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<1>
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Accession Number
2020240418
Title
Early Rhythm Control in Patients With Atrial Fibrillation and High
Comorbidity Burden.
Source
Circulation. 146(11) (pp 836-847), 2022. Date of Publication: 13 Sep 2022.
Author
Rillig A.; Borof K.; Breithardt G.; Camm A.J.; Crijns H.J.G.M.; Goette A.;
Kuck K.-H.; Metzner A.; Vardas P.; Vettorazzi E.; Wegscheider K.; Zapf A.;
Kirchhof P.
Institution
(Rillig, Borof, Metzner, Kirchhof) Department of Cardiology, University
Heart and Vascular Center, University Medical Center Hamburg-Eppendorf,
Germany
(Vettorazzi, Wegscheider, Zapf) Institute of Medical Biometry and
Epidemiology, University Medical Center Hamburg-Eppendorf, Germany
(Kuck) German Center for Cardiovascular Research, Partner Site
Hamburg/Luebeck/Kiel, Germany
(Breithardt, Goette) Atrial Fibrillation Network (AFNET), Munster, Germany
(Breithardt) Department of Cardiology Ii (Electrophysiology), University
Hospital Munster, Germany
(Camm) Cardiology Clinical Academic Group, Molecular and Clinical Sciences
Research Institute, St George's University of London, United Kingdom
(Crijns) Department of Cardiology, Maastricht University Medical Center
and Cardiovascular Research Institute, Netherlands
(Goette) St Vincenz Hospital, Paderborn, Germany
(Goette) Working Group of Molecular Electrophysiology, University Hospital
Magdeburg, Germany
(Kuck) Lans Cardio, Hamburg, Germany
(Vardas) Heart Sector, Hygeia Hospitals Group, Athens, Greece
(Kirchhof) Institute of Cardiovascular Sciences, University of Birmingham,
United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The randomized EAST-AFNET4 (Early Treatment of Atrial
Fibrillation for Stroke Prevention Trial-Atrial Fibrillation Network)
demonstrated that early rhythm control (ERC) reduces adverse
cardiovascular outcomes in patients with recently diagnosed atrial
fibrillation and stroke risk factors. The effectiveness and safety of ERC
in patients with multiple cardiovascular comorbidities is not known.
 Method(s): These prespecified subanalyses of EAST-AFNET4 compared the
effectiveness and safety of ERC with usual care (UC) stratified into
patients with higher (CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=4) and
lower comorbidity burden. Sensitivity analyses ignored sex
(CHA<inf>2</inf>DS<inf>2</inf>-VA score). Result(s): EAST-AFNET4
randomized 1093 patients with CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=4
(74.8+/-6.8 years, 61% female) and 1696 with
CHA<inf>2</inf>DS<inf>2</inf>-VASc score <4 (67.4+/-8.0 years, 37%
female). ERC reduced the composite primary efficacy outcome of
cardiovascular death, stroke, or hospitalization for worsening of heart
failure or for acute coronary syndrome in patients with
CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=4 (ERC, 127/549 patients with
events; UC, 183/544 patients with events; hazard ratio [HR], 0.64
[0.51-0.81]; P < 0.001) but not in patients with
CHA<inf>2</inf>DS<inf>2</inf>-VASc score <4 (ERC, 122/846 patients with
events; UC, 133/850 patients with events; HR, 0.93 [0.73-1.19]; P=0.56,
P<inf>interaction</inf>=0.037). The primary safety outcome (death, stroke,
or serious adverse events of rhythm control therapy) was not different
between study groups in patients with CHA<inf>2</inf>DS<inf>2</inf>-VASc
score >=4 (ERC, 112/549 patients with events; UC, 132/544 patients with
events; HR, 0.84 [0.65, 1.08]; P=0.175), but occurred more often in
patients with CHA<inf>2</inf>DS<inf>2</inf>-VASc scores <4 randomized to
ERC (ERC, 119/846 patients with events; UC, 91/850 patients with events;
HR, 1.39 [1.05-1.82]; P=0.019, P<inf>interaction</inf>=0.008).
Life-threatening events or death were not different between groups
(CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=4, ERC, 84/549 patients with
event, UC, 96/544 patients with event; CHA<inf>2</inf>DS<inf>2</inf>-VASc
scores <4, ERC, 75/846 patients with event, UC, 73/850 patients with
event). When female sex was ignored for the creation of higher and lower
risk groups (CHA<inf>2</inf>DS<inf>2</inf>-VA score), the
P<inf>interaction</inf>was not significant for the primary efficacy
outcome (P=0.25), but remained significant (P=0.044) for the primary
safety outcome. Conclusion(s): Patients with recently diagnosed
atrial fibrillation and CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=4
should be considered for ERC to reduce cardiovascular outcomes, whereas
those with fewer comorbidities may have less favorable outcomes with ERC.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01288352. URL: https://www.clinicaltrialsregister.eu; Unique
identifier: 2010-021258-20. URL: https://www.isrctn.com/; Unique
identifier: ISRCTN04708680. Copyright © 2022 Lippincott Williams
and Wilkins. All rights reserved.

<2>
Accession Number
2018375080
Title
Comparing health outcomes between coronary interventions in frail patients
aged 75 years or older with acute coronary syndrome: a systematic review.
Source
European Geriatric Medicine. 13(5) (pp 1057-1069), 2022. Date of
Publication: October 2022.
Author
van Wyk G.W.; Berkovsky S.; Fraile Navarro D.; Coiera E.
Institution
(van Wyk, Berkovsky, Fraile Navarro, Coiera) Australian Institute of
Health Innovation, Faculty of Medicine, Health and Human Sciences,
Macquarie University, 75 Talavera Rd, Macquarie Park, NSW 2113, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: To assess current evidence comparing the impact of available
coronary interventions in frail patients aged 75 years or older with
different subtypes of acute coronary syndrome (ACS) on health outcomes.
 Method(s): Scopus, Embase and PubMed were systematically searched in
May 2022 for studies comparing outcomes between coronary interventions in
frail older patients with ACS. Studies were excluded if they provided no
objective assessment of frailty during the index admission,
under-represented patients aged 75 years or older, or included patients
with non-ACS coronary disease without presenting results for the ACS
subgroup. Following data extraction from the included studies, a
qualitative synthesis of results was undertaken. Result(s): Nine
studies met all eligibility criteria. All eligible studies were
observational. Substantial heterogeneity was observed across study designs
regarding ACS subtypes included, frailty assessments used, coronary
interventions compared, and outcomes studied. All studies were assessed to
be at high risk of bias. Notably, adjustment for confounders was limited
or not adequately reported in all studies. The comparative assessment
suggested a possible efficacy signal for invasive treatment relative to
conservative treatment but possibly at the risk of increased bleeding
events. Conclusion(s): There is a paucity of evidence comparing
health outcomes between different coronary interventions in frail patients
aged 75 years or older with ACS. Available evidence is at high risk of
bias. Given the growing importance of ACS in frail patients aged 75 years
or older, new studies are needed to inform optimal ACS care for this
population. Future studies should rigorously adjust for
confounders. Copyright © 2022, The Author(s).

<3>
Accession Number
2017776840
Title
Effect of Preincisional Liposomal Bupivacaine Sternal Blockade on
Poststernotomy Opioid Use.
Source
Annals of Thoracic Surgery. 114(5) (pp 1562-1567), 2022. Date of
Publication: November 2022.
Author
Shih E.; DiMaio J.M.; Squiers J.J.; Wheeless J.; Hoffman W.J.; Banwait
J.K.; Hamandi M.; Baxter R.; Harrington K.B.
Institution
(Shih, Squiers, Baxter) Department of Surgery, Baylor University Medical
Center, Dallas, Texas, United States
(Shih, DiMaio, Banwait, Hamandi) Baylor Scott and White Research
Institute, Dallas, Texas, United States
(DiMaio, Harrington) Department of Cardiothoracic Surgery, Baylor Scott
and White The Heart Hospital, Plano, Texas, United States
(Wheeless, Hoffman) Department of Anesthesiology, Baylor Scott and White
The Heart Hospital, Plano, Texas, United States
Publisher
Elsevier Inc.
Abstract
Background: Prolonged and excessive opioid use in the postoperative
setting is associated with multiple complications. The use of regional
analgesia may reduce postoperative opioid use. Method(s): In a
placebo-controlled, double-blinded trial patients undergoing sternotomy
were randomly assigned in a 1:1 ratio to receive either a liposomal
bupivacaine parasternal block or a normal saline parasternal injection.
The primary endpoint was total morphine milligram equivalents (MMEs) used
in the immediate 72-hour postoperative period. Secondary endpoints were
intraoperative opioid use, pain scores, time to reach recovery milestones,
and incidence of postoperative complications. Result(s): Twenty-five
patients received a normal saline injection, and 27 patients received an
anesthetic sternal block. Randomization achieved excellent balance in
demographics and comorbidities between the groups. Total postoperative
opioid requirements at 72 hours were similar between the treatment and
control groups (25.8 +/- 10.4 vs 29.4 +/- 16.3 MMEs, P = .60).
Intraoperative opioid requirements were also similar between the 2 groups
(124.8 +/- 222.5 vs 114.9 +/- 148.0 MMEs, P = .86). Length of stay in the
intensive care unit (3.4 +/- 2.5 vs 3.5 +/- 2.6 days, P = .86) and
hospital (8.7 +/- 5.0 vs 7.5 +/- 3.0 days, P = .45), time until return of
bowel function (3.7 +/- 1.4 vs 3.3 +/- 1.4 days, P = .42), incidence of
postoperative atrial fibrillation (24% vs 22.2%, P = .88), and incidence
of nausea (24% vs 33.3%, P = .46) were similar. Conclusion(s):
Preincisional sternal blockade with liposomal bupivacaine did not reduce
the amount of opioid medication administered to patients in the first 72
hours after sternotomy. Copyright © 2022 The Society of Thoracic
Surgeons

<4>
Accession Number
2016179757
Title
Enhancing Recovery in Congenital Cardiac Surgery.
Source
Annals of Thoracic Surgery. 114(5) (pp 1754-1761), 2022. Date of
Publication: November 2022.
Author
Roy N.; Parra M.F.; Brown M.L.; Sleeper L.A.; Carlson L.; Rhodes B.;
Nathan M.; Mistry K.P.; del Nido P.J.
Institution
(Roy, Parra, Carlson, Rhodes, Nathan, del Nido) Department of Cardiac
Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
(Roy, Parra, Brown) Department of Anesthesiology, Critical Care and Pain
Medicine, Boston Children's Hospital, Boston, Massachusetts, United States
(Roy, Parra, Sleeper, Mistry) Department of Cardiology, Boston Children's
Hospital, Boston, Massachusetts, United States
(Roy, Parra, Brown, Sleeper, Nathan, Mistry, del Nido) Departments of
Surgery, Anaesthesia, and Pediatrics, Harvard Medical School, Boston,
Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Background: The benefits of a comprehensive enhanced recovery after
surgery (ERAS) program for patients with congenital heart disease are
largely unknown. This study evaluated adherence and to outcomes of a
recently implemented enhanced recovery program (ERP) in congenital cardiac
surgery. Method(s): Patients undergoing elective procedures for
simple and moderately complex congenital cardiac surgery have followed
institutional ERP guidelines since October 2018. Adherence to guidelines
over a 12-month period (P2) was compared with implementation data (P1, 5
months). The association of outcomes with continuous time was estimated
using linear regression. Result(s): Among 559 patients (representing
40% of the cardiac surgical volume) following the ERP over a period of 17
months, no differences in patient characteristics were observed between
periods, except a higher incidence of previous operations in P2. Adherence
to many aspects of guidelines improved from P1 to P2. The following
improvements were notable: operating room extubation, 27% in P2 vs16% in
P1 (P = .006); and a decrease in median ventilation time, 6.0 hours
(interquartile range [IQR], 0-9.2 hours) in P2 vs 7.6 hours (IQR, 3.8-12.3
hours) in P1 (P = .002). In addition, there was a reduction in opioids,
reported as oral morphine equivalents, that was most significant for
intraoperative oral morphine equivalents: 5.00 mg/kg (IQR, 3.11-7.60
mg/kg) in P2 vs 6.05 mg/kg (IQR, 3.77-9.78 mg/kg) in P1 (P = .001). There
was no difference in overall intensive care unit and postoperative lengths
of stay, except in lower-risk surgical procedures. Surgical outcomes were
similar in the 2 periods. Conclusion(s): An enhanced recovery program
reduced the use of opioids, led to more extubation in the operating room,
and reduced mechanical ventilation duration in patients undergoing
congenital cardiac surgery. Copyright © 2022 The Society of
Thoracic Surgeons

<5>
Accession Number
2020781297
Title
A Systematic Review and Meta-Analysis of the Effectiveness of
High-Intensity Interval Training in People with Cardiovascular Disease at
Improving Depression and Anxiety.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 8322484. Date of Publication: 2022.
Author
Gu T.; Hao P.; Chen P.; Wu Y.
Institution
(Gu, Hao, Chen, Wu) Department of Rehabilitation Medicine, Huashan
Hospital, Fudan University, Shanghai 200040, China
Publisher
Hindawi Limited
Abstract
Background. To assess the effects of high-intensity interval training
(HIIT) on depression and anxiety symptom in people with cardiovascular
diseases (CVDs) compared with usual care (UC) and traditional aerobic
continuous training (CT). Methods. Randomized controlled trials (RCTs)
that investigated the effectiveness of HIIT on depression and/or anxiety
outcomes before and after treatment in people with CVDs were included. A
systematic search of database containing PubMed, Web of Science, Cochrane
Central Register of Controlled Trials (CENTRAL), EMBASE, SPORTSDiscus, and
CINAHL (EBSCOhost) was performed up to December 2021. The analyses of
study characteristics, heterogeneity, and forest plot in analyses
analogous were conducted via the pooled standardized mean difference (SMD)
in random- or fixed-effect models as the measure of effectiveness.
Results. Twelve independent studies (515 participants) were included. One
study was rated as low quality, and four studies were evaluated as high
quality. The other studies were rated as moderate quality. Visual
interpretation of funnel plots and Egger test indicated no evidence of
publication bias. There was a statistically significant reduction in the
severity of depression (12 studies, SMD = -0.42 [Random], 95% CI, -0.69 to
-0.16, p=0.002, I2 = 52%) rather than that of anxiety symptoms (8 studies,
SMD = -0.14 [Fixed], 95% CI, -0.35 to 0.06, p=0.18, I2 = 0%) following
HIIT compared with UC and CT control groups. Subgroup analysis revealed
that high-intensity treadmill training significantly improved (p=0.01) the
depression symptom instead of training with a cycle ergometer (p=0.07) and
strength training (p=0.40). Conclusions. High-intensity interval treadmill
training can significantly improve symptoms of depression rather than
anxiety in cardiovascular patients compared to usual care and conventional
aerobic continuous training. Copyright © 2022 Tingting Gu et al.

<6>
Accession Number
2020742806
Title
Life-threatening cardiac arrhythmia and sudden death during electronic
gaming: An international case series and systematic review.
Source
Heart Rhythm. 19(11) (pp 1826-1833), 2022. Date of Publication: November
2022.
Author
Lawley C.M.; Tester M.; Sanatani S.; Prendiville T.; Beach C.M.; Vinocur
J.M.; Horie M.; Uhm J.-S.; Khongphatthanayothin A.; Ayers M.D.; Starling
L.; Yoshida Y.; Shah M.J.; Skinner J.R.; Turner C.
Institution
(Lawley, Skinner, Turner) The Heart Centre for Children, Sydney Children's
Hospitals Network, Sydney, NSW, Australia
(Lawley) The University of Sydney Children's Hospital Westmead Clinical
School, Faculty of Medicine and Health, The University of Sydney, Sydney,
NSW, Australia
(Lawley, Starling) Department of Paediatric Cardiology, Great Ormond
Street Hospital for Children NHS Foundation Trust, London, United Kingdom
(Tester, Sanatani) Children's Heart Centre, The University of British
Columbia, Vancouver, BC, Canada
(Prendiville) Department of Cardiology and Cardiac Surgery, Children's
Health Ireland at Crumlin, Republic of Ireland, Dublin, Ireland
(Beach, Vinocur) Department of Pediatrics, Division of Pediatric
Cardiology, Yale University School of Medicine, New Haven, Connecticut,
United States
(Vinocur) Department of Pediatrics, University of Rochester School of
Medicine and Dentistry, Rochester, New York, United States
(Horie) Department of Cardiovascular Medicine, Shiga University of Medical
Science, Shiga, Japan
(Uhm) Department of Cardiology, Yongin Severance Hospital, College of
Medicine, Yonsei University, Gyeonggi-do, Yongin, South Korea
(Khongphatthanayothin) Department of Cardiology, Yongin Severance
Hospital, College of Medicine, Yonsei University, Gyeonggi-do, Yongin,
South Korea
(Ayers) Department of Pediatrics, Division of Pediatric Cardiology,
Pediatric Electrophysiology, Indiana University School of Medicine,
Indianapolis, IN, United States
(Yoshida) Department of Pediatric Electrophysiology, Osaka City General
Hospital, Miyakojima-hondori, Osaka, Miyakojima-ku, Japan
(Shah) Department of Pediatrics, University of Pennsylvania Perelman
School of Medicine, Children's Hospital of Philadelphia, Philadelphia,
Pennsylvania, United States
(Khongphatthanayothin) Department of Medicine, Faculty of Medicine,
Chulalongkorn University, Bangkok, Thailand
Publisher
Elsevier B.V.
Abstract
Background: Electronic gaming has recently been reported as a precipitant
of life-threatening cardiac arrhythmia in susceptible individuals.
 Objective(s): The purpose of this study was to describe the
population at risk, the nature of cardiac events, and the type of game
linked to cardiac arrhythmia associated with electronic gaming.
 Method(s): A multisite international case series of suspected or
proven cardiac arrhythmia during electronic gaming in children and a
systematic review of the literature were performed. Result(s):
Twenty-two patients (18 in the case series and 4 via systematic review;
aged 7-16 years; 19 males [86%]) were identified as having experienced
suspected or proven ventricular arrhythmia during electronic gaming; 6
(27%) had experienced cardiac arrest, and 4 (18%) died suddenly. A
proarrhythmic cardiac diagnosis was known in 7 (31%) patients before their
gaming event and was established afterward in 12 (54%). Ten patients (45%)
had catecholaminergic polymorphic ventricular tachycardia, 4 (18%) had
long QT syndrome, 2 (9%) were post-congenital cardiac surgery, 2 (9%) had
"idiopathic" ventricular fibrillation, and 1 (after Kawasaki disease) had
coronary ischemia. In 3 patients (14%), including 2 who died, the
diagnosis remains unknown. In 13 (59%) patients for whom the electronic
game details were known, 8 (62%) were war games. Conclusion(s):
Electronic gaming can precipitate lethal cardiac arrhythmias in
susceptible children. The incidence appears to be low, but syncope in this
setting should be investigated thoroughly. In children with proarrhythmic
cardiac conditions, electronic war games in particular are a potent
arrhythmic trigger. Copyright © 2022

<7>
Accession Number
2020723858
Title
Plasma microRNA-221-3p as a biomarker for POCD after non-cardiac surgery.
Source
PLoS ONE. 17(10 October) (no pagination), 2022. Article Number: e0275917.
Date of Publication: October 2022.
Author
Fan D.; Chen X.; Zhou H.; Hu N.; Chen C.; Yao Y.; Bai Y.; Feng J.; Jia J.;
Wang X.
Institution
(Fan, Chen, Zhou, Hu, Chen, Yao, Bai, Wang) Department of Anesthesiology,
The Affiliated Hospital of Southwest Medical University, Sichuan Province,
Luzhou, China
(Feng, Jia) Laboratoryof Anesthesiology, Southwest Medical University,
Sichuan Province, Luzhou, China
Publisher
Public Library of Science
Abstract
Our previous study showed that the plasma microRNA-221-3p level could
serve as a biomarker for major depression or mood. This study aimed to
further investigate the role of plasma microRNA-221-3p level in
postoperative cognitive dysfunction (POCD). Patients undergoing
non-cardiac surgery were randomly assigned according to the inclusion and
exclusion criteria. POCD was diagnosed by the Z score method. The relative
level of plasma microRNA-221-3p was decided by quantitative real-time
polymerase chain reaction. Multiple logistic regression analysis and
receiver operating characteristic(ROC) curves were used for the analysis
of plasma microRNA-221-3p prediction performance for POCD. At 7 days
post-surgery, the rate of POCD was 34.04%. Patients in the POCD group had
a higher preoperative depression score, older age, and longer operation
duration than that in the NPOCD group. The relative level of plasma
microRNA-221-3p in the POCD group was 1.78 and 2.73 times higher than that
in the NPOCD group at 1 day before and 7 days after the surgery,
respectively. The relative content of plasma microRNA-221-3p at 7 days
after operation was an independent risk factor for POCD. The ROC curves
showed that the area under the curve was 0.938 for plasma microRNA-221-3p
at postoperative 7 days, and the threshold for POCD detection was 12.33
with a sensitivity and specificity of 81.3% and 96.3%, respectively. Our
results indicate that the plasma postoperative microRNA-221-3p levels
could be an effective predictor for POCD after non-cardiac
surgery. Copyright: © 2022 Fan et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<8>
Accession Number
639161788
Title
Preventive Effect of Berberine on Postoperative Atrial Fibrillation.
Source
Circulation. Arrhythmia and electrophysiology. 15(10) (pp e011160), 2022.
Date of Publication: 01 Oct 2022.
Author
Zhang J.; Wang Y.; Jiang H.; Tao D.; Zhao K.; Yin Z.; Han J.; Xin F.; Jin
Y.; Wang H.
Institution
(Zhang, Wang, Jiang, Tao, Zhao, Yin, Han, Xin, Jin, Wang) Department of
Cardiovascular Surgery, General Hospital of Northern Theater Command,
Liaoning, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is one of the most
common complications of cardiac surgery, but the underlying factors
governing POAF are not well understood. The aim of this study was to
investigate the efficacy of berberine administration on POAF.
 METHOD(S): We conducted a randomized, double-blind,
placebo-controlled trial with patients who underwent isolated coronary
artery bypass grafting in China to study the impact of oral berberine on
the incidence of POAF. A total of 200 patients who underwent coronary
artery bypass grafting were randomized into the berberine group (n=100)
and the placebo group (n=100). All patients underwent 7-day continuous
telemetry and Holter monitoring. RESULT(S): The primary outcome was
the incidence of POAF at 7 days. Secondary outcomes included clinical
outcomes, POAF burden, intestinal endotoxin, and serum inflammatory
biomarker levels. The POAF incidence was reduced from 35% to 20% under
berberine treatment (hazard ratio, 0.5 [95% CI, 0.29-0.78]; P=0.0143).
Perioperative mortality and morbidity did not differ between the 2 groups.
POAF burden and the dose of amiodarone were significantly reduced in the
berberine group. Oral berberine significantly decreased
lipopolysaccharide, CRP (C-reactive protein), and IL (interleukin)-6
levels. Elevated lipopolysaccharide after surgery has been associated with
POAF. CONCLUSION(S): Our results showed that administration of
berberine may be effective for reducing the occurrence of POAF after
coronary artery bypass grafting. REGISTRATION: URL:
https://www.chictr.org.cn; Unique identifier: ChiCTR2000028839.

<9>
Accession Number
2018968990
Title
Long-term results after simultaneous carotid and coronary
revascularisation.
Source
Asian Cardiovascular and Thoracic Annals. 30(9) (pp 977-984), 2022. Date
of Publication: November 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, Dedinje Cardiovascular Institute,
Belgrade, Serbia
(Krasic) Cardiology Department, Mother and Child Health Institute of
Serbia, Belgrade, Serbia
(Sagic) Department of Interventional Radiology, Dedinje Cardiovascular
Institute, Belgrade, Serbia
(Ilijevski) Department of Vascular Surgery, Dedinje Cardiovascular
Institute, Belgrade, Serbia
Publisher
SAGE Publications Inc.
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. Copyright © The Author(s) 2022.

<10>
Accession Number
2016697681
Title
Topical Vancomycin and Risk of Sternal Wound Infections: A Double-Blind
Randomized Controlled Trial.
Source
Annals of Thoracic Surgery. 114(5) (pp 1555-1561), 2022. Date of
Publication: November 2022.
Author
Servito M.; Khani-Hanjani A.; Smith K.-M.; Tsuyuki R.T.; Mullen J.C.
Institution
(Servito) School of Medicine, Faculty of Health Sciences, Queen's
University, Kingston, ON, Canada
(Khani-Hanjani) Division of Cardiac Surgery, Royal University Hospital,
University of Saskatchewan, Saskatoon, SK, Canada
(Smith, Mullen) Division of Cardiac Surgery, Faculty of Medicine and
Dentistry, University of Alberta, Edmonton, AB, Canada
(Tsuyuki) Department of Pharmacology, Faculty of Medicine and Dentistry,
University of Alberta, Edmonton, AB, Canada
(Tsuyuki) Division of Cardiology, Department of Medicine, Faculty of
Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
Publisher
Elsevier Inc.
Abstract
Background: The use of topical vancomycin in the reduction of sternal
wound infection (SWI) risk has become a point of contention. The earlier
literature consists of observational studies and 1 unblinded trial. Hence,
the objective of this study was to assess whether vancomycin reduces the
incidence of SWI in a double-blind randomized controlled trial.
 Method(s): Patients were randomized 1:1 to either vancomycin-soaked
(vancomycin) or saline-soaked (control) sponges. The sponges were applied
once the sternum was opened and were removed just before sternal closure.
Patients were followed up at 3 months and at 1 year postoperatively to
determine the incidence of SWI in each group. Results were analyzed
according to the modified intention-to-treat principle. Result(s):
This study assessed 1038 patients for eligibility and enrolled 1037
patients. There were 517 patients randomized to the vancomycin group and
520 patients randomized to the control group. Analysis was performed on
1021 patients. At 3 months postoperatively, there was no significant
difference in the incidence of SWI between the vancomycin and control
groups (2.7% vs 4.1%; P = .23). There was also no significant difference
between the vancomycin and control groups in the risk of superficial,
deep, and organ-space infections. Similar findings were observed 1 year
postoperatively. The most common organism isolated was coagulase-negative
Staphylococcus. Conclusion(s): The use of vancomycin applied to the
sternum during cardiac surgery does not reduce the incidence of
SWI. Copyright © 2022 The Society of Thoracic Surgeons

<11>
Accession Number
639322026
Title
GUIDE BASED ON EVIDENCE OF MULTIPROFESSIONAL GUIDANCE FOR FLUID OVERLOAD
IN PEDIATRIC ONCOLOGICAL PATIENTS.
Source
Pediatric Blood and Cancer. Conference: 54th Congress of the International
Society of Paediatric Oncology, SIOP 2022. Barcelona Spain. 69(Supplement
5) (pp S362-S363), 2022. Date of Publication: November 2022.
Author
Facholi M.; Neto M.; Lopes L.F.; De Paula A.
Institution
(Facholi, Neto) Barretos Cancer Hospital, Pediatric Oncology, Barretos,
Brazil
(Lopes, De Paula) Barretos Children's Cancer Hospital, Pediatric Hospital,
Bairro Paulo Prata, Barretos, San Paulo, Brazil
Publisher
John Wiley and Sons Inc.
Abstract
Background and Aims: BACKGROUND: Excessive use of fluids can cause tissue
edema and organ dysfunction, which can result in high levels of morbidity,
prolonged length of stay and mortality in pediatric cancer patients. The
multiprofessional team assists in the recognition of this clinical
condition, bringing an important contribution to this scenario, which
impacts on improving patient care and reducing admission to the Pediatric
Intensive Care Unit. Thus, the present study is justified for the
recognition and early approach of these patients, aiming to reduce the
morbidity and mortality related to fluid overload, through the
construction of an evidence-based multiprofessional guidance flowchart.
AIM: To create a multiprofessional guidance guide based on evidence of
fluid overload in pediatric cancer patients. Method(s): Review of
articles, for integrative study, selected by research in PubMed- MEDLINE,
BVS and Cochrane, looking for articles on fluid overload in pediatric
patients. Result(s): A bibliographic search was carried out in
PubMed, Cochrane and VHL databases for studies on water overload in
pediatric patients, from 1932 to September 2020. A total of 3692 articles,
after removing articles such as those in the Pediatrics area, resulted in
general themes: diarrhea, pneumonia and in areas of specialties. Other
E-Poster Topics were evaluated: neonatology, burns, cardiac surgery, but
they did not contribute to this work, review of duplicate articles and 76
articles were selected for data extraction according to my inclusion
criteria. Conclusion(s): FO is an important and current E-Poster
Topic, as, reported in the studies found, it is a factor of morbidity and
mortality. In pediatric oncology, the literature is scarce, so further
studies are needed, since excess fluids may be related to reduced
survivorship in these patients, and should therefore be detected earlier
if present and avoided.

<12>
Accession Number
2020813263
Title
Coronary Artery Bypass Surgery Without Saphenous Vein Grafting: JACC
Review Topic of the Week.
Source
Journal of the American College of Cardiology. 80(19) (pp 1833-1843),
2022. Date of Publication: 08 Nov 2022.
Author
Royse A.; Ren J.; Royse C.; Tian D.H.; Fremes S.; Gaudino M.; Benedetto
U.; Woo Y.J.; Goldstone A.B.; Davierwala P.; Borger M.; Vallely M.; Reid
C.M.; Rocha R.; Glineur D.; Grau J.; Shaw R.; Paterson H.; El-Ansary D.;
Boggett S.; Srivastav N.; Pawanis Z.; Canty D.; Bellomo R.
Institution
(Royse, Ren, Royse, El-Ansary, Boggett, Srivastav, Canty) Department of
Surgery, University of Melbourne, Melbourne, VIC, Australia
(Royse, Royse) Royal Melbourne Hospital, Melbourne, VIC, Australia
(Royse) Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH,
United States
(Tian) Department of Anesthesia, Westmead Hospital, Sydney, NSW, Australia
(Fremes, Davierwala, Rocha) Department of Surgery, University of Toronto,
Toronto, ON, Canada
(Gaudino) Department of Surgery, Weill Cornell Medicine, New York, NY,
United States
(Benedetto) Universita degli Studi G. d'Annunzio, Chieti-Pescara, Italy
(Woo) Surgery, Stanford University, San Francisco, CA, United States
(Goldstone) Department of Surgery, New York Presbyterian Morgan Stanley
Children's Hospital, New York, NY, United States
(Davierwala, Borger) Department of Surgery, University Clinic of Cardiac
Surgery, Leipzig Heart Center, Leipzig, Germany
(Vallely) Department of Surgery, Ohio State University, Columbus, OH,
United States
(Reid) Department of Epidemiology, Curtin University, Perth, WA, Australia
(Glineur, Grau) Department of Surgery, Ottawa Heart Institute, Ottawa, ON,
Canada
(Glineur) Department of Surgery, Clinique St Luc Bouge, Bouge, Belgium
(Shaw) Department of Surgery, Valley Health, Ridgewood, NJ, United States
(Paterson) Department of Surgery, University of Sydney, Sydney, NSW,
Australia
(El-Ansary) Swinburn University, Melbourne, VIC, Australia
(Pawanis) Department of Surgery, Universitas Airlangga, Surabaya,
Indonesia
(Bellomo) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
Publisher
Elsevier Inc.
Abstract
Approximately 95% of patients of any age undergoing contemporary, coronary
bypass surgery will receive at least 1 saphenous vein graft (SVG). It is
recognized that SVG will develop progressive and accelerated
atherosclerosis, resulting in a stenosis, and in occlusion that occurs in
50% by 10 years postoperatively. For arterial conduits, there is little
evidence of progressive failure as for SVG. Could avoidance of SVG (total
arterial revascularization [TAR]) lead to a different late (>5 year)
survival? A literature review of 23 studies (N = 100,314 matched patients)
at a mean 8.8 years postoperative found reduced all-cause mortality for
TAR (HR: 0.77; 95% CI: 0.71-0.84; P < 0.001). An expanded analysis with a
new unpublished data set (N = 63,288 matched patients) was combined with
the literature review (N = 127,565). It found reduced all-cause mortality
for TAR (HR: 0.78; 95% CI: 0.72-0.85; P < 0.001). Additional Bayesian
analysis found a very high probability of a TAR-associated reduction
all-cause mortality. Copyright © 2022

<13>
Accession Number
639325739
Title
Effects of propofol and inhaled anesthetics on postoperative complications
for the patients undergoing one lung ventilation: A meta-analysis.
Source
PloS one. 17(10) (pp e0266988), 2022. Date of Publication: 2022.
Author
Yang J.; Huang Q.; Cao R.; Cui Y.
Institution
(Yang, Huang, Cao, Cui) Department of Anesthesiology, Affiliated Hospital,
School of Medicine, UESTC Chengdu Women's & Children's Central Hospital,
Chengdu, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: With the widespread use of one-lung ventilation (OLV) in
thoracic surgery, it is unclear whether maintenance anesthetics such as
propofol and inhaled anesthetics are associated with postoperative
complications. The purpose of this study was to compare the effects of
propofol and inhaled anesthetics on postoperative complications in OLV
patients. METHOD(S): PubMed, EMBASE, Medline, and Cochrane Library
were searched for relevant randomized controlled trials until 09/2021. All
randomized controlled trials comparing the effect of propofol versus
inhaled anesthetics on postoperative complications in OLV patients were
included. All randomized controlled trials comparing:(a) major
complications (b) postoperative pulmonary complications (c) postoperative
cognitive function (MMSE score) (d) length of hospital stay (e) 30-day
mortality, were included. RESULT(S): Thirteen randomized controlled
trials involving 2522 patients were included in the analysis. Overall,
there was no significant difference in major postoperative complications
between the inhaled anesthetic and propofol groups (OR 0.78, 95%CI 0.54 to
1.13, p = 0.19; I2 = 0%). However, more PPCs were detected in the propofol
group compared to the inhalation anesthesia group (OR 0.62, 95%CI 0.44 to
0.87, p = 0.005; I2 = 37%). Both postoperative MMSE score (SMD -1.94,
95%CI -4.87 to 0.99, p = 0.19; I2 = 100%) and hospital stay (SMD 0.05,
95%CI -0.29 to 0.39, p = 0.76; I2 = 73%) were similar between the two
groups. The 30-day mortality rate was also not significantly different
between groups (OR 0.79, 95%CI 0.03 to 18, p = 0.88; I2 = 63%).
 CONCLUSION(S): In patients undergoing OLV, general anesthesia with
inhaled anesthetics reduced PPC compared to propofol, but did not provide
clear benefits on other major complications, cognitive function, length of
hospital stay, or mortality.

<14>
Accession Number
2020832216
Title
Cardiac Magnetic Resonance Imaging for the Diagnosis of Infective
Endocarditis in the COVID-19 Era.
Source
Current Problems in Cardiology. 48(1) (no pagination), 2023. Article
Number: 101396. Date of Publication: January 2023.
Author
Bhuta S.; Patel N.J.; Ciricillo J.A.; Haddad M.N.; Khokher W.; Mhanna M.;
Patel M.; Burmeister C.; Malas H.; Kammeyer J.A.
Institution
(Bhuta, Burmeister) The Ohio State University Wexner Medical Center,
Columbus, OH, United States
(Patel, Ciricillo, Haddad, Khokher, Patel, Malas, Kammeyer) University of
Toledo, College of Medicine and Life Sciences, Toledo, OH
(Mhanna) Division of Cardiology, Department of Medicine, University of
Iowa, Iowa City, IA, United States
Publisher
Elsevier Inc.
Abstract
In the COVID-19 pandemic, to minimize aerosol-generating procedures,
cardiac magnetic resonance imaging (CMR) was utilized at our institution
as an alternative to transesophageal echocardiography (TEE) for diagnosing
infective endocarditis (IE). This retrospective study evaluated the
clinical utility of CMR for detecting IE among 14 patients growing typical
microorganisms on blood cultures or meeting modified Duke Criteria. Seven
cases were treated for IE. In 2 cases, CMR results were notable for
possible leaflet vegetations and were clinically meaningful in guiding
antibiotic therapy, obtaining further imaging, and/or pursuing surgical
intervention. In 2 cases, vegetations were missed on CMR but detected on
TEE. In 3 cases, CMR was non-diagnostic, but patients were treated
empirically. There was no difference in antibiotic duration or outcomes
over 1 year. CMR demonstrated mixed results in diagnosing valvular
vegetations and guiding clinical decision-making. Further prospective
controlled trials of CMR Vs TEE are warranted. Copyright © 2022
Elsevier Inc.

