligthart
J.M.R.; Witberg K.T.; Groenland F.T.W.; Cummins P.; Lenzen M.J.; Boersma
E.; Nuis R.-J.; den Dekker W.K.; Diletti R.; Wilschut J.; Zijlstra F.; Van
Mieghem N.M.; Daemen J.
Institution
(Neleman, van Zandvoort, Tovar Forero, Masdjedi, Ligthart, Witberg,
Groenland, Cummins, Lenzen, Boersma, Nuis, den Dekker, Diletti, Wilschut,
Zijlstra, Van Mieghem, Daemen) Department of Cardiology, Erasmus
University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Post-percutaneous coronary intervention (PCI) fractional flow
reserve (FFR) <0.90 is common and has been related to impaired patient
outcome. Objective(s): The authors sought to evaluate if PCI
optimization directed by intravascular ultrasound (IVUS) in patients with
post-PCI FFR <0.90 could improve 1-year target vessel failure (TVF) rates.
 Method(s): In this single-center, randomized, double-blind trial,
patients with a post-PCI FFR <0.90 at the time of angiographically
successful PCI were randomized to IVUS-guided optimization or the standard
of care (control arm). The primary endpoint was TVF (a composite of
cardiac death, spontaneous target vessel myocardial infarction, and
clinically driven target vessel revascularization) at 1 year.
 Result(s): A total of 291 patients with post-PCI FFR <0.90 were
randomized (IVUS-guided optimization arm: n = 145/152 vessels, control
arm: n = 146/157 vessels). The mean post-PCI FFR was 0.84 +/- 0.05. A
total of 104 (68.4%) vessels in the IVUS-guided optimization arm underwent
additional optimization including additional stenting (34.9%) or
postdilatation only (33.6%), resulting in a mean increase in post-PCI FFR
in these vessels from 0.82 +/- 0.06 to 0.85 +/- 0.05 (P < 0.001) and a
post-PCI FFR >=0.90 in 20% of the vessels. The 1-year TVF rate was
comparable between the 2 study arms (IVUS-guided optimization arm: 4.2%,
control arm: 4.8%; P = 0.79). There was a trend toward a lower incidence
of clinically driven target vessel revascularization in the IVUS-guided
optimization arm (0.7% vs. 4.2%, P = 0.06). Conclusion(s):
IVUS-guided post-PCI FFR optimization significantly improved post-PCI FFR.
Because of lower-than-expected event rates, post-PCI FFR optimization did
not significantly lower TVF at the 1-year follow-up. Copyright ©
2022 The Authors

<83>
Accession Number
2019591122
Title
Efficacy of ultrasound-guided parasternal block in adult cardiac surgery:
a meta-analysis of randomized controlled trials.
Source
Minerva Anestesiologica. 88(9) (pp 719-728), 2022. Date of Publication:
September 2022.
Author
Li J.; Lin L.; Peng J.; He S.; Wen Y.; Zhang M.
Institution
(Li, Peng, He) Department of Anesthesiology, People's Hospital of Yilong
County, Nanchong, China
(Lin) Department of Anesthesiology, The General Hospital of Western
Theater Command Hospital, Chengdu, China
(Wen) Department of Anesthesiology, Traditional Chinese Medicine Hospital
of Nanchong, Nanchong, China
(Zhang) Department of Neurology, People's Hospital of Yilong County,
Nanchong, China
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Pain after cardiac surgery is a common and severe
postoperative complication. As a new regional nerve block method,
ultrasound-guided parasternal block (PSB) has been increasingly used to
supplement the analgesic effects of opioids in order to eliminate
opioid-related adverse drug events, but its efficacy still remains
controversial. In the present meta-analysis, we aim to screen all eligible
randomized controlled trials (RCTs) and give a comprehensive summary of
the clinical value of PSB after adult cardiac surgery. EVIDENCE
ACQUISITION: We searched all RCTs about PSB after cardiac surgery in the
database of PubMed, Embase, Cochrane, CNKI and Wanfang with no limitation
of language from inception to September 2021. Two reviewers were
independently involved in the process of data extraction. Meta-analysis
was performed by using Review Manager software. The quality of included
RCTs were assessed by using Cochrane's risk of bias assessment tool, and
funnel plots were drawn to assess publication bias. EVIDENCE SYNTHESIS: A
total of 12 RCTs with 366 patients in PSB group and 364 patients in
control group were included in the present meta-analysis. Pooled analysis
revealed that intraoperative and postoperative consumption of sufentanil
were significantly decreased with the addition of PSB (P<0.05). Numerical
rating scale (NRS) scores in PSB group were found to be significantly
lower than that of control group at extubation, postoperative 4 h and 8 h
(P<0.05) instead of postoperative 24 h or longer. PSB could reduce the
incidence of postoperative nausea and vomiting (PONV) (P<0.05). In
addition, we demonstrated that PSB was significantly related to decreased
mechanical ventilation time, total length of ICU stay and hospital days
(P<0.05). CONCLUSION(S): Through decreasing the consumption of
opioids, ultrasound-guided PSB could relieve pain and limit opioid-related
complications. Clinical outcomes, such as mechanical ventilation time,
total length of ICU stay and hospital days, will also be improved. Our
findings prove that ultrasound-guided PSB is an effective regional
analgesic method after adult cardiac surgery. Copyright © 2022
EDIZIONI MINERVA MEDICA.

<84>
Accession Number
2019010269
Title
Impact of cardiopulmonary bypass duration on efficacy of fibrinogen
replacement with cryoprecipitate compared with fibrinogen concentrate: a
post hoc analysis of the Fibrinogen Replenishment in Surgery (FIBRES)
randomised controlled trial.
Source
British Journal of Anaesthesia. 129(3) (pp 294-307), 2022. Date of
Publication: September 2022.
Author
Bartoszko J.; Martinez-Perez S.; Callum J.; Karkouti K.; Farouh M.E.;
Scales D.C.; Heddle N.M.; Crowther M.; Rao V.; Hucke H.-P.; Carroll J.;
Grewal D.; Brar S.; Brussieres J.; Grocott H.; Harle C.; Pavenski K.;
Rochon A.; Saha T.; Shepherd L.; Syed S.; Tran D.; Wong D.; Zeller M.
Institution
(Bartoszko, Martinez-Perez, Karkouti) Department of Anesthesia and Pain
Management, University Health Network, Sinai Health System, Women's
College Hospital, University of Toronto, Toronto, ON, Canada
(Bartoszko, Karkouti) Peter Munk Cardiac Centre and Toronto General
Hospital Research Institute, University Health Network, Toronto, ON,
Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Queen's
University, Toronto, ON, Canada
(Karkouti) Institute of Health Policy Management and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Ltd
Abstract
Background: Coagulopathy in cardiac surgery is frequently associated with
acquired hypofibrinogenaemia, which can be treated with either purified
fibrinogen concentrate (FC) or cryoprecipitate. Because the latter is not
purified and therefore contains additional coagulation factors, it is
thought to be more effective for treatment of coagulopathy that occurs
after prolonged cardiopulmonary bypass (CPB). We examined the impact of
CPB duration on the efficacy of the two therapies in cardiac surgery.
 Method(s): This was a post hoc analysis of the Fibrinogen
Replenishment in Surgery (FIBRES) RCT comparing FC (4 g) to
cryoprecipitate (10 U) in adult patients undergoing cardiac surgery and
experiencing bleeding with acquired hypofibrinogenaemia (n=735). The
primary outcome was allogeneic blood products transfused within 24 h after
CPB. Subjects were stratified by CPB duration (<=120, 121-180, and >180
min). The interaction of treatment assignment with CPB duration was
tested. Result(s): Subjects with longer CPB duration experienced more
bleeding and transfusion. With CPB time <=120 min (FC, n=134;
cryoprecipitate, n=146), the ratio of least-squares means between the FC
and cryoprecipitate groups for total allogeneic blood products at 24 h was
0.90 (one-sided 97.5% confidence interval [CI]: 0.00-1.12); P=0.004. For
subjects with CPB time 121-180 min, it was 1.00 ([one-sided 97.5% CI:
0.00-1.22]; P=0.03], and for CPB time >180 min it was 0.91 ([one-sided
97.5% CI: 0.00-1.12]; P=0.005). Results were similar for all secondary
outcomes, with no interaction between treatment and CPB duration for all
outcomes. Conclusion(s): The haemostatic efficacy of FC was
non-inferior to cryoprecipitate irrespective of CPB duration in cardiac
surgery. Clinical trial registration: NCT03037424. Copyright ©
2022 British Journal of Anaesthesia

<85>
Accession Number
2018871709
Title
Validation of the ARC-HBR criteria in 68,874 patients undergoing PCI: A
systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. 66 (pp 59-66), 2022. Date of Publication:
01 Jul 2022.
Author
Montalto C.; Munafo A.R.; Arzuffi L.; Casula M.; Mandurino-Mirizzi A.;
Costa F.; Leonardi S.; Oltrona Visconti L.; Ferlini M.
Institution
(Montalto, Munafo, Arzuffi, Casula, Leonardi) Department of Molecular
Medicine, University of Pavia, Pavia, Italy
(Montalto) De Gasperis Cardio Center, Interventional Cardiology Unit,
Niguarda Hospital, Milan, Italy
(Mandurino-Mirizzi, Leonardi, Oltrona Visconti, Ferlini) Division of
Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
(Costa) Department of Clinical and Experimental Medicine, Policlinic "G.
Martino", University of Messina, Messina, Italy
Publisher
Hellenic Cardiological Society
Abstract
The Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria
aims to stratify patients undergoing percutaneous coronary intervention
(PCI) and are now recommended by international guidelines to stratify
bleeding risk in clinical practice. We searched electronic databases from
2019 (ARC-HBR proposal) up to February 2021 for studies that reported the
occurrence of major bleedings according to ARC-HBR status in patients
undergoing PCI and pooled them as relative risk (RR) in a random-effect
analysis. Only studies that reported events according to the number of
times the ARC-HBR definition was met were included in a sensitivity
analysis and RR for each stratum was calculated. Nine studies and 68,874
subjects were included in our analysis; 39.2% of them were at HBR and they
had a significantly higher risk of major bleedings (RR: 2.70; 95% CI:
2.35-3.10; p < 0.0001). The ARC-HBR definition also had a moderate
discriminative power (pooled c-stat: 0.69; 95% CI: 0.61-0.75) while
calibration was suboptimal with a tendency toward underpredicting bleeding
events (pooled observed:expected ratio: 1.47; 95% CI: 0.82-2.60). Our
sensitivity analysis included 5 studies and 46,712 patients and confirmed
the incremental, additive power of the ARC-HBR when it is met multiple
times. Finally, among baseline characteristics explored, only presenting
with an acute coronary syndrome had a significant impact on the ARC-HBR
predictive ability. The ARC-HBR definition is a useful clinical tool, but
with a tendency towards underpredicting major bleedings and its predictive
ability might be optimized by including the number of times the definition
is met. Copyright © 2022 Hellenic Society of Cardiology

<86>
Accession Number
2018369570
Title
Cardiac cephalalgia: a case series of four patients and updated literature
review.
Source
International Journal of Emergency Medicine. 15(1) (no pagination), 2022.
Article Number: 33. Date of Publication: December 2022.
Author
Kobata H.
Institution
(Kobata) Osaka Mishima Emergency Critical Care Center, 11-1
Minamiakutagawa-cho Takatsuki, Osaka 569-1124, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac damage is common in patients with acute brain injury;
however, little is known regarding cardiac-induced neurological symptoms.
In the International Classification of Headache, Third Edition (ICHD-III),
cardiac cephalalgia is classified as a headache caused by impaired
homeostasis. Method(s): This report presents four patients with acute
myocardial infarction (AMI) who presented with headache that fulfilled the
ICHD-III diagnostic criteria for cardiac cephalalgia. A systematic review
of cardiac cephalalgia using the Preferred Reporting Items for Systematic
Reviews and Meta-analyses guidelines is also presented. Result(s):
Case 1: A 69-year-old man with a history of percutaneous coronary
intervention (PCI) developed sudden severe occipital pain, nausea, and
cold sweating. Coronary angiography (CAG) revealed occlusion of the right
coronary artery (RCA). Case 2: A 66-year-old woman complained of
increasing occipitalgia and chest discomfort while riding a bicycle. CAG
demonstrated 99% stenosis of the left anterior descending artery. Case 3:
A 54-year-old man presented with faintness, cold sweating, and
occipitalgia after eating lunch. CAG detected occlusion of the RCA. Case
4: A 72-year-old man went into shock after complaining of a sudden severe
headache and nausea. Vasopressors were initiated and emergency CAG was
performed, which detected three-vessel disease. In all four,
electrocardiography (ECG) showed ST segment elevation or depression and
echocardiography revealed a left ventricular wall motion abnormality. All
patients underwent PCI, which resulted in headache resolution after
successful coronary reperfusion. A total of 59 cases of cardiac
cephalalgia were reviewed, including the four reported here. Although the
typical manifestation of cardiac cephalalgia is migraine-like pain on
exertion, it may present with thunderclap headache without a trigger or
chest symptoms, mimicking subarachnoid hemorrhage. ECG may not always show
an abnormality. Headaches resolve after successful coronary reperfusion.
 Conclusion(s): Cardiac cephalalgia resulting from AMI can present
with or without chest discomfort and even mimic the classic thunderclap
headache associated with SAH. It should be recognized as a neurological
emergency and treated without delay. Copyright © 2022, The
Author(s).

<87>
Accession Number
2018077005
Title
Permanent pacemaker implantation after valve and arrhythmia surgery in
patients with preoperative atrial fibrillation.
Source
Heart Rhythm. 19(9) (pp 1442-1449), 2022. Date of Publication: September
2022.
Author
Kowalewski M.; Pasierski M.; Finke J.; Kolodziejczak M.; Staromlynski J.;
Litwinowicz R.; Filip G.; Kowalowka A.; Wanha W.; Blawat P.; Los A.;
Stefaniak S.; Wojakowski W.; Jemielity M.; Rogowski J.; Deja M.; Jagielak
D.; Bartus K.; Sierakowska K.; Mariani S.; Li T.; Ravaux J.M.; Matteucci
M.; Ronco D.; Jiritano F.; Fina D.; Martucci G.; Meani P.; Raffa G.M.;
Malvindi P.G.; Lorusso R.; Suwalski P.
Institution
(Kowalewski, Pasierski, Finke, Staromlynski, Suwalski) Department of
Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior,
Centre of Postgraduate Medical Education, Warsaw, Poland
(Kowalewski, Mariani, Ravaux, Matteucci, Ronco, Fina, Meani, Lorusso)
Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht
University Medical Centre, Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Kowalewski, Pasierski, Kolodziejczak, Staromlynski, Litwinowicz, Wanha,
Matteucci, Ronco, Jiritano, Fina, Martucci, Meani, Raffa, Suwalski)
Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus
University, Innovative Medical Forum, Bydgoszcz, Poland
(Kolodziejczak, Sierakowska) Department of Anaesthesiology and Intensive
Care, Collegium Medicum Nicolaus Copernicus University, Antoni Jurasz
University Hospital No. 1, Bydgoszcz, Poland
(Kolodziejczak) Division of Cardiology, Yale School of Medicine, New
Haven, Connecticut
(Litwinowicz, Filip, Bartus) Department of Cardiovascular Surgery and
Transplantology, Jagiellonian University Medical College, John Paul II
Hospital, Krakow, Poland
(Kowalowka, Deja) Department of Cardiac Surgery, Medical University of
Silesia, School of Medicine in Katowice, Katowice, Poland
(Kowalowka, Deja) Department of Cardiac Surgery, Upper-Silesian Heart
Center, Katowice, Poland
(Wanha, Wojakowski) Department of Cardiology and Structural Heart
Diseases, Medical University of Silesia, Katowice, Poland
(Blawat) Department of Thoracic Surgery and Tumours, Oncology Centre,
Bydgoszcz, Poland
(Los, Rogowski, Jagielak) Department of Cardiac and Vascular Surgery,
Medical University of Gdansk, Gdansk, Poland
(Stefaniak, Jemielity) Department of Cardiac Surgery and Transplantology,
Poznan University of Medical Sciences, Poznan, Poland
(Li) Department of Cardiothoracic, Transplantation and Vascular Surgery,
Hannover Medical School, Hannover, Germany
(Matteucci, Ronco) Department of Cardiac Surgery, Circolo Hospital,
University of Insubria, Varese, Italy
(Martucci) Anesthesia and Intensive Care Department, IRCCS-ISMETT,
Palermo, Italy
(Raffa) Cardiac Surgery Unit, IRCCS-ISMETT, Palermo, Italy
(Malvindi) Cardiac Surgery Unit, Lancisi Cardiovascular Center,
Polytechnic University of Marche, Ancona, Italy
(Jiritano) Department of Cardiac Surgery, University Magna Graecia of
Catanzaro, Catanzaro, Italy
(Li) Department of Cardiac Surgery, University Hospital Duesseldorf,
Duesseldorf, Germany
(Fina, Meani) Department of Cardiothoracic and Vascular Anesthesia and
Intensive Care Unit (ICU), Istituto di Ricovero e Cura a Carattere
Scientifico Policlinico San Donato, San Donato Milanese, Milan, Italy
Publisher
Elsevier B.V.
Abstract
Background: Among patients referred for cardiac surgery, atrial
fibrillation (AF) is a common comorbidity and a risk factor for
postoperative arrhythmias (eg, sinus node dysfunction, atrioventricular
heart block), including those requiring permanent pacemaker (PPM)
implantation. Objective(s): The purpose of this study was to evaluate
the prevalence and long-term survival of postoperative PPM implantation in
patients with preoperative AF who underwent valve surgery with or without
concomitant procedures. Method(s): Presented analysis pertains to the
HEIST (HEart surgery In atrial fibrillation and Supraventricular
Tachycardia) registry. During the study period, 11,949 patients underwent
valvular (aortic, mitral, or tricuspid valve replacement or repair)
surgery and/or surgical ablation (SA) and were stratified according to
postoperative PPM status. Result(s): PPM implantation after surgery
was necessary in 2.5% of patients, with significant variation depending on
the type of surgery (from 1.1% in mitral valve repair to 3.3% in combined
mitral and tricuspid valve surgery). In a multivariate logistic regression
model, tricuspid intervention (P <.001), cardiopulmonary bypass time (P =
.024), and endocarditis (P = .014) were shown to be risk factors for PPM.
Over long-term follow-up, PPM was not associated with increased mortality
compared to no PPM (hazard ratio 0.96; 95% confidence interval 0.77-1.19;
P = .679). SA was not associated with PPM implantation. However, SA
improved survival regardless of PPM status (log rank P <.001).
 Conclusion(s): In patients with preoperative AF, the need for PPM
implantation after valve surgery or SA is not an infrequent outcome, with
SA not affecting its prevalence but actually improving long-term
survival. Copyright © 2022 Heart Rhythm Society

<88>
Accession Number
2019743035
Title
Midterm Results Comparing Perventricular Device Closure with Surgical
Repair for Isolated Congenital Ventricular Septal Defects: A Systematic
Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 23(8) (no pagination), 2022. Article
Number: 262. Date of Publication: August 2022.
Author
Yu J.; Liufu R.; Wang X.; Liu X.; Zhuang J.
Institution
(Yu) School of Medicine, South China University of Technology, Guangdong,
Guangzhou 510641, China
(Yu, Liu, Zhuang) Department of Cardiovascular Surgery, Guangdong
Cardiovascular Institute, Guangdong Provincial Key Laboratory of South
China Structural Heart Disease, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, Guangzhou 510260, China
(Liufu) Department of Cardiovascular Intensive Care Unit, Guangdong
Cardiovascular Institute, Guangdong Provincial Key Laboratory of South
China Structural Heart Disease, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, Guangzhou 510260, China
(Wang) Department of Epidemiology, Guangdong Cardiovascular Institute,
Guangdong Provincial People's Hospital, Guangdong Academy of Medical
Sciences, Guangdong, Guangzhou 510260, China
Publisher
IMR Press Limited
Abstract
Background: This systematic review and meta-analysis aimed at comparing
the midterm outcomes of perventricular device closure (PDC) with
conventional surgical repair (CSR) for VSD. Method(s): PubMed,
Cochrane Library, and Web of Science databases were searched from January
1, 2005, to October 15, 2020, for English or Chinese language studies
comparing outcomes of PDC with CSR for VSD. The midterm results were
assessed as a primary outcome. A systematic review and meta-analysis was
performed under the frequentist frame with risk ratio (RR) and 95%
confidence interval (CI). Result(s): A total of 4381 patients (PDC =
2016, CSR = 2365) from 15 studies were included. The pooled estimates of
success rate favored the CSR compared with the PDC (RR, 0.97; 95% CI, 0.96
to 0.99; p = 0.001). No significant differences in minor complications or
severe complications were found between the PDC and CSR (RR, 0.79; 95% CI,
0.50 to 1.23; p = 0.29; RR, 1.43; 95% CI, 0.74 to 2.75; p = 0.29). The
pooled estimates of residual shunts favored the PDC compared with the CSR
(RR, 9.07; 95% CI, 4.77 to 17.24; p < 0.001), the pooled estimates of
aortic regurgitation favored the CSR compared with the PDC (RR, 1.59; 95%
CI, 1.05 to 2.39; p = 0.03). Conclusion(s): PDC is a safe and
effective procedure with less surgical injury and shorter perioperative
hospital stay. However, aortic regurgitation is a concern during
follow-up. Copyright: © 2022 The Author(s).

