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<1>
Accession Number
2016601258
Title
The use of FEIBA for refractory bleeding in cardiac surgery - a systematic
review.
Source
Expert Review of Cardiovascular Therapy. 20(5) (pp 403-408), 2022. Date of
Publication: 2022.
Author
Khoury W.; Servito M.; Wang L.; Baranchuk A.; Callum J.; Payne D.;
El-Diasty M.
Institution
(Khoury, Servito) School of Medicine, Queen's University, Kingston, ON,
Canada
(Wang) Department of Anesthesiology, Queen's University, Kingston, ON,
Canada
(Baranchuk) Division of Cardiology, Queen's University, Kingston, ON,
Canada
(Callum) Department of Pathology and Molecular Medicine, Queen's
University, Kingston, ON, Canada
(Payne, El-Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Significant blood loss during cardiac surgery is associated
with a dramatic increase in morbidity and mortality. Factor Eight
Inhibitor Bypassing Activity (FEIBA), a hemostatic bypassing agent mainly
used in hemophiliac patients, has also been used for intractable bleeding
during cardiac surgical procedures in non-hemophiliac patients. However,
concerns exist that its use may be linked to increased incidence of
perioperative adverse effects including thrombotic complications. Areas
covered: A systematic literature search was performed on MEDLINE, EMBASE,
and the Cochrane Central Register of Controlled Trials databases for all
studies that reported the administration of FEIBA for treatment of
bleeding during adult cardiac surgery in non-hemophiliac patients. After
selecting the title and abstracts, two authors assessed the methodological
quality of the full-text articles prior to final inclusion in the
manuscript. Expert opinion: The safety profile of FEIBA was determined
through an aggregate count of adverse events. Major complications included
renal failure, re-operation for unresolved bleeding, postoperative
mortality, and thromboembolic events. Overall, there is insufficient
robust evidence to make a definitive conclusion about the safety or
efficacy of using of FEIBA as a hemostatic agent in the setting of cardiac
surgery. Copyright © 2022 Informa UK Limited, trading as Taylor &
Francis Group.

<2>
Accession Number
2014185199
Title
Direct Endovascular Thrombectomy Alone vs. Bridging Thrombolysis for
Patients with Acute Ischemic Stroke: A Meta-analysis.
Source
Clinical Neuroradiology. 32(3) (pp 603-613), 2022. Date of Publication:
September 2022.
Author
Jang K.M.; Choi H.H.; Jang M.-J.; Cho Y.D.
Institution
(Jang, Choi) Department of Neurosurgery, Chung-Ang University Hospital,
Chung-Ang University College of Medicine, Seoul, South Korea
(Jang) Medical Research Collaborating Center, Seoul National University
Hospital, Seoul, South Korea
(Cho) Department of Radiology, Seoul National University Hospital, Seoul
National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul
03080, South Korea
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Although the current guidelines recommend bridging thrombolysis
(BT) therapy, which is intravenous thrombolysis (IVT) followed by
endovascular thrombectomy (EVT), for patients with acute ischemic stroke
from large vessel occlusion (AIS-LVO), the effectiveness and safety of IVT
remain controversial. We performed a meta-analysis to demonstrate the
non-inferiority of direct EVT alone (DEVT) compared to BT for the efficacy
and safety in patients with AIS-LVO who were eligible for IVT.
 Method(s): The literature was searched in big databases between 1
January 1990 and 1 April 2021. The search included both randomized
clinical trials (RCTs) and nonrandomized studies (NRSs) that compared DEVT
with BT for patients with AIS-LVO who were eligible for IVT (time from
stroke onset <=4.5h). Only NRSs with good intergroup variable matching
were included in the study. Outcomes measured included 90-day functional
independence, mortality, symptomatic intracranial hemorrhage (sICH), and
successful recanalization. The noninferiority margin for risk difference
was set at 5% from the literature review. Result(s): Three RCTs (n=
1094) and four NRSs (n= 1366) were included in the meta-analysis. There
were 1227 patients (49.9%) in the DEVT group and 1233 patients (50.1%) in
the BT group. A statistically significant noninferiority of DEVT compared
to BT was concluded in 90-day functional independence, mortality and
successful reperfusion. Even in the sICH rate, DEVT group showed a
superiority (risk difference, -2%; 95% confidence interval, -4 to
-0.002%). Conclusion(s): Evidence from RCTs and observational NRSs
supports the use of DEVT (without IVT) as the first choice for treatment
of patients with AIS-LVO within a time span of 4.5h or less from stroke
onset. Copyright © 2021, The Author(s), under exclusive licence
to Springer-Verlag GmbH Germany.

<3>
Accession Number
2020053863
Title
Clinical Outcomes of Revascularization with Percutaneous Coronary
Intervention Prior to Transcatheter Aortic Valve Replacement: A
Comprehensive Meta-Analysis.
Source
Current Problems in Cardiology. 47(11) (no pagination), 2022. Article
Number: 101339. Date of Publication: November 2022.
Author
Altibi A.M.; Ghanem F.; Hammad F.; Patel J.; Song H.K.; Golwala H.; Zahr
F.E.; Rahmouni H.
Institution
(Altibi, Song, Golwala, Zahr, Rahmouni) Knight Cardiovascular Institute,
Oregon Health and Science University, Portland, OR, United States
(Ghanem, Patel) Internal Medicine Department, East Tennessee State
University, Johnson City, TN, United States
(Hammad) Internal Medicine Department, St. Vincent Charity Medical Center,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Prior studies on revascularization prior to transcatheter
aortic valve replacement (TAVR), in patients with significant coronary
artery disease (CAD), have reported mixed results. Aim(s): We sought
to perform a meta-analysis combining current evidence by investigating
outcomes of revascularization in patients who undergo TAVR with coexisting
CAD. Method(s): We searched literature for studies reporting on
outcomes following TAVR performed with versus without pre-TAVR PCI, for
coexisting CAD. Random-effect model was used to pool estimates of odds
ratios (ORs). Result(s): Twenty-four reports with 12,182 TAVR
patients were included: 22 observational and 2 clinical trials. 4,110
(33.7%) were in the pre-TAVR PCI group, 51.4% were females, and mean age
was 81.9 years. The 30-day mortality was 5.2% versus 5.0% in patients with
versus without pre-TAVR PCI, respectively [OR= 1.19 (95% CI: 0.91-1.55, P=
0.20)]. Pooled 1-year mortality was 18.1% versus 19.1% in patients with
versus without pre-TAVR PCI (OR= 1.12, 95% CI: 0.95-1.31, P= 0.61). There
was no significant difference between the groups for myocardial
infarction, stroke, acute kidney injury, pacemaker implantation, or
re-hospitalization. Pre-TAVR PCI was associated with an increased risk of
life-threatening bleeding at 30 days. Conclusion(s): Pre-TAVR
revascularization with PCI was not associated with improved 30-day or
1-year mortality; however, it was associated with an increased risk of
life-threatening bleeding at 30-day post-TAVR. Our results do not support
routine revascularization with PCI prior to TAVR with coexisting CAD.
Future trials addressing anatomical complexity and symptom burden may help
better risk stratify patients who may benefit from pre-TAVR
revascularization. Copyright © 2022 Elsevier Inc.

<4>
Accession Number
2020053356
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. 121 (no pagination), 2022. Article Number:
106898. Date of Publication: October 2022.
Author
Landoni G.; Brambillasca C.; Baiardo Redaelli M.; 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, Baiardo Redaelli, Scandroglio, Franco, Calabro, Monaco, Barucco,
Licheri, Belletti, Dalessandro, Galbiati, Giardina, Lembo, Nakhnoukh,
Zangrillo, Fominskiy) IRCCS San Raffaele Scientific Institute, Via
Olgettina, 60, Milan 20132, Italy
(Landoni, Zangrillo) Vita-Salute San Raffaele University, Via Olgettina,
58, Milan 20132, Italy
(Brambillasca, Ballotta, Rondello) IRCCS Centro Cardiologico Monzino, Via
Carlo Parea, 4, Milan 20138, Italy
(Bradic) University Hospital Dubrava, Avenija Gojka Suska 6, Zagreb 10000,
Croatia
(Bradic) University North, Ul. 104. brigade 3, Varazdin 42000, Croatia
(Ti) National University Health System, 5 Lower Kent Ridge Rd, Singapore
City 119074, Singapore
(Povsic-Cevra) Special Hospital for Cardiovascular Surgery and Cardiology
Magdalena, Ul. Ljudevita Gaja 2, Krapinske Toplice 49217, Croatia
(Povsic-Cevra) Josip Juraj Strossmayer University of Osijek, Trg Svetog
Trojstva 3, Osijek 31000, Croatia
(Nepomniashchikh) E.N. Meshalkin National Medical Research Center,
Rechkunovskaya Ulitsa, 15, Novosibirsk, Russian Federation
(Zoccai) Sapienza Universita di Roma, Piazzale Aldo Moro, 5, Rome 00185,
Italy
(Zoccai) Mediterranea Cardiocentro, Via Orazio, 2, Naples 80122, 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, Rome 00168, Italy
(Romagnoli) Universita Cattolica del Sacro Cuore, Campus di Roma, Largo
Francesco Vito, 1, Rome 00168, Italy
(Massaro, Viscido) ASO Ordine Mauriziano, Via Magellano, 1, Turin 10128,
Italy
(Garofalo, Longhini) Magna Graecia University, Viale Europa, Catanzaro
88100, Italy
(Canichella, Severi) Azienda Ospedaliera San Camillo Forlanini,
Circonvallazione Gianicolense, 87, Rome 00152, Italy
(Pisano, Venditto) A.O.R.N. "Dei Colli", Monaldi Hospital, Via Leonardo
Bianchi, Naples, Italy
(Federici) Azienda Ospedaliero-Universitaria Sant'Andrea di Roma, Via di
Grottarossa, 1035/1039, Rome 00189, Italy
(Paternoster) Azienda Ospedaliera Regionale San Carlo, Via Potito Petrone,
Potenza 85100, Italy
(Mantovani) GVM - Maria Cecilia Hospital, Via Corriera, 1, Cotignola (RA)
48033, Italy
(Perone) Pineta Grande Hospital, Via Domitiana, km 30/00, Castel Volturno
(CE) 81030, Italy
(Kroeller) IRCCS Humanitas Research Hospital, Via Alessandro Manzoni, 56,
Rozzano (MI) 20089, Italy
(Haxhiademi) Ospedale del Cuore, Fondazione Toscana "Gabriele Monasterio",
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, 67, Pisa
56126, Italy
(Bove) Universita degli Studi di Udine, Via Palladio 8, Udine 33100, Italy
(Bove) Azienda Sanitaria Universitaria Friuli Centrale, Via Pozzuolo, 330,
Udine 33100, Italy
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
Publisher
Elsevier Inc.
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 2 g/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 72 h 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 180 days after
randomization; quality of life at 180 days. Data will be analyzed in 3500
patients on an intention-to-treat basis. Discussion(s): 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 Elsevier Inc.

<5>
Accession Number
2020022886
Title
Perioperative mental health intervention bundle for older surgical
patients: protocol for an intervention development and feasibility study.
Source
BMJ Open. 12(8) (no pagination), 2022. Article Number: e062398. Date of
Publication: 23 Aug 2022.
Author
Abraham J.; Holzer K.J.; Lenard E.M.; Freedland K.E.; Pennington B.R.T.;
Wolfe R.C.; Cordner T.A.; Baumann A.A.; Politi M.; Avidan M.S.; Lenze E.
Institution
(Abraham, Holzer, Pennington, Cordner, Avidan) Department of
Anesthesiology, Washington University, St Louis School of Medicine, St
Louis, MO, United States
(Lenard, Lenze) Department of Psychiatry, Washington University, St Louis
School of Medicine, St Louis, MO, United States
(Freedland) Department of Psychiatry, Washington University in St Louis,
St Louis, MO, United States
(Wolfe) Department of Pharmacy, Barnes-Jewish Hospital, St Louis, MO,
United States
(Baumann, Politi) Department of Surgery, Washington University, St Louis
School of Medicine, St Louis, MO, United States
Publisher
BMJ Publishing Group
Abstract
Introduction The perioperative period is high risk for older adults.
Depression and anxiety are common perioperative problems, frequently
coexisting with cognitive impairment. Older patients with these conditions
are more likely than younger patients to experience postoperative
delirium, long hospital stays, poor quality of life and rehospitalisation.
These experiences can, in turn, exacerbate anxiety and depressive
symptoms. Despite these risks, little is known about how to treat
perioperative anxiety and depression among older adults. Methods and
analysis We designed a feasibility study of a perioperative mental health
intervention bundle to improve perioperative mental health, specifically
depression and anxiety. The overarching goals of this study are twofold:
first, to adapt and refine an intervention bundle comprised of behavioural
activation and medication optimisation to meet the needs of older adults
within three surgical patient populations (ie, orthopaedic, oncological
and cardiac); and second, to test the feasibility of study procedures and
intervention bundle implementation. Quantitative data on clinical outcomes
such as depression, anxiety, quality of life, delirium, falls, length of
stay, hospitalisation and pain will be collected and tabulated for
descriptive purposes. A hybrid inductive-deductive thematic approach will
be employed to analyse qualitative feedback from key stakeholders. Ethics
and dissemination The study received approval from the Washington
University Institutional Review Board. Results of this study will be
presented in peer-reviewed journals, at professional conferences, and to
our perioperative mental health advisory board. 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.

<6>
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Accession Number
2019581018
Title
Effects of Randomized Treatment with Icosapent Ethyl and a Mineral Oil
Comparator on Interleukin-1beta, Interleukin-6, C-Reactive Protein,
Oxidized Low-Density Lipoprotein Cholesterol, Homocysteine,
Lipoprotein(a), and Lipoprotein-Associated Phospholipase A2: A REDUCE-IT
Biomarker Substudy.
Source
Circulation. 146(5) (pp 372-379), 2022. Date of Publication: 02 Aug 2022.
Author
Ridker P.M.; Rifai N.; Macfadyen J.; Glynn R.J.; Jiao L.; Steg P.G.;
Miller M.; Brinton E.A.; Jacobson T.A.; Tardif J.-C.; Ballantyne C.M.;
Mason R.P.; Bhatt D.L.
Institution
(Ridker, Macfadyen, Glynn, Mason, Bhatt) Center for Cardiovascular Disease
Prevention, Brigham and Women's Hospital, 900 Commonwealth Ave, Boston,
MA, United States
(Rifai) Children's Hospital Medical Center, Boston, MA, United States
(Jiao) Amarin Pharma, Bridgewater, NJ, United States
(Steg) Universite de Paris, FACT and INSERM-U1148 F75018, France
(Miller) University of Maryland School of Medicine, Baltimore, United
States
(Brinton) Utah Lipid Center, Salt Lake City, United States
(Jacobson) Emory University School of Medicine, Atlanta, GA, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, Canada
(Ballantyne) Methodist De-Bakey Heart and Vascular Center, Houston, TX,
United States
(Steg) Assistance Publique-Hopitaux de Paris, Hopital Bichat, France
Publisher
Lippincott Williams and Wilkins
Abstract
Background: REDUCE-IT (Reduction of Cardiovascular Events With Icosapent
Ethyl-Intervention Trial) reported a 25% relative risk reduction in major
adverse cardiovascular events with use of icosapent ethyl compared with
pharmaceutical grade mineral oil. The mechanisms underlying this benefit
remain uncertain. We explored whether treatment allocation in REDUCE-IT
might affect a series of biomarkers in pathways known to associate with
atherosclerosis risk. Method(s): Serum levels of interleukin-1beta,
interleukin-6, high-sensitivity C-reactive protein, oxidized low-density
lipoprotein cholesterol, homocysteine, lipoprotein(a), and
lipoprotein-associated phospholipase A2 (Lp-PLA2) were measured at
baseline, at 12 months, at 24 months, and at the end-of-study visit among
REDUCE-IT participants with triglyceride levels >=135 mg/dL and <500 mg/dL
who were randomly allocated to treatment with either 4 grams daily of
icosapent ethyl or mineral oil used as a comparator. Result(s): At
baseline, median levels of each biomarker were similar in the 2 treatment
groups. The levels of biomarkers associated with atherosclerosis increased
over time among those allocated to mineral oil treatment; in this group at
12 months, the median percent increases from baseline were 1.5% for
homocysteine, 2.2% for lipoprotein(a), 10.9% for oxidized low-density
lipoprotein cholesterol, 16.2% for interleukin-6, 18.5% for
lipoprotein-associated phospholipase A2, 21.9% for high-sensitivity
C-reactive protein, and 28.9% for interleukin-1beta (all P values <0.001),
with similar changes at 24 months. In the icosapent ethyl group, there
were minimal changes in these biomarkers at 12 and 24 months. As such, at
study conclusion, between-group treatment differences largely reflected
increases in the mineral oil group with median percent differences of 2.4%
for lipoprotein(a), 3.0% for homocysteine, 4.2% for oxidized low-density
lipoprotein cholesterol, 19.8% for interleukin-6, 26.2% for Lp-PLA2, 38.5%
for high-sensitivity C-reactive protein, and 48.7% for interleukin-1beta
(all P values <=0.007). These data are consistent with previous REDUCE-IT
results in which the median percent change for low-density lipoprotein
cholesterol at 12 months was-1.2% among those allocated to icosapent ethyl
and 10.9% among those allocated to the mineral oil comparator.
 Conclusion(s): Among participants in REDUCE-IT, allocation to
icosapent ethyl had minimal effects on a series of biomarkers associated
with atherosclerotic disease, whereas levels increased among those
allocated to mineral oil. The effect of these findings on interpretation
of the overall risk reductions in clinical events observed within
REDUCE-IT is uncertain. Registration: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT01492361. Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

<7>
Accession Number
2019347431
Title
Euglycemic Diabetic Ketoacidosis Associated With Sodium-Glucose
Cotransporter-2 Inhibitors After Cardiac Surgery: A Review of Current
Literature.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(10) (pp 3877-3886),
2022. Date of Publication: October 2022.
Author
Branco A.; Fatima R.; Liblik K.; Jackson R.; Payne D.; El-Diasty M.
Institution
(Branco, Liblik) School of Medicine, Queen's University, Kingston, ON,
Canada
(Jackson) Department of Cardiology, Queen's University, Kingston, ON,
Canada
(Fatima, Payne, El-Diasty) Department of Cardiac Surgery, Queen's
University, Kingston, ON, Canada
Publisher
W.B. Saunders
Abstract
There is growing evidence to support the use of sodium-glucose
cotransporter-2 (SGLT2) inhibitors for type 2 diabetes mellitus (T2DM) and
the management of heart failure. As such, more patients undergoing cardiac
surgery are on SGLT2-inhibitor therapy. Despite the numerous benefits of
SGLT2 inhibitors on cardiac health, they can be associated with an
increased risk of diabetic ketoacidosis, often with normal glucose levels
(euglycemic diabetic ketoacidosis or EDKA), which potentially can be
detrimental in this vulnerable patient population. In this narrative
review, the authors discuss 17 papers that described EDKA in perioperative
cardiac surgical patients. The authors discuss suggested preventative
measures and management options, with a particular emphasis on raising the
clinical awareness of the care teams toward this complication. SGLT2
inhibitor-induced EDKA is a medical emergency that can be difficult to
identify in the postcardiac surgical patient due to the overlap of signs
and symptoms with other frequent scenarios in these patients. A reduction
in SGLT2 inhibitor-associated EDKA can be mitigated by the appropriate
perioperative discontinuation of the medication, clinical awareness, and
early investigation to diagnose the condition, with emphasis on serum
beta-hydroxybutyrate. Future quality improvement initiatives are needed to
assist in reducing EDKA in patients taking SGLT2 inhibitors in the
perioperative surgical setting. Copyright © 2022 Elsevier Inc.

<8>
Accession Number
2018845735
Title
Left ventricular strain derived from cardiac magnetic resonance can
predict outcomes of pulmonary valve replacement in patients with repaired
tetralogy of Fallot.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 917026. Date of Publication: 18 Aug 2022.
Author
Zhuang B.; Yu S.; Feng Z.; He F.; Jiang Y.; Zhao S.; Lu M.; Li S.
Institution
(Zhuang, Yu, Zhao, Lu) Department of Magnetic Resonance Imaging,
Cardiovascular Imaging and Intervention Center, Fuwai Hospital, State Key
Laboratory of Cardiovascular Disease, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Feng, Li) Pediatric Cardiac Surgery Center, Fuwai Hospital, State Key
Laboratory of Cardiovascular Disease, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(He) Department of Cardiovascular Surgery, The First Affiliated Hospital,
Zhejiang University College of Medicine, Hangzhou, China
(Jiang) Department of Echocardiography, Fuwai Hospital, State Key
Laboratory of Cardiovascular Disease, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Jiang) Department of Echocardiography, Fuwai Hospital Chinese Academy of
Medical Sciences, Shenzhen, China
(Lu) Key Laboratory of Cardiovascular Imaging (Cultivation), Chinese
Academy of Medical Sciences, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Purpose: Several adults with repaired tetralogy of Fallot (rToF) undergo
pulmonary valve replacement (PVR) to reduce the right ventricular volume
and retain right ventricular function. However, there is currently no
consensus on the ideal time for PVR surgery in asymptomatic patients with
rTOF with pulmonary regurgitation (PR). Clinical outcomes after PVR are
also indeterminate. Recently, myocardial strain and strain rate derived
from cardiac magnetic resonance (CMR) feature tracking were found to be
more sensitive to right ventricular dysfunction than conventional
parameters and therefore may add prognostic value in patients with rToF.
We aimed to analyze whether pre-PVR left ventricular (LV) strain and
strain rate detected by CMR feature tracking are associated with midterm
outcomes after PVR in patients with rToF. Method(s): Seventy-eight
asymptomatic patients with rToF who required PVR due to moderate or severe
PR were prospectively enrolled between January 2014 and June 2020. CMR
cine sequences were obtained, and feature tracking parameters were
measured preoperatively. Adverse events were documented during the
follow-up. Receiver operating characteristic analysis was performed to
determine the cutoff value. Kaplan-Meier curves were drawn with log-rank
statistics; moreover, univariate and multivariate Cox proportional hazards
regression analyses and Harrel C-indices were analyzed. Result(s):
During 3.6 +/- 1.8 years of follow-up, 25 adverse events were recorded.
Kaplan-Meier survival curves and univariate Cox analysis verified that
patients with significantly reduced radial strain (RS), circumferential
strain (CS), longitudinal strain (LS), RS rate at systole and diastole
(RSRs and RSRe), and circumferential and LS rates at diastole (CSRe and
LSRe) had worse event-free survival. After multivariate correction, only
LS and LSRe remained significantly associated with adverse outcomes
(hazard ratio = 1.243 [1.083-1.428] and 0.067 [0.017-0.258], respectively,
all p < 0.05). The cutoff values of LS and LSRe were -12.30 (%) and 1.07
(s-1), respectively. Conclusion(s): The LV strain and
strain rate prior to PVR are important prognostic factors for adverse
events after PVR in rToF. Copyright © 2022 Zhuang, Yu, Feng, He,
Jiang, Zhao, Lu and Li.

<9>
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Accession Number
2018478649
Title
Cardiac Transplantation in HIV-Positive Patients: A Narrative Review.
Source
Journal of Acquired Immune Deficiency Syndromes. 87(2) (pp 763-768), 2021.
Date of Publication: 01 Jun 2021.
Author
Wairimu F.; Ward N.C.; Liu Y.; Dwivedi G.
Institution
(Ward, Liu, Dwivedi) The Division of Cardiology, University of Ottawa
Heart Institute, University of Ottawa, Ottawa, Canada
(Ward, Dwivedi) School of Medicine University of Western Australia, Perth,
Australia
(Wairimu, Dwivedi) Harry Perkins Institute for Medical Research, Fiona
Stanley Hospital, Perth, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Before the introduction of highly active antiretroviral therapy, patients
infected with HIV experienced poor prognosis including high rates of
opportunistic infections, rapid progression to AIDS, and significant
mortality. Increased life expectancy after therapeutic improvements has
led to an increase in other chronic diseases for these patients, including
cardiovascular disease and, in particular, end-stage heart failure.
Historically, HIV infection was deemed an absolute contraindication for
transplantation. Since the development of highly active antiretroviral
therapy, however, life expectancy for HIV-positive patients has
significantly improved. In addition, there is a low incidence of
opportunistic infections and the current antiretrovirals have an improved
toxicity profile. Despite this, the current status of cardiac transplants
in HIV-positive patients remains unclear. With this in mind, we conducted
a narrative review on cardiac transplantation in patients with
HIV. Copyright © 2021 Wolters Kluwer Health, Inc. All rights
reserved.

<10>
Accession Number
2019037875
Title
Long-term outcomes of total arch replacement versus proximal aortic
replacement in acute type A aortic dissection: Meta-analysis of
Kaplan-Meier-derived individual patient data.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Sa M.P.; Jacquemyn X.; Tasoudis P.T.; Van den Eynde J.; Erten O.; Sicouri
S.; Dokollari A.; Torregrossa G.; Kurz S.; Heuts S.; Nienaber C.A.;
Coselli J.S.; Ramlawi B.
Institution
(Sa, Torregrossa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau
Medical Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA,
United States
(Sa, Tasoudis, Erten, Sicouri, Dokollari, Torregrossa, Ramlawi) Department
of Cardiothoracic Surgery Research, Lankenau Institute for Medical
Research, Wynnewood, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Kurz) Department of Cardiothoracic and Vascular Surgery, German Heart
Center Berlin, Berlin, Germany
(Kurz) Department of Cardiovascular Surgery, Charite-Universitatsmedizin,
Berlin, Germany
(Heuts) Department of Cardiothoracic Surgery, Maastricht University
Medical Centre, Maastricht, Netherlands
(Nienaber) Cardiology and Aortic Centre, The Royal Brompton & Harefield
NHS Trust, London, United Kingdom
(Coselli) Department of Surgery, Division of Cardiothoracic Surgery,
Michael E. DeBakey Baylor College of Medicine, Houston, TX, United States
(Coselli) Department of Cardiovascular Surgery, Texas Heart Institute,
Houston, TX, United States
(Coselli) CHI St Luke's-Baylor St. Luke's Medical Center, Houston, TX,
United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To evaluate the long-term outcomes of a conservative approach
(with proximal aortic replacement with or without hemiarch replacement)
versus an aggressive approach (with total aortic arch replacement) in the
treatment of acute type A aortic dissection (ATAAD). Method(s): We
performed a pooled analysis of Kaplan-Meier-derived individual patient
data from studies with follow-up comparing the aforementioned approaches
to treat patients with ATAAD. Result(s): Eighteen studies met our
eligibility criteria, comprising 5243 patients with follow-up
(Conservative: 3676 patients; Aggressive: 1567 patients). We observed a
statistically significant difference in overall survival favoring the
aggressive approach (hazard ratios [HR] 0.86, 95% confidence interval [CI]
0.76-0.98, p =.022), but no statistically significant difference in the
risk of reoperation (HR 0.89, 95% CI 0.66-1.2, p =.439) in the overall
follow-up. Landmark analyses revealed that, in the first 3 months after
the procedure, mortality rates were comparable between conservative and
aggressive approaches (HR 1.04, 95% CI 0.88-1.24, p =.627), but the
results beyond 3 months showed improved survival in patients undergoing
the aggressive surgical procedure (HR 0.71, 95% CI 0.59-0.85, p <.001).
The landmark analyses also revealed that, in the first 7 years after the
procedure, reoperation rates were comparable between the approaches (HR
1.03, 95% CI 0.76-1.40, p =.848), but the results beyond 7 years showed a
lower risk of reoperation in patients undergoing the aggressive surgical
procedure (HR 0.10, 95% CI 0.01-0.75, p =.025). Conclusion(s): The
aggressive approach seems to confer better long-term survival and lower
risk of the need for reoperation in the follow-up of patients treated for
ATAAD. Copyright © 2022 Wiley Periodicals LLC.

<11>
Accession Number
638967802
Title
Impact of tight glycemic control and hypoglycemia after pediatric cardiac
surgery on neurodevelopmental outcomes at three years of age: Findings
from a randomized clinical trial.
Source
BMC pediatrics. 22(1) (pp 531), 2022. Date of Publication: 07 Sep 2022.
Author
Sadhwani A.; Asaro L.A.; Goldberg C.S.; Ware J.; Butcher J.; Gaies M.;
Smith C.; Alexander J.L.; Wypij D.; Agus M.S.D.
Institution
(Sadhwani) Departments of Psychiatry and Behavioral Sciences, Boston
Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston,
MA 02115, United States
(Asaro, Wypij) Department of Cardiology, Boston Children's Hospital,
Boston, MA, United States
(Goldberg, Gaies, Smith) Division of Cardiology, C.S. Mott Children's
Hospital, Ann Arbor, MI, United States
(Goldberg, Butcher, Gaies) Department of Pediatrics, University of
Michigan Medical School, Ann Arbor, MI, United States
(Ware) Department of Medicine, Boston Children's Hospital and Harvard
Medical School, Boston, United States
(Butcher) Division of Pediatric Psychology, C.S. Mott Children's Hospital
and University of Michigan Medical School, Ann Arbor, MI, United States
(Alexander, Agus) Boston Children's Hospital and Harvard Medical School,
Boston, MA, United States
(Wypij) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Studies examining the impact of randomization As per standard
instruction, city is required for affiliations; however, this information
is missing in affiliation 6. Please check if the provided city is correct
and amend if necessary. to tight glycemic control (TGC) and resultant
hypoglycemia on later neurodevelopmental outcomes have produced mixed
results. Our study examined this association in children undergoing
cardiac surgery. METHOD(S): Participants who were enrolled in the
Safe Pediatric Euglycemia after Cardiac Surgery (SPECS) trial returned for
neurodevelopmental (ND) follow-up between 30 to 42.5 months of age. ND
outcomes were assessed using the Bayley Scales of Infant and Toddler
Development, Third Edition. ND scores were compared between the TGC and
standard care treatment groups and between patients with moderate to
severe and no to mild hypoglycemia. As a secondary analysis, to increase
sample size and power, we combined the three-year-old assessments with
previously collected assessments done at<30 months of age to further
examine differences between groups longitudinally. RESULT(S): Among
the 269 participants who completed neurodevelopmental evaluation
(in-person testing or questionnaires) at three years of age (follow-up
rate, 31%), there were no statistically significant differences in ND
outcomes according to treatment group or hypoglycemia status. In the
combined analysis of all evaluations (from 9 to 42.5 months of age), we
found no treatment group differences. However, in these longitudinal
analyses, children who experienced moderate to severe hypoglycemia had
lower scores on the Bayley-III cognitive and motor domains compared to
children with no to mild hypoglycemia. CONCLUSION(S): For infants
undergoing cardiac surgery, there was no impact of tight glycemic control
on neurodevelopmental outcomes. Moderate to severe hypoglycemia was
associated with worse ND outcomes in longitudinal analyses. TRIAL
REGISTRATION: ClinicalTrials.gov NCT00443599. Registered: November
2016. Copyright © 2022. The Author(s).

<12>
Accession Number
638880638
Title
Routine Functional Testing or Standard Care in High-Risk Patients after
PCI.
Source
The New England journal of medicine. 387(10) (pp 905-915), 2022. Date of
Publication: 08 Sep 2022.
Author
Park D.-W.; Kang D.-Y.; Ahn J.-M.; Yun S.-C.; Yoon Y.-H.; Hur S.-H.; Lee
C.H.; Kim W.-J.; Kang S.H.; Park C.S.; Lee B.-K.; Suh J.-W.; Yoon J.H.;
Choi J.W.; Kim K.-S.; Choi S.W.; Lee S.N.; Park S.-J.
Institution
(Park, Kang, Ahn, Yun, Yoon, Hur, Lee, Kim, Kang, Park, Lee, Suh, Yoon,
Choi, Kim, Choi, Lee, Park) From the Divisions of Cardiology (D.-W.P.,
D.-Y.K., J.-M.A., S.-J.P.) and Biostatistics (S.-C.Y.), Asan Medical
Center, University of Ulsan College of Medicine, the Cardiovascular Center
and Cardiology Division, Yeouido St. Mary's Hospital (C.S.P.), and the
Division of Cardiology, Eulji General Hospital (J.W.C.), Seoul, the
Division of Cardiology, Chungnam National University Sejong Hospital,
Sejong (Y.-H.Y.), the Division of Cardiology, Keimyung University Dongsan
Hospital (S.-H.H., C.H.L.), and the Division of Cardiology, Daegu Catholic
University Medical Center (K.-S.K.), Daegu, the Division of Cardiology,
CHA Bundang Medical Center (W.-J.K., S.H.K.), and the Cardiovascular
Center, Seoul National University Bundang Hospital (J.-W.S.), Seongnam,
the Division of Cardiology, Kangwon National University Hospital,
Chuncheon (B.-K.L.), the Division of Cardiology, Wonju Severance Christian
Hospital, Wonju (J.H.Y.), the Division of Cardiology, Chungnam National
University Hospital, Daejeon (S.W.C.), and the Division of Cardiology, St.
Vincent's Hospital, Suwon (S.N.L.) - all in South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: There are limited data from randomized trials to guide a
specific follow-up surveillance approach after myocardial
revascularization. Whether a follow-up strategy that includes routine
functional testing improves clinical outcomes among high-risk patients who
have undergone percutaneous coronary intervention (PCI) is uncertain.
 METHOD(S): We randomly assigned 1706 patients with high-risk
anatomical or clinical characteristics who had undergone PCI to a
follow-up strategy of routine functional testing (nuclear stress testing,
exercise electrocardiography, or stress echocardiography) at 1 year after
PCI or to standard care alone. The primary outcome was a composite of
death from any cause, myocardial infarction, or hospitalization for
unstable angina at 2 years. Key secondary outcomes included invasive
coronary angiography and repeat revascularization. RESULT(S): The
mean age of the patients was 64.7 years, 21.0% had left main disease,
43.5% had bifurcation disease, 69.8% had multivessel disease, 70.1% had
diffuse long lesions, 38.7% had diabetes, and 96.4% had been treated with
drug-eluting stents. At 2 years, a primary-outcome event had occurred in
46 of 849 patients (Kaplan-Meier estimate, 5.5%) in the functional-testing
group and in 51 of 857 (Kaplan-Meier estimate, 6.0%) in the standard-care
group (hazard ratio, 0.90; 95% confidence interval [CI], 0.61 to 1.35;
P=0.62). There were no between-group differences with respect to the
components of the primary outcome. At 2 years, 12.3% of the patients in
the functional-testing group and 9.3% in the standard-care group had
undergone invasive coronary angiography (difference, 2.99 percentage
points; 95% CI, -0.01 to 5.99), and 8.1% and 5.8% of patients,
respectively, had undergone repeat revascularization (difference, 2.23
percentage points; 95% CI, -0.22 to 4.68). CONCLUSION(S): Among
high-risk patients who had undergone PCI, a follow-up strategy of routine
functional testing, as compared with standard care alone, did not improve
clinical outcomes at 2 years. (Funded by the CardioVascular Research
Foundation and Daewoong Pharmaceutical; POST-PCI ClinicalTrials.gov
number, NCT03217877.). Copyright © 2022 Massachusetts Medical
Society.

<13>
Accession Number
2020109457
Title
Surgery for early-stage lung cancer with video-assisted thoracoscopic
surgery versus open thoracotomy: A narrative review.
Source
Seminars in Oncology. (no pagination), 2022. Date of Publication: 2022.
Author
Alban J.; Kennedy K.; Hulbert A.; Lighter M.; Pasquinelli M.; Rubinstein
I.; Ghelani S.; Clayburn A.; Feldman L.E.
Institution
(Alban) Department of Medicine, University of Chicago Medical Center,
Chicago, Illinois
(Kennedy, Feldman) Division of Hematology/Oncology, Department of
Medicine, University of Illinois at Chicago
(Hulbert, Lighter) Department of Surgery, University of Illinois at
Chicago, College of Medicine, Chicago, Illinois
(Pasquinelli, Rubinstein) Division of Pulmonary, Critical Care, Sleep, and
Allergy Medicine, Department of Medicine, University of Illinois at
Chicago
(Hulbert, Feldman) Section of Hematology/Oncology, Medical Service, Jesse
Brown VA Medical Center
(Rubinstein) Section of Pulmonary, Critical Care, and Sleep Medicine,
Medical Service, Jesse Brown VA Medical Center
(Ghelani) Department of Emergency Medicine, Johns Hopkins University,
Baltimore, Maryland
(Clayburn) New York University School of Medicine, New York, New York
Publisher
W.B. Saunders
Abstract
Recommending video-assisted thoracic surgery (VATS) over open thoracotomy
to patients with early-stage non-small-cell lung cancer (NSCLC) is
controversial. Accordingly, we reviewed randomized comparative studies to
determine the risks and benefits of VATS lobectomy. Electronic searches on
PubMed with standard search terms revealed 97 comparative studies
published between 1990 and 2022. Of those, only 5 were randomized
controlled clinical trials (RCT) and 1 is still ongoing although initial
data has been published as an abstract form. A total of 918 patients were
evaluated in 5 RCT's. All studies included patients with known or
suspected primary lung cancer randomized in a 1:1 ratio to VATS or
thoracotomy. Between 2 studies, reports of 1-year, 3-year and 5-year
overall survival were found to be similar across surgical modalities.
Additionally, no differences were found in the rates of locoregional and
distant recurrence. Three studies reported no statistical differences in
the number of hilar and mediastinal lymph nodes sampled. Two studies found
decreased length of stay following VATS (4 days v 5 days, P = 0.027 and P
= 0.008), while 2 found no difference. Increased in-hospital complications
were seen in 2 studies (P = 0.008 and P = 0.039). VATS was associated with
decreased pain scores, better self-reported QOL at 52 weeks (P = 0.014).
Few randomized clinical trials comparing VATS lobectomy to open
thoracotomy and lobectomy in early stage NSCLC have been reported. These
studies suggest that VATS lobectomy offers similar outcomes with decreased
in-hospital complications, pain, length of stay, and improved physical
functioning when compared to thoracotomy. Copyright © 2022
Elsevier Inc.