<15>
Accession Number
2020807078
Title
Aortic valve neocuspidization using the Ozaki technique: A meta-analysis
of reconstructed patient-level data.
Source
American Heart Journal. 255 (pp 1-11), 2023. Date of Publication: January
2023.
Author
Mylonas K.S.; Tasoudis P.T.; Pavlopoulos D.; Kanakis M.; Stavridis G.T.;
Avgerinos D.V.
Institution
(Mylonas, Pavlopoulos, Stavridis, Avgerinos) Department of Cardiac
Surgery, Onassis Cardiac Surgery Center, Athens, Greece
(Tasoudis) Faculty of Medicine, School of Health Sciences, University of
Thessaly, Larissa, Biopolis, Greece
(Kanakis) Department of Pediatric and Adult Congenital Cardiac Surgery,
Onassis Cardiac Surgery Center, Athens, Greece
Publisher
Elsevier Inc.
Abstract
Background: Aortic valve neocuspidization using the Ozaki technique has
shown promising results both in adults and children. Method(s): A
systematic search of the PubMed and Cochrane databases was performed up to
November 13, 2021. Individual patient data were reconstructed and analyzed
from the Kaplan-Meier curves of all eligible studies for time-to-event
outcomes. Result(s): We included a total of 22 studies reporting on
1,891 patients that underwent Ozaki reconstruction. Mean age at the time
of surgery was 43.2 +/- 24.5 years (65 +/- 12.3 years for adult patients
and 12.3 +/- 3.8 years for pediatric patients). The most common indication
was aortic stenosis (46.4%, 95% CI 34.1-58.6). Mean cross-clamp and
cardiopulmonary bypass duration were 106.8 +/- 24.8 minutes and 135.2 +/-
35.1 minutes, respectively. Permanent pacemaker was implanted in 0.7% (95%
CI 0.4-1.2) of the patients. At discharge, mean effective orifice area was
2.1 +/- 0.5 cm2/m2. At latest follow-up, peak
gradient was 15.7 +/- 7.4 mm Hg and only 0.25% (95% CI 0-2.3) had moderate
aortic insufficiency. In-hospital mortality was 0.7% (95% CI 0.1-1.7).
Late mortality was 1.9% during a mean follow-up of 38.1 +/- 23.8 months.
One-year, 3-year, and 5-year freedom from reoperation rates were 98.0 %,
97.0 % and 96.5%, respectively. More than half of the reoperations were
due to infective endocarditis (51.5%, 95% CI 18.3-84.0). In our cohort,
the risk of endocarditis per patient per year was 0.5%.
 Conclusion(s): The midterm outcomes of the Ozaki procedure are
excellent in terms of hemodynamics, survival, and freedom from
reoperation. Acquiring long-term follow-up will help solidify this
technique in the cardiac surgery armamentarium. Copyright © 2022

<16>
Accession Number
2020781834
Title
Intensive versus conservative glycemic control in patients undergoing
coronary artery bypass graft surgery: A protocol for systematic review of
randomised controlled trials.
Source
PLoS ONE. 17(10 October) (no pagination), 2022. Article Number: e0276228.
Date of Publication: October 2022.
Author
Liu Y.; Sun X.-X.; Du W.-Y.; Chen T.-T.; Lv M.
Institution
(Liu, Sun, Du, Chen, Lv) Department of Anesthesiology, The First
Affiliated Hospital of Shandong First Medical University, Shandong
Provincial Qianfoshan Hospital, Shandong Province, Ji'nan, China
Publisher
Public Library of Science
Abstract
Introduction Hyperglycemia and hypoglycemia are common during coronary
artery bypass graft (CABG) and are associated with a variety of
postoperative outcomes. Therefore, the strategy of intraoperative glycemic
control is an important issue for the patients undergoing CABG. This
systematic review aims to evaluate the effect of different intraoperative
glycemic control strategies on postoperative outcomes. Methods and
analyses We will perform this systematic review of randomised controlled
trials (RCTs) according to the recommendations of the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA). Relevant studies
will be searched in Medline, Embase, Cochrane Library and Web of Science.
Two independent reviewers will conduct study selection, data extraction,
risk of bias and quality assessment. The primary outcome is postoperative
mortality, and the secondary outcomes include the duration of mechanical
ventilation in the intensive care unit (ICU), the incidence of
postoperative myocardial infarction (MI), the incidence of postoperative
atrial fibrillation (AF), the type and volume of blood product
transfusion, the rate of rehospitalization, the rate of cerebrovascular
accident, the rate of significant postoperative bleeding, the rate of
infection, the incidence of acute kidney failure (AKF), hospital and ICU
lengths of stay (LOS). ReviewManager 5.4 will be used for data management
and statistical analysis. The Cochrane risk-of -bias tool 2.0 and GRADEpro
will be applied for risk of bias and quality assessment of the evidence.
Discussion There is no consensus that which strategy of glycemic control
is better for improving postoperative complications of patients undergoing
CABG. The results of our study might provide some evidence for the
relationship between intraoperative glycemic control strategies and
postoperative outcomes in patients undergoing CABG. Copyright ©
2022 Liu et al. This is an open access article distributed under the terms
of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original
author and source are credited.

<17>
Accession Number
2020772087
Title
Effect of Ascorbic Acid on Cardiac Surgery-Associated Acute Kidney Injury
Incidence.
Source
Thoracic and Cardiovascular Surgeon. 70(7) (pp 566-574), 2022. Date of
Publication: 01 Oct 2022.
Author
Djordjevic A.; Susak S.; Kotnik P.; Gorenjak M.; Knez Z.; Antonic M.
Institution
(Djordjevic, Antonic) Department of Cardiac Surgery, University Medical
Centre Maribor, Maribor, Slovenia
(Susak) Department of Cardiovascular Surgery, Institute of Cardiovascular
Diseases of Vojvodina, Sremska Kamenica, Vojvodina, Serbia
(Kotnik, Gorenjak, Knez) Faculty of Medicine, University of Maribor,
Maribor, Slovenia
Publisher
Georg Thieme Verlag
Abstract
Objectives a Acute kidney injury (AKI) is associated with higher
perioperative mortality and morbidity. Oxidative stress has been proposed
as a cause of postoperative AKI. Ascorbic acid (AA) supplementation was
suggested as a novel and promising antioxidant. The aim of this study was
to evaluate the capability of AA to reduce the incidence of postoperative
AKI in cardiac surgery patients. Methods a A prospective randomized trial
was conducted in patients scheduled for on-pump cardiac surgery. Subjects
in the AA group received 2 g of AA intravenously during the induction of
anesthesia, 2 g before aortic cross-clamp removal and 1 g every 8 hours
for five postoperative days (the JERICA protocol). Postoperatively, the
patients were monitored for AKI and other complications. Malondialdehyde
levels were monitored in a subpopulation of 100 patients to evaluate the
effect of AA on oxidative stress level. Results a The AA and control group
consisted of 163 and 169 patients, respectively. The groups were well
matched for baseline demographics and had similar intraoperative
characteristics. The incidence of AKI in the AA and control group was 20.9
and 28.4%, respectively (p = 0.127). The estimated glomerular filtration
rate did not differ between the study groups in the entire postoperative
period. There was a trend toward higher malondialdehyde values with
statistical significance on postoperative day 1 and lower in-hospital
mortality in the AA group (0.6 vs. 4.1%, p = 0.067). Conclusion a Our
results do not support the effectiveness of AA supplementation in reducing
the incidence of postoperative AKI in on-pump cardiac surgery patients.
Clinical Registration Number a This study was registered with the ISRCTN
Registry under the trial registration number ISRCTN98572043. Copyright
© 2022 Georg Thieme Verlag. All rights reserved.

<18>
Accession Number
2019702988
Title
The effect of topical airway anesthesia on hemodynamic profiles during the
induction period in patients undergoing cardiac surgery: Study protocol
for a randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 992534. Date of Publication: 10 Oct 2022.
Author
Du W.; Lv M.; Chen T.; Sun X.; Wang J.; Zhang H.; Wei C.; Liu Y.; Qiao C.;
Wang Y.
Institution
(Du, Chen, Sun) Shandong First Medical University, Taian, China
(Lv, Wang, Zhang, Wei, Liu, Qiao, Wang) Department of Anesthesiology and
Perioperative Medicine, The First Affiliated Hospital of Shandong First
Medical University, Jinan, China
Publisher
Frontiers Media S.A.
Abstract
Background: Patients scheduled for cardiac surgery are often accompanied
by cardiac dysfunction and hemodynamic instability. However, the
conventional induction strategy for anesthesia using high-dose intravenous
anesthetics is often associated with persistent and recurrent hypotension
after tracheal intubation. The purpose of this study is to investigate the
effects of topical airway anesthesia on the hemodynamic profile of
patients undergoing cardiac surgery during the induction period.
 Method(s): This is a superiority, single-blind, randomized controlled
study with two parallel groups. Participants scheduled to undergo elective
cardiac surgery will be allocated into two blocks according to the New
York Heart Association (NYHA) classification and then randomly assigned to
the following two groups at a 1:1 ratio: the conventional induction group
and the combined topical airway anesthesia induction group. The combined
topical airway anesthesia induction strategy includes aerosol inhalation
airway anesthesia, subglottic airway anesthesia, and general anesthesia
induction using low-dose intravenous anesthetics. The primary outcome is
the area under the curve (AUC) of blood pressure below baseline mean
arterial pressure (MAP) from 3 to 15 min after endotracheal intubation.
Secondary outcomes include the AUC above baseline MAP and below baseline
MAP at other time points, the highest and lowest arterial blood pressure
values during the induction period, type and dose of vasoactive drugs,
incidence of arrhythmias, cardiac function, and the incidence of
postoperative hoarseness and sore throat. Discussion(s): The study
will explore whether aerosol inhalation airway anesthesia and subglottic
airway anesthesia could reduce the incidence and duration of hypotension
during the induction period in patients undergoing cardiac surgery.
Clinical Trial Registration: This trial was registered on
www.ClinicalTrials.gov (NCT05323786). Copyright © 2022 Du, Lv,
Chen, Sun, Wang, Zhang, Wei, Liu, Qiao and Wang.

<19>
Accession Number
2020810831
Title
Clinical outcomes of off-pump coronary artery bypass graft in patients
with diabetes and non-diabetics: A systematic review and meta-analysis.
Source
Diabetes and Metabolic Syndrome: Clinical Research and Reviews. 16(11) (no
pagination), 2022. Article Number: 102643. Date of Publication: November
2022.
Author
aeen F.B.; Pakzad R.; Tayebi Z.; Kashkooli R.I.; Abdi F.
Institution
(aeen, Kashkooli) Student Research Committee, School of Nursing and
Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Pakzad) Department of Epidemiology, Faculty of Health, Ilam University of
Medical Sciences, Ilam, Iran, Islamic Republic of
(Tayebi) Faculty of Nursing and Midwifery, Alborz University of Medical
Sciences, Karaj, Iran, Islamic Republic of
(Abdi) Non-communicable Diseases Research Center, Alborz University of
Medical Sciences, Karaj, Iran, Islamic Republic of
Publisher
Elsevier Ltd
Abstract
Background and aim: Diabetes mellitus is a prevalent risk factor for
developing coronary artery disease which worsens the clinical outcomes of
patients undergoing coronary artery bypass grafting (CABG). This study
aimed to determine the clinical outcomes of patients with diabetes and
non-diabetic patients who underwent off-pump CABG surgery. Method(s):
Medline, Scopus, Proquest, Embase, Web of Science, and Google scholar were
searched until September 10, 2021. The effect sizes including
unstandardized mean difference and odds ratio with 95% confidence interval
were calculated using "Metan" package. The Cochran's Q-test and
I2 statistic were used to assess heterogeneity, a
random-effects model was applied to estimate the pooled effect sizes, and
meta-regression was used to investigate the factors affecting
heterogeneity between studies. Result(s): 10 studies with 6200 sample
sizes were included in the study. In groups with diabetes, Summary odds
ratio (SOR) and 95% confidence interval of infection was 2.18 more than
non-diabetic groups. Also, odds renal complication was 1.74 more than
non-diabetic groups, and the odds cardiovascular complication in groups
with diabetes was 1.30 more than non-diabetics. There were no differences
in mortality, neurologic, respiratory and surgical complications between
groups with diabetes and non-diabetics. Based on meta-regression results,
age (Coefficient: 0.942; p = 0.009) had a significant direct relationship
and sample size (Coefficient: 0.001; p = 0.009) had an indirect
significant relationship with heterogeneity of neurologic outcomes. There
was no significant publication bias in our results. Conclusion(s):
Our study revealed that off-pump CABG led to some significant outcomes in
patients with diabetes compared to non-diabetics. Renal and infection
complications were higher in patients with diabetes but no significant
differences were seen in most of other postoperative outcomes between the
two groups. Copyright © 2022

<20>
Accession Number
2020853388
Title
A meta-analysis of pharmacological treatments for preventing acute renal
injury after juvenile heart surgery.
Source
Progress in Pediatric Cardiology. 67 (no pagination), 2022. Article
Number: 101573. Date of Publication: December 2022.
Author
Saeed H.; Abdelrahim M.E.A.
Institution
(Saeed, Abdelrahim) Clinical Pharmacy Department, Faculty of Pharmacy,
Beni-Suef University, Beni-Suef, Egypt
Publisher
Elsevier Ireland Ltd
Abstract
Background: Children who have had heart surgery frequently develop an
acute renal injury, which complicates postoperative care and is associated
with a high mortality rate. Several pharmacological interventions are
introduced for preventing postoperative renal dysfunction. Aim of review:
The current meta-analysis aims to evaluate the effectiveness of
pharmacological interventions in preventing postoperative renal
dysfunction after congenital heart surgery in pediatric subjects. Key
scientific concepts of review: A systematic literature search up to July
2021 was performed and 20 studies included 2612 subjects with congenital
heart surgery at the start of the study; 1527 of them were administered
pharmacological interventions and 1070 were placebo. The odds ratio (OR)
with 95 % confidence intervals (CIs) was calculated to assess the effects
of pharmacological interventions compared to placebo on preventing
postoperative renal dysfunction after congenital heart surgery in
pediatric subjects using the dichotomous method with a random or
fixed-effect model. Pharmacological interventions had significantly lower
postoperative renal dysfunction after congenital heart surgery in
pediatric subjects when using dexmedetomidine (OR, 0.44; 95 % CI,
0.28-0.68, p < 0.001), and compared to placebo. However, pharmacological
interventions had no significant effect on postoperative renal dysfunction
after congenital heart surgery in pediatric subjects when using
corticosteroids (OR, 0.86; 95 % CI, 0.60-1.25, p = 0.44), fenoldopam (OR,
0.47; 95 % CI, 0.22-1.02, p = 0.06), and aminophylline (OR, 0.72; 95 % CI,
0.22-2.33, p = 0.58) compared to placebo. Dexmedetomidine may reduce
postoperative renal impairment after congenital heart surgery in children
compared to placebo. Pediatric corticosteroids, fenoldopam, and
aminophylline did not affect postoperative renal impairment after
congenital heart surgery compared to placebo. Additional research is
needed to confirm these results. Copyright © 2022 Elsevier B.V.

<21>
Accession Number
2020851619
Title
Comparison of subcutaneous analgesic system and epidural analgesia for
postoperative pain control in open pediatric oncology operations: A
randomized controlled trial.
Source
Journal of Pediatric Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Mehl S.C.; Johnson B.; Patel N.; Todd H.; Vasudevan S.; Nuchtern J.;
Naik-Mathuria B.
Institution
(Mehl, Todd, Vasudevan, Nuchtern, Naik-Mathuria) Michael E DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX, United
States
(Mehl, Johnson, Vasudevan, Nuchtern, Naik-Mathuria) Department of Surgery,
Division of Pediatric Surgery, Texas Children's Hospital, Houston, TX,
United States
(Patel) Department of Pediatric Anesthesiology, Perioperative and Pain
Medicine, Texas Children's Hospital, Houston, TX, United States
Publisher
W.B. Saunders
Abstract
Purpose: Children undergoing open oncologic surgery can have significant
post-operative pain. The purpose of this trial was to compare a
surgeon-placed subcutaneous analgesic system (SAS) to epidural analgesia.
 Method(s): Single center randomized controlled trial including
children <=18 years undergoing open tumor resection between October 2018
and April 2021. Randomization to SAS or epidural was done preoperatively
and perioperative pain management was standardized. Families were blinded
to the modality. Comparisons of oral morphine equivalents (OME) and pain
scores for three postoperative days, clinical outcome parameters, and
parental satisfaction following unblinding were completed using
non-parametric analyses. Result(s): Of 36 patients (SAS 18, Epidural
18), median age was 5 years (range <1-17). The Epidural cohort had less
OME demand on postoperative day one (SAS 0.76 mg/kg, Epidural 0.11 mg/kg;
p<0.01) and two (SAS 0.48 mg/kg, Epidural 0.07 mg/kg, p = 0.03). Pain
scores were similar on postoperative days 1-3 (0-2 in both groups). The
Epidural cohort had more device complications (SAS 11%, Epidural 50%; p =
0.03) and higher urinary catheter use (SAS 50%, Epidural 89%; p = 0.03).
More than 80% of parents would use the same device in the future (SAS
100%, Epidural 84%, p = 0.23). Conclusion(s): For children undergoing
open oncologic abdominal or thoracic surgery, early post-operative pain
control appears to be better with epidural analgesia; however, SAS has
decreased incidence of device complications and urinary catheter use.
Parental satisfaction is excellent with both modalities. SAS could be
considered as an alternative to epidural, especially in settings when
epidural placement is not available or contraindicated. Type of
Study: Treatment study, Randomized controlled trial. Level of
Evidence: Level 1. Copyright © 2022

<22>
Accession Number
2020808315
Title
Cardiac Autonomic Neuropathy in Type 1 and 2 Diabetes: Epidemiology,
Pathophysiology, and Management.
Source
Clinical Therapeutics. (no pagination), 2022. Date of Publication: 2022.
Author
Williams S.; Raheim S.A.; Khan M.I.; Rubab U.; Kanagala P.; Zhao S.S.;
Marshall A.; Brown E.; Alam U.
Institution
(Williams, Raheim, Khan, Rubab, Kanagala, Brown, Alam) Department of
Medicine, Aintree University Hospital, Liverpool University Hospitals NHS
Foundation Trust, Liverpool, United Kingdom
(Kanagala, Zhao, Marshall, Brown, Alam) Department of Eye & Vision
Sciences, Institute of Life Course and Medical Sciences, University of
Liverpool, Liverpool, United Kingdom
(Zhao) Centre for Epidemiology Versus Arthritis, Division of
Musculoskeletal and Dermatological Sciences, School of Biological
Sciences, Faculty of Biology Medicine and Health, Manchester Academic
Health Science Centre, University of Manchester, Manchester, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Purpose: Cardiac autonomic neuropathy (CAN) is a serious complication of
type 1 and type 2 diabetes and is independently associated with major
cardiovascular events, morbidity, and mortality. This narrative review
examines the epidemiology, pathophysiology, and management and identifies
areas of future research to address the challenge posed by CAN.
 Method(s): We conducted a comprehensive literature search using a
range of sources, including the electronic databases PubMed Central,
Google Scholar, OVID, and Open Athens, to search for studies on CAN,
diabetes mellitus, lifestyle intervention, and cardiovascular risk. We set
inclusion criteria to consider review articles or original research
published in peer-reviewed journals that examined CAN in diabetes.
 Finding(s): Epidemiologic data indicate a varied prevalence of CAN in
type 1 and 2 diabetes, with prevalences of 17% to 73%) depending on
clinical and demographic factors. Indeed, duration of diabetes and
hyperglycemia are the strongest risk factors for CAN development in type 1
diabetes. However, in type 2 diabetes, multifactorial risk factors,
including obesity, hypertension, and hyperlipidemia, are associated with
the development of CAN. Insulin resistance, which underpins type 2
diabetes and metabolic syndrome, has a direct role in the pathogenesis of
CAN. Lifestyle interventions, including dietary measures and tailored
exercise programs, have been beneficial in improving cardiac autonomic
function primarily measured through heart rate variability. In addition,
weight loss through bariatric surgery also improves heart rate variability
and may prevent or reduce CAN progression in people living with obesity
and concomitant type 2 diabetes. For optimization in type 2 diabetes, both
lifestyle and targeted pharmacologic interventions are required to achieve
glycemic/metabolic targets, and weight loss is required to prevent or
reverse early CAN or prevent the progression to definite and severe CAN.
Implications: The focused use of diagnostic testing for CAN, including
cardiac autonomic reflex testing in those at high risk of CAN, will enable
earlier diagnosis. This testing will allow timely interventions at a
reversible stage. Future research should examine targeted early diagnostic
testing with subsequent intervention with a combination of lifestyle
measures and newer pharmacotherapeutics (eg, sodium-glucose cotransporter
2 inhibitors and glucagon-like peptide 1 receptor agonists), which have
produced significant cardiovascular benefit in diabetes. (Clin Ther.
2022;XX:XXX-XXX) © 2022 Elsevier HS Journals, Inc.

<23>
Accession Number
2020808294
Title
Long-term consequences of acute kidney injury after pediatric cardiac
surgery: A systematic review.
Source
Journal of Pediatrics. (no pagination), 2022. Date of Publication: 2022.
Author
Van den Eynde J.; Rotbi H.; Schuermans A.; Hassanabad A.F.; Gewillig M.;
Budts W.; Kutty S.; Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, MA
(Van den Eynde, Schuermans, Gewillig, Budts) Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Rotbi) Faculty of Medicine, Radboud University, Nijmegen, Netherlands
(Rotbi) Radboud Institute for Health Sciences, Department of Physiology,
Radboud University Medical Center, Nijmegen, Netherlands
(Hassanabad) Section of Cardiac Surgery, Department of Cardiac Sciences,
Libin Cardiovascular Institute, Cumming School of Medicine, Calgary, AB,
Canada
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Budts) Congenital and Structural Cardiology, UZ Leuven, Leuven, Belgium
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
Elsevier Inc.
Abstract
Objective: The objective of this study was to evaluate the available data
on long-term kidney dysfunction, hypertension, and mortality after cardiac
surgery-associated acute kidney injury (AKI) in the pediatric population.
Study design: PubMed/MEDLINE, Embase, Scopus, and reference lists of
relevant articles were searched for eligible studies published from
inception through March 2022. Long-term outcomes after pediatric cardiac
surgery complicated by AKI and those without were investigated.
 Result(s): We identified 14 studies published between 2013 and 2022
that included a total of 6701 patients (AKI: 1376 patients; no AKI: 5325
patients). These studies used different well-established classifications
to define AKI. All the studies suggested that AKI after heart surgery is
common in the pediatric patient population and reported a potential link
between cardiac surgery-associated AKI and important clinical outcomes.
However, only 4 out of 11 studies found a strong association between
(absence of recovery from) cardiac surgery-associated AKI and risk of
developing chronic kidney disease, and 3 out of 5 studies found a
significant increase in mortality rates for pediatric patients who
developed AKI after cardiac surgery. Only 1 out of 4 studies found an
association between AKI and hypertension at 12 months postoperatively, but
found no association at later follow-up times. Conclusion(s):
Although there is a trend, evidence on the long-term consequences of
cardiac surgery-associated AKI in the pediatric population is mixed.
Genetic syndromes, preexisting kidney disease, univentricular or cyanotic
heart conditions, and/or high-complexity surgery may be more important for
the development of kidney dysfunction by adolescence and early adulthood.
Regardless, these children may benefit from a long-term kidney
follow-up. Copyright © 2022 Elsevier Inc.

<24>
Accession Number
639328848
Title
Revascularization strategies versus optimal medical therapy in chronic
coronary syndrome: A network meta-analysis.
Source
International journal of cardiology. (no pagination), 2022. Date of
Publication: 17 Oct 2022.
Author
Galli M.; Benenati S.; Zito A.; Capodanno D.; Zoccai G.B.; Ortega-Paz L.;
Iaconelli A.; D'Amario D.; Porto I.; Burzotta F.; Trani C.; De Caterina
R.; Gaudino M.; Escaned J.; Angiolillo D.J.; Crea F.
Institution
(Galli) Catholic University of the Sacred Heart, Rome, Italy; Maria
Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Benenati) Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San
Martino, IRCCS Italian Cardiology Network, Genova, Italy
(Zito, Iaconelli, D'Amario) Department of Cardiovascular and Thoracic
Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Rome, Italy
(Capodanno) Division of Cardiology, Azienda Ospedaliero Universitaria
Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
(Zoccai) Department of Medical-Surgical Sciences and Biotechnologies,
Sapienza University, Latina, Rome, Italy; Mediterranea Cardiocentro,
Napoli, Italy
(Ortega-Paz, Angiolillo) Division of Cardiology, University of Florida
College of Medicine, Jacksonville, FL, United States
(Porto) Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San
Martino, IRCCS Italian Cardiology Network, Genova, Italy; Cardiovascular
Disease Chair, Department of Internal Medicine (Di.M.I.), University of
Genoa, Genoa, Italy
(Burzotta, Trani, Crea) Catholic University of the Sacred Heart, Rome,
Italy; Department of Cardiovascular and Thoracic Sciences, Fondazione
Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
(De Caterina) University of Pisa and University Cardiology Division, Pisa
University Hospital, Pisa, Italy; Fondazione VillaSerena per la Ricerca,
Citta Sant'Angelo, Pescara, Italy
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York City, NY, United States
(Escaned) Hospital Clinico San Carlos IDISSC, Complutense University,
Madrid, Spain
Publisher
NLM (Medline)
Abstract
BACKGROUND: The impact of myocardial revascularization on outcomes and
prognosis in patients with chronic coronary syndrome (CCS) without left
main (LM) disease or reduced left ventricle ejection fraction (LVEF) may
be influenced by the revascularization strategy adopted. METHOD(S):
We performed a network meta-analysis including 18 randomized controlled
trials comparing different revascularization strategies, including
angiography-guided percutaneous coronary intervention (PCI),
physiology-guided PCI and coronary artery bypass graft (CABG), in patients
with CCS without LM disease or reduced LVEF. RESULT(S): Compared with
medical therapy, all revascularization strategies were associated with a
reduction of the primary endpoint, as defined in each trial, the extent of
which was modest with angiography-guided PCI (IRR 0.86, 95% CI 0.75-0.99)
and greater with physiology-guided PCI (IRR 0.60, 95% CI 0.47-0.77) and
CABG (IRR 0.58, 95% CI 0.48-0.70). Moreover, angiography-guided PCI was
associated with an increase of the primary endpoint compared to
physiology-guided PCI (IRR 1.43, 95% CI 1.14-1.79) and CABG (IRR 1.49, 95%
CI 1.27-1.74). CABG was the only strategy associated with reduced
myocardial infarction (IRR 0.68, 95% CI 0.52-0.90), cardiovascular death
(IRR 0.76, 95% CI 0.64-0.89), and all-cause death (IRR 0.87, 95% CI
0.77-0.99), but increased stroke (IRR 1.69, 95% CI 1.04-2.76).
 CONCLUSION(S): In CCS patients without LM disease or reduced LVEF,
physiology-guided PCI and CABG are associated with better outcomes than
angiography-guided PCI. Compared with medical therapy, CABG is the only
revascularization strategy associated with a reduction of myocardial
infarction and death rates, at the cost of higher risk of stroke. STUDY
REGISTRATION: This study is registered in PROSPERO
(CRD42022313612). Copyright © 2022. Published by Elsevier B.V.

<25>
Accession Number
639319255
Title
The Impact of Gut Microbiome Constitution to reduce Cardiovascular Disease
Risk: A Systematic Review And Meta-Analysis.
Source
Current problems in cardiology. (pp 101459), 2022. Date of Publication:
16 Oct 2022.
Author
Hassan D.; Zahra T.; Kanaan G.; Khan M.U.; Mushtaq K.; Nashwan A.J.; Hamid
P.F.
Institution
(Hassan) Department of Healthcare Profession ((DHP), Ministry of Public
Health, Qatar
(Zahra) California Institute of Behavioral Neurosciences and Psychology,
United States
(Kanaan) ECPE, Harvard TH Chan School of Public Health, United States
(Khan) Department of Gastroenterology, South Warwickshire NHS Foundation
Trust
(Mushtaq) Department of Gastroenterology Southampton NHS Foundation Trust
(Nashwan) Department of Statistics, American University in Cairo, United
States
(Hamid) Department of Pediatrics, Allied Hospital, Faisalabad, Pakistan
Publisher
NLM (Medline)
Abstract
Gut microbiome has effective impact on health including cardiovascular
issues that reduces complications. As per different studies, self-help
management and medical service upgradation is impactful for securing
public life from different complications. Through systematic review this
article followed the process of RevMan analysis and database of PubMed,
google scholar is used to collect valuable articles. Through CASP,
Newcastle-Ottawa questionnaire and AMSTAR questionnaire the quality of
different research articles are assessed. Initially, 50 articles are
collected and through inclusion and exclusion criteria 11 articles are
sorted which directly connects the topic. Results supports that quality
information regarding personal health and food hygiene can improve the
operational facilities of heart and improve lifestyle can reduce the scope
of cardiovascular issues. Lack of data inclusion from 50 articles and time
creates specific barriers that might not satisfy readers and
researchers. Copyright © 2022. Published by Elsevier Inc.

<26>
Accession Number
2019626523
Title
Impact on clinical outcomes from transcatheter closure of the Fontan
fenestration: A systematic review and meta-analysis.
Source
Frontiers in Pediatrics. 10 (no pagination), 2022. Article Number: 915045.
Date of Publication: 04 Oct 2022.
Author
Greenleaf C.E.; Lim Z.N.; Li W.; LaPar D.J.; Salazar J.D.; Corno A.F.
Institution
(Greenleaf, LaPar, Salazar, Corno) Pediatric and Congenital Cardiac
Surgery, Children's Heart Institute, Memorial Hermann Children's Hospital,
UTHealth, McGovern Medical School, Houston, TX, United States
(Lim) University College of London (UCL) Great Ormond Street Institute of
Child Health, University College London, London, United Kingdom
(Li) Division of Clinical and Translational Sciences, Department of
Internal Medicine, UTHealth, McGovern Medical School, Houston, TX, United
States
Publisher
Frontiers Media S.A.
Abstract
Background: Meta-analysis of the impact on clinical outcome from
transcatheter closure of Fontan fenestration. Method(s): Cochrane,
Embase, MEDLINE, and Open-Gray were searched. Parameters such as changes
in oxygen saturation, cavo-pulmonary pressure, maximum heart rate during
exercise, exercise duration, and oxygen saturation after fenestration
closure were pooled and statistical analysis performed. Result(s):
Among 922 publications, 12 retrospective observational studies were
included. The included studies involved 610 patients, of which 552
patients (90.5%) had a fenestration. Of those patients, 505 patients
(91.5%) underwent attempt at trans-catheter closure. When it could be
estimated, the pooled overall mean age at trans-catheter fenestration
closure was 6.6 +/- 7.4 years, and the mean follow-up time was 34.4 +/-
10.7 months. There were 32 minor (6.3%) and 20 major (4.0%) complications
during or after trans-catheter Fontan fenestration closure. The forest
plots demonstrate that following fenestration closure, there was a
significant increase in the mean arterial oxygen saturation of 7.9% (95%
CI 6.4-9.4%, p < 0.01). There was also a significant increase in the mean
cavo-pulmonary pressure of 1.4 mmHg (95% CI 1.0-1.8 mmHg, p < 0.01)
following fenestration closure. The exercise parameters reported in 3
studies also favored closing the fenestration as well, yet the exercise
duration increase of 1.7 min (95% CI 0.7-2.8 min, p < 0.01) after
fenestration closure is probably clinically insignificant.
 Conclusion(s): Late closure of a Fontan fenestration has the impact
of improving resting oxygen saturation, exercise oxygen saturation, and a
modest improvement of exercise duration. These clinical benefits, however,
may be at the expense of tolerating slightly higher cavo-pulmonary mean
pressures. Copyright © 2022 Greenleaf, Lim, Li, LaPar, Salazar
and Corno.

<27>
Accession Number
2019169385
Title
Prognostic Value of Global Longitudinal Strain in Asymptomatic Aortic
Stenosis: A Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 778027. Date of Publication: 18 Feb 2022.
Author
Wang Y.; Zhang M.; Chen H.; Li H.
Institution
(Wang, Zhang, Chen, Li) Affiliated Beijing Friendship Hospital, Capital
Medical University, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Backgrounds: The presence of impaired global longitudinal strain (GLS) may
be a valuable bio-marker in the early diagnosis for left ventricle (LV)
impairment, which would help scrutinize asymptomatic aortic stenosis (AS)
patients with high risk of adverse outcomes, such as major adverse
cardiovascular events (MACE). Method(s): The study was prospectively
registered in PROPSERO (CRD 42021223472). Databases, such as Pubmed,
Embase, Cochrane Library, Web of science, and Scopus were searched for
studies evaluating the impact of impaired GLS on MACE, all-cause
mortality, and aortic valve replacement (AVR) in asymptomatic AS. Hazard
ratios (HRs) with 95% CIs were calculated with meta-analysis for binary
variants. Meta-regression, subgroup analysis, and sensitivity analyses
were applied as needed to explore the heterogeneity. Result(s):
Eventually, a total of nine studies reporting 1,512 patients were
enrolled. Compared with the normal GLS group, impaired GLS significantly
increased MACE (HR = 1.20, 95% CI: 1.10-1.30, I2 = 79%) with
evident heterogeneity, all-cause mortality (HR = 1.42, 95% CI: 1.24-1.63),
and AVR (HR = 1.17, 95% CI: 1.07-1.28). Subgroup analyses stratified by
left ventricular ejection fraction (LVEF) > 50% or LVEF without precise
cut-off point found that compared with the normal GLS group, impaired GLS
remarkably increased MACE both in two subgroups (LVEF > 50%: HR: 1.22, 95%
CI: 1.05-1.50; LVEF without cutpoint: HR: 1.25, 95% CI: 1.05-1.50). The
results stratified by AS severity (mild/moderate and severe) or follow-up
time resembled those stratified by LVEF. In addition, when subgroup
analysis was stratified by mean aortic valve pressure gradient (MG >= 40
mm Hg and MG <40 mm Hg), compared with normal GLS, impaired GLS
significantly increased MACE both in two subgroups (MG >= 40 mm Hg: HR:
3.41, 95% CI: 1.64-7.09; MG below 40 mm Hg: HR: 3.17, 95% CI: 1.87-5.38).
Moreover, the effect sizes here were substantially higher than those in
the former two stratified factors. Conclusion(s): The presence of
impaired GLS substantially worsens the outcomes for adverse cardiovascular
events in asymptomatic patients with AS regardless of LVEF or AS severity
or follow-up time or mean aortic valve pressure gradient, which highlights
the importance of incorporating impaired GLS into risk algorithms in
asymptomatic AS. Systematic Review Registration: PROSPERO (registration
number: CRD42021223472). Copyright © 2022 Wang, Zhang, Chen and
Li.