<89>
[Use Link to view the full text]
Accession Number
2019708205
Title
Statin and Postcardiac Surgery Atrial Fibrillation Prevention: A
Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Pharmacology. 80(2) (pp 180-186), 2022. Date of
Publication: 30 Aug 2022.
Author
Oliveri F.; Bongiorno A.; Compagnoni S.; Fasolino A.; Gentile F.R.; Pepe
A.; Tua L.
Institution
(Oliveri, Bongiorno, Compagnoni, Fasolino, Gentile, Pepe, Tua) Department
of Molecular Medicine, University of Pavia, Pavia, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Postoperative atrial fibrillation (POAF) is a frequently reported
postcardiac surgery complication leading to increased in-hospital and
long-term mortality rates. Many randomized controlled trials (RCTs) have
recently suggested using statins to protect against POAF. Therefore, we
performed a systematic literature search and meta-analysis in electronic
databases for eligible studies published between January 2006 and January
2022. The principal inclusion criteria were as follows: RCTs' study
design, statin-naive patients, total study participants >=50 units, and
statin pretreatment started no more than 21 days before cardiac surgery.
In the primary analysis, statin pretreatment reduced the incidence of POAF
compared with placebo. Analyzing different molecules, atorvastatin was
associated with lower incidence of POAF but rosuvastatin was not. We
therefore performed a sensitivity analysis excluding RCTs affected by
important risk of biases. Thus, studies whose participants were >=199 were
those eligible for the secondary analysis. No statistically significant
difference between statin pretreatment and placebo (OR 0.87; 95% CI:
0.71-1.07, P = 0.18) as well as for atorvastatin (OR 0.88; 95% CI:
0.61-1.28; P = 0.48; I2 = 84%) and rosuvastatin (OR 0.87; 95% CI:
0.68-1.12, P = 0.29) was observed. To conclude, statin pretreatment before
cardiac surgery is not associated with a significant reduction in POAF
occurrence. Copyright © 2022 Wolters Kluwer Health, Inc. All
rights reserved.

<90>
Accession Number
2019823089
Title
Efficacy and safety of proton pump inhibitors versus histamine-2 receptor
blockers in the cardiac surgical population: Insights from the PEPTIC
trial.
Source
European Journal of Cardio-thoracic Surgery. 62(2) (no pagination), 2022.
Article Number: ezac124. Date of Publication: 01 Aug 2022.
Author
Van Diepen S.; Coulson T.; Wang X.; Opgenorth D.; Zuege D.J.; Harris J.;
Agyemang M.; Niven D.J.; Bellomo R.; Wright S.E.; Young P.J.; Bagshaw S.M.
Institution
(Van Diepen, Opgenorth, Bagshaw) Department of Critical Care Medicine,
University of Alberta, Alberta Health Services, Edmonton, AB, Canada
(Van Diepen) Division of Cardiology, Department of Medicine, University of
Alberta, Edmonton, AB, Canada
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred
Hospital, Melbourne, VIC, Australia
(Coulson, Bellomo, Young) Australian and New Zealand Intensive Care
Research Centre, Department of Epidemiology and Preventive Medicine,
School of Public Health and Preventive Medicine, Monash University,
Melbourne, VIC, Australia
(Coulson, Bellomo, Young) Department of Critical Care, University of
Melbourne, Parkville, VIC, Australia
(Wang) Health Services Statistical and Analytic Methods, Alberta Health
Services, Calgary, AB, Canada
(Zuege, Niven) Department of Critical Care Medicine, University of
Calgary, Alberta Health Services, Calgary, AB, Canada
(Zuege, Bagshaw) Critical Care Strategic Clinical Network, Alberta Health
Services, Calgary, AB, Canada
(Harris) ECritical Alberta, Alberta Health Services, Calgary, AB, Canada
(Agyemang, Niven) Department of Community Health Sciences, University of
Calgary, Calgary, AB, Canada
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, University of
Melbourne and Austin Hospital, Melbourne, VIC, Australia
(Wright) Intensive Care Unit, Freeman Hospital, Newcastle upon Tyne,
United Kingdom
(Young) Medical Research Institute of New Zealand, Wellington, New Zealand
(Young) Intensive Care Unit, Wellington Regional Hospital, Wellington, New
Zealand
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The comparative effectiveness and safety of proton pump
inhibitors (PPIs) versus histamine-2 receptor blockers for stress ulcer
prophylaxis in the cardiac surgical intensive care unit population is
uncertain. Although the Proton Pump Inhibitors versus Histamine-2 Receptor
Blockers for Ulcer Prophylaxis Therapy in the Intensive Care Unit (PEPTIC)
trial reported a higher risk of mortality in the PPI arm with no
difference in gastrointestinal bleeding, detailed information on surgical
variables and clinically relevant surgical subgroups was not available.
 METHOD(S): The analysis included all Canadian cardiac surgery
patients enrolled in the PEPTIC trial. Data were electronically linked
using unique patient identifiers to a clinical information system.
Outcomes of interest included in-hospital mortality, gastrointestinal
bleeding, Clostridium difficile infections, ventilator-associated
conditions and length of stay. RESULT(S): We studied 823 (50.6%)
randomized to PPIs and 805 (49.4%) to histamine-2-receptor blockers. In
the intention-to-treat analysis, there were no differences in hospital
mortality [PPI: 4.3% vs histamine-2 receptor blockers: 4.8%, adjusted odds
ratio (aOR) 0.97, 95% confidence interval (CI) 0.55-1.70],
gastrointestinal bleeding (3.9% vs 4.8%, aOR 1.09, 95% CI 0.66-1.81), C.
difficile infections (0.9% vs 0.1%, aOR 0.18, 95% CI 0.02-1.59),
ventilator-associated conditions (1.6% vs 1.7%, aOR 0.92, 95% CI
0.85-1.00) or median length of stay (9.2 vs 9.8 days, adjusted risk ratio
1.06, 85% CI 0.99-1.13). No significant treatment differences were
observed among subgroups of interest or per-protocol populations.
 CONCLUSION(S): In a secondary analysis of cardiac surgery patients
enrolled in the PEPTIC trial in Canada, no differences in effectiveness or
safety were observed between use of PPIs and histamine-2 receptor blockers
for stress ulcer prophylaxis. Clinical trial registration number:
anzctr.org.au identifier: ACTRN12616000481471. Copyright © 2022
The Author(s). Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<91>
Accession Number
2019811109
Title
Comparison of Analgesic Requirement and Pain Intensity in Lower Segment
Cesarean Section (LSCS) with Ketofol and Conventional Induction of General
Anesthesia.
Source
Pakistan Journal of Medical and Health Sciences. 16(7) (pp 269-271), 2022.
Date of Publication: July 2022.
Author
Khosa M.S.; Siddiqa A.; Ejaz S.T.; Ahmad M.S.; Aziz M.A.; Naqvi S.A.A.
Institution
(Khosa, Siddiqa, Ejaz) Obstetrics & Gynecology Dept. Ghazi Medical
College, Teaching Hospital, Dera Ghazi Khan, Pakistan
(Ahmad, Naqvi) Anesthesia Dept. Ghazi Medical College, Teaching Hospital,
Dera Ghazi Khan, Pakistan
(Aziz) Anesthesia Dept., Sahara Medical College, Narowal, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Objective: to compare the analgesic requirement and pain intensity in LSCS
with ketofol and conventional induction of general anesthesia Study Type:
randomized controlled trial Study Place and Duration: department of
Anesthesiology at Ghazi Medical College & Teaching Hospital, Dera Ghazi
Khan, from 1st January 2019 to 30th June 2019. Material(s) and
Method(s): 100 adult participants (20-40 years) ASA physical status 1 and
2, with no previous case of neurologic or cardiovascular undergoing LSCS
operations were enlisted in a randomised prospective comparative study
after receiving approval from the ethical research committee. Patients
were divided into two groups, each with 50 patients: group P (propofol)
and group KP (ketamine) (ketofol). The surgeon picked a closed envelope as
the method of randomization. Visual analogue scale was used to assess the
postoperative pain where, 0 means no pain, 1-3 means mild pain, 4-7 means
moderate pain, and 8-10 means severe pain using a visual analog scale,
where 0 means no pain, 1-3 means mild pain, 4-7 means moderate pain, and
8-10 means severe pain. Furthermore, the need for postoperative analgesia
was examined, including the need for fentanyl. Result(s): The
majority of the patient's Group P and Group KP had 0 VAS scoresof28
(56.0%) and 26 (52.0%), respectively, (p=0.475). Intra operation fentanyl
was required 3 (6.0%) in Group P and 1 (2.0%) in Group PK, (p=0.307).
While, postoperation fentanyl was required 7 (14.0) in Group P and 4 (8.0)
in Group PK, (p=0.338). Conclusion(s): Ketofol as an induction agent
can be used as an alternative which is relatively safe and show less side
effects in comparison to propofol alone. Copyright © 2022 Lahore
Medical And Dental College. All rights reserved.

<92>
[Use Link to view the full text]
Accession Number
2019748622
Title
Impact of chronic kidney disease on the prognosis of transcatheter aortic
valve replacement in patients with aortic stenosis: A protocol for
systematic review and meta-Analysis.
Source
Medicine (United States). 100(29) (pp E26696), 2021. Date of Publication:
23 Jul 2021.
Author
Wang J.; Liu S.; Han X.; Wan Z.; Chen Y.; Chen H.; Song B.
Institution
(Wang, Han, Chen, Chen) First Clinical Medical College of Lanzhou
University, Lanzhou University, Lanzhou, China
(Liu, Wan, Song) Department of Cardiovascular Surgery, First Hospital of
Lanzhou University, Lanzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background:The prognosis of patients with aortic stenosis, in conjunction
with chronic kidney disease (CKD), after transcatheter aortic valve
replacement (TAVR) remains unclear. This study assessed the impact of CKD,
and different stages of CKD, on prognosis of patients undergoing TAVR.
 Method(s):The protocol was written following the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses Protocols statement
guidelines. As of June 2021, we performed a comprehensive literature
search on studies related to CKD and TAVR, using databases such as PubMed,
Embase, Cochrane Library, and Web of Science. Two researchers
independently screened the literature, extracted the data, and evaluated
the risk of bias in the included studies. Then, Stata 15.0 software was
used for meta-Analysis.Results and Conclusion(s):The purpose of this
study was to evaluate the effect of CKD and different stages of CKD on the
prognosis of patients with TAVR. It is hoped to provide a comprehensive
reference for clinical practice and related clinical trials in the
future. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<93>
Accession Number
2011581891
Title
Short term outcomes of Impella circulatory support for high-risk
percutaneous coronary intervention a systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(1) (pp 27-36), 2022.
Date of Publication: 01 Jan 2022.
Author
Elia E.; Iannaccone M.; D'Ascenzo F.; Gallone G.; Colombo F.; Albani S.;
Attisani M.; Rinaldi M.; Boccuzzi G.; Conrotto F.; Noussan P.; De Ferrari
G.M.
Institution
(Elia, D'Ascenzo, Gallone, De Ferrari) Division of Cardiology, Department
of Medical Science, University of Turin, Turin, Italy
(Iannaccone, Colombo, Albani, Boccuzzi, Conrotto, Noussan) Division of
Cardiology, Ospedale San Giovanni Bosco, Turin, Italy
(Attisani, Rinaldi) Department of Cardiac Surgery, AOU "Citta della Salute
e della Scienza" Hospital, Turin, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objective: Aim of this study is to evaluate short term safety and efficacy
of Impella in high risk percutaneous coronary intervention (HR-PCI)
population. Background(s): While several studies demonstrated the
clinical significance of Impella in HR-PCI, few data exist about its
impact on short term outcome. Method(s): All studies reporting short
term outcomes of PCI with any Impella device were included. The primary
endpoint was either in-hospital or 30-day mortality, while vascular
complications, post-procedural stroke, post-procedural dialysis and
bleeding complications were assessed as secondary outcomes.
 Result(s): Nine studies with 7448 patients were included. Median age
was 69.5 years old (67-73), with a mean ejection fraction of 29.7%
(20%-39%) and a Syntax score of 30.2 (25. 5-33, interquartile [IQR]).
Impella 2.5 was the most commonly used axial flow pump used to support
these PCIs (88.7%). In-hospital death was observed in 5.09% of patients
(95% confidence interval [CI] 3.69-6.49, I2 = 78%), while
vascular complications in 2.53% of patients (1.07-4.00, I2 =
89%) and post-procedural stroke in 2.77% of patients (0.50-6.05,
I2 = 98%). Major bleeding occurred in 5.98% of patients
(3.66-8.31, I2 = 90%) and post-procedural dialysis in 4.44% of
patients (1.50-7.37, I2 = 93% all CI 93%). Conclusion(s):
Use of Impella in high risk PCI appears to have an acceptable rate of
complication, especially regarding vascular complications and major
bleedings. Copyright © 2021 Wiley Periodicals LLC.

<94>
Accession Number
2017001232
Title
Impact of Stent Types on In-Hospital Outcomes of Patients With Cancer
Undergoing Percutaneous Coronary Intervention: A Nationwide Analysis.
Source
Cardiovascular Revascularization Medicine. 42 (pp 102-106), 2022. Date of
Publication: September 2022.
Author
Munawar M.M.; Brgdar A.; Awan A.; Balogun A.F.; Ogunti R.; Ahmad B.;
Fatima U.; Prafulla M.; Opoku I.
Institution
(Brgdar, Ogunti, Ahmad) Department of Medicine, Howard University
Hospital, Washington, DC, United States
(Munawar, Awan, Balogun, Fatima, Prafulla, Opoku) Cardiovascular disease,
Howard University Hospital, Washington, DC, United States
Publisher
Elsevier Inc.
Abstract
Background: Cardiovascular disease and cancer frequently coexist, and
patients with cancer are at increased risk of cardiovascular events,
including myocardial infarction and stroke. However, the impact of stent
types on in-hospital outcomes of patients with malignancy is largely
unknown. Method(s): Patients with concomitant diagnosis of cancer
undergoing PCI between January 2005 and December 2014 were identified in
the National Inpatient Sample. They were then categorized into those who
have undergone coronary stenting with bare-metal stent (BMS) or
drug-eluting stent (DES). Primary outcomes were in-hospital mortality and
stent thrombosis. Adjusted and unadjusted analysis was employed on
appropriate variables of interest. Result(s): 8755 patients were
included in the BMS group and 11,611 patients in the DES group. Following
propensity matching, 4313 patients were randomly selected in both groups
using a 1:1 ratio. There was high use of BMS stent in cancer patient (BMS
43.0%, DES 57.0%) compared to general population (BMS 23.2%, DES 76.8%).
When comparing BMS to DES group, there was no statistically significant
difference in mortality (4.7% vs. 3.8%, p = 0.097), acute kidney injury
(11.3% vs. 10.6%, p = 0.425), bleeding complications (3.50% vs. 3.45%, p =
0.914), and length of hospital stay (5.4% vs. 5.2%, p = 0.119). However,
an increased incidence of stent thrombosis was observed in the DES group
(4.26% vs. 3.01%, p = 0.002). Conclusion(s): A higher incidence of
BMS placement was noted in patients with cancer than in the general
population. Paradoxically there was a high incidence of stent thrombosis
in the DES group without increasing mortality. Copyright © 2022
Elsevier Inc.

<95>
Accession Number
2018689492
Title
The effect of continuing versus withholding angiotensin-converting enzyme
inhibitors/angiotensin II receptor blockers on mortality and major adverse
cardiovascular events in hypertensive patients undergoing elective
non-cardiac surgery: study protocol for a multi-centric open-label
randomised controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 670. Date of
Publication: December 2022.
Author
Misra S.; Parida S.; Sahajanandan R.; Behera B.K.; Senthilnathan M.;
Mariappan R.; Chandy T.T.
Institution
(Misra, Behera) AIIMS Bhubaneswar, Odisha, Bhubaneswar 751019, India
(Parida, Senthilnathan) JIPMER Puducherry, Puducherry, India
(Sahajanandan, Mariappan, Chandy) CMC Vellore, Vellore, India
Publisher
BioMed Central Ltd
Abstract
Background: Angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin
receptor blockers (ARBs) are commonly prescribed to patients with
hypertension. These drugs are cardioprotective in addition to their blood
pressure-lowering effects. However, it is debatable whether hypertensive
patients who present for non-cardiac surgery should continue or
discontinue these drugs preoperatively. Continuing the drugs entails the
risk of perioperative refractory hypotension and/or angioneurotic oedema,
while discontinuing the drugs entails the risk of rebound hypertension and
myocardial ischaemia. The aim of this study is to evaluate the effect of
continuation vs withholding of ACEIs/ARBs on mortality and other major
outcomes in hypertensive patients undergoing elective non-cardiac surgery.
 Method(s): The continuing vs withholding of ACEIs/ARBs in patients
undergoing non-cardiac surgery is a prospective, multi-centric, open-label
randomised controlled trial. Two thousand one hundred hypertensive
patients receiving ACEIs/ARBs and planned for elective non-cardiac surgery
will be enrolled. They will be randomised to either continue the
ACEIs/ARBs including on the day of surgery (group A) or to withhold it
24-36 h before surgery (group B). The primary endpoint will be the
difference in the composite outcome of all-cause in-hospital/30-day
mortality and major adverse cardiovascular and non-cardiovascular events.
Secondary endpoints will be to evaluate the differences in perioperative
hypotension, angioneurotic oedema, myocardial injury, ICU and hospital
stay. The impact of the continuation vs withholding of the ACEIs/ARBs on
the incidence of case cancellation will also be studied.
 Discussion(s): The results of this trial should provide sufficient
evidence on whether to continue or withhold ACEIs/ARBs before major
non-cardiac surgery. Trial registration: Clinical Trials Registry of India
CTRI/2021/01/030199. Registered on 4 January 2021. Copyright ©
2022, The Author(s).

<96>
Accession Number
2018669768
Title
TAVI with the ACURATE neo transcatheter heart valve in special
populations: A systematic review.
Source
Hellenic Journal of Cardiology. 66 (pp 67-71), 2022. Date of Publication:
01 Jul 2022.
Author
Koliastasis L.; Doundoulakis I.; Kokkinidis D.G.; Milkas A.; Drakopoulou
M.; Benetos G.; Latsios G.; Synetos A.; Aggeli K.; Tousoulis D.; Tsioufis
K.; Toutouzas K.
Institution
(Koliastasis, Doundoulakis, Drakopoulou, Benetos, Latsios, Synetos,
Aggeli, Tousoulis, Tsioufis, Toutouzas) First Department of Cardiology,
National and Kapodistrian University, "Hippokration" Hospital, Athens,
Greece
(Koliastasis, Milkas) Athens Naval and Veterans Hospital, Athens, Greece
(Doundoulakis) Department of Cardiology, 424 General Military Training
Hospital, Thessaloniki, Greece
(Kokkinidis) Section of Cardiovascular Medicine, Yale University School of
Medicine, Yale New Haven Hospital, New Haven, CT, United States
Publisher
Hellenic Cardiological Society
Abstract
The ACURATE neo transcatheter aortic valve is a self-expanding device
suitable for both transfemoral and transapical approach, but specific
groups of patients are under-represented in clinical trials. We aim to
provide a comprehensive systematic review on TAVI with ACURATE neo in
those special populations. TAVI in bicuspid aortic valve, TAVI in patients
with small aortic annulus, TAVI for pure aortic regurgitation and
valve-in-valve procedures, were systematically reviewed. The primary
endpoint was device success as defined by VARC-2 criteria. The secondary
endpoints were safety and performance outcomes according to VARC-2
consensus document.ACURATE neo exhibited similar outcomes in bicuspid vs
tricuspid aortic valve except for pre and post-dilatation rates in one
observational study. Lower mean aortic gradient and higher pre-dilatation
rates with comparable safety outcomes were described for ACURATE neo when
compared to Lotus and Evolut-R for bicuspid aortic valve stenosis. 2
studies compared ACURATE in small aortic annuli. ACURATE neo showed lower
transvalvular gradients and lower patient prosthesis mismatch rates
compared to Sapien 3 and when compared to Evolut R/ Evolut PRO/ Portico,
results were similar except for pre-dilatation rates. 3 studies
investigated ACURATE neo for pure aortic regurgitation and one for
valve-in-valve procedure and demonstrated safety and efficacy, with the
exception of malposition events in patients designated for higher valve
deployment in the valve-in-valve implantation study.ACURATE neo valve may
be a feasible and safe option for patients with bicuspid anatomy, small
aortic annulus, previously implanted bioprosthetic aortic valve and pure
aortic regurgitation. Registration number: Available at
https://osf.io/aus26 (DOI 10.17605/OSF.IO/AUS26). Copyright ©
2022 Hellenic Society of Cardiology

<97>
Accession Number
2014818391
Title
Higher body mass index raises immature platelet count: potential
contribution to obesity-related thrombosis.
Source
Platelets. 33(6) (pp 869-878), 2022. Date of Publication: 2022.
Author
Goudswaard L.J.; Corbin L.J.; Burley K.L.; Mumford A.; Akbari P.; Soranzo
N.; Butterworth A.S.; Watkins N.A.; Pournaras D.J.; Harris J.; Timpson
N.J.; Hers I.
Institution
(Goudswaard, Burley, Hers) School of Physiology, Pharmacology and
Neuroscience, University of Bristol, Bristol, United Kingdom
(Goudswaard, Hers) Bristol Heart Institute, Bristol, United Kingdom
(Goudswaard, Corbin, Timpson) Medical Research Council (MRC) Integrative
Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
(Goudswaard, Corbin, Timpson) Department of Population Health Sciences,
Bristol Medical School, University of Bristol, Bristol, United Kingdom
(Mumford) School of Cellular and Molecular Medicine, University of
Bristol, Bristol, United Kingdom
(Akbari, Butterworth) Department of Public Health and Primary Care,
British Heart Foundation Cardiovascular Epidemiology Unit, University of
Cambridge, Cambridge, United Kingdom
(Akbari, Soranzo, Butterworth) National Institute for Health Research
Blood and Transplant Research Unit (NIHR BTRU) in Donor Health and
Genomics, University of Cambridge, Cambridge, United Kingdom
(Akbari) MRC Biostatistics Unit, University of Cambridge, Cambridge,
United Kingdom
(Akbari, Soranzo) Human Genetics, Wellcome Sanger Institute, Hinxton,
United Kingdom
(Soranzo) Department of Haematology, School of Clinical Medicine,
University of Cambridge, Cambridge, United Kingdom
(Butterworth) British Heart Foundation Centre of Research Excellence,
University of Cambridge, Cambridge, United Kingdom
(Butterworth) NIHR Cambridge Biomedical Research Centre, University of
Cambridge and Cambridge University Hospitals, Cambridge, United Kingdom
(Butterworth) Health Data Research UK Cambridge, Wellcome Genome Campus
and University of Cambridge, Cambridge, United Kingdom
(Watkins) NHS Blood and Transplant, Cambridge Biomedical Campus,
Cambridge, United Kingdom
(Pournaras) Department of Bariatric and Metabolic Surgery, Southmead
Hospital, North Bristol NHS Trust, Bristol, United Kingdom
(Harris) Bristol Trials Centre, Faculty of Health Sciences, University of
Bristol, Bristol, United Kingdom
Publisher
Taylor and Francis Ltd.
Abstract
Higher body mass index (BMI) is a risk factor for thrombosis. Platelets
are essential for hemostasis but contribute to thrombosis when activated
pathologically. We hypothesized that higher BMI leads to changes in
platelet characteristics, thereby increasing thrombotic risk. The effect
of BMI on platelet traits (measured by Sysmex) was explored in 33 388 UK
blood donors (INTERVAL study). Linear regression showed that higher BMI
was positively associated with greater plateletcrit (PCT), platelet count
(PLT), immature platelet count (IPC), and side fluorescence (SFL, a
measure of mRNA content used to derive IPC). Mendelian randomization (MR),
applied to estimate a causal effect with BMI proxied by a genetic risk
score, provided causal estimates for a positive effect of BMI on both SFL
and IPC, but there was little evidence for a causal effect of BMI on PCT
or PLT. Follow-up analyses explored the functional relevance of platelet
characteristics in a pre-operative cardiac cohort (COPTIC). Linear
regression provided observational evidence for a positive association
between IPC and agonist-induced whole blood platelet aggregation. Results
indicate that higher BMI raises the number of immature platelets, which is
associated with greater whole blood platelet aggregation in a cardiac
cohort. Higher IPC could therefore contribute to obesity-related
thrombosis. Copyright © 2021 The Author(s). Published with
license by Taylor & Francis Group, LLC.