<14>
Accession Number
2017064696
Title
Transcatheter Valve-in-Valve Implantation for Degenerated Mitral or
Tricuspid Bioprosthetic Valves: A Health Technology Assessment.
Source
Ontario Health Technology Assessment Series. 22(1) (pp 1-87), 2022. Date
of Publication: 2022.
Author
Anonymous
Publisher
Health Quality Ontario
Abstract
Background Bioprosthetic valves used to treat mitral or tricuspid valve
disease can be expected to deteriorate and eventually fail after 10 to 15
years. For patients who are considered inoperable or high-risk for
surgery, medical management (i.e., drug therapy, the current standard of
care in Ontario) does not significantly alter the course of valvular heart
disease or improve degenerated bioprosthetic valves. An alternative for
these patients is transcatheter mitral or tricuspid valve-in-valve
implantation (TMViV or TTViV). We conducted a health technology assessment
of transcatheter valve-in-valve implantation for adults with degenerated
mitral or tricuspid bioprosthetic valves who are considered inoperable or
high-risk for surgery, which included an evaluation of effectiveness,
safety, the budget impact of publicly funding TMViV or TTViV, and patient
preferences and values. Methods We leveraged a previously published
systematic review, supplementing the work with two new registry studies
identified during the development of this report. We assessed the risk of
bias of each included study using the Downs and Black checklist and the
quality of the body of evidence according to the Grading of
Recommendations Assessment, Development, and Evaluation (GRADE) Working
Group criteria. As the earlier systematic review did not identify any
cost-effectiveness studies, we conducted a hand search of the grey
literature using targeted websites to identify relevant cost-effectiveness
studies. We analyzed the budget impact of publicly funding transcatheter
valve-in-valve implantation for adults with degenerated mitral or
tricuspid bioprostheses who are considered inoperable or high-risk for
surgery in Ontario. To contextualize the potential value of TMViV and
TTViV, we spoke with people who had experience with heart valve
replacement or who were awaiting heart valve replacement. Results We
included 19 studies in the clinical evidence review. No studies compared
TMViV or TTViV to medical management (standard care). TMViV was associated
with in-hospital, 30-day and 1-year mortality rates of 0% to 5%, 0% to
15%, and 14% to 27%, respectively (GRADE: Very low). TTViV was associated
with 30-day and 1-year mortality rates of 0% to 3% and 0% to 14%,
respectively (GRADE: Very low). Patients experienced functional
improvement related to their heart failure symptoms after TMViV or TTViV.
Compared to before the intervention, both TMViV and TTViV were associated
with a decrease in the number of patients with New York Heart Association
class III or IV symptoms in hospital and at 30-day follow-up (GRADE: Low).
We identified no relevant cost-effectiveness studies from our targeted
search. The annual budget impact of publicly funding TMViV and TTViV in
Ontario over the next 5 years ranges from an additional $0.35 million in
year 1 to a cost saving of $0.19 million in year 5, for a total cost
saving of $0.33 million. The people we spoke to who had bioprosthetic
heart valve failure reported the negative effects of valvular heart
disease and described their positive perceptions of transcatheter
valve-in-valve implantation. They valued the minimally invasive nature of
transcatheter procedures and the quick recovery time. Conclusions TMViV or
TTViV may reduce mortality, but the evidence is very uncertain. TMViV or
TTViV may improve heart failure symptoms. We estimated that publicly
funding TMViV and TTViV in Ontario would result in a cost saving of $0.33
million over the next 5 years. People with valvular heart disease reported
their preference for a minimally invasive transcatheter procedure with a
quick recovery time. Copyright © Queen's Printer for Ontario,
2022.

<15>
Accession Number
2018842536
Title
Comparison of cusp-overlap projection and standard three-cusp coplanar
view during self-expanding transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 927642. Date of Publication: 17 Aug 2022.
Author
Chen Y.; Zhu G.; Liu X.; Wu W.; Chai H.; Tao M.; Kong D.; Li Y.; Wang L.
Institution
(Chen, Chai, Tao, Kong, Li, Wang) Department of Hepatobiliary Surgery,
Affiliated Hangzhou First People's Hospital, Zhejiang University School of
Medicine, Hangzhou, China
(Zhu, Liu) Department of Cardiology, Affiliated Hangzhou First People's
Hospital, Zhejiang University School of Medicine, Hangzhou, China
(Wu) Department of Endocrinology, Affiliated Hangzhou First People's
Hospital, Zhejiang University School of Medicine, Hangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Objective: Permanent pacemaker implantation (PPI) is a common complication
after transcatheter aortic valve replacement (TAVR). Recently, the
cusp-overlap projection (COP) technique was thought to be a feasible
method to reduce PPI risk. However, the evidence is still relatively
scarce. Therefore, this meta-analysis was performed to compare COP and
standard three-cusp coplanar (TCC) projection technique. Method(s):
PubMed and EMBASE databases were systematically searched for relevant
literature published from the inception (EMBASE from 1974 and PubMed from
1966) to 16 April 2022, following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary
outcome of interest was post-operative (including in-hospital and 30-day)
PPI. Result(s): Total of 3,647 subjects from 11 studies were included
in this meta-analysis. Of those, 1,453 underwent self-expanding TAVR using
COP and 2,194 using TCC technique. In a pooled analysis, the cumulative
PPI incidence was 9.3% [95% confidence interval (CI): 6.9-11.7%] and 18.9%
(95% CI: 15.5-22.3%) in the COP group and TCC group, respectively. The
application of the COP technique was associated with a significant PPI
risk reduction (I2 = 40.3% and heterogeneity Chi-square p =
0.070, random-effects OR: 0.49, 95% CI: 0.36-0.66, p < 0.001). A higher
implantation depth was achieved in the COP group compared with the TCC
group [standardized mean difference (SMD) = -0.324, 95% CI: (-0.469,
-0.180)]. There was no significant difference between the two groups in
second valve implantation, prosthesis pop-out, fluoroscopic time,
post-operative left bundle branch block, mortality, stroke,
moderate/severe paravalvular leakage, mean gradient, and length of
hospital stay. However, radiation doses were higher in the COP group [SMD
= 0.394, 95% CI: (0.216, 0.572), p < 0.001]. Conclusion(s): In
self-expanding TAVR, the application of the cusp overlap projection
technique was associated with a lower risk of PPI compared with the
standard TCC technique. Systematic review registration:
[https://inplasy.com/inplasy-2022-4-0092/], identifier
[INPLASY202240092]. Copyright © 2022 Chen, Zhu, Liu, Wu, Chai,
Tao, Kong, Li and Wang.

<16>
Accession Number
2017958401
Title
Comparison of a ketamine-propofol combination and etomidate for
anaesthesia induction on haemodynamic parameters in patients undergoing
coronary artery bypass grafting.
Source
Southern African Journal of Anaesthesia and Analgesia. 28(4) (pp 151-155),
2022. Date of Publication: 2022.
Author
Luna A.; Gupta A.; Aggarwal S.
Institution
(Luna, Gupta, Aggarwal) Department of Anaesthesiology and Intensive Care,
Vardhman Mahavir Medical College and Safdarjung Hospital, India
Publisher
Medpharm Publications
Abstract
Objective: To compare the haemodynamic response of both a
ketamine-propofol (ketofol) combination and etomidate for anaesthesia
induction in patients undergoing coronary artery bypass grafting (CABG).
 Method(s): This randomised study was conducted in 120 patients (n =
60 for each group) who were scheduled for elective CABG surgery. Patients
in group K received ketofol (a ketamine and propofol combination [1:1])
and group E received etomidate, until loss of verbal response. Baseline
haemodynamic variables including heart rate (HR), systolic arterial
pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure
(MAP), cardiac output (CO), cardiac index (CI) and systemic vascular
resistance (SVR) were measured for all patients at 1, 2 and 3 minutes post
induction. Serum cortisol and blood sugar levels were also compared before
induction, after cardiopulmonary bypass (CPB) and at 24 hours
postoperatively. Result(s): Statistically significant reduction
occurred in HR, SAP, DAP and MAP from baseline until 3 minutes post
induction in both groups (p < 0.001), but intergroup comparison was
comparable. Maximum fall in CO and CI from baseline at 3 minutes were
greater in group E than in group K (38.18% and 22.36%, and 34.16% and
19.86%, respectively). Maximum fall in SVR at 3 minutes post induction was
greater in group K than in group E and was statistically significant (p <
0.05). Significant increase in cortisol levels occurred within group K
from baseline until 24 hours postoperatively. Significant fall in serum
cortisol levels occurred after weaning off CPB within group E, which
returned to almost baseline at 24 hours. Blood glucose levels rose from
baseline until 24 hours postoperatively in both groups, but peaked more in
group K after weaning from CPB than in group E (p < 0.05).
 Conclusion(s): We concluded that both ketofol and etomidate produced
stable haemodynamics in patients undergoing CABG. Copyright ©
2022 The Author(s).

<17>
Accession Number
638994795
Title
A Systematic Review of Non-Galenic Pial Arteriovenous Fistulas.
Source
World neurosurgery. (no pagination), 2022. Date of Publication: 07 Sep
2022.
Author
Lim J.; Kuo C.C.; Waqas M.; Cappuzzo J.M.; Monteiro A.; Baig A.A.; Snyder
K.V.; Davies J.M.; Levy E.I.; Siddiqui A.H.
Institution
(Lim, Waqas, Cappuzzo, Monteiro, Baig) Department of Neurosurgery, Jacobs
School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo
New York USA; Department of Neurosurgery, Gates Vascular Institute at
Kaleida Health, Buffalo, New York, USA
(Kuo) Jacobs School of Medicine and Biomedical Sciences, University at
Buffalo, Buffalo, NY, United States
(Snyder) Department of Neurosurgery, Jacobs School of Medicine and
Biomedical Sciences, University at Buffalo, Buffalo New York USA;
Department of Neurosurgery, Gates Vascular Institute at Kaleida Health,
Buffalo, New York, USA; Canon Stroke and Vascular Research Center,
University at Buffalo, Buffalo, New York, USA; Jacobs Institute, Buffalo,
New York, USA
(Davies) Department of Neurosurgery, Jacobs School of Medicine and
Biomedical Sciences, University at Buffalo, Buffalo New York USA;
Department of Neurosurgery, Gates Vascular Institute at Kaleida Health,
Buffalo, New York, USA; Canon Stroke and Vascular Research Center,
University at Buffalo, Buffalo, New York, USA; Jacobs Institute, Buffalo,
New York, USA; Department of Bioinformatics, Jacobs School of Medicine and
Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
(Levy, Siddiqui) Department of Neurosurgery, Jacobs School of Medicine and
Biomedical Sciences, University at Buffalo, Buffalo New York USA;
Department of Neurosurgery, Gates Vascular Institute at Kaleida Health,
Buffalo, New York, USA; Canon Stroke and Vascular Research Center,
University at Buffalo, Buffalo, New York, USA; Jacobs Institute, Buffalo,
New York, USA; Department of Radiology, Jacobs School of Medicine and
Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Non-galenic pial arteriovenous fistulas (NGPAVFs) are rare
cerebrovascular pathologies accounting for only 1.6-4.8% of all brain
vascular malformations. We performed a comprehensive review of NGPAVF
cases reported in the literature to further characterize their clinical
patterns of presentation, angiographic features, management, clinical
outcomes, and complications. METHOD(S): We searched PubMed, Google
Scholar, and Embase from each database's earliest records to April 2022
for all relevant English language articles. A total of 3,280 articles were
screened to identify those that met prespecified inclusion criteria.
Differences in clinical outcomes between children (<=18 years old) and
adults (>18 years old) and those associated with the presence of a varix
or a hemorrhage were statistically examined. RESULT(S): A total of
242 patients in 86 articles were included. Mean patient age was
18.51+/-18.80 years. Male-to-female ratio was 1.44:1. Headache was the
most common initial presentation (42.6%) in the study cohort. Hemorrhage
occurred at a significantly higher frequency in adults (p=.004), whereas
more children presented with congestive heart failure (p<.001). Surgical,
endovascular, and combination therapy led to comparable rates of complete
NGPAVF obliteration (86.8%, 85.2%, and 88.5%, respectively). Fifty-nine
patients (24.4%) experienced a complication, ranging from minor
neurological deficit to severe hemorrhage. The mortality rate for the
overall cohort was 3.3%, and all deceased patients had a varix associated
with their fistulas. CONCLUSION(S): To our knowledge, we report the
largest literature review describing the clinical course and
characteristics of NGPAVFs. All treatment approaches resulted in favorable
obliteration rates and overall patient outcomes. Copyright © 2022
Elsevier Inc. All rights reserved.

<18>
[Use Link to view the full text]
Accession Number
638992635
Title
Safety of Vitamin K in mechanical heart valve patients with
supratherapeutic INR: A systematic review and meta-analysis.
Source
Medicine. 101(36) (pp e30388), 2022. Date of Publication: 09 Sep 2022.
Author
Sapapsap B.; Srisawat C.; Suthumpoung P.; Luengrungkiat O.; Leelakanok N.;
Saokaew S.; Kanchanasurakit S.
Institution
(Sapapsap, Leelakanok) Division of Clinical Pharmacy, Faculty of
Pharmaceutical Sciences, Burapha University, Thailand
(Srisawat) Division of Pharmaceutical care, Department of Pharmacy,
Banphaeo General Hospital, Samut Sakhon, Thailand
(Suthumpoung) Division of Pharmaceutical care, Department of Pharmacy,
Fort Khuncheangthammikkarat Hospital, Phayao, Thailand
(Luengrungkiat) Division of Pharmaceutical Care, Department of Pharmacy,
Wichaivej International Omnoi Hospital, Thailand
(Saokaew) Division of Social and Administration Pharmacy, Department of
Pharmaceutical Care, School of Pharmaceutical Sciences, University of
Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Center of Health Outcomes Research and
Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences,
University of Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Unit of Excellence on Clinical Outcomes
Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences,
University of Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Unit of Excellence on Herbal Medicine, School
of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
(Saokaew) Biofunctional Molecule Exploratory Research Group, Biomedicine
Research Advancement Centre, School of Pharmacy, Monash University
Malaysia, Bandar Sunway ,Selangor Darul Ehsan, Malaysia
(Saokaew) Novel Bacteria and Drug Discovery Research Group, Microbiome and
Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health
Sciences, Monash University Malaysia, Bandar Sunway ,Selangor Darul Ehsan,
Malaysia
(Kanchanasurakit) Division of Clinical Pharmacy, Department of
Pharmaceutical Care, School of Pharmaceutical Sciences, University of
Phayao, Phayao, Thailand
(Kanchanasurakit) Division of Pharmaceutical care, Department of Pharmacy,
Phrae Hospital, Phrae, Thailand
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients who had mechanical heart valves and an international
normalized ratio (INR) of >5.0 should be managed by temporary cessation of
vitamin K antagonist. This study aimed to investigate the safety of
low-dose vitamin K1 in patients with mechanical heart valves who have
supratherapeutic INR. METHOD(S): CINAHL, Cochran Library, Clinical
trial.gov, OpenGrey, PubMed, ScienceDirect, and Scopus were systematically
searched from the inception up to October 2021 without language
restriction. Studies comparing the safety of low-dose vitamin K1 treatment
in patients with placebo or other anticoagulant reversal agents were
included. We used a random-effect model for the meta-analysis. Publication
bias was determined by a funnel plot with subsequent Begg's test and
Egger's test. RESULT(S): From 7529 retrieved studies, 3 randomized
control trials were included in the meta-analysis. Pooled data
demonstrated that low-dose vitamin K was not associated with
thromboembolism rate (risk ratio [RR] = 0.94; 95% CI: 0.19-4.55) major
bleeding rate (RR = 0.58; 95% CI: 0.07-4.82), and minor bleeding rate (RR
= 0.60; 95% CI: 0.07-5.09). Subgroup and sensitivity analysis demonstrated
the nonsignificant effect of low-dose vitamin K on the risk of
thromboembolism. Publication bias was not apparent, according to Begg's
test and Egger's test (P = .090 and 0.134, respectively).
 CONCLUSION(S): The current evidence does not support the role of
low-dose vitamin K as a trigger of thromboembolism in supratherapeutic INR
patients with mechanical heart valves. Nevertheless, more well-designed
studies with larger sample sizes are required to justify this research
question. Copyright © 2022 the Author(s). Published by Wolters
Kluwer Health, Inc.

<19>
Accession Number
2018287374
Title
Mortality and Clinical Predictors After Percutaneous Mitral Valve Repair
for Secondary Mitral Regurgitation: A Systematic Review and
Meta-Regression Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 918712. Date of Publication: 04 Jul 2022.
Author
Shi W.; Zhang W.; Zhang D.; Ye G.; Ding C.
Institution
(Shi, Zhang, Zhang, Ye, Ding) Aerospace Center Hospital, Beijing, China
(Shi, Zhang, Zhang, Ye, Ding) Peking University Aerospace School of
Clinical Medicine, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Percutaneous mitral valve repair (PMVR) provides an available
choice for patients suffering from secondary mitral regurgitation (SMR),
especially those whose symptoms persist after optimal, conventional,
heart-failure therapy. However, conflicting results from clinical trials
have created a problem in identifying patients who will benefit the most
from PMVR. Objective(s): To pool mortality data and assess clinical
predictors after PMVR among patients with SMR. To this end, subgroup and
meta-regression analyses were additionally performed. Method(s): We
searched PubMed, EMBASE, and Cochrane databases, and 13 studies were
finally included for meta-analysis. Estimated mortality and 95% confidence
intervals (CIs) were obtained using a random-effects proportional
meta-analysis. We also carried out a meta-regression analysis to clarify
the potential influence of important covariates on mortality.
 Result(s): A total of 1,259 patients with SMR who had undergone PMVR
were enrolled in our meta-analysis. The long-term estimated pooled
mortality of PMVR was 19.3% (95% CI: 13.6-25.1). Meta-regression analysis
showed that mortality was directly proportional to cardiac
resynchronization therapy (CRT) (beta = 0.009; 95% CI: 0.002-0.016; p =
0.009), an effective regurgitant orifice (ERO) (beta = 0.009; 95% CI:
0.000-0.018; p = 0.047), and a mineralocorticoid receptor antagonist (MRA)
use (beta = -0.015; 95% CI: -0.023--0.006; p < 0.001). Subgroup analysis
indicated that patients with preexisting AF (beta = -0.002; 95% CI:
-0.005- -0.000; p = 0.018) were associated with decreased mortality if
they received a mitral annuloplasty device. Among the edge-to-edge repair
device group, a higher left ventricular (LV) ejection fraction, or lower
LV end-systolic diameter, LV end-systolic volume, and LV end-diastolic
volume were proportional to lower mortality. Conclusion and Relevance: The
pooled mortality of PMVR was 19.3% (95% CI: 13.6-25.1). Further
meta-regression indicated that AF was associated with a better outcome in
conjunction with the use of a mitral annuloplasty device, while better LV
functioning predicted a better outcome after the implantation of an
edge-to-edge repair device. Copyright © 2022 Shi, Zhang, Zhang,
Ye and Ding.

<20>
Accession Number
2017632589
Title
Intravenous iron supplement for iron deficiency in patients with severe
aortic stenosis scheduled for transcatheter aortic valve implantation:
results of the IIISAS randomised trial.
Source
European Journal of Heart Failure. 24(7) (pp 1269-1279), 2022. Date of
Publication: July 2022.
Author
Kvaslerud A.B.; Bardan S.; Andresen K.; Klove S.F.; Fagerland M.W.;
Edvardsen T.; Gullestad L.; Broch K.
Institution
(Kvaslerud, Bardan, Andresen, Edvardsen, Gullestad, Broch) Faculty of
Medicine, University of Oslo, Oslo, Norway
(Kvaslerud, Andresen, Klove, Edvardsen, Gullestad, Broch) Department of
Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
(Kvaslerud, Gullestad, Broch) KG Jebsen Center for Cardiac Research and
Center for Heart Failure Research, University of Oslo, Oslo, Norway
(Fagerland) Oslo Centre for Biostatistics and Epidemiology, Research
Support Services, Oslo University Hospital, Oslo, Norway
Publisher
John Wiley and Sons Ltd
Abstract
Aims: The aim of this trial was to evaluate whether intravenous iron could
provide benefit beyond transcatheter aortic valve implantation (TAVI) in
iron-deficient patients with severe aortic stenosis. Methods and
Results: In this randomised, placebo-controlled, double-blind,
single-centre trial, we enrolled patients with severe aortic stenosis and
iron deficiency (defined as ferritin <100 microg/L, or 100-299 microg/L
with a transferrin saturation <20%) who were evaluated for TAVI. Patients
were randomly assigned (1:1) to receive intravenous ferric derisomaltose
or placebo ~3 months before TAVI. The primary endpoint was the
between-group, baseline-adjusted 6-min walk distance measured 3 months
after TAVI. Secondary outcomes included quality of life, iron stores, hand
grip strength, New York Heart Association (NYHA) class, and safety.
Between January 2020 and September 2021, we randomised 74 patients to
ferric derisomaltose and 75 patients to placebo. The modified
intention-to-treat population comprised the 104 patients who completed the
6-min walk test at baseline and 3 months after successful TAVI. Iron
stores were restored in 76% of the patients allocated to iron and 13% of
the patients allocated to placebo (p < 0.001). There was no difference in
the baseline-adjusted 6-min walk distance between the two treatment arms
(p = 0.82). The number of serious adverse events, quality of life, hand
grip strength, and NYHA class did not differ between the treatment arms.
 Conclusion(s): Treatment with intravenous iron did not provide
clinical benefit beyond TAVI in iron-deficient patients with severe aortic
stenosis. Clinical Trial Registration: ClinicalTrials.gov
NCT04206228. Copyright © 2022 The Authors. European Journal of
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<21>
Accession Number
2017229878
Title
Surgical Aortic Valve Replacement Versus Conservative Treatment in
Asymptomatic Severe Aortic Stenosis: An Updated Systematic Review and
Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 42 (pp 36-44), 2022. Date of
Publication: September 2022.
Author
Ismayl M.; Machanahalli Balakrishna A.; Abusnina W.; Thandra A.; Walters
R.W.; Alugubelli N.R.; Yackley S.; Betts L.; Smer A.; Goldsweig A.M.;
Dahal K.
Institution
(Ismayl, Machanahalli Balakrishna, Yackley, Betts) Department of Medicine,
Creighton University School of Medicine, Omaha, NE, United States
(Abusnina, Thandra, Alugubelli, Smer, Dahal) Department of Medicine,
Division of Cardiology, Creighton University School of Medicine, Omaha,
NE, United States
(Walters) Department of Medicine, Division of Clinical Research and
Evaluative Sciences, Creighton University School of Medicine, Omaha, NE,
United States
(Goldsweig) Department of Medicine, Division of Cardiovascular Medicine,
University of Nebraska Medical Center, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Background: While aortic valve replacement (AVR) is indicated for
symptomatic severe aortic stenosis (AS), the appropriate management of
asymptomatic severe AS remains unclear. We conducted an updated
meta-analysis to compare the outcomes of surgical AVR (SAVR) versus
conservative treatment in patients with asymptomatic severe AS.
 Method(s): We searched PubMed, EMBASE, Cochrane, clinicaltrials.gov,
and Google Scholar for studies comparing outcomes of SAVR versus
conservative treatment in asymptomatic severe AS. Risk ratios (RRs) and
95% confidence intervals (CIs) were calculated for each individual study.
Outcomes included all-cause mortality, cardiovascular and
non-cardiovascular mortality, 30-day operative mortality, sudden cardiac
death (SCD), heart failure hospitalization (HFH), myocardial infarction
(MI), and stroke. Result(s): A total of 8 studies with 2685 patients
were included. The mean age was above 60 years, and the median follow-up
duration was 4 years. Compared to conservative treatment, SAVR was
associated with significantly lower all-cause mortality (RR 0.39; 95% CI
0.23-0.64) and HFH rates (RR 0.18; 95% CI 0.05-0.71). There were no
significant differences in cardiovascular mortality (RR 0.24; 95% CI
0.03-1.67), non-cardiovascular mortality (RR 0.49; 95% CI 0.23-1.03),
30-day operative mortality (RR 0.48; 95% CI 0.10-2.32), SCD (RR 0.37; 95%
CI 0.05-2.89), MI (RR 0.48; 95% CI 0.04-5.52), and stroke rates (RR 1.20;
95% CI 0.35-4.11) between the two strategies. Conclusion(s): In
patients with asymptomatic severe AS, SAVR is associated with
significantly lower all-cause mortality and HFH compared to conservative
treatment. While SAVR is a promising option for asymptomatic severe AS,
most studies were observational and nonrandomized; randomized trials are
needed to establish a clear benefit. Copyright © 2022

<22>
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.

<23>
Accession Number
2019844792
Title
Meta-Analysis Comparing Venoarterial Extracorporeal Membrane Oxygenation
With or Without Impella in Patients With Cardiogenic Shock.
Source
American Journal of Cardiology. 181 (pp 94-101), 2022. Date of
Publication: 15 Oct 2022.
Author
Bhatia K.; Jain V.; Hendrickson M.J.; Aggarwal D.; Aguilar-Gallardo J.S.;
Lopez P.D.; Narasimhan B.; Wu L.; Arora S.; Joshi A.; Tomey M.I.; Mahmood
K.; Qamar A.; Birati E.Y.; Fox A.
Institution
(Bhatia, Aguilar-Gallardo, Lopez, Wu, Joshi) Mount Sinai Heart, Mount
Sinai Morningside Hospital, New York, New York
(Jain) Division of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, Ohio
(Hendrickson) Department of Medicine, Massachusetts General Hospital,
Harvard Medical School, Boston, MA
(Aggarwal) Department of Internal Medicine, Beaumont Hospital, Royal Oak,
MI, United States
(Narasimhan) Department of Cardiology, Debakey Cardiovascular Center,
Houston Methodist, Texas
(Arora) Division of Cardiology, University of North Carolina School of
Medicine, Chapel Hill, NC, United States
(Tomey, Mahmood, Fox) Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, New York
(Qamar) Section of Interventional Cardiology, NorthShore Cardiovascular
Institute, University of Chicago, Chicago, Illinois
(Birati) Poriya Medical Center, Bar-Ilan University, Israel
Publisher
Elsevier Inc.
Abstract
Cardiogenic shock is associated with high short-term mortality.
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly
used as a mechanical circulatory support strategy for patients with
refractory cardiogenic shock. A drawback of this hemodynamic support
strategy is increased left ventricular (LV) afterload, which is mitigated
by concomitant use of Impella (extracorporeal membrane oxygenation with
Impella [ECPELLA]). However, data regarding the benefits of this approach
are limited. We conducted a systematic search of Medline, EMBASE, and
Cochrane databases to identify studies including patients with cardiogenic
shock reporting clinical outcomes with Impella plus VA-ECMO compared with
VA-ECMO alone. Primary outcome was short-term all-cause mortality
(in-hospital or 30-day mortality). Secondary outcomes included major
bleeding, hemolysis, continuous renal replacement therapy, weaning from
mechanical circulatory support, limb ischemia, and transition to
destination therapy with LV assist device (LVAD) or cardiac transplant. Of
2,790 citations, 7 observational studies were included. Of 1,054 patients
with cardiogenic shock, 391 were supported with ECPELLA (37%). Compared
with patients on only VA-ECMO support, patients with ECPELLA had a lower
risk of short-term mortality (risk ratio [RR] 0.89 [0.80 to 0.99],
I2 = 0%, p = 0.04) and were significantly more likely to
receive a heart transplant/LVAD (RR 2.03 [1.44 to 2.87], I2 =
0%, p <0.01). However, patients with ECPELLA had a higher risk of
hemolysis (RR 2.03 [1.60 to 2.57], I2 = 0%, p <0.001), renal
failure requiring continuous renal replacement therapy (RR 1.46 [1.23 to
174], I2 = 11%, p <0.0001), and limb ischemia (RR 1.67 [1.15 to
2.43], I2 = 0%, p = 0.01). In conclusion, among patients with
cardiogenic shock requiring VA-ECMO support, concurrent LV unloading with
Impella had a lower likelihood of short-term mortality and a higher
likelihood of progression to durable LVAD or heart transplant. However,
patients supported with ECPELLA had higher rates of hemolysis, limb
ischemia, and renal failure requiring continuous renal replacement
therapy. Future prospective randomized are needed to define the optimal
treatment strategy in this high-risk cohort. Copyright © 2022
Elsevier Inc.

<24>
Accession Number
2019347447
Title
Effect of Volatile Anesthesia Versus Total Intravenous Anesthesia on
Postoperative Pulmonary Complications in Patients Undergoing Cardiac
Surgery: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(10) (pp 3758-3765),
2022. Date of Publication: October 2022.
Author
He L.-L.; Li X.-F.; Jiang J.-L.; Dai S.-H.; Jing W.-W.; Yu H.
Institution
(He, Li, Jiang, Yu, Dai, Yu) Department of Anesthesiology, West China
Hospital, Sichuan University, Chengdu, China
(He) Department of Anesthesiology, Sichuan Jinxin Women and Children's
Hospital, Chengdu, China
(Jing) Department of Anesthesiology, West China Second University
Hospital, Sichuan University, Chengdu, China
Publisher
W.B. Saunders
Abstract
Objectives: The purpose of this study was to evaluate the effect of
volatile anesthesia and propofol-based total intravenous anesthesia (TIVA)
on postoperative pulmonary complications (PPCs) among patients undergoing
cardiac surgery. Design(s): Parallel-group, randomized controlled
trial. Setting(s): Single-center tertiary care hospital.
 Participant(s): Five hundred twenty-four patients undergoing cardiac
surgery with cardiopulmonary bypass. Intervention(s): The patients
were assigned randomly (1:1) to receive anesthesia maintenance with a
volatile anesthetic (sevoflurane or desflurane) or propofol-based TIVA.
 Measurements and Main Results: The primary outcome was a composite of
postoperative pulmonary complications within the first 7 postoperative
days. The PPCs occurred in 118 of 262 patients (45.0%) in the volatile
anesthesia group compared with 105 of 262 patients (40.1%) in the
propofol-based intravenous anesthesia group (relative risk: 1.17 [95% CI
0.96-1.42], p = 0.123). There were no significant differences in the
severity of PPCs within 7 days postoperatively, the occurrence and
severity grade of PPCs within 30 days, the incidence of hypoxia, and
30-day mortality. Conclusion(s): In adult patients undergoing cardiac
surgery with cardiopulmonary bypass, general anesthesia with a volatile
anesthetic compared with propofol-based TIVA had not reduced pulmonary
complications within the first 7 days after surgery. Copyright ©
2022 Elsevier Inc.

<25>
Accession Number
2019194733
Title
Effect of High-Frequency Oscillatory Ventilation, Combined With Prone
Positioning, in Infants With Acute Respiratory Distress Syndrome After
Congenital Heart Surgery: A Prospective Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(10) (pp 3847-3854),
2022. Date of Publication: October 2022.
Author
Zheng Y.-R.; Chen Y.-K.; Lin S.-H.; Cao H.; Chen Q.
Institution
(Zheng, Chen, Lin, Cao, Chen) Department of Cardiac Surgery, Fujian Branch
of Shanghai Children's Medical Center, Fuzhou, China
(Zheng, Chen, Lin, Cao, Chen) Fujian Children's Hospital, Fuzhou, China
(Zheng, Chen, Lin, Cao, Chen) Fujian Maternity and Child Health Hospital
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics,
Fujian Medical University, Fuzhou, China
(Zheng, Chen, Lin, Cao, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: This study aimed to evaluate the effect of high-frequency
oscillatory ventilation, (HFOV) combined with prone positioning, on
oxygenation and pulmonary ventilation in infants with acute respiratory
distress syndrome (ARDS) after congenital heart surgery. Design(s): A
randomized controlled trial. Setting(s): A single-center study at a
tertiary teaching hospital. Participant(s): Patients with
postoperative ARDS after congenital heart disease were divided randomly
into the following 2 groups: HFOV combined with prone position (HFOV-PP),
and HFOV combined with supine position (HFOV-SP). Intervention(s):
The primary outcomes were the PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf>
ratio and the oxygenation index after the intervention, and the secondary
outcomes were respiratory variables, hemodynamics, complications, and
other short-term outcomes. Result(s): Sixty-five eligible infants
with ARDS were randomized to either the HFOV-PP (n = 32) or HFOV-SP (n =
33) group. No significant difference in baseline data was found between
the 2 groups (p > 0.05). Oxygenation was improved in both groups after
HFOV intervention. Compared with the HFOV-SP group, the HFOV-PP group had
significantly increased PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf> and
oxygenation index and a shorter duration of invasive ventilation and
length of cardiac intensive care unit stay. No serious complications
occurred in the 2 groups. Conclusion(s): HFOV-PP significantly
improved oxygenation in infants with ARDS after cardiac surgery and had no
serious complications. Copyright © 2022 Elsevier Inc.

<26>
Accession Number
2019194096
Title
The effect of melatonin on cardiac biomarkers after coronary artery bypass
graft surgery: A double-blind, randomized pilot study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(10) (pp 3800-3805),
2022. Date of Publication: October 2022.
Author
Nasseh N.; Khezri M.B.; Farzam S.; Shiravandi S.; Shafikhani A.A.
Institution
(Nasseh, Khezri, Shiravandi) Department of Anesthesiology, Faculty of
Medicine, Metabolic Diseases Research Center, Qazvin University of Medical
Sciences, Shahid Bahonar Ave., PO Box 3419759811, Qazvin, Iran, Islamic
Republic of
(Farzam) Department of Cardiovascular surgery, Faculty of Medicine, Qazvin
University of Medical Sciences, Qazvin, Iran, Islamic Republic of
(Shafikhani) Department of Occupational safety and Health Engineering,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
W.B. Saunders
Abstract
Objectives: Melatonin has emerged as an anti-inflammatory agent, potent
direct free-radical scavenger, and an indirect antioxidant in preventing
ischemia-reperfusion injury. This study aimed to evaluate melatonin's
effect on cardiac biomarkers after coronary artery bypass grafting (CABG).
 Design(s): A double-blind, randomized placebo-controlled pilot
clinical study. Setting(s): Booali Sina Hospital, Qazvin University
of Medical Sciences, Qazvin, Iran. Participant(s): One hundred
patients undergoing elective CABG. The patients were divided randomly into
control (C) and melatonin (M) groups (50 patients per group).
 Intervention(s): The M group received 3 mg of melatonin the night
before surgery, 3 mg in the morning, and routine cardiac surgery
medications. The C group received 1 placebo tablet rather than melatonin.
After surgery, the patients in the M group received 3 mg of melatonin, and
the C group received 1 placebo tablet at bedtime until the third day after
CABG. Measurements and Main Results: In both groups, creatine
kinase-MB (CPK-MB), cardiac troponin I, erythrocyte sedimentation rate
(ESR), and C-reactive protein (CRP) were measured before surgery and on
the first, second, and third postoperative days. Serum CPK-MB levels on
the second and third day after CABG were significantly lower in the M
group than in the C group (p < 0.05). Regarding cardiac troponin I, CRP,
and ESR markers, there were no significant changes in serum concentration
before surgery and on the first, second, and third days after surgery
between the 2 groups (p > 0.05). The mean length of hospitalization in the
ICU was lower in the M group (3.4 +/- 1.05) compared with the C group
(3.96 +/- 1.06, p = 0.01). Conclusion(s): Melatonin reduced the
postoperative level of CPK-MB and the length of hospitalization in the ICU
in patients who underwent cardiac surgery. Copyright © 2022

<27>
Accession Number
2018982962
Title
Comparison of the analgesic effect of inhaled lavender vs vanilla
essential oil for neonatal frenotomy: a randomized clinical trial
(NCT04867824).
Source
European Journal of Pediatrics. (no pagination), 2022. Date of
Publication: 2022.
Author
Maya-Enero S.; Fabregas-Mitjans M.; Llufriu-Marques R.M.; Candel-Pau J.;
Garcia-Garcia J.; Lopez-Vilchez M.A.
Institution
(Maya-Enero, Fabregas-Mitjans, Llufriu-Marques, Candel-Pau, Garcia-Garcia,
Lopez-Vilchez) Department of Neonatology, Service of Pediatrics, Hospital
del Mar, Parc de Salut Mar, Universitat Pompeu Fabra, Passeig Maritim
25-29, Barcelona 08003, Spain
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
It is necessary to treat neonatal pain because it may have short- and
long-term adverse effects. Frenotomy is a painful procedure where sucking,
a common strategy to relieve pain, cannot be used because the technique is
performed on the tongue. In a previous randomized clinical trial, we
demonstrated that inhaled lavender essential oil (LEO) reduced the signs
of pain during neonatal frenotomy. We aimed to find out whether inhaled
vanilla essential oil (VEO) is more effective in reducing pain during
frenotomy than LEO. Randomized clinical trial with neonates who underwent
a frenotomy for type 3 tongue-ties between May and October 2021. Pain was
assessed using pre and post-procedure heart rate (HR) and oxygen
saturation (SatO2), crying time, and NIPS score. Neonates were randomized
into "experimental" and "control" group. In both groups, we performed
swaddling, administered oral sucrose, and let the newborn suck for 2 min.
We placed a gauze pad with one drop of LEO (control group) or of VEO
(experimental group) under the neonate's nose for 2 min prior to and
during the frenotomy. We enrolled 142 neonates (71 per group). Both groups
showed similar NIPS scores (2.02 vs 2.38) and crying times (15.3 vs 18.7
s). We observed no differences in HR increase or in SatO2 decrease between
both groups. We observed no side effects in either of the groups.
 Conclusion(s): We observed no appreciable difference between LEO and
VEO; therefore, we cannot conclude which of them was more effective in
treating pain in neonates who underwent a frenotomy. Trial registration:
This clinical trial is registered with www.clinicaltrials.gov with
NCT04867824.What is Known:* Pain management is one of the most important
goals of neonatal care as it can have long-term neurodevelopmental
effects.* Lavender essential oil can help relieve pain due to its
sedative, antispasmodic, and anticolic properties.What is New:* Lavender
and vanilla essential oils are safe, beneficial, easy to use, and cheap in
relieving pain in neonates who undergo a frenotomy for type 3
tongue-ties. Copyright © 2022, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<28>
Accession Number
2018663386
Title
Immediate and late outcomes of transcatheter aortic valve implantation
versus surgical aortic valve replacement in bicuspid valves: Meta-analysis
of reconstructed time-to-event data.
Source
Journal of Cardiac Surgery. 37(10) (pp 3300-3310), 2022. Date of
Publication: October 2022.
Author
Michel Pompeu S.a.; Jacquemyn X.; Tasoudis P.T.; Van den Eynde J.; Erten
O.; Dokollari A.; Torregrossa G.; Sicouri S.; Weymann A.; Ruhparwar A.;
Athanasiou T.; Ramlawi B.
Institution
(Michel Pompeu, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Tasoudis, Erten, Dokollari, Torregrossa, Sicouri, Ramlawi)
Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University of Duisburg-Essen, Essen, Germany
(Athanasiou) Department of Surgery and Cancer, St Mary's Hospital, London,
United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Outcomes of transcatheter aortic valve implantation (TAVI)
versus surgical aortic valve replacement (SAVR) in patients with aortic
stenosis and bicuspid aortic valve (BAV) must be better investigated.
 Method(s): A meta-analysis including studies published by January
2022 reporting immediate outcomes (in-hospital death, stroke, acute kidney
injury [AKI], major bleeding, new permanent pacemaker implantation [PPI],
paravalvular leakage [PVL]), mortality in the follow-up (with Kaplan-Meier
curves for reconstruction of individual patient data). Result(s):
Five studies met our eligibility criteria. No statistically significant
difference was observed for in-hospital death, stroke, AKI, and PVL. TAVI
was associated with lower risk of major bleeding (odds ratio [OR]: 0.29;
95% confidence interval [CI]: 0.12-0.69; p =.025), but higher risk of PPI
(OR: 2.00; 95% CI: 1.05-3.77; p =.041). In the follow-up, mortality after
TAVI was significantly higher in the analysis with the largest samples
(HR: 1.24, 95% CI: 1.01-1.53, p =.043), but no statistically significant
difference was observed with risk-adjusted populations (HR: 1.06, 95% CI:
0.86-1.32, p =.57). Landmark analyses suggested a time-varying risk with
TAVI after 10 and 13 months in both largest and risk-adjusted populations
(HR: 2.13, 95% CI: 1.45-3.12, p <.001; HR: 1.7, 95% CI: 1.11-2.61, p
=.015, respectively). Conclusion(s): Considering the immediate
outcomes and comparable overall survival observed in risk-adjusted
populations, TAVI can be used safely in selected BAV patients. However, a
time-varying risk is present (favoring SAVR over TAVI at a later
timepoint). This finding was likely driven by higher rates of PPI with
TAVI. Copyright © 2022 Wiley Periodicals LLC.