<28>
Accession Number
2019167642
Title
Outcomes after right ventricular outflow tract reconstruction with valve
substitutes: A systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 897946. Date of Publication: 07 Sep 2022.
Author
Wang X.; Bakhuis W.; Veen K.M.; Bogers A.J.J.C.; Etnel J.R.G.; van Der Ven
C.C.E.M.; Roos-Hesselink J.W.; Andrinopoulou E.-R.; Takkenberg J.J.M.
Institution
(Wang, Bakhuis, Veen, Bogers, Etnel, van Der Ven, Takkenberg) Department
of Cardiothoracic Surgery, Erasmus Medical Center, University Medical
Center Rotterdam, Rotterdam, Netherlands
(Roos-Hesselink) Department of Cardiology, Erasmus Medical Center,
University Medical Center Rotterdam, Rotterdam, Netherlands
(Andrinopoulou) Department of Biostatistics, Erasmus Medical Center,
University Medical Center Rotterdam, Rotterdam, Netherlands
(Andrinopoulou) Department of Epidemiology, Erasmus Medical Center,
University Medical Center Rotterdam, Rotterdam, Netherlands
Publisher
Frontiers Media S.A.
Abstract
Introduction: This study aims to provide an overview of outcomes after
right ventricular outflow tract (RVOT) reconstruction using different
valve substitutes in different age groups for different indications.
 Method(s): The literature was systematically searched for articles
published between January 2000 and June 2021 reporting on clinical and/or
echocardiographic outcomes after RVOT reconstruction with valve
substitutes. A random-effects meta-analysis was conducted for outcomes,
and time-related outcomes were visualized by pooled Kaplan-Meier curves.
Subgroup analyses were performed according to etiology, implanted valve
substitute and patient age. Result(s): Two hundred and seventeen
articles were included, comprising 37,078 patients (age: 22.86 +/- 11.29
years; 31.6% female) and 240,581 patient-years of follow-up. Aortic valve
disease (Ross procedure, 46.6%) and Tetralogy of Fallot (TOF, 27.0%) were
the two main underlying etiologies. Homograft and xenograft accounted for
83.7 and 32.6% of the overall valve substitutes, respectively. The early
mortality, late mortality, reintervention and endocarditis rates were
3.36% (2.91-3.88), 0.72%/y (95% CI: 0.62-0.82), 2.62%/y (95% CI:
2.28-3.00), and 0.38%/y (95%CI: 0.31-0.47) for all patients. The early
mortality for TOF and truncus arteriosus (TA) were 1.95% (1.31-2.90) and
10.67% (7.79-14.61). Pooled late mortality and reintervention rate were
0.59%/y (0.39-0.89), 1.41%/y (0.87-2.27), and 1.20%/y (0.74-1.94),
10.15%/y (7.42-13.90) for TOF and TA, respectively. Endocarditis rate was
0.21%/y (95% CI: 0.16-0.27) for a homograft substitute and 0.80%/y (95%CI:
0.60-1.09) for a xenograft substitute. Reintervention rate for infants,
children and adults was 8.80%/y (95% CI: 6.49-11.95), 4.75%/y (95% CI:
3.67-6.14), and 0.72%/y (95% CI: 0.36-1.42), respectively.
 Conclusion(s): This study shows RVOT reconstruction with valve
substitutes can be performed with acceptable mortality and morbidity rates
for most patients. Reinterventions after RVOT reconstruction with valve
substitutes are inevitable for most patients in their life-time,
emphasizing the necessity of life-long follow-up and multidisciplinary
care. Follow-up protocols should be tailored to individual patients
because patients with different etiologies, ages, and implanted valve
substitutes have different rates of mortality and morbidity. Systematic
review registration: [www.crd.york.ac.uk/prospero], identifier
[CRD42021271622]. Copyright © 2022 Wang, Bakhuis, Veen, Bogers,
Etnel, van Der Ven, Roos-Hesselink, Andrinopoulou and Takkenberg.

<29>
Accession Number
2018328344
Title
Surgical versus catheter ablation in atrial fibrillation: A systematic
review and meta-analysis of randomized controlled trials.
Source
Journal of Cardiovascular Electrophysiology. 33(10) (pp 2152-2163), 2022.
Date of Publication: October 2022.
Author
Rattanawong P.; Kanitsoraphan C.; Kewcharoen J.; Sriramoju A.; Shanbhag
A.; Ko Ko N.L.; Barry T.; Vutthikraivit W.; Shen W.-K.
Institution
(Rattanawong, Sriramoju, Shanbhag, Ko Ko, Barry, Shen) Department of
Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, United States
(Rattanawong) Faculty of Medicine Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand
(Kanitsoraphan) University of Hawaii Internal Medicine Residency Program,
Honolulu, HI, United States
(Kewcharoen) Department of Medicine, Division of Cardiology, Loma Linda
University Medical Center, Loma Linda, CA, United States
(Vutthikraivit) Division of Cardiovascular Medicine, University of Iowa
Hospitals and Clinics, Iowa City, IA, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Atrial fibrillation (AF) is the most common cardiac
arrhythmia with a high stroke and mortality rate. The video-assisted
thoracoscopic radiofrequency pulmonary vein ablation is a treatment option
for patients who fail catheter ablation. Randomized data comparing
surgical versus catheter ablation are limited. We performed a
meta-analysis of randomized control trials to explore the outcome efficacy
between surgical and catheter radiofrequency pulmonary vein ablation in
patients with AF. Method(s): We comprehensively searched the
databases of MEDLINE and EMBASE from inception to December 2020. Included
studies were published randomized control trials that compared
video-assisted thoracoscopic and catheter radiofrequency pulmonary vein
ablation. Data from each study were combined using the fixed-effects,
generic inverse variance method of DerSimonian, and Laird to calculate
odds ratios and 95% confidence intervals. Result(s): Six studies from
November 2013 to 2020 were included in this meta-analysis involving 511 AF
patients (79% paroxysmal) with 263 catheter ablation (mean age 56 +/- 3
years) and 248 surgical ablations (mean age 52 +/- 4 years). Catheter
ablation was associated with increased atrial arrhythmias recurrence when
compared to surgical ablation (pooled relative risk = 1.85, 95% confidence
interval: 1.44-2.39, p <.001, I2 = 0.0%) but associated with
less total major adverse events (pooled relative risk = 0.29, 95%
confidence interval: 0.16-0.53, p <.001, I2 = 0.0%). In
subgroup analysis, catheter ablation was associated with increased AF
recurrence in refractory paroxysmal AF when compared to surgical ablation
(pooled relative risk = 2.47, 95% confidence interval: 1.31-4.65, p =.005,
I2 = 0.0%) but not in persistent AF (relative risk = 1.09, 95%
confidence interval: 0.60-2.0, p =.773). Conclusion(s): Catheter
ablation was associated with higher atrial arrhythmia recurrence when
compared with surgical ablation. However, our study suggests that the
benefit of surgical ablation in patients with persistent AF is unclear.
More studies and alternative ablation strategies investigation in
persistent AF are warranted. Copyright © 2022 Wiley Periodicals
LLC.

<30>
Accession Number
2016569242
Title
Comparing Single- and Dual-Antiplatelet Therapies After Transcatheter
Aortic Valve Implantation.
Source
Annals of Thoracic Surgery. 114(5) (pp 1951-1964), 2022. Date of
Publication: November 2022.
Author
Chiu H.-T.; Jhou H.-J.; Chen P.-H.; Lee C.-H.; Lin C.-Y.
Institution
(Chiu) Department of Surgery, Tri-Service General Hospital, National
Defense Medical Center, Taiwan, Taipei, Taiwan (Republic of China)
(Jhou) Department of Neurology, Changhua Christian Hospital, Taiwan,
Changhua, Taiwan (Republic of China)
(Jhou) School of Medicine, Kaohsiung Medical University, Taiwan,
Kaohsiung, Taiwan (Republic of China)
(Chen) Department of Internal Medicine, Tri-Service General Hospital,
National Defense Medical Center, Taiwan, Taipei, Taiwan (Republic of
China)
(Lee) Division of Hematology and Oncology Medicine, Department of Internal
Medicine, Tri-Service General Hospital, National Defense Medical Center,
Taiwan, Taipei, Taiwan (Republic of China)
(Lin) Division of Cardiovascular Surgery, Department of Surgery,
Tri-Service General Hospital, National Defense Medical Center, Taiwan,
Taipei, Taiwan (Republic of China)
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve implantation has been an
established treatment in patients with symptomatic severe aortic stenosis.
However, the postoperative antiplatelet regimen after transcatheter aortic
valve implantation has not been established with certainty. This
meta-analysis compared the safety and efficacy of single- antiplatelet
therapies (SAPTs) and dual-antiplatelet therapies (DAPT) in patients
undergoing transcatheter aortic valve implantation. Method(s):
Eligible randomized controlled trials and cohort studies published before
February 2021 were retrieved from PubMed, Embase, and the Cochrane
Library. We calculated odds ratios (ORs) with 95% CIs. Result(s):
Nine articles, involving 19 277 patients, met the selection criteria. In
the short-term outcome, compared with SAPT, DAPT was associated with a
significantly higher rate of bleeding (OR, 3.00; 95% CI, 1.67-5.38) and
showed no significant differences in thrombotic events (OR, 1.25; 95% CI,
0.74-2.11) and all-cause mortality (OR, 0.84; 95% CI, 0.42-1.69). In the
long-term outcome, DAPT was associated with a significantly higher
bleeding rate (OR, 1.85; 95% CI, 1.24-.78) and showed no differences in
thrombotic events (OR, 1.13; 95% CI, 0.86-1.48) and all-cause mortality
(OR, 1.12; 95% CI, 0.95-1.32). Our trial sequential analysis confirmed
DAPT did not confer any benefit for reducing all-cause mortality and
thrombotic events and carried a higher risk of bleeding than SAPT.
 Conclusion(s): SAPT should be a sufficient antiplatelet strategy in
patients after transcatheter aortic valve implantation who do not have
indications for oral anticoagulation medication, especially in the
long-term follow-up period. Copyright © 2022 The Society of
Thoracic Surgeons

<31>
Accession Number
2015502851
Title
Intraarterial papaverine for relief of catheter-induced peripheral
arterial vasospasm during pediatric cardiac surgery: A randomized
double-blind controlled trial.
Source
Paediatric Anaesthesia. 32(6) (pp 764-771), 2022. Date of Publication:
June 2022.
Author
Gautam N.K.; Griffin E.; Hubbard R.; Pawelek O.; Edmonds K.; Rydalch E.;
Zhang X.; Sharma S.; Hoffmann C.
Institution
(Gautam, Griffin, Hubbard, Pawelek, Edmonds, Rydalch, Zhang, Hoffmann)
Department of Anesthesiology, McGovern Medical School, UT Health Houston,
Houston, TX, United States
(Sharma) Mayo Clinic, Scottsdale, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Maintaining the patency of peripheral arterial lines in
pediatric patients during surgery can be challenging due to multiple
factors, and catheter-related arterial vasospasm is a potentially
modifiable cause. Papaverine, a potent vasodilator, improves arterial line
patency when used as a continuous infusion in the pediatric intensive care
setting, but this method is not convenient during surgery. Aim(s):
Extrapolating from the benefit seen in the intensive care unit, the
authors hypothesize that a small-volume intraarterial bolus of papaverine
immediately after arterial line placement will reduce vasospasm-related
arterial line malfunction. Method(s): This was a prospective,
randomized, double-blind study. Patients less than 17 years of age
undergoing cardiac surgery were enrolled. Patients were randomized into
the heparin or papaverine groups. Immediately after arterial line
insertion, an intraarterial bolus of heparin (2 units/ml, 1 ml) or
papaverine (0.12 mg/ml, 1 ml) was administered (T1, Figure 1). An optimal
waveform was defined as the ease of aspirating a standardized blood sample
within 30 s, absence of cavitation when sampling, absence of color change
at the catheter site during injection, and presence of a dicrotic notch.
The primary outcome evaluated was the presence of an optimal arterial
waveform at 5 min after the first randomized dose (T1 + 5 min). The
secondary outcomes were the presence of optimal arterial waveform an hour
after the first dose and the ability of papaverine to rescue suboptimal
waveforms. Result(s): A total of 100 patients were enrolled in the
study. Twelve patients were excluded from the analysis. Complete datasets
after randomization were available in 88 patients (heparin group, n = 46;
papaverine group, n = 42). At baseline, groups were similar for age,
weight, arterial vessel size, and arterial line patency. At T1 + 5 min, an
improvement in the waveform characteristics was observed in the papaverine
group (heparin,39% [8/46] vs. papaverine, 64% [27/42]; p =.02; odds ratio,
2.8; 95% CI, 1.2 to 6.6, Figure 3, Table 2). At the end of 1 h, both
groups showed continued improvement in arterial line patency. After the
second dose, a higher number of patients in the heparin group had
suboptimal waveforms and were treated with papaverine (heparin,37% [17/46]
vs. papaverine,17% [7/42], p =.05). Patients in the heparin group treated
with papaverine showed significant improvement in patency (13/17 vs. 3/7,
p =.01). No serious adverse events were reported. Conclusion(s): In
pediatric patients, papaverine injection immediately after peripheral
arterial catheter placement was associated with relief of vasospasm and
improved initial arterial line patency. Further, papaverine can be used as
a rescue to improve and maintain arterial line patency. Copyright
© 2022 John Wiley & Sons Ltd.

<32>
[Use Link to view the full text]
Accession Number
2020805715
Title
Comparison of regional cerebral oxygen saturation during one-lung
ventilation under desflurane or propofol anesthesia: A randomized trial.
Source
Medicine (United States). 101(41) (pp E30030), 2022. Date of Publication:
14 Oct 2022.
Author
Hayashi K.; Yamada Y.; Ishihara T.; Tanabe K.; Iida H.
Institution
(Hayashi, Yamada, Tanabe, Iida) Department of Anesthesiology and Pain
Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
(Ishihara) Innovative and Clinical Research Promotion Center, Gifu
University Hospital, Gifu, Japan
(Iida) Anesthesiology and Pain Relief Center, Central Japan Medical
Center, Minokamo, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Background: During one-lung ventilation (OLV), deterioration of pulmonary
oxygenation reduces arterial oxygen saturation and cerebral oxygen
saturation (rSO2). However, oxidative stress during OLV causes lung
injury, so the fraction of inspiratory oxygen (FiO2) should be kept as low
as possible. We investigated the changes in rSO2 under propofol or
desflurane anesthesia while percutaneous oxygen saturation (SpO2) was kept
as low as possible during OLV. Method(s): Thirty-six patients
scheduled for thoracic surgery under OLV in the lateral decubitus position
were randomly assigned to propofol (n = 19) or desflurane (n = 17)
anesthesia. FiO2 was set to 0.4 at the start of surgery under two-lung
ventilation (measurement point: T3) and then adjusted to maintain an SpO2
of 92% to 94% after the initiation of OLV. The primary outcome was the
difference in the absolute value of the decrease in rSO2 from T3 to 30
minutes after the initiation of OLV (T5), which was analyzed by an
analysis of covariance adjusted for the rSO2 value at T3. Result(s):
The mean rSO2 values were 61.5% +/- 5.1% at T3 and 57.1% +/- 5.3% at T5 in
the propofol group and 62.2% +/- 6.0% at T3 and 58.6% +/- 5.3% at T5 in
the desflurane group. The difference in the absolute value of decrease
between groups (propofol group - desflurane group) was 0.95 (95%
confidence interval, [-0.32, 2.2]; P =.152). Conclusion(s): Both
propofol and desflurane anesthesia maintain comparable cerebral
oxygenation and can be used safely, even when the SpO2 is kept as low as
possible during OLV. Copyright © 2022 the Author(s). Published
by Wolters Kluwer Health, Inc.

<33>
[Use Link to view the full text]
Accession Number
2020805678
Title
The effectiveness of massage interventions on procedural pain in neonates:
A systematic review and meta-analysis.
Source
Medicine (United States). 101(41) (pp E30939), 2022. Date of Publication:
14 Oct 2022.
Author
Liu J.; Fang S.; Wang Y.; Gao L.; Xin T.; Liu Y.
Institution
(Liu, Gao, Xin, Liu) School of Nursing, Weifang Medical University,
Weifang, China
(Fang) Weifang People's Hospital, Weifang Medical University, Weifang,
China
(Wang) Weifang Maternal and Child Health Hospital, Weifang, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The painful procedures experienced by neonates during
hospitalization have short-term or long-term effects on neonates. While
the limitations of previous interventions make it imperative to explore
effective interventions that are readily available. This systematic review
and meta-analysis was conducted to evaluate the safety and effectiveness
of massage for pain management in neonates. Method(s): This
systematic review was registered in PROSPER. PubMed, Embase, Cochrane
Library, and the Clinical Trials Registry were searched to December 2021.
Two reviewers independently carried out study selection, data extraction,
bias risk assessment. Continuous data were analyzed by mean differences
(MD). Dichotomous data were reported using relative risk. If at least two
studies reported identical results by the same pain assessment tool, a
meta-analysis was conducted using random effect model and inverse
variance. Result(s): Total 11 included studies involving 755 neonates
investigated the effects of massage on neonatal pain response compared to
standard care. The meta-analysis showed that massage could effectively
improve pain response in neonates compared to standard care no matter
whether neonatal infant pain scale (NIPS) or premature infant pain profile
(PIPP) was used as an assessment tool. Besides, massage was also effective
for crying duration, blood oxygen saturation both during and after the
procedure, but non-effective for the variation of respiratory rate after
the procedure, and heart rate both during and after the procedure.
 Conclusion(s): Massage may have a positive effect on pain relief of
neonate, and rigorous trials are needed in the future to determine the
most effective massage method. Copyright © 2022 the Author(s).
Published by Wolters Kluwer Health, Inc.

<34>
Accession Number
637699379
Title
The role of duloxetine in reducing opioid consumption after thoracotomy: a
prospective, randomized, double-blinded, placebo-controlled pilot trial.
Source
Minerva anestesiologica. 88(10) (pp 780-788), 2022. Date of Publication:
01 Oct 2022.
Author
Abdelghafar E.M.; Othman A.H.; Elrawas M.M.; Kilany A.M.; Shaker E.H.
Institution
(Abdelghafar, Elrawas) Department of Anesthesia and Pain Management,
National Cancer Institute, Cairo University, Cairo, Egypt
(Othman) Department of Anesthesia, ICU and Pain Relief, South Egypt Cancer
Institute, Assiut University, Egypt
(Kilany) Department of Research on Children with Special Needs, National
Research Center, Cairo, Egypt
(Shaker) Department of Anesthesia and Pain Management, National Cancer
Institute, Cairo University, Cairo, Egypt
Publisher
NLM (Medline)
Abstract
BACKGROUND: Exploration of the thoracic cavity through a thoracotomy
incision for thoracic malignancies is accompanied by severe, excruciating
acute postoperative pain. The objective of this study is to evaluate the
efficacy of perioperative duloxetine when given as part of a multimodal
analgesia in reducing the dose of opioids needed to treat acute
postoperative pain after thoracotomy. METHOD(S): Sixty patients
scheduled for thoracotomy were randomly assigned to one of two treatment
groups. The duloxetine group (D) received duloxetine 60 mg orally two
hours before the surgical procedure and 24 hours after surgery, and the
placebo group (P) received oral equivalent placebo capsules during the
same time schedule. The primary outcome was the postoperative consumption
of narcotics. Secondary outcome measures were assessment of postoperative
pain scores (VAS) during rest, walking and coughing, hemodynamic variables
and development of any side effects. RESULT(S): Total dose of
morphine needed to treat postoperative pain in first 48 hours,
intraoperative isoflurane concentrations, intra- and postoperative
epidural infusion rates all were significantly lower in group D (P<0.001).
Postoperative pain at rest (VAS-R) was significantly less frequent in
group D compared to group P at all-time intervals so as during walking
(VAS-W) (P<0.001). While during cough (VAS-C), it was comparable at all
time point except at 12 hours which was significantly low in group D
(P<0.001). The intra-, postoperative mean blood pressure and development
of side effects were comparable between the two groups.
 CONCLUSION(S): Oral duloxetine used perioperatively during thoracic
surgery may play an important role as multimodal analgesia for acute
postoperative pain without any added side effects.

<35>
Accession Number
2019674472
Title
StOP? II trial: cluster randomized clinical trial to test the
implementation of a toolbox for structured communication in the operating
room-study protocol.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 878. Date of
Publication: December 2022.
Author
Keller S.; Tschan F.; Semmer N.K.; Trelle S.; Manser T.; Beldi G.
Institution
(Keller, Beldi) Department of Visceral Surgery and Medicine, Inselspital,
Bern University Hospital, University of Bern, Bern, Switzerland
(Tschan) Institute for Work and Organizational Psychology, University of
Neuchatel, Neuchatel, Switzerland
(Semmer) Department of Psychology, University of Bern, Bern, Switzerland
(Trelle) CTU Bern, University of Bern, Bern, Switzerland
(Manser) FHNW School of Applied Psychology, University of Applied Sciences
and Arts Northwestern Switzerland, Olten, Switzerland
Publisher
BioMed Central Ltd
Abstract
Background: Surgical care, which is performed by intensely interacting
multidisciplinary teams of surgeons, anesthetists, and nurses, remains
associated with significant morbidity and mortality. Intraoperative
communication has been shown to be associated with surgical outcomes, but
tools ensuring efficient intraoperative communication are lacking. In a
previous study, we developed the StOP?-protocol that fosters structured
intraoperative communication. Before the critical phases of the operation,
the responsible surgeon initiates and leads one or several StOP?s. During
a StOP?, the surgeon informs about the progress of the operation (status),
next steps and proximal goals (objectives), and possible problems
(problems) and encourages all team members to voice their observations and
ask questions (?). In a before-after study performed mainly in visceral
surgery, we found effects of the StOP?-protocol on mortality, length of
hospital stay, and reoperation. We intend to assess the impact of the
StOP?-protocol in a cluster randomized trial, in a wider variety of
surgical specialties (i.e., general, visceral, thoracic, vascular surgery,
surgical urology, and gynecology). The primary hypothesis is that the
consistent use of the StOP?-protocol by the main surgeon reduces patient
mortality within 30 days after the operation. The secondary hypothesis is
that the consistent use of the StOP?-protocol by the main surgeon reduces
unplanned reoperations, length of hospital stay, and unplanned hospital
readmissions. Method(s): This study is designed as a multicenter,
cluster-randomized parallel-group trial. Board-certified surgeons of
participating clinical departments will be randomized 1:1 to the StOP?
intervention group or to the standard of care (control) group. The
intervention group will undergo a training to use the StOP?-protocol and
receive regular feedback on their compliance with the protocol. The
surgeons in the control group will communicate as usual during their
operations. The unit of observation will be operations performed by
cluster surgeons. Consecutive patients will be enrolled over 4 months per
cluster. A total of 400 surgeons will be recruited, and we expect to
collect patient outcome data for 14,000 surgical procedures.
 Discussion(s): The StOP?-protocol was designed as a tool to structure
communication during surgical procedures. Testing its effects on patient
outcomes will contribute to implementing evidenced-based interventions to
reduce surgical complications. Trial registration: ClinicalTrials.gov
NCT05356962. Registered on May 2, 2022. Copyright © 2022, The
Author(s).

<36>
Accession Number
2019659546
Title
Octreotide for Acquired Chylothorax in Pediatric Patients
Post-Cardiothoracic Surgery for Congenital Heart Disease: A Systematic
Review.
Source
Pediatric Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Jenkinson A.C.; McGuinness J.; Prendiville T.
Institution
(Jenkinson, Prendiville) Department of Cardiology, Children's Heart
Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
(McGuinness) Department of Cardiothoracic Surgery, Children's Heart
Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
(Prendiville) Department of Pediatric Cardiology, Children's Heart Centre,
Children's Health Ireland at Crumlin Hospital, Dublin, Ireland
Publisher
Springer
Abstract
Chylothorax is a life-threatening complication post-corrective congenital
heart surgery. Octreotide is used for treatment of refractory
chylothoraces, with no standardized treatment protocol and a paucity of
literature describing its efficacy. Our aim was to provide an update on
the safety and efficacy of octreotide for the treatment of refractory
chylothoraces in neonatal and pediatric patients' post-corrective
congenital heart surgery. We performed a systematic review of PubMed,
Medline, CINAHL, and Cochrane Library databases. Only intravenous
octreotide treatment was included. A total of 621 patients across 27
studies were included. Studies included were 11 case series, 5 case
studies, and 11 retrospective cohort studies. Variation in treatment
regimens were reported. Treatment efficacy was reported in 95% (23/27) of
studies. Definitions of treatment efficacy were reported in 33% (9/27) of
studies. No prospective or randomized control trials were available for
inclusion. Octreotide efficacy is widely reported despite a lack of
standardization on criteria for treatment initiation or what defines an
appropriate response to therapy.Please check and confirm whether the edit
made to the article title is in order.Yes. Copyright © 2022, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<37>
Accession Number
2019657017
Title
Long-term outcomes of percutaneous versus surgical revascularization in
patients with diabetes and left main coronary artery disease: A
meta-analysis of randomized controlled trials.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Carvalho P.E.P.; Veiga T.M.A.; Machado F.S.L.; Porto G.V.; Pirez J.;
Rivera M.; Melo P.C.; Braghiroli J.; Cardoso R.
Institution
(Carvalho, Veiga, Machado, Porto) Department of Medicine, Federal
University of Minas Gerais, Belo Horizonte, Brazil
(Pirez) Department of Medicine, Cesumar University, Maringa, Brazil
(Rivera) Division of Cardiology, Washington University in St. Louis, St.
Louis, MO, United States
(Melo) Cardiovascular Research Foundation, New York, NY, United States
(Braghiroli) Jackson Memorial Hospital, Miami, FL, United States
(Cardoso) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The efficacy and safety of percutaneous coronary interventions
(PCI) relative to coronary artery bypass grafting (CABG) in patients with
diabetes and unprotected left main coronary artery disease (LMCAD) are not
well established. Objective(s): To perform a meta-analysis evaluating
the long-term outcomes after PCI with drug-eluting stents (DES), as
compared with CABG, in patients with diabetes and unprotected LMCAD.
 Method(s): MEDLINE, Cochrane, and Embase were searched for randomized
controlled trials (RCTs) that reported outcomes after PCI with DES versus
CABG in unprotected LMCAD among patients with diabetes. To evaluate the
long-term effects of these interventions, we restricted this analysis to
studies with a minimum follow-up period of 3 years. Risk ratios (RRs) with
95% confidence intervals (CIs) were pooled with a random-effects model.
Quality assessment and risk of bias were performed according to Cochrane
recommendations. Result(s): Four RCTs with a total of 1080 patients
were included, 553 (51.2%) of whom underwent PCI. There was no difference
for individual outcomes of all-cause mortality (RR: 1.21; 95% CI:
0.86-1.71; p =.27; I2 = 28%), cardiovascular death (RR 1.29;
95% CI: 0.76-2.18; p =.34; I2 = 0%), or myocardial infarction
(MI) (RR: 0.94; 95% CI: 0.61-1.45; p =.79; I2 = 0%). However,
the risk of stroke was reduced with PCI relative to CABG (RR: 0.41; 95%
CI: 0.18-0.94; p =.04; I2 = 0%), whereas the risk of any repeat
revascularization was higher in the PCI group (RR: 1.99; 95% CI:
1.44-2.75; p <.001; I2 = 0%). The risk of the composite outcome
of all-cause mortality, MI, stroke, or repeat revascularization was higher
after PCI compared with CABG (RR: 1.30; 95% CI: 1.09-1.56; p =.004;
I2 = 0%). Conclusion(s): In this meta-analysis with more
than 1000 patients with diabetes and unprotected LMCAD followed for a
minimum of 3 years, the incidence of repeat revascularization was higher
among those treated with PCI, whereas the risk of stroke was higher in
patients treated with CABG. Copyright © 2022 Wiley Periodicals
LLC.

<38>
Accession Number
2018886897
Title
Effectiveness of Acapella along with institutional based chest
physiotherapy techniques on pulmonary functions and airway clearance in
post-operative CABG patients.
Source
Hong Kong Physiotherapy Journal. 42(2) (pp 81-89), 2022. Date of
Publication: 01 Dec 2022.
Author
Jage B.; Thakur A.
Institution
(Jage, Thakur) School of Physiotherapy, D. Y. Patil University,
Maharashtra, Navi Mumbai, India
Publisher
World Scientific
Abstract
Background: Patients undergoing Coronary Artery Bypass Graft (CABG)
surgery often develop pulmonary complications in the early post-operative
period as result of decreased lung function and impaired cough.
Conventional physiotherapy in early post-operative period aims at
increasing lung volumes and airway clearance. Objective(s): This
study aimed to determine the effectiveness of the addition of Acapella to
conventional chest physiotherapy in improving lung volumes and secretion
clearance in early post-operative CABG patients. Method(s): Twenty
patients of both genders (40-70 years) who had undergone CABG and were in
Phase I of Cardiac Rehabilitation were involved in this pilot randomized
control trial (9 control, 11 experimental). Post-surgery intervention
commenced on post-operative day 2 (POD 2) and continued till POD 6.
Patients in the control group were given conventional physiotherapy that
included breathing exercises, incentive spirometry and manual techniques.
Patient in the experimental group used an Acapella device along with the
conventional intervention. Outcome measures considered were pulmonary
function parameters (FVC, FEV1 & PEFR) and amount of sputum expectorated.
 Result(s): A significant increase in lung volumes was observed in
both the groups on POD 6 as compared to POD 2 (both<0.01). However, the
increase was significantly greater on POD 6 in experimental group than the
control group [mean difference (95% CI) FVC: 0.44L (0.24-0.63), FEV1:
0.43L (0.19-0.66), PEFR: 0.86L/s (0.57-1.14)]. The amount of sputum
expectoration significantly greater in the experimental group as compared
to the control group [2.71mL (0.53-4.90)]. Conclusion(s): The
addition of Acapella enhanced the effect conventional physiotherapy in
improving lung volumes and airway clearance in the early post-operative
period for CABG patients. Copyright © 2022 Hong Kong
Physiotherapy Association.

<39>
Accession Number
639311755
Title
Randomized control study of nebulized colistin as an adjunctive therapy in
ventilator-associated pneumonia in pediatric postoperative cardiac
surgical population.
Source
Annals of cardiac anaesthesia. 25(4) (pp 435-440), 2022. Date of
Publication: 01 Oct 2022.
Author
Bharathi K.S.; Bhat A.; Pruthi G.; Simha P.P.
Institution
(Bharathi) Department of Cardiac Anaesthesiology, Sri Jayadeva Institute
of Cardiovascular Sciences and Research, Mysore, Karnataka, India
(Bhat, Pruthi, Simha) Department of Cardiac Anaesthesiology, Sri Jayadeva
Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka,
India
Publisher
NLM (Medline)
Abstract
Background: Ventilator-associated pneumonia (VAP) with multidrug-resistant
(MDR) gram negative organisms is a common problem in intensive care unit
(ICU). Aerosolized antibiotics enhance the efficacy of systemic
antibiotics when added as adjuvants. Aim(s): The primary objective of
the study was to compare the clinical and bacteriological outcome of
patients with VAP who were administered intravenous (IV) antibiotics alone
with those patients who were treated with adjunctive nebulized colistin
(NC) along with IV antibiotics. The secondary objective was to study the
occurrence of any adverse events during colistin nebulization. Settings
and Design: The study was a prospective, randomized, double-blinded
controlled study conducted at a tertiary-care teaching institution.
 Material(s) and Method(s): Ninety-eight children from surgical ICU
aged less than 12 years who were diagnosed with VAP due to gram negative
bacteria following cardiac surgery were chosen and divided randomly into
two groups. The experimental group (NC group) was treated with systemic
antibiotics along with NC, whereas the control group (NS group) was
administered systemic antibiotics with nebulized normal saline (NS).
Clinical and bacteriological outcomes were noted. Statistical analysis was
done using SPSS Version 20.0 software. The patient characteristics were
compared using independent Student's t test and Chi-square test.
 Result(s): There was a statistically significant reduction in the
duration of mechanical ventilation, postoperative ICU and hospital stay (P
< 0.05) in the NC group compared with the NS group. Conclusion(s):
Aerosolized colistin may be considered as an adjunct to systemic IV
antibiotics in pediatric patients with VAP due to gram negative bacteria
susceptible to colistin.

<40>
Accession Number
639311680
Title
The use of cerebral oximetry in cardiac surgery: A systematic review and
meta-analysis of randomized controlled trials.
Source
Annals of cardiac anaesthesia. 25(4) (pp 384-398), 2022. Date of
Publication: 01 Oct 2022.
Author
Chiong X.H.; Wong Z.Z.; Lim S.M.; Ng T.Y.; Ng K.T.
Institution
(Chiong) School of Medicine, University of Aberdeen, United Kingdom
(Wong) School of Medicine, International Medical University, Kuala Lumpur,
Malaysia
(Lim, Ng, Ng) Department of Anesthesiology, Faculty of Medicine,
University of Malaya, Kuala Lumpur, Malaysia
Publisher
NLM (Medline)
Abstract
High prevalence of cerebral desaturation is associated with postoperative
neurological complications in cardiac surgery. However, the evidence use
of cerebral oximetry by correcting cerebral desaturation in the reduction
of postoperative complications remains uncertain in the literature. This
systematic review and meta-analysis aimed to examine the effect of
cerebral oximetry on the incidence of postoperative cognitive dysfunction
in cardiac surgery. Databases of MEDLINE, EMBASE, and CENTRAL were
searched from their inception until April 2021. All randomized controlled
trials comparing cerebral oximetry and blinded/no cerebral oximetry in
adult patients undergoing cardiac surgery were included. Observational
studies, case series, and case reports were excluded. A total of 14 trials
(n = 2,033) were included in this review. Our pooled data demonstrated
that patients with cerebral oximetry were associated with a lower
incidence of postoperative cognitive dysfunction than the control group
(studies = 4, n = 609, odds ratio [OR]: 0.15, 95% confidence interval
[CI]: 0.04 to 0.54, P = 0.003, I2 = 88%; certainty of evidence = very
low). In terms of postoperative delirium (OR: 0.75, 95%CI: 0.50-1.14, P =
0.18, I2 = 0%; certainty of evidence = low) and postoperative stroke (OR:
0.81 95%CI: 0.37-1.80, P = 0.61, I2 = 0%; certainty of evidence = high),
no significant differences (P > 0.05) were reported between the cerebral
oximetry and control groups. In this meta-analysis, the use of cerebral
oximetry monitoring in cardiac surgery demonstrated a lower incidence of
postoperative cognitive dysfunction. However, this finding must be
interpreted with caution due to the low level of evidence, high degree of
heterogeneity, lack of standardized cognitive assessments, and cerebral
desaturation interventions.