<98>
Accession Number
2019570903
Title
Conventional sternotomy versus right mini-thoracotomy versus robotic
approach for mitral valve replacement/repair: insights from a network
meta-analysis.
Source
Journal of Cardiovascular Surgery. 63(4) (pp 492-497), 2022. Date of
Publication: August 2022.
Author
Yokoyama Y.; Kuno T.; Takagi H.; Briasoulis A.; Ota T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Fountain Hill, PA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein Medical College, Bronx, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Briasoulis) Division of Cardiovascular Medicine, Section of Heart Failure
and Transplantation, University of Iowa, Iowa City, IA, United States
(Ota) Department of Surgery, The University of Chicago Medicine, Chicago,
IL, United States
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Minimally invasive cardiac surgery (MICS) through right
mini-thoracotomy as well as robotic surgery has emerged for the last
decade for mitral valve surgery. However, their risks and benefits are not
fully understood yet. Thus, we conducted a network meta-analysis comparing
the early- and long-term outcomes of mitral valve surgery via the
conventional sternotomy, MICS, and robotic approaches. EVIDENCE
ACQUISITION: MEDLINE and EMBASE were searched through November 2020 to
identify randomized controlled trials (RCTs) and propensity-score matched
(PSM) trials that investigated early- and long-term outcomes after mitral
surgery via the conventional sternotomy, MICS, and robotic approaches. A
subanalysis focusing on only subjects who initially underwent mitral valve
repair was also conducted. EVIDENCE SYNTHESIS: Our systematic literature
search identified two RCTs and 19 PSM studies. MICS was related to
significant risk reductions of permanent pacemaker implantation, surgical
site infection, and transfusion compared to the sternotomy approach. The
robotic approach was associated with a significant increase in
re-exploration for bleeding compared to sternotomy. The subanalysis showed
that MICS was associated with a significant increase requiring mitral
valve reoperation compared to the sternotomy approach (hazard ratio 7.33
[95% CI: 1.54-34.97], P=0.012), while no significant difference was
observed between the sternotomy and the robotic approach.
 CONCLUSION(S): Our network meta-analysis demonstrated that MICS was
associated with better short-term outcomes compared to the sternotomy
approach. Mitral valve reoperation was more frequent with MICS compared
with the sternotomy approach after mitral valve repair, while no
difference was observed between the sternotomy and robotic
approaches. Copyright © 2021 EDIZIONI MINERVA MEDICA.

<99>
Accession Number
2019458619
Title
Alirocumab after acute coronary syndrome in patients with a history of
heart failure.
Source
European Heart Journal. 43(16) (pp 1554-1565), 2022. Date of Publication:
21 Apr 2022.
Author
White H.D.; Schwartz G.G.; Szarek M.; Bhatt D.L.; Bittner V.A.; Chiang
C.-E.; Diaz R.; Goodman S.G.; Jukema J.W.; Loy M.; Pagidipati N.; Pordy
R.; Ristic A.D.; Zeiher A.M.; Wojdyla D.M.; Steg P.G.
Institution
(White) Green Lane Cardiovascular Services, Auckland City Hospital, 5 Park
Road, Grafton, Auckland, New Zealand
(Szarek) Department of Epidemiology and Biostatistics, State University of
New York, Downstate School of Public Health, 450 Clarkson Avenue, MS 43,
Brooklyn, NY 11203, United States
(Szarek) CPC Clinical Research, 13199 E Montview Blvd Suite 200, Aurora,
CO 80045, United States
(Szarek) Division of Cardiology, University of Colorado School of
Medicine, Fitzsimons Building - 13001 E. 17th Place, Campus Box C290,
Aurora, CO 80045, United States
(Bhatt) Department of Medicine, Brigham and Women's Hospital Heart and
Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA
02115, United States
(Bittner) Division of Cardiovascular Disease, University of Alabama at
Birmingham, 701 19th Street South-LHRB 310, Birmingham, AL 35294, United
States
(Chiang) General Clinical Research Center, Taipei Veterans General
Hospital, Taiwan School of Medicine, National Yang-Ming University, 201,
Sec. 2, Shih-Pai road, Taipei, Taiwan (Republic of China)
(Diaz) Estudios Clinicos Latino America, Instituto Cardiovascular de
Rosario, Paraguay 160, Santa Fe, Rosario 2000, Argentina
(Goodman) Canadian VIGOUR Centre, University of Alberta, 87 Ave NW,
Edmonton, AB T6G 2E1, Canada
(Goodman) Division of Cardiology, St. Michael's Hospital, Room 6-034
Donnelly Wing, Toronto, ON M5B 1W8, Canada
(Jukema) Department of Cardiology, Leiden University Medical Center,
Albinusdreef 2, Leiden 2333 ZA, Netherlands
(Jukema) Netherlands Heart Institute, Moreelsepark 1, Utrecht 3511 EP,
Netherlands
(Loy) Sanofi, 55 Corporate Dr, Bridgewater, NJ 08807, United States
(Pagidipati, Wojdyla) Duke Clinical Research Institute, Duke University,
School of Medicine, 300 W. Morgan St., NC 27701, United States
(Pordy) Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown,
NY 10591, United States
(Ristic) Department of Cardiology, University Clinical Center of Serbia,
Belgrade University School of Medicine, 8 Dr Subotica Street, Belgrade,
Serbia
(Zeiher) Department of Medicine III, Goethe University, Theodor-Stern-Kai
7, Frankfurt am Main 60590, Germany
(Steg) Assistance Publique-Hopitaux de Paris, Hopital Bichat, Universite
de Paris, FACT (French Alliance for Cardiovascular Trials), INSERM U1148,
46 Rue Henri Huchard, Paris 75018, France
(Steg) National Heart and Lung Institute, Imperial College, Royal Brompton
Hospital, Sydney St, Chelsea, London SW3 6NP, United Kingdom
Publisher
Oxford University Press
Abstract
Aims Patients with heart failure (HF) have not been shown to benefit from
statins. In a post hoc analysis, we evaluated outcomes in ODYSSEY OUTCOMES
in patients with vs. without a history of HF randomized to the proprotein
convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab or
placebo. Methods Among 18 924 patients with recent acute coronary syndrome
(ACS) receiving intensive or maximum-tolerated sta- and results tin
treatment, the primary outcome of major adverse cardiovascular events
(MACE) was compared in patients with or without a history of HF. The
pre-specified secondary outcome of hospitalization for HF was also
analysed. Overall, 2815 (14.9%) patients had a history of HF. Alirocumab
reduced low-density lipoprotein cholesterol and lipoprotein(a) similarly
in patients with or without HF. Overall, alirocumab reduced MACE compared
with placebo [hazard ratio (HR): 0.85; 95% confidence interval (CI):
0.78-0.93; P = 0.0001]. This effect was observed among patients without a
history of HF (HR: 0.78; 95% CI: 0.70-0.86; P < 0.0001), but not in those
with a history of HF (HR: 1.17; 95% CI: 0.97-1.40; P = 0.10)
(P<inf>interaction</inf> = 0.0001). Alirocumab did not reduce
hospitalization for HF, overall or in patients with or without prior HF.
Conclusion Alirocumab reduced MACE in patients without a history of HF but
not in patients with a history of HF. Alirocumab did not reduce
hospitalizations for HF in either group. Patients with a history of HF are
a high-risk group that does not appear to benefit from PCSK9 inhibition
after ACS. Copyright © 2022 Oxford University Press. All rights
reserved.

<100>
Accession Number
2018439666
Title
Pathology-related changes in cardiac energy metabolites, inflammatory
response and reperfusion injury following cardioplegic arrest in patients
undergoing open-heart surgery.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 911557. Date of Publication: 22 Jul 2022.
Author
Skeffington K.L.; Moscarelli M.; Abdul-Ghani S.; Fiorentino F.; Emanueli
C.; Reeves B.C.; Punjabi P.P.; Angelini G.D.; Suleiman M.-S.
Institution
(Skeffington, Reeves, Angelini, Suleiman) Bristol Heart Institute and
Bristol Medical School, University of Bristol, Bristol, United Kingdom
(Moscarelli, Emanueli, Punjabi) National Heart and Lung Institute,
Imperial College, London, United Kingdom
(Moscarelli) GVM Care Research, Anthea Hospital, Bari, Italy
(Abdul-Ghani) Department of Physiology, Faculty of Medicine, Al-Quds
University, Jerusalem, Palestine
(Fiorentino) Nightingale-Saunders Clinical Trials and Epidemiology Unit
(King's Clinical Trials Unit, King's College London, London, United
Kingdom
Publisher
Frontiers Media S.A.
Abstract
Introduction: Changes in cardiac metabolites in adult patients undergoing
open-heart surgery using ischemic cardioplegic arrest have largely been
reported for non-ventricular tissue or diseased left ventricular tissue,
with few studies attempting to assess such changes in both ventricular
chambers. It is also unknown whether such changes are altered in different
pathologies or linked to the degree of reperfusion injury and inflammatory
response. The aim of the present work was to address these issues by
monitoring myocardial metabolites in both ventricles and to establish
whether these changes are linked to reperfusion injury and
inflammatory/stress response in patients undergoing surgery using cold
blood cardioplegia for either coronary artery bypass graft (CABG, n = 25)
or aortic valve replacement (AVR, n = 16). Method(s): Ventricular
biopsies from both left (LV) and right (RV) ventricles were collected
before ischemic cardioplegic arrest and 20 min after reperfusion. The
biopsies were processed for measuring selected metabolites (adenine
nucleotides, purines, and amino acids) using HPLC. Blood markers of
cardiac injury (Troponin I, cTnI), inflammation (IL- 6, IL-8, Il-10, and
TNFalpha, measured using Multiplex) and oxidative stress (Myeloperoxidase,
MPO) were measured pre- and up to 72 hours post-operatively.
 Result(s): The CABG group had a significantly shorter ischemic
cardioplegic arrest time (38.6 +/- 2.3 min) compared to AVR group (63.0
+/- 4.9 min, p = 2 x 10-6). Cardiac injury (cTnI release) was
similar for both CABG and AVR groups. The inflammatory markers IL-6 and
Il-8 were significantly higher in CABG patients compared to AVR patients.
Metabolic markers of cardiac ischemic stress were relatively and
significantly more altered in the LV of CABG patients. Comparing diabetic
and non-diabetic CABG patients shows that only the RV of diabetic patients
sustained major ischemic stress during reperfusion and that diabetic
patients had a significantly higher inflammatory response.
 Discussion(s): CABG patients sustain relatively more ischemic stress,
systemic inflammatory response and similar injury and oxidative stress
compared to AVR patients despite having significantly shorter cross-clamp
time. The higher inflammatory response in CABG patients appears to be at
least partly driven by a higher incidence of diabetes amongst CABG
patients. In addition to pathology, the use of cold blood cardioplegic
arrest may underlie these differences. Copyright © 2022
Skeffington, Moscarelli, Abdul-Ghani, Fiorentino, Emanueli, Reeves,
Punjabi, Angelini and Suleiman.

<101>
Accession Number
2017997119
Title
Fraction of inspired oxygen during general anesthesia for non-cardiac
surgery: Systematic review and meta-analysis.
Source
Acta Anaesthesiologica Scandinavica. 66(8) (pp 923-933), 2022. Date of
Publication: September 2022.
Author
Hoybye M.; Lind P.C.; Holmberg M.J.; Bolther M.; Jessen M.K.; Vallentin
M.F.; Hansen F.B.; Holst J.M.; Magnussen A.; Hansen N.S.; Johannsen C.M.;
Enevoldsen J.; Jensen T.H.; Roessler L.L.; Klitholm M.P.; Eggertsen M.A.;
Caap P.; Boye C.; Dabrowski K.M.; Vormfenne L.; Henriksen J.; Karlsson M.;
Balleby I.R.; Rasmussen M.S.; Paelestik K.; Granfeldt A.; Andersen L.W.
Institution
(Hoybye, Holmberg, Jessen, Andersen) Research Center for Emergency
Medicine, Aarhus University Hospital, Aarhus, Denmark
(Hoybye, Holmberg, Jessen, Vallentin, Hansen, Magnussen, Johannsen,
Enevoldsen, Eggertsen, Boye, Vormfenne, Granfeldt, Andersen) Department of
Clinical Medicine, Aarhus University, Aarhus, Denmark
(Lind) Department of Surgical Gastroenterology, Aalborg University
Hospital, Aalborg, Denmark
(Holmberg) Department of Cardiology, Viborg Regional Hospital, Viborg,
Denmark
(Bolther, Holst, Hansen, Klitholm, Caap, Dabrowski, Henriksen, Granfeldt,
Andersen) Department of Anesthesiology and Intensive Care, Aarhus
University Hospital, Aarhus, Denmark
(Vallentin, Andersen) Prehospital Emergency Medical Services, Aarhus,
Denmark
(Jensen) Department of Internal Medicine, University Hospital of North
Norway, Narvik, Norway
(Roessler) Department of Emergency Medicine, Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
(Karlsson, Rasmussen) Department of Anesthesiology and Intensive Care,
Aalborg University Hospital, Aalborg, Denmark
(Balleby) National Hospital of the Faroe Islands, Torshavn, Faroe Islands
(Paelestik) Department of Anesthesiology and Intensive Care, Viborg
Regional Hospital, Viborg, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Controversy exists regarding the effects of a high versus a
low intraoperative fraction of inspired oxygen (FiO<inf>2</inf>) in adults
undergoing general anesthesia. This systematic review and meta-analysis
investigated the effect of a high versus a low FiO<inf>2</inf> on
postoperative outcomes. Method(s): PubMed and Embase were searched on
March 22, 2022 for randomized clinical trials investigating the effect of
different FiO<inf>2</inf> levels in adults undergoing general anesthesia
for non-cardiac surgery. Two investigators independently reviewed studies
for relevance, extracted data, and assessed risk of bias. Meta-analyses
were performed for relevant outcomes, and potential effect measure
modification was assessed in subgroup analyses and meta-regression. The
evidence certainty was evaluated using GRADE. Result(s): This review
included 25 original trials investigating the effect of a high (mostly
80%) versus a low (mostly 30%) FiO<inf>2</inf>. Risk of bias was
intermediate for all trials. A high FiO<inf>2</inf> did not result in a
significant reduction in surgical site infections (OR: 0.91, 95% CI
0.81-1.02 [p =.10]). No effect was found for all other included outcomes,
including mortality (OR = 1.27, 95% CI: 0.90-1.79 [p =.18]) and hospital
length of stay (mean difference = 0.03 days, 95% CI -0.25 to 0.30 [p
=.84). Results from subgroup analyses and meta-regression did not identify
any clear effect modifiers across outcomes. The certainty of evidence
(GRADE) was rated as low for most outcomes. Conclusion(s): In adults
undergoing general anesthesia for non-cardiac surgery, a high
FiO<inf>2</inf> did not improve outcomes including surgical site
infections, length of stay, or mortality. However, the certainty of the
evidence was assessed as low. Copyright © 2022 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

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

<103>
Accession Number
2017598638
Title
Prognostic Impact of Pre- and Post-Procedural Renal Dysfunction on Late
All-Cause Mortality Outcome Following Transcatheter Edge-to-Edge Repair of
the Mitral Valve: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 42 (pp 6-14), 2022. Date of
Publication: September 2022.
Author
Safiriyu I.; Nagraj S.; Otulana R.; Saralidze T.; Kokkinidis D.G.;
Faillace R.
Institution
(Safiriyu, Nagraj, Saralidze, Faillace) Department of Medicine, Jacobi
Medical Center, Bronx, NY, United States
(Safiriyu, Nagraj, Saralidze, Faillace) Albert Einstein College of
Medicine, Bronx, NY, United States
(Otulana) Federal Medical Center, OG, Abeokuta, Nigeria
(Kokkinidis) Department of Cardiology, Yale University School of Medicine,
New Haven, CT, United States
(Faillace) Department of Cardiology, Jacobi Medical Center, Bronx, NY,
United States
Publisher
Elsevier Inc.
Abstract
Introduction: Impaired renal function, a well-recognized complication of
severe heart failure is associated with adverse outcomes following
cardiovascular interventions. There are conflicting data reported about
its impact on late all-cause mortality following transcatheter
edge-to-edge mitral valve repair (TEER) with MitraClip (MC) implantation.
 Aim(s): To evaluate the impact of pre- and post- procedural renal
dysfunction on late (>=12 months) all-cause mortality following TEER with
MC. Method(s): Electronic databases PubMed, Embase, and Web of
Science were systematically reviewed from inception to February 2021 for
studies evaluating MC outcomes, according to the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses guidelines. A random-effects
model meta-analysis was performed and heterogeneity of the included
studies was assessed using I-squared test. Result(s): Out of 2606
articles, 15 studies with 19,545 patients were included. Pre-procedural
renal dysfunction i.e. chronic kidney disease (CKD) was independently
associated with higher late all-cause mortality (Hazard ratio [HR] 1.57,
95% CI 1.25-1.97, I2 = 57%) after TEER with MC. A similar
association was observed irrespective of CKD severity (HR 1.62 95% CI
1.21-2.16, I2 = 0% and HR 2.86, 95% CI 1.87-4.39, I2
= 26% for CKD stage 3 and >= stage 4 respectively). In addition, the
development of post-procedural renal dysfunction was independently
associated with higher late all-cause mortality (HR = 2.32, 95% CI
1.71-3.15, I2 = 42%) after TEER with MC. Conclusion(s):
Pre- and post-procedural renal dysfunction is a strong independent
predictor of late all-cause mortality following TEER with MC and this
should be considered during periprocedural planning for these
patients. Copyright © 2022 Elsevier Inc.

<104>
Accession Number
2017586977
Title
Mechanisms of Death in Low-Risk Patients After Transcatheter or Surgical
Aortic Valve Replacement.
Source
Cardiovascular Revascularization Medicine. 42 (pp 1-5), 2022. Date of
Publication: September 2022.
Author
Ramlawi B.; Deeb G.M.; Yakubov S.J.; Markowitz A.H.; Hughes G.C.; Kiaii
R.B.; Huang J.; Kleiman N.S.; Reardon M.J.
Institution
(Ramlawi) Lankenau Heart Institute, 100 East Lancaster Ave., Suite 356,
Wynnewood, PA 19096, United States
(Deeb) Department of Cardiac Surgery, University of Michigan Hospitals,
1500 E. Medical Center Drive, 5144 Frankel Cardiovascular Center, SPC
#5864, Ann Arbor, MI 48109-5864, United States
(Yakubov) Department of Interventional Cardiology, OhioHealth-Riverside
Methodist Hospital, 3705 Olentangy River Rd Ste 100, Columbus, OH 43214,
United States
(Markowitz) Department of Cardiothoracic Surgery, University Hospitals
Cleveland Medical Center, 11100 Euclid Ave Ste 1800, Cleveland, OH 44106,
United States
(Hughes) Division of Thoracic and Cardiovascular Surgery, Duke University
Medical Center, 2301 Erwin Rd, Durham, NC 27707, United States
(Kiaii) Department of Cardiovascular and Thoracic Surgery, London Health
Sciences Centre, 800 Commissioners Rd E, London, ON N6A 5W9, Canada
(Huang) Department of Statistics, Medtronic, 8200 Coral Sea Street,
Minneapolis, MN 55112, United States
(Kleiman, Reardon) Department of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, 6550 Fannin Street, Suite 1401, Houston,
TX 77030, United States
Publisher
Elsevier Inc.
Abstract
Background: Death in high- and intermediate-risk patients after
self-expanding transcatheter (TAVR) and surgical aortic valve replacement
(surgery) differed in mechanisms and timing. In both risk groups, 1-year
all-cause mortality was lower in TAVR than in surgery patients. The
differences in mechanism and timing of death in low-risk patients has not
been studied. This report explores the mechanisms of death during 3 time
periods; 0 to 30 days (early), 31 to 120 days (recovery), and 121 to 365
days (late). Method(s): We retrospectively examined the mechanisms
and timing of death following TAVR or surgery in the randomized Evolut Low
Risk Trial. Patients were enrolled between March 2016 and November 2018
from 86 designated TAVR centers. Mechanisms of death were categorized as
due to technical reasons, failure to repair, complications linked to
death, failure to recover or other. Result(s): All-cause mortality at
1 year was 2.2% for TAVR and 2.8% for surgery, p = 0.44. Early deaths
included 3 TAVR patients, all due to technical reasons, and 8 surgery
patients (1 technical, 5 complications and 2 failed to recover). Recovery
period deaths included 6 TAVR patients (4 complications, 1 failed to
recover and 1 other), and 1 surgery patient from complications of valve
endocarditis. Late period deaths included 6 TAVR patients and 9 surgery
patients, primarily due to complications. Conclusion(s): In this
low-risk study cohort, no patient died from failure to repair the valve;
reduction in procedural complications in the TAVR and surgery groups
remain opportunities for further improvement in outcomes. Clinical Trial
Registrations (clinicaltrials.gov): NCT02701283 (Evolut Low
Risk). Copyright © 2022 Elsevier Inc.