<29>
Accession Number
2018278516
Title
Prospective, randomized, controlled, noninferiority clinical trial to
evaluate the safety and efficacy of absorbable macroporous polysaccharide
composites as adjunct to hemostasis during open surgery.
Source
Journal of Cardiac Surgery. 37(10) (pp 3060-3069), 2022. Date of
Publication: October 2022.
Author
Li H.; Li Z.; He X.; Zhang F.; OuYang Z.; Wu G.; Liu P.; Yang S.; Dong L.;
Zhen M.; Xu L.
Institution
(Li, Xu) State Key Laboratory of Molecular Immunology and Molecular
Diagnostics, School of Public Health, Xiamen University, Xiamen, China
(Li) General Surgery, Peking University Third Hospital, Beijing, China
(He, Dong) General Surgery, Tianjin Medical University General Hospital,
Tianjin, China
(Zhang, OuYang) General Surgery, Breast Surgery, The First Affiliated
Hospital of Xiamen University, Xiamen, China
(Wu, Liu, Yang, Zhen) General Surgery, Hepatopancreatobiliary Surgery,
Breast Surgery, Zhongshan Hospital Affiliated to Xiamen University,
Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
Background: To address intraoperative bleeding in cardiac surgery,
reducing blood transfusion requirements, is mandatory to achieve effective
hemostasis. Hemostatic agents may limit localized persistent bleeding. The
introduction of carboxymethyl-chitosan component into the hemostatic agent
and the application of the radiation crosslinking technique maintain its
capacity for achieving intraoperative hemostasis, thus increasing the
clinical utility. Method(s): A prospective, noninferiority and
randomized controlled clinical trial to compare the safety and efficacy of
absorbable macroporous polysaccharide composites (AMPC, treatment group)
with compound microporous polysaccharide hemostatic powder (CMPHP, control
group) (2:1 ratio) as adjuncts to hemostasis in open surgery. The main
indication was used for hemostasis in various traumatic hemorrhage areas,
including cardiothoracic, vascular, and general surgery. The primary
endpoint was success rate of hemostasis within 300 s (at a 10%
noninferiority margin). The secondary endpoint was hemostasis time. Both
endpoints were assessed in the modified intention-to-treat (MITT)
population. Safety parameters were assessed. This study is fully compliant
with the CONSORT statement. Result(s): Randomized patients in AMPC
and CMPHP groups were 168 and 84, respectively. In MITT population, the
success rates of hemostasis within 300 s were 98.8% (163 of 165) in AMPC
and 94.0% (78 of 83) in CMPHP (treatment difference 4.8% [95% CI -0.57% to
10.20%]). AMPC was thus noninferior to CMPHP. Hemostasis time (median
[interquartile range]) with AMPC (87 [52.5, 180] s) was better than CMPHP
(110 [54.5, 181] s). Changes in laboratory parameters over time and shifts
to abnormal values were typical of surgeries and similar between two
groups. No noticeable adverse effects associated with AMPC or CMPHP were
observed. Conclusion(s): AMPC is well tolerated as topical hemostatic
agent, noninferior to commercial CMPHP, and exhibits excellent safety.
This study provides a novel hemostatic agent which appears to offer
significant clinical advantage in various hemorrhage areas. Copyright
© 2022 Wiley Periodicals LLC.

<30>
Accession Number
2017612143
Title
Intramuscular stimulation as a new modality to control postthoracotomy
pain: A randomized clinical trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(4) (pp 1236-1245),
2022. Date of Publication: October 2022.
Author
Moon D.H.; Park J.; Park Y.G.; Kim B.J.; Woo W.; Na H.; Oh S.; Lee H.S.;
Lee S.
Institution
(Moon, Kim, Woo, Na, Oh, Lee) Department of Thoracic and Cardiovascular
Surgery, Gangnam Severance Hospital, Yonsei University College of
Medicine, Seoul, South Korea
(Park, Park) Department of Rehabilitation Medicine, Gangnam Severance
Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei
University College of Medicine, Seoul, South Korea
(Lee) Biostatistics Collaboration Unit, Department of Research Affairs,
Yonsei University College of Medicine, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Objective: Postoperative pain after thoracic surgery primarily hinders
patients' mobility, decreasing the quality of life. To date, various
modalities have been suggested to improve postoperative pain. However,
pain alleviation still remains a challenge, resulting in continued
reliance on opioids. To tackle this problem, this study introduces a
needle electrical twitch obtaining intramuscular stimulation (NETOIMS) as
a new effective treatment modality for postoperative pain after
thoracoscopic surgery. Method(s): This randomized clinical trial
analyzed patients receiving video-assisted thoracoscopic surgery pulmonary
resection between March 2018 and June 2020 at a single institution. A
total of 77 patients (NETOIMS, 36; intravenous patient-controlled
analgesia, 41) were included. NETOIMS was conducted on the retracted
intercostal muscle immediately following the main procedure, just before
skin closure. Postoperative pain (numeric rating scale) and oral opioid
morphine milligram equivalent were assessed daily until postoperative day
5. Result(s): The NETOIMS group had a significantly lower numeric
rating scale score on postoperative day (POD) 0 (P < .01), POD2 (P <
.001), POD4 (P < .001), and POD5 (P = .01). The predicted time to complete
pain resolution was 6.15 days in the NETOIMS group and 20.7 days in the
intravenous patient-controlled analgesia group. The oral opioid morphine
milligram equivalent was significantly lower in the NETOIMS group on POD0
(P < .001) and POD1 (P < .001). Conclusion(s): NETOIMS appears to be
an effective modality in alleviating postoperative pain after
thoracoscopic surgery, thereby reducing the reliance on opioid
use. Copyright © 2022 The American Association for Thoracic
Surgery

<31>
Accession Number
638968611
Title
Evaluation of pain and opioid consumption in local preemptive anesthesia
and the erector spine plane block in thoracoscopic surgery: A randomized
clinical trial.
Source
Revista do Colegio Brasileiro de Cirurgioes. 49 (pp e20223291), 2022. Date
of Publication: 2022.
Author
Pallu I.; Boscoli S.S.; Zaleski T.; Andrade D.P.; Cherubini G.R.L.;
Czepula A.I.D.S.; Souza J.M.
Institution
(Pallu, Boscoli, Zaleski, Andrade, Czepula, Souza) Faculdades Pequeno
Principe, Curso de Medicina - Curitiba - PR - Brasil, Brazil
(Cherubini) Hospital Nossa Senhora das Gracas, Departamento de
Anestesiologia - Curitiba - PR - Brasil, Brazil
(Souza) Hospital Nossa Senhora das Gracas, Departamento de Cirurgia
Toracica - Curitiba - PR - Brasil, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: assess pain and opioid consumption in patients undergoing
anesthetic techniques of spinal erector plane block and local anesthetic
block in video-assisted thoracic surgery in the immediate postoperative
period. METHOD(S): ninety-two patients undergoing video assisted
thoracic surgery were randomized to receive ESPB or BAL before starting
the surgical procedure. Using the numerical verbal scale, the primary
outcome assessed was the patient's pain in the immediate postoperative
period (POI). The secondary outcome comprises the assessment of opioid
consumption in the IPP by quantifying the medication used in an
equianalgesic dose of morphine expressed in milligrams, in the immediate
post-anesthetic recovery period, 6h, 12h, and 24h after surgery.
 RESULT(S): the EVN scores in the LBA and ESPB group in the POI had a
mean of 0,8 (+/-1,89) vs 0,58 (+/-2,02) in the post-anesthesia care room
(REPAI), 1,06 (+/-2,00) vs 1,30 (+/-2,30) in 6 hours of POI, 0,84
(+/-1,74) vs 1,19 (+/-2,01) within 12 hours of POI and 0,95 (+/-1,88) vs 1
( +/-1,66) within 24 hours of POI, all with p>0.05. Mean opioid
consumption in the BAL and ESPB groups in the POI was 12.9 (+/- 10.4) mg
vs 14.9 (+/-10.2) mg, respectively, with p = 0.416. Sixteen participants
in the ESPB group and seventeen in the BAL group did not use opioids
during the first 24 hours of the PO analyzed. CONCLUSION(S): local
anesthesic block and ESP block techniques showed similar results in terms
of low pain scores and opioid consumption during the period evaluated.

<32>
Accession Number
2020097446
Title
P1.09-03 Multidisciplinary Thoracic Tumors Board Survey in Spain.
Source
Journal of Thoracic Oncology. Conference: Proceedings of the American
Society for Radiation Oncology 64th Annual Meeting. San Antonio United
States. 17(9 Supplement) (pp S107), 2022. Date of Publication: September
2022.
Author
Massuti B.; Nadal E.; Camps C.; Carcereny E.; Cobo M.; Domine M.;
Garcia-Campelo M.R.; Gonzalez-Larriba J.L.; Guirado M.; Hernando-Trancho
F.; Rodriguez-Abreu D.; Sanchez A.; Sullivan I.; Provencio M.
Institution
(Massuti) Hospital Universitario Alicante Dr Balmis ISABIAL, Alicante,
Spain
(Nadal) Institut Catala d'Oncologia L'Hospitalet, Barcelona, Spain
(Camps) Hospital General Universitario Valencia, Valencia, Spain
(Carcereny) Institut Catala d'Oncologia Badalona, Badalona (Barcelona),
Spain
(Cobo) Hospital Regional Universitario Malaga, Malaga, Spain
(Domine) Fundacion Jimenez Diaz, Madrid, Spain
(Garcia-Campelo) Complejo Hospitalario Universitario A Coruna, A Coruna,
Spain
(Gonzalez-Larriba, Hernando-Trancho) Hospital Clinico Universitario San
Carlos, Madrid, Spain
(Guirado) Hospital General Universitario Elche, ES, Elche, Spain
(Rodriguez-Abreu) Hospital Universitario Insular de Gran Canaria., Las
Palmas, Spain
(Sanchez) Consorci Hospitalari Provincial Castello, Castellon, Spain
(Sullivan) Hospital Sant Pau, Barcelona, Spain
(Provencio) Hospital Universitario Puerta de Hierro, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Introduction: Increasing complexity in diagnosis and management of lung
cancer requires collaboration of multiple specialists. In Spain there are
few Cancer Centers. Medical Oncology is in the center of cancer care
covering academic and community hospitals but other resources like
Thoracic Surgery, Nuclear Medicine and Radiotherapy are limited to larger
centers. Spanish Lung Cancer Group/Grupo Espanol Cancer Pulmon performed a
survey to describe current structure, network and standard operational
procedures (SOPs) of Thoracic Tumor Boards (TTB) in the country.
 Method(s): Between April-June 2021, 92 hospitals with different
complexity level (< 300 beds, 301-500 beds and > 500 beds) distributed at
different regions in Spain answered an online survey. The survey covered
different items about facilities' characteristics, access to diagnostic
techniques, biomarkers and NGS access and operational organization.
 Result(s): -Overall facilities: Pneumology, Radiology, Pathology and
Medical Oncology Units in 100% of centers, Radiotherapy in 75%, Nuclear
Medicine in 63%, Molecular Diagnostic Unit 61% and Thoracic Surgery in
59%. Fast diagnostic pathways in 90%. - Molecular diagnosis: NGS access
53%. Liquid biopsy 72% (65% in house). Biomarkers reflex ordered by
pathologist 59%.- Significant differences were found between Academic and
Community centers for: EBUS disposal (60 vs 98%), NGS access (36 vs 68%),
mediastinoscopy facilities (32 vs 100%), SBRT (32 vs 98%), clinical trials
recruitment rate (12 vs 55%), timelines control (16 vs 35%)- Tumor Board
Coordinator: medical oncologist 49%, pneumologist 37%, thoracic surgeon
11%. Members of MTB: mean 7 different specialties. Weekly meetings in 96%
of centers. Mixed format (presential and virtual) in 36%. Specific case
manager in 39%. Molecular biologist 19%. Palliative Care 12%.- Mean
patients per session: 10. All new cases presented in 65%. Stage
distribution: St I-II (16%), St III (42%), St IV (42%). Discussion before
and after surgery in 67%. - Timeline evaluation recorded in 24%. Mean time
from decision to treatment: 3.7 week (w) for surgery, 2.6 w for
radiotherapy and 1.4 w for systemic treatment. - Reference guidelines
used: ESMO 72%, SEOM (Spanish Medical Oncology Society) 65%, NCCN 61% -
SOPs in 69%, Continuous Medical Education activity 39%.
 Conclusion(s): Multidisciplinary Thoracic Tumors Boards are
implemented at every center of Spanish Lung Cancer Group but differs
according complexity level of the center. Facilities and access to
diagnostic tools and therapeutic options show significant differences
especially for EBUS, NGS and SBRT. Timelines recording from initial
symptom to diagnosis and treatment and outcomes metrics need to be
implemented more widely. Specific case managers could be a key tool for
improvement. Virtually meetings for tumor boards are feasible and increase
the TTB networking could be useful to preserve equity for lung cancer
patients. Keywords: Thoracic Tumors Board, Molecular diagnosis, Lung
Cancer Network Copyright © 2022

<33>
Accession Number
2020097316
Title
EP13.01-017 Assessing Variance Between Radiology versus Multidisciplinary
Clinic Recommendations in the Pulmonary Nodule and Lung Screening Clinic.
Source
Journal of Thoracic Oncology. Conference: Proceedings of the American
Society for Radiation Oncology 64th Annual Meeting. San Antonio United
States. 17(9 Supplement) (pp S526), 2022. Date of Publication: September
2022.
Author
Noonan E.; Lennes I.
Institution
(Noonan, Lennes) Massachusetts General Hospital, Boston/MA/USA
Publisher
Elsevier Inc.
Abstract
Introduction: A multidisciplinary approach presents many benefits to
treating patients. When providers from an array of expertise come
together, health outcomes of patients can be enhanced. The Pulmonary
Nodule and Lung Screening Clinic is a multidisciplinary clinic that
consists of a collaboration between the Cancer Center, Thoracic Imaging,
Pulmonary Medicine, Radiation Oncology and Thoracic Surgery. Providers of
each department assess the best treatment for patients attending the
PNLSC. We analyzed if there are significant benefits of having multiple
providers assess each patient by comparing the recommendation from the
PNLSC in comparison to the recommendation from the Radiology Department.
 Method(s): Patients recommended to the PNLSC are evaluated in a group
setting by the following types of providers: Medical Oncologist,
Radiologist, Surgeon, Radiation Oncologist, Pulmonologist, Nurse
Practitioner. Patients are referred to the PNLSC after pulmonary nodules
are incidentally found on CT scans or through low-dose computed tomography
(LDCT) screening. The providers assess the imaging scans of each patient
as well as past medical history to recommend the best plan of action.
Routine radiology recommendations include: follow-up CT Scan interval,
biopsy, intervention, PET Scan, other, or no specific recommendation.
Recommendations by the multidisciplinary clinic include: Follow-up Scan
(LDCT, CT, MRI, PET/PET CT), Biopsy, Surgery, Radiation, Other, or a
combination. Data was analyzed between the radiology recommendation and
multidisciplinary clinic recommendation and placed into the following
categories: discordant-less aggressive vs. discordant-more aggressive vs.
concordant-equal. Result(s): Data was collected using Research
Electronic Database Capture (REDCap). Forty-four dates (between February
12, 2021 through February 4, 2022) of PNCSL were analyzed which included a
total of 742 patients. Completed assessments indicate that 50% of clinic
recommendations are concordant to that of the radiology recommendations,
33% of clinic recommendations are discordant-more aggressive than the
radiology recommendations and 17% of clinic recommendations are
discordant-less aggressive than the radiology recommendations.
 Conclusion(s): Preliminary data shows that half of clinic
recommendations are concordant and equally aggressive than that of
radiology recommendations. However, a significant percentage of the data
shows that clinic recommendations are discordant with more aggressive
recommendations than that of the original radiology recommendations.
Therefore, this may indicate that the use of a multidisciplinary clinic,
with intra-specialty discussion is beneficial to the treatment of
patient's pulmonary nodules as compared to a single radiology provider
determining the correct follow-up. Research is needed to determine if
these results remain consistent dependent on the patient's smoking status
and number of visits to the PNLSC. [Formula presented] Keywords:
Pulmonary, multidisciplinary, radiology Copyright © 2022

<34>
Accession Number
2018927996
Title
Revascularization outcomes in diabetic patients presenting with acute
coronary syndrome with non-ST elevation.
Source
Cardiovascular Diabetology. 21(1) (no pagination), 2022. Article Number:
175. Date of Publication: December 2022.
Author
Ram E.; Fisman E.Z.; Tenenbaum A.; Iakobishvili Z.; Peled Y.; Raanani E.;
Sternik L.
Institution
(Ram, Fisman, Raanani, Sternik) Department of Cardiac Surgery, Tel Aviv
University, Tel Aviv, Israel
(Peled) Department of Cardiology, Tel Aviv University, Tel Aviv, Israel
(Ram, Fisman, Tenenbaum, Iakobishvili, Peled, Raanani, Sternik) Leviev
Cardiothoracic and Vascular Center, Sheba Medical Center, affiliated to
the Sackler School of Medicine, Tel Aviv University, Ramat Gan, Israel
(Ram) The Sheba Talpiot Medical Leadership Program, Ramat Gan, Israel
(Iakobishvili) Clalit Health Services, Tel Aviv, Israel
(Iakobishvili) Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv,
Israel
(Ram) Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer,
Ramat Gan 52621, Israel
Publisher
BioMed Central Ltd
Abstract
Background: To compare the outcomes of diabetic patients hospitalized with
non-ST elevation myocardial infarction (NSTEMI) or unstable angina (UA)
referred for revascularization by either coronary artery bypass grafting
(CABG) or percutaneous coronary intervention (PCI) in a real-life setting.
 Method(s): The study included 1987 patients with diabetes mellitus
enrolled from the biennial Acute Coronary Syndrome Israeli Survey between
2000 and 2016, who were hospitalized for NSTEMI or UA, and underwent
either PCI (N = 1652, 83%) or CABG (N = 335, 17%). Propensity
score-matching analysis compared all-cause mortality in 200 pairs (1:1)
who underwent revascularization by either PCI or CABG. Result(s):
Independent predictors for CABG referral included 3-vessel coronary artery
disease (OR 4.9, 95% CI 3.6-6.8, p < 0.001), absence of on-site cardiac
surgery (OR 1.4, 95% CI 1.1-1.9, p = 0.013), no previous PCI (OR 1.5, 95%
CI 1.1-2.2, p = 0.024) or MI (OR 1.7, 95% CI 1.2-2.6, p = 0.002). While at
2 years of follow-up, survival analysis revealed no differences in
mortality risk between the surgical and percutaneous revascularization
groups (log-rank p = 0.996), after 2 years CABG was associated with a
significant survival benefit (HR 1.53, 95% CI 1.07-2.21; p = 0.021).
Comparison of the propensity score matching pairs also revealed a
consistent long-term advantage toward CABG (log-rank p = 0.031).
 Conclusion(s): In a real-life setting, revascularization by CABG of
diabetic patients hospitalized with NSTEMI/UA is associated with better
long-term outcomes. Prospective randomized studies are warranted in order
to provide more effective recommendations in future
guidelines. Copyright © 2022, The Author(s).

<35>
Accession Number
2018891930
Title
Mechanical Unloading of the Left Ventricle before Coronary Reperfusion in
Preclinical Models of Myocardial Infarction without Cardiogenic Shock: A
Meta-Analysis.
Source
Journal of Clinical Medicine. 11(16) (no pagination), 2022. Article
Number: 4913. Date of Publication: August 2022.
Author
Benenati S.; Crimi G.; Macchione A.; Giachero C.; Pescetelli F.; Balbi M.;
Porto I.; Vercellino M.
Institution
(Benenati, Porto) Cardiovascular Disease Chair, Department of Internal
Medicine (Di.M.I.), University of Genoa, Genoa 16132, Italy
(Crimi, Macchione, Giachero, Pescetelli, Balbi, Porto, Vercellino)
Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, IRCCS
Italian Cardiology Network, Genova 16132, Italy
Publisher
MDPI
Abstract
Aim: to compare a conventional primary reperfusion strategy with a primary
unloading approach before reperfusion in preclinical studies.
 Method(s): we performed a meta-analysis of preclinical studies. The
primary endpoint was infarct size (IS). Secondary endpoints were left
ventricle end-diastolic pressure (LVEDP), mean arterial pressure (MAP),
heart rate (HR), cardiac output (CO). We calculated mean differences (MDs)
and associated 95% confidence intervals (CIs). Sensitivity and subgroup
analyses on the primary and secondary endpoints, as well as a
meta-regression on the primary endpoint using the year of publication as a
covariate, were also conducted. Result(s): 11 studies (n = 142) were
selected and entered in the meta-analysis. Primary unloading reduced IS
(MD -28.82, 95% CI -35.78 to -21.86, I2 96%, p < 0.01) and
LVEDP (MD -3.88, 95% CI -5.33 to -2.44, I2 56%, p = 0.02) and
increased MAP (MD 7.26, 95% CI 1.40 to 13.12, I2 43%, p < 0.01)
and HR (MD 5.26, 95% CI 1.97 to 8.55, I2 1%, p < 0.01), while
being neutral on CO (MD -0.11, 95% CI -0.95 to 0.72, I2 88%, p
= 0.79). Sensitivity and subgroup analyses showed, overall, consistent
results. The meta-regression on the primary endpoint demonstrated a
significant influence of the year of publication on effect estimate.
 Conclusion(s): in animal models of myocardial infarction, a primary
unloading significantly reduces IS and exerts beneficial hemodynamic
effects compared to a primary reperfusion. Copyright © 2022 by
the authors.

<36>
Accession Number
2018869605
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) (no pagination), 2022. Article Number: 732. Date of
Publication: December 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) Haute-Ecole Arc Sante, HES-SO University of Applied Sciences and
Arts Western Switzerland, Neuchatel, Switzerland
Publisher
BioMed Central Ltd
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(s):
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.govNCT04745520. Registered on 8 February
2021. Copyright © 2022, The Author(s).

<37>
Accession Number
2018868444
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) (no pagination), 2022. Article Number: 726. Date of
Publication: December 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
BioMed Central Ltd
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(s): 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).

<38>
Accession Number
2018867080
Title
The application of 3D printing in preoperative planning for transcatheter
aortic valve replacement: a systematic review.
Source
BioMedical Engineering Online. 21(1) (no pagination), 2022. Article
Number: 59. Date of Publication: December 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,
and Physical Sciences, University of Exeter, Exeter, United Kingdom
Publisher
BioMed Central Ltd
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).

<39>
Accession Number
2017953495
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. 11(17) (no pagination), 2022.
Article Number: e025229. Date of Publication: 06 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
(Becker) Institute of Medical Statistics and Computational Biology,
Institute of Medical Statistics and Computational Biology, University of
Cologne, Faculty of Medicine and University Hospital Cologne, Cologne,
Germany
(Koehler, Benzing, Muller) Cologne Excellence Cluster on Cellular Stress
Responses in Aging-Associated Diseases (CECAD), Institute of Medical
Statistics and Computational Biology, University of Cologne, Faculty of
Medicine and University Hospital Cologne, Cologne, Germany
(Faust) Polyclinic for Endocrinology, Diabetes and Preventive Medicine,
University of Cologne, Faculty of Medicine and University Hospital
Cologne, Cologne, Germany
(Wahlers) Department of Cardiothoracic Surgery, University of Cologne,
Faculty of Medicine and University Hospital, Cologne, Germany
Publisher
American Heart Association Inc.
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 7 days
before scheduled cardiac surgery. The primary end point was incidence of
AKI within 72 hours after surgery, secondary end points included increase
of serum creatinine at 24, 48, and 72 hours as well as safety parameters.
Quantitative variables were analyzed with nonparamet-ric 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
me-thionine. 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, 72 hours after surgery) as well as in subgroup
analysis focusing on age, sex, body mass index and diabetes.
 CONCLUSION(S): 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. Copyright © 2022 The Authors. Published
on behalf of the American Heart Association, Inc., by Wiley.

<40>
Accession Number
2020148769
Title
Apixaban and Valve Thrombosis After Transcatheter Aortic Valve
Replacement: The ATLANTIS-4D-CT Randomized Clinical Trial Substudy.
Source
JACC: Cardiovascular Interventions. 15(18) (pp 1794-1804), 2022. Date of
Publication: 26 Sep 2022.
Author
Montalescot G.; Redheuil A.; Vincent F.; Desch S.; De Benedictis M.;
Eltchaninoff H.; Trenk D.; Serfaty J.-M.; Charpentier E.; Bouazizi K.;
Prigent M.; Guedeney P.; Salloum T.; Berti S.; Cequier A.; Lefevre T.;
Leprince P.; Silvain J.; Van Belle E.; Neumann F.-J.; Portal J.-J.; Vicaut
E.; Collet J.-P.
Institution
(Montalescot, Guedeney, Salloum, Silvain, Collet) Sorbonne Universite,
ACTION Group, INSERM UMRS 1166, Hopital Pitie-Salpetriere (AP-HP),
Institut de Cardiologie, Paris, France
(Redheuil, Charpentier, Bouazizi, Prigent) Sorbonne Universite,
Laboratoire Imagerie Biomedicale, ICAN, ACTION Group, Hopital
Pitie-Salpetriere (AP-HP), Institut de Cardiologie, Paris, France
(Vincent, Van Belle) CHU Lille, Institut Coeur Poumon, Pole
Cardiovasculaire et Pulmonaire, ACTION Group, Inserm U1011, Institut
Pasteur de Lille, EGID, Universite de Lille, Lille, France
(Desch) Department of Internal Medicine/Cardiology, Heart Center Leipzig
at University of Leipzig, Leipzig, Germany
(De Benedictis) Azienda Ospedaliera Ordine Mauriziano di Torino, Torino,
Italy
(Eltchaninoff) Normandie Universite, UNIROUEN, U1096, CHU Rouen,
Departement de Cardiologie, FHU CARNAVAL, Rouen, France
(Trenk, Neumann) Division of Cardiology and Angiology II, University Heart
Centre Freiburg, Bad Krozingen, Germany
(Serfaty) Hopital Guillaume et Rene Laennec, Institut du Thorax-Clinique
Cardiologique, Unite d'Imagerie Cardiaque et Vasculaire Diagnostique,
Nantes, France
(Berti) Fondazione Toscana G. Monasterio, Ospedale del Cuore G.
Pasquinucci, Massa, Italy
(Cequier) Hospital Universitario de Bellvitge, University of Barcelona,
Heart Disease Institute, L'Hospitalet de Llobregat, Barcelona, Spain
(Lefevre) Hopital Prive Jacques Cartier, Institut Cardiovasculaire Paris
Sud, Massy, France
(Leprince) Sorbonne Universite, Hopital Pitie-Salpetriere (AP-HP),
Institut de Cardiologie, Chirurgie Cardiaque, Paris, France
(Portal, Vicaut) Unite de Recherche Clinique Lariboisiere St-Louis, ACTION
Group, Hopital St-Louis & Fernand Widal, Paris, France
Publisher
Elsevier Inc.
Abstract
Background: Subclinical obstructive valve thrombosis after transcatheter
aortic valve replacement (TAVR) is of uncertain frequency and clinical
impact. Objective(s): The aim of this study was to determine the
effects of apixaban vs standard of care on post-TAVR valve thrombosis
detected by 4-dimensional (4D) computed tomography. Method(s): The
randomized ATLANTIS (Anti-Thrombotic Strategy to Lower All Cardiovascular
and Neurologic Ischemic and Hemorrhagic Events After Trans-Aortic Valve
Implantation for Aortic Stenosis) trial demonstrated that apixaban 5 mg
twice daily was not superior to standard of care (vitamin K antagonists or
antiplatelet therapy) after successful TAVR and was associated with
similar safety but with more noncardiovascular deaths. Three months after
randomization, 4D computed tomography was proposed to all patients to
determine the percentage of patients with >=1 prosthetic valve leaflet
with grade 3 or 4 reduced leaflet motion or grade 3 or 4 hypoattenuated
leaflet thickening (the primary endpoint) in the intention-to-treat
population. Result(s): Seven hundred sixty-two participants had
complete multiphase datasets and were included in the 4D computed
tomographic analysis. The primary endpoint occurred in 33 (8.9%) and 51
(13.0%) patients in the apixaban and standard-of-care groups,
respectively. It was reduced with apixaban vs antiplatelet therapy (OR:
0.51; 95% CI: 0.30-0.86) but not vs vitamin K antagonists (OR: 1.80; 95%
CI: 0.62-5.25) (P<inf>interaction</inf> = 0.037). The composite of death,
myocardial infarction, any stroke, or systemic embolism at 1 year occurred
in 10.7% (n = 9 of 84) and 7.1% (n = 48 of 178) of patients with and
without subclinical valve thrombosis at 90 days, respectively (HR: 1.68;
95% CI: 0.82-3.44). Conclusion(s): Apixaban reduced subclinical
obstructive valve thrombosis in the majority of patients who underwent
TAVR without having an established indication for anticoagulation. This
study was not powered for clinical outcomes. (Anti-Thrombotic Strategy
After Trans-Aortic Valve Implantation for Aortic Stenosis [ATLANTIS];
NCT02664649) Copyright © 2022 American College of Cardiology
Foundation

<41>
Accession Number
2020131432
Title
Transcatheter mitral valve repair for inotrope dependent cardiogenic shock
- Design and rationale of the CAPITAL MINOS trial.
Source
American Heart Journal. 254 (pp 81-87), 2022. Date of Publication:
December 2022.
Author
Parlow S.; Di Santo P.; Jung R.G.; Fam N.; Czarnecki A.; Horlick E.;
Abdel-Razek O.; Chan V.; Hynes M.; Nicholson D.; Dryden A.; Fernando S.M.;
Wells G.A.; Bernick J.; Labinaz M.; Mathew R.; Simard T.; Hibbert B.
Institution
(Parlow, Di Santo, Abdel-Razek, Labinaz, Mathew, Hibbert) Division of
Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
(Parlow, Di Santo, Jung, Abdel-Razek, Labinaz, Mathew, Hibbert) CAPITAL
Research Group, University of Ottawa Heart Institute, Ottawa, ON, Canada
(Di Santo, Wells) School of Epidemiology and Public Health, University of
Ottawa, Ottawa, ON, Canada
(Jung, Hibbert) Vascular Biology and Experimental Medicine Laboratory,
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Jung) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
(Fam) Division of Cardiology, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Czarnecki) Division of Cardiology, Sunnybrook Hospital, University of
Toronto, Toronto, ON, Canada
(Horlick) Division of Cardiology, Toronto General Hospital, University of
Toronto, Toronto, ON, Canada
(Chan) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Hynes, Nicholson, Dryden) Division of Cardiac Anesthesiology, University
of Ottawa Heart Institute, Ottawa, ON, Canada
(Fernando) Division of Critical Care Medicine, Department of Medicine,
University of Ottawa, Ottawa, ON, Canada
(Fernando) Clinical Epidemiology Program, Ottawa Hospital Research
Institute, University of Ottawa, Ottawa, ON, Canada
(Wells, Bernick) Cardiovascular Research Methods Center, University of
Ottawa Heart Institute, Ottawa, ON, Canada
(Simard) Department of Cardiovascular Diseases, Mayo Clinic School of
Medicine, Rochester, Minnesota, United States
Publisher
Elsevier Inc.
Abstract
Background: Functional mitral regurgitation (MR) is an important clinical
consideration in patients with heart failure. Transcatheter edge-to-edge
repair (TEER) has emerged as a useful therapeutic tool for patients with
chronic heart failure, however the role of TEER in patients with
cardiogenic shock (CS) and MR has not yet been studied in a randomized
trial. The Transcatheter Mitral Valve Repair for Inotrope Dependent
Cardiogenic Shock (CAPITAL MINOS) trial was therefore designed to
determine if TEER improves clinical outcomes in the CS population. Methods
and Design: The CAPITAL MINOS trial is an open-label, multi-center
randomized clinical trial comparing TEER to medical therapy in patients
with CS and MR. A total of 144 patients with Society for Cardiovascular
Angiography and Interventions (SCAI) class C or D CS and at least 3+ MR
will be randomized in a 1:1 ratio to TEER or medical therapy alone. The
primary outcome will be a composite of in-hospital all-cause mortality,
cardiac transplantation, implantation of durable left ventricular assist
device, or discharge on palliative inotropic therapy. Patients will be
followed for the duration of their index hospitalization for the primary
outcome. Secondary outcomes include 6 month mortality. Implications: The
CAPITAL MINOS trial will determine whether TEER improves outcomes in
patients with CS and MR and will be an important step in optimizing
treatment for this high-risk patient population. Copyright © 2022

<42>
Accession Number
2020140721
Title
Immediate versus staged complete myocardial revascularization in patients
with ST-segment elevation myocardial infarction and multivessel disease: A
post hoc analysis of the randomized FLOWER-MI trial.
Source
Archives of Cardiovascular Diseases. (no pagination), 2022. Date of
Publication: 2022.
Author
Tea V.; Morelle J.-F.; Gallet R.; Cayla G.; Lemesle G.; Lhermusier T.;
Dillinger J.-G.; Ducrocq G.; Angouvant D.; Cottin Y.; Chamandi C.; le Bras
A.; Steg P.G.; Montalescot G.; Nelson A.C.; Simon T.; Chatellier G.;
Danchin N.; Puymirat E.
Institution
(Tea, Chamandi, Danchin, Puymirat) Department of Cardiology, Hopital
Europeen Georges Pompidou, AP-HP, Paris 75015, France
(Morelle) Clinique St. Martin, Caen 14000, France
(Gallet) Service de cardiologie, Hopitaux Universitaires Henri Mondor,
AP-HP, Creteil 94000, France
(Cayla) Centre Hospitalier Universitaire de Nimes, Nimes 30900, France
(Cayla, Lemesle, Dillinger, Ducrocq, Angouvant, Steg, Simon, Danchin,
Puymirat) French Alliance for Cardiovascular Trials (FACT), Paris 75018,
France
(Lemesle) Cardiac Intensive Care Unit, CHU de Lille, Lille 59000, France
(Lhermusier) Department of Cardiology, Intensive Cardiac Care Unit,
Rangueil University Hospital, Toulouse 31059, France
(Dillinger) Department of Cardiology, Hopital Lariboisiere, AP-HP, Inserm
U-942, Universite de Paris, Paris 75010, France
(Ducrocq, Steg) Department of Cardiology, Hopital Bichat, AP-HP, Paris
75018, France
(Angouvant) Cardiology Department, University Hospital of Tours, Tours
37000, France
(Cottin) PEC2, EA 7460, University of Bourgogne Franche-Comte, Dijon
21000, France
(le Bras) Clinical Research Unit Eco Ile de France, Hopital Hotel Dieu,
AP-HP, Paris 75004, France
(Montalescot) Sorbonne Universite, ACTION Study Group, Institut de
Cardiologie (AP-HP), Inserm UMRS 1166, Hopital Pitie-Salpetriere, Paris
75013, France
(Nelson, Chatellier) Clinical Research Unit and CIC 1418 Inserm, Hopital
Europeen Georges Pompidou, AP-HP, Paris 75015, France
(Simon) Department of Clinical Pharmacology and Unite de Recherche
Clinique (URCEST), Hopital Saint Antoine, AP-HP, Paris 75012, France
(Tea, Chamandi, Danchin, Puymirat) Universite de Paris, Paris 75006,
France
(Gallet) U955-IMRB, Equipe 03, Inserm, Universite Paris Est Creteil
(UPEC), Ecole Nationale Veterinaire D'Alfort (EnVA), Maisons-Alfort 94700,
France
(Lemesle) Heart and Lung Institute, CHU de Lille, Institut Pasteur of
Lille, Inserm U1011, Lille 59000, France
(Lhermusier) Medical School, Toulouse III Paul Sabatier University,
Toulouse 31059, France
(Ducrocq, Steg) Inserm U1148, Laboratory for Vascular Translational
Science, Paris 75018, France
(Ducrocq, Steg) Universite de Paris, Paris 75005, France
(Cottin) Cardiology Department, University Hospital Centre of Dijon
Bourgogne, Dijon 21000, France
(Simon) Universite Pierre et Marie Curie (UPMC-Paris 06), Paris 75005,
France
(Simon) Inserm U-698, Paris 75012, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: In patients with ST-segment elevation myocardial infarction
and multivessel disease, percutaneous coronary intervention for
non-culprit lesions is superior to treatment of the culprit lesion alone.
The optimal timing for non-infarct-related artery revascularization -
immediate versus staged - has not been investigated adequately.
 Aim(s): We aimed to assess clinical outcomes at 1 year in patients
with ST-segment elevation myocardial infarction with multivessel disease
using immediate versus staged non-infarct-related artery
revascularization. Method(s): Outcomes were analysed in patients from
the randomized FLOWER-MI trial, in whom, after successful primary
percutaneous coronary intervention, non-culprit lesions were assessed
using fractional flow reserve or angiography during the index procedure or
during a staged procedure during the initial hospital stay, <= 5 days
after the index procedure. The primary outcome was a composite of
all-cause death, non-fatal myocardial infarction and unplanned
hospitalization with urgent revascularization at 1 year. Result(s):
Among 1171 patients enrolled in this study, 1119 (96.2%) had complete
revascularization performed during a staged procedure, and 44 (3.8%) at
the time of primary percutaneous coronary intervention. During follow-up,
a primary outcome event occurred in one of the patients (2.3%) with an
immediate strategy and in 55 patients (4.9%) with a staged strategy
(adjusted hazard ratio 1.44, 95% confidence interval 0.39-12.69; P =
0.64). Conclusion(s): Staged non-infarct-related artery complete
revascularization was the strategy preferred by investigators in practice
in patients with ST-segment elevation myocardial infarction with
multivessel disease. This strategy was not superior to immediate
revascularization, which, in the context of this trial, was used in a
small proportion of patients. Further randomized studies are needed to
confirm these observational findings. Copyright © 2022 Elsevier
Masson SAS

<43>
Accession Number
2018960497
Title
Adverse complications of frozen elephant trunk, do we have enough quality
data?.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Howard C.; Al-Tawil M.; Geragotellis A.; Abdelhaliem A.
Institution
(Howard) Faculty of Biology, Medicine and Health, The University of
Manchester, Manchester, United Kingdom
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Geragotellis) Faculty of Health Sciences, University of Cape Town, Cape
Town, South Africa
(Abdelhaliem) Department of Vascular and Endovascular Surgery, Royal
Blackburn Teaching Hospital, Blackburn, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Frozen elephant trunk has in recent times become a mainstay
for total arch replacement in aortovascular surgery and is indicated to
treat a spectrum of complex aortic pathologies. However, despite
associated excellent postoperative results it is incredibly important to
recognize potential adverse complications such as negative aortic
remodeling, endoleak, and distal stent-graft induced new entry so that
outcomes can be further improved. Aim of the study: Below we provide
commentary on a recent article in the Journal of Cardiac Surgery
discussing the topic. Conclusion(s): Despite the fascinating outcomes
of this systematic review and meta-analysis the heterogeneity of the
literature regarding these adverse outcomes remains an issue which can
only be solved with large multicenter trials directly comparing graft
types as well as indications for surgery. Copyright © 2022 Wiley
Periodicals LLC.