<41>
Accession Number
639311379
Title
Effects of recombinant erythropoietin on hemoglobin levels and blood
transfusion needs in patients with preoperative anemia undergoing cardiac
surgery.
Source
Annals of cardiac anaesthesia. 25(4) (pp 466-471), 2022. Date of
Publication: 01 Oct 2022.
Author
Totonchi Z.; Noohi F.; Futuhi F.; Azarfarin R.; Radbin P.
Institution
(Totonchi, Radbin) Department of Cardiac Anesthesia, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Noohi) Department of Cardiology, Cardiovascular Intervention Research
Center, Rajaie Cardiovascular Medical and Research Center, Iran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Futuhi) Department of Nephrology, Loghman Hakim Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Azarfarin) Department of Cardiology, Cardio-Oncology Research Center,
Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
Introduction: Preoperative anemia is an important and relatively common
problem in patients undergoing cardiac surgery, and its treatment is
crucial in improving postoperative outcomes. The use of recombinant
erythropoietin is one of the suggested methods in this field. Therefore,
in the present study, we sought to evaluate the effects of recombinant
erythropoietin on hemoglobin (Hb) levels and blood transfusion needs in
cardiac surgery in patients with preoperative anemia. Method(s): This
randomized nonblind clinical trial was performed on patients with
mild-to-moderate anemia (Hb <12 g/dL in men and Hb <11 g/dL in women)
undergoing cardiac surgery at a referral heart hospital (Tehran, Iran).
The patients were randomly divided into two groups of 33 patients. In the
intervention group, recombinant erythropoietin was administered at a dose
of 500 IU/kg one to three days before surgery. Intra- and postoperative Hb
levels and the need for blood transfusion were recorded during surgery and
for 3 days afterward. Result(s): The use of packed red blood cells in
the operating room was similar in the intervention and control groups (P =
0.156), but it was significantly lower in the intensive care unit in the
intervention group (P = 0.030). The mean Hb, which was initially identical
in the two groups (P > 0.05), showed a significantly lower decrease in the
intervention group (P = 0.001). No significant differences were observed
concerning other variables. Conclusion(s): The use of recombinant
erythropoietin (500 IU/kg/day) one to three days before cardiac surgery in
our anemic patients blunted a reduction in Hb levels and decreased blood
transfusion needs.

<42>
Accession Number
639311293
Title
A comparison of the success rate of radial artery cannulation between the
ultrasound-guided and conventional palpation techniques in elderly
patients undergoing cardiothoracic surgery.
Source
Annals of cardiac anaesthesia. 25(4) (pp 447-452), 2022. Date of
Publication: 01 Oct 2022.
Author
Chanthawong S.; Tribuddharat S.; Sathitkarnmanee T.; Suwongkrua T.;
Silarat S.; Plengpanich P.
Institution
(Chanthawong, Tribuddharat, Sathitkarnmanee, Suwongkrua, Silarat,
Plengpanich) Department of Anesthesiology, Faculty of Medicine, Khon Kaen
University, Khon Kaen, Thailand
Publisher
NLM (Medline)
Abstract
Background: Ultrasound-guided (USG) radial artery cannulation against the
standard palpation technique increases the first attempt rate in both
pediatric and adult patients. The objective of this study was to evaluate
the benefits of USG versus the palpation technique in improving the first
attempt rate in elderly patients. Method(s): The patients over 65
years of age were randomized to the USG or Palpation group. The radial
artery identification in the USG group was performed with the aid of the
Sonimage HS 1. In the Palpation group, the radial artery was identified by
manual palpation. The operators were cardiothoracic anesthesiologists.
Overall success was defined as cannulation completed within 10 min.
 Result(s): Eighty patients (40 in each group) were recruited. The
respective first attempt and overall success rate for the USG group were
similar to the Palpation group (P > 0.999 and P = 0.732). The time to the
first attempt and overall success were also similar (P = 0.075 and P =
0.636). The number of attempts, number of catheters used, and failure
rates were similar between the groups (P = 0.935, P = 0.938, and P =
0.723). The number of successful cannulations within 10 min was similar
for both the groups as categorized by the radial artery diameter (P =
0.169). Conclusion(s): The USG did not increase the first attempt or
overall success rate of radial artery cannulation in the elderly patients
undergoing cardiothoracic surgery. The time to first attempt and overall
success were similar between both the groups. The number of attempts and
number of catheters used were similar between both groups.

<43>
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. 7(10) (pp 1000-1008), 2022. Date of Publication: October
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, 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, Michigan, 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) Now with 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) Now with 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] cm2vs 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.

<44>
Accession Number
639307234
Title
Platelet Transfusion in Cardiopulmonary Bypass Surgery; A Systematic.
Source
Transfusion. Conference: American Association of Blood Banks Annual
Meeting, AABB 2022. Orlando, FL United States. 62(Supplement 2) (pp
257A-258A), 2022. Date of Publication: September 2022.
Author
Al-Riyami R.A.Z.; Keshavarz H.; Jug R.; La Rocca U.; Stanworth S.J.;
Nahrniak S.
Institution
(Al-Riyami) Department of Hematology, Sultan Qaboos University Hospital,
Oman
(Keshavarz) Innovation and Portfolio Management, Canadian Blood Services,
Canada
(Keshavarz) International Collaboration for Transfusion Medicine
Guidelines (ICTMG), Canada
(Jug) William Osler Health System, Canada
(La Rocca) Department of Translational and Precision Medicine, Italian
National Blood Center, Italy
(La Rocca) Immunohematology and Transfusion Medicine, Policlinico Umberto
I, Sapienza University, Rome, Italy
(Stanworth) Radcliffe Department of Medicine, University of Oxford, United
Kingdom
(Stanworth) Department of Clinical Hematology, Oxford University Hospitals
NHS Foundation Trust, United Kingdom
(Nahrniak) Department of Laboratory Medicine and Pathology, University of
Alberta, Canada
(Nahrniak) Transfusion and Transplantation Medicine, Alberta Precision
Laboratories, Canada
Publisher
Blackwell Publishing Inc.
Abstract
Background/Case Studies: Cardiac surgery is a common clinical context for
platelet (PLT) transfusion. Cardiac surgery carries a high risk of
peri-operative bleeding and need for transfusion due to many factors
including the use of anticoagulant and anti-PLT agents, use of
cardiopulmonary bypass (CPB) and hypothermia. CPB leads to activation and
consumption of the coagulation factors and PLT dysfunction. This
systematic review aimed to assess available evidence on the use of PLT
transfusion in patients undergoing CPB surgeries. Study Design/Methods:
MEDLINE, Cochrane and EMBASE were systematically searched for studies
until December 2018, update on-going. Citations were reviewed in duplicate
for inclusion. Three physicians and one methodologist used a database
instrument tool to extract data. Discrepancies in data collection were
resolved by consensus or by involving a third reviewer. Outcomes assessed
were the volume of hemorrhage, the proportion of patients and number of
blood components transfused, mortality, thromboembolism, intensive care
unit (ICU) and hospital length of stay. Assessment of heterogeneity and a
meta-analysis of outcomes in which there were comparable effect measures
for more than one study was performed. Results/Findings: Abstracts of 3813
records were screened, and 77 full-text articles were reviewed. From
these, a total of five studies [1 non-randomized, 4 randomized control
trials (RCT)] were included for analysis (Table). These trials had small
sample sizes, were singlecentered, with different comparative arms and
transfusion triggers. Two indicated excluding patients on anti- PLT
agents. There were no differences between the compared arms in terms of
the volume of hemorrhage [4 RCTs, overall standard mean difference (SMD)
-0.06, 95% CI -1.44 to 1.32, I2=93%] or in proportion of patients
transfused [2 RCTs, overall SMD 0.21, 95% CI 0.01 to 4.14, I2=75%]. There
was only one RCT that assessed mortality, thromboembolism, hospital and
ICU length of stay and reported no difference between the groups compared.
The overall risk of bias and imprecision for all outcomes assessed was
ranked as serious using GRADE. Conclusion(s): There is poor quality
and limited evidence to define optimal use of PLTs post-operatively in
patients who have undergone non-urgent open heart surgery with CPB. One
important research gap is use of PLTs in patients on anti-PLT agents. More
primary research is needed before a recommendation can be made.

<45>
Accession Number
2019691126
Title
Limited clinical utility for GWAS or polygenic risk score for
postoperative acute kidney injury in non-cardiac surgery in
European-ancestry patients.
Source
BMC Nephrology. 23(1) (no pagination), 2022. Article Number: 339. Date of
Publication: December 2022.
Author
Larach D.B.; Lewis A.; Bastarache L.; Pandit A.; He J.; Sinha A.; Douville
N.J.; Heung M.; Mathis M.R.; Mosley J.D.; Wanderer J.P.; Kheterpal S.;
Zawistowski M.; Brummett C.M.; Siew E.D.; Robinson-Cohen C.; Kertai M.D.
Institution
(Larach, Wanderer) Department of Anesthesiology, Vanderbilt University
Medical Center, Nashville, TN, United States
(Lewis, Bastarache, He, Mosley, Wanderer) Department of Biomedical
Informatics, Vanderbilt University Medical Center, Nashville, TN, United
States
(Pandit, Zawistowski) Department of Biostatistics, University of Michigan,
Ann Arbor, MI, United States
(Sinha, Douville, Mathis, Kheterpal, Brummett) Department of
Anesthesiology, University of Michigan, Ann Arbor, MI, United States
(Douville) Institute of Healthcare Policy & Innovation, University of
Michigan, Ann Arbor, MI, United States
(Heung) Division of Nephrology, Department of Internal Medicine,
University of Michigan, Ann Arbor, MI, United States
(Mathis) Department of Computational Medicine and Bioinformatics,
University of Michigan, Ann Arbor, MI, United States
(Mosley) Department of Medicine, Vanderbilt University Medical Center,
Nashville, TN, United States
(Siew) Division of Nephrology and Hypertension, Vanderbilt Center for
Kidney Disease (VCKD) and Integrated Program for AKI (VIP-AKI), Tennessee
Valley Health System, Nashville Veterans Affairs Hospital, Nashville, TN,
United States
(Robinson-Cohen) Vanderbilt O'Brien Kidney Center, Division of Nephrology
and Hypertension, Department of Medicine, Vanderbilt University Medical
Center, Nashville, TN, United States
(Kertai) Division of Adult Cardiothoracic Anesthesiology, Department of
Anesthesiology, Vanderbilt University Medical Center, 1211 21st Avenue
South, Medical Arts Building, Office 526E, Nashville, TN 37212, United
States
Publisher
BioMed Central Ltd
Abstract
Background: Prior studies support a genetic basis for postoperative acute
kidney injury (AKI). We conducted a genome-wide association study (GWAS),
assessed the clinical utility of a polygenic risk score (PRS), and
estimated the heritable component of AKI in patients who underwent
noncardiac surgery. Method(s): We performed a retrospective
large-scale genome-wide association study followed by a meta-analysis of
patients who underwent noncardiac surgery at the Vanderbilt University
Medical Center ("Vanderbilt" cohort) or Michigan Medicine, the academic
medical center of the University of Michigan ("Michigan" cohort). In the
Vanderbilt cohort, the relationship between polygenic risk score for
estimated glomerular filtration rate and postoperative AKI was also tested
to explore the predictive power of aggregating multiple common genetic
variants associated with AKI risk. Similarly, in the Vanderbilt cohort
genome-wide complex trait analysis was used to estimate the heritable
component of AKI due to common genetic variants. Result(s): The study
population included 8248 adults in the Vanderbilt cohort (mean [SD] 58.05
[15.23] years, 50.2% men) and 5998 adults in Michigan cohort (56.24
[14.76] years, 49% men). Incident postoperative AKI events occurred in 959
patients (11.6%) and in 277 patients (4.6%), respectively. No loci met
genome-wide significance in the GWAS and meta-analysis. PRS for estimated
glomerular filtration rate explained a very small percentage of variance
in rates of postoperative AKI and was not significantly associated with
AKI (odds ratio 1.050 per 1 SD increase in polygenic risk score [95% CI,
0.971-1.134]). The estimated heritability among common variants for AKI
was 4.5% (SE = 4.5%) suggesting low heritability. Conclusion(s): The
findings of this study indicate that common genetic variation minimally
contributes to postoperative AKI after noncardiac surgery, and likely has
little clinical utility for identifying high-risk patients. Copyright
© 2022, The Author(s).

<46>
Accession Number
2019673505
Title
Analgesic efficacy and risk of low-to-medium dose intrathecal morphine in
patients undergoing cardiac surgery: An updated meta-analysis.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 1017676.
Date of Publication: 05 Oct 2022.
Author
Chen I.-W.; Sun C.-K.; Ko C.-C.; Fu P.-H.; Teng I.-C.; Liu W.-C.; Lin
C.-M.; Hung K.-C.
Institution
(Chen) Department of Anesthesiology, Chi Mei Medical Center, Tainan City,
Liouying, Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung City,
Taiwan (Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung City, Taiwan
(Republic of China)
(Ko) Department of Medical Imaging, Chi Mei Medical Center, Tainan City,
Taiwan (Republic of China)
(Ko) Department of Health and Nutrition, Chia Nan University of Pharmacy
and Science, Tainan City, Taiwan (Republic of China)
(Ko) Institute of Biomedical Sciences, National Sun Yat-sen University,
Kaohsiung City, Taiwan (Republic of China)
(Fu, Teng, Liu, Lin, Hung) Department of Anesthesiology, Chi Mei Medical
Center, Tainan City, Taiwan (Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Background: To evaluate the analgesic efficacy and risk of low-to-medium
dose intrathecal morphine (ITM) (i.e., <=0.5 mg) following cardiac
surgery. Method(s): Medline, Cochrane Library, Google scholar and
EMBASE databases were searched from inception to February 2022. The
primary outcome was pain intensity at postoperative 24 h, while the
secondary outcomes included intravenous morphine consumption (IMC),
extubation time, hospital/intensive care unit (ICU) length of stay (LOS),
and ITM-associated side effects (e.g., respiratory depression). Subgroup
analysis was performed on ITM dosage (low: <0.3 mg vs. medium: 0.3-0.5
mg). Result(s): Fifteen RCTs involving 683 patients published from
1988 to 2021 were included. Pooled results showed significantly lower
postoperative 24-h pain scores [mean difference (MD) = -1.61, 95%
confidence interval: -1.98 to -1.24, p < 0.00001; trial sequential
analysis: sufficient evidence; certainty of evidence: moderate] in the ITM
group compared to the controls. Similar positive findings were noted at 12
(MD = -2.1) and 48 h (MD = -1.88). Use of ITM was also associated with
lower IMC at 24 and 48 h (MD: -13.69 and -14.57 mg, respectively; all p <
0.05) and early tracheal extubation (i.e., 48.08 min). No difference was
noted in hospital/ICU LOS, and nausea/vomiting in both groups, but
patients receiving ITM had higher risk of pruritus (relative risk = 2.88,
p = 0.008). There was no subgroup difference in IMC except a lower pain
score with 0.3-0.5 mg than <0.3 mg at postoperative 24 h. Respiratory
depression events were not noted in the ITM group. Conclusion(s): Our
results validated the analgesic efficacy of low-to-medium dose ITM for
patients receiving cardiac surgery without increasing the risk of
respiratory depression. Copyright © 2022 Chen, Sun, Ko, Fu, Teng,
Liu, Lin and Hung.

<47>
Accession Number
2019658470
Title
Machine learning derived ECG risk score improves cardiovascular risk
assessment in conjunction with coronary artery calcium scoring.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 976769. Date of Publication: 05 Oct 2022.
Author
Siva Kumar S.; Al-Kindi S.; Tashtish N.; Rajagopalan V.; Fu P.;
Rajagopalan S.; Madabhushi A.
Institution
(Siva Kumar) Department of Biomedical Engineering, Case Western Reserve
University, Cleveland, OH, United States
(Al-Kindi, Tashtish, Rajagopalan, Rajagopalan) Harrington Heart and
Vascular Institute, University Hospitals, Cleveland, OH, United States
(Al-Kindi, Tashtish, Rajagopalan, Rajagopalan) School of Medicine, Case
Western Reserve University, Cleveland, OH, United States
(Fu) Department of Population and Quantitative Health Sciences, Case
Western Reserve University, Cleveland, OH, United States
(Madabhushi) Department of Biomedical Engineering, Radiology and Imaging
Sciences, Biomedical Informatics (BMI) and Pathology, Georgia Institute of
Technology and Emory University, Research Health Scientist, Atlanta
Veterans Administration Medical Center, Atlanta, GA, United States
Publisher
Frontiers Media S.A.
Abstract
Background: Precision estimation of cardiovascular risk remains the
cornerstone of atherosclerotic cardiovascular disease (ASCVD) prevention.
While coronary artery calcium (CAC) scoring is the best available
non-invasive quantitative modality to evaluate risk of ASCVD, it excludes
risk related to prior myocardial infarction, cardiomyopathy, and
arrhythmia which are implicated in ASCVD. The high-dimensional and
inter-correlated nature of ECG data makes it a good candidate for analysis
using machine learning techniques and may provide additional prognostic
information not captured by CAC. In this study, we aimed to develop a
quantitative ECG risk score (eRiS) to predict major adverse cardiovascular
events (MACE) alone, or when added to CAC. Further, we aimed to construct
and validate a novel nomogram incorporating ECG, CAC and clinical factors
for ASCVD. Method(s): We analyzed 5,864 patients with at least 1
cardiovascular risk factor who underwent CAC scoring and a standard ECG as
part of the CLARIFY study (ClinicalTrials.gov Identifier: NCT04075162).
Events were defined as myocardial infarction, coronary revascularization,
stroke or death. A total of 649 ECG features, consisting of measurements
such as amplitude and interval measurements from all deflections in the
ECG waveform (53 per lead and 13 overall) were automatically extracted
using a clinical software (GE MuseTM Cardiology Information System, GE
Healthcare). The data was split into 4 training (S<inf>tr</inf>) and
internal validation (S<inf>v</inf>) sets [S<inf>tr</inf> (1):
S<inf>v</inf> (1): 50:50; S<inf>tr</inf> (2): S<inf>v</inf> (2): 60:40;
S<inf>tr</inf> (3): S<inf>v</inf> (3): 70:30; S<inf>tr</inf> (4):
S<inf>v</inf> (4): 80:20], and the results were compared across all the
subsets. We used the ECG features derived from S<inf>tr</inf> to develop
eRiS. A least absolute shrinkage and selection operator-Cox (LASSO-Cox)
regularization model was used for data dimension reduction, feature
selection, and eRiS construction. A Cox-proportional hazards model was
used to assess the benefit of using an eRiS alone (M<inf>ecg</inf>), CAC
alone (M<inf>cac</inf>) and a combination of eRiS and CAC
(M<inf>ecg+cac</inf>) for MACE prediction. A nomogram (M<inf>nom</inf>)
was further constructed by integrating eRiS with CAC and demographics (age
and sex). The primary endpoint of the study was the assessment of the
performance of M<inf>ecg</inf>, M<inf>cac</inf>, M<inf>ecg+cac</inf> and
M<inf>nom</inf> in predicting CV disease-free survival in ASCVD.
 Finding(s): Over a median follow-up of 14 months, 494 patients had
MACE. The feature selection strategy preserved only about 18% of the
features that were consistent across the various strata (S<inf>tr</inf>).
The M<inf>ecg</inf> model, comprising of eRiS alone was found to be
significantly associated with MACE and had good discrimination of MACE
(C-Index: 0.7, p = <2e-16). eRiS could predict time-to MACE (C-Index: 0.6,
p = <2e-16 across all S<inf>v</inf>). The M<inf>ecg+cac</inf> model was
associated with MACE (C-index: 0.71). Model comparison showed that
M<inf>ecg+cac</inf> was superior to M<inf>ecg</inf> (p = 1.8e-10) or
M<inf>cac</inf> (p < 2.2e-16) alone. The M<inf>nom</inf>, comprising of
eRiS, CAC, age and sex was associated with MACE (C-index 0.71). eRiS had
the most significant contribution, followed by CAC score and other
clinical variables. Further, M<inf>nom</inf> was able to identify unique
patient risk-groups based on eRiS, CAC and clinical variables.
 Conclusion(s): The use of ECG features in conjunction with CAC may
allow for improved prognostication and identification of populations at
risk. Future directions will involve prospective validation of the risk
score and the nomogram across diverse populations with a heterogeneity of
treatment effects. Copyright © 2022 Siva Kumar, Al-Kindi,
Tashtish, Rajagopalan, Fu, Rajagopalan and Madabhushi.

<48>
Accession Number
2020737825
Title
Comparison between coil and hook-wire localization before video-assisted
thoracoscopic surgery for lung nodules: a systematic review and
meta-analysis.
Source
Wideochirurgia I Inne Techniki Maloinwazyjne. 17(3) (pp 441-449), 2022.
Date of Publication: 2022.
Author
Wang J.-L.; Xia F.-F.; Dong A.-H.; Lu Y.
Institution
(Wang) Department of Radiology, Beijing Huairou Hospital of Traditional
Chinese Medicine, Beijing, China
(Xia) Department of Interventional Vascular Surgery, Binzhou People's
Hospital, Binzhou, China
(Dong) Center of Health Management, Binzhou People's Hospital, Binzhou,
China
(Lu) Department of Radiology, Xuzhou Central Hospital, Xuzhou, China
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Both coil and hook-wire localization techniques are commonly
employed prior to video-assisted thoracic surgery (VATS) resection in
patients with lung nodules (LNs), but the relative advantages of each
remain uncertain. Aim(s): This meta-analysis was performed to explore
the relative safety and efficacy of coil localization (CL) and hookwire
localization (HWL) for patients with LNs. Material(s) and Method(s):
The PubMed, Embase, Cochrane Library, Wanfang, and CINK databases were
searched to identify relevant studies published as of February 2022, after
which pooled analyses of study outcomes were conducted. Result(s): In
total, 8 studies met the inclusion criteria for the present meta-analysis.
Successful localization rates were higher for the CL group relative to the
HWL group (p = 0.0001). The CL group additionally exhibited significantly
lower pooled total complication, pneumothorax, and lung hemorrhage rates
relative to the HWL group (p = 0.01, p = 0.0001, p = 0.0009). Pooled
duration of localization, VATS procedure duration, and wedge resection
duration values were comparable in both groups (p = 0.69, p = 0.16, p =
0.76), as were chest pain scores (p = 0.06). When specifically analyzing
the subset of patients with ground-glass LNs, pooled pneumothorax rates
were significantly lower in the CL group relative to the HWL group (p =
0.03). Significant publication bias was detected with respect to rates of
lung hemorrhage (Egger test, p = 0.029), but was not evident for other
analyzed variables. Conclusion(s): These results suggest that the
coil-based localization of LNs before VATS resection is safer and more
effective than hook-wire localization. Copyright © 2022 Termedia
Publishing House Ltd.. All rights reserved.

<49>
Accession Number
2020726031
Title
Appropriate tube temperature for fiberoptic bronchoscope-guided intubation
of thermally softened double-lumen endotracheal tubes: A CONSORT-compliant
article.
Source
Medicine (United States). 101(40) (pp E29999), 2022. Date of Publication:
07 Oct 2022.
Author
Yu Y.; Jia Q.; Zhou L.; Liu Z.; Liang S.; Yang Z.; Wan Q.
Institution
(Yu, Jia, Zhou, Liu, Liang) Department of Anesthesiology, The First
Hospital of Qinhuangdao City, Hebei, Qinhuangdao, China
(Yang) Research and Development Center, Contec Medical Systems Co. Ltd.,
Economic and Technological Development Zone, Hebei, Qinhuangdao, China
(Wan) Department of Health Services, Third Medical Center of Chinese Pla
General Hospital, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: To compare the effects of thermal softening of double-lumen
endotracheal tubes (DLT) at different temperatures during fiberoptic
bronchoscopy (FOB)-guided intubation. Method(s): We randomly divided
144 patients undergoing thoracic surgery into 4 groups as follows: T1 (T =
24 +/- 1degreeC, n = 36), T2 (T = 36 +/- 1degreeC, n = 36), T3 (T = 40 +/-
1degreeC, n = 36), and T4 (T = 48 +/- 1degreeC, n = 36). All groups
underwent FOB-guided double-lumen endotracheal intubation and positioning.
We recorded the duration of positioning and intubation using DLT,
intubation resistance (IR), the success rate of the first attempt at
endotracheal intubation, and the incidence of postoperative vocal cord
injury and hoarseness. Result(s): The time to intubation was longer
in the T1 group than that in the T2, T3, and T4 groups (P <.05). The time
for positioning was longer in the T4 group than that in the T1, T2, and T3
groups (P <.05). IR was lower in the T3 and T4 groups than those in T1 and
T2 groups (P <.05). The success rate of the first attempt at endotracheal
intubation was higher in the T2, T3, and T4 groups than that in the T1
group (P <.05). Postoperative glottic injury and hoarseness were higher in
the T1 and T2 groups than those in the T3 and T4 groups (P <.05).
 Conclusion(s): A thermally softened DLT shortened the time to
intubation, reduced the IR, improved the success rate of the first attempt
at endotracheal intubation, and lowered the incidence of postoperative
glottic injury and hoarseness. The optimal tube temperature for FOB-guided
intubation of thermally softened DLT was 40 +/- 1degreeC. Copyright
© 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

<50>
Accession Number
2020808126
Title
Novel hardening bone putty enhances sternal closure and accelerates
postoperative recovery.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Vasanthan V.; Hassanabad A.F.; Kang S.; Dundas J.; Ramadan D.; Holloway
D.; Adams C.; Ahsan M.; Fedak P.W.M.
Institution
(Vasanthan, Hassanabad, Kang, Dundas, Ramadan, Holloway, Adams, Ahsan,
Fedak) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin
Cardiovascular Institute, Cumming School of Medicine, University of
Calgary, Calgary, AB, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: Regaining and maintaining sternal stability are key to
recovery after cardiac surgery and resuming baseline quality of life.
Montage (ABYRX) is a moldable, calcium phosphate-based putty that adheres
to bleeding bone, hardens after application, and is resorbed and replaced
with bone during the remodeling process. We evaluate the feasibility,
safety, and efficacy of enhanced sternal closure with this novel putty to
accelerate recovery in patients after sternotomy. Method(s): A
single-center, single-blinded, randomized controlled trial was performed
(NCT03365843). Patients undergoing elective cardiac surgery via sternotomy
received sternal closure with either Montage bone putty and wire cerclage
(enhanced sternal closure; n = 33) or wire cerclage alone (control; n =
27). Standardized patient-reported outcomes assessed health-related
quality of life (EQ-5D Index) and physical disability (Health Assessment
Questionnaire). A Likert-type 11-point scale quantified pain. Spirometry
assessed respiratory function. Patients reached 6-week follow-up, with
1-year follow-up for safety end points. Result(s): There were no
device-related adverse events. Enhanced sternal closure improved physical
functional recovery (reduced Healthcare Index and Quality) and quality of
life (increased EQ-5D Index) at day 5/discharge, week 2, and week 4.
Enhanced sternal closure reduced incisional pain while resting, breathing,
sleeping, and walking at day 5/discharge. Enhanced sternal closure reduced
chest wall and back pain at day 3 and day 5 discharge. A higher proportion
of patients with enhanced sternal closure recovered to 60% of their
baseline forced vital capacity by day 5/discharge. Enhanced sternal
closure shortened hospital stay. Conclusion(s): Enhanced sternal
closure improves and accelerates postoperative recovery compared with
conventional wire closure. Earlier discharge may provide substantial cost
benefits for the healthcare system. Copyright © 2022 The American
Association for Thoracic Surgery

<51>
Accession Number
2020666927
Title
Efficacy of ultrasound-guided single-injection erector spinae plane block
for thoracoscopic wedge resection: A prospective randomized control trial.
Source
Regional Anesthesia and Pain Medicine. (no pagination), 2022. Article
Number: 103602. Date of Publication: 2022.
Author
Klaibert B.; Lohser J.; Tang R.; Jew M.; McGuire A.; Wilson J.
Institution
(Klaibert, Lohser, Tang, Jew, Wilson) Department of Anesthesiology and
Perioperative Care, Vancouver General Hospital, Vancouver, BC, Canada
(McGuire) Department of Surgery, Division of Thoracic Surgery, Vancouver
General Hospital, Vancouver, BC, Canada
Publisher
BMJ Publishing Group
Abstract
Background: Despite advances in minimally invasive thoracic surgery,
patients remain at risk of adverse pulmonary events with suboptimal
postoperative analgesia. Novel methods of regional analgesia are
warranted. Our objective was to prospectively evaluate the impact of
ultrasound-guided single-injection erector spinae plane (ESP) block with
ropivacaine compared with placebo control on standard of care
postoperative recovery in subjects undergoing video-assisted thoracoscopic
surgery (VATS) wedge resection. Method(s): This prospective,
randomized, placebo-controlled, double-blinded study was conducted at a
tertiary thoracic surgical center. Consecutive subjects undergoing VATS
wedge resection were randomized to receive a single-injection ESP block
with 0.5% ropivacaine or 0.9% saline placebo, in addition to the current
standard of care of multimodal analgesia including patient-controlled
analgesia and surgical local anesthetic wound infiltration. The primary
outcome was difference in 40-point Quality of Recovery (QoR-40) on day 1
postoperatively. The secondary outcomes included opioid consumption,
Visual Analog Pain Scale (VAS) score, time spent in the postanesthesia
care unit (PACU), and block-related and postoperative complications.
 Result(s): Eighty subjects were enrolled, 40 in each group, with 76
completing follow-up (38 subjects in each group). There was no difference
in the median QoR-40 score between groups, 169.5 for the ropivacaine group
and 172.5 for the control group (difference 3, p=0.843). No significant
differences existed between groups in all secondary outcomes, with the
exception of the ropivacaine group having lower VAS pain scores measured
at 1 hour postoperatively and a shorter duration of stay in the PACU of
117 min. Conclusion(s): Following VATS wedge resection, the addition
of an ESP block with ropivacaine to standard multimodal analgesia is
unlikely to add meaningful clinical value. Trial registration number:
NCT03419117. Copyright © 2022 BMJ Publishing Group. All rights
reserved.

<52>
Accession Number
2019702256
Title
Acute iatrogenic complications after mitral valve repair.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Paparella D.; Squiccimarro E.; Di Mauro M.; Katsavrias K.; Calafiore A.M.
Institution
(Paparella, Squiccimarro) Department of Medical and Surgical Sciences,
Division of Cardiac Surgery, University of Foggia, Foggia, Italy
(Paparella) Division of Cardiac Surgery, Santa Maria Hospital, GVM Care &
Research, Bari, Italy
(Squiccimarro, Di Mauro) Cardio-Thoracic Surgery Department, Heart &
Vascular Centre, Maastricht University Medical Centre, Maastricht,
Netherlands
(Katsavrias) Division of Cardiac Surgery A, Henry Dunant Hospital, Athens,
Greece
(Calafiore) Department of Cardiovascular Diseases, Gemelli Molise,
Campobasso, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim of the Study: Mitral valve repair is the procedure of
choice to correct mitral regurgitation. However, some dangerous iatrogenic
complications can occur at the end of the procedure. Therefore, we sought
to review the most frequent and clinically relevant acute iatrogenic
complication following mitral valve repair. Method(s): A thorough
review of the literature has been performed. Criteria for considering
studies for this non-systematic review were as follows: observational and
interventional studies investigating the acute iatrogenic complications
following mitral valve repair, and essential review studies pertinent to
the topic. Result(s): The most frequent is the systolic anterior
motion. Due to a systolic dislocation of the anterior leaflet toward the
outflow tract, it causes both obstruction of the outflow tract and mitral
regurgitation. Often it is due to excess of catecholamines or to reduced
filling of the left ventricle but sometimes needs further surgical
maneuvers, focused on moving posteriorly the coaptation line. It can be
obtained by shortening the posterior leaflet or increasing the size of the
ring or applying an Alfieri stitch to limit the movements of the anterior
leaflet. Another complication, often underdiagnosed and potentially
lethal, is the injury of the circumflex artery that happens at the level
of the anterolateral commissure or P1 zone. Two mechanisms are involved.
The first one is the direct injury of the artery by a stitch (roughly 25%
of the patients present a distance artery-annulus <3 mm. The second one is
the distortion of the artery, attracted toward the annulus by a misplaced
stitch. The attraction causes kinking with stenosis of different degrees
till functional occlusion. However, the artery has to be far from the
annulus and the atrial tissue has to be stiff and resistant, as after an
infective process, to move the circumflex artery toward the annulus
without tearing. Positioning the stitches very close to the mitral
leaflets in the dangerous area is the only prevention to the complication.
The treatment in the operating theater is partial or total
removal/reimplantation of the annular sutures or coronary artery bypass
grafting to the circumflex area. If the injury is demonstrated only after
coronary angiography, percutaneous revascularization can be attempted
before further surgical treatment. Conclusion(s): Acute iatrogenic
complication after mitral repair exists and may compromize patient
outcome. Raising awareness about these issues, the precautions to prevent
them, and the manners of resolution is therefore mandatory. Copyright
© 2022 Wiley Periodicals LLC.

<53>
Accession Number
639309839
Title
Effect of dexamethasone on myocardial injury after total knee arthroplasty
- a substudy of the randomized clinical DEX-2-TKA Trial.
Source
The American journal of medicine. (no pagination), 2022. Date of
Publication: 14 Oct 2022.
Author
Molgaard A.K.; Gasbjerg K.S.; Meyhoff C.S.; Lunn T.H.; Jakobsen J.C.;
Gogenur I.; Mathiesen O.; Hagi-Pedersen D.
Institution
(Molgaard) Research Centre of Anaesthesiology and Intensive Care Medicine,
Department of Anesthesiology, Slagelse and Ringsted Hospitals, Faelledvej
11, Slagelse 4200, Denmark
(Gasbjerg) Research Centre of Anaesthesiology and Intensive Care Medicine,
Department of Anesthesiology, Slagelse and Ringsted Hospitals, Faelledvej
11, Slagelse 4200, Denmark
(Meyhoff, Lunn) Department of Anesthesia and Intensive Care, Copenhagen
University Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23,
2400 Copenhagen, Denmark; Department of Clinical Medicine, University of
Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
(Jakobsen) Chief Physician, Copenhagen Trial Unit, Centre for Clinical
Intervention Research, Blegdamsvej 9, 2100 Copenhagen O, Denmark;
Department of Regional Health Research, Faculty of Health Sciences,
University of Southern Denmark, Studiestraede 6, 1455 Copenhagen, Denmark
(Gogenur) Department of Clinical Medicine, University of Copenhagen,
Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Center of Surgical Science,
Department of Gastrointestinal Surgery, Zealand University Hospital,
Lykkebaekvej 1, 4600 Koge, Denmark. Electronic address:
igo@regionsjaelland.dk
(Mathiesen) Department of Clinical Medicine, University of Copenhagen,
Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Centre of Anaesthesiological
Research, Department of Anesthesiology, Zealand University Hospital,
Lykkebaekvej 1, 4600 Koge, Denmark. Electronic address:
omat@regionsjaelland.dk
(Hagi-Pedersen) Research Centre of Anaesthesiology and Intensive Care
Medicine, Department of Anesthesiology, Naestved, Slagelse and Ringsted
Hospitals, Faelledvej 11, 4200 Slagelse, Denmark; Department of Clinical
Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N,
Denmark. Electronic address: dhag@regionsjaelland.dk
Publisher
NLM (Medline)
Abstract
BACKGROUND: Myocardial Injury after Non-cardiac Surgery (MINS) carries a
high postoperative mortality. In this pre-planned, subgroup analysis of
the randomized DEX-2-TKA trial, we investigated the effect of
dexamethasone versus placebo on the concentration of cardiac troponin I
and T (TnI and TnT) on the first postoperative morning after total knee
arthroplasty. In addition, frequency of MINS, myocardial infarction, and
major adverse cardiovascular events where evaluated. METHOD(S): We
included 290 patients who received either 24 mg of dexamethasone IV (given
perioperatively) or placebo. Blood samples were analysed as either TnI or
T depending on trial site. RESULT(S): 236 samples were eligible for
analysis of TnI and 38 samples for TnT on the first postoperative morning.
The median (IQR) TnI concentration was 4.6ng/l (0-7.2ng/l) in the
dexamethasone group and 4.5ng/l (0-7.0ng/l) in the placebo group (p=0.96)
on the first postoperative morning. The median TnT was 9ng/l (6-11ng/l) in
the dexamethasone group and 8ng/l (5-10ng/l) in the placebo group
(p=0.68). The frequencies of MINS, myocardial infarction and major adverse
cardiovascular events were similar in the compared groups but these
analyses were underpowered. CONCLUSION(S): We found no effect of
dexamethasone on postoperative concentration of troponin I or T on the
first postoperative morning after total knee arthroplasty. Copyright
© 2022. Published by Elsevier Inc.