<105>
Accession Number
2014125555
Title
Steroid withdrawal after heart transplantation in adults.
Source
Transplant International. 34(12) (pp 2469-2482), 2021. Date of
Publication: December 2021.
Author
Heegaard B.; Nelson L.M.; Gustafsson F.
Institution
(Heegaard, Nelson, Gustafsson) Department of Cardiology, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Gustafsson) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
Publisher
European Society for Organ Transplantation
Abstract
Corticosteroids (CSs) are a key component of immunosuppressive treatment
after heart transplantation (HTx). While effectively preventing acute
rejection, several adverse effects including diabetes, hypertension,
osteoporosis, and hyperlipidemia are associated with long-term use. As
these complications may impair long-term outcome in HTx recipients,
withdrawal of CSs is highly desirable, however, no uniform approach
exists. Previous experience suggests that CS withdrawal can be
accomplished without an increase in the incidence of acute rejection and
even carrying a survival benefit. Also, common complications related to
long-term CS use appear to be less frequent following CS discontinuation.
Recipients who successfully discontinue CSs, however, likely belong to an
immune-privileged subset of patients with low risk of post-transplant
complications. Available studies evaluating CS withdrawal are highly
heterogeneous and consensus on optimal timing and eligibility for
withdrawal is lacking. Efforts to improve the understanding of optimal CS
withdrawal strategy are of great importance in order to safely promote CS
weaning in eligible patients and thereby alleviate the adverse effects of
long-term CS use on post-transplant outcomes. The purpose of this review
was to evaluate different protocols of CS withdrawal after HTx in terms of
clinical outcomes and to explore criteria for successful CS
withdrawal. Copyright © 2021 Steunstichting ESOT. Published by
John Wiley & Sons Ltd

<106>
Accession Number
2019685108
Title
Biomarker Prediction of Complex Coronary Revascularization Procedures in
the FOURIER Trial.
Source
Journal of the American College of Cardiology. 80(9) (pp 887-897), 2022.
Date of Publication: 30 Aug 2022.
Author
Fagundes A.; Morrow D.A.; Oyama K.; Furtado R.H.M.; Zelniker T.A.; Tang
M.; Kuder J.F.; Murphy S.A.; Hamer A.; Keech A.C.; Sever P.; Giugliano
R.P.; Sabatine M.S.; Bergmark B.A.
Institution
(Fagundes) IDOR -D'Or Institute for Research and Education, Sao Paolo,
Brazil, Brazil
(Fagundes, Morrow, Oyama, Furtado, Zelniker, Tang, Kuder, Murphy,
Giugliano, Sabatine, Bergmark) Thrombolysis in Myocardial Infarction
(TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and
Women's Hospital, Harvard Medical School, Boston, Massachusetts, United
States
(Oyama) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Furtado) Hospital Israelita Albert Einstein and Instituto do Coracao da
Faculdade de Medicina da U.S.P., Sao Paulo, Brazil
(Zelniker) Division of Cardiology, Vienna General Hospital and Medical
University of Vienna, Vienna, Austria
(Hamer) Cardiol Therapeutics, Oakville, ON, Canada
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Sydney Medical School, University of Sydney, Sydney, NSW,
Australia
(Sever) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Biomarkers are known to predict major adverse cardiovascular
events. However, the association of biomarkers with complex coronary
revascularization procedures or high-risk coronary anatomy at the time of
revascularization is not understood. Objective(s): We examined the
associations between baseline biomarkers and major coronary events (MCE)
and complex revascularization procedures. Method(s): FOURIER was a
randomized trial of the proprotein convertase subtilisin-kexin type 9
inhibitor evolocumab vs placebo in 27,564 patients with stable
atherosclerosis. We analyzed adjusted associations among the biomarkers,
MCE (coronary death, myocardial infarction, or revascularization), and
complex revascularization (coronary artery bypass graft or complex
percutaneous coronary intervention) using a multimarker score with 1 point
assigned for each elevated biomarker (high-sensitivity C-reactive protein
>=2 mg/L; N-terminal pro-B-type natriuretic peptide >=450 pg/mL;
high-sensitivity troponin I >=6 ng/L; growth-differentiation factor-15
>=1,800 pg/mL). Result(s): When patients were grouped by the number
of elevated biomarkers (0 biomarkers, n = 6,444; 1-2 biomarkers, n =
12,439; >=3 biomarkers, n = 2,761), there was a significant graded
association between biomarker score and the risk of MCE (intermediate
score: HR<inf>adj</inf>: 1.57 [95% CI: 1.38-1.78]; high score:
HR<inf>adj</inf>: 2.90 [95% CI: 2.47-3.40]), and for complex
revascularization (intermediate: HR<inf>adj</inf>: 1.33 [95% CI:
1.06-1.67]; high score: HR<inf>adj</inf>: 2.07 [95% CI: 1.52-2.83]) and
its components (P<inf>trend</inf> <0.05 for each). The number of elevated
biomarkers also correlated with the presence of left main disease,
multivessel disease, or chronic total occlusion at the time of
revascularization (P < 0.05 for each). Conclusion(s): A
biomarker-based strategy identifies stable patients at risk for coronary
events, including coronary artery bypass graft surgery and complex
percutaneous coronary intervention, and predicts high-risk coronary
anatomy at the time of revascularization. These findings provide insight
into the relationships between cardiovascular biomarkers, coronary
anatomical complexity, and incident clinical events. (Further
Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With
Elevated Risk [FOURIER]; NCT01764633) Copyright © 2022 American
College of Cardiology Foundation

<107>
Accession Number
2019027402
Title
Epidemiology of persistent postoperative opioid use after cardiac surgery:
a systematic review and meta-analysis.
Source
British Journal of Anaesthesia. 129(3) (pp 366-377), 2022. Date of
Publication: September 2022.
Author
Liu Z.; Karamesinis A.D.; Plummer M.; Segal R.; Bellomo R.; Smith J.A.;
Perry L.A.
Institution
(Liu, Segal, Perry) Department of Anaesthesia and Pain Management, Royal
Melbourne Hospital, Parkville, VIC, Australia
(Liu, Plummer, Segal, Bellomo, Perry) Department of Critical Care,
Melbourne Medical School, Faculty of Medicine, Dentistry and Health
Sciences, University of Melbourne, Parkville, VIC, Australia
(Karamesinis) Department of Anaesthesia, Peninsula Health, Frankston, VIC,
Australia
(Plummer) Intensive Care Unit, Royal Adelaide Hospital, Adelaide, SA,
Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Heidelberg, VIC,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Melbourne, VIC, Australia
(Bellomo) Monash University School and Public Health and Preventive
Medicine, Monash University, Clayton, VIC, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Heidelberg, VIC, Australia
(Smith) Department of Surgery (School of Clinical Sciences at Monash
Health), Monash University, Clayton, VIC, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC,
Australia
Publisher
Elsevier Ltd
Abstract
Background: The epidemiology of persistent postoperative opioid use at
least 3 months after cardiac surgery is poorly characterised despite its
potential public health importance. Method(s): We searched MEDLINE,
Embase, and Google Scholar from inception to December 2021 and included
studies reporting the rate and risk factors of persistent postoperative
opioid use after cardiac surgery in opioid-naive and opioid-exposed
patients. We recorded incidence rates and odds ratios (ORs) with 95%
confidence intervals (CIs) for risk factors from individual studies and
used random-effects inverse variance modelling to generate pooled
estimates. Result(s): From 10 studies involving 112 298 patients, the
pooled rate of persistent postoperative opioid use in opioid-naive
patients was 5.7% (95% CI: 4.2-7.2%). Risk factors included female sex (OR
1.18; 95% CI: 1.09-1.29), smoking (OR 1.34; 95% CI: 1.06-1.69), alcohol
use (OR 1.43; 95% CI: 1.17-1.76), congestive cardiac failure (OR 1.17; 95%
CI: 1.08-1.27), diabetes mellitus (OR 1.21; 95% CI: 1.07-1.37), chronic
lung disease (OR 1.42; 95% CI: 1.16-1.75), chronic kidney disease (OR
1.35; 95% CI: 1.08-1.68), and length of hospital stay (per day) (OR 1.03;
95% CI: 1.02-1.04). Conclusion(s): Persistent postoperative opioid
use after cardiac surgery affects at least one in 20 patients. The
identification of risk factors, such as female sex, smoking, alcohol use,
congestive cardiac failure, diabetes mellitus, chronic lung disease,
chronic kidney disease, and length of hospital stay, should help target
interventions aimed at decreasing its prevalence. Copyright ©
2022 British Journal of Anaesthesia

<108>
Accession Number
2019950583
Title
Use of a Video Laryngoscope to Reduce Complications of Transesophageal
Echocardiography Probe Insertion: A Multicenter Randomized Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Borde D.; C K.; Jasapara A.; Shetty V.; Juvekar N.; Desurkar V.; Gaidu J.;
Joshi P.; Asegaonkar B.; KP U.; V V.; Joshi S.; Koshy T.
Institution
(Borde, Joshi, Asegaonkar) Department of Cardiac Anesthesia, Ozone
Anesthesia Group, Maharashtra, Aurangabad, India
(C) Department of Cardiac Anesthesia, Madras Medical Mission, Tamilnadu,
Chennai, India
(Jasapara, Shetty) Department of Cardiac Anesthesia, Fortis Hospitals,
Maharashtra, MulundMumbai, India
(Juvekar, Desurkar, Gaidu) Department of Cardiac Anesthesia, Deenanath
Maneshkar Hospital, Maharashtra, Pune, India
(KP, V, Koshy) Department of Cardiac Anesthesia, Sree Chitra Tirunal
Institute of Medical Sciences and Technology, Kerala, Trivandrum, India
(Joshi) Department of Cardiac Anesthesia, Narayana Institute of Cardiac
Sciences, Karnataka, Bengaluru, India
Publisher
W.B. Saunders
Abstract
Objective: The objective of this multicenter study was to test the
hypothesis of whether the use of a video laryngoscope (VL) reduces
complications related to transesophageal echocardiography (TEE) probe
insertion. Design(s): A multicenter randomized control study.
 Setting(s): At 5 tertiary care level hospitals. Participant(s):
Three hundred sixty-three adult patients undergoing elective cardiac
surgery. Intervention(s): The patients were randomized into 2
groups-the conventional group (C group; n = 177) and the VL group (n =
186) for TEE probe insertion. Measurements and Main Results: The
primary endpoint of the study was the incidence of oropharyngeal injury,
which was defined as blood at the tip of the TEE probe at the end of
surgery and/or evidence of injury on VL examination at the end of surgery.
The secondary endpoints of the study were the number of attempts required
for successful TEE probe insertion and the relation between the esophageal
inlet and the larynx. There was a higher incidence of injuries in the C
group (n = 26; 14.7%) compared to the VL group (n = 14; 7.5%; p = 0.029).
The number of attempts for probe insertion was significantly lower in the
VL group (p = 0.0023). The most common relation between the esophageal
inlet and the larynx was posterolateral (n = 88; 47%), followed by
posterior (n = 77; 41%) and lateral (n = 21;12%). Conclusion(s): The
use of VL was associated with a lesser incidence of injury compared to the
conventional technique, and its use for this purpose is recommended. The
use of VL for probe insertion resulted in fewer attempts compared with the
conventional technique. Significant variations do exist in the relation
between the esophageal inlet and the larynx, and direct visualization with
VL may contribute to better safety. Copyright © 2022 Elsevier
Inc.

<109>
Accession Number
2019914414
Title
A systematic review and meta-analysis of periprocedural bridging for
patients with mechanical heart valves undergoing non-cardiac
interventions.
Source
Thrombosis Research. 218 (pp 130-137), 2022. Date of Publication: October
2022.
Author
Bontinis V.; Theodosiadis E.; Bontinis A.; Koutsoumpelis A.; Donikidis I.;
Giannakopoulos N.-N.; Ktenidis K.
Institution
(Bontinis, Bontinis, Koutsoumpelis, Ktenidis) Department of Vascular
Surgery, Aristotle University of Thessaloniki, AHEPA University General
Hospital, Thessaloniki, Greece
(Theodosiadis) Department of Anesthesiology and Intensive Care, Aristotle
University of Thessaloniki, AHEPA University General Hospital,
Thessaloniki, Greece
(Donikidis) Department of Orthopedic Surgery, General Hospital of Edessa,
Edessa, Greece
(Giannakopoulos) 3rd Department of General Surgery, Tzaneio General
Hospital, Piraeus, Greece
Publisher
Elsevier Ltd
Abstract
Objective: To evaluate the safety and efficacy of perioperative bridging
in patients with mechanical heart valves undergoing non-cardiac
interventions. Material(s) and Method(s): A systematic research using
Medline, EMBASE, and Google Scholar was implemented corresponding to the
Preferred Reporting Items for Systematic reviews and Meta-analysis
(PRISMA) statement. Data from the eligible studies were obtained and
meta-analyzed. Primary endpoints included major bleeding and
thromboembolism. Secondary endpoints included minor bleeding, overall
mortality, and overall bleeding (major and minor bleeding). We conducted a
comparative analysis between bridging and non-bridging along with a
sensitivity analysis for patients undergoing major and minor operations.
 Result(s): Fifteen studies comprised of 2305 patients (2453 bridging
episodes) were included. Pooled major bleeding and thromboembolism rates
were 3.85 % (95 % CI: 2.12-5.98) (I2 = 69 %, p < 0.01) and 0.39
% (95 % CI: 0.00-1.41) (I2 = 64 %, p < 0.01). Bridging versus
non-bridging major bleeding, thromboembolism, and overall bleeding risk
ratios (RR) were RR 2.05 (95 % CI: 0.98-4.28) (I2 = 10 %, p =
0.34), RR 1.63 (95 % CI: 0.41-6.50) (I2 = 0 %, p = 0.63) and RR
1.79 (95 % CI: 1.17-2.72) (I2 = 55 %, p = 0.09) respectively.
Subgroup analysis displayed major and minor operation thromboembolism and
overall bleeding rates of 3.09 % (95 % CI: 0.78-6.43) (I2 = 0
%, p = 0.89) versus 0.14 % (95 % CI: 0.00-1.40) (I2 = 0 %, p =
0.93), test for subgroup differences (p < 0.01) and 17.37 % (95 % CI:
11.73-23.77) (I2 = 0 %, p = 0.61) versus 28.18 % (95 % CI:
22.80-33.88) (I2 = 0 %, p = 0.47), test for subgroup
differences (p = 0.01) respectively. Conclusion(s): Our analysis
suggests that bridging may potentially put patients at an increased
bleeding risk regarding overall bleeding rates, while failing to provide
statistically significant benefits concerning thromboembolism and overall
mortality compared to non-bridging. Limitations such as the mixed patient
population don't allow for definite conclusions to be drawn warrantying
further research through randomized controlled trials. Copyright
© 2022 Elsevier Ltd

<110>
Accession Number
638864249
Title
3D-PRINTING FOR ABLATION PLANNING IN PATIENTS UNDERGOING ATRIAL
FIBRILLATION ABLATION (3D-GALA TRIAL).
Source
Journal of hypertension. 40(Supplement 1) (pp e68), 2022. Date of
Publication: 01 Jun 2022.
Author
Xydis P.; Printzios D.T.; Gourgouli I.; Tampakis K.; Andrikopoulos G.;
Vlachopoulos C.
Institution
(Xydis, Printzios, Gourgouli, Vlachopoulos) First Department of
Cardiology, National and Kapodistrian University of Athens, Athens, Greece
(Tampakis, Andrikopoulos) 1st Clinic of Cardiology/Cardiac
Electrophysiology and Pacing, Henry Dunant Hospital Center, Athens, Greece
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Atrial fibrillation (AF) remains one of the major causes of
cardiovascular morbidity. Ablation techniques are becoming more appealing
after latest results of andomised trials showing the overall clinical
benefit. On the other hand imaging techniques and the frontier application
of 3D printing are emerging as valuable ally for cardiac procedures.
However, no andomised trial has directly assessed the impact of
preprocedural imaging and especially 3D printing guidance for AF
ablation.The present study is designed to investigate for the first time
the effect of 3D-printing of the heart on the safety and effectiveness of
the ablation procedure. DESIGN AND METHOD: The 3D-GALA trial is a
andomised, open- label, controlled, multicentre clinical trial of 2
parallel groups designed to enrol a total of 100 patients undergoing
ablation using cryo-balloon for paroxysmal and persistent AF. Patients
will be andomised with a patient allocation ratio of 1: 1 to preprocedural
MRI scan of the heart and 3D printing of left atrium and pulmonary veins
and cryoablation versus standard cryoablation without imaging. Patients
will be followed up to 6 months after the index procedure. RESULT(S):
The primary outcome measure is the reduction of radiation dose and
contrast amount during pulmonary veins isolation. Secondary endpoints will
include the percentage of atrial fibrillation relapse at 24h-Holter
electrocardiogram monitoring at 6 months after initial treatment.
 CONCLUSION(S): To our knowledge, the 3D-GALA trial will be the first
study to provide evidence about the clinical impact of preprocedural
imaging and 3D printing before cryoablation. Copyright © 2022
Wolters Kluwer Health, Inc. All rights reserved.

<111>
[Use Link to view the full text]
Accession Number
638863334
Title
GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS DO NOT DECREASE THE RISK FOR
CORONARY REVASCULARIZATION IN PATIENTS WITH TYPE 2 DIABETES: A
META-ANALYSIS OF CARDIOVASCULAR OUTCOME TRIALS.
Source
Journal of hypertension. 40(Supplement 1) (pp e164), 2022. Date of
Publication: 01 Jun 2022.
Author
Patoulias D.; Katsimardou A.; Imprialos K.; Stavropoulos K.; Siskos F.;
Kassimis G.; Petidis K.; Papadopoulos C.; Karagiannis A.; Doumas M.
Institution
(Patoulias, Katsimardou, Imprialos, Stavropoulos, Siskos, Petidis,
Papadopoulos, Karagiannis, Doumas) Aristotle University of Thessaloniki,
Second Propedeutic Department of Internal Medicine, Thessaloniki, Greece
(Kassimis) Aristotle University of Thessaloniki, Second Department of
Cardiology, Thessaloniki, Greece
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Cardiovascular disease (CVD) is common among subjects with type
2 diabetes mellitus (T2DM), while it represents the main cause of death,
accounting for half of deaths in this population. Prevalence of coronary
artery disease (CAD) among diabetic subjects is relatively high, more than
20%. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), a class of
antidiabetics with established cardiovascular benefits for patients with
T2DM, have been shown to decrease the risk for major adverse
cardiovascular events, cardiovascular and all-cause mortality, while they
have been shown to decrease the risk for fatal or non-fatal myocardial
infarction; therefore they have been suggested as second-line treatment
option for patients with T2DM and established atherosclerotic
cardiovascular disease. DESIGN AND METHOD: We searched PubMed from
inception to September 1st, 2021, for the relevant cardiovascular outcome
trials with GLP-1RAs in patients with T2DM, to pool data concerning
coronary revascularization. We searched both published reports and
supplementary appendices. We evaluated the surrogate outcome of coronary
revascularization with GLP-1RAs versus placebo. RESULT(S): We pooled
data from 5 trials in a total of 41,355 subjects with T2DM. GLP-1RA
treatment compared to placebo did not have a significant effect on the
risk for coronary revascularization (risk ratio = 0.95, 95% CI; 0.81 -
1.11, I2 = 77%, p = 0.51). No significant differences were observed during
various subgroup analyses. CONCLUSION(S): Despite their established
cardioprotective effects in high-risk patients with T2DM, GLP-1RAs do not
seem to confer a significant risk reduction in terms of coronary
revascularization. Additional analyses according to the type of
revascularization procedure might provide interesting
insights. Copyright © 2022 Wolters Kluwer Health, Inc. All rights
reserved.