<44>
Accession Number
2018878356
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: 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,
Vejle-Kolding, 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
John Wiley and Sons Inc
Abstract
Introduction: Coronary CT angiography (CTA) derived fractional flow
reserve (FFR<inf>CT</inf>) 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(s): To test whether lipid lowering
therapy is associated with significant improvement in FFR<inf>CT</inf>,
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 FFR<inf>CT</inf> <= 0.80 in whom
coronary revascularization was deferred. Patients are randomized to
standard (atorvastatin 40 mg daily) or intensive (rosuvastatin 40 mg +
ezetimibe 10 mg daily) lipid lowering therapy for 18 months. Coronary CTA
scans with blinded coronary plaque and FFR<inf>CT</inf> analyses will be
repeated after 9 and 18 months. The primary endpoint is the 18-month
difference in FFR<inf>CT</inf> using (1) the FFR<inf>CT</inf> value 2 cm
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.

<45>
Accession Number
638985208
Title
Five-Year Results of Coronary Artery Bypass Grafting With or Without
Carotid Endarterectomy in Patients With Asymptomatic Carotid Artery
Stenosis: CABACS RCT.
Source
Stroke. (pp 101161STROKEAHA121037493), 2022. Date of Publication: 09 Sep
2022.
Author
Knipp S.C.; Holst T.; Bilbilis K.; von Velsen O.; Ose C.; Diener H.-C.;
Jakob H.; Ruhparwar A.; Jockel K.-H.; Weimar C.
Institution
(Knipp, Jakob, Ruhparwar) Department of Thoracic and Cardiovascular
Surgery, University Hospital Essen, Germany (S.C.K., Germany
(Holst) Department of Cardiac Surgery, Medical Faculty and University
Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
(T.H.), Germany
(Bilbilis, von Velsen, Ose, Jockel) Center for Clinical Trials Essen
(ZKSE), c/o Institute for Medical Informatics, Biometry and Epidemiology
(IMIBE), University Hospital Essen, Germany (K.B., C.O
(Diener, Jockel, Weimar) Institute for Medical Informatics, Biometry and
Epidemiology (IMIBE), University Hospital Essen, Germany (H.-C.D., Germany
(Weimar) BDH Clinic Elzach GmbH, Germany (C.W.), Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: In patients with coronary artery disease and concomitant
asymptomatic severe carotid stenosis, combined simultaneous coronary
artery bypass grafting (CABG) and carotid endarterectomy (CEA) has been
widely performed despite lack of evidence from randomized trials. We
recently showed that the risk of stroke or death within 30 days was higher
following CABG+CEA compared with CABG alone. Here, we report long-term
outcomes following CABG with versus without CEA. METHOD(S): The
CABACS (Coronary Artery Bypass Graft Surgery in Patients With Asymptomatic
Carotid Stenosis Study) is a randomized, controlled, multicenter, open
trial. Patients with asymptomatic severe (>=70%) carotid stenosis
undergoing CABG were allocated either CABG+CEA or CABG alone, and
follow-up was 5 years. Major secondary end points included nonfatal stroke
or death, any death and any nonfatal stroke. Due to low recruitment, the
study was stopped prematurely after randomization of 127 patients in 17
centers. RESULT(S): By 5 years, the rate of stroke or death did not
significantly differ between groups (CABG+CEA 40.6% [95% CI, 0.285-0.536],
CABG alone 35.0% [95% CI, 0.231-0.484]; P=0.58). Higher albeit
statistically nonsignificant rates of nonfatal strokes occurred at any
time following CABG+CEA versus CABG alone (1 year: 19.3% versus 7.1%,
P=0.09; 5 years: 29.4% versus 18.8%, P=0.25). All-cause mortality up to 5
years was similar in both groups (CABG+CEA: 25.4% versus CABG alone:
23.3%, hazard ratio, 1.148 [95% CI, 0.560-2.353]; P=0.71). Subgroup
analyses did not reveal any significant effect of age, sex, preoperative
modified Rankin Scale and center on outcome events. CONCLUSION(S):
During 5-years follow-up, combined simultaneous CABG+CEA was associated
with a higher albeit statistically nonsignificant rate of stroke or death
compared with CABG alone. This was mainly due to a nonsignificantly higher
perioperative risk following CABG+CEA. Since the power of our study was
not sufficient, no significant effect of either procedure could be
observed at any time during follow-up. REGISTRATION:
http://www.controlled-trials.com; ISRCTN13486906.

<46>
Accession Number
638983662
Title
Clinical factors affecting survival in patients with D-transposition of
the great arteries after atrial switch repair: A meta-analysis.
Source
Kardiologia polska. (no pagination), 2022. Date of Publication: 09 Sep
2022.
Author
Nartowicz S.A.; Jakielska E.; Cieplucha A.; Ratajczak P.; Grajek S.;
Lesiak M.; Trojnarska O.
Institution
(Nartowicz, Jakielska, Grajek, Lesiak, Trojnarska) Poznan University of
Medical Sciences, Poznan, Poland
(Cieplucha) 1st Department of Cardiology, Poznan University of Medical
Sciences, Poznan, Poland
(Ratajczak) Department of Pharmacoeconomics and Social Pharmacy, Poznan
University of Medical Sciences, Poznan, Poland
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial switch repair (AtrSR) was the initial method of
operation in patients with D-transposition of the great arteries (D-TGA)
constituting the right ventricle as a systemic one. Currently, it has been
replaced with arterial switch operation (ASO), but the cohort of adults
after AtrSR is still large and requires strict cardiological management of
late complications. For this reason, we aimed to evaluate potential
long-term mortality risk factors in patients with D-TGA after AtrSR
(either Mustard or Senning procedure) METHOD: We searched MEDLINE database
for suitable trials. We included 22 retrospective and prospective cohort
studies of patients with D-TGA with at least 5 years mean/median follow-up
time after Mustard or Senning procedure, with an end-point of non-sudden
cardiac death (n-SCD) and sudden cardiac death (SCD) after at least 30
days after surgery. RESULT(S): A total of 2912 patients were
enrolled, of which 351 met the combined endpoint of n-SCD/SCD. The
long-term mortality risk factors were: New York Heart Association class >=
III /heart failure hospitalization (OR = 7.25; 95% CI, 2.67-19.7),
tricuspid valve regurgitation (OR = 4.64; 95% CI, 1.95-11.05), Mustard
procedure (OR = 2.15; 95% CI, 1.37-3.35), complex D-TGA (OR = 2.41; 95%
CI, 1.31-4.43); and right ventricle dysfunction (OR = 1.94; 95% CI,
0.99-3.79) tends to be a risk factor. Supraventricular arrhythmia (SVT; OR
= 2.07; 95% CI, 0.88-4.85) and pacemaker implantation (OR = 2.37; 95% CI,
0.48-11.69) did not affect long-term survival in this group of patients.
In an additional analysis, SVT showed a statistically significant impact
on SCD (OR = 2.74; 95% CI, 1.36-5.53) but not on n-SCD (OR = 1.5; 95% CI,
0.37-6.0). CONCLUSION(S): This meta-analysis identified that at least
moderate tricuspid valve regurgitation, NYHA class >= III / heart failure
hospitalization, right ventricle dysfunction, complex D-TGA and Mustard
procedure as risk factors of long-term mortality in patients after AtrSR.

<47>
Accession Number
2007327342
Title
Interventions and neonatal outcomes of fetuses with hypoplastic left heart
syndrome and congenital diaphragmatic hernia: a systematic review.
Source
Journal of Maternal-Fetal and Neonatal Medicine. 35(21) (pp 4184-4189),
2022. Date of Publication: 2022.
Author
Kanade R.; Shazly S.; Ruano R.
Institution
(Kanade, Shazly, Ruano) Department of Obstetrics and Gynecology,
Maternal-Fetal Medicine Division, Mayo Clinic College of Medicine,
Rochester, MN, United States
Publisher
Taylor and Francis Ltd.
Abstract
Objective: To evaluate the current interventions and outcomes in neonates
born with hypoplastic left heart syndrome (HLHS) and congenital
diaphragmatic hernias (CDHs). Method(s): A comprehensive search of
the literature using relevant search words was conducted from the date of
each database inception to August 2018 to identify interventions and
outcomes in patients with CDH and HLHS. Conference papers, review
articles, case reports, and animal studies were not eligible for this
review. Articles were also excluded if left heart hypoplasia, rather than
HLHS, was studied. Neither language nor sample size was used for
exclusion. A preliminary screening of article titles was performed to rule
out irrelevant articles and article types by a single reviewer. A second
screening circle was performed by two independent reviewers to assess
remaining abstracts. Data were presented as a systematic review and were
descriptively summarized. Result(s): Of the 162 retrieved articles,
five studies were eligible for inclusion. The total number of neonates
included in this systematic review was 5063. One hundred and eighteen
(2.3%) presented specifically with CDH and HLHS. Overall, a total of 62 of
the 118 patients underwent a surgical procedure (51%) with 36 (59%)
surviving to discharge. Conclusion(s): Available data suggest current
surgical interventions still result in a high degree of mortality. Age at
which surgery occurred, pulmonary function and the use of extra-corporeal
membrane oxygenation (ECMO) are potential variables that may determine and
improve outcomes in these patients in the future. However, long-term
outcomes and analyses of more variables are needed to determine effective
treatment for this rare but often fatal comorbid congenital
diagnosis. Copyright © 2020 Informa UK Limited, trading as Taylor
& Francis Group.

<48>
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.

<49>
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

<50>
Accession Number
2019941132
Title
The effects of hydroxyethyl starch 130/0.4 on perioperative renal function
in patients undergoing cardiac surgery: A randomised controlled trial.
Source
Annals of Medicine and Surgery. 81 (no pagination), 2022. Article Number:
104475. Date of Publication: September 2022.
Author
Nagaya K.; Yoshida A.; Ito Y.; Watanabe S.; Minagawa T.; Saijo Y.
Institution
(Nagaya, Yoshida, Ito) Department of Anesthesia, Tohoku Medical and
Pharmaceutical University Hospital, Sendai, Japan
(Watanabe) Department of Cardiovascular Surgery, Sendai Medical Center,
Sendai, Japan
(Minagawa) Department of Cardiovascular Surgery, Tohoku Medical and
Pharmaceutical University Hospital, Sendai, Japan
(Saijo) Biomedical Imaging Laboratory, Graduate School of Biomedical
Engineering, Tohoku University, Sendai, Japan
Publisher
Elsevier Ltd
Abstract
Background: Acute kidney injury (AKI) after cardiac surgery increases the
risk of morbidity and mortality. Hydroxyethyl starch (HES) is often used
during surgery due to its plasma-volume expanding effect, but the impact
of HES 130/0.4 on renal function in patients undergoing cardiac surgery
remains unclear. The aim of our study is to investigate the impact of HES
130/0.4 on postoperative renal function in patients undergoing cardiac
surgery using cardiopulmonary bypass. Method(s): Our study was a
randomised, single-center, single-blind study conducted on 60 adult
patients who underwent cardiac surgery using cardiopulmonary bypass: 30
patients were intraoperatively administered with HES 130/0.4; the other 30
with Ringer's bicarbonate. The primary endpoints were occurrence of AKI
within 30 days of surgery and the disease stages. Result(s): The mean
dose of 6% HES 130/0.4 was 28 ml/kg. AKI occurred within 30 days of the
operation in 8 cases (28.6%) in the HES group and 6 cases (21.4%) in the
crystalloid group (no significance: p = 0.5371). Disease stages were as
follows: "no AKI", "stage 1", "stage 2 and "stage 3, accounting for 20
cases (71.5%), 6 cases (21,4%), 2 cases (7.1%), and 0 cases, respectively,
in the HES group, and 22 cases (78.6%), 6 cases (21.4%), 0 cases, and 0
cases, respectively, in the crystalloid group (no significance: p =
0.3508). Conclusion(s): There was no significant difference in the
occurrences or stages of AKI during the 30 days following cardiac surgery
with cardiopulmonary bypass between patients administered with HES 130/0.4
or Ringer's bicarbonate. Copyright © 2022 The Authors

<51>
[Use Link to view the full text]
Accession Number
2019652672
Title
Heart Disease and Stroke Statistics-2022 Update: A Report from the
American Heart Association.
Source
Circulation. 145(8) (pp E153-E639), 2022. Date of Publication: 22 Feb
2022.
Author
Tsao C.W.; Aday A.W.; Almarzooq Z.I.; Alonso A.; Beaton A.Z.; Bittencourt
M.S.; Boehme A.K.; Buxton A.E.; Carson A.P.; Commodore-Mensah Y.; Elkind
M.S.V.; Evenson K.R.; Eze-Nliam C.; Ferguson J.F.; Generoso G.; Ho J.E.;
Kalani R.; Khan S.S.; Kissela B.M.; Knutson K.L.; Levine D.A.; Lewis T.T.;
Liu J.; Loop M.S.; Ma J.; Mussolino M.E.; Navaneethan S.D.; Perak A.M.;
Poudel R.; Rezk-Hanna M.; Roth G.A.; Schroeder E.B.; Shah S.H.; Thacker
E.L.; Vanwagner L.B.; Virani S.S.; Voecks J.H.; Wang N.-Y.; Yaffe K.;
Martin S.S.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The American Heart Association, in conjunction with the
National Institutes of Health, annually reports the most up-to-date
statistics related to heart disease, stroke, and cardiovascular risk
factors, including core health behaviors (smoking, physical activity,
diet, and weight) and health factors (cholesterol, blood pressure, and
glucose control) that contribute to cardiovascular health. The Statistical
Update presents the latest data on a range of major clinical heart and
circulatory disease conditions (including stroke, congenital heart
disease, rhythm disorders, subclinical atherosclerosis, coronary heart
disease, heart failure, valvular disease, venous disease, and peripheral
artery disease) and the associated outcomes (including quality of care,
procedures, and economic costs). Method(s): The American Heart
Association, through its Statistics Committee, continuously monitors and
evaluates sources of data on heart disease and stroke in the United States
to provide the most current information available in the annual
Statistical Update. The 2022 Statistical Update is the product of a full
year's worth of effort by dedicated volunteer clinicians and scientists,
committed government professionals, and American Heart Association staff
members. This year's edition includes data on the monitoring and benefits
of cardiovascular health in the population and an enhanced focus on social
determinants of health, adverse pregnancy outcomes, vascular contributions
to brain health, and the global burden of cardiovascular disease and
healthy life expectancy. Result(s): Each of the chapters in the
Statistical Update focuses on a different topic related to heart disease
and stroke statistics. Conclusion(s): The Statistical Update
represents a critical resource for the lay public, policymakers, media
professionals, clinicians, health care administrators, researchers, health
advocates, and others seeking the best available data on these factors and
conditions. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<52>
Accession Number
2019117347
Title
Anesthetics to Prevent Lung Injury in Cardiac Surgery: A Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(10) (pp 3747-3757),
2022. Date of Publication: October 2022.
Author
O'Gara B.P.; Shaefi S.; Gasangwa D.V.; Patxot M.; Beydoun N.; Mueller
A.L.; Sagy I.; Novack V.; Banner-Goodspeed V.M.; Kumaresan A.; Shapeton
A.; Spear K.; Bose S.; Baedorf Kassis E.N.; Gosling A.F.; Mahmood
F.-U.-D.; Khabbaz K.; Subramaniam B.; Talmor D.S.
Institution
(O'Gara, Shaefi, Gasangwa, Patxot, Beydoun, Banner-Goodspeed, Bose,
Baedorf Kassis, Mahmood, Subramaniam, Talmor) Beth Israel Deaconess
Medical Center, Department of Anesthesia, Critical Care, and Pain
Medicine, Boston, MA
(Mueller) Massachusetts General Hospital, Department of Anesthesia,
Boston, MA
(Sagy, Novack) Clinical Research Center, Soroka University Medical Center,
Beer-Sheva, Israel
(Kumaresan) Keck Medical Center, Department of Anesthesiology, Los
Angeles, CA
(Shapeton) Veterans Affairs Boston Healthcare, West Roxbury, MA, United
States
(Spear) Beth Israel Deaconess Medical Center, Department of Perfusion,
Boston, MA
(Gosling) Duke University Medical Center, Department of Anesthesia,
Raleigh, NC
(Khabbaz) Beth Israel Deaconess Medical Center, Department of Surgery,
Division of Cardiac Surgery, Boston, MA
Publisher
W.B. Saunders
Abstract
Objectives: To investigate if sevoflurane based anesthesia is superior to
propofol in preventing lung inflammation and preventing postoperative
pulmonary complications. Design(s): Randomized controlled trial.
 Setting(s): Single tertiary care university hospital.
 Participant(s): Forty adults undergoing cardiac surgery with
cardiopulmonary bypass. Intervention(s): Patients were randomized in
a 1:1 ratio to anesthetic maintenance with sevoflurane or propofol.
 Measurements and Main Results: Blood and bronchoalveolar lavage fluid
was sampled before and after bypass to measure pulmonary inflammation
using a biomarker panel. The change in bronchoalveolar lavage
concentration of tumor necrosis factor alpha (TNFalpha) was the primary
outcome. Secondary outcomes included lung inflammation defined as changes
in other biomarkers and postoperative pulmonary complications. There were
no significant differences between groups in the change in bronchoalveolar
lavage TNFalpha concentration (median [IQR] change, 17.24 [1.11-536.77] v
101.51 [1.47-402.84] pg/mL, sevoflurane v propofol, p = 0.31). There was a
significantly lower postbypass concentration of plasma interleukin 8
(median [IQR], 53.92 [34.5-55.91] v 66.92 [53.03-94.44] pg/mL, p = 0.04)
and a significantly smaller postbypass increase in the plasma receptor for
advanced glycosylation end products (median [IQR], 174.59 [73.59-446.06] v
548.22 [193.15-852.39] pg/mL, p = 0.03) in the sevoflurane group compared
with propofol. The incidence of postoperative pulmonary complications was
100% in both groups, with high rates of pleural effusion (17/18 [94.44%] v
19/22 [86.36%], p = 0.39) and hypoxemia (16/18 [88.88%] v 22/22 [100%], p
= 0.11). Conclusion(s): Sevoflurane anesthesia during cardiac surgery
did not consistently prevent lung inflammation or prevent postoperative
pulmonary complications compared to propofol. There were significantly
lower levels of 2 plasma biomarkers specific for lung injury and
inflammation in the sevoflurane group. Copyright © 2022 Elsevier
Inc.

<53>
Accession Number
2018793364
Title
Implementation of early rehabilitation for critically ill children in
China: A survey and narrative review of the literature.
Source
Frontiers in Pediatrics. 10 (no pagination), 2022. Article Number: 941669.
Date of Publication: 12 Aug 2022.
Author
Zhang T.; Duan X.; Feng Y.; Jiang W.; Hou X.; Liu L.; Huang Q.; Tang X.;
Lin L.; Zhang M.; Tao L.; Liu G.; Chen Y.; Xiao N.
Institution
(Zhang, Duan, Feng, Jiang, Hou, Liu, Huang, Tang, Lin, Zhang, Tao, Liu,
Chen, Xiao) Department of Rehabilitation, Children's Hospital of Chongqing
Medical University, Chongqing, China
(Zhang, Duan, Feng, Jiang, Hou, Liu, Huang, Tang, Lin, Zhang, Tao, Liu,
Chen, Xiao) National Clinical Research Center for Child Health and
Disorders, Chongqing, China
(Zhang, Duan, Feng, Jiang, Hou, Liu, Huang, Tang, Lin, Zhang, Tao, Liu,
Chen, Xiao) Ministry of Education Key Laboratory of Child Development and
Disorders, Chongqing, China
(Zhang, Duan, Feng, Jiang, Hou, Liu, Huang, Tang, Lin, Zhang, Tao, Liu,
Chen, Xiao) Chongqing Key Laboratory of Pediatrics, Chongqing, China
Publisher
Frontiers Media S.A.
Abstract
Introduction: The focus of this survey was to understand the current
status of implementation of early rehabilitation for critically ill
children in China. We also reviewed the available literature on this topic
for further insights to inform its future development. Material(s)
and Method(s): We used a cross-sectional study design to survey tertiary
hospitals nationwide. Questionnaires were distributed via the social media
platform "WeChat Questionnaire Star" within the framework of the
Rehabilitation Group of the Pediatrics Branch of the Chinese Medical
Association. A narrative literature review on the implementation of the
early rehabilitation for critically ill pediatric and/or adult patients
was carried out. Result(s): A total of 202 valid questionnaires were
received. About half (n = 105, 52.0%) of respondent hospitals reported
that they implement early rehabilitation for critically ill children.
Among these 105 hospitals, 28 implemented a continuous chain of early
rehabilitation. A total of 24 hospitals had set up permanent specialized
centralized early rehabilitation units for critically ill children.
Implications and future directions: Early rehabilitation for critically
ill children is not widely available in China and only a minority of
hospitals implement a continuous chain of early rehabilitation. To improve
this undesirable situation, we suggest creating a two-level integrated
system comprising centralized early rehabilitation units and surrounding
early rehabilitation networks within a region. Copyright © 2022
Zhang, Duan, Feng, Jiang, Hou, Liu, Huang, Tang, Lin, Zhang, Tao, Liu,
Chen and Xiao.

<54>
Accession Number
2018755322
Title
Thromboembolic complications in children with COVID-19 and MIS-C: A
narrative review.
Source
Frontiers in Pediatrics. 10 (no pagination), 2022. Article Number: 944743.
Date of Publication: 11 Aug 2022.
Author
Trapani S.; Rubino C.; Lasagni D.; Pegoraro F.; Resti M.; Simonini G.;
Indolfi G.
Institution
(Trapani, Pegoraro) Department of Health Sciences, Meyer Children's
University Hospital, University of Florence, Florence, Italy
(Trapani, Rubino, Lasagni, Resti, Indolfi) Pediatric Unit, Meyer
Children's University Hospital, Florence, Italy
(Simonini) Rheumatology Unit, Meyer Children's University Hospital,
University of Florence, Florence, Italy
(Simonini, Indolfi) Department of NEUROFARBA, Meyer Children's University
Hospital, University of Florence, Florence, Italy
Publisher
Frontiers Media S.A.
Abstract
COVID-19 and multisystem inflammatory syndrome in children (MIS-C) have
been associated with a higher incidence of hypercoagulability and
thromboembolic events (TEs), even in children, leading to relevant
morbidity, and mortality. However, our understanding of such complications
in childhood is limited. To better understand the incidence, clinical
manifestations, risk factors, and management of COVID-19 and MIS-C-related
TEs in children, a review of the current literature and a brief update on
pathophysiology are given. Sixty-two studies, describing 138 patients with
TEs associated with COVID-19 or MIS-C, were included. The overall number
of TEs was 157, as 16 patients developed multiple TEs: venous TEs
represented the majority (54%), followed by arterial thrombosis (38%,
mainly represented by arterial ischemic stroke-AIS), and intracardiac
thrombosis (ICT) (8%). Within the venous TEs group, pulmonary embolism
(PE) was the most frequent, followed by deep venous thrombosis, central
venous sinus thrombosis, and splanchnic venous thrombosis. Notably, 10
patients had multiple types of venous TEs, and four had both venous and
arterial thrombosis including a newborn. Most of them (79 cases,57%) had
at least one predisposing condition, being obesity the most frequent
(21%), especially in patients with PE, followed by malignancy (9%). In 35%
of cases, no data about the outcome were available About one-third of
cases recovered, 12% improved at discharge or follow-up, and 6% had
persistent neurological sequelae. The mortality rate was 12%, with death
due to comorbidities in most cases. Most fatalities occurred in patients
with arterial thrombosis. Pediatricians should be aware of this
life-threatening possibility facing children with SARS-CoV-2 infection or
its multisystemic inflammatory complication, who abruptly develop
neurological or respiratory impairment. A prompt intensive care is
essential to avoid severe sequelae or even exitus. Copyright ©
2022 Trapani, Rubino, Lasagni, Pegoraro, Resti, Simonini and Indolfi.

<55>
Accession Number
2018731703
Title
Commissural alignment in transcatheter aortic valve replacement: A
literature review.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 938653. Date of Publication: 09 Aug 2022.
Author
Khalid A.M.; O'Sullivan C.J.
Institution
(Khalid, O'Sullivan) College of Medicine and Health, University College
Cork, Cork, Ireland
Publisher
Frontiers Media S.A.
Abstract
Introduction: Transcatheter aortic valve replacement (TAVR) is a minimally
invasive procedure to replace a diseased and faulty aortic valve in
patients with severe aortic stenosis. As TAVR gains popularity among
lower-risk younger patients with a longer life expectancy; there is a need
to investigate the long-term shortcomings and limitations of the procedure
for this patient group. One such shortcoming is that commissural alignment
of transcatheter heart valves (THV) appears to be random; meaning that the
THV neo-commissures can misalign with the native commissures of the aortic
valve during deployment or self-expansion. Objective(s): Identify
techniques and procedures used to obtain commissural alignment in TAVR.
Evaluate the effectiveness of these procedures in terms of the degree of
commissural alignment. Analyse the impact of commissural alignment on
coronary filling and re-access. Method(s): Two electronic online
databases were searched to identify existing literature relevant to the
aim and objectives of this review: EBSCOhost and PubMed. After search
filters were applied and duplicates removed; a total of 64 articles from
both databases were screened against the inclusion/exclusion criteria.
This resulted in a total of thirteen articles which met the objectives of
this review and thus; were included. Result(s): All studies focused
on a patient centered approach involving pre-TAVR computed tomography to
obtain commissural alignment. Other studies modified this approach and
combined techniques. All studies that implemented a technique to reduce
commissural misalignment were significantly successful in obtaining
commissural alignment when compared to a study in which alignment was
random when no technique was implemented. Severe coronary overlapping in
commissural aligned heart valves was relatively low compared to severe
coronary overlapping when no technique was implemented.
 Conclusion(s): An increase in optimal commissural alignment via
introduction of an alignment technique may seem attractive; however; the
categorization of commissural alignment is arbitrary and does not
accurately reflect real life clinical implications. Further research is
needed to determine whether a routine procedure to achieve commissural
alignment is necessary in low-risk younger patients undergoing
TAVR. Copyright © 2022 Khalid and O'Sullivan.

<56>
Accession Number
2018729383
Title
First-in-human pilot trial of combined intracoronary and intravenous
mesenchymal stem cell therapy in acute myocardial infarction.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 961920. Date of Publication: 09 Aug 2022.
Author
Hsiao L.-C.; Lin Y.-N.; Shyu W.-C.; Ho M.; Lu C.-R.; Chang S.-S.; Wang
Y.-C.; Chen J.-Y.; Lu S.-Y.; Wu M.-Y.; Li K.-Y.; Lin Y.-K.; Tseng W.-Y.I.;
Su M.-Y.; Hsu C.-T.; Tsai C.-K.; Chiu L.-T.; Chen C.-L.; Lin C.-L.; Hu
K.-C.; Cho D.-Y.; Tsai C.-H.; Chang K.-C.; Jeng L.-B.
Institution
(Hsiao, Lin, Lu, Chang, Wang, Chen, Lu, Li, Lin, Chang) Division of
Cardiovascular Medicine, Department of Medicine, China Medical University
Hospital, Taichung, Taiwan (Republic of China)
(Hsiao, Lin, Chang, Chen, Lin, Hu, Cho, Tsai, Chang, Jeng) School of
Medicine, China Medical University, Taichung, Taiwan (Republic of China)
(Shyu) Department of Neurology and Translational Medicine Research Center,
China Medical University Hospital, Taichung, Taiwan (Republic of China)
(Shyu, Hsu, Tsai, Chiu, Chen) Ever Supreme Bio Technology Co., Ltd,
Taichung, Taiwan (Republic of China)
(Ho) Department of Obstetrics and Gynecology, China Medical University
Hospital, Taichung, Taiwan (Republic of China)
(Wu) School of Post-Baccalaureate Chinese Medicine, China Medical
University, Taichung, Taiwan (Republic of China)
(Wu) Department of Chinese Medicine, China Medical University Hospital,
Taichung, Taiwan (Republic of China)
(Tseng, Su) Molecular Imaging Center, National Taiwan University, Taipei,
Taiwan (Republic of China)
(Lin, Hu) Management Office for Health Data, China Medical University
Hospital, Taichung, Taiwan (Republic of China)
(Cho) Department of Neurosurgery, China Medical University Hospital,
Taichung, Taiwan (Republic of China)
(Jeng) Organ Transplantation Center, China Medical University Hospital,
Taichung, Taiwan (Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Background: Acute ST-elevation myocardial infarction (STEMI) elicits a
robust cardiomyocyte death and inflammatory responses despite timely
revascularization. Objective(s): This phase 1, open-label,
single-arm, first-in-human study aimed to assess the safety and efficacy
of combined intracoronary (IC) and intravenous (IV) transplantation of
umbilical cord-derived mesenchymal stem cells (UMSC01) for heart repair in
STEMI patients with impaired left ventricular ejection fraction (LVEF
30-49%) following successful reperfusion by percutaneous coronary
intervention. Method(s): Consenting patients received the first dose
of UMSC01 through IC injection 4-5 days after STEMI followed by the second
dose of UMSC01 via IV infusion 2 days later. The primary endpoint was
occurrence of any treatment-related adverse events and the secondary
endpoint was changes of serum biomarkers and heart function by cardiac
magnetic resonance imaging during a 12-month follow-up period.
 Result(s): Eight patients gave informed consents, of whom six
completed the study. None of the subjects experienced treatment-related
serious adverse events or major adverse cardiovascular events during IC or
IV infusion of UMSC01 and during the follow-up period. The NT-proBNP level
decreased (1362 +/- 1801 vs. 109 +/- 115 pg/mL, p = 0.0313), the LVEF
increased (52.67 +/- 12.75% vs. 62.47 +/- 17.35%, p = 0.0246), and the
wall motion score decreased (26.33 +/- 5.57 vs. 22.33 +/- 5.85, p =
0.0180) at the 12-month follow-up compared to the baseline values. The
serial changes of LVEF were 0.67 +/- 3.98, 8.09 +/- 6.18, 9.04 +/- 10.91,
and 9.80 +/- 7.56 at 1, 3, 6, and 12 months, respectively as compared to
the baseline. Conclusion(s): This pilot study shows that combined IC
and IV transplantation of UMSC01 in STEMI patients with impaired LVEF
appears to be safe, feasible, and potentially beneficial in improving
heart function. Further phase 2 studies are required to explore the
effectiveness of dual-route transplantation of UMSC01 in STEMI
patients. Copyright © 2022 Hsiao, Lin, Shyu, Ho, Lu, Chang, Wang,
Chen, Lu, Wu, Li, Lin, Tseng, Su, Hsu, Tsai, Chiu, Chen, Lin, Hu, Cho,
Tsai, Chang and Jeng.

<57>
Accession Number
2018197830
Title
Influence of dexmedetomidine on postoperative cognitive dysfunction in the
elderly: A meta-analysis of randomized controlled trials.
Source
Brain and Behavior. 12(8) (no pagination), 2022. Article Number: e2665.
Date of Publication: August 2022.
Author
Yu H.; Kang H.; Fan J.; Cao G.; Liu B.
Institution
(Yu, Kang, Fan, Cao) Department of Cardiovascular Surgery, West China
Hospital of Sichuan University, Chengdu, China
(Liu) Department of Anesthesiology, West China Hospital of Sichuan
University, Chengdu, China
Publisher
John Wiley and Sons Ltd
Abstract
Introduction: Dexmedetomidine (Dex) is suggested to be neuroprotective.
However, influence of Dex on postoperative cognitive dysfunction (POCD) in
the elderly remains unknown. Method(s): We performed a meta-analysis
of randomized controlled trials (RCTs) to evaluate the effect of Dex on
POCD. Relevant studies were obtained by search of PubMed, Embase, and
Cochrane's Library databases. A random-effect model was used to pool the
results. Result(s): Fourteen RCTs including 1626 adults of 60 years
or older who received surgery with general anesthesia were included.
Because methodologically diverse scales were used for POCD, eight RCTs
with POCD diagnosed with Mini-Mental State Examination (MMSE) were
included in the meta-analysis, while the remaining six RCTs with POCD
diagnosed with other scales were qualitative synthesized. Pooled results
of RCTs with MMSE showed that Dex significantly reduced the incidence of
POCD (risk ratio: 0.47, 95% confidence interval: 0.37-0.60, p < 0.001)
with no significant heterogeneity (I2 = 0%) or publication bias
(p for Egger's regression test = 0.579). For the remaining six RCTs with
POCD diagnosed with other scales, three of them showed that Dex was
associated with a significantly lower incidence of POCD, while the other
three RCTs did not show a significant difference. Conclusion(s): Dex
is associated with a reduced risk of POCD in elderly patients receiving
surgeries with general anesthesia, and the results were mainly obtained in
studies with POCD diagnosed with MMSE. Based on these findings, Dex may be
considered as a preventative measure for POCD in elderly
patients. Copyright © 2022 The Authors. Brain and Behavior
published by Wiley Periodicals LLC.