<54>
Accession Number
2020659407
Title
Meta-Resolve of Risk Factors for Nosocomial Infection in Patients
Undergoing Thoracic Surgery.
Source
Contrast Media and Molecular Imaging. 2022 (no pagination), 2022. Article
Number: 2836014. Date of Publication: 2022.
Author
Chen J.; Zhang W.; Yang D.
Institution
(Chen, Zhang, Yang) Department of Cardiothoracic Surgery, Chongqing
Emergency Medical Center, Chongqing University Central Hospital,
Chongqing, China
Publisher
Hindawi Limited
Abstract
As we all know, various complications may occur after surgery, and
postoperative bleeding and infection are the most common in clinical
practice. Postoperative infection mainly manifests as abdominal abscess,
peritonitis, and fungal infection. Thoracic surgery is a very common
clinical operation. It can directly deal with the relevant lesions, so a
better curative effect can usually be obtained. However, patients
undergoing thoracic surgery are generally more severely ill, with low
immune resistance, long duration, and complicated surgical treatment
process. Therefore, the probability of nosocomial infection is high, and
there are many risk factors for infection. After the occurrence of HAI, it
not only increases the suffering and economic burden of patients and the
workload of medical staff but also prolongs the hospitalization time of
patients, reduces the turnover rate of hospital beds, causes unnecessary
economic losses, and affects the social and economic benefits of
hospitals. Based on this, this paper proposes to analyze the risk factors
of nosocomial infection in patients undergoing thoracic surgery, so as to
provide a reference for the prevention or control of nosocomial infection.
This paper analyzes the actual situation of nosocomial infection in a city
hospital and then uses meta-analysis to determine the factors of
nosocomial infection from the perspective of relevant research literature.
Meta-analysis results show that patients older than 60 years have twice
the risk of postoperative infection compared with patients younger than 60
years. Copyright © 2022 Junjian Chen et al.

<55>
Accession Number
2016445079
Title
Intra-Aortic Balloon Pump for Left Ventricular Unloading in Veno-Arterial
Extracorporeal Membrane Oxygenation: The Last Remaining Indication in
Cardiogenic Shock.
Source
Journal of the American Heart Association. 11(7) (no pagination), 2022.
Article Number: e025274. Date of Publication: April 2022.
Author
Bansal A.; Verghese D.; Vallabhajosyula S.
Institution
(Bansal) Department of Medicine, Cleveland Clinic Foundation, Cleveland,
OH, United States
(Verghese) Section of Advanced Cardiac Imaging, Division of Cardiovascular
Medicine, Department of Medicine, Harbor-UCLA Medical Center, Los Angeles,
CA, United States
(Vallabhajosyula) Division of Cardiovascular Medicine, Department of
Medicine, Wake Forest University School of Medicine, Winston-Salem, NC,
United States
Publisher
American Heart Association Inc.

<56>
Accession Number
2015585854
Title
Tranexamic acid alters the immunophenotype of phagocytes after lower limb
surgery.
Source
Thrombosis Journal. 20(1) (no pagination), 2022. Article Number: 17. Date
of Publication: December 2022.
Author
Draxler D.F.; Hanafi G.; Zahra S.; McCutcheon F.; Ho H.; Keragala C.B.;
Liu Z.; Daly D.; Painter T.; Wallace S.; Plebanski M.; Myles P.S.; Medcalf
R.L.
Institution
(Draxler, Hanafi, Zahra, McCutcheon, Ho, Keragala, Liu, Medcalf)
Australian Centre for Blood Diseases, Monash University, Melbourne,
Australia
(Draxler) Department of Cardiology, University hospital of Bern, Bern,
Switzerland
(Draxler) Bern Center for Precision Medicine, Bern, Switzerland
(Daly, Wallace, Myles) Department of Anaesthesiology and Perioperative
Medicine, The Alfred Hospital and Monash University, Melbourne, Australia
(Painter) Clinical Senior Lecturer, Discipline of Acute Care Medicine,
University of Adelaide, Adelaide, Australia
(Painter) Department of Anaesthesia, Royal Adelaide Hospital, Adelaide,
Australia
(Plebanski) School of Health and Biomedical Sciences, Royal Melbourne
Institute of Technology University, Melbourne, Australia
(Plebanski) Vaccine and Infectious Diseases Laboratory, Department of
Immunology and Pathology, Monash University, Melbourne, Australia
Publisher
BioMed Central Ltd
Abstract
Background: Tranexamic acid (TXA) is an antifibrinolytic agent frequently
used in elective surgery to reduce blood loss. We recently found it also
acts as a potent immune-modulator in patients undergoing cardiac surgery.
 Method(s): Patients undergoing lower limb surgery were enrolled into
the "Tranexamic Acid in Lower Limb Arthroplasty" (TALLAS) pilot study. The
cellular immune response was characterised longitudinally pre- and
post-operatively using full blood examination (FBE) and comprehensive
immune cell phenotyping by flowcytometry. Red blood cells and platelets
were determined in the FBE and levels of T cell cytokines and the
plasmin-antiplasmin complex determined using ELISA. Result(s): TXA
administration increased the proportion of circulating CD141+ conventional
dendritic cells (cDC) on post-operative day (POD) 3. It also reduced the
expression of CD83 and TNFR2 on classical monocytes and levels of
circulating IL-10 at the end of surgery (EOS) time point, whilst
increasing the expression of CCR4 on natural killer (NK) cells at EOS, and
reducing TNFR2 on POD-3 on NK cells. Red blood cells and platelets were
decreased to a lower extent at POD-1 in the TXA group, representing
reduced blood loss. Conclusion(s): In this investigation we have
extended our examination on the immunomodulatory effects of TXA in surgery
by also characterising the end of surgery time point and including B cells
and neutrophils in our immune analysis, elucidating new immunophenotypic
changes in phagocytes as well as NK cells. This study enhances our
understanding of TXA-mediated effects on the haemostatic and immune
response in surgery, validating changes in important functional immune
cell subsets in orthopaedic patients. Copyright © 2022, The
Author(s).

<57>
Accession Number
2015145984
Title
Infective endocarditis by Serratia species: a systematic review.
Source
Journal of Chemotherapy. 34(6) (pp 347-359), 2022. Date of Publication:
2022.
Author
Ioannou P.; Alexakis K.; Spentzouri D.; Kofteridis D.P.
Institution
(Ioannou, Alexakis, Spentzouri, Kofteridis) Department of Internal
Medicine & Infectious Diseases, University Hospital of Heraklion,
Heraklion, Greece
Publisher
Taylor and Francis Ltd.
Abstract
Serratia species are facultative anaerobes, non-spore-forming, motile
Gram-negative bacteria. Serratia spp. are currently thought to cause a
variety of infections, such as bacteremia, urinary tract infections, and
pneumonia, as well as other, less common infections, including ocular
infections or skin and soft tissue infections. On the other hand,
Infective Endocarditis (IE) is an infrequent disease with notable
morbidity and mortality. Even though IE is rarely caused by Serratia spp.,
these infections can be quite problematic due to the lack of experience in
their management. This study aimed to systematically review all published
cases of IE by Serratia spp. in the literature. A systematic review of
PubMed, Scopus, and Cochrane library (through 13th May 2021)
for studies providing epidemiological, clinical, microbiological data as
well as data on treatment and outcomes of IE by Serratia spp. was
performed. In total, 50 studies, containing data for 72 patients, were
included. A prosthetic valve was present in 18.1%. The mitral valve was
the most commonly infected site, followed by the aortic valve. The
diagnosis was facilitated by transthoracic echocardiography in 34.7%,
while the diagnosis was set at autopsy in 22.4%. Fever, sepsis, and
embolic phenomena were the most common clinical presentations, followed by
heart failure. Aminoglycosides, cephalosporins, and carbapenems were the
most commonly used antimicrobials. Clinical cure was noted only in 53.5%,
while overall mortality was 47.2%. Having surgery along with antimicrobial
treatment was independently associated with reduced overall mortality. IE
by Serratia spp. was more likely to be associated with intravenous drug
use, and to present with heart failure and embolic phenomena compared to
IE by other non-HACEK Gram-negative bacilli, while mortality was also
higher in IE by Serratia spp. Copyright © 2022 Edizioni Scientifi
che per l'Informazione su Farmaci e Terapia.

<58>
Accession Number
2018329267
Title
Custodiol versus Blood Cardioplegia: Comparison of Myocardial
Immunohistochemical Analysis and Clinical Outcomes.
Source
Brazilian Journal of Cardiovascular Surgery. 37(5) (pp 680-687), 2022.
Date of Publication: 2022.
Author
Sen O.; Aydin U.; Kadirogullari E.; Guler S.; Gonca S.; Solakoglu S.;
Karacalilar M.; Timur B.; Onan B.
Institution
(Sen, Aydin, Kadirogullari, Karacalilar, Timur, Onan) Department of
Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and
Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
(Guler) Department of Cardiovascular Surgery, GATA, Ankara, Turkey
(Gonca) Department of Histology and Embryology, Kocaeli University School
of Medicine, Kocaeli, Turkey
(Solakoglu) Department of Histology and Embryology, Istanbul University
School of Medicine, Istanbul, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Custodiol (histidine-tryptophan-ketoglutarate) and
repetitive blood cardioplegia are the solutions for myocardial protection
and cardiac arrest. In this study, we aimed to compare immunohistochemical
analysis, clinical outcomes, and cardiac enzyme values of Custodiol and
blood cardioplegia groups. Method(s): This was a randomized
prospective study consisting of 2 groups and 20 patients, 10 patients for
each group, who underwent mitral and mitral/tricuspid valve surgery. Group
1 was formed for Custodiol cardioplegia and group 2 for blood
cardioplegia. Perioperative and postoperative cardiac events were
recorded, cardiac enzymes were analyzed with intervals, and myocardial
samples were taken for immunohistochemical analysis. Recorded data were
statistically evaluated. Result(s): There was no significant
difference for the Custodiol and blood cardioplegia groups in
perioperative and postoperative cardiac performance and adverse events.
Cardiac enzyme analysis showed no significant difference between groups.
However, two parameters (eNOS, Bcl-2) were in favor of the Custodiol group
in immunohistochemical studies. Custodiol performed better in cellular
oxidative stress resistance and cellular viability. Conclusion(s):
Clinical outcomes and cardiac enzyme analysis results were similar
regarding myocardial protection. However, Custodiol performed better in
the immunohistochemical analysis. Copyright © 2022, Sociedade
Brasileira de Cirurgia Cardiovascular. All rights reserved.

<59>
Accession Number
2019504136
Title
Erector spinae plane block as perioperative analgesia for midline
sternotomy in cardiac surgery: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
King M.; Stambulic T.; Servito M.; Mizubuti G.B.; Payne D.; El-Diasty M.
Institution
(King, Stambulic, Servito) School of Medicine, Queen's University,
Kingston, ON, Canada
(Mizubuti) Department of Anesthesiology and Perioperative Medicine,
Queen's University, Kingston, ON, Canada
(Payne, El-Diasty) Division of Cardiac Surgery, Department of Surgery,
Queen's University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Inadequate analgesia following cardiac surgery increases
postoperative complications. Opioid-based analgesia is associated with
side effects that may compromise postoperative recovery. Regional
anesthetic techniques provide an alternative thereby reducing opioid
requirements and potentially enhancing postoperative recovery. The erector
spinae plane block has been used in multiple surgical procedures including
sternotomy for cardiac surgery. We, therefore, aimed to characterize the
impact of this block on post-sternotomy pain and recovery in cardiac
surgery patients. Method(s): We conducted an electronic search for
studies reporting on the use of the erector spinae plane block in adult
cardiac surgery via midline sternotomy. Randomized controlled trials,
cohort studies, and case-control studies were considered for inclusion.
Outcomes of interest included postoperative pain, time-to-extubation, and
intensive care unit length of stay. Result(s): In total, 498
citations were identified and five were included in the meta-analysis. The
erector spinae plane block did not significantly reduce self-reported
postoperative pain scores at 4 h (-2.04; 95% confidence interval [CI]
-8.15 to 4.07; p =.29) or 12 h (-0.27; 95% CI -2.48 to 1.94; p =.65)
postextubation, intraoperative opioid requirements (-3.07; 95% CI -6.25 to
0.11; p =.05], time-to-extubation (-1.17; 95% CI -2.81 to 0.46; p =.12),
or intensive care unit (ICU) length of stay (-4.51; 95% CI -14.23 to 5.22;
p =.24). Conclusion(s): Erector spinae plane block was not associated
with significant reduction in postoperative pain, intraoperative opioid
requirements, time-to-extubation, and ICU length of stay in patients
undergoing cardiac surgery. The paucity of large randomized controlled
trials and the high heterogeneity among studies suggest that further
studies are required to assess its effectiveness in cardiac surgery
patients. Copyright © 2022 Wiley Periodicals LLC.

<60>
Accession Number
2015104620
Title
Cardiovascular disease in hereditary haemophilia: The challenges of
longevity.
Source
British Journal of Haematology. 197(4) (pp 397-406), 2022. Date of
Publication: May 2022.
Author
Shapiro S.; Benson G.; Evans G.; Harrison C.; Mangles S.; Makris M.
Institution
(Shapiro) Oxford University Hospitals NHS Foundation Trust, Oxford NIHR
Biomedical Research Centre, Oxford, United Kingdom
(Shapiro) Radcliffe Department of Medicine, Oxford University, Oxford,
United Kingdom
(Benson) Belfast City Hospital, Belfast, United Kingdom
(Evans) Kent Haemophilia and Thrombosis Centre, East Kent Hospitals
University Foundation NHS Trust, Canterbury, United Kingdom
(Harrison, Makris) Sheffield Haemophilia and Thrombosis Centre, Royal
Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust,
Sheffield, United Kingdom
(Mangles) Haemophilia, Haemostasis and Thrombosis Centre, Hampshire
Hospitals NHS Foundation Trust, Basingstoke, United Kingdom
(Makris) Department of Infection, Immunity and Cardiovascular Disease,
University of Sheffield, Sheffield, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
The development of effective and safe treatments has significantly
increased the life expectancy of persons with haemophilia (PWH). This has
been accompanied by an increase in the comorbidities of ageing including
cardiovascular disease, which poses particular challenges due to the
opposing risks of bleeding from haemophilia and antithrombotic treatments
versus thrombosis. Although mortality secondary to coronary artery disease
in PWH is less than in the general population, the rate of atherosclerosis
appears similar. The prevalence of atrial fibrillation in PWH and risk of
secondary thromboembolic stroke are not well established. PWH can be
safely supported through acute coronary interventions but data on the
safety and efficacy of long-term antithrombotics are scarce. Increased
awareness and research on cardiovascular disease in PWH will be crucial to
improve primary prevention, acute management, secondary prevention and to
best support ageing PWH. Copyright © 2022 The Authors. British
Journal of Haematology published by British Society for Haematology and
John Wiley & Sons Ltd.

<61>
Accession Number
2020555094
Title
The effect of aggressive management of intraoperative body temperature on
postoperative APACHE II score and prognosis in high-risk patients
undergoing thoracoscopic surgery.
Source
Journal of Thoracic Disease. 14(9) (pp 3429-3437), 2022. Date of
Publication: September 2022.
Author
Li W.; Hu Z.; Liu J.; Yuan Y.; Li K.
Institution
(Li, Hu, Liu, Yuan, Li) Department of Anesthesiology, China-Japan Union
Hospital, Jilin University, Changchun, China
Publisher
AME Publishing Company
Abstract
Background: Intraoperative hypothermia is related with postoperative
complication, longer length of stay (LoS) and mortality. Acute Physiology
and Chronic Health Evaluation II (APACHE II) it the most commonly used
evaluation system for assessing the severity and clinical prognosis of
patients. This study sought to examine the effect of intraoperative body
temperature on postoperative APACHE II scores and the prognosis of
high-risk patients undergoing thoracoscopic surgery. Method(s): This
study used the clinical data of patients from a multicenter randomized
controlled trial who had undergone thoracoscopic surgery at our center
(NCT03111875). In our center were randomly assigned (1:1) to receive
either aggressive warming to a target core temperature of 37 or routine
thermal management to a target of 35.5 during non-cardiac surgery.
Randomisation was computer-generated. Eligible patients (aged >=45 years)
had at least one cardiovascular risk factor, were scheduled for inpatient
noncardiac surgery expected to last 2-6 h with general anaesthesia. We
retrieved medical information through the electronic medical record
system. The primary outcome was the postoperative APACHE II scores, APACHE
II score variation. The secondary outcome was Quality of Recovery-15
(QoR-15) scores, LoS in hospital, postoperative complications, infections,
and deaths of the patients were recorded, and a logistic regression
analysis was conducted to stratify the risk factors for the APACHE II
score. Result(s): Group R comprised 121 patients and Group A
comprised 84 patients. Group A had lower postoperative APACHE II scores
(P=0.046) and a lower probability of a grade increase than Group R
(P=0.005). However, no significant differences were found in terms of the
QoR-15 scores, LoS, postoperative complications, infections, and deaths
between the 2 groups. The logistic regression showed that aggressive
warming, age, and the American Society of Anesthesiologists (ASA) grade
were risk factors for the deterioration of postoperative APACHE II scores.
 Conclusion(s): The active adoption of various passive and aggressive
warming strategies to keep the core body temperature >=37 during
thoracoscopic surgery significantly reduced increases in APACHE II scores,
which is different from age and ASA grade, and was the only intervention
factor. Copyright © Journal of Thoracic Disease. All rights
reserved.

<62>
Accession Number
2020520250
Title
Research Progress on Coping Strategies of Cognitive Impairment after
Cardiac Surgery: A Systematic Review of Literature.
Source
Heart Surgery Forum. 25(1) (pp E118-E123), 2022. Date of Publication: 12
Jan 2022.
Author
Yan Y.; Sandeep B.; Ding W.; Ma C.; Peng S.; Xiao Z.
Institution
(Yan, Ding, Peng) Zunyi Medical University, Guizhou, Zunyi, China
(Sandeep, Ma) Department of Cardio-Thoracic Surgery, Chengdu Second
People's Hospital, Sichuan, Chengdu, China
(Xiao) Department of Cardio-Thoracic Surgery, Zunyi Medical University,
Chengdu Second People's Hospital, Sichuan, Chengdu, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Postoperative cognitive dysfunction (POCD) refers to a complication of
neurological dysfunction after surgery, including one or more changes that
are significantly lower than those before surgery. The purpose of this
study was to review the coping strategies and risk factors of POCD.
Systemic research was conducted searching Pubmed, Web of Science, MEDLINE,
and other websites with the keywords of cardiac surgery, cognitive
impairment, and POCD. Multiple factors have been associated with the
treatment of POCD, including anesthetic, choice of analgesic drugs,
anti-inflammatory drugs, erythropoietin, atherosclerosis, emotional
factors, surgical, and other factors. Targeted treatments are carried out
for risk factors that may affect POCD prevention, such as anesthetic drug
prevention, anti-inflammatory drug prevention, and intraoperative
prevention and other preventive measures are aimed at reducing the
incidence of POCD after cardiac surgery. Copyright © 2022 Forum
Multimedia Publishing, LLC.

<63>
Accession Number
2017603659
Title
The use of steroids in treating chylothorax following cardiac surgery in
children: a unique perspective.
Source
Cardiology in the Young. 32(4) (pp 525-530), 2022. Date of Publication: 01
Apr 2022.
Author
Saad D.; Makarem A.; Fakhri G.; Al Amin F.; Bitar F.; El Rassi I.; Arabi
M.
Institution
(Saad, Fakhri) Department Of Pediatrics And Adolescent Medicine, American
University Of Beirut Medical Center, Beirut, Lebanon
(Makarem) Faculty Of Medicine, American University Of Beirut Medical
Center, Beirut, Lebanon
(Al Amin, Bitar, Arabi) Division Of Pediatric Cardiology, Department Of
Pediatrics And Adolescent Medicine, American University Of Beirut Medical
Center, Beirut, Lebanon
(El Rassi) Department Of Cardiothoracic Surgery, American University Of
Beirut Medical Center, Beirut, Lebanon
Publisher
Cambridge University Press
Abstract
Background: Chylothorax is the accumulation of chyle fluid in the pleural
space. The incidence of chylothorax is quite common post-cardiac surgeries
in pediatrics especially in Fontan procedures. Although several treatment
lines are known for the management of chylothorax, steroids were scarcely
reported as a treatment option. We present a unique case of a 4-year-old
child who underwent Fontan procedure and suffered a long-term consequence
of chylothorax. The chylothorax only fully resolved after introducing
corticosteroids as part of her management. Method(s): A literature
review about management of chylothorax post-cardiac surgery in children
using Ovid Medline (19462021), PubMed, and google scholar was performed.
 Conclusion(s): Conservative management without additional surgical
intervention is adequate in most patients. Additionally, somatostatin can
be used with variable success rate. However, a few cases mentioned using
steroids in such cases. More research and reporting on the use of steroids
in the treatment of chylothorax post-cardiac surgeries in children is
needed to prove its effectivity. In this article, we describe a case of
chylothorax post-Fontan procedure that supports the use of
steroids. Copyright ©

<64>
Accession Number
2017039819
Title
Outcomes of heart transplantation in cardiac amyloidosis: an updated
systematic review.
Source
Heart Failure Reviews. 27(6) (pp 2201-2209), 2022. Date of Publication:
November 2022.
Author
Lakhdar S.; Buttar C.; Nassar M.; Ciobanu C.; Patel R.; Munira M.S.
Institution
(Lakhdar, Nassar) Department of Medicine, Icahn School of Medicine at
Mount Sinai/NYC H+H/Queens, 82-68 164th St. Queens, New York, NY 11432,
United States
(Buttar) Department of Cardiology, Ochsner Medical Center, New Orleans,
LA, United States
(Ciobanu) St. Barnabas Hospital/Albert Einstein College of Medicine, New
York, NY, United States
(Patel, Munira) Division of Cardiology, Icahn School of Medicine at Mount
Sinai/NYC H+H/Queens, New York, NY, United States
(Munira) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
New York, NY, United States
Publisher
Springer
Abstract
Cardiac amyloidosis is one of the most common infiltrative
cardiomyopathies that is characterized by the extracellular deposition of
misfolded fibrillar protein. Several studies have previously found that
patients with amyloid in the past have performed poorly after heart
transplantation. Recent advancements in treatments have been made that
have significantly improved outcomes in these patients. The study aimed to
evaluate the outcomes of heart transplantation in cardiac amyloidosis. We
systematically searched EMBASE, PubMed/MEDLINE, and Cochrane Library
databases on 30 December 2021 following the Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) guidelines. We identified 22
studies that examined 42,951 patients with cardiac amyloidosis of which
only 1,329 patients underwent isolated heart transplantation. Seven
studies reported individual patient data. The results of 123 patients have
been pooled for analysis. There were 70 male patients, 45 female patients,
and eight patients who did not report their gender. Among the types of
amyloids, 63 (51%) patients were found to have light chain amyloidosis
(AL) and 33 (27%) patients had transthyretin amyloidosis (ATTR). Only 41
patients (33.3%) reported a monoclonal component. There were 30 patients
with AL that underwent autologous hematopoietic stem cell transplant
(ASCT). The mean survival of 24 out of 30 patients was 4.33 years. In
addition, the reported data include 13 patients requiring intra-aortic
balloon pump (IABP), six with cardiac resynchronization therapy (CRT), and
four with implantable cardioverter defibrillator (ICD). With the current
advancements in treatments in combination with a multidisciplinary
approach and careful patient selection, patients undergoing heart
transplantation for amyloidosis may have encouraging results in the
current era. Further studies will be needed to evaluate the outcomes of
heart transplantation in amyloidosis patients now that several advances
have been made in the field. Copyright © 2022, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<65>
[Use Link to view the full text]
Accession Number
2020088132
Title
Comparison of Ratings of Perceived Exertion and Target Heart Rate-Based
Exercise Prescription in Cardiac Rehabilitation: A RANDOMIZED CONTROLLED
PILOT STUDY.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 42(5) (pp
352-358), 2022. Date of Publication: Sep-22.
Author
Shea M.G.; Headley S.; Mullin E.M.; Brawner C.A.; Schilling P.; Pack Q.R.
Institution
(Shea, Schilling) Division of Cardiovascular Medicine
(Headley, Pack) Institute for Healthcare Delivery and Population Science
(Pack) Department of Medicine, University of Massachusetts Medical
School-Baystate, Springfield, United States
(Shea, Headley, Mullin) Springfield College Department of Exercise Science
and Athletic Training, Springfield, MA, United States
(Shea) Mayo Clinic Arizona, Scottsdale, United States
(Brawner) Division of Cardiovascular Medicine, Henry Ford Hospital,
Detroit, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: Although ratings of perceived exertion (RPE) are widely used to
guide exercise intensity in cardiac rehabilitation (CR), it is unclear
whether target heart rate ranges (THRRs) can be implemented in CR programs
that predominantly use RPE and what impact this has on changes in exercise
capacity. Method(s): We conducted a three-group pilot randomized
control trial (#NCT03925493) comparing RPE of 3-4 on the 10-point modified
Borg scale, 60-80% of heart rate reserve (HRR) with heart rate (HR)
monitored by telemetry, or 60-80% of HRR with a personal HR monitor (HRM)
for high-fidelity adherence to THRR. Primary outcomes were protocol
fidelity and feasibility. Secondary outcomes included exercise HR, RPE,
and changes in functional exercise capacity. Result(s): Of 48
participants randomized, four patients dropped out, 20 stopped prematurely
(COVID-19 pandemic), and 24 completed the protocol. Adherence to THRR was
high regardless of HRM, and patients attended a median (IQR) of 33 (23,
36) sessions with no difference between groups. After randomization, HR
increased by 1 +/- 6, 6 +/- 5, and 10 +/- 9 bpm (P =.02); RPE (average
score 3.0 +/- 0.05) was unchanged, and functional exercise capacity
increased by 1.0 +/- 1.0, 1.9 +/- 1.5, 2.0 +/- 1.3 workload METs (effect
size between groups, eta <inf>p</inf> 2= 0.11, P =.20) for the
RPE, THRR, and THRR + HRM groups, respectively. Conclusion(s): We
successfully implemented THRR in an all-RPE CR program without needing an
HRM. Patients randomized to THRR had higher exercise HR but similar RPE
ratings. The THRR may be preferable to RPE in CR populations for
cardiorespiratory fitness gains, but this needs confirmation in an
adequately powered trial. Copyright © 2022 Lippincott Williams
and Wilkins. All rights reserved.

<66>
Accession Number
2019560527
Title
Tranexamic Acid and Its Potential Anti-Inflammatory Effect: A Systematic
Review.
Source
Seminars in Thrombosis and Hemostasis. 48(5) (pp 568-595), 2022. Date of
Publication: 26 Jul 2022.
Author
Okholm S.H.; Krog J.; Hvas A.-M.
Institution
(Okholm, Hvas) Department of Clinical Medicine, Health, Aarhus University,
Vennelyst Boulevard 4, Aarhus C DK 8000, Denmark
(Krog) Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Aarhus C, Denmark
(Hvas) Department of Clinical Biochemistry, Aarhus University Hospital,
Aarhus C, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Tranexamic acid (TXA) is an antifibrinolytic drug primarily used for
reducing blood loss in patients with major bleedings. Animal and cell
studies have shown that TXA might modulate the inflammatory response by
either enhancing or inhibiting cytokine levels. Furthermore, recent human
studies have found altered inflammatory biomarkers in patients receiving
TXA when compared with patients who did not receive TXA. In this
systematic review we investigated the effect of TXA on inflammatory
biomarkers in different patient groups. A systematic literature search was
conducted on the databases PubMed and Embase to identify all original
articles that investigated inflammatory biomarkers in patients receiving
TXA and compared them to a relevant control group. The review was
performed according to the PRISMA guidelines, and the literature search
was performed on November 29, 2021. Thirty-three studies were included,
among which 14 studies compared patients receiving TXA with patients
getting no medication, another 14 studies investigated different dosing
regimens of TXA, and finally five studies examined the administration form
of TXA. The present review suggests that TXA has an anti-inflammatory
effect in patients undergoing orthopaedic surgery illustrated by decreased
levels of C-reactive protein and interleukin-6 in patients receiving TXA
compared with patients receiving no or lower doses of TXA. However, the
anti-inflammatory effect was not found in patients undergoing cardiac
surgery, pediatric craniosynostosis patients, or in rheumatoid arthritis
patients. The inflammatory response was not affected by administration
form of TXA (oral, intravenous, or topical). In conclusion, an
anti-inflammatory effect of TXA was consistently found among orthopaedic
patients only. Copyright © 2022. Thieme. All rights reserved.

<67>
Accession Number
2018182199
Title
Small Dense Low-Density Lipoprotein Cholesterol and Cardiovascular Risk in
Statin-Treated Patients with Coronary Artery Disease.
Source
Journal of Atherosclerosis and Thrombosis. 29(10) (pp 1458-1474), 2022.
Date of Publication: 2022.
Author
Ishii J.; Kashiwabara K.; Ozaki Y.; Takahashi H.; Kitagawa F.; Nishimura
H.; Ishii H.; Iimuro S.; Kawai H.; Muramatsu T.; Naruse H.; Iwata H.;
Tanizawa-Motoyama S.; Ito H.; Watanabe E.; Matsuyama Y.; Fukumoto Y.;
Sakuma I.; Nakagawa Y.; Hibi K.; Hiro T.; Hokimoto S.; Miyauchi K.; Ohtsu
H.; Izawa H.; Ogawa H.; Daida H.; Shimokawa H.; Saito Y.; Kimura T.;
Matsuzaki M.; Nagai R.
Institution
(Ishii) Department of Clinical Laboratory, Bantane Hospital, Fujita Health
University School of Medicine, Nagoya, Japan
(Kashiwabara) Data Science Office, Clinical Research Promotion Center, The
University of Tokyo Hospital, Tokyo, Japan
(Ozaki, Nishimura, Kawai, Muramatsu, Tanizawa-Motoyama, Watanabe, Izawa)
Department of Cardiology, Fujita Health University School of Medicine,
Toyoake, Japan
(Takahashi) Division of Statics, Fujita Health University School of
Medicine, Toyoake, Japan
(Kitagawa, Ito) Department of Joint Research Laboratory of Clinical
Medicine, Fujita Health University School of Medicine, Toyoake, Japan
(Ishii) Department of Cardiovascular Medicine, Gunma University Graduate
School of Medicine, Maebashi, Japan
(Iimuro) Innovation and Research Support Center, International University
of Health and Welfare, Tokyo, Japan
(Naruse) Faculty of Medical Technology, School of Health Sciences, Fujita
Health University, Toyoake, Japan
(Iwata, Miyauchi, Daida) Department of Cardiovascular Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Matsuyama) Department of Biostatistics, School of Public Health, The
University of Tokyo, Tokyo, Japan
(Fukumoto) Division of Cardiovascular Medicine, Department of Internal
Medicine, Kurume University School of Medicine, Kurume, Japan
(Sakuma) Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
(Nakagawa) Department of Cardiovascular Medicine, Shiga University of
Medical Science, Otsu, Japan
(Hibi) Division of Cardiology, Yokohama City University Medical Center,
Yokohama, Japan
(Hiro) Division of Cardiology, Department of Medicine, Nihon University
School of Medicine, Tokyo, Japan
(Hokimoto) Kumamoto Municipal Ueki Hospital, Kumamoto, Japan
(Ohtsu) Clinical Pharmacology and Regulatory Science, Graduate School of
Medicine, Juntendo University, Tokyo, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
(Shimokawa) Department of Cardiovascular Medicine, Tohoku University
Graduate School of Medicine, Sendai, Japan
(Shimokawa) International University of Health and Welfare, Narita, Japan
(Saito) Chiba University, Chiba, Japan
(Kimura) Department of Cardiovascular Medicine, Kyoto University Graduate
School of Medicine, Kyoto, Japan
(Matsuzaki) St. Hill Hospital, Ube, Japan
(Nagai) Jichi Medical University, Shimotsuke, Japan
Publisher
Japan Atherosclerosis Society
Abstract
Aim: We investigated the relationship between small dense low-density
cholesterol (sdLDL-C) and risk of major adverse cardiovascular events
(MACE) in patients treated with high-or low-dose statin therapy.
 Method(s): This was a prospective case-cohort study within the
Randomized Evaluation of Aggressive or Moderate Lipid-Lowering Therapy
with Pitavastatin in Coronary Artery Disease (REAL-CAD) study, a
randomized trial of high-or low-dose (4 or 1 mg/d pitavastatin,
respectively) statin therapy, in patients with stable coronary artery
disease (CAD). Serum sdLDL-C was determined using an automated homogenous
assay at baseline (randomization after a rule-in period, 1 month with 1
mg/d pitavastatin) and 6 months after randomization, in 497 MACE cases,
and 1543 participants randomly selected from the REAL-CAD study
population. Result(s): High-dose pitavastatin reduced sdLDL-C by 20%
than low-dose pitavastatin (p for interaction 0.001). Among patients
receiving low-dose pitavastatin, baseline sdLDL-C demonstrated higher MACE
risk independent of LDL-C (hazard ratio [95% confidence interval], 4th
versus 1st quartile, 1.67 [1.04-2.68]; p for trend =0.034). High-dose
(versus low-dose) pitavastatin reduced MACE risk by 46% in patients in the
highest baseline sdLDL-C quartile (34.3 mg/dL; 0.54 [0.36-0.81]; p
=0.003), but increased relative risk by 40% in patients with 1st quartile
(<= 19.5 mg/dL; 1.40 [0.94-2.09]; p =0.099) and did not alter risk in
those in 2nd and 3rd quartiles (p for interaction =0.002).
 Conclusion(s): These findings associate sdLDL-C and cardiovascular
risk, independent of LDL-C, in statin-treated CAD patients. Notably,
high-dose statin therapy reduces this risk in those with the highest
baseline sdLDL-C. Copyright © 2022 Japan Atherosclerosis Society.