<112>
[Use Link to view the full text]
Accession Number
638860432
Title
THE DANTON STUDY - DISCONTINUATION OF ANTIHYPERTENSIVE TREATMENT IN OLDER
PEOPLE WITH DEMENTIA LIVING IN A NURSING HOME: RESULTS OF A RANDOMIZED
CONTROLLED TRIAL.
Source
Journal of hypertension. 40(Supplement 1) (pp e1), 2022. Date of
Publication: 01 Jun 2022.
Author
Bogaerts J.; Gussekloo J.; De Jong-Schmit B.; Achterberg W.; Poortvliet R.
Institution
(Bogaerts, Gussekloo, De Jong-Schmit, Achterberg, Poortvliet) Leiden
University Medical Center, Department of Public Health and Primary Care,
Leiden, Netherlands
(Gussekloo) Leiden University Medical Center, Department of Internal
medicine, Section Gerontology and Geriatrics, Leiden, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Neuropsychiatric symptoms (NPS), such as apathy and agitation,
are highly prevalent in nursing home (NH) residents with dementia.
Literature suggests an association of both cerebral hypoperfusion and
antihypertensive treatment (AHT) with NPS in patients with dementia.
Therefore, we investigated whether discontinuation of AHT in NH residents
with dementia reduces NPS and improves quality of life (QoL). DESIGN AND
METHOD: Randomized, single-blinded trial conducted in 26 Dutch NH
organisations. Residents with moderate-severe dementia and a systolic
blood pressure < 160 mmHg during AHT were randomized in an intervention
(semi-protocolized discontinuation) and control (continuation) group
during a period of 8 months. Exclusion criteria were heart failure
NYHA-class-III/IV, angina pectoris, a recent cardiovascular
event/reperfusion procedure, or a life-expectancy < 4 months. Co-primary
endpoints were NPS (Neuropsychiatric Inventory-Nursing Home version) and
QoL (Qualidem) at 4 months. Secondary endpoints include cognitive
function, care dependency, general daily functioning and falls.
 RESULT(S): Between December 2018 and May 2021, 205 NH residents with
dementia (median age 86 years-79.5% women) were randomized, of which 177
(86.3%) reached the primary endpoint at 4 months. During trial, 63 severe
adverse events occurred in 61 residents. On advice of the Data Safety
Monitoring Board, the study was preliminary finished in December 2021 due
to futility based on the co-primary endpoints. Definitive results for all
endpoints measured at 4 and 8 months follow-up will be available in April
2022. CONCLUSION(S): This is, to our knowledge, the largest AHT
deprescription trial in NH residents with dementia. Based on preliminary
results of this study, the benefits of deprescribing AHT in NH residents
with dementia for reduction of NPS and improvement of QoL, are unclear and
may not be without any potential risk. Copyright © 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<113>
[Use Link to view the full text]
Accession Number
638859911
Title
EFFECT OF MOBILE APPLICATIONS FOR PHYSICAL ACTIVITY TRACKING ON EXERCISE
TOLERANCE IN PATIENTS WITH HYPERTENSION AND CORONARY ARTERY DISEASE.
Source
Journal of hypertension. 40(Supplement 1) (pp e163), 2022. Date of
Publication: 01 Jun 2022.
Author
Tsygankova O.; Ponkin S.; Veretyuk V.
Institution
(Tsygankova, Veretyuk) Novosibirsk State Medical University, Department of
Urgent Internal Medicine, Endocrinology and Occupational Medicine,
Novosibirsk, Russian Federation
(Tsygankova) Research Institute of Therapy and Preventive Medicine, branch
of the Institute of Cytology and Genetics of RAS, Novosibirsk, Russian
Federation
(Ponkin) BerdskRussian Federation
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To assess the effect of smartphone applications designed for
physical activity tracking on exercise tolerance of patients with arterial
hypertension (HTN) and coronary artery disease (CAD) during rehabilitation
program. DESIGN AND METHOD: We examined 464 patients with HTN (men 176,
37.9%) aged 61.7 +/- 11.0 who attended rehabilitation programs in 5 days
to 6 months after myocardial infarction (median 24 [6; 92] days) in health
campus. Most of the patients undergone coronary revascularization: 371
(80.0%) - percutaneous coronary intervention and 75 (16.1%) coronary
artery bypass grafting; 18 patients (3.9%) had non-invasive management.
Patients were randomized in two groups: I (n = 238, 51.3%) were using
mobile apps with activity trackers and II (control, n = 226, 48.7%)
without intervention. The six-minute walk test (6MWT) was performed at the
time of admission, in the middle of the rehabilitation course (the 6th
day) and before discharge (the 12th day) (6MWT1, 6MWT2 and 6MWT3,
respectively). We compared groups using Mann-Whitney U test and assessed
changes in 6MWT distance as the difference between measurements ( 6MWT2-1
= 6MWT2 - 6MWT1 and 6MWT3-1 = 6MWT3 - 6MWT1). RESULT(S): The 6MWT1
distance on admission did not differ between the experimental and control
groups (440.1 +/- 82.3 m vs 421.3 +/- 78.1 m, p = 0.81). The 6MWT distance
increased over time in both groups. In the middle and at the end of the
course difference between the groups became statistically significant:
6MWT2 in I group 499.3 +/- 88.5 m vs 446.0 +/- 82.7 in group II, p <
0.001; 6MWT3 was 570.6 +/- 89.5 m vs 473.6 +/- 88.3 m, respectively, p <
0.001. Experimental group had a more pronounced increase in 6MWT after the
2nd measurement ( 6MWT2-1 59.1 +/- 26.3 m vs 25.6 +/- 17.7m, p < 0.001)
and the 3rd measurement ( 6MWT3-1 was 130.5 +/- 45.2 m vs 52.5 +/- 30.6 m,
p < 0.001). CONCLUSION(S): The use of mobile apps for physical
activity tracking in patients with HTN and CAD after MI was associated
with an increase in the 6MWT distance on the 6th and 12th day of cardiac
rehabilitation program compared with the control group. Copyright
© 2022 Wolters Kluwer Health, Inc. All rights reserved.

<114>
Accession Number
638859765
Title
THE INFLUENCE OF SHORT-TERM EXERCISE TRAINING ON ARTERIAL BLOOD PRESSURE
AND QT DISPERSION IN PATIENCE AFTER SURGICAL AORTIC VALVE REPLACEMENT.
Source
Journal of hypertension. 40(Supplement 1) (pp e293), 2022. Date of
Publication: 01 Jun 2022.
Author
Stoickov V.; Ilic M.D.; Stoickov M.; Tasic I.; Stoickov I.; Kostic S.;
Marinkovic D.; Simonovic D.
Institution
(Stoickov, Ilic, Tasic) University of Nis, Medical Faculty, Institute of
Cardiology Niska Banja, Nis, Serbia
(Stoickov, Kostic, Marinkovic, Simonovic) Institute of Cardiology Niska
Banja, Nis, Serbia
(Stoickov) Human polyclinic, Nis, Serbia
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The aim of this study was to establish the influence of
short-term exercise training on arterial blood pressure and QT dispersion
in patients after surgical aortic valve replacement (SAVR). DESIGN AND
METHOD: The study involved 103 patients after SAVR, in the sinus rhythm
without AV blocks or branch blocks. Average age of patients was 60.8
years. Patients were randomly divided into the physical training group
(training group: 85 patients) and control group (non-training group: 18
patients). Patients were similar as to age and baseline stress test
duration. In all subjects clinical examination, standard ECG and exercise
test on treadmill according to Bruce protocol were performed and after
that training group patients were included in physical training program
for three weeks. Training group patients were instructed to follow a
training program using the bicycle ergometer (10 min, 2 times a day),
gymnastic exercises and walking. The patients continued to take the same
medicaments in same doses. From standard ECG corrected QT dispersion
(QTdc) was calculated. RESULT(S): After three weeks, we have found
significant reduction of QTdc from 79.1 +/- 19.7 to 70.8 +/- 20.4 ms; p <
0.02 in the training group. Also, in the training group, we have found
significant reduction of heart rate from 78.6 +/- 7.1 to 65.9 +/- 6.1
beats/min (p < 0.001), of systolic blood pressure from 137.4 +/- 13.1 to
127.7 +/- 11.5 mmHg (p < 0.025), of diastolic blood pressure from 87.8 +/-
8.9 to 84.2 +/- 7.5 mmHg (p < 0.01) and of double product from 11996.7 +/-
1162.4 to 10518.8 +/- 794.3 beat/min x mmHg; p < 0.001. In contrast, the
non-training group showed no significant changes. CONCLUSION(S): The
study showed that short-term exercise training have favourable effects on
arterial blood pressure and QT dispersion in patients after SAVR. Physical
training led to the significant decrease of myocardial oxygen uptake at
rest and probably decreased the possibility of arrhythmia events in
patients after SAVR. Copyright © 2022 Wolters Kluwer Health, Inc.
All rights reserved.

<115>
Accession Number
638838140
Title
Can Chest Ultrasound Replace Chest X-ray in Thoracic Surgery?.
Source
Tomography (Ann Arbor, Mich.). 8(4) (pp 2083-2092), 2022. Date of
Publication: 20 Aug 2022.
Author
Grapatsas K.; Leivaditis V.; Ehle B.; Papaporfyriou A.
Institution
(Grapatsas) Department of Thoracic Surgery, Klinikum Bielefeld, Bielefeld
33647, Germany
(Leivaditis) Department of Cardiothoracic and Vascular Surgery,
Westpfalz-Klinikum, Kaiserslautern 67655, Germany
(Ehle) Department of Thoracic Surgery, Medical Center-University of
Freiburg, Faculty of Medicine, Freiburg 79098, Germany
(Papaporfyriou) Division of Pulmonology, Department of Internal Medicine
II, Medical University of Vienna, Vienna 1090, Austria
Publisher
NLM (Medline)
Abstract
Background: There is growing evidence that supports the use of chest
ultrasound (CUS) versus conventional chest X-ray (CXR) in order to
diagnose postoperative complications. However, data regarding its use
after thoracic surgery are scarce and contradictory. The aim of this study
was to conduct a systematic review to evaluate the accuracy of CUS after
thoracic surgery. Method(s): An electronic search in MEDLINE (via
PubMed), complemented by manual searches in article references, was
conducted to identify eligible studies. Result(s): Six studies with a
total of 789 patients were included in this meta-analysis. Performing CXR
decreased in up to 61.6% of cases, with the main reasons for performing
CXR being massive subcutaneous emphysema or complex hydrothorax. Agreement
between CUS and routine-based therapeutic options was, in some studies, up
to 97%. Conclusion(s): The selectively postoperative use of CUS may
reduce the number of routinely performed CXR. However, if CUS findings are
inconclusive, further radiological examinations are obligatory.

<116>
Accession Number
637939213
Title
Effects of crystalloid and colloid priming strategies for cardiopulmonary
bypass on colloid oncotic pressure and haemostasis: a meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. 35(3) (no pagination),
2022. Date of Publication: 03 Aug 2022.
Author
Beukers A.M.; de Ruijter J.A.C.; Loer S.A.; Vonk A.; Bulte C.S.E.
Institution
(Beukers, de Ruijter, Loer, Bulte) Amsterdam UMC Location Vrije
Universiteit Amsterdam, Department of Anaesthesiology, Amsterdam,
Netherlands
(Vonk) Amsterdam UMC Location University of Amsterdam, Department of
Cardiothoracic Surgery, Amsterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Colloid oncotic pressure (COP) is an important factor in
cardiac surgery, owing to its role in haemodilution. The effect of
cardiopulmonary bypass prime fluids on the COP is unknown. In this study,
the effect of crystalloid and colloid prime fluids, with or without
retrograde autologous priming (RAP), on the COP during elective cardiac
surgery was evaluated. METHOD(S): Randomized controlled trials and
prospective clinical trials comparing crystalloid and colloid priming
fluids or with RAP were selected. The primary outcome was the COP;
secondary outcomes were fluid balance, fluid requirements, weight gain,
blood loss, platelet count and transfusion requirements. RESULT(S):
From 1582 records, 29 eligible studies were identified. COPs were
comparable between gelofusine and hydroxyethyl starch (HES) during bypass
[mean difference (MD): 0.69; 95% confidence interval (CI): -2.05, 3.43;
P=0.621], after bypass (MD: -0.11; 95% CI: -2.54, 2.32; P=0.930) and
postoperative (MD: -0.61; 95% CI: -1.60, 0.38; P=0.228). Fluid balance was
lower with HES than with crystalloids. RAP reduced transfusion
requirements compared with crystalloids. Blood loss was comparable between
groups. CONCLUSION(S): COPs did not differ between crystalloids and
colloids. As a result of increased transcapillary fluid movement, fluid
balance was lower with HES than with crystalloids. Haematocrit and
transfusion requirements were comparable between groups. However, the
latter was lower when RAP was applied to crystalloid priming compared with
crystalloids alone. Finally, no differences in blood loss were observed
between the groups. Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<117>
Accession Number
636964319
Title
The effectiveness of preoperative education interventions on improving
perioperative outcomes of adult patients undergoing cardiac surgery: a
systematic review and meta-analysis.
Source
European journal of cardiovascular nursing. 21(6) (pp 521-536), 2022. Date
of Publication: 29 Aug 2022.
Author
Ng S.X.; Wang W.; Shen Q.; Toh Z.A.; He H.G.
Institution
(Ng, Wang, Toh, He) Alice Lee Centre for Nursing Studies, Yong Loo Lin
School of Medicine, National University of Singapore, Clinical Research
Centre, Level 2Block MD11 ,10 Medical Drive 117597, Singapore
(Ng, Wang, Toh, He) National University Health System, NUHS Tower Block,
1E Kent Ridge Rd 119228, Singapore
(Shen) Department of Nursing, School of Medicine, Xiamen University, Room
220, Xiang An District, Fujian Province, Alice Lee Building ,Xiang An
South Road, Xiamen 361102, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac surgeries pose as an emotional experience for
patients. Preoperative education is known to positively alter people's
perceptions, emotions, and mitigate surgical distress. However, this
intervention's effectiveness in improving perioperative outcomes among
patients undergoing cardiac surgery lacked rigorous statistical synthesis
and remains inconclusive. AIMS: The aim was to synthesize the
effectiveness of preoperative education on improving perioperative
outcomes [anxiety, depression, knowledge, pain intensity, pain
interference with daily activities, postoperative complications, length of
hospitalization, length of intensive care unit (ICU) stay, satisfaction
with the intervention and care, and health-related quality of life] among
patients undergoing cardiac surgery. METHOD(S): This systematic
review and meta-analysis conducted a comprehensive search of nine
electronic databases (PubMed, EMBASE, Scopus, MEDLINE, CINAHL, Cochrane
CENTRAL, Web of Science, PsycINFO, and ERIC) and grey literature for
randomized controlled trials examining the preoperative educational
interventional effects on patients undergoing cardiac surgery from
inception to 31 December 2020. The studies' quality was evaluated using
Cochrane Risk-of-Bias Tool 1 (RoB1). Meta-analyses via RevMan 5.4 software
synthesized interventional effects. RESULT(S): Twenty-two trials
involving 3167 participants were included. Preoperative education had
large significant effects on reducing post-intervention preoperative
anxiety (P = 0.02), length of ICU stay (P = 0.02), and improving knowledge
(P < 0.00001), but small significant effect sizes on lowering
postoperative anxiety (P < 0.0001), depression (P = 0.03), and enhancing
satisfaction (P = 0.04). CONCLUSION(S): This review indicates the
feasibility of preoperative education in clinical use to enhance health
outcomes of patients undergoing cardiac surgery. Future studies need to
explore knowledge outcomes in-depth and more innovative technologies in
preoperative education delivery. Copyright Published on behalf of the
European Society of Cardiology. All rights reserved. © The Author(s)
2021. For permissions, please email: journals.permissions@oup.com.

<118>
Accession Number
616626249
Title
The practice pattern of percutaneous coronary intervention in Korea -based
on year 2014 cohort of Korean percutaneous coronary intervention (K-PCI)
Registry.
Source
Korean Circulation Journal. 47(3) (pp 320-327), 2017. Date of Publication:
May 2017.
Author
Gwon H.-C.; Jeon D.W.; Kang H.-J.; Jang J.-S.; Park D.-W.; Shin D.-H.;
Moon K.-W.; Kim J.-S.; Kim J.; Bae J.-W.; Hur S.-H.; Kim B.O.; Choi D.;
Han K.-R.; Kim H.-S.
Institution
(Gwon) Samsung Medical Center, Heart Vascular and Stroke Institute,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Jeon) Division of Cardiology, National Health Insurance Service Ilsan
Hospital, 100 Ilsan-ro, Ilsan-donggu, Goyang 10444, South Korea
(Kang, Kim) Department of Internal Medicine, Seoul National University
Hospital, Seoul, South Korea
(Jang) Division of Cardiology, University of Inje College of Medicine,
Busan Paik Hospital, Busan, South Korea
(Park) Division of Cardiology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Shin, Kim, Choi) Division of Cardiology, Yonsei University College of
Medicine, Severance Cardiovascular Hospital, Seoul, South Korea
(Moon) Division of Cardiology, College of Medicine, Catholic University of
Korea, St. Vincent's Hospital, Suwon, South Korea
(Kim) Division of Cardiology, Heart Center of Chonnam National University
Hospital, Gwangju, South Korea
(Bae) Department of Internal Medicine, Chungbuk National University
College of Medicine, Cheongju, South Korea
(Hur) Division of Cardiology, Keimyung University Dongsan Medical Center,
Daegu, South Korea
(Kim) Division of Cardiology, University of Inje College of Medicine,
Sanggye-Paik Hospital, Seoul, South Korea
(Han) Department of Internal Medicine, Hallym University Medical Center,
Kangdong Sacred Heart Hospital, Seoul, South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: Appropriate use criteria (AUC) was developed to
improve the quality of percutaneous coronary intervention (PCI). However,
these criteria should consider the current practice pattern in the country
where they are being applied. Material(s) and Method(s): The
algorithm for the Korean PCI practice pattern (KP3) was developed by
modifying the United States-derived AUC in expert consensus meetings. KP3
class A was defined as any strategy with evidence from randomized trials
that was more conservative for PCI than medical therapy or coronary artery
bypass graft (CABG). Class C was defined as any strategy with less
evidence from randomized trials and more aggressive for PCI than medical
therapy or CABG. Class B was defined as a strategy that was partly class A
and partly class C. We applied the KP3 classification system to the Korean
PCI registry. Result(s): The KP3 class A was noted in 67.7% of
patients, class B in 28.8%, and class C in 3.5%. The median proportion of
class C cases per center was 2.0%. The distribution of KP3 classes varied
significantly depending on clinical and angiographic characteristics. The
proportion of KP3 class C cases per center was not significantly dependent
on PCI volume, but rather on the percentage of ACS cases in each center.
 Conclusion(s): We report the current PCI practice pattern by applying
the new KP3 classification in a nationwide PCI registry. The results
should be interpreted carefully with due regard for the complex
relationships between the determining variables and the healthcare system
in Korea. Copyright © 2017 The Korean Society of Cardiology.

<119>
Accession Number
638843905
Title
Integrated analysis of genomic alterations of Chinese lung adenocarcinoma
with micropapillary component.
Source
Journal of Clinical Oncology. Conference: Annual Meeting of the American
Society of Clinical Oncology, ASCO 2022. Online. 40(16 Supplement 1) (no
pagination), 2022. Date of Publication: June 2022.
Author
Wang Y.; Yang R.; Wang D.; Zhang S.; Xuan Y.; Li P.; Wang L.; Che S.; Han
M.; Yu Y.
Institution
(Wang, Yang, Wang, Zhang, Xuan, Li, Wang, Che, Han, Yu) 1The Affiliated
Hospital of Qingdao University, Qingdao, China; Shanghai OrigiMed Co.,
Ltd, Shanghai, China; Qingdao Medical College, Qingdao University,
Qingdao, China; Qingdao Huangdao District Central Hospital, Qingdao, China
Publisher
American Society of Clinical Oncology
Abstract
Background: Lung adenocarcinoma (LADC) with micropapillary component (MPC)
is a special pathological subtype of LADC, which poses higher invasive
with poor prognosis, regardless of proportion of MPC. The effectiveness of
molecular targeted therapy in MPC-LADC patients is still being explored
without sufficient clinical evidence. Herein, we comprehensive analyzed
the genetic alterations of MPC-LADC in order to find effective potential
drug-target genes and guide new therapeutic strategies. Method(s): We
enrolled 31 MPC-LADC patients at Department of Thoracic Surgery, The
Affiliated Hospital of Qingdao University from January 2019 to December
2020, and also randomly selected 89 non- MPC-LADC patients as a reference
cohort. FFPE or fresh tumors and matched blood samples were performed for
NGS-based target panel detection of at least 420 genes (range 420-638
genes), and we analyzed the genomic alterations of the genes with
intersection in the above panels sequencing. Result(s): In our
MPC-LADC cohort, the proportion of micropapillary component in 31 tumors
were: 5 cases with MPC < 5%, 13 cases with MPC 5% - 20%, 10 cases with MPC
>=20% and other 3 cases unclear. The most frequently mutant genes were
EGFR (61.3%, 19/31), TP53 (41.9%, 13/31), ALK (19.4%, 6/ 31), CTNNB1
(16.1%, 5/31), KRAS (12.9%, 4/31) and SMAD4 (12.9%, 4/31). Moreover, 90.3%
(28/31) patients harbored genomic alterations in RTK/RAS/MAPK pathway,
54.8% (17/31) in cell-cycle pathway, 38.7% (12/31) in Wnt pathway, and
19.4% (6/31) in PI3K/AKT/mTOR pathway. Notably, the median age of patients
with ALK fusions were younger than wild-type patients (53 vs 60 years, p <
0.05). Patients with KRAS mutations had larger tumor sizes than wild-type
patients (Median: 3.4 vs 2.2 cm, p < 0.05), and their lesions are more
prone to vascular invasion (p < 0.05). Compared with the reference group
of non-MPC-LADC patients, three mutant genes were significantly enriched
in MPC-LADC group, namely, CTNNB1 (16.1% vs 1.1%, p < 0.01), ALK (16.1% vs
2.2%, p < 0.05) and SMAD4 (12.9% vs 2.2%, p < 0.05). Finally, we obtained
the date of micropapillary lung adenocarcinoma in Memorial Sloan-Kettering
Cancer Center (MSK) from cBioPortal database, and survival outcome
analysis displayed that EGFR mutations were significantly associated with
poor overall survival (OS) (p < 0.05). Conclusion(s): In this study,
we comprehensive revealed the genomic alterations of Chinese MPC-LADC
patients and their association with clinicopathological characteristic.
Several MPC-enriched genes including EGFR, ALK, KRAS, CTNNB1 and SMAD4
were identified which may be potential genetic drivers of micropapillary
lung tumors and could help us to reveal distinct therapeutic avenues of
MPC-LADC.