<58>
Accession Number
638949567
Title
Comparative study of a modified double-lumen tube ventilation control
connector and traditional connector in clinical use: a
randomised-controlled trial.
Source
BMC anesthesiology. 22(1) (pp 281), 2022. Date of Publication: 06 Sep
2022.
Author
Liu C.; Zhao Y.; Li Y.; Guan H.; Feng J.; Cheng S.; Wang X.; Wang Y.; Sun
X.
Institution
(Liu, Zhao, Li, Guan, Feng, Cheng, Wang, Wang, Sun) Department of
Anesthesiology, Second Hospital of Jilin University, Jilin Province,
Ziqiang street ,Nanguan District 130000, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: A Y-shaped rotatable connector (YRC) for double-lumen tubes
(DLT) is invented and compared with the traditional connector (Y-shaped
connector, YC). METHOD(S): Sixty patients with ASA grade I-III,
aged>=18 years, who needed to insert a DLT for thoracic surgery were
recruited and assigned into the YRC group (n=30) and the YC group (n=30)
randomly. The primary endpoints included the inhaled air concentration
(Fi) and the exhaled air concentration (Et) of sevoflurane before and
after the switch between two-lung ventilation and one-lung ventilation at
different times, positioning time, and switching time. The secondary
endpoints were the internal gas volume of the two connectors, airway
pressure, and the sputum suction time. RESULT(S): The Et and Fi of
the YRC group and the YC group were significantly different (all p<0.05)
at 5s, 10s, and 30s after the patient switched from two-lung ventilation
to one-lung ventilation. The positioning time of the YRC group was less
than YC group (89.75+/-14.28 s vs 107.80+/-14.96 s, p<0.05), as well as
the switching time (3.60+/-1.20 s vs 9.05+/-2.53 s, p<0.05) and the
internal gas volume (17.20 ml vs 24.12 ml). There was no difference in
airway pressure and the sputum suction time in two groups.
 CONCLUSION(S): Compared with YC, YRC was beneficial for maintaining
depth of anesthesia, improves efficiency for the switch between one-lung
and two-lung ventilation, and shortens the tube positioning
time. Copyright © 2022. The Author(s).

<59>
[Use Link to view the full text]
Accession Number
638947693
Title
Letter by Condello Regarding Article, "Cytokine Hemadsorption During
Cardiac Surgery Versus Standard Surgical Care for Infective Endocarditis
(REMOVE): Results From a Multicenter Randomized Controlled Trial".
Source
Circulation. 146(10) (pp e138-e139), 2022. Date of Publication: 06 Sep
2022.
Author
Condello I.
Institution
(Condello) Department of Cardiac Surgery, Anthea Hospital, GVM Care &
Research, Bari, Italy
Publisher
NLM (Medline)

<60>
[Use Link to view the full text]
Accession Number
638947457
Title
Response by Diab et al to Letter Regarding Article, "Cytokine
Hemoadsorption During Cardiac Surgery Versus Standard Surgical Care for
Infective Endocarditis (REMOVE): Results From a Multicenter Randomized
Controlled Trial".
Source
Circulation. 146(10) (pp e140), 2022. Date of Publication: 06 Sep 2022.
Author
Diab M.; Faerber G.; Doenst T.
Institution
(Diab, Faerber, Doenst) Department of Cardiothoracic Surgery (M.D., Jena
University Hospital-Friedrich Schiller University of Jena, Germany
(Diab) Center for Sepsis Control and Care (M.D.), Jena University
Hospital-Friedrich Schiller University of Jena, Germany
Publisher
NLM (Medline)

<61>
Accession Number
638932768
Title
Ideal Suggestions for Discharge Training and Telephone Counseling of
Patients With Coronary Artery Bypass Graft Surgery: A Randomized
Controlled and Experimental Study.
Source
Journal of Korean medical science. 37(35) (pp e269), 2022. Date of
Publication: 05 Sep 2022.
Author
Kaya U.; Dal Yilmaz U.
Institution
(Kaya) Department of Nursing, Faculty of Health Sciences, Eastern
Mediterranean University, Famagusta, Cyprus
(Dal Yilmaz) Faculty of Nursing, Near East University, Nicosia, Cyprus
Publisher
NLM (Medline)
Abstract
BACKGROUND: In this context, discharge training and telephone counseling
given to patients who underwent coronary artery bypass graft surgery
increase the ability of patients to cope with and adapt to their
self-care. METHOD(S): This study was a randomized controlled,
experimental design. Both experimental and control groups consisted of 35
individuals with G*power analysis (n = 70). Patients in the experimental
group were given discharge training and telephone counseling for two
months. At the end of the process, data collection forms were administered
to both groups for the last time. Necessary ethical approvals were taken
and consent was taken from the patients. RESULT(S): After the
discharge training and telephone counseling given to the experimental
group, the mean Exercise of Self-Care Agency Scale (ESCA) score of the
patients increased by 13.94; the mean Coping and Adaptation Processing
Scale (CAPS) increased by 13.6. The mean ESCA score of the control group
increased by 7.86; the mean CAPS score increased by 9.14. The effect size
that occurred for both groups was statistically significant (P < 0.05).
 CONCLUSION(S): Positive results were achieved in the experimental
group which received given discharge training and telephone counseling.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier:
NCT05104996. Copyright © 2022 The Korean Academy of Medical
Sciences.

<62>
Accession Number
2014191705
Title
The MITRA-HR study: design and rationale of a randomised study of
MitraClip transcatheter mitral valve repair in patients with severe
primary mitral regurgitation eligible for high-risk surgery.
Source
EuroIntervention. 15(4) (pp E329-E335), 2019. Date of Publication: July
2019.
Author
Piriou N.; Al Habash O.; Donal E.; Senage T.; Tourneau T.L.; Pattier S.;
Guyomarch B.; Roussel J.C.; Trochu J.N.; Vahanian A.; Obadia J.F.; Iung
B.; Guerin P.
Institution
(Piriou, Al Habash, Senage, Tourneau, Pattier, Guyomarch, Roussel, Trochu,
Guerin) Institut du Thorax, Centre Hospitalier Universitaire de Nantes,
Nantes, France
(Donal) Centre Hospitalier Universitaire de Rennes, Service de
Cardiologie, Rennes, France
(Vahanian, Iung) Assistance Publique-Hopitaux de Paris, Hopital Bichat,
DHU Fire, Universite Paris Diderot, Paris, France
(Obadia) Service de Chirurgie Cardiothoracique et Transplantation, Hopital
Cardiothoracique Louis Pradel, Lyon-Bron, France
Publisher
Europa Group
Abstract
Aims: Percutaneous mitral valve repair has become an alternative to
conventional surgery in patients suffering primary mitral regurgitation
(MR) with a contraindication to surgery and could benefit patients at high
surgical risk. The aim of the MITRA-HR study is to raise the level of
evidence supporting the use of the MitraClip device in primary MR patients
with a predefined high risk for surgery. Methods and Results:
MITRA-HR is a prospective, multicentre, randomised study designed to
compare mitral valve repair using the MitraClip with conventional surgery
in patients with severe primary mitral regurgitation at high risk for
surgery. The surgical risk is defined by age, Society of Thoracic Surgeons
(STS) risk estimate score, frailty, major organ system dysfunction, and
procedure-specific impediments. The study will enrol 330 patients
randomised between conventional surgery and MitraClip with a 1:1 ratio.
The composite primary endpoint includes all-cause mortality, unplanned
rehospitalisation for cardiovascular reasons, and mitral valve
reintervention at 12 months. The main secondary safety endpoint is a major
adverse event composite assessment evaluated 30 days after the procedure.
 Conclusion(s): The randomised MITRA-HR study is designed to provide
additional supportive evidence of non-inferiority in efficacy and
superiority in safety for percutaneous mitral valve repair using the
MitraClip compared to conventional surgery in high surgical risk
patients. Copyright © Europa Digital & Publishing 2019.

<63>
Accession Number
2014376295
Title
Synchronous or staged carotid endarterectomy and coronary artery bypass
grafting? Propensity score matched study.
Source
Heart Surgery Forum. 21(5) (pp E359-E364), 2018. Date of Publication: 06
Nov 2018.
Author
Hempe S.; Moza A.; Goetzenich A.; Tewarie L.; Bleilevens C.; Autschbach
R.; Schnoering H.; Zayat R.
Institution
(Hempe, Moza, Goetzenich, Tewarie, Autschbach, Schnoering, Zayat)
Department of Thoracic and Cardiovascular Surgery, University Hospital
RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany
(Bleilevens) Department of Anesthesiology, University Hospital RWTH
Aachen, Pauwelsstrasse 30, Aachen 52074, Germany
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: The optimal treatment strategy in patients presenting with
hemodynamically significant carotid artery disease who are to undergo
cardiac surgery, remains controversial. In this study, we retrospectively
analyzed the outcome data of patients receiving synchronous or staged
coronary artery bypass graft (CABG) surgery and carotid endarterectomy
(CEA). Method(s): Between 2011 and 2016, 3173 patients underwent CABG
surgery in our institution, of whom 323 received CABG and CEA either as
synchronous (N = 307) or as staged (N = 16) procedures. Patients'
characteristics, peri- and postoperative data were collected from our
digital medical database. Propensity score matching was used to match each
patient from the staged group to two appropriate patients (1:2 matching)
from the synchronous group (synchronousmatched). Result(s): The
overall incidence of ischemic stroke (IS) and transitory ischemic attack
(TIA) was 4.9% and 5.6%, respectively. No hemorrhagic stroke was noted in
both groups. Incidence of IS did not differ significantly between matched
groups (P = 1.000). Significantly higher rates of postoperative
neurological complications, such as TIA and delirium, were found in the
synchronousmatched group (P = .041 and P = .043, respectively) compared
with the staged group. Additionally, there were more postoperative
respiratory insufficiencies in the synchronousmatched group (P = .043).
Thirty days mortality did not differ significantly between the matched
groups. Conclusion(s): In this experience combined with the data
given in literature, our findings suggest a possible superiority of the
staged CABG/CEA approach. Large, randomized studies are required to verify
our findings and to establish applicable guidelines. Copyright ©
2018 Forum Multimedia Publishing, LLC.

<64>
Accession Number
2014376280
Title
A novel risk score to predict new onset atrial fibrillation in patients
undergoing isolated coronary artery bypass grafting.
Source
Heart Surgery Forum. 21(6) (pp E489-E496), 2018. Date of Publication: 06
Nov 2018.
Author
Lin S.Z.; Crawford T.C.; Suarez-Pierre A.; Magruder J.T.; Carter M.V.;
Cameron D.E.; Whitman G.J.; Lawton J.; Baumgartner W.A.; Mandal K.
Institution
(Lin, Crawford, Suarez-Pierre, Magruder, Carter, Cameron, Whitman, Lawton,
Baumgartner, Mandal) Division of Cardiac Surgery, Johns Hopkins
University, School of Medicine, Baltimore, MD, United States
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Atrial fibrillation (AF) is common after cardiac surgery and
contributes to increased morbidity and mortality. Our objective was to
derive and validate a predictive model for AF after CABG in patients,
incorporating novel echocardiographic and laboratory values.
 Method(s): We retrospectively reviewed patients at our institution
without preexisting dysrhythmia who underwent on-pump, isolated CABG from
2011-2015. The primary outcome was new onset AF lasting >1 hour on
continuous telemetry or requiring medical treatment. Patients with a
preoperative echocardiographic measurement of left atrial diameter were
included in a risk model, and were randomly divided into derivation (80%)
and validation (20%) cohorts. The predictors of AF after CABG (PAFAC)
score was derived from a multivariable logistic regression model by
multiplying the adjusted odds ratios of significant risk factors (P < .05)
by a factor of 4 to derive an integer point system. Result(s): 1307
patients underwent isolated CABG, including 762/1307 patients with a
preoperative left atrial diameter measurement. 209/762 patients (27%)
developed new onset AF including 165/611 (27%) in the derivation cohort.
We identified four risk factors independently associated with
postoperative AF which comprised the PAFAC score: age > 60 years (5
points), White race (5 points), baseline GFR < 90 mL/min (4 points) and
left atrial diameter > 4.5 cm (4 points). Scores ranged from 0-18. The
PAFAC score was then applied to the validation cohort and predicted
incidence of AF strongly correlated with observed incidence (r = 0.92).
 Conclusion(s): The PAFAC score is easy to calculate and can be used
upon ICU admission to reliably identify patients at high risk of
developing AF after isolated CABG. Copyright © 2018 Forum
Multimedia Publishing, LLC.

<65>
Accession Number
2014915415
Title
A meta-analysis of pharmacological neuroprotection in noncardiac surgery:
Focus on statins, lidocaine, ketamine, and magnesium sulfate.
Source
European Review for Medical and Pharmacological Sciences. 22(6) (pp
1798-1811), 2018. Date of Publication: 2018.
Author
ZENG Z.-W.; ZHANG Y.-N.; LIN W.-X.; ZHANG W.-Q.; LUO R.
Institution
(ZENG, ZHANG, LIN, ZHANG, LUO) First Anesthesia Department, Meizhou
People's Hospital, Guangdong Province, China
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: Non-cardiac surgery is associated with perioperative cerebral
complications (delirium, postoperative cognition dysfunction, stroke).
While rare, these complications can lead to disabilities and deaths.
Information is ambiguous as to whether pharmacological preoperative
treatment exerts neuroprotection. We wished to systematically assess
potential modulation by statins, lidocaine, ketamine or magnesium sulfate
of the relative risk of cerebral complications in noncardiac surgery.
Selection of these pharmacological agents was based on their known
neuroprotective abilities. PATIENTS AND METHODS: By searching
Medline, EMBASE and Cochrane databases, we identified 4 suitable
publications that collectively enrolled 1358 patients (intent-to-treat
population), of which 679 patients were treated preoperatively with
statins (404 patients on atorvastatin and 275 on rosuvastatin) and 679
patients with preoperative placebo. The reported cerebral outcome was
stroke, assessed either within 30 days (4 publications) or 6 months (2
publications) after surgery. RESULT(S): Episodes of stroke within 30
days and 6 months postoperatively were observed in several publications,
enabling aggregate analyses. No modulation by statins of the relative risk
of stroke at 30 days was observed (risk ratio 1.59, 95% confidence
interval 0.08-30.97; p = 0.76). At 6 months, statins showed an
insignificant trend toward neuroprotection (risk ratio 0.33, 95%
confidence interval 0.05-2.10; p = 0.24). CONCLUSION(S): The
available clinical data are still scarce. Our analyses indicate no
protective effects by statins against perioperative stroke but some
favorable trends toward delayed stroke. Further randomized trials are
needed to unequivocally assess the neuroprotective potential of current
pharmacological agents in non-cardiac surgery. Copyright © 2018
Verduci Editore s.r.l. All rights reserved.

<66>
Accession Number
633075975
Title
Efficacy of a WeChat-based intervention for adherence to secondary
prevention therapies in patients undergoing coronary artery bypass graft
in China: A randomized controlled trial.
Source
Journal of telemedicine and telecare. 28(9) (pp 653-661), 2022. Date of
Publication: 01 Oct 2022.
Author
Wang J.; Zeng Z.; Dong R.; Sheng J.; Lai Y.; Yu J.; Zuo H.
Institution
(Wang, Zeng, Zuo) Beijing Anzhen Hospital, Capital Medical University,
Beijing Institute of Heart Lung and Blood Vessel Disease, China
(Dong, Sheng, Lai, Yu) Department of Cardiac Surgery, Beijing An Zhen
Hospital, Capital Medical University, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: We assessed whether the social media-based (WeChat)
intervention integrated with follow-up care could improve adherence to
drugs, lifestyle changes and clinical risk markers in patients undergoing
coronary artery bypass graft (CABG) in China. METHOD(S): We
randomized patients at hospital discharge following CABG to intervention
group or control care in China. The intervention is a structured programme
of cardiac health education, medication reminders and cardiologist-based
follow-up service using WeChat platform. The control group maintains a
routine practice pattern. The primary outcome is adherence to
cardioprotective medications measured for 12 months after discharge. We
also evaluated the lifestyle modifications and clinical risk markers at 12
months. RESULT(S): A total of 164 participants completed the trial
for analysis. The intervention group had significantly greater adherence
to statins use 98.6% vs. 75.0% (p<0.01), beta-blockers 93.4% vs. 69.3%
(p<0.01) and aspirin 98.8% vs. 87.8% (p<0.001). The intervention group had
significantly greater adherence to regular physical activity (64.2% vs.
48.2%; p<0.039). Furthermore, intervention versus standard group at 12
months had significantly lower mean systolic blood pressure and
low-density lipoprotein cholesterol (p<0.05). DISCUSSION: A WeChat-based
intervention strategy in post-CABG patients improved adherence to
medications, including statin, aspirin and beta-blockers, and regular
physical activity and resulted in an improvement in systolic blood
pressure and low-density lipoprotein cholesterol level.

<67>
Accession Number
636227328
Title
Weight Gain After Heart Transplantation in Adults: Systematic Review and
Meta-Analysis.
Source
ASAIO journal (American Society for Artificial Internal Organs : 1992).
68(9) (pp 1107-1116), 2022. Date of Publication: 01 Sep 2022.
Author
Miura K.; Yu R.; Sivapalan K.; Liyanage U.E.; Entwistle T.; McKenzie S.C.;
Green A.C.
Institution
(Miura, Yu, Liyanage, Green) From the Population Health Department, QIMR
Berghofer Medical Research Institute, Herston, QLD, Australia
(Miura, Sivapalan, Liyanage, McKenzie) Faculty of Medicine, University of
Queensland, Herston, QLD, Australia
(Entwistle) Transplant Centre, University Hospital of South Manchester NHS
Foundation Trust, Manchester, United Kingdom
(McKenzie) Advanced Heart Failure and Cardiac Transplant Unit, Prince
Charles Hospital, QLD, Australia
(Green) CRUK Manchester Institute and University of Manchester, Manchester
Academic Health Science Centre, Manchester, United Kingdom
Publisher
NLM (Medline)
Abstract
Gain in weight is common after heart transplantation but the magnitude of
usual weight gain and whether this varies by country is unknown. We
systematically reviewed all relevant studies to quantify weight change
among heart transplant recipients (HTRs) in the years after
transplantation and assess variation with geographic location. We searched
PubMed, Cumulative Index to Nursing and Allied Health Literature, and
Excerpta Medica Database databases to September 2020. Eligible studies
reported adult HTRs' mean/median weight and/or body mass index (BMI) up to
time of transplantation (baseline) and posttransplantation in any
language. Weighted mean differences (WMDs) (95% confidence intervals
[CIs]) of weight/BMI from baseline to posttransplantation were estimated
using a random-effects model. Ten studies met the inclusion criteria.
Pooled analysis showed weight gain of 7.1kg (95% CI, 4.4-9.8kg) in HTRs 12
months posttransplant, with corresponding BMI increase of 1.69kg/m 2 (95%
CI, 0.83-2.55kg/m 2 ). Greatest weight gain at 12 months posttransplant
occurred in US HTRs (WMD weight 10.42kg, BMI 3.25kg/m 2 ) and least, in
European HTRs (WMD weight 3.10kg, BMI 0.78kg/m 2 ). In conclusion, HTRs
gain substantial weight in the years after transplantation, but varying
widely by geographic location. Copyright © ASAIO 2021.

<68>
Accession Number
638915150
Title
Endoscopic Versus Conventional Vein Harvest Technique: Histological and
Immunohistochemical Evaluation of Venous Wall Integrity.
Source
The heart surgery forum. 25(4) (pp E520-E524), 2022. Date of Publication:
13 Jul 2022.
Author
Aboollo M.F.; Awadallah K.M.; Elsharkawy T.; Abd Elaziz M.E.; Hafez B.A.
Institution
(Aboollo) Cardiothoracic Surgery Department, Faculty of Medicine, Menoufia
University, Egypt
(Awadallah) Cardiothoracic Surgery Department, Faculty of Medicine, Cairo
University, Egypt
(Elsharkawy) King Fahd Hospital of the University-ImamAbdulrahman Bin
Faisal University, Khobar, Saudi Arabia
(Abd Elaziz) Cardiothoracic Surgery Department, Faculty of Medicine,
Menoufia University, Egypt
(Hafez) Cardiothoracic Surgery Department, Faculty of Medicine, Menoufia
University, Egypt
Publisher
NLM (Medline)
Abstract
BACKGROUND: The introduction of endoscopic saphenous vein graft harvesting
has been known for two decades. It offers benefits related to decreased
rate of donner site complications. Debates related to its safety in terms
of trauma to the wall of the venous graft and long-term graft patency have
been raised, but few studies had investigated this point. Our aim is to
compare the endoscopic saphenous vein harvest and conventional harvest
techniques, in terms of the integrity of the wall of the vein graft.
 METHOD(S): A prospective study in which we examined 80 samples of
saphenous vein from 80 patients to whom coronary artery bypass grafting
was done. Patients randomly were assigned to either technique. Vein
samples were taken from patients having the conventional technique (group
1, 40 patients) and from patients having endoscopic vein harvest (group 2,
40 patients). Vein samples were stained with Hematoxylin & Eosin, Masson's
trichrome, and immunohistochemical stain for CD 31 and then examined by
light microscopy. The degree of intimal staining was graded from 0% to
100%, which is directly related to the degree of intimal preservation (the
least injury, the more the staining score) and vein media changes were
reported. RESULT(S): Patient characteristics were comparable in the
groups. Group 1 (conventional group) was better than group 2 (endoscopic
group), regarding endothelial integrity and medial changes although it was
statistically not significant. CONCLUSION(S): Both the conventional
and endoscopic techniques are comparable, regarding the intimal
preservation of the venous graft.

<69>
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).

<70>
[Use Link to view the full text]
Accession Number
638953234
Title
Microaxial support after orthotopic heart transplantation.
Source
ASAIO Journal. Conference: 67th Annual Conference of the American Society
for Artificial Internal Organs, ASAIO 2022. Chicago, IL United States.
68(Supplement 2) (pp 109-111), 2022. Date of Publication: June 2022.
Author
Pritting C.D.; Ahmad D.; Miyamoto T.; Rajab T.; Rajapreyar I.N.; Massey
H.; Tchantchaleishvili V.
Institution
(Pritting, Ahmad, Miyamoto, Massey, Tchantchaleishvili) Division of
Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United
States
(Rajab) Division of Cardiothoracic Surgery, Medical University Of South
Carolina, Charleston, SC, United States
(Rajapreyar) Division of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: We aimed to assess utilization patterns of microaxial
mechanical circulatory support (MxMCS) after heart transplantation (HTx)
in adolescents and adults. Method(s): Electronic search was performed
to identify all relevant studies on post-HTx use of microaxial support in
adults and adolescents. A total of 16 studies were selected and
patient-level data were extracted for statistical analysis.
 Result(s): All patients (N= 21), including adults (n= 15) and
adolescents (n= 6), underwent Impella MxMCS after HTx. Median age was 38
[IQR 18-57] years [Adults, 52 (37-59); adolescents 17 (15-18)]. Primary
right ventricular graft dysfunction was an indication exclusively seen in
the adults 40% (6/15), while acute graft rejection was present in 46.7%
(7/15) of adults. In all adolescents, the indication for MxMCS was some
form of graft rejection [acute, 50.0% (3/6), chronic 33.3% (2/6), and
unspecified 16.7% (1/6)]. Median time from HTx to MxMCS was 3.4 [0-32]
months in adults compared to 10.5 [2-84] months in adolescents (p=0.51).
Biventricular support was required in 6.7% (1/15) of adults vs 83.3% (5/6)
of adolescents (p<0.01). Duration of MxMCS was comparable between adults
and adolescents [5 (2.5-8) vs 6 (4-7) days, p=0.48]. Overall improvement
was observed both in median LV ejection fraction [23.5% (11.2-28) to 42%
(37.8-47.2), p=0.01] and cardiac index [1.9 (1.4-2.6) to 3.0 (2.5-3.2),
p=0.02]. Retransplantation was required in two adolescents (33.3%, 2/6).
Survival to discharge was achieved by 60.0% (9/15) of adults and 83.3%
(5/6) of adolescents respectively (p=0.61). Conclusion(s):
Indications for MxMCS appear to vary between adult and adolescent
patients. Overall improvement in LVEF and cardiac index was observed,
however, with suboptimal survival to discharge. (Figure Presented).

<71>
[Use Link to view the full text]
Accession Number
638953218
Title
Utilization and Outcomes of VAV-ECMO: A Systematic Review And Meta-
Analysis.
Source
ASAIO Journal. Conference: 67th Annual Conference of the American Society
for Artificial Internal Organs, ASAIO 2022. Chicago, IL United States.
68(Supplement 2) (pp 38), 2022. Date of Publication: June 2022.
Author
Saxena A.; Curran J.; Ahmad D.; Brailovsky E.; Shah M.K.; Rajapreyar I.N.;
Rame J.E.; Entwistle J.; Massey H.; Tchantchaleishvili V.
Institution
(Saxena, Curran, Ahmad, Entwistle, Massey, Tchantchaleishvili) Division of
Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United
States
(Brailovsky, Shah, Rajapreyar, Rame) Division of Cardiology, Thomas
Jefferson University, Philadelphia, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: We sought to understand the indications, utilization patterns,
and outcomes of veno-arterial-venous extracorporeal membrane oxygenation
(VAV-ECMO) by quantitatively pooling the existing evidence from the
literature. Method(s): Electronic search was performed to identify
all relevant studies reporting VAV-ECMO usage. Five studies comprising 77
patients were selected and cohort-level data were extracted for further
analysis. Result(s): Mean patient age was 60.9 (95% CI: 55.2, 66.5)
years and 30% (23/77) were female. The majority of cases [91% (70/77)]
were transitioned to VAV-ECMO from another pre-existing ECMO
configuration: VA-ECMO in 55% (42/77) vs. VV-ECMO in 36% (28/77), p=0.04.
Only 9% (7/77) of cases were directly placed on VAV-ECMO. Patients
supported on VA-ECMO were transitioned to VAV-ECMO for differential
hypoxia [59.5% (25/42)] and cardiopulmonary failure [40.5% (17/42)], while
patients supported on VV-ECMO were transitioned to VAV-ECMO due to left
ventricular failure [21.4% (6/28)], right ventricular failure [21.4%
(6/28)], biventricular failure [14.3% (4/28)], or otherwise unspecified
decrease in cardiac function [42.9% (12/28)]. Direct placement of VAV-ECMO
was performed in 9% (7/77) for cardiopulmonary failure due to septic
cardiomyopathy. The mean duration of hospital stay was 42.3 (95% CI: 10.5,
74.2) days, while ICU mortality was 46% (29, 64). Transition to durable
LVAD was performed in 3% (2/64), while 3% (2/64) underwent heart
transplantation. VAV-ECMO was successfully weaned to explantation in 33%
(21/64) (Figure). Conclusion(s): VAV-ECMO is a viable option for
optimizing cardiopulmonary support in selected patients. Survival to
weaning or bridging therapy appears comparable to more common ECMO
configurations. (Figure Presented).

<72>
Accession Number
638953017
Title
The effect of complication prevention nursing for coronary heart disease
patients undergoing coronary angiography and coronary stenting.
Source
Asia-Pacific Journal of Clinical Oncology. Conference: 4th International
Conference on Advances in Biological Science and Technology, ICABST 2022.
Virtual. 18(Supplement 2) (pp 20-21), 2022. Date of Publication: August
2022.
Author
Zhang J.; Li Y.; Niu X.; Zheng M.
Institution
(Zhang) Operation Room, Jiyang People's Hospital, Jinan, China
(Li) Supply Room, Jiyang People's Hospital, Jinan, China
(Niu) ECG Room, Zhangqiu District People's Hospital, Jinan, China
(Zheng) Ward Department, Zhangqiu District People's Hospital, Jinan, China
(Zheng) Ward Department, Zhangqiu District People's Hospital, No. 1920,
Huiquan Road, Jinan 250200, China
Publisher
Blackwell Publishing Ltd
Abstract
Objective: To investigate the effect of complication prevention nursing
coronary heart disease patients undergoing coronary angiography and
coronary stenting. Method(s): Total 84 coronary heart disease
patients undergoing coronary angiography and coronary stenting in our
hospital were randomly divided into control group and observation group.
Both groups received routine care. On this basis, the patients in the
observation group were given preventive care for complications. The scores
of the Chinese Cardiovascular Patient Quality of Life Assessment
Questionnaire (CQQC) and the incidence of complications were measured.
 Result(s): At admission, there was no significant difference in the
scores of CQQC between the two groups. At the time of discharge and 2
weeks after discharge, the scores of CQQC in the observation group were
higher than those in the control group. The incidence of subcutaneous
hematoma and hemorrhage, coronary spasm, thromboembolism, hypotension, and
the contrast agent reaction in the observation group was lower than those
in the control group, that is, after nursing, the quality of life of the
observation group was significantly better than that of the control group.
 Conclusion(s): On the basis of routine nursing care for patients with
coronary heart disease undergoing coronary angiography and coronary stent
implantation, prevention of complications can effectively reduce the
incidence of complications and improve their quality of life.

<73>
Accession Number
638956398
Title
Melatonin for the prevention of postoperative delirium in older adults.
Source
Anaesthesia. Conference: Trainee Conference 2022. Bristol United Kingdom.
77(Supplement 3) (pp 7), 2022. Date of Publication: July 2022.
Author
Barnes J.; Sewart E.; Armstrong R.; Pufulete M.; Hinchliffe R.; Gibbinson
B.; Mouton R.
Institution
(Barnes) University Hospitals Bristol, United Kingdom
(Sewart, Hinchliffe, Mouton) North Bristol Hospitals Trust, United Kingdom
(Armstrong) Royal United Hospitals, Bath, United Kingdom
(Pufulete) University of Bristol, United Kingdom
(Gibbinson) Bristol Heart Institute, United Kingdom
Publisher
Blackwell Publishing Ltd
Abstract
Postoperative delirium (POD) is a major cause of morbidity [1]. Melatonin
and melatonin receptor agonists have been suggested as a promising,
low-risk, low cost therapies to prevent POD. A previous systematic review
found limited evidence to support the use of melatonin in the prevention
of POD [2]. However, several randomised, controlled trials (RCTs) have
since been published. This updated systematic review provides an updated
analysis of melatonin for prevention of POD, including a meta-analysis of
results and assessment of study methodology. Methods A systematic search
of studies examining melatonin in POD was performed, across EMBASE,
Medline, CINAHL and PsychInfo. RCTs studying melatonin or melatonin
receptor agonists in patient groups with mean age of >= 50 years were
included. No restrictions were placed on the programme of drug
administration, including timing, dose and additional treatments used.
Studies were excluded if they did not report outcomes related to POD. The
search strategy mirrored that used in the previous review. Data synthesis
of POD incidence across the 10 studies was undertaken using random effects
meta-analysis. This study is registered with PROSPERO. Results The
literature search identified 339 articles of which 10 met the inclusion
criteria (1220 patients). Studies included patients undergoing general,
cardiac and orthopaedic surgeries. Six trials used melatonin and four used
ramelteon. Duration of therapy in the intervention groups ranged from 1-7
days and five different doses of melatonin were used (all ramelteon doses
were 8 mg). Eight different diagnostic tools were used for diagnosis of
delirium. Meta-analysis showed a significantly reduced incidence of POD in
the treatment versus intervention groups (odds ratio 0.46, 95% confidence
interval 0.24-0.90). (Figure Presented) Discussion We found evidence that
peri-operative melatonin use is associated with a significant reduction in
POD incidence across a range of surgeries. This could make it an
invaluable peri-operative tool, particularly for an increasingly frail and
comorbid population. Melatonin should be considered when developing care
bundles to reduce POD; however, studies to date are heterogeneous in their
methodology and standardisation of intervention and outcome measures is
needed to maximise usefulness of future research.

<74>
Accession Number
638955894
Title
ACUTE GASTRIC VOLVULUS DISGUISED AS ACUTE CORONARY SYNDROME.
Source
Journal of the Canadian Association of Gastroenterology. Conference:
Canadian Digestive Diseases Week, CDDW 2021. Online. 4(Supplement 1) (no
pagination), 2021. Date of Publication: March 2021.
Author
Lee J.G.; Nap-Hill E.; Bressler B.
Institution
(Lee, Nap-Hill) University of British Columbia, Vancouver, BC, Canada
(Bressler) Pacific Gastroenterology Associates, Vancouver, BC, Canada
Publisher
Oxford University Press
Abstract
Background: Acute gastric volvulus is a rare but potentially
life-threatening condition that warrants emergent assessment. Its clinical
presentation may encompass the Borchardt's triad of vomiting, epigastric
pain, and inability to insert a nasogastric tube. However, it can also
present as chest pain and is often not cited within the typical
differential diagnosis of non-cardiac causes of chest pain. We report the
first known case of mesenterico-axial gastric volvulus presenting as acute
coronary syndrome with a normal electrocardiogram, complete with
radiographic and endoscopic images. Aim(s): To present a case of
acute gastric volvulus disguised as an acute coronary syndrome and
describe its management. Method(s): Case report and review of
literature. Result(s): A 68 year-old female with history of recent
coronary artery bypass graft surgery presented to hospital with sudden
onset chest pain radiating to her left shoulder and jaw while having
dinner. Initial high sensitivity troponin (normal <9ng/L) was 15ng/L,
which increased to a modest peak at 115ng/L. ECG at presentation and
through admission consistently showed normal sinus rhythm x 5. She was
assessed by Cardiology and given her rising troponin and chest pain, she
was treated as a non-ST elevation myocardial infarction with dual
antiplatelet therapy. She underwent cardiac catheterization showing distal
graft anastomotic site stenosis and was stented x2. Post procedure, her
severe retrosternal chest pain recurred. GI was consulted for dysphagia
and odynophagia, which was then noted to be present concurrent with her
initial chest pain presentation. An urgent CT scan of the abdomen and
pelvis revealed acute mesenterico-axial gastric volvulus (Figure 1A), a
rarer form of gastric volvulus in the adult population compared to its
organo-axial counterpart. After a failed nasogastric decompression, an
emergent upper endoscopy was attempted and demonstrated mucosal necrosis
(Figure 1B) but was unsuccessful in relieving the volvulus. The patient
then underwent overnight surgery, which showed gastric volvulus with
contained perforation and 50% necrosis of the stomach with sparing of the
cardia and antrum. This resulted in a subtotal gastrectomy, hiatus hernia
repair, pyloromyotomy, jejunostomy, and bilateral chest tube insertion.
She then recovered in ICU before being successfully discharged home from
hospital. Conclusion(s): Acute gastric volvulus can present while
disguised as more common causes of chest pain, such as acute coronary
syndrome. Those who present with chest pain who also have a history of a
large hiatal hernia, or an intrathoracic stomach should be evaluated with
gastric volvulus in the differential diagnosis as its prompt management is
critical to reduce morbidity and mortality.

<75>
Accession Number
638959435
Title
Early versus late surgical decompression for acute traumatic spinal cord
injury: a pooled analysis of prospective, multicentre data in 1548
patients.
Source
CMAJ. Canadian Medical Association Journal. Conference: 20th Annual
Scientific Conference of the Canadian Spine Society. Whistler, BC Canada.
63(4 Supplement 1) (pp S29), 2020. Date of Publication: July-August 2020.
Author
Badhiwala J.; Witiw C.; Wilson J.; Fehlings M.
Institution
(Badhiwala, Witiw, Wilson, Fehlings) University of Toronto, Toronto, ON,
Canada
Publisher
Canadian Medical Association
Abstract
Background: The effect of time to decompression on neurologic recovery
following acute traumatic spinal cord injury (SCI) remains unclear. This
study leverages high-quality prospective data from over 1500 acute SCI
patients to compare sensorimotor recovery with early (< 24 h) versus late
(>= 24 h) surgical decompression. Method(s): Patients with acute SCI
who underwent surgical decompression were identified from 4 prospective,
multicentre SCI data sets (NACTN, STASCIS, Sygen, NASCIS III). Patients
were dichotomized into early (< 24 h) and late (>= 24 h) surgery groups.
The primary end point was change in American Spinal Injury Association
(ASIA) motor score (AMS) at 1 year. Secondary outcomes included ASIA
Impairment Scale (AIS) grade and change in ASIA light-touch and pinprick
scores at 1 year. One-stage meta-analyses comparing outcomes for early
versus late surgery were performed by hierarchical mixed-effects
regression using a stratified intercept to account for clustering of
patients within individual studies. Fixed-effect covariates were specified
for baseline score, age, injury mechanism, AIS grade, neurologic level and
steroids. Result(s): A total of 1548 patients were eligible. Patients
who underwent early surgery had greater improvements than the late surgery
group at 1 year for AMS (mean difference [MD] 4.0, 95% confidence interval
[CI] 1.7- 6.2, p = 0.001), light-touch score (MD 4.6, 95% CI 1.9-7.2, p =
0.001) and pinprick score (MD 4.2, 95% CI 1.5-6.9, p = 0.003). Further, on
shift analysis, the early surgery group achieved a more favourable
distribution of AIS grades at 1 year (crude odds ratio 1.46, 95% CI
1.14-1.87, p = 0.003). The effect of early surgery was strongest for
cervical SCI (p = 0.003); however, there was a trend toward improved
recovery with early versus late surgery for thoracic SCI as well (p =
0.088). Conclusion(s): In an individual patient data meta-analysis
adjusting for confounders, we found early surgery, within 24 hours of
injury, to be associated with superior sensorimotor recovery at 1 year
following acute SCI, as compared with late surgery. These findings will
inform clinical practice guidelines for acute SCI.