<68>
Accession Number
2020677547
Title
The pediatric heart network's study on long-term outcomes of children with
HLHS and the impact of Norwood Shunt type in the single ventricle
reconstruction trial cohort (SVRIII): Design and adaptations.
Source
American Heart Journal. 254 (pp 216-227), 2022. Date of Publication:
December 2022.
Author
Goldberg C.S.; Gaynor J.W.; Mahle W.T.; Ravishankar C.; Frommelt P.;
Ilardi D.; Bellinger D.; Paridon S.; Taylor M.; Hill K.D.; Minich L.L.;
Schwartz S.; Afton K.; Lamberti M.; Trachtenberg F.L.; Gongwer R.; Atz A.;
Burns K.M.; Chowdhury S.; Cnota J.; Detterich J.; Frommelt M.; Jacobs
J.P.; Miller T.A.; Ohye R.G.; Pizarro C.; Shah A.; Walters P.; Newburger
J.W.
Institution
(Goldberg) Department of Pediatrics, C.S. Mott Children's Hospital,
University of Michigan, Ann Arbor, MI, United States
(Gaynor) Division of Cardiothoracic Surgery, Department of Surgery,
Children's Hospital of Philadelphia, the Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA
(Mahle) Department of Pediatrics, Children's Healthcare of Atlanta,
Atlanta, GE
(Ravishankar, Paridon) Department of Pediatrics, Children's Hospital of
Philadelphia and the Perelman School of Medicine, Philadelphia, PA
(Frommelt, Frommelt) Department of Pediatrics, Children's University of
Pennsylvania Hospital of Wisconsin, Milwaukee, WI, United States
(Ilardi) Department of Neuropsychology, Children's Healthcare of Atlanta,
Emory University, Atlanta, GE
(Bellinger) Department of Neurology, Boston Children's Hospital, Boston,
MA
(Taylor) Department of Pediatrics, Cincinnati Children's Hospital and
Medical Center, Cincinnati, OH
(Hill) Department of Pediatrics, Duke University, Durham, NC
(Minich) Department of Pediatrics, The University of Utah and Primary
Children's Hospital, Salt Lake City, UT
(Schwartz) Department of Critical Care Medicine, The Hospital for Sick
Children, Toronto, ON
(Afton) Michigan Congenital Heart Center Research and Discovery,
University of Michigan, Ann Arbor, MI, United States
(Lamberti, Trachtenberg, Gongwer) HealthCore Inc, Newton, MA
(Atz, Burns, Chowdhury) Department of Pediatrics, Medical University of
South Carolina, Charleston, SC
(Cnota) Division of Pediatric Cardiology, Cincinnati Children's Hospital
and Medical Center, Cincinnati, OH
(Detterich) Department of Pediatrics, Children's Hospital of Los Angeles,
Los Angeles, CA
(Jacobs) Department of Surgery, University of Florida, Gainseville, FL
(Miller) Maine Medical Center, University of Utah, PortlandSalt Lake City,
MEUT
(Ohye) Department of Cardiac Surgery, University of Michigan, Ann Arbor,
MI, United States
(Pizarro) Department of Surgery, Nemours Cardiac Center, Wilmington, DE
(Shah) Department of Pediatrics, Columbia University Medical Center, New
York, NY, United States
(Walters) Hospital for Sick Children, Toronto, Ontario
(Newburger) Department of Pediatric Cardiology, Boston Children's
Hospital, Boston, MA
Publisher
Elsevier Inc.
Abstract
Background: The Single Ventricle Reconstruction (SVR) Trial was the first
randomized clinical trial of a surgical approach for treatment of
congenital heart disease. Infants with hypoplastic left heart syndrome
(HLHS) and other single right ventricle (RV) anomalies were randomized to
a modified Blalock Taussig Thomas shunt (mBTTS) or a
right-ventricular-to-pulmonary-artery shunt (RVPAS) at the time of the
Norwood procedure. The aim of the Long-term Outcomes of Children with HLHS
and the Impact of Norwood Shunt Type (SVR III) study is to compare early
adolescent outcomes including measures of cardiac function,
transplant-free survival, and neurodevelopment, between those who received
a mBTTS and those who received an RVPAS. Method(s): Transplant-free
survivors of the SVR cohort were enrolled at 10 to 15 years of age for
multifaceted in-person evaluation of cardiac function (cardiac magnetic
resonance [CMR], echocardiogram and exercise test) and neurodevelopmental
evaluation. Right ventricular ejection fraction measured by CMR served as
the primary outcome. Development of arrhythmias, protein losing
enteropathy, and other comorbidities were assessed through annual medical
history interview. Through the course of SVR III, protocol modifications
to engage SVR trial participants were designed to enhance recruitment and
retention. Conclusion(s): Evaluation of long-term outcomes will
provide important data to inform decisions about the shunt type placed at
the Norwood operation and will improve the understanding of cardiovascular
and neurodevelopmental outcomes for early adolescents with
HLHS. Copyright © 2022 Elsevier Inc.

<69>
[Use Link to view the full text]
Accession Number
2020240299
Title
Effects of high-intensity statin combined with telmisartan versus
amlodipine on glucose metabolism in hypertensive atherosclerotic
cardiovascular disease patients with impaired fasting glucose: A
randomized multicenter trial.
Source
Medicine (United States). 101(36) (pp E30496), 2022. Date of Publication:
09 Sep 2022.
Author
Lee C.J.; Sung J.-H.; Kang T.-S.; Park S.; Lee S.-H.; Kim J.-Y.; Kim B.-K.
Institution
(Lee, Park, Lee, Kim) Division of Cardiology, Severance Cardiovascular
Hospital, Yonsei University College of Medicine, Seoul, South Korea
(Sung) Department of Cardiology, Cha Bundang Medical Center, Cha
University, Seongnam, Gyeonggi-do, South Korea
(Kang) Division of Cardiology, Department of Internal Medicine, Dankook
University College of Medicine, Cheonan, South Korea
(Kim) Division of Cardiology, Heart Center, Gangnam Severance Hospital,
Yonsei University College of Medicine, Seoul, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background: There is lacking evidence that telmisartan can improve insulin
resistance in patients on high-intensity statins. This study compared the
effects of telmisartan and amlodipine on glucose metabolism in
hypertensive atherosclerotic cardiovascular disease (ASCVD) patients with
impaired fasting glucose (IFG) requiring high-intensity rosuvastatin
therapy. Method(s): Ninety-nine patients were randomly assigned to 2
groups [telmisartan-statin group (n=48) and amlodipine-statin group
(n=51)] as add-on therapy to high-intensity rosuvastatin therapy (20 mg).
The primary endpoint was to assess insulin resistance using the
homeostatic model assessment (HOMA-IR) value at week 24. The secondary
endpoint was the change in glucose metabolism indices from baseline to
week 24. Result(s): The HOMA-IR at week 24 (2.4 [interquartile range,
1.8-3.8] versus 2.7 [1.7-3.7]; P =.809) and changes in the HOMA-IR from
baseline to week 24 (-7.0 [-29.0 to 21.0] versus-5.5 [-53.3 to 27.3]; P
=.539) were not significantly different between 2 groups. However, the
fasting glucose level at week 24 was significantly lower in the
telmisartan-statin group than in the amlodipine-statin group (107.7 +/-
13.4 mg/dL versus 113.3 +/- 12.4 mg/dL; P =.039) and significantly
decreased in the telmisartan-statin group (-3.2 +/- 8.6% versus 3.8 +/-
13.2%; P =.003). The proportion of patients with fasting glucose >=100
mg/dL (71.1% versus 89.6%; P =.047) or new-onset diabetes mellitus (12.5%
versus 31.4%, P =.044) at week 24 was also significantly lower in the
telmisartan-statin group than in the amlodipine-statin group.
 Conclusion(s): In comparison to amlodipine, telmisartan did not
decrease the HOMA-IR. However, telmisartan preserved insulin secretion,
led to a regression from IFG to euglycemia and prevented new-onset
diabetes mellitus in ASCVD patients with IFG requiring high-intensity
statins. Copyright © 2022 Wolters Kluwer Health, Inc. All rights
reserved.

<70>
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

<71>
Accession Number
2015507120
Title
Meta-Analysis Evaluating High-Sensitivity Cardiac Troponin T Kinetics
after Coronary Artery Bypass Grafting in Relation to the Current
Definitions of Myocardial Infarction.
Source
American Journal of Cardiology. 163 (pp 25-31), 2022. Date of Publication:
15 Jan 2022.
Author
Heuts S.; Denessen E.J.S.; Daemen J.H.T.; Vroemen W.H.M.; Sels J.-W.;
Segers P.; Bekers O.; van 't Hof A.W.J.; Maessen J.G.; van der Horst
I.C.C.; Mingels A.M.A.
Institution
(Heuts, Segers, Maessen) Department of Cardiothoracic Surgery
(Denessen, Vroemen, Bekers, Mingels) Department of Central Diagnostic
Laboratory
(Sels, van der Horst) Department of Intensive Care Medicine, and
(Sels, van 't Hof) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
(Denessen, Bekers, van 't Hof, Maessen, van der Horst, Mingels)
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Daemen) Department of Surgery, and
(van 't Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
Elsevier Inc.
Abstract
Various definitions of myocardial infarction type 5 after coronary artery
bypass grafting (CABG) have been proposed (myocardial infarction [MI-5],
also known as peri-procedural MI), using different biomarkers and
different and arbitrary cut-off values. This meta-analysis aims to
determine the expected release of high-sensitivity cardiac troponin T
(hs-cTnT) after CABG in general and after uncomplicated surgery and
off-pump CABG in particular. A systematic search was applied to 3
databases. Studies on CABG as a single intervention and reporting on
postoperative hs-cTnT concentrations on at least 2 different time points
were included. All data on hs-cTnT concentrations were extracted, and mean
concentrations at various points in time were stratified. Eventually, 15
studies were included, encompassing 2,646 patients. Preoperative hs-cTnT
was 17 ng/L (95% confidence interval [CI] 13 to 20 ng/L). Hs-cTnT peaked
at 6 to 8 hours postoperatively (628 ng/L, 95% CI 400 to 856 ng/L; 45x
upper reference limit [URL]) and was still increased after 48 hours. In
addition, peak hs-cTnT concentration was 614 ng/L (95% CI 282 to 947 ng/L)
in patients with a definite uncomplicated postoperative course (i.e.,
without MI). For patients after off-pump CABG compared to on-pump CABG,
the mean peak hs-cTnT concentration was 186 ng/L (95% CI 172 to 200 ng/L,
13 x URL) versus 629 ng/L (95% CI 529 to 726 ng/L, 45 x URL),
respectively. In conclusion, postoperative hs-cTnT concentrations surpass
most of the currently defined cut-off values for MI-5, even in perceived
uncomplicated surgery, suggesting thorough reassessment. Hs-cTnT release
differences following on-pump CABG versus off-pump CABG were observed,
implying the need for different cut-off values for different surgical
strategies. Copyright © 2021 The Author(s)

<72>
Accession Number
2016871161
Title
Clinical outcomes of heart transplantation using hepatitis c-viremic
donors: A systematic review with meta-analysis.
Source
Journal of Heart and Lung Transplantation. 41(4) (pp 538-549), 2022. Date
of Publication: April 2022.
Author
Villegas-Galaviz J.; Anderson E.; Guglin M.
Institution
(Villegas-Galaviz) Department of Medicine, Indiana University School of
Medicine, Indianapolis, IN, United States
(Anderson) Cardiothoracic Transplant, Indiana University Health Methodist
Hospital, Indianapolis, IN, United States
(Guglin) Heart Failure/Heart Transplantation/MCS Services, Krannert
Institute of Cardiology, Indiana University School of Medicine,
Indianapolis, IN, United States
Publisher
Elsevier Inc.
Abstract
Background: Heart transplantation (HTx) from hepatitis C virus
(HCV)-viremic donors to nonviremic recipients decreases mortality and
costs. Consequently, many transplant centers have reported their results
using this strategy. Hence, there is a need for an outcome analysis.
 Method(s): We performed a systematic review with meta-analysis. In
August 2020, we searched PubMed and EMBASE for publications containing
data of nonviremic recipients who underwent HTx from HCV-viremic donors
once direct-acting antiviral (DAA) therapy had become available (>=2014).
 Result(s): We identified 398 publications, 13 of which met inclusion
criteria, and analyzed the outcomes of 195 recipients. The
HCV-transmission rate was >97% but, the cure rate was 100% with DAA
therapy. The 6 and 12-month survival were 95.6% and 92.9%, respectively.
Of 10 deaths reported, none were associated with HCV infection. The acute
cellular rejection (ACR) rate was 31.1%. The overall DAA failure rate was
1.1%, defined as the need to alter the initial DAA therapy due to failure
to cure HCV. However, the DAA failure rate was 0% when the DAA therapy was
started within the first 2 weeks post-HTx. No statistically significant
differences in HCV cure rates, survivals, ACR rates, and DAA failure rates
were observed when outcomes were stratified by therapeutic approach type
(i.e., a prophylactic approach in which DAA was given to the recipient
before confirming HCV-transmission vs a reactive approach, in which DAA
was given to the recipient only after an HCV-transmission was confirmed).
 Conclusion(s): Excellent clinical outcomes have been observed in
nonviremic recipients of HTx from HCV-viremic donors since DAA had become
available. Copyright © 2022 International Society for Heart and
Lung Transplantation

<73>
Accession Number
2016751483
Title
Perioperative Cardiometabolic Targets and Coronary Artery Bypass Surgery
Mortality in Patients With Diabetes.
Source
Journal of the American Heart Association. 11(9) (no pagination), 2022.
Article Number: e023558. Date of Publication: 03 May 2022.
Author
Skendelas J.P.; Phan D.K.; Friedmann P.; Rodriguez C.J.; Stein D.;
Arbab-Zadeh A.; Forest S.J.; Slipczuk L.
Institution
(Skendelas, Phan, Friedmann, Forest) Cardiothoracic and Vascular Surgery
Department, Montefiore Medical Center/Albert Einstein College of Medicine,
Bronx, NY, United States
(Rodriguez, Slipczuk) Cardiology Division, Montefiore Medical
Center/Albert Einstein College of Medicine, Bronx, NY, United States
(Stein) Endocrinology Division, Montefiore Medical Center/Albert Einstein
College of Medicine, Bronx, NY, United States
(Arbab-Zadeh) Heart and Vascular Institute, Johns Hopkins University,
Baltimore, MD, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Coronary artery bypass graft (CABG) surgery represents the
preferred revascularization strategy for most patients with diabetes and
multivessel disease. We aimed to evaluate the role of optimized,
perioperative cardiometabolic targets on long-term survival in patients
who underwent CABG. METHODS AND RESULTS: Single-institution retrospective
study was conducted in patients with diabetes who underwent CABG between
January 2010 and June 2018. Demographic, surgical, and cardiometabolic
determinants were identified during the perioperative period. Clinical
characteristics and longitudinal survival outcomes data were obtained. A
total of 1534 patients with CABG were considered for analysis and 1273 met
inclusion criteria. The mean age of patients was 63.3 years (95% CI, 62.7-
63.8 years), and most were men (65%) and Hispanic or Latino (47%).
Comorbidities included hypertension (95%) and dyslipidemia (88%). In
total, 490 patients (52%) had a low-density lipoprotein cholesterol level
>70 mg/dL. Furthermore, 390 patients (31%) had uncontrolled systolic blood
pressure >130 mm Hg. Last, only 386 patients (29%) had a hemoglobin
A<inf>1c</inf> level between 6% and 7%. At 5 years, 121 patients (10%)
died. Failure to achieve goal systolic blood pressure was associated with
all-cause (hazard ratio [HR], 1.573; 95% CI, 1.048- 2.362 [P=0.029]) and
cardiovascular (HR, 2.023; 95% CI, 1.196- 3.422 [P=0.009]) mortality at 5
years post-CABG. In contrast, prescription of a statin during the
perioperative interval demonstrated a protective effect for all-cause (HR,
0.484; 95% CI, 0.286- 0.819 [P=0.007]) and cardiovascular (HR, 0.459; 95%
CI, 0.229- 0.920 [P=0.028]) mortality. There was no association between
achievement of low-density lipoprotein cholesterol, triglycer-ides, non-
high-density lipoprotein cholesterol, or hemoglobin A<inf>1c</inf> level
goals and mortality risk at 5 years. CONCLUSION(S): Among patients
with diabetes, blood pressure control and statin therapy were the most
important perioperative cardiometabolic survival determinants 5 years
after CABG. Copyright © 2022 The Authors. Published on behalf of
the American Heart Association, Inc., by Wiley.

<74>
Accession Number
2016632488
Title
Acute glycemic variability and mortality of patients with acute stroke: a
meta-analysis.
Source
Diabetology and Metabolic Syndrome. 14(1) (no pagination), 2022. Article
Number: 69. Date of Publication: December 2022.
Author
Lin J.; Cai C.; Xie Y.; Yi L.
Institution
(Lin, Cai, Xie) Department of Neurology, Huizhou First Hospital, Huizhou
516000, China
(Yi) Department of Neurology, Peking University Shenzhen Hospital, 1120
Lianhua Road, Shenzhen 518000, China
Publisher
BioMed Central Ltd
Abstract
Background: Increased glucose fluctuation has been related to poor
prognosis in patients with critical illnesses, while its prognostic role
in patients with acute stroke remains unknown. The meta-analysis aimed to
evaluate the association between the acute glycemic variation (GV) and
mortality risk in patients with acute stroke. Method(s): Cohort
studies were obtained by searching Medline, Web of Science, Embase,
Wanfang and CNKI databases. A random-effect model which incorporates the
intra-study heterogeneity was chosen to pool the results. Result(s):
Ten cohort studies with 1433 patients were included, and 280 (19.5%) of
them died within 90 days of disease onset. Results of the meta-analyses
showed that a higher acute GV was associated with an increased risk of
early mortality in patients with acute stroke, as indicated by GV measured
with the coefficient of variation of blood glucose (CVBG, odds ratio [OR]:
2.24, 95% CI 1.40 to 3.58, p < 0.001, I2 = 73%), the standard
deviation of blood glucose (SDBG, OR: 2.31, 95% CI 1.70 to 3.13, p <
0.001, I2 = 50%), and the mean amplitude of glycemic excursion
(OR: 3.57, 95% CI 1.44 to 8.85, p = 0.006, I2 = 23%). For acute
GV measured with CVBG and SDBG, subgroup analyses showed consistent
results in patients with acute ischemic and hemorrhagic stroke, and for
studies reporting 28-day and 90-day all-cause mortality (p for subgroup
analysis all > 0.05). Conclusion(s): Higher acute GV may be an
independent risk factor of early mortality in patients with acute
stroke. Copyright © 2022, The Author(s).

<75>
Accession Number
2020221049
Title
Use of Anticoagulation Therapy in Patients With Perioperative Atrial
Fibrillation After Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
CJC Open. 4(10) (pp 840-847), 2022. Date of Publication: October 2022.
Author
Wang M.K.; Heo R.; Meyre P.; Park L.; Blum S.; McIntyre W.F.; Belley-Cote
E.; Birchenough L.; Vuong K.; Healey J.S.; Devereaux P.J.; Lamy A.; Conen
D.
Institution
(Wang, McIntyre, Belley-Cote, Healey, Devereaux, Conen) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Wang, Blum, McIntyre, Belley-Cote, Healey, Devereaux, Lamy, Conen)
Population Health Research Institute, McMaster University, Hamilton, ON,
Canada
(Wang, McIntyre, Belley-Cote, Healey, Devereaux, Lamy, Conen) Department
of Health Research Methods, Evidence & Impact, McMaster University,
Hamilton, ON, Canada
(Heo) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Meyre, Blum) Division of Cardiology and Cardiovascular Research Institute
Basel, University Hospital Basel, Basel, Switzerland
(Park, Birchenough) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Vuong) Faculty of Sciences, Western University, London, ON, Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Perioperative atrial fibrillation (POAF) after cardiac surgery
is associated with an increased risk of stroke. However, the efficacy and
safety of using anticoagulation therapy in this population are unknown.
 Method(s): We performed a systematic review and meta-analysis of
studies comparing use of anticoagulation therapy vs no anticoagulation
therapy in patients with POAF after cardiac surgery. Outcomes included
arterial thromboembolism (ie, stroke +/- systemic embolism) and bleeding.
Data were pooled using fixed-effects models. We reported summary risk
ratios (RRs) for studies with multivariable adjustment and estimated
absolute risk differences with 95% confidence intervals (CIs).
 Result(s): Nine observational studies met eligibility criteria. No
randomized trials were identified. Of the 254,200 POAF patients included,
27.3% received anticoagulation. Six studies reported outcomes after
long-term follow-up (median 5.0 years; range 4.2-10.0). The risk of
arterial thromboembolism was lower in patients receiving anticoagulation
therapy (RR 0.83; 95% CI, 0.69-0.99; I2 = 57%; P = 0.04; 6
studies). The estimated short-term and long-term absolute risk reductions
in arterial thromboembolism with use of anticoagulation therapy were 0.8%
(95% CI, 0.4-1.4) and 2 events per 1000 person-years (95% CI, 0-4),
respectively. The risk of bleeding was higher in patients receiving
anticoagulation therapy (RR 3.22; 95% CI, 2.82-3.68; I2 = 98%;
P < 0.001; 2 studies). The estimated short-term and long-term absolute
risk increases in bleeding with use of anticoagulation therapy were 0.5%
(95% CI, 0.4-0.6) and 42 events per 1000 person-years (95% CI, 35-51),
respectively. Conclusion(s): Use of anticoagulation therapy is
associated with a small reduction in the risk of arterial thromboembolism,
but also an increased risk of bleeding. Randomized controlled trials are
needed to address this issue. Copyright © 2022 The Authors

<76>
Accession Number
2019804991
Title
Practice-Changing Updates in Perioperative Medicine Literature 2020-2021:
A Systematic Review.
Source
American Journal of Medicine. 135(11) (pp 1306-1314.e1), 2022. Date of
Publication: November 2022.
Author
Khambaty M.; Silbert R.E.; Devalapalli A.P.; Kashiwagi D.T.; Regan D.W.;
Sundsted K.K.; Mauck K.F.
Institution
(Khambaty, Devalapalli, Kashiwagi, Regan) Division of Hospital Internal
Medicine, Department of Medicine
(Silbert, Sundsted, Mauck) Division of General Internal Medicine,
Department of Medicine, Mayo Clinic and Mayo Clinic College of Medicine,
Rochester, Minn
(Kashiwagi) Division of, Internal Medicine, Sheikh Shakhbout Medical City
in partnership with Mayo Clinic, Abu Dhabi, United Arab Emirates
Publisher
Elsevier Inc.
Abstract
Recent literature published in a variety of multidisciplinary journals has
significantly influenced perioperative patient care. Distilling and
synthesizing the clinically important literature can be challenging. This
review summarizes practice-changing articles in perioperative medicine
from the years 2020 and 2021. Embase, Ovid, and EBM reviews databases were
queried from January 2020 to December 2021. Inclusion criteria were
original research, systematic review, meta-analysis, and important
guidelines. Exclusion criteria were conference abstracts, case reports,
letters, protocols, pediatric and obstetric articles, and cardiac surgery
literature. Two authors reviewed each reference using the Distiller SR
systematic review software (Evidence Partners Inc., Ottawa, Ont., Canada).
A modified Delphi technique was used to identify 9 practice-changing
articles. We identified another 13 articles for tabular summaries, as they
were relevant to an internist's perioperative evaluation of a patient.
Articles were selected to highlight the clinical implications of new
evidence in each field. We have also pointed out limitations of each study
and clinical populations where they are not applicable. Copyright
© 2022 Elsevier Inc.

<77>
Accession Number
2018813828
Title
The effects of preoperative focused cardiac ultrasound in high-risk
patients: A randomised controlled trial (PREOPFOCUS).
Source
Acta Anaesthesiologica Scandinavica. 66(10) (pp 1174-1184), 2022. Date of
Publication: November 2022.
Author
Pallesen J.; Bhavsar R.; Fjolner J.; Bakke S.A.; Krog J.; Andersen M.A.S.;
Bondergaard M.H.; Jessing T.D.; Mortensen L.; Nielsen M.B.; Vang M.;
Malachauskiene L.; Juhl-Olsen P.
Institution
(Pallesen, Bondergaard, Jessing, Mortensen, Vang) Department of
Anaesthesiology, Randers Regional Hospital, Randers, Denmark
(Bhavsar, Bakke, Nielsen, Malachauskiene) Department of Anaesthesiology,
Hospital of Southern Jutland, Aabenraa, Denmark
(Fjolner) Department of Surgery & Intensive Care, Regional Hospital
Central Jutland, Viborg, Denmark
(Krog, Andersen) Department of Anaesthesiology, Aarhus University
Hospital, Aarhus, Denmark
(Krog, Juhl-Olsen) Department of Clinical Medicine, Aarhus University,
Aarhus, Denmark
(Juhl-Olsen) Department of Cardiothoracic and Vascular Surgery,
Anaesthesia Section, Aarhus University Hospital, Aarhus, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Surgery is the third most common cause of mortality worldwide.
Focused cardiac ultrasound (FOCUS) yields information on cardiac status
and discloses the presence of unknown pathology. Preoperative FOCUS
changes patient treatment, allowing for a patient-tailored anaesthesia. We
hypothesised that preoperative FOCUS would reduce the proportion of
patients who were either admitted to hospital for more than 10 days or who
were dead within 30 days after high-risk, non-cardiac surgery.
 Method(s): This was a randomised, controlled, multi-center study.
Patients >=65 years of age, admitted for urgent orthopaedic- or abdominal
surgery, scheduled for general- or neuraxial anaesthesia and with ASA 3/4
were eligible for inclusion. Patients were randomised in a 1:1 ratio to
preoperative FOCUS or no preoperative FOCUS performed in accordance with a
predefined protocol. Primary endpoint was the proportion of patients
admitted more than 10 days or who were dead within 30 days. Secondary
endpoints included major complications, days of admission and changes in
anaesthesia handling. Result(s): During the second COVID-19 wave the
study monitoring committee terminated the study prematurely. We included
338 patients of which 327 were included in the final analysis. In the
FOCUS group, 41/163 (25%) patients met the criteria for the primary
endpoint versus 35/164 (21%) for the control group, adjusted odds ratio
1.37 (95% CI 0.86-2.30), p =.36. The proportions of patients who developed
major complications did not differ significantly between groups. Length of
hospital stay was 4 (3-8) days in the FOCUS group and 4 (3-7) days on the
control group (adjusted p =.24). Conclusion(s): The routine
availability of preoperative FOCUS assessment in this cohort does not
appear to reduce the risk for hospitalisation exceeding 10 days or 30-day
mortality, although study enrolment was prematurely
terminated. Copyright © 2022 The Authors. Acta Anaesthesiologica
Scandinavica published by John Wiley & Sons Ltd on behalf of Acta
Anaesthesiologica Scandinavica Foundation.

<78>
Accession Number
2019626577
Title
Postoperative analgesia efficacy of erector spinae plane block in adult
abdominal surgery: A systematic review and meta-analysis of randomized
trials.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 934866.
Date of Publication: 04 Oct 2022.
Author
Gao Y.; Liu L.; Cui Y.; Zhang J.; Wu X.
Institution
(Gao, Liu, Cui, Zhang, Wu) Department of Anesthesiology, Shengjing
Hospital, China Medical University, Shenyang, China
Publisher
Frontiers Media S.A.
Abstract
Objectives: Erector spinae plane block (ESPB) has been used for many
thoracic and abdominal surgeries. However, evidence of its analgesic
efficacy following abdominal surgery, compared with that of thoracic
analgesia, is insufficient. Our study explored the analgesic effect of
ESPB after abdominal surgery. Method(s): We searched PubMed, Embase,
Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov.
Primary outcomes were pain scores at 6, 12 and 24 h and 24-h opioid
consumption. Secondary outcomes included time to first rescue analgesia,
length of hospital stay, and incidence of postoperative nausea and
vomiting (PONV). We calculated standardized mean differences (SMDs) with
95% confidence intervals (CIs) for primary outcomes and mean differences
(MDs) and risk ratios (RRs) with 95% CIs for secondary outcomes.
 Result(s): We systematically included 1,502 cases in 24 trials.
Compared with placebo, ESPB significantly reduced pain scores at 6 h (SMD
-1.25; 95% CI -1.79 to -0.71), 12 h (SMD -0.85; 95% CI -1.33 to -0.37) and
24 h (SMD -0.84; 95% CI -1.30 to -0.37) and 24-h opioid consumption (SMD
-0.62; 95% CI -1.19 to -0.06) post-surgery. ESPB prolonged the time to
first rescue analgesia and decreased the incidence of PONV. Compared with
transversus abdominal plane block (TAPB), ESPB significantly reduced pain
scores at 6, 12, and 24 h and 24-h opioid consumption and prolonged the
time to first rescue analgesia postsurgically. Furthermore, subgroup
analysis showed that ESPB significantly reduced pain scores at various
time points and opioid consumption within 24 h after laparoscopic
cholecystectomy, percutaneous nephrolithotomy and bariatric surgery.
 Conclusion(s): Compared with placebo, ESPB improves the postoperative
analgesic efficacy after abdominal surgery. Furthermore, our meta-analysis
confirmed that ESPB provides more beneficial analgesic efficacy than TAPB.
Systematic review registration:
[https://www.crd.york.ac.uk/PROSPEROFILES/301491_STRATEGY_20220104.pdf],
identifier [CRD42022301491]. Copyright © 2022 Gao, Liu, Cui,
Zhang and Wu.

<79>
Accession Number
2019518409
Title
Strategies for post-cardiac surgery acute kidney injury prevention: A
network meta-analysis of randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 960581. Date of Publication: 27 Sep 2022.
Author
Chen J.-J.; Lee T.H.; Kuo G.; Huang Y.-T.; Chen P.-R.; Chen S.-W.; Yang
H.-Y.; Hsu H.-H.; Hsiao C.-C.; Yang C.-H.; Lee C.-C.; Chen Y.-C.; Chang
C.-H.
Institution
(Chen, Kuo, Yang, Hsu, Lee, Chen, Chang) Department of Nephrology, Chang
Gung Memorial Hospital, Taoyuan, Taiwan (Republic of China)
(Lee) Chansn Hospital, Taoyuan, Taiwan (Republic of China)
(Kuo, Yang, Hsu, Lee, Chen, Chang) Department of Nephrology, Kidney
Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
(Republic of China)
(Huang) Department of Surgery, National Cheng Kung University Hospital,
College of Medicine, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
(Chen) Department of Anesthesiology, Mackay Memorial Hospital, Taipei,
Taiwan (Republic of China)
(Chen) Department of Cardiothoracic and Vascular Surgery, Chang Gung
Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan (Republic of
China)
(Hsiao) Department of Nephrology, New Taipei Municipal TuCheng Hospital,
New Taipei City, Taiwan (Republic of China)
(Yang) Department of Cardiology, Chang Gung Memorial Hospital, Taoyuan,
Taiwan (Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Objects: Cardiac surgery is associated with acute kidney injury (AKI).
However, the effects of various pharmacological and non-pharmacological
strategies for AKI prevention have not been thoroughly investigated, and
their effectiveness in preventing AKI-related adverse outcomes has not
been systematically evaluated. Method(s): Studies from PubMed,
Embase, and Medline and registered trials from published through December
2021 that evaluated strategies for preventing post-cardiac surgery AKI
were identified. The effectiveness of these strategies was assessed
through a network meta-analysis (NMA). The secondary outcomes were
prevention of dialysis-requiring AKI, mortality, intensive care unit (ICU)
length of stay (LOS), and hospital LOS. The interventions were ranked
using the P-score method. Confidence in the results of the NMA was
assessed using the Confidence in NMA (CINeMA) framework. Result(s): A
total of 161 trials (involving 46,619 participants) and 53 strategies were
identified. Eight pharmacological strategies {natriuretic peptides [odds
ratio (OR): 0.30, 95% confidence interval (CI): 0.19-0.47], nitroprusside
[OR: 0.29, 95% CI: 0.12-0.68], fenoldopam [OR: 0.36, 95% CI: 0.17-0.76],
tolvaptan [OR: 0.35, 95% CI: 0.14-0.90], N-acetyl cysteine with carvedilol
[OR: 0.37, 95% CI: 0.16-0.85], dexmedetomidine [OR: 0.49, 95% CI:
0.32-0.76;], levosimendan [OR: 0.56, 95% CI: 0.37-0.84], and
erythropoietin [OR: 0.62, 95% CI: 0.41-0.94]} and one non-pharmacological
intervention (remote ischemic preconditioning, OR: 0.76, 95% CI:
0.63-0.92) were associated with a lower incidence of post-cardiac surgery
AKI with moderate to low confidence. Among these nine strategies, five
(fenoldopam, erythropoietin, natriuretic peptides, levosimendan, and
remote ischemic preconditioning) were associated with a shorter ICU LOS,
and two (natriuretic peptides [OR: 0.30, 95% CI: 0.15-0.60] and
levosimendan [OR: 0.68, 95% CI: 0.49-0.95]) were associated with a lower
incidence of dialysis-requiring AKI. Natriuretic peptides were also
associated with a lower risk of mortality (OR: 0.50, 95% CI: 0.29-0.86).
The results of a sensitivity analysis support the robustness and
effectiveness of natriuretic peptides and dexmedetomidine.
 Conclusion(s): Nine potentially effective strategies were identified.
Natriuretic peptide therapy was the most effective pharmacological
strategy, and remote ischemic preconditioning was the only effective
non-pharmacological strategy. Preventive strategies might also help
prevent AKI-related adverse outcomes. Additional studies are required to
explore the optimal dosages and protocols for potentially effective AKI
prevention strategies. Copyright © 2022 Chen, Lee, Kuo, Huang,
Chen, Chen, Yang, Hsu, Hsiao, Yang, Lee, Chen and Chang.

<80>
[Use Link to view the full text]
Accession Number
2020726167
Title
Long-Term Evolocumab in Patients with Established Atherosclerotic
Cardiovascular Disease.
Source
Circulation. 146(15) (pp 1109-1119), 2022. Date of Publication: 11 Oct
2022.
Author
O'Donoghue M.L.; Giugliano R.P.; Wiviott S.D.; Atar D.; Keech A.; Kuder
J.F.; Im K.; Murphy S.A.; Flores-Arredondo J.H.; Lopez J.A.G.;
Elliott-Davey M.; Wang B.; Monsalvo M.L.; Abbasi S.; Sabatine M.S.
Institution
(O'Donoghue, Giugliano, Wiviott, Kuder, Im, Murphy, Sabatine) TIMI Study
Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital
and Harvard Medical School, Boston, MA, United States
(Atar) Department of Cardiology, Oslo University Hospital Ulleval, Norway
(Atar) Institute of Clinical Medicine, University of Oslo, Norway
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Faculty of Health and Medical Sciences, University of Sydney,
Australia
(Flores-Arredondo, Lopez, Wang, Monsalvo, Abbasi) Global Development,
Amgen, Thousand Oaks, CA, United States
(Elliott-Davey) Amgen Ltd, Cambridge, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In FOURIER (Further Cardiovascular Outcomes Research With
PCSK9 Inhibition in Subjects With Elevated Risk), the proprotein
convertase subtilisin-kexin type 9 inhibitor evolocumab reduced
low-density lipoprotein cholesterol (LDL-C) and risk of cardiovascular
events and was safe and well tolerated over a median of 2.2 years of
follow-up. However, large-scale, long-term data are lacking.
 Method(s): The parent FOURIER trial randomized 27 564 patients with
atherosclerotic cardiovascular disease and LDL-C >=70 mg/dL on statin to
evolocumab versus placebo. Patients completing FOURIER at participating
sites were eligible to receive evolocumab in 2 open-label extension
studies (FOURIER-OLE [FOURIER Open-Label Extension]) in the United States
and Europe; primary analyses were pooled across studies. The primary end
point was the incidence of adverse events. Lipid values and major adverse
cardiovascular events were prospectively collected. Result(s): A
total of 6635 patients were enrolled in FOURIER-OLE (3355 randomized to
evolocumab and 3280 to placebo in the parent study). Median follow-up in
FOURIER-OLE was 5.0 years; maximum exposure to evolocumab in parent plus
FOURIER-OLE was 8.4 years. At 12 weeks in FOURIER-OLE, median LDL-C was 30
mg/dL, and 63.2% of patients achieved LDL-C <40 mg/dL on evolocumab.
Incidences of serious adverse events, muscle-related events, new-onset
diabetes, hemorrhagic stroke, and neurocognitive events with evolocumab
long term did not exceed those for placebo-treated patients during the
parent study and did not increase over time. During the FOURIER-OLE
follow-up period, patients originally randomized in the parent trial to
evolocumab versus placebo had a 15% lower risk of cardiovascular death,
myocardial infarction, stroke, or hospitalization for unstable angina or
coronary revascularization (hazard ratio, 0.85 [95% CI, 0.75-0.96];
P=0.008); a 20% lower risk of cardiovascular death, myocardial infarction,
or stroke (hazard ratio, 0.80 [95% CI, 0.68-0.93]; P=0.003); and a 23%
lower risk of cardiovascular death (hazard ratio, 0.77 [95% CI,
0.60-0.99]; P=0.04). Conclusion(s): Long-term LDL-C lowering with
evolocumab was associated with persistently low rates of adverse events
for >8 years that did not exceed those observed in the original placebo
arm during the parent study and led to further reductions in
cardiovascular events compared with delayed treatment initiation.
Registration: URL: https://www.clinicaltrials.gov; Unique identifiers:
NCT02867813 and NCT03080935. Copyright © 2022 Lippincott Williams
and Wilkins. All rights reserved.