<120>
Accession Number
638873003
Title
Procedure-specific assessment in cardiothoracic and vascular surgery: a
scoping review.
Source
CMAJ. Canadian Medical Association Journal. Conference: Canadian
Conference for the Advancement of Surgical Education, C-CASE 2021.
Virtual. 64(6 Supplement 1) (pp S73), 2021. Date of Publication: November
2021.
Author
White A.; Hellmuth R.; Moran M.; Ryan J.; Mador B.; Campbell S.; Turner S.
Institution
(White, Ryan, Mador, Campbell, Turner) University of Alberta, Edmonton,
AB, Canada
(Hellmuth, Moran) University of Manitoba, Winnipeg, MB, Canada
Publisher
Canadian Medical Association
Abstract
Background: Surgical education has shifted from a time-based approach to
the achievement and demonstration of procedural competency. This study
comprehensively reviewed the literature to identify and evaluate available
procedure-specific assessment instruments in cardiothoracic and vascular
surgery. Method(s): A systematic search of 8 databases identified
studies containing procedure- specific operative assessment instruments in
cardiothoracic and vascular surgery. Generic global rating scales were
excluded, unless modified to be procedure-specific. Two reviewers
independently evaluated the validity evidence, methodological rigour and
educational utility of each instrument using objective scoring criteria.
 Result(s): There were 2130 studies describing procedure-specific
assessment in surgery. Of these, 208 pertained to cardiothoracic and
vascular surgery, of which 9 met inclusion criteria. Five instruments were
identified in thoracic surgery, 2 in cardiac surgery and 2 in vascular
surgery. Study participants included residents and surgeons, with only 1
instrument designed to evaluate surgeon performance and the remainder
designed to evaluate residents. No single instrument scored 15/15 for
validity. Though consistently high scores were attained in the content
domain of validity, little to no evidence was generally provided regarding
the consequences of assessment using a particular instrument. All studies
except 1 scored higher than 11 out of a maximum 16.5 points for
methodological rigour. Procedure-specific assessment instruments were
deemed to have high educational utility, but few reported their
educational impact. Conclusion(s): Few procedure-specific assessment
instruments in cardiothoracic and vascular surgery demonstrate high levels
of validity evidence, emphasizing the need for such instruments to ensure
the success of competency-based education models.

<121>
Accession Number
638872980
Title
Teaching heart valve surgery techniques using simulators: a review.
Source
CMAJ. Canadian Medical Association Journal. Conference: Canadian
Conference for the Advancement of Surgical Education, C-CASE 2021.
Virtual. 64(6 Supplement 1) (pp S66), 2021. Date of Publication: November
2021.
Author
El-Andari R.; Bozso S.J.; Kang J.J.H.; Adams C.; Nagendran J.
Institution
(El-Andari, Bozso, Kang, Nagendran) University of Alberta, Edmonton, AB,
Canada
(Adams) University of Calgary, Calgary, AB, Canada
Publisher
Canadian Medical Association
Abstract
Background: The apprentice model has been the primary method of teaching
cardiac surgery trainees. Limitations of the apprentice model include
insufficient time to learn all necessary skills, minimal exposure to rare
cases, complex repair techniques, limited number of patients in small
centres, high cost, and absence of objective measures of feedback. In
recent years, simulation- based training (SBT) has been used to address
the gaps left by the apprentice model. Method(s): This review aimed
to summarize the current literature regarding the use of SBT for trainees
learning surgical valve repair and replacement techniques. PubMed was
searched for all articles investigating the use of SBT in teaching
surgical valve techniques published in 2020 or earlier. Data showing the
impact of SBT on time to completion of tasks, number of mistakes, skills
scores, and theoretical knowledge were compiled in this study.
 Result(s): Studies that evaluated the outcomes after SBT showed
significant improvement in time to completion of tasks, number of
mistakes, skills scores, and theoretical knowledge after participation in
SBT. Conclusion(s): In recent years, SBT has become increasingly
prevalent and has shown a remarkable ability to improve the surgical
skills of trainees in a relatively short period of time. As hands-on
experience in the field of cardiac surgery is invaluable and often
difficult to reproduce effectively, it is likely that a combination of
handson training and SBT will be adopted to provide optimal exposure for
surgical trainees.

<122>
Accession Number
638872784
Title
Move For Surgery, a novel preconditioning program to optimize health
before thoracic surgery: a randomized controlled trial.
Source
CMAJ. Canadian Medical Association Journal. Conference: 2021 Canadian
Surgery Forum. Virtual. 64(6 Supplement 2) (pp S107), 2021. Date of
Publication: December 2021.
Author
Patel Y.; Churchill I.; Sullivan K.; Beauchamp M.; Wald J.; Mbuagbaw L.;
Agzarian J.; Shargall Y.; Finley C.; Fahim C.; Hanna W.
Institution
(Patel, Churchill, Sullivan, Beauchamp, Wald, Mbuagbaw, Agzarian,
Shargall, Finley, Fahim, Hanna) McMaster University and St. Joseph's
Healthcare Hamilton, Hamilton, ON, Canada
Publisher
Canadian Medical Association
Abstract
Background: Preconditioning before surgery can lower complication rates
after surgery and hence length of stay (LOS) in hospital. Therefore, we
designed and compared Move For Surgery (MFS), a home-based, preoperative,
preconditioning program intervention for thoracic surgery patients that
involves aerobic exercise using wearable technology and deep breathing
exercises, with the usual preoperative standard of care (control) through
a prospective randomized controlled trial. Method(s): Patients
undergoing resection for early-stage non-small cell lung cancer were
preoperatively enrolled and randomly assigned to either the MFS or control
group in a 1:1 allocation ratio. Those in the MFS group were provided with
a wearable activity tracker and a booklet describing various aerobic and
deep breathing exercises and nutritional and smoking cessation tips, and
they underwent the intervention, whereas those in the control group
underwent usual preoperative care. Daily step count, sleep cycle and
calories burned were synced and tracked remotely. Daily step goals were
set by increasing the participants' baseline step count by 10% each week
until the day of surgery. Participants were encouraged and motivated to
reach their daily step goal by automatic reminders through the tracker.
Participants completed the EQ- 5D-5L health-related quality of life
instrument at baseline and on the day of surgery. Continuous variables
were compared using the Student t test, and categorical variables were
compared using the chi2 test, with a level of significance of p
less than 0.05. Result(s): Of the 117 patients screened, 87.2%
(102/117) were eligible and 93.1% (95/102) completed the trial. The median
age was 68 (range 45-87) years and 57.9% (55/95) were women. The mean
predicted forced expiratory volume in 1 second and diffusing capacity for
carbon monoxide were 88.9% (standard deviation [SD] 17.0%) and 77.1% (SD
17.6%), respectively. LOS in hospital after surgery for the MFS and
control groups was 2.67 (SD 1.61) and 4.44 (SD 3.48) days (p = 0.002),
respectively. Significant improvement was seen in the overall health
component of the EQ-5D-5L from before MFS (69.38 [SD 17.11]) to after
(79.60 [SD 11.63]; p < 0.001). Conclusion(s): MFS significantly
shortened LOS in hospital after surgery when compared with usual
preoperative care and resulted in improved patientreported quality of
life.

<123>
Accession Number
638872728
Title
A systematic review and meta-analysis of randomized controlled trials
comparing intraoperative red blood cell transfusion strategies.
Source
CMAJ. Canadian Medical Association Journal. Conference: 2021 Canadian
Surgery Forum. Virtual. 64(6 Supplement 2) (pp S84), 2021. Date of
Publication: December 2021.
Author
Lenet T.; Baker L.; Park L.; Vered M.; Zahrai A.; Shorr R.; Davis A.;
McIsaac D.; Tinmouth A.; Fergusson D.; Martel G.
Institution
(Lenet, Baker, Park, Zahrai, Shorr, Davis, McIsaac, Tinmouth, Martel)
University of Ottawa, Ottawa, ON, Canada
(Vered) Royal College of Surgeons in Ireland, Dublin, Ireland
(Fergusson) Ottawa Hospital Research Institute, Ottawa, ON, Canada
Publisher
Canadian Medical Association
Abstract
Background: Red blood cell (RBC) transfusions are common in surgery and
associated with widespread interpractitioner variability despite
adjustment for case mix. Evidence-based recommendations guiding RBC
transfusion in the operative setting are limited. The objective of this
work was to carry out a systematic review and meta-analysis of randomized
controlled trials (RCTs) comparing intraoperative RBC transfusion
strategies to determine their impact on postoperative morbidity, mortality
and blood product use. Method(s): The search strategy was adapted
from a previous Cochrane review. Electronic databases were searched from
January 2016 to February 2021. Included studies from the previous Cochrane
review were considered for eligibility from before 2016. RCTs comparing
intraoperative transfusion strategies were considered for inclusion.
Co-primary outcomes were 30-day mortality and morbidity. Secondary
outcomes included intraoperative and perioperative RBC transfusion.
Meta-analysis was carried out using random-effects models. Result(s):
Fourteen trials (8641 patients) were included. One cardiac surgery trial
accounted for 56% of patients. There was no difference in 30-day mortality
(relative risk [RR] 0.96, 95% confidence interval [CI] 0.71-1.29) and
pooled postoperative morbidity among the studied outcomes when we compared
restrictive and liberal protocols. Two trials reported significantly worse
composite outcomes with restrictive triggers. Intraoperative (RR 0.53, 95%
CI 0.43-0.64) and perioperative (RR 0.70, 95% CI 0.62-0.79) blood
transfusions were significantly lower in the restrictive group than in the
liberal group. Conclusion(s): Perioperative restrictive transfusion
strategies decreased intraoperative and perioperative RBC transfusion and
were not associated with increased morbidity and mortality in 12 of 14
trials. Given trial design heterogeneity and generalizability limitations,
uncertainty remains regarding the safety of the broad application of
restrictive transfusion triggers in the operating room. Trials
specifically designed to address intraoperative transfusions are urgently
needed.

<124>
Accession Number
638872705
Title
Investigating disparities in surgical outcomes in Canadian Indigenous
populations.
Source
CMAJ. Canadian Medical Association Journal. Conference: 2021 Canadian
Surgery Forum. Virtual. 64(6 Supplement 2) (pp S100-S101), 2021. Date of
Publication: December 2021.
Author
Patro N.; Li B.; Lee Y.
Institution
(Patro, Li, Lee) McMaster University, Hamilton, ON, Canada
Publisher
Canadian Medical Association
Abstract
Background: Indigenous health has increasingly become a focus in improving
Canadian health care. The Indigenous population is known to experience
disparities including higher rates of chronic disease and lower life
expectancy. However, disparities in surgical outcomes are less well
described. The purpose of this systematic review is to identify available
studies comparing surgical outcomes among Indigenous and non- Indigenous
populations in Canada to better characterize research in this area and the
presence of any disparities. Method(s): A systematic review was
conducted in accordance with Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guidelines using Medline and Embase.
All studies reporting comparative surgical outcomes for both Indigenous
and non-Indigenous populations in Canada were identified from database
inception to February 2021. Indigenous populations included those
described as Indigenous, Aboriginal, Native or North American Indian,
Eskimo, Inuit, First Nations and Metis. Noncomparative studies, review
articles, case reports and studies reporting only nonsurgical outcomes
were excluded. Result(s): Eighteen studies were included. Five
studies related to general surgery, 5 related to urology, 4 related to
vascular surgery, 2 related to orthopedic surgery and 1 related to each of
cardiac and thoracic surgery. Thirteen studies reported a disparity in
Indigenous patients with worse rates of 11 separate postoperative
complication types in this population. Eight of these were major
complication types as determined using the Clavien-Dindo classification of
surgical complications (grades III-IV). Areas of disparity included rates
of graft rejection following solid organ transplantation, postoperative
infection risk including septicemia and postoperative all-cause mortality.
One study reported a better outcome in Indigenous patients for phantom
limb pain following lower extremity amputation. Conclusion(s):
Further comparative studies across other surgical disciplines and analyses
of barriers to accessing care can help provide a broader picture of
existing disparities and inform approaches to address these gaps.

<125>
Accession Number
638872703
Title
Measuring cost of adverse events following thoracic surgery: a scoping
review.
Source
CMAJ. Canadian Medical Association Journal. Conference: 2021 Canadian
Surgery Forum. Virtual. 64(6 Supplement 2) (pp S119), 2021. Date of
Publication: December 2021.
Author
Jones D.; Anstee C.; Kumar S.; Gingrich M.; Simone A.; Ahmadzai Z.;
Thavorn K.; Seely A.
Institution
(Jones, Anstee, Kumar, Gingrich, Simone, Ahmadzai, Thavorn, Seely) Ottawa
Hospital, Ottawa, ON, Canada
Publisher
Canadian Medical Association
Abstract
Background: Adverse events (AEs) following thoracic surgery place
considerable strain on patients, care providers and an overburdened health
care system. AEs are common (e.g., they occur in 60% of patients who
undergo esophagectomy and 30% of patients who undergo lobectomy), and no
matter how minor, AEs negatively affect length of stay, patient experience
and hospital costs. However, a rigorous evaluation of the economic impact
of thoracic surgical AEs remains lacking, and it is required to understand
the essential cost-saving nature of formal quality improvement programs.
 Method(s): We performed a systematic search of studies using Medline,
Embase and the Cochrane Library. Search criteria included adult patients
who underwent a thoracic surgical procedure and studies reporting
estimated costs of postoperative AEs. Studies published after 1999 were
included without language restrictions. Two reviewers independently
screened eligible studies using predefined criteria, extracted data using
a standardized template and synthesized results using a descriptive
approach. All costs were adjusted to 2021 US dollars to facilitate
comparisons. Result(s): A total of 3349 abstracts were identified, of
which 21 studies met the inclusion criteria. Most studies were conducted
in the United States (10/21) evaluating impact on hospital expenditures
(18/21). Forty-four procedurespecific AE mean costs were characterized.
The most commonly described AE-related costs were anastomotic leak (mean
US$21 369, range US$6176-US$37 397) and pneumonia (mean US$18 599, range
US$2608-US$34 591) following esophagectomy, and prolonged air leak (mean
US$2565, range US$571- US$3573), respiratory failure (mean US$19 786,
range US$11 841-US$37 812), pneumonia (mean US$15 362, US$2542-US$28 183)
and arrhythmia (mean US$6835, range US$5833-US$8659) following lobectomy.
 Conclusion(s): Our systematic search demonstrates that the costs
associated with postoperative AEs following thoracic surgery are
substantial and variable. Quantifying the costs of AEs will focus
attention upon the importance of remediable care processes, helping
translate a reduction of AEs into cost savings for hospitals. Further
analyses and generation of models capable of identifying patients at risk
for specific AEs will be vital for mobilizing health care resources to
improve clinical outcomes and reduce costs.

<126>
Accession Number
638865883
Title
Development of a surgical procedures video library for cardiac surgery
training in competency-based medical education.
Source
CMAJ. Canadian Medical Association Journal. Conference: Canadian
Conference for the Advancement of Surgical Education, C-CASE 2019. Ottawa,
ON Canada. 62(6 Supplement 1) (pp S218), 2019. Date of Publication:
December 2019.
Author
Fei L.Y.N.; Boodhwani M.; Vo T.P.; Mussani J.
Institution
(Fei, Boodhwani, Vo, Mussani) 1University of Ottawa, Ottawa, Ont. (Fei);
the Unviersity of Ottawa Heart Institute (Boodhwani, Vo); and Queen's
University, Kingson, Ont. (Mussani)
Publisher
Canadian Medical Association
Abstract
Background: Median sternotomy and saphenous vein graft removal are
foundational skills in cardiac surgery. However, there are few
comprehensive, reliable educational videos for teaching this procedure in
Canadian postgraduate medical education (PGME) programs. As Canadian
cardiac surgery PGME programs adopt the competency-based curriculum, there
is a need for evolution in surgical teaching to meet this more
learner-centred and outcomefocused curriculum. There is significant
heterogeneity in the cardiac operative experience of residents. This may
lead to insufficient training in certain procedures or a delay in
achieving entrustable professional activities (EPAs) in many residents.
Video-based surgical learning is 1 part of the educational armamentarium
that can complement operating room teaching. Method(s): A modified
Delphi consensus process will be used with cardiac surgery staff to
develop a 20-point checklist for the safe performance of a median
sternotomy and saphenous vein graft harvest. Junior cardiac surgery
trainees from across Canada will be randomly assigned to a novideo group
or to watch an instructional video of the procedure. Trainees will perform
the procedure immediately after video viewing. Senior cardiac surgery
residents will assess the participants on the basis of the checklists.
Participants will also fill out entry and exit questionnaires on the value
of the videos. Result(s): Participants are currently being recruited
for this study. Conclusion(s): This study aims to determine the value
of a surgical procedure video library in helping cardiac surgery residents
achieve practical EPAs. The results of this project will identify needs in
the technical skills training of future cardiac surgery residents.

<127>
Accession Number
638857527
Title
Impact of goal-directed fluid therapy on postoperative outcomes after
spine and orthopedic surgery: a systematic review and meta-analysis.
Source
CMAJ. Canadian Medical Association Journal. Conference: 18th Annual
Scientific Conference of the Canadian Spine Society. Banff, AB Canada.
61(4 Supplement 1) (pp S84-S85), 2018. Date of Publication: August 2018.
Author
Bokhari R.; You E.L.; Lasry O.; Baldini G.; Weber M.
Institution
(Bokhari) Division of Neurosurgery, King Abdulzaziz University, Jeddah,
Saudi Arabia
(Bokhari, You, Lasry) McGill University, Montreal, QC, Canada
(Baldini) Department of Anesthesia, Montreal General Hospital, Montreal,
QC, Canada
(Weber) Orthopa, Montreal, QC, Canada
(Weber) Department of Orthopaedic Surgery, Montreal General Hospital,
Montreal, QC, Canada
Publisher
Canadian Medical Association
Abstract
Background: Goal-directed fluid therapy (GDFT) is a perioperative fluid
management strategy that tailors resuscitation based on the objective
measures of hypovolemia and fluid responsiveness, with the ultimate goal
of optimizing cardiac output and achieving adequate tissue perfusion while
avoiding excessive fluid restriction or overload. It has been shown to
improve patient outcomes in high-risk patients undergoing cardiac and
noncardiac surgeries. However, its role in orthopedic subspecialties,
including spine surgery, remains poorly studied. We therefore
systematically review the orthopedic literature with the purpose of
presenting what is known about the effect of GDFT after spine and
orthopedic surgery. Method(s): We systematically searched MEDLINE and
Embase were systematically searched for randomized trials and
nonrandomized cohort studies that compared outcomes between patients
treated with GDFT or conventional fluid management (control group).
Patients who received fluid therapy based on physiologic parameters other
than urine output, blood pressure and heart rate in the context of an
intraoperative protocol were included. Result(s): Of the 6783
articles retrieved, 11 studies that enrolled a total of 992 patients (n =
493 GDFT, n = 499 control) were included. Of these studies, only 2
involved patients undergoing spine surgery. Goal-directed fluid therapy
was associated with a significant decrease in overall complications (odds
ratio [OR] 0.52, 95% confidence interval [CI] 0.36-0.75). There was no
effect on mortality, length of stay or any organ-specific complication,
with the exception of a lower incidence of kidney dysfunction (OR 0.47,
95% CI 0.25-0.89) and gastrointestinal complications (OR 0.49, 95% CI
0.27-0.90). These results were mainly driven by outcomes reported in
studies conducted in patients undergoing nonspine surgery.
 Conclusion(s): Goal-directed fluid therapy in spine surgery is
understudied despite showing promise in the orthopedic population. This
systematic review provides rationale for further determining the impact of
GDFT on postoperative outcomes after major spine surgery. A randomized
clinical trial is currently underway at our centre.

<128>
Accession Number
638853151
Title
The effect of colchicine administration on postoperative pleural effusion
following thoracic surgery - a randomized, double blind,
placebo-controlled feasibility pilot study.
Source
CMAJ. Canadian Medical Association Journal. Conference: Canadian Surgery
Forum, CSF 2016. Toronto, ON Canada. 59(4 Supplement 1) (pp S111), 2016.
Date of Publication: August 2016.
Author
Agzarian J.; Bessissow A.; Srinathan S.; Schneider L.; Devereaux P.J.;
Neary J.; Dechert W.; Gandy L.; Finley C.J.; Hanna W.C.; Schieman C.;
Shargall Y.
Institution
(Agzarian, Bessissow, Srinathan, Schneider, Devereaux, Neary, Dechert,
Gandy, Finley, Hanna, Schieman, Shargall) McMaster University, Hamilton,
ON, Canada
Publisher
Canadian Medical Association
Abstract
With potent anti-inflammatory effect, colchicine was previously found to
be effective in preventing postoperative pericardial effusion following
cardiac surgery. The purpose of this pilot randomized controlled trial is
to assess the effect of colchicine on the volume of postoperative pleural
drainage, duration of chest tube in situ and length of stay following lung
resection. Between April 2014 and April 2015, 100 patients undergoing lung
resection at 2 tertiary care centres were randomized to either colchicine
(n = 49) or placebo (n = 51), as part of a feasibility double-blind study
assessing colchicine for prevention of perioperative atrial fibrillation.
Patients received either colchicine 0.6 mg or placebo orally twice daily
for 10 days, with the first dose given 4 hours before surgery. Pleural
drainage volumes were recorded in 8-hour intervals until chest tube
removal as per a standardized, predefined protocol. Univariate analysis
demonstrated that the 2 groups were comparable with regards to certain
baseline characteristics of cancer stage, comorbidities, surgical approach
and extent of resection (51% open procedures; 86% anatomic resections),
but not for sex, coronary artery disease and hypertension. Analysis of
total drainage volumes demonstrated a statistically significant difference
in favour of the colchicine group (583.8 v. 763.3 mL, p = 0.039). This
finding remained consistent across the time intervals assessed. The volume
of pleural drainage at 1-hour post-op was significantly less in the
colchicine group (92.9 v. 156.6 mL, p = 0.008) and remained lower at the
40-hour interval (550.9 v. 741.3 mL, p = 0.039). There were no differences
in time to chest tube removal (6.8 v. 5.9 days, p = 0.585) or hospital
length of stay (7.4 v. 6.9 days, p = 0.641) or with regards to major
bleeding, infection or adverse events. Perioperative administration of
oral colchicine is potentially effective in diminishing the amount of
pleural drainage after lung resection. A full-scale, prospective,
placebo-controlled randomized trial is needed to assess the clinical
significance of perioperative colchicine administration.