<76>
Accession Number
2020113616
Title
Abbreviated Antiplatelet Therapy After Coronary Stenting in Patients With
Myocardial Infarction at High Bleeding Risk.
Source
Journal of the American College of Cardiology. 80(13) (pp 1220-1237),
2022. Date of Publication: 27 Sep 2022.
Author
Smits P.C.; Frigoli E.; Vranckx P.; Ozaki Y.; Morice M.-C.; Chevalier B.;
Onuma Y.; Windecker S.; Tonino P.A.L.; Roffi M.; Lesiak M.; Mahfoud F.;
Bartunek J.; Hildick-Smith D.; Colombo A.; Stankovic G.; Iniguez A.;
Schultz C.; Kornowski R.; Ong P.J.L.; Alasnag M.; Rodriguez A.E.; Paradies
V.; Kala P.; Kedev S.; Al Mafragi A.; Dewilde W.; Heg D.; Valgimigli M.
Institution
(Smits, Paradies) Department of Cardiology, Maasstad Hospital, Rotterdam,
Netherlands
(Frigoli, Heg) Clinical Trial Unit, University of Bern, Bern, Switzerland
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, Hasselt University,
Hasselt, Belgium
(Ozaki) Department of Cardiology, Fujita Health University School of
Medicine, Aichi, Toyoake, Japan
(Morice) Cardiovascular European Research Center (CERC), Massy, France
(Chevalier) Ramsay Generale de Sante, Interventional Cardiology
Department, Institut Cardiovasculaire Paris Sud, Massy, France
(Onuma) National University of Ireland, Galway, Ireland
(Windecker) Department of Cardiology, Bern University Hospital, Bern,
Switzerland
(Tonino) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Roffi) Division of Cardiology, Geneva University Hospitals, Geneva,
Switzerland
(Lesiak) 1st Department of Cardiology, University of Medical Sciences,
Poznan, Poland
(Mahfoud) Department of Cardiology, Angiology, Intensive Care Medicine,
Saarland University, Homburg, Germany
(Bartunek) Cardiovascular Center, OLV Hospital, Aalst, Belgium
(Hildick-Smith) Brighton and Sussex University Hospitals NHS Trust,
Brighton, United Kingdom
(Colombo) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele-Milan and Humanitas Clinical and Research Center IRCCS,
Rozzano-Milan, Italy
(Stankovic) Department of Cardiology, Clinical Center of Serbia, Faculty
of Medicine, University of Belgrade, Belgrade, Serbia
(Iniguez) Hospital Alvaro Cunqueiro, Vigo, Spain
(Schultz) Department of Cardiology, Royal Perth Hospital Campus,
University of Western Australia, Perth, WA, Australia
(Kornowski) Rabin Medical Center, Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel
(Ong) Tan Tock Seng Hospital, Singapore
(Alasnag) Cardiac Center, King Fahad Armed Forces Hospital, Jeddah, Saudi
Arabia
(Rodriguez) Cardiac Unit Otamendi Hospital, Buenos Aires School of
Medicine Cardiovascular Research Center (CECI), Buenos Aires, Argentina
(Kala) University Hospital Brno, Brno, Czechia
(Kedev) University Clinic of Cardiology, Ss Cyril and Methodius
University, Skopje, North Macedonia
(Al Mafragi) Department of Cardiology, Zorgsaam Hospital, Terneuzen,
Netherlands
(Dewilde) Department of Cardiology, Imelda Hospital Bonheiden, Bonheiden,
Belgium
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Universita della Svizzera Italiana (USI), Lugano CH-6900, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: The optimal duration of antiplatelet therapy (APT) after
coronary stenting in patients at high bleeding risk (HBR) presenting with
an acute coronary syndrome remains unclear. Objective(s): The
objective of this study was to investigate the safety and efficacy of an
abbreviated APT regimen after coronary stenting in an HBR population
presenting with acute or recent myocardial infarction. Method(s): In
the MASTER DAPT trial, 4,579 patients at HBR were randomized after 1 month
of dual APT (DAPT) to abbreviated (DAPT stopped and 11 months single APT
or 5 months in patients with oral anticoagulants) or nonabbreviated APT
(DAPT for minimum 3 months) strategies. Randomization was stratified by
acute or recent myocardial infarction at index procedure. Coprimary
outcomes at 335 days after randomization were net adverse clinical
outcomes events (NACE); major adverse cardiac and cerebral events (MACCE);
and type 2, 3, or 5 Bleeding Academic Research Consortium bleeding.
 Result(s): NACE and MACCE did not differ with abbreviated vs
nonabbreviated APT regimens in patients with an acute or recent myocardial
infarction (n = 1,780; HR: 0.83; 95% CI: 0.61-1.12 and HR: 0.86; 95% CI:
0.62-1.19, respectively) or without an acute or recent myocardial
infarction (n = 2,799; HR: 1.03; 95% CI: 0.77-1.38 and HR: 1.13; 95% CI:
0.80-1.59; P<inf>interaction</inf> = 0.31 and 0.25, respectively).
Bleeding Academic Research Consortium 2, 3, or 5 bleeding was
significantly reduced in patients with or without an acute or recent
myocardial infarction (HR: 0.65; 95% CI: 0.46-0.91 and HR: 0.71; 95% CI:
0.54-0.92; P<inf>interaction</inf> = 0.72) with abbreviated APT.
 Conclusion(s): A 1-month DAPT strategy in patients with HBR
presenting with an acute or recent myocardial infarction results in
similar NACE and MACCE rates and reduces bleedings compared with a
nonabbreviated DAPT strategy. (Management of High Bleeding Risk Patients
Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated
Versus Prolonged DAPT Regimen [MASTER DAPT]; NCT03023020) Copyright
© 2022 The Authors

<77>
Accession Number
2020050823
Title
Sevoflurane alleviates myocardial ischemia/reperfusion injury via
actitation of heat shock protein-70 in patients undergoing double valve
replacement surgery.
Source
American Journal of Translational Research. 14(8) (pp 5529-5540), 2022.
Date of Publication: 2022.
Author
Shan Y.; Xie K.; Zhou Q.; He R.; Chen Z.; Feng W.
Institution
(Shan, Xie, Zhou, He, Chen) Department of Anesthesiology, Shaoxing
People's Hospital (Shaoxing Hospital, Zhejiang University School of
Medicine), Zhejiang, Shaoxing 312000, China
(Feng) Department of Cardiac Surgery, Shaoxing People's Hospital (Shaoxing
Hospital, Zhejiang University School of Medicine), Zhejiang, Shaoxing
312000, China
Publisher
E-Century Publishing Corporation
Abstract
This study investigated the cardioprotective effect(s) of sevoflurane in
rheumatic heart disease patients undergoing double valve replacement
surgery (DVRS) under cardiopulmonary bypass (CPB) and its potential
mechanisms (ChiCTR2100051220 on http://www.ChiCTR.org.cn). Forty-six
patients were randomly assigned to undergo propofol or sevoflurane
anesthesia during surgery. The levels of myocardial injury markers,
inflammatory cytokines, heat shock protein-70 (HSP70), and superoxide
dismutase (SOD) activity were measured from blood samples. Mean arterial
pressure, cardiac index, and stroke volume index were significantly higher
in the sevoflurane group than in the propofol group at the end of CPB.
However, there were no significant differences in operative duration,
length of CPB or aortic cross-clamp time, auto-resuscitation heart rate,
drainage within 48 h after surgery, time to extubation, and recovery time
after DVRS. The dose of inotropic agents (dopamine and noradrenaline) was
significantly lower in the sevoflurane group than in the propofol group.
Sevoflurane was associated with smaller increases in the levels of
myocardial injury-associated markers (CK-MB and cardiac troponin I [cTnI])
and inflammatory cytokines (interleukin [IL]-6, IL-8, and tumor-necrosis
factor-alpha [TNF-alpha]); however, there was a greater increase in HSP70
levels compared with propofol after surgery. Moreover, SOD activity after
surgery was significantly higher in the sevoflurane group than in the
propofol group. Increased HSP70 levels in the sevoflurane group were
positively correlated with cTnI, IL-6, IL-8, and TNF-alpha levels, and
negatively correlated with SOD activity. These results suggest a
cardioprotective effect of sevoflurane during DVRS. Sevoflurane may reduce
biomarkers of cardiac injury through its anti-inflammatory effects via
upregulation of HSP70. Copyright © 2022 E-Century Publishing
Corporation. All rights reserved.

<78>
Accession Number
2019892821
Title
Bicuspid Aortic Stenosis with and without Aortopathy: Considerations for
Surgical Aortic Valve Replacement versus Transcatheter Aortic Valve
Replacement.
Source
US Cardiology Review. 16 (no pagination), 2022. Article Number: e21. Date
of Publication: 2022.
Author
Lee A.J.; Baig I.; Harrington K.B.; Szerlip M.
Institution
(Lee, Baig, Harrington, Szerlip) Baylor Scott and White Heart, The Heart
Hospital Plano, Plano, TX, United States
Publisher
Radcliffe Medical Media
Abstract
The treatment of aortic stenosis has evolved in recent years with the
introduction of transcatheter aortic valve replacement (TAVR) as a
complementary strategy to surgical aortic valve replacement (SAVR). The
majority of clinical trials to date have included only tricuspid aortic
stenosis and excluded bicuspid aortic valves (BAVs). BAVs are associated
with unique challenges related to their anatomy, clinical presentation,
and association with aortopathy. BAV has a spectrum of phenotypes and the
classification is still evolving. There have been no definitive clinical
guidelines on triaging BAV patients towards TAVR or SAVR. Given that TAVR
is moving from high-risk to low-risk patients and becoming more widely
used in the treatment of BAV, there are many factors that must be
considered. The aim of this article is to review the literature and
present considerations for heart teams to discuss in order to offer
patients the best lifetime management strategy for BAV
stenosis. Copyright © RADCLIFFE CARDIOLOGY 2022.

<79>
Accession Number
2018867478
Title
Cardiovascular risk factors, exercise capacity and health literacy in
patients with chronic ischaemic heart disease and type 2 diabetes mellitus
in Germany: Baseline characteristics of the Lifestyle Intervention in
Chronic Ischaemic Heart Disease and Type 2 Diabetes study.
Source
Diabetes and Vascular Disease Research. 19(4) (no pagination), 2022. Date
of Publication: July 2022.
Author
Dinges S.M.T.; Krotz J.; Gass F.; Treitschke J.; Fegers-Wustrow I.;
Geisberger M.; Esefeld K.; von Korn P.; Duvinage A.; Edelmann F.; Wolfram
O.; Brandts J.; Winzer E.B.; Wolfarth B.; Freigang F.; Neubauer S.;
Nebling T.; Hackenberg B.; Amelung V.; Mueller S.; Halle M.
Institution
(Dinges, Gass, Treitschke, Fegers-Wustrow, Geisberger, Esefeld, von Korn,
Duvinage, Mueller, Halle) Department of Prevention and Sports Medicine,
University Hospital Klinikum Rechts der Isar, Technical University of
Munich, Munich, Germany
(Dinges, Gass, Fegers-Wustrow, Esefeld, von Korn, Duvinage, Mueller,
Halle) DZHK (German Centre for Cardiovascular Research), Partner Site
Munich Heart Alliance, Munich, Germany
(Krotz, Freigang, Amelung) Institute for Applied Healthcare Research GmbH
(inav), Berlin, Germany
(Edelmann) Department of Internal Medicine and Cardiology, Charite
Universitatsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
(Edelmann) German Centre for Cardiovascular Research (DZHK), Partner Site
Berlin, Berlin, Germany
(Wolfram) Department of Cardiology and Angiology, University Hospital
Magdeburg, Magdeburg, Germany
(Brandts) Department of Medicine I, University Hospital Aachen, Aachen,
Germany
(Winzer) Heart Centre Dresden, University Hospital, Technische Universitat
Dresden, Dresden, Germany
(Wolfarth) Department of Sports Medicine, Humboldt University and Charite
University School of Medicine, Berlin, Germany
(Neubauer, Nebling) Techniker Krankenkasse, Hamburg, Germany
(Hackenberg) IDS Diagnostic Systems GmbH, Bonn, Germany
Publisher
SAGE Publications Ltd
Abstract
Background: Lifestyle interventions are a cornerstone in the treatment of
chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus
(T2DM). This study aimed at identifying differences in clinical
characteristics between categories of the common lifestyle intervention
targets BMI, exercise capacity (peak VO<inf>2</inf>) and health literacy
(HL). Method(s): Cross-sectional baseline characteristics of patients
enrolled in the LeIKD trial (Clinicaltrials.gov NCT03835923) are presented
in total, grouped by BMI, %-predicted peak VO<inf>2</inf> and HL
(HLS-EU-Q16), and compared to other clinical trials with similar
populations. Result(s): Among 499 patients (68.3+/-7.7 years; 16.2%
female; HbA1c, 6.9+/-0.9%), baseline characteristics were similar to other
trials and revealed insufficient treatment of several risk factors (LDL-C
92+/-34 mg/dl; BMI, 30.1+/-4.8 kg/m2; 69.6% with peak
VO<inf>2</inf><90% predicted). Patients with lower peak VO<inf>2</inf>
showed significantly higher (p < 0.05) CIHD and T2DM disease severity
(HbA1c, CIHD symptoms, coronary artery bypass graft). Obese patients had a
significantly higher prevalence of hypertension and higher triglyceride
levels, whereas in patients with low HL both quality of life components
(physical, mental) were significantly reduced. Conclusion(s): In
patients with CIHD and T2DM, peak VO2, BMI and HL are important indicators
of disease severity, risk factor burden and quality of life, which
reinforces the relevance of lifestyle interventions. Copyright ©
The Author(s) 2022.

<80>
Accession Number
2017953906
Title
Low-molecular Weight Heparin Calcium with Intermittent Pneumatic
Compression Prevents Deep Venous Thrombosis after Thoracic Surgery and its
Influence on Coagulation and Inflammatory Indexes.
Source
Latin American Journal of Pharmacy. 41(9) (pp 1821-1826), 2022. Date of
Publication: 2022.
Author
Xie B.
Institution
(Xie) Department of Thoracic Surgery, Funan County People's Hospital,
Fuyang 236300, China
Publisher
Colegio de Farmaceuticos de la Provincia de Buenos Aires
Abstract
This study was designed to investigate the efficacy of low-molecular
weight heparin calcium with intermittent pneumatic compression on deep
venous thrombosis (DVT) after thoracic surgery and its influence on
coagulation function and inflammatory response. A total 46 patients
undergoing thoracic surgery were randomized to control group containing 23
cases and observation group containing 23 cases. After oper-ation, the
control group received the intermittent pneumatic compression treatment.
On the base of therapy scheme in control group, the observation group
received the low-molecular weight heparin calcium treatment. The
treatments were performed for 10 successive days. During the treatment
period, no DVT occurred in each group. The out of-bed time,
hospitalization time in observation were remarkably shorter comparing to
control group (p < 0.05). After treatment, comparing to control group, in
observation group the platelet count, fibrin-ogen and D-dimer were
obviously decreased (p < 0.05), and the prothrombin time, activated
partial throm-boplastin time were obviously increased (p < 0.05), the
whole blood high-, medium-and low-shear viscosities were obviously
decreased (p < 0.05), and the serum interleukin 2 and high-sensitivity
C-reactive protein levels were obviously decreased (p < 0.05). To sum, the
low-molecular weight heparin calcium with intermittent pneumatic
compression can effectively improve the coagulation function and blood
viscosity, and reduce the inflammatory response, thus preventing the
DVT. Copyright © 2022, Colegio de Farmaceuticos de la Provincia
de Buenos Aires. All rights reserved.

<81>
Accession Number
2020109337
Title
Predicting Non-home Discharge After Lung Surgery: Analysis of the General
Thoracic Surgery Database.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Karush J.M.; Alex G.; Geissen N.; Wakefield C.; Basu S.; Liptay M.J.;
Seder C.W.
Institution
(Karush, Alex, Geissen, Basu, Liptay, Seder) Department of Cardiovascular
and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois
(Wakefield) Rush Medical College, Chicago, Illinois
Publisher
Elsevier Inc.
Abstract
Background: Anticipating the need for non-home discharge (NHD) enables
improved patient counseling and expedites placement, potentially reducing
length of stay and hospital readmission. The objective of this study was
to create a simple, preoperative, clinical prediction tool for NHD using
The Society of Thoracic Surgeons General Thoracic Surgery Database (STS
GTSD). Method(s): The STS GTSD was queried for patients who underwent
elective anatomic lung cancer resection between 2009 and 2019. Exclusion
criteria included age <18 years, percentage predicted diffusion capacity
of the lung for carbon monoxide <20% or >150%, N3 or M1 disease,
incomplete datasets, and mortality. The primary outcome was defined as
discharge to an extended care, transitional care, rehabilitation center,
or another hospital. Multivariable logistic regression was used to select
risk factors and a nomogram for predicting risk of NHD was developed. The
approach was cross-validated in 100 replications of a training set
consisting of randomly selected two-thirds of the cohort and a validation
set of remaining patients. Result(s): A total of 35 948 patients from
the STS GTSD met inclusion criteria. Final model variables used to derive
the nomogram for NHD risk prediction included age (P < .001), percentage
predicted diffusion capacity of the lung for carbon monoxide (P < .001),
open surgery (P < .001), cerebrovascular history (P < .001), and Zubrod
score (P < .001). The receiver operating characteristic curve, using
sensitivities and specificities of the model, yielded area under the curve
of 0.74. In 100 replicated cross-validations, out-of-sample area under the
curve ranged from 0.72-0.76. Conclusion(s): Using readily available
preoperative variables, our nomogram prognosticates the risk of NHD after
anatomic lung resection with good discriminatory ability. Such risk
stratification can enable improved patient counseling and facilitate
better planning of patients' postoperative needs. Copyright ©
2022 The Society of Thoracic Surgeons

<82>
Accession Number
2020109304
Title
Visualizing Inside Conduits-Intraoperative Screening of Grafts by Optical
Coherence Tomography.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Lundy E.F.; Karimi Galougahi K.; Dominguez-Sulca D.; Chowdhury E.; Thomas
S.V.; Porter C.R.; Mintz G.S.; Matsumura M.; Maehara A.; Cohen D.J.; Moses
J.W.; Shlofmitz E.S.; Jeremias A.; West N.E.J.; Robinson N.B.; Shlofmitz
R.A.; Ali Z.A.
Institution
(Lundy, Karimi Galougahi, Dominguez-Sulca, Chowdhury, Thomas, Porter,
Cohen, Moses, Shlofmitz, Jeremias, Robinson, Shlofmitz, Ali) St Francis
Hospital & Heart Center, Roslyn, New York
(Mintz, Matsumura, Maehara, Cohen, Moses, Jeremias, Ali) Cardiovascular
Research Foundation, New York, New York
(West) Abbott Vascular, Santa Clara, California
Publisher
Elsevier Inc.
Abstract
Purpose: Saphenous vein graft (SVG) failure is a complex phenomenon, with
technical, biologic, and local factors contributing to early and medium-
and long-term failure after coronary artery bypass graft. Both technical
and conduit factors may have significant impact on early SVG failure.
Description: We review the complex factors that play a pathogenic role in
SVG failure, followed by review of the existing literature on potential
utility of high-definition optical coherence tomography (OCT) in
comprehensive intraoperative assessment of SVGs. Evaluation: We describe a
new technique for intraoperative acquisition of OCT images in the
harvested SVGs and introduce a classification system for pathologic
processes that can be detected in the harvested SVG conduits by OCT.
 Conclusion(s): The potential impact on early graft failure of the
exclusion of segments of SVGs that are less than optimal (ie, containing
fibroatheroma, retained thrombus, sclerotic valves, or procurement injury)
will be examined in the randomized controlled OCTOCAB (Intraoperative
Optical Coherence Tomography of the Saphenous Vein Conduit in Patients
Undergoing Coronary Artery Bypass Surgery) trial. Copyright ©
2022 The Society of Thoracic Surgeons

<83>
Accession Number
638963099
Title
Self-expanding Transcatheter vs Surgical Aortic Valve Replacement in
Intermediate-Risk Patients: 5-Year Outcomes of the SURTAVI Randomized
Clinical Trial.
Source
JAMA Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Van Mieghem N.M.; Deeb G.M.; Sondergaard L.; Grube E.; Windecker S.; Gada
H.; Mumtaz M.; Olsen P.S.; Heiser J.C.; Merhi W.; Kleiman N.S.; Chetcuti
S.J.; Gleason T.G.; Lee J.S.; Cheng W.; Makkar R.R.; Crestanello J.;
George B.; George I.; Kodali S.; Yakubov S.J.; Serruys P.W.; Lange R.;
Piazza N.; Williams M.R.; Oh J.K.; Adams D.H.; Li S.; Reardon M.J.
Institution
(Van Mieghem, Serruys) Department of Interventional Cardiology, Erasmus
University Medical Center, Rotterdam, Netherlands
(Deeb, Chetcuti) Department of Interventional Cardiology, University of
Michigan, Ann Arbor, United States
(Deeb) Department of Cardiac Surgery, University of Michigan, Ann Arbor,
United States
(Sondergaard, Olsen) Department of Cardiology, The Heart Center,
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Grube) Department of Interventional Cardiology, University of Bonn, Bonn,
Germany
(Windecker) Department of Cardiology, Inselspital, University of Bern,
Bern, Switzerland
(Gada, Mumtaz) Department of Interventional Cardiology, University of
Pittsburgh Medical Center, Pinnacle Health, Harrisburg, PA, United States
(Gada, Mumtaz) Department of Cardiothoracic Surgery, University of
Pittsburgh Medical Center, Pinnacle Health, Harrisburg, PA, United States
(Heiser, Merhi) Department of Interventional Cardiology, Spectrum Health,
Grand Rapids, MI, United States
(Heiser, Merhi) Department of Cardiothoracic Surgery, Spectrum Health,
Grand Rapids, MI, United States
(Kleiman, Reardon) Department of Interventional Cardiology, Houston
Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
(Kleiman, Reardon) Department of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart and Vascular Center, Houston, TX, United States
(Gleason, Lee) Department of Interventional Cardiology, University of
Pittsburgh, Pittsburgh, PA, United States
(Gleason) Now with Division of Cardiac Surgery, Department of Surgery,
University of Maryland, School of Medicine, Baltimore, United States
(Gleason, Lee) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Cheng, Makkar) Department of Interventional Cardiology, Cedars-Sinai
Medical Center, Los Angeles, CA, United States
(Cheng, Makkar) Department of Cardiothoracic Surgery, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Crestanello, George) Department of Interventional Cardiology, Ohio State
University, Wexner Medical Center, Columbus, United States
(Crestanello) Mayo Clinic, Rochester, MN, United States
(Crestanello, George) Department of Cardiovascular Surgery, Ohio State
University, Wexner Medical Center, Columbus, United States
(George, Kodali) Department of Interventional Cardiology, New York
Presbyterian Hospital-Columbia University Irving Medical Center, New York,
United States
(George, Kodali) Department of Cardiothoracic Surgery, New York
Presbyterian Hospital-Columbia University Irving Medical Center, New York,
United States
(Yakubov) Department of Interventional Cardiology, OhioHealth Riverside
Methodist Hospital, Columbus, United States
(Serruys) National University of Ireland, Galway, Ireland
(Lange) Department of Cardiac Surgery, German Heart Center, Munich,
Germany
(Piazza) Department of Interventional Cardiology, McGill University,
Health Centre, Montreal, QC, Canada
(Williams) Department of Interventional Cardiology and Cardiac Surgery,
Langone-New York University, New York, United States
(Oh) Echocardiography Core Laboratory, Mayo Clinic, Rochester, MN, United
States
(Adams) Department of Cardiovascular Surgery, Mount Sinai Health System,
New York, NY, United States
(Li) Clinical Research, Medtronic, Minneapolis, MN, United States
Publisher
American Medical Association
Abstract
Importance: In patients with severe aortic valve stenosis at intermediate
surgical risk, transcatheter aortic valve replacement (TAVR) with a
self-expanding supra-annular valve was noninferior to surgery for
all-cause mortality or disabling stroke at 2 years. Comparisons of
longer-term clinical and hemodynamic outcomes in these patients are
limited. Objective(s): To report prespecified secondary 5-year
outcomes from the Symptomatic Aortic Stenosis in Intermediate Risk
Subjects Who Need Aortic Valve Replacement (SURTAVI) randomized clinical
trial. Design, Setting, and Participant(s): SURTAVI is a prospective
randomized, unblinded clinical trial. Randomization was stratified by
investigational site and need for revascularization determined by the
local heart teams. Patients with severe aortic valve stenosis deemed to be
at intermediate risk of 30-day surgical mortality were enrolled at 87
centers from June 19, 2012, to June 30, 2016, in Europe and North America.
Analysis took place between August and October 2021. Intervention(s):
Patients were randomized to TAVR with a self-expanding, supra-annular
transcatheter or a surgical bioprosthesis. Main Outcomes and
Measures: The prespecified secondary end points of death or disabling
stroke and other adverse events and hemodynamic findings at 5 years. An
independent clinical event committee adjudicated all serious adverse
events and an independent echocardiographic core laboratory evaluated all
echocardiograms at 5 years. Result(s): A total of 1660 individuals
underwent an attempted TAVR (n = 864) or surgical (n = 796) procedure. The
mean (SD) age was 79.8 (6.2) years, 724 (43.6%) were female, and the mean
(SD) Society of Thoracic Surgery Predicted Risk of Mortality score was
4.5% (1.6%). At 5 years, the rates of death or disabling stroke were
similar (TAVR, 31.3% vs surgery, 30.8%; hazard ratio, 1.02 [95% CI,
0.85-1.22]; P =.85). Transprosthetic gradients remained lower (mean [SD],
8.6 [5.5] mm Hg vs 11.2 [6.0] mm Hg; P <.001) and aortic valve areas were
higher (mean [SD], 2.2 [0.7] cm2 vs 1.8 [0.6] cm2; P <.001) with TAVR vs
surgery. More patients had moderate/severe paravalvular leak with TAVR
than surgery (11 [3.0%] vs 2 [0.7%]; risk difference, 2.37% [95% CI,
0.17%- 4.85%]; P =.05). New pacemaker implantation rates were higher for
TAVR than surgery at 5 years (289 [39.1%] vs 94 [15.1%]; hazard ratio,
3.30 [95% CI, 2.61-4.17]; log-rank P <.001), as were valve reintervention
rates (27 [3.5%] vs 11 [1.9%]; hazard ratio, 2.21 [95% CI, 1.10-4.45];
log-rank P =.02), although between 2 and 5 years only 6 patients who
underwent TAVR and 7 who underwent surgery required a reintervention.
 Conclusions and Relevance: Among intermediate-risk patients with
symptomatic severe aortic stenosis, major clinical outcomes at 5 years
were similar for TAVR and surgery. TAVR was associated with superior
hemodynamic valve performance but also with more paravalvular leak and
valve reinterventions. Copyright © 2022 American Medical
Association. All rights reserved.

<84>
Accession Number
2016392425
Title
Single-injection caudal thoracic paravertebral block improves pain control
and recovery quality in female dogs undergoing unilateral radical
mastectomy: A randomized controlled trial.
Source
Journal of the American Veterinary Medical Association. 260(S1) (pp
53-58), 2022. Date of Publication: 15 Jan 2022.
Author
Santoro F.; Debidda P.; Franci P.
Institution
(Santoro) Department of Clinical Sciences and Services, Royal Veterinary
College, Hertfordshire, Hatfield, United Kingdom
(Debidda) Centro Veterinario Professionale La Fenice, Assemini, Italy
(Franci) Department of Veterinary Medical Science, Largo Paolo Braccini,
Grugliasco, Italy
Publisher
American Veterinary Medical Association
Abstract
OBJECTIVE To test clinical and analgesic effects of a single-injection
caudal thoracic paravertebral block (TPVB) after localization of the
thoracic paravertebral space with a loss-of-resistance to air injection
technique in female dogs undergoing unilateral radical mastectomy. ANIMALS
14 client-owned dogs. PROCEDURES Dogs were premedicated with methadone,
anesthetized with propofol and sevoflurane, and randomly assigned to
receive a TPVB or no block preoperatively. Rescue analgesia with fentanyl
and methadone was provided on the basis of cardiovascular responses during
surgery and postoperative pain scores assigned with a validated pain
scale. Required dose of rescue opioids; mean end-tidal sevoflurane
concentration; episodes of hypotension, bradycardia, and other
complications; quality of recovery scores; and postoperative pain scores
were compared between groups. RESULTS Median intraoperative fentanyl doses
were 0 mug/kg (range, 0 to 2 mug/kg) and 4 mug/kg (range, 2 to 6 mug/kg)
for the TPVB and control groups, respectively. Median postoperative
methadone doses were 0 mg/kg (range, 0 to 0.2 mg/kg) and 0.6 mg/kg (range,
0.4 to 0.6 mg/kg) for the TPVB and control groups, respectively. Recovery
scores and pain scores assigned at the time of and 1 hour after extubation
were significantly lower in the TPVB group than in the control group.
CONCLUSIONS AND CLINICAL RELEVANCE A single-injection caudal TPVB improved
pain control and recovery quality in female dogs undergoing unilateral
radical mastectomy. Because the TPVB involves only a single injection,
does not take long to perform, and requires only readily available lowcost
equipment, the technique may be a valuable option in both referral and
first-opinion practice. Copyright © 2022 American Veterinary
Medical Association. All rights reserved.

<85>
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.

<86>
Accession Number
2017846497
Title
Outcomes of cardiac surgery with left atrial appendage occlusion versus no
Occlusion, direct oral Anticoagulants, and vitamin K Antagonists: A
systematic review with Meta-analysis.
Source
IJC Heart and Vasculature. 40 (no pagination), 2022. Article Number:
100998. Date of Publication: June 2022.
Author
Nso N.; Nassar M.; Zirkiyeva M.; Lakhdar S.; Shaukat T.; Guzman L.;
Alshamam M.; Foster A.; Bhangal R.; Badejoko S.; Lyonga Ngonge A.;
Tabot-Tabot M.; Mbome Y.; Rizzo V.; Munira M.S.; Thambidorai S.
Institution
(Nso, Nassar, Zirkiyeva, Lakhdar, Shaukat, Guzman, Alshamam, Foster,
Bhangal, Rizzo) Department of Medicine, Icahn School of Medicine at Mount
Sinai/NYC H+H/Queens, NY, United States
(Badejoko) Department of Medicine, St. Joseph's Medical Center, Stockton,
CA, United States
(Lyonga Ngonge, Tabot-Tabot) Department of Medicine, Howard University
Hospital, Washington, DC, United States
(Mbome) Department of Medicine, Richmond University Medical Center, Staten
Island, NY, United States
(Munira) Division of Cardiovascular Disease, Icahn School of Medicine at
Mount Sinai/NYC H+H/Queens, NY, United States
(Thambidorai) Chief of Cardiovascular Medicine Division, HCA Medical City
of Fort Worth, TX/ Assistant Professor of Medicine -TCU and UNTHSc School
of Medicine, Fort Worth, TX, United States
Publisher
Elsevier Ireland Ltd
Abstract
Surgical left atrial appendage occlusion (LAAO) is being used increasingly
in the setting of atrial fibrillation but has been associated with
procedural complications. This systematic review and meta-analysis
compared the outcomes of surgical LAAO with those of no LAAO and the use
of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs)
using the PRISMA guidelines. A literature search was undertaken for
relevant studies published between January 1, 2003, and August 15, 2021.
Primary clinical outcomes were all-cause mortality, embolic events, and
stroke. Secondary clinical outcomes included major adverse cardiac events
(MACE), postoperative atrial fibrillation, postoperative complications,
reoperation for bleeding, and major bleeding. There was a statistically
significant 34% reduction in incidence of embolic events (odds ratio [OR]
0.66, 95% confidence interval [CI] 0.57-0.77, p < 0.001) and a significant
42% reduction in risk of MACE (OR 0.58, 95% CI 0.38-0.88, p = 0.01) in
patients who underwent LAAO.Surgical LAAO has the potential to reduce
embolic events and MACE in patients undergoing cardiac surgery for atrial
fibrillation. However, complete replacement of DOACs and warfarin therapy
with surgical LAAO is unlikely despite its non-inferiority in terms of
minimizing all-cause mortality, embolic events, MACE, major bleeding, and
stroke in patients on oral anticoagulation therapies. Copyright ©
2022 The Authors

<87>
Accession Number
2016031416
Title
Short-term and Long-term Risk of Stroke in Patients With Perioperative
Atrial Fibrillation After Cardiac Surgery: Systematic Review and
Meta-analysis.
Source
CJC Open. 4(1) (pp 85-96), 2022. Date of Publication: January 2022.
Author
Wang M.K.; Meyre P.B.; Heo R.; Devereaux P.J.; Birchenough L.; Whitlock
R.; McIntyre W.F.; Peter Chen Y.C.; Ali M.Z.; Biancari F.; Butt J.H.;
Healey J.S.; Belley-Cote E.P.; Lamy A.; Conen D.
Institution
(Wang, Devereaux, McIntyre, Healey, Belley-Cote, Conen) Department of
Medicine, McMaster University, Hamilton, Ontario, Canada
(Wang, Devereaux, Whitlock, McIntyre, Healey, Belley-Cote, Lamy, Conen)
Population Health Research Institute, McMaster University, Hamilton,
Ontario, Canada
(Wang, Devereaux, Whitlock, McIntyre, Healey, Lamy, Conen) Department of
Health Research Methods, Evidence & Impact, McMaster University, Hamilton,
Ontario, Canada
(Meyre) Division of Cardiology and Basel Cardiovascular Research
Institute, Basel University Hospital, Basel, Switzerland
(Heo) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, Ontario, Canada
(Birchenough) Faculty of Health Sciences, McMaster University, Hamilton,
Ontario, Canada
(Whitlock, Lamy) Department of Surgery, McMaster University, Hamilton,
Ontario, Canada
(Peter Chen) Department of Medicine, University of British Columbia,
Vancouver, BC, Canada
(Ali) School of Medicine, Royal College of Surgeons in Ireland, Dublin,
Ireland
(Biancari) Clinica Montevergine, GVM Care & Research, Mercogliano, Italy
(Butt) Department of Cardiology, Rigshopitalet, Copenhagen University
Hospital, Copenhagen, Denmark
Publisher
Elsevier Inc.
Abstract
Background: Perioperative atrial fibrillation (POAF) after cardiac surgery
has been associated with an increased risk of stroke in some studies.
However, the exact magnitude of this association during short-term and
long-term follow-up remains unclear. Method(s): We searched PubMed,
Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) for
the time period from database inception to October 2020. We included
observational studies with >= 100 patients that reported data on
short-term or long-term stroke risk in patients with and without POAF
after cardiac surgery. Data were pooled using random-effects models. We
reported summary risk ratios (RRs) for studies reporting multivariable
adjusted results and calculated absolute risk differences (ARDs) with 95%
confidence intervals (CIs). Result(s): A total of 55 studies with
540,209 patients were included. POAF was associated with both an increased
relative risk (RR 1.69; 95% CI, 1.41-2.03; I2 = 82%; 9 studies)
and absolute risk of short-term stroke (4.5% vs 2.5%; ARD 2.0%; 95% CI,
1.28-2.89). POAF was associated with an increased relative risk (RR 1.20;
95% CI, 1.12-1.29; I2 = 16%; 10 studies) and absolute risk of
long-term stroke (1.06 vs 0.88 per 100 patient-years; ARD 0.18 per 100
patient-years; 95% CI, 0.07-0.26). Sensitivity analyses of high-quality
studies and studies reporting either ischemic or embolic strokes yielded
similar findings. Conclusion(s): POAF after cardiac surgery was
associated with an increased risk of both short-term and long-term stroke.
However, the long-term stroke ARD was small, and whether these patients
will benefit from long-term oral anticoagulation therapy is
unclear. Copyright © 2021 The Authors

<88>
Accession Number
2019868555
Title
Cardiovascular outcomes of transradial versus transfemoral percutaneous
coronary intervention in End-Stage renal Disease: A Regression-Based
comparison.
Source
IJC Heart and Vasculature. 43 (no pagination), 2022. Article Number:
101110. Date of Publication: December 2022.
Author
Sattar Y.; Faisaluddin M.; Almas T.; Alhajri N.; Shah R.; Zghouzi M.;
Zafrullah F.; Sengodon P.M.; Zia Khan M.; Ullah W.; Alam M.; Balla S.;
Lakkis N.; Kawsara A.; Daggubati R.; Chadi Alraies M.
Institution
(Sattar, Sengodon, Zia Khan, Balla, Kawsara, Daggubati) West Virginia
University, Morgantown, WV, United States
(Faisaluddin) Rochester General Hospital, NY, United States
(Almas) Royal College of Surgeons in Ireland, Dublin, Ireland
(Alhajri) College of Medicine and Health Science, Khalifa University, Abu
Dhabi, United Arab Emirates
(Shah) Health Quest Systems, Inc, Poughkeepsie, NY, United States
(Zghouzi, Lakkis, Chadi Alraies) Detroit Medical Center, Detroit, MI,
United States
(Zafrullah) University of Toledo, Toledo, OH, United States
(Ullah) Thomas Jefferson University, Philadelphia, PA, United States
(Alam) Baylor College of Medicine, Houston, TX, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Limited data is available on the comparison of outcomes of
transradial (TR) and transfemoral (TF) access for percutaneous coronary
intervention (PCI) in patients with end-stage stage renal disease (ESRD).
 Method(s): Online databases were queried to compare cardiovascular
outcomes among TR. and TF in ESRD patients. The outcomes assessed included
differences in mortality, cerebrovascular accidents (CVA), periprocedural
myocardial infarction (MI), bleeding, transfusion, and periprocedural
cardiogenic shock (CS). Unadjusted odds ratios (OR) were calculated using
a random-effect effect model. Result(s): A total of 6 studies
including 7,607 patients (TR-PCI = 1,288; TF-PCI = 6,319) were included.
The overall mean age was 67.7 years, while the mean age for TR-PCI and
TF-PCI was 69.7 years and 67.9 years, respectively. TR-PCI was associated
with lower incidence of mortality (OR 0.46 95 % CI 0.30-0.70, p < 0.05, I2
0.00 %), bleeding (OR 0.45 95 % CI 0.29, 0.68, p < 0.05, I2 3.48 %), and
transfusion requirement (OR 0.52 95 % CI 0.40, 0.67, p < 0.05, I2 0.00 %)
(Fig. 1). There were no differences among TR-PCI and TF-PCI for
periprocedural MI, periprocedural CS, and CVA outcomes.
 Conclusion(s): TR access was associated with lower mortality,
bleeding, and transfusion requirement as compared to TF access in patients
with ESRD undergoing PCI. Copyright © 2022

<89>
Accession Number
2019615518
Title
Meta-analysis Comparing Percutaneous Coronary Intervention With Coronary
Artery Bypass Grafting for Non-ST Elevation Acute Coronary Syndrome in
Patients With Multivessel or Left Main Disease.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 101306. Date of Publication: October 2022.
Author
Barssoum K.; Kumar A.; Rai D.; Kharsa A.; Chowdhury M.; Thakkar S.; Patel
H.P.; Amin A.; Tan B.E.-X.; Ibrahim F.; Bandyopadhyay D.; Elkaryoni A.;
Elbadawi A.; Abtahian F.; Nanda N.C.; Depta J.
Institution
(Barssoum) Department of Internal Medicine, Unity Hospital, Rochester
Regional Health System, Rochester, NY, United States
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, United States
(Barssoum, Rai, Kharsa, Chowdhury, Thakkar, Amin, Tan) Department of
Internal Medicine, Rochester General Hospital, Rochester, NY, United
States
(Patel) Department of Internal Medicine, Louis A Weiss Memorial Hospital,
Chicago, IL, United States
(Ibrahim) Department of Internal Medicine, American University of Antigua,
Antigua and Barbuda, Antigua and Barbuda
(Bandyopadhyay) Department of Cardiovascular Medicine, Loyola University
Medical Center, Maywood, IL, United States
(Elkaryoni, Abtahian) Department of Cardiology, Sands Constellation Heart
Institute, Rochester Regional Health, Rochester, NY, United States
(Elbadawi) Division of Cardiovascular Medicine, University of Texas
Medical Branch, Galveston, TX, United States
(Nanda) Division of Cardiovascular Disease, University of Alabama at
Birmingham, Birmingham, AL, United States
(Depta) Department of Cardiology, Sands Constellation Heart Institute,
Rochester Regional Health, Rochester, NY, United States
Publisher
Elsevier Inc.
Abstract
Outcomes of patients presenting with non-ST-elevation acute coronary
syndrome (NSTE-ACS) with multivessel coronary disease (MVD) and/or
unprotected left main coronary artery disease (CAD) revascularized with
percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG) is not well defined. MEDLINE/PubMed and EMBASE/Ovid were
queried for studies that investigated PCI vs CABG in this disease subset.
The primary outcome was major cardiac adverse events (MACE) at 30 days and
long-term follow-up (3-5 years). The final analysis included 9 studies
with a total of 9299 patients. No significant difference was observed
between PCI and CABG in 30 days MACE (risk ratio [RR] 0.96; 95% confidence
interval [CI] 0.38-2.39, all-cause mortality, myocardial infarction, and
stroke. A meta-regression analysis revealed patients with a history of PCI
had higher risk of MACE with PCI as compared with CABG. At long-term
follow-up, PCI compared with CABG was associated with higher risk of MACE
(RR 1.52; 95% CI 1.28-1.81), myocardial infarction, and repeat
revascularization, while no difference was observed in the risk of stroke
and all-cause mortality. In patients with NSTE-ACS and MVD or unprotected
left main CAD, no differences were observed in the clinical outcomes
between PCI and CABG at 30 days follow-up. With long-term follow-up, PCI
was associated with a higher risk of MACE. Copyright © 2022
Elsevier Inc.