<81>
[Use Link to view the full text]
Accession Number
2020686530
Title
Transcatheter Aortic Valve Replacement for Severe Symptomatic Aortic
Stenosis in Rheumatic Heart Disease: A Systematic Review.
Source
Cardiology in Review. 30(6) (pp 318-323), 2022. Date of Publication: 01
Nov 2022.
Author
Fernandes A.D.F.; Fernandes G.C.; Grant J.; Knijnik L.; Cardoso R.; Cohen
M.G.; Ferreira A.C.; Alfonso C.E.
Institution
(Fernandes, Grant, Knijnik) Department of Internal Medicine, University of
Miami, Jackson Memorial Hospital, Miami, FL, United States
(Fernandes) Division of Cardiology, University of Miami, Jackson Memorial
Hospital, Miami, FL, United States
(Cardoso) Division of Cardiology, Brigham and Women's Hospital, Boston,
MA, United States
(Cohen, Alfonso) Division of Cardiology, University of Miami, Miami, FL,
United States
(Ferreira) Division of Cardiology, Jackson Memorial Hospital, Miami, FL,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve replacement (TAVR) is well-established for
severe symptomatic aortic stenosis (AS), but its use in rheumatic heart
disease (RHD) has been limited. We systematically review the use of TAVR
for severe symptomatic AS in RHD. Pubmed, Embase, and Scopus were searched
for TAVR for symptomatic severe AS and proven or suspected RHD. Procedure
characteristics, efficacy, and safety endpoints were collected and all
definitions were based on the Valve Academic Research Consortium-2
(VARC-2) criteria. We included 3 case series and 12 case reports, with a
total of 43 patients. Mean age was 76 years, 75% were female, and 85% had
NYHA class III-IV symptoms. Follow up ranged from 1 to 29 months. Patients
were moderate to high risk, with Society of Thoracic Surgery score ranging
from 6.1% to 17.6%. The approach was transfemoral in 30 (83%) cases.
Procedural success occurred in 37 (86%) patients. Of the 7 patients with
periprocedural complications, 4 had valve dislodgement, 1 deployment
failure, 1 unplanned cardiopulmonary bypass, and 1 moderate aortic
regurgitation. Paravalvular leak was reported in 5 (11.6%) patients. Only
1 patient had heart block requiring pacemaker. Among 13 studies (23
patients), 30-day mortality was 0%. One case series with 19 patients had a
30-day, 1-year, 2-year, and 5-year mortality of 5%, 11%, 31%, and 48%,
respectively. TAVR appears feasible for selected patients with rheumatic
severe AS, albeit our results indicate a 14% incidence of device failure.
Future randomized clinical trials may clarify the role of TAVR in this
group. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<82>
Accession Number
2020663009
Title
Meta-Analysis on the Anesthetic Effects of Remifentanil plus
Dexmedetomidine versus Remifentanil Alone in Cardiac Surgery.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 1077980. Date of Publication: 2022.
Author
Zeng X.-L.; Liao J.-H.; Zhong H.-S.; Yin X.-H.; Wang R.; Liang J.-P.;
Zhang Z.-S.
Institution
(Zeng, Yin, Wang) Department of Cardiology, Shenzhen University General
Hospital, Shenzhen, China
(Liao) Guangzhou Yujia Biotechnology Co., Ltd., Guangzhou, China
(Zhong) Cardiac Surgery Center, The First Affiliated Hospital of Gannan
Medical University, Jiangxi, China
(Liang) Department of Radiology, Shenzhen bao'An District Songgang
People's Hospital, Shenzhen, China
(Zhang) Department of Cardiology, Pingshan District People's Hospital of
Shenzhen, Pingshan General Hospital, Southern Medical University,
Guangdong, Shenzhen, China
Publisher
Hindawi Limited
Abstract
In this study, we performed a meta-analysis to investigate the anesthesia
effects of remifentanil plus dexmedetomidine versus remifentanil alone in
cardiac surgery. Literature search was performed on PubMed, Web of
Science, Embase, China Knowledge Infrastructure, Wanfang Data, and other
databases for relevant literature published in English or Chinese before
October 2021. A total of 17 studies, consisting of 1350 patients, were
included in this study. Of these, 10 studies showed that remifentanil plus
dexmedetomidine had a good anesthesia effect in cardiac surgery (OR=3.61,
95% CI: 1.73, 7.52, P<0.001), and 8 studies showed that the Ramsay score
test of anesthesia (SMD=0.88; 95% CI: -0.77, 2.53; P<0.001) in the
experimental group was better than that in the control group. In addition,
changes in the hemodynamic heart rate (SMD=-0.74; 95% CI: -1.41, -0.07;
P<0.001) and mean arterial pressure (SMD=-0.18; 95% CI: -0.72, 0.36;
P<0.001) of the two groups of anesthesia were counted in 17 studies, which
also showed that the anesthesia effect of remifentanil plus
dexmedetomidine was good. Thus, remifentanil plus dexmedetomidine may be a
more promising option for cardiac surgery anesthesia than remifentanil
alone. Copyright © 2022 Xiao-Lin Zeng et al.

<83>
Accession Number
2014723469
Title
Comparative evaluation of high-flow nasal cannula oxygenation vs nasal
intermittent ventilation in postoperative paediatric patients operated for
acyanotic congenital cardiac defects.
Source
Medical Journal Armed Forces India. 78(4) (pp 454-462), 2022. Date of
Publication: October 2022.
Author
Kumar A.; Joshi S.; Tiwari N.; Kumar V.; Ramamurthy H.R.; Kumar G.; Sharma
V.
Institution
(Kumar) Classified Specialist (Anaesthesia & Cardio-Thoracic Anaesthesia),
Army Hospital (R&R), New Delhi, India
(Joshi) Senior Advisor (Anaesthesia) & Trained in Paediatric Anaesthesia,
Army Hospital (R&R), New Delhi, India
(Tiwari) Senior Advisor (Surgery) & Cardio-Thoracic Surgeon, Army Hospital
(R&R), New Delhi, India
(Kumar) Classified Specialist (Paediatric) & Trained in Paediatric
Cardiology, Army Hospital (R&R), New Delhi, India
(Ramamurthy) Senior Advisor (Paediatric) & Trained in Paediatric
Cardiology, Army Hospital (R&R), New Delhi, India
(Kumar) Senior Consultant (Paediatric Cardiac Surgery), Fortis Hospital,
Delhi, India
(Sharma) Professor (Cardiac Anaesthesia), Dr. D.Y. Patil Medical College,
Pune, India
Publisher
Elsevier B.V.
Abstract
Background: This study aimed to compare high-flow nasal cannula (HFNC)
oxygenation vs nasal intermittent ventilation (NIV) oxygenation for
respiratory care after extubation in postoperative paediatric cardiac
patients. Method(s): This study was a randomised controlled trial.
One hundred twenty-one paediatric patients with acyanotic congenital heart
disease undergoing corrective cardiac surgery on cardiopulmonary bypass
were included in the study. Patients were randomised to receive either
HFNC (AIRVO) or NIV (RAM Cannula) postextubation. Arterial blood gas was
analysed at different time points perioperatively. Result(s):
Patients in both the groups were matched with respect to diagnosis and
demographic profiles. Baseline hemodynamic and respiratory parameters were
also similar in both the groups. Patients in HFNC/AIRVO group did not show
improved carbon dioxide (CO<inf>2</inf>) washout but showed improved
pO<inf>2</inf> and pO<inf>2</inf>/FiO<inf>2</inf> ratio immediate
postextubation. Reintubation rate and other intensive care unit (ICU)
complications were similar in both the groups. Conclusion(s):
Postcardiopulmonary bypass respiratory complications in paediatric
patients with congenital acyanotic heart disease can be minimised with
newer oxygen therapy devices such as AIRVO (HFNC) or RAM cannula (NIV). In
comparison between these two, AIRVO did not show improved CO<inf>2</inf>
washout over RAM cannula; however, it did provide better oxygenation as
measured by pO<inf>2</inf> in arterial blood and
pO<inf>2</inf>/FiO<inf>2</inf> ratio immediate postextubation. Also,
long-term results such as duration of mechanical ventilation and ICU stay
were not affected by the choice of device. Copyright © 2021

<84>
Accession Number
2014261122
Title
Robot-assisted thoracic surgery versus video-assisted thoracic surgery for
treatment of patients with thymoma: A systematic review and meta-analysis.
Source
Thoracic Cancer. 13(2) (pp 151-161), 2022. Date of Publication: January
2022.
Author
Shen C.; Li J.; Che G.
Institution
(Shen, Li, Li, Che) Department of Thoracic Surgery, West-China Hospital,
Sichuan University, Chengdu, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Surgical resection of the thymus is indicated in the presence
of primary thymic diseases such as thymoma. Video-assisted thoracoscopic
surgery (VATS) and robot-assisted thoracic surgery (RATS) offer a
minimally invasive approach to thymectomy. However, there is no clear
conclusion whether RATS can achieve an equal or even better surgical
effect when compared with VATS in treatment of thymoma. We performed this
meta-analysis to explore and compare the outcomes of RATS versus VATS for
thymectomy in patients with thymoma. Method(s): PubMed, Cochrane
Library, EMBASE, China National Knowledge Infrastructure (CNKI), Medline,
and Web of Science databases were searched for full-text literature
citations. The quality of the articles was evaluated using the
Newcastle-Ottawa Scale and the data analyzed using Review Manager 5.3
software. Fixed or random effect models were applied according to
heterogeneity. Subgroup analysis was conducted. Result(s): A total of
11 studies with 1418 patients, of whom 688 patients were in the RATS group
and 730 in the VATS group, were involved in the analysis. Compared with
VATS, RATS was associated with less blood loss in operation, lower volume
of drainage, fewer postoperative pleural drainage days, shorter
postoperative hospital stay, and fewer postoperative complications. There
was no significant difference in operative time and patients with or
without myasthenia gravis between the two groups. Conclusion(s): RATS
has more advantages over VATS, indicating that RATS is better than VATS in
terms of postoperative recovery. We look forward to more large-sample,
high-quality randomized controlled studies published in the
future. Copyright © 2021 The Authors. Thoracic Cancer published
by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

<85>
Accession Number
2008432308
Title
Utility and safety of coronary angiography in patients with acute
infective endocarditis who required surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(3) (pp 905-913.e19),
2022. Date of Publication: September 2022.
Author
Spanneut T.-A.; Paquet P.; Bauters C.; Modine T.; Richardson M.; Bonello
L.; Juthier F.; Lemesle G.
Institution
(Spanneut, Paquet, Lemesle) USIC et Centre Hemodynamique, Institut Coeur
Poumon, Centre Hospitalier Universitaire de Lille, Lille, France
(Bauters) Service de Cardiologie, Institut Coeur Poumon, Centre
Hospitalier Universitaire de Lille, Lille, France
(Bauters) INSERM UMR 1067, Institut Pasteur de Lille, Lille, France
(Bauters, Juthier, Lemesle) Faculte de Medecine de l'Universite de Lille,
Lille, France
(Modine, Juthier) Service de chirurgie cardiaque et vasculaire, Institut
Coeur Poumon, Centre Hospitalier Universitaire de Lille, Lille, France
(Richardson) Service d'exploration fonctionnelle cardiovasculaire,
Institut Coeur Poumon, Centre Hospitalier Universitaire de Lille, Lille,
France
(Bonello) Service de Cardiologie, Hopital Nord de Marseille, Assistance
Publique des Hopitaux de Marseille, Marseille, France
(Juthier, Lemesle) INSERM UMR 1011, Institut Pasteur de Lille, Lille,
France
(Lemesle) FACT (French Alliance for Cardiovascular Trials), Paris, France
Publisher
Elsevier Inc.
Abstract
Objectives: To assess the benefit/risk ratio to perform a coronary
angiography (CA) before surgery for infective endocarditis (IE).
 Method(s): We conducted a single-center prospective registry
including 272 patients with acute IE intended for surgery and compared
patients who underwent a preoperative CA (n = 160) with those who did not
(n = 112). A meta-analysis of 3 observational studies was also conducted
and included 551 patients: 342 who underwent a CA and 209 who did not.
 Result(s): In our registry, combined bypass surgery (CABG) was
performed in 17% of the patients with preoperative CA. At 2 years, the
rate of the primary composite end point (all-cause death, new systemic
embolism, stroke, new hemodialysis) was similar in the CA (38%) and no-CA
(37%) groups. In-hospital and 2-year individual end points were all
similar between groups. There were only 2 episodes of systemic embolism
after CA and only one possibly related to a vegetation dislodgement. In
the meta-analysis, combined CABG was performed in 18% of the patients with
preoperative CA. All-cause death was similar in both groups: odds ratio,
0.98 [0.62-1.53], P =.92. Only 5 cases of systemic embolism possibly
related to a vegetation dislodgement were reported. New hemodialysis was
numerically more frequent in the CA group: odds ratio, 1.68 [0.79-3.58]
(18% vs 14%, P =.18). Conclusion(s): In daily practice, two-thirds of
the patients with acute IE who required surgery have a preoperative CA
leading to a combined CABG in 18% of the patients. Our results suggest
that to perform a preoperative CA in this context is not associated with
improved prognosis. Copyright © 2020 The American Association for
Thoracic Surgery

<86>
Accession Number
2018098890
Title
Pharmacology Management in Improving Exercise Capacity of Patients with
Fontan Circulation: A Systematic Review and Meta-analysis.
Source
Current Cardiology Reviews. 18(5) (no pagination), 2022. Article Number:
e040422203048. Date of Publication: September 2022.
Author
Mendel B.; Christianto; Setiawan M.; Siagian S.N.; Prakoso R.
Institution
(Mendel, Christianto, Setiawan) Faculty of Medicine, Universitas
Indonesia, Jakarta, Indonesia
(Mendel, Siagian, Prakoso) Department of Cardiology and Vascular Medicine,
Pediatric Cardiology and Congenital Heart Defect Division, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Publisher
Bentham Science Publishers
Abstract
Background: The Fontan procedure is currently the mainstay therapy for
single functional ventricles. However, with prolonged follow-up duration,
various complications have been observed that seriously influence the
quality of life of patients. Objective(s): The aim of this
meta-analysis is to compare the effectiveness of pharmacologic agents in
improving exercise capacity in patients with Fontan circulation.
 Method(s): This meta-analysis was conducted according to the
Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA)
statement and has been registered in the International Prospective
Register for Systematic Reviews database with registration no. 282352.
Quality as-sessments of the included studies were assessed using the
Strengthening Reporting of Observational Studies in Epidemiology (STROBE)
statement. Result(s): Twelve studies met the predetermined inclusion
criteria and were included in this meta-analysis. This meta-analysis found
that treatment with bosentan significantly improved New York Heart
Association Functional Class (NYHA FC) in Fontan patients (standard mean
difference-0.59, 95% CI-0.94 --0.25; P=0.0008; I2 = 1%).
However, the use of bosentan (P=0.66) and sildenafil (P=0.13) did not show
a significant improvement in the maximum rate of oxygen consumption
(VO<inf>2</inf> max). Conclusion(s): This meta-analysis shows that
people with Fontan circulation may benefit from using bosentan as it
decreases postexercise heart rate and improves NYHA FC and 6-minute
walking test results. Therefore, indirectly improving exercise capacity.
Nonetheless, considerable work is re-quired to strengthen our knowledge in
improving the exercise capacity of Fontan patients. Copyright ©
2022 Bentham Science Publishers.

<87>
Accession Number
2017987430
Title
Incidence and Outcomes of Postoperative Atrial Fibrillation after Coronary
Artery Bypass Grafting of a Randomized Controlled Trial: A Blinded
End-of-cycle Analysis.
Source
Reviews in Cardiovascular Medicine. 23(4) (no pagination), 2022. Article
Number: 122. Date of Publication: 2022.
Author
Musa A.F.; Dillon J.; Taib M.E.M.; Yunus A.M.; Sanusi A.R.; Nordin M.N.;
Smith J.A.
Institution
(Musa) Jeffrey Cheah School of Medicine & Health Sciences, Monash
University Malaysia, Selangor, Subang Jaya 47500, Malaysia
(Musa) Victorian Heart Institute, Monash University, Melbourne 3168,
Australia
(Dillon, Taib, Yunus, Sanusi, Nordin) Department of Cardiothoracic
Surgery, National Heart Institute, Kuala Lumpur 50400, Malaysia
(Smith) Department of Surgery, School of Clinical Sciences at Monash
Health, Monash University, Melbourne 3168, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Melbourne
3168, Australia
Publisher
IMR Press Limited
Abstract
Objective: The objective of this study is to analyse the incidence of
postoperative atrial fibrillation (POAF), demography, post-operative
outcomes including morbidity and mortality, length of Cardiac Intensive
Care Unit (CICU) stay, High Dependency Unit (HDU) stay, and total hospital
stay in patients undergoing coronary bypass grafting (CABG) at Institut
Jantung Negana (IJN). Method(s): We conducted a prospective,
randomised, controlled trial. We supplied the treatment group with Tocovid
capsules and the control group with placebo containing palm superolein.
 Result(s): Since January 2019, we have recruited the target
population of 250 patients. However, the result is still blinded as we are
still analysing blood samples for tocotrienol levels. 89.2% of patients
completed the study with a 3.6% mortality and a 7.6% attrition rate. 35.2%
of the patients developed POAF, the mean time being 46.06 +/- 26.96 hours
post-CABG. We did not observe any statistically significant difference
when we compared left atrial size, New York Heart Association (NYHA)
functional class, ejection fraction and premorbid history, besides
EuroSCORE II (The European System for Cardiac Operative Risk Evaluation
II) status except for older age group, right atrial size, and pleural
effusion. There was also no difference in bypass time, cross clamp time or
number of anastomoses. However, we noted a significant difference in death
(p = 0.01) and renal failure requiring dialysis (p = 0.007) among patients
with POAF; those patients also had a longer CICU stay (p = 0.005), HDU
stay (p = 0.02), and total hospital stay (p = 0.001). Conclusion(s):
POAF is associated with a higher incidence of renal failure and death
while it increases CICU, HDU, and total hospital stay. It remains to be
seen whether Tocovid reduces POAF and its associated
sequelae. Copyright © 2022 IMR Press Limited. All rights
reserved.

<88>
[Use Link to view the full text]
Accession Number
2020580164
Title
Effect of a balanced colloid on acute kidney injury in paediatric cardiac
surgery: A post hoc analysis of a randomised controlled trial.
Source
European Journal of Anaesthesiology. 39(11) (pp 895-897), 2022. Date of
Publication: 01 Nov 2022.
Author
Willems A.; Arend S.; Schmartz D.; Van Der Linden P.
Institution
(Willems) Paediatric Intensive Care Unit, Department of Intensive Care,
Leiden University Medical Centre, Leiden, Netherlands
(Arend, Schmartz, Van Der Linden) Department of Anaesthesiology,
University Hospital Brugmann, Queen Fabiola University Children's
Hospital, Brussels, Belgium
Publisher
Lippincott Williams and Wilkins

<89>
Accession Number
2020555394
Title
Comparing near-infrared spectroscopy-measured cerebral oxygen saturation
and corresponding venous oxygen saturations in children with congenital
heart disease: a systematic review and meta-analysis.
Source
Translational Pediatrics. 11(8) (pp 1374-1388), 2022. Date of Publication:
August 2022.
Author
Ma Y.; Zhao L.; Wei J.; Wang Z.; Lui S.; Song B.; Gong Q.; Wang P.; Wu M.
Institution
(Ma, Zhao, Wang, Lui, Song, Gong, Wu) Department of Radiology, Functional
and Molecular Imaging Key Laboratory of Sichuan Province, West China
Hospital, Sichuan University, Chengdu, China
(Wei) Department of Cardiology, West China Hospital, Sichuan University,
Chengdu, China
(Gong) Department of Radiology, West China Xiamen Hospital of Sichuan
University, Xiamen, China
(Wang) Department of Rehabilitation Medicine, The Seventh Hospital of Sun
Yat-Sen University, Shenzhen, China
(Wang) Guangdong Engineering Technology Research Center for Rehabilitation
Medicine and Clinical Translation, Guangzhou, China
Publisher
AME Publishing Company
Abstract
Background: Near-infrared spectroscopy (NIRS) is a non-invasive approach
that measures cerebral regional oxygen saturation (rScO<inf>2</inf>). In
this study, we evaluated the evidence on the validity of NIRS and the
interchangeability between NIRS and common invasive approaches by
exploring the correlation and consistency and comparing the mean and
standard deviation between the NIRS rScO<inf>2</inf> and jugular bulb
venous oxygen saturation (SjvO<inf>2</inf>) as well as central venous
oxygen saturation (ScvO<inf>2</inf>) in the perioperative period of
children with congenital heart disease (CHD). Method(s): We searched
electronic bibliographic databases (PubMed, The Cochrane Library and
Embase) and screened the studies that met the inclusion criteria. We
included cross-sectional studies of CHD pediatric patients in the
perioperative period receiving both tests for NIRS rScO<inf>2</inf> and
SjvO<inf>2</inf> or NIRS rScO<inf>2</inf> and ScvO<inf>2</inf>.
Methodological quality assessment and heterogeneity analyses were
performed. We qualitatively summarized the results of Bland-Altman's
analysis. Meta-regression, subgroup analyses, and sensitivity analyses
were carried out to explore the causes of heterogeneity. Result(s):
There was no significant difference in Cohen's d between rScO<inf>2</inf>
and ScvO<inf>2</inf> or between rScO<inf>2</inf> and SjvO<inf>2</inf>
(Cohen's d =0.06, 95% CI: -0.16 to 0.28; Cohen's d =0.03, 95% CI: -0.25 to
0.31, respectively) and notable heterogeneity existed
(I2=76.0%, P<0.001; I2=73.6%, P<0.001,
respectively). A positive linear correlation was present between
rScO<inf>2</inf> and ScvO<inf>2</inf> or between rScO<inf>2</inf> and
SjvO<inf>2</inf> (r=0.58, 95% CI: 0.54 to 0.63; r=0.60, 95% CI: 0.54 to
0.66, respectively) and the heterogeneity was not significant
(I2=36.7%, P=0.065; I2=12.7%, P=0.328,
respectively). In most studies, the 95% limits of agreements of
Bland-Altman's analysis were large. No evidence of publication bias was
observed. Conclusion(s): The rScO<inf>2</inf> measured by NIRS
reflected the SjvO<inf>2</inf> and ScvO<inf>2</inf> monitored by invasive
measurements in the perioperative period of children with CHD to some
extent. However, wide limits of agreements between rScO<inf>2</inf> and
SjvO<inf>2</inf> as well as ScvO<inf>2</inf> indicated that NIRS and
SjvO<inf>2</inf> as well as ScvO<inf>2</inf> are not interchangeable.
Whether NIRS plays a prominent role in monitoring cerebral oxygen
saturation in children with CHD needs further research. Copyright
© Translational Pediatrics. All rights reserved.

<90>
Accession Number
2019346718
Title
Comparison of techniques for left subclavian artery preservation during
thoracic endovascular aortic repair: A systematic review and single-arm
meta-analysis of both endovascular and surgical revascularization.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 991937. Date of Publication: 15 Sep 2022.
Author
Zhang Y.; Xie X.; Yuan Y.; Hu C.; Wang E.; Zhao Y.; Lin P.; Li Z.; Mo F.;
Fu W.; Wang L.
Institution
(Zhang, Xie, Yuan, Hu, Wang, Zhao, Lin, Li, Mo, Fu, Wang) Department of
Vascular Surgery, Zhongshan Hospital, Fudan University, Xiamen, China
(Zhang, Yuan, Hu, Wang, Zhao, Lin, Li, Mo, Fu, Wang) Department of
Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
(Zhang, Yuan, Hu, Wang, Zhao, Lin, Li, Mo, Fu, Wang) Vascular Surgery
Institute of Fudan University, Shanghai, China
(Zhang, Yuan, Hu, Wang, Zhao, Lin, Li, Mo, Fu, Wang) National Clinical
Research Center for Interventional Medicine, Shanghai, China
(Zhang, Yuan, Hu, Wang, Zhao, Lin, Li, Mo, Fu, Wang) Fudan Zhangjiang
Institute, Shanghai, China
Publisher
Frontiers Media S.A.
Abstract
Background: Currently, the optimal technique to revascularize the left
subclavian artery (LSA) during thoracic endovascular aortic repair (TEVAR)
remains controversial. Our study seeks to characterize early and late
clinical results and to assess the advantages and disadvantages of
endovascular vs. surgical strategies for the preservation of LSA.
 Method(s): PubMed, Embase and Cochrane Library searches were
conducted under the PRISMA (Preferred Reporting Items for Systematic
review and Meta-Analyses) standards. Only literature published after
January 1994 was included. Studies reporting on endovascular
revascularization (ER), surgical revascularization (SR) for LSA
preservation were included. 30-day mortality and morbidity rates,
restenosis rates, and rates of early and late reintervention are measured
as outcomes. Result(s): A total of 28 studies involving 2,759
patients were reviewed. All articles were retrospective in design.
Single-arm analysis found no significant statistical differences in ER vs.
SR in terms of 30-day mortality and perioperative complication rates. The
mean follow-up time for the ER cohort was 12.9 months and for the SR
cohort was 26.6 months, respectively. Subgroup analysis revealed a higher
risk of perioperative stroke (4.2%) and endoleaks (14.2%) with the chimney
technique compared to the fenestrated and single-branched stent
approaches. Analysis of the double-arm studies did not yield statistically
significant results. Conclusion(s): Both ER and SR are safe and
feasible in the preservation of LSA while achieving an adequate proximal
landing zone. Among ER strategies, the chimney technique may presents a
greater risk of neurological complications and endoleaks, while the
single-branched stent grafts demonstrate the lowest complication rate, and
the fenestration method for revascularization lies in an intermediate
position. Given that the data quality of the included studies were
relatively not satisfactory, more randomized controlled trials (RCTs) are
needed to provide convincing evidence for optimal approaches to LSA
revascularization in the future. Copyright © 2022 Zhang, Xie,
Yuan, Hu, Wang, Zhao, Lin, Li, Mo, Fu and Wang.

<91>
Accession Number
2018736725
Title
Impact of Brain MRI on the Diagnosis of Infective Endocarditis and
Treatment Decisions: Systematic Review and Meta-Analysis.
Source
American Journal of Roentgenology. 218(6) (pp 958-969), 2022. Date of
Publication: June 2022.
Author
Ahn Y.; Joo L.; Suh C.H.; Kim S.; Shim W.H.; Kim S.J.; Lee S.-A.
Institution
(Ahn, Suh, Kim, Shim, Kim) Department of Radiology and Research Institute
of Radiology, Asan Medical Center, University of Ulsan College of
Medicine, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul 05505, South Korea
(Joo) Department of Radiology, Korea University Guro Hospital, Seoul,
South Korea
(Lee) Department of Cardiology, Asan Medical Center, University of Ulsan,
College of Medicine, Seoul, South Korea
Publisher
American Roentgen Ray Society
Abstract
BACKGROUND. Despite increasing use of brain MRI to evaluate patients with
suspected infective endocarditis, the clinical impact of brain MRI in this
setting has not yet been systematically reviewed. OBJECTIVE. The purpose
of this study was to evaluate the frequency of brain MRI findings in
patients with suspected or confirmed infective endocarditis and to
determine the impact of such findings on clinical decisions. EVIDENCE
ACQUISITION. A systematic search of the PubMed, Embase, and Cochrane
databases was performed from January 1, 1990, to December 31, 2020, to
identify original research investigations of brain MRI in patients with
suspected or confirmed infective endocarditis. Study quality was assessed
with QUADAS-2. Study endpoints included the frequency of brain MRI
findings and the frequency of diagnostic modifications, modification of
therapeutic plan, and modification of valve surgery plan resulting from
MRI findings. Frequencies were pooled by means of the inverse variance
method. Subgroup analysis was performed. EVIDENCE SYNTHESIS. A total of 21
studies with 2133 patients were included. Overall study quality was
considered moderate. In terms of brain MRI findings, the pooled frequency
of acute ischemic lesions was 61.9% (95% CI, 50.7-71.9%); of cerebral
microbleeds, 52.9% (95% CI, 41.6-63.9%); hemorrhagic lesions, 24.7% (95%
CI, 15.1-37.9%); abscess or meningitis, 9.5% (95% CI, 5.6-15.6%); and
intracranial mycotic aneurysm, 6.2% (95% CI, 4.0-9.4%). Subgroup analysis
after exclusion of three studies in which neurologic findings were the
indication for all brain MRI examinations yielded similar frequencies of
these findings. Six studies included results on the impact of brain MRI
findings on clinical decisions. The frequencies of diagnostic
modifications in two studies were 5.4% and 32.1%. The pooled frequency of
therapeutic plan modification in six studies was 12.8% (95% CI, 6.5-23.7%)
and of surgical plan modification in five studies was 14.2% (95% CI,
8.2-23.4%). CONCLUSION. In patients with suspected or confirmed infective
endocarditis, brain MRI examinations commonly show relevant abnormalities
that affect diagnostic and therapeutic clinical decisions. CLINICAL
IMPACT. The findings support a potential role for screening brain MRI in
the evaluation of patients with suspected or confirmed infective
endocarditis, regardless of the presence or absence of neurologic
symptoms. Copyright © 2022 American Roentgen Ray Society. All
rights reserved.

<92>
Accession Number
2016609562
Title
Mitochondrial-cell cycle cross-talk drives endoreplication in heart
disease.
Source
Science Translational Medicine. 13(623) (no pagination), 2021. Article
Number: eabi7964. Date of Publication: 08 Dec 2021.
Author
Bischof C.; Mirtschink P.; Yuan T.; Wu M.; Zhu C.; Kaur J.; Pham M.D.;
Gonzalez-Gonoggia S.; Hammer M.; Rogg E.-M.; Sharma R.; Bottermann K.;
Gercken B.; Hagag E.; Berthonneche C.; Sossalla S.; Stehr S.N.; Maxeiner
J.; Duda M.A.; Latreille M.; Zamboni N.; Martelli F.; Pedrazzini T.;
Dimmeler S.; Krishnan J.
Institution
(Bischof, Gonzalez-Gonoggia, Latreille, Krishnan) MRC Clinical Sciences
Centre, Imperial College London, London W12 0NN, United Kingdom
(Bischof, Yuan, Wu, Zhu, Kaur, Pham, Hammer, Rogg, Sharma, Bottermann,
Dimmeler, Krishnan) Institute of Cardiovascular Regeneration, Centre for
Molecular Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7,
Frankfurt am Main 60590, Germany
(Mirtschink, Gercken, Hagag) Institute of Clinical Chemistry and
Laboratory Medicine, Department of Clinical Pathobiochemistry, University
Hospital Dresden, Fetscherstasse 74, Dresden 01307, Germany
(Yuan, Wu, Zhu, Kaur, Krishnan) Department of Medicine III, Division of
Cardiology/Nephrology/Angiology, Goethe University Frankfurt,
Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
(Pham, Maxeiner, Duda) Genome Biologics, Goethe University Frankfurt,
Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany
(Berthonneche) Cardiovascular Assessment Facility, University of Lausanne,
CHUV, Lausanne CH-1011, Switzerland
(Sossalla) Department of Internal Medicine II, University Medical Center
Regensburg, Regensburg 93053, Germany
(Sossalla) Klinik fur Kardiologie und Pneumologie,
Georg-August-Universitat Goettingen, DZHK (German Centre for
Cardiovascular Research), Robert-Koch Str. 40, Goettingen D-37075, Germany
(Stehr) Department of Anesthesiology and Critical Care Medicine,
University Hospital Leipzig, Liebigstrasse 20, Leipzig D-04103, Germany
(Zamboni) Institute of Molecular Systems Biology, ETH Zurich, Zurich 8093,
Switzerland
(Martelli) Molecular Cardiology Laboratory, IRCCS-Policlinico San Donato,
Milan, San Donato Milanese 20097, Italy
(Pedrazzini) Department of Medicine, University of Lausanne Medical
School, CHUV., MP14-220, Lausanne 1011, Switzerland
(Dimmeler) DZHK Partner Site RheinMain, Mainz, Germany
(Dimmeler, Krishnan) Cardio-Pulmonary Institute, Giessen, Germany
Publisher
American Association for the Advancement of Science
Abstract
Endoreplication, duplication of the nuclear genome without cell division,
occurs in disease to drive morphologic growth, cell fate, and function.
Despite its criticality, the metabolic underpinnings of disease-induced
endoreplication and its link to morphologic growth are unknown. Heart
disease is characterized by endoreplication preceding cardiac hypertrophy.
We identify ATP synthase as a central control node and determinant of
cardiac endoreplication and hypertrophy by rechanneling free mitochondrial
ADP to methylenetetrahydrofolate dehydrogenase 1 L (MTHFD1L), a
mitochondrial localized rate-limiting enzyme of formate and de novo
nucleotide biosynthesis. Concomitant activation of the adenosine
monophosphate-activated protein kinase (AMPK)-retinoblastoma protein
(Rb)-E2F axis co-opts metabolic products of MTHFD1L function to support
DNA endoreplication and pathologic growth. Gain- and loss-of-function
studies in genetic and surgical mouse heart disease models and correlation
in individuals confirm direct coupling of deregulated energetics with
endoreplication and pathologic overgrowth. Together, we identify
cardiometabolic endoreplication as a hitherto unknown mechanism dictating
pathologic growth progression in the failing myocardium. Copyright
© 2021 American Association for the Advancement of Science. All
rights reserved.

<93>
Accession Number
2020648013
Title
The Impact of Cognitive Impairment on Clinical Outcomes After
Transcatheter Aortic Valve Implantation (from a Systematic Review and
Meta-Analysis).
Source
American Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Sim J.J.L.; Ling R.R.; Neo V.S.Q.; Tan F.L.; Djohan A.H.; Yeo L.L.L.; Chan
K.A.; Lim Y.; Tan B.Y.Q.; Yeo T.-C.; Chan M.Y.; Poh K.-K.; Kong W.K.F.;
Yip J.W.L.; Chong Y.F.; Sharma V.K.; Kuntjoro I.; Sia C.-H.
Institution
(Sim, Ling, Neo, Tan, Yeo, Tan, Yeo, Chan, Poh, Kong, Yip, Chong, Sharma,
Sia) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
(Djohan, Lim, Yeo, Chan, Poh, Kong, Yip, Kuntjoro, Sia) Department of
Cardiology, National University Heart Centre, Singapore
(Yeo, Tan, Chong, Sharma) Division of Neurology, Department of Medicine,
National University Hospital, Singapore
(Chan) Section of Adult Cardiology, Chong Hua Heart Institute, Chong Hua
Hospital, Cebu, Philippines
Publisher
Elsevier Inc.
Abstract
This study sought to investigate the impact of pre-existing cognitive
impairment on outcomes after transcatheter aortic valve implantation
(TAVI). TAVI has been increasingly used in seniors, and evidence suggests
better outcomes than surgical aortic valve replacement. Although frailty
has been shown to be associated with poorer outcomes after TAVI, the
effect of pre-existing cognitive impairment on patient outcomes after TAVI
remains unclear. We searched the Medline, Embase, Scopus and Cochrane
databases until May 14, 2022. The risk of bias was assessed using the
Newcastle-Ottawa scale. The primary outcome was short-term (6 months to 1
year) mortality, and secondary outcomes included long-term (1 year to 3
years) mortality, in-hospital mortality, and postoperative delirium. A
total of 14 studies with 32,746 patients (5,098 patients with cognitive
impairment at baseline, 27,648 without) were included in our
meta-analysis. Among studies that reported the raw proportion of patients
with mortality of postoperative delirium, cognitive impairment
significantly increased mortality (risk ratio 2.10, 95% confidence
intervals [CIs] 1.43 to 3.08, p = 0.0002) and postoperative delirium (risk
ratio 2.27, 95% CI 1.76 to 2.93, p <0.0001). Studies which reported the
hazards for mortality (pooled hazards ratio 1.97, 95% CI 1.50 to 2.60, p
<0.0001) and odds of postoperative delirium (pooled odds ratio 2.40, 95%
CI: 1.51 to 3.80, p = 0.0002) yielded results consistent with the primary
meta-analysis. In conclusion, pre-existing cognitive impairment is a
significant risk factor for poorer outcomes after TAVI and should be
carefully considered in this group of patients. Guidelines and future
studies should take cognitive impairment into consideration for
preoperative risk stratification. Copyright © 2022 Elsevier Inc.