<129>
Accession Number
638874673
Title
Has the quality of reporting of randomized controlled trials in thoracic
surgery improved?.
Source
CMAJ. Canadian Medical Association Journal. Conference: 2015 Canadian
Surgery Forum. Quebec City, QC Canada. 58(4 Supplement 2) (pp S199), 2015.
Date of Publication: August 2015.
Author
Dharampal N.; Edwards J.P.; Chung W.; Brar M.S.; Ball C.G.; Seto J.;
Grondin S.C.
Institution
(Dharampal, Edwards, Chung, Brar, Ball, Seto, Grondin) University of
Calgary, Calgary, AB, Canada
Publisher
Canadian Medical Association
Abstract
We evaluated the quality of reporting of randomized controlled trials
(RCTs) in the thoracic surgery literature according to CONSORT and to
determine predictors of quality. All RCTs published in 4 principal
journals between 1998 and 2013 were identified in PubMed. Two independent
reviewers assessed each trial using the CONSORT checklist (1996) with
discrepancies resolved by a third reviewer. Mean checklist score were
compared between trials published from 1998 to 2005 and 2006 to 2013. The
kappa statistic for interrater agreement was calculated. Univariable and
multivariable linear regression were then performed to identify
independent predictors of quality. After 2 rounds of review, 203 of the
2838 identified articles met inclusion criteria. The overall kappa
coefficient was 0.95 indicating very good agreement between reviewers. The
mean CONSORT score was significantly higher in 2006-2013 (mean 10.8, 95%
CI 10.3-11.2) than 1998-2005 (mean 9.3, 95% CI 8.7-9.6). On multivariable
analysis there was strong evidence of an increased mean CONSORT score in
studies comparing nonsurgical interventions, multicentre trials,
publications after 2006, studies with increased number of authors, and
studies funded by industry. Our study suggests that the quality of
reporting in the thoracic surgery literature is improving with time and is
predicted by factors including number of authors, multicentre trials, type
of comparison, time period of publication, and industry sponsorship.
Ongoing efforts should be made to improve quality of reporting in thoracic
surgery.

<130>
Accession Number
638874608
Title
A randomized comparison of electronic versus handwritten daily notes in
thoracic surgery.
Source
CMAJ. Canadian Medical Association Journal. Conference: 2015 Canadian
Surgery Forum. Quebec City, QC Canada. 58(4 Supplement 2) (pp S195), 2015.
Date of Publication: August 2015.
Author
French D.; Anstee C.; Gilbert S.; Maziak D.; Shamji F.; Sundarean S.;
Villeneuve J.; Seely A.
Institution
(French, Anstee, Gilbert, Maziak, Shamji, Sundarean, Villeneuve, Seely)
University of Ottawa, Ottawa, ON, Canada
Publisher
Canadian Medical Association
Abstract
Daily progress notes communicate a patient's clinical status and plan to
other health care professionals. The objective of this study is to compare
the quality of synoptic digitally recorded notes to handwritten daily
progress notes. For 20 consecutive weekdays, patients were randomized to
have a daily progress note produced using a synoptic electronic note
created on a portable computer or a traditional handwritten note. On the
same day, note readers were asked to evaluate the overall quality of the
note on a scale of 1-10, and specific aspects of the note on a scale of
1-5. Note writers were asked to evaluate the ease and effectiveness of
creating their own notes using a similar scale. Outcomes were compared
using a Mann-Whitney U test. Note readers evaluated 57 electronic notes
and 59 handwritten notes. There was a statistical significant difference
in the median score of the overall quality of the notes (electronic = 8;
handwritten = 6; p < 0.001). The median scores for quality of the
documentation of the subjective and physical exam findings, and
anticipated discharge information, and the clarity, completeness, and
legibility of the note all showed a statistical significant difference
favouring the electronic notes. There was no difference in the median
score for the documentation of the clinical plan (both groups = 4; p =
0.309). Note writers evaluated 36 electronic notes and 38 handwritten
notes. The median scores for the overall quality, completeness and
legibility showed a significant difference favouring electronic notes.
There was no difference in the other categories, including the time
required to create each type of note. This is the first randomized
controlled trial comparing the quality of electronic daily surgical
progress notes to traditional handwritten notes. Higher quality progress
notes are created using a synoptic electronic daily note without
increasing the time required to create the note.

<131>
Accession Number
638874581
Title
Does rater training improve the reliability of surgical skill assessments?
A randomized control trial.
Source
CMAJ. Canadian Medical Association Journal. Conference: 2015 Canadian
Surgery Forum. Quebec City, QC Canada. 58(4 Supplement 2) (pp S192-S193),
2015. Date of Publication: August 2015.
Author
Maniar R.L.; Vergis A.; Gillman L.; Hardy K.; Park J.
Institution
(Maniar, Vergis, Gillman, Hardy, Park) University of Manitoba, Winnipeg,
MB, Canada
Publisher
Canadian Medical Association
Abstract
Surgical training programs require reliable forms of assessment to
evaluate surgical skills and measure technical competence. Rater training
(RT) has been shown to improve the psychometric properties of assessment
tools in other disciplines, but has not been previously studied in
relation to surgical skills. This study evaluated whether RT improved the
reliability of surgical skill assessments. Royal College-certified
surgeons from multiple specialties, including general surgery, urology,
orthopedics, otolaryngology, neurosurgery, thoracic, cardiac, and plastic
surgery (n = 47) were randomized to either RT or no training groups. Frame
of reference RT was administered using a brief 5-minute training video.
All participants then assessed 10 videos of junior trainees performing a
suturing and knot-tying task using a previously validated global rating
scale (GRS). Interrater reliability was measured using interclass
correlation coefficient (ICC). Mixed-effects modelling was used to assess
mean GRS scores. The ICC was 0.71 (95% CI 0.51-0.89) for the RT group and
0.61 (95% CI 0.41-0.84) for the untrained group. Mean GRS scores were not
significantly different between the 2 groups (mean difference 0.02, p =
0.51). For education purposes, the reliabilities demonstrated in this
study would be considered good for the RT group but only moderate for the
nontrained group. However, the CIs did overlap and the reliability
coefficients for both groups were below the threshold of 0.8, which is
considered the minimum desirable level for high-stakes testing. These
results suggest that surgical skill assessments may still be improved. RT
may represent a way to improve reliability, but further study is needed to
identify the most effective methods of training.

<132>
Accession Number
638874476
Title
The effect of early mobilization protocols on postoperative outcomes
following abdominal and thoracic surgery: a systematic review.
Source
CMAJ. Canadian Medical Association Journal. Conference: 2015 Canadian
Surgery Forum. Quebec City, QC Canada. 58(4 Supplement 2) (pp S186-S187),
2015. Date of Publication: August 2015.
Author
Castelino T.; Fiore J.F.; Niculiseanu P.; Augustin B.; Feldman L.S.
Institution
(Castelino, Fiore, Niculiseanu, Augustin, Feldman) McGill University,
Montreal, QC, Canada
Publisher
Canadian Medical Association
Abstract
The negative effects of prolonged immobilization are well described, and
early postoperative mobilization is strongly recommended. However, there
is low evidence regarding the relative contribution of early mobilization
to patient recovery. This systematic review aims to summarize the evidence
regarding the impact of early mobilization on outcomes after thoracic and
abdominal surgery compared with standard care. Studies were identified
from a comprehensive search of 8 electronic databases. Studies were
included if they compared a group of adult patients receiving a protocol
of early mobilization (no later than postoperative day 1) to a control
group receiving no structured protocol. Studies were also included if the
control group received an institution- specific standardized mobilization
protocol compared with an intervention group receiving additional
mobilization goals and exercises. Outcomes of interest included
complications, length of stay (LOS), gastrointestinal (GI) function,
performance- based functional tests, and patient-reported outcomes (PROs).
Four studies in abdominal surgery and 4 studies in thoracic surgery met
the inclusion criteria. The overall methodological quality of the studies
was moderate. A wide variety of protocols were used, some including
supervised exercises and others providing education and clear
goal-setting. Outcomes reported were variable. In abdominal surgery, 1
study evaluating LOS reported a shorter stay in patients who were
mobilized. One study reported faster recovery of GI function. None of the
studies reported differences in postoperative complications, performance-
based tests or PROs. In thoracic surgery, while 2 of the studies reported
that mobilization was safe, none reported differences in any of the
outcomes of interest. Few comparative studies evaluated the impact of
early mobilization on outcomes after thoracic and abdominal surgery. The
quality of these studies was generally moderate; however, results were
conflicting. Further studies of high methodological quality must be done
to contribute evidence about the importance of early mobilization in
postoperative care.

<133>
Accession Number
2019967984
Title
Effects of Video-Based Patient Education and Consultation on Unplanned
Health Care Utilization and Early Recovery After Coronary Artery Bypass
Surgery (IMPROV-ED): Randomized Controlled Trial.
Source
Journal of Medical Internet Research. 24(8) (no pagination), 2022. Article
Number: e37728. Date of Publication: 01 Aug 2022.
Author
van Steenbergen G.; van Veghel D.; van Lieshout D.; Sperwer M.; ter Woorst
J.; Dekker L.
Institution
(van Steenbergen, van Veghel, ter Woorst, Dekker) Cardiothoracic Surgery
Department, Catharina Heart Centre, Catharina Hospital, Eindhoven,
Netherlands
(van Lieshout, Sperwer) Dutch Heart Foundation, The Hague, Netherlands
(Dekker) Department of Biomedical Technology, Eindhoven University of
Technology, Eindhoven, Netherlands
Publisher
JMIR Publications Inc.
Abstract
: Health care utilization after coronary artery bypass graft (CABG)
surgery is high and is partly of an unplanned nature. eHealth applications
have been proposed to reduce care consumption, which involve and assist
patients in their recovery. In this way, health care expenses could be
reduced and quality of care could be improved. Objective(s): The aim
of this study was to evaluate if an eHealth program can reduce unplanned
health care utilization and improve mental and physical health in the
first 6 weeks after CABG surgery. Method(s): A single-blind
randomized controlled trial was performed, in which patients scheduled for
nonacute CABG surgery were included from a single center in the
Netherlands between February 2020 and October 2021. Participants in the
intervention group had, alongside standard care, access to an eHealth
program consisting of online education videos and video consultations
developed in conjunction with the Dutch Heart Foundation. The control
group received standard care. The primary outcome was the volume and costs
of a composite of unplanned health care utilization, including emergency
department visits, outpatient clinic visits, rehospitalization,
patient-initiated telephone consultations, and visits to a general
practitioner, measured using the Medical Technology Assessment Medical
Consumption Questionnaire. Patient-reported anxiety and recovery were also
assessed. Intention-to-treat and "users-only" analyses were used.
 Result(s): During the study period, 280 patients were enrolled and
randomly allocated at a 1:1 ratio to the intervention or control group.
The intention-to-treat analysis consisted of 136 and 135 patients in the
intervention and control group, respectively. At 6 weeks, the primary
endpoint had occurred in 43 of 136 (31.6%) patients in the intervention
group and in 61 of 135 (45.2%) patients in the control group (hazard ratio
0.56, 95% CI 0.34-0.92). Recovery was faster in the intervention group,
whereas anxiety was similar between study groups. "Users-only" analysis
yielded similar results. Conclusion(s): An eHealth strategy
comprising educational videos and video consultations can reduce unplanned
health care utilization and can aid in faster patient-reported recovery in
patients following CABG surgery. Copyright © 2022 Journal of
Medical Internet Research. All rights reserved.

<134>
[Use Link to view the full text]
Accession Number
2019938232
Title
Normothermic Ex Situ Heart Perfusion with the Organ Care System for
Cardiac Transplantation: A Meta-analysis.
Source
Transplantation. 106(9) (pp 1745-1753), 2022. Date of Publication: 01 Sep
2022.
Author
Langmuur S.J.J.; Amesz J.H.; Veen K.M.; Bogers A.J.J.C.; Manintveld O.C.;
Taverne Y.J.H.J.
Institution
(Langmuur, Amesz, Veen, Bogers, Taverne) Department of Cardiothoracic
Surgery, Translational Cardiothoracic Surgery Research Lab, Erasmus
Medical Center, Dr Molewaterplein 40, Rotterdam 3015GD, Netherlands
(Langmuur, Amesz, Taverne) Translational Cardiothoracic Surgery Research
Lab, Erasmus Medical Center, Rotterdam, Netherlands
(Manintveld) Department of Cardiology, Erasmus Medical Center, Rotterdam,
Netherlands
(Manintveld, Taverne) Erasmus MC Transplant Institute, Erasmus Medical
Center, University Medical Center, Rotterdam, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
Background. Heart transplantation (HTx) is, at present, the most effective
therapy for end-stage heart failure patients; however, the number of
patients on the waiting list is rising globally, further increasing the
gap between demand and supply of donors for HTx. First studies using the
Organ Care System (OCS) for normothermic machine perfusion show promising
results yet are limited in sample size. This article presents a
meta-analysis of heart donation either after brain death (OCS-DBD) or
circulatory death (OCS-DCD) on using OCS versus static cold storage used
for HTx. Methods. A systematic literature search was performed for
articles discussing the use of normothermic ex situ heart perfusion in
adult patients. Thirty-day survival outcomes were pooled, and odds ratios
were calculated using random-effects models. Long-term survival was
visualized with Kaplan-Meier curves, hazard ratios were calculated and
pooled using fixed-effects models, and secondary outcomes were analyzed.
Results. A total of 12 studies were included, with 741 patients undergoing
HTx, of which 260 with the OCS (173 DBD and 87 DCD). No differences were
found between the 3 groups for early and late survival outcomes or for
secondary outcomes. Conclusions. OCS outcomes, for both DBD and DCD
hearts, appeared similar as for static cold storage. Therefore, OCS is a
safe and effective technique to enlarge the cardiac donor pool in both DBD
and DCD, with additional benefits for long-distance transport and
surgically complex procedures. Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

<135>
[Use Link to view the full text]
Accession Number
2019922603
Title
Early surgical aortic valve replacement in asymptomatic patients with
severe aortic stenosis: a systematic review and meta-analysis.
Source
Journal of Cardiovascular Medicine. 23(9) (pp 632-634), 2022. Date of
Publication: 01 Sep 2022.
Author
Ferlini M.; Munafo A.R.; Lanzillo G.; Aiello M.; Gazzoli F.; Mirizzi A.M.;
Magrini G.; Pelenghi S.; Visconti L.O.
Institution
(Ferlini, Mirizzi, Magrini, Visconti) Division of Cardiology, Fondazione
Irccs Policlinico San Matteo, Italy
(Aiello, Gazzoli, Pelenghi) Division of Cardiac Surgery, Fondazione Irccs
Policlinico San Matteo, Italy
(Munafo, Lanzillo) Department of Molecular Medicine, Unit of Cardiology,
University of Pavia, Pavia, Italy
Publisher
Lippincott Williams and Wilkins

<136>
Accession Number
2019846703
Title
Comment on "The effect of preoperative chest physiotherapy on oxygenation
and lung function in cardiac surgery patients: a randomized controlled
study".
Source
Annals of Saudi Medicine. 42(4) (pp 288), 2022. Date of Publication: July
2022.
Author
Kashoo F.Z.; Ahmad M.; Sidiq M.
Institution
(Kashoo) The Department of Physical Therapy and Health Rehabilitation,
Majmaah University College of Applied Medical Sciences, King Khalid
Hospital Majmaah, Riyadh, Saudi Arabia
(Ahmad) Department of Nursing, Majmaah University College of Applied
Medical Sciences, King Khalid Hospital Majmaah, Riyadh, Saudi Arabia
(Sidiq) Faculty of Physiotherapy, Madhav University, Rajasthan, India
Publisher
King Faisal Specialist Hospital and Research Centre

<137>
Accession Number
2019967942
Title
Effects of eHealth Interventions on Quality of Life and Psychological
Outcomes in Cardiac Surgery Patients: Systematic Review and Meta-analysis.
Source
Journal of Medical Internet Research. 24(8) (no pagination), 2022. Article
Number: e40090. Date of Publication: 01 Aug 2022.
Author
Ni R.; Liu M.; Huang S.; Yang J.
Institution
(Ni, Liu, Huang, Yang) Department of Pharmacy, Fujian Medical University
Union Hospital, Fuzhou, China
(Ni, Liu, Huang, Yang) College of Pharmacy, Fujian Medical University,
Fuzhou, China
Publisher
JMIR Publications Inc.
Abstract
Background: Patients undergoing heart surgery may experience a range of
physiological changes, and the postoperative recovery time is long.
Patients and their families often have concerns about quality of life
(QoL) after discharge. eHealth interventions may improve patient
participation, ensure positive and effective health management, improve
the quality of at-home care and the patient's quality of life, and reduce
rates of depression. Objective(s): The purpose of this study was to
evaluate the effects of eHealth interventions on the physiology,
psychology, and compliance of adult patients after cardiac surgery to
provide a theoretical basis for clinical practice. Method(s): We
conducted systematic searches of the following 4 electronic databases:
PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled
Trials. Mean (SD) values were used to calculate the pooled effect sizes
for all consecutive data, including QoL, anxiety, and depression. Where
the same results were obtained using different instruments, we chose the
standardized mean difference with a 95% CI to represent the combined
effect size; otherwise, the mean difference (MD) with a 95% CI was used.
Odds ratios were used to calculate the combined effect size for all
dichotomous data. The Cohen Q test for chi-square distribution and an
inconsistency index (I2) were used to test for heterogeneity among the
studies. We chose a fixed-effects model to estimate the effect size if
there was no significant heterogeneity in the data (I2<=50%); otherwise, a
random-effects model was used. The quality of the included studies was
assessed using the Cochrane risk-of-bias tool for randomized trials (RoB
2). Result(s): The search identified 3632 papers, of which 19 met the
inclusion criteria. In terms of physical outcomes, the score of the
control group was lower than that of the intervention group (MD 0.15, 95%
CI 0.03-0.27, I2=0%, P=.02). There was no significant difference in the
mental outcomes between the intervention and control groups (MD 0.10, 95%
CI -0.03 to 0.24, I2=46.4%, P=.14). The control group's score was lower
than that of the intervention group for the depression outcomes (MD -0.53,
95% CI -0.89 to -0.17, I2=57.1%, P=.004). Compliance outcomes improved in
most intervention groups. The results of the sensitivity analysis were
robust. Nearly half of the included studies (9/19, 47%) had a moderate to
high risk of bias. The quality of the evidence was medium to low.
 Conclusion(s): eHealth improved the physical component of quality of
life and depression after cardiac surgery; however, there was no
statistical difference in the mental component of quality of life. The
effectiveness of eHealth on patient compliance has been debated. Further
high-quality studies on digital health are required. Copyright ©
2022 Journal of Medical Internet Research. All rights reserved.

<138>
Accession Number
2018749642
Title
Muscle usage and workload assessment of cardiac ablation procedure with
the use of a novel catheter torque tool in a pediatric simulator.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2022. Date of Publication: 2022.
Author
Mass P.N.; Kumthekar R.N.; Clark B.C.; Opfermann J.D.; Sherwin E.D.;
DiBiase L.; Berul C.I.
Institution
(Mass, Berul) Shiekh Zayed Institute, Children's National Hospital, 111
Michigan Ave NW, Washington, DC 20010, United States
(Mass, Sherwin, Berul) Department of Cardiology, Children's National
Hospital, 111 Michigan Ave NW, Washington, DC 20010, United States
(Kumthekar) Division of Cardiology, Nationwide Children's Hospital,
Columbus, OH, United States
(Clark) Division of Cardiology, Children's Hospital at Montefiore, New
York, NY, United States
(Opfermann) Department of Mechanical Engineering, Johns Hopkins
University, Baltimore, MD, United States
(DiBiase) Division of Cardiology, Montefiore Medical Center, New York, NY,
United States
Publisher
Springer
Abstract
Background: Cardiac ablation catheters are small in diameter and pose
ergonomic challenges that can affect catheter stability. Significant
finger dexterity and strength are necessary to maneuver them safely. We
evaluated a novel torque tool to reduce muscle activation when
manipulating catheters and improve perceived workload of ablation tasks.
The objective was to evaluate measurable success, user perception of
workload, and muscle usage when completing a simulated ablation task with
and without the use of a catheter torque tool. Method(s): Cardiology
attendings and fellows were fitted with surface electromyographic (EMG)
sensors on 6 key muscle groups in the left hand and forearm. A standard
ablation catheter was inserted into a pediatric cardiac ablation simulator
and subjects navigated the catheter tip to 6 specific electrophysiologic
targets, including a 1-min simulated radiofrequency ablation lesion. Time
to complete the task, number of attempts required to complete the lesion,
and EMG activity normalized to percentage of maximum voluntary contraction
were collected throughout the task. The task was completed 4 times, twice
with and twice without the torque tool, in semi-randomized order. A NASA
Task Load Index survey was completed by the participant at the conclusion
of each task. Result(s): Time to complete the task and number of
attempts to create a lesion were not altered by the tool. Subjectively,
participants reported a significant decrease in physical demand, effort,
and frustration, and a significant increase in performance. Muscle
activation was decreased in 4 of 6 muscle groups. Conclusion(s): The
catheter torque tool may improve the perceived workload of cardiac
ablation procedures and reduce muscle fatigue caused by manipulating
catheters. This may result in improved catheter stability and increased
procedural safety. Copyright © 2022, The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<139>
Accession Number
2018512710
Title
Negative-Pressure Wound Therapy for Prevention of Sternal Wound Infection
after Adult Cardiac Surgery: Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 11(15) (no pagination), 2022. Article
Number: 4268. Date of Publication: August 2022.
Author
Biancari F.; Santoro G.; Provenzano F.; Savarese L.; Iorio F.; Giordano
S.; Zebele C.; Speziale G.
Institution
(Biancari, Santoro, Provenzano, Savarese, Iorio, Giordano, Zebele) Clinica
Montevergine, GVM Care Research, Mercogliano 83013, Italy
(Biancari) Heart and Lung Center, Helsinki University Hospital, University
of Helsinki, Helsinki 00029, Finland
(Speziale) Anthea Hospital, GVM Care Research, Bari 70124, Italy
Publisher
MDPI
Abstract
The results of current studies are not conclusive on the efficacy of
incisional negative-pressure wound therapy (NPWT) for the prevention of
sternal wound infection (SWI) after adult cardiac surgery. A systematic
review of the literature was performed through PubMed, Scopus and Google
to identify studies which investigated the efficacy of NPWT to prevent SWI
after adult cardiac surgery. Available data were pooled using RevMan and
Meta-analyst with random effect models. Out of 191 studies retrieved from
the literature, ten fulfilled the inclusion criteria and were included in
this analysis. The quality of these studies was judged fair for three of
them and poor for seven studies. Only one study was powered to address the
efficacy of NPWT for the prevention of postoperative SWI. Pooled analysis
of these studies showed that NPWT was associated with lower risk of any
SWI (4.5% vs. 9.0%, RR 0.54, 95% CI 0.34-0.84, I2 48%),
superficial SWI (3.8% vs. 4.4%, RR 0.63, 95% CI 0.29-1.36, I2
65%), and deep SWI (1.8% vs. 4.7%, RR 0.46, 95% CI 0.26-0.74,
I2 0%), but such a difference was not statistically significant
for superficial SWI. When only randomized and alternating allocated
studies were included, NPWT was associated with a significantly lower risk
of any SWI (3.3% vs. 16.5%, RR 0.22, 95% CI 0.08-0.62, I2 0%),
superficial SWI (2.6% vs. 12.4%, RR 0.21, 95% CI 0.06-0.69, I2
0%), and deep SWI (1.2% vs. 4.8%, RR 0.17, 95% CI 0.03-0.95, I2
0%). This pooled analysis showed that NPWT may prevent postoperative SWI
after adult cardiac surgery. NPWT is expected to be particularly useful in
patients at risk for surgical site infection and may significantly reduce
the burden of resources needed to treat such a complication. However, the
methodology of the available studies was judged as poor for most of them.
Further studies are needed to obtain conclusive results on the potential
benefits of this preventative strategy. Copyright © 2022 by the
authors.