<90>
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

<91>
Accession Number
2018690789
Title
Imaging-Based, Patient-Specific Three-Dimensional Printing to Plan, Train,
and Guide Cardiovascular Interventions: A Systematic Review and
Meta-Analysis.
Source
Heart Lung and Circulation. 31(9) (pp 1203-1218), 2022. Date of
Publication: September 2022.
Author
Bernhard B.; Illi J.; Gloeckler M.; Pilgrim T.; Praz F.; Windecker S.;
Haeberlin A.; Grani C.
Institution
(Bernhard, Illi, Gloeckler, Pilgrim, Praz, Windecker, Haeberlin, Grani)
Department of Cardiology, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Illi) Swiss MedTech Center, Switzerland Innovation Park Biel/Bienne AG,
Switzerland
(Haeberlin, Grani) Translational Imaging Center, Sitem Center, University
of Bern, Switzerland
Publisher
Elsevier Ltd
Abstract
Background: To tailor cardiovascular interventions, the use of
three-dimensional (3D), patient-specific phantoms (3DPSP) encompasses
patient education, training, simulation, procedure planning, and
outcome-prediction. Aim(s): This systematic review and meta-analysis
aims to investigate the current and future perspective of 3D printing for
cardiovascular interventions. Method(s): We systematically screened
articles on Medline and EMBASE reporting the prospective use of 3DPSP in
cardiovascular interventions by using combined search terms. Studies that
compared intervention time depending on 3DPSP utilisation were included
into a meta-analysis. Result(s): We identified 107 studies that
prospectively investigated a total of 814 3DPSP in cardiovascular
interventions. Most common settings were congenital heart disease (CHD)
(38 articles, 6 comparative studies), left atrial appendage (LAA)
occlusion (11 articles, 5 comparative, 1 randomised controlled trial
[RCT]), and aortic disease (10 articles). All authors described 3DPSP as
helpful in assessing complex anatomic conditions, whereas poor tissue
mimicry and the non-consideration of physiological properties were cited
as limitations. Compared to controls, meta-analysis of six studies showed
a significant reduction of intervention time in LAA occlusion (n=3
studies), and surgery due to CHD (n=3) if 3DPSPs were used (Cohen's
d=0.54; 95% confidence interval 0.13 to 0.95; p=0.001), however
heterogeneity across studies should be taken into account.
 Conclusion(s): 3DPSP are helpful to plan, train, and guide
interventions in patients with complex cardiovascular anatomy. Benefits
for patients include reduced intervention time with the potential for
lower radiation exposure and shorter mechanical ventilation times. More
evidence and RCTs including clinical endpoints are needed to warrant
adoption of 3DPSP into routine clinical practice. Copyright ©
2022 The Author(s)

<92>
Accession Number
2018003697
Title
Re-analysis of the Effect of Coronary Artery Bypass Surgery in Patients
With Left Ventricular Dysfunction.
Source
Journal of Cardiac Failure. 28(8) (pp 1375-1377), 2022. Date of
Publication: August 2022.
Author
Ferket B.S.; Bagiella E.; Giustino G.; Mancini D.
Institution
(Ferket, Bagiella, Giustino, Mancini) From the Department of Population
Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1
Gustave L. Levy Place, New York, NY Box 107710029
Publisher
Elsevier B.V.

<93>
Accession Number
2017771276
Title
Role of Procalcitonin in the Prognosis of Mortality in Patients Admitted
to the Intensive Care Unit: A Review Study.
Source
Tanaffos. 20(4) (pp 296-305), 2021. Date of Publication: October 2021.
Author
Jafari M.; Fazeli F.; Sezavar M.; Khashkhashi S.; Fazli B.; Abdollahpour
N.; Sedaghat A.
Institution
(Jafari, Fazeli, Khashkhashi, Fazli) Department of Anesthesiology, Faculty
of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,
Islamic Republic of
(Sezavar) Department of Pediatrics, Faculty of Medicine, Mashhad
University of Medical Science, Mashhad, Iran, Islamic Republic of
(Abdollahpour) Department of Biology, Faculty of Sciences, Mashhad Branch,
Islamic Azad University, Mashhad, Iran, Islamic Republic of
(Sedaghat) Lung Disease Research Center, Faculty of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Shaheed Beheshti University of Medical Sciences and Health Services
Abstract
Background: This review study aimed to investigate the role of PCT in the
prognosis of mortality among patients admitted to the intensive care units
(ICU). Procalcitonin (PCT) is a polypeptide and prohormone of calcitonin.
This prohormone is secreted by thyroid gland C cells in response to
hypercalcemia, and Its elevated level indicates infection, especially
bacterial infections, in which there is a systematic response to
infection. Material(s) and Method(s): This narrative review study was
performed based on Cochrane collaboration recommendations for reviews. We
reviewed all the titles and abstracts of published research articles with
the following inclusion criteria studies aimed to confirm the function of
a prognostic model in predicting mortality or survival, (b) mortality or
survival of a specific endpoint (for example, 30 days), (c) patients
admitted to intensive care units, and d) the articles written in English.
The exclusion criteria of the current review included: (a) articles whose
data were not specifically focused on prognosis of patients in ICU, (b)
articles that did not provide sufficient information on the cause of death
of patients in ICU, and (c) articles focusing on the treatment of comorbid
patients with infections in ICU. The search was conducted on Google
Scholar, PubMed, Magiran, ScienceDirect, and SID. Also, to search Iranian
databases, including SID and Magiran, the same terms and expressions were
searched. Result(s): Based on the findings of this review, serum
levels of PCT were reported within the range of at least 5 to more than 16
ng/ml in patients admitted to ICU. The mortality rate was estimated at
5.7% to 79% in these patients. Moreover, the incidence of sepsis was
reported from 13% to 77.6%. Conclusion(s): Serum levels of PCT as a
prognostic factor may help early detection, and better classification of
the poor prognoses sepsis patients and more invasive treatment of patients
admitted to ICU and are at risk for mortality. Copyright © 2021
NRITLD, National Research Institute of Tuberculosis and Lung Disease,
Iran.

<94>
[Use Link to view the full text]
Accession Number
2007540395
Title
Antioxidant treatment to reduce mortality and serious adverse events in
adult surgical patients: A systematic review with meta-analysis and trial
sequential analysis.
Source
Acta Anaesthesiologica Scandinavica. 65(4) (pp 438-450), 2021. Date of
Publication: April 2021.
Author
Pedersen S.S.; Fabritius M.L.; Kongebro E.K.; Meyhoff C.S.
Institution
(Pedersen, Fabritius, Kongebro, Meyhoff) Department of Anaesthesia and
Intensive Care, Bispebjerg and Frederiksberg Hospital, University of
Copenhagen, Copenhagen, Denmark
(Pedersen, Meyhoff) Copenhagen Center for Translational Research,
Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital,
Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Hyperoxia during anesthesia can increase cellular oxidative
stress, and perioperative antioxidant treatment may reduce the resulting
damage. The aim of this review was to evaluate risks and benefits of
antioxidant treatment in surgical patients. We hypothesized that
antioxidant treatment reduced mortality compared to placebo/no
intervention. Method(s): This systematic review with meta-analyses
and trial sequential analysis (TSA) was conducted using Cochrane standards
and GRADE methodology. Randomized clinical trials comparing perioperative
antioxidant treatment vs. placebo/no intervention in adults were included.
Primary outcome was mortality at longest follow-up. Result(s):
Ninety-seven trials with 8156 patients were included. The most common
interventions were N-Acetylcysteine (36 trials) and vitamin C (29 trials).
Trials were primarily performed during cardiac surgery (53 trials).
Fifty-six trials with 4890 patients reported information on mortality (243
events). The meta-analysis of mortality at longest follow-up showed a
reduced mortality in antioxidant treated patients (RR 0.74, 95% CI 0.59;
0.94, I2 0%), however, TSA-adjusted CI was broadened
(0.55-1.02) and only 31% of the required information size was reached.
Furthermore, in the subgroup of three trials with overall low risk of bias
the RR for mortality was 1.18 (95% CI 0.39, 3.63). Based on GRADE, our
findings are of low quality of evidence due to high risk of bias,
imprecision, and indirectness. Conclusion(s): We found a 26% relative
risk reduction of mortality in surgical patients treated with antioxidants
but the quality of evidence supporting our findings is low and influenced
by clinical heterogeneity and high risk of systematic- and random
errors. Copyright © 2020 The Acta Anaesthesiologica Scandinavica
Foundation. Published by John Wiley & Sons Ltd

<95>
Accession Number
2018357125
Title
The use of sutureless and rapid-deployment aortic valve prosthesis in
patients with bicuspid aortic valve: A focused review.
Source
Journal of Cardiac Surgery. 37(10) (pp 3355-3362), 2022. Date of
Publication: October 2022.
Author
King M.; Stambulic T.; Payne D.; Fernandez A.L.; El-Diasty M.
Institution
(King, Stambulic) Queen's School of Medicine, Kingston, ON, Canada
(Payne, El-Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
(Fernandez) Cardiac Surgery Department, University of Santiago de
Compostela, Santiago, Spain
Publisher
John Wiley and Sons Inc
Abstract
Objective: The objective of this scoping review is to describe the
postoperative outcomes and complications of patients with bicuspid aortic
valve (BAV) treated with sutureless or rapid-deployment prosthesis.
 Background(s): The use of sutureless and rapid-deployment prostheses
is generally avoided in patients with BAV due to anatomical concerns and
the elevated risk of para-prosthetic leaks. Multiple studies have reported
the use of these prostheses into patients with BAV with varying degrees of
success. The focus of this review is to consolidate the current available
evidence on this topic. Method(s): A scoping review was conducted
using a comprehensive search strategy in multiple databases (Medline,
Embase, Cochrane Central Register of Controlled Clinical Trials) for
relevant articles. All abstracts and full texts were screened by two
independent reviewers according to predefined inclusion and exclusion
criteria. Thirteen articles, including case reports and case series were
ultimately included for analysis. Result(s): Of 1052 total citations,
44 underwent full text review and 13 (4 case reports, 6 retrospective
analyses, and 3 prospective analyses) were included in the scoping review.
Across all 13 studies, a total of 314 patients with BAV were used for data
analysis. In sutureless and rapid-deployment prostheses, the mean
postoperative aortic valvular gradients were less than 15 mmHg in all
studies with mean postoperative aortic valvular areas all greater than 1.3
cm.2 There were 186 total complications for an overall
complication rate of 59%. Individual complications included new onset
atrial fibrillation (n = 65), required pacemaker insertion (n = 24),
intraprosthetic aortic regurgitation (n = 20), new onset atrioventricular
block (n = 18), and new onset paravalvular leakage (n = 10).
 Conclusion(s): The use of sutureless and rapid deployment prostheses
in patients with BAV showed comparable intraoperative and implantation
success rates to patients without BAV. Postoperative complications from
using these prostheses in patients with BAV included new onset atrial
fibrillation, intraprosthetic aortic regurgitation, new onset
atrioventricular block, and required pacemaker insertion. Various
techniques have been described to minimize these complications in patients
with BAV receiving sutureless or rapid deployment
prostheses. Copyright © 2022 Wiley Periodicals LLC.

<96>
Accession Number
2018331969
Title
Percutaneous coronary intervention versus coronary artery bypass graft
surgery in dialysis-dependent patients: A pooled meta-analysis of
reconstructed time-to-event data.
Source
Journal of Cardiac Surgery. 37(10) (pp 3365-3373), 2022. Date of
Publication: October 2022.
Author
Tasoudis P.T.; Varvoglis D.N.; Tzoumas A.; Doulamis I.P.; Tzani A.; Sa
M.P.; Kampaktsis P.N.; Gallo M.
Institution
(Tasoudis, Varvoglis) Department of Cardiothoracic Surgery, School of
Health Sciences, University of Thessaly, Larisa, Greece
(Tzoumas) Department of Internal Medicine, University of Cincinnati
Medical Center, Cincinnati, OH, United States
(Doulamis) Department of Surgery, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Tzani) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sa) Department of Cardiothoracic Surgery Research, Lankenau Institute for
Medical Research, Wynnewood, PA, United States
(Kampaktsis) Department of Medicine, Division of Cardiology, New York
University Langone Medical Center, New York, NY, United States
(Gallo) Department of Cardiac Surgery, Cardiocentro Ticino, Lugano,
Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Objective: Tomicron perform a systematic review with meta-analysis of
published data comparing outcomes between a percutaneous coronary
intervention (PCI) and coronary artery bypass grafting (CABG) in
dialysis-dependent patients. Method(s): We searched PubMed, Scopus,
and Cochrane databases for studies including dialysis-dependent patients
who underwent either CABG or PCI. This meta-analysis follows the
recommendations of the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses statement. We conducted one-stage and two-stage
meta-analysis with Kaplan-Meier-derived individual patient data for
overall survival and meta-analysis with the random-effects model for the
in-hospital mortality and repeat revascularization. Result(s): Twelve
studies met our eligibility criteria, including 13,651 and 28,493 patients
were identified in the CABG and PCI arms, respectively. Patients who
underwent CABG had overall improved survival compared with those who
underwent PCI at the one-stage meta-analysis (hazard ratio [HR]: 1.12, 95%
confidence interval [CI]: 1.09-1.16, p <.0001) and the two-stage
meta-analysis (HR: 1.15, 95% CI: 1.08-1.23, p <.001, I2 =
30.0%). Landmark analysis suggested that PCI offers better survival before
the 8.5 months of follow-up (HR: 0.96, 95% CI: 0.92-0.99, p =.043), while
CABG offers an advantage after this timepoint (HR: 1.3, 95% CI: 1.22-1.32,
p <.001). CABG was associated with increased odds for in-hospital
mortality (odds ratio [OR]: 1.70, 95% CI: 1.50-1.92, p <.001,
I2 = 0.0%) and decreased odds for repeat revascularization (OR:
0.22, 95% CI: 0.14-0.34, p <.001, I2 = 58.08%).
 Conclusion(s): In dialysis-dependent patients, CABG was associated
with long-term survival but a higher risk for early mortality. The risk
for repeat revascularization was higher with PCI. Copyright ©
2022 Wiley Periodicals LLC.

<97>
Accession Number
2018199925
Title
Lung transplantation and concomitant cardiac surgical procedures: A
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(10) (pp 3342-3352), 2022. Date of
Publication: October 2022.
Author
Meng E.; Jiang S.M.; Servito T.; Payne D.; El-Diasty M.
Institution
(Meng, Jiang, Servito, Payne, El-Diasty) Division of Cardiac Surgery,
Queen's University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Lung transplantation is an effective treatment option for
end-stage lung diseases. In some cases, these patients may also have
underlying cardiac disease which may require surgical intervention before
or during transplantation. Concomitant cardiac surgery may often be
preferred, as reduced lung function precludes these patients from
pre-transplant surgery. Our meta-analysis sought to examine the impact of
lung transplantation paired with concomitant cardiac surgery on long-term
mortality. Method(s): We conducted a systematic review of the
MEDLINE, Embase, and Cochrane databases. Our primary outcome was overall
mortality. Secondary outcomes included length of stay (LOS) in hospital
and serious postoperative complication rates. We used a meta-analytic
model to determine the differences in the above outcomes between patients
who underwent lung transplantation with or without concomitant cardiac
surgery. Result(s): Out of the 1876 articles screened, 7 met our
pre-determined inclusion criteria. Lung transplantation with concomitant
cardiac surgery was not associated with increased mortality compared to
lung transplantation alone (hazard ratio = 1.02; 95% confidence interval
[CI] = 0.80-1.31; I2 = 0%; p =.99). LOS in hospital was not
significantly different between groups (standardized mean difference =
0.32; 95% CI = -0.91 to 1.55). Postoperative complication rates were also
reported but not analyzed due to missing data. Conclusion(s): There
was no significant difference in mortality rates in patients undergoing
lung transplantation with or without concomitant cardiac surgery at 1, 3,
and 5 years. However, postoperative complication rates were higher in the
concomitant group. The decision to perform concomitant procedures should
be tailored to each patient's clinical condition. Copyright ©
2022 Wiley Periodicals LLC.

<98>
Accession Number
2013930341
Title
Analgesic effect of intercostal nerve block given preventively or at the
end of operation in video-assisted thoracic surgery: a randomized clinical
trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 72(5) (pp 574-578),
2022. Date of Publication: 01 Sep 2022.
Author
Xiao W.; Zhou W.; Chen X.; Zhu J.; Xue Q.; Shi J.
Institution
(Xiao, Chen, Zhu, Xue, Shi) Affiliated Hospital of Nantong University,
Department of Cardiothoracic Surgery, Nantong, China
(Xiao, Shi) Affiliated Hospital of Nantong University, Nantong Key
Laboratory of Translational Medicine in Cardiothoracic Diseases, Nantong,
China
(Zhou) Affiliated Hospital of Nantong University, Department of
Anaesthesiology, Nantong, China
Publisher
Elsevier Editora Ltda
Abstract
Objective: To compare the analgesic effect of intercostal nerve block
(INB) with ropivacaine when given preventively or at the end of the
operation in patients undergoing video-assisted thoracic surgery (VATS).
 Method(s): A total of 50 patients undergoing VATS were randomly
divided into two groups. The patients in the preventive analgesia group
(PR group) were given INB with ropivacaine before the intrathoracic
manipulation combined with patient-controlled analgesia (PCA). The
patients in the post-procedural block group (PO group) were administered
INB with ropivacaine at the end of the operation combined with PCA. To
evaluate the analgesic effect, postoperative pain was assessed with the
visual analogue scale (VAS) at rest and Prince Henry Pain Scale (PHPS)
scale at 6, 12, 24, 48, and 72 hours after surgery. Result(s): At 6 h
and 12 h post-surgery, the VAS at rest and PHPS scores in the PR group
were significantly lower than those in the PO group. There were no
significant differences in pain scores between two groups at 24, 48, and
72 hours post-surgery. Conclusion(s): In patients undergoing VATS,
preventive INB with ropivacaine provided a significantly better analgesic
effect in the early postoperative period (at least through 12 h
post-surgery) than did INB given at the end of surgery. Copyright
© 2021 Sociedade Brasileira de Anestesiologia

<99>
Accession Number
2012871355
Title
Update on surgical repair in functional mitral regurgitation.
Source
Journal of Cardiac Surgery. 37(10) (pp 3328-3335), 2022. Date of
Publication: October 2022.
Author
Hu J.; Lee A.P.W.; Wei X.; Cheng Z.-Y.; Ho A.M.H.; Wan S.
Institution
(Hu) Department of Cardiovascular Surgery, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
(Lee) Division of Cardiology, Prince of Wales Hospital, The Chinese
University of Hong Kong, Hong Kong
(Wei) Department of Cardiothoracic and Vascular Surgery, Tongji Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
(Cheng) Department of Cardiovascular Surgery, Fuwai Central China
Cardiovascular Hospital, Zhengzhou, China
(Ho) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Queen's University, Kingston, ON, Canada
(Wan) Division of Cardiothoracic Surgery, Department of Surgery, The
Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
Publisher
John Wiley and Sons Inc
Abstract
Background: Functional mitral regurgitation (FMR) is common in patients
with myocardial infarction or dilated cardiomyopathy, and portends a poor
prognosis despite guideline-directed medical therapy (GDMT). Surgical or
transcatheter mitral repair for FMR from recent randomized clinical trials
showed disappointing or conflicting results. Aim(s): To provide an
update on the role of surgical repair in the management of FMR.
 Material(s) and Method(s): A literature search was conducted
utilizing PubMed, Ovid, Web of Science, Embase, and Cochrane Library. The
search terms included secondary/FMR, ischemic mitral regurgitation, mitral
repair, mitral replacement, mitral annuloplasty, transcatheter mitral
repair, and percutaneous mitral repair. Randomized clinical trials over
the past decade were the particular focus of the current review.
 Result(s): Recent data underlined the complexity and poor prognosis
of FMR. GDMT and cardiac resynchronization, when indicated, should always
be applied. Accurate assessment of the interplay between ventricular
geometry and mitral valve function is essential to differentiate
proportionate FMR from the disproportionate subgroup, which could be
helpful in selecting appropriate transcatheter intervention strategies.
Surgical repair, most commonly performed with an undersized ring
annuloplasty, remains controversial. Adjunctive valvular or subvalvular
repair techniques are evolving and may produce improved results in
selected FMR patients. Conclusion(s): FMR resulted from complex
valve-ventricular interaction and remodeling. Distinguishing proportionate
FMR from disproportionate FMR is important in exploring their underlying
mechanisms and to guide medical treatment with surgical or transcatheter
interventions. Further studies are warranted to confirm the clinical
benefit of appropriate surgical repair in selected FMR
patients. Copyright © 2021 Wiley Periodicals LLC.

<100>
Accession Number
2018897106
Title
A Systematic Review and Meta-Analysis of Serologic Response following
Coronavirus Disease 2019 (COVID-19) Vaccination in Solid Organ Transplant
Recipients.
Source
Viruses. 14(8) (no pagination), 2022. Article Number: 1822. Date of
Publication: August 2022.
Author
Sakuraba A.; Luna A.; Micic D.
Institution
(Sakuraba, Luna, Micic) Division of Gastroenterology, Hepatology and
Nutrition, Department of Internal Medicine, The University of Chicago
Medicine, 5841 S. Maryland Ave. MC 4076, Chicago, IL 60637, United States
Publisher
MDPI
Abstract
Solid organ transplant (SOT) recipients are at greater risk of coronavirus
disease 2019 (COVID-19) and have attenuated response to vaccinations. In
the present meta-analysis, we aimed to evaluate the serologic response to
the COVID-19 vaccine in SOT recipients. A search of electronic databases
was conducted to identify SOT studies that reported the serologic response
to COVID-19 vaccination. We analyzed 44 observational studies including
6158 SOT recipients. Most studies were on mRNA vaccination (mRNA-1273 or
BNT162b2). After a single and two doses of vaccine, serologic response
rates were 8.6% (95% CI 6.8-11.0) and 34.2% (95% CI 30.1-38.7),
respectively. Compared to controls, response rates were lower after a
single and two doses of vaccine (OR 0.0049 [95% CI 0.0021-0.012] and
0.0057 [95% CI 0.0030-0.011], respectively). A third dose improved the
rate to 65.6% (95% CI 60.4-70.2), but in a subset of patients who had not
achieved a response after two doses, it remained low at 35.7% (95% CI
21.2-53.3). In summary, only a small proportion of SOT recipients achieved
serologic response to the COVID-19 mRNA vaccine, and that even the third
dose had an insufficient response. Alternative strategies for prophylaxis
in SOT patients need to be developed. Key Contribution: In this
meta-analysis that included 6158 solid organ transplant recipients, the
serologic response to the COVID-19 vaccine was extremely low after one
(8.6%) and two doses (34.2%). The third dose of the vaccine improved the
rate only to 66%, and in the subset of patients who had not achieved a
response after two doses, it remained low at 36%. The results of our study
suggest that a significant proportion of solid organ transplant recipients
are unable to achieve a sufficient serologic response after completing not
only the two series of vaccination but also the third booster dose. There
is an urgent need to develop strategies for prophylaxis including modified
vaccine schedules or the use of monoclonal antibodies in this vulnerable
patient population. Copyright © 2022 by the authors.

<101>
Accession Number
2018891905
Title
Bariatric Surgery and Myocardial Mechanics: A Meta-Analysis of Speckle
Tracking Echocardiographic Studies.
Source
Journal of Clinical Medicine. 11(16) (no pagination), 2022. Article
Number: 4655. Date of Publication: August 2022.
Author
Gherbesi E.; Cuspidi C.; Faggiano A.; Sala C.; Carugo S.; Tadic M.
Institution
(Gherbesi, Faggiano, Sala) Department of Clinical Sciences and Community
Health, University of Milano and Fondazione Ospedale Maggiore IRCCS
Policlinico di Milano, Milan 20122, Italy
(Cuspidi, Carugo) Department of Medicine and Surgery, University of
Milano-Bicocca, Milan 20126, Italy
(Tadic) Department of Cardiology, University Clinical Hospital Centre
"Dragisa Misovic", Heroja Milana Tepica 1, Belgrade 11000, Serbia
Publisher
MDPI
Abstract
Aim: Current evidence on the effects of bariatric surgery on cardiac
mechanics in patients with obesity is based on a few single studies. We
investigated this issue through a meta-analysis of speckle tracking
echocardiography (STE) studies that reported data on changes in left
ventricular (LV) mechanics as assessed by global longitudinal strain
(GLS). Method(s): The PubMed, OVID-MEDLINE and Cochrane library
databases were systematically analysed to search English-language articles
published from inception to 31 May 2022. Studies were identified by using
Me-SH terms and crossing the following terms: "obesity", "bariatric
surgery", "left ventricular mechanics", "left ventricular hypertrophy",
"systolic dysfunction", "global longitudinal strain", "echocardiography"
and "STE echocardiography". Result(s): The meta-analysis, including a
total of 512 patients with obesity from 13 studies (follow-up 1-23
months), showed a significant GLS improvement after bariatric procedures,
with standard mean difference (SMD) being 0.50 +/- 0.08, CI: 0.34/0.65, p
< 0.0001. Corresponding SMD value for LV ejection fraction (LVEF) was 0.15
+/- 0.09, CI: -0.04/0.34, p = 0.11. A sensitivity analysis restricted to
11 studies with follow-up >= 6 months confirmed that GLS (SMD: 0.47 +/-
0.08, CI: 0.30/0.63, p < 0.0001) but not LVEF (SMD: 0.14 +/- 0.11, CI:
-0.08/0.37, p = 0.21) improved after surgery. Conclusion(s): Our
meta-analysis adds a new piece of information on the beneficial effects of
bariatric surgery on LV systolic function and, more importantly, suggests
that the assessment of myocardial strain should be routinely implemented
for a comprehensive evaluation of cardiac functional changes associated
with bariatric procedures. Copyright © 2022 by the authors.

<102>
Accession Number
2017908567
Title
Angiographic Patency of Coronary Artery Bypass Conduits: An Updated
Network Meta-Analysis of Randomized Trials.
Source
Brazilian Journal of Cardiovascular Surgery. 37(Special Issue 1) (pp
7-31), 2022. Date of Publication: 2022.
Author
Deng M.X.; Lia H.; Lee G.; Rahouma M.; Di Franco A.; Demetres M.; Angelini
G.D.; Gaudino M.; Fremes S.E.
Institution
(Deng, Fremes) Division of Cardiac Surgery, Schulich Heart Centre,
Department of Surgery, Sunnybrook Health Sciences Centre, University of
Toronto, Toronto, ON, Canada
(Lia, Lee) Temerty School of Medicine, University of Toronto, Toronto, ON,
Canada
(Rahouma, Di Franco, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, NY, United States
(Demetres) Samuel J. Wood Library & C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Angelini) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The second best conduit for coronary artery bypass grafting
is uncertain. The objective of this study is to determine the second best
conduit according to graft patency results from randomized controlled
trials using a network meta-analysis. Method(s): A systematic
literature search was conducted for randomized controlled trials comparing
the angiographic patency rate of the no-touch saphenous vein (NT-SV), the
radial artery (RA), the right internal thoracic artery (RITA), and the
gastroepiploic artery (GEA) in reference to the conventionally harvested
saphenous vein (CON-SV). The primary outcome was graft occlusion, and the
secondary outcome was all-cause mortality. Result(s): A total of 859
studies were retrieved, of which 18 were included. A total of 6,543
patients and 8,272 grafts were analyzed. The weighted mean angiographic
follow-up time was 3.5 years. Compared with CON-SV, RA (incidence rate
ratio [IRR] 0.56; 95% confidence interval [CI], 0.43-0.74) and NT-SV (IRR
0.56; 95% CI, 0.44-0.70) demonstrated lower graft occlusion. NT-SV and RA
were ranked as the best conduits (rank score for NT-SV 0.88 vs. 0.87 for
RA, 0.29 for GEA, 0.27 for CON-SV, and 0.20 for RITA). There was no
significant difference in late mortality between different conduit types.
 Conclusion(s): RA and NT-SV are associated with significantly lower
graft occlusion rates and are comparably ranked as the best conduit for
patency. Copyright © 2022, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<103>
Accession Number
2017908545
Title
Pathophysiology and Mechanisms of Saphenous Vein Graft Failure.
Source
Brazilian Journal of Cardiovascular Surgery. 37(Special Issue 1) (pp
32-37), 2022. Date of Publication: 2022.
Author
Guida G.A.; Angelini G.D.
Institution
(Guida, Angelini) Department of Cardiac Surgery, Bristol Heart Institute,
Bristol University, Bristol, United Kingdom
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Coronary artery bypass grafting remains one of the best
therapies for advanced coronary artery disease. The most used conduit
remains the great saphenous vein, which is susceptible to short-term and
long-term failure, the result of acute thrombosis, intimal hyperplasia,
and late superimposed atheroma. In this review, we present the current
findings related to the pathophysiology of vein graft failure.
 Method(s): A search of three databases - MEDLINE, Web of ScienceTM,
and Cochrane Library - was undertaken for the terms "pathophysiolo-gy",
"prevention", and "treatment" plus the term "vein graft failure".
 Result(s): The pathophysiology of saphenous graft failure can be
classified in three distinct phases - acute thrombosis, intimal
hyperplasia, and accelerated atherosclerosis. All these processes start
with an underlying histological predisposition of the vein and at the time
of harvesting and preparation for grafting. These mechanisms are a result
of localized inflammatory and prothrombotic cascades that obey different
causes, but ultimately result in the stenosis or occlusion of the vein
graft. Conclusion(s): The interaction between the different parts of
the pathophysiology of vein graft failure is extremely complex and
variable. Recent improvements in surgical techniques and secondary
pharmaceutical prevention like early aspirin administration and long-term
statin treatment have significantly reduced early and late saphenous vein
graft failure. However, this continues to be a fascinating area of
research with the potential for further improvement for patients and
health service provision. Copyright © 2022, Sociedade Brasileira
de Cirurgia Cardiovascular. All rights reserved.

<104>
Accession Number
2019890043
Title
Delayed hospitalisation for heart failure after transcatheter repair or
medical treatment for secondary mitral regurgitation: a landmark analysis
of the MITRA-FR trial.
Source
EuroIntervention. 18(6) (pp 514-523), 2022. Date of Publication: August
2022.
Author
Leurent G.; Auffret V.; Donal E.; Corbineau H.; Grinberg D.; Bonnet G.;
Leroux P.-Y.; Guerin P.; Wautot F.; Lefevre T.; Messika-Zeitoun D.; Iung
B.; Armoiry X.; Trochu J.-N.; Boutitie F.; Obadia J.-F.
Institution
(Leurent, Auffret, Donal) Universite de Rennes, CHU Rennes, INSERM, LTSI,
UMR 1099, Rennes, France
(Leurent, Auffret, Donal) Service de Cardiologie, CHU Rennes, Rennes,
France
(Corbineau) Division of Thoracic and Cardiovascular Surgery, CHU Rennes,
Rennes, France
(Grinberg, Obadia) Hopital Cardiovasculaire Louis Pradel, Chirurgie
Cardio-Vasculaire et Transplantation Cardiaque, Hospices Civils de Lyon,
Claude Bernard University, Lyon, France
(Bonnet) Service de Cardiologie Interventionnelle, CHU Timone, Assistance
Publique-Hopitaux de Marseille, Marseille, France
(Leroux) Cardiologie Medicale et Structurelle, Medipole Lyon-Villeurbanne,
France
(Guerin, Trochu) Universite Nantes, CHU Nantes, CNRS, INSERM, L'Institut
du Thorax, Nantes, France
(Wautot) Centre Cardio-Thoracique de Monaco, Monaco
(Lefevre) Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques
Cartier, Ramsay Sante, Massy, France
(Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, Canada
(Iung) Hopital Bichat, Claude Bernard, DHU FIRE, Paris, France
(Armoiry) Pharmacy Department, University of Lyon, School of Pharmacy
(ISPB), UMR CNRS 5510 MATEIS, Edouard Herriot Hospital, Lyon, France
(Armoiry) University of Warwick, Warwick Medical School, Coventry, United
Kingdom
(Boutitie) Service de Biostatistique - Bioinformatique, Pole Sante
Publique, Hospices Civils de Lyon, Lyon, France
(Boutitie) CNRS, UMR 5558, Laboratoire de Biometrie et Biologie Evolutive,
Equipe Biostatistique-Sante, Villeurbanne, France
(Bonnet) Aix-Marseille Universite, INSERM, Marseille, France
(Iung) Universite de Paris, INSERM 1148, Paris, France
(Boutitie) Universite Lyon 1, Villeurbanne, France
Publisher
Europa Group
Abstract
Background: In the MITRA-FR trial, transcatheter mitral valve repair
(TMVR) was not associated with a 2-year clinical benefit in patients with
secondary mitral regurgitation (SMR). Aim(s): This landmark analysis
aimed at investigating a potential reduction of the hospitalisation rate
for heart failure (HF) between 12 and 24 months after inclusion in the
MITRA-FR trial in patients randomised to the intervention group (TMVR with
the MitraClip device), as compared with patients randomised to the control
group (guideline-directed medical therapy [GDMT]). Method(s): The
MITRA-FR trial randomised 307 patients with SMR for TMVR on top of GDMT
(TMVR group; n=152) or for GDMT alone (control group; n=155). We conducted
a 12-month landmark analysis in surviving patients who were not
hospitalised for HF within the first 12 months of follow-up. The primary
endpoint was the 1-year cumulative number of HF hospitalisations.
 Result(s): A total of 140 patients (TMVR group: 67; GDMT group: 73)
were selected for this landmark analysis with similar characteristics at
inclusion in the trial. The primary endpoint was 28 events per 100
patient-years in the TMVR group, as compared with 60 events per 100
patient-years in the GDMT group (hazard ratio [HR] 0.46, 95% confidence
interval [CI]: 0.20-1.02; p=0.057). Conclusion(s): In this landmark
analysis of the MITRA-FR trial, the cumulative rate of HF hospitalisation
between 12 and 24 months among patients treated with TMVR on top of GDMT
was approximately half as many as those of patients treated with GDMT
alone, a difference which did not reach statistical significance in the
setting of a low number of events. Copyright © Europa Digital &
Publishing 2022. All rights reserved.