<94>
Accession Number
2019627586
Title
Should nasogastric tube be used routinely in patients undergoing cardiac
surgery? A narrative review.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Paleczny S.; Fatima R.; Amador Y.; El Diasty M.
Institution
(Paleczny, Fatima, El Diasty) Department of Surgery, Division of Cardiac
Surgery, Kingston General Hospital, Queen's University, Kingston, ON,
Canada
(Amador) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Queen's University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim: Nasogastric tube (NGT) use has been common in the
immediate postoperative period in surgical patients for decades. Potential
advantages include the decompression of gastric contents and the early
administration of time-sensitive medications. However, its routine use
after cardiac surgery has not been established as a gold standard yet. The
NGT use for prevention of postoperative nausea and vomiting has been a
matter of debate in literature. Also, NGT use has also been associated
with the incidence of some respiratory and gastrointestinal complications
and it may be a source of significant pain and discomfort to patients. In
this article, we review the current available literature regarding the use
of NGT during and immediately after cardiac surgery, with particular
emphasis on its potential role in enhanced postoperative recovery.
 Method(s): We performed a database search in October 2021 using
Embase, Cochrane Library, and Medline to identify studies that examined
the use of NGT in patients that underwent cardiac surgery. Data and
literature about NGT's impact on post-operative nausea and vomiting, early
administration of medications, interference with imaging, post-operative
complications, respiratory complications, gastrointestinal complications,
pain and discomfort, and enhanced recovery after surgery were examined.
 Result(s): Three reports investigating the use of NGT to reduce
post-operative nausea and vomiting were examined with sample sizes of 114,
104, and 202. The use of NGT did not significantly reduce the incidence of
post-operative nausea and vomiting in 2/3 of the studies: a 2% nausea
reduction with NGT (p < 0.05), a 7.7% nausea reduction with NGT (p = 0.6),
and a 14% vomiting reduction with NGT (p = 0.007). The prevalence of
pneumonia following NGT use has been shown to vary ranging from 4 to 95%
with associated mortality rates of 17 to 62%. Conclusion(s): Based on
our findings, there is currently not sufficient evidence to support the
routine use of NGT during cardiac surgery. Further research is needed to
establish the role of NGT in this patient population. Copyright ©
2022 Wiley Periodicals LLC.

<95>
Accession Number
2018804630
Title
Comparison of efficacy and safety between VKAs and DOACs in patients with
atrial fibrillation after transcatheter aortic valve replacement: A
systematic review and meta-analysis.
Source
Clinical Cardiology. 45(10) (pp 1002-1010), 2022. Date of Publication:
October 2022.
Author
Yan J.; Liu M.; Zhang Y.; Yang D.; An F.
Institution
(Yan, Liu, Zhang, Yang, An) The Key Laboratory of Cardiovascular
Remodeling and Function Research, Chinese Ministry of Education, Chinese
National Health Commission and Chinese Academy of Medical Sciences, The
State and Shandong Province Joint Key Laboratory of Translational
Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of
Shandong University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
In the past decade, direct oral anticoagulants (DOACs) have proven to be
the best option for patients with nonvalvular atrial fibrillation.
Nevertheless, evidence for the use of DOACs for anticoagulation in
valvular atrial fibrillation, particularly after aortic valve replacement,
remains inadequate. Thus, we conducted a meta-analysis to compare the
efficacy and safety of vitamin K antagonists (VKAs) and DOACs in patients
with atrial fibrillation after transcatheter aortic valve replacement
(TAVR). We conducted a comprehensive search of online databases, and 11
studies were included in the final analysis. The primary endpoint was
all-cause mortality. Secondary endpoints included stroke and
cardiovascular death. The safe endpoint is major and/or life-threatening
bleeding. Subgroup analysis was conducted according to the different
follow-up time of each study. Random-effects models were used for all
outcomes. Statistical heterogeneity was assessed using chi2
tests and quantified using I2 statistics. Patients in the DOACs
group had a significantly lower risk of all-cause mortality compared with
patients in the VKAs group (relative risk [RR]: 1.20, 95% confidence
interval [CI]: 1.01-1.43, p =.04). This benefit may be greater with longer
follow-up. In a subgroup analysis based on the length of follow-up, a
significantly lower risk of all-cause mortality was found in the DOACs
group in the subgroup with a follow-up time of >12 months (RR: 1.50, 95%
CI: 1.07-2.09, p =.001). There were no significant differences between the
two groups in cardiovascular death, stroke, and major and/or
life-threatening bleeding. For patients with atrial fibrillation after
TAVR, the use of DOACs may be superior to VKAs, and the benefit may be
greater with longer follow-up. The anticoagulant strategy for atrial
fibrillation after TAVR is a valuable direction for future
research. Copyright © 2022 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<96>
Accession Number
2018674773
Title
Ischemic Hepatitis Induced by Uremic Cardiac Tamponade in a Patient with
Underlying Hepatitis C with a Review of the Literature.
Source
Case Reports in Gastroenterology. 16(2) (pp 326-332), 2022. Date of
Publication: 30 May 2022.
Author
Alsultan M.K.; Bakr A.; Hassan Q.
Institution
(Alsultan) Department of Nephrology, Al Assad and Al Mouwasat University
hospitals, Damascus University- Faculty of medicine, Damascus, Syrian Arab
Republic
(Bakr) Department of Oncology, Al Biruni University hospital, Damascus
University- Faculty of medicine, Damascus, Syrian Arab Republic
(Hassan) Department of Nephrology, Al Assad University hospital, Damascus
University- Faculty of medicine, Damascus, Syrian Arab Republic
Publisher
S. Karger AG
Abstract
Ischemic hepatitis is a rare cause of acute liver injury (ALI) and is
associated with various etiologies including cardiac failure, trauma,
hemorrhage, and respiratory failure that all result in poor perfusion and
oxygen delivery to the liver. A 30-year-old patient complained of
orthopnea with a history of hepatitis C treatment and is currently on
hemodialysis (HD) due to chronic allograft rejection. Also, he had
previous pericardial effusion (PEFF) due to inadequate dialysis.
Laboratory tests on admission revealed urinary tract infection, HCV PCR
positive, and high blood urea nitrogen. Computed tomography of the chest
showed massive PEFF. Echocardiography revealed a massive PEFF that
measured 3.6 cm on the apical four-chamber window, and the inferior vena
cava diameter was 27 mm with a decreased collapsibility of ?20% in
inspiration. The patient was treated for UTI and started the treatment for
HCV. Also, increased HD sessions with minimal heparinization of the
dialyzer circuit were obtained along with daily monitoring of PEFF by
echocardiography. At first, echocardiography did not reveal frank signs of
cardiac tamponade, but after 2 sessions of HD, the patient developed chest
pain, worsening orthopnea, JVP elevation, and dropping of the systolic BP.
Echocardiography showed specific signs of cardiac tamponade, which
included an increased effusion to 4.4 cm and changes in velocities of the
mitral valve and tricuspid valve during the respiratory cycle by more than
25% and 40%, respectively. The patient was transmitted to ICU, and
pericardiocentesis was obtained. Two days later, asymptomatic ALI was
noticed by elevation of the following tests: ALT, AST, LDH, PT, and INR.
However, ALI exhibits a rapid and spontaneous resolution to nearly normal
tests after 10 days. Although the patient was hemodynamically stable, the
liver injury occurred and might be attributed to ESRD and hypertension
that caused thickened heart walls, diastolic dysfunction, and subsequently
hepatic congestion, in addition to previous liver injury due to HCV. We
present a rare case of ALI caused by uremic pericardial tamponade with an
overview of the current literature with regard to this entity. So, we
emphasize monitoring liver function tests in the context of PEFF,
especially in patients with chronic kidney disease. Copyright ©
2022 The Author(s).

<97>
Accession Number
2012114963
Title
External stenting and disease progression in saphenous vein grafts two
years after coronary artery bypass grafting: A multicenter randomized
trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(5) (pp 1532-1541.e2),
2022. Date of Publication: November 2022.
Author
Taggart D.P.; Gavrilov Y.; Krasopoulos G.; Rajakaruna C.; Zacharias J.; De
Silva R.; Channon K.M.; Gehrig T.; Donovan T.J.; Friedrich I.; Benedetto
U.; Vohra H.; Bittar M.N.; Bose A.; Berman M.; Kharbanda R.; Paraforos A.;
Ladyshenskij L.; Bonaros N.; Schachner T.; Sandner S.; Angleitner P.;
Bolotin G.; Jacobs S.; Thielmann M.; Wendt D.; Choi Y.-H.; Liakopoulos O.;
Ohri S.; Lipey A.
Institution
(Taggart) Nuffield Department of Surgical Sciences, University of Oxford,
John Radcliffe Hospital, Oxford, United Kingdom
(Gavrilov) TechnoSTAT Ltd, Raanana, Israel
(Krasopoulos) Oxford University Hospitals NHS Foundation Trust, Oxford,
United Kingdom
(Rajakaruna, Benedetto, Vohra) Department of Cardiothoracic Surgery,
University Hospitals Bristol, Bristol, United Kingdom
(Zacharias, Bittar, Bose) Department of Cardiothoracic Surgery, Blackpool
Victoria Hospital, Blackpool, United Kingdom
(De Silva, Berman) Department of Cardiothoracic Surgery, Papworth
Hospital, Cambridge, United Kingdom
(Channon, Kharbanda) Department of Cardiovascular Medicine, University of
Oxford, John Radcliffe Hospital, Oxford, United Kingdom
(Gehrig, Donovan, Friedrich, Paraforos) Herzzentrum Trier, Krankenhaus der
Barmherzigen Bruder, Trier, Germany
(Ladyshenskij) Department of Cardiothoracic Surgery, Immanuel Klinikum
Bernau Herzzentrum Brandenburg, Brandenburg, Bernau bei Berlin, Germany
(Bonaros, Schachner) Department of Cardiothoracic Surgery, Medical
University of Innsbruck, Innsbruck, Austria
(Sandner, Angleitner) Department of Cardiothoracic Surgery, Medizinische
Universitat Wien, Vienna, Wien, Austria
(Bolotin) Department of Cardiothoracic Surgery, Rambam Medical Center,
Haifa, Israel
(Jacobs) Department of Cardiothoracic Surgery, German Heart Centre Berlin,
Berlin, Germany
(Thielmann, Wendt) Department of Cardiothoracic Surgery, West-German Heart
and Vascular Center Essen, University Hospital Essen, Essen, Germany
(Choi, Liakopoulos) Department of Cardiac Surgery, Kerckhoff Heart Center,
Bad Nauheim, Germany
(Choi, Liakopoulos) Justus-Liebig-University Giesen, Campus Kerckhoff, Bad
Nauheim, Germany
(Choi, Liakopoulos) German Center for Cardiovascular Research (DZHK),
Partner Site Rhine Main, Frankfurt/Main, Germany
(Choi, Liakopoulos) Department of Cardiothoracic Surgery, Uniklinik Koln,
Koln, Germany
(Ohri) Department of Cardiothoracic Surgery, University Hospital
Southampton, Southampton, United Kingdom
(Lipey) Department of Cardiothoracic Surgery, Sheba Medical Center, Ramat
Gan, Israel
Publisher
Elsevier Inc.
Abstract
Objectives: Little data exist regarding the potential of external stents
to mitigate long-term disease progression in saphenous vein grafts. We
investigated the effect of external stents on the progression of saphenous
vein graft disease. Method(s): A total of 184 patients undergoing
isolated coronary artery bypass grafting, using an internal thoracic
artery graft and at least 2 additional saphenous vein grafts, were
enrolled in 14 European centers. One saphenous vein graft was randomized
to an external stent, and 1 nonstented saphenous vein graft served as the
control. The primary end point was the saphenous vein graft Fitzgibbon
patency scale assessed by angiography, and the secondary end point was
saphenous vein graft intimal hyperplasia assessed by intravascular
ultrasound in a prespecified subgroup at 2 years. Result(s):
Angiography was completed in 128 patients and intravascular ultrasound in
the entire prespecified cohort (n = 51) at 2 years. Overall patency rates
were similar between stented and nonstented saphenous vein grafts (78.3%
vs 82.2%, P =.43). However, the Fitzgibbon patency scale was significantly
improved in stented versus nonstented saphenous vein grafts, with
Fitzgibbon patency scale I, II, and III rates of 66.7% versus 54.9%, 27.8%
versus 34.3%, and 5.5% versus 10.8%, respectively (odds ratio, 2.02; P
=.03). Fitzgibbon patency scale was inversely related to saphenous vein
graft minimal lumen diameter, with Fitzgibbon patency scale I, II, and III
saphenous vein grafts having an average minimal lumen diameter of 2.62 mm,
1.98 mm, and 1.32 mm, respectively (P <.05). Externally stented saphenous
vein grafts also showed significant reductions in mean intimal hyperplasia
area (22.5%; P <.001) and thickness (23.5%; P <.001). Conclusion(s):
Two years after coronary artery bypass grafting, external stenting
improves Fitzgibbon patency scales of saphenous vein grafts and
significantly reduces intimal hyperplasia area and thickness. Whether this
will eventually lead to improved long-term patency is still
unknown. Copyright © 2021 The Authors

<98>
Accession Number
638299167
Title
A randomized trial of non-fasting vs. fasting for cardiac implantable
electronic device procedures (Fast-CIED Study).
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. 24(10)
(pp 1617-1626), 2022. Date of Publication: 13 Oct 2022.
Author
Bode K.; Gerhards M.; Doering M.; Lucas J.; Tijssen J.; Dagres N.; Hilbert
S.; Richter S.; Nedios S.; Lurz J.; Moscoso-Luduena C.; Arya A.; Shamloo
A.S.; Hindricks G.
Institution
(Bode, Gerhards, Doering, Lucas, Dagres, Hilbert, Richter, Nedios, Lurz,
Moscoso-Luduena, Arya, Shamloo, Hindricks) Department of
Electrophysiology, Heart Center Leipzig at University of Leipzig,
Naumburger Str. 76, Germany
(Bode) Department of Cardiology, Asklepios Clinic Weisenfels, Germany
(Tijssen, Shamloo) Leipzig Heart Institute, Leipzig, Germany
Publisher
NLM (Medline)
Abstract
AIMS: Data on safety and efficacy of a non-fasting strategy in minimal
invasive cardiac procedures are lacking. We assessed a non-fasting
strategy compared with a fasting strategy regarding patient's well-being
and safety in elective cardiac implantable electronic device (CIED)
procedures. METHODS AND RESULTS: In this randomized, single-blinded
clinical trial, 201 patients (non-fasting=100, fasting=101) with a mean
age of 72.0+/-11.6 years (66.7% male) were assigned to a non-fasting
strategy (solids/fluids allowed up to 1 h) or a fasting strategy (at least
6 h no solids and 2 h no fluids) before the procedure and analysed on an
intention-to-treat basis. The co-primary outcomes were patients'
well-being scores (based on numeric rating scale, 0-10) and incidence of
intra-procedural food-related adverse events, including vomiting,
perioperative pulmonary aspiration, and emergency intubation. Renal,
haematological, and metabolic blood parameters and 30-day follow-up data
were gathered. The summed pre-procedural patients' well-being score was
significantly lower in the non-fasting group [non-fasting: 13.1+/-9.6 vs.
fasting: 16.5+/-11.4, 95% confidence interval (CI) of mean difference (MD)
-6.35 to -0.46, P=0.029], which was mainly driven by significantly lower
scores for hunger and tiredness in the non-fasting group (non-fasting vs.
fasting; hunger: 0.9+/-1.9 vs. 3.1+/-3.2, 95% CI of MD -2.86 to -1.42,
P<0.001; tiredness: 1.6+/-2.3 vs. 2.6+/-2.7, 95% CI of MD -1.68 to -0.29,
P=0.023). No intra-procedural food-related adverse events were observed.
Relevant blood parameters and 30-day follow-up did not show significant
differences. CONCLUSION(S): These results showed that a non-fasting
strategy is beneficial to a fasting one regarding patient's well-being and
comparable in terms of safety for CIED procedures
(NCT04389697). Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please email:
journals.permissions@oup.com.

<99>
Accession Number
638002515
Title
Fractional flow reserve versus angiography alone in guiding myocardial
revascularisation: a systematic review and meta-analysis of randomised
trials.
Source
Heart (British Cardiac Society). 108(21) (pp 1699-1706), 2022. Date of
Publication: 13 Oct 2022.
Author
Elbadawi A.; Sedhom R.; Dang A.T.; Gad M.M.; Rahman F.; Brilakis E.S.;
Elgendy I.Y.; Jneid H.
Institution
(Elbadawi, Rahman, Jneid) Cardiology, Baylor College of Medicine, Houston,
TX, United States
(Sedhom) Internal Medicine, Albert Einstein Medical Center, Philadelphia,
PA, United States
(Dang) Internal Medicine, University of Texas Medical Branch at Galveston,
Galveston, TX, United States
(Gad) Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH,
United States
(Brilakis) Cardiology, Minneapolis Heart Institute and Minneapolis Heart
Institute Foundation, Minneapolis, MN, United States
(Elgendy) Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
Publisher
NLM (Medline)
Abstract
BACKGROUND: Randomised trials evaluating the efficacy and safety of
fractional flow reserve (FFR)-guided versus angiography-guided
revascularisation among patients with obstructive coronary artery disease
(CAD) have yielded mixed results. AIMS: To examine the comparative
efficacy and safety of FFR-guided versus angiography-guided
revascularisation among patients with obstructive CAD. METHOD(S): An
electronic search of MEDLINE, SCOPUS and Cochrane databases without
language restrictions was performed through November 2021 for randomised
controlled trials that evaluated the outcomes of FFR-guided versus
angiography-guided revascularisation. The primary outcome was major
adverse cardiac events (MACE). Data were pooled using a random-effects
model. RESULT(S): The final analysis included seven trials with 5094
patients. The weighted mean follow-up duration was 38 months. Compared
with angiography guidance, FFR guidance was associated with fewer number
of stents during revascularisation (standardised mean difference=-0.80;
95% CI -1.33 to -0.27), but no difference in total hospital cost. There
was no difference between FFR-guided and angiography-guided
revascularisation in long-term MACE (13.6% vs 13.9%; risk ratio (RR) 0.97,
95% CI 0.85 to 1.11). Meta-regression analyses did not reveal any evidence
of effect modification for MACE with acute coronary syndrome (p=0.36),
proportion of three-vessel disease (p=0.88) or left main disease (p=0.50).
There were no differences between FFR-guided and angiography-guided
revascularisation in the outcomes all-cause mortality (RR 1.16, 95% CI
0.80 to 1.68), cardiovascular mortality (RR 1.27, 95% CI 0.50 to 3.26),
repeat revascularisation (RR 0.99, 95% CI 0.81 to 1.21), recurrent
myocardial infarction (RR 0.92, 95% CI 0.74 to 1.14) or stent thrombosis
(RR 0.61, 95% CI 0.31 to 1.21). CONCLUSION(S): Among patients with
obstructive CAD, FFR-guided revascularisation did not reduce the risk of
long-term adverse cardiac events or the individual outcomes. However,
FFR-guided revascularisation was associated with fewer number of stents.
PROSPERO REGISTRATION NUMBER: CRD42021291596. Copyright ©
Author(s) (or their employer(s)) 2022. No commercial re-use. See rights
and permissions. Published by BMJ.

<100>
Accession Number
2019626524
Title
Early identification of delayed extubation following cardiac surgery:
Development and validation of a risk prediction model.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1002768. Date of Publication: 04 Oct 2022.
Author
Li X.; Liu J.; Xu Z.; Wang Y.; Chen L.; Bai Y.; Xie W.; Wu Q.
Institution
(Li, Liu, Xu, Wang, Chen, Bai, Xie, Wu) Department of Anesthesiology,
Union Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, China
Publisher
Frontiers Media S.A.
Abstract
Background: Successful weaning and extubation after cardiac surgery is an
important step of postoperative recovery. Delayed extubation is associated
with poor prognosis and high mortality, thereby contributing to a
substantial economic burden. The aim of this study was to develop and
validate a prediction model estimate the risk of delayed extubation after
cardiac surgery based on perioperative risk factors. Method(s): We
performed a retrospective cohort study of adult patients undergoing
cardiac surgery from 2014 to 2019. Eligible participants were randomly
assigned into the development and validation cohorts, with a ratio of 7:3.
Variables were selected using least absolute shrinkage and selection
operator (LASSO) logistic regression model with 10-fold cross-validation.
Multivariable logistic regression was applied to develop a predictive
model by introducing the predictors selected from the LASSO regression.
Receiver operating characteristic (ROC) curve, calibration plot, decision
curve analysis (DCA) and clinical impact curve were used to evaluate the
performance of the predictive risk score model. Result(s): Among the
3,919 adults included in our study, 533 patients (13.6%) experienced
delayed extubation. The median ventilation time was 68 h in the group with
delayed extubation and 21 h in the group without delayed extubation. A
predictive scoring system was derived based on 10 identified risk factors
based on 10 identified risk factors including age, BMI >= 28
kg/m2, EF < 50%, history of cardiac surgery, type of operation,
emergency surgery, CPB >= 120 min, duration of surgery, IABP and eGFR < 60
mL/min/1.73 m2. According to the scoring system, the patients
were classified into three risk intervals: low, medium and high risk. The
model performed well in the validation set with AUC of 0.782 and a
non-significant p-value of 0.901 in the Hosmer-Lemeshow test. The DCA
curve and clinical impact curve showed a good clinical utility of this
model. Conclusion(s): We developed and validated a prediction score
model to predict the risk of delayed extubation after cardiac surgery,
which may help identify high-risk patients to target with potential
preventive measures. Copyright © 2022 Li, Liu, Xu, Wang, Chen,
Bai, Xie and Wu.

<101>
Accession Number
2020664012
Title
Mechanical Heart Valves, Pregnancy, and Bleeding: A Systematic Review and
Meta-Analysis.
Source
Seminars in Thrombosis and Hemostasis. (no pagination), 2022. Date of
Publication: 2022.
Author
Jakobsen C.; Larsen J.B.; Fuglsang J.; Hvas A.-M.
Institution
(Jakobsen, Larsen) Thrombosis and Hemostasis Research Unit, Department of
Clinical Biochemistry, Aarhus University Hospital, Aarhus C, Denmark
(Larsen, Fuglsang) Department of Clinical Medicine, Aarhus University,
Aarhus C, Denmark
(Fuglsang) Department of Obstetrics and Gynecology, Aarhus University
Hospital, Aarhus C, Denmark
(Hvas) Faculty of Health, Aarhus University, Aarhus C, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Anticoagulant therapy is essential in pregnant women with mechanical heart
valves to prevent valve thrombosis. The risk of bleeding complications in
these patients has not gained much attention. This systematic review and
meta-analysis investigate the prevalence of bleeding peri-partum and
post-partum in women with mechanical heart valves and also investigate
whether bleeding risk differed across anticoagulant regimens or according
to delivery mode. The present study was conducted according to The
Preferred Reporting Items for Systematic reviews and Meta-Analyses
(PRISMA) statement. Studies reporting bleeding prevalence in pregnant
women with mechanical heart valves receiving anticoagulant therapy were
identified through PubMed and Embase on December 08, 2021. Data on
bleeding complications, delivery mode, and anticoagulation therapy were
extracted. A total of 37 studies were included, reporting 423 bleeding
complications in 2,508 pregnancies. A meta-analysis calculated a pooled
prevalence of 0.13 (95% confidence interval [CI]: 0.09-0.18) bleeding
episodes per pregnancy across anticoagulant regimens. The combination of
unfractionated heparin (UFH) and vitamin K antagonist (VKA) and single VKA
therapy showed the lowest risk of bleeding (8 and 12%). Unexpectedly, the
highest risk of bleeding was found in women receiving a combination of
low-molecular-weight-heparin (LMWH) and VKA (33%) or mono-therapy with
LMWH (22%). However, this could be dose related. No difference in bleeding
was found between caesarean section versus vaginal delivery (p = 0.08). In
conclusion, bleeding episodes are common during pregnancy in women with
mechanical heart valves receiving anticoagulant therapy. A combination of
UFH and VKA or VKA monotherapy showed the lowest risk of
bleeding. Copyright © 2022 Thieme Medical Publishers, Inc.. All
rights reserved.

<102>
Accession Number
2019429246
Title
Right displacement of trachea to reduce right bronchial misplacement of
left double lumen tube: a prospective, double-blind, randomized study.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 312. Date
of Publication: December 2022.
Author
Guan J.; Zhu W.; Xiao X.; Huang Z.; Xing J.; Hei Z.; Zhang Y.; Yao W.
Institution
(Guan, Zhu, Xiao, Huang, Xing, Hei, Zhang, Yao) Department of
Anesthesiology, The Third Affiliated Hospital of Sun Yat-Sen University,
Guangzhou 510630, China
Publisher
BioMed Central Ltd
Abstract
Background: Misplacement of double-lumen endobronchial tubes (DLTs) during
bronchial intubation, especially when bronchoscopy guidance is not
applicable, threatens effective lung isolation and brings about airway
injury during reposition. We aimed to examine whether a novel maneuver
called right tracheal displacement (RTD) can reduce left-sided DLT
misplacement during first-attempt intubation without bronchoscopy
guidance. Method(s): Patients that underwent thoracic surgeries
requiring one-lung ventilation during November 2020 to January 2021 were
recruited and randomized into control and RTD group, with 54 cases in each
group. The primary outcomes included the incidence of DLT misplacement and
the time to complete desired bronchial intubation. The secondary outcomes
included mucosal injury, sore throat and hoarseness upon emergence and at
24 h post-operatively. Result(s): The incidence of DLT misplacement
in RTD group was significantly lower compared to control group (0% vs.
16.7%) The time to complete bronchial intubation was also significantly
shortened in RTD group compared to control (52.88 +/- 9.36 s vs. 63.04 +/-
20.02 s). The incidence of mucosal injury, sore throat and hoarseness were
comparable between two groups. Conclusion(s): RTD maneuver can
effectively improve the success rate of first-attempt proper DLT
positioning and shorten the time required by bronchial intubation. Trial
registration: This prospective, double-blind, randomized study has
completed the registration of the Chinese Clinical Trial Center at
2/11/2020 with the registration number ChiCTR2000040212. It was conducted
from 26/11/2020 to 31/7/2021 in third affiliated hospital of Sun Yat-sen
university. Copyright © 2022, The Author(s).

<103>
Accession Number
2018232908
Title
Comparative Study Between Early versus Late Intraperitoneal Administration
of Either Bupivacaine/ Tramadol or Bupivacaine/Dexmedetomidine for
Perioperative Analgesia in Abdominal Laparoscopic Cancer Surgeries: A
Prospective Randomized Study.
Source
Journal of Pain Research. 15 (pp 3233-3243), 2022. Date of Publication:
2022.
Author
Shaker E.H.; Soliman M.S.; Hanafy A.; Elsabeeny W.Y.
Institution
(Shaker, Elsabeeny) Department of Anesthesia, Intensive Care and Pain
Management, National Cancer Institute, Cairo University, Cairo, Egypt
(Soliman) Department of Anesthesia, Surgical ICU and Pain Management,
Faculty of Medicine, Cairo University, Cairo, Egypt
(Hanafy) Department of Surgical Oncology, National Cancer Institute, Cairo
University, Cairo, Egypt
Publisher
Dove Medical Press Ltd
Abstract
Objective: Several modalities for analgesia after laparoscopic procedures
have been used. This study aimed to investigate the efficacy of early
versus late bupivacaine/tramadol combination and
bupivacaine/dexmedetomidine combination in analgesia for laparoscopic
cancer surgeries. Method(s): A total of 100 patients of both genders
scheduled for elective laparoscopic cancer surgeries were included.
Patients were randomly assigned to one of four groups each comprises 25
patients. Group 1: early bupivacaine/tramadol, Group 2: late bupivacaine/
tramadol, Group 3: early bupivacaine/dexmedetomidine, and Group 4: late
bupivacaine/dexmedetomidine. Early groups received the intraperitoneal
instillation before start of surgery and late groups received the
instillation after completion of surgery. Perioperative heart rate (HR)
and mean arterial blood pressure (MAP) were recorded. The degree of
postoperative pain was measured at rest and with cough using Visual
analogue scale (VAS) score at 2, 4, 6, 12, 18 and 24 h after surgery. In
addition, the total intraoperative fentanyl and postoperative morphine
doses were calculated. Result(s): Both late bupivacaine/tramadol,
bupivacaine/dexmedetomidine groups had longer time to receive first
analgesic requirement (13.4+/-3.9, 11.3+/-3.9 h) respectively as compared
to early bupivacaine/tramadol, bupivacaine/dexmedetomidine groups (9.8+/-
3.6, 8.4+/- 2.8 h), respectively. Between each early and late group,
intraoperative fentanyl consumption was higher for the late groups (75+/-
22.8, 73+/- 21.55microg) versus (32.7+/- 10.9, 37.5+/- 13.3 microg),
respectively. As regards to rescue analgesic requirements, both early
bupivacaine/ tramadol and bupivacaine/dexmedetomidine groups consumed more
analgesics (5.2+/- 2.0 and 6.1+/- 1.8 mg) as compared to the late groups
(3.2+/- 0.8 and 4.3+/- 1.5 mg), respectively. The four groups were
comparable for their perioperative HR and MAP values. Conclusion(s):
Intraperitoneal instillation of bupivacaine/tramadol and
bupivacaine/dexmedetomidine could be considered an effective route for
analgesic administration during laparoscopic cancer surgeries. Early
instillation reduced the intraoperative opioid consumption and late
instillation resulted in reduced postoperative opioid
consumption. Copyright © The Authors.

<104>
Accession Number
2019558118
Title
Prevalence and Predictors of Chronic Postsurgical Pain After
Video-Assisted Thoracoscopic Surgery: A Systematic Review and
Meta-analysis.
Source
Pain and Therapy. (no pagination), 2022. Date of Publication: 2022.
Author
Chen W.-C.; Bai Y.-Y.; Zhang L.-H.; Liu Y.-B.; Liu C.-Y.; Liang J.-W.; He
H.-F.
Institution
(Chen, Bai, Zhang, Liu, Liu, Liang, He) Department of Anesthesiology, The
Second Affiliated Hospital, Fujian Medical University, 34 Zhongshan North
Road, Quanzhou, China
Publisher
Adis
Abstract
Introduction: Determining the prevalence of chronic postsurgical pain
(CPSP) after video-assisted thoracoscopic surgery (VATS) and identifying
CPSP predictors should improve the prognosis of patients undergoing VATS.
Although several studies have investigated predictors of CPSP after VATS,
there were significant dissimilarities in the findings due to the
confounding of predictors. Method(s): PubMed, Cochrane, MEDLINE, Web
of Science, Chinese Biomedical Literature, and China National Knowledge
Infrastructure databases were comprehensively searched using the Medical
Subject Headings terms "pain, postoperative," "thoracic surgery,
video-assisted," and all related free terms from inception until March 27,
2022. The Stata metaprop package was used to comprehensively analyze the
incidence of CPSP following VATS. Furthermore, the pooled odds ratios (OR)
or the standardized mean differences (SMD) and their corresponding 95%
confidence intervals (95% CI) were calculated, and qualitative analyses
were performed for predictors that could not be assessed quantitatively to
evaluate the effects of the included risk factors on the occurrence of
CPSP. Unadjusted odds ratios were utilized to consider the impact of
non-significant estimates if the original study did not report them.
 Result(s): Of the 4302 studies, 183 were considered eligible, and 17
were finally included in this study. The overall incidence of CPSP after
VATS was 35.3% (95% CI 27.1-43.5%). The qualitative synthesis results
revealed that female sex, age, and acute postoperative pain were definite
predictors of CPSP after VATS. The number of ports, operation time,
duration of drainage, and insufficient analgesia were also considered
predictors. Consistent, quantitative synthesis results also showed that
the aforementioned predictors were closely related to the occurrence of
CPSP after VATS. Only by quantitative analysis, postoperative chemotherapy
and an educational level less than junior school were also risk factors
for CPSP. Other predictors displayed no evidence or unclear evidence of
association with CPSP after VATS. Conclusion(s): This study
preliminarily determined the incidence of CPSP after VATS based on the
existing literature. Female sex, age, and acute pain were identified as
risk factors for CPSP after VATS, and other potential risk factors were
also identified and analyzed. However, as a result of the inclusion of
retrospective studies and inevitable limitations in this systematic review
and meta-analysis, the results of this study still need to be verified by
large-scale prospective clinical studies. Trial Registration:
CRD42022323179. Copyright © 2022, The Author(s).

<105>
Accession Number
639287315
Title
A Systematic Review and Meta-analysis of General versus Regional
Anesthesia for Lower Extremity Amputation.
Source
Journal of vascular surgery. (no pagination), 2022. Date of Publication:
12 Oct 2022.
Author
Mufarrih S.H.; Qureshi N.Q.; Yunus R.A.; Katsiampoura A.; Quraishi I.;
Sharkey A.; Mahmood F.; Matyal R.
Institution
(Mufarrih, Qureshi, Yunus, Katsiampoura, Quraishi, Sharkey, Mahmood,
Matyal) Department of Anesthesia, Critical Care and Pain Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Postoperative morbidity in patients' undergoing lower extremity
amputation remains high. Studies investigating the influence of anesthetic
modality on postoperative outcomes yield conflicting results. The aim of
our study was to assess the impact of regional anesthesia versus general
anesthesia on post-operative complications in patients undergoing lower
extremity amputation. METHOD(S): We systematically searched PubMed,
Embase, MEDLINE, Web of Science and Google Scholar from 1990 - 2022 for
studies investigating the effect of anesthetic modality on postoperative
outcomes following lower extremity amputation. Regional anesthesia
included neuraxial anesthesia and peripheral nerve blocks. Outcomes
included 30-day mortality, respiratory failure (unplanned postoperative
intubation, failure to wean, and mechanical ventilation > 24 hours),
surgical site infections, cardiac complications, urinary tract infection,
renal failure, sepsis, venous thrombosis, pneumonia, and myocardial
infarction. RESULT(S): Of the 25 studies identified, we included 10
retrospective observational studies comprising 81,736 patients with 69,754
(85.3%) receiving general anesthesia and 11,980 (14.7%) receiving regional
anesthesia. There were 50,468 (63.8%) male patients in the general
anesthesia group and 7,813 (62.3%) male patients in the regional
anesthesia group. Results of the meta-analyses revealed that general
anesthesia was associated with a higher rate of respiratory failure (1.38
[1.06, 1.80], p=0.02) and sepsis (1.21 [1.11, 1.33], p<0.0001) when
compared to patients receiving regional anesthesia. There was no
difference in post-operative 30-day mortality, surgical site infections,
cardiac complications, urinary tract infection, renal failure, venous
thrombosis, pneumonia, and myocardial infarction between patients
receiving general anesthesia versus regional anesthesia for lower
extremity amputation. CONCLUSION(S): The results of our meta-analysis
show that general anesthesia may be associated with a higher rate of
respiratory failure and sepsis when compared to regional anesthesia for
lower extremity amputation. Copyright © 2022. Published by
Elsevier Inc.

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