<140>
Accession Number
2018512669
Title
Impact of Service-Learning on Physiotherapy Students: Exercise Programs
for Patients with Heart Transplantation and Acute Coronary Syndrome-A
Randomized Clinical Trial.
Source
Journal of Clinical Medicine. 11(15) (no pagination), 2022. Article
Number: 4360. Date of Publication: August 2022.
Author
Marques-Sule E.; Chiva-Bartoll O.; Carrasco J.J.; Hernandez-Guillen D.;
Perez-Alenda S.; Francisco-Garces X.; Sentandreu-Mano T.; Blesa J.
Institution
(Marques-Sule, Carrasco, Perez-Alenda) Physiotherapy in Motion,
Multispeciality Research Group (PTinMOTION), Department of Physiotherapy,
University of Valencia, Valencia 46010, Spain
(Marques-Sule, Hernandez-Guillen, Sentandreu-Mano) Department of
Physiotherapy, University of Valencia, Gasco Oliag 5, Valencia 46010,
Spain
(Chiva-Bartoll) Department of Education and Specific Didactics, Faculty of
Human and Social Sciences, University Jaume I, Avda. Sos Baynat, s/n,
Castellon 12005, Spain
(Carrasco) Intelligent Data Analysis Laboratory, University of Valencia,
Av. Universitat, s/n, Burjassot, Valencia 46100, Spain
(Francisco-Garces) Faculty of Physical Activity and Sports Sciences,
University of Valencia, Valencia 46010, Spain
(Blesa) Nutrition and Food Chemistry, Faculty of Pharmacy, University of
Valencia, Avda. Vicent Andres Estelles, s/n, Burjassot, Valencia 46100,
Spain
Publisher
MDPI
Abstract
Introduction. Service-learning (SL) seems to be useful for healthcare
students. This study aimed at comparing an SL program versus a traditional
approach (TA) on moral sensitivity, ethical competences, knowledge,
teaching quality, SL participation and performance, and satisfaction in
physiotherapy students. Methods. Randomized clinical trial. A total of 32
physiotherapy students were allocated to an SL group (SLG, n = 16), or to
a TA group (TAG, n = 16). Participants had to create an exercise program
for patients with heart transplantation and acute coronary syndrome. The
SLG performed the program with real patients, whilst the TAG performed a
traditional collaborative approach. Moral sensitivity, ethical
competences, knowledge and teaching quality were assessed pre- and
post-intervention. SL participation and performance and satisfaction of
the SLG were assessed post-intervention. Results. After the intervention,
the SLG showed higher moral sensitivity, ethical competences, knowledge
and reported better teaching quality than the TAG. The SL program was
useful, addressed a real need, contributed to learning, helped to solve
problems, facilitated better comprehension, increased motivation, and
students would like to use SL in other subjects. Conclusions. The SL
program had a positive impact on students, encouraging the implementation
of similar SL interventions. SL may be considered a teaching-learning
methodology of choice in physiotherapy students. Copyright © 2022
by the authors.

<141>
Accession Number
638881656
Title
Intravenous amino acid therapy for kidney protection in cardiac surgery a
protocol for a multi-Centre randomized blinded placebo controlled clinical
trial. The PROTECTION trial.
Source
Contemporary clinical trials. (pp 106898), 2022. Date of Publication: 26
Aug 2022.
Author
Landoni G.; Brambillasca C.; Redaelli M.B.; Bradic N.; Ti L.K.;
Povsic-Cevra Z.; Nepomniashchikh V.A.; Zoccai G.B.; D'Ascenzo F.;
Romagnoli E.; Scandroglio A.M.; Ballotta A.; Rondello N.; Franco A.;
Massaro C.; Viscido C.; Calabro M.G.; Garofalo E.; Canichella F.; Monaco
F.; Severi L.; Pisano A.; Barucco G.; Venditto M.; Federici F.; Licheri
M.; Paternoster G.; Trompeo A.; Belletti A.; Mantovani L.F.; Perone R.;
Dalessandro G.; Kroeller D.; Haxhiademi D.; Galbiati C.; Tripodi V.F.;
Giardina G.; Lembo R.; Nakhnoukh C.; Guarracino F.; Longhini F.; Bove T.;
Zangrillo A.; Bellomo R.; Fominskiy E.
Institution
(Landoni, Zangrillo) IRCCS San Raffaele Scientific Institute, Via
Olgettina, 60, 20132 Milan, Italy; Vita-Salute San Raffaele University,
Via Olgettina, 58, 20132 Milan, Italy
(Brambillasca, Ballotta, Rondello) IRCCS Centro Cardiologico Monzino, Via
Carlo Parea, Milan 20138, Italy
(Redaelli, Scandroglio, Franco, Calabro, Monaco, Barucco, Licheri,
Belletti, Dalessandro, Galbiati, Giardina, Lembo, Nakhnoukh, Fominskiy)
IRCCS San Raffaele Scientific Institute, Via Olgettina, Milan 20132, Italy
(Bradic) University Hospital Dubrava, Avenija Gojka Suska 6, 10000 Zagreb,
Croatia; University North, Ul. 104. brigade 3, 42000 Varazdin, Croatia
(Ti) National University Health System, Singapore City, 5 Lower Kent Ridge
Rd 119074, Singapore
(Povsic-Cevra) Special Hospital for Cardiovascular Surgery and Cardiology
Magdalena, Ul. Ljudevita Gaja 2, 49217 Krapinske Toplice, Croatia; Josip
Juraj Strossmayer University of Osijek, Trg Svetog Trojstva 3, 31000
Osijek, Croatia
(Nepomniashchikh) E.N. Meshalkin National Medical Research Center, 15,
Novosibirsk, Russian Federation
(Zoccai) Sapienza Universita di Roma, Piazzale Aldo Moro, 5, 00185 Rome,
Italy; Mediterranea Cardiocentro, Via Orazio, 2, 80122 Naples, Italy
(D'Ascenzo, Trompeo) Azienda Ospedaliero Universitaria Citta della Salute
e della Scienza, Corso Bramante ,88, Turin 10126, Italy
(Romagnoli) Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Via Pineta Sacchetti, 217, 00168 Rome, Italy; Universita Cattolica del
Sacro Cuore, Campus di Roma, Largo Francesco Vito, 1, 00168 Rome, Italy
(Massaro, Viscido) ASO Ordine Mauriziano, Via Magellano, Turin 10128,
Italy
(Garofalo, Longhini) Magna Graecia University, Viale Europa, 88100
Catanzaro, Italy
(Canichella, Severi) Azienda Ospedaliera San Camillo Forlanini,
Circonvallazione Gianicolense, Rome 00152, Italy
(Pisano, Venditto) Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
(Federici) Via di Grottarossa, Rome 00189, Italy
(Paternoster) Azienda Ospedaliera Regionale San Carlo, Via Potito Petrone,
Potenza 85100, Italy
(Mantovani) GVM - Maria Cecilia Hospital, Via Corriera, 48033 Cotignola
(RA), Italy
(Perone) Pineta Grande Hospital, Via Domitiana ,km 30/00, 81030 Castel
Volturno (CE), Italy
(Kroeller) IRCCS Humanitas Research Hospital, Via Alessandro Manzoni,
20089 Rozzano (MI), Italy
(Haxhiademi) Ospedale del Cuore, Via Aurelia Sud, Massa 54100, Italy
(Tripodi) Grande Ospedale Metropolitano, Via Giuseppe Melacrino ,21,
Reggio Calabria 89124, Italy
(Guarracino) Azienda Ospedaliero Universitaria Pisana, Via Roma, Pisa
56126, Italy
(Bove) Universita degli Studi di Udine, Via Palladio 8, 33100 Udine,
Italy; Azienda Sanitaria Universitaria Friuli Centrale, Via Pozzuolo, 330,
33100 Udine, Italy
(Bellomo) Austin Hospital, Heidelberg VIC 3084, 145 Studley Rd, Melbourne,
Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative acute kidney injury (AKI) is frequent in cardiac
surgery patients. Its pathophysiology is complex and involves decreased
renal perfusion. Preliminary clinical evidence in critically ill patients
shows that amino acids infusion increases renal blood flow and may
decrease the incidence and severity of AKI. We designed a study to
evaluate the effectiveness of perioperative continuous infusion of amino
acids in decreasing AKI. METHOD(S): This is a phase III,
multi-center, randomized, double-blind, placebo-controlled trial. Adults
undergoing cardiac surgery with cardiopulmonary bypass (CPB) are included.
Patients are randomly assigned to receive either continuous infusion of a
balanced mixture of amino acids in a dose of 2g/kg ideal body weight/day
or placebo (balanced crystalloid solution) from the operating room up to
start of renal replacement therapy (RRT), or ICU discharge, or 72h after
the first dose. The primary outcome is the incidence of AKI during
hospital stay defined by KDIGO (Kidney Disease: Improving Global
Outcomes). Secondary outcomes include the need for, and duration of, RRT,
mechanical ventilation; ICU and hospital length of stay; all-cause
mortality at ICU, hospital discharge, 30, 90, and 180days after
randomization; quality of life at 180days. Data will be analyzed in 3500
patients on an intention-to-treat basis. DISCUSSION: The trial is ongoing
and currently recruiting. It will be one of the first randomized
controlled studies to assess the relationship between amino acids use and
kidney injury in cardiac surgery. If our hypothesis is confirmed, this
practice could reduce morbidity in the studied population. STUDY
REGISTRATION: This trial was registered on ClinicalTrials.gov with the
trial identification NCT03709264 in October 2018. Copyright ©
2022. Published by Elsevier Inc.

<142>
Accession Number
638878888
Title
Long-Term Evolocumab in Patients with Established Atherosclerotic
Cardiovascular Disease.
Source
Circulation. (no pagination), 2022. Date of Publication: 29 Aug 2022.
Author
O'Donoghue M.L.; Giugliano R.P.; Wiviott S.D.; Atar D.; Keech A.C.; Kuder
J.F.; Im K.; Murphy S.A.; Flores-Arredondo J.H.; Lopez J.A.G.;
Elliott-Davey M.; Wang B.; Monsalvo M.L.; Abbasi S.; Sabatine M.S.
Institution
(O'Donoghue, Giugliano, Wiviott, Kuder, Im, Murphy, Sabatine) TIMI Study
Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital
and Harvard Medical School, Boston, MA, United States
(Atar) Oslo University Hospital Ulleval, Department of Cardiology, Oslo,
Norway; University of Oslo, Institute of Clinical Medicine, Oslo, Norway
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Faculty of Health and Medical Sciences, University of Sydney,
Sydney, Australia
(Flores-Arredondo, Lopez, Wang, Monsalvo, Abbasi) Global Development,
Amgen, Thousand Oaks, CA, United States
(Elliott-Davey) Amgen Ltd, Cambridge, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: In FOURIER, the PCSK9 inhibitor evolocumab reduced LDL-C and
risk of cardiovascular events and was safe and well-tolerated over 2.2
years median follow-up. However, large-scale, long-term data are lacking.
 METHOD(S): The parent FOURIER trial randomized 27,564 patients with
ASCVD and LDL-C >=70mg/dl on statin to evolocumab versus placebo. Patients
completing FOURIER at participating sites were eligible to receive
evolocumab in two open-label extension studies (FOURIER-OLE) in the United
States and Europe; primary analyses were pooled across studies. The
primary endpoint was the incidence of adverse events. Lipid values and
major adverse cardiovascular events were prospectively collected.
 RESULT(S): 6,635 patients were enrolled in FOURIER-OLE (3355
randomized to evolocumab and 3280 to placebo in parent study). Median
follow-up in FOURIER-OLE was 5.0 years; maximum exposure to evolocumab in
parent plus FOURIER-OLE was 8.4 years. At 12 weeks in FOURIER-OLE, median
LDL-C was 30 mg/dl and 63.2% achieved LDL-C <40 mg/dl on evolocumab.
Incidences of serious adverse events, muscle-related events, new-onset
diabetes, hemorrhagic stroke, and neurocognitive events with evolocumab
long-term did not exceed those for placebo-treated patients during parent
study and did not increase over time. During the FOURIER-OLE follow-up
period, patients originally randomized in the parent trial to evolocumab
versus placebo had a 15% lower risk of cardiovascular death, MI, stroke,
hospitalization for unstable angina or coronary revascularization (HR 0.85
[95% CI 0.75-0.96]; P=0.008), a 20% lower risk of cardiovascular death, MI
or stroke of (HR 0.80 [0.68-0.93]; P=0.003), and a 23% lower risk of
cardiovascular death (HR 0.77 [0.60-0.99]; P=0.04). CONCLUSION(S):
Long-term LDL-C lowering with evolocumab was associated with persistently
low rates of adverse events for over >8 years that did not exceed those
observed in the original placebo arm during the parent study and led to
further reductions in cardiovascular events compared with delayed
treatment initiation.

<143>
Accession Number
638877853
Title
The use of Indocyanine Green Fluorescence Imaging in Thoracic and
Esophageal Surgery.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 25 Aug 2022.
Author
Sze-Hang Ng C.; Ong B.-H.; Chao Y.K.; Wright G.M.; Sekine Y.; Yu-Hong Wong
I.; Hao Z.; Zhang G.; Chaturvedi H.; Thammineedi S.R.; Ying-Kit Law S.;
Kim H.K.
Institution
(Sze-Hang Ng) Department of Surgery, Chinese University of Hong Kong, HONG
KONG, China
(Ong) Department of Cardiothoracic Surgery, National Heart Centre
Singapore, Singapore
(Chao) Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linko,
Chang Gung University, Taoyuan, Taiwan (Republic of China)
(Wright) Department of Surgery, Peter MacCallum Cancer Centre, St.
Vincent's Hospital, Melbourne, VIC, Australia
(Sekine) Department of Thoracic Surgery, Tokyo Women's Medical University,
Yachiyo Medical Center, Japan
(Yu-Hong Wong, Ying-Kit Law) Department of Surgery, University of Hong
Kong, HONG KONG, China
(Hao) Department of Thoracic Surgery, First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
(Zhang) Department of Thoracic Surgery, First Affiliated Hospital of Xi'an
Jiaotong University, Xi'an, China
(Chaturvedi) Department of Surgical Oncology, Max Hospital, New Delhi,
India
(Thammineedi) Department of Surgical Oncology, Basavatarakam Indo American
Cancer Hospital and Research Institute, Hyderabad, India
(Kim) Department of Thoracic and Cardiovascular Surgery, College of
Medicine, Korea University Guro Hospital, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Fluorescence imaging using indocyanine green in thoracic and
esophageal surgery is gaining popularity because of the potential to
facilitate surgical planning, disease staging, and reduce postoperative
complications. To optimize use of fluorescence imaging in thoracic and
esophageal surgery, an expert panel sought to establish a set of
recommendations at a consensus meeting. METHOD(S): The panel included
12 experts in thoracic and/or upper gastrointestinal surgery from Asia
Pacific countries. Prior to meeting, seven focus areas were defined: i)
intersegmental plane identification for sublobar resections ii) pulmonary
nodule localization; iii) lung tumor detection; iv) bullous lesion
detection; v) lymphatic mapping of lung tumors; vi) evaluation of gastric
conduit perfusion; and vii) lymphatic mapping in esophageal surgery. A
literature search of the PubMed database was conducted using keywords
'indocyanine green', 'fluorescence', 'thoracic', 'surgery' and
'esophagectomy'. At the meeting, panelists addressed each focus area by
discussing the most relevant evidence and their clinical experiences.
Consensus statements were derived from the proceedings, followed by
further discussions, revisions, finalization and unanimous agreement. Each
statement was assigned a level of evidence and a grade of recommendation.
 RESULT(S): A total of nine consensus recommendations were
established. Identification of the intersegmental plane for sublobar
resections, localization of pulmonary nodules, lymphatic mapping in lung
tumors, and assessment of gastric conduit perfusion were applications of
fluorescence imaging that have the most robust current evidence.
 CONCLUSION(S): Based on best available evidence and expert opinions,
these consensus recommendations may facilitate thoracic and esophageal
surgery using fluorescence imaging. Copyright © 2022 The Society
of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

<144>
Accession Number
638863900
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. (pp 101360), 2022. Date of Publication:
22 Aug 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, Rochester,
MN, Pakistan
(Aamir) Carle Illinois College of Medicine, Champaign, IL, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Tricuspid valve surgery is recommended for both, classes I and
IIb while being essential for class II patients undergoing MVS.
AIMS/OBJECTIVES: The meta-analysis aimed to evaluate the efficacy and
safety of tricuspid valve repair in patients undergoing MVS.
 METHOD(S): We systematically searched PubMed, Embase, and Google
Scholar through January 2022, and studies comparing patients with
tricuspid valve repair (TVR) and those without TVR were selected. The
primary outcome was 30-day and all-cause mortality. RESULT(S): In
this meta-analysis, 20 studies were included with a patient population of
72,422. 30-day mortality studies (RR: 1.14, 95% CI [0.69, 1.87]) and
all-cause mortality studies (RR: 1.16, 95% CI [0.86, 1.57]) at follow-up
both were insignificant. 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.
Whereas 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. CONCLUSION(S): No significant difference
was observed between patients undergoing TVR with MVS in comparison to MVS
group only for the primary outcomes, 30-day mortality and all-cause
mortality, respectively. Copyright © 2022 Elsevier Ltd. All
rights reserved.

<145>
Accession Number
638860094
Title
De-frailing intervention for hospitalized cardiovascular patients in the
TARGET-EFT randomized clinical trial.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2022. Date of Publication: 26 Aug 2022.
Author
Ahmad F.; Fountotos R.; Goldfarb M.; Bharaj N.; Munir H.; Marsala J.;
Rudski L.G.; Afilalo J.
Institution
(Ahmad, Fountotos, Goldfarb, Munir, Afilalo) Division of Experimental
Medicine, McGill University, Montreal, Canada
(Ahmad, Fountotos, Bharaj, Munir, Afilalo) Centre for Clinical
Epidemiology, Jewish General Hospital, Montreal, Canada
(Goldfarb, Marsala, Rudski, Afilalo) Division of Cardiology, Jewish
General Hospital, McGill University, Montreal, Canada
(Bharaj) Department of Kinesiology & Physical Education, McGill
University, Canada Institution of research trial: Jewish General Hospital,
Montreal, France
Publisher
NLM (Medline)
Abstract
AIMS: Frailty is disproportionately prevalent in cardiovascular disease
patients and exacerbated during hospital admissions, heightening the risk
for adverse events and functional decline. Using the Essential Frailty
Toolset (EFT) to target physical weakness, cognitive impairment,
malnourishment, and anemia, we tested a multicomponent intervention to
de-frail older adults with acute cardiovascular conditions during their
hospital admission. METHODS AND RESULTS: The TARGET-EFT trial was a
single-center randomized clinical trial at the Jewish General Hospital,
Montreal, Canada. We compared a multicomponent de-frailing intervention
with usual clinical care. Intervention group patients received exercise,
cognitive stimulation, protein supplementation, and iron replacement, as
required. In this study, the primary outcome was frailty, as assessed by
the SPPB score (Short Physical Performance Battery) at discharge, and the
secondary outcome was the SARC-F score (Strength, Assistance walking,
Rising from chair, Climbing, Falls) 30 days later. The analysis consisted
of 135 patient (mean age of 79.3 years; 54% female) who survived and
completed the frailty assessments.Compared to control patients,
intervention group patients had a 1.52-point superior SPPB score and a
0.74-point superior SARC-F score. Subgroup analysis suggested that
patients with low left ventricular ejection fraction may have attenuated
benefits, and that patients who underwent invasive cardiac procedures had
the greatest benefits from the intervention. CONCLUSION(S): We
achieved our objective of de-frailing older cardiac inpatients on a
short-term basis by improving their physical performance and functioning
using a pragmatic multicomponent intervention. This could have positive
impacts on their clinical outcomes and ability to maintain independent
living in the future. Copyright © The Author(s) 2022. Published
by Oxford University Press on behalf of the European Society of
Cardiology.

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