<105>
Accession Number
2019890040
Title
Bleeding risk differences after TAVR according to the ARC-HBR criteria:
insights from SCOPE 2.
Source
EuroIntervention. 18(6) (pp 503-513), 2022. Date of Publication: August
2022.
Author
Garot P.; Neylon A.; Morice M.-C.; Tamburino C.; Bleiziffer S.; Thiele H.;
Scholtz S.; Schramm R.; Cockburn J.; Cunnington M.; Wolf A.; Barbanti M.;
Tchetche D.; Pagnotta P.; Gilard M.; Bedogni F.; Van Belle E.;
Vasa-Nicotera M.; Chieffo A.; Bogaerts K.; Hengstenberg C.; Capodanno D.
Institution
(Garot, Neylon, Morice) Institut Cardiovasculaire Paris-Sud, Hopital Prive
Jacques Cartier, Ramsay-Sante, Massy, France
(Tamburino, Capodanno) Division of Cardiology, Azienda Ospedaliero
Universitaria Policlinico-Vittorio Emanuele, University of Catania,
Catania, Italy
(Bleiziffer, Schramm) Department of Thoracic and Cardiovascular Surgery,
Heart and Diabetes Center Northrhein-Westfalia, University Hospital,
Ruhr-University Bochum, Bad Oeynhausen, Germany
(Thiele) Department of Cardiology, Leipzig Heart Center, University of
Leipzig, Leipzig, Germany
(Scholtz) Department of Interventional Cardiology, Heart and Diabetes
Center North Rhine Westfalia, Bad Oeynhausen, Germany
(Cockburn) Department of Cardiology, Brighton & Sussex University
Hospitals NHS Trust, Brighton, United Kingdom
(Cunnington) Department of Cardiology, Leeds General Infirmary, Leeds
Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Wolf) Department of Interventional Cardiology, Elisabeth Hospital Essen,
Essen, Germany
(Barbanti) Department of Cardio-Thoracic-Vascular Diseases and
Transplantation, Azienda Ospedaliero-Universitaria Policlinico G.
Rodolico-San Marco, Catania, Italy
(Tchetche) Groupe Cardio Vasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
(Pagnotta) Department of Cardiovascular Medicine, Humanitas Clinical and
Research Center, Milano, Italy
(Gilard) Department of Cardiology, Brest University Hospital, Brest,
France
(Bedogni) Cardiology Department, IRCCS Policlinico San Donato, Milano,
Italy
(Van Belle) Department of Cardiology, Lille University Hospital, Lille,
France
(Vasa-Nicotera) Department of Cardiology, Goethe University Hospital
Frankfurt, Frankfurt am Main, Germany
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Bogaerts) KU Leuven, Faculty of Medicine, I-BioStat, Leuven, Belgium
(Bogaerts) UHasselt, I-BioStat, Hasselt, Belgium
(Hengstenberg) Department of Internal Medicine II, Medical University of
Vienna, Vienna, Austria
Publisher
Europa Group
Abstract
Background: The Academic Research Consortium - High Bleeding Risk
(ARC-HBR) initiative defined conditions associated with percutaneous
coronary intervention (PCI)-related bleeding. Aim(s): We sought to
further explore these HBR conditions in the setting of transcatheter
aortic valve replacement (TAVR). Method(s): Patients from the SCOPE 2
trial were stratified by their bleeding risk status based on the ARC-HBR
definitions. Baseline and procedural characteristics, as well as key
clinical outcomes including Bleeding Academic Research Consortium (BARC)
3-5 bleeding, were compared in ARC-HBR positive (HBR+) and ARC-HBR
negative (HBR-) patients. Result(s): Of 787 patients randomised in
SCOPE 2 and included in this study, 633 were HBR+ (80.4%). Compared with
HBR- patients, those HBR+ were older and more frequently presented with
diabetes, a history of coronary artery disease, atrial fibrillation, prior
cerebrovascular accident, and a Society of Thoracic Surgeons predicted
risk of 30-day mortality (STS-PROM) (4.9+/-2.9% vs 3.3%+/-2.1%; p<0.0001).
In addition, HBR+ patients were more frequently on oral anticoagulation
therapy. At 1 year, HBR+ patients had higher rates of all-cause death
(12.4% vs 4.3%, respectively, risk difference 8.09%; 95% confidence
interval [CI]: 3.76-12.41; p=0.0002); the rates of BARC 3-5 type bleeding
were relatively high but not statistically different compared with HBR-
patients (7.7% vs 6.1%, risk difference 1.67%; 95% CI: -2.72 to 6.06;
p=0.46). Subgroup analyses for bleeding events showed no significant
interaction in terms of STS-PROM score, age, or medications.
 Conclusion(s): The ARC-HBR criteria failed to isolate a subgroup of
patients at higher bleeding risk in TAVR patients from a randomised trial.
These findings have potential implications, especially for the selection
of post-TAVR antithrombotic regimens based on individual bleeding-risk
profiles. Specific HBR criteria should be defined for TAVR patients.
 Copyright © Europa Digital & Publishing 2022. All rights
reserved.

<106>
Accession Number
2018426224
Title
The current practice of transcatheter aortic valve replacement in China.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Xie C.-M.; Yao Y.-T.
Institution
(Xie) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming,
China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: The purpose of this study is to summarize the current practice
and experience of transcatheter aortic valve replacement in China.
 Method(s): The relevant articles were identified through computerized
searches of the CNKI, WANFANG, VIP, and PubMed databases through February
1, 2022, using the search terms: "transcatheter aortic valve replacement,"
"transcatheter aortic valve implantation," "China.". Result(s): The
database searches identified 22 articles, 2092 patients, 57.65% were male,
with a mean age of 74.2 +/- 6.0 years, 71.51% of patients were classified
by New York Heart Association as class III/IV, Society of Thoracic
Surgeons score 8.4 +/- 4.1, mean left ventricular ejection fraction 52.8
+/- 14.2%, mean transvalvular aortic pressure gradient 59.9 +/- 18.9 mmHg.
The overall procedural success rate was 97.85%, and 2.15% of patients were
converted to sternotomy, mainly due to transcatheter aortic bioprosthesis
dislocation. The most common vascular access approach was transfemoral
(1071 patients, 51.20%). General anesthesia (48.90%) was the commonly used
anesthesia technique. The incidence of postprocedural complications was as
follows: permanent pacemaker implantation (10.47%), bleeding events
(8.60%), mild paravalvular leakage (17.73%), moderate and severe
paravalvular leakage (4.16%), vascular complications (3.30%), stroke
(1.43%), respectively. The overall periprocedural period and
postprocedural 30-day mortality was 2.72%. Conclusion(s): Among
patients undergoing transcatheter aortic valve replacement in China,
device implantation success was achieved in 97.85% of cases. The most
common vascular access approach was transfemoral. General anesthesia was
the most commonly used anesthetic technique. Paravalvular leakage (458
patients, 21.89%) was the most common complication. Copyright ©
2022 Wiley Periodicals LLC.

<107>
Accession Number
638950120
Title
Statins and Mortality of Patients After Transcatheter Aortic Valve
Implantation: A Systematic Review and Meta-analysis.
Source
Angiology. (pp 33197221124778), 2022. Date of Publication: 06 Sep 2022.
Author
Yarahmadi P.; Kabiri A.; Forouzannia S.M.; Yousefifard M.
Institution
(Yarahmadi, Forouzannia) School of Medicine, 48504Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Kabiri) School of Medicine, 440827Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Yousefifard) Physiology Research Center, 440827Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
While TAVI is widely used, optimal medical therapy to reduce the mortality
rate after transcatheter aortic valve implantation (TAVI) is still
unclear. We performed a systematic review and meta-analysis to evaluate
the impact of statins on mortality following TAVI. Present systematic
review of the literature was performed using Medline, Embase, Scopus, and
Web of Science; all studies reported all-cause mortality in patients who
underwent TAVI and received or did not receive statin therapy. Data were
analyzed using random-effects models. Seventeen articles (21 380 patients)
were included in the meta-analysis. Statin therapy was associated with a
reduction of all-cause mortality (Hazard ratio [HR] = .78, 95% Confidence
interval [CI] .68-.89, P < .001). Moderate between-study heterogeneity was
observed (I2 = 45.2). High-intensity statin therapy was more effective
than low or moderate intensity statin therapy in reduction of all-cause
mortality (Risk ratio [RR] = .62, 95% CI 0.45-.85, P = .003, I2 = .0).
Statin therapy could reduce the mid-term all-cause mortality rate
following TAVI. However, all included studies were observational and,
therefore, randomized controlled trials are still needed to assess the
effect of statin therapy on mortality after TAVI.

<108>
Accession Number
638949940
Title
Double-lung versus heart-lung transplantation for end-stage
cardiopulmonary disease: a systematic review and meta-analysis.
Source
Surgery today. (no pagination), 2022. Date of Publication: 06 Sep 2022.
Author
Yan H.-J.; Zheng X.-Y.; Huang H.; Xu L.; Tang H.-T.; Wang J.-J.; Li C.-H.;
Zhang S.-X.; Fu S.-Y.; Wen H.-Y.; Tian D.
Institution
(Yan, Tian) Department of Thoracic Surgery, West China Hospital, Sichuan
University, 37 Guo Xue Xiang, Chengdu 610041, China
(Yan, Zheng, Huang, Xu, Tang, Wang, Li, Zhang, Fu, Tian) Heart and Lung
Transplant Research Laboratory, Affiliated Hospital of North Sichuan
Medical College 637000, China
(Wen) Department of Cardiothoracic Intensive Care Unit, Affiliated
Hospital of North Sichuan Medical College 637000, China
Publisher
NLM (Medline)
Abstract
We compared posttransplant outcomes following double-lung transplantation
(DLTx) and heart-lung transplantation (HLTx), based on a search of PubMed,
Cochrane Library, and Embase, from inception to March 8, 2022, for studies
that report outcomes of these procedures. We then performed a
meta-analysis of baseline characteristics and posttransplant outcomes.
Subgroup analyses were implemented according to indication, publication
year, and center. This study was registered on PROSPERO (number
CRD42020223493). Ten studies were included in this meta-analysis,
involving 1230 DLTx patients and 1022 HLTx patients. The DLTx group was
characterized by older donors (P=0.04) and a longer allograft ischemia
time (P<0.001) than the HLTx group. The two groups had comparable 1-year,
3-year, 5-year, 10-year survival rates (all P>0.05), with similar results
identified in subgroup analyses. We found no significant differences in
1-year, 5-year, and 10-year chronic lung allograft dysfunction (CLAD)-free
survival, length of intensive care unit stay and hospital stay, length of
postoperative ventilation, in-hospital mortality, or surgical
complications between the groups (all P>0.05). Thus, DLTx provides similar
posttransplant survival to HLTx for end-stage cardiopulmonary disease.
These two procedures have a comparable risk of CLAD and other
posttransplant outcomes. Copyright © 2022. The Author(s) under
exclusive licence to Springer Nature Singapore Pte Ltd.

<109>
Accession Number
638949249
Title
European Society of Cardiology Quality Indicators for the Cardiovascular
Preoperative Assessment and Management of patients considered for
non-cardiac surgery. Developed in collaboration with the European Society
of Anaesthesiology & Intensive Care.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2022. Date of Publication: 07 Sep 2022.
Author
Gencer B.; Gale C.P.; Aktaa S.; Halvorsen S.; Beska B.; Abdelhamid M.;
Mueller C.; Tutarel O.; McGreavy P.; Schirmer H.; Geissler T.; Sillesen
H.; Niessner A.; Zacharowski K.; Mehilli J.; Potpara T.
Institution
(Gencer) Cardiology Division, Geneva University Hospitals, Geneva,
Switzerland
(Gencer) Institute of Primary Health Care (BIHAM), Bern University, Bern,
Switzerland
(Gale, Aktaa, Beska) Leeds Institute of Cardiovascular and Metabolic
Medicine, University of Leeds, United Kingdom
(Gale, Aktaa, Beska) Leeds Institute for Data Analytics and Leeds
Institute of Cardiovascular and Metabolic Medicine, University of Leeds,
Leeds, United Kingdom
(Gale, Aktaa, Beska) Department of Cardiology, Leeds Teaching Hospitals
NHS Trust, Leeds, United Kingdom
(Halvorsen) Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(Abdelhamid) Cardiology Department, Faculty of Medicine, Kase Al Ainy,
Cairo University, Cairo, Egypt
(Mueller) Cardiovascular Research Institute Basel, University Heart
Center, University Hospital Basel, University of Basel, Basel, Switzerland
(Tutarel) Department of Congenital Heart Disease and Paediatric
Cardiology, German Heart Centre Munich, TUM School of Medicine, Technical
University of Munich, Munich, Germany
(McGreavy) Patient representatives, European Society of Cardiology (ESC)
(Schirmer) Department of Cardiology, Akershus University Hospital, Norway
(Schirmer) Institute of Clinical Medicine, University of Oslo, Campus
Ahus, Norway
(Geissler) Department of Cardiology and Angiology, University Hospital
Tubingen, Tubingen, Germany
(Sillesen) Vascular Surgery, Rigshospitalet, Clinical Medicine, University
of Copenhagen, Copenhagen, Denmark
(Niessner) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Zacharowski) Department Anaesthesiology, Intensive Care Medicine & Pain
Therapy, University Hospital Frankfurt, Goethe University, Frankfurt,
Germany
(Mehilli) Department of Cardiology, LMU University Hospital and German
Centre for Cardiovascular Research (DZHK), partner site Munich Heart
Alliance, Munich, Germany
(Mehilli) Department of Cardiology, Landshut-Achdorf Hospital,
Medizinische Klinik I, Landshut, Germany
(Potpara) Cardiology Clinic, University Clinical Centre of Serbia,
Belgrade, Serbia
(Potpara) School of Medicine, University of Belgrade, Serbia
Publisher
NLM (Medline)
Abstract
AIMS: To establish a set of quality indicators (QIs) for the
cardiovascular (CV) assessment and management of patients undergoing
non-cardiac surgery. METHODS AND RESULTS: The Quality Indicator Committee
of the European Society of Cardiology (ESC) and European Society of
Anaesthesiology & Intensive Care (ESAIC) in collaboration with Task Force
members of the 2022 ESC Guidelines on CV assessment and management of
patients undergoing non-cardiac surgery followed the ESC methodology for
QI development. This included 1) identification, by constructing a
conceptual framework of care, of domains of the CV assessment and
management of patients with risk factors or established cardiovascular
disease (CVD) who are considered for or undergoing non-cardiac surgery, 2)
development of candidate QIs following a systematic literature review, 3)
selection of the final set of QIs using a modified Delphi method, 4)
evaluation of the feasibility of the developed QIs. In total, eight main
and nine secondary QIs were selected across six domains: 1) Structural
framework (written policy), 2) Patient education and quality of life (CV
risk discussion), 3) Peri-operative risk assessment (indication for
diagnostic tests), 4) Peri-operative risk mitigation (use of hospital
therapies), 5) Follow-up (post-discharge assessment) and 6) Outcomes
(major CV events). CONCLUSION(S): We present the 2022 ESC/ESAIC QIs
for the CV assessment and management of patients with risk factors or
established CVD who are considered for or are undergoing non-cardiac
surgery. These indicators are supported by evidence from the literature,
underpinned by expert consensus and align with 2022 ESC Guidelines on CV
assessment and management of patients undergoing non-cardiac
surgery. Copyright © The Author(s) 2022. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<110>
Accession Number
638948952
Title
Perioperative mortality in pediatric patients: a systematic review of risk
assessment tools for use in the preoperative setting.
Source
Anesthesiology. (no pagination), 2022. Date of Publication: 07 Sep 2022.
Author
Tangel V.E.; Krul S.D.; Stolker R.J.; Bramer W.M.; de Graaff J.C.; Hoeks
S.E.
Institution
(Tangel, Krul, Stolker, de Graaff, Hoeks) Department of Anesthesiology,
Erasmus University Medical Center, Rotterdam, Netherlands
(Tangel) Department of Anesthesiology, Weill Cornell Medicine, New York,
NY, United States
(Bramer) Medical Library, Erasmus University Medical Center, Rotterdam,
Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: There are multiple preoperative risk scores for pediatric
mortality. The aim of this study was to systematically describe and
compare the existing studies of patient-specific multispecialty risk
prediction scores for perioperative mortality in pediatric populations,
with the goal of guiding clinicians on which may be most appropriate for
use in the preoperative setting. METHOD(S): We conducted a systematic
literature review of published journal articles that presented the
development, extension/updating, and/or validation of a risk score which
predicted all-cause mortality (up to 30 days postoperatively) in pediatric
patients undergoing a procedure in which anesthesia was used. Scores
needed to be applicable to surgeries in more than one non-cardiac surgical
specialty and had to be able to be calculated by the anesthesiologist at
the time of the pre-anesthetic assessment. Two investigators independently
screened studies for inclusion and assessed study quality in the domains
of clinical applicability, feasibility/ease of use in the clinical
setting, and risk of bias. RESULT(S): A total of 1,681 titles were
retrieved. Of these, 10 studies met inclusion criteria: nine reported the
development and validation of scores, and one was an external validation
of an existing score. Seven studies used varying years of multicenter data
from the National Surgical Quality Improvement Program - Pediatric
Participant Use File for development and/or validation. The unadjusted
rate of mortality in the studies ranged from 0.3% to 3.6%. The
preoperative predictors of mortality used in score development included
patient demographics, preoperative therapies, and chronic conditions,
among others. All models showed good discrimination upon validation (AUC >
0.8). Most risk scores had high or unclear risks of bias.
 CONCLUSION(S): There are numerous scores available for the prediction
of mortality in pediatric populations, all of which exhibited good
performance. However, many have high or unclear risks of bias, and most
have not undergone external validation. Copyright © 2022, the
American Society of Anesthesiologists. All Rights Reserved.

<111>
Accession Number
638934090
Title
Direct Oral Anticoagulants Versus Antiplatelet Therapy After Transcatheter
Aortic Valve Replacement: A Meta-Analysis of Randomized Trials.
Source
Circulation. Cardiovascular interventions. (pp
101161CIRCINTERVENTIONS122012194), 2022. Date of Publication: 06 Sep 2022.
Author
Elbadawi A.; Dang A.T.; Sedhom R.; Hamed M.; Eid M.; Golwala H.; Goel
S.S.; Mamas M.A.; Elgendy I.Y.
Institution
(Elbadawi) Division of Cardiology' University of Texas Southwestern
Medical Center' Dallas (A.E.)
(Dang) Department of Internal Medicine, University of Texas Medical Branch
(Sedhom) Division of Cardiology' Loma Linda University Health' CA (R.S.)
(Hamed) Division of Internal Medicine, Florida Atlantic University
(Eid) Department of Internal Medicine, Lincoln Medical Center, NY, United
States
(Golwala) Division of Cardiology, Oregon Health and Science University
(Goel) Houston Methodist DeBakey Heart & Vascular Center
(Mamas) Keele Cardiovascular Research Group, Keele University, United
Kingdom (M.A.M.), United Kingdom
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky
Publisher
NLM (Medline)

<112>
Accession Number
638933482
Title
Effect of ventilation mode on postoperative pulmonary complications
following lung resection surgery: a randomised controlled trial.
Source
Anaesthesia. (no pagination), 2022. Date of Publication: 06 Sep 2022.
Author
Li X.-F.; Jin L.; Yang J.-M.; Luo Q.-S.; Liu H.-M.; Yu H.
Institution
(Li, Liu, Yu) Department of Anaesthesiology, West China Hospital of
Sichuan University, Chengdu, China
(Jin, Yang, Luo) Department of Anaesthesiology, Leshan People's Hospital,
Leshan, China
Publisher
NLM (Medline)
Abstract
The effect of intra-operative mechanical ventilation modes on pulmonary
outcomes after thoracic surgery with one-lung ventilation has not been
well established. We evaluated the impact of three common ventilation
modes on postoperative pulmonary complications in patients undergoing lung
resection surgery. In this two-centre randomised controlled trial, 1224
adults scheduled for lung resection surgery with one-lung ventilation were
randomised to one of three groups: volume-controlled ventilation;
pressure-controlled ventilation; and pressure-control with volume
guaranteed ventilation. Enhanced recovery after surgery pathways and
lung-protective ventilation protocols were implemented in all groups. The
primary outcome was a composite of postoperative pulmonary complications
within the first seven postoperative days. The outcome occurred in 270
(22%), with 87 (21%) in the volume control group, 89 (22%) in the pressure
control group and 94 (23%) in the pressure-control with volume guaranteed
group (p=0.831). The secondary outcomes also did not differ across study
groups. In patients undergoing lung resection surgery with one-lung
ventilation, the choice of ventilation mode did not influence the risk of
developing postoperative pulmonary complications. This is the first
randomised controlled trial examining the effect of three ventilation
modes on pulmonary outcomes in patients undergoing lung resection
surgery. Copyright © 2022 Association of Anaesthetists.

<113>
Accession Number
638933336
Title
Health-related quality of life after restrictive versus liberal RBC
transfusion for cardiac surgery: Sub-study from a randomized clinical
trial.
Source
Transfusion. (no pagination), 2022. Date of Publication: 06 Sep 2022.
Author
Hu R.T.; Royse A.G.; Royse C.; Scott D.A.; Bowyer A.; Boggett S.; Summers
P.; Mazer C.D.
Institution
(Hu, Royse, Royse, Scott, Bowyer, Boggett) Department of Surgery,
University of Melbourne, Parkville, VIC, Australia
(Hu) Department of Anaesthesia, Austin Health, Heidelberg, VIC, Australia
(Royse, Royse, Bowyer) Department of Anaesthesia and Pain Management,
Royal Melbourne Hospital, Parkville, VIC, Australia
(Royse) Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH,
United States
(Scott) Department of Anaesthesia and Acute Pain Medicine, St Vincent's
Hospital Melbourne, VIC, Australia
(Summers) Statistical Consulting Centre, University of Melbourne,
Parkville, VIC, Australia
(Summers) Melbourne Disability Institute, University of Melbourne,
Parkville, VIC, Australia
(Summers) Centre for Health Analytics, Murdoch Children's Research
Institute, Royal Children's Hospital, Parkville, VIC, Australia
(Mazer) Department of Anaesthesia, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transfusion Requirements in Cardiac Surgery III (TRICS III), a
multi-center randomized controlled trial, demonstrated clinical
non-inferiority for restrictive versus liberal RBC transfusion for
patients undergoing cardiac surgery. However, it is uncertain if
transfusion strategy affects long-term health-related quality of life
(HRQOL). STUDY DESIGN AND METHODS: In this planned sub-study of Australian
patients in TRICS III, we sought to determine the non-inferiority of
restrictive versus liberal transfusion strategy on long-term HRQOL and to
describe clinical outcomes 24months postoperatively. The restrictive
strategy involved transfusing RBCs when hemoglobin was <7.5 g/dl; the
transfusion triggers in the liberal group were:<9.5 g/L intraoperatively,
<9.5 g/L in intensive care, or <8.5 g/dl on the ward. HRQOL assessments
were performed using the 36-item short form survey version 2 (SF-36v2).
Primary outcome was non-inferiority of summary measures of SF-36v2 at
12months, (non-inferiority margin: -0.25 effect size; restrictive minus
liberal scores). Secondary outcomes included non-inferiority of HRQOL at
18 and 24months. RESULT(S): Six hundred seventeen Australian patients
received allocated randomization; HRQOL data were available for 208/311 in
restrictive and 217/306 in liberal group. After multiple imputation,
non-inferiority of restrictive transfusion at 12months was not
demonstrated for HRQOL, and the estimates were directionally in favor of
liberal transfusion. Non-inferiority also could not be concluded at 18 and
24months. Sensitivity analyses supported these results. There were no
differences in quality-adjusted life years or composite clinical outcomes
up to 24months after surgery. DISCUSSION: The non-inferiority of a
restrictive compared to a liberal transfusion strategy was not established
for long-term HRQOL in this dataset. Copyright © 2022 AABB.

<114>
Accession Number
638932785
Title
Long-term results after simultaneous carotid and coronary
revascularisation.
Source
Asian cardiovascular & thoracic annals. (pp 2184923221124881), 2022. Date
of Publication: 06 Sep 2022.
Author
Zivkovic I.; Krasic S.; Milacic P.; Vukovic P.; Milicic M.; Jovanovic M.;
Tabakovic Z.; Sagic D.; Ilijevski N.; Peric M.; Bojic M.; Micovic S.
Institution
(Zivkovic, Milacic, Vukovic, Milicic, Jovanovic, Tabakovic, Peric, Bojic,
Micovic) Department of Cardiac Surgery, 606093Dedinje Cardiovascular
Institute, Belgrade, Serbia
(Krasic) Cardiology Department, Mother and Child Health Institute of
Serbia, Belgrade, Serbia
(Sagic) Department of Interventional Radiology, 606093Dedinje
Cardiovascular Institute, Belgrade, Serbia
(Ilijevski) Department of Vascular Surgery, 606093Dedinje Cardiovascular
Institute, Belgrade, Serbia
Publisher
NLM (Medline)
Abstract
BACKGROUND: The revascularisation strategy for concomitant carotid and
coronary disease is unknown. Simultaneous or stage coronary artery
stenting and carotid endarterectomy are the most common revascularisation
approach in the CABG population. This study aimed to evaluate long-term
results after simultaneous carotid artery stenting or carotid
endarterectomy in patients who underwent coronary artery bypass surgery.
 METHOD(S): This is a prospective cohort non-randomised
single-institution study. During the period from 2012 to 2015, sixty
consecutive patients (65.9+/-7.41 mean) underwent simultaneous carotid
artery stenting and coronary artery bypass surgery (n=30) or simultaneous
carotid endarterectomy and coronary artery bypass surgery (n=30). The
primary endpoints were short- and long-term rates of adverse events
(transient ischemic attack, stroke, myocardial infarction, and death). The
mean follow-up was 62.05+/-11.12 months. RESULT(S): In-hospital
mortality was insignificantly higher in the carotid endarterectomy, and
coronary artery bypass surgery group (6.6% vs. 0%), the rate of stroke and
myocardial infarction was similar (13.3% and 0% in the carotid
endarterectomy and coronary artery bypass surgery group vs. 6.6% and 3.3%
in the carotid artery stenting and coronary artery bypass surgery group,
respectively). The intensive care unit readmission was significantly
higher in the surgical revascularisation approach; it was an independent
predictor of hospital mortality. The overall mortality during the
follow-up period was 14.28% in both groups. Freedom of the composite
adverse outcomes (stroke, myocardial infarction, and death) was 78.55%.
 CONCLUSION(S): Comparing two revascularisation strategies is not
straightforward due to different anatomical indications for carotid artery
stenting and endarterectomy. We consider that each technique has an
essential role in carotid revascularisation. Good selection of patients,
according to indications, contributes to satisfactory short- and long-term
results.

<115>
Accession Number
638932290
Title
Primary Left Ventricular Unloading with Delayed Reperfusion in Patients
with Anterior ST-Elevation Myocardial Infarction: Rationale and Design of
the STEMI-DTU Randomized Pivotal Trial.
Source
American heart journal. (no pagination), 2022. Date of Publication: 01
Sep 2022.
Author
Kapur N.K.; Kim R.J.; Moses J.W.; Stone G.W.; Udelson J.E.; Ben-Yehuda O.;
Redfors B.; Issever M.O.; Josephy N.; Polak S.J.; Neill W.W.O.
Institution
(Kapur, Udelson) Tufts Medical Center, Boston, MA, United States
(Kim) Duke University Medical Center, Durham, NC, United States
(Moses) Columbia University Irving Medical Center/NewYork-Presbyterian
Hospital, NY, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York; Cardiovascular Research Foundation,
New York
(Ben-Yehuda, Redfors, Issever) Cardiovascular Research Foundation, NY,
United States
(Josephy) Abiomed; Massachusetts Institute of Technology, Cambridge,
Massachusetts
(Polak) Abiomed
(Neill) Henry Ford Hospital, Detroit, MI, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Despite successful primary percutaneous coronary intervention
(PCI) in ST-elevation myocardial infarction (STEMI), myocardial salvage is
often suboptimal, resulting in large infarct size and increased rates of
heart failure and mortality. Unloading of the left ventricle (LV) before
primary PCI may reduce infarct size and improve prognosis. STUDY DESIGN
AND OBJECTIVES: STEMI-DTU (NCT03947619) is a prospective, randomized,
multicenter trial designed to compare mechanical LV unloading with the
Impella CP device for 30 minutes prior to primary PCI to primary PCI alone
without LV unloading. The trial aims to enroll approximately 668 subjects,
with a potential sample size adaptation, with anterior STEMI with a
primary endpoint of infarct size as a percent of LV mass evaluated by
cardiac magnetic resonance at 3-5 days after PCI. The key secondary
efficacy endpoint is a hierarchical composite of the 1-year rates of
cardiovascular mortality, cardiogenic shock >=24 hours after PCI, use of a
surgical left ventricular assist device or heart transplant, heart
failure, intra-cardiac defibrillator or chronic resynchronization therapy
placement, and infarct size at 3-5 days post-PCI. The key secondary safety
endpoint is Impella CP-related major bleeding or major vascular
complications within 30 days. Clinical follow-up is planned for 5 years.
 CONCLUSION(S): STEMI-DTU is a large-scale, prospective, randomized
trial evaluating whether mechanical unloading of the LV by the Impella CP
prior to primary PCI reduces infarct size and improves prognosis in
patients with STEMI compared to primary PCI alone without LV
unloading. Copyright © 2022. Published by Elsevier Inc.

<116>
Accession Number
638930130
Title
Surgical valvotomy versus balloon dilatation for children with severe
aortic valve stenosis: a systematic review.
Source
Future cardiology. (no pagination), 2022. Date of Publication: 05 Sep
2022.
Author
Elhedai H.; S Mohamed S.S.; Idriss H.; Bhattacharya P.; Y Mohamedahmed
A.Y.
Institution
(Elhedai) Department of Cardiology, Birmingham Women's & Children's NHS
Foundation Trust, Birmingham, United Kingdom
(S Mohamed) Anaesthesia & Intensive Care department, Sudan Medical
Specialization Board, Khartoum, Sudan
(Idriss) Department of Paediatrics, Homerton University Hospitals NHS
Trust, London, United Kingdom
(Bhattacharya, Y Mohamedahmed) Department of General Surgery, Sandwell &
West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
Publisher
NLM (Medline)
Abstract
Aim: To evaluate outcomes of interventions for severe aortic valve
stenosis (AS), whether it is done by surgical aortic valvotomy (SAV) or
balloon aortic dilatation (BAD). Result(s): Eleven studies with total
number of 1733 patients; 743 patients had SAV, while 990 patients received
BAD. There was no significant difference in early mortality (odds ratio
[OR]: 0.96, p = 0.86), late mortality (OR: 1.28, p = 0.25), total
mortality (OR: 1.10, p = 0.56), and freedom from aortic valve replacement
(OR: 1.00, p = 1.00). Reduction of aortic systolic gradient was
significantly higher in the SAV group (OR: 2.24, p = 0.00001), and
postprocedural AR rate was lower in SAV group (OR: 0.21, p = 0.00001).
 Conclusion(s): SAV is associated with better reduction of aortic
systolic gradient and lesser post procedural AR which reduce when compared
with BAD.

<117>
Accession Number
638929492
Title
Red blood cell distribution width to predict mortality in heart transplant
recipients: a systematic review.
Source
Monaldi archives for chest disease = Archivio Monaldi per le malattie del
torace. (no pagination), 2022. Date of Publication: 05 Sep 2022.
Author
Acuna-Chavez L.M.; Cruzalegui-Bazan C.; Quispe-Vicuna C.; Saldarriaga C.;
Contreras J.; Chavez-Peche J.A.; Alvarez-Vargas M.; Segura-Saldana P.
Institution
(Acuna-Chavez) Sociedad Cientifica de Estudiantes de Medicina de la
Universidad Nacional de Trujillo; Department of Cardiology Research,
Torres de Salud National Research Center, Lima. lmiguel.acunac@gmail.com
(Cruzalegui-Bazan) Department of Cardiology Research, Torres de Salud
National Research Center, Lima; Sociedad Cientifica de San Fernando,
Universidad Nacional Mayor de San Marcos, Lima. claucruba2019@gmail.com
(Quispe-Vicuna) Department of Cardiology Research, Torres de Salud
National Research Center, Lima; Sociedad Cientifica de San Fernando,
Universidad Nacional Mayor de San Marcos, Lima. vicunas998@gmail.com
(Saldarriaga) University of Antioquia, Medellin; Pontificia Bolivariana
University, Medellin; CardioVID Clinic, Medellin
(Contreras) Director of Ambulatory Heart Failure Network, The Mount Sinai
Health System, NY, United States
(Chavez-Peche) Department of Cardiology Research, Torres de Salud National
Research Center, Lima; Clinica San Felipe, Lima.
jchavez@clinicasanfelipe.com
(Alvarez-Vargas) Department of Cardiology Research, Torres de Salud
National Research Center, Lima; Departamento de Medicina Interna, Hospital
Nacional Guillermo Almenara, Lima
(Segura-Saldana) Department of Cardiology Research, Torres de Salud
National Research Center, Lima; Ingenieria Biomedica, Facultad de Ciencias
y Filosofia, Universidad Peruana Cayetano Heredia, Lima; Departamento de
Cardiologia, Hospital Nacional Edgardo Rebagliati Martins, Lima
Publisher
NLM (Medline)
Abstract
Red blood cell distribution width (RDW) has been shown to have prognostic
value in a number of different clinical settings, such as cardiovascular
disease, including heart failure. However, its prognostic value in heart
transplant (HT) recipients remains unknown. The aim of this systematic
review is to determine the prognostic value of pre-transplant RDW for
mortality in HT recipients. There is a pre-published protocol of this
review. The terms "Heart transplant", "Red cell distribution width" and
their synonyms were used in the search strategy. PubMed/Medline, Embase,
Scopus, Web of Science and LILACS were searched until May 17th, 2022,
without date or language restrictions. Two authors independently carried
out the selection, first by title and abstract, second by full-text
revision. Discrepancies were discussed and resolved with three other
authors. Quality of individual studies was assessed with Newcastle Ottawa
Scale (NOS) for cohorts. After removing the duplicates, 3885 articles were
identified. Four articles were included in the qualitative synthesis.
Three studies were classified as "good quality": whereas one as "poor
quality" according to NOS scale. All the included articles evaluated
long-term mortality and one study also evaluated short-term mortality. In
this one, a correlation between higher RDW values and short-term mortality
was reported. Meanwhile, in all the studies, a high pre-HT RDW was a
marker of long-term mortality following cardiac transplantation. Our
review shows that an elevated on-admission RDW is associated with
long-term mortality in heart transplantation recipients.

<118>
Accession Number
638929230
Title
Right Heart Catheterization Timing and Outcomes of Cardiogenic Shock:
Analysis from the National Readmission Database.
Source
Current problems in cardiology. (pp 101388), 2022. Date of Publication:
01 Sep 2022.
Author
Elzanaty A.M.; Maraey A.; Khalil M.; Elsharnoby H.; Nazir S.; Moukarbel
G.V.
Institution
(Elzanaty, Nazir, Moukarbel) Division of Cardiovascular Medicine,
University of Toledo, Toledo, OH, USA
(Maraey) Department of Hospital Medicine, University of North Dakota,
Bismarck, ND, United States
(Khalil) Department of Internal Medicine, Lincoln Medical Center, New
York, NY, USA
(Elsharnoby) Department of Cardiovascular Medicine, Tanta University,
Egypt
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Recent studies showed significant mortality benefit with
right heart catheterization (RHC) use in cardiogenic (CS). The optimal
timing of RHC in those patients is unknown owing to the lack of available
data. METHOD(S): The Nationwide Readmission Database 2016-2018 was
queried for hospitalizations with CS. We excluded patients presented with
cardiac arrest or with a history of ventricular assist devices or heart
transplantation. Complex samples multivariable logistic, cox, and linear
regression models were used to determine the association between RHC
timing in the index admission (<2 days [early RHC] vs >= 2 days [late
RHC]) and in-hospital outcomes (mortality, acute kidney injury [AKI],
mechanical circulatory device use [MCD], index length of stay [LOS],
hospital charges), and all-cause 30-day readmissions. RESULT(S): A
total of 46,963 hospitalizations [18,632 in the early group and 28,332 in
the late group] were included in this analysis. RHC was more likely to
happen in large teaching hospitals. Although there was no difference in
mortality (adjusted odds ratio [aOR]: 1.05; Confidence interval [CI] 0.97
- 1.14; p=0.233). Patients in the early RHC group had a lower incidence of
AKI (aOR: 0.69; CI: 0.64-0.74; p<0.01), higher rate of MCS use (aOR:1.67;
CI:1.54-1.81; p<0.001), shorter LOS (abeta:-6.2; CI -6.62 to -5.77;
p<0.001), lower hospital charges, and lower readmission rates (adjusted
hazards ratio [aHR]: 0.91; CI: 0.84- 0.98; p=0.01) compared to the late
RHC group. CONCLUSION(S): Early RHC was associated with decreased
incidence of AKI, decreased LOS, total charges, and readmission rates with
no difference in survival. Subgroup analysis of patients who did not
receive MCS during the index admission showed similar outcomes albeit with
increased mortality. Further randomized controlled trials are needed to
validate these results. Copyright © 2022. Published by Elsevier
Inc.